Current Events April/May

http://www.nytimes.com/2012/04/13/health/states-seek-to-curb-exorbitant-drug-costs-incurred-by-patients.html?_r=1&nl=todaysheadlines&emc=edit_th_20120413

Diving Bell & the Butterfly

What other observations or questions do you have about the film?

Case 10 Cultural Differences

Case 10: Pain Relief, Cultural Beliefs, and the Role of a Family Member

Josh, Megan, and Eric

This case considers challenges that occur when an individual’s request for medical treatment conflicts with her religious beliefs. Marie F. is suffering from terminal lung cancer, and requested pain medication, which made her delirious. She and her brother, Jean, are Haitian immigrants, and her brother believes that her incoherence is due to evil spirits brought on by the pain medication. He demands that the pain treatments be stopped.

Facts to consider:

·         Marie was coherent when she originally requested pain medication

·         Religious beliefs dictate that evil spirits be exorcised; if Marie were aware of her current behavior, she might agree with her brother’s demands

·         Their cultural beliefs may state that male family members make decisions on behalf of females

Options:

·         The nurse could continue treating Marie’s pain against Jean’s wishes

·         The nurse could discontinue Marie’s treatment

·         The nurse could come up with an alternative (and possibly less-effective) method of pain relief that might have less extreme side effects

Questions:

1.      Whose requests should the nurse follow?

2.      Would your response to Question 1 be different if Marie had named Jean as the person responsible for her medical care and end-of-life decisions, i.e. power of attorney?

3.      If Jean did legally have power of attorney status, should he be able to base his decisions about his sister’s care on religious beliefs, rather than medical science? How much of a role should religion have in influencing medical treatment?

4.      If the nurse chooses to obey Marie’s initial request, how could she go about explaining her decision to Jean? Would educating him on the known side effects of pain medication make a difference?

US SupCt Overall Assessment Turner-Wyatt

Commentary about the general state of affairs regarding health care & health insurance:
http://opinionator.blogs.nytimes.com/2012/04/04/embarrass-the-future/?nl=todaysheadlines&emc=edit_th_20120405

http://www.nytimes.com/2012/04/05/opinion/down-the-insurance-rabbit-hole.html?nl=todaysheadlines&emc=edit_th_20120405

US SupCt Day 3 Pennekamp-Spriggs

http://www.pbs.org/newshour/bb/health/jan-june12/scotusday3_03-28.html

US SupCt, Day 2 Luipold-Norman

US Sup Ct, Day 1 arguments (Chambers-Huggins)

U.S. Supreme Court Case: Affordable Care Act, group 1

Allen to Capella post here on background information about the case.  Major provisions of the law.

26Mar12 Affordable Care Act at the U.S. Supreme Court
Overview coverage:
http://www.npr.org/blogs/health/2012/03/26/149218060/4-questions-that-could-make-or-break-the-health-care-law

Background info on the U.S. Affordable Health Care Act & the ensuing court battles
http://www.nytimes.com/interactive/2012/03/19/us/guide-to-supreme-court-challenges-to-obama-health-care-law.html?ref=affordablecareact

Genetics -- further discussion

*new* Genetic mutations and autism
http://www.nytimes.com/2012/04/05/health/research/scientists-link-rare-gene-mutations-to-heightened-risk-of-autism.html?_r=1&nl=todaysheadlines&emc=edit_th_20120405

Our guest last week led us into a discussion of gene patenting. . . here are related articles about the U.S. Supreme Court overruling the patenting of genes (the case involves those BRCA genes that our genetics counselor guest spoke of a few weeks ago):
* http://www.nytimes.com/2012/03/27/business/high-court-orders-new-look-at-gene-patents.html?_r=1&nl=todaysheadlines&emc=edit_th_20120327
* http://www.cfnews13.com/content/news/cfnews13/news/article.html/content/news/articles/ap/2012/03/26/High_court_throws_out_human_gene_patents/

Social Justice & HC (4 April)

*new* 24April12 Philosopher Peter Singer's 2009 essay on rationing health care.
http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?pagewanted=all

16April12 http://www.pbs.org/newshour/rundown/2012/04/health-reform-on-the-brink-sick-in-missouri.html

Case 38 IVF, Embryo Splitting, and Delayed Twinning

Case led by Nicole, Brooke, Katie.

Current Events Mar/April 2012

*new* 9 April 12 Unnecessary Medical Tests?
http://www.nytimes.com/2012/04/09/opinion/do-you-really-need-that-medical-test.html?nl=todaysheadlines&emc=edit_th_20120409
http://www.pbs.org/newshour/rundown/2012/04/top-45-ways-to-cut-health-care-costs-according-to-medical-groups.html

28 Mar 12 Face Transplant
http://www.bbc.co.uk/news/world-us-canada-17534646

26Mar12  Research on Bird Flu
http://www.npr.org/blogs/health/2012/03/26/149357569/bird-flu-studies-getting-another-round-of-scrutiny-by-panel

End to Chinese prisoner organ donation
http://www.bbc.co.uk/news/world-asia-china-17485103

U.S. Supreme Court case re: IVF children conceived after their father had died (and whether they are eligible for federal survivor benefits)
http://www.npr.org/2012/03/19/148935151/justices-weigh-ivf-technology-against-1939-law

IVF conception & citizenship
http://www.usatoday.com/news/world/story/2012-03-19/in-vitro-citizenship/53656616/1

McMahan's "Killing Embryos for Stem Cell Research"

Questions for discussion:
1. What is the moral status of embryos?
2. What is McMahan's argument?
3. What does it mean, according to McMahan, to exist as an early embryo?
4. Did you or I exist as an early embryo?

Case 30 (Stem Cell Research)

(Fatmah, Colleen, Morgan)

Case 30:

                This case presents the arguments about which stem cell lines should be used in research. The arguments are based on the presidential decisions of Barack Obama and George W. Bush. Bush’s decision limited federal funding to already destroyed embryos. Obama’s decision was to lift the Bush restrictions and used the National Institute of Health to define the ethical guidelines to which stem cell lines should be used. The National Institute of Health limited federal funding to stem cell lines created from excess fertility clinic embryos, given that the parents were not offered any incentives to giving up their embryos.

                There are different views about the moral status of the embryo. Groups are divided in their beliefs of when the embryo is considered a human being.  The differing views are:

1.       Fertilization onward

2.       14 days after fertilization

3.       Increasing status as it develops

4.       Birth

5.       Embryo has no moral status

Questions:

1.       What status should the embryo hold?

2.       Did Bush put too many restrictions on embryo stem cell research?

3.       Between the decisions of Bush and Obama, which one was more morally grounded?

4.       What conditions would limit federal funding of stem cell research?

Genetics -- basic info

We'll watch this first one in class on 14 March, but I wanted you to have the link:
http://www.ted.com/talks/lang/en/paul_root_wolpe_it_s_time_to_question_bio_engineering.html
Bio of speaker
http://www.ted.com/speakers/paul_root_wolpe.html 

TED Talk by James Watson, who co-discovered structure of DNA
http://www.ted.com/talks/lang/en/james_watson_on_how_he_discovered_dna.html

Basic primers on genetics; we'll watch in class on 14 March.

 http://www.sciencemuseum.org.uk/WhoAmI/FindOutMore/Yourgenes.aspx

http://www.eyeondna.com/2008/01/19/dna-video-23andme-genetics-101-part-1/(4.25min)

http://www.eyeondna.com/2008/01/19/dna-video-23andme-genetics-101-part-1/ (< 2min)

http://www.eyeondna.com/2008/02/02/dna-video-23andme-genetics-101-part-3/ (4.14 min)

http://www.eyeondna.com/2008/02/09/dna-video-23andme-genetics-101-part-4/ (~2min)

Other resources
http://www.ted.com/talks/lang/eng/barry_schuler_genomics_101.html (21min)

http://www.cancer.gov/cancertopics/understandingcancer/geneticvariation/page1 (individual slides; go at your own pace)
http://www.ted.com/talks/david_bolinsky_animates_a_cell.html 
       (especially the last 3 minutes of animation within a cell) 
http://www.biology-online.org/2/13_genetic_engineering.htm 
http://topics.nytimes.com/top/news/science/topics/genetic_engineering/index.html

Case 12 (29 Feb 12)

Colleen, Katie M., Catilin:  please post your discussion questions here.

Case 19 followup (29 Feb 12)

Confidentiality (29 Feb 12)

Post your questions, comments, and observations about the tensions in confidentiality, beneficence, and nonmaleficence.

Global Research (29 Feb 12)

Comments here about what you've read and/or what we discuss in class.

Current Events Feb/Mar 2012

*new* 22Feb12 burn pain & recovery
A long story, but well worth it, about a solider who was burned in Afghanistan and his recovery.  The focus of the story is the man, but also a treatment for pain.   You'll have a better sense of the experience of severe burns, the treatments, including many surgeries, and especially the mental fortitude necessary to survive. http://m.gq.com/news-politics/newsmakers/201202/burning-man-sam-brown-jay-kirk-gq-february-2012

Pay it forward:  a chain of altruism in kidney donations
http://www.nytimes.com/2012/02/19/health/lives-forever-linked-through-kidney-transplant-chain-124.html?_r=1&nl=todaysheadlines&emc=tha2

Informed Consent (22Feb12)

Comment on your readings for this week regarding informed consent.  Do you read the forms at the doctor's office or hospital?  Are you really informed?  What values underlie informed consent?  Why is it important to protect informed consent.  How is informed consent related to autonomy and paternalism?

Health Professionalism (15Feb12)

Students:  post comments about how nurses & doctors & other health professionals ought to behave.  Should they be held to higher moral standards than other people?  Explain.  Should doctors etc. take oaths before they practice?  Which oaths, saying what?  Why?  Are there better and worse ways for health professionals to treat patients?  Explain.

You don't have to answer all of these questions -- start a thread on something you find interesting, or continue the discussion on something someone else posted.

Case 8 Nurse & Informed Consent (22Feb12)

Brittany's group post discussion questions here.

Case 25 Anacephalic Newborn (15Feb12)

Katie's group post discussion questions here.

Panicola's Catholic Teaching on care for the dying (by 8 Feb)

Feel free to comment on the reading I sent on 1 Feb regarding Catholic teaching about care for the dying (what's obligatory, what's not, Principle of Double-Effect, etc.).

Cosmetic Surgery (15Feb12)

*new* 5Feb12
With declining insurance reimbursements, more doctors are expanding their practices to include things like breast augmentation and liposuction paid for out-of-pocket by patients. http://nyti.ms/zJxfz7

http://www.nytimes.com/2012/01/31/us/for-soldier-disfigured-in-afghanistan-a-way-to-return-to-the-world.html?pagewanted=2&_r=1&nl=todaysheadlines&emc=tha2

Provider Autonomy & Respect (mid-Feb12)

*new* 5Feb12 but related to below:
A rising number of registered nurses rank "on-the-job assault" as one of their three greatest safety concerns. http://nyti.ms/zEf01v

Patients in the emergency department can be quite disrespectful to providers, who can't really walk away.
http://onlinelibrary.wiley.com/doi/10.1002/hast.5/full

Current Events Jan/Feb12 & class follow-up

*new* 12 Feb Conjoined Twins
http://m.youtube.com/#/watch?desktop_uri=%2Fwatch%3Fv%3DDuIzpU9W_Bk%26feature%3Dchannel_video_title&feature=channel_video_title&v=DuIzpU9W_Bk&gl=US

8 Feb Support Wanes in Africa for Female Circumcision
http://latimesblogs.latimes.com/world_now/2012/02/female-genital-cutting-africa.html

Re: discussion of sperm donation and children who might be related to each other.
http://onlinelibrary.wiley.com/doi/10.1002/hast.9/full

Case 27 (1 Feb)

Case leaders:  use the case model in your course materials.

Case 23 (1 Feb)

Case leaders: Please follow the case model in your syllabus.

Case 21 (1 Feb)

Case leaders:  please follow the case model in your assignments directions.

Sandel lectures

Brett & Jaime are discussing one of the lectures in class, but if you have other comments or questions please post here.
www.JusticeHarvard.org   

Case 4 (25 Jan)

Ms. Burger, Callahan, & Capella please lead us through this case.  Monitor the case and provide challenges as appropriate.

Case 3 vasectomy for 25yr old (~18Jan)

Sarah, Ashley, & Corey discussed this case in class; follow-up here if you'd like.

Frontline Facing Death video (by 20 Jan)

Comments, questions, observations about the film.

Introductions (by 20 Jan)

Introduce yourselves again -- say something interesting!