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Paper Topics (Paper #1) PAS/VAE 8 Abortion 3 Female genital “mutilation” 2 Drugs for behavioral disorders in children Managed care & patient advocacy Cloning- organ farms Parental responsibility Determining death Animal experimentation Conjoined twins Religious refusal Terminal sedation Care of neonates Genetics Stem cell research Advance directives Genetic Screening Human Genome Project Goal: Map the entire human genome Limits Map = static Genome = dynamic; constantly interacting with other parts of itself and with the chemical environment How many humans have to be sampled to arrive at the human genome? Genetic Determinism Idea that genes mostly or completely determine who we are and how we behave Best scientific evidence: complex continuous interaction between genes and environment Less an explicit position than a trap one falls into when not thinking carefully Problem with Genome Early ability to screen for genetic defects or risk factors Much later ability to intervene to fix those factors (if ever) How good is a screening test with which no treatment is associated? A Brief Catalog of Ethical Concerns Privacy Conceal genetic info from: Employers? Insurance companies? Other members of family? Would knowing prenatal risk lead to inevitable social coercion to prevent birth of “expensive” babies? (or demand that individual pay for care?) Safety Genetic technology may be experimental and relatively untested When is it acceptable to attempt first human application? Ethical to experiment on future child without its consent? Justice Genetic screening and technologies likely to be very costly Either would add greatly to costs of health care in US… Or would worsen two-tier system leaving “lower class” without access Example: Drug to raise IQ by 20 points Eco-Ethics Ecological risks of “messing around” with genetic material and genetic diversity Probably mostly applies to agricultural uses which are currently little regulated How rational is European distrust of genetically engineered food products? Is genetic engineering really different from selective breeding? Somatic vs. Germ Cells Somatic manipulation: affects only one individual Germ line manipulation: in theory affects a complete family tree indefinitely into future Germ line therapy seems more intrusive and invasive re: the human gene pool (but is a “better fix”) Commercialization Patenting of genes and gene products Granting exclusive licenses for genetic tests and methods Patenting Genes? Sounds ridiculous Probably not a great threat Patenting gives one exclusionary rights (not any positive rights) Patenting assures public access to information Cannot patent your gene or your genome Exclusive Licenses May be a bigger threat Replaces scientific exchange with industrial secrecy Conflict of interest for scientists and universities Makes it difficult for practitioner to trust information from journals, etc. (informed consent) Licenses: Example Brca1 gene: 86% risk of breast cancer if a relative has disease Based on this test, some women had preventive mastectomies Now thought to be only 40% predictive Did new information get out fast enough, given company’s financial interest? Eugenics Negative eugenics: Prevent or treat genetic diseases Positive eugenics: Improve or enhance function of future generations Eugenics (cont.) Usually argue negative eugenics is defensible, positive is not (due to who gets to define “enhancement”) Recent criticisms: There may be no hard and fast line between remedying a defect and “enhancement” Treatment vs. Enhancement Therapy Enhancement 0 Child’s Right to an Open Future In favor: Protects child’s exercise of developing autonomy Prevents parents from exploiting their children in the name of their own interests or those of the group Child’s Right to an Open Future Opposed: Idealizes a picture of a child as a future chooser At some time of full maturity, looks around among communities and makes a free choice as to where to live Is this a coherent, meaningful picture of a child? Child’s Right to an Open Future-- Opposed All “parenting” is an exercise in limiting a child’s future Doing one thing always means you did not do something else (opportunity costs) Doing something else would have provided child with some additional future choice Cannot teach values, beliefs, moral rules without limiting child’s future in some way Child’s Right to an Open Future-- Opposed Being a child means not getting to choose Who your parents are What is your community of origin Your family’s religious or philosophical allegiances Future choices cannot undo your “roots” Against Exploiting Children All good parenting means closing off some futures One way parents can exploit their children is to close off futures No easy formula to distinguish good and bad parenting Hence cases like Old Order Amish & schools are tough cases Genetics in its place Nazi Germany proved that if you want to do evil in the name of positive eugenics, you don’t need newest genetic technologies McGee: If you want to really mess up your kids you don’t need gene therapy to do it Genetics not a special ethical category Disabilities perspectives J. Andre: Much of ethical thinking and moral development is “learning to see” Typically we are blind to the many ways our society disadvantages and discriminates against persons with disabilities Ethical thinking, at least, should not promote more blindness