Is it Ethical for Violent Felons to Receive Organ Transplants?Posted on May 19, 2015 by Ashly Mohankumar

Imagine getting a call from your relative saying

that your Grandma fell into sudden cardiac arrest

and is in dire need of a heart transplant. A few

hours later you receive the news that she has

passed away due to a lack of a heart transplant.

After feelings of shock and grief surface you hear

of a convicted felon on death row receiving a heart

transplant and getting another chance to live.

Most people would no doubt be heartbroken to find

that a convicted felon was receiving priority of an

organ transplant over their close relative. It would

be so disheartening to read about an inmate being

prioritized over an honest, innocent individual.

With such a morally and ethically complex issue, it

may be hard to determine who is prioritized in

terms of patient care. This essay examines

whether doctors should serve any human in need

no matter what their criminal background? If a law

abiding citizen is in dire need of a transplant

shouldn’t they have precedence over a convicted

felon?

In the article, “Should Violent Felons Receive

Organ Transplants?” by David L. Perry, Ph.D. this

heated issue of exactly who takes priority when

receiving an organ is discussed. According to Dr.

Perry’s beliefs he asserts that organs should be

distributed according to “1) degree of need 2)

probability that the transplant will be successful

and 3) a history of violent crime.” The quote

implies that the sole basis for deciding who the

organ goes to is if you need the organ more than

the other individual. If degree of need can be

overlooked due to similar severity it is then

necessary to see the chances of survival of both

patients and outweigh who will again most likely

die, then you’re eligibility for a transplant

increases. Lastly, if the other patient does in fact

have a history of violent crime than the organ will

go to the innocent citizen. The third point of his

beliefs suggests that violence is not considered if

a felon’s medical need is more severe. Yet, is that

fair?

There are a lot of

issues with prison health care ranging from

privatization, mental health, tax payers money

distribution, along with receiving of care

specifically transplants in this case. My opinion on

this matter is split because I would ultimately feel

outraged if my mother who suffered with Breast

Cancer was unable to receive a bone marrow

transplant to help her through chemotherapy

because someone who was a repeated criminal

offender was given the chance to prolong his/her

life. However, I can envision conditions where

denying basic care to a felon would be cruel and

unjustified depending on the circumstances. For

example, felons could be in jail for robbing and not

necessarily harming people. Instances such as the

War on Drugs have put a lot of non-violent people

in jail. The number of people arrested in 2013 in

the United States on non-violent drug charges was

1.5 million. With these matters, it is difficult to

assess the whole situation knowing that there is

not much a family member or friend can do when

each organ is allocated based on specific criteria.

Perhaps, having criteria such as Dr. Perry’s is the

only way to make such a convoluted issue

manageable as objectively as possible. Doctors

are likely to face controversial issues with the

advancement of medical and social ethics. Meeting

the individual needs of a patient is a complex task

when there are demands for making adequate use

of medical resources.

Sources:

http://www.scu.edu/ethics/publications/submitted/

Perry/transplant.html

http://www.donors1.org/learn2/donorprogram/

http://www.drugpolicy.org/drug-war-statistics

http://www.uclamls.com/2015/05/is-it-ethical-for-violent-felons-to-receive-organ-transplants/

The Brave New World of Gene EditingPosted on May 17, 2015 by Runi Tanna

Recently, my brother got a new cell phone. It

boasts excellent features at a comparatively low

price. However, its biggest selling point is that it

can be customized. You can choose the colors on

the back of the phone, the material of the ring

around the camera, and even the welcome

message the phone displays upon starting the

phone. This trend of catering our purchases to our

individual tastes is seen in so many other products

today: our cars, apparel, home appliances, and the

food we eat – everything can be designed to our

specific desires. For the most part, this is not an

issue; it is just a marketing gimmick. However,

this idea shows a different perspective when you

put it in the context of human beings themselves.

What if we started customizing humans to what we

“desired”?

Chinese scientists from Sun Yat-sen University

explored that very notion. Their end goal was to

prevent beta thalassemia, a blood disorder, but

their methodology and results brought up ethical

questions and issues. In order to achieve this goal,

they cut out the

gene that caused the

disorder from embryos using CRISPR. This widely

used technology allows scientists to efficiently

edit genomes based on a mechanism that bacteria

and archaea use for protection against viruses.

Specifically, a protein is guided towards a specific

gene by an RNA molecule and then used to remove

the specific gene. In the same way we cut and

paste words and images on a Microsoft Word

document, these scientists wanted to cut and

paste genes in embryos to achieve a perfect final

product. Unfortunately, the results were

unsatisfactory. All eighty five attempts to remove

the gene (and therefore the disorder) were either

unsuccessful or caused irreparable damage to the

embryo.

Although the embryos used by the researchers

were donated by in vitro fertilization clinics due to

chromosomal mutations and other defects,

imagine if the same results were found with

healthy embryos destined to develop into babies.

David Baltimore, a Nobel laureate molecular

biologist, warns that the science is too immature

to rely on. The failure of these specific

experiments is only part of a slew of obstacles

that can result from genetic engineering. Another

potential issue is the necessity of gene editing.

Genetic diseases are passed from parent to

offspring, so each offspring gets half of its DNA

from one parent and the other half of its DNA from

the other parent. This means that the embryos

only have a 50% chance of having the deleterious

gene. Only half the embryos that were destroyed,

as a result of this experiment, were actually

afflicted with the disorder, while the other half

were simply collateral damage. In my opinion, any

benefit of the genetic engineering should be

higher than the chance of harming a perfectly

healthy embryo.

In the event that such a procedure succeeds, gene

editing can also be used to create “super babies” –

babies whose traits were optimized by their

parents. This essentially turns reproduction into a

mechanized and superficial process.

Aside from removing

diseases, scientists can edit embryos to make

taller, smarter, more physically attractive babies,

at the discretion of their parents. The process can

be likened to choosing the ingredients for baking a

cake or choosing the materials to build a house. In

addition to these unnecessary changes, scientists

may even cause unwanted changes in the genome

of the embryo, such as damage to the genome and

incorrect insertion of genes. Due to the hereditary

nature of genes, these detrimental changes would

then be passed on from the genetically modified

individual to its offspring. Edward Lanphier of

Sangamo Biosciences points out that these pitfalls

with genetic engineering are a result of limited

research and make it a dangerous endeavor. He

believes that these costs are reason enough to

stall such research.

This is not to say that genetic engineering in

humans does not have its benefits. Its biggest

advantage is its potential to remove gene-based

diseases from the population, also referred to as

“gene therapy”. By pinpointing and extracting

certain deleterious alleles, scientists could put an

end to even the most devastating genetic diseases

such as Huntington’s disease, hemophilia, and

sickle cell anemia. It should be noted that each of

these diseases can cause death if not treated and

monitored carefully. They also do not have a cure,

which means that the best way to fight off such

diseases is to prevent them from occurring in the

first place. If this process can be done in embryos,

before these children are even born, the healthy

genes would then be passed from the individual to

its offspring as well. Another by-product of genetic

engineering is its use in pharmaceutical

development. Proteins can be taken from humans

or animals and inserted into plants or other

organisms to design medication for diseases. For

example, insulin can now be produced in E.

coli bacteria when human genes that code for

insulin are cloned in the bacteria. This insulin is

used for individuals with Type I diabetes because

their bodies are incapable of producing enough

insulin on their own.

Ultimately, the ethics of genetic engineering

involves questioning its use. Will the science be

used to help those with genetic diseases or create

synthetic babies? Should parents-to-be have the

power to determine the traits of their children? It

was determined that parents who chose to use IVF

did it to screen for and eliminate genetic diseases.

Hopefully the same would apply to gene therapy.

However, the potential to use genetic engineering

to choose traits like athleticism and intelligence is

a dangerous option. I believe the process should

only be used to edit harmful genes that can cause

disease. Unfortunately, once this science becomes

perfected and widely understood, it will be difficult

to control who makes the decisions about which

genes can be edited and which genes should

remain untouched.

Whether or not you support this methodology, it

must be admitted that the prospect that our

society is now even thinking of such science is

astounding. The pace and complexity of our

scientific exploration is shocking. Only one

hundred years ago, we were still developing the

first antibiotic. Perhaps, one hundred years from

now, editing genes will be as commonplace as

penicillin. That “brave new world” will be dealing

with entirely new ethical and scientific dilemmas.

New York Times article:

http://www.nytimes.com/2015/04/24/health/

chinese-scientists-edit-genes-of-human-embryos-

raising-concerns.html

Additional Sources:

http://www.nature.com/nbt/journal/v32/n4/full/

nbt.2842.html

http://www.who.int/genomics/public/

geneticdiseases/en/index2.html

http://www.sciencemag.org/content/348/6230/36

http://agbiosafety.unl.edu/biopharm.shtmlhttp://www.uclamls.com/2015/05/the-brave-new-world-of-gene-editing/

Death with Dignity: Physician-Assisted DyingPosted on November 17, 2014 by Suhani

“The way that my brain cancer would take me is

terrible…I am not suicidal… I do not want to die.

But I am dying. And I want to die on my own

terms.”

On November 1st, 2014, Brittany Maynard,

surrounded by close family and friends, chose to

end her life at the age of 29. In January of 2014,

Maynard was diagnosed with grade 2 astrocytoma,

a type of brain cancer affecting glial cells. She

underwent a craniotomy and tumor resection, only

to find that her cancer had returned months later.

By April of the same year, Maynard was diagnosed

with a grade 4 astrocytoma, also known as

glioblastoma, and given only six months to live.

Glioblastoma is a particularly aggressive and

highly malignant form of brain cancer, and

generally has a grave prognosis. Terminally ill,

given a prognosis of a slow and painful death,

Maynard made the difficult decision to move from

California to Oregon, one of five states which

allows physician-assisted dying. Maynard took

advantage of Oregon’s Death with Dignity Act,

which gives capable, but terminally ill, adults the

right to take their life with prescribed medication.

Since her decision, Brittany Maynard has become

the face movement for death with dignity.

In 1994, Oregon passed Measure 16, establishing

the Death with Dignity Act, and became the first

state in the United States to legalize physician-

assisted dying. This measure gives mentally

stable, terminally ill residents, over the age of

eighteen, the right to decide their time of death if

they have less than six months to live. Patients

are prescribed a lethal dosage of medication

allowing them to end their life on their own terms.

Since its passage in Oregon, Washington, Vermont

and other U.S. states have also followed suit in

implementing death with dignity laws. In the past

year, there have been 71 physician-assisted death

in Oregon, under the Death with Dignity Act.

Following her diagnosis, Brittany Maynard became

a strong proponent for death with dignity. She has

since worked with Compassion & Choices as an

advocate for the establishment of death with

dignity laws in her home state of California.

Maynard’s story captured the attention of media,

when she released a video advocating the

implementation of death with dignity laws

throughout the United States.

The death with dignity movement in Oregon, as

well as the present movement across the country,

faces harsh criticism. Many opponents of death

with dignity, commonly religious organizations,

are skeptical of the unethical approaches of

physician-assisted death. Ethical medical practices

are, in fact, crucial in providing adequate patient

care. Several opponents claim that other

approaches can be taken in the case of terminally

ill patients, such as palliative care, psychotherapy,

and medication to help ease their pain and accept

the time they have left to live. Furthermore,

opponents claim that the death with dignity act

discourages family involvement, and promotes

medically assisted suicide, whether or not it is

legal. Many proponents of physician-assisted dying

believe that terminally ill patients, who are given

a life expectancy of less than six months, deserve

the right to die in a humane way in the presence

of their loved ones. The many anecdotes of

terminal patients, such as Brittany Maynard,

capture the essence of the struggle, fear, but

ultimate reward in having the ability to choose

their fate. Many illnesses cause patients to lose

cognitive functions, leading to slow and painful

deaths. Advocates of death with dignity argue that

terminally ill individuals, who are mentally

capable, should be allowed to make such crucial

decisions regarding their life. Physician-assisted

dying gives capable individuals the ability to end

their lives under the circumstances they prefer, as

opposed to allowing ruthless diseases to end their

lives in pain and suffering.

Physician-assisted dying is a controversial

concept, often misconstrued and confused with

inhumane forms of dying. Physician-assisted dying

is also commonly referred to as physician-assisted

suicide. However, the term “suicide” is generally

linked to altered mental status, in which

individuals take their own lives. Physician-assisted

suicide, rather, is the the practice in which a

physician aids a patient in taking their own lives.

Although very similar, physician-assisted dying is

only legal under few, impending circumstances.

Suicide, on the other hand, is due to a person’s

incapability to make clear judgements, often due

to mental illness or emotional pressures. Many

also argue that physician-assisted dying is a form

of euthanasia.  However, euthanasia is defined as

the administration of lethal doses of drugs to a

patient by a physician. Euthanasia is illegal

throughout the United States. However, physician-

assisted death requires patients to self-administer

the lethal prescription that ends their life. Highly

debated across the country, the goal of death with

dignity is to provide terminal patients the comfort

of choice. Though often misunderstood, there are

clear distinguishments between physician-assisted

death, physician-assisted suicide, and euthanasia.

The death with dignity movement has swept our

nation, making immense progress and raising

awareness of the pros and cons of physician-

assisted dying. The vitality of such an issue in

medicine, as well as in the political arena, creates

a divisive population. The expansion of the death

with dignity movement raises both wide support,

as well as many questions. Further legalization of

physician-assisted dying serves as a pivotal point

in medical ethics.

 

References:

“Asking Peg Sandeen: Why Are so Many against

Death with Dignity?”Washington Times

Communities. N.p., 29 Apr. 2013. Web. 14 Nov.

2014.

“Death with Dignity: The Laws & How to Access

Them.” Death with Dignity National Center . N.p.,

n.d. Web. 12 Nov. 2014.

“Glioblastoma Multiforme.” Wikipedia. Wikimedia

Foundation, 14 Nov. 2014. Web. 14 Nov. 2014.

Griggs, Brandon. “Dying Young: Why Brittany

Maynard’s Story Resonates.”CNN. Cable News

Network, 01 Jan. 1970. Web. 14 Nov. 2014.

Kurzweil, Anthony, and Sara Welch. “Terminally Ill

Brittany Maynard May Postpone Her Death, as

Rally Held in Los Angeles.” KTLA. N.p., 30 Oct.

2014. Web. 13 Nov. 2014.

Maynard, Brittany. “My Right to Death with Dignity

at 29.” CNN. Cable News Network, 02 Nov. 2014.

Web. 14 Nov. 2014.

Purvis, Taylor E. “Abstract.” National Center for

Biotechnology Information. U.S. National Library of

Medicine, 25 June 2012. Web. 13 Nov. 2014.Filed Under: Ethics

http://www.uclamls.com/2014/11/death-with-dignity-physician-assisted-dying/

What is Euthanasia?

Euthanasia is the termination of a very sick person's life in order to relieve them of their suffering.

A person who undergoes euthanasia usually has an incurable condition. But there are other instances where some people want their life to be ended.

In many cases, it is carried out at the person's request but there are times when they may be too ill and the decision is made by relatives, medics or, in some instances, the courts.

The term is derived from the Greek word euthanatos which means easy death.

Euthanasia is against the law in the UK where it is illegal to help anyone kill themselves. Voluntary euthanasia or assisted suicide can lead to imprisonment of up to 14 years.

The issue has been at the centre of very heated debates for many years and is surrounded by religious, ethical and practical considerations.

The ethics of euthanasia

Euthanasia raises a number of agonising moral dilemmas:

is it ever right to end the life of a terminally ill patient who is undergoing severe pain and suffering?

under what circumstances can euthanasia be justifiable, if at all?

is there a moral difference between killing someone and letting them die?

At the heart of these arguments are the different ideas that people have about the meaning and value of human existence.

Should human beings have the right to decide on issues of life and death?

There are also a number of arguments based on practical issues.

Some people think that euthanasia shouldn't be allowed, even if it was morally right, because it could be abused and used as a cover for murder.

Killing or letting die

Euthanasia can be carried out either by taking actions, including giving a lethal injection, or by not doing what is necessary to keep a person alive (such as failing to keep their feeding tube going).

'Extraordinary' medical care

It is not euthanasia if a patient dies as a result of refusing extraordinary or burdensome medical treatment.

Euthanasia and pain relief

It's not euthanasia to give a drug in order to reduce pain, even though the drug causes the patient to die sooner. This is because the doctor's intention was to relieve the pain, not to kill the patient. This argument is sometimes known as the Doctrine of Double Effect.

Mercy killing

Very often people call euthanasia 'mercy killing', perhaps thinking of it for someone who is terminally ill and suffering prolonged, unbearable pain.

Why people want euthanasia

Most people think unbearable pain is the main reason people seek euthanasia, but some surveys in the USA and the

Netherlands showed that less than a third of requests for euthanasia were because of severe pain.

Terminally ill people can have their quality of life severely damaged by physical conditions such as incontinence, nausea and vomiting, breathlessness, paralysis and difficulty in swallowing.

Psychological factors that cause people to think of euthanasia include depression, fearing loss of control or dignity, feeling a burden, or dislike of being dependent.

Is Euthanasia Morally Acceptable?Probably most of us have had experiences

with friends or relatives who suffered greatly towards the end of their lives. Some of you reading this may even have loved ones who are terminally ill and forced to endure significant and unrelenting pain. There are limits to how far modern medicine can go in alleviating this pain.

Anyone who sees and hears the anguish of someone dear to them will to some extent share in this suffering and will desperately wish to end the suffering that the other is experiencing. If it happens that the doctors and the medications are not able to put an end to the constant pain, then there are some terminally ill patients who will wish to end their lives, but are unable or unwilling to do this themselves. In such situations, there are likely close loved ones who want to assist in

the suicide of the one who is terminally ill, because this would mean that the suffering would finally end. But is the practice of euthanasia morallyacceptable?

Certainly it is natural for us to want to prevent others whom we hold dear from suffering unnecessarily. And it does seem undignified to force people who are terminally ill to live their lives until they die naturally when they are forced to endure constant suffering. Euthanasia means “good death” because it is supposed to be a way for someone to die with dignity.

That being said however, I believe that euthanasia is morally wrong. The problem with this is that it puts happiness vs. suffering ahead of life itself. Arguments in favor of euthanasia seem to imply that life is only worth living if one is happy. The truth is that everyone suffers in life and we have the ability to endure it though positive thinking and focus. Those who want to commit suicide or to assist others in suicide are probably focusing too much on the suffering and not enough on the inherent ability of the mind to endure suffering and find meaning that transcends any negative feelings.

Of course we will all die eventually, and this will come sooner for those who are terminally ill.

For anyone in such a condition, even a few more years of endurance is quite doable given the right determination and focus on the meaning of life. Anyone who is forced to endure suffering should be able to find their own dignity regardless of the circumstances and any of their loved ones should be able to do the same. The friends and family of terminally ill should never want them to die in order to end their suffering but should instead celebrate their lives and always keep in mind the inherent value of life that is incomparably more important than happiness or suffering. To say that live has immeasurable value is the same as saying that life is sacred.

If we, as a society, decide that the value of life is entirely based on the level of happiness vs. suffering that one experiences, then it seems to make sense that we should allow poor people to die as well. Of course, very few people will seriously entertain such a notion and this will likely sound abhorrent to most people. The truth is, however, that if we don't ground our morals in a foundation that makes sense, then there will be more creeping immorality that might blindside us. If we don't solidly proclaim that life has inherent value no matter what degree of suffering one might experience, then we are possibly opening

ourselves up to actions that currently sound inhumane but might sound normal to majorities of people in the future.

Life is sacred and we should always seek to protect life and allow people to live until they die of natural causes. When we keep in mind the sanctity of life, there should always be personal dignity in life no matter how tough it gets.

What are your thoughts on this topic? Is euthanasia morally acceptable? Let your voice be heard in the forum. You can also email the me atbrandon@enlightenedworldview.comPermalink • 

http://www.bbc.co.uk/ethics/euthanasia/overview/introduction.shtml

http://www.bbc.co.uk/ethics/euthanasia/overview/doubleeffect.shtml

The doctrine of double effect

This doctrine says that if doing something morally good has a morally bad side-effect it's ethically OK to do it providing the

bad side-effect wasn't intended. This is true even if you foresaw that the bad effect would probably happen.

The principle is used to justify the case where a doctor gives drugs to a patient to relieve distressing symptoms even though he knows doing this may shorten the patient's life.

This is because the doctor is not aiming directly at killing the patient - the bad result of the patient's death is a side-effect of the good result of reducing the patient's pain.

Many doctors use this doctrine to justify the use of high doses of drugs such as morphine for the purpose of relieving suffering in terminally-ill patients even though they know the drugs are likely to cause the patient to die sooner.

Factors involved in the doctrine of double effect

The good result must be achieved independently of the bad one: For the doctrine to apply, the bad result must not be the means of achieving the good one. So if the only way the drug relieves the patient's pain is by killing him, the doctrine of double effect doesn't apply.

The action must be proportional to the cause: If I give a patient a dose of drugs so large that it is certain to kill them, and that is also far greater than the dose needed to control their pain, I can't use the Doctrine of Double Effect to say that what I did was right.

The action must be appropriate (a): I also have to give the patient the right medicine. If I give the patient a fatal dose of pain-killing drugs, it's no use saying that my intention was to relieve their symptoms of vomiting if the drug doesn't have any effect on vomiting.

The action must be appropriate (b): I also have to give the patient the right medicine for their symptoms. If I give the patient a fatal dose of pain-killing drugs, it's no use

saying that my intention was to relieve their symptoms of pain if the patient wasn't suffering from pain but from breathlessness.

The patient must be in a terminal condition: If I give the patient a fatal dose of pain-killing drugs and they would have recovered from their disease or injury if I hadn't given them the drugs, it's no use saying that my intention was to relieve their pain. And that applies even if there was no other way of controlling their pain.

Problems with the doctrine of double effect

Some philosophers think this argument is too clever for its own good.

We are responsible for all the anticipated consequences of our actions: If we can foresee the two effects of our action we have to take the moral responsibility for both effects - we can't get out of trouble by deciding to intend only the effect that suits us.

Intention is irrelevant: Some people take the view that it's sloppy morality to decide the rightness or wrongness of an act by looking at the intention of the doctor. They think that some acts are objectively right or wrong, and that the intention of the person who does them is irrelevant. But most legal systems regard the intention of a person as a vital element in deciding whether they have committed a crime, and how serious a crime, in cases of causing death.

Death is not always bad - so double effect is irrelevant:Other philosophers say that the Doctrine of Double Effect assumes that we think that death is always bad. They say that if continued life holds nothing for the patient but the negative things of pain and suffering, then death is a good thing, and we don't need to use the doctrine of double effect.

Double effect can produce an unexpected moral result: If you do think that a quicker death is better than a slower one then the Doctrine of Double Effect shows that a doctor who intended to kill the patient is morally superior to a doctor who merely intended to relieve pain.

The Sulmasy test

Daniel P. Sulmasy has put forward a way for a doctor to check what their intention really is. The doctor should ask himself, "If the patient were not to die after my actions, would I feel that I had failed to accomplish what I had set out to do?"