2015-2016

MEDICAL DECISION MAKING AND THE HUMAN LIFESPAN

Everyday we make hundreds and even thousands of decisions.  What to eat for breakfast, when to leave for work, and when to stop working and go to sleep.  These decisions are usually quick and are lower stakes.  However, sometimes we are required to make decisions that are not as easy and could have significant consequences.  Questions about life and death are not simple and sometimes there is not correct answer.  This is what defines an ethical decision.It is important to discuss our values and our wishes so that they can be clearly communicate them when the time comes.  This is a topic that applies to all of us and one that we should all familiarize ourselves with.  Ethical conundrums can sometimes seem far fetched and disconnected from real life.  Medical decision making in the human lifespan is significant to all of our lives.
How much of a say do you really have in making medical decisions? How do autonomy, fairness, and justice inform/affect these decisions? The topic of Medical Decision Making and the Human Lifespan covers many topics. It involves the beginning of life, end of life treatments and palliative care, issues surrounding competence and informed consent, and other related ethical considerations. These ethical considerations are significant in allowing us to make informed medical decisions, and ensure that legal systems we have in place are fair for all involved.
Meet the 2015-2016 Scholars

THE ETHICS OF CATHOLIC HOSPITALS REFUSING TREATMENT/INFORMATION TO PATIENTS

Description:  Do Catholic hospitals have the right to deny treatment or withhold information from patients if the treatment/information goes against the religious and moral beliefs of the hospital? In the United States, Catholic affiliated hospitals care for one in six patients. Many Catholic affiliated hospitals act as the sole provider of reproductive healthcare in rural areas. Women in need of lifesaving abortions are often denied treatment and information. How do physicians at Catholic hospitals balance their obligations towards their patients (best medical practice) while retaining their autonomy? What legal mechanisms are in place that allow Catholic hospitals to refuse to perform lifesaving abortions? To what extent do physicians at Catholic hospitals have the right to conscientiously object to treatments such abortion and sterilization? What is the distinction between a moral decision and a legal obligation? Can institutions have the same religious freedom as individuals? What can be done about the issue of equity, and the fact that poor women in rural areas often do not have access to secular hospitals? These questions are explored through the lenses of autonomy and fairness.
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ETHICAL CONSIDERATIONS REGARDING CHILDREN WITH GENDER DYSPHORIA: DO YOUNGER PEOPLE HAVE THE ETHICAL RIGHT AND COGNITIVE ABILITY TO MAKE DECISIONS ABOUT TREATMENT?

Description:  Are children affected by gender dysphoria any different from adolescents and adults affected by the same condition? If so, should they maintain the same autonomy and ability to make decisions in situations regarding treatment options, and what role do other stakeholders play in this issue? Recently there has been an increase in diagnosed cases involving children with gender dysphoria, the condition of feeling one’s emotional and psychological identity as male or female to be opposite to one’s biological sex. These cases have brought medical professionals to reconsider common pediatric practices, and involve close counseling and monitoring until signs of puberty emerge. At this point, a child has many options for treatment. However, there are still many restrictions on which treatments can be utilized by younger children– for example, hormone therapies can only be undergone if the patient is sixteen years or older. How can we determine when a child is legally mature to make such decisions? And how do we handle situations in which different stakeholders have conflicting opinions in the matter?
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BIOPRINTING HUMAN ORGANS: SAVING LIFE OR REDEFINING IT?

Description:  Just because we, as a human race, have the ability to do something, should we? Bioprinting, though a fairly new concept, has a very promising future. The waiting list for an organ transplant is over 120,000 people! Bioprinting would drastically decrease this number. However, if we were to allow people to use this as a new means to replace failing organs, what would it mean for the future of our society? Will humans become irresponsible with their bodies and therefore dependent on their ability to have these organs? Are humans an inherently greedy species that will take advantage of any opportunity given to them? Bioprinting could also be used to medically enhance someone’s body. Should we therefore regulate how people are using this process? If we allow people to further enhance their already working bodies, will this increase the divide between the healthy and unhealthy? The desire to enhance one’s body would not only create a new standard for humans, but it would potentially subject people deemed “unhealthy” to even more ridicule than they already face. Knowing all of this, should we allow bioprinting to continue to develop, or should we stop it before it gets out of hand?
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IS IT YOUR RIGHT TO DECIDE WHAT’S RIGHT? THE ETHICS OF USING GENETIC TESTING TO SCREEN FOR ADULT ONSET DISEASES IN EMBRYOS

Description: If you could use a technology that would allow you to see the fate of your child, would you? And would you still have that child if you knew that they were going to have cancer suffer or from a disease like Alzheimer’s in the future? Preimplantation genetic diagnosis is a process that can be used to screen embryos about to be used in in vitro fertilization for adult onset diseases, such as Huntington’s Disease or ALS, and detect predispositions to cancer. While PGD has helped lead to an increase in the number of successful pregnancies through IVF, many people argue that it is unethical to use this technology to screen for adult onset diseases out of concern for the potential future child. However, are these concerns enough to stop a parent from getting testing for their own child? These arguments and the ethics of limiting PGD for adult onset diseases will be explored in this project.
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CHRONIC DEPRESSION AND ASSISTED SUICIDE: WHO DESERVES THE RIGHT TO DIE?

Description:  Are depressed people competent enough to make life or death decisions? How can we balance what’s in the best interest for the patient and still respect their wishes?  Will the legalization of assisted suicide for those with depression destigmatize suicide as the “easy way out” and what consequences will this have for society? These are some of the questions that arise when debating whether or not chronic depression is a valid reason for assisted suicide. Chronic depression is a serious and debilitating illness many people face throughout their lives. Those with depression experience feelings of extreme sadness and misery that can interfere with their ability to live a full and productive life. Although some treatments are available now, they may not always be effective. In these cases, patients with depression may feel as though life is not worth living and seek out physician assisted suicide. This project will explore whether or not depressed patients should have access to this treatment while taking into account issues of competence, autonomy, fairness, and beneficence.
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THE ETHICS OF LONGEVITY OUR TECHNOLOGICAL IMPERATIVE

Description:  One of the most quintessential questions we ask as humans is: Can we live forever? In the media and movies, the question of the possibility of living forever is usually answered with some far-fetched response involving the word “magic;” however, scientists are starting to develop technologies such as cryonics, organ replacement, and caloric restriction, that may provide us with a little more Life. With this possibility on the horizon, the new question is: Should we use it? This project will explore this issue through arguments of accessibility and quality of life; focusing on the ethical values of equality, fairness, and justice. Should everyone have access? Should no one? How will the technology affect day-to-day life? Our social structure? All of these questions and more are essential in answering the classic question that new technology always poses.
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ADOLESCENT AUTONOMY AND END OF LIFE DECISION MAKING

Description:  What types of decisions should adolescents be able to make? Are they competent and capable to make end of life decisions? Is it right to hold back information from the adolescent? These are the questions that come up when deciding whether an adolescent has the capability to have a say in their end of life decision. Although it may seem simple to say that they are not capable to do so, there are many factors that influence this complicated decision. This paper will explore these questions throughout many different lenses and eventually answer the question of how much say an adolescent should have in their own end of life decision. It will also evaluate the three stakeholders, the patient, parents, and physician, throughout the values autonomy, responsibility and the doctor’s care for the patient’s voice.
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HUMAN POSTERITY VS. PLANETARY SUSTAINABILITY: THE HARD CHOICE OF A CURE FOR A DISEASE OR A CURE FOR THE PLANET

Description:  Is it ethical to explore methods of longevity, and cures for certain diseases that affect large amounts of the population, with the knowledge of what population growth will do to the safety of the planet? In 2050, the projected population of the world will be 9.6 billion people. Many scientific studies suggest that Earth’s carrying capacity is 8 billion people. After this point, very limited amounts of resources will be available to the population. On the other hand, medical technology will greatly advance within that span of time. The FDA approves an average of 12 new cancer drugs a year. The number of people to become centenarians will increase by 1000% within the next 40 years. These circumstances are ones the human race has never encountered before and therefore, no clear answers exist to the questions they will raise. This project will explore this issue through the ethical lenses of justice and fairness. It will discuss the idea of justice for the earth, and the earth as a stakeholder. It will also discuss fairness in relation to the human race, specifically whether we as humans can limit anyone’s access to medical treatment, and the good of the many versus the good of the few.
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