Tuesday, December 9, 2008

I Missed You!!

Picture from here.

Hey, I'm back! You may have noticed a few minor-ish changes to the blog format and the pic in the header. I bet you missed me as much as I missed you (or maybe you didn't notice my absence). A few things to update.

Yesterday was my friend JW-M's birthday. He's in Beijing studying abroad right now. I wished him a happy birthday online and on Facebook. I also told him that I loved him as a friend, something I've never said to a friend before (I think). And it's true, I value his friendship very dearly. He also told me that I was the one "true friend" he made in college, so that was really touching. I almost teared up a little.

I took my toxicology (anti-pharmacy) exam today. It was kind of rough but shouldn't be too bad, considering I just started studying for it yesterday.

I finished my term paper!! It is epic 12 pages with 13 references. The policy proposal I came up with is quite novel, if I do say so myself, as it doesn't involve government legislation to proceed with regulation. My topic is the need for regulation on PGD (pre-implantation genetic diagnosis).

In a nutshell: PGD is where they take 1-2 cells from the early embryo and do a genetic test on the DNA to see if that embryo has any genetic diseases. The embryo isn't destroyed in the process and can be implanted into the womb.

Now, some issues I had to address in my paper:

1. Cost and access. PGD isn't cheap at about $5000 and most health insurances won't cover it. That's clearly a health disparity along economic lines, and the poor who may need this technology can't access it.

2. PGD for controversial medical use. There is the case of Molly Nash. She was born with Fanconi's anemia, a fatal childhood genetic disease. Her parents used PGD to conceive a second child who was born free of the disease and was an HLA match with her sister. Because he was selected as an embryo to be an HLA match, doctors could then transfer his bone marrow into Molly to save her life. Were the parents ethically/morally right in "commissioning" a second child to save a first?

3. PGD for sex selection. Should PGD be used to select the gender of one's child? The only accepted indication in the medical field is when there's an X-linked disease in the family that would be bad for a male offspring. But the private sector can do whatever it wants in this respect.

4. PGD for non-disease genetic traits. Let's put it this way. Should deaf parents use PGD to make sure that their children are also deaf? Should straight parents use PGD to ensure their children are straight, or gay parents use PGD to ensure their children are gay (assuming the children is conceived via surrogacy and there is a single gay gene - which there is NOT)?

5. PGD and public health. If we could use PGD to eliminate genetic diseases from the population, should we? Can we? There are dire ramifications when we mess with the diversity of the human genome. For example, when a person only has one copy of the sickle-cell anemia gene mutation that person is resistant to malaria, but two copies of that gene mutation causes full-blown sickle-cell anemia. We don't know enough about the human genome to mess with it. And even if we do, I don't think we should.

So those are the interesting issues I had to consider and ponder and come up with some kind of regulatory policy on. If your head's spinning, don't worry. Mine was too on Saturday as I was on page 4 of 12.

Anyway, I realize (for the 100th time or something) that I post really long posts. I apologize, but that's unlikely to change, and that's probably why I don't have 20,000+ page-views. I mean, I'm not THAT boring am I?

Picture from here.

I really liked that picture. A lot of bloggers have been down lately. If you're one of them, and you see this, or you know a blogger who is in need of some cheer, send them this or an e-hug or something.


Anonymous said...

I did miss your posting. And you know I read it all avidly regardless. But yes, sometimes you are long-winded. Typical mid-westerner. Lol!

naturgesetz said...

Those are important issues.

One question to muddy things a bit more:why must all medical procedures be equally available regardless of the patient's ability to pay? Patient's inability to pay effectively means that others are required to pay for it. While that may be reasonable enough when we are looking at a procedure which is necessary to save the patient's life and which is customary practice, when the patient is not at grave risk and the procedure is not customary — when in fact there are even ethical questions about its propriety — it may not be right to consider it a right to be funded by others if the patient can't afford it.

Aek said...

James: Hey!

Naturgesetz: Your question also touches on the issue of whether or not health care is a right or a privilege. There are tons of ethical questions about various common procedures done through the US health care system.

This is an interesting article highlight some of the issues: http://www.nytimes.com/2008/12/09/health/views/09essa.html?_r=1&ref=health.

With the case of vaccines, it's in everyone's best interest to get vaccinated regardless of ability to pay if for no other reason, than for the concept called "herd immunity."