This I Have Learned

1. Autonomy, truth-telling, and confidentiality-I didn’t realize the complications that can come
from merely being honest. A patient can seriously hurt themself if they are not honest with the
care team. I always think it’s funny when I read a patient’s allergy list and something like
strawberries are on it because unless someone gets hungry operating it shouldn’t be an issue,
however this is them taking control of their care. Someone could sabotage themself by not
giving the doctor all their information and I now understand that. I also wonder about the
autonomy my patients have after this chapter. When there are patients coming to the OR when
they are in their 80s or 90s I now wonder if they are doing it for their family or if they really still
have a desire to get treatment. This also helped me to realize the importance of keeping my
patient’s information to myself and other people caring for them. It is very unfair for the patient
and helped me to realize that. This chapter really gave me an idea of what the rest of the course
would be like as I began to realize how complicated medical decisions really were.

2. Research ethics and informed consent-I have a completely new respect and appreciation for
consents now. Each case before we make incision we take a pause to talk about the patient and
what we will be doing as well as confirm that a consent was filled out outlining what will take
place. It is frightening that there have been times where people were not given the chance to
make their own decision for their own body. I think that the patient should be a member of their
treatment just like the doctor or nurse. They should know exactly what will happen and what the
potential outcomes could be if things were to go wrong. Shielding patients from this is taking
away their autonomy which is completely their right. As far as research is concerned, I think that
human participants are necessary, but researchers really need to do their best to remember that
these are real people who are being experimented on and they should be careful with what they
do.

3. Genetic control-I now think that there could be a small place for genetic control but it should
be strictly limited to diseases that will kill the patient young in their life as well as give pain and
make the last bit miserable. It makes me nervous that this could be used to eventually make
designer babies as I believe that will ruin the diversity we have that we should cherish. I also
believe that this could be used to eliminate people with special needs and I think that they bring
so much positivity to our world that needs to be saved. Just because they don’t work like the
majority of people do should not lessen their worth. I do understand that this is something were
each person will have a polar perspective from the next though and that it is the ethically sound
decision to stop genetic control in a whole.

4. Reproductive control-As with the common theme, I was very for egg and sperm donation
before and now am concerned. I do not like the idea that it is looked at as a sort of business and
that people gain extreme amounts of money from. There should be a limit on how much a
person can be paid for their egg or sperm. I do agree that there could be a sliding scale of
payment based on their medical history or accomplishments however. I liked the way an article I
read explained it by comparing it to choosing a partner. We are born with innate desires and
one is to create successful offspring. It should not be viewed as cruel or unethical to choose egg
or sperm based on characteristics of the donor. Though this could be pushed into a field of
designer babies, not everyone will look for the same characteristics and unlike genetic
modifying, it will not guarantee anything.

5. Abortion- After completing this chapter I have an even stronger belief that abortion should
only be acceptable in a few scenarios. So often people can use it as an excuse to take away a
mistake they made and I think that that is not responsible and should not be encouraged. This
chapter taught me even more that the way to go about solving this problem is contraceptives.
Education is very important to teach people what the consequences could be of their actions as
well as the proper way to avoid it. If we can teach them how to prevent unwanted pregnancy
both parties are happy as the mother does not have to carry the baby and those opposed will
not have to watch a life stopped.

6. Treating or terminating impaired infants-This chapter really opened my eyes about how
severely infants can be impaired upon birth. I am still torn about whether or not I think that there
should be a time or place for it but I am considering the possibility of it being a reasonable
option in some cases now. If I had to decide my stance now it would be that I do not find it
morally permissible to terminate an infant. However, a doctor should be able to approve this for
some people when they feel like they are saving the baby from inevitable pain. I think the way to
go could be to create a list of diseases that are always bad enough to terminate and then have
a myriad of physicians approve it before things are changed.

7. Euthanasia and physician-assisted suicide-My opinion has flipped more than I thought it
would about any of the topics. I used to see a place in society for this as people have severe
suffering but now believe that it shouldn’t be allowed at all. I believe that instead of these
options we should focus on palliative care and making the patient more comfortable in their last
hours. It is too easy for people to take advantage of PAS and the lines to create are too easy to
blur. This should not be a way for people to get a free pass out of a tough time that could be
temporary. The biggest point of opposition I have to this is the way it normalizes suicide in the
population and makes it look like a solution to a problem. There is already a significant problem
with youth suicide in our country and if we legalized PAS and euthanasia I believe it would go
up. I think that instead of spending money and energy on creating new ways to euthanize we
should focus on new ways to alleviate pain.

8. Organ transplants, scarce medical resources-This was one of the few areas where my
opinion has not changed. I still firmly believe that we need to be doing all we can to generate
more organs for the transplant list. What I did gain from this chapter however, is how difficult it
will be to be able to legalize the selling of organs from live donors for transplant. I had never
thought about the ethical side of it when it came to people feeling the need to sell their organ
because I had always thought of it being a nice way to earn extra cash but not a way to survive.
In the end though, if a child needs a surgery and the family cannot afford it it would be nice to at
least have this as an option when times became dire. I would hope that it would never come to a
situation where the person was looked down on if they chose a different path, but in all paths
there will be people who do and don’t agree with it so It should not be avoided only because of
that.

9. Distributing health care-This is even more complicated than I thought possible to a point
where I think doctors should have to take an entire course outlining how to make each different
distribution decision. I have a hard time imagining a way to properly create a system that could
analyze a person so completely as to fairly deem them more worthy of some treatment than
another. When it comes to distributing organs I think it should have a slight scale where people
can prove they will take care of their organ which moves them up the list. This could include
things like having a sure way to pay for the follow up care after the transplant to keep the organ
alive as well as not drinking or smoking. Factors that will not directly affect the organ should not
influence it though. Some ways that may help decide who is more worthy may be a strength of
one and a weakness to others but this is unfair as there are many different ways one person
could outshine another.

10. Women and medicine- I knew that there were a lot of places in society that created
disadvantages for women but I didn’t know that medicine, especially research was one of them.
As a women I find it startling that the medication I take could be a less ideal version for me
because my genetic makeup is not the same as the men it was tested for. Women are unique
and should be given the chance to be cared for that way. The job of OBGYNs should be very
respectable as they should take special consideration of each way women are different. One
prime example is as a woman is pregnant, there should be unique ethical rules to her that only
apply at that time. Her life is two now and should be treated that way.

11. Health care for minorities- This is another area where I did not realize that research chose
favorites. I think that it is incredibly unfair that we do not test medicine and treatments in
minorities consistently. It was amazing to learn that these different groups could possibly react
to these treatments differently due to their genetic make up. I do think it’s important to realize
however, that since they are minorities we should not spend too many resources on this
research as it only affects a smaller group. To a point money needs to be distributed in a
manner that will help more people.

12. Those with AIDS/HIV-One if the things I found shocking about this chapter was the cost of
treatment. It is insane to think that people with AIDS could have to pay over $100,000 just to
live. However, I do have a problem with paying for their treatment. The ted talk we watched
suggested paying for clean needles for drug users to lower their likelihood of sharing needles
but I think this is not the right way to use taxpayer money. The majority of adults who contract
this disease do so because of choices they have made. Unlike those with genetic conditions
they could have taken steps to protect themselves against it. The children with HIV are another
story though. They are completely innocent and doomed to a condition that will take their life.
We should do everything we can to continue to find ways to stop spreading it to children and
treating them as much as we can after they do get it.