Infectious Diseases, Genetic Testing, and Medical Ethics

(Many thanks to Nazifa for these articles)

Dealing with infections diseases and advancements in human genetics provides several questions with regard to medical ethics.

For example, there is an uptick in an infectious disease known as Chagas disease, that can be fatal and that is now spread through mosquitoes.  http://www.nytimes.com/2012/05/29/science/spread-of-chagas-is-called-the-new-aids-of-the-americas.html?_r=1  The question this provokes, similar to our West Nile virus problem, is whether the need for health safety overrides concerns about environmental and ecological damage in using insecticides or other pest control methods.  In addition, from where will the resources come to protect populations in countries with limited resources?

We now have the power to do several kinds of genetic testing on humans.  In fact, diseases can be found to have genetic foundations.  http://www.nytimes.com/2012/05/18/science/many-rare-mutations-may-underpin-diseases.html?adxnnl=1&adxnnlx=1338649721-zq+0oFL98KtbvNZvroVprA  Will we (or insurance companies) foot the bill for expensive genetic testing for diseases, if we do not yet have the ability to treat these genetic defects and prevent the diseases?  In a similar vein, since some diseases are passed from parents to children, untested donated sperm can give a woman a baby with a genetic defect.  http://www.nytimes.com/2012/05/15/health/in-sperm-banks-a-matrix-of-untested-genetic-diseases.html?pagewanted=all  Should genetic testing of sperm and egg donations and/or donors be uniform and/or mandatory?  Should the offspring allowed from one donor be limited to a specific number?  Should potential parents be able to make selection of sperm, eggs, and/or fetuses on the basis of genetic test results?  Should this be limited to health-related characteristics, or be expanded to include other traits such as race, sex, intelligence, height, etc.?

Finally, it has been determined that both warfare and contact sports result in similar brain injuries: http://www.nytimes.com/2012/05/17/us/brain-disease-is-found-in-veterans-exposed-to-bombs.html?pagewanted=all.  Should military personnel be better protected from these injuries, or is the known inherent risk of injury or death implicit in military enrollment enough to cover these brain injuries?  Put otherwise, is modern warfare so dangerous to make it incompatible with the human condition?  (Advances in war-zone medical treatment have decreased deaths but increased casualties, meaning that far more soldiers survive with far more serious injuries than previously.)  Also, should intense contact sports, such as football, be limited to older athletes; should they be banned entirely; or is this concern just a sign of our increasing softness as a society?  Remember, in the old days football and hockey players didn't even wear helmets.

Lots of questions, which will hopefully spur lots of discussion for our last week together.  See you Tuesday.