Brother, Can You Spare a Sotalol?

When I started out in the medical field, I worked in Orange and Washington counties in southern Indiana. Save for one kid who was bi-racial at my school, I can’t even think of when I first ran into someone with a different cultural background than myself. Everyone around me – including me, I guess – were redneck WASPs (white, Anglo-Saxon, protestants). As far as religion went, you were either a Baptist or hell-bound. It’s kind of sad when the Amish were the most exotic people I’d ever met.

Now: I won’t cop to the idea that I was a redneck. I didn’t grow up on a farm, and I certainly never drove a tractor to school on Drive Your Tractor to School Day. Yes, that was actually a real thing. I’m completely serious. Don’t even get me started about all the confederate flags. We had three extracurricular activities at my high school: football, Future Farmers of America (FFA), and the Klu Klux Klan (KKK).

I’ve always found culture as a whole to be interesting. And I think coming from such a culturally arrested community helps to drive that interest today. My academic safe place is well rooted in the Humanities, but my career safe place is – and always has been – in biomedical equipment and gadgets. The importance of scientific and technological innovations in the United States is directly related to what makes our country attractive to racially diverse countries abroad. And how those biomedical factors have shaped the history and will shape the future of our medical industry are worth considering. Trust me when I say I get that.

When I was a medic, I was lucky enough to work for a service that valued innovation, so we would have biomedical reps come in all the time to try and sell us their products. They would often leave a fully functional demo model for us for a few weeks to see if we liked their products. And that may be were my love of medical gadgets was sewn. When I left the field, I came in to work for a cardiologist who was also an electrophysiologist. I was always learning something new about gadgets because I tended to implanted biomedical devices, mostly pacemakers and defibrillators. Now I do diagnostic testing in a nuclear cardiology lab. It sometimes amazes me how the industry has changed in a biomedical sense over just the last 15 years. I also feel like we, as citizens of the U.S., should understand just how lucky we are in that specific respect. Even compared with the other countries of the civilized world, we still have the best toys.

In a sense, though, I do think that laypersons outside the industry have been spoiled by our technological sophistications. I don’t remember the company, but one of the cell phone providers has a tag line something like “There’s an app for that.” This is a telling example of just how technologically integrated our lives have become. There is pretty much an app for everything. And people expect everything to have an app. Our cell phones double as MP3 players, compasses, photographic cameras, video cameras, biometric monitors, televisions, and God knows whatever else I am forgetting. If you look at cellphone gadgetry as an analogy for healthcare technologies, we expect our cell phones to be a phone and all these other things, too. So if we can have a cell phone that is also a tiny vacuum cleaner, or humidifier, or full-size printer, why can’t we develop a ventricular assist device that is completely implantable and doesn’t come with a harness because it weighs 50 pounds. Or why haven’t we developed a feasible Terminator-style cybernetic arm as a replacement for those who have lost a limb? We can clone sheep, we can transplant faces, we can even counsel peopled on a genetic level, but we can’t cure HIV and people are still dying of a variety of cancers. And I really think the general public expects medical science to be limitless in its ability to diagnose, treat, and cure based on the assumption that if we can make a cell phone that has a thousand different functions then we should also be able to correct chromosomal defects in utero.

If you read my posts over the course of the evolution of this blog, it won’t be long until you come to find that I am fairly critical of both the biomedical model for healthcare and the role capitalism plays in how we deliver our healthcare in this country. I believe that a nearly exclusive amount of healthcare in this country is styled to respond to the biomedical model of care delivery. Sometimes I will listen to my peers talk about an ethical subject from a biomedical standpoint, and it will make me sad. And you might expect me to come from the biomedical point-of-view knowing a little bit about my background, but there are so many things that are healthcare related, as well as culturally related, that hinge on the opposite side of the biomedical model. In my view, the psychosocial model is probably slightly more than two-thirds as important as the biomedical model and terribly under-addressed in our society. If you look only at the pathology, to steal a word from the biomedical model, to help gauge the importance of the psychosocial model in just our country, we begin to recognize that almost all the biomedical maladies we treat from an empirical basis have psychosocial foundations. Obesity, alcoholism, preventable cancers, addiction, cardiovascular illnesses, depression, indigent care, pregnancy prevention, STDs, and the newer disorders of ADD, ADHD and the rise of autism diagnoses have a huge amount of psychosocial issues intertwined with them. Sure, we can attack some of these problems from a biomedical standpoint, but there are some instances, as with, say, autism, that I find hard-pressed to be successfully treated in any other form than from the psychosocial model stand-point.

A further complication that pits the biomedical and the psychosocial model against one another is the dichotomy of the market justice and the social justice of healthcare services delivery. It shouldn’t be surprising that I strongly believe that the social market is the best route of distribution. This has less to do with capitalism, in my mind, than it has to do with the universality of the access to healthcare services. Here’s a short story: while working at the cardiologist’s office, I had a patient call me and ask if there was another medication she could be put on that was different than a drug called Sotalol. Sotalol is used for treating ventricular tachycardia (VT), amongst other things. The patient had a recent VT ablation. An ablation is a procedure where the EP doc goes in and finds the irritated pathway that causes the patient to go in and out of ventricular tachycardia. That pathway is burned with a catheter that basically cauterizes the irritated focus. After the procedure, the patient is still prone to arrhythmia for the simple fact that the ablated pathway has to have time to heal for it to be completely “deactivated.” A day after this specific patient’s procedure, she calls me and says she can’t afford the medication. Sotalol is important post-ablation because the patient has the risk of going back into VT, which can eventually deteriorate into Ventricular fibrillation. VF is incompatible with life. So I end up with a patient that has decent hospitalization insurance, but she has no prescription benefits, and she can’t buy the medicine that might keep her alive. I passed around a hat, and the office staff was able to pitch in enough for her to buy a months’ prescription of Sotalol. Some employees didn’t chip in because they said they had medication to buy for themselves. Even though I completely felt the same, I also felt like I didn’t have much of a choice. What do you do? Sure, I could have contacted the drug company, and that is what I ended up doing, but that doesn’t take care of the immediate need. Ethically, how do you walk away from someone like that?

In our quest to create new technologies to make caring for patients better or more efficient, are we looking over the real problems that are at hand. I mean, we performed an ablation of a patient that didn’t have the money to care for herself after the produce but also because of the procedure. Would it have been better for her if we didn’t do the ablation and focused only on medicating her and making sure she could meet the needs of her day-to-day medical expenses? What kind of a standard does that set for culturally diverse populations that come to the United States for medical school?

There are people who can’t afford a $25 flu shot in our community. How much more are we contributing to personal medical disaster for people who can’t afford Coumadin after a heart valve replacement or Plavix after a stent placement? As much as I love innovation and truly believe in medical research, I worry what kind of a state we’re placing minorities and the working poor into by not considering the end-user of what we rush for approval.

Socialist! Communist! Marxist! Hyperbole-ist!

It seems as though I have been hearing a lot of talk lately about the U.S. and whether or not we should adopt a socialized system of healthcare. I say a bumper sticker the other day that read “Socialized Healthcare is Cheaper than Corporate Welfare.” I have been a fan of the socialization of healthcare for a very long time. It’s not something I talk about much because when some people hear the word “socialized” or “socialism” they immediately think Marxism (whether they know they are thinking Marxism or not) and then it is just a short few seconds before people start calling me a “Communist!” and soon after, somehow, I get accused of being in the Taliban and labeled unpatriotic. I’m 100% not kidding. It’s ridiculous.

There is something about the capitalist slant of making money on healthcare that seems wrong to me. Healthcare is the only industry I have ever worked within – a year and a half of teaching English at JCTC. I worked in medical devices, and if you have ever had a vacuum cleaner salesperson solicit your house, it’s very similar to a device sales rep. visiting your clinic. I can’t even tell you how many thousands of dollars that have been spent on me trying to win my affection for a specific company’s device. And as much as I love being taken out to dinner or flown to X-location for “training,” it’s a side of healthcare that makes me feel horrible about the “perks” associated with my previous life.

Now: I am going to be a little rough with the United States in discussing the “unique” way we deal in healthcare. I’m not saying at all that I don’t treasure the fact that I am a citizen of the United States, but, when it comes to how healthcare is made into a commodity, we are victims of our own wants. We want to live in a country that is the “home of the free” and a place where the “American Dream” can flourish. However, I feel like the American Dream should include low-to-no-cost health insurance. I am insured through the university, and it’s only because I am a fellow in the Bioethics program. If health insurance wasn’t part of my fellowship, I wouldn’t have any. For me, the American Dream is made possible by going back to university to acquire more knowledge. But if I don’t have at least a part-time job – and sometimes not even that will bring health insurance – I can’t receive insurance benefits. Why is health insurance considered a benefit of employment? Are the people who are unemployed or under-employed not the people who need health insurance coverage the most when it comes to off-setting out-of-pocket expenses?

I am taking a health policy class this semester, and the authors of our textbook – Leiyu Shi & Douglas Singh – use the term “fragmented” to discuss the delivery of healthcare in the United States. Fragmented  is just a fancy word for “ broken.” and the top 10 differentiating characteristics the authors give as the reasons the United States current healthcare system is unwell reads like a laundry list of excess-based problems:

1. No central agency governs the system.

2. Access to health care services is selectively based on insurance coverage.

3. Health care is delivered under imperfect market decisions.

4. Third-party insurers act as intermediaries between the financing and delivery functions.

5. Existence of multiples payers makes the system cumbersome.

6. Balancing of power among various players prevents any single entity from dominating the system.

7. Legal risks influences practice behavior.

8. Development of new technology creates demand for its use.

9. New Service settings have evolved along a continuum.

10. Quality is no longer accepted as an unachievable goal in the delivery of healthcare.

As conduits of health care providers within the already established system in the United States, physicians have to get paid. Reimbursement is a constant hot button topic with physicians. If a doctor can’t make enough money to exceed payroll and the overhead for his or her office, there’s not much hope for that doctor continuing to be part of a viable heath care delivery point. It’s a give and take. Patients give fees; doctors collect payment from the fees patients pay. One positive in this arrangement is that patients are customers. We pay for services that are expected to be rendered in a satisfactory way. Doctors are bound to deliver care to paying customers. (SIDE NOTE: the original wording of the Hippocratic Oath reads that physicians should always render care under a moral obligation even when patients cannot pay.) However, reimbursement is slight in some cases, so a negative might be that a physician might not elect to see people who are uninsured. I also can’t help but wonder if doctors don’t throw a battery of tests at their patients just to boost the amount of money that can be generated by over-testing. It happens all the time.

Insurance companies, on the other hand, want people as subscribers. This is a customer service-client relationship all the way. One positive effect from insurance companies is offering a variety of plan benefits so as to entice the subscriber to use their plan. Getting a new health insurance policy is like buying a new car: you want as many bells and whistles as you can get for a reasonable amount of money. Even if the perk is something useless, like a heated ashtray or preventative stroke insurance “just in case” you stroke out. Insurance companies feed of the fear of the unknown, and it’s one way that they can offer a private insurance policy with a $1200 premium. People will pay for it if they feel it will pay for itself. But the truth is that the insurance companies want to keep you as health as they can with yearly “well-visits” because the better you are physically, the fewer amounts of claims you will claim. Insurance companies hate when they have to give your money back.

I realize that I am being terribly long-winded, but there are four players in the healthcare system that seems to muck it up for all of us. But like everything else, there are both positives and negative to each role these players play.

Player: Managed Care Organizations

Positive: They make being sick simpler by acting as a means of delivery for payment to providers.

Negative: Who cares if you have been going to the same doctor for 25 years? Now you will see who the MCOs want you to see, or you can forget about them paying out.

Player: Employers

Positive: Employers make health insurance costs manageable by putting everyone into a pot of sorts. That $1200 a month premium might be a tenth of that cost thanks to employer contributions.

Negative: unless you work for a very large employer that can take a hit when someone makes a $1M claim, one sick person and his or her claim could torpedo low premiums for all his or her fellow employees.

Player: Institutional Representatives

Positive: So. Many. Regulations. It’s near impossible for people to keep up with their own healthcare benefits because there are so many regulations. Institutional representative keep up with all that bureaucracy for us.

Negative: See positive.

 

Player: The Government

Positive: Governmental involvement helps with programs that are an asset to subscribers. The Veteran’s Administration (VA) is a good example of how the government does make certain social programs available for those in need. The office of Women, Infants, and Children (WIC) would also be a positive that can be claimed to the defense of governmental involvement.

Negative: In an imperfect society – in a capitalist society – the government can be, and is, subverted by the private sector. Therefore, the government’s role can sometimes be nullified at the expense of its People.

All this business can get me fired up. So the thought I am left with is a terribly unpatriotic one: is the American Dream killing our healthcare system

— Michael M.

Bioethics in Film: Hell and Back Again

I throw an Oscar party every year. It’s small, but it’s fun, and there are prizes. I love movies. I probably watch at least 4 movies a week. One of my favorite things is to sneak off to a dark theatre by myself and tune the rest of the world out for 88+ minutes. Nothing else exists when I am watching a movie.

In preparation for this years Academy Awards my wife and I are playing catch up with some of the smaller films, mostly documentaries. The other night we watched one called “Hell and Back again.” I don’t say this lightly, but it was the best feature-length documentary I have seen in a decade. It follows the life of USMC Sgt. Nathan Harris, both while he is serving in Afghanistan and after he comes home via a life changing injury only a few days before his deployment ends.

The film shows a young man in trouble as he deals with being placed back into civilian life, the management — or lack thereof — of his PTSD, and how frustrating interacting with the health care industry can be in general.

There are parts of the film that are difficult to watch, and one scene in particular shows the death of one of Harris’s platoon members. I just want to put that out as a warning for people easily disturbed by such things. See the trailer below.

-Michael M.

Medical Technology and the Course of Nature

I ❤ medical technology. It’s true; I do. Maybe it’s a guy thing? The cliché is that men have an affinity for electronics, or at least that is what my wife would tell you. I don’t get to go to the grocery anymore because she is tired of coming to the electronics section to find what I have decided we have been nothing short of lucky living without.

I worked for a cardiologist for a couple of years. The human heart is the ultimate gadget for me. I mean, it makes its own electricity! Take that liver, you lazy wad of tissues! I joined the practice as his medical assistant, but I was quickly shepherded over to his device clinic, and that is where I remained until I left the job. I worked exclusively with implanted pacemakers and defibrillators. For a short time – about nine months – I also worked at an audiology clinic servicing and maintaining hearing devices. If you think about it, there are so many different medical devices that can enhance or replace our organic parts that creating a cyborg-human hybrid (Star Trek fan here) doesn’t seem all that fanciful.

I’m in the Bioethics program, so a lot of our conversations include the application of bio-mechanical devices. I want to concentrate on how I look at biomedical technology from the aspect of how my program questions their use. Head-to-toe, if I just let my mind do the sorting, I come up with the following biomedical technologies: cochlear implants, hearing aids, heart valves excluding xenografting (look how fancy I am), artificial hearts, pacemakers, defibrillators, ventricular-assist devices (or VADs), insulin pumps, and dialysis machines. So that list encompasses the inner and outer ear, the heart, the pancreas, and the kidneys. If I sit and think about it, I can purposefully come up with in vitro procedures; ECMO (extra-corporeal membrane oxygenation) and its grandfather, the heart-lung bypass machine; oh, and CPAPs, we can’t forget those; and then there are the devices we don’t know about because none of us works with the doctors that use the technology or the patients who would benefit from it. Here’s my deal: out of the things I have listed, all of the devices, in one urgency or another, prolongs life. In the case of a VAD, it’s a bridge device to hold over until a heart transplant. With a cochlear implant, maybe it’s the thing that keeps the hearing impaired person from walking in front of a bus. I will go to my grave believing that the 12-lead ECG transmission I sent over a cell phone saved a 48 year-old guy’s life. This dude was infarcting like he stepped out of a Mosby’s Cardiology textbook. When I made it to the ED with him, the streptokinase was ready to go. After that run, I was like “hells yeah,” but I’m not always like that. And maybe more so than not, when I think about medical technology and the lives it prolongs, I can’t help but think to myself: aren’t people allowed to die anymore?

For us folks in healthcare, I think that question alienates everything we have been taught or told. Keeping people alive is a multi-trillion dollar business. The sicker we are the more price points we produce in managing our illnesses. Although we are keeping people alive, using biotechnology, maybe those people who would have otherwise died aren’t supposed to live. Maybe diabetes, heart disease, kidney disease – maybe those maladies are supposed to kill people. Survival of the fittest and all. And maybe people who can’t conceive aren’t supposed to be mothers or fathers. Maybe some of us are supposed to be sicklier than others. We, as a species, are so dependent on medicine, and we’re slowly growing ever so more dependent on the technology medical need creates. I wonder what life would be like if we entered a modern Dark Ages? What would happen if we were hit with a solar flare that in some sci-fi fashion zapped out technology? How many people would just be dead? I’d be walking alone with Larry talking about how Fringe is the show Lost should have been when he just winks out because a coronal mass ejection fried his fixed-rate pacer. This is why I don’t get invited to many parties. I am one hell of a downer.

Granted, we as living things don’t get excited about meeting death. My wife says that death is her biggest fear, even though I know her real greatest fear is a global shortage of Fun Dip. I obsess over death quite often because I have undiagnosed PTSD (post-traumatic stress disorder) –hint, hint my current family doctor—or for no other reason than there is something in my constitutional make-up that enjoys my own mental self-torture. I’ll make a sweeping generalization by saying that no one would want to live in a world where biomedical technology that could or would extend our lives didn’t exist. But it is a bit like comparison shopping in that I can see people weighing the options. It is one thing to wear an insulin pump on your belt. It is something completely different to be strapped into a VAD harness and walk around with a power cord sticking out of your stomach.

What is your quality of life, then, when you have to be put on a charger every 6 to 8 hours? I can’t even remember to charge my phone at night, let alone need to charge the batteries for something that keeps me from dying! Then again, what is your quality of life without biomedical technology if you need it to remain among the living? It seems like to me – and this is just me talking – that I would have two very well outlined fears in such a state: my first fear would be that the technology I needed wasn’t available, and my second fear would be that the technology might fail once I had it. Either way I would be anticipating my death every second of the day. And I have to circle back and ask the same question as before: aren’t people allowed to die anymore? Because I would rather go out as a victim of sudden cardiac death than as a patient living with an artificially protracted cardiac life. I have a living will, a healthcare surrogate, and a plan for my body once I give up the ghost that doesn’t include a funeral. Pulling away from all the fancy gadgets that keep us going, the real thing I fear the most is a ventilator. I don’t know what I would say or do at this point in my life if I was told I needed a VAD in order to see my daughter graduate from high school, but I already know that “life” on a ventilator hooked to a Kangaroo pump spiked with endless enteral feed bags isn’t for me. And let me own the fact that I do think there is a huge difference between therapeutic biomedical devices that increase our quality of life (hello, again, insulin pumps) and machines that do nothing but keep us in a state of living that more than fits the definition of futile care.

Other than the fact that we live in a capitalistic society hell-bent on producing revenues, the need to be reimbursed for every single part of the healthcare encounter works against us. Going back to the guy I wrote of earlier whose ECG I tele-transmitted to the ED, I wonder how much that phone call ended us costing him.  You know it wasn’t cheap. I wouldn’t have charged him for it, but that is also why I could never be a business owner. I would be the guy who traded 2 chickens and a bushel of apples for a heart cath. It would have probably been cheaper for the guy to make a collect call to the moon. There’s a great line in the 3rd edition of Delivering Health Care in America: A Systems Approach where the authors Shi and Singh write on page 173: “[M]anaged care would not be possible [without technology] because it is based on managing information, and managing information requires technology.” That’s the foundation of a paradox if I have ever read one. MCOs (managed care organizations), Medicare, Medicaid – everybody wants to jam their hand in the cookie jar of medical technology. The people in the power positions within these organizations know they have to evolve with the onslaught of technological advancements if they are going to stay alive. Semi-pun semi-intended. I certainly hope that my wife never ends up on a ventilator for several reasons, but I super-hope that, should she meet such a fate, I never get a letter in the mail from whatever bill payer we have stating that her life is no longer in the best fiscal interest of the company or organization. I don’t know if that has ever happened or not, and for God’s sake don’t tell me if it has. Let me have this specific ignorance as long as I can before we have the Santa-isn’t-real talk.

Biomedical technology is important to the science of medicine as well as the soul of the people who use it. I can’t claim that I don’t get excited about new medical technologies even when the applications sound horrifying. I hope that I see a day when medical technology ends cancer, AIDS, neuro-degenerative conditions, and the gout I am stricken with about twice a year. At the end of the day, I feel like medical technology isn’t in itself a negative thing. What I do think is bad, however, is using medical technology as a bio-mechanical fountain of youth. People were made with planned obsolescence in mind. Living things are meant to die.

–Michael M.

FDA Changes Indications for Breast Cancer Drug Avastin

I am in the Bioethics and Medical Humanities program because I am interested in the fields of general medical research and advocacy. I believe that both are vital parts of the healthcare machine. So when I read that Avastin, a popularly used breast cancer treatment drug, had lost its FDA backing in the recent days, I was sad to feel like medical research had set the stage to fail some of our ailing women dealing with a breast cancer diagnosis.

The FDA says tan Avastin study showed the drug to be ineffective in treating metastatic breast cancer. From what little I have read about it, I guess the authorization for that specific use was always controversial. I was watching a news report this morning, and any patient who wants to continue using the drug will have to pay around $8,000 every three weeks out-of-pocket. Those with Medicare are the only ones that have any hope of help when it comes to the price. Although it is to note that the drug’s approval was continued for use in treating other cancers.

In the interview, a woman with a 10 and 15 year-old said she has been cancer-free for the past 2 years, and she believes that it is because of Avastin. She said that, within the first couple treatments, she could tell that the size of her palpable breast tumor decreased in size. She’s afraid that once she stops taking the drug the cancer will reappear and she won’t have a chance to see her children graduate high school and enter into adulthood. In the same interview, a woman sitting in on the FDA news conference after the findings were announced said that the discontinuation of the drug was a mistake and that the FDA “just killed 70,000 women.” Obviously there is a population of women who really believe in the drug and its benefits. And although the FDA reports that Avastin neither shows an increase in the quality of life or a decrease in patient morbidity, I wonder if there is a fringe group out there being saved by the drug nonetheless.

The emotion that surrounds the entire case reminds me why Bioethics is such an important field.

It’s my hope that the FDA would recognize if there was even the smallest sample of women helped by the drug. I know medication R&D is expensive, and I know that production costs for oncological drugs are crazy high, but healthcare decisions based on money scare me to death. And I am not necessarily saying that the FDA made its decision to change the drug’s indications based on profits and losses. I can only hope that, since Avastin has been taken away from women, that there is a new substitute for the drug ready or at least soon to come out of the pipe.

–Michael M.

Not Cool Historical Artifact: Syphilis Poster from the 1930s

I just snatched this off Wikipedia. I wonder if there is any significance to the fact that the man in woman are represented by the color black?

–Michael M.

Bioethics in Film: Movies for November

I am a huge fan of movies. I’ve said it before. I am. Huge. So around the beginning of every month, I am going to recommend 3 films I have watched and enjoyed that  have strong bioethical themes. If you have Netflix — and I realize that not everyone does — all of these films can be streamed for free at the time I post the articles. My wife says I only like depressing movies. So keep that in mind.

Hilary and  Jackie

Emily Watson and Rachel Griffiths are amazing in this based-on-true-events film.

Lorenzo’s Oil 

If you haven’t seen this Nick Nolte-Susan Sarandon film, you really should take the time to watch it. It’s one of the best bioethics-in-film examples I’ve watched.

21 Grams

It’s a devastating movie. Naomi Watts is a revelation as a grief-stricken mother losing her grip on life after an accident destroys her family.

Mississippi: Egg + Sperm = Person?

Ever have a topic that you hope no one asks you about because you’re not really sure how you feel concerning the subject? Or better still, ever have a subject that you know exactly where you stand concerning the issue, yet you know your position will start a huge battle that will eventually end a relationship? Been there, both situations. I tend to see myself as a moderate with leftist leanings; somewhat fair and balanced. Others tend to see me as a dick. Sometimes middle ground is hard to find.

When I read an article about how Mississippi’s Republican Governor, Haley Barbour, was supporting an amendment to the state’s constitution supporting the claim that life begins at the moment of fertilization, I found myself having to reevaluate how I felt about abortion. So after some consideration, I came to the conclusion that how I feel about abortion is less a discussion for a web-posting and more a discussion to have over coffee. The me of just 5 years ago would have never copped-out like that, but the me of now realizes that there’s a whole lot of grey when it comes to the bioethical considerations of when and how life emerges.

I did do some research, though, about the abortion laws in both Kentucky and Indiana. And I also pondered my attitudes about this sentence in the news story:

“[Mississippi] Initiative 26 would define personhood as ‘every human being from the moment of fertilization, cloning or the functional equivalent thereof’.”

I hate when people use the c-word. My Christian-programmed brain is definitely atypical in discussions of morality…but clones!?

It just so happens that Kentucky and Indiana both have cloning legislation to some degree too. Which is good because, if I could, I would clone the hell out of myself. There would be Michaels everywhere. Driving a TARC bus? Michael. Eating at Hot Diggity Dog? Michael. Simultaneously eating at Mimosa Cafe? Still Michael. Just passed you on the interstate on my way to crash Space Camp? You betcha. I have always wondered what it would be like to be a duodecuplet. You can never have too much of a good thing.

So when does life begin, and how do we know for certain when that time is? And are clones really “real” people? What constitutes a “real” person?

Can these questions ever truly be answered?

-Michael M.

Bioethics in Film: The Undertaking

I am a fan of Thomas Lynch. He is an undertaker, a celebrated poet, and a witty and wonderful essayist. One of the funniest and most entertaining poems I have ever read is called “Y2Kat”, and it is a lament about how Lynch wishes his kid’s cat would die. He’s a little dark. But I seriously recommend reading Bodies in Motion and at Rest. It’s a beautiful mix of science and philosophy. I’ve given two copies over the years as gifts.

But what brings me to Lynch for this post is a Frontline episode from PBS called “The Undertaking”. The episode revolves around Lynch and his dichotomous life as scientist and philosopher. There is also a heart-wrenching story about a young couple and the death of their son. It’s really one of the better documentary pieces about death and dying I have ever seen. Is it hard to watch at times? Yes. Is it worth allowing yourself to go to that place? Without a doubt. You won’t soon forget the Verrino’s story of the life and death of their son, Anthony, and how their dying 2 year-old has reshaped their lives. See the link below to stream the video:

The Undertaking | Frontline | PBS

-Michael M.

Is a liberal arts degree worth it? | PBS

I guess we need to chop off the ampersand and everything after and rechristen ourselves “Bioethics Students.” That is if we believe that “& Medical Humanities” cheapens our degree program. Personally, the idea of “Bioethics” + “& Medical Humanities” = the entire reason I decided to apply to the program in the first place. And  the thought of being in a STEM discipline sounds like something awful. Later in the article, the author reports that humanities can be mixed in with engineering and such. We have a term for that. It’s called interdisciplinarity. We can’t stop learning about the humanities. Is math not a form of poetry? Is archaeology not as important as biology? You can’t be human without the humanities. Here’s a quote from the article:

With debt from student loans nearing or, by some accounts, surpassing the amount of debt from credit cards in 2011, there’s been a lot of talk lately about whether a traditional liberal arts education is worth the cost. The 20-somethings who fill the ranks of the Occupy Wall Street movement, for example, have been ridiculed for their gold-plated fine arts degrees, which can cost as much as $100,000. Rick Scott, the Republican governor of Florida, has derided public funding for anthropology and other humanities disciplines as a waste of taxpayer money. “I want that money to go to degrees where people can get jobs in this state,” Scott said in a radio interview earlier this month.

Read the full text here: Is a liberal arts degree worth it?

–Michael M.