DALLAS?When Robert Orr was in medical school in the 1960s, the training he received in medical ethics amounted to an hour-long presentation on etiquette. Only three students showed up for the Saturday morning lecture.
“It had nothing to do with what we think of now as medical ethics,” Orr said during the opening session of “Cutting-Edge Bioethics: Human Life on the Line,” held May 6-7 at Criswell College.
The two-day conference on “end-of-life issues, reproductive technologies, stem cell research and beyond” was jointly sponsored by The Center for Bioethics and Human Dignity, Christian Medical & Dental Associations, Trinity International University, The American Academy of Medical Ethics together with Criswell College and Baylor Health Care System of Dallas.
After a lifetime of practicing medicine for which he was named Vermont’s Family Doctor of the year in 1995, Orr now serves as an ethics consultant. In the more than 1,400 cases for which he’s offered advice, questions often center less on what can be done than what should be done.
“The first people who started asking questions about what should be done [in terms of medical care] were the theologians,” he said, alluding to moral issues such as abortion that moved medical ethics to the forefront. “Sadly, over time, the voice of the theologian has gotten weaker and weaker and less listened to as the baton was handed over?first to philosophers,” Orr said. “Then clinicians?the physicians, nurses and social workers who deal with patients daily?became involved and engaged.” Next came the attorneys and judges, he said, and more recently people with a business background analyzing the cost of care.
Ethics committees were formed in the 1980s in response to cases such as that of brain-damaged Karen Ann Quinlan whose family fought for the right to remove the respirator when she was in a comatose state. Nowadays, teams of 12 to 20 consultants deal with educating patients, evaluating policy regarding ‘do not resuscitate’ instructions and informed consent, as well as offering help with decision-making for those receiving the care.
The ethical questions raised in the medical community have changed in response to technological advances. “When I was in medical school in the 1960s the question was, ‘Should we tell the patient he or she is dying?’ Ninety percent of the time patients were not told,” Orr said of his early experience. “Now there’s been a sea change to 98 percent of the time we do [tell them].”
Orr said breakthroughs in medical treatment have led to:
?involvement of medical personnel in executing prisoners through lethal injections;
?protecting patient confidentiality as records are stored electronically;
?access to healthcare among patients who are uninsured or underinsured and the rising cost of care;
?xenotransplantation utilizing organs from animals to replace diseased human organs;
?reproductive technology that provides “babies without sex;”
?so-called “gene enhancement” to remove unwanted traits that threaten a patient’s health; and
?artificial intelligence and artificial life, which raise the question of what it means to be human.
“What is normal?” Orr asked. “Should we eliminate those who are not normal? Once we start being able to change genes we’ll be asking the same question of who should live and with what characteristics.”
Orr said: “Technology raises questions of can-do versus should-do. When you have a man dying of lung cancer with difficulty breathing, can we put him on a ventilator to postpone dying a few days or weeks? We can, but should we?”
Raising the issue of “marginal benefit,” Orr said decisions must be made between differing plans such as one tr
AUSTIN?More than 200 ministers gathered in Round Rock, near Austin, May 5-7 for the SBTC-sponsored “Breathe Deep” Conference.
The event, geared for all church staff members, marked its third year and is hosted by the SBTC’s Church Ministry Support team.
“It enabled me to get away from the routine, make new relationships with fellow ministers, rekindle old relationships, learn new ideas for ministry and share some effective ideas,” said Barry Wilson of Second Baptist Church, Houston.
Wilson attended the education ministry fellowship led by Mike Northen of FBC Pflugerville. Three additional fellowships?youth, children’s ministry and music?were held.
The retreat, at the Round Rock Marriott, included a Friday evening banquet.
Brad Bunting hopes this summer’s SBTC Youth Evangelism Conference (YEC) offers a good time for students. But more important, he’s praying it will reach lost teens and motivate and equip Christian students to evangelize.
YEC, scheduled July 15?16 at Will Rogers Auditorium in Fort Worth, annually draws students from throughout Texas for intense worship and Bible teaching. Bunting, SBTC youth evangelism associate, chose this year’s speakers, bands and other personalities very purposefully, he said.
The weekend will center on the theme “Search and Rescue,” which describes the mission of Christ in saving people and the same mission to which Christians are called, Bunting noted. The theme is based on Luke 19:10: “The Son of Man has come to seek and to save the lost!”
The conference’s primary speakers are Clayton King and Wade Morris.
“Clayton King has the ability to stand up there and present the gospel in a clear and compelling way,” Bunting said. “[His goal] is not just to entertain [students] and make them laugh, but he’s a guy that believes in the power of the word of God.” King hails from Boiling Springs, N.C., and speaks to hundreds of thousands of college and high school students annually.
While King will preach an evangelistic message, Morris will challenge Christian youths to participate in a “Search and Rescue” mission. Morris, who earned a master of divinity degree at Southwestern Baptist Theological Seminary before moving to Birmingham, Ala., “is really going to call out the students to be a witness for Christ on their campuses and in their homes and in their cities,” Bunting said.
Also, Scott O’Grady, the Air Force fighter pilot who survived six days in enemy territory after his plane was downed in Bosnia in 1995, will use the “Search and Rescue” theme in telling how his faith sustained him and how his rescue by U.S. Marines “pales in comparison” to his salvation by Christ. He is a Dallas Theological Seminary student.
“Shane & Shane,” a group known nationally among students, will perform music in a concert style on the first night. “Among Thorns” will do the same Saturday morning, appearing together as a band for one of the last times before its members head in new directions in August. A Christian humor and drama group, “Skitiots,” will also perform.
“The Jeff Berry Band” will serve as the main worship leaders. Berry “is as good as they come,” Bunting said. “He’s not all about himself; he’ll really point those students to Christ.”
Ministry leaders will encourage and train students in evangelism throughout the YEC weekend. This conference is ideal “for the youth minister who really wants to see his youth taken to the next level in sharing their faith,” Bunting said. “If he wants to see evangelism take off in his youth ministry, that is what this event is designed for.”
Bunting said he is especially excited about the unsaved youth who will respond to the Lord’s call during YEC. To enhance this outreach to lost students, the SBTC is offering discounted Six Flags over Texas tickets to any groups wishing to attend the park Saturday afternoon and evening. “Some groups might have a difficult time convincing lost kids to come to an evangelism conference,” Bunting noted, but Six Flags “might be a way to get lost students there.”
“We want them to see this as something they can bring lost friends to.”
“[YEC] could be a key outreach event for a youth ministry,” Bunting said. “I would encourage youth ministers to really build this up, because it’s certain that [kids] are going to hear the gospel in a clear and compelling way.”
For registration information, visit www.sbtexas.com and click on the planetstudents.org link or call the SBTC student evangelism department at 817-552-2500.
DALLAS?In the last 20 years, more than half of all marriages involving Jewish people have been with non-Jews. “That means that Jewish people are unexpectedly turning up in American environments where they are encountering Christians up close and personal?sometimes as family members,” stated Tuvya Zaretsky, director of the Los Angeles branch of Jews for Jesus.
Zaretsky sees this challenging family situation as an opportunity for Christians to share the good news of Jesus Christ with Jewish people.
At a June 13-17 class in Dallas on “Principles of Jewish Evangelism,” Zaretsky will help participants meet the cross-cultural challenge between Gentiles and Jews. “Intermarriages are opening a shaft of gospel light to a people who have heretofore been in spiritual blindness,” he added. “There is hope and communication tools for those who are ready to learn how to do it.”
The weeklong class is one of two courses the Pasche Institute for Jewish Studies at Criswell College is offering this summer. A July 11-15 study taught by Arnold Fruchtenbaum will address the “Theology of Israel.”
“American Jewish Gen-Xers are post-modern and predisposed to reject the message of Christ,” Zaretsky said. “The lessons from Jewish evangelism will uniquely equip ordinary Christians, pastors, mission and youth workers to minister spiritual truth to a people who are open in a remarkable way at this time.”
Zaretsky was raised in Northern California where he attended Hebrew school and was bar mitzvah. During that ceremony, he read from Isaiah 6:1-8 where the prophet had dedicated himself to God saying, “Hineni?here am I.” Zaretsky recalled that he wanted to say, “Hineni,” too, but was acutely aware that he had no personal relationship with God.
Disenchanted with religion, he began a search for truth during the late 1960s and was encouraged by a Christian friend to pray that God would reveal himself. “I started reading the Bible and found that because of Jesus, I could finally say, ‘Hineni?here am I,’ to God.”
In advising Christians who are married to Jews, Zaretsky said they understand no one is ever convinced of the gospel through conflict. “However, the Jewish reaction to the gospel is one of fierce cultural opposition.” He said many Christians assume that this is the end of the discussion, when it is often the starting point.
“Some Christians fear that initial reaction and so avoid gospel communication with Jewish people,” Zaretsky stated. “However, the Jewish religion, Judaism, operates from a survival mode. We can help Christians understand the basis for that core Jewish value and how to engage it in a manner that is informed and considerate. It is a uniquely strong response, but not an insurmountable barrier,” he insisted, adding that the course next month will teach how to do that.
Zaretsky received both a bachelor and master of arts degree from University of Redlands in Southern California. He graduated from the Fuller School of World Missions with a master’s degree in missiology concentrating in Jewish evangelism. His dissertation addressed, “The Challenges of Jewish-Gentile Couples: A Pre-Evangelistic Ethnographic Study.”
Zaretsky finds it is helpful to establish a set of terms to use in discussing the subject of Jewish evangelism. “There are at least seven ways to use the term ‘t1:country-region w:st=”on”>Israel,'” he noted. “We make a clear distinction between Jewish people, Jewish ethnicity and Jewish culture. Knowing the difference makes it easier to understand how to approach Jewish people with the gospel.”
“With no other hope of eternal life or the forgiveness of sin available to Jewish people apart from Jesus Christ,” Zaretsky said, “we should learn how to reach them in a manner that is culturally sensitive and biblically true.”
FORT WORTH?Three educational institutions and the Southern Baptists of Texas Convention signed an agreement at Southwestern Baptist Theological Seminary May 3 to provide accredited higher education for Hispanics.
Jacksonville College, represented by President Edwin Crank, Criswell College, represented by President Jerry Johnson, Southwestern Seminary, represented by President Paige Patterson, and the SBTC, represented by Executive Director Jim Richards and Hispanic Initiative Director Mike Gonzales, made official an agreement to assist Hispanics in obtaining college and graduate training.
“We are excited to help provide quality education, built on the inerrancy of God’s word, for leaders of our state’s Hispanic churches. No one else is working in Texas to provide this kind of biblically-based, comprehensive training,” said SBTC Executive Director Jim Richards.
Hispanic Initiative Director Mike Gonzales added, “It is amazing how God brought all this together. Texas Hispanic pastors have a golden opportunity to further their education.”
The agreement is intended to create an “educational superhighway for Hispanic ministers.” Students may obtain certificate-level training in ministry and continue to a doctoral degree through the participating schools.
The basic curriculum consists of 24 hours of biblical studies courses and six hours of English language courses. These courses will be offered at five sites provided by the partner institutions. SBTC will confer a certificate to students completing the courses and they may also be applied to undergraduate studies at the partnering schools. The three institutions plan to offer courses beginning this fall.
President Edwin Crank of Jacksonville College noted: “The potential to help reach 6.7 million Hispanics in Texas is challenging. This is not only an educational endeavor, but an outreach opportunity.”
Expanding this thought, SWBTS President Paige Patterson said: “t1:State w:st=”on”>Texas, and the whole Southwest, is characterized by increasing Hispanic ethnicity. What a noble assignment the SBTC has undertaken and how appropriate for the three great schools to cooperative together to make available to our Hispanic brothers and sisters an approach to Christian leadership for the churches. This is cooperative missions at its best.”
Criswell College President Jerry Johnson stated: “The Hispanic population in Texas is growing and will continue to grow in the future. Christians must see it as an opportunity. God has commanded us to evangelize the nations and in this case an ethnic group is coming to us. We should not only walk through this open door to evangelize, but also to disciple and train a generation of Hispanic church leaders. Criswell is excited to be a part of the Hispanic Studies Agreement with the SBTC, Southwestern Seminary and Jacksonville College.”
Earlier this year and as a part of the Hispanic Initiative, the SBTC announced a scholarship program at Southwestern for Hispanic Ph.D. students?named for Rudy A. and Lucy L. Hernandez. The late Dr. Hernandez was a vocational evangelist and the first director of the SBTC’s Hispanic Initiative.
FORT WORTH– Tres instituciones educacionales y la SBTC (Convención de los Bautistas del Sur de Texas) firmaron un acuerdo en el recinto de SWBTS (Seminario Bautista Teológico Sudoeste) para proveer educación superior acreditada a hispanos.
Jacksonville College, representado por su Presidente Edwin Crank, Criswell College, representado por el Presidente Jerry Johnson, Southwestern Baptist Theological Seminary, representado por el Presidente Paige Patterson, y la SBTC, representada por el Director Ejecutivo Jim Richards y el Director de la Iniciativa Hispana Mike Gonzales, hicieron oficial un acuerdo de ayudar a hispanos a obtener educación superior.
“Nos entusiasma proveer una educación de calidad, edificada en la inerrancia de la palabra de Dios, para líderes de nuestras iglesias hispanas en nuestro estado.” Nadie más en Texas está trabajando para proveer este tipo de educación y entrenamiento comprensivo basado en la Biblia,” dijo el Director Ejecutivo de la SBTC Jim Richards.
El Director de la Iniciativa Hispana, Mike Gonzales agregó, “Es increíble cómo Dios unió todo esto. Los pastores hispanos de Texas tienen una oportunidad de oro de ampliar su educación.”
La intención del acuerdo es crear una “supercarretera de educación para ministros hispanos.” Alumnos pueden obtener entrenamiento ministerial, recibir un certificado y continuar hasta obtener un doctorado por medio de las escuelas participantes.
El currículo de estudios básicos consiste de 24 horas de estudios bíblicos y seis horas de inglés. Estos cursos se ofrecerán en cinco sitios proveídos por las instituciones colaboradoras. La SBTC conferirá un certificado a alumnos que hayan completado los cursos y también se podrán aplicar a estudios superiores en las escuelas colaboradoras. Las tres instituciones piensan ofrecer los cursos empezando este otoño.
El Presidente Edwin Crank de Jacksonville College notó: “El potencial de ayudar a alcanzar a 6.7 millones de hispanos en Texas es desafiante.” No sólo es un esfuerzo educativo, pero es una oportunidad de alcance.”
Ampliando este pensamiento, Presidente Paige Patterson de SWBTS dijo: “El estado de Texas y todo el sudoeste, es caracterizado por una creciente etnicidad hispana. Cuán noble asignatura ha asumido la SBTC y cuán apropiado para las tres grandes escuelas que cooperando juntas han hecho disponible a nuestros hermanos y hermanas un enfoque de liderazgo cristiano para las iglesias. Estas son misiones cooperativas en el mejor de los casos.”
El Presidente Jerry Johnson de Criswell College declaró: “La población hispana en Texas está creciendo y continuará creciendo en el futuro. Los cristianos debemos verlo como una oportunidad. Dios nos ha mandado a que evangelicemos a las naciones y en este caso un grupo étnico está viniendo a nosotros. No sólo deberíamos caminar por esta puerta abierta para evangelizar, pero también para discipular y entrenar a una generación de líderes hispanos de la iglesia. Criswell está entusiasmado de ser parte del Acuerdo de Estudios para Hispanos con la SBTC, Southwestern Seminary y Jacksonville College.”
Temprano en el año y como parte de la Iniciativa Hispana, la
DALLAS?Even unbelievers have the law of God written on their hearts and can perceive the value of a human life?even if they can’t identify the source of such value, an Oxford bioethicist told a Dallas conference May 7.
“Conscience is there and we can use that conscience, we can appeal to that conscience,” E. David Cook said during the “Cutting-Edge Bioethics: Human Life on the Line” conference at Criswell College. “We can work with people who do not share our God, do not share our faith, do not share all that we hold dear but have God’s law written on their hearts. Now maybe (their understanding) is twisted. It may be fallen, but it’s there. And we can use that and build on it.”
His lecture, “Who Lives, Who Dies? Allocating Healthcare Resource,” covered the factors healthcare professionals use in deciding who gets care and how far care should be extended.
Every country in the world, from second- and third-world nations to technologically advanced countries, has some level of healthcare crisis, Cook said. How they deal with it depends on the worldview of the decision-makers, he said.
Improved medical technology has expanded physicians’ ability to sustain life, creating an allocation-of-resources dilemma compounded by patients who are surviving longer, Cook said.
“It’s a problem today because of the very success of medical science.”
In a nationalized healthcare system such as Britain’s, economists have entered the debate, providing formulas for determining healthcare allocation.
“Healthcare economics has become a major opportunity for our failed economics professors,” Cook quipped.
During a healthcare conference that included leading British economists, healthcare professional and politicians, and at which Cook was the lone ethicist, the term “quality-adjusted life years” was discussed to describe a formula for determining a numerical value for patients. Cook said the economists considered it an objective factor in making allocation decisions.
“You’ll discover if you are very young you will do very well under a quota system. If you are old you won’t do so well. If you are well, you will do very well under a quota system. If you are sick, you will not do very well under a quota system.”
Various factors can affect one’s healthcare, including the perception that a patient has family members who monitor his care. Other factors include a perceived value to society, the ability to pay, age and gender bias and the worldview of healthcare providers.
“I tell elderly people, ‘If you go to the hospital, tell them ‘I’ve got lots of relatives and they’ll create lots of trouble if you don’t look after me well,'” Cook said. “Because the single, elderly person is very vulnerable in a hospital setting.”
He told of one teaching hospital where a heart patient was removed from a machine to make room for a college history professor who suffered a heart attack. “Is the professor of European history worth more than someone who works in garbage disposal, who drive a bus, who’s at home looking after the family? We can have bias or we can have merit. He deserves or she doesn’t deserve. How do you decide who is worthy of treatment?”
In reality, rationed healthcare works on a first-come. first-served basis, Cook contended.
“I know if I go on the first, second or third of the month, I am likely to get my flu vaccine. But if I go on the twenty-fifth, twenty-sixth, twenty-seventh of the month, ‘Sorry, no vaccine left.’ Because that’s the way they allocate?first come, first served.”
DALLAS?At a college committed to the Bible that informs a Christian worldview, Criswell College President Jerry Johnson told participants at an April 29-30 bioethics conference that it makes sense for the school to host such a meeting.
“We believed this kind of a conference would help us understand how the Christian worldview would inform medical life-and-death decisions,” he said, noting the joint sponsorship of several groups drawn from bioethical, religious, medical and academic disciplines.
Criswell College trustee board chairman Royce Laycock, emeritus professor of surgery at University of Texas Southwestern Medical Center, set the tone of the meeting, praying for “better understanding of the issues we face each day” as participants seek to “line them up with a Christian worldview.” That approach, he said, would lead to decisions that please God and “avoid expediency of political correctness and disregard for sanctity of God-given human life.”
Conference leader Robert Orr of The Center for Bioethics and Human Dignity explained that morally consistent people make different decisions on similar cases based on their own prioritization of principles and particular worldview. “We as believers have principles for guidance and sometimes that makes things easier and sometimes more difficult,” he said, trying to balance man’s free will with the need to be obedient to God.
“Are we to do justice, love mercy and walk arrogantly as a free moral agent?” he asked. “My Bible doesn’t say that. ‘Walk humbly with thy God’ makes all the difference in the world. Yes, we are free agents, but we are to walk humbly in the presence of our God,” he added.
“We’ve been so schooled in Western thought that that we think making ethical decisions is all about me,” stated Ben Mitchell, professor of bioethics and contemporary culture at Trinity International University. He told conference participants that such reasoning assumes “I make ethical decisions in my autonomous bubble and I don’t need influence from anyone else.”
Instead of only seeing the church as a worship community, Mitchell reminded the gathering of Christians that the church is a moral community. “Together, the community discerns the will of God.”
Mitchell spoke of the need to establish appropriate boundaries in making end-of-life decisions while recognizing the difficulty of such questions. “If we have the same God, the same Bible and the same moral values, we ought to be able to reach some kind of consensus,” he stated.
“The Holy Spirit is going to help us come to some consensus on these issues over time,” Mitchell said. “We need to have the conversation as the community of faith.”
He encouraged Christians to start bioethics centers, participate in journal clubs and attend local book discussions at stores like Barnes & Noble when reading about culture and ethics. “Participate as a citizen of two kingdoms.”
Mitchell agreed with Orr’s belief that knowledge is not the problem so much as a lack of wisdom. “We don’t know what to do with the knowledge we have sometimes.”
He described wisdom as knowledge that is harnessed to moral responsibility. “I want to develop a morally responsible knowledge base and not just go after knowledge for the blind sake of knowing something I hadn’t known before.”
He conceded, “That’s a hard sell for scientists. Scientists have committed themselves to increasing the knowledge and understanding of the world that is their laboratory and I appreciate that.”
When the map of the human genome structure was unveiled, Mitchell said it helped him know how fully and wonderfully human beings are made. “That doesn’t threaten God. But I do worry about the consequences of knowledge without wisdom.”
DALLAS?Robert Orr expected that some people attending the bioethics conference at Criswell College might chuck rotten tomatoes at him. Nothing was thrown, but likely he surprised them with his view that end-of-life decisions are not always as morally clear as some believe.
Orr, a physician and bioethicist at the University of Vermont medical school, is a Christian pro-lifer and an outspoken opponent of euthanasia and physician-assisted suicide. He is the clinical director of The Center for Bioethics and Human Dignity, a bioethics think tank and one of the cosponsors of the conference, “Cutting-Edge Bioethics: Human Life on the Line.”
But his views on artificially administered feeding and hydration?that such treatment is sometimes inappropriate?pits him against some other pro-lifers.
Orr, speaking during an afternoon session, told the conference that after-lunch lectures are conducive to napping. “I’m actually hoping that some of you do fall asleep this hour. Because I’m going to say some things that some of you don’t want to hear. In conversations and so on I’ve gotten the idea that some of you have already decided on some issues that I think are not necessarily already decided.”
In the cases of persons such as Terri Schiavo?the severely disabled Florida woman who died this year after fluids and nutrition were removed?Orr said family members nearly always make the right decision on what the patient would have wanted regarding extraordinary life-extending treatment. But such decisions are best made at the bedside, not in the courts, he said.
Orr said removal of artificially given food and water?with proper family or patient directives?is appropriate where continued nutrition extends life but does not enhance the patient’s recovery chances. Removal of fluids, done with constant moistening of the mouth and with pain relief, is often preferable to extended suffering for terminal patients and sometimes may be the ethical choice, he argued.
Orr used a graph to explain the “trajectory of death.” Some people die suddenly (accidents or heart attacks), some die predictably (terminal illness) and others “dwindle,” as many elderly people do.
But the most complex ethical decisions, Orr said, arise from cases of people with chronic disease. They spiral downward, improve, worsen, and improve again. “There’s crisis after crisis?you never know which one will be fatal. And so the uncertainty of how they’re going to do really colors the issue of how you make decisions in these circumstances.”
Because medicine can prolong life much more than in previous generations, new issues arose in the 1970s and ’80s along with a slew of publicized court cases that centered on medical ethics and patient and family rights.
“Some of these media cases resulted in decisions about different types of treatment,” Orr said, citing specific cases such as that of Karen Ann Quinlin, where a ventilator was removed.
“Bottom line is that it’s OK sometimes to use less than maximal treatment even if that means sometimes the patient will die. This change in approach led to advance directives, hospice, palliative care?very positive things.”
Orr cited eight things bioethicists learned from court cases between 1976 and 1990.
41. A competent patient has the right to refuse even life-prolonging treatment.
42. Incompetent patients have the same right and a surrogate may exercise that right.
43. The family is the presumptive surrogate, except in Britain where physicians make the call, sometimes with the family’s influence.
44. Courts are inappropriate places to settle end-of-life issues.
DALLAS?C. Ben Mitchell believes ethical responses to questions about medical treatment start with an understanding of what it means to be a human being.
As a professor of bioethics and contemporary culture at Trinity International University and senior fellow of The Center for Bioethics and Human Dignity, Mitchell strives to apply a Christian worldview to developing biotechnologies.
“As you think about living in the 21st century, we have seen and Dr. (Robert) Orr has promised some amazing technological developments,” Mitchell told a bioethics conference at Criswell College May 7. “Some are even talking about extending human life indefinitely,” he projected, well beyond 100, 150, 300 or 1,000 years. “Some are arguing that technologies are going to enable us to have an immortal life in this physical body or in some bodily form.”
The two-day conference, “Cutting-Edge Bioethics: Human Life on the Line,” dealt with “end-of-life issues, reproductive technologies, stem cell research and beyond” and was jointly sponsored by The Center for Bioethics and Human Dignity, Christian Medical & Dental Associations, Trinity International University, The American Academy of Medical Ethics together with Criswell College and Baylor Health Care System of Dallas.
Mitchell asked participants to imagine standing on a platform with a spouse to affirm “til death do us part” when that could be 450 years. As startling as that seems, Mitchell said developments in physics raise the question of whether aging can be postponed. Other prognosticators are confident life will be created in the lab, he added.
“Sex selection is already with us as various clinics will guarantee to some degree that you can have the gender child you want. Is the gender of our children something we receive as gifts or do we choose gender?” Mitchell asked. Current discussion in pharmacode genetics moves on to imagine manipulating a person’s genes so that those linked to certain diseases might be turned off, he noted.
Mitchell said “the list is huge” for the number of conditions known to have a genetic link or contribution.
“Increasingly, physicians are more interested in your genetic information than they are other patient information.” As a result, the practice of diagnosing an ailment by listening to heart rhythms and touching the patient has been replaced by ordering a lab work-up to gain insight into the condition, he explained.
The underlying biology leads to developing drug therapies that could prevent or possibly cure certain illnesses through gene therapy. But Mitchell warned, “Right now we are in a no man’s land where we know a lot about the map but we don’t have much on this side of the scale. We can diagnose a lot more conditions and diseases genetically than we can do anything about.”
What Mitchell referred to as “a diagnostic therapy gap” raises the question of how early the knowledge of a disease would affect how the patient lives his life. Using Huntington’s Disease as an example, Mitchell said the loss of fine motor coordination and nervous system atrophies arising between 40 and 50 years of age are symptoms that precede an earlier than normal death. “If you’re 45 years old and know the symptoms might start at 50 do you want to know when there’s no treatment for it? Would knowing at 25?even though there are no symptoms until age 45 or 50?significantly reorient your life?”
Backing up to telling a 15-year that such a disease is inevitable, Mitchell asked, “What would it mean to know as an adolescent that you had what some would call a ticking time-bomb syndrome? Would parents want to know when the child is 2 or before birth?”
Citing Orr’s principle that “knowledge brings with it responsibility,” Mitchell said doctors are dealing with making diagnoses without a lot of therapies in the near future. The discussion takes a more unusual turn in addressing how genes affect behavior. Mitchell said some socio-biologists believe there are risk-taking genes prompting them to watch and play extreme sports while risk-aversive genes pass by such programs on ESPN because they don’t even want to see it. Whether the behavior is aggression, anxiety or cleptomania?”the stealing gene,” Mitchell said, “We just blame it on our genes now.”
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