Tuesday, 22 February 2011

Ethics of Transplants

This has come up recently:

Should a convicted sex offender be accepted as an organ doner?

Just off the top of my head ...

The morality of the donor can impact the medical risk to the recipient ... someone convicted of sex offences could pose a higher risk of disease. This risk would need to be balanced against the need for the organ. We should realise that there are restriction on all srts of biological material donated by the public, for instance, you cannot donate blood if you have visited some countries. It is not always proactical to screen people who are seen to be high risk to the extent needed to be assured that the risk is justified.

In this case we are assured that the offending in question was non-contact and of a manner which does not lend itself to the conclusion that the donor was engaged in risky activity.

The situation of the donor refects the freedom of the choice they are making to donate. A prisoner of the state may feel, whatever the actual situation, that they are compelled to make the offer. By definition, a prisoner is not free. Even if we can determine that a particular prisoner is makig a free and informed choice, accepting the offer may lead to a situation where other prisoners feel pressured to follow suit.

The organisation performing the operation is also at risk.
The operation harvesting the organ is, itself, risky - as is follow up treatment for the donor. If anything went wrong, the surgeon etc are vulnerable to the accusation that they were less careful than they would otherwise have been.

But thats just me: have a look at this.
Nondirected donation raises different ethical concerns. The radical altruism that motivates a person to make a potentially life-threatening sacrifice for a stranger calls for careful scrutiny. One recent case involved a man who seemed pathologically obsessed with giving away everything, from his money to his organs, saying that doing so was "as much a necessity as food, water, and air."[3] After donating one kidney to a stranger, he wondered how he might give away all his other organs in a dramatic suicide. Other psychologically suspect motivations need to be ruled out as well. Is the person trying to compensate for depression or low self-esteem, seeking media attention, or harboring hopes of becoming involved in the life of the recipient? Transplantation teams have an obligation to assess potential donors in all these dimensions and prohibit donations that arouse serious concern.[1]
The references are:
[1] Abecassis M, Adams M, Adams P, et al. Consensus statement on the live organ donor. JAMA 2000;284:2919-2926.
[3] Parker I. The gift: Zell Kravinsky gave away millions: but somehow it wasn't enough. The New Yorker. August 2, 2004:54-63.
John Campbell was asking the wrong questions.


Say someone flips a coin and it keeps coming up heads ... how long before you will have to concede that they are using a double-headed coin? It seems most of us will give up after about five or so ... you'd certainly want to grab the coin of that person and take a closer look.

But how reasonable is this? If you only have the run of heads to go on, don't you have to give the person the benefit of the doubt? What if there's money riding on it? You life? Your immortal soul?

I decided to work it out.

This is actually related to the other stuff about religion: we commonly hear that Atheists cannot be sure of the nonexistence of God since we don't know everything. Or variations on that theme. Just because we have disproved a whole bunch of stuff as having to do with God does not mean that God is not true right? Can you really gain proof from negative results?

This is also related to the problem of induction. At stake is the long-term viability of scientific investigation. Science assumes that induction via falsifiability can be used to discover general rules about the way the Universe works. To put it in a theist context: God rarely intervenes in human affairs.

Christchurch hit again?

It seems God has it in for the cathedral city.

I just finished watching scenes of rescues from an office block that has four floors but no supporting walls -   layer cake - a woman who stepped out for lunch just before the quake tells the camera that there were about 200 people in there ... I though "meat sandwich" and decided to get the digest version on the main news tonight. I am just in the wrong space for this.

The coverage was interesting on technical merit - mostly because we got to see people fronting the news who would not normally be there. They actually did a good job considering the strain ... you could tell what it was doing to the reporters when the impromptu anchor on TV3 reported "fatalities" as "injuries" three times before it sank in ... and she was replaced right after. The woman on the spot (Rebecca Wright?) was holding up very well though the strain showed in her voice.

This is a real disaster Brucie - none of this Cyclone stuff we get out of Ozzie.

I wonder if Christchurch Cathedral is insured against acts of God?

Thursday, 3 February 2011

Christianity Questions #18, and a conclusion - sort of.

Many non–Christians are offended by the "exclusiveness" of Christianity. Can anything be said in response?
A) Christianity is "universal" in the sense that Jesus invites all people everywhere to receive the gift of eternal life made possible by the death on the cross.

.. Jesus has never been recorded making that invitation - correct me if I'm wrong but I understand that the doctrine of the crucifixion postdates Christ by a long way. However, the story of Jesus healing Canaanites, Romans and tax collectors, and his comments about this, indicate that he did intend his teachings to include everyone. So it is an exclusive club that everyone can join... Schaeffers strongest point here and the best response. Unfortunately he undermines his arguments in the follow up... mistaking the conclusion for the start (common with theists).
B) Since many basic tenets of different religions are contradictory, someone has to be wrong.
... isn't it the Christian perspective that everyone is wrong except for me? Even within Christianity there is conflict over which Christians have got it right. Other positions include "everyone is wrong" and "all religions have some merit - vis: everyone is right to some extent, wrong to some extent, and meaningless to some extent."
C) Exclusivity seem unavoidable. Who wants to board a commercial airplane on which the pilot is not exclusively committed to a safe landing? "Doesn’t the pluralist believe exclusively that several religions provide acceptable paths to God?" The exclusion of exclusivity is also exclusive. 
... this is a mistake: he thinks that exclusivity is the exclusion of anything however trivial. In fact, it is the exclusion of all else besides some small group considered privileged. Thus you can exclude exclucivity without being exclusive. However, we can include exclusivity and still find it offencive - Schaeffer needs to be less impressed with himself... but then, so do I.

Aside: there is more to a pilots job than landing the plane ... so I would not want him to be exclusive to that one task.
D) Christianity’s uniqueness arises not from the narrow–mindedness of individual Christians, but from the extraordinary claims of Jesus Christ, attested by those who were eyewitnesses of His life, death, and resurrection
Its uniqueness arises from the assertion that only Christianity is correct - everything else is common to a wide variety of different religions. Only Christians can get into Heaven. If Heaven was a nightclub we'd say it was an exclusive nightclub. His best answer so far is the one at the start. After all there are websites which are like this: you can only post if you are a member but anyone can join... what's the problem?

While there are many other questions that intelligent people ask about God, these are some of the principal ones that could become intellectual roadblocks to those who are truly seeking to know the truth about God. As you can see from the answers I have put forth, I do not believe that any of these are sufficient to keep a reasonable person from pursuing a personal relationship with God.
I'm going to have to agree with this statement, such deliberately misrepresented and poorly phrased questions should not trouble an intellegent persona at all - though a thoughtful person will wonder why these answers should be at all pursuasive.

All about the Weather and the Best Time to Avoid Dying

Watched the Cyclone Yasi coverage coming out of Oz ... and couldn't help laughing at the antics of journalists. After all the buid-up, Yasi crossed over mostly unpopulated areas, and the commentators are faced with having to talk excitedly about how there's a few power cuts, leaves on the roads, the odd tree blown over and so on. There are parts of Waiheke that look worse normally.

They go around asking the usual journo-stupid questions ... "Aw we had a bit of a blow yep." In responce to "What was it like last night?" In the buildup there were lots of journalists telling us excidely how they are going to hide out in hotel bathrooms and ballrooms where the hotel service seems to have improved - kitchen open all night and so on ... will this deprivation never stop?

It's all in marked contrast to the war coverage we've seen, where journalists make a big deal of the (very real) risks they were taking to get us the news. Similar with the regime-change demonstrations coming out of the middle east. I guess we'll have to wait for the footage from storm chasers and similar nutters, bless-em, who drive out into these things to get something actually exciting to sell to the networks. Probably it's already uploaded to YouTube.

I like this one - look at how big NZ is in this satellite shot! Anyway - it seems the storm was much weaker than expected when it hit - if I got this right it was expected to be cat5 but manages cat3 ... which would be 100x weaker.

Right after the news was Dr Oz: Best time to avoid dying?

I wouldn't normally watch this show - I an ad for it early on and put it in the burn before viewing basket. Still, catchy title.

At a guess, I'd say: "Probably while you are still alive", but I could be mistaken ....

Dr Oz presents the #1 cause of death in a bathroom scene. At first sight you'd say the woman (dummy - I hope) on the floor has slipped and fallen only she's wearing ug-boots, not generally good for sliding. Then we remember that the #1 killer in the US is heart disease and Oz points ut that when someone says "I fell in the bathroom" he thinks "heart attack".

"Fall in bathroom = heart attack."
Heart attacks 3x more likely to occur in the morning.
BP higher in the am. Looks like you shouldn't get out of bed.

... suggestion: he advises 5 medications before you go to bed. Good grief!

Aspirin, Magnesium, Calcium, BP & colesterol meds, and floss your teeth too.
The first three were shown in branded bottles - with the brand turned to the camera. That's called a product placement - which means the show got paid to do that. The general gist is that before bed is the time to take preventative action ... even so, the one ad-lib in that section had him point out that you are best to take medicines throughout the day so you keep the blood concentration up.

There's actually a bunch of surveys being used here - against a vinear of "biorythms" - the trouble is that they do not show causation. For example - best time for a flu shot is 11am because there is the lowest report of pain at that time. But we don't know what reason for this. Maybe the patient is looking forward to lunch ... so the advise should be to promise yourself a treat after vaccinations, then the time doesn't matter.

Its also not quantitative - how much pain is reported in each time-slot? If the respondents rated pain levels out of 10 (there is a whole feild studying pain which has ways to handle the subjectivity involved) and the pain rating only dropped one point at 11, this would not be compelling. OTOH: if it dropped 9 points, then Dr Oz would be on to something.

The food-times (when to cheat on your diet to minimize the effect) the audience all got right - but I noticed they were almost all overweight. So it's not really all that effective - it's this qualitative thing again: how much effect does this have? Clearly not enough, in relation to how much (there it is again) they were eating.

Curiously, the best time for medical procedures and so on is supposed to be in the morning - when, according to the the first item (bathroom, above) you are most likely to get a heart attack. But not first-thing, nope, give the surgeons a chance to practice on another patient first. Presumably someone who has not watched the show.

Mondays to do chores and housework because your analytical mind is slowest then. But some housework needs analytical thinking surely? Anyway, who feels like doing chores on Mondays? And why Mondays anyway: is a seven-day week built in? Perhaps it is a rhythm enforced by the 5-day working week? Perhaps the answer is to have a seven-day working week, but a shorter working day so you can get up late in the morning (reducing heart attacks as well).

Time to have a fight with your SO - 8am - high seritonen level ... but also high BP anyway: this is not panning out. The idea is that the fight is most likely to be fair. But this is not what you want - you want to win. Later - best time to exercize is 7am ... more heart stresses. Best time to vaccuum is at 4pm - due to minimising allergies as vaccuuming stirs up pollen and dust. Pardon? Then he gives away a vaccuum cleaner which he touts as capable of trapping the dust and other allergins. This reveals the usual conflict US shows have between actually telling the truth and pandering to the sponsor.

Best time to have sex?

Sex is like a massage chair - sounds like the start of a woody allen joke. Best tie is in the morning ... with all this stuff, our mornings will be very crowded. Personally I usually find sex in the morning to be intensely irritating. I'm just too groggy.

So we take our pills just before bed, next day at 7am we're having sex - then we are havig a fight at 8. Breakfast is bacon and eggs (or nachos - according to the show). But you have to have your mammogram at 9 - before your coffee ... which must be at 9:15 - if the appointment is on time.

And so it goes.