answer the following THREE questions 1) The Heart Transplant The

answer the following THREE questions 1) The Heart Transplant The hospital ethics committee was discussing an important and urgent case. A donor heart had become available, but an extremely rare thing had happened. Two heart-transplant candidates in the hospital were both matches for the donor heart. One patient was known to the committee as Mr. X, the other as Ms. Y. For someone with heart failure, Mr. X had been on the transplant waiting list a long time. He had been waiting one year and was near death. Ms. Y had just been placed on the list and could be sustained with medication for quite some time, possibly until another heart became available. The answer seemed obvious-give the heart to Mr. X. A number of the members of the committee did not agree with this answer. They argued that time on the transplant list should be only one factor considered. They saw a problem in Mr. X’s medical record. Mr. X was 64 years old and had suffered from a heart condition for years. He had had two angioplasties and two bypass operations to correct a blockage of the heart’s blood vessels. The problem seen by some committee members was that Mr. X still smoked, ate fatty foods, and was very overweight. After each procedure, doctors had warned Mr. X that he must change his life-style, and that if he didn’t, his condition would worsen. He never stopped smoking, however, and never changed his diet. He said it was too hard. Research has proven that smoking and high cholesterol are risk factors for heart problems. Blockage of the coronary arteries is directly attributed to these two factors. Treatments such as angioplasty (opening the blood vessels by passing a tube into the arteries) and bypass surgery (connecting new blood vessels that go around the clogged ones) can correct the problem, but they are not a total cure. To avoid further problems, patients must control their diet, stop smoking, and alleviate stress. This, of course, is not easy. Mr. X appeared not even to try. The heart was about to be airlifted to the hospital. The committee had to make their decision very soon. Questions 1. What should the committee do? 2. How would you vote if you were on the committee? 2) Liposuction Liposuction is an elective procedure in which fat cells are removed from select parts of the body for cosmetic purposes. This type of elective surgery is considered safe compared to most other medical surgeries. However, sometimes the risks are minimized to the point where patients think of it as not much more than having a tooth pulled. The risks exist but no one is able to define them with precise numbers. Potential negative outcomes from the surgery can be quite severe and people have died from this surgery. In addition to the risks, the potential health benefits are not as definitive as sometime claimed. This is the most common procedure performed by plastic surgeons in the US with hundreds of thousands operations performed. Some overseas companies offer a vacation package as part of the surgery to entice patients. Some news agencies have sensationalized some of the less successful operations even though most patients do not experience severe effects. Others claim that this procedure has long term health benefits like improved cardiovascular health from the weight loss. However, some studies have concluded that the actual health benefits do not equal old fashioned diet and exercise. They maintain that the weight loss and improvement in appearance are temporary with liposuction surgery. Even with the limited overall health benefits and the risks associated with the surgery itself, liposuction is a relatively popular elective procedure. Plastic surgeons tout the benefits. As with any type of surgery it pays to know what the risks actually are so they can be weighed with the benefits. See: https://www.mayoclinic.org/tests-procedures/liposuction/about/pac-20384586#:~:text=Liposuction%20is%20a%20type%20of,include%20lipoplasty%20and%20body%20contouring. Q: How do the benefits of the liposuction procedure outweigh the risks? What are the risks of liposuction surgery in comparison to other daily activities like driving in a car? Explain your reasoning. 3) Cord Blood Should You Bank Your Baby’s Cord Blood? Today’s medical advances allow us to treat a wide variety of conditions that a few decades ago were nearly untreatable. One such advance is the use of transplants for patients who have failing organs or organ systems. In addition to transplanting organs, it’s possible to exchange defective blood cells with properly functioning ones. Transfusions are particularly useful in cases of leukemia or sickle cell anemia. Normally it’s possible to get correctly matched blood from a family member but this does not always work out so another source is needed. One good source is from the blood taken from the umbilical cord after an infant is born. Normally this blood would be discarded but it’s now seen as a valuable source of donated tissue that can be used by a patient suffering from a variety of illnesses. In addition this blood can serve as a source of stem cells for the new baby if he or she develops illnesses themselves later in life. Many people are starting to store this unique source of cells for the future use of their children. One of the big controversies surrounding this storage is the question of who should take charge. Should private companies store the tissues of an individual for profit of should the cord blood be donated to a public institution that can use the blood to help whoever needs it? The process of storing, collecting and cataloging blood samples is fairly expensive. There is much discussion over how this process should be funded. Along with funding come the issues then of who should be able to access the cord blood if it’s needed. There is debate of should patients pay a fee and if so who would pay. Insurance companies could offer plans or a government agency could cover the costs with tax dollars. This is a classic example of something that makes good medical sense conflicting with ideas over the best way to pay for potentially life saving procedures.’ Interestingly it is reported that there are large supplies not being used. For more, see: http://www.scientificamerican.com/article/vast-majority-of-life-saving-cord-blood-sits-unused/?WT.mc_id=SA_HLTH_20141209 Q: Given the option, would you consider banking the umbilical cord blood of your child? Would you prefer to keep it stored, for a fee, to be used for your family’s own use or would you donate it to a public storage facility to be used by anyone? Explain your decision.

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