Issues in Transplants and Eugenics

PRESENTERS

Muhammad Umair

Muhammad Hamza

Aiman Mahmood

Pernian Dhillon

CONTENTS

• Introduction to organic transplants

• Issues in transplants

• Eugenics

Introduction to TransplantsASAD RAZZAQ

Transplant

An operation in which an organ or tissue is transplanted.

Organ transplant

The surgical removal of a healthy organ from one person and its transplantation into another person whose organ has failed or was injured is often lifesaving and gives the recipient a wonderful new lease on life.

e.g. heart, kidneys, liver, lungs, pancreas, intestine, and thymus

Tissue Transplant

Tissues include bones, tendons, cornea, skin, heart valves, nerves and veins.

Organ transplant candidates need to make some substantial lifestyle changes

• Such as losing a moderate or large amount of weight

• Stopping smoking

• Don’t be a silent sufferer!

• Dental cleaning is generally recommended every six months for transplant recipients.

• Keep stress low

How long will it take?

Transplant surgery times differ a lot. A few examples include:

• Liver, 5 to 8 hours

• Kidney, 4 to 5 hours

• Pancreas, 2 to 4 hours

• Both kidney and pancreas, 5 to 7 hours

Your surgeon can give you a better estimate, taking into account your specific circumstances.

After the Treatment• After an organ transplant, most patients quickly feel better. They go on to enjoy a significantly

improved quality of life.

• You will need to take immunosuppressant (anti-rejection) drugs. These drugs help prevent your immune system from attacking ("rejecting") the donor organ. (for lifetime)

• Hair growth or hair loss

• Acne

• Mood swings

• Weight gain

• Diarrhea

• High blood pressure and High cholesterol

• Elevated blood sugar level

The symptoms of rejection

• The organ's function may start to decrease

• General discomfort, uneasiness, or ill feeling

• Pain or swelling in the area of the organ (rare)

• Fever (rare)

• Flu-like symptoms, including chills, body aches, nausea, cough, and shortness of breath

• The symptoms depend on the transplanted organ or tissue. For example, patients who reject a kidney may have less urine and patients who reject a heart may have symptoms of heart failure

Precautions after Transplant

• Wash your hands often

• Avoid people who are sick.

• Avoid people who have been recently vaccinated.

• Stay out of crowded areas

• Don't take care of pets.

• Don't garden.

• Brush and floss daily.

• Don't ignore cuts or scratches.

Issues of Transplantation

Organ Transplantation:

• Organ donation is the donation of biological tissue or an organ of the human body, from a living or dead person to a living recipient in need of a transplantation

Ethical Principles:

• AutonomyImplies that a person should be given choices in regards to the situations involved in their dying

• Non-maleficenceProtects the patient from more harm. A patient can donate their vital organs for as long as it does not cause further harm

Issues:

• Deontological Issues

• Clonning Issues

• Xenotransplant Issues

Deontological Issues:

• Certain groups oppose organ donation on religious grounds,

• Most of the world's religions support donation as a charitable act of great benefit to the community.

• Issues surrounding patient autonomy, living wills, and guardianship.

Cloning Issues• The use of cloning to produce organs with an identical genotype to

the recipient has issues all its own.

• Creation of an entire being for the sole purpose of using it as spare parts.

• zero-percent chance of transplant rejection.

• The use of cloning to produce organs.

• However, it may be possible in the future to use cloned stem-cells to grow a new organ without creating a new human being.

Xenotransplant Issues

• Highly successful means of transplant

• Xenotransplantation, the transplantation of organs, tissues or cells from one species to another.

• If applied to man, would offer the possibility of a huge supply of organs, tissues and cells for transplantation thereby relieving the “chronic” shortage of human donor.

Health Risks:

• the introduction of new infectious agents into the human population.

• Risk by means of two characteristics: the level of probability and the extent of damage.

EUGENICS

Eugenics

• Good genes” or “good birth”

• Term coined 1883

• The use of genetics to improve the health of a population.

• It is a movement that is aimed at improving the genetic composition of the human race.

• Eugenicists advocated selective breeding to achieve these goals.

Defining Eugenics

• “Improving human genetic qualities”

• "Eugenics is the study of agencies under social control that may

improve or impair the racial qualities of future generations,

whether physically or mentally."

Eugenics is influenced by

• Origin of Species: Natural Selection

• “Survival of the fittest”

• Mendel’s studies on the inheritance of traits

• Agriculture/Animal Breeding

Types• Eugenics can be divided into two types : Negative & positive eugenics

Positive eugenics:

Encourage people with “good genes” to have more children.

Negative selection:

People with inferior and undesirable trait are prevented from reproducing . It don’t allow “bad genes” to be reproduced.

Positive Eugenics

Positive eugenics - increase frequency of beneficial genes

• Sperm banks

• Genetic engineering

• Parthenogenesis

• Cloning

Negative Eugenics

Decrease frequency of deleterious genes

• 2 - 2.5% of children born in the US are markedly defective - mentally or physically

• Two reasons for prevalence of deleterious genes

1. Although deleterious in homozygous condition, may produce hybrid vigor in heterozygous

2. Frequency of deleterious genes is now high because natural selection has been artificially reduced

EXAMPLE

• Sterilization of men is done by vasectomy involving an operation in which sperm duct is blocked.

• Sterilization of women is done by tubectomy which involves an operation in which fallopian tube is blocked.

US Laws supporting Eugenics

• Miscegenation laws against mixing races

• Immigration Laws

Limits on Eastern and Southern Europeans (based on IQ tests, inmate/asylum studies

• Sterilization Laws

Model Eugenical Sterilization Law (Laughlin, 1922) defines socially inadequate classes

US Supreme Court Case

The case of Buck vs. Bell Carrie Buck

• Mother, Emma, was in asylum

• Gave birth at age 17 out of wedlock

• Daughter, Vivian, was examined at seven months and deemed feebleminded

• Charged with feeblemindedness, immorality, prostitution, and untruthfulness

• Supreme Court Ruling: “It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind…Three generations of imbeciles is enough.” – Justice Oliver Holmes

Eugenics and Research

EUGENICS CLAIMED THROUGH SCIENCE THEY WERE ABLE TO IDENTIFY……

Desirables

• Emotional stability

• Strong character

• Considerateness for other people

• Intelligence

• Tendency to uphold or improve moral standards

• The quality which makes people feel a personal responsibility for the public welfare

Undesirables

• Pauperism

• Alcoholism

• Feeblemindedness

• Promiscuity

• Criminality

Concepts of Eugenics

Concepts in Eugenics

• Intelligence and social class

• Miscegenation (racial purity)

• Hemophilia and Huntington’s Disease

• Genetic defects

How they are doing it?

• Genetic screening

• Birth control

• Promotion differential birth rates

• Marriage restrictions

• Segregation (racial and mentally ill)

• Forced abortions or pregnancies

• Genocide

Methods of Eugenics

• Mandatory eugenics: government-mandated

• Promotional voluntary eugenics: suggested to the general population

• Private eugenics: voluntary participation

Genetic Testing

• Predictive testing: Polycystic kidney disease

• Fluid-filled sacs grow on kidneys, possibly other organs

• Autosomal dominant (50% chance if one parent is affected)

• Onset: 30 to 40 years, possibly earlier/later

• No cure available; life-prolonging treatment possible (dialysis or kidney transplantation)

Genetic Counseling

• “An informative and supportive dialogue regarding a known, potential, or unsuspected genetic condition.”

• Manic-depressive illness (Kay Redfield Jamison)

“To whom is the genetic counselor responsible? The patient or married couple alone? Other family members? Future generations who may suffer increasing numbers of persons with genetic defects?” Ruth Macklin, “Moral Issues in Human Genetics: Counseling or Control?”

Prenatal Genetic Testing

• Cystic fibrosis

• Recessive (25% chance if both parents are carriers)

• Life expectancy: 30 years

• Carrier test available to pregnant couples or those planning to become pregnant

Flaws of Eugenics

• Failure to recognize the complexity of human traits

• Disregard of environmental/social factors

• Skewed results

• Linking undesirable traits with racial and ethnic groups

• Disregard of effects on genetic diversity

• Flawed IQ testing

The Fall of Eugenics

• Mainly due to atrocities committed by Nazis

• Emerging evidence against Eugenic claims

• Reginald Punnet

• Hardy-Weinberg

• Opposition from the Church/Mosque

Eugenics Then and Now

• Then: Focus on selective breeding.

• Now: Focus on prenatal testing and screening, genetic counseling, birth control, in vitro fertilization, and genetic engineering.

Role-Play Activity

• The Review Board has to determine a policy for the hospital regarding whether PGD should be permitted for the following purposes:

• to help two CF carriers avoid passing on the disease;

• to help a couple produce umbilical cord cells for an existing child with Fanconi’s anemia;

• to help a couple select the sex of their child for “family balancing”;

• To help a short couple produce a taller child.