What are some potential harms to consider? A study providing a Tai Chi program for older adults in a community setting. The effectiveness of drug X for pain
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What are some potential harms to consider?
- A study providing a Tai Chi program for older adults in a community setting.
- The effectiveness of drug X for pain management among cancer patients.
- A study identifying prevalence and risk factors for rare cancers among Indigenous Peoples
- A genetics study that map out DNA for young children.
Step by step
Solved in 2 steps
- how does systems thinking, critical analysis, and other ethical, evidence-based decision-making principles impact the planning for a cancer program.Ethical values may vary regionally. For example, while stem cell administration is not considered ethical in a region, there is no reason why it should not be ethical worldwide.Give 1 sample in accordance with the example given above.Note: The example you will give should be general as above (no person, time etc.). The sample should be unique to you and should be explained in detail.Should he go ahead and enroll on the chance that he would receive the DNA vaccine and that it would be more effective than chemotherapy? Bruce and his parents moved to a semi-tropical region of the United States when he was about 3 years old. He loved to be outside year-round and swim, surf, snorkel, and play baseball. Bruce was fair-skinned, and in his childhood years, was sunburned quite often. In his teen years, he began using sunscreens, and although he never tanned very much, he did not have the painful sunburns of his younger years. After graduation from the local community college, Bruce wanted an outdoor job and was hired at a dive shop. He took people out to one of the local reefs to snorkel and scuba dive. He didnt give a second thought to sun exposure because he used sunscreen. His employer did not provide health insurance, so Bruce did not go for annual checkups, and tried to stay in good health. In his late 20s, Bruce was injured trying to keep a tourist from getting caught between the dive boat and the dock. He went to an internist, who treated his injury and told Bruce he was going to give him a complete physical exam. During the exam, the internist noticed a discolored patch of skin on Bruces back. She told him that she suspected Bruce had skin cancer and referred him to a dermatologist, who biopsied the patch. At a follow-up visit, Bruce was told that he had melanoma, a deadly form of skin cancer. Further testing revealed that the melanoma had spread to his liver and his lungs. The dermatologist explained that treatment options at this stage are limited. The drugs available for chemotherapy have only temporary effects, and surgery is not effective for melanoma at this stage. The dermatologist recommended that Bruce consider entering a clinical trial that was testing a DNA vaccine for melanoma treatment. These vaccines deliver DNA encoding a gene expressed by the cancer cells to the immune system. This primes the immune system to respond by producing large quantities of antibodies that destroy melanoma cells wherever they occur in the body. A clinical trial using one such DNA vaccine was being conducted at a nearby medical center, and Bruce decided to participate. At the study clinic, Bruce learned that he would be in a Phase Ill trial, comparing the DNA vaccine against the standard treatment, which is chemotherapy, and that he would be randomly assigned to receive either the DNA vaccine or the chemotherapy. He was disappointed to learn this. He thought he would be receiving the DNA vaccine.
- The following family has a history of inherited breast cancer. Betty (grandmother) does not carry the gene. Don, her husband, does. Dons mother and sister had breast cancer. One of Betty and Dons daughters (Sarah) has breast cancer; the other (Karen) does not. Sarahs daughters are in their 30s. Dawn, 33, has breast cancer; Debbie, 31, does not. Debbie is wondering if she will get the disease because she looks like her mother. Dawn is wondering if her 2-year-old daughter (Nicole) will get the disease. a. Draw a pedigree indicating affected individuals and identify all individuals. b. What is the most likely mode of inheritance of this trait? c. What are Dons genotype and phenotype? d. What is the genotype of the unaffected women (Betty and Karen)? e. A genetic marker has been found that maps very close to the gene. Given the following marker data for chromosomes 4 and 17, which chromosome does this gene map to? f. Using the same genetic marker, Debbie and Nicole were tested. The results are shown in the following figure. Based on their genotypes, is either of them at increased risk for breast cancer?You are a genetic counselor, and your patient has asked to be tested to determine if she carries a gene that predisposes her to early-onset cancer. If your patient has this gene, there is a 50/50 chance that all of her siblings inherited the gene as well; there is also a 50/50 chance that it will be passed on to their offspring. Your patient is concerned about confidentiality and does not want anyone in her family to know she is being tested, including her identical twin sister. Your patient is tested and found to carry a mutant allele that gives her an 85% lifetime risk of developing breast cancer and a 60% lifetime risk of developing ovarian cancer. At the result-disclosure session, she once again reiterates that she does not want anyone in her family to know her test results. a. Knowing that a familial mutation is occurring in this family, what would be your next course of action in this case? b. Is it your duty to contact members of this family despite the request of your patient? Where do your obligations lie: with your patient or with the patients family? Would it be inappropriate to try to persuade the patient to share her results with her family members?Genetics in Practice case studies are critical-thinking exercises that allow you to apply your new knowledge of human genetics to real-life problems. Case study Michelle was a 42-year-old woman who had declined counselling and amniocentesis at 16 weeks of pregnancy but was referred for genetic counseling after an abnormal ultrasound at 20 weeks of gestation. After the ultrasound, a number of findings suggested a possible chromosome abnormality in the fetus. The ultrasound showed swelling under the skin at the back of the fetuss neck; shortness of the femur, humerus, and ear length; and underdevelopment of the middle section of the fifth finger. Michelles physician performed an amniocentesis and referred her to the genetics program. Michelle and her husband did not want genetic counseling before receiving the results of the cytogenetic analysis. This was Michelles third pregnancy; she and her husband, Mike, had a 6-year-old daughter and a 3-year-old son. At their next session, the counselor informed the couple that the results revealed trisomy 21, explored their understanding of Down syndrome, and elicited their experiences with people with disabilities. She also reviewed the clinical concerns revealed by the ultrasound and associated anomalies (mild to severe intellectual disability, cardiac defects, and kidney problems). The options available to the couple were outlined. They were provided with a booklet written for parents making choices after the prenatal diagnosis of Down syndrome. After a week of careful deliberation with their family, friends, and clergy, they elected to terminate the pregnancy. Should physicians discourage a 42-year-old woman from having children because of an increased chance of a chromosomal abnormality?
- Studies have shown that there are significant differences in cancer rates among different ethnic groups. For example, the Japanese have very high rates of colon cancer but very low rates of breast cancer. It has also been demonstrated that when members of low-risk ethnic groups move to high-risk areas, their cancer risks rise to those of the high-risk area. For example, Japanese who live in the United States, where the risk of breast cancer is high, have higher rates of breast cancer than do Japanese who live in Japan. What are some of the possible explanations for this phenomenon? What factors may explain why the Japanese have higher rates of colon cancer than do other ethnic groups?You are in charge of a new gene therapy clinic. Two cases have been referred to you for review and possible therapy. Case 1. A mutation in the promoter of a proto-oncogene causes the gene to make too much of its normal product, a receptor protein that promotes cell division. The uncontrolled cell division has caused cancer. Case 2. A mutation in an exon of a tumor-suppressor gene makes this gene nonfunctional. The product of this gene normally suppresses cell division. The mutant gene cannot suppress cell division, and this has led to cancer. What treatment options can you suggest for each case?Importance of impact evaluation for a cancer program
- A) Ensuring Equal Access to Customized Medicine How can healthcare providers ensure equitable access to expensive technologies that not only treat illnesses but also promise to promote longevity and enhance patients’ quality of life? What are the ethics of cost/benefit analyses when human lives are at stake? What policies could help avoid “genetic discrimination” when medical test results reveal conditions or genetic susceptibilities to specific diseases that weren’t the subject of the original tests?Define the following notions and elaborate on their ethical implications: Stem Cell Tourism. Therapeutic MisconceptionWhich of the following are therapies used for cancer treatment? Check All That Apply immunotherapy surgery radiation therapy