Tuesday, March 25, 2014
Case 34 Huntington's (by 1 April)
Address the questions at the end of the case. As a group, be sure to address multiple sides of the questions (e.g., some of you might have to play devil's advocate and champion a position you don't actually believe). Respond to at least 2 posts from your classmates.
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1. I do not think that Heather's decision is either wise or unwise. While there are certainly many benefits to knowing one's status of Huntington's (relief at knowing you don't have it, for example) there are also disadvantages (such as knowing you have it and dreading its beginnings).
ReplyDelete2. I believe the genetic counselor's suggestion provides a workable solution to the problem that benefits to most sides of the situation. Heather benefits from retaining her choice to not know her status of Huntington's, can still have a child, and the child benefits from not possessing the disease. The only possible mire is found in the third question.
3. I believe the preimplantation genetic diagnosis is different in this case from prenatal diagnosis and selective abortion because the parents have made a definite decision before the incident as to the condition of the child.
I agree with you on two and three but I believe that she should know her Huntington's status especially because she wants to have children. If she has Huntington's and her son doesn't and she becomes diagnosed early she could value her time with her child better knowing that she has a limited amount of time with that child. She is 24 and could start having symptoms very soon so I believe that it is very important for her to find this information out.
DeleteI agree that there are a lot of benefits she's missing out on by choosing not to know her Huntington's status, and think it would be better overall for her if she learns it. However, I would also say that as long as she guarantees that her child would not have Huntington's (as the solution proposes) then she isn't doing anything wrong.
DeleteI agree with your point on number three. I too believe that there is a difference and I like your point about how the parents are deciding before the child is actually conceived.
DeleteI agree with the point that you made on the first question. Knowing that she has the gene may affect that she lives her life, and it may also affect her relationship with her husband. While not knowing if she has the gene may put her child in risk.
Delete1. I'm not so sure that her decision is a wise one, but perhaps that's because I would want to know if I was in her position. I also think that she should know because that's the decision that will ultimately affect her life and the lives of those in her family. However, it is her decision and in the end, it is her choice.
ReplyDelete2. I do believe that the genetic counselor's suggestion provides a satisfactory solution to the problem. The option of preimplantation genetic diagnosis means that no one in the family is harmed and the child will not contain the disease. This is a win-win for each person in the family.
3. In my opinion, I do not believe that preimplantation genetic diagnosis and the discarding of affected embryos are morally equivalent to prenatal diagnosis and selective abortion. I think this because I do not believe that discarding embryos means killing a life, whereas I do believe that abortion means killing a life. I believe that the first option means that no one is harmed, whereas I believe that the second option can harm those in the family emotionally as well as psychologically, as well as harming the child.
I like your answer to number two. Preimplantation genetic diagnosis ensures ta win-win situation. It wouldn't affect the family as greatly as an abortion would.
Delete1. I personally don't think that her decision was a wise one especially because she and her husband want to have to child. I would understand her decision if she was single or if her and her husband didn't want to have children, because knowing you have it and living with it day to day is an extremely hard task to do I feel like. However, since they want to have children I think she should be tested to see if she has it or not.
ReplyDelete2. Personally, I believe that it doesn't. I think that she is just beating delaying the inevitable, however it is her decision and I have to respect it. If i was her I would want to know so I would get tested because that would change how I lived my life, but I can certainly understand why people don't want to know because that is a weighty thing to have hovering over you day in and day out.
3. They are not morally equivalent. I believe that prenatal diagnosis and selective abortion is killing a life and the preimplantation genetic diagnosis and the discarding of affected embryos is not killing developing life. I think that selective abortion would have a strain on their marriage because the husband is against abortion so I think he would rather have the baby with Huntington's disease than have it aborted.
I disagree with #2. I think that shes trying to avoid changing how she lives her life because of a disease. I think thats why people wouldn't want to find out in the first place. How would you change how you lived if you found out that you had Huntington's?
DeleteI personally would want to know my status on such a disease, because I would want to live my life while taking that into account. In this case particularly, since Huntington's comes into effect usually around 35-40, I would want to know that I would have a deteriorating quality of living around midlife and that I should make the most of when I'm well. I would look into any possibilities of ways to delay the disease (good diet, exercise, anything that might reduce my chances) and let my closest family and friends know ahead of time so we can work out issues before it happens.
DeleteOn the other hand, I can also see why people would not want to know. Some would not deal well with what they'd see as a sword waiting over their heads. To some, changing one's lifestyle is letting the disease win. It might not be an action I would take myself, but I can certainly see why others would.
I agree with your statement on number 1. She should know not just for her sake, but for her husband as well as her future children.
DeleteI definitely can see your point, Katie, about how much life would change after knowing it was predestined to be corrupted by Huntington's. I think the main point that made my opinion (that Heather should find out), was for the child's sake.
Delete1. I think that this decision is simply a matter of opinion. I don't think that Heather was being un-wise at all when she decided that she didn't want to be tested. If she did find out that she had the defective gene, the rest of her life would be one big waiting game. Knowing that you have the defective gene doesn't put you any closer to surviving the disease than not knowing.
ReplyDelete2. I think that the genetic councelors suggestion solves all of the couples' issues. It's making sure that their child doesn't have the defective gene, and it's also ensuring Heather that she won't find out if she has the gene or not. It accomplishes both.
3. I don't think that the two are morally equivalent at all. Preimplantation genetic diagnosis is witholding life from existing while selective abortion is killing life. As long as the husband is okay with discarding the affected embryos, the councelors suggestion kills two birds with one stone.
I agree with two and three. But I disagree with one, I think that they would save themselves a lot of time knowing if she has the gene or not especially because she wants to have kids I think it is in her best interest to know if she has the gene or not.
DeleteI agree with number 3, if the husband is okay with it, than they should go ahead with the procedure
DeleteI have to disagree with you on the second question. I don't believe that the counselor's solves all of the couples issues. Wouldn't the discarding of the embryos to the husband be equivalent to abortion?
DeleteI would have to agree with you on all the points that you made except for the third point. An embryo has the potential to develop into human life, am I correct? If that statement is true, isn't that very similar to selective abortion? Although it may not be fully developed like a fetus, it still has potential.
Delete1. I believe that Heather should get tested for Huntington's. I understand that she doesn't want to know but in all honesty she is just making it harder not knowing she should really see if she is a carrier for this gene. If she is then it is easier to make a plan according to that but if she is not a carrier then she can continue on with her life and the parents can come up with a new plan.
ReplyDelete2. I think that the suggestion is a very good one. The genetic counselor is going to only implant embryos without the disease. Issues could arise if all of the embryos have the disease then they would have to tell the mother and she doesn't want to know. All in all it is a good idea and should go along with what both of the parents want.
3.I believe that there is a significant difference with discarding the affected embryos and having an abortion. The two are not morally equivalent. I believe that abortion is killing life but the discarding of the embryos is not they are not yet fertilized.
I agree with your point on number one. I think she should get tested for Huntington's. However, it would be hard for a person to live day to day knowing that they have a disease such as Huntington's
DeleteI have to disagree with your point on the third question. Your argument is that they aren't morally equivalent because the embryo is not yet fertilized. With all due respect an embryo develops from a zygote about two weeks after fertilization. Based on this isn't the discarding of the embryos equivalent to abortion?
DeleteI agree that it would be difficult to continue on not knowing, especially when wanting a child. It's not only because of the possibility of giving the gene to your child, but the lack of care you will provide because of the progressive disease.
Delete1. I think that Heather D's decision not to be tested is a wise one. The only positive that could come out of being tested for the disease is knowing that she doesn't have it. The negative on the other hand is knowing that she does have it. This will come with a large mental toll as she has to go through life knowing that she has to deal with Huntington's disease one day.
ReplyDelete2. I don't think that the genetic counselor's decision is a satisfactory one. His suggestion is most likely going to clash with the morality of the father. If the father expressed moral opposition to abortion then he is most likely going to express opposition to a procedure that will ultimately end up with fertilized eggs that have the potentiality to develop fully into human beings essentially being discarded as waste.
3. Yes it is morally equivalent. In both cases the embryos are going suffer the same fate if they have the gene. Is there somehow a difference between discarding an embryo fertilized outside of the mother and discarding an embryo fertilized inside of the mother?
You think that if the father views abortion as moral wrong that he will object to the fertilized eggs being discarded as well. Are you sure that this will be the case? Not everyone can see something growing in a "test tub" as their own human child there is a different stigma attached to discarding fertilized embryos versus an abortion to some.
DeleteI agree with you on number 3. There is no difference. The only difference is that the embryo is already developing and is further along. Basically it is only living long enough to see if it will be sick or not, then thrown away. Whether it happens while it's in the womb or outside, it's still the loss of a life.
Delete1. I do not believe that Heather's decision is a particularly wise one. But that's why its Heather's decision and not mine. She has her reasons for not wanting to know and she will live with whatever comes with that. I can see how knowing that she did have the disease could affect her life, but if it were me I would want to know.
ReplyDelete2. I do believe that the genetic counselor's decision provides a satisfactory solution to this problem. Although I'm not sure how the husband will feel based on his views of abortion. Aside from that it covers every issue the couple is facing.
3. In my mind no, they are not morally equivalent. To me there is a difference is aborting a fetus that is alive and growing and removing bad embryos. But some will argue that life is started at conception and they will see no difference between the two.
I agree with you number 1 statement, if I were Heather I would like to know in order to prepare myself and my family members that could potentially be affected by the change as well.
DeleteWhat do you see as the cause of the difference in the morality of an abortion versus the removal of tainted embryos? Do you believe that this is because not is not as fully human as the other or that at some stage there is simply the obligation to see that the organism growing receives the chance to live?
Delete1. I don't think Heather's decision is a wise one. Because Huntington's disease first expresses as a middle aged adult, she will find out relatively in the near future whether she has it or not. If she and her husband have such a strong desire to have a child, Heather should get tested to prepare to have a child with Huntington's, or decide on other options to avoid the disease, like adoption.
ReplyDelete2. The suggestion gives the implantation without Heather knowing if she has the disease, which is what she wants. However, it does include discarding the embryos that carry the disease, and Heather's husband is opposed to abortion. He may believe discarding the disease embryos is equivalent to abortion. Also, the goal is for Heather not to find out if she has the disease or not, not to have a baby only if it is disease free.According to those reasons, I don't believe the suggestion is a satisfactory one
3. I don't believe they are equivalent. They have a distinct difference in the subject. Preimplantation diagnosis is based on the embryo, before it is developed. Prenatal diagnosis focuses on the fetus, a more developed substance. However, I can see how they are similar, but the question is which weighs more as a life (embryos or fetuses)? The same is for discarding the disease embryos and abortion. Because embryos don't weigh as much as a fetus, discarding wouldn't have the same connection as an abortion would.
I agree with you on number 1. It is very unwise and she needs to be prepared for the possibilty that she does carry it. If she does, then she can choose to raise the child, or go through the same process as now. Adoption is also a good idea.
Delete1. I do not think it is a wise decision. Heather is going to find out anyways if she has the disease because she will begin displaying symptoms later in her life. I think if she wants to have the responsibility of having a child, and desperately wishes her child to not have the Huntington's disease, she should be tested to find out if she actually has it. It could definitely lead her to some options that she might have not even thought of. I think her reason as to why she doesn't want to be tested for the sake of not knowing isn't very valid. I understand the fear or dread that would accompany a disease such as Huntington's, but she would feel the relief of not having the disease and not having the worry of passing it on to the next generation if she does not have it. She could additionally receive medication that depresses her symptoms at a sooner time that could ultimately help her cope with the disease if she discovers she does have Huntington's. The complicated process of preimplantation could even be avoided if she chooses to get tested and the results are negative.
ReplyDelete2. It's difficult to provide a solution that makes both Heather and her husband happy because they are such strong desires and moral values. It definitely is a solution for Heather; she would not know if she has Huntington's disease or not, and her baby would be Huntington's disease free. Although, her husband desires their baby to be Huntington's disease free as well, he is opposed to the idea of abortion, which is "discarding" those carrying the gene basically is.
3. I think they are all very similar morally. They all involve some sort of alteration with a living organism, whether it be a fetus or embryo. In both preimplantation genetic diagnosis and prenatal diagnosis you are discovering a gene or disease a being may have, even though they are diagnosed at different times of development. Selective abortion and discarding affected embryos are very similar because both involve getting rid of fetus/embryos with undesirable characteristics or genes.
I agree with what you've said in the first question, it seems pretty ridiculous to me that Heather could be going through this ordeal and not even have Huntington's in the first place.
DeleteHeather D's decision not to be tested for the Huntington's gene is a wise one. Obviously from her actions and decision she believes or knows that she would not be able to handle the information given to her if she tested positive. Therefore it is best for her never to know for sure if she is a carrier.
ReplyDeleteFrom a biological and medical standpoint the doctor's suggestion does indeed provide a satisfactory solution to the problem. Heather does not learn information she is not capable of handling and she and her husband can have a child without selective abortion and his moral opposition to that action.
Do you believe, since the husband seems to be so adamantly against abortion, that he might also be against preimplantation genetic diagnosis because it could result in the discarding of embryos?
DeleteThat is a question that I can not truly answer. I can say that I would like to think that the husband does would be against the preimplantation genetic diagnosis because it could result in the discarding of embryos. However I understand that some people do not necessary see the embryo at a cellular level as a human person and therefore have no compunction against discarding it then. This is a question that in my mind I only have a 50/50 shot of answering right.
Deletewhat if she has hd and passes it to her child. this could be prevented if she would just get tested & give her child the best possible chance at life if she has it.
Delete1. No—I can understand Heather not wanting to know whether or not she carries this disease, and I wouldn’t be so opposed to her choice to remain ignorant if she were not planning to carry a child. Once pregnant, she will be responsible for another life, and that life deserves the best chance of not carrying the gene for Huntington’s disease. In order to prevent this, Heather should be fully aware of her genetic makeup. Though I admit that this gets a bit foggy once we consider the option of preimplantation genetic diagnosis, where it seems as though Heather may not need to be aware of her own status regarding this disease.
ReplyDelete2. Yes, I believe that this is a satisfactory solution. Heather and her husband can make sure that their future child will not contract Huntington’s disease. This way they can have a healthy child. I do question how Heather’s husband will view this procedure, though, considering his firm stance against abortion.
3. No, I don’t believe that these options are all morally equivalent. Preimplantation focuses on the study of embryos, and the discarding of them if need be. Prenatal diagnosis and selective abortion could be a little trickier, since we would then be dealing with a growing and more fully developed fetus.
I agree that Heather D should be fully aware of her genetic makeup with the knowledge that HD runs in her family. Do you think that if she were not to carry the child herself would she still need to know her genetic makeup?
DeleteIf she were not to carry the child herself, I still think she would need to know her genetic makeup. Even if she were to use a surrogate, for example, her DNA would still be passed onto her child since the only change in this situation is that someone else will be carrying her child/giving birth to it.
Delete1. I would say that her decision is not a wise one, but that is her decision. Knowing the fact that she may carry the gene may change the way that she live's her life, which is why I respect her decision for not getting tested for the gene.
ReplyDelete2. I would think that the suggestion is a very good suggestion for heather's case. This would give her child the chance to not carry the gene, and it would allow heather to not know if she is a carrier of the gene or not. I personally would not want to have that solution but it is a feasible solution for heather.
3. I believe that they are all morally equivalent. Discarding the affected embryos in my understanding is nearly the same as prenatal diagnosis and selective abortion. You are still "throwing away" the possibility of human life, which definitely raises a moral concern.
I agree that knowing whether or not she may carry the gene may change the way she lives her life. However, the fact that she may or may not begin to exhibit symptoms of HD when she hits 30 still looms over her. With this possibility I think it could put her at ease; knowing she carries the gene and that is inevitable that she will exhibit symptoms so she needs to make the best of her life earlier on or knowing she doesn't carry the gene and will be fine.
Delete1. I would say that the decision is not wise. If she knew the answer it would change her life and then she would already know the risks. If she didn't know, then every time they want to have a child, they will have to go through the same process.
ReplyDelete2. Yes it is a good solution. That is because it is not a guaranteed abortion. She has a chance to where maybe some embryos won't be discarded.
3. I believe it is morally equivalent. It is the same, the only difference is that the child is already developing. Take it from Dr. Suess in "Horton Hears A Who", "Whether you can't see them or hear them at all, a person's a person, no matter how small."
1. I don’t think Heather D’s decision not to be tested for Huntington’s gene was a wise one. I understand her not wanting to know who she inherited the disease from but, the well-being of her future children and also grandchildren is dependent on knowing. If she initially knew before having children, she could plan accordingly. Now that she doesn't know, she has to go through the expensive selective embryo process every time she wishes to have a child.
ReplyDelete2. I do think that the counselor’s suggestion provides a satisfactory solution to the problem. It allows Heather D and her husband to eliminate the chance of them having a child prone to HD.
3. To me, preimplantation genetic diagnosis and the discarding of affected embryos is morally equivalent to prenatal diagnosis and selective abortion. They both deal with prenatal testing and choosing the embryo without HD. The only difference is the amount of time the embryo is allowed to cultivate.
i agree with your point on 3, they are both prenatal testing and picking and choosing embryos
Delete1. I dont think her decision is very wise. she may potentially have a life threatening illness and with her dad having the illness she should know what her chances are so that she can make the proper life alterations.
ReplyDelete2.yes, if she wont go and find out if she has the illness then they should have their tested as early in the pregnancy as possible so they can make the decision to terminate or not.
3. yes you are picking and choosing embryos in both cases