Medical Law and Ethics Chapter 11

Parens patriae

"Father of the people"

Produce asexually, from a single ancestor, and have the same genetic make up as the original

A clone

Can explain test results and help patients deal with difficult questions concerning genetic testing results

A genetic counselor

Single men, gay singles, and homosexual couples may not specifically be prevented from adopting by state law, but they may have

A more difficult time meeting state and agency requirements than married couples would.

A woman who agrees to carry child to term for a couple, often for a fee

A surrogate mother

The nitrogen bases found in DNA are

Adenine (A), thymine (T), guanine (G), and cytosine (C).

When state license and/or state regulated public or private adoption agencies plays children with adoptive parents.

Agency adoption

How many states have laws regulating adoption

All 50 states

How many states have safe haven laws

All 50 states

Mutations in mitochondrial DNA may contribute to the loss of neurons in

Alzheimer's and Parkinson's disease and has been associated with diabetes, autism, and a variety of metabolic disorders

When more than one gene is involved, environmental factors such as the changes caused by aging, smoking, exposure to environmental toxins, or other factors, may trigger the onset of a genetic disease, as in cases of

Alzheimer's disease, diabetes, obesity, and some forms of cancer

Generally, couples can adopt a child of different race. Adoptions of Native American children, however, are governed by the Indian Child welfare act, and the act provisions outline specific rules and procedures that must be followed if the adoption of a Native American child is to be

Approved

Legally, the legal rights of newborns Are the same as those of any other American citizen of any age. For newborns who are severely disabled, however, existing law provides for several treatment options. Under the federal child abuse amendments, if the parents agree, physicians may legally withhold treatment, including food and water, from infants who

Are chronically and irreversibly comatose. Will most certainly die and for whom treatment is considered futile. Would suffer inhumanely if treatment were provided.

This process involves the mechanical injection of viable semen into the vagina.

Artificial insemination

Laws in some states give minors the right to consent to general medical and surgical care under some circumstances such as

Being a parent themselves, being pregnant, or reaching a certain age.

Family history is often one of the strongest risk factors for common disease complexes such as

Cancer, cardiovascular disease, diabetes, autoimmune disorders, and psychiatric illnesses

This type of testing is offered to individuals who have a family history of a genetic disorder and to people in certain ethnic groups with an increased risk of specific genetic conditions. It is used to identify people who carry one copy of a gene mutation that, when present in two copies, causes a genetic disorder.

Carrier testing

The jeans that make up the human genome-all the genetic information necessary to create human beings-are responsible for all the

Cells, organs, tissues, and traits that make up each individual

Describes the process used to create an exact genetic replica of another cell, tissue, or organism

Cloning

Deoxyribonucleic acid

DNA

Goals of the human genome project that have largely been accomplished where to locate a map the location of each gene on all 46 chromosomes and to create a

Databank of the information that would be available to all scientists or physicians to use

Most embryos used in the stem cell research in the United States are the frozen products of Vitro fertilization that were not used to produce pregnancy and are destined to be

Destroyed

Used to identify or rule out a specific genetic or chromosomal condition or to confirm a diagnosis when a particular condition is suspected based on physical signs and symptoms. Testing may be done at any time during a persons life, but it is not available for all genes or all genetic conditions.

Diagnostic testing

It is estimated in the United States that about 10 to 15% of reproductive age couples will have

Difficulty conceiving

Under the ADA a person with a disability cannot be denied insurance or be subject to different terms or conditions of insurance based on disability alone, if the disability

Does not pose increased risk

Gene therapy may involve replacing a

Efficiency or blocking an overactive pathway

46 chromosomes (23) pairs are found inside the nucleus of every human cell, except

Egg and sperm cells, which have 23 chromosomes each

Legally live outside their parents or guardians control

Emancipated minors

Legal age for purchasing alcohol or tobacco products, voting age, mandatory school attendance age unless married, and other legal age restriction still apply

Emancipated minors restrictions

Gene therapy could also involve turning off genes before their harmful properties can be

Expressed

Another type of genetic disease can arise from abnormalities in the structure or number of whole chromosomes. Down syndrome, for example, results from an

Extra copy of chromosome 21

Law enforcement use this to identify an individual for legal purposes. This type of testing can identify crime or catastrophe victims, rule out or implicate a crime suspect, or establish biological relationships between people.

Forensic testing

Produces exact copies of the segment of DNA called genes

Gene cloning

Is rapidly becoming an effective tool for collecting and preventing certain diseases

Gene therapy

The order of the nitrogen bases inside the DNA molecule form the

Genetic code that relays DNAs instructions

Permanent changes in DNA, or mutation, often cause

Genetic diseases

Scientist manipulate DNA within the cells of plants, animals, and other organisms to ensure that certain advantageous traits will appear and be passed on and that certain harmful traits are eliminated. This is called

Genetic engineering

Traditional surrogacy differs from gestational surrogacy and that a traditional surrogate is

Genetically related to the fetus she carries

The science that accounts for differences and resemblance among people and other organisms related by descent

Genetics

Involves the correction of an abnormality in the genes of a sperm or egg but is presently considered an inappropriate way to deal with genetic diseases because of ethical issues, cost, lack of research in humans, lack of knowledge about whether or not the changes would be maintained in the growing embryo, and the relative ease of treating the pertinent conditions somatically when needed

Germ-line gene therapy

If the surrogate is not genetically related to the embryo, the type of surrogacy is called

Gestational surrogacy

Other stem cell cultures are grown specifically for research purposes and are scrutinized through

Government regulation

The process by which genetic traits are passed on to one's offspring

Heredity

If the partner sperm cells are not viable, a donor sperm may be used to fertilize the woman's eggs during artificial insemination and this is called

Heterologous artificial insemination

If a man's sperm cells are used to fertilize his partners eggs during artificial insemination the process is called

Homologous artificial insemination

Adopting parents locate a birth mother or vice versa and then ask an agency to take over the adoption process. Prospective parents can find a birth mother willing to give up her child and can bypass the long waiting list most agencies maintain for adoption and can perhaps be better assured that the adoption will proceed in an orderly and legal fashion.

Identified adoption

Does the minor live at home with parents or other supervising adults, or is he or she living independently? If living at home, does he or she pay for room and board? Does the Miner have a job, and does he or she spent his or her earnings without parental supervision? Does the minor pay his or her own debts? Is the minor claimed as a dependent on the parents tax return?

Important factors to be considered before a judge will issue an emancipation order

In this process, eggs and sperm are brought together outside the body in a test tube or petri dish. When fertilization takes place, the resulting embryo can then be frozen in liquid nitrogen for future use or implanted in the female uterus for pregnancy to occur.

In vitro fertilization (IVF)

Arranged without the involvement of adoption agencies. Potential adoptive parents may hear of a mother who wants to give her child, or they may advertise in newspapers or on the Internet to find such a mother. At some point in the process, an attorney must be involved to ensure the legality of the adoption. A few states prohibit and it is strictly regulated in states that do allow this form of adoption.

Independent or private adoption

The failure to conceive for a period of 12 months or longer due to a deviation from or interruption of the normal structure or function of any reproductive part, organ, or system.

Infertility

Occur when couples adopt children who are citizens of foreign countries. In these procedures, adoptive parents must not only meet requirements of the foreign country where the child resides, they must also meet all the US state requirements and US immigration and naturalization service rules

International adoption

In many states, minors seeking an abortion must involve at least one parent in the decision. This means that teenagers who do not tell their parents about a pregnancy must either travel out of state or obtain approval from a judge a process known as

Judicial bypass

Individuals in their mid to late teens who are considered mature enough to comprehend a physicians recommendations and give informed consent

Mature minors

Most states allow them to seek medical treatment without the consent of a parent or guardian in certain critical areas, such as mental health, drug and/or alcohol addiction, treatment for sexually transmitted diseases, pregnancy, and contraceptive services

Mature minors

Several states also allow minors who are parents to consent to medical care for their children. In many states, mothers who are minors may also legally place their children up for adoption without the consent or knowledge of the

Mother's parents

Diseases can also result from mutations in mitochondrial DNA, which multicelled organisms inherit mostly from

Mothers

Those found in adult blood forming tissue, can become only a limited number of types of tissues and cells in the body

Multi potent stem cells

This testing is used after birth to identify genetic disorders that can be treated early in life. Two examples are phenylketonuria urea and congenital hypothyroidism

Newborn screening

To date, animal cloning does not always yield viable offspring, with only one or two healthy animals resulting from approximately every 100 experiments. Not only do most attempts to clone mammals fail about 30% of clones born alive are affected with large offspring syndrome and other debilitating conditions. Scientist do not yet understand the process involved in reproductive cloning well enough to ensure success, and a large failure rate in human clones is unacceptable. Like Dolly the sheep, many animals have died prematurely from infection and other complications the and same problems would be expected to occur in human cloning. Scientists do not know how cloning could impact mental development. While factors such as intellect and mood may not be important for a cloned cow or mouse, they are crucial for development of healthy humans

Objections to human cloning based on animal biology and physiology

The state may act as a parental authority. This doctrine is the legal principle that grants the state the broad authority to act in the best interest of the child, sometimes overriding parental decisions, and allows the state to remove abused or neglected children from the custody of offending parents.

Parens patriae

Each nucleotide that comprises DNA contains a

Phosphate group, a sugar group, and a nitrogen base

Found in embryonic tissue, can become almost all types of tissues and cells. Such cells have shown promise for treating patients with a wide variety of medical problems, such as Parkinson's, Alzheimer's, diabetes, strokes, burns, spinal cord injuries, and other neurological disorders.

Pluripotent stem cells

This type of testing is used to detect gene mutations associated with disorders that appear after birth, often later in life. These tests can be helpful to people who have a family member with a genetic disorder, but who have no features of the disorder themselves at the time of testing. Predictive testing can identify mutations that increase a persons risk of developing disorders with a genetic basis, such as certain types of cancer.

Predictive and pre-symptomatic testing

Is a specialized technique that can reduce the risk of having a child with a particular genetic or chromosomal disorder. It is used to detect genetic changes in embryos that were created using assisted reproductive techniques such as in vitro fertilization

Preimplantation testing, also called preimplantation genetic diagnosis (PGD)

The adoption assistance in child welfare act of 1980, the child abuse prevention and treatment and adoption reform act, and the Indian Child welfare act all contain

Provisions that pertain to adoptive parents and their children

The child is related to the adoptive parent by blood or marriage. The stepparent and grandparent-grandchildren adoption fall within this category

Relative adoption

RNA comes into play when DNA

Replicates itself

Which produces copies of entire animals

Reproductive cloning

In some states, the baby can be handed over to a doctor or police officer, or left at a fire station or hospital

Safe haven laws

Most states place limits on the ages of children who can be abandon without prosecution for two reasons. To encourage parents determined to abandon their children to do so early, while the children can receive adequate nutrition and medical care, and to prevent situations that occurred when Safehaven laws were new in which parents have a abandoned problem children of all ages to the care of the state.

Safe haven laws

Most states specify which locations are considered safe havens to prevent parents from leaving infants on the step of empty churches or in other locations where discovery and emergency care are unavailable

Safe haven laws

Required under most state laws, to take the child into custody, provide medical care as necessary, and inform the abandoning parent, if possible, that he or she is relinquishing the child for adoption. Some state laws also require safe haven providers to try to determine the identity of the non-relinquishing parent and to attempt to learn family and medical history

Safe haven laws

Some states do not entirely eliminate prosecution but will allow reduction in charges

Safe haven laws

Some states, the parent can remain anonymous, while in others, he or she must reveal their identity and give a medical history. In some states, medical history can also be dropped off anonymously

Safe haven laws

Depending on the state law, both married and unmarried couples may adopt, and single people may adopt through a process called

Single parent adoption

Specifically trained technicians perform DNA test. The test are conducted on samples of

Solid tissues such as hair roots, skin, muscle, or bone and on body fluids such as blood, sweat, semen, and or saliva

Each gene is a tiny segment of DNA that holds the formula for making a

Specific enzyme or protein

Gene therapy may also involve the insertion of normal copies of gene into the cells of persons with a

Specific genetic disease, this is called somatic gene therapy

Early embryonic cells and adult cells derived from certain tissues that have the potential to become any type of body cell.

Stem cells

If a woman cannot carry an embryo to term, the couple may elect to contract with a surrogate mother

Surrogacy

Offers some protection against genetic discrimination in the workplace. It protects against discrimination those who have a genetic condition or disease, or are regarded as having a disability.

The Americans with disabilities act of 1990

The standard is used in child placement situations. It is also used when we legal authorities must work with healthcare practitioners to determine the least harmful and most appropriate treatment for an ailing child

The common standard is "best interest of the child." In other words which alternative will be the best safeguard for the child's growth, development, and health

They are self-supporting. They are married, provided the marriage is legal. In most states, persons must be at least 16 to Mary and those under the age of 18 must have parental consent. Emancipation is not forfeited if the minor divorces or separated or widowed. They are serving in the Armed Forces.

The court may declare minors emancipated if one or more of the following criteria are met

An act was passed in to law, prohibiting discrimination in the workplace and by health insurance issuers. In addition, there are other legal protections against genetic discrimination by employers, insurers of health insurance, and others.

The genetic information nondiscrimination act (GINA) of 2008

Describes the differential treatment of individuals based on their actual or presumed genetic differences

The term genetic discrimination

Produces copies of embryonic stem cells with the professed purpose of repairing injured or diseased tissue in the human body.

Therapeutic cloning

If the surrogate contributes eggs to produce the embryo or is related to either partner in the relationship, the type of surrogacy is called

Traditional surrogacy

In some states, however, laws leave the decision about whether or not to inform parents that minor sons and daughters have received or are seeking contraceptives, prenatal care, or treatment for sexually transmitted diseases to the discretion of the

Treating physician, based on the best interest of the minor

Under this ruling the ADA applies to anyone who is discriminated against on the basis of genetic information relating to illness, disease, condition, or other disorders

Under the 1995 ruling by the equal employment opportunity commission

Pigs are similar to humans in organ size and other biological aspects, an objective in cloning them is to grow a potential source of organs and tissues for transplanting into human patients, a process called

Xenotransplantation

DNA makes up

chromosomes

DNA was first isolated in 1868, but the structure of the molecule was not mapped out until 1953, when JD Watson and FHC Crick proposed an arrangement that consists of a _________ ______ (a ladder like structure) of nucleotide chains coiled around the same axis. Pairs of the bases, represented by the letters A, T, G, and C, make up the rungs of the helix ladder the order of these for chemical functions as an alphabetic code, allowing organisms to create long, _____________ codes.

double helix, complicated

Fortunately, an organism does not need to read and interpret the ________ DNA strand each time it needs to build proteins. Instead, the organism needs to access only a small part of the DNA, called a gene,to build a protein for which it carries the code. Some genes are only a few hundred base pairs long whereas others may be _________ ________ base pairs long.

entire, several million

Scientist involved in the human genome project also vowed to continue to examine the ______, _____, and ________ _______originating with human genetics research and train other scientist use the technologies developed to improve human health

ethical, legal, social issues

In addition to Gina at the federal level and state laws against genetic discrimination, the health insurance portability and accountability act HIPAA, passed in 1996, prevents health insurance from denying coverage based on genetic information. HIPAA, however, applies only to individuals moving between ________ __________ ____________ _______

group health insurance plans

The __________ __________ project, funded by the US government, was started in 1990 to analyze the entire human genome. Scientists around the world who worked on the project set out to map all of the genes within 23 pairs of human chromosomes. The project was scheduled for completion in 2003, but was 90% complete in 2001. One of the findings of the first draft was that the number of human genes appeared to be significantly less than previous estimates of 50,000 to 140,000. The full sequence of __________ _______ was published in April 2003

human genome, 20,500 genes

There are two main reasons why a geneticist may want to clone genes. The first reason for cloning genes is to gain information about the nucleotide sequence of the gene. A second reason is to ___________ a gene, either by altering its DNA sequence or by combining it with new DNA mixtures, which might mean placing the gene inside the DNA of a different __________

manipulate, organism

DNA and its partner in the chromosome replication process, RNA (Ribonucleic acid), or nucleic acid made up of molecules called _____________.

nucleotides

Mutations can involve _____ ______, as in sickle cell anemia, hemophilia, cystic fibrosis, Aicardi syndrome, and Huntington's disease, or they can involve more than one gene

one gene