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Disability Bioethics, Ashley X, and Disability Justice For People with Cognitive Impairments
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
In 2010, SWG—comprised of 20 bioethicists, pediatricians, professors, and community members—published their position on growth attenuation. Most group members concur that it was morally acceptable to perform growth attenuation on Ashley and express support for allowing parents to choose this set of procedures for children with similar diagnoses, claiming that “the potential impacts of growth attenuation are no more profound than the impacts of other decisions that parents routinely make” (2010, 29). They argue that parents are the ones who should decide what is in the best interest of their children. They also claim that these procedures were intended to benefit Ashley—to improve her quality of life by making it easier for her family members to care for her and include her in family activities.
Care of Children and Youth with Special Health Care Needs
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Sarah Vermilyea, Elisabeth Pordes
Another ethical issue that may arise when working with CYSHCN is growth attenuation therapy, which is a hormone-based therapy to accelerate growth plate closure, requested by some families of children with severe neurologic impairment and functional limitations to limit overall growth. The main reason caregivers request this therapy is to enable them to care for their child as she ages. It is therefore important that the dietitian also work with families to ensure that the child is at a healthy weight, without excessive weight gain or obesity. As with much of the decision making and care plans for CYSHCN, dietitians should be comfortable discussing and reaching out to their colleagues such as endocrinology, ethics, and palliative care for assistance with these situations. It is typical of pediatric institutions to require review of each individual growth attenuation request with input from the ethics committee.
Consent with Competence and Without
Published in Gary Seay, Susana Nuccetelli, Engaging Bioethics, 2017
Appeal to Ashley’s best interests may justify only Part 1, growth attenuation. The removal of breast buds, for example, carries all the risks of surgery with at most speculative benefits (3a). As for (3b), the surgery amounts to penalizing a victim and might not even deter sexual predators (Liao et al, 2007). Arthur Caplan (2007) concedes reasons (1a) and (1b) above but finds the treatment morally wrong because it attempts a medical solution for a social problem, and “a decent society” should provide resources to help families care for their disabled children. Yet support for growth attenuation is now compatible with advocacy for better social services for the disabled. The parents may agree with Caplan’s argument yet reply that, given the scarce social services available, growth attenuation is justified.
Hypoxia-inducible factor stabilisation-related lncRNAs in retinopathy of prematurity
Published in Journal of Obstetrics and Gynaecology, 2023
Mengkai Du, Zhenghui Cui, Deqin Chen, Yanmin Chen, Zhu Cao, Danqing Chen
In 1942, retrolental fibroplasia (RLF) was first reported in retinopathy of prematurity (ROP), which occurs in premature infants born under 36-week gestation with a low birth weight and long-term oxygen supplementation. Uncontrolled supplemental administration of oxygen was found to be the cause of RLF (Sola and Zuluaga 2013). Retinopathy of prematurity was called RLF in the 1940s (Terry 1942). Retinovascular growth attenuation and vascular obliteration created by hyperoxia cause ROP, resulting in approximately 100,000 new cases of childhood blindness each year (Hartnett and Penn 2012). Clinical trials have demonstrated that oxygen saturation reduces ROP, but increases mortality. A recent study found significant international practice variation and uncertainty pertaining to target oxygen saturation in premature infants (Terry 1942). Roxadustat (RXD) and dimethyloxalylglycine (DMOG) used in hypoxia-inducible factor (HIF) stabilisation are reported to have the potential to cure infants with ROP through oxygen tension response, and the cells were regulated by HIFs (Wang et al.1995).
Review of John McMillan, The Methods of Bioethics: An Essay in Meta-Bioethics
Published in The American Journal of Bioethics, 2019
Bearing in mind the amount of space dedicated to speculative reason and conceptual analysis, McMillan’s monograph posits an account of “good bioethics” that, although empirically aware, is situated more toward the philosophical end of the methodological spectrum. As a result, nonphilosophers might find it difficult to fully comprehend the ways in which their respective disciplines can contribute to such an argument-centered, factually premised account. After all, it is not just philosophy that suffers from problems internal to the discipline. Questions concerning the necessary conditions for something to count as evidence, the validity of causal inferences, and the practicalities of justifiably making normative claims based on nonnormative facts have resulted in well-reasoned disagreement in all areas of the medical, behavioral, and social sciences. That said, McMillan includes a number of detailed examples in order to demonstrate how his approach can work in an interdisciplinary context. He brings both his negative and positive accounts of bioethics to bear on an impressively broad range of concrete issues concerning abortion, anencephalic infants, castration of sex offenders, euthanasia and aid-in-dying, growth attenuation therapy, noninvasive prenatal testing, reproductive technologies, persistent vegetative states, and artificial nutrition and hydration. Consequently, those looking to engage with bioethics from traditionally nonphilosophical fields should, with relative ease, be able to identify ways in which their own expertise and preferred empirical methods can operate within the Socratic dimension of McMillan’s approach.
Inhibition of biofilm formation and virulence factors of cariogenic oral pathogen Streptococcus mutans by natural flavonoid phloretin
Published in Journal of Oral Microbiology, 2023
Lucille Rudin, Michael M. Bornstein, Viktoriya Shyp
The MIC and MBC of phloretin tested on planktonic S. mutans culture was 400 μg/ml. At sub-inhibitory concentration, gradual growth attenuation and reduction of cell viability were observed indicating a dose-dependent inhibitory effect of phloretin (Figure 1a, Figure S1). Dose-dependent biofilm inhibition was also observed in 4 h and 24 h biofilm assay with MBIC of 200 μg/ml and 400 μg/ml, respectively (Figure 1b). Similarly, on saliva-coated hydroxyapatite (sHA) surfaces, a condition mimicking a human oral environment, in 24 h, 200 ug/ml of phloretin drastically reduced biofilm formation (Figure 1c, Figure S2) resulting in a scarce number of surface-associated cells detected by SEM (Figure 2). These cells also underwent a notable change in shape and structure (Figure 2, Figure S3). In comparison to non-treated cells with symmetric ellipsoidal shape, in the presence of 200 µg/mL phloretin, bacteria appeared elongated, with multiple dysmorphic or swollen cells and asymmetric division sign (Figure S3A, red arrows). On average, non-treated control cells were 0.72 ± 0.11 µm long, while the length of the cells treated with 200 µg/ml phloretin was 1.1 ± 0.2 µm (Figure S3B). These observations might potentially indicate a perturbation in the coordination of cell elongation and cell division which is also reflected in compromised growth kinetics (Figure 1a). As assessed by the live/dead staining technique combined with CLSM, phloretin significantly reduced the proportion of live cells in 24 h biofilm, while the proportion of cells with compromised membrane, stained with PI, increased with increasing phloretin concentration (Figure 3).