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Does Personhood Begin at Conception?
Published in Christopher Kaczor, The Ethics of Abortion, 2023
Distinction of species is also ethically relevant because we simply cannot assign moral duties based on all the unique characteristics of each animal (human or nonhuman) in question. As Richard Epstein put it, “Coordinating the rights and duties of countless pairs of unrelated individuals cannot rest on subtle sliding scales with uncertain substantive content. It depends on clear classifications known and observable by all” (2004, pp. 150–151). Assigning moral worth to members of a species rather than to particular individuals facilitates moral judgment and provides a level standard for equal basic rights. An important objection to the view that human beings are always rational animals comes from brain transplant cases; this objection is examined elsewhere (Lee & George 2007).
Drugs of the Future
Published in Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray, Government, Big Pharma, and the People, 2020
Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray
“Courage” is really no problem anymore because right on the corner of the Yellow Brick Road and Bluebird of Happiness Lane is the latest “Brain” store (subsidiary of Microsoft). While the folks cannot offer you a human brain transplant, they have a range of products that are even better. The new “cyber brain” is literally filled to over flowing with artificial intelligence.
Early attempts at NHS reform and heart transplants
Published in John Marks, The NHS: Beginning, Middle and End?, 2017
In clinical medicine renal transplants had become commonplace in the United Kingdom in the 1960s and Professor Christiaan Barnard had carried out the first heart transplant in South Africa in 1967. This aroused enormous interest worldwide in both the medical profession and the general public, and the subject was scheduled to be considered at the BMA meeting in Aberdeen in 1969, which I would be attending. I decided to oppose the whole idea on the grounds of cost effectiveness – the cost of one heart transplant, about £15 000, being equivalent to the cost of treating five or six other surgical patients needing routine operations. I wrote a speech to that effect and tried it out on my children over Sunday lunch. My son Richard, then 13, listened carefully and said, ‘Daddy you are stupid. Of course the transplant must go on. When I am your age the one case will be a brain transplant and the others five heart transplants’. I realised at once that he was talking sense and rewrote my speech, quoting Richard directly. The speech was widely reported in the national press, being quoted verbatim in some of the more serious papers.5 The Association decided to support the continuation of heart transplant surgery within the NHS and the Government ultimately agreed to fund such a programme. At the time of my writing this Richard is older than I was when I made that speech. We have not yet seen a brain transplant, but we have seen a face transplant and heart surgery is now routine, so at least part of his prophecy has been fulfilled.
Personhood, Welfare, and Enhancement
Published in The American Journal of Bioethics, 2022
What is the object of enhancement? The standard answer is: a person, and more specifically, a person’s welfare (defined as the total of benefits minus harms befalling that person). However, Parfit divorces welfare from personhood. According to Parfit, there is nothing more to a person than different gradations of “psychological connectedness” (Parfit 1984, 215). Parfit argued for this by means various futuristic puzzles regarding personal identity (brain transplants; teletransportation; and so on), but his metaphysics ultimately concerned ethics: if one could adopt this reductionist stance on personhood, the impersonality required by genuine utilitarianism made sense. What matters is the quality of experiences being had, not whether those experiences are being had by you or by me, or even by someone at great spatiotemporal distance (Parfit 1984, 346).
ROS1-positive non-small cell lung cancer (NSCLC): biology, diagnostics, therapeutics and resistance
Published in Journal of Drug Targeting, 2022
Zhi-Qiong Yu, Meng Wang, Wen Zhou, Meng-Xia Mao, Yuan-Yuan Chen, Na Li, Xiao-Chun Peng, Jun Cai, Zhi-Qiang Cai
Brigatinib is a centrally-permeable TKI targeting ALK and ROS1 positive patients with preclinical activity against most known ALK and ROS1 resistant mutations. A cell line trial found that brigatinib inhibited ALK 12 times more potently than crizotinib, while a better inhibitory effect of brigatinib on subcutaneous and brain transplant tumours was observed in a mouse model. A case report in a ROS1-positive patient showed that brigatinib showed stable brain metastatic lesions in patients with crizotinib and certinib-resistant ROS1 rearranged NSCLC. A search of the Cancer Data Bank, PubMed and Google Scholar identified 10 patients with ROS1-positive advanced NSCLC treated with brigatinib and of the 8 patients evaluable for response, 3 patients demonstrated a partial response (ORR:37%). One patient who had not received crizotinib had a sustained response at 21.6 months. Of the seven crizotinib-resistant patients, two patients demonstrated partial remission (ORR:29%) and one patient (14%) had stable disease. Crizotinib-resistant patients had a PFS of 7.6+, 2.9, 2.0 and 0.4 months, respectively. Among crizotinib-resistant patients, duration of therapy (DOT) was 9.7 +, 7.7 +, 7.6 +, 4.0, 2.0, 1.1, 0.4 months and two patients were not reported. Genomic analysis of one respondent showed ROS1(wt) alterations, suggesting that the response could be attributed to 'off-target' brigatinib activity. This study showed modest clinical activity of brigatinib in crizotinib-resistant ROS1 rearranged NSCLC [101–103]. Although the CNS activity of brigatinib in ROS1-positive NSCLC was not documented, it may be superior to crizotinib and possibly even to ceritinib given the findings in ALK-relay NSCLC [104]. More real-world data are needed to validate the clinical activity of brigatinib against ROS1-positive. In an ALK-positive III clinical study, the most common adverse events with brigatinib were elevated blood creatine kinase levels, elevated alanine aminotransferase levels and gastrointestinal symptoms (>25%). Adverse events occurring at rates higher than 5 percentage points with brigatinib compared to crizotinib included hypertension, cough, elevated lipase levels, and elevated creatine kinase levels. Grade 3–5 adverse events occurred in 61% of patients in the brigatinib group, 11% higher compared with the crizotinib group [105].