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PowerPoint to accompany
Law & Ethics For Medical Careers
Fourth Edition
Judson · Harrison · Hicks
Chapter 10—The Beginning of Life
and Childhood
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display
The Beginning of Life and Childhood

Objectives
Define genetics and heredity
 Distinguish between DNA, chromosomes
and genes
 List several situations in which genetic
testing might be appropriate
 Discuss genetic discrimination

The Beginning of Life and Childhood

Objectives continued
Define cloning and explain why it is a
controversial issue
 Discuss some of the pros and cons of
genetic engineering
 Explain why stem cells are useful for
scientific research
 Distinguish between mature and
emancipated minors and discuss those
situations where such minors might legally
make their own health care decisions

Influence of Technology on the
Beginning of Life

Genetics


The study of heredity
Human Genome Project
Project to identify and map the human
genomes
 Completed in 2000, available to all
physicians and scientists who could use it

Genetic Testing

DNA testing has become a reliable
source of testing for
Forensics
 Determining parenthood/tracing lineage
 Screening for inherited diseases or
conditions


How test results are used has become
an important ethical and legal issue
Genetic Testing and Discrimination

Genetic discrimination


Differential treatment of individuals based
on their actual or presumed genetic
differences
Examples of where potential genetic
discrimination may exist
-employment
-life insurance
-health insurance benefits
Genetic Testing and Discrimination
continued
Most states prohibit genetic
discrimination based on genetic testing
for purchase of health insurance
 HIPAA prohibits discrimination as part of
the portability of group health insurance
 ADA offers some protection
 Under Executive Order, genetic testing
for employment is prohibited

Genetic Engineering
Manipulation of DNA within the cells of
plants and animals to ensure that certain
traits will appear and be passed on
 A clone is an organism from a single cell
of a parent and is genetically identical to
the parent
 Useful in medicine and potential for
transplantation-but ethical issues create
controversy

Human Stem Cell Research
An early stage stem cell (blastocyst) has
the ability to become any type of tissue
 May be used in therapeutic research to
develop treatments for many diseases
 The use of stem cells in reproductive
research is considered by most as
unethical

Human Stem Cell Research
Controversy
Blastocysts are removed from the frozen
products of in vitro fertilization
 Blastocysts are removed from those
products that would eventually be
destroyed
 Those who argue that an embryo is life
argue that the embryo is entitled to legal
protection, thus the controversy

Gene Therapy

Gene therapy may involve
Replacing a deficiency or blocking an
overactive pathway
 Inserting a normal copy of gene into a
patient with a specific genetic disease


Current research into turning “off” a gene
to avoid a disease
Conception and the Beginning of Life

Infertility Options

In vitro fertilization (IVF)


Egg and sperm develop into an embryo in a test
tube or petri dish
Artificial insemination

Injection of viable semen into the vagina


Homologous-use of husband’s sperm
Heterologous-use of donor sperm
Conception and the Beginning of Life

Infertility options continued

Surrogacy
Use of surrogate—a woman who agrees to carry
a child to term
 Used when mother is unable to carry embryo to
term
 Gestational surrogacy—when surrogate is not
related to embryo
 Traditional surrogacy—when surrogate is related
to embryo

Conception and the Beginning of Life

Adoption
Both State and Federal laws regulate
adoption
 Agency adoptions



State-licensed, public or private, agency that
places children with adoptive parents
Private adoptions

No agency involvement; some states prohibit
Rights of Children

Common law


Parents have the right to make health care
decisions for minor children
Doctrine of parens patriae
State may act as parental authority for the
child’s “best interest”
 Allows the state to remove abused or
neglected children from parents

Rights of Children-Newborns

Under the 1974 Child Abuse Protection
and Treatment Act (with subsequent
Child Abuse Amendments) physicians
may legally withhold treatment from
infants who
are chronically and irreversibly comatose
 will most certainly die and to treat would be
futile
 would suffer inhumanely if treatment was
provided

Rights of Children-Abandoned Infants
Safe haven laws in many states allow
abandonment of an infant at a fire or
police station or a hospital
 Laws vary as to prosecution, age of
infant, whether medical history is
necessary
 Safe haven law controversial; may be
seen as condoning abandonment

Rights of Children—Minors

Mature minors
 Considered mature enough to understand a
physician’s recommendation and give
informed consent
 Emancipated Minors
 Legally live outside parent or guardian
control
 Court may declare minors emancipated if
they are self supporting, married or serving
in the armed forces
Ethics Guide Discussion
Your best friend comes to you with a problem.
She was adopted at birth and due to strict
privacy laws when she was adopted, knows
little about her birth parents—only that she
was born to a Jewish mother from Germany.
She is very worried about breast cancer and
learns that German Jews with a mutated
BRAC1 gene have a very high incidence of
breast and other cancers. What advice will
you give her?