Tag: health policy

The Kidney Dialysis Puzzle

Posted on by Godfrey Onime

by Godfrey Onime

Arm hooked up to dialysis tubing
Arm hooked up to dialysis tubing – from Wikipedia

“Dr. Onime, your patient in room 607 is throwing a fit,” read the nurse’s message on my iPhone. “He wants to leave. What should I do?”

I was half-way through lunch. I placed a call to the nurse and asked her to try and convince the patient to stay until I got there. “I have called security,” she said, “but we can’t continue to hold him if he doesn’t want to wait.” Gobbling down the rest of my meal, I clutched my drink and dashed to the elevator.

I’ll call the patient Mr. Freeman. He had irreversible kidney failure, or End Stage Renal Disease (ESRD). He often missed outpatient dialysis. He would end up in the emergency room huffing and puffing from volume-overload, his lungs bathed in fluids, and his potassium level dangerously elevated.

This time, Mr. Freeman had also suffered a heart attack and had been admitted to the ICU. He had received urgent hemodialysis, the on-call kidney specialist physician, or nephrologist, and nurse dashing to the hospital in the middle of the night for the task. Mr. Freeman had only been transferred out of the ICU to a monitored bed earlier today, the plan being for him to be observed for one more day and to receive another dialysis session tomorrow. Read more »



Monday, July 26, 2010

Moral Questions in the Ancient Art of Human Enhancement (Now With Venn Diagrams)

Posted on by Richard Eskow

Electric flesh brushI've been named an “Affiliate Scholar” at the Institute for Ethics and Emerging Technologies, so I thought I'd think about where I fit in the Humanist/Transhumanist matrix. Then I thought I'd draw a Venn diagram or two.

Somewhere along the line we've developed the habit of announcing that, thanks to new technology, we're forever on the verge of revolutionizing what it means to be human. Maybe it came in with the Industrial Revolution and our parallel discovery of modern medical science. Whatever the source, consider this 1933 quote from British engineer Allan Young, in his book Forward From Chaos. As Jo-Anne Pemberton noted in her book Global Metaphors, Young heralded the dawn of what he called the 'Electric-Machine-Power Age' as follows:

“The advent of radio art has provided a revolutionary change in the method and rate of thought dissemination. The human voice is now able to encircle the globe in the twinkling of an eye … It is thus possible for me to project my thoughts instantly into the mind of someone living on the opposite side of the planet …”

“The evolution of the radio machine … seems to be one of the very biggest happenings in our civilization … I stresss the importance of the great acceleration we are now witnessing in the whole process of translating thought into action …”

To which the modern mind can only add, “Really? From radio?” If he were alive today, Allan Young would probably be a Transhumanist like most of my friends at the IEET. In 1933, as in the decades before and since, people have been announcing that technology is about to radically alter the scope, power, and nature of human existence.

And the funny thing is, then it actually does. Humanity was transformed by radio – and by what Young called “the aeroplane.” By the time these transformations became ubiquitious, however, they had also become ordinary – even boring. The truth is that we've been transforming our minds and our bodies for generations. Take life extension, a favorite topic for Transhumanists: Life expectancy increased from 18 years in the Bronze Age to 25 years in Colonial America (although infant mortality affected the numbers significantly), and it approaches 80 years in that country today. Medicine and public health lowered infant mortality in London from nearly 75% before the Industrial Revolution to 31% afterward[i]. But these advances have been unequal. Life expectancy in the poverty-stricken Calton area of Glasgow, for example, is 8 years less than in the Lenzie neighborhood less than ten miles away.[ii]

Somebody already engineered the human lifespan – but they did it with the (often unequal) distribution of resources like food, shelter, disease and accident prevention, and medical care.

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