Are we taking healthcare too far (ethics)

[derkvanl]

More and more diseases are found, more and more ways to deal with them are found. We have allready been around for some time and still survived and managed to get "healthier" and older. That's all good. But are we actually healthier this way as a species?

We seem to accept the natural selection among all other species except ourselves. We are trying to save lifes that are, from a natural point of view, not capable of surviving due to birth defects. We put organs from people in other people to cure defects. We start injecting things into ourselves if only we think of some virusses as dangerous. Kids get litteraly checked out like a product within their first minutes of life. For every kid that doesn't fit the normal healthy good looking baby is a treatment ready.

We are continuously trying to defeat natural selection among our own species. Really long term effects of this and certain treatments are not even in sight. What is going to be left of our health in 100 or 200 years? We might end up a species that can't survive without medical technology and does't know where to get natural health no more.

Is it unethical to say that "it's better to let it go the natural way" sometimes?

 

[obsidianavenger]

er... natural selection is still a "fact" in relation to our species. its just that we've modified our environment to such an extent that the "selection pressures" we face are very different from those faced by most other species.

that said, i don't think people should be compelled to sacrifice their sickly relatives "for the good of the species". its really up to the individuals involved...

 

[Nogre]

Is it unethical to say that "it's better to let it go the natural way" sometimes?

I would say that it is when it causes suffering. By the way, what you're talking about is essentially eugenics, just so you know. We have too much control over ourselves and our environments for any kind of natural selection-like selection not to be eugenic. That doesn't mean it's bad. You should just know exactly what you're dealing with here.

 

[borrofburi]

er... natural selection is still a "fact" in relation to our species. its just that we've modified our environment to such an extent that the "selection pressures" we face are very different from those faced by most other species

And his fear is we've disconnected our selection pressures too much from "nature" and are generally allowing "bad genes" to survive and propogate.

 

[obsidianavenger]

er... natural selection is still a "fact" in relation to our species. its just that we've modified our environment to such an extent that the "selection pressures" we face are very different from those faced by most other species

And his fear is we've disconnected our selection pressures too much from "nature" and are generally allowing "bad genes" to survive and propogate.

and my contention is that "the good of the species" isn't any individuals concern or responsibility, since the species is not an entity of itself, but only a collection of individuals making choices that they think will benefit them personally or bring about results they desire

 

[borrofburi]

And his fear is we've disconnected our selection pressures too much from "nature" and are generally allowing "bad genes" to survive and propogate.

and my contention is that "the good of the species" isn't any individuals concern or responsibility, since the species is not an entity of itself, but only a collection of individuals making choices that they think will benefit them personally or bring about results they desire

While I won't speak for derkanvl, I think I'll enjoy taking the opposite position for a bit:
Individuals are a short sighted greedy algorithm, this is inherently inefficient and non-optimal; we as humans with our greater planning abilities can remedy this and come up with better solutions.

 

[Nogre]

and my contention is that "the good of the species" isn't any individuals concern or responsibility, since the species is not an entity of itself, but only a collection of individuals making choices that they think will benefit them personally or bring about results they desire

I also can't let this slide by, regardless of my position on the issue. You can't say that the whole isn't important because it's not a part. That doesn't work. Two individuals aren't irrelevent compared to one simply because the two together aren't an entity. You can consider more than one person without being logically unsound. Does the "greater good" thing sometimes get abused? Yes. Is it inconsistant with logic? No. We just have to make sure we're considering individuality as part of the whole, meaning we give consideration to the fact that any group is going to be inherently heterogenous.

 

[Gunboat Diplomat]

er... natural selection is still a "fact" in relation to our species. its just that we've modified our environment to such an extent that the "selection pressures" we face are very different from those faced by most other species

And his fear is we've disconnected our selection pressures too much from "nature" and are generally allowing "bad genes" to survive and propogate.

How bad can these genes be if they survived and propagated?

By the way, I appreciate your advocacy for the devil...

 

[obsidianavenger]

I also can't let this slide by, regardless of my position on the issue. You can't say that the whole isn't important because it's not a part. That doesn't work. Two individuals aren't irrelevent compared to one simply because the two together aren't an entity. You can consider more than one person without being logically unsound. Does the "greater good" thing sometimes get abused? Yes. Is it inconsistant with logic? No. We just have to make sure we're considering individuality as part of the whole, meaning we give consideration to the fact that any group is going to be inherently heterogenous.

the "greater good" is perfectly logically consistent. however, it is completely inconsistent with individual rights. you can only have one or the other without fudging both doctrines into dependence on whim.

While I won't speak for derkanvl, I think I'll enjoy taking the opposite position for a bit:
Individuals are a short sighted greedy algorithm, this is inherently inefficient and non-optimal; we as humans with our greater planning abilities can remedy this and come up with better solutions.

only at the cost of individual rights!

 

[Andiferous]

I think this risks spiraling into a discussion on social Darwinism which is a bit of a neanderthal concept in itself.

It might be worth noting that human birth rates are generally quite different from most animal species. There is generally less desperation to procreate in most first-world situations in comparison to life in the wild, likely because we are quite comfortable and modern medicine secures that comfort.

I think it's also worth mentioning that our brain is probably our best evolutionary advantage, and had we not constructed this very complex society, and were thrown out of our niche and into the planes of Africa without modern conveniences, most of us wouldn't make it very long.

 

[borrofburi]

How bad can these genes be if they survived and propagated?

Well, they need on technology, they rely on it. Without selection pressures keeping them relatively rare, they could, through genetic drift, permeate our entire population, and then should any major (or possibly even slight) destabilization occur, then goodbye technology, and potentially, goodbye humanity.

While I won't speak for derkanvl, I think I'll enjoy taking the opposite position for a bit:
Individuals are a short sighted greedy algorithm, this is inherently inefficient and non-optimal; we as humans with our greater planning abilities can remedy this and come up with better solutions.

only at the cost of individual rights!

What does "individual rights" even mean in this situation? Are you saying individual rights includes potentially humanity ending actions?

 

[obsidianavenger]

referring back to my original comment: the right to keep a sickly relative alive, or to choose to mate with a "genetically inferior person", even if it means so called bad genes propagate and "weaken the race"

 

[Doc.]

genes are more stable that we think, natural selection had thousands of years to do it's job, but we can't wait for that no more. I mean, i doubt we will survive long enough to see the effect of natural selection if we were to decrease treatment for it.

 

[derkvanl]

First thx for all the replies. I posted this before going to bed yesterday, so didn't have much time to take part in the discussion.

I personally don't look at this from the point of "creating a better / healthier human race" I just think there's not enough research and sense that curing someone now regardless of the long term consequences is the most important thing to medical science. The more medicin the better. The more doctors the better. Saving every life is the ultimate goal.

It's the "regardless of the long term consequences" that worries me.

I'll try to keep it readable thru quoting.

er... natural selection is still a "fact" in relation to our species. its just that we've modified our environment to such an extent that the "selection pressures" we face are very different from those faced by most other species.

Not entirely. We are saving lifes that normally wouldn't have grown to the age that they can have children. That way we keep things in our genepool that through natural selection wouldn't have survived.

that said, i don't think people should be compelled to sacrifice their sickly relatives "for the good of the species". its really up to the individuals involved...

The good of the species isn't my point of discussion. I just wonder what we are doing the way we are now. I think we are degrading our health on the long terms.

and my contention is that "the good of the species" isn't any individuals concern or responsibility, since the species is not an entity of itself, but only a collection of individuals making choices that they think will benefit them personally or bring about results they desire

While I won't speak for derkanvl, I think I'll enjoy taking the opposite position for a bit:
Individuals are a short sighted greedy algorithm, this is inherently inefficient and non-optimal; we as humans with our greater planning abilities can remedy this and come up with better solutions.

I must say I agree on the bold text. We don't do enough research and don't use enough modelling to see what the long term benefits of our healthcare are now (there's been several medicines causing more trouble than they solved). Every new disease got to be cured, there's hardly been investigation on long term effects of trying to cure everything we see as a disease.

Well, they need on technology, they rely on it. Without selection pressures keeping them relatively rare, they could, through genetic drift, permeate our entire population, and then should any major (or possibly even slight) destabilization occur, then goodbye technology, and potentially, goodbye humanity.

This is what worries me the most. There's allready a lot of people that depend on technology to survive. And I think it's allready visible that it's going onto next generations. There are diseases allready that have exploded in numbers the last decades (cancer, heartdiseases, diabetes, psychologically there's also a lot of medicine pumped into people) and in general we consider ourselves getting more healthy.

only at the cost of individual rights!

I hope I cleared up that it's not really my point. Changing the way we deal with disease and health doesn't mean going to draw a straight line between mass and individual. And what "individual rights" are we talking about. There's countries that don't allow people to end their own lives or end an unwanted pregnancy, which is a whole other discussion.

 

[Gunboat Diplomat]

How bad can these genes be if they survived and propagated?

Well, they need on technology, they rely on it. Without selection pressures keeping them relatively rare, they could, through genetic drift, permeate our entire population, and then should any major (or possibly even slight) destabilization occur, then goodbye technology, and potentially, goodbye humanity.

Ants need a colony but that's okay 'cause they always stick together and can build such a structure... and impressively so. They're one of the most hardy animals on Earth!

We're not the only species that has to do and build things, even with each other, in order to survive. Being able to do so allows us to survive things like "bad genes." It is part of our survival mechanism and is a sign of our strength rather than a potential for weakness...

Besides, it takes more than a lack of pressure to promote a "bad gene." Without a selective pressure to actively culture the bad gene, it will simply be diluted in the population. That's why sexual reproduction is so popular among us eukaryotes. Our children only have a 50% chance of inheriting our bad genes...

 

[borrofburi]

That's why sexual reproduction is so popular among us eukaryotes. Our children only have a 50% chance of inheriting our bad genes...

50% is vastly more than 0% for genes that would have led to death before reproductive age.

 

[Gunboat Diplomat]

50% is vastly more than 0% for genes that would have led to death before reproductive age.

Firstly, how many genes have 0% survivability? Perhaps some birth defects do but not the stuff we inoculate ourselves from... and this only matters if these were the result of actual genetic traits rather than, for example, environmental factors...

Secondly, 50% is good enough. As long as there's no selective advantage, it will simply get diluted into the population...

Besides, who's to say what a "bad gene" is? Sickle cell anemia might seem bad but if your population were ever to be attacked by malaria...

 

[Doc.]

plus unhealthy person is potentially less likely to have offsprings

 

[Aught3]

This is a very interesting discussion, I can't believe I haven't commented yet.

It is a bit of a conundrum, as modern medicine becomes more adept at curing genetic diseases we do face the problem of contaminating our gene pool to a greater and greater extent. Take the example of haemophilia a recessive genetic disorder of the X chromosome, normally natural selection would weed out anyone suffering the effects and the allele frequency would tend to decrease in a large population. As Gunboat says this allele can't be too bad because it is able to propagate generally by hiding in the female line waiting to strike in the male offspring. Thanks to the miracle of medicine we can now treat haemophilia and keep the sufferers alive, but this also means that they will reproduce leading to more sufferers of haemophilia which require more resources to treat. The medicine makes the haemophilia gene neutral and as Borr rightly points out this increases the chance of genetic drift fixing it in the population.

The problem of genetic disease is one many parents already face. When a genetic disease runs in the family there is always a debate whether the risk of potential suffering is enough to put off having kids. Also unborn children can be genetically tested to see whether they carry the alleles, but these tests usually can't say with 100% certainty.

What's the most moral thing to do about this issue? Probably to continue what we are doing. If the parents know the risk of a simple inherited disease they are the only ones who can decide whether it is worth trying for a child that might face medical issues. They should get the embryo/foetus tested and abort if there is a high likelihood of the child presenting or carrying the disease. With more complicated issues like heart disease or cancer we don't know enough about the genetics to set up a sensible policy.

 

[derkvanl]

Firstly, how many genes have 0% survivability? Perhaps some birth defects do but not the stuff we inoculate ourselves from... and this only matters if these were the result of actual genetic traits rather than, for example, environmental factors...

I'll give you some examples
- There seem to be a lot of open heart surgery on very young kids that won't be able to grow up to adulthood without it.
- If a kid is diagnosed with diabetes, it get's saved by insuline, treated his whole life.
- If a newborn kid has kidney failure, it gets treated his whole life and put on a transplant list.
- Kids with leukemia get radiated and treated all their life (this goes for every cancer)
- hemophilia B

Ants need a colony but that's okay 'cause they always stick together and can build such a structure... and impressively so. They're one of the most hardy animals on Earth!

When is the first ant-bone transplant? I allways wondered where background radiation came from, must be from their cancer-treatments? Did you ever find a hospital in an antcolony? Ants kill what doesn't benefit the colony.

What's the most moral thing to do about this issue? Probably to continue what we are doing. If the parents know the risk of a simple inherited disease they are the only ones who can decide whether it is worth trying for a child that might face medical issues. They should get the embryo/foetus tested and abort if there is a high likelihood of the child presenting or carrying the disease. With more complicated issues like heart disease or cancer we don't know enough about the genetics to set up a sensible policy.

I don't think there's any policy now. It's all being handed to the individual. And I don't think it's getting enough attention, because so many are blinded by the "we need to cure everything" or by religious points of view or just never heard of this hypothesis. I think it's hard for science to put up this kind of a discussion, because it will probably result in a religiously / scientific-neverending debate like evolution or people will start to see science as a possible super-race creator.

Your question "What's the most moral thing to do about this issue?" Is why I think this should be an ethical question. Ethics are preventing a lot of people doing good research (for example: stemm-cell). Ethics try to tell us that even the first cell of a foetus should be considered a full living thing. How ethical can we be when it comes to the mass versus the individual? Should there be a line. If not, then there should be full freedom for people to choose, also allowing people "ethically not treating" certain diseases.