Columbia University Journal of Bioethics 1 2 Fall 2008 Columbia University Journal of Bioethics And Supplement on BIOCEP Volume VI. No 1, Fall 2008 Editorial Board Faculty Editors Editors-in-Chief Dr. John D. Loike Dr. Ruth L. Fischbach Copy Editors Soo Han Cover Design: “Entwine‖ Komal Kaothari Robyn Scheinder and Dr. John D. Loike Please send your comments to Dr. John D. Loike at: [email protected] Production & Creative Directors Robyn Scheinder Jana Bassman Web Version is available through the undergraduate page: http://www.columbia.edu/cu/ Or through http://www.bioethicscolumbia.org/ Copyright 2008 by: Columbia University Center for Bioethics NO PART OF THIS JOURNAL MAY BE COPIED OR USED WITHOUT PERMISSION. All views in the articles reflect those of the authors only. Columbia University Journal of Bioethics 3 TABLE OF CONTENTS Acknowledgements ............................................................................................................................. 5 Introductions by Dr. John Loike and Dr. Ruth Fischbach ............ …………………………………..…….6-7 Section I: Genetics The Sound and the Fury By Katie O‘Neill and Wei-Jen Hsieh……………………………………………….. Majority Report: DNA Data-banking As an Opt-Out System By Emilia Javorsky and Robyn Schneider………………………………………... Could Genetic Research Interfere with Medicine? By Jorge Jara and Joanna Etra………………………………………………. Charging You for Being You By Elisa Fung and Gabriela Vargas…………………………………………. Section II: Stem Cells and Reproductive Medicine Altered Nuclear Transfer: A Novel Way of Developing Pluripotent Stem Cells By Sarah Eberle and Tabby Khan………………………………………………... Secrets and Lies: Mandating Disclosure in Oocyte Donation By Tiffany Hsieh………………………………………………………………….. Diagnosing Disability… And Keeping It by David Yin and John Tseng……………………………………………….. Section III: Neuroethics Programmed Free Will By Elisa Fung and Lindsay Kugler………………………………………………….. Neuroimaging for InterGender Peace By David Yin and Kathleen O‘Neill…………………………………………………. Do You Mind If I Read Your Mind? By Adela Aguirre and Alan Daboin……………………………………………… GLBT Flies: The Application of Mind Control To Sexual Preference By Viktor Gamarnik and Shu Pan………………………………………………….. Memory Upgrades: Not Just For Your Computer By Emilia Javorsky & Wei-Jen Hsieh………………………………………………... 4 Fall 2008 TABLE OF CONTENTS (continued) Section IV: Contemporary Issues Say No to Blow: Preventing Cocaine Addiction through Vaccination By Soo Han and Tabby Khan Building Athletes By Yonah Heller and Jean Pierre Rabbah Molecular Imaging and Ultrasound-assisted Drug Delivery By Ashok Ilankovan and Andrew Arnold Bioartificial Hearts, Bioethical Issues By Esty Rajwan and Ditty Vick One Word: ―Synthetics‖: The Ethics of Synthetic Biology By Savino Sguera and Benjamin Stern A Dearth of Donations By VikrumThimmappa and Jocelyn Lo A Bun in the Oven By Jennifer Gillman, Anna Plitt and Andrew Behrens Paying For Patient Performance Viktor Gamarnik and Ben Koo Section V: Cross-cultural Bioethics-BioCEP Sex and Education. Can they go together? By Elizabeth Edwards, Yoon Joo Kang, and Caroline Leone Behind Their Smiles: Cosmetic Dentistry and Medical Tourism in Thailand By Mikilena Greusel and Dr. William Bloch The Ethical Concerns of Propranolol and Memory Dampening By Donna Taraborelli, Tasha Smith, and Siwachapol Monyakul Finding the Middle Path to Stem Cell Nirvana By Melissa Bauer and Shanshan Tang To breach or not to breach doctor-patient confidentiality involving children with AIDS By Risa Hoshino, Janice Liu, and Sun-Chai Waleecharoenpong Enlightenment: Just a Pill Away! By Marlon Danilewitz, Margarita Borovka, Mariangels de Planell-Saguer Columbia University Journal of Bioethics 5 Acknowledgements Columbia University Journal of Bioethics would like to acknowledge the following individuals and organizations for their advice and support to help publish this journal: Dr. Deborah Mowshowitz, Director of Undergraduate Programs; , Chief Communications Officer of the Department of External Relations; Anna Sobkowski, Director of Science Communications of the Department of External Relations; Dr. Ruth Fischbach, Director of the Center for Bioethics, Columbia University College of Physicians and Surgeons; Ms. Jana Bassman, Center for Bioethics, Dr. John D. Loike, course director for Topics in Biology: Frontiers in Bioethics (W3995) and Ethics for Biomedical Engineers (BEN4010); and all the students who contributed to this Journal. 6 Fall 2008 Introduction In 2008, the number of articles submitted to The Journal increased almost three fold as more and more students became captivated with bioethics. Bioethical issues related to reproductive medicine, neuroethics, and genetics received high visibility in both the public press and in scholarly journals. The authors of papers published in this Journal have voiced their opinions and proposed innovative insights and solutions in response to these issues. These student contributors are aspiring scientists, physicians, lawyers, and philosophers whose thoughts and opinions are the heartbeat of this Journal. These students will emerge as the front line of scientific and medical discovery. Their future innovative research and ability to communicate science to the public will elicit and inspire bioethical debates. Furthermore, they will become essential players in helping society resolve many bioethical dilemmas. This year‘s Journal volume also includes a special section on Cross-cultural bioethics with articles written by those American University students and students from Mahidol University in Bangkok, Thailand, who participated in an innovative cross-cultural educational program called Bioethical Cross-cultural Educational Program (BIOCEP). Twenty students from various universities in the East Coast and ten Mahidol students attended this special two week program in Bangkok, Thailand exchanging ideas and learning how culture and religion influence bioethical dilemmas. Their articles reflect some of the lessons derived from their exposure to various cross-cultural humanistic values. John D. Loike, Ph.D. Course Director for Frontiers in Bioethics and Ethics for Biomedical Engineers Co-Director of Graduate Studies, Department of Physiology, Director of Special Projects, Center for Bioethics, Columbia University College of Physicians and Surgeons Columbia University Journal of Bioethics 7 Preface Ruth L. Fischbach, PhD, MPE Professor of Bioethics Director, Center for Bioethics Columbia University College of Physicians and Surgeons 8 Fall 2008 I. Genetics The Sound and the Fury By Katie O‘Neill and Wei-Jen Hsieh Columbia University If you were given a choice to be deaf or to in order for the device‘s electrode array to hear, which would you choose? Now, what be threaded into the scala tympani (Papsin if you had to make the decision for someone and Gordon, 2007). Three to four weeks else? later, the device is activated when a transmitter and microphone are placed over One out of every thousand children is born the ear. Since stimulation levels may shift deaf, and for the parents of these children, over time, the implant must be continuously this question is not just hypothetical (Papsin monitored throughout the patient‘s life. and Gordon, 2007). Ninety percent of deaf Moreover, implantation may cause inner ear children have hearing parents who want damage and children who undergo this their child to be ―normal‖, yet members of the deaf community contend that deafness is a normal and natural condition (National Association of the Deaf). Only recently has this issue have practical implications. Due to a new technology, the sensation of sound can be transmitted to the brain through the implantation of an electrical device. The cochlear implant was approved by the FDA in 1985 and since then it has been successful in delivering auditory stimulation to both children and adults. However, in a study following eighty-two children for ten procedure are often at an increased risk for years after implantation, only 40% had contracting meningitis (Papsin and Gordon, speech that was intelligible to the average 2007). Furthermore, three to six percent of listener. The same study found that the time, re-implantation is necessary due to although 79% of these children could use traumatic or ―hard failure‖ which may result the telephone, more than 70% had in intracochlear changes. vocabulary scores that were below average. For the most part, cochlear implants are For these reasons, many parents believe imperfect, yet many physicians view that the implant is not worthwhile. The deafness as pathology: a disease that needs invasive procedure is performed under to be cured. Thus, pediatricians will strongly general anesthesia and calls for a small hole encourage parents to pay $40,000 to give of approximately two to three centimeters in their child the gift of sound. On the other diameter to be drilled into the patient‘s skull hand, the deaf community insists that Columbia University Journal of Bioethics 9 deafness is a natural condition and allows birthday; thus, we depend on the child‘s for the survival of a unique culture. parents to make the best decision. Moreover, deaf parents want their children to be a part of the community to which they If society were to conceptualize deafness as were born, a community whose primary a disease, do parents even have the right to language is American Sign Language. choose for their child to be deaf? As the technology is now, there are many The media often describes deafness in a complications with cochlear