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I'm posting this thread because recently I've been wondering about the increase in medical conditions in people such as allergies, blood disorders, deformities etc. and I've been thinking-Would this type of thing decrease if we no longer used our technology to save the people who have them?
I mean, is our medical treatment weakening the human race? As you all probably know, we as animals survive by what is commonly known as "the survival of the fittest". Those who are weaker than others or are prone to illness/have an illness will die therefore not passing down their "bad" genes to another generation. This ensures that the next generation would be as healthy as possible.
However, with our technology we are preventing people who suffer from such conditions form dying and therefore allowing them to have children and pass down "bad genes" and therefore more and more people are suffering from diseases/comditions passed down genetically. I know that just because a parent has a condition it doesn't mean their children will have it as well but I'm pretty sure there IS a genetic link in this matter. Turn the clocks back 100 years, 50 years even. How many people had nut allergies then? How many people had asthma? Probably much less than today.
I also understand that some of the conditions are due to the fact that we are now much more unhealthy in terms of diet and exercise but some of the conditions definitely do have a genetic factor involved.
I'm not trying to sound insensitive (apologies if this upsets anyone) but if we just let those with conditions die then maybe there'll be an increase in general health.
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Very interesting topic. I hope you won’t mind a bit of a long post.
As a medical student my immediate reaction is to claim that you can never have enough medicine. :w00t: However, given a moment more to consider the subject I must admit that your points do provide food for thought; can the survival of the unfit against all rules of evolution be considered a threat to humanity as a race? Or is humanity, by virtue of being a race of self-aware individuals, raised above natural evolution?
Some people would of course claim that evolution does not exist and that humanity as a race can therefore not be influenced by ‘bad genes’. :rolleyes: However, the rest of us are painfully aware that for each successive generation more and more malign mutations are accumulated in the human gene pool. It’s true that there are arguments, however inhuman, for avoiding treatment of the genetically and chronically sick. Treatment is usually costly and time-consuming, and there is always the risk of the affected passing on their ailments to the next generation when the evolutionary mechanism of natural selection is hindered by the advancements of modern medicine. If this development is allowed to continue it will eventually lead to a general physical weakening of the human race and make us more and more dependent on the very medicine and technology that created this dependency in the first place. At some point we will reach a stage where degenerative genetic mutations are considered not abnormalities but natural variations of the human genome.
However, one can also argue that it is in fact a benefit to the human race that individuals with physically debilitating disorders are able to lead long, productive lives in spite of their disadvantages. Evolution has granted us an asset far more important than mere physical strength, namely our intelligence. Intelligence is not dependent on brute strength, and it would not be to humanity’s advantage to encourage natural selection favouring bodily health over mental abilities. Throughout time, many of the world’s most brilliant minds have been contained in bodies that were less than perfect, and in spite of this (or perhaps because of this?) they have enabled us to make leaps of progress that would otherwise have been impossible. Few if any feats of physical strength have had the same massive impact on human history as the technological developments made possible by intelligent thought and problem-solving skills, and while the average health in civilised countries might recently have been declining due to the spreading of genetic and life-style diseases, research shows that we as a race have never been smarter than we are now; an indication that evolution is in spite apparent evidence to the contrary still working in our favour.
On the question of whether we should deny anyone with a genetic disorder treatment to prevent the potential spreading of this particular disorder, I must most definitely and vehemently say no. As a doctor I am sworn to treat everybody asking for my help regardless of how they came about their problems, and those suffering from genetic disorders are more than anyone else innocent of having brought their pains upon themselves. While I do find the current development worrying I don’t think the way forward is to commit genocide on those deemed ‘unfit’; the mere thought is beyond horrifying, and nothing sickens me more than knowing that doctors were once the instigators of a nationwide purge of the handicapped and mentally disabled in their care in an attempt to purify and strengthen their race. Rather, I hope that future technology can perhaps give us a way to avoid genetic disorders; perhaps in the future we will be able to cure genetic diseases by genetically engineering and repairing the defect genome of adults. Currently, however, we must focus on informing about genetic disorders and the option of in vitro fertilisation that allows doctors to artificially inseminate a woman with only healthy embryos, thereby making sure that no malign mutations will be passed on to future generations. This, not discrimination and genocide, is the way forward in my opinion.
Last edited by Grephaun; February 24th, 2006 at 00:25.
"Girls are nice and cuddly on the outside, and freaky on the inside." ~ Lost Nemesis.
Here in Australia, there was a rise in visits to the doctor in the late 80's and early 90's, it rose from about 6 visits a year to 9, which is a massive increase.
The government cut positions to study medicine at universities drastically in 1993, and Australia is now facing the cost.
In the early to mid 90's doctors were in fierce competition, most doctor visits were bulk billed (government pays 85% of cost) so the doctor could see enough patients to make a living.
Now the competition has waned, people are paying more than ever to visit a doctor. As a result, people are going to the doctor a lot less, visits have dropped down to around 7.5 per year.
The 'doctor shortage' became a huge issue last year and 2004, and so the government's response was to pay doctors a lot more so they would charge patients less, and to increase positions to study medicine at university.
It's interesting to note that this 'doctor shortage' was the only way to stop the rapid increase people were seeing the doctor. Basically, people were seeing doctors unneccesarily.
The solution the current government has come up with has only made the situation 'worse', doctors now work a lot less than they did 5 years ago, because they can make so much more money for every patient they see. Doctors aren't the greedy types that want a lot of money, they earn what they feel comfortable with, and so the increase in payments from the government has only worsened the 'doctor shortage' in the short term.
It's a very slow ebb and flow tide that I can only expect to happen 6 or 7 times in my lifetime .
ANYWAY, I believe that people are still seeing the doctor too much in Australia, but I highly disagree with the concept that we should lower our treatment of the sick, injured, or disabled to strengthen the human race's genes.
An interesting topic. I know that a lot of ancient cultrures would kill children that they considred to be inferior due to disabilitys and disfigurements, the romans and greeks did this quite often. Also the Spartans after a child was born would leave the child outside to survive by itself in the elements for it's first night if it lived then it would have a chance at life.
Now the question that has to be asked is what conditions does a person have to have in order for them to no longer benefit from treatment. Myself i have bad eyesight, eczma, thrombphillia(sp), and due to the last i had perthes in my right hip meaning that i will get arthritis in it and will need a hip replacement eventually (hopefully when i'm in my fifties).
Would i quailify for medical care as some of those conditions can be genetic. Out of my brothers and sisters whom are all fully health i am the only one whom has had these conditions. That's the problem that you encounter if you start down this road whom decides what condition is worth treating and what value that said life has. I am fairly intelligent and a hard worker, however does that ofset my genetic deffeciancies, In a system based on a form of Eugenics (which is what that would be) perhaps i wouldn't be killed rather maybe i would be unable to breed to stamp out any "abnormalities" that i would put into the Gene Pool therfore ensuring the strength of the next generation.
If you start refusing medical treatment based on genetics then you are on a slippery slope.
There was another man who once tried something similar in the 20th century Adolf Hitler, who beleived that those whom are genetically inferior should be removed from the Gene pool.
One flaw to this thinking is that many disorders have no effect until well after the typical reproductive age range of humans. If a condition will kill you dead (with no other effects) when you turn 50, it's unlikely to be weeded out of the gene pool by means of evolution because by the time it hits you, you're done reproducing (almost always.) So treating this class of (call them post reproductive) conditions cannot effect the gene pool negatively unless it increases the reproductive age of people. Treating these conditions is a good thing.
Of course, where your question becomes relevent is the case of conditions that take effect either before one is capable of reproduction or during reproductive viability. If a condition causes you to die upon your first menstruation (for example), you will not be reproducing very much. If you are able to treat these conditionss, then the population will begin to see an increase in the condition that is proportional to some function of the increase in reproductive life expectancy. This will indeed create additional strain on the medical industry, however there are plenty of clever people in the world that can perform these jobs. It will increase the number (and percentage) of the population with these conditions... however this increase will be -precisely- the people that would never have been born without the treatment. Further, they will have a treatment available to them. So if treating these diseases is good or bad depends partly on if you think it's better to be alive but with flaws or to simply never be. I don't think that there's any question that it is good to treat those already living with the disease, if we ignore this consequence.
I think that's about it. I'm sure I've missed a few points, but if I did either nobody will notice or they'll point them out for me to fix.
My chief point would be that humanity generally exists outside the of the "survival of the fittest" realm by virtue of our intelligence. The only succesful predators of humans are now virus's, which I would have to say we have been at war with our whole existence.
We no longer compete with other animal kingdom species for whatever it takes to survive, it's the other species' that survive now only because we allow them to for various reasons ( i.e. food source, comfort, novelty, nostalgia, morality or ethics ).
The chief reason to keep treating people with 'bad genes' is that, while they may otherwise be a genetic mess, they may still be capable of having some useful; or even essential; genes that humanity might require for future success's either in evolution or our war against the virus's.
Also keep this in mind when discussing medicine:
The real money lies in treating people, not curing them. You want to generate repeat business if you are going to make any money in medicine. And medicine is big, big business. :wacko:
Last edited by Joker; February 24th, 2006 at 16:27.
Capitalism and the free market economy ideal is pretty ****ty, really.
"It fits like clothes made out of wasps!"
I think a few things need clarifying.
First, in order to "pass on" a genetic defect, that implies that these individuals need to reproduce. However, many people with large scale genetic defects a) don't survice to adulthood, and b) are either biologically infertile, or socially unable to reproduce even if they do reach adulthood. As one can imagine, even for in-vitro fertilization, they are not highly sought-after. So true transmission of a significant genetic defect from generation to generation is relatively rare.
Secondly, many "genetic" disorders are not truly inherited, but rather result from spontaneous mutations, transcription errors, or other mishaps during fetal development. For example, though there is a genetic defect in cystic fibrosis (specifically the delta- F508 gene), the overwhelming majority of cases are due to spontaneous mutations in this gene, rather than the hereditary transmission of said gene. So eliminating all people with CF would certainly not rid the planet of the disease.
As a third point, even in "hereditary" cases of disease, there are many sticking points to the idea of genocide of those groups. First, what about people with 1 copy of recessive genes, who themselves have no signs or symptoms of disease, and whose offspring with another "recessive" gene carry only a 25% chance of expressing the disease? Should we kill them off too? What about certain genetic "abnormalities" that confer a survival BENEFIT (i.e. africans with sickle-cell trait have a greater resistance to the malaria endemic in their area). Should they likewise be eliminated based solely on their genetic difference?
Finally, most genetic mutations are not clinically important, and even when they are, often they only indicate an increased RISK of disease, not an absolute certainty of developing the disease itself. If you eliminate those people (or refuse to treat them) based on their increased RISK of disease, then by corollary one would have to likewise cull those people who increase their risk through actions and/or behavior (smoking, obesity, etc.).
Hopefully this rather expansive text helps explain why they idea of culling the "abnormal" is not only unethical, but would not even solve the problem it purports to address. It is clearly in contradiction to the true nature of genetic disease.
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I agree that a few things need clarifying. I donâ€™t intend to start a longer debate on the subject of genetics itself, but I still would like to mention that I donâ€™t agree with RJSuperfreakyâ€™s assessment of the clinical importance of hereditary genetic disorders. I feel he is giving spontaneous mutations too much responsibility, forgetting the fact that genetic disorders can be inherited recessively as well as dominantly, and that even dominant disorders have varying penetrance in each generation and can therefore be overlooked in the parents of an affected child. Also, some disorders are linked to a specific gender and can therefore be passed on by successive generations of a single gender until being revealed at the birth of an affected child of the opposite gender.
It might be true that significant, high-penetrance, dominant genetic defects are not normally passed from one generation to the next (Huntington Chorea being only one of many exceptions from this general rule), but that doesnâ€™t mean that genetic disorders in general are not a large problem, because they are. Adding to that is the fact that most if not nearly all multifactorial disorders such as coronary heart disease, hypertension, stroke, and cancer all have a genetic component that needs to be considered too.
As for the illustrating example using the cystic fibrosis delta-508 gene I would also like to add that this defect is a recessively inherited disorder and that I have not been able to find any information indicating that spontaneous mutations should be the cause of this disorder, except for one site mentioning the risk of spontaneous mutation in this specific gene to be â€˜minuteâ€™. Cystic fibrosis is such a common disorder (1:2500) not because of a high rate of spontaneous mutation, but because there are so many carriers (1:25) of the recessive genes. Carriers are not affected themselves, but when two carriers meet there is a 25% risk of their child getting cystic fibrosis.If their children have one defect gene and are at risk of expressing the disorder, then it is not recessive but low-penetrance dominant. Recessive disorders require two defect genes to be expressed, whereas dominant disorders require only one, as is the case in this example of yours. I assume that you are talking about that when two carriers of a recessive disorder have children there is only 25% risk of their children receiving a defect gene from both parents and thereby be affected, but your explanation is faulty and rather confusing.Originally Posted by RJSuperfreakyThis is true for dominant disorders, which can have varying penetrance, and multifactorial disorders, which require more factors than just the defect gene(s), but not recessive disorders, which will always be expressed due to the affected person not having any healthy gene to alleviate the effect of the defect one. Also, recessive disorders will always be passed from an affected individual to his or her children, who will then become carriers or - if the other parent is a carrier of the same disorder â€“ be affected themselves.Originally Posted by RJSuperfreaky
The only way to stop a genetic disorder from spreading is to either prevent all affected and carriers from proliferating, or by ensuring that all children born of affected and carriers receive only healthy genes (this is not possible if one parent is affected by a recessive disorder, though.) I agree with you that the idea of culling carriers and affected is very unethical, but in vitro fertilisation could, if applied to all children of a single generation, entirely stop the spreading of hereditary genetic disorders, which is why I find it so important to inform about. Spontaneous mutations are always a risk, but the majority of genetic disorders are inheritable in some way or other. I rather feel we owe it to future generations to do all we can now to keep our children and their children healthy in the future.
"Girls are nice and cuddly on the outside, and freaky on the inside." ~ Lost Nemesis.
Is technology weakening the human race?
In a sense, yes. But only in terms of the outdated "survival of the fittest" way. Blood disorders and genetic abnormalities are being allowed to propogate, but that is not necessarily a bad thing. Quite a few genetic disorders and diseases do not show symptoms until, or after, puberty. This means that there is always a chance that it can be passed on before it is realised. Such is the case with Stephen Hawkins, possibly the most intelligent person on the planet.
Even then, there are developmental issues that are impossible to identify genetically. I was born with a congenital heart defect. Genetically I'm fine, and it would never have been picked up in any tests. Typically the only way this defect would have been identified, is by autopsy after the child died on the kindergarten playground aged 4-5. I was lucky and it was detected very early on, and it was "corrected" with surgery, but does that make me less "fit" than Jessie Ventura (old old wrestler) who can't think for himself, but can beat the daylights out of anyone who points that fact out?
Allergies I feel are a whole seperate matter, since there seems to be an environmental factor to their existance. If someone has never lived where there are nuts, does an allergy to nuts make them less likely to survive? (Why has an allergy to nuts become so common?)
It is impossible to place any kind of value on a life based on physical ability alone. By the same token however, it is impossible to place a value on life based solely on intellectual ability. Too many people would automatically be discounted if either was all important, or conversely, both were required to a high standard.
EDIT - I know, it's all over the place, I couldn't get my thoughts straight and sensible, but I hope I got my point across
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