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Charon, Rita. and Montello, Martha.(editors), Stories matter: the role of narrative in medical ethics |
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Coates, Joseph F., Treatment of Disease in the 21st Century- Toward the Manipulatible Human/the Human as a Building Block |
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The reality must be faced squarely that we are the first species to be able to directly intervene in shaping its own evolution. That Lamarckian capability will be uniquely ours, and it will effectively be irrepressible. Our choice is not yes or no. Our choice is to intelligently or stupidly manage that capability.
In the last 50 years, research has established the following:
- All heritable characteristics of living things are carried by a class of chemicals called deoxyribonucleic acid [DNA].
- This is a long chain made up of basically four components, which one can consider as A, B, C, and D.
- Those components comprise a code.
- The code forms units, which are called genes, which represent the heritable characteristics of the organism.
That code has been deciphered. It leads, in the egg, to the production of proteins. Those special proteins are catalysts, or more properly, enzymes, which working with the material in the immediate environment proceed to restructure those materials into the organism that the DNA is programmed to produce.
- We have learned to synthesize DNA.
- We have developed means for taking DNA apart, for putting it back together, and for combining synthetic DNA with natural DNA.
- We have learned that we can take DNA from any organism and put it in any other organism, and if circumstances permit the resulting organism will manifest the newly transferred characteristics.
- In brief, we have developed a technology of DNA.
About 4,500 human diseases and disorders are genetically based. At the one extreme is Huntington's disease, formerly called Huntington's chorea, which normally strikes its victim in the fifth decade. Basically, mental functions are lost, physical functions degrade, and over a period of several years the person dies a thoroughly miserable death, miserable for himself or herself and for the people in care and attendance. That is destiny implicit in that gene. There are no if, ands, or buts. If you carry the gene and live long enough, you will develop the disease.
On the other extreme, consider tuberculosis. There is no human gene for tuberculosis, but there are genes that make us more or less resistant. The likelihood of getting tuberculosis is probabilistic. All of the thousands of diseases and disorders fall somewhere on a spectrum from absolute certainty to probabilism.
The Human Genome Project, which is the most important biologic project now under way, had its origins in medical concerns and has consequently, been primarily focused on diseases and disorders. Its goal is to create the first map of all of the human genes, which are collectively known as a genome. Genome refers to both the collective genes of an individual and the collective genes of a species. With that information we should be in a better position to identify and relate the structure of DNA to specific diseases and susceptibilities. It is virtually daily news that a connection has been made between some disease and its genetic base. Six percent of breast cancer, X% of disease Y, unequivocal location of gene for disease Z, and so on.（參閱網址） |
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