Conversion Therapy

Gender identity is a relevant topic for discussion more now than it has ever been.  It is very prevalent in today’s society with changes in laws and a push for equality among a divided country.  Our ethics topic is based in relation to gender identity, questioning the ethical legitimacy of conversion therapy for those who do not identify as heterosexual.  To first be able to attempt to answer this question, one must understand the current beliefs and research about how gender identity develops.  The sciences have generally found a difference in the hypothalamus between homo and heterosexuals.  Also, there has been a difference in specific cerebral portions of the brain.  Others have seen a correlation with left-handedness and homosexuality.  What’s the general consensus?  We cannot necessarily come to a conclusion of where gender sexuality--be it heterosexuality or non-heterosexuality--develops but we can say that research is showing it is not a choice.  Some people may in fact choose to be homosexual, but more often than not, we find that it is a biological development.

Regardless of how gender development may occur, people deal with bigger issues than trying to figure out with what they identify.  There are so many cultural pressures--societal, religious, family, peer, school, government, and more--that dictate what is normal and acceptable.  The ultimate question is not converting all non-heterosexuals to heterosexuals; the ultimate question is: Is it our job to help “fix” these people to what is culturally normal and acceptable, or is it to help these people accept who they are and allow them to live their lives to the fullest?  How much is someone identifying as a non-heterosexual really going to affect your life?  - written by students

Sources read before class:

http://www.huffingtonpost.com/entry/realities-of-conversion-therapy_us_582b6cf2e4b01d8a014aea66

https://www.lifesitenews.com/news/ex-gay-homosexuality-is-just-another-human-brokenness

Other sources used:

Pinel JP.  Basics of biopsychology.  New York (NY): Pearson; 2007.

Zgourides GD.  Human sexuality: contemporary perspectives.  New York (NY): HarperCollins College Publishers; 1996.

Recommended sources for further engagement/Bibliography

APA:

http://www.apa.org/pi/lgbt/resources/just-the-facts.aspx

http://www.apa.org/news/press/releases/2015/04/therapies-sexual-orientation.aspx

Trump:

https://www.washingtonpost.com/news/to-your-health/wp/2016/11/19/gays-can-be-reformed-just-like-arsonists-trumps-new-domestic-policy-adviser-has-said/?utm_term=.20677faea316

https://www.whitehouse.gov/the-press-office/2017/01/31/president-donald-j-trump-will-continue-enforce-executive-order

https://www.washingtonpost.com/news/to-your-health/wp/2016/11/19/gays-can-be-reformed-just-like-arsonists-trumps-new-domestic-policy-adviser-has-said/?utm_term=.20677faea316

http://www.politifact.com/california/statements/2016/dec/02/gavin-newsom/pences-support-conversion-therapy-not-settled-matt/

https://www.washingtonpost.com/news/to-your-health/wp/2016/11/19/gays-can-be-reformed-just-like-arsonists-trumps-new-domestic-policy-adviser-has-said/?utm_term=.20677faea316

Obama Administration:

https://www.nytimes.com/2015/04/09/us/politics/obama-to-call-for-end-to-conversion-therapies-for-gay-and-transgender-youth.html?_r=0

Gayness is a choice (Cynthia Nixon):

http://www.slate.com/blogs/xx_factor/2012/01/23/is_cynthia_nixon_s_sexuality_really_a_choice_.html?wpisrc=slate_river

ELCA:

https://www.elca.org/JLE/Articles/742

Evolution:

http://www.bbc.com/news/magazine-26089486

Stem Cells

Using stem cells for research and potential treatments options become ethically challenging due to the techniques used to acquire these cells. The ethical dilemma most frequently explored when discussing the use of stem cells is the use of human embryonic stem cells as these must be acquired from embryos and therefore the embryos cannot be implanted into the uterus for growth and development to become a human. Similar to ethical considerations with abortion, the determination of when a life begins becomes an important topic within this conversation. The central argument that destroying embryos to use stem cells for research or treatments relies on the idea that the proliferation of cells occurring within an embryo constitutes, at least, a being that has the potential for productive human life. The issue with this argument lies in defining what is truly a “productive human life.” Another ethical concern regarding the use of human embryos entails the use of discarded embryos following in-vitro fertilization. Those who support using these embryos as a viable option for collecting stem cells posit that without the proper environment, implanted in the uterus, these embryos have no chance at surviving and developing. - written by students

Aside from the use of embryonic stem cells, other types of stem cells have also been and are currently being explored to determine their usefulness and procedural aspects in treatment conditions. Recent research and discoveries, along with an example of a well understood stem cell treatment - bone marrow transplant, are reviewed within the powerpoint found here.

An overview video on the topic of stem cell treatment and its possibilities can be found here.

Source read before coming to class:

Ethics of Stem Cell Research. Stanford Encyclopedia of Philosophy.

Recommended sources for future engagement

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726839/

http://learn.genetics.utah.edu/content/stemcells/scissues/

http://www.bbsrc.ac.uk/documents/1007-stem-cell-resourse-edition3-pdf/

Consciousness, Pain, and End of Life Decisions

End of life and quality of life decisions have great relevance to the field of neuroethics as impacted individuals often present alterations or reductions in mental capacity or nerve-mediated physical capacity. Two neuroscientific features that are important to consider in maintenance or withdrawal of life-sustaining treatment is the perceived consciousness and pain of the patient. While technologies such as neuroimaging, electrophysiology, and specialized devices claim to quantify these parameters, much research still needs to be done to ensure that consciousness and pain are depicted accurately in appropriate brain regions or circuits, especially for those who lack speech abilities. Quality of life itself surprisingly increases in self-reports from disabled or severely injured patients, representing a disability paradox that brings into question how quality of life is itself defined. Finally, conflicts of who has the responsibility to dictate these end of life or quality of life decisions (family, physicians, or legislature) also arise and have not come to a settled consensus.

As many people choose career paths that fit under the health care profession, it seems beneficial to understand the ethical standpoint that future careers take when it comes to pain and consciousness pertaining to quality of life and end of life decisions. Though not all health care professions deal with end of life decisions as often as others, quality of life is a very important point when it comes to health care treatment. Specifically, there seems to be a discrepancy between health care occupations when it comes to the perception of pain for patients whose consciousness may be impaired. This discrepancy can lead to disagreements on the ethical standpoint about pain and consciousness for those who have consciousness disorders, making an established code of procedure difficult to follow through with.  - written by students

Sources read before this class:

Can they suffer? The ethical priority of quality of life research in disorders of consciousness. By L.S.M. Johnson in Neuroethics. 2013.

Recommended sources for further engagement:

1. Pain perception in disorders of consciousness: Neuroscience, clinical care, andethics in dialogue. By A. Demertzi et al. in Neuroethics. 2013.  This article provides some of the background data we mentioned during class, such as ageism in medication administration and the roles of religion and specific healthcare profession in influencing end of life opinions.

2. Coma: Detecting signs of consciousness in severely brain injured patientsrecovering from coma. By C. Schnakers, J. Giacino, & S. Laureys in International Encyclopedia of Rehabilitation. 2010.

Contains good definitions regarding the different types of consciousness disorders and types of behavioral assessments that can be done to help with diagnosis. 

3. Slowing Down Brain Is Still Fraught With Risk. By Ceci Connolly in the Washington Post. 2006. This article discusses the questions that still exist regarding the safety of medically induced comas and suggests alternative treatments such as hypothermia and craniectomy to reduce brain injury.

4. “The locked-in syndrome”: Can it be unlocked? By Kunal Khanna, Ajit Verma, & Bella Richard in Journal of Clinical Gerontology and Geriatrics. 2011.  Demonstrates the format of a AEIOU alphabet board used in eye scanning communication for ALS patients in addition to other techniques such electromyographical (EMG) technology, which is used by theoretical physicist Stephen Hawking.

Popular books or movies that address the topic:

1.  Mar Adentro (“The Sea Inside”) (2004) - A Spanish drama starring Javier Bardem that portrays the real-life story of Ramon Sampedro who fought for the right to end his life for 28 years after a diving incident left him paralyzed from the neck down.

2. Me Before You (book or movie) (2012, 2016) - A romantic novel about a girl who takes a job working for Will Traynor, who is bound to a wheelchair after an accident. The book tells the story about the two’s relationship and the choices Will makes based on his paralysis condition. Made into a major motion picture in 2016.

3. The Diving Bell and the Butterfly (book or adapted movie) (1997, 2007) - A memoir of the editor-in-chief of French Elle magazine, Jean-Dominique Bauby, who describes what life is like in locked-in syndrome following a massive stroke.