PhilBiol317 Group Study Project: Is there merit in the raceethnicityculturegender based medical prac

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Phil/Biol317 Group Study ProjectIs there merit
in the race/ethnicity/culture/gender based
medical practices?
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Taylor, et.al. N Engl J Med. 2004 Nov
11351(20)2035-7. Combination of isosorbide
dinitrate and hydralazine in blacks with heart
failure.

• Background We examined whether a fixed dose of
  both isosorbide dinitrate and hydralazine
  provides additional benefit in blacks with
  advanced heart failure, a subgroup previously
  noted to have a favorable response to this
  therapy.
• Methods A total of 1050 black patients who had
  New York Heart Association class III or IV heart
  failure with dilated ventricles were randomly
  assigned to receive a fixed dose of isosorbide
  dinitrate plus hydralazine or placebo in addition
  to standard therapy for heart failure. The
  primary end point was a composite score made up
  of weighted values for death from any cause, a
  first hospitalization for heart failure, and
  change in the quality of life.
• Results The study was terminated early owing to a
  significantly higher mortality rate in the
  placebo group than in the group given isosorbide
  dinitrate plus hydralazine (10.2 percent vs. 6.2
  percent, P0.02). The mean primary composite
  score was significantly better in the group given
  isosorbide dinitrate plus hydralazine than in the
  placebo group (0.11.9 vs. 0.52.0, P0.01
  range of possible values, 6 to 2), as were its
  individual components (43 percent reduction in
  the rate of death from any cause hazard ratio,
  0.57 P0.01 33 percent relative reduction in
  the rate of first hospitalization for heart
  failure 16.4 percent vs. 22.4 percent, P0.001,
  and an improvement in the quality of life change
  in score, 5.620.6 vs. 2.721.2, with lower
  scores indicating better quality of life P0.02
  range of possible values, 0 to 105).
• Conclusions The addition of a fixed dose of
  isosorbide dinitrate plus hydralazine to standard
  therapy for heart failure including neurohormonal
  blockers is efficacious and increases survival
  among black patients with advanced heart failure.

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• Race-Based Medicine?
• On June 16, 2005, the FDA approved BiDil as a
  cardiovascular drug to be marketed exclusively to
  African-Americans.
• BiDil hydralazine and isosorbide dinitrate (H/I)
• BiDil was being marketed exclusively to
  African-American patients based on a higher
  efficacy of BiDil for their race or for targeted
  profits?

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What is Race The Power of Illusionhttp//www.pb
s.org/race/005_MeMyRaceAndI/005_00-home.htm

• 1. Race is a modern idea
• 2. Race has no genetic basis
• 3. Human subspecies don't exist
• 4. Skin color really is only skin deep
• 5. Most variation is within, not between,
  "races."
• 6. Slavery predates race
• 7. Race and freedom evolved together
• 8. Race justified social inequalities as natural
• 9. Race isn't biological, but racism is still
  real
• 10. Colorblindness will not end racism

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• Population landscape of the USA, 1990 2060

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A Theological Rationale for Diversity at Wheaton
Collegehttp//intra/Academic/ITIR/assessmentplan
s.htm

• Humans were created in the image of a triune God
  who exists eternally as Father, Son, and Holy
  Spirit. The one in whose image we are created
  establishes the basis for all human relations (Jn
  1720-23).
• God's first command to the human creatures was
  that they should fill and subdue the earth as
  God's representative caretakers (Gen
  128).Though initially Israel was to be God's
  chosen and holy people, from the beginning God
  made it clear to Abraham that all the families of
  the earth would be the recipients of his blessing.

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A Theological Rationale for Diversity at Wheaton
College

• But sin had intruded before the call to Abraham
  in humanity's desire to be like God (Gen
  31-7)strengthening our fallen tendencies to
  seek our own ways rather than God's and to serve
  ourselves rather than the needs of
  otherstendencies that often burrow their way
  into human systems and institutions, often as
  subtle or overt forms of racism, nationalism,
  cultural imperialism, and ethnocentrism (Eph
  612).
• The reversal of Babel (is) the prevision of a
  time in the New City when all peoples shall come
  to praise God (Rev 2124-26). The church's
  proclamation begins with the announcement that
  our justification comes through Jesus Christ
  alone. Therefore, we can stop attempting to
  justify ourselves in our efforts to establish our
  worth on something other than our new identity in
  Christ (Gal 328).

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A Theological Rationale for Diversity at Wheaton
College

• The church is to be a witness to the original
  fact that we cannot live and grow independently
  of one another and that our God-designated
  diversity is inseparable from Christian maturity
  (Eph 314-19, 411-16 1Cor 124-26). The church
  is to image God's character by showing no
  partiality and by responding to others as the
  brothers and sisters who they are (Deut 1017,
  1618 2Chron 197 Rom 211, Gal 26).
• Christians testify to the supernatural source
  of their unity by the manner in which they love
  one another (Jn 1334-35, 1723-26). The church
  point(s) the world to its future order (of
  Christs 2nd Coming in) which all Christians
  anticipate and the vision of which should guide
  us in our daily lived-out witness to the
  lordship, not of a culture, race, nation, or
  ideology, but of Jesus Christ.

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• There seems to be disparities in health and
  disease statistics amongst various ethnic and
  cultural groups. In addition, gender differences
  in health care have not been sufficiently
  explored.
• Recent outbreaks of global pandemics such as
  AIDS, SARS and the bird flu exasperate the need
  of developing public health policies and medical
  practices that can be effective across cultural
  and racial divides.
• The effective use of limited medical resources is
  a top priority in the 21st century.
• The traditional distrust between races and
  cultures made the effective use of available
  drugs against AIDS such as HAART (Highly Active
  AntiRetroviral Therapy) amongst American ethnic
  minorities as well in Third World countries not
  easily achievable.
• The emerging field of pharmocogenomics also needs
  attention. The newly completed Human Genome
  Project provides the genetic basis of variable
  drug response in individual people.
  Pharmacogenomics attempts to provide
  individualized drug therapy based on genetically
  determined variation in effectiveness and side
  effects.
• However, the question of whether there is a
  biological basis for race and ethnicity is not
  easily answered. Some of the disparities in
  disease or death rates in different racial/ethnic
  groups may be attributable more to socioeconomic
  factors than to genetics.
• The Human Genome Project thus far has not
  provided evidence to support the genetic basis of
  race.
• The preferential treatment of certain races have
  led to atrocities such as the slavery, genocide
  of the Native Americans, and internment of
  Japanese Americans during WWII in the US, the
  holocaust in Europe and genocides in Africa.

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• The students are to form groups of 3 to address
  the pros and cons of the race/ethnicity/culture/ge
  nder based medical practices. Half of the groups
  will affirm this practice while the other half
  will oppose it. The arguments presented should be
  based on sound scientific research and ethical
  principles.
• Each group will carry out appropriate research on
  this matter. Research should be not only on the
  progress of public interest over the recent
  years, but the contributions of the methodology
  and findings of science, philosophy, and
  theology. The research will result in a
  well-constructed position on whatever form of the
  issue is decided upon. Then the group will write
  an essay which develops the reasoning of merits
  and demerits of the outstanding positions and
  arrives at the establishment of the group
  position. A powerpoint presentation will be made
  to the class.
• Suggested length of the final paper
• 7-10 pages (minimum pages of double spaced
  typewritten paper with font size of 12 or
  smaller). Include literature cited. In this
  paper, you will not have to rehearse what you
  have already done in your group presentation.

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• Guidelines of Group Case Study Paper
• Suggested format of the group case study report
• Title
• Signatures (each group member should sign and
  indicate amount of contribution in percentage)
• I. Abbreviated background information
• Scientific advances relevant to your ethical
  argument
• Pros How the race/ethnicity/culture/gender based
  medical practices will benefit mankind.
• Cons How the race/ethnicity/culture/gender based
  medical practices may lead to further prejudice
  with no tangible benefits to mankind.
• II. Ethical position with its philosophical and
  theological justifications and Responses
• Identify your ethical position and supply
  philosophical justification for it. Respond to
  some of the points made by the other side. (You
  should have a record of those points in the
  handouts and notes you collected in class on
  presentation day. You can work with the brief
  remarks made in class in addition, each group
  will submit to the instructors on Friday in the
  week of presentation a statement of their
  positions and the major arguments. The
  instructors will forward this to all students so
  that they will have more to work with in their
  response.)
• III. Literature cited.
• A PowerPoint presentation incorporating all of
  the above will be part of your project.

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• Timeline and grade distribution of the project
  (completed topics 10, detailed outlines 10
  first draft 10, presentation 20, final paper
  50).
• (1) Completed topics for the integrative papers
  with key references followed by a one page
  synopsis of your developmental plans are due from
  each student in week 8. Students should make
  appointments to discuss their topics before week
  4.
• (2) Detailed outlines, (a), with step by step
  presentation of your arguments and bibliographies
  and (b), first drafts of the students papers are
  due 3 weeks and 1 week ahead of their class
  presentations respectively.