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Stem Cells, Building Blocks for Tissue Engineering

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Stem Cells, Building Blocks for Tissue Engineering – PowerPoint PPT presentation

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Title: Stem Cells, Building Blocks for Tissue Engineering


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Sarah Murnaghan
  • 10 yo F with cyctic fibrosis
  • Denied lung transplant with adult lungs
  • Would be eligible for adult lung if 12
  • 50 5 year survival with CF
  • Federal Court ruled Sarah should be placed on
    adult transplant list
  • First transplant failed, received second

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Anthony Stokes
  • 15 yo with heart failure, 6 mo prognosis
  • Childrens Healthcare of Atlanta declined to place
    him on heart transplant list due to failure to
    comply with medications
  • Poor grades, minor legal difficulties
  • Civil rights groups taking up cause

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Herbert and Catherine Schaible
  • Charged with murder in death of 8 month old who
    died of pneumonia
  • 2 yo son died in 2009 of untreated pneumonia,
    parents placed on probation, required to seek
    medical care
  • Members of First Century Gospel Church, believe
    in divine healing
  • If parents can choose abortion, can they choose
    to withhold medical care?

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Ethics and Professionalism
  • 34 year-old single woman, on public assistance,
    comes to you for IVF
  • Previous IVF resulted in six children, all living
    with her
  • What would you do?
  • Why?

10
Ethics and Professionalism
  • Richard L. Elliott, MD, PhD, FAPA
  • Professor and Director, Medical Ethics
  • Mercer University School of Medicine
  • Adjunct Professor
  • Mercer University School of Law

11
Ethics and Professionalism at MUSM Faculty
  • Richard L. Elliott, MD, PhD (Macon)
  • Room 62, East Hall, MUSM
  • Elliott_rl_at_mercer.edu
  • Martin H. Greenberg, MD (Savannah)
  • R. Stephen Williams, MD, MHSA (Macon)
  • Others

12
Ethics and Professionalism at MUSM Office of
Professional Practice
  • Medical ethics
  • Professionalism
  • Legal regulation
  • Malpractice, EMTALA, HIPAA, . . .
  • Health administration
  • Payment systems, accreditation, reform
  • Interest group

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Ethics and Professionalism at MUSM Curriculum
  • Orientation
  • Community Medicine I
  • Informed consent, confidentiality,
    professionalism
  • Community Medicine II
  • Research ethics, abuse of trainees,
    pharmaceutical industry malpractice
  • Clerkships
  • Internal medicine, pediatrics, ob-gyn, family
    medicine, surgery, EC
  • Senior papers and electives
  • Capstone

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What to do?
  • A child in an MVA is losing blood rapidly, mom
    refuses permission for transfusion based
    religious beliefs

15
What to do?
  • An HIV-positive man admits he is sexually active,
    states he cannot tell his fiancee his HIV status

16
What to do?
  • A patient comes repeatedly to the EC demanding
    opiates for headaches

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Medical Ethics Current Controversies
  • Use of embryonic stem cells is it OK to
    sacrifice embryos to save lives of adults?
  • Transplantation how do we establish priorities
    for recipient lists
  • Futility of care when can MDs pull the plug
    over the wishes of patient and family?
  • When can we override wishes of parents and treat
    children (e.g., JW)?
  • How do we handle performance enhancers?

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A helpful resource?
  • A faculty member provides a list of the answers
    to an upcoming test and tells you to let everyone
    know on your campus, but not to let the other
    campus know about the list.

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Is it cheating?
  • A first year student asks a second year student
    for advice regarding his upcoming MDE exam. She
    gives him a list of old exam questions and review
    sheets that will help you greatly. She states
    that you should keep it quiet when around
    faculty, because some have been disgruntled with
    old questions floating around, but that each
    class has done so in the past. She encourages
    you to pass the materials on to your friends.

22
Cant we be friends?
  • You are a woman third year student who studied in
    the company of a group of friends the first two
    years. During your first clerkship one of the
    group begins to make unwanted advances and,
    despite your insistence this can go no further,
    he persists and becomes aggressive.

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Its tough to make predictions.
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Especially about the future.
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Who will be disciplined by medical boards?
  • Greatest risk if disciplined during medical
    school
  • Drugs and alcohol
  • Who is your AIMS representative?
  • Reliability
  • Preparation, on time
  • Volunteering
  • Respect for colleagues

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Professionalism in non-clinical years
  • Be on time
  • Dress appropriately
  • Courtesy and respect for all
  • Preparation
  • Help your brothers and sisters
  • Academically
  • Substances, recreation, etc
  • Social media

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  • Between your first and second years of medical
    school, you do laboratory research at a hospital
    near your home. After a couple of months of hard
    work, you collate your data and write a draft
    paper for the faculty advisor to revise before
    submitting it for publication. After reviewing
    your draft and making many comments, you see that
    they have included the name of one of the
    second-year students, although he didnt have
    anything to do with your work. Afraid of
    angering him, you dont say anything. However, a
    few weeks later, you discover that your name has
    been added to a paper the other student has
    written with you were not involved with.

30
Financial Aid
  • A third year student receives the FAFSA packet in
    February of her second year, signing a form
    acknowledging that she received it. The Office
    of Financial Aid sends several reminder emails to
    the student that she needs to fill out the
    application. In the first week of her third
    year, her financial aid check is not at the
    bursars office. The student calls the Director
    of Financial Aid and yells at her saying that no
    one gave her the packet, she didnt get any
    emails reminding her, and demands a check

31
Im lonely
  • You are interested in a competitive specialty and
    you have heard that the best way to get in is to
    have a lot of research publications. A male
    faculty member has a reputation of having many
    students in his lab and many of them get
    published. One evening, he calls a female
    student and tells her that his wife is out of
    town, he is lonely, and he wants her to come over
    to keep him company.
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