SusanLai

KellyBryce
HamzaSaleem
ChaquinnCook

Topic:Genetictestsshouldnotbeperformedoncertaingroupofpeople

Statement1:

Genetictestingshouldnotbeperformedonspecificgroupsofpeoplebecause
anyonecandevelopadiseaseovertime,notjustspecificgroupsofpeople.
Ethicaltheory/principle:
Utilitarianism,becausetestingtheentirepopulationleadstothe
greatestbenefitforthegreatestnumberofpeople.
QuoteA:
Anumberofstateschoseatvarioustimestoscreenonlysomesubsetofinfants,some
testingonlyblackinfants,othersonlynonwhiteinfants.Problems,notsurprisingly,followed.
Affectedchildrenwhowerenotscreened,ofcourse,weremissed.
Summary:
Ifsicklecelldiseaseisonlytestedinsubgroupsofinfants,manychildren
whohavethediseasewillbemissedandsubsequentlynotgetanymedicalcare.
Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.
QuoteB:
"Therearenoracesbutindividualsthatsometimesaremorerelatedtoeach[other]
than[to]others,"hesaid."Ifyouseeitthatwaythenalldatawillmakemoresense.Tryingtofit
groupsofpeopleinto"races"wasbiologicallyinaccurateinthefirstplace.
Summary:
Doingtestsandscreeningsonpeoplejustbecauseoftheirskincolordoesn't
meantheothergroupofpeopleofadifferentskincolordonthavethesamedisease.
Source:
Loria,Kevin."RaceAndEthnicityHaveNoRealBiologicalMeaning".
Tech
Insider
.N.p.,2016.Web.28Feb.2016.
QuoteC:
Oneexplanationproposedtoexplainthedifferentratesofhypertensionanddiabetes
inblackAfricansandblackAmericansisthatnewenvironmentsencounteredintheAfrican
diasporatriggeredexpressionofcertaingeneticvariationsquiescentinAfrica.Evenifthis
explanationiscorrect,theheterogeneityandvariabilityoftheenvironmentsencounteredmakeit
unlikelythatthedirectionofthistriggeringwasnearlyalwaystoconferonblacksillhealth.
Summary:
Makingitknownthatneighborhoodsandenvironmentsarecausinghealth
problemsforblacksdoesn'tmeanthatsomeotherracesdon'tliveinthesameconditions
orworse.
Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.

Statement2:

Genetictestingshouldnotbeperformedonspecificgroupsofpeoplebecauseit
willgivepeopleareasontocategorizeindividualsintocertaingroups,whichwillleadto
discriminationandracialissues.
Ethicaltheory/principle:
Kantianismbecausejudgingpeopleprimarilybasedontheirraceis
morallywrong.
QuoteA:
SeveralstatesmandatedscreeningAfricanAmericansforthedisease[sicklecell].
Thishadtwounfortunateeffects.Thefirstwasanincreaseinactsofdiscriminationby
government,insurers,andemployersagainstpersonsafflictedwiththediseases,aswellas

againstpersonswhoweremerelycarriersofthetraits.Thesecondwasatendencytoregard
sicklecellasablackdisease.
Summary:
BecausesicklecelldiseaseswasprominentwithpeopleofAfricandescent,it
hadbeenlabeledasablackdisease,whichleaddiscriminationagainstpeoplewill
Africantraits.
Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.
QuoteB:
Dependingonnumerousfactors,suchasthenatureofthediseasethatissoughttobe
identifiedorprevented,howthediseaseiscontracted,andthenatureofthetargetedgroup,the
programmaycausethegrouptobecomestigmatizedorincreasealreadyexistingstigma.
Summary:
Programsinvolvinggenetictestingmaymakegroupsofpeoplefeel
singledout,orcausethegrouptodevelopanunwantedreputation.
Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.
QuoteC:
Personswhoqualifyforgenetictestingmaybelieveitismoredifficulttoobtain
insurancebecauseofthetestingorareafraidtochangejobsbecauseoffearoflosinghealth
insurance.SomepersonsatriskforHDhavebeenreluctanttodiscussgenetictestingwiththeir
healthcareproviderbecauseoffearsthatthisinformationmayberevealedtotheirhealth
insurancecarrier.
Summary:
Manypeopleareafraidthatiftheytestpositiveforaseriousdisease,they
willlosetheirhealthinsuranceandbecomestigmatizedasdisabledorunqualified.
Source:
Lea,D.H.,Williams,J.,&Donahue,P.(2005).EthicalIssuesinGenetic
Testing.
JournalofMidwifery&WomensHealth
,
50
(3),234240.

Statement3:

Genetictestingshouldnotbeperformedonspecificgroupsofpeoplebecauseit
canleadthemtobelievethattheyarebeingcategorizedorperceivednegativelybyothers.Itcan
alsohurtthatspecificindividual'sselfimagewhichcancausethemtothinkofthemselvesasless
thanornotgoodenoughaswellashurttheirrelationswithothers.
Ethicaltheory/principle:
Kantianismbecausetheultimatebeliefistoallowotherstobeas
happyaspossible.Thisisdonethroughmoralsandethicsbecauseitiswrongtoknowingly
harmingotherspsychologically.
QuoteA:
Forinstance,supposeanindividualhasaknownhypersensitivitytoan
environmentalexposurethatisverycommonanddifficulttoavoidexposuretolowlevelof
directsunlight,forexample.Anindividualmaybeabletoavoidsuchadverseexposure,butonly
bytakingextraordinarymeasures.Althoughpreventiveinterventionsareavailable,itisunclear
howweshouldviewthoseindividualswhofailtotakesuchextraordinarymeasurestolower
theirriskofdisease.Insures,forexample,mayclaimthatindividualswhodonotminimizetheir
exposuretotheseagentsareresponsibleforanysubsequentillnessbecausetheyknowingly
placedthemselvesatrisk.(p.372)
Summary:
Theinitialimpressionofapproachingsomeoneinordertoparticipateina
studybasedsolelyonthembelongingtoagroupcancausethemtoassumethatitis
wrongtobefromthatcultureorbackgroundorwhateveritmaybe.Thiscanleadtoa
negativeselfimagingbecausetheyunconsciouslymadethosedecisionsandnowarefor
beingjudgedforthem.

 Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.
QuoteB:
Itmustberecognizedthatgeneticconditionswillbeexperiencedbyindividuals
withinawebofsocialrelations.Wefrequentlydiscussthesocialimplicationsofhavinga
disfavoredtraitintermsofstigma,butthereisfarmoretothesocialriskofageneticillnessor
predispositiontogeneticillnessthanthepsychologicalexperienceofaspoiledidentity.Social
riskinhealthmaybedefinedasthedangerthatanindividualwillbesociallyoreconomically
penalizedshouldhe/shebecomeidentifiedwithanexpensive,disfavoredorfearedmedical
conditions.Socialriskhastwodistinctcomponents,eachofwhichimposesitsowncostsona
healthmeasure:(1)thethreati.e.,attitudesandbehaviorthatcauseorthreatensocialharm
and(2)theperceptionofrisk,i.e.,theattitudesandbeliefsaboutthethreatamongthosewho
areinsomewaytiedtothetraitordisease
Summary:
Apersonmayfacestigmaandsocialharm,suchasdiscriminationfrombeing
associatedtoanillnessbecauseofhis/herconnectiontoaspecificgroupwhentheperson
maynotevenhavetheillness.
Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.
QuoteC:
Otherlongtermconsiderationsrelatetoincreasedemphasisonthegeneticcausesof
disease.Thistrend,whichhasbeendescribedasthegeneticizationofdisease,couldfosterthe
beliefthatsocialproblemsaretheprimaryresultofgeneticcauses.Thisreductionofsocial
problemstobiologicalproblemscouldchangehowwethinkaboutsocialpriorities.(p.373)
Summary:
Categorizinggroupsofpeopleinordertoperformtestsonthemmaylead
themtotalkaboutissuesthathadneverbeenbroughtupbefore,whichcandisruptsocial
relationsbetweenfamilymembersandlovedones.Thisrelatesbacktothemapplying
thesestereotypesandfindingstothemselves.
Source:
Bayer,R.,&Beauchamp,D.E.(2007).
PublicHealthEthics:Theory,Policy,
andPractice
.NewYork:OxfordUniversityPress.

TASKS:

1.Readingsfrom
PublicHealthEthics
(thatbluebookwehadtobuy)
!!Due:Tuesday,Feb23

Introduction
(pages351354)
EVERYONE

22.GeneticScreeningfromaPublicHealthPerspective
(pages357365)
SUSAN

23.EnvironmentalGenomeProject
(pages369374)
HAMZA

24.ComplexRelationshipsofGenetics,Groups,&Health
(pages377387)
KELLY

25.

GeneticResearchandHealthDisparities
(pages391397)
CHAQUINN

Whenreading,note...

Noteany
mainpoints/evidence
thatbestfillunderourtopic

Statement1:
Avoidcertaindiseases

Statement2:
Discrimination/raceissues

Statement3:
Socialrisks

Noteimportant
quotes

thatcouldbeusedforthedebatebrief(rememberthatasagroup,weneed3quotesperstatement)

Noteofanypointsthatcanbeusedasa
rebuttal
againsttheside

2.Research
doresearchonyourassignedstatement+rebuttals

Statement1Chaquinn/Kelly
Statement2Susan/Kelly
Statement3Susan/Hamza

Rebuttal
EVERYONE

3.Debatebrief
!!Due:Thursday,Feb25

Statement1
CHAQUINN

Ethicaltheory/principle
KELLY

QuoteA/Summary/Source
KELLY

QuoteB/Summary/Source
CHAQUINN

QuoteC/Summary/Source
CHAQUINN

Statement2
SUSAN

Ethicaltheory/principle
SUSAN

QuoteA/Summary/Source
SUSAN

QuoteB/Summary/Source
KELLY

QuoteC/Summary/Source
KELLY

Statement3
HAMZA

Ethicaltheory/principle
HAMZA

QuoteA/Summary/Source
HAMZA

QuoteB/Summary/Source
SUSAN

QuoteC/Summary/Source
HAMZA

4.Presentation

OpeningStatements(5min)
Chaquinn
stateourposition
Chaquinn
statement1
Susan
statement2
Hamza
statement3
Susan
statement3
Hamza
statement3

Rebuttal(3min)
Everyone
Everyonecomeupwithrebuttals
Summary(3min)
1minaboutopposingview
2minaboutwhyourviewisbetter
Duringdebate,thinkofcounterargumentstocounterwhattheysaidonus
Kelly
Chaquinn

5.Meeting
rundebateoverdebate
!!When:Saturday,Feb27
!!Where:PSUlibrary(2ndfloor)
!!Time:

Idealsforrebuttal:


Costefficient

SUSAN
Whattheymightsay:
Genetictestingonspecificgroupsofpeoplewillsave
moneybecausenoresourceswillbewasted
WhatIllsay:
Wrong.Anyonecandevelopadiseaseovertime,soifnotdetected
atanearlystage,itcancostthepeople(orinsurance)tonsofmoneyinthefuture
Evidence:Breastcancer
Whattheymightsay:
Somegeneticdiseasesarebasedsolelyon
theparentsbeingcarriers,anddonotdevelopovertime.
KELLY
WhatIllsay:
Manygenerationscanpasswithoutaperson
knowingtheyareacarrier,andsomepeoplemaynotknowthe
extentoftheirfamilyhistory.
Testsubjects

SUSAN
EverythingiswrittenonmypersonalGoogleDoc
Repetitionandpatterns
HAMZA
Whattheymightsay:
Withoutmoreinformationonanindividual'sgenomeand
pastenvironmentalexposures,thedetectionofsuchpolymorphismisofuncertain
valueinpredictingfuturedisease.(page.370)Thisiswhyitisimportantto
categorizegroupsofpeopleandapplythesestereotypes.
WhatI'llSay:
Tosaythataperson'sentirehealthhistorycanbedeterminedby
lookingatthefindingsofanotherwithoutconsideringenvironmentaleffectsdoes
dotreallypaintaclearpictureofhowtotreatthatindividual.Evenifthegenetic
andenvironmentalfactorsdidlineupaccordingly,therethenisthisissueof
assumingisisokaytotaketheproperstepstotreattheperson.Thisisaproblem
becauseofinformedconsentandhownoteveryoneisokaywithbeingtestedon
ortreated.
Notenoughresources
SUSAN
and
KELLY
Whattheymightsay:
Theyarenotenoughresourcestotesteveryone,soits
besttousethelimitedresourcesonspecificgroupsofpeoplewhohaveahigher
riskofdevelopingthedisease.
Whatwellsay:
Ifgenetictestingwasmoreprioritizedinthehealthindustry,
thentherearemoreresourcesmadeavailablesincetherewillbemoremoney
beingputintoit.
Evidence:
Accordingtonlm.nih.gov,dependingonthetypeofgenetic
test,thecostcanrangefromunder$100upto$2000.Andforinfants,the
costcanrangefrom$10to$60perinfant.