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Biomedical subjects

Joseph G Schenker

Publications and source records attributed to Joseph G Schenker.

11 recordsLinked to original sources
PubMed2005

Ethical consideration of intentioned preimplantation genetic diagnosis to enable future tissue transplantation.

Recently, a case was presented where a couple with one normal child requested preimplantation genetic diagnosis (PGD) with human leukocyte antigen (HLA) typing in order to conceive children who could serve as mutual donors for future transplantations if needed. While PGD for medical reasons is well defined and accepted, application for non-medical conditions is less obvious and still in debate. The present case calls to further extend the indications for PGD and raises a moral question as to whether to allow such intentioned treatment. Although it seems that all siblings might benefit from the procedure, when weighing the risks benefits and the ethical issues included in performing intentioned PGD, it seems that the procedure harbours risks and ethical issues that outweigh the benefit it offers. Therefore, it is time to constrain the slippery slope and state that intentioned PGD for conceiving children who might serve as siblings for mutual tissue donations should be declined.

Directed Tissue Donation↗
PubMed2005

Cesarean section upon request: is it appropriate for everybody?

The request for cesarean section without medical indication has become one of the dilemmas faced by the obstetrician. Most recent studies that compare vaginal delivery with elective cesarean section find them equally safe. This comparison is lacking in the option of trial of labor, which may result in an assisted vaginal delivery or intrapartum cesarean section, both with increased morbidity and mortality for the mother and newborn. When considering elective cesarean section, the obstetrician has to take into account improved anesthetic techniques and the decrease in morbidity and mortality after cesarean section with the trend toward patient autonomy to decide on her own treatment. On the other hand, the obstetrician has to advise his patient of the best treatment with respect to possible complications in future pregnancies, such as placental complications and increased morbidity and mortality resulting from repeated cesarean sections. The advantage of cesarean section for pelvic floor protection does not exist after three consecutive cesarean sections and equals the rate of urinary incontinence after consecutive three vaginal deliveries. In countries such as ours, where most women wish for several children, the risk-benefit balance is toward repeated spontaneous vaginal deliveries.

Anal Canal↗
PubMed2003

Codes of perinatal ethics: an international perspective.

The research on different aspects of perinatal medicine offers valuable avenues into developmental biology and medicine that could markedly improve therapy of the pregnant patient and premature and newborn babies. Research with all sources of human cell stems should be supported to provide new therapeutic modalities. This research should be regulated, peer reviewed, and ethically controlled. The range of ethical questions raised by new scientific achievements in the life science, and methods of taking care of women's health especially, have been debated by international political and professional bodies. Biomedical ethical issues, guidelines, principles, and regulations cut across national boundaries and often have universal implications. Although cultures differ, certain values are common to all. In this context, the most important value is respect for human dignity, and this should not be negotiable. The establishment of international and interdisciplinary forums in which scientists and lay people can exchange views on topics of immediate concern, unhampered by administrative, political, or other considerations, was needed. They are intended especially for the discussion of the scientific and technical bases of advances in biology and medicine and other related areas and their social, economic, ethical, administrative, and legal implications. Commissions appointed by institutions, governments, and international bodies serve to alleviate the medical profession from making ethical decisions and to protect human subjects from any harm. The deliberations of these committees are usually followed by guidelines of operation, which in many cases have become abiding law. For these committees to be of full advantage, they must convene promptly as issues arise so as not to delay medical advances from being implemented.

Abortion, Induced↗
PubMed2003

Ethical aspects of advanced reproductive technologies.

The progress achieved during the last 25 years in the assisted reproductive technology field has been phenomenal. Many countries currently practice genetic material donation, human embryo cryopreservation, selective embryo reduction, preimplantation genetic diagnosis, and surrogacy. While embryo research and therapeutic cloning are carried out only in a few centers, thus far human cloning has been universally condemned. Nonetheless, the rapid evolution and progress of these various techniques of assisted reproduction has opened a Pandora's box of ethical issues that must be urgently addressed.

Adult↗
PubMed2002

Gender selection: cultural and religious perspectives.

OBJECTIVE: To review the current developments in the field of preconceptual sex selection and to discuss the cultural and religious perspectives as that accompany the scientific progress. DESIGN: A survey of the major publications in Judaism, Christianity and Islam regarding the issue of gender selection. Examination of current methods of preconceptual gender selection revealed that in vivo methods such as timing of intercourse, the use of ovulation induction medications, and artificial insemination do not appear to affect the sex ratio to a clinically significant degree. In vitro separation of X- and Y-bearing spermatozoa by gradient techniques have been reported to alter significantly the sex ratio at birth. However, these trials were not controlled, and molecular biological techniques could not validate that these methods indeed change the Y- to X bearing spermatozoa ratio sufficiently for clinical use. Nevertheless recent scientific advances have made highly reliable preconceptual sex selection possible by using preimplantation diagnosis (PGD) or sperm separation by flow cytometry combined with AIH or IVF. At present, these methods have been used to avoid sex-linked disorders. Both involve the invasive procedure of IVF and thus are held by most as inappropriate for nonmedical indications. However, improvement in flow cytometry output of sexed spermatozoa might provide in the near future sufficient sorted gametes for artificial insemination. It may be that in the near future, an improvement in flow cytometry output of sexed spermatozoa will provide sufficient sorted gametes for artificial insemination. In such a case, the medical community will be forced to take a stand, whether this reliable noninvasive method of sexing will be allowed for social purposes and even if the practice of PGD should be allowed for nonmedical indications. CONCLUSION: The requirement for a man to procreate by having a minimum of two children-a boy and a girl-is obligatory according to Jewish law. According to both schools, Beit Shamai and Beit Hillel, in order to fulfill the obligation of procreation at least one son is required. Therefore the application of sex preselection for nonmedical indications may by of practical importance using the method of sperm separation or sex selection of pre-embryo by PGD. According to Christian view, especially the one of the Catholic Church, gender preselection even for medical indications is forbidden. Islamic legal viewpoint is that fetal sex selection is lawful when it is practiced on an individual basis, to fulfill the wish of a married couple to have a boy or a girl through available medical means.

Christianity↗
PubMedDate not supplied

Maternal mortality following diagnostic 2nd-trimester amniocentesis.

We present 2 cases of maternal mortality after transabdominal amniocentesis performed during the 2nd trimester of pregnancy. In both these cases, blood cultures revealed Escherichia coli. Broad-spectrum intravenous antibiotic treatment started immediately after admission to the hospital did not change the rapid progression of the disease. Despite evacuation of the uterus within <10 h from the diagnosis of septic abortion and transfer to the intensive care units to treat multiorgan failure, these patients died. Septic abortion and septic shock following transabdominal amniocentesis are very rare; however, they carry a serious risk to the patients' life. The combination of fever and leukopenia several days after amniocentesis should alert the physician to the evolution of sepsis. Because of the risk involved, information given to the patient prior to amniocentesis should refer to possible fetal complications and to the remote possibility of maternal risks as well.

Adult↗