Constitutional adjudication and standards of review under pressure from biological technologies.
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Biomedical subjects
Publications and source records attributed to M H Shapiro.
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There apparently is a genuine possibility that genetic and non-genetic mechanisms eventually will be able to significantly enhance human capabilities and traits generally. Examining this prospect from the standpoint of equality considerations is one useful way to inquire into the effects of such enhancement technologies. Because of the nature and limitations of competing ideas of equality, we are inevitably led to investigate a very broad range of issues. This Article considers matters of distribution and withholding of scarce enhancement resources and links different versions of equality to different modes of distribution. It briefly addresses the difficulties of defining "enhancement" and "trait" and links the idea of a "merit attribute" to that of a "resource attractor." The role of disorder-based justifications is related to equality considerations, as is the possibility of the reduction or "objectification" of persons arising from the use of enhancement resources. Risks of intensified and more entrenched forms of social stratification are outlined. The Article also considers whether the notion of merit can survive, and whether the stability of democratic institutions based on a one-person, one-vote standard is threatened by attitude shifts given the new technological prospects. It refers to John Stuart Mill's "plural voting" proposal to illustrate one challenge to equal-vote democracy.
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The analgesic effect of intramuscular ketorolac was assessed by double blind study in forty women presenting for day-case laparoscopic sterilisation. The patients were randomly allocated to receive either ketorolac 30 mg or saline by intramuscular injection immediately following induction of general anaesthesia. There was no statistically significant difference between the groups in pain scores, opioid requirements or incidence of nausea and vomiting in the postoperative period. In view of the potential side-effects of ketorolac, and the apparent lack of efficacy when used prophylactically, the routine use of the drug in this group of patients cannot be recommended.
Ion exposure chambers that have been designed and tested for use in biological and behavioral research with small animals are described in this report. The chambers exhibit an acceptable degree of uniformity in ion concentration, current density, and electric field within the exposure area. Gaseous by-products of corona discharge (O3 and NO2) have been measured and found to be less than .01 ppm and less than .1 ppm, respectively. Filtered air is fed to the individual exposure chambers, and temperature and humidity are well controlled. Noise due to corona and the air delivery system has been measured.
Diseases that cause malfunction of the sympathetic nervous system provide insight into how the sympathetic nerves normally modulate responses to stress. This paper discusses insight from a number of such diseases. Transection of the cervical spinal cord leads to autonomic dysreflexia. This syndrome causes episodic hypertension in quadriplegic patients from excess sympathetic activity reflexly activated by bowel or bladder distention. These patients lack cerebral control of spinal sympathetic reflexes. Radiotherapy to the neck can destroy the arterial baroreceptors that monitor blood pressure fluctuations. Patients who lack baroreceptors have exaggerated blood pressure responses to stress. They have episodes of hypertension and hypotension that cause headaches and dizziness. Diabetics and uremics often develop a peripheral sympathetic neuropathy. They have postural hypotension and diminished blood pressure responses to stress. They are often unable to tolerate heat, exercise, or fluid deprivation. Patients with heart failure deplete sympathetic neuronal norepinephrine stores. The continual stress of heart failure diminishes their ability to respond to further stresses such as standing upright or exercising. Patients with diseases of the sympathetic nervous system illustrate that everyday occurrences such as a change in posture or ambient temperature are stresses requiring a marked change in sympathetic nervous activity. Both physical and psychological stresses elicit large initial sympathetic neuronal responses that are subsequently damped by feedback inhibition from structures such as the baroreceptors. Damage to part of these feedback loops leads to exaggerated pressor responses to stress.