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Biomedical subjects

Timothy F Murphy

Publications and source records attributed to Timothy F Murphy.

69 records · Page 4Linked to original sources
PubMed2002

Chronic obstructive pulmonary disease: role of bacteria and guide to antibacterial selection in the older patient.

Chronic obstructive pulmonary disease (COPD) is a common problem in the elderly. The disease is characterised by intermittent worsening of symptoms and these episodes are called acute exacerbations. The best estimate, based on several lines of evidence, is that approximately half of all exacerbations are caused by bacteria. These lines of evidence include studies of lower respiratory tract bacteriology during exacerbations, correlation of airways' inflammation with results of sputum cultures during exacerbations, analysis of immune responses to bacterial pathogens, and the observation in randomised, prospective, placebo-controlled trials that antibacterial therapy is of benefit. The most important bacterial causes of exacerbations of COPD are nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and Chlamydia pneumoniae. In approaching the elderly patient with an exacerbation, it is useful to consider the severity of the exacerbation based on three cardinal symptoms: increased sputum volume, increased sputum purulence and increased dyspnoea compared with baseline. Patients experiencing moderate (two symptoms) or severe (all three symptoms) exacerbations benefit from antibacterial therapy. Consideration of underlying host factors allows for a rational choice of antibacterial agent. Patients are considered to have 'simple COPD' or 'complicated COPD' based on: (i) the severity of underlying lung disease; (ii) the frequency of exacerbations; and (iii) the presence of comorbid conditions. It is proposed that patients with simple COPD are treated with doxycycline, a newer macrolide, or an extended-spectrum oral cephalosporin; and patients with complicated COPD are treated with amoxicillin/clavulanate or a fluoroquinolone. The major goals of antibacterial therapy for exacerbations of COPD are acceleration of symptom resolution and prevention of the complications of exacerbation.

Aged↗
PubMed1995

Sperm harvesting and post-mortem fatherhood.

The motives and consequences of harvesting sperm from brain dead males for the purpose of effecting post mortem fatherhood are examined. I argue that sperm harvesting and post mortem fatherhood raise no harms of a magnitude that would justify forbidding the practice outright. Dead men are not obviously harmed by the practice; children need not be harmed by this kind of birth; and the practice enlarges rather than diminishes the reproductive choices of surviving partners. Certain ethical and legal issues nevertheless require attention. As a matter of consistency with other harvesting protocols, there ought to be a mechanism for respecting the wishes of men who when alive do not wish to become fathers post mortem. Mechanisms governing entitlement to harvest and use sperm will also be required. I note that the law is unlikely to recognize the paternity of children born from harvested sperm, though there may be reasons to recognize that paternity in some instances.

Advance Directives↗
PubMed1993

The ethics of HIV testing by physicians.

This essay argues that informed consent remains desirable for both moral and practical reasons in regard to HIV testing by physicians. At the very least, respect for consent preserves patient control over treatment and affords the opportunity for education about the nature of HIV-related disorders. Nevertheless, there do appear to be circumstances under which involuntary testing may occur especially when health care workers may have become occupationally exposed to risk of HIV infection. To eliminate conflicts between health workers and their patients, however, it is desirable to work to eliminate the stigmatizing and discriminatory effects of HIV infection that can induce persons to resist testing.

AIDS Serodiagnosis↗
PubMed1993

Lesbian motherhood and genetic choices.

Rhonda, a physician, and Clara, a registered nurse, have been lovers for the past 7 years. Both women are in their 30s, in good health, and financially stable. Clara has contacted Dr. Robinson, a highly regarded obstetrician and geneticist, with an unusual request. Clara is seeking to become pregnant by means of in vitro fertilization (IVF) with an embryo transfer (ET) technology. She proposes being implanted with ova harvested from her partner, Rhonda, and fertilized in vitro with donor sperm from a local medical-school sperm bank. Dr. Robinson explains the relatively low success rate involved in IVF and ET techniques and suggests artificial insemination of Clara's own ova. Clara and Rhonda understand the low success rates but are undeterred. Their mutual goal is not merely to have a child but to share in the maternity of their children. What ethical issues are raised by the plan Clara and Rhonda propose? What are Dr. Robinson's ethical responsibilities with respect to the request by Clara and Rhonda?

Child↗
PubMed1991

The ethics of conversion therapy.

... Both the past and present have seen a number of methods being used to extinguish homoerotic desire and behavior and to inaugurate heteroeroticism in their place, methods I will here call conversion therapies... The typical defense of such therapy holds that even if homoeroticism is not necessarily a disease or evil, neither is it a universal good... Conversion therapy is morally defensible, on such a view, because some people suffer from the perceived consequences of homoerotic orientations despite the freedom and toleration extended to gay men and lesbians in certain areas... Against the view that conversion therapy is morally defensible as a matter of personal preference, I here argue that such therapy is morally suspect and should be resisted for a number of reasons....

Adult↗