Question: What medical and surgical treatments should be offered to an infant with a birth diagnosis that portends a lifetime of chronic problematic therapeutic needs?
History: Chelsea is a 7-week-old girl with thanatophoric dysplasia (TD) who has had a long and tumultuous hospital course since birth. Her diagnosis was discovered on prenatal ultrasounds, and her parents met with pediatric subspecialists, including both neonatology and pediatric palliative care. They received counseling on Chelsea’s diagnosis, its severe lung pathology, and poor survival rates. They discussed possible management and anticipated challenges, including the possibility that Chelsea would not respond to such interventions. The team and the parents focused on the “moment-by-moment” information gathering and decision-making in the delivery room, only briefly touching on the inevitable long-term support needs if Chelsea survived. Despite the counseling the parents received, they felt as if a trial of resuscitation was in Chelsea’s best interests after birth.
Tag Archives: disability
Ten Critical Ethical, Conceptual, and Clinical Cautions Concerning the Diagnosis and Treatment of Gender Dysphoria and Transgender Identification
Abstract
There is an urgent need for ethical, conceptual, and clinical clarity regarding the diagnosis and treatment of gender dysphoria and transgender identification. In this essay, I highlight ten critical concerns in this arena, namely, those involving: (1) conceptual parallels between sexual reassignment surgery and elective limb amputation; (2) the lack of long-term data that demonstrates reliable long-term relief from gender dysphoria in those undergoing hormonal or surgical treatment for gender dysphoria; (3) special problems with informed consent in the context of “gender affirming” treatments; (4) the importance of very high desistance rates of gender dysphoria and transgender identification, particularly in children, even without treatment; (5) the extensive differential diagnosis and the need for thorough and subtle assessments in the face of gender-related complaints; (6) a deep religiously based objection to transgender ideology involving the ordering of creation; (7) controversies concerning the existence of rapid-onset gender dysphoria; (8) the recent depathologizing of gender dysphoria; (9) the roles of genetics and environment in transgender identification and gender dysphoria; and (10) reflections on the role of psychotherapeutic treatment in patients with gender dysphoria and transgender identification.
Keywords: transgenderism, gender dysphoria, transsexualism, sexual reassignment surgery, gender affirming care
Mitochondrial Replacement Therapy, the Embryo, and Community
Abstract
Mitochondrial replacement therapy (MRT), also known as mitochondrial donation (MD), is promoted as an option to prevent transmission of mitochondrial disorders to offspring. Since its first reported use in humans, MRT has raised numerous ethical and medical concerns. This article will explore the technology behind MRT and arguments in favor of and opposing it, concluding that a response through the lens of Scripture promotes flourishing of individuals and families affected by mitochondrial disorders without sacrificing others in the process.
Keywords: Mitochondrial Disorders, Mitochondrial Replacement Therapy, DNA, Embryo, Germ Line, Disability, Parenthood