Drug addict

That wouldn't be a problem as you would only be transferring white blood cells, not red ones. Agree with that, the immune systems is vital in differentiating self from foreign, which is you have to give immunosuppressive drugs with transplants.

I've started this thread partly so I can check my own understanding of the theories, but also in the hope it will be useful and informative to others. There are four main principles in ethical decision making: The Principle of Autonomy - in certain areas, an individual has the right to be self-governing The Principle of Beneficence - promote well-being or benefit The Principle of Non-maleficence - do no harm The Principle of Justice - equals ought to be considered equally (perhaps more important in looking at allocation of resources) There are two main ethical theories: consequentialism and deontologism. Consequentialism This theory is concerned with outcomes, and has been formulated by Parfit as: '... there is one ultimate moral aim: that outcomes be as good as possible.' We therefore need to define what a good outcome is. In the classic version of consequentialism put forward by Bentham and John Stuart Mill, and known as utilitarianism or hedonistic consequentialism, it is argued that what has ultimate value is hapiness. Therefore good outcomes are those which yield hapiness, hapiness being equated with the sensation of pleasure and the absence of pain. This again presents problems - how are pleasure and pain to be measured, and how can they be recognised in those who cannot express their experiences. Deontological theory This theory is concerned with doing what is right. Certain actions or rules are right, regardless of the consequence they have. But how do you determine if an action is right? Kant proposed a test, the 'Categorical Imperative' which could be used to test whether a certain rule was really a duty. The Categorical Imperative, as formulated by Kant is: 'Act only on the maxim through which you can at the same time will that it should become a universal law' As a minimum, in order for a maxim to be capable of becoming a universal law it must not be self-contradictory when stated in its universal form. For example, to take the maxim of making promises with no intention of keeping them. If this was universalised it would become contradictory since the practice of promise keeping would disappear as no one could believe promises as they would know there was no intention of them being kept. There are maxims which do not become contradictory when universalised, but are still not duties as they fail the second part of the test in the Categorical Imperative, that is we can want it to become a universal law. An example would be only taking care of yourself. While this is not contradictory when universalised, Kant argues it would be in conflict with itself, since there are many situations where you may need help from others. Kant also argues that we need to recognise other humans are also ends in themselves and must not be treated as a means to an end. Consequentialism seems to have an advantage in that only one thing has intrinsic value - happiness. However, how do you convert everything into the currency of happiness? A more fundamental critiscism of consequentialism is that separate individuals are not of paramount importance - the maximisation of happiness is the goal. If this is achieved by unequal distribution between individuals, nothing can be done about it. Deontological theories may present problems in moral dilemmas, as they provide no procedure to solve conflicts between duties. Perhaps the fundamental advantage of deontological theories over consequentialist theories is the recognition of the importance of the individuals - it is not legitimate to sacrifice individuals for the sake of a particular favourable outcome. That's enough for now (I've got work to do!), but later I'll add justifications for the principles of autonomy, beneficence, non-maleficence and justice from both consequentialist and deontological viewpoints, as well as a discussion of acts and omissions, the doctrine of double effect and ordinary and extraordinary means.

The level of evidence for conventional medicines is not always great, and it doesn't help when companies withhold evidence. However, there has been a move to evidence based practice in order to improve practice. What I find interesting (amusing? disturbing perhaps), is that the majority of conditions alternative therapies are advocated for are those where conventional medicine is ineffective or has nasty side effects. I mean why do you not see alternative therapies for blood pressure control, asthma, or epilepsy to name a few? Alternative therapies generally target those people who are vulnerable. If these therapies are effective, prove it properly not by using anedoctes or testimonials. Should conventional medicine be more open minded? I'm ready to listen if there is decent evidence behind the claims being made. Medicine is built on science, and I don't think anyone involved in medical science would claim that we know everything. There are huge areas where comparitively little is known, for example nervous system diseases. If medicine did claim to know everything, why is there so much medical research being conducted? Look at the amount being invested by drug companies into R&D - it's an astronomical amount. Look at the number of journals there are in the medical research area. To take cancer research as an example, you have the British Journal of Cancer, the European Journal of cancer, Cancer Research, Cancer Letters, Clinical Cancer Research, Anticancer Research, Cancer,and Nutrition and Cancer, and I'm sure there are many more. One of the fundamental differences between conventional medicine and alternative medicine is that conventional medicine is always evolving and moving forward, it is open to new ideas (eg bacteria causing stomach ulcers, prions etc., etc), whereas alternative medicine is static. I've heard justifications of some alternative therapies on the basis that they are 'traditional' or old. Well they really did a lot for life expectancy didn't they!

a slightly clearer explanation of sex influenced from http://dorakmt.tripod.com/genetics/notes02.html

I don't know about computer speeds, but I do know that the number of viruses would be large. HIV viral load tests measure the number of HIV viruses per ml of blood. A high load can be 5,000 - 10,000 copies, and can be as high as one million copies per ml of blood. A low load is 200 - 500 copies per ml. Given that blood volume for a male adult is about 5 litres, thats a lot of viruses. Because of their small size (10 - 50 nanometres [10^-9 m] compared to 1-100 micrometres for mamalian cells), viruses can only be imaged by electron microscopy, which needs a vacum and the sample to be conductive (usually done by coating with gold), so you couldn't really do it with blood.

why not? People with haemophilia (historically) don't live long, especially if they're female , but the condition still exists today.

It's interesting to read the responses (http://bmj.bmjjournals.com/cgi/eletters/329/7480/1450) on the BMJ website to the article by Harlow et al regarding use of magnets to alleviate pain in OA (http://bmj.bmjjournals.com/cgi/content/full/329/7480/1450). Surprising how most of those who are supportitive of the trial manufacture or distribute magnets...

It's worse than you think; not only can doctors prescribe homeopathic products, there are also NHS homeopathic hospitals!

It's still a little way down the track, but at Aston uni they are doing research into development of an anti-obesity drug based on zinc alpha 2 glycoprotein (Prof. Michael Tisdale). There's also Prof. Graham Harding, who has done a lot of research into photosensitive epilepsy. And we're developing a new TB vaccine, and have developed a method for rapid identification for MRSA. Aston uni also developed temozolamide (Temodal), an anticancer drug for brain tumours. Not as impressive as some others, I know, but its only been a university since 1966,there are only 6500 students, there aren't that many science degrees, and it seems like the business school are the ones who get all the damn money But our chancellor was Sir Adrian Cadbury.

There are four different protozan organisms which can infect man and cause malaria. Plasmodium ovalae, P.vivax and P.malariae cause recurring malaria, which doesn't kill you. P. falciparum does (if you are not immune). The difference really is that P.falciparum produces more merozites (the blood form of the protozoa) when in the liver than the others do. The inital symptoms are the same (fevers, general discomfort, though falciparum is more severe), but the non-fatal ones let you off the hook after about a week. Unfortunately, falciparum goes on to cause cerebral malaria where the organisms block the capillaries in the brain, causing coma and then death. Luckily, prophylactic drugs are available, though which ones you need to take depends on where you are going to. However, some of the drugs are a bit pricey and have unpleasant side effects (but not as bad as getting malaria.) Developing a vaccine is problematic. Protozoa are more complex than bacteria or viruses, with much larger genomes. Also, the vaccine would have to be 100% effective in less than 1 hour, as that is how long the organism is in the blood for before entering the liver. With P.falciparum, if you miss just one, thats it. And of course, a vaccine would only be affordable to western holiday makers, who account for a tiny proportion of the people infected by malaria. But they would complain about the price anyway...

I guess Staph. aureus or E.coli should both be ok to use, they are both pretty easy to culture. As for choice of antibiotic, it depends on how much money you have to spend. The older antibiotics, penicillin for example, are dirt cheap, but newer ones are far more expensive ( a course of methicillin is something like 2000x more expensive than metronidazole). Safety would also be an issue in choice of antibiotic - not a great idea to go messing around with things like vancomycin. It should be easy to get hold of what you need from any major supplier, but the place you're at has probably got preferred suppliers. If you want any information on modes of antibiotic action, just ask (or look in a pharmacology or medical microbiology textbook)

It was a private clinic, so he was making a financial gain. And wouldn't you want your doctor to tell you the truth about test results so that if anything is wrong you can sort it out earlier?

A doctor has just been jailed for faking some blood test results: http://society.guardian.co.uk/publichealth/story/0,11098,1378756,00.html For there to be anydoubt over whether this doctor will be struck off shows the incompetence of the GMC. The GMC really is just an old boys club which will be lucky to survive another few years. The Royal Pharmaceutical Society, which is both a regulatory and representative body has far better disciplinary procedures than the GMC (which is only regulatory.)

Here's the patient summary of the study on acupuncture use in arthritis: http://www.annals.org/cgi/content/summary/141/12/901 (the full text of the paper reporting the study isn't free for six months, and my uni doesn't subscribe to annals of internal medicine ) Edzard Ernst, professor of complementary medicine at the Penisula Medical School, universities of Exeter and Plymouth, writes a column in the Guardian (http://www.guardian.co.uk) about complementary medicine which is interesting. His latest column is about the use of misletoe in cancer (http://www.guardian.co.uk/g2/story/0,,1377721,00.html). All I want is the same level of evidence for alternative therapies as is demanded for conventional medicines. If the evidence shows that they are effective, fine, make them available on the NHS (but why is homeopathy available on the NHS? )

a couple of journals you might want to look at: The journal of medical ethics: http://jme.bmjjournals.com the british medical journal: http://bmj.bmjjournals.com JAMA: http://jama.ama-assn.org New England Journal of medicine: http://content.nejm.org and any other medical journals you can get access to, such as the Lancet. there's also the PJ: http://www.pharmj.com hope these are of some use

stuff I'm listening to at the moment: Franz Ferdinand Killers Muse The Music British Sea Power Razorlight Yeah Yeah Yeahs The Cooper Temple Clause Queens of the Stone Age

It's a TV series, not a movie, but Peep Show (http://www.amazon.co.uk/exec/obidos/ASIN/B0002W1190/qid=1103651403/sr=1-1/ref=sr_1_10_1/202-0570582-3753426) is fantastic , though it could be tough getting hold of it outside the UK

The range of alternative medicines is huge, going from accupuncture to homeopathy to traditional chinese medicine, and so it is somewhat difficult to come up with a definition for 'alternative medicine'. I guess what I mean when I talk about alternative medicine is those interventions for which there is no supporting evidence (which may also cover some conventional therapies), but more importantly practitioners do not want to take part in rigourous trials to show that their intervention is better than a placebo. If any trial shows that an alternative medicine is not effective, the design of the trial is automatically derided. Another huge sticking point with alternative medicine is their rejection of science when they talk about things like 'chi' and 'ying and yang'. For example with accupuncture there are no known anatomical structures which correspond to meridians. I am not blindly against 'alternative medicine'; herbal medicine makes sense as so many drugs come from natural sources (though there are problems with dose standardisation and quality assurance.) What I really want though is hard evidence (i.e. RCTs) that these interventions are effective and not just due to placebo effects.

In the UK the British National Formulary (http:///www.bnf.org) is a twice yearly publication from the Royal Pharmaceutical Society and the British Medical Association (as well as some more frequent publications such as Monthly Index of Medical Specialities [MIMS]). A scheme for reporting adverse drug reactions (ADRs) has been in place for sometime in the UK and is known as the yelllow card scheme, basically because you fill out a yellow piece of paper to tell the Medicines and Healthcare products Regulatory Agency (UK equivalent of the FDA) of ADRs. Forms are available in both theh BNF and MIMS. The scheme is open to both doctors and pharmacists (not sure about nurses.) The yellow card scheme works slightly differently for new and old drugs. With old drugs, only serious ADRs should be reported (i.e. such as thrombocytopenia), whereas for new drugs (= black triangle drugs) all ADRs should be reported, not matter how trivial so that a reasonable picture of ADRs can be built up. I assume that by 'pavochol' you are talking about pravastatin. The BNF notes that thrombocytopenia is reported rarely. A more common side effect of the statins is myopathy (muscle damage) and whenever I dispense a statin I speak to the patient about this, even though the probability of it occuring is small. Talking to people about side effects of medication can be difficult; if you look at patient information leaflets the list of side effects can be huge. Where potential side effects are serious, such as myopathy with statins or agranulocytosis with clozapine, patients should be told about the possibilty of these side effects and what to do if they occur, while reassuring patients that the risk of these side effects is small. Where you taking the pravochol as part of a trial? (you said that your doctor gave you some samples.) Pravastatin is the only statin that can cause thrombocytopenia, and so if you were part of a trial, it is possible that this side effect wasn't encountered in earlier trials with less patients, though your doctor should have warned you about the risk of myopathy and told you to report and unexplained muscle pains. When a new drug comes onto the market, it is possible that rare side effects are discovered, purely because it is being given to far more people than it was in the trials. This is why it is essential to have a robust system in place for monitoring ADRs to new drugs.l

isn't planning terrorist attacks a crime?

You think doctors know that much about medicines? I'm in the final year of a pharmacy degree, so medicines are what I know about.

The Law lords in the UK recently decided that indefinite detention of suspected terroists without charging them with a crime, or even telling them why they were being detained was unlawful http://www.guardian.co.uk/uk_news/story/0,,1375684,00.html http://www.guardian.co.uk/uk_news/story/0,,1375603,00.html Does anyone think that detention without charge can ever be justified?