PHL 223 RachelsExam # 3 Study Guide Lectures: 24-36Lecture 24 (November 3)When did Adult-to-adult liver transplants begin? What is Drindee’s case, in a nutshell? What arethe statistics on liver donors? What does Professor Rachels have to do with Drindee’s case?- Drindees Doctor, Thomas Heffron, advised her to seek living organ donors.o Like a lizards tail, livers never grow back- Adult-to-adult liver transplants began in 1997.- In 2002, 1 in 12 transplants were from living donorsWho donates their liver?- 75%--blood relative- 13%-- friend- 11%--spouse- 1%--altruist (stranger)Drindee sent a group email in March 2002, she said that professor Rachels should call her doctor if he wanted information on the situation - Professor Rachels was afraid- 20+ people called the surgeon- They looked at one person at a time to determine if they were able to be Drindee’s liver donoro Why? Expense to the insurance companyLecture 25 (November 5) Know the reasons why each donor was eliminated.1. Elimnateda. Blood Vessel is out of placeb. Potential donor #2—friend2. Eliminateda. On a medicationb. Potential donor #3—friend3. Eliminateda. Drank too much red wineb. Doctors are very cautiousMay 2002: 4. Potential donor #4—frienda. Eliminated because he suddenly changed his mindb. Confidentiality in this case was broken5. Potential donor #5—friend (Professor Rachels)a. He got an appointment with Dr. Hefron at Emory b. Dr. Hefron told Professor Rachels that he had a 1% chance of dyingi. Really its more like 1/5 (1 in 500)c. 15% chance of surgical complicationsd. 100% chance of pain and scarringe. The doctor tried to talk him out of it – Professor Rachels could change his mind whenever he wanted to.f. They booted his car while he was at the hospital (side note, possible test question)g. On another day, the doctors took his blood, MRI and administered a psychiatric interviewh. Everyone he spoke to said they underestimated the pain of the surgery. Lecture 26 (November 7)What was the outcome of Drindee’s case? Who did she receive a liver from? Know the course of events that happened while Drindee was in and out of the hospital after her first transplant.Potential donor #6-Altruist- Backed out after 6 weeks**Drindee got her transplant on 8/20/02 from a 9 year old boy that died in a car crash. - Car crash donors usually make for good donors because their organs are normally healthy. - Successful surgery, difficult recovery.Emory Hospital:- They sent letters and called Rachels telling him to pay his hospital bills- Drindees insurance paid for all of the bills- She wrote about her scars “perfect Mercedes benz logo”- 2004- they told her her disease was back.o 1/3 of the time this happens- 2005-they took it back- 2006- no more overnight hospital stays- 2009- needed another transplanto Went into septic shock sometimes- Emory no longer does adult to adult liver transplantso Why? Because 4 healthy donors died. However, 400,000 people lived. o Risks are too high, lawsuits, government shutting down- January 2010, she got her second liver transplant, which was much easier than the first one. - August 2010, Drindee met the parents of her first donor. Never met the second. - Success storyOrgan Transplants:- Every day, 21 people die waiting.- UNOS- United Network of Organ Sharing- Created Nationwide standards for recipient priority.o Sickest first- He question this because the sickest may be more likely to die during the operation- To get a transplant, you must live near a transplant centero There are 250 Centers in the USo Multiple listing: getting on the list at more than one center Unfair Outlawed in NYCLecture 27 (November 10)What percent of transplants are cadaveric? How can we increase the supply of organ donation?- Donors are 58% cadaveric, 42% living- 80% transplants are cadaveric- ½ of those will die while waiting- Each year 5,000-7,000 people die who donate, but don’t.o Under 2% of American adults sign organ donor formso Checking the box on your license isn’t enougho Doctors are cautious about harvesting o Its hard to approach grieving familieso Many people are needlessly dying  No one wants to die before they have too How can we increase the supply? Forced donation- Freedom vs. human life People have insurance, know the system and can leave work (they get thetransplants earlier)  # people waiting- Kidney-101933- Liver- 15643- Heart- 4012- Lung- 1625- Kidney and Pancreas- 2071Lecture 28 (November 12)Are organs more readily available for the rich? How can stem cell research potentially assist in organ production?- Exploitation of the poor?o Danger with living donors only- Rich people can get organs if they pay privately and they get taken off of the waiting listEven if you think I shouldn’t sell my organs, don’t I still have the right to?Is selling ones organs so stupid that we shouldn’t allow it?- Of course not!Stem Cell Research may allow us to clone organsLecture 29 (November 14)What is the God Committee? What is the Dialysis Machine? Who invented it? What are the 3approaches to assessing Animal Reseach?- The God Committeeo Dialysis- cleans blood and returns it to the body Kidney substituteo Dialysis machine- invented in 1943 by William Wolfe- Dutcho 1960: Belding Scriber (a doctor from Seattle) invented the Scriber Shunto 1962: Scribers Hospital conserved 17 dialysis patientso 1961: God committee set up to decide who to accept They limited candidates Don Marquis argument (less than 45 could pay) Other considerations: Employed, educated, had dependent children, acheivements and could potentially help others. o Were they “playing God”? Some choice had to be made.o The end stage: Renial Disease Act 1972: Government funds all dialysis- Animal Reseacho How many birds/mammals are used for research in the US? 25 million/yro Mainly rodentso Animal Core and Use Committees (Required since 1986) 3 Approaches to assessing animal research:- Anything goes, its just an animal- No research is ok, animal rights must be protected- Research is judged based on harms and benefitsLecture 30 (November 17)What are the main groups we discussed in lecture and what are their attached stereotypes? What is a speciesist? How are the animals that we eat treated in Factory Farms?Group Belief- African Americans Racism- Jews Antisemitism- Women Sexism- Everyone but you Selfishness- Elderly Ageism- Foreingers Nationalism- Nonhumans SpeciesismMost people are