Both classical and unique ethical issues surrounding the use of genetic information to inform precision medicine in clinical practice.

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Both classical and unique ethical issues surrounding the use of genetic information to
inform precision medicine in clinical practice. Describe examples of
pharmacogenomic medicine and critically discuss the ethical issues for the patient,
their family, medical practitioners, the health board and / or health insurance
companies paying for the treatment, regulatory bodies and the pharmaceutical and
biotechnology industries.
The main body of the essay should be a maximum of 1500 words, not including
references. Reference lists should be formatted appropriately using the Harvard style.
Background reading is provided to help start your research. However, it should be noted
that you have been provided with older reading material to give you the background. It
is expected that you will use your own literature searches for original primary
reference sources that are up to date with respect to current state of knowledge.
-Use of a specific example. The use of specific examples of pharmacogenomics medicine is completely flexible. The focus of the essay is on the ethical issues facing patients, their families, medical practitioners, the health board and / or health insurance companies paying for the treatment, regulatory bodies and the pharmaceutical and biotechnology industries. The requirement to use examples is just to place these discussions on ethics in the “real world”. Therefore the way you use examples is entirely flexible. They can be theoretical, or real examples from your lectures. You can use different examples to highlight different issues, or you can use the same example throughout. You can present an introductory “case” focussing on a specific pharmacogenomics example, before embarking on your presentation of the ethical issues, or you discuss the ethical issues in general and then highlight an example as you progress. This is entirely up to you. But the key part of the task is to focus on and recognise the ethical issues for each of the groups above.
-Background resources. You were provided with a set of literature to get you started on your research. These resources should be used as you to choose to support your essay. You can utilise the information and cite the references in your essay. However, you should also include more up to date references. By this it is meant that the background references were older and that there are perhaps more recent and updated information on ethical issues. Perhaps some of the theoretical issues presented in the resources have recently been studied in patient populations, perhaps there is recognition of new issues, etc. It is important to demonstrate, by citing appropriate references, that you read more widely than the provided resources to produce your essay.
– write in academic way (use academic words)

How might you harness modern technology to transform the role of the primary care physician, creating a “Marcus Welby for the 21st Century?”

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Primary care physician is like the “captain of the ship” who directs our health care
system. Despite being fondly remembered as an “ideal” example of how a primary
care physician (PCP) should operate, the Marcus Welby Medicine (MWM) model
was subject to inefficiencies such as moral hazard, demand inducement and practice variations2
.
Today, technology has changed everything. Individuals now buy drugs on the
Internet and Tweet about their latest trip to the dentist. They can book appointment
through zocdoc.com. They can rate their doctors on healthgrades.com. They can
research their own illnesses (after being diagnosed) through websites such
asWebMD.com and MDAdvice.com. (Yet these sites are not always a good source
for determining what caused their illnesses or accurately providing a selfdiagnosis.
Sometimes these sites even create frustration and unnecessary
worrying.) Moreover, the recent development of Health Information Technology
(HIT) such as Electronic Medical Records (EMR) could help prevent medical
errors and exchange patient information among healthcare providers.
How might you harness modern technology to transform the role of the primary
care physician, creating a “Marcus Welby for the 21st Century?”

Early Detection of Bioterrorism

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Writer: Please write 1 page, you wrote case 1, and this is case 2.

Early Detection of Bioterrorism
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Please review the Biological Incident Annex—FEMA at https://www.fema.gov/pdf/emergency/nrf/nrf_BiologicalIncidentAnnex.pdf

Especially the following:

“The introduction of biological agents, both natural and deliberate, is often first detected through clinical or hospital presentation. However, there are other methods of detection, including environmental surveillance technologies such as BioWatch, and medical and syndromic surveillance systems. Early detection of biological agents offers an opportunity to take proactive measures to mitigate the consequences of disease outbreak.

“Routine fish and wildlife health and disease surveillance, including investigation of wildlife mortality events conducted on public lands and in public laboratories, provides the opportunity for early detection of biological agents and acts of bioterrorism. Animal health surveillance in the agriculture sector provides similar opportunities” (Biological Incident Annex, 2008, pp. 4-5).

As a policy-maker, what would you propose as a national strategy to improve early detection of bioterrorism? Remember the anthrax outbreak of 2001.
Rubrics
• MSHA/MSEDM/MSHLS Discussion Grading Rubric – Timeliness v1

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

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Case Scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has high blood pressure, which he tries to control with sodium restriction and sleep apnea. He current works at a catalog telephone center.

Objective Data

Height: 68 inches; Weight 134.5 kg
BP: 172/96, HR 88, RR 26
Fasting Blood Glucose: 146/mg/dL
Total Cholesterol: 250mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?
Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered: (a) Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime; (b) Ranitidine (Zantac) 300 mg PO at bedtime; and (c) Sucralfate / Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.
The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

Assess each of Mr. C.’s functional health patterns using the information given (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance).
What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.