Issues in today’s health care

The medicine of the present has reached a point where just curing illnesses is not enough. It might form an important part of health care, but it is far from the only aspect. Genetic engineering, alternative aproaches, these are new ways to look at health care. Ethics has due to this formed a noticeable presence in medcine.

Health Risks

Health is all about risk, and risk factors. There are several studies searching and/or eliminating risk factors. The cohort study is one of these studies: it is looking at two groups and finding out whether a factor is health risking or not. They use two groups, one where the persons have been exposed to the factor and a group where the persons are not. But it is very difficult, sometimes it’s not obvious that the factor does have an effect for example.
If a factor has a major effect it is easy to see, but there are also factors which have a very small minor effect, a solution to this is using lager samples.
You also have case-control study: this also compares two groups, but this looks at a group which have a illness and a group who doesn’t have the illness, then they look to which factors the groups have been exposed to. It’s like working backwards.
Epidemiology is the study which looks at the causes of the diseases, many diseases like cancer don’t have a obvious cause, this makes the study hard.
Epidemiology looks at two aspects, one is morbidity, looking at how many people were made ill, and mortality, looking at people who died of the illness.
Smoking is bad for your health. Scientists didn’t believe in it at first because they thought that the increase of lung cancer among people was due to the increase in cars and air pollution.
But it was difficult to prove the link. Smoking is one of the main causes of lung cancer, cigarette smoke contains nicotine, carbon monoxide and tar. Nicotine makes you addictive while carbon monoxide is a poisonous gas reducing the amount of oxygen the blood can carry. Tar is a brown mixture with carcinogens (a agent causing cancer) and damage the genes which control cell devision, causing the cells to develop a lot and stimulating cells causing cancerous tumours. (Cells devide all the time but sometimes it devides wrong causing mutation and/or cancer.)
Evidence shows that giving up smoking reduces the chance of getting a disease, but there are smokers who smoke 15 cigarettes a day and don’t get ill.
Heart disease is also a very common disease nowadays. You’re arteries will become thinner and roughened  making you sometimes get a cramp-like pain in your chest or other parts of your body, you call this angina, you may lie in agony with angina for years, or it may result very soon in a heart attack. This is caused when one of the coronary arteries flow is interrupted, so the blood can’t reach your heart. The blood flow is interrupted because of a blockage which you call (coronary) thrombosis. Factors giving you a heart disease include: lots of cholesterol in your body, obesity, etc.
Overweight people have a higher chance of getting a heart disease, they are also more likely to develop diabetes and high blood pressure. Cholesterol in the blood may also increase. Cholesterol is a clear oily liquid, it is a part of animal cell membranes and a component of hormones like testosterone or oestrogen. The higher amount of cholesterol in your body, the higher is the risk of getting a heart disease. It is transported by a carrier protein: a lipoprotein. You have a Low- and High density lipoproteins (LDL + HDL), LDL increases the risk of a heart disease and HDL lowers it. Stress and heart disease are also closely linked.
When you exercise, your heart size increases and the volume of the chambers. It pumps more blood than a non-fit heart.
If you have none of the risk factors, the chance you get a heart disease is very low, but when you have all three: (stress, obesity/high cholesterol level, a non-fit heart) the chance of getting a heart disease is three times as normal.

Alternative approaches to medicine

The 3 main aims of the health policy of the UK:

- Increasing the length of people’s lives
- Extending the number of years that people are free from illness.  
- Narrowing the health gap between those worst of in society and those that are better of.

There are two main indicators to compare the health of populations:
- Life expectancy
- Infant mortality

A holistic approach to disease: an approach which sees the patient as a whole person and not as  a biological machine, consisting of interacting organs.
Orthodox medicine: Orthodox means: following the rules. Patterns/rules we use in the western world. A doctor can tell you exactly what a medicine does.  

Positive sides of orthodox medicine: it can often effect into a complete cure. The doctor can tell you exactly what is in the medicine and what it does to you.
Positive sides of unorthodox medicine: It has been used for a number of ages, so it’s been proven you won’t get even more ill.
Negative sides of orthodox medicine: Because so many medicines are needed, some medicines aren’t tested very well, but just sold without tested carefully. This means that these medicines can have very bad side-effects.
Negative sides of unorthodox medicines: They have no proof that they work. They make a lot of times use of “energy-fields”, which is, in some people’s eyes, non-sense.

There are several reasons why people turn to complementary medicine, one of them is that orthodox medicines can’t cure them, so the try complementary medicine which probably will be their last hope.
Some examples of complementary medicine, or unorthodox medicine are:

- acupuncture,
- chiropractic: restore balance and health in the body, so that the body van resist allergic illnesses.(kind of massage)
- herbalism,
- homeopathy: based on “like cures like” and “less is more”, very small quantities are given to the patient so that the patient becomes immune.
- reflexology.

These therapies can be divided into several groups:
- nutritional medicine: clinical ecology, herbalism and homeopathy claim to help the whole body to work better

1. Acupuncture and healing claim to free up the flow of energy around the body
2. Mind-body therapies which relax and focus the mind
3. Osteopathy and chiropractic which make structural changes in the body

More and more people are making use of elementary medicine. There are a lot of cases where these types of medicines have appeared to be working. But you have to keep in mind the complementary approach isn’t suitable for everything, if you have had a car crash for example, you need surgery and drugs, no acupuncture.

Genetic Engineering

The issues: GM has led to great controversial in the UK and other parts or the world. The opponents say it is bad for human health and the environment. Whilst others think it will be beneficial for the food supply in development countries. The science behind the issues: GM relies on the fact that all organisms have genes which can be moved from one organism to the other. What does this tell us about science and society: GM is not just a science it’s an industry. People’s views on this are very different because they all trust other statements about this topic.
Genes are written in a chemical code on the DNA. There are four different letters in this code and this is the same for all organisms. This is how the basic principle of genetic engineering works: You find the piece of DNA that you want to move from one cell to another. Than you cut it out with a special enzyme and you use the same enzyme to cut out the place where the piece of DNA should be placed. Than the piece is placed into the open space by another enzyme. Now the organism will make proteins that are coded in the piece of DNA.
Human insulin is a very successful example of genetic engineering. Also other ways of transporting genes are used, for example: shoot the genes in with a tiny gun, let the genes be carried by a virus or bacteria and even inject the DNA directly into the fertilised egg of an organism.
A very old way of selecting characteristics in crops is crossing. You take two plant that both have a good characteristic. Now you cross them and you’ll have plant with both the characteristics. But this method takes a lot of time, sometimes even 10 years. GM can speed up this process a lot. Weeds are a big problem because they use the nutrition’s that should be used by the crops. In low wage countries these weeds are pulled out by hand but in the western world they are usually controlled by herbicides. By GM crops can be resistant to the most desirable herbicides that kill the weeds. This will be beneficial for the farmer the environment and even the consumers. So if you look at it in this way it seems that there are only positive effects, however this is not completely true. Some say GM crops are not safe for humans to eat. Others say that nothing in life is proofed safe. Now the question is: Are genetically modified foods safe enough? Experts say most modified foods that are now available are safe, but there’s one exception. Some crops have been injected with an antibiotic resistant gene. Some claim that if these crops are eaten in large amounts the genes can move to diseases in the human or animal and so make these diseases antibiotic resistant. The chance that this happens is small but still, it’s possible. It’s difficult to test what the effects of GM crops on humans are because you can’t test it on long term. GM crops can also be bad for the environment. The modified crops can invade the natural habitat of other species. Another problem is that the modified genes might escape to weeds. And it might lead to a shrink in biodiversity. Now GM is mainly used to make plats more resistant, but in future people want to give plant characteristics that will increase the human health (by producing vitamins and vaccines in plants).
Animals are mainly modified to have a model of human diseases. Whilst experts say these animal experiments are necessary others say they have no use. Another purpose that animals are genetically engineered for is organs transplant. Since there are not enough human transplants they try to give pig organs a human protein layer so the human body will accept the organ. But ethical committees have done research to the dangers of these xenotransplantations. They say the organ can carry on diseases. The people wanting to do these transplantations responded to this saying that people who will get a pig organ will have to agree to certain conditions for the rest of his/her life. Also will all of the person’s family have to be seen to make sure they all know about the consequences.  Modified salmon may also have some dangers. If the fish escape they can spread diseases and can disturb the competition of the natural inhabitants. The eventual effects of this are uncertain. But there are also examples known in which salmons cross with other types of fish.
Genetic engineering raises a lot of ethical problems. Some say that if it can safe lives, xenotransplantation is a right thing to do. But others say you shouldn’t use pigs in such a way. But than again the pigs used for transplantation live in much better conditions than they’d do on a pig farm. The other thing is: isn’t this kind of transplantation unnatural? Yes, of course it is because in nature people don’t have pig hearts. A better question would be: Is natural the same as good? The answer to this question would be no. There are lots of examples of natural things killing humans and unnatural things saving lives.
Not only the fact if GM is good or bad plays a role in the demand for it. What’s even more important is if people want to buy GM foods. Mass media have played a bog role in this issue. They haven’t only informed the public but also made a statement.

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