Question

1- According to what could a nurse know who is the doctor that is in charge of her/his patient? How does the nurse know who is the doctor of the patient that he / she is taking care of?

2- Discuss some of the ethical issues relating to genetic testing

3- Some ethicists argue that patients with alcohol-related end-stage liver disease (ARESLD) should not be considered for a liver transplant due to the poor results and limited long-term survival. Others argue that since alcoholism is a disease, write about it.

Answer 1

Ans 1. The nurse always seeks attention for the patient after getting information from physician. The nurses responsibility is to take care of patients after consultation of the physician. She always check the physician signature after the consultation of the doctor.Nurse must check for the details of the patient with whom the patient had consulted... She must check the patient file as well as the signatures of the doctor to know about the doctor who is in charge of the patient. Moreover, the nurse should take proper charge of the patient while taking over from the shift with full details of the patient that she is taking care of.

Ans 2. The role of genetics and the environment in the onset of many major noncommunicable diseases particularly monogenic diseases is well established. Consequently, genetic testing is gaining recognition for the many advantages it has to offer in the prevention, management and treatment of disease. Among their many uses, genetic tests most commonly present an opportunity for individuals to become informed about their genetic predisposition to disease, and for couples to be aware of the possible genetic characteristics of their unborn children.Stemming from the informative potential of genetic testing some critical ethical, legal and social issues come to the forefront.

The Individual’s right to choose.

In an effort to reduce genetic diseases, especially those peculiar to certain populations, many communities encourage couples to perform genetic testing prior to marriage as well as on the fetus during pregnancy, to determine any risk of disease. While this strategy has effectively reduced the prevalence of some genetic diseases like thalassaemia, for which there is still no cure, it is argued by some that it limits the individual's freedom of choice.

Confidentiality

As with other areas of clinical medicine or science, confidentiality is important in genetic testing. If anything, the confidentiality of genetic information may need to be guarded even more stringently than in the ordinary case. Genetic tests give an assessment of an individual's inherent risk for disease and disability. This predictive power makes genetic testing particularly liable for misuse.

Stigmatisation and discrimination

Knowledge of genetic risks can lead to potential social and psychological consequences for the individual. Socially, knowledge from genetic tests may lead to stigmatization and discrimination within the community. Refusing to undergo genetic testing as well as choosing to undergo genetic testing can both lead to discrimination and stigmatization depending on the prevalent social norms regarding acceptance and use of the technology.

Ans 3. In many patients, long–term heavy drinking leads to chronic liver disease, liver failure, and even death. Orthotopic liver transplantation (OLT) is the only definitive treatment for end–stage liver disease, including alcoholic liver disease (ALD). Because of a shortage of donor organs, OLT for ALD patients remains controversial out of concerns that patients may resume drinking, thereby harming the transplanted organ. Therefore, transplant centers conduct careful screening procedures that assess patients’ coexisting medical problems and psychosocial status to identify those patients who are medically most suited for the procedure and who are most likely to remain abstinent after OLT. Studies assessing the outcomes of ALD patients after OLT found that the survival rates of the transplanted organ and the patient were comparable to those of patients with nonalcoholic liver disease and that relapse rates among the ALD patients were low. Similarly, ALD patients and patients with other types of liver disease had comparable rates of compliance with complex medication regimens after OLT. Enhanced efforts to identify risk factors for relapse among OLT candidates with ALD and to target interventions specifically to those patients who are at high risk of relapse may further improve patient outcome and enhance the acceptance of OLT for alcoholic patients in the general population.

Alcoholism, also known as alcohol addiction, is a chronic disease of the brain that’s characterized by compulsive decision-making, impulsive behavior and relapse. It’s triggered by genetic and environmental factors, and it causes biological changes in the brain that make abstaining from alcohol nearly impossible without medical treatment.

Many people say that you can never become an alcoholic if you choose to never drink alcohol. However, that logic doesn’t mean that alcoholism isn’t a disease.