Final Exam, Bio 4, 99W

Rules:

In compliance with the Dartmouth honor principle, all the work you hand in on this exam is to be your own.

For this exam, please choose one of the following questions. Do not answer more than one question. Your answer should be a maximum of 6 printed pages (this is a limit not a goal) -- anything beyond six pages will be ignored. A page is defined as an 8.5" x 11" sheet with one inch margins. The font should be 12 point Times and text should be double spaced. The bibliography (and any figures you might have) should be at the end of the paper and will not count towards the page limit. You can cite references in the body of the text using numbers.

This exam is open book. You can use your notes, the web, the library, newspapers, etc. You cannot talk to others about your answer, though -- the work you hand in must be entirely your own.

There is a defined format to be followed for the paper.

Good luck.

Questions (choose ONE):

Please be sure to state the question (A or B) you are answering and be sure to provide a title for your essay. You should address the general issues raised and not necessarily focus on answering the specific items that are mentioned (although you certainly can address them). They are provided to help you understand some of the issues that need to be addressed. The question you should address is in red.

A. It has been recognized for some time that some patients respond better to certain drugs than others. This has been a mystery and a source of frustration to those who are trying to provide care. Recently, however, there has been a breakthrough. Scientists have found that those individuals who fail to respond to certain drugs (e.g. chemotherapy drugs or Prozac) have certain alleles of specific genes that prevents them from responding. For example, in the case of Prozac, it is known that those patients who fail to respond cannot metabolize the drug to its useful (active) form in the body; they actually build up toxic levels of Prozac without reaping any benefit. This realization raises a number of issues regarding testing and treatment. Determining the best drug to be used in chemotherapy might be facilitated by knowing ahead of time which drug has the best chance of success based on the patient's genetic profile. Similar testing might determine which anti-allergy drug is best or which antidepressant is best.

Should these kinds of tests be required before any treatment is undertaken? What if the tests are very expensive? Should the same considerations apply to testing chemotherapy drugs as to less life situations, such as drugs designed for treatment of allergies or depression? What happens 5-10 years from now when there may be tests available for almost any treatment? How does one decide when it is appropriate to test and when not? Are there legal responsibilities? What role (if any) should insurance companies play in this process? Discuss this issue using some (or all) of the questions raised here. Think about the implications of your answer/ideas carefully in trying to decide what should be done and what should not be done.

B. There are currently about 50,000 people in the USA who register with an organ donor network to receive organ transplants. The center coordinates which organs are needed and which are available. They determine tissue matches and make recommendations to facilities requiring organs for transplantation. At this time there is a chronic and critical shortage of donor organs and the shortage will only increase. Patients are dying because of a lack of donor organs -- not because the transplantation technology is unavailable. Some biotechnology companies are trying to address this by creating transgenic animals that could serve as donors of organs for humans. In general, transplanted animal organs are rejected immediately. By introducing human genes that code for surface proteins, however, the organs are recognized as human organs and can be transplanted much more effectively. The protocol is performed by introducing the appropriate human genes into pig (or other) cells, growing the cells, and then creating cloned animals from these cells. All the resulting pigs would be transgenic and would have organs that are not rejected by humans because they have human surface antigens. The idea would be to create "organ farms" to provide the badly needed organs for transplantation into humans. The animals would be grown and harvested for their organs, just as they are now for meat.

Does this seem like a good idea? Is this any different from raising animals for meat? Are there any ethical concerns if an animal is raised for its organs rather than its meat? If so, why? If not, why not? Are there any other concerns this possibility raises, either scientific/medical or otherwise? Discuss this issue and its implications for our society.