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Medicine

Medicine. 24 April 2014. Extending life: just because we can, should we?. Life Support. Permanent vegetative state Being kept alive through Mechanical Ventilation Feeding Tube. Economics. 1 billion people living on less than $1 a day

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Medicine

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  1. Medicine 24April 2014

  2. Extending life: just because we can, should we?

  3. Life Support • Permanent vegetative state • Being kept alive through • Mechanical Ventilation • Feeding Tube

  4. Economics • 1 billion people living on less than $1 a day • 40% world population (2.6 billion) less than $2 a day • Life support more than $1000 a day • Distribution of medical technology • Other uses of those funds

  5. Quality of Life • Statistical Measure: Quality of Adjusted Life-Year (QALY) • Very personal decision • Influenced by and impacts • Family • Friends • Finances • Ageism

  6. Physician-assisted suicide • Legal in Switzerland, Netherlands, Belgium, Washington, Montana, Oregon • Jack Kevorkian • “Dying is not a crime.” • Thanatron: pushing a button to release drugs to end own life • Biggest concern is free will

  7. Nancy Cruzan case (1983) Nancy Cruzan case (1983) • First time the right-to-die issue brought before the Supreme Court

  8. Terry Schiavo (1990) • cardiac arrest • persistent vegetative state • 15 years: feeding tube • husband vs. parents • Florida courts and governor • Estimated cost: $400,000 a year

  9. Daily living

  10. Kidney Failure: Home Dialysis Chronic Illness support Diabetes: Insulin Pumps No injections Flexible eating Fewer glucose swings Diabetic ketoacidosis Costly Continual attachment Training and set up Replace lost kidney function Avoids hospital visits Training and set up

  11. Artificial Heart • Completely self-contained artificial heart • Readily available • No need for immunosuppressive drugs • Able to prolong life until a heart transplant • Now, improved power supply

  12. Computerized Prosthetics • Sensing • Finer motor skills • Balance and support • Bionic Hand is a reality • Todd Kuiken • Aimee Mullins

  13. Addressing Blindness • For macular degeneration: embedded telescope • Bionic eye: Argus II Retinal Prosthesis System • Camera built into a pair of glasses. • video-processing microchip in handheld unit • radio transmitter to implanted receiver • sends pulses to retinal implant

  14. Speech-easy for Stuttering • People who stutter can speak “in chorus” • Hearing aid repeats own voice to fool brain

  15. Diagnostics and treatment

  16. MRI: Magnetic Resonance ImaginG • Uses nuclear magnetic resonance • MRI: soft tissues • Functional MRI (fMRI): blood flow

  17. Pill Cam • Capsule endoscopy • Way to record images of the digestive tract

  18. Electronic health records • Benefits • Patient Care • Research • Problems • Transition costs • Security

  19. Simplified Automotive Ventilator (SAVE) • Completely self-contained • Weighs only 3 pounds • No compressed gas source needed • Mask or secure airway. • Delivers ambient air for up to 5.5 hours on a single battery charge • Rugged

  20. Robotic Surgery • Less invasive • Ability to work on smaller scale

  21. problems • Woman dies during a hysterectomy • surgeon-controlled robot accidentally nicks a blood vessel • Man dies from an infection • intestines punctured during spleen surgery • doctor using system for first time • Man’s colon perforated during prostate surgery • Robotic arm wouldn't release tissue during colorectal surgery • Required total system shutdown • Robotic arm hits a patient in the face • Surgeon switched to open, more invasive operation

  22. Trauma Pod • Medical treatment on the battlefield • Operating room with no people • Will not require human medical personnel on-site • Human surgeon in remote location • Small enough to be carried by a medical ground or air vehicle

  23. BURNS: The Skin Gun • Today • skin grafts • several weeks or months to heal • Skin gun • electronically controlled pneumatic device • healthy stem cells isolated from the patient’s undamaged skin • aqueous solution containing the cells is sprayed on burn • heals in days

  24. cancer therapy • Nanotechnology • Radio Surgery

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