Survival of the Fittest and Health Care

Sure...but I am not talking about that....I am more talking about stuff like certain kinds of stress seemingly triggering the expression of a genetic vulnerability to schizophrenia, or interfering with optimal foetal development etc., not health choices made by people after they become able to make choices.

You have documentation that the number of people carrying such genes is growing?

No. Whether or not gene frequency is changing in a population depends on how genes behave, so my explanation is very relevant.

Without mutations and without controlling mating habits in a population, it is biologically impossible for gene frequencies to change.

Are the genes that cause black skin defective?

Are the genes found among Jews defective?

If homosexuality is caused by genes, are these genes defective?

If alcoholism is caused by genes, are these genes defective?

If it is possible to identify defective genes, who gets to do the identifying?

So what should we do? Sterilize people who have genes for schizophrenia or prevent stressful environments for people that have schizophrenia?

If medical care in the western world allows the medically "unfit" to survive, presumably people in 3rd world countries that lack adequate health care would be far more fit because those with defects simply die before reproducing. But that's not the case. If lifespans are increasing and overall health in the western world is improving, I'd say that indicates a general increase in fitness whether it is due to genes or environment.

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So what should we do? Sterilize people who have genes for schizophrenia or prevent stressful environments for people that have schizophrenia?

Just a note : I doubt it's possible to achieve the second option to any great degree or effectiveness.

If you frame the problem as preventing stress, for instance, then that cannot be done....

however, really good understanding of the actual mechanisms that do harm, allows for intervention that has the potential to be really effective.

Nope. It does however seem a likely outcome of the removal of survival of the fittest - those who would otherwise have died get to pass on lesser quality genes. Of course, it's not quite that simple - I'm boiling it down.

The natural order of things has changed through the health cares removal of survival of the fittest.

This statement is in error - there are a wide variety of genes out there to play with.

There is a gene that contributes to alcoholism. Whether it is a defective gene or not would be debatable.

Scientists are identifying genes and their roles all the time.

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If you frame the problem as preventing stress, for instance, then that cannot be done....

That's what I think also.

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however, really good understanding of the actual mechanisms that do harm, allows for intervention that has the potential to be really effective.

We are in agreement on this - what you quoted me on was specifically in relation to stress triggered bouts of schizophrenia, not to other illnesses.

Sorry...not meaning to nit-pick with you, I just think it's an interesting topic, and I know about it, so I can't shut up.

A major proof against sterilisation being effective eugenically was the Hardy-Weinberg Law, from 1908. They had observed that while "undesirable" genes are seen in the sufferers of some diseases, the genes that might be responsible for the traits were widely dispersed in people who do not manifest these diseases or traits. This analysis describes the behaviour of recessive harmful alleles. It was subsequently found that some of these harmful traits have been positively selected in some populations, because in the heterozygous state they confer an advantage on the carriers, for example sickle cell disease in many Africans, and the gene for Tay-Sach's disease in many eastern European Jews. This argument is also a powerful argument against future eugenic selection: we do not know the future diseases in which some apparent defect may be advantageous. If we used a sterilisation program against a recessive allele that is in the population at a frequency of 5%, it would take 200 generations of total sterilisation of the homozygous individuals to reduce the frequency to 2.5% of the individuals carrying the allele. Though there would be significant reductions in the number of homozygous individuals born during the first few generations. The presence of carriers who did not express the defective trait meant there would always be potentially new homozygous individuals in the population, and continued screening would be required to detect them.
Some claim that because we are keeping many genetically handicapped people alive long enough for them to reproduce this has led to genetic decay. This has been an argument of eugenics' supporters for the last century (Huxley 1963). This has been a much used argument in the past, but it is not substantiated by evidence. There is no evidence to say that the human gene pool is deteriorating because we can treat genetic disease. Even if there are many people reproducing with the genetic diseases the impact on the gene pool is very slow. In the case of a single recessive gene in the population at a frequency of 0.5%, it might take 70 generations for the incidence of the gene to double, to 1% (Crow 1968). What may be more important is the rate of new mutations occuring, because of environmental hazards such as radiation or chemicals, and the best strategy is to eliminate these hazards from the environment. Certainly pPrenatal screening and selective abortion can reduce the number of individuals born with genetic diseases. However, the ethical justification for using these techniques is not to be found in protecting the interests of society but on protecting the interests of individuals and their families. This screening can have a major affect on the next generation, for instance the annual number of children born with Tay-Sach's disease in the USA used to be 50, but since the use of genetic screening the number has fallen to 10-12. For the forty families that do not have a child born, it makes a major difference.

Well if we had survival of the fitess then a lot of people would die and that would be bad though we end up with a stronger specie. that we don't have survival of the fitess differenciate us from animals so I guess if we want humanity to "progress" we need to eliminate that natural selection so smart who are weak can help out.

actually we have the power to control ("stop" is too strong for this) natural selection to some point. with our technology we can keep people with unfavorable genotypes alive.

we do have some natural selection, for example men look for woman with big boobs and wide hips while woman look for healthy good-looking males so after many generation we may end up only with people with this characteristics.

Terry wrote:

Natural selection quite often leads to extinction - 99% of all species that ever existed are gone - some to catastrophe, but others (Neanderthals, for instance) lost out in the survival game.

Natural selection or catastrophic environmental conditions? Are you familiar with Bumpus' sparrows? As long as the environment remains constant or changes very slowly the genes in a population seem to be preserved even when they put the bearer at a disadvantage. But when catastrophe strikes the change is too quick for some genes and their bearers die off.

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I agree with Phoenix that spending millions on one hopeless case at the expense of thousands of other children who suffer due to inadequate medical care does not seem right.

When have millions ever been spent on one hopeless case?

And what happens if we do spend millions on one "hopeless" case so that doctors can learn from it and thus develop ways to better treat such cases in the future? If money hadn't been spent on the fist incubator that saved a premature baby, I wouldn't be alive. And the money that was spent on me has, no doubt, enabled babies that are born far more premature than I was to survive.

If money hadn't been spent treating a patient with terminal kidney disease, we likely wouldn't have dialysis machines or kidney transplant operations.

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No one said anything about killing off the sick and infirm.

If you don't kill them off, how do you not spend money caring for them?

I had never heard of Bumpus' sparrows, but after looking it up it seems that he failed to consider all of the sparrows that weren't incapacitated by the storm or found cover, thus avoiding collection.

I agree with Phoenix that spending millions on one hopeless case at the expense of thousands of other children who suffer due to inadequate medical care does not seem right.

I do know that special education of the untrainable costs my school system quite a lot of money, and that surgery and other treatments in many cases is quite expensive with no hope of improvement (I personally know one such case with cerebral palsy).

I agree that money needs to be spent on medical resources, but not on repeating non-effective treatments that do nothing more than keep bodies alive.

You were not a "hopeless case" and I have no doubt that the money spent on you was justified.

Being brain-dead or involuntary suffering due to a non-curable condition might be. It would have to be determined on a case-by-case basis.

I am not aware right off how many sparrows Bumpus collected, but how would you determine the number of sparrows needed to be a representative sample of the entire sparrow population? And if the dead sparrows that Bumpus did collect couldn't find shelter or otherwise survive the storm, why should we conclude that some sparrows with similar morphologies did find shelter or otherwise survive the storm? If sparrows with usual physical traits survived, wouldn't you have to conclude that roughly an equal number with normal morphologies survived as well? How else could you explain the fact that among the sparrows that were collected it was mostly the ones with unusual morphologies that died?

But, then Hardy-Weinberg explains how unusual traits are preserved in recessive genes so natural selection may not really lead anywhere. Species either survive or go extinct, but they don't evolve into different species.

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I agree with Phoenix that spending millions on one hopeless case at the expense of thousands of other children who suffer due to inadequate medical care does not seem right.

But what right do thousands have to demand that one die?

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I do know that special education of the untrainable costs my school system quite a lot of money, and that surgery and other treatments in many cases is quite expensive with no hope of improvement (I personally know one such case with cerebral palsy).

So every person with CP should be taken out and gassed so they don't cost you money?

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I agree that money needs to be spent on medical resources, but not on repeating non-effective treatments that do nothing more than keep bodies alive.

Doctors may see every "hopeless" case as a learning opportunity.

Define brain dead. And what happens if society's definition of brain dead changes in the future to include people that decide to join a particular political party or religion? And who gets to decide when suffering is involuntary? And how do you keep the opportunity ("right" if you will) to die rather than suffer from becoming an obligation to die rather than burden society?

He was given 136. Over half revived in his lab. We cannot conclude ANYTHING about the sparrows that were not collected since we know nothing about them, other than that they weren't lying around half dead when the collectors came by.

Of course species evolve into other species! Sometimes the original species survives as well, sometimes it doesn't. What makes you think that they don't evolve?

No one demands that anyone die.

I didn't say that,

but in this particular case, the one being kept alive has no quality of life and seems (to me) to be suffering needlessly.

So you think that it is OK to use disabled children as medical guinea pigs? (This is how you have been distorting what I write.)

Brain dead is when EEGs or other tests of brain function show that consciousness is no longer possible.

While I may think that a person who believes in a particular religion must be brain-dead :wink: , they are NOT brain-dead by any medical definition.

Suffering is involuntary if the person experiencing it has no choice in the matter.

(such as a consensus by 3 doctors and counseling)

Why would a sample collected in nature not indicate anything about the general population found in nature?

Because natural selection is a conservative force, not an innovative one. Bumpus' work shows that natural selection tries to preserve what is normal, i.e., a species does not change.

Refusing to give care that can save someone life isn't demanding that they die?

You have someone with CP and you refuse to try to train them and refuse to give them medical care. That person will shortly die, so how have you not effectively demanded that person be killed?

Where is it your place to make these judgment calls for another person?

I am saying that this is how medicine works. We will never learn how to save the terminally sick or the severely disabled if we don't try to save the terminal and disabled people we have now.

That's the definition now, but what happens if society changes the definition in the future so that not having a certain kind of brain function makes you brain dead?

But if people like you are willing to say believing in a particular religion makes a person brain dead, what will keep society from forcing doctors to make your definition the medical definition sometime in the future?

So you are willing to let others make medical decisions for people. This is just what the Nazis did with Aktion T4 when it took 3 medical experts to decide when people from birth to age 3 were life unworthy of life and thus had to be euthanized http://www.historyplace.com/worldwar2/holocaust/h-euthanasia.htm.

Has anyone given thought to the fact that we are removing survival of the fittest from the (western world) human equation?

Has anyone given thought to the fact that we are removing survival of the fittest from the (western world) human equation?

I mean, people with heritage of things like breast cancer, heart disease etc, are more likely to develop said problems.

Allergies seem to be spreading rapidly, and each generation seems to have more allergies (though I could be wrong on this one).

Survival of the fittest means those people with 'defective' genes would die out and not pass them on, yet with our health care they are.

What happens 3, 4, 5, 10 generations down the track - will every single person have a health problem? Multiple health problems?

If so, should something be done about it...or is it something that should be consigned to the 'too hard basket'?

...or hope that genetic engineering advances enough that we won't have to worry the answer to that question