Ethical and Legal Aspects of Genomic Engineering and Germline Gene Modification

The article "A prudent path forward for genomic engineering and germline gene modification" by Baltimore and colleagues explains the advancements in the issue of genomics. The authors explain that there is a great potential of altering both human and nonhuman gene content. The article states that the significance of the gene modification is to provide solutions to some genetic diseases. Besides, gene replication and modification help in changing the productivity of both plants and animals hence enhancing food security. Genomics provides the ability to correct errors that occur during plant or animal growth. However, there are risks involved in applying genome engineering expert in the modification of plants and animals. The article gives a report of discussion that was held in Napa, California to check the medical, ethical, legal, and scientific implications emanating from the use of genome technology. Also, the article highlights the crucial areas that need to be addressed to facilitate the use of the technology in future developments (Baltimore et al., 2015). Further, the article lists the procedure that should be followed when practicing genomics and ensure that the procedures are safe and follow ethical protocols.

There are various ethical actions that should be undertaken by a nurse when handling the issue of genomics. Firstly, nurses should perform a risk assessment to ascertain whether the patient is legible for genetic operation. The nurse should ensure that the health of the patient is not at risk before being allowed to undergo genetic modification. Secondly, a nurse should analyze the relationship between genetics and the disease being treated. If the correlation between genetics and type of disease is insignificant, the patient should not undergo genetic alteration (Haber & Singh, 2014). Thirdly, the patient's consent should be obtained by the nurse before any genetic modification is carried out. The nurse should ensure that the patient is in sound mind while signing the consent form. Before issuing the consent form, the nurse should clearly explain to the patient the impacts of genetic modification on his/her health. Nurses are also obliged to provide information on genetics to patients if they are likely to undergo genomic procedures. Moreover, nurses should keep family members informed of the progress of genomic operation being performed. Additionally, a nurse should discuss with patient's family the implications of the genomic procedure on the life of the patient.

There are legal issues that may be associated with genomics is the patient's right to treatment. It is the right of the patient to be treated, failure to which the healthcare professional may be sued. Also, the nurse should ensure that the consent form is duly signed by the patient while in a sober state. Also, a genomic procedure should not be performed on patients without their knowledge or against their will (Haber & Singh, 2014). The nurse should categorically inform the patient and family members of the procedure to be performed so as to give an opinion on the matter. If the parties reject the genomic operation, their will should be respected and no procedure should be performed.

Case Study

The ethical issues in the case study are that the patient is in need of immediate medical treatment. The nurses have to attend to the patient first before others so as to save a life. The patient has the right to be treated regardless of whether they are conscious or not. Another ethical issue is that the trauma alert has gone off, and therefore nurses who are in a position to assist should move to the emergency section to attend to the patient who is in a critical condition. It is ethical for nurses to volunteer in times of emergency to assist in any way with the purpose of trying to save a life (Cohen et al., 2013). Besides, it is ethical for the neurosurgeon to discuss the progress of the treatment with patient's family members and informing them of their father's condition.

One of the legal issues is that the patient has self-inflicted Gun Shot Wound (GSW), and therefore the local police should inform on the incident as treatment is in progress.

 After receiving the information that the patient had signed DNR orders, there arise both legal and ethical issues. The patient left a signed Do Not Resuscitate (DNR) note two days ago. The DNR is a legal document that should be respected and downplaying its significance may result in a legal case (Haber & Singh, 2014). It is an ethical aspect to respect the wishes of the patient as expressed in the DNR form. Besides, it ethical to consider the circumstances under which the DNR was signed to determine whether to honor it or continue with the surgery. Also, it is ethical to consider the input of the family members towards the treatment process to understand the best course of action. It can be stated that the patient was not in a sound state of mind while signing the DNR note owing to the emotional stress of bereavement, and therefore the neurosurgeon should continue with the operation as per the family members' wishes. The conditions surrounding the patient at the time of signing the DNR may have clouded his decision.

References

Baltimore, D., Berg, P., Botchan, M., Carroll, D., Charo, R. A., Church, G., & Greely, H. T. (2015). A prudent path forward for genomic engineering and germline gene modification. Science, 348(6230), 36-38.

Cohen, D., Sevdalis, N., Taylor, D., Kerr, K., Heys, M., Willett, K., & Darzi, A. (2013). Emergency preparedness in the 21st century: Training and preparation modules in virtual environments. Resuscitation, 84(1), 78-84.

Haber, J., & Singh, M. D. (2014). Legal and ethical issues. Nursing Research in Canada-E-Book: Methods, Critical Appraisal, and Utilization, 112.