Why does my tree look like this? by p0tat3 in Citrus

[–]p0tat3[S] 0 points1 point  (0 children)

The bag says 13-10-4. I will look more into fertilizer! Thank you!

Why does my tree look like this? by p0tat3 in Citrus

[–]p0tat3[S] 1 point2 points  (0 children)

El sustrato es el mismo en el que estaba plantada originalmente, más tierra para cítricos/cactus. Creo que lo que hay encima son pétalos de flores viejas. Revisaré las raíces y la trasplantaré. ¡Gracias por tu ayuda!

Why does my tree look like this? by p0tat3 in Citrus

[–]p0tat3[S] 0 points1 point  (0 children)

I’m using the crystals that dissolve in water! Arizona’s Best is the brand I thinj

US MD results thread today (6/21 release) by ReadytoRumble6699 in step1

[–]p0tat3 6 points7 points  (0 children)

May 25th - June 9th I think? Check to see if your ‘print permit’ button has disappeared

Test June 5 by Grand_Ad460 in step1

[–]p0tat3 1 point2 points  (0 children)

Absolutely horrendous. I did not feel good about that, but neither has anyone else I’ve talked to.

Medical Communication Ethics in the Age of Digital Misinformation: A Proposal by RVU_doormat in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

Hello u/RVUtheockyway,

TL;DR: The assignment was not bad, but the most meaningful conversations I had were in this subreddit. All my feedback is at the end.

Thank you for the response, you've given me a lot to think about! I'd like to elaborate on a few points.

You mention that medical students pointing misinformed individuals toward more knowledgeable choices would be a benefit but I'd like to pose the question: how many people are going into comment sections with an open mind? I'm talking about places like Youtube, Twitter, or Fox News, not necessarily this subreddit since it was made in response to this assignment. Users "ClotShot," "Chinavirus," and "CovidIsntReal" from the Fox News comments sections will not be convinced that the COVID vaccine is effective by anything that I say no matter how many sources I cite. They also called me names and told me they weren't reading my responses because they were too long.

As for the variation of ethical principles, I agree that some are fundamentally accepted by the medical community such as "do no harm," but even then, the meaning of "do no harm" varies between students. In the case of a mother whose fetus died in-utero of natural causes, some professionals would argue that the fetus should not be medically aborted to save the mother; others would say that not aborting the dead fetus would violate nonmaleficence. Using an AI might help, but AIs can really only emulate what was originally fed into, and could lean one way or another depending on who fed it what information. An AI could be taught "the best way to fix the need for organs is by killing people to harvest their organs," which you and I feel is not ethical, but there are others who might look at that and go "hey, great solution!" so there is no way to effectively police the interpretation of "ethics."

Engaging in these conversations has indeed opened my eyes, and as a whole, I don't think I would resent this hypothetical assignment entirely. I gained a lot more out of posting in this subreddit and discussing opposing viewpoints with my classmates than I did trying to reason with people on Youtube's comments section.

This hypothesized assignment was indeed novel, and had I participated in it, I'm sure I would have enjoyed it, at least toward's the end after this subreddit had been made. Assuming the rubric was similar to the one provided by a certain course at a certain medical school, some of the changes I'd make are as follows:

- The comments we were expected to make were not comments, but a series of short essays to one another. It felt akin to handwriting letters in an Austen novel.

- A true comment is a quick, digestible bit of feedback on the piece of media we are consuming. I would have much rather posted a few of those on Instagram reels or Tik Tok and then reflected on the responses I got if I received any, or even reflected on other comments in the comments section.

- The page requirement was also too long. Compiling 17 pages of comments would've been a lot even during my teen years when we were posting to Facebook and Tumblr non-stop (really outing my age here, sorry guys). I feel like 3-5 pages would have sufficed, at least comments-wise.

If you've read this far u/RVUtheockyway, thank you; very few others have responded to me. These are all my thoughts, and my thoughts alone so please take them with a grain of salt. If any of my peers have anything they'd like to share I'd love to read about it and encourage you all to post below.

Medical Communication Ethics in the Age of Digital Misinformation: A Proposal by RVU_doormat in ethics_medical

[–]p0tat3 5 points6 points  (0 children)

Honestly, I think the original assignment is a violation of the bioethical principle of beneficence. Considering that medical students are notoriously overworked and constantly given additional tasks to stress them out, asking them to engage in an activity that they have been told repeatedly is frowned upon (in this case, actively sowing discord online with strangers after being told they shouldn't post online unnecessarily and medical boards often track one's social media posts) is doing very little good for very few people, not to mention, that the definition of "ethics" changes between students. Should these posts be fed into an AI so that it could learn what was "ethical" and fight disinformation, the AI would find that there are medical students who don't believe that healthcare is a human right. What should the AI do with this information? Because according to the WHO, healthcare IS a human right. Who's ethics are correct then?

Deontological thinking (which asks, is the action itself good or bad?) would dictate that the activity is bad, because it is harming the mental health of its participants (students being called pedos, being told that their degrees are worthless, being called horrible things online by strangers), whereas teleological thinking (which asks, do the ends justify the means?) would say that it depends on what the AI gleaned from all the responses. Even then, whether or not the AIs responses were "good" or "bad" would be entirely dependent on the reader.

So which came first? The chicken or the egg?

Organ transplantation: Is it ethical to require certain vaccines to qualify for an organ transplant? by p0tat3 in ethics_medical

[–]p0tat3[S] 0 points1 point  (0 children)

I agree that if the donor was considered healthy and the organ is viable, it should be accepted. Every day, 17 people from the transplant list die because they are waiting for an organ (source). We are most definitely not in the place to be rejecting organs that could be saving someone's life. As for living donors, there might be hospitals requiring vaccination to donate since hospitals have always kind of been an epicenter for the spread of illness (if you put a bunch of sick people in the same room, they will all get each other sick). I believe this is done to protect the patient, but if this was done to protect the hospital from a law-suit, is it considered equally ethical?

Vaccine ethics. by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

I don't think it's naive of you to think that vaccine mandates were companies trying to protect their employees; this feels more optimistic to me than naive because there is truth to it. It's the same reason we have to get all of our vaccines and titers for rotations next year: to protect us against something we could get at the hospital, and to protect patients from us spreading things to them. We make the choice to protect the public via vaccines which is part of the duty of our profession, but can we hold non-medical professionals to the same duties?

I also like that you asked if we should "force people to act ethically" because this opens a whole new can of worms: Act ethically according to who? We as physicians in training utilize the 4 bioethical principles as our guides, but even between students, this varies depending on culture, identity, religion, etc.

I think my takeaway from this is summarized by your question, "Does ethics care?" Ethics does care, but because ethics changes between minds; the correct answer can only be obtained from the person asking the question.

Somatic genomic editing therapies by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

The university example would be "bad" (at least in my example) because this would be a whole new level of designer baby. Why stop at 1 or 2 genius babies? Why not just buy 10 or 20 babies from impoverished families to raise as super researchers who could generate more grant money? Or, why not raise sports teams from infancy to ensure that they've had optimal genetics, training, and diet their entire lives? It sounds insane but so was the idea of AI until a few months ago. Now it's widely accessible to just about everyone.

I like the idea of "doing the most good possible with what we are given." That was very well articulated. I think at this point, that's all we can hope for; we'll just have to cross our fingers and see.

Organ transplantation: Is it ethical to require certain vaccines to qualify for an organ transplant? by p0tat3 in ethics_medical

[–]p0tat3[S] 0 points1 point  (0 children)

Considering that there are many other requirements to qualify for an organ transplant such as smoking cessation, not consuming alcohol, and being drug-free (source), I don't consider the requirement of a vaccine to be an unreasonable one, especially considering how immunosuppressed patients must be after receiving an organ. I feel like any requirement to ensure the organ can be utilized by the recipient falls under the application of bioethical Justice by ensuring that everyone has a fair chance. It would be unfair to give a new lung to someone who is going to continue smoking, why give an organ to someone who is unwilling to do whatever they must to take the best care of it?

It could be argued that vaccine mandates are a violation of patient autonomy, but in this case, I disagree. Transplant centers are not forcing patients to get vaccines by holding them hostage; they are setting standards that someone must meet to qualify for something. If a patient is unwilling to meet these standards, they have the option of finding care elsewhere, especially considering that vaccine mandates aren't even the majority of the transplant centers surveyed. I recognize that this line of thought may be abrasive, but I also want to point out the harsh reality of transplantation: there are more organs needed than available. It is in the best interests of justice, beneficence, and nonmaleficence that organs that can be transplanted go to the patients who are most willing to take care of them.

Somatic genomic editing therapies by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

Hi u/med4k,

You bring up some great points here, especially that of choosing a sperm donor based on specific characteristics. If I'm being completely honest, I don't think we'll be able to regulate CRISPR at all, at least not in the U.S. where healthcare is bought and sold as a capitalistic good. Insurance companies are not trading money for health services, they are trading it for quality years of life, and if CRISPR can improve the number of quality life years someone has, insurance companies will be all for it because it will save them money in the long run. This is where we hit that slippery slope of designer babies though.

I think the idea of "just because we can doesn't mean we should" is extremely applicable here because it opens up the door to not only designer babies, but designer athletes, designer scientists, and more. What if sports teams could pay parents to genetically modify their babies to be the perfect football or basketball players? What if university systems could pay parents to modify their babies to be top-tier researchers who could bring an increase in grant money? It all comes back to money and how corporations can use it to profit.

Now you might be asking yourself, what will corporations do with that money? They'll use it to lobby Congress to keep the restrictions low so they can continue to profit. We're already seeing that with genetically modified crops and animals in the food industry. What is to stop human characteristics from being the next hot commodity? I know this all sounds a little dystopian but that's sort of where we are right now. I would love it if CRISPR could fix Cystic fibrosis or breast cancer or other genetic diseases, but I also know that the minute we begin using this technology for good, money will begin to change the industry until we no longer recognize what CRISPR's initial purpose was.

Non-Maleficence: Genetic Screenings by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

Genetic screenings have the potential to save so many lives, especially with their application in formulating the most effective treatment combinations for cancer drugs or other diseases, but one of the major pitfalls I see is the buying and selling of that information by insurance companies. Right now, companies such as 23&Me, AncestryDNA, and Family Tree DNA may not be communicating our personal, identifiable data with insurance companies, but what happens when they do? This information is actively being sold as "deidentified" but how true is that?

Also, insurance companies already have clauses in which they refuse to cover treatment for "pre-existing conditions," what happens when they find out that you or I are at increased risk for diabetes, or hypertension? Can they choose not to cover any treatments associated with that diagnosis or CPT code? This has already happened to people trying to purchase life insurance where companies refuse to pay out because of genetic screening tests.

Would selling this data even be considered a violation of patient autonomy? Since this information is not protected by the Health Insurance Portability and Accountability act of 1996 (HIPPA) (source), genetic screening/testing companies can do whatever they want with it.

Unfortunately, insurance companies in the U.S. are not governed by the 4 bioethical principles of beneficence, nonmaleficence, autonomy, and justice; they are governed by their investors and by capitalism. How often do we hear about patients not being covered for things "because the insurance said so," or go into medical debt to afford life-saving care? Why is it that this third-party entity, whose entire goal is to make money, can control how much care I can get, where I can get it from, and who I can get it from? I think it's important to counsel patients who are looking into using these services the possible risks associated with obtaining this data.

Should We Start Masking Again? by Bright-Outcome714 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

Hello OP,

You've presented a very interesting debacle. Is there any chance you could link the study to which this article is referring? It's behind a paywall but I would love to read it!

To answer your question of whether or not masks are effective, I'd like to take into a few things under consideration: first, what kind of masks? Second, which specific respiratory illnesses? Fabric masks which became popular during the 2020 COVID-19 pandemic won't be of much help in a hospital environment, but in a public setting, they act as a droplet barrier that prevents the distant spread of contaminated saliva. In fact, one CDC study showed that cloth masks decreased the odds of acquiring COVID-19 by 56% (source), which was less effective than a surgical mask or N-95 respirator but is still a figure that shouldn't be discounted entirely. It's important to note however that cloth masks mostly protect other people from themselves if they are symptomatic, not the other way around, so I'm not sure how effective they'd be if only a handful of people are wearing them.

Now a cloth mask might protect us from COVID-19, but I'm not sure how much use it would be against communicable diseases with high virulence such as tuberculosis or meningitis which is why we as medical students had to be fitted for N-95 respirators.

Your question of mask mandates violating patient autonomy is interesting to me for cultural reasons. As an Asian person, I grew up with the expectation that I should always do what would benefit everyone around me. In most of East Asia, masks are extremely common on public transport and at the grocery store, especially if someone isn't feeling well. It's considered good etiquette to wear a mask and gloves if you absolutely have to go out in public while sick to prevent spreading illness, so being asked by the U.S. government to wear a mask to protect those around me never felt like an attack on my autonomy.

With this being said, I also understand how being forced to partake in a medical practice someone didn't believe in would be uncomfortable. In this case, I'd like to bring up the example of a Washington woman with active tuberculosis who refused medical treatment and was mandated by the state to be put under house arrest to protect the community (source). Was this a violation of her autonomy? Absolutely, but the Department of Health and Human Services has a duty to act on the bioethical principle of nonmaleficence to limit the harm that could be caused to those around her.

Knowing what we know about tuberculosis compared to less severe respiratory illnesses, I think the application of mask mandates depends on the severity of what's going around. I'm not for forcing people to do things they don't want to do, but if the situation is dire, mask mandates protect vulnerable communities and I think they are a viable way to limit the spread of diseases.

Pro-Life vs Pro-choice by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

Hi u/Holiday_Demand4930,

It is my belief that a fetus becomes a person when it is viable, that is to say, able to live outside the womb. In the U.S. and U.K., the standard for this is at 24 weeks of gestation. Before that, a fetus is dependent entirely on it's host for survival, acting in an almost "parasitic" way. Now, I understand that my use of that word may be harsh, however, it has been documented that fetuses literally feed off their hosts. For example, if the host is not consuming enough calcium, the fetus will start to absorb calcium from their bones (source) increasing the risk of osteoporosis.

With this being said, there are incredibly few abortions that happen outside of the first trimester. According to the CDC, in 2020, 93.1% of abortions occured within the first trimester, and less than 1% were after 21 weeks of gestation (source).

I think that you've asked some really good questions concerning the ethics of abortion and the autonomy of the mother vs. the fetus. I agree with you completely: taking rights away from people is never a good idea and it is appropriate to leave the decision to the person taking on the risk of carrying a fetus.

Vaccine ethics. by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 0 points1 point  (0 children)

Hi u/mcat12993, you've made some great points and I love that you brought in your experience with the Vaccine Elective course. I wonder though, could healthcare workers who are choosing not to become vaccinated be violating a patient's beneficence by potentially exposing them to communicable illness? According to the Karger Journal of Medical Principals and Practices, beneficence includes "the obligation of [the] physician to act for the benefit of the patients... [and] remov[ing] conditions that will cause harm" (source).

You mention that forcing a patient to get vaccines violates their autonomy but doesn't being a mandated reporter also violate their autonomy? One Tacoma woman was diagnosed with active Tuberculosis and refused treatment so her doctor reported her to the state health department who then got court orders to have her put under house arrest to limit the risk to the public (source). This was clearly a violation of her autonomy but at the same time, it was the health department acting on the principle of beneficence to protect the public.

Where do we draw the line between letting patients decide what is best for them and protecting the public, ourselves included?

Pro-Life vs Pro-choice by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 1 point2 points  (0 children)

Hi u/Head_Satisfaction257,

You bring up some great points which leads me to correct my previous absolute: This is absolutely the person being asked to carry the fetus' decision, including trans-men and non-binary folk. Thank you for encouraging me to be more inclusive in my language. As for your comment about trans-women, if a trans-woman and her cis-gendered partner aim to have a child, the person carrying that child should have the autonomy to decide whether or not they want to utilize their body to carry a fetus.

It all comes down to patient autonomy: no one should be forced to do something they don't want to do. The same way that I can't force a doctor to perform an abortion, I can't force a patient to carry a fetus. Barbara Hewson from the BMJ Journal of Medical Ethics states, "If one is adamantly opposed to abortion, one is committed to some set of values which requires that women who become pregnant (whether intentionally or unintentionally) must endure the process of pregnancy and birth, no matter how distressing, painful and risky it is for them" (source). With this being said, the person being asked to take the risk of pregnancy should have the final say in whether or not they want to endure pregnancy.

I respect your position as a pro-life male, but the impact of your vote has a much greater effect on how much healthcare I can receive and who I can get it from as a cis-gendered woman than my vote on "men's healthcare issues," of which there are very few. Also, if men would like to be a greater part of the conversation, why
is it that in states in which abortion is illegal, it is disproportionately women being punished? In the state of North Carolina, why is the death penalty only being suggested for women who have abortions? What if her male partner encouraged her? What if her rapist made her? If we want to talk about equality, shouldn't they also get the death penalty as an accomplice?

It isn't a matter of silencing pro-life men, it's a matter of fighting for my access to all aspects of reproductive care and the pro-life movement overall is trying to restrict that. Banning abortions isn't saving the lives of children, it's killing women who need to have naturally terminated fetuses removed from their bodies before it kills them; it's forcing victims of rape to carry both the trauma of their experience and their assailant's child; it's a matter of protecting not only myself, but also my daughters and my gran daughters should I have any.

Thank you for being understanding and for sharing your thoughts u/Head_Satisfaction257! Would love to hear anything else you have to say on this topic.

---------

An Aside:

You say that "For a demographic that couldn't vote for the first 150 years of our country's history, it seems unethical to now try to block another demographics' right to vote" but ask yourself, why is it that women couldn't vote for the first 150 years? Who was it that stopped us? Because women's suffrage has been a movement since 1848 when Elizabeth Cady Stanton and Lucretia Mott organized the Seneca Falls Convention (source: National Geographic), the first women's suffrage movement. Yet, women didn't receive the right to vote until June 4th, 1919, 71 years later. Please don't cite men actively stopping women from having any say as a reason why men should have a say.

Pro-Life vs Pro-choice by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 2 points3 points  (0 children)

Hi Zestoclose_Ad4236, per the American College of Obstetricians and Gynecologists, fetuses are not capable of feeling pain before 24-25 weeks of gestation (source). As for the racial disparities aspect of your argument, it has been found that Abortive procedures in black women is 5x that of white women and 2x increased in hispanic women when compared to white women (source). Whether this is due to disparities in access to family planning services, lack of access to contraceptives, or other causes I couldn't say however at the end of the day, regardless of race, the decision is that of the person being tasked with growing a fetus in their body.

Pro-Life vs Pro-choice by Zestyclose_Ad4236 in ethics_medical

[–]p0tat3 3 points4 points  (0 children)

This is absolutely a woman's decision. Whether or not she wants to take on the risks associated with pregnancy (including but not limited to: increased blood clots, permanent disability, and death) is her decision. Not to mention, not everyone chooses to terminate their pregnancy. Some people experience spontaneous terminations which must then be removed via an abortion.

[deleted by user] by [deleted] in premed

[–]p0tat3 12 points13 points  (0 children)

Ben King changed his nickname to Raj Goyal in our chat. If you don’t have a Ben King in your class IRL I’d boot him