Ricardo Gonzalez
ID: L31156909
October 10, 2021
Journal Entry: Next Steps
Liberty University
Master of Arts in Medical Sciences
MSCI 640-B01
Introduction
As this class comes to an end this week, the lessons and opposing viewpoints that have been
presented through the weeks have been the impetus that has driven me to further educate myself
about the world around me. Much to my chagrin and austerity, I have learned to be open-minded
and listen without interruption as we all have essential and equal opinions about everything. I
have always kept in mind to always be mindful. It has paid dividends as I have gotten the chance
to learn from all my classmates and engage in robust and cathartic conversations. All the topics
that we have covered, no matter the difficultly, I believe were put in place to take us outside of our
comfort zone and think critically and thoughtfully to all of the case studies presented. These were
all situations that could happen in any setting, so learning for them has prepared me for any
complex topic of conversation that I might encounter throughout my journey through medicine.
This week's video parting thoughts featuring the famous Dr.Fabich was really inspiring and has left
me with an everlasting impression. In his remarks suggesting if we viewed this as just passing a
course, it would have been pointless. The right way to continue this journey is by having a biblical
worldview. He firmly remarked when he looked at us and sent write down why you want to
become a "Doctor" and always keep it with you because you will question yourself throughout the
journey. I stopped the video, and I actually did that; I wrote down all the things that came from my
heart as to why I wanted to do this. I accept the bible and understand that we live in a fallen world,
which is a God-given duty, and I want to help the most people I can before my time is up. I kept
the note saved in my phone in a folder titled dream. Psalm 119:105 Your Word is a lamp to my feet
and a light to my path.
Next on our topics was the ethical issues surrounding gene therapy. The general consensus of the
class, although somewhat ambiguous, was leaning on its approved use for defects only. The
problem with gene therapy has several important implications; who will be the governing body
that chooses what and who will be allowed to partake in gene therapy? At the current time, gene
therapy is an experimental technique that is used to prevent or treat disease.1 The process itself
remains a hazardous procedure that must be treated with the utmost caution. The FDA has no
actual approved treatment for any disease or disorder; all therapies are currently under a research
setting. For a scientist to insert a gene inside someone, they have to use what is called a vector. A
vector serves as the vehicle for which the gene will be delivered into the organism. One of the
best-known vectors is viruses; however, they must be modified to not cause harm or disease to
the individual it is injected into. A study conducted by Cederfjäll et al. concerning the use of L-
DOPA in patients with advanced Parkinson's outlined that as the disease progresses, the drug
becomes less effective.2 One of the main concerns with these patients is that continuous
dopaminergic stimulation of L-DOPA usually occurs peripherally with an undesirable side effect
profile. The viral vector, as mentioned above, would be a promising alternative paradigm that
can alter a side effect profile. There have been preclinical studies in animals that have shown
progress through therapeutic gene replacement that encode the enzymes required for dopamine
biosynthesis.2 However, this trial is still in phase II, which has yet to outline safety protocols and
prove efficacy for continued use. I believe the shift for that study and for any future gene therapy
project is to determine the safest way that a functional delivery system will not cause unwanted
side effects. One of the contentious ideas with gene therapies is determining whether a gene is
bad or good? We are still years away from anything viable in the human body that will not cause
chaos within the internal environment. It will be incredibly technology, not just to fix genetic
defects, but this could possibly be a cure for cancer and familial disease every known to man.
From years of research, we know that a combination of factors leads to oncogenic growth, the
constitutive activation of oncogenes like SRC, and the inactivation of tumor suppressor genes
coupled with a conducive microenvironment that promotes cell proliferation. Now think of
turning those genes on or off it would be revolutionary worthy of the Nobel prize. If we could
simultaneously shut off oncogene and active a TSG there, we could stop cell proliferation. A
systemic disease needs a systemic cure; gene replacement would be a systemic operation. This
field will be exciting to continue to follow. I think gene therapy can be an ethical practice, but
only if it is highly regulated. I mean oversight from an independent board in every institution that
plans to use it. That is because gene therapy borders on science fiction, and the minute we start
tampering with the human genome, we start to play God. I think God presented us with the tools
to help people in need, not abusing technology by picking desirable traits. It was not just
seventy-six years ago that six million Jews got systemically murdered because they did not have
desirable characteristics. The term neo-eugenics conjures up feelings of discontent with the
thought of the past. Genesis 1:27 So God Created man in his own image, in the image of God, he
created him; male and female he created them. I am a Christian, and I believe that we are all gifts
of God, and as scriptures say, we are made in his image no matter the defect present. It would be
immoral to decide to change a child's eye color for vanities sake.
The GMO debate was a rather exciting concept everything that we eat or have eaten has been
modified in some kind of manner; the new environmental working group analysis shows that, on
average, Americans eat almost 193 pounds of genetically engineered food in a year; 8 pounds of
beet sugar, 58 pounds of corn syrup, 38 pounds of soybean oil, and 29 pounds of corn-based
products.5 The number of GMOs consumed daily outweighs the number of people eating them.
That thought of that is just mindboggling, but that begs the question if life expectancy in
America has shot up drastically, how detrimental can GMOs actually be if we have been
consuming them for decades but continue to live longer? The better questions are to what extent,
or they modified? We know that the world's population is growing exponentially, so the solution
for feeding the world is another question to be answered. That is precisely why GMOs were
created in the first place, with crop yields having an average of 25% growth over time. There will
always be proponents for the other side, but just to wake up suddenly and disown GMOs when
they are ubiquitous without doing some proper research would be a source of chagrin for all of
us.
I want to do medicine as I mentioned above because I believe it is a calling; I am particularly
interested in cancer as my impetus for studying medicine in the hopes that the more the 619,000
Americans that will die from cancer this year will one day not have to fear for posterity. As a
society that has recapitulated the war on cancer for nearly six decades with the emergence of an
intractable enemy and only modest advancements with around a 15%-24% drop in mortality
rates, it only fuels my dedication more. A Pulitzer Prize-winning book by Siddartha Mukherjee
named The Emperor of All Maladies, a biographical account of cancers history, was a significant
eye-opener on the depths of this disease. This disease would be a prime candidate for gene
therapy if we ever reach that stage.
I would like to take some time to offer praise for the beautiful job this course and these
discussions have done. I can not speak for the entire class but what I can say is that I will leave
this course having grown intellectually and spiritually. These conversations were challenging, the
readings were challenging, but at the end of the day, the message was always to have an open
mind and an open heart. Thank you for giving back to your students.
References
1.What are the ethical issues surrounding gene therapy?
https://medlineplus.gov/genetics/understanding/therapy/ethics/.
2.Cederfjäll E, Sahin G, Kirik D. Key factors determining the efficacy of gene therapy for
continuous DOPA delivery in the parkinsonian brain. Neurobiol Dis. 2012;48(2):222-227.
https://www.sciencedirect.com/science/article/pii/S0969996111003494. doi:
https://doi.org/10.1016/j.nbd.2011.10.017.
3.. Commissioner Oot. What is gene therapy? how does it work? FDA. 2020.
https://www.fda.gov/consumers/consumer-updates/what-gene-therapy-how-does-it-work.
Accessed Oct 14, 2021.
4.Carroll, R. Bible-kjv. Oxford University Press, USA. 2008
5.Americans eat their weight in genetically engineered food | environmental working
group. https://www.ewg.org/news-insights/news/americans-eat-their-weight-genetically-
engineered-food. Accessed Oct 13, 2021.
