ABSTRACT
Advances in medicine promise healthier lives through therapy in the womb, genetic manipulation, construction of artificial organs, use of designer drugs and application of other ingenious techniques for restoring organ function. Pediatric liver transplants require skilled surgery, long hospitalizations, many transfusions of blood, perpetual suppression of the patient’s immune system and extended counseling for the family and child. Identifying fetuses at risk for congenital liver disease during pregnancy and then repairing the disorder by gene therapy should prove considerably cheaper, particularly if such therapy could be given once, early in life. Treatment with designer drugs made to order for the problems, with microchip implants that release needed chemicals into the body or perhaps with virtual-reality therapy, in which patients find relief from their condition in a computer-generated fantasy world, may well prove far less costly. The very reductionism to the molecular level that is fueling the medical revolution also poses the greatest moral challenge we face.
