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By Michael J. Hyde, James A. Herrick

Technology, rhetoric, and talking in regards to the post-human future.

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technological know-how, rhetoric, and talking concerning the post-human future Read more...

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Additional info for After the genome : a language for our biotechnological future

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Alternatively, what is considered normal kidney function might not change, such that use of a regenerative medicine intervention would be categorized as “prevention” or “treatment” depending solely on the measured kidney function that serves as the basis for the intervention. And here some additional nonmedical factors are likely to come into play. Because health insurance reimbursement is provided only for medically indicated treatment and a small select category of preventive interventions, such as immunizations (primary prevention) and some diagnostic screening and testing (secondary prevention), unless the category of reimbursable preventive interventions expands considerably, patients and their doctors will prefer to change the point at which kidney disease is diagnosed in order to be assured that health insurers will provide them with financial access to earlier “treatment”—which then is not readily distinguishable from secondary prevention.

As these treatment methodologies continue to evolve, they must follow strict scientific guidelines in order to produce credible, high-quality results that are accurately reproducible. Researchers must create a thorough fund of knowledge by conducting extensive investigations at the basic science level in the areas of cell and molecular biology, biochemistry, biomedical and chemical engineering, and biomaterials science. There are still many gaps in our fundamental understanding of biological processes, and much more laboratory, animal, and clinical research is needed.

And when direct benefit is at least somewhat likely for subjects, the line between treatment and research can be difficult to maintain. it can also be difficult to articulate—and to understand—outside the highly specific context of the informed consent process in a given clinical trial, as the following example will demonstrate. The decision to publish the results of the bladder augmentation trial reflected a determination that follow-up had been sufficiently extensive to declare the intervention successful.

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