Ethics in Medicine

Medical Research

Cloning• American scientists at a private company have

stunned the world’s medical community by cloning (reproducing asexually) a human embryo for the first time, a move they say holds hope of ridding our species of illness and pain.

• Massachusetts-based Advanced Cell Technology Inc. said it had created the clones in order to produce a store of lifesaving embryonic stem cells, not cloned humans. At present, though, few rules prohibit other scientists from using the technique as they wish (Mitchell, 2001, p. A1)

Thoughts????

The debate

• Much debate has arisen within the medical profession about whether scientists and doctors have the right to manipulate human cells, no matter how beneficial the potential outcome

• Is it ethical to clone embryos for research and medical treatments? Should scientists develop techniques that could be used unethically by others?

For example…

• Although ACT Inc. has said it will not clone humans, nothing is stopping other scientists from using ACT’s research to do so

Dolly the Sheep

• Dolly was cloned in 1996 (died 2003) and had three mothers (one provided the egg, the other provided the DNA, and the third carried her to term).

• She was created using the technique of somatic cell nuclear transfer, where the cell nucleus from an adult cell is transferred into an developing egg cell that has had its cell nucleus removed. The hybrid cell is then stimulated to divide by an electric shock, and when it develops into a blastocyst it is implanted in a surrogate mother

Nuremberg Code

• Medical ethics have always been important, however when evidence of Nazi experiments on inmates of concentration camps became public at the end of WWII, interest and concern was heightened

Nuremberg Code• Between December 1946 – August 1937, 23 Nazi

doctors and medical researchers were tried in Nuremberg, Germany for performing cruel and inhumane experiments on prisoners

• An estimated 100,000 people died horrible deaths in the concentration camps as doctors researched things like how long people could survive while immersed in cold water, how long they could survive while drinking only sea water, and at what point the lungs burst because of atmospheric pressures.

Nuremberg Trials

• http://www.youtube.com/watch?v=kWR2I5Q9d9U

Experiments

• These experiments were conducted supposedly to assist in developing better survival procedures for Nazi pilots whose planes were shot down.

• Such experiments were clearly unethical, primarily because the experiments required that the subjects be killed, but also because they were inhumane and were conducted without the informed consent of their subjects

Informed Consent

• …means the subject of a medical procedure or experiment must be able to understand the risks involved and give permission for it to proceed, knowing these risks

Nuremberg Code

• When the three-judge panel delivered its verdict at Nuremberg, (seven were executed, eight sent down for long prison sentences), it also created the Nuremberg Code, an ethical guideline for researchers

• “The voluntary consent of the human subject is absolutely essential…”

• Although the code has no legal authority, it was a powerful statement to future courts dealing with similar cases

Did it stop there?

• Between the 1930s and 1970s, the US Public Health Service engaged in a longitudinal study of more than 400 African-American men in Alabama who were suffering from syphilis.

• The subjects were not told that they had the disease, nor were they offered any kind of treatment, even after the introduction of penicillin as an excellent treatment in 1943

What about Canada?

• McGill University administered LSD and electroconvulsive treatment on 23 female prisoners at the Kingston Prison for women in the 1960s as part of MK-ULTRA.

• The prisoners were not informed of the possible side effects of these treatments

• Such experiments are no longer permissible in Canada. Doctors must obtain informed consent from patients first.

Your Task…• With a partner, review the Nuremberg Code.

What sections do you agree with? Disagree with? • Together, create an 11th point to add to the code• Keep in mind, this was created in the 1940s. The

world, and technology, has changed drastically since then. Try to amend the Code to reflect these changes in society.

• Be prepared to share• Tomorrow’s Topic: Stem Cell Research, Prejudice

& Discrimination