SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 BIOETHICS ONCEPT OUTLINE} |. Introduction to Bioethics 1.1 Bioethics. Very prevalent in the areas of medicine, healthcare, and biomedical research. 1.2 Origin of Bioethics. The American biochemist Van Rensselaer Potter coined the term bioethics in 1970 to describe a new philosophy that sought to integrate biology, ecology, medicine, and human values, 1.3 Importance of Bioethics. Bioethics in healthcare brings understanding and knowledge among healthcare professionals about medical practice. Il. Principle of Bioethics 2.1 Principle of Autonomy. These are the rights of an individual to self-determination and respect for their ability to make informed decisions about personal matters in freedom. 2.2 Principle of Beneficence. These are actions that promote the welfare of others. 2.3 Principle of Nonmaleficence. The principle that states that there is an obligation not to inflict others. 2.4 Principle of Justice. The principle that seeks to eliminate discrimination in biological studies and healthcare. Ill, Environmental Bioethics 3.1 Human’s Responsibility for the Environment With climate change posing a threat to future generations, itis crucial for individuals, organizations, governments, and businesses to take responsibilty for environmental protection through such initiatives. IV. Topics in Bioethics 4.1 The Use of Stem Cells. These are undifferentiated cells that can become specialized in order to address a therapeutic purpose. 4.2 Cloning. A process by which a duplicate organism is produced 4.3 Cryonics. A field that involves the preservation of human bodies or brains at extremely low temperatures in the hope of reviving them in the future, V. Bioethics Development Over the years, bioethics has evolved and developed as new discoveries and technologies have emerged.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 VI. Bioethical Issues a b, c. Abortion. The premature ending of a pregnancy which occurred in itself Surrogacy. Process of assisting the reproduction of parents. Whole Genome Diagnosis. Enables access to and viewing of a newborn's entire genome for researchers and medical professionals. Cloning. A process of creating a new population of genetically-similar and identical naturally occurring organisms. Stem Cells. Undeveloped cells that can divide and differentiate into specialized cells, Eugenics. Social movement that believes in the possibility of creating the best human society and race. Genetically Modified Organisms. Transplanting genes or DNA sequences from ‘one organism to another through genetic engineering, Healthcare. The provision of medical care aims to enhance quality of life. ‘Aged Care. The needs and support for the elderly population are prioritized through funding and public policies. Euthenasia. “Good Death.” Euthanasia is the process of intending to end the life of an individual to stop his or her pain and suffering, Organ Donation/Transplantation. Organ donation and transplantation is removing an organ from one person (the donor) and surgically placing it in another (the recipient) whose organ has failed. Organs that can be donated include the liver, kidney, pancreas and heart. Head Transplant. an experimental surgical operation involving the grafting of one organism's head onto the body of another. Bone Conduction. A method of sound transmission where sound waves are transferred to the inner ear through the bones of the skul Artificial Exoskeleton. A wearable device designed to enhance the physical abilities of the wearer. Artificial Conception. Medical procedures and techniques that help individuals or couples achieve pregnancy. Cryonics. The scientific method of freezing a newly-dead individual to reanimate or bring him to life at a later period, Introduction to Bioethics We have laws that tell us what we cannot do. Most of them are straightforward, either something is legal, or it is not. They make it easy to distinguish what we should or should not do. Things become very ambiguous when we start to look at right and wrong based on morals or other beliefs. This refers to what we call ethics. Ethical decisions are presented in our livesSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 daily. Some ethical situations present a clear distinction between what is right while others present a huge gray area that can be debated until the end of time. Ethics permeates every facet of life. Bioethics refers to ethics pertaining to life and how we alter life. Bioethics is very prevalent in the areas of medicine, healthcare, and biomedical research. Each of these areas requires respect for the lives of others. It is considered by many to be human nature to want to succeed in life and as such, the value of another person's life may be diminished or the effect of manipulations on another persons life may not be taken into ‘as much consideration as it should be. Since this is the case, four basic principles were put into place to help people govern themselves. The American biochemist Van Rensselaer Potter coined the term bioethics in 1970 to describe a new philosophy that sought to integrate biology, ecology, medicine, and human values. In the years that followed, a conception developed in the United States that restricted bioethics to the field of medicine. In response to this reductionism, Potter took up his original conception and expanded it to define bioethics that also embraced the relationship between the biosphere and the human population. joethics finds application in many ines and human issues. From debates regarding the boundaries of life, such as abortion or euthanasia, to surrogate motherhood, the allocation of organs for transplantation, or the right to refuse medical care on religious grounds. The field of bioethics also extends to the applications of biotechnology, including genetic engineering, which affects humans, animals, and plants, or to the impact of air, soil, and water pollution on living beings. Its importance is such that the United Nations Educational, Scientific and Cultural Organization (UNESCO) has hosted the International Bioethics Committee (IBC) since 1993, This body, which is made up of 36 independent experts, monitors advances in the life sciences and their applications to ensure respect for human dignity and freedom. In addition, bioethics committees have gradually emerged at the national level. Il. Principles of Bioethics| In 1978, the Belmont Report, created by a commission of the US Department of Health, Education, and Welfare, established the basic principles of research on human subjects. In the same year, philosopher Tom Beauchamp and theologian James Franklin ChildressSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 published Principles of Biomedical Ethics, a seminal work in which they described the four fundamental principles of bioethics: PRINCIPLES OF ETHICS io s autonomy BENEFICENCE —-NONMALEFICENCE JUSTICE Principle of Autonomy ‘Autonomy is the principle that states people should be educated and able to make decisions regarding what happens to them without being influenced. This simply means that all aspects of the decision should be presented to someone to allow them to make an educated decision, The information presented should be as factual as possible without bias or personal options being asserted. These are the rights of an individual to seff-determination and respect for their ability to make informed decisions about personal matters in freedom. Principle of Beneficence This refers to actions that promote the welfare of others. In the medical context, this means looking after the interests of patients and their families. Principle of Non-maleficence Non-non-maleficence is from the Latin phrase ‘primum non nocere’, or ‘do no harm’ towards patients. Not harming the patient, which is part of the Hippocratic Oath, is considered to be of the highest importance. The principle of nonmaleficence obligates us to abstain from causing harm to others. The principles of non-maleficence support several moral rules, with examples here including: Do not kill. Do not cause pain or suffering, Do not incapacitate Do not deprive others of the goods of life. The obligations of nonmaleficence include not only obligations not to inflict harm, but also not to impose risks of harmSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 Principle of Justice This relates to the allocation of scarce health resources and the decision on who receives treatment, as well as the appropriate selection of research participants. The principle of justice can almost be summed up in the word ‘equal’. In bioethics, justice refers to everyone having an ‘equal opportunity. This principle seeks to eliminate discrimination in biological studies and healthcare. Healthcare and research should not be based on sex, race, religious beliefs, sexual orientation, ete., if possible. Il. Environmental Bioethics Environmental bioethics is a branch of philosophy that examines the ethical implications of human interactions with the natural world. It focuses on issues related to the impact of human activities on the environment, including climate change, biodiversity loss, pollution, overconsumption, and natural resource depletion Environmental bioethics also considers the ethical dimensions of environmental policy and decision-making, the responsibilities of individuals and institutions to protect the environment, and the rights of future generations to a clean and healthy environment. It draws ‘on the principles of environmental ethics, such as respect for nature, sustainability, and intergenerational equity, as well as on scientific understanding of the environment. However, in environmental bioethics, it is widely believed that humans have a moral responsibility to protect the environment because we rely on it for our survival and well-being, This includes protecting biodiversity, mitigating climate change, promoting sustainable development, and reducing pollution, Human activities such as deforestation, industrialization, and the use of fossil fuels have contributed to environmental degradation and climate change, which in turn affects various species, ecosystems, and even human health. Environmental ethics urges us to respect the environment and recognize that it has inherent value beyond its instrumental value for human Use. Therefore, its our duty to act with moral conscience and make informed decisions which are beneficial for us, the environment, and all living beings, including the generations to come. Human's Responsibility for the Environment 1. In order to address the threat of climate change, it is important for individuals, organizations, governments, and businesses to take responsibilty and work towards environmental protectionSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 and sustainability. The 2030 Agenda and Sustainable Development Goals (SDGs) serve as a UN action plan for the betterment of people and the planet. 2. Measures like climate change policies and negotiations, exemplified by the Paris Agreement, are being implemented worldwide to reduce greenhouse gas emissions and prevent global warming. 3. Environmental education plays a crucial role in fostering respect and care for nature from an early age, as it is considered essential for the preservation of our planet. 4, Organizations like the International Union for Conservation of Nature (IUCN) are actively ‘engaged in conservationism efforts to protect numerous species from facing extinction. IV. Topics in Bioethics} There are many topics in the field of bioethics that are currently generating controversy. Cloning, cryonics, and the use of stem cells are all topics that have been in the news and that have caused people considerable anxiety. In addition, topic areas that have been the focus of bioethics for a long time are organ donation and transplantation, genetic research, death and dying, and environmental concerns. Scientific knowledge imparts power to those who have it, and this power can be used for good or for evil. That is why a strong ethical code needs to exist that is accepted by all who conduct and apply scientific research. The Use of Stem Cells Stem cells are undifferentiated (no specific function) cells that can become specialized to address a therapeutic purpose. They are a type of cell that have the remarkable ability to develop into different cell types in the body as they also serve as a repair system for the body. ‘Stem cells are different from other cells in the body in three ways: 1. They can divide and renew themselves over a long time 2. They are unspecialized, so they cannot do specific functions in the body 3. They have the potential to become specialized cells, such as muscle cells, blood cells, and brain cells Stem cells have the ability to become any type of cells because they are not specialized. They have gamered considerable attention from doctors and scientists because they can be used to repair damaged organs, bones, and cartilage. They can also be used toSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 help treat diseases, such as by making new brain cells to treat people with Parkinson's disease or they can be used to repair damaged immune systems. Through the study of stem cells, researchers aim to gain insights into the development and progression of complex conditions like birth defects and cancer. Furthermore, there is hope that stem cells could be utilized in the future to create specialized cells and tissues for therapeutic purposes, offering potential treatments for a wide range of diseases. There are two sources of stem cells, which are: 1. Adult stem cells - These cells are found within various body tissues in an adult human, When applied therapeutically, they can become any type of cell desired. Adult stem cells, also known as somatic or tissue-specific stem cells, are a type of stem cell found in various tissues and organs throughout the body. Unlike embryonic stem cells, adult stem cells are more limited in their potential to differentiate into different cell types. Adult stem cells come from tissues such as bone marrow. 2. Embryonic stem cells (ESC) - These cells come from blastocysts, which are embryos that are a few days old (3-5 days). They are usually donated with informed consent at in vitro (in a test tube) fertilization clinics, These cells have attracted significant scientific interest due to their unique properties and potential applications in medical research. ESCs are unspecialized cells that can develop into any type of cell Cloning Cloning is the process by which a duplicate organism is produced. This new organism is ‘a genetic copy of the original organism. Cloning does occur in nature. For example, some types. of plants and protozoa can clone themselves, However, cloning can also be done in a lab and ‘can produce cloned animals or even human embryos for the purpose of generating stem cells. Since the embryos are then destroyed, this has generated controversy and brings up the issue of whether or not life begins at conception There are different types of clor 9: 1. Reproductive Cloning: This involves creating an entire organism with the same genetic makeup as the original. It typically involves transferring the genetic material of the original organism into an egg cell that has had its genetic material removed, The resulting embryo develops into a genetically identical organism.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 2. Therapeutic Cloning: This type of cloning is focused on producing embryonic stem cells for medical research and potential therapies. It involves creating embryos through, cloning techniques and extracting stem cells from them. The purpose is to study these cells or use them to generate specialized cells for regenerative medicine. The cloning of animals, such as Dolly the sheep in 1996, has been achieved through reproductive cloning techniques. However, the cloning of humans has not been successfully accomplished and is widely considered ethically and morally problematic. The controversy surrounding cloning primarily stems from the ethical implications associated with the creation and destruction of embryos. The use of cloning to produce human ‘embryos for the purpose of generating stem cells involves the destruction of those embryos, which raises questions about the beginning of life and the moral status of embryos. The issue of whether life begins at conception is a complex and debated topic with diverse perspectives. Some argue that life and personhood begin at the moment of conception, while others believe that personhood develops gradually or at different stages of fetal development The ethical concems and debates surrounding cloning, particularly reproductive cloning and the destruction of embryos in therapeutic cloning, highlight the ongoing discussions about the value of human life, the rights of embryos, and the appropriate use of scientific advancements in reproductive and regenerative medicine Cryonics Cryonies (from Greek: kryos meaning ‘cold’) is the low-temperature freezing (usually at -196 °C of -320.8 °F of 77.1 K) and storage of human remains, with the speculative hope that resurrection may be possible in the future, Cryonics is regarded with skepticism within the mainstream scientific community. It is generally viewed as pseudoscience, and its practice has been characterized as quackery. Cryonics procedures can begin only after the "patients" are clinically and legally dead. Cryonics procedures may begin within minutes of death and use cryoprotectants to prevent ice formation during cryopreservation. It is, however, not possible for a corpse to be reanimated after undergoing vitrification, as this causes damage to the brain including its neural circuits. ‘The first corpse to be frozen was that of Dr. James Bedford in 1967. As of 2014, about 250 dead bodies had been cryopreserved in the United States, and 1,500 people had made arrangements for cryopreservation of their corpses.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 Cryopreservation was applied to human cells beginning in 1954 with frozen sperm, which was thawed and used to inseminate three women. The freezing of humans was first scientifically proposed by Michigan professor Robert Ettinger when he wrote The Prospect of Immortality (1962). In April 1966, the first human body was frozen—though it had been ‘embalmed for two months—by being placed in liquid nitrogen and stored at just above freezing ‘The middle-aged woman from Los Angeles, whose name is unknown, was soon thawed out and buried by relatives. In 2009, writing in Bioethics, David Shaw examined the ethical status of cryonics. The arguments against it include changing the concept of death, the expense of preservation and revival, lack of scientific advancement to permit revival, temptation to use premature ‘euthanasia, and failure due to catastrophe. Arguments in favor of cryonics include the potential benefit to society, the prospect of immortality, and the benefits associated with avoiding death. Shaw explores the expense and the potential payoff and applies an adapted version of Pascal's Wager to the question. Bioethics Developme Harvard Definition of Brain Death (1968) ‘On August 5, 1968, the New England Journal of Medicine (NEJM) published an article titled "A Definition of Irreversible Coma: Report of the Ad Hoc Committee at Harvard Medical School to Examine the Definition of Brain Death." This article played a significant role in redefining the concept of death, which had previously been defined as the “ireversible ‘cessation of respiration and circulation.” The article highlighted the need for a new definition of death in light of advancements in medical technology, such as modern respirators and the emergence of heart transplantation The committee described the physical and neurological characteristics of irreversible coma, including unresponsiveness, absence of movements or breathing, lack of reflexes, and a flat electroencephalogram indicating a state of permanent and irreversible coma Over time, efforts were made to establish more standardized and widely accepted criteria for brain death. In 1981, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research issued a report that provided uniform criteria for determining brain death. This helped to address the inconsistencies and provide clearer guidelines for the determination of death based on neurological criteria Thomson's “A Defense of Abortis 1974)SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 “A Defense of Abortion" by Judith Jarvis Thompson, published in 1971. In this influential ‘essay, Thompson presents a thought experiment known as the "Violinist" analogy to argue for the permissibility of abortion even if we assume the personhood of the unborn. Thompson's "Violinist" analogy goes as follows: Imagine you wake up one day to find yourself surgically connected to a famous violinist who needs your body to survive Disconnecting from the violinist would result in his death. Thompson argues that even though the violinist has a right to life, it does not necessarily mean you are morally obligated to remain connected to him. She analogizes this to the situation of a woman carrying an unwanted pregnancy, asserting that a woman should have the right to disconnect from the fetus even if we ‘consider it a person with a right to life. ‘Thompson's paper, with its novel approach and compelling analogies, had a significant impact on the contemporary discourse surrounding the ethics of abortion. It stimulated discussion and helped shape the arguments put forth in the landmark Supreme Court case Roe v. Wade (1973), which established the constitutional right to abortion in the United States. U.S. Public Health Service Tuskegee study Exposed 1972 ( began 1932) The U.S. Public Health Service Tuskegee Study, exposed in 1972, was a notorious research study conducted by Drs. Taliaferro Clark and Dr. Oliver Wenger of the U.S. Public Health Service. The study began in 1932 and lasted for 40 years, with the purpose of examining the effects of syphilis on the human body through autopsies. The study predominantly targeted poor, uneducated African American sharecroppers in Alabama, One of the major problems with the study was that the 400 men who were diagnosed with syphilis were never informed of their diagnosis. Instead, they were falsely told that they were being treated for "bad blood." Even after the discovery of penicillin as an effective treatment for syphilis in 1947, the participants were not provided with the drug, nor were they informed about it. The study continued for several decades, with multiple reviews and approvals by the U.S. Public Health Service, In 1972, the exposure of the Tuskegee Study led to a public outcry, particularly during a period of heightened racial tensions. The study faced criticism for the government taking advantage of vulnerable and marginalized populations, the lack of informed consent, and the absence of any benefits for the participants. In 1973, Senator Edward M. Kennedy held ‘congressional hearings on the matter, which prompted the Centers for Disease Control and Prevention (CDC) and the Public Health Service (PHS) to appoint an ad hoc panel to investigate. The study was eventually terminated The consequences of the Tuskegee Study were significant. In 1974, the National Research Act was passed, leading to the establishment of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, which aimed to ensureSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 the ethical conduct of research involving human subjects. The study's revelation also resulted in lingering distrust within the African American community toward U.S, public health efforts, which posed challenges during the subsequent AIDS epidemic. ‘On May 16, 1997, President Bill Clinton formally apologized to the survivors of the ‘Tuskegee Study, acknowledging the harm and ethical violations that occurred during the study. ‘The Tuskegee Study remains a tragic example of unethical research practices and serves as a reminder of the importance of protecting the rights and well-being of research participants. Roe v. Wade (1973) ‘On January 22, 1973, the U.S, Supreme Court made a landmark decision in the case of Roe v. Wade. In a 7-2 decision, with the majority opinion written by Justice Harry Blackmun, the Court ruled that state laws cannot restrict a woman's right to have an abortion during the first trimester of pregnancy. During the second trimester, states can regulate abortion to protect the health of the mother, and in the third trimester, regulations can be imposed to protect the potential life of the fetus. The Court based its decision on the interpretation of the 14th Amendment, particularly the right to privacy, and argued that a woman's decision to have an abortion falls within the realm of personal privacy. The Court explicitly stated that it did not need to resolve the question ‘of when life begins, acknowledging the complexity of the issue. The Roe v. Wade decision had significant implications, as it brought the abortion debate to the forefront of national politics and divided the country into two camps: those who supported the right to abortion as a matter of reproductive choice and women's autonomy, and those who ‘opposed it based on the belief in the rights of the unborn. The Roe v. Wade decision remains one of the most significant and controversial decisions in the history of the U.S. Supreme Court, and it continues to shape the ongoing discourse and legislation surrounding abortion rights and reproductive justice. Karen Ann Quintan Case (1976) The Karen Ann Quinlan case in 1976 was a landmark legal case that brought attention to the medical, ethical, and legal issues surrounding the right to die and the use of life support technologies. Here is a summary of the background and consequences of the case (On April 14, 1975, Karen Ann Quinlan was admitted to a hospital in New Jersey in a coma. It was determined that she had ingested a combination of barbiturates, Valium, and alcohol, which led to her condition, Karen was declared to be in a persistent vegetative state, and her parents requested that the hospital remove her breathing tube to allow her to die naturally,SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 However, the physicians faced potential prosecution and declined to remove the life support. In response, Karen's parents took the case to court. On March 31, 1976, the New Jersey Supreme Court ruled that Karen's life support could be removed based on her privacy rights, and her parents were allowed to act as surrogates in making medical decisions on her behalf. After the breathing tube was removed, Karen began to breathe on her own and lived ina vegetative state in a nursing home for ten more years. ‘The Karen Ann Quinlan case had significant consequences for the field of medical ethics and end-of-life care. It was the first legal case that explicitly addressed the issue of life support and the right to die. Baby Louise Brown - First IVF Birth (1978) The birth of Louise Joy Brown on July 25, 1978, marked a significant milestone in reproductive medicine as she was the world’s first baby conceived through in vitro fertilization (IVF). Her birth was made possible by the pioneering work of Drs. Patrick C. Steptoe and Robert G. Edwards. ‘The advent of IVF raised various ethical concems that continue to be debated. Some of the ethical issues associated with assisted reproductive technologies include: 1, Creating babies outside the womb: The ability to conceive and develop embryos outside the human body raises questions about the sanctity and naturalness of the reproductive process. Some individuals and groups have raised moral objections to the creation of life in a laboratory setting 2. Designing babies: As technologies advance, the potential to select specific traits or characteristics in embryos becomes a possibility. This raises ethical questions about the pursuit of “designer babies" and the potential for eugenics 3, Ownership and parental rights: The status and rights of embryos created through IVF are topics of ethical and legal debate. Questions arise regarding who owns the embryos and who has the right to make decisions about their fate. Additionally, issues surrounding surrogate parenting and the definition of legal parenthood have emerged in the context of assisted reproductive technologies. The ethical considerations surrounding IVF and related technologies involve balancing the desires and rights of individuals and couples to have children with the potential risks and implications of these interventions. AIDS is first reported in the U.S (1981) The first cases of what would later be identified as AIDS (Acquired Immunodeficiency Syndrome) were reported in the United States in 1981. The disease was initially recognizedSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 among a small group of gay men in Los Angeles and New York City who were experiencing rare ‘opportunistic infections and cancers that were typically seen in individuals with weakened immune systems. The emergence of AIDS raised significant public health concerns and led to extensive research efforts to understand the disease, its causes, and transmission methods. In ‘subsequent years, it was discovered that AIDS is caused by the human immunodeficiency virus (HIV), which attacks and weakens the immune system, making individuals more susceptible to infections and certain cancers The discovery and subsequent spread of AIDS sparked a global health crisis, particularly in the 1980s and 1990s. The disease had a profound impact on public health, healthcare policies, and social attitudes. The epidemic led to increased awareness of HIV transmission and prevention methods, as well as the development of antiretroviral therapies that have significantly improved the prognosis and quality of life for individuals living with HIV/AIDS. Nancy Cruzan Case (1990) The case of Nancy Cruzan, which began on January 11, 1983, in Missouri, brought attention to the issue of the right to die, Nancy Cruzan was involved in a car accident that ‘caused severe brain damage, rendering her in a persistent vegetative state, Despite her parents and husband's request to remove her feeding tube after four years of no improvement, the state of Missouri refused to grant their request. The case eventually reached the U.S. Supreme Court in 1990, marking the first right-to-die case heard by the Court. In a §-4 ruling, the Court determined that individuals have the right to refuse medical treatment under the Due Process Clause. The decision emphasized the importance of clear and convincing evidence of a person's wishes, often documented through means such as a living will After the ruling, Nancy Cruzan’s family provided additional evidence of her desires, and her life support was eventually removed. She passed away on December 26, 1990, The ‘emotional toll of the legal battle took a tragic toll on Nancy's father, who committed suicide six years later. Human Genome Project Begins (1990) The Human Genome Project, which began in October 1990, was a 15-year international ‘endeavor with the aim of mapping and sequencing the entire human genome. It was a collaborative effort led by the National Institutes of Health (NIH) and the Department of Energy (DOE) in the United States. Scientists from various countries, including the UK, France, Australia, Japan, and Spain, participated in the project. Additionally, private competition and collaborations were present.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 ‘One notable aspect of the project was the allocation of 3-5% of its annual budget for addressing the Ethical, Legal, and Social Implications (ELSI) associated with genome research. This commitment reflected the recognition that ethical, legal, and social issues would arise alongside the scientific advancements. In March 2000, President Clinton made an important announcement that the genome sequence should not be patented and should be made freely available to all researchers. This decision aimed to encourage collaboration and ensure that the benefits of genomic research would reach a wider community. In 2000, the project achieved a significant milestone when both the NIH and Celera Genomics announced the completion of a draft of the entire human genome using a "shotgun" sequencing approach. The final completion of the project occurred in 2003, and the findings were published in 2004. ‘The Human Genome Project brought forth numerous benefits and ethical concerns. On the positive side, it has paved the way for personalized diagnosis, treatment, and prevention of diseases. It has also enhanced our understanding of human biology and evolution, and it has opened up possibilities for energy and environmental applications. However, the project has raised various ethical concems. Issues of faimess have ‘emerged, particularly regarding the use of genetic information by insurance companies, ‘employers, and in legal contexts. Reproductive issues related to fetal genetic testing have also been a subject of debate. The development of gene testing and gene therapy has introduced ethical questions regarding the responsible use of these technologies. Furthermore, questions. ‘about property rights and commercialization have arisen in the context of genetic research and the potential monetization of genomic information. Finally, the project has triggered philosophical discussions about genetic determinants of behavior and the acceptance of genetic diversity. Planned Parenthood v. Casey (1992) The case, Planned Parenthood v, Casey, which took place in 1992, The Pennsylvania Abortion Control Act of 1982 was the subject of the challenge. The act included several provisions that were seen as restrictions on access to abortion, and they were challenged as unconstitutional under the landmark Supreme Court case of Roe v. Wade. In Planned Parenthood v. Casey, the Supreme Court had the opportunity to reconsider the constitutional framework established in Roe v. Wade. Many believed that the Court, with its new composition of justices appointed by President Ronald Reagan and President George H.W. Bush had a serious chance of overturning or significantly modifying the Roe decision. However, the Court ultimately upheld the core holding of Roe v. Wade, The justices, ina plurality opinion, reaffirmed the constitutional right to abortion based on the principles ofSCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 personal autonomy and equal citizenship rather than solely relying on the right to privacy, which was the basis of the Roe docision. The Court held that a woman has the right to choose to have an abortion before the fetus reaches viability, and the state cannot impose an “undue burden" on that right. The decision in Planned Parenthood v. Casey did allow for some restrictions on abortion access, such as a 24-hour waiting period and parental consent for minors. However, it set a standard to determine whether these restrictions constituted an “undue burden" on a woman's right to choose. The Court established that an undue burden exists if a law's purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion before the fetus attains viability, Oregon Assisted Suicide Legistation (1994) The key milestones and implications of Oregon's assisted suicide legislation, known as the Death with Dignity Act, up until 2006. 1, 1994: Oregon approves Death with Dignity Act, becoming the first state to legalize physician-assisted suicide with certain regulations. This means that individuals diagnosed with a terminal illness and a prognosis of six months or less to live can request medical assistance in dying 2, 1997: Oregon voters approve an initiative supporting the Death with Dignity Act. This indicates that the majority of voters in Oregon supported the legalization of physician-assisted suicide. 3. 1998: The first legal physician-assisted suicide in the United States ocours in Oregon when a woman takes lethal drugs prescribed by her physician. This marked the first known instance of a terminally ill patient utilizing the provisions of the Death with Dignity Act. 4, 2002: The Netherlands becomes the first nation to legalize euthanasia. This is relevant in the context of assisted suicide, as it reflects a broader international trend towards end-of-life choices and medical assistance in dying 5. 2006: The U.S. Supreme Court, in a 6-3 decision, upholds Oregon's Death with Dignity Act in Gonzales v. Oregon. This legal case determined that the federal government ‘could not interfere with the implementation of the state law, affirming Oregon's right to regulate physician-assisted suicide within its borders. Ethical implications Apart from the debates surrounding the right to die and conflicts with the Hippocratic, Oath, there are concems about the potential risks faced by vulnerable populations. This includes the elderly, minorities, individuals with mental health issues, and others who may face greater challenges in making informed decisions regarding their end-of-life choices. Critics argue that these populations may be more susceptible to coercion, lack of access to alternative healthcare options, or inadequate support in navigating complex decisions. Dolly the Sheep (1996)SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 The birth of Dolly the Sheep in 1996 was a significant milestone in the field of cloning and raised various ethical questions. Here are some of the key issues associated with Dolly's cloning 1. Creation and Manipulation of Life: Dolly's birth challenged the traditional understanding that cell differentiation was irreversible. It raised questions about the ability to create life using cloning techniques and manipulate genetic material. This prompted discussions about the boundaries of scientific intervention in the creation and modification of living organisms. 2. Ethical Considerations: Cloning, particularly human cloning, raises profound ethical concerns. The prospect of human cloning raises questions about the potential misuse of cloning technology, the commodification of life, and the implications for personal identity and individuality. Ethical considerations also encompass concerns about the welfare of cloned animals and the potential for harm or suffering during the cloning process. 3. Reproductive Cloning of Humans: The birth of Dolly ignited debates about whether humans should ever be cloned. Reproductive cloning, which involves creating a cloned human being, presents ethical dilemmas related to autonomy, personal identity, and the potential risks and harms associated with cloning, Discussions revolve around the ethical justifications for and the societal implications of allowing or prohibiting human reproduetive cloning. 4, Public Perception and Acceptance: Dolly's birth sparked public interest and ignited debates ‘on the societal acceptance of cloning. The concerns and attitudes of the general publi including religious, cultural, and moral perspectives, play a significant role in shaping the ethical discourse surrounding cloning. Human Embryonic Stem Cells (1998) In 1998, Dr. James Thompson and his laboratory at the University of Wisconsin made a significant breakthrough by announcing the successful isolation of stem cells from human ‘embryos, This discovery held great promise for the study and potential treatment of various diseases. However, it also sparked public controversy due to the use of human embryos, even those donated with the consent of parents and destined to be discarded. The ethical debate surrounding the use of human embryos raised questions about the beginning of life and the moral status of embryos. These concems influenced public opinion and shaped the discourse surrounding stem cell research In February 2001, President George W. Bush announced a policy limiting goverment funding for stem cell research to existing stem cell ines, The policy prohibited the use of new ‘embryos for research purposes. This decision was influenced by ethical considerations and the sensitivity of the issue.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 In 2007, Dr. Thomson was part of a team that published an article on induced pluripotent stem cells, These cells were derived by reprogramming adult cells to an embryonic stem cell-like state. This breakthrough reduced the reliance on the use of embryonic stem cells, as it offered an alternative method for generating pluripotent cells. In March 2009, President Barack Obama signed an executive order that reversed the previous administration's policy on embryonic stem cell research. The new policy allowed federal funding for research on embryonic stem cell lines, including the creation of new lines under certain ethical guidelines The developments in stem cell research, including the discovery of induced pluripotent stem cells and changes in government policies, reflect the ongoing ethical considerations and ‘evolving scientific advancements in the field. The debates continue to revolve around the moral status of human embryos, the appropriate use of public funding, and the potential benefits of stem cell research in advancing medical treatments. Dr. Kevorkian Convicted (1999) In 1990, in Detroit, Dr. Jack Kevorkian assisted a woman who had been recently diagnosed with Alzheimer’s disease in committing suicide, He utilized a euthanasia device, allowing the patient to self-administer a lethal cocktail of drugs. Although he was not charged with murder due to the absence of laws on physician-assisted suicide in Michigan at the time, his medical license was revoked. Between 1990 and 1998, Kevorkian reportedly assisted in the deaths of approximately 130 individuals, all of whom were claimed to be terminally il. However, an article published in the Detroit Fuse Press in 1997 raised doubts about whether all of his patients were truly terminally ill or experiencing significant pain. The article also questioned the adequacy of his psychiatric and medical evaluations prior to performing the procedures. There were concerns regarding the potential bias in Kevorkian’s patient selection, as a majority of his patients were female. In November 1998, Kevorkian appeared on the television program 60 Minutes, which aired footage of him delivering a lethal cocktail to a man with amyotrophic lateral sclerosis (as) Dr. Kevorkian Convicted, 1999 (con't) In April 1999, Dr. Jack Kevorkian, a prominent advocate for physician-assisted suicide, was convicted of second-degree murder based on evidence presented in a 60 Minutes television program, He had previously avoided conviction multiple times in cases related to assisted suicides. Kevorkian was sentenced to 10-25 years in prison, but he was released on parole in 2007 and passed away in 2011SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 Kevorkian's actions and the subsequent legal proceedings brought the issue of assisted suicide and euthanasia to the forefront of public awareness, His efforts sparked debates and discussions about end-of-life choices, patient autonomy, and the role of physicians in assisting patients with terminal illnesses. The case also prompted healthcare providers to be more attentive to the needs of patients in pain and to consider the ethical and legal implications of end-ofife decisions. Partial-birth Abortion Ban Act (2003) ‘On November 5, 2003, President George W. Bush signed the Partial-Birth Abortion Ban ‘Act of 2003 into law. This legislation prohibited a specific method of abortion commonly referred to as “partial-birth abortion," typically performed during the second trimester of pregnancy. Unlike previous abortion regulations that focused on the age or viability of the fetus, this law specifically targeted the method of abortion. The Partial-Birth Abortion Ban Act faced legal challenges and was ultimately brought before the U.S. Supreme Court in the case of Gonzales v. Carhart in 2007. In a 5-4 decision, the Court upheld the ban, ruling that it did not impose an undue burden on a woman's right to obtain an abortion. This decision marked a significant development in the legal landscape surrounding abortion and indicated a shift towards more restrictions on abortion rights. The enactment of the Partial-Birth Abortion Ban Act and its subsequent affirmation by the Supreme Court in Gonzales v. Carhart represented a pivotal moment in the ongoing debate ‘over abortion rights in the United States. It signaled a growing trend of legislative efforts to restrict access to certain types of abortion procedures and set the stage for further legal and political battles over reproductive rights. Terri Schiavo Case (2005) The case of Terri Schiavo, which unfolded over several years, brought national attention to the complex and sensitive issues surrounding end-of-life care and the right to make medical decisions. Terri Schiavo suffered a cardiac arrest in 1990, resulting in severe brain damage and a diagnosis of a persistent vegetative state (PVS). She required a feeding tube for nourishment. In 1998, Terri Schiavo's husband, Michael Schiavo, petitioned the court to have her feeding tube removed, asserting that she would not have wanted to be kept alive in her current condition. However, Terri Schiavo's parents strongly opposed the removal of the feeding tube and the case went to court. In 2001, the court ruled in favor of Michael Schiavo and ordered the tube to be removed The legal battle continued for several more years as various appeals and legislative interventions took place, The case reached the U.S. Supreme Court, which declined to hear the case. Both the U.S, Congress and President George W. Bush attempted to intervene and pass legislation to keep the feeding tube in place, but these efforts were ultimately unsuccessful.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 After a lengthy legal and public debate, Terri Schiavo's feeding tube was removed on March 18, 2005. She passed away on March 31, 2005. An autopsy conducted after her death revealed extensive brain damage consistent with her diagnosis of PVS. 1. Bioethical Issues Abortion © Itis the premature ending of a pregnancy which occurred in itself or by force through surgery or taking medications. * Itraises intense personal issues about morals, religion, sexual and science and medicine. * The chief argument is focused on whether or not unborn children have moral status and significance. * Despite long debates about abortion, there is still no moral consensus achieved. , autonomy, politics, Surrogacy * Process of assisting the reproduction of parents who are incapable of doing so * Mostly carried out by gestational women or gestational surrogates who carry the child in their womb. * This may cause confusion in the identity of the child, whether or not his biological parents are considered his “true” parents. Whole Genome Diagnosis * This technology allows researchers and physi the whole genome of a newborn. © It is used to determine the individual's chances of acquiring and developing certain diseases. * Criticisms from this technology arise primarily because of the lack of consent from the individual, particularly the newborn. Cloning * Process of creating a new population of genetically-similar and identical naturally ‘occurring organisms. * Humans becoming the subject of such experiments raises issues in cloning, * The primary concem is the the moral status of the cloned organism (e.g., for destruction and as source of organs).SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 * Other issues include health risks to both mother and child, damage to the clone, very low success rates, psychological effect to the clone, and commodification and ‘commercialization of life itself Stem Cells * Undifferentiated (not mature and undeveloped) cells that can divide and differentiate into specialized cells. * Similar to cfoning, the issue about stem cell research revolves around the violation of respect for life * Source organism, which is usually an embryo, is destroyed during the process. ‘* Creation of stem cell lines may lead to the uncontrolled commodification of cells and life. Eugenics * Social movement that believes in the possibility of creating the best human society and race by promoting the reproduction of populations with positive or desirable traits while controlling and prohibiting the reproduction of populations with negative or undesirable traits. * There is fear that another era where the principle of genetics will prevail * Issues are concemed with the moral principle associated with racial equality and the subjective belief in perfection Genetically Modified Organisms * Genetically modified organisms (GMOs) are created by inserting a desired gene or DNA sequence from one organism into another. © This process primarily occurs in crops and animals and involves genetic manipulation. * Bioethical concems surrounding GMOs are comparable to those related to cloning, stem cell research, and eugenics, involving ethical issues concerning human involvement and respect for life Healthcare Healthcare refers to the organized delivery of medical care to individuals or ‘communities. * The primary goal of healthcare is to improve quality of life by enhancing overall health. * Ethical issues in healthcare include the fair allocation of funds, decision-making processes, determining recipients of benefits, cost-efficiency, and measuring success. Aged Care ‘With a significant portion of the global population being elderly, aged care and ‘accommodation services become a priority in terms of funding and public policy, * Similar to healthcare, ethical concems arise regarding who should be responsible for providing support to the elderly and determining the standards of living they should have.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 Questions around maintaining a balance between independence, freedom, and safety for elderly individuals also emerge. Euthenasia * “Good Death.” Euthanasia is the process of intending to end the life of an individual to stop his or her pain and suffering. * Also loosely called as a mercy-ki suicide. * Euthanasia challenges the belief that is concemed with the sanctity and equality of all life forms. Euthanasia is believed to corrupt the practice of medicine as well as undermine the value of suicide prevention 1g. assisted suicide, or physician-assisted Organ Donation/Transplantation Organ donation and transplantation is removing an organ from one person (the donor) and surgically placing it in another (the recipient) whose organ has failed. Organs that can be donated include the liver, kidney, pancreas and heart. * The first bioethical issue on organ donation is that there is a big shortage of organs for those who need it. There are thousands of people on the waiting list to receive the organ transplants either from living or deceased, * The next bioethical issue on this matter is unequal access of organs (distributive justice theory) to those who need by the length of waiting time and by their age. * Another biggest ethical issue is that as there is a big demand for organ transplants, there is a fear of illegal organ stealing from livings (human trafficking) without their consent to create organ farming to sell body parts for big prices Head Transplant * an experimental surgical operation involving the grafting of one organism's head onto the body of another. * Absurd as it may sound, experiments about the transplantation of an organism's head to another are being done. * During the 1970s, the first ever head transplant in monkeys occurred successfully (the recipient only lived for ten days). * While such application on humans is still being studied, serious health and bioethical concems are associated with it. Questions like the reaction of the brain to the new body, as well as the memory and individual identity are of concems. Bone Conduction * Bone conduction technology involves the replacement of an individual's ear bones to transducers that can transmit sounds, * Despite being promising, the problem with this technology is that it basically can transform an individual into a billboard with countless advertisements. In this case, the consent of the individual is not a concern.SCI 402- MODERN BIOLOGY Group 6 - Sixynthesis LECTURE 5 BIOTECHNOLOGY (ChE-1305 jal Exoskeleton © The development of an artificial skeleton for the elderly to improve their strength and help them move can give elderly the ability to walk, run, bend like someone who is younger than them * The bioethical concem with this is the possible abuse that the elderly may experience when they are forced to work longer before and even after retirement age. ial Conception * Artificial insemination, in vitro fertilization, and the manipulation of embryos. They challenge deeply held moral, ethical, and religious values, particularly those values that concern the family and relationships among its members. * They involve the deliberate separation of reproduction from the act of human sexuality and from the human body. © Some theologians and other critics in the United States and other countries attacked the procedure as representing unethical experimentation on human beings. The chief moral argument against the fertilization of a human egg in a laboratory dish was that the parents’ desire for a child did not entitle them to have it by a possibly unsafe method that, might result in a deformed infant. 3s * Cryonis refers to the scientific method of freezing a newly-dead individual to reanimate or bring him to life at a later period. Because this process involves reversing the process of death, several bioethical issues were raised against it. * One of the main problems about cryonics is immortality. While immortality is believed by some to be beneficial, supporters of bioethics believe that this idea should not prevail given that the planet is already under the crisis of unsustainable population and limited resources.