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Bioethics: Issues and Concerns Prof. Monique Frize, ELG5123/94.526. Definitions: Morality and ethics Codes and oaths Some current dilemmas Problems in measuring a living system Human experimentation and consent Universality in research and health services? . Definition.

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Bioethics issues and concerns prof monique frize elg5123 94 526 l.jpg

Bioethics: Issues and ConcernsProf. Monique Frize, ELG5123/94.526

Definitions: Morality and ethics

Codes and oaths

Some current dilemmas

Problems in measuring a living system

Human experimentation and consent

Universality in research and health services?

M. Frize, ELG5123/94.526


Definition l.jpg
Definition

  • Morality: What people believe to be right and good, and the reasons for it

  • Ethics: Study of right and wrong; of good and evil (in human conduct)

  • Greek: ethos = custom

  • Latin: mos/mores = morals

M. Frize, ELG5123/94.526


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Ethical principles

  • From ethical theories

  • From codes of ethics (nurses, engineers, physicians, etc…)

    Code for physicians (Hypocratic oath)

    Helsinki Declaration

    Tri-Council principles for research on humans

    Hypocratic Oath

M. Frize, ELG5123/94.526


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Some realities today...

  • Assisted suicide is now legal in Oregon

  • A sheep has been cloned. (A human?)

  • Many people try alternative medicines and therapies

    We need to learn ethical decision-making.

M. Frize, ELG5123/94.526


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Examples of difficult questions

  • Should badly deformed infants be kept alive?

  • When should a particular pregnancy be terminated?

  • Should treatment cease to allow a terminally ill (and suffering) patient to die?

  • How do you define death?

  • Organ transplants; human and animal experimentation

    How decisions are made is the ethical problem- solving

M. Frize, ELG5123/94.526


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What is involved...

  • Quality of life

  • Heroic efforts

  • Acts of mercy

  • Patient’s (guardian’s) will

    Future? ...

M. Frize, ELG5123/94.526


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Definition of death

  • Absence of breathing (earliest);

  • absence of the beating of the heart (later); no reflexes;

  • absence of a vital functioning brain (now, add EEG)

  • Repeat after 24 hours--no change

    (Valid in absence of hypothermia or barbiturates)

M. Frize, ELG5123/94.526


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Major issues in measuring living systems (human experimentation)

1. Inaccessibility of variables to measure

2. Variability of data

3. Lack of knowledge about inter-relationships

4. Inter-action among physiological systems

5. Effect of the transducer on the measurement

M. Frize, ELG5123/94.526


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Some of the basic principles experimentation)

  • Must have research protocol approved by an Ethics Review Committee

  • Conform to generally accepted scientific principles and based on solid previous evidence (lab, animal,…)

  • Must have the safety of the subjects in mind at all times (may need a physician present)

  • Importance of the objective is in proportion to inherent risk to subjects

  • Inform subject thoroughly and have a consent form signed

  • Preserve confidentiality and privacy of subjects

M. Frize, ELG5123/94.526


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Elements of informed consent experimentation)

  • Autononous choice, competence

  • Information disclosure

  • Understanding

  • Voluntariness

M. Frize, ELG5123/94.526


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Material for decision-making experimentation)

  • Purpose of experiment

  • Benefits expected

  • Diagnostic or therapeutic?

  • Elective or essential?

  • Known consequences?

  • Probable and possible risks

  • Alternative treatments and risks

  • Possible consequences of refusing

M. Frize, ELG5123/94.526


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Gender equality? Not yet... experimentation)

  • Many research experiments carried out on men only (iron loading, coffee and heart, etc..)

  • More angiograms and other expensive tests done on men than on women for equal risk

  • Higher proportion of women die after heart attack than men

  • Research dollars controlled by male-dominated committees and COUNCILS

M. Frize, ELG5123/94.526


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Sources experimentation)

  • http://www.apnet.com/ethics/etharts.htm

  • http://wwwgeorgetown.edu/research/nrcbl/

  • http://www.learner.org/exhibits/medicalethics/

  • http://www.uwc.edu/fonddulac/faculty/rrigteri/biomed.htm

  • http://www.onlineethics.com/text/reseth/helsinki.html

  • http://summit.whitaker.org/white/ethics1.html

M. Frize, ELG5123/94.526


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