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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

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
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

ethical principles
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

some realities today
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

examples of difficult questions
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

what is involved
What is involved...
  • Quality of life
  • Heroic efforts
  • Acts of mercy
  • Patient’s (guardian’s) will

Future? ...

M. Frize, ELG5123/94.526

definition of death
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

major issues in measuring living systems human experimentation
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

some of the basic principles
Some of the basic principles
  • 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

elements of informed consent
Elements of informed consent
  • Autononous choice, competence
  • Information disclosure
  • Understanding
  • Voluntariness

M. Frize, ELG5123/94.526

material for decision making
Material for decision-making
  • 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

gender equality not yet
Gender equality? Not yet...
  • 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

sources
Sources
  • 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