...Week 5: Confidentiality and Bioethical Issues (Nov 20 - Nov 27) Welcome to Week 5! This week, we discuss issues related to bioethics. Since the time of Hippocrates, “First Do No Harm” has been the medical mandate. It is the basic concept that drives all of the codes of ethics for the health professions. The concept is one of the first you learn in school. From this comes the duty to make ethical decisions “in the best interest of the patient.” While all medical professionals would agree that this is the goal, not all would agree on exactly what IS the best interest of the patient in a given situation. Healthcare workers—and specifically physicians—work hard to save lives. Many times, death is seen as a medical failure. Health professionals go to great lengths to preserve life with the assumption that saving the life—at all costs—is in the best interest of all patients. In the past, if that left the patient paralyzed or in a vegetative coma, it was still success - they were alive. Today, this assumption is being reconsidered as patients themselves demand to decide for themselves what is in their own best interest. Of particular interest is Oregon law which states, "an adult who is capable and has been determined by the attending doctor to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die, may make a written request for medication for the purpose of ending his or her life in a humane and dignified manner." In short, the patient can...
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...Stem Cell Research in Human Transplantation [Name of the Writer] [Name of the Institution] Abstract Skeletal Bone Marrow that is decimated by disease, chemo, or radioactive emission can be refurbished by utilizing stem cell transplants. For certain infectious ailments like leukemia, aplastic anemia, certain inherited body-fluid infections, and some infections of the immune cell, and the stem cells in the skeletal bone marrow do not effectively function the way that it is intended to function. The stem cell is subjected to immunity issues where the recipient body site does not accept the donor cells. This paper will look to enquire the benefits to following stem cell research in human transplantation. Stem Cell Research Introduction Unique functional cells such as for example, a red blood cell start out originally as unspecialized cells known as stem cells. These stem cells have the uncanny ability to keep separating through division and multiplying in culture to produce specialized cell for a specific bodily function. In the context of normal human development, they are best described for their diversity, adaptability and longevity. As the laws of biology dictate, a human being is formed when a sperm cell fertilizing a female egg cell to produce a zygote. The zygote is already specialized in the fact that it is on the way to the formation of a whole individual. Furthermore the zygote, also known as the fertilized egg is tot potent that simply...
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...Embryonic Stem Cell Research Legislation and related legal issues Heidi Brannen Law 310 Professor Floyd June 1 Human embryonic stem cell research has been and will continue to be a very controversial issue in society all over the world. Many countries have recognized the importance of this research and its benefits, while others have continued to make such research illegal with no plans to change in the near future. This paper will be discussing the past, current, and hopeful future legislation in regards to embryonic stem cell research and how it could affect the future of medical advancement. Embryonic Stem Cell Research Legislation and related legal issues Research on human embryos and fetuses has been in development for decades with the first well known development being the polio vaccine which stemmed from work on cultures of human fetal kidney cells in the 1950’s. The controversy of such research is not so much in the science of the research itself, but in how the cells are obtained from unborn embryos and fetuses in their earliest stages of development. In the 1970’s, the controversy focused on research involving fetuses in utero, aimed at developing techniques such as amniocentesis and improving the understanding of conditions such as congenital heart disease, as well as on research involving tissue from aborted fetuses of the type that led to the polio vaccine. Federal funding of this research was halted until guidelines and safeguards...
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...Recent advances in human stem cell research have not only generated enormous enthusiasm on the part of researchers and optimistic predictions of revolutionary advances in biomedicine, but have also sparked considerable ethical and emotional public debate. There has been much controversy in the press about pros and cons of stem cell research . The important question to think about is Why the prospect of stem cell therapy has been greeted not as an innovation to be welcomed but as a threat to be resisted? The enormous capabilities of stem cells announce the beginning of an extraordinary advanced field of medicine that can help to cure deadly diseases . The present method , however, destroys human blastocyst that gives rise to intense controversy. (Monroe, Miller, & Tobis , 2008, p. 1) Stem cell controversy is the ethical debate centered on research involving the creation, usage and destruction of human embryonic stem cells. Around the world, many people believe that human embryo research , including the deliberate creation of embryos for valid research or clinical purposes , is wrong . Due to the controversy , some people argues that we should allow stem cell research but some of them are not in favour of stem cell research . According to S Holm , the author of Going to the Roots of Stem Cell Controversy, “A stem cell is a non – differentiated cell that can divide and multiply in its undifferentiated state, but which can also give rise to more specialized...
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...either ‘‘embryo splitting’’ or ‘‘nuclear transfer’’. Embryo splitting involves the separation of an early human embryo into two or more parts. Each of these parts has the potential to develop into a blastocyst (late embryo), which, if implanted, can develop into a child. This is how genetically identical monozygotic twins are created. Artificial embryo splitting has been successfully implemented in various mammals including sheep (Willadsen, 1981), cows (Willadsen, 1989), mice (Agrawal and Polge, 1989) and monkeys (Chan et al., 2000), but has been performed only to the pre-implantation stages in humans (Hall et al., 1993). Recently the American Society for Reproductive Medicine declared that human cloning by artificial embryo splitting was an ethical procedure to increase the number of implantable human blastocysts used in certain infertility treatments (ASRM, 2000). However, embryo splitting can produce only a limited number of cloned individuals as the early embryo can be separated only a limited number of times, and the procedure is not able to produce a ‘‘clone’’ of an adult that already exists. The other method for producing cloned humans, nuclear transfer, does not suffer from these limitations, and the rest of this article will focus on human cloning achieved via this technique. Nuclear transfer (or more specifically somatic cell nuclear transfer) is a conceptually simple procedure. The J. A. Byrne ¡ J. B. Gurdon ( ) Wellcome CRC Institute, Tennis Court Road Cambridge CB2 1QR...
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...there are no specific diagnostic criteria for Parkinson's disease. Diagnosis can only be made by an expert examination after the person has already developed symptoms. Biochemical measures can be used such as a screening strategy monitoring the dopamine levels in the cerebrospinal fluid. Otherwise, specifically 6(18F)dopa positron emission tomography can be used for a direct measurement of dopamine activity. Using a computer to assess movement time is another test for Parkinson's disease. To examine the electrophysiological characteristics of tremor and preclinical nigral dysfunction characteristic of Parkinson's EMG (electromyography recordings) can be used. Finally, a symptomatic screening is often utilized and consists of nine symptom related questions, as well as disease specific and drug specific questions. This provides an indirect functional measure of the nigrostriatal dopamine system. Increasing age strongly increases the risk of Parkinson's disease. Male gender and possibly Caucasian ancestry are associated with more modest increases in risk. The reported prevalence of Parkinson's disease varies widely in international community-based studies; ranging from 31 to 328 per 100,000 people. Whether these differences represent actual differences in the...
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...Pluripotent Challenge Recent advances in human stem cell research have generated enormous enthusiasm on the part of researchers and optimistic predictions of revolutionary advances in biomedicine. These same advances have also sparked considerable ethical debate. The main ethical challenges associated with stem cell research have to do with the source of those cells. Although some advances have been made in the use of adult stem cells, the consensus seems to be that the most promising categories of stem cells are embryonic stem (ES) cells (derived from the five- to seven-day-old embryos known as blastocysts) and embryonic germ (EG) cells, derived from immature aborted fetuses. In fact, there are four main sources of (non-adult) stem cells, and each presents its own challenging ethical issues. The first such source (of ES cells) is the surplus embryos that are a by-product of the activities of in vitro fertilisation (IVF) labs. One ethical concern here has to do with the status of the embryo itself. The degree of respect that ought to be granted to a human embryo is highly controversial. Some hold that the embryo - genetically human and a potential person - deserves our full respect and protection. Others hold that while the embryo may be genetically human, it has (particularly at early stages) none of the characteristics of persons. It is not conscious; it is not self-aware. It is a cluster of cells with no independent ethical status. Still others hold an in-between view, arguing...
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...BACKGROUND The research paper addresses the diagnosis of aneuploidy during the first trimester using Nuchal Translucency. The study was done in the fetal medicine unit in Chris Hani Baragwanath Hospital in South Africa. It included a total of 428 patients who were screened between July 2003 and July 2005. Those patients were chosen using a set of criteria that the Fetal Medicine Foundation (FMF) has established. The patients had a mean age of 30 years. Of all the patients, 59 were screened positive and the remaining 356 were screened negative. 24 of those that screened positive had Chorionic Villus Sampling (CVS) performed. CVS is an invasive prenatal test that takes a sample of the chorionic villi to asses for chromosomal defects4. Therefore,...
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... 21 6. Bibliography 22 Stem cells Stem cells are cells found in all multi cellular organisms. They are characterized by the ability to renew themselves through mitotic cell division and differentiate into a diverse range of specialized cell types. Research in the stem cell field grew out of findings by Ernest A. McCulloch and James E. Till at the University of Toronto in the 1960s. The two broad types of mammalian stem cells are: embryonic stem cells that are isolated from the inner cell mass of blastocysts, and adult stem cells that are found in adult tissues. In a developing embryo, stem cells can differentiate into all of the specialized embryonic tissues. In adult organisms, stem cells and progenitor cells act as a repair system for the body, replenishing specialized cells, but also maintain the normal turnover of regenerative organs, such as blood, skin, or intestinal tissues. Stem cells can now be grown and transformed into...
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...embryonic and adult stem cells is the cell potency. Cell potency comes from the term potential and basically means a cells’ potential to differentiate and take on different functions. Embryonic stem cells are pluripotent and thus can form all types of cells (endoderm, mesoderm, and ectoderm). Adult stem cells on the other hand are mostly multipotent, meaning the cells can only differentiate to different cell types from the same tissue of origin. For instance, blood stem cells can differentiate into many different type of blood cells but cannot differentiate to become muscle or neuron cells. To put it simply, adult stem cell are more specialized (focused on a particular tissue lineage) whereas, embryonic stem cells are more versatile. (Stem Cell Research- Pros and Cons, Date retrieved: 17th September 2011) Another difference between adult stem cells and embryonic stem cells is the ease of culturing these cells. It is significantly easier to cultivate embryonic stem cells in comparison to adult stem cells. Adult stem cells are hard to isolate in mature tissue and have a hard time surviving past a few generations during the in-vitro culturing. Considering stem cell therapy requires a large amount cells, embryonic stem cells are a more feasible alternative as they can grow rather easily in the lab. (Stem Cell Information, Date retrieved: 20th September 2011) However, until now there hasn’t been any accepted medical treatment using embryonic stem cells. This is because embryonic...
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...Ethics & Social Responsibility Ashley Arends September 10, 2012 Stalemate Scientific research has come a long way since the first use of human embryos to treat and prevent diseases. The polio vaccine was invented in the 1950’s from the use of human fetal kidney cells, fetuses in uteri were used to develop techniques like amniocenteses and improving knowledge about congenital heart disease in the 1970’s, and in the 1980’s the transplantation of fetal tissue into adults to help with serious conditions like, diabetes or Parkinson’s (Gold, 2004). While there has always been concern and controversy over the use of human embryonic cells, today the debate is ethical. This ethical debate lies within the destruction of human embryos in order to use them for medical research. This paper will talk about how two different theories; utilitarianism and relativism view this ethical issue and the problem it presents, as well as my personal views on use of embryonic stem cell research. The theory of utilitarianism determines what is best by looking at the results of an act. According to Mosser (2010, section 1.7), “utilitarianism argues that, given a set of choices, the act we should choose is that which produces the best results for the greatest number affected by that choice.” When looking at the use of embryonic stem cells for research, utilitarianism looks at the end result. Embryonic stem cells have the potential to save lives by curing diseases and through...
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...Ethical Health Care Issues In 1953, two scientists James Watson and Francis Click published the description of the double helix structure of the DNA. Little did they know that voyage from the double helix to The Human Genome Project (HGP) would become a reality. Fifty years later in 2003, National Institute Health accomplished mapping of 32,000 genes of the human genome. Gene mapping was a significant research that enabled researchers to focus on gene specific diseases and birth defects. More than 1000 research projects started inward voyage discovery of human kind rather outward exploration of the planets. Clinical research involving human beings have greater potential for risk of misusing the technology. Potential for misusing the genetic research and fear of unknown long term effects on the successive generations have sparked bioethics debates. Like abortion, gene mapping is a very controversial subject and both sides have strong views. For example, should a woman abort the pregnancy based on the abnormal genetic screening results? Genetic technology provides an enormous power within our grips and with this enormous power comes following the ethical standards. Ethical standards should be followed involving human subjects. Genetic screening standards should align with four ethical principles of: • Respect for the human autonomy, dignity, and obtaining informed consent • Genetic screening should cause the minimal amount of harm to the subject • Provides maximum benefit to...
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...‘super cells’ have a major clinical potential in tissue repair, with their proponents believing that they represent the future relief or cure of a wide range of common disabilities; replacement of defective cells in a patient by transplantation of hES cell‐derived equivalents would restore normal function. On the other hand, the use of hES cells is highly controversial because they are derived from human pre‐implantation embryos. To date, most embryos used for the establishment of hES cell lines have been spare embryos from IVF, but the creation of embryos specifically for deriving hES cells is also under discussion. The most controversial variant of this is the transfer of a somatic cell‐nucleus from a patient to an enucleated oocyte (unfertilized egg) in order to produce hES cells genetically identical to that patient for ‘autologous’ transplantation (so‐called ‘therapeutic’ cloning); this may prevent tissue rejection. The question ‘Can these cells be isolated and used and, if so, under what conditions and restrictions’ is presently high on the political and ethical agenda, with policies and legislation being formulated in many countries to regulate their derivation. The UK has been the first to pass a law governing the use of human embryos for stem cell research. The European Science Foundation has established a committee to make an inventory of the positions taken by governments of countries within Europe on this issue (European Science Foundation, 2001). In order...
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...Cloned genes can also be used for DNA sequencing, which is the determination of the precise order of all the base pairs in the gene. All of these applications require many copies of the DNA molecule that is being studied. Gene cloning also enables scientists to manipulate and study genes in isolation from the organism they came from. This allows researchers to conduct many experiments that would be impossible without cloned genes. For research on humans, this is clearly a major advantage, as direct experimentation on humans has many technical, financial, and ethical limitations. Importance for Medicine and Industry The ability to clone a gene is not only valuable for conducting biological research. Many important pharmaceutical drugs and industrial enzymes are produced from cloned genes. For example, insulin, clotting factors, human growth hormone, cytokines (cell growth stimulants), and several anticancer drugs in use are produced from cloned genes. Before the advent of gene cloning, these proteins had to be purified from their natural tissue sources, a difficult, expensive, and inefficient process. Using recombinant methods, biomedical companies can prepare these...
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...the past 30 years there has been debate over Stem Cell Research. In November of 1998 when researchers first reported the isolation of human embryonic stem cells. The discovery, made by Dr. James A. Thomson, a biologist at the University of Wisconsin, Madison, offered great promise for new ways of treating disease. With this great discovery much debate came over stem cell research. Even though Dr. Thomson research was extraordinary this topic has been in debate for over thirty-years. During this time the legislation had been revised to in compass new advancement in the research along with protect the public interest. The question that is continually being evaluated is the use of stem cell ethical. In 1973, Supreme Court decision in Roe v. Wade rules that decisions about abortion are private, between a woman and her doctor. Some States may not forbid abortion in first two trimesters. This decision sparks a large, politically active anti-abortion movement that opposes research on embryos. Members of Congress become concerned about research exploitation of embryos and fetuses that will be aborted. (Wertz, 2002) In 1974,Congress applies its own temporary moratorium on federally funded clinical research on embryos and embryonic tissue, including research on IVF, infertility, and prenatal diagnosis, until national guidelines can be established. A de facto moratorium continues until the present. Basic, non-therapeutic, research using embryonic cells continues, out of public view...
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