M. 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 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 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... 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

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

experimentationHow decisions are made is the ethical problem-

solving

M. Frize, ELG5123/94.526

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 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)

1. Inaccessibility of variables to measure

2. Variability of data3. Lack of knowledge about inter-

relationships4. Inter-action among physiological

systems5. Effect of the transducer on the

measurement

M. Frize, ELG5123/94.526

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

Autononous choice, competence Information disclosure Understanding Voluntariness

M. Frize, ELG5123/94.526

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...

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 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