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Bioethics: Issues and Concerns Prof. Monique Frize, ELG5123/94.526

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

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  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. What is involved... • Quality of life • Heroic efforts • Acts of mercy • Patient’s (guardian’s) will Future? ... M. Frize, ELG5123/94.526

  7. 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

  8. 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

  9. 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

  10. Elements of informed consent • Autononous choice, competence • Information disclosure • Understanding • Voluntariness M. Frize, ELG5123/94.526

  11. 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

  12. 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

  13. 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

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