BTE 421 Int. Pro &Bioethics

1. BTE 421 Int. Pro &Bioethics Dr. Friday Nwalo

2. What is Bioethics? • The term “bioethics” was introduced in the 70’s by Van Rensselaer Potter for a study aiming at ensuring the preservation of the biosphere. • It was later used to refer a study of the ethical issues arising from health care, biological and medical sciences. • It is a major area in applied ethics.

3. The emergence of this new area of study has been triggered by and a response to the new scientific/technological developments in biomedical and life sciences. • Medical ethics and nursing ethics are more concerned with the ethics of the health care professionals and their relationship with the patient. Bioethics has a broader scope.

4. Some historical examples • Abortion • Contraception • Kidney dialysis machine (Who had the priority?) • Organ transplant, artificial ventilator, and brain death • In virtro fertilization (IVF) • Cloning and stem cell research • Genetic engineering

5. Main topics in Bioethics • Death and dying • Pre-birth Issues • Issues in human reproduction • Human cloning • Stem cell research • The new genetics

6. Resources allocation • Organ transplant • Doctor-patient relationships • Experimentation with human subjects & animals

7. Human Reproductive Technologies (HRT) • Contraception: sex without procreation • HRTs: procreation without sex

8. Types of HRTs: • Artificial insemination by husband (AIH) • Artificial insemination by donor (AID) • In virtro fertilization (IVF) • Egg donation • Embryo donation • Surrogacy

9. Ethical considerations • Procreation rights of infertile couples • It is unnatural • Inequality and exploitation • Selling babies? • The moral status of extra embryos left over from IVF • Definition of parent-child relation • Integrity of the family • Best interests of the child

10. Human Cloning • Two techniques: • Embryo splitting • Nuclear substitution • Embryo splitting • The clone is usually used for tests of abnormality, and will be destroyed subsequently.

11. Nuclear Substitution • What is the relationship between the nuclear donor and the clone? • The same person? • (Technologically-aided and birth delayed) identical twins? • Siblings? • Parent-child? • Should a homosexual be allowed to use the technology to obtain his/her own child?

12. Is it moral alright for parents to clone their beloved children who die young? • Should it be used as an infertility treatment or gene therapy if it is safe? • No third party is involved. • According to the parent-child ordinance in HK, whoever gives birth to a baby is its mother, and the husband who goes through the infertility treatment with her is his father. • Yet, human cloning has been banned by the HRT Ordinance.

13. The New Genetics • Gene testing • Create unnecessary psychological distress • Discrimination by employers and insurance companies • Confidentiality and Privacy • Social stigmatization

14. Prenatal Screening • Sex selection: Gender discrimination and imbalance of sex ratio unless it is done solely for therapeutic purpose. • Discrimination: Lives of the disable are not worth living.

15. Genetic Engineering • Is it a form of eugenics? • Germ-line changes, unlike somatic modification, can pass onto the next generation and be with us forever. So germ-line changes could be very risky. • Is genetic enhancement moral?

16. Doctor-patient relationships • Who has the final authority in medical decision making? The patient, the family or the individual? • Three models: • Individualism • Familism • Medical Paternalism

17. Organ Transplant and Resources Allocation • what criteria should organs be allocated to patients for transplantation? • What is a just distribution of healthcare resources?

18. 1.Medical ethics • The expressions “professional ethics” and “medical ethics” were coined by Thomas Percival. • Medical ethics is a special kind of ethics only as it relates to a particular realm of facts and concerns and not because it embodies or appeals to some special moral principles or methodology.

19. It is applied ethics. It consists of the same moral principles and rules that we would appeal to ,and argue for, in ordinary circumstances. • It is just that in medical ethics these familiar moral rules are being applied to situations peculiar to the medical world.

20. 2.Bioethics • Bioethics could be defined as the study of ethical issues and decision-making associated with the use of living organisms • Bioethics includes both medical ethics and environmental ethics. Bioethics is learning how to balance different benefits, risks and duties.

21. 3.Clinical ethics Clinical ethics is a practical discipline that provides a structured approach for identifying ,analyzing, and resolving ethical issues in clinical medicine.