Topic 9: Bioethics and Stem Cell Research

Topic 9: Bioethics and Stem Cell Research

Ethics and Regulations

  • Key Differences:   - Ethics:     - Defined as moral guidelines based on individual values.   - Regulation:     - Established as rules imposed by an external agency.

  • Examples of Agencies Relevant to Biotechnology:   - Canadian Food Inspection Agency (CFIA):     - In Canada, responsible for the regulation of food safety and other related entities.   - U.S. Food and Drug Administration (FDA):     - In the USA, oversees the safety and efficacy of drugs and treatments, including those involving biotechnology.

Bioethics Overview

  • Definition:   - Study of ethical issues related to the advancement of biology and medicine.

  • Key Areas of Concern in Bioethics:   - Access to medicines and healthcare devices.   - Assisted procreation.   - Genetically modified organisms (GMOs).   - Human cloning.   - Biodiversity conservation.   - Biotechnology and nanotechnology implications.   - End-of-life issues.   - Organ trafficking.   - Protecting the integrity of participants in therapeutic trials.

Factors Influencing Ethics/Bioethics

  • Legal Factors:   - Rules can guide individuals in differentiating right from wrong.

  • Organizational Factors:   - Ethics influenced by leadership values, policies, and publications.

  • Individual Factors:   - Shaped by personal moral development and values.   - Influenced by:     - Religious beliefs.     - Family and peer perspectives.     - Life experiences and situational factors.

Embryonic Stem Cells: Ethical Dilemma

  • Definition Inquiry:   - What are stem cells?

  • Types of Stem Cells:   - Different definitions explored, including:     - Embryonic stem cells.     - Alternatives to embryonic stem cells.

  • Why use Embryonic Stem Cells (ESCs)?   - Potential for medical applications raises ethical questions.

Ethical Dilemma of ESCs

  • Moral Principles at Conflict:   - Duty to prevent or alleviate suffering vs. duty to respect the value of human life.

  • Complications:   - Respecting both principles is often impossible.   - Obtaining ESCs requires the destruction of early embryos, which raises concerns over the destruction of potential human life.   - ESC research may provide treatments that alleviate suffering; thus, the decision about importance relies on views about the embryo's status.

Status of the Embryo: Perspectives

  • Complexity of the Issue:   - Various viewpoints on when an embryo holds moral status:     - Full moral status from fertilization.     - Full moral status after 14 days post-fertilization.     - Increasing moral status as development progresses.     - No moral status attributed to the embryo.

  • Scientific Consensus:   - No widespread agreement on when life begins.

Ethical Question: When Does Life Start?

  • Diverse Perspectives:   - Life as beginning at conception.   - Life commencing at birth.   - Humorous consideration of arbitrary milestones (e.g., obtaining a driver’s license).

Stem Cell Classification

  • Stem Cell Types and Characteristics:   - Totipotent Stem Cells:     - Definition: Can develop into a new individual. [Cells from early (1-2 days) embryos]   - Pluripotent Stem Cells:     - Definition: Can form almost any (over 200) cell types. [Cells from blastocyst (5 days)]   - Multipotent Stem Cells:     - Definition: Can differentiate but only into a limited number of tissue types. [Examples: fetal tissue, cord blood, adult stem cells]   - Unipotent Stem Cells:     - Definition: Lineage-specific stem cells, present in every organ.

Obtaining Embryonic Stem Cells

  • Process of Creation:   - In Vitro Fertilization:     - Conception occurs in a controlled environment (dish).   - ICSI (Intracytoplasmic Sperm Injection):     - A method of in vitro fertilization used to treat infertility.

In Vitro Development Stages

  • Stages of Embryonic Development:   - Fertilized Egg → 2-Cell Embryo → 4-Cell Embryo → 8-Cell Embryo → Morula → Blastocyst.

Assisted Reproductive Technology (ART)

  • Definitions and Purpose:   - ART refers to fertility treatments that manage both egg and sperm, primarily used to treat infertility.   - Procedure Overview:     - Eggs are extracted from the woman, fertilized with sperm to create embryos, which are then reintroduced into the woman’s body.   - In Vitro Fertilization (IVF):     - Most common and effective form of ART.

  • Case Study: Bioethical Issues in IVF:   - Ethical concerns arise with the existence of frozen embryos post-treatment, such as ownership, consent, reproductive rights, and the status of embryos.

Case Study: Ethical Dilemma in IVF Scenario

  • Case Summary:   - Maria and David undergo IVF, resulting in several frozen embryos. Post-divorce, a dispute arises over the disposition of the embryos.

  • Decision Dilemmas Include:   - Allowing Maria to use the embryos.   - Destroying the embryos.   - Donating them for research.   - Requiring mutual consent from both parties.

  • Involved Roles:   - Patient (Maria)   - Doctor (Fertility Specialist)   - Bioethicist   - Lawyer

  • Considerations:   - Evaluation based on the four basic principles of health care ethics: autonomy, justice, beneficence, and non-maleficence.

The Four Basic Ethical Principles

  • 1. Respect for Autonomy:   - Norm obliging respect for the decisions made by adults with decision-making capacity.

  • 2. Principle of Beneficence:   - Moral obligation to act for others' benefit, encompassing:     - Providing benefits.     - Balancing benefits with risks/harms.

  • 3. Principle of Nonmaleficence:   - Obligation not to inflict harm, associated with “primum non nocere” (first do no harm).

  • 4. Principle of Justice:   - The necessity for equitable distribution of benefits, risks, costs, and resources among individuals.

  • Guidelines: Professional societies establish ethical standards concerning human dignity, confidentiality, privacy, and patients’ rights.