2. Legal Scientific Religious Ethical 3. Legal Scientific Religious Ethical 4. Principles of Bioethics
Ethical 5. Evolution of Ethical Priorities Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology144,168-172 (1997) Social control Autonomy Beneficence Social justice Autonomy Beneficence Autonomy Beneficence Social justice Beneficence Autonomy Justice 2000+ 1990s 1970s-1980s 1950s-1960s 6. Human Genetic Intervention Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology144,168-172 (1997) Genetic Engineering Genetic Engineering Enhancement of capabilities Genetic Engineering Gene therapy Cure or prevention of disease Germ-line Somatic cells 7. Ethical Issues for Gene Therapy and Genetic Engineering
Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology144,168-172 (1997) 8. Ethical issues in assisted reproduction Ethics, Advertising and Assisted Reproduction:The Goals and Methods of AdvertisingConcern for commodification of life and life products Concern for availability, allocation, and pricingof the technology Allen R. Dyer:Womens Health Issues7:3,pp. 143-148.May/June 1997 9. 10. Human Embryo Blastocyst stageImmunosurgeryEmbryonic stem cells Scientific 11. STEM CELL (DEFINITION) A cell that has the ability to continuouslydivide and differentiate (develop)into various other kind(s) of cells/tissuesFetal tissue, cord blood, and adult stem cells Cells differentiated, but can form a number of other tissues Multipotent Some cells of blastocyst (5 to 14 days) Cells can form any (over 200) cell types Pluripotent Cells from early (1-3 days) embryos Each cell can develop into a new individual Totipotent Examples Description Stem cell type 12. History of Human Stem Cell Research
13. Bone Marrow Stem Cells 14. Genetics Cancer is a genetic illness: It is not necessarily a hereditary illness. 15. 16. Glass, D. A. et. al. N Engl J Med December 25, 2003 Formation of Osteolytic Lesions in Multiple Myeloma 17. 18. 19. History of Human EmbryonicStem Cell Research
20. History of Human EmbryonicStem Cell Research
21. History of Somatic Cell Nuclear Transfer (Cloning)
22. Possible Uses ofStem Cell Technology
23. Diseases potentially treatable with stem cells Cancer Diabetes Parkinson's Alzheimers Spinal Cord injury Heart Disease Infertility Basic knowledgeof cell development 24. Who are stakeholders? People with illnesses Parents of children with illnesses Physicians and scientists Research Institutes:NIH, Universities,Corporations and shareholders (those who might profit) Government (s) USA, California, UK, Australia, Czech Republic, South Korea Taxpayers Churches and clergy The cells themselves 25. Misconceptions hamper understanding Sources of stem cells:Adult stem cells:bone marrow, blood, muscle, fat, nerves , etc. Umbilical cord stem cells: Umbilical cord blood and placenta Embryonic stem cells:From TABs or (supernumerary) IVFs Embryos made solely for research purposes Embryos made using somatic cell nuclear transfer (SCNT) DNA 26. Possible points of contention
27. 28. Legal Considerations: Embryonic Stem Cell Research
Legal 29. Legal Issues: Embryonic Stem Cell Research
30. Legal Consideration: Embryonic Stem Cell Research
31. Laws BanningReproductiveCloning 32. Laws BanningResearchCloning 33. EmbryonicReproductive Cloning Laws Worldwide 34. EmbryonicResearch Cloning Laws Worldwide 35. Legislation on Reproductive/Therapeutic Cloning, Embryo Research,and Stem Cell Research 2003 Source:Encyclopedia of Bioethics 12 Stem Cell Research on Spare Embryos allowed 13 (General) Research on Embryos allowed +Australia, Brazil, Canada, Finland, France, Iceland, Spain, Sweden 5 Therapeutic Cloning (SCNT) allowed (US, UK, Netherlands, Japan, Israel) None Reproductive Cloning allowed 36. Allow for the procurement of human embryonic cells from supernumerary embryos by law
Prohibit procurement but allow by law the import and useof human embryonic stem cell lines Germany 37. IVF cells only to be used for medical assisted reproduction
Allowing for creation of human embryos for stem cell procurement by law United Kingdom 38. The Case for Federal Funding
39. The Case for Federal Funding The only possible source for adequate support of our medical schools and medical research is the taxing power of the Federal Government.Such a program must assure complete freedom for the institutions and the individual scientists in developing and conducting their research work. b) 1945US Surgeon General Thomas Parran arguing for the establishment of the National Institutes of Health (NIH) 40. California Stem Cell Research and Cures Initiative
41. Contributions fromReligious traditions
(No consistent positions) Religious 42. Early Judaism
43. Early Christianity
44. Catholicism
45. Another distinction
46. 47. Protestant
48. Contemporary Judaism
49. Islam
50. Asian Traditions
51. Buddhist Ethics "Cloning is a different way of thinking about the recycling of life, "It's a Buddhist way of thinking. Professor Yong Moon from Korea's Seoul National University at the American Association for the Advancement of Science 2004 Just a few days earlier at the same conference, Moon was part of the team that announced it had successfully cloned human embryos and extracted sought-after and versatile embryonic stem cells. *Hwang, W.S., et al. 2004. Evidence of a Pluripotent Human Embryonic Stem Cell Line Derived from a Cloned Blastocyst.Science303: 1669-1674. 52. Confucian tradition
53. Cloned Embryos
54. Ethical principles for Embryonic Stem Cell Research
55. Preimplantation Genetic Diagnosis P.G.D. 56. PGD Cancer (Colon and Breast) Cystic fibrosis Cycle cell anemia Ankylosing spondylosis Huntingtons disease 57. Partial Birth Abortion Currently under consideration by US Supreme Court Challenges constitutionality of Partial-Birth Abortion Act of November 2003. (Nebraska law struck down in 2000) Fails to providean exception for procedures preformed to protect the health of the pregnant woman. Vaguely written Places undue burden on women seeking abortion.Supporters of the law argued that procedure was never medicallynecessary. 58. Partial-birth abortion With the ban, Congress targeted an abortion procedure, known medically as "intact dilation and extraction," that involves the partial delivery of a fetus. The skull is then punctured and its contents evacuated to make it easier for the head to pass through the birth canal. Doctors say it is used only in exceedingly rare circumstances (1 in 500). American College of Obstetricians and Gynecologistshas said that the procedures banned under the measure -- called "intact dilation and extraction and evacuation" and "dilation and extraction (D & X) -- are increasingly regarded as the safest abortion procedures during the second trimester of pregnancy. 59. Partial-birth abortion Constitutional issues: Right to privacy Right to life (and definition of life) Child or Fetus Interest of the state Freedom of religion Legal versus moral considerations Responsibility to make moral choices 60. Principles of Bioethics
Ethical 61. Conclusion The religions today, even in their disagreements, serve to focus both our awe at the mysteries of our humanity and our anxieties about our futures.Religious traditions will probably continue to adapt to our changing knowledge of ourselves and our growing powers to modify our nature.In so doing they will perhaps shed some light on our biological origins and on our technological destiny. Ronald Cole-Turner Encyclopedia of Bioethics 62. Your role in 21st century medicine There are still many unanswered questions: As physicians, you will be concerned with the particular details of your patients lives. You will face situations in which there will inevitably be uncomfortable choices. You will hope to be able to make those decisions with your patients and for your patients best interests. You will hope to be able to practice with in a legal environment that respects science, knowledge, your training, and your own moral convictions.