seminar etika stem cell unimus

8/8/2019 Seminar Etika Stem Cell Unimus

http://slidepdf.com/reader/full/seminar-etika-stem-cell-unimus 1/40

STEM CELLSSTEM CELLS&&

BIOBIOETHICSETHICSOOlehleh

Sofwan DahlanSofwan Dahlan



We have to realize that major advances of We have to realize that major advances of science, technology and health care duringscience, technology and health care during

the past 50 years havethe past 50 years have outoutpaced the abilitiespaced the abilitiesof those in ethicsof those in ethics andand law to solve problemslaw to solve problemscreated by thesecreated by these advances.advances.

(Catalano, 1991)(Catalano, 1991)



PROGRESS INPROGRESS INMEDICAL TECHNOLOGYMEDICAL TECHNOLOGY

It was triggered by the ability of under It was triggered by the ability of under--

standing genetics.standing genetics.

It uses a lot of advanced in imaging,It uses a lot of advanced in imaging, comcom--putingputing and telecommunication.and telecommunication.

Modern technology was founded for Modern technology was founded for therathera--peutic and diagnostic needs.peutic and diagnostic needs.

SSome medical paradoxes then appearsome medical paradoxes then appears !!!!!!



PARADOX OF MODERN MEDICINE PARADOX OF MODERN MEDICINE

1.1. Modern medicine makes it possibleModern medicine makes it possible..2.2. Modern medicine tries to cure nonModern medicine tries to cure non--

illnessesillnesses..

3.3. It identifies asymptomatic medical It identifies asymptomatic medical cinditi cinditi--ons as diseases.ons as diseases.

4.4. Sometimes it even classifies risks asSometimes it even classifies risks as

diseases.diseases.In general, it tends to blur the distinctionIn general, it tends to blur the distinction bet bet--ween diseases and risksween diseases and risks !!! !!!

(Prof. John Ladd)(Prof. John Ladd)



MEDICAL TECHNOLOGYMEDICAL TECHNOLOGY

NeedsNeeds aa process that¶s just understand well by process that¶s just understand well by the scientist.the scientist.

Public suspicious often comes about the truth of Public suspicious often comes about the truth of the information and independency of the scientist.the information and independency of the scientist.

The suspicious appears because of the exact and The suspicious appears because of the exact and absolute answer can not been given by scientists.absolute answer can not been given by scientists.

The scientists themselves have some limitation or The scientists themselves have some limitation or

even incapability to eliminate every risk element.even incapability to eliminate every risk element.The suspicious increased because in reality, theThe suspicious increased because in reality, thetechnology is under technology is under--controlled by multinational controlled by multinational company.company.



MEDICAL TECHNOLOGYMEDICAL TECHNOLOGY

1.1. GiveGive chanceschances toto createcreate technological comtechnological com--

pulsion, that is, ³if we can do it, let¶s do it´. pulsion, that is, ³if we can do it, let¶s do it´.

2. Then, ethical and law problems appear 2. Then, ethical and law problems appear..

3.3. ³The³The slippery slippery slopeslope argument´ argument´ may may comecome

toto try to solve ethical and law problems.try to solve ethical and law problems.4.4. So, needed ethics and law discussion toSo, needed ethics and law discussion to

somethingsomething that that technically technically not not aa problem. problem.



THE POSITION OFTHE POSITION OFMEDICAL SCIENTISTS IN SOCIETYMEDICAL SCIENTISTS IN SOCIETY

It¶s very important, because only the scientists who canIt¶s very important, because only the scientists who can

analyze the potential of benefits and risks.analyze the potential of benefits and risks.

They have an ethical duty to make a fair They have an ethical duty to make a fair && openopen aanalysis.nalysis.

But, the final decision must not been given fully toBut, the final decision must not been given fully tot themhem (scientists)(scientists),, becausebecause sciencescience monopoly monopoly doesdoes not not meanmean ethics and wisdom monopoly.ethics and wisdom monopoly.

Also can not been given to the patient hi Also can not been given to the patient himself mself becausebecause

bias of interest can influence in making decision.bias of interest can influence in making decision.

The society¶s position is important too, so needed The society¶s position is important too, so needed comcom--mumunicationnication and and opinionopinion buildingbuilding about about thethe very sensitivevery sensitivetopics.topics.



BIOTECHNOLOGYBIOTECHNOLOGY

Some people use the term only to refer to newer Some people use the term only to refer to newer tools of genetic science.tools of genetic science.

In this context, biotech may be defined as the use of In this context, biotech may be defined as the use of biotechnical methods to modify the genetic materialsbiotechnical methods to modify the genetic materialsof living cells so they will produce new substancesof living cells so they will produce new substancesor perform new functions.or perform new functions.

Examples include recombinant DNA technology, inExamples include recombinant DNA technology, inwhich a copy of a piece of DNA containing one or awhich a copy of a piece of DNA containing one or afew genes is transferred between organisms or few genes is transferred between organisms or "recombined" within an organism."recombined" within an organism.

Biotechnology is any technological application thatBiotechnology is any technological application thatuses biological systems, living organisms, or uses biological systems, living organisms, or derivatives thereof, to make or modify products or derivatives thereof, to make or modify products or processes for specific use.processes for specific use.

((the UN Convention on Biological Diversitythe UN Convention on Biological Diversity))



APPLICATION APPLICATION

RED BIOTECH RED BIOTECH Biotech applied to medical processes:Biotech applied to medical processes:

-- organism designed to produce antibiotic.organism designed to produce antibiotic.

-- engineering genetic cures to diseasesengineering genetic cures to diseasesthroughthrough genomic genomic manipumanipulation.lation.

WHITE (GREY) BIOTECH WHITE (GREY) BIOTECH

Biotech applied to industrial procesBiotech applied to industrial processesses::

-- organism designed to produce useful organism designed to produce useful chemical.chemical.



GREEN BIOTECH GREEN BIOTECH

Biotech applied to agricultural processes:Biotech applied to agricultural processes:-- organismorganism designed to grow under specific designed to grow under specific

environmental conditions.environmental conditions.

-- plant engineered to express a pesticide, plant engineered to express a pesticide,therebthereby y eliminatingeliminating the need for external the need for external

appli applicacation of pesticide.tion of pesticide.

BLUE BIOTECH BLUE BIOTECH

-- t to describe the marine or aquatic o describe the marine or aquatic aaplication. plication.



ASPECTS OFMEDICAL PRACTICES

GENETIC BASIS OF DISEASES GENETIC BASIS OF DISEASES

The number of diseases known to have a genetic The number of diseases known to have a genetic

component component hashas increased significantly inincreased significantly in recent recent years, includes:years, includes:-- cardiovascular cardiovascular diseasedisease.. -- diabetesdiabetes..-- strokestroke.. -- Parkinson¶sParkinson¶s disease.disease.

-- obesity obesity.. -- Alzheimer¶s disease Alzheimer¶s disease..-- hypertension, etc.hypertension, etc.



DISEASE DISCOVERY DISEASE DISCOVERY && DIAGNOSIS DIAGNOSIS

One direct clinical impact of the reported One direct clinical impact of the reported

progress in the discovery of disease gene is the progress in the discovery of disease gene is the

d development of gene or DNAevelopment of gene or DNA--based diagnostic based diagnostic

tests for the respective genetic disorders.tests for the respective genetic disorders.

DRUGE DEVELOPMENT AND THERAPY DRUGE DEVELOPMENT AND THERAPY

-- Pharmacogenomics.Pharmacogenomics.

-- Gene therapy.Gene therapy.

ETHICAL, LEGAL AND SOCIAL ISSUES ETHICAL, LEGAL AND SOCIAL ISSUES



PHARMACOGENOMICS PHARMACOGENOMICS (1)(1)

1.1. Pharmacogenomics is concerned with individuPharmacogenomics is concerned with individu--al response to drugs based on genetic makeal response to drugs based on genetic make--up.up.

2.2. Actual patient response (including processing Actual patient response (including processing

and metabolization of drug and any adverseand metabolization of drug and any adverseside effectsside effects) ) is largely determined by genetic is largely determined by genetic inheritance.inheritance.

3.3. Understanding these processes throughUnderstanding these processes through

genetic analysis of individual patient is likely togenetic analysis of individual patient is likely tolead to more effectve treatment and improved lead to more effectve treatment and improved

drug development.drug development.



PHARMACOGENOMICS PHARMACOGENOMICS (2)(2)

1.1. Treatment could be tailor Treatment could be tailor--made for the patient,made for the patient,resulting in :resulting in :

a.a. faster recovery.faster recovery.

b.b. more cost more cost--effective use of drugs.effective use of drugs.c.c. decrease in adverse reactions to somedecrease in adverse reactions to some d drugs.rugs.

2.2. Genetic analysis of individuals, and ready Genetic analysis of individuals, and ready

access to a wide range of drug options, will of access to a wide range of drug options, will of course be prerequisites for taking advantage of course be prerequisites for taking advantage of

the opportunities offered.the opportunities offered.



GENE THERAPY GENE THERAPY

Gene therapy involves the genetic engineering of patient¶sGene therapy involves the genetic engineering of patient¶sgenetic code to removed or replace a mutant gene that isgenetic code to removed or replace a mutant gene that iscausing disease.causing disease.

1.1. GermGerm--line, or stemline, or stem--cell gene therapy cell gene therapy..

It involves altering a patient¶s DNA in their stem cell.It involves altering a patient¶s DNA in their stem cell.The modification to their genetic blueprint is permanent The modification to their genetic blueprint is permanent and hereditary.and hereditary.

This type of gene therapy is complex, and is considered This type of gene therapy is complex, and is considered

too risky to undertake until the underlying biology istoo risky to undertake until the underlying biology isbetter understood.better understood.

It also rises many ethical problems, for example theIt also rises many ethical problems, for example the po po--tential misuse of the therapy to create designer babies.tential misuse of the therapy to create designer babies.



2.2. Somatic gene therapy Somatic gene therapy..

This involves engineering cell on localized This involves engineering cell on localized basis, without affecting the patients basic basis, without affecting the patients basic gege--netic blueprint.netic blueprint.

Such therapy was approved in 1990 to treat aSuch therapy was approved in 1990 to treat afour years old child suffering from severefour years old child suffering from severe

combined immune deficiency.combined immune deficiency.

Some of the child¶s white blood cells wereSome of the child¶s white blood cells wereextracted, genetically engineered in theextracted, genetically engineered in the labolabo--ratory and infused back ratory and infused back into her bloodstream.into her bloodstream.



STEM CELLSSTEM CELLS

Stem cellsStem cells == single cells that can regeneratesingle cells that can regenerateand turn themselves into several types of speand turn themselves into several types of spe--

cialized cells.cialized cells.

They come from:They come from:

-- adult tissues;adult tissues;-- embryonic cells; andembryonic cells; and

-- umbilical cord blood.umbilical cord blood.

(Lewis M A; Tamparo C D; 2007)(Lewis M A; Tamparo C D; 2007)

Pluripotent = capable of giving rise to mostPluripotent = capable of giving rise to mosttissues of an organism.tissues of an organism.

Totipotent = having unlimited capability.Totipotent = having unlimited capability.

(Ruse, M & Pynes, C, A; 2006)(Ruse, M & Pynes, C, A; 2006)



GOALSGOALS

IN MIND OFR

ESEAR

CHER

SIN MIND OFR

ESEAR

CHER

SSeveral different goals in mind:Several different goals in mind:

a. To use stem cells as the basis of new a. To use stem cells as the basis of new

therapies for those with serious deseases.therapies for those with serious deseases.b. To gain increased understanding of theb. To gain increased understanding of the

processes of human development. processes of human development.

c. To provide new ways to test drugs for c. To provide new ways to test drugs for efficacy, toxicity, and safety.efficacy, toxicity, and safety.

(Cohen, C, B; 2007)(Cohen, C, B; 2007)



THERAP THERAPEUTIC USES OF STEM CELLS EUTIC USES OF STEM CELLS

1.1. Current Therapeutic AppiclationsCurrent Therapeutic Appiclations::

-- Blood and Immune System Disorders.Blood and Immune System Disorders.

-- Metabolic diseases.Metabolic diseases.

2.2. Experimental Therapeutic ApplicationsExperimental Therapeutic Applications::

-- Multiple Sclerosis.Multiple Sclerosis.

3.3. Potential Therapeutic ApplicationsPotential Therapeutic Applications::

-- Parkinson¶s Disease.Parkinson¶s Disease. -- Spinal Cord Injury.Spinal Cord Injury.

-- Retinal Degeneration.Retinal Degeneration. -- Type I Diabetes.Type I Diabetes.-- Cardiovascular Disease.Cardiovascular Disease. -- Metabolic Disease.Metabolic Disease.

-- Osteoporosis.Osteoporosis.



4.4. Avoiding or Overcoming Immune Rejection in Stem Avoiding or Overcoming Immune Rejection in Stem

Cell TransplantationCell Transplantation::

-- Immunosuppression.Immunosuppression.

-- HLA Matching.HLA Matching.

-- Somatic Cell Nuclear Transfer.Somatic Cell Nuclear Transfer.-- Induction of Immune Tolerance.Induction of Immune Tolerance.

-- Expansion of Autologous Transplantion.Expansion of Autologous Transplantion.

((Monroe KRMonroe KR,, Miller RB, Tobis JS; 2008Miller RB, Tobis JS; 2008))



SCIENTIFIC ISSUES SCIENTIFIC ISSUES

ARISING IN STEM CELLS THERAPY ARISING IN STEM CELLS THERAPY 1. Use of Animal Cells or Product.1. Use of Animal Cells or Product.

2. Quantitative and Qualitative Limitation of Adult 2. Quantitative and Qualitative Limitation of Adult

Stem Cells.Stem Cells.3.3. Tumor Tumor--Forming Potential of Embryonic StemForming Potential of Embryonic Stem

Cells.Cells.

4. Assessing the Genetic Normality of Embryonic 4. Assessing the Genetic Normality of Embryonic

Stem Cells.Stem Cells.

( (Monroe KR Monroe KR,, Miller RB, Tobis JS; 2008 Miller RB, Tobis JS; 2008) )



SIX POLICY OPTIONS SIX POLICY OPTIONS

Op. 1:Op. 1: No human embryo research is permitted,No human embryo research is permitted,and no explicit permission is given to per and no explicit permission is given to per--

form research on existing HESCs.form research on existing HESCs.

Op. 2: Research is permitted only on existingOp. 2: Research is permitted only on existing

HESC lines, not on human embryos.HESC lines, not on human embryos.

Op. 3: Research is permitted only on remainingOp. 3: Research is permitted only on remaining

embryos no longer needed for reproduction.embryos no longer needed for reproduction.

Op. 4: Research is permitted both on remainingOp. 4: Research is permitted both on remainingembryos and on embryos created specifical embryos and on embryos created specifical--

ly for research purposes through in vitroly for research purposes through in vitro

fertilization.fertilization.



Op. 5: Research is permitted both on remainingOp. 5: Research is permitted both on remaining

embryos and on embryos created specifical embryos and on embryos created specifical--ly for reseach purposes through somatic ly for reseach purposes through somatic

cell nuclear transfer into human eggs or zy cell nuclear transfer into human eggs or zy--

gotes.gotes.

Op. 6: Research is permitted only on remainingOp. 6: Research is permitted only on remainingembryos and on embryos created specifical embryos and on embryos created specifical--

ly for research purposes through thely for research purposes through the

transfer of human somatic cell nuclei intotransfer of human somatic cell nuclei intononhuman animal eggs, for example, rabbit nonhuman animal eggs, for example, rabbit

eggs.eggs.

( (Ruse M & Pynes C; 2006 Ruse M & Pynes C; 2006) )



EETHICAL ISSUES (1)THICAL ISSUES (1)

The complex ways in transplanted stem cells may benefit The complex ways in transplanted stem cells may benefit the patient.the patient.

Clinical trial being stated and stem cell treatment programClinical trial being stated and stem cell treatment programbeing offered without any clinical trials, involving transbeing offered without any clinical trials, involving trans-- plantation of stem cells with very little knowledge of wether plantation of stem cells with very little knowledge of wether the treatment will work or about the mechanisms of any the treatment will work or about the mechanisms of any effect that does occur.effect that does occur.

At least five company are offering stem cell therapies in At least five company are offering stem cell therapies incountries where regulations governing experimental procecountries where regulations governing experimental proce--dures area less stringent than in the United State.dures area less stringent than in the United State.

This is bypassing the generally acceppted goals of clinical This is bypassing the generally acceppted goals of clinical trials to show, first, that the proposed treatment does not trials to show, first, that the proposed treatment does not cause harm, and, second, that it is effective.cause harm, and, second, that it is effective.




Similar ethical issues have arisen in many other areas of Similar ethical issues have arisen in many other areas of medicine, since the precise mechanism of many therapies,medicine, since the precise mechanism of many therapies,especially pharmaceutical ones, is incompletely under especially pharmaceutical ones, is incompletely under--stood.stood.

However, the issue is heightened in the case of cell However, the issue is heightened in the case of cell--based based therapies, since the mechanisms of action are likely to betherapies, since the mechanisms of action are likely to bemuchmuch more complicated than is the case for more conventi more complicated than is the case for more conventi--onal therapies, since reversing the transplantation may not onal therapies, since reversing the transplantation may not be possible, and be possible, and since cell since cell--based therapies are being probased therapies are being pro--moted as a potential solution for many major injures and moted as a potential solution for many major injures and devastating, proggressive, and otherwise in curabledevastating, proggressive, and otherwise in curablediseases.diseases.




In these cases the patients and their families can beIn these cases the patients and their families can bedesperate enough to try innovative, risky, and expensivedesperate enough to try innovative, risky, and expensiveapproaches with very little proof that they will be helpfull.approaches with very little proof that they will be helpfull.

It is difficult to deny them this one glimmer of hope.It is difficult to deny them this one glimmer of hope.

However, lessons from gene therapy story show that theHowever, lessons from gene therapy story show that thehasty application of innovative therapies can be disashasty application of innovative therapies can be disas--trously harmfull to the patient and counterproductive for trously harmfull to the patient and counterproductive for

the field.the field.

(Glilley and Gee 2003; Rubanyi 2001; Somia and Verma 2000)(Glilley and Gee 2003; Rubanyi 2001; Somia and Verma 2000)




Finally,Finally,with regard to the level of optimism that has beenwith regard to the level of optimism that has beengenerated over the potential of stem cell therapiesgenerated over the potential of stem cell therapies

to cure deseases and heal injuries, it is important to cure deseases and heal injuries, it is important that from time to time a realistic appraisal of thisthat from time to time a realistic appraisal of thisoptimism be made.optimism be made.

As an example, spinal cord injury has been in the As an example, spinal cord injury has been in thespotlight as one of the nervous system injuries that spotlight as one of the nervous system injuries that could be best benefit from stem cell therapies.could be best benefit from stem cell therapies.

(Mc Donald et al. 1999)(Mc Donald et al. 1999)



LEGAL &LEGAL & E ETHICAL IMPLICATION THICAL IMPLICATION

OF TISSUE CELL RESEARCH OF TISSUE CELL RESEARCH It is difficult to identify all the legal and ethical It is difficult to identify all the legal and ethical

implications of tissue research.implications of tissue research.

There areThere are more questions than answersmore questions than answers !!! !!! In some cultures and countries, human cloning of In some cultures and countries, human cloning of

any form is forbidden.any form is forbidden.

Other culturs and countries are more eager toOther culturs and countries are more eager to

step into the arena, always pushing science fur step into the arena, always pushing science fur--

ther into the future.ther into the future.(Lewis M A; Tamparo C D; 2007)(Lewis M A; Tamparo C D; 2007)



THE QUESTIONS THE QUESTIONS

Who monitors fraudulent or false researchWho monitors fraudulent or false researchresults? results? Should there be an international advisory group of Should there be an international advisory group of scientists and ethicists to help determine how scientists and ethicists to help determine how

tissue research should move forward? tissue research should move forward? If funding for tissue research comes mostly fromIf funding for tissue research comes mostly from

private entities, who will claim ownership to the private entities, who will claim ownership to theresults? results?

If tissue research has the potential for curing evenIf tissue research has the potential for curing evenene devastating disease, why would we not run asene devastating disease, why would we not run asfast as possible toward a successful result? fast as possible toward a successful result?

(Lewis M A; Tamparo C D; 2007)(Lewis M A; Tamparo C D; 2007)



CLINICAL TRANSLATION CLINICAL TRANSLATION

From laboratory to clinic:From laboratory to clinic:1. Safety;1. Safety;

2. Potenstial benefit;2. Potenstial benefit;3. Design; and 3. Design; and

4. Informed consent.4. Informed consent.

(Marhaen, 2009)(Marhaen, 2009)



PRECAUTIONARY PRINCIPLE PRECAUTIONARY PRINCIPLE

There are two broad classes:There are two broad classes: The Strong Precautionary Principle:The Strong Precautionary Principle:

Take no action unless you are certain that it Take no action unless you are certain that it

will do no harm.will do no harm.

The Weak Precautionary Principle :The Weak Precautionary Principle :Lack of full certainty is not justification for Lack of full certainty is not justification for

preventing an action that might be harmful. preventing an action that might be harmful.

Both types are problematic, although the latter Both types are problematic, although the latter

considerably less so than the former.considerably less so than the former.

(International Consumers for Civil Society)



CRITICISMS OF STRONG PP CRITICISMS OF STRONG PP

PreventingPreventing ( (or attempting to prevent or attempting to prevent) ) some actionsome action

that might lead to the death of human beings may that might lead to the death of human beings may itself result in the death of all human beings.itself result in the death of all human beings.

Demanding that a technology should not be admitted Demanding that a technology should not be admitted untill it has been proved to be harmless is equivalent untill it has been proved to be harmless is equivalent

to requiring an infinitely high standard of proof to requiring an infinitely high standard of proof --------which can never be achieved.which can never be achieved.

The notion that regulations should be based on theThe notion that regulations should be based on the presumption that there is no safe dose for any presumption that there is no safe dose for any

chemical that exhibits harmful properties at somechemical that exhibits harmful properties at somedose has been widely refuted.dose has been widely refuted.

Applied generally, the strong precautionary principle Applied generally, the strong precautionary principlewould end civilization.would end civilization.

((International Consumers for Civil SocietyInternational Consumers for Civil Society))



WORLDWIDE REGULATION WORLDWIDE REGULATION

ON CLONING ON CLONING

Reproductive Cloning:Reproductive Cloning:

-- Universally opposed (most are guided by ethical Universally opposed (most are guided by ethical

rather than legal considerations).rather than legal considerations).-- Human reproductive cloning and inherritableHuman reproductive cloning and inherritable

genetic modification are illegal in >50 countries.genetic modification are illegal in >50 countries.

Therapuetic Cloning:Therapuetic Cloning:

-- Rather devided.Rather devided.

-- Country like Australia, China, Thailand, Vietnam,Country like Australia, China, Thailand, Vietnam,

and India allowes this.and India allowes this. (A Rahman A Jamal, 2009(A Rahman A Jamal, 2009) )



KEY POINTS OF MALAYSIAN GUIDLINE KEY POINTS OF MALAYSIAN GUIDLINE

Source of stem cells:Source of stem cells:-- Creation of embryos for the sole purposes of Creation of embryos for the sole purposes of

stem cells research is not allowed.stem cells research is not allowed.

-- Ban on reproductive cloning.Ban on reproductive cloning.-- Use of leftover embryos from invitro fertilizationUse of leftover embryos from invitro fertilization

is allowed with consent from the donor and theis allowed with consent from the donor and the

relevant regulatories (consistent also withrelevant regulatories (consistent also with

Fatwa).Fatwa).-- Use of adult cells and commercial stem cell lineUse of adult cells and commercial stem cell line

is allowed.is allowed.(A Rahman A Jamal, 2009(A Rahman A Jamal, 2009) )



Xenotransplantation: Xenotransplantation:

-- This is not allowed untill more scientific This is not allowed untill more scientific

and clinical evidence is obtained.and clinical evidence is obtained.

-- Clinical trials shall be allowed only whenClinical trials shall be allowed only whenthere are preclinical data indicating a highthere are preclinical data indicating a high

probability of benefit to the recipients and probability of benefit to the recipients and

data on safety.data on safety.(A Rahman A Jamal, 2009(A Rahman A Jamal, 2009) )



APPLICATION of APPLICATION of

MEDICAL TE MEDICAL TEC CHNOLOGY HNOLOGY 1. Respect to life and living1. Respect to life and living..

2. Respect to human dignity and their 2. Respect to human dignity and their rights.rights.

2.2. Equality between risk and advantageEquality between risk and advantage..

3. Awareness that ethics were not as3. Awareness that ethics were not as

simple as the naturesimple as the nature..



MORAL PRINCIPLES MORAL PRINCIPLES

Beauchamp, Childress:Beauchamp, Childress:11. Beneficence.. Beneficence.2 2. Non. Non--maleficence.maleficence.

33. Autonomy.. Autonomy.4. J 4. Justice.ustice.

Catalano, J, T, 1991):Catalano, J, T, 1991):11. Autonomy.. Autonomy.2 2. Justice.. Justice.33. Fidelity.. Fidelity.44. Beneficence.. Beneficence.



SUMMARY SUMMARY

Bioethics refers to the ethical implicationsBioethics refers to the ethical implicationsof biomedical technology and its practice.of biomedical technology and its practice.

The change in ethics related to modernThe change in ethics related to modern

medicine and research in the past few medicine and research in the past few decades is most intriguing.decades is most intriguing.

Medicine & technology rapidly change and Medicine & technology rapidly change and

offer choices to clients and their families.offer choices to clients and their families.

Consumers are actively involved in their Consumers are actively involved in their

health care and more knowledgeable of health care and more knowledgeable of

medical technology and its implications.medical technology and its implications.



The public evaluates this technology and The public evaluates this technology and

how it relates the daily lives.how it relates the daily lives. The application of bioethics in our every The application of bioethics in our every--

day lives provides:day lives provides:

-- opportunities;opportunities;-- challenges;challenges;

-- enthusiasm; and enthusiasm; and

-- choices;choices;albeit difficult for each of us.albeit difficult for each of us.

seminar etika stem cell unimus

Documents