Bioethics

What is bioethics? Humans and other animals Some issues of human reproduction

Linda Baggott la Velle

(linda.lavelle@bris.ac.uk)
Bioethics for VIth formers

What is Bioethics?
Biology: the science of life is concerned
with the normal structure and function of living things at various levels of organisation Biomedical Science: usually incorporates biochemistry, physiology, pharmacology and medicine (human and veterinary) Ethics: sometimes called moral philosophy, is concerned with how we should decide what is right and what is wrong
Bioethics for VIth formers

Biology/Biomedical science + Ethics =

Bioethics
http://www.beep.ac.uk/content/46.0.html
Bioethics for VIth formers

Ethics
Straw Poll: Do you believe that there are some some things that are always right or wrong? Cultural differences Two main categories of ethics:
Deontology Consequentialism
Bioethics for VIth formers

Deontology
Deontological ethics (deon = Greek for duty) arise from an absolute set of values that apply in all circumstances. For example, the Roman Catholic Churchs teaching that abortion is always wrong.

Bioethics for VIth formers

Consequentialism
Consequentialist ethics arise from the belief that there are no absolutes, and that the likely outcomes in any situation should be calculated. Benefit and harm are weighed, and the best situation is opted for.

Bioethics for VIth formers

Thought Experiment

Telling lies is wrong.

Consider this claim from the point of view of a) a deontologist, and b) a consequentialist.

Bioethics for VIth formers

Decision Making and Reaching Ethical Conclusions

Ethical conclusions are valid if they are based on:
1. reason; 2. a well established ethical framework; 3. a reasonable level of consensus arising from genuine debate.
Bioethics for VIth formers

A bioethical dilemma: Straw Poll

Should calves be taken from their mothers before weaning to provide more milk for people?
Bioethics for VIth formers

Human Life: two big questions

When does life begin? Is human life uniquely different from that of other organisms? Two important bioethical areas:
Human reproduction Humans and other animals
Bioethics for VIth formers

Humans and other animals

http://www.beep.ac.uk/content/ 425.0.htmlhttp://www.beep.ac .uk/content/425.0.html
Bioethics for VIth formers

How are we different?

1. Language 2. Self awareness 3. Ability to make moral decisions
But are these really unique to humans?

Bioethics for VIth formers

Some evidence..
Washoe and Koko Mirror test Macaque experiment

Bioethics for VIth formers

From Shadows of Forgotten Ancestors by Carl Sagan and Ann Druyan

In a laboratory setting, macaque monkeys were fed if they were willing to pull a chain and electrically shock an unrelated macaque whose agony was in plain view through a one-way mirror. Otherwise, they starved. After learning the ropes, the monkeys frequently refused to pull the chain; in one experiment only 13% would do so - 87% preferred to go hungry. One macaque went without food for nearly two weeks rather than hurt its fellow.
Bioethics for VIth formers

Genesis 1:28
Be fruitful and multiply, and replenish the Earth and subdue it: and have dominion over the fish of the sea and over the fowl of the air and over every living thing that moveth upon the Earth.

Bioethics for VIth formers

The Use of Animals by You

(if you are an average UK citizen)

Bioethics for VIth formers

Straw Poll
1. Humans are more important than animals. They are there for us to use. 2. Animals should have equal rights with humans 3. Animals should be treated with more consideration than humans as they have no way to complain
Bioethics for VIth formers

Another Straw Poll

Are you:
1. In favour of all scientific research with animals 2. In favour only of medical research with animals 3. Against all research with animals
Bioethics for VIth formers

Animal Experiments - for

major medical advances impossible without human life more intrinsically valuable no scientifically valid alternatives cannot train new medical practitioners/scientists without strict legislation to provide welfare limited research funding available, so funded expts must be worthwhile
Bioethics for VIth formers

20 major medical advances that depended on animal research

Anaesthetics Anticoagulants Blood transfusion Corneal transplants Diphtheria vaccine Drugs for asthma Drugs for high blood pressure Drugs to control transplant rejection Gene therapy for inherited diseases Heart lung machine for open heart surgery

Heart transplants The hib meningitis vaccine Insulin for diabetes Kidney dialysis Kidney transplants Penicillin to treat infections Polio vaccine Replacement heart valves Treatments for leukaemia Whooping cough vaccine

Bioethics for VIth formers

The guiding principles in animal research

Refinement: to make sure animals suffer as
little as possible

animals used

Reduction: to minimise the number of

Replacement: to replace animal procedures

with non-animal techniques wherever possible.
Bioethics for VIth formers

Animal Experiments against

little effect on life expectancy/ disease rate alternatives available evidence for cruelty research trivial desensitisation by educational process
Bioethics for VIth formers

Thought experiment - consider this evidence:

Results of LD50 tests of dioxin on various animals:

Guinea pig - 1 microgram/kilogram Hamster - 5000 micrograms/kilogram Female rat - 45 micrograms/kilogram Male rat - 22 micrograms/kilogram
Bioethics for VIth formers

Animal research in context are there alternatives?

tissue culture, computer modelling, studies of patients and populations

Bioethics for VIth formers

A Final Straw Poll

Are you:
1. In favour of all scientific research with animals 2. In favour only of medical research with animals 3. Against all research with animals
Bioethics for VIth formers

Some ethical aspects of Human Reproduction

http://www.beep.ac.uk/content/188.0.h tml

Bioethics for VIth formers

The Meaning of Life

1. Organisms have no control over whether or not they become alive 2. Once alive they strive to stay alive 3. They have a strong and instinctive drive to reproduce 4. They die.
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When does life begin?

Bioethics for VIth formers

Structure of a Mammalian Egg (oocyte)

Cumulus oophorus

Ooplasm Oocyte surface membrane Zona pellucida Perivitelline space

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Bioethics for VIth formers

Bioethics for VIth formers

Ethics and Human Reproduction

Abortion Contraception Assisted Reproduction Embryo Research

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Assisted reproduction
Subfertility affects 1 in 6 couples Male and female partner equally likely to have the problem Childlessness causes real suffering

Bioethics for VIth formers

Causes of Male Subfertility

Low or no sperm count Abnormal sperm cells Vasectomy Testicular/tract damage:
chemotherapy surgery accident
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Causes of Female Infertility

ovulation failure tubal damage cervical mucus problems endometriosis unexplained no male partner
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Subfertility involving both partners

incompatible blood groups carrier/s of serious genetic disorder:
Huntingtons Chorea Tay-Sachs disease CF

coital failure

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Assisted reproduction: possible treatments

Counselling Hormones Surgery Procedures on gametes outside the body
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Gamete Manipulation procedures

Donor insemination [DI] In vitro fertilisation [IVF] Subzonal insemination [SUZI] Intracytoplasmic insemination [ICSI]

Bioethics for VIth formers

SUZI

Bioethics for VIth formers

ICSI

Bioethics for VIth formers

Ethical arguments in favour of assisted reproduction

suffering of the infertile genetic death can do, so should do - advances in technology

Bioethics for VIth formers

Ethical Arguments against assisted reproduction

not everyones right to have a baby resources should be diverted to:
prevention and cure of disease promoting better parenting

adds to world population problem against evolution

Bioethics for VIth formers

Fertility Clinic Team: Case Study 1

Mrs A is a divorcee in her late 50s and wants to have hormone treatment to enable her to become pregnant. She will need both an egg and a sperm donor. What are the arguments for and against her getting the treatment?
Bioethics for VIth formers

Fertility Clinic Team: Case Study 2

Jane and Mary have been together for 10 years in a stable and committed relationship. They have their own house and Jane has a very well paid job. They would like a child, and Mary has come to the Clinic to ask for DI treatment.
What are the arguments for and against her getting the treatment?
Bioethics for VIth formers

Fertility Clinic Team: Case Study 3

Mrs Y had treatment for cancer, which involved removal of her uterus (womb). Her ovaries are still functioning normally, and her sister, Mrs X has volunteered to act as a surrogate mother. Mr and Mrs Y will undergo gamete collection and Mrs X will need hormone treatment. What are the arguments for and against them getting the treatment?
Bioethics for VIth formers

Fertility Clinic Team: Case Study 4

Two couples had IVF treatment at your clinic. Mrs C does not become pregnant, but Couple D are successful and go on to have healthy twins. It is realised some weeks later that there was a mix-up in the embryology lab and the twins are genetically those of Mr and Mrs A.
What are the ethical issues?
Bioethics for VIth formers

Fertility Clinic Team: Case Study 5

Mixed-race twins were born to a couple after sperm of a donor of different ethnicity was mistakenly used in IVF treatment. What are the ethical issues?

Bioethics for VIth formers

Fertility Clinic Team: Case Study 6

Mrs W had several unsuccessful attempts at IVF, although the procedures produced many spare embryos, which were frozen. Mrs W got cancer and although she recovered, her ovaries were lost during the treatment. Sadly, her marriage broke down and her ex-husband withheld his consent (as is his right under the law) to her using the frozen embryos to try to have a baby. After 10 years frozen embryos must be destroyed if consent to use them is not given. This period has elapsed. What are the ethical issues?
Bioethics for VIth formers