Research in the medical field unveils new drugs, forms of treatment and disease prevention measures. The science behind the trial of new techniques in medical procedures including use of new drugs faces lots of challenges today. Any discovery has to be tested to ascertain the impact on the life of both plants and animals and the entire environment. Most of the new discoveries require models for trial experiments, some of the trial models include plants and animals. The success of which is determined by the ethical implications and regulations.
There challenges in medicine especially where the cause, cure and prevention of a disease is no yet known. For new drug discoveries meant to be tried in animal models known to mimick similar responses expected in human beings, animal protection agencies argue that this violates the animal right to life, unfortunately there cases where no other trial model other than animals are available, this paper focuses on the progress in medical research especially with regard to areas of controversy and the ethical implications.
The major controversial medical undertaking range from; tissue healing, growth and development, organ transplants, gene therapy, recombinant DNA technology in drug discovery and food manufacture, invitro fertilization, gene cloning alongside all medical undertaking that entails an artificial modification of the natural make of an animal or plant. Most of the research in regard to human health is best done in animal models that can not be replaced by micro-organisms and invitro testing. Researchers have been threatened by animal protection agencies like Animal Liberation Front and the People for Ethical Treatment of Animals (PETA).
With such obstacles most researchers have no choice but to risk their own lives and undertake such procedures with the hope that the outcome will definitely be positive. The question thus remains whether it’s ethical to fall back to the fears and eventually stop research or rather stop the trial procedures in animal models and perhaps try them directly on human beings (R, E Sonnino &R. E Banks1996). With regard to human health the world medical declaration of Helsinki serves as a statement of ethical principles providing guidelines to physicians and researchers involve d with human subjects.
According to the statement, physicians are under an obligation to ensure safety of human life with their knowledge and conscience geared to the fulfillment of this duty, the patient first. Medical research involving human subjects is to improve the prophalytic, diagnosis and the therapeutic index alongside understanding the pathogenesis of the disease. The statement therefore approves that it’s okay for even existing procedures to be challenged by research and re-evaluated to ascertain their efficacy. It’s in agreement with the statement that there obstacles and risks involved.
According to this statement any research involving human subjects should guaranty protection of the right to life. It’s true that there vulnerable groups and they should thus be given special protection alongside those who can not consent for themselves (National Institute of Health 2004). The principles outlined with regard to medical research implies that any involvement of human subjects should be based on valid and adequate information with laboratory and prior animal experimentation that have shown to be safe . Caution should be taken with regard to the impact on the entire environment as well.
Approval for any undertaking by a known organization is required. The organization deserves the right to ascertain the source of funding alongside monitoring the progress of the research. It’s in line with the regulations that any research be done by professionals who should be under medical supervision . Physicians are warned to only undertake research with human subjects when the risks involved are ascertained and known to be lower than the benefits. It’s necessary that the human subjects be fully informed of the aims of the research and be given the option to consent or not to.
It’s advisable that at the end of the research the human subjects involved in the research be assured of the best prophylactic, disease diagnosis and the therapeutic impact of the research work (National Institute of Health 2004) According to the Bioethics and the impact of the human genome research in the 21st century, ethical issues surrounding research are many and if all considered may mean no progress in research. Well, there issues that may not be overlooked like obtaining consent for human subjects, but there life threatening situations or rather cases where the subject is likely no to consent .
will it be ethical then not to undertake the research just because there’s no consent of the subject even if the conditions is alarming and research hopes to offer them a second chance to live (Frank & Learit 2001). Sometimes it’s not so necessary to value the consent especially where chances are that the subject will not consent not because of a life threatening risk involved but as a result of other minimal factors like fear of being embarrassed. A case is implicated where Ashkensai Jews are known to have a high genetic predisposition to conditions like Tay Sachs, Gaucher and BRCs.
If an Arkensai Jew is asked to consent on this for a research undertaking there’s possibility that he/she will refuse for the fear of being termed as genetically defective. An arkensai doctor will approve such a deal since people prefer researching on what affects them and those close to them. Researchers are left to question whether it is ethical for someone to stay healthy regardless of what people say or stay back and suffer at some point in life from the disease condition. (Frank & Learit 2001).
It’s worthy noting that there’s no medical procedure done in research where the benefit does not outweigh the risk, nobody can freely admit to take a risk when the benefit is less than the risk involved. Justice is an issue of concern that should be taken seriously and fairness accorded to all regardless of the race. . (Frank & Learit 2001). Gene therapy is so controversial, so far a number of genetic disorders have had their cure discovered through gene therapy. The procedure involves analysis of the genetic information underlying a disease condition which calls for a comparison between the diseased and a non diseased individual.
Conditions like Huntington disease that initially had no known cure or cause have been diagnosed through gene therapy . Its very devastating to watch one die from this condition. Researchers had to analyze the genetic information and identify the genes responsible on a chromosomal arm. Though cure could not be identified as soon, the possibility of an individual knowing if he /she has a genetic predisposition to the condition is made possible. Gene therapy has the promise of treatment through replacement therapy where the defective genes can be removed and replaced with functional genes.
Ethics surrounding gene therapy is that the information regarding an individual’s predisposition to the disease condition causes panic and anxiety owing to the fear of the possibility of death in the event of the disease emerging. It’s argued that with the certain possibility of death, such people are bound to be exploited by insurance policies on their life if such information is made public. Ethical issues surrounding the consent to genetic analysis are that such information be kept confidential between the researcher and the client . Any violation is thus punishable (Trevor Smith 1999).
The battle between ethics and research dates back to the 2nd world war where Nazi doctors tried to test the ability of pilots to survive in the sea in the event of a plane crash by purposely throwing native people in cold waters. It’s with this event that the international community responded to and saw the creation of the Helsinki Declaration in 1964 alongside the Medical Organization of Medical Sciences (CIOMS) and the world health organization (WHO). Ethics thus tries to forbid the abuse of medical research as in the case implicated in the 2nd world war (Michael parker Donna Dickenson 2001).
Ethics argue that medical research making it possible for people to know so much information about their genotypes through genetic screening gives people the power to decide on very crucial issues in life. Couples seeking to ascertain their genotypes in relation to genetic disease predisposition may end up devastated especially when one of the spouses terminates the relationship on grounds that there lies a risk of passing the trait in the family. Parents are bound to use genetic information to determine the traits in their kids.
The cost of managing these diseases may drive parents to terminate the life of unborn kids diagnosed of certain genetic diseases. Ethically life begins at conception and there’s no justification for one to terminate another’s life (National Research Council US committee 1988) The question surrounding the controversy on whether human beings should determine the genetic composition of their kids is tied up when such attempts are geared at generating traits that can confer a great chance of survival like in the case of incorporating genes that can confer resistance to HIV/AIDS which is an epidemic in the world (Leland Hartwell et al 2002)
One other very controversial field in medical research is assisted reproduction technology. With the advent of invitro fertilization, it’s possible to circumvent the problem of childlessness in marriage . Couples that have not had kids of their own are beneficiaries of this technology. Medical procedures involving embryo transplants and stem cell research have met strong opposition. However the gains accrued from such technology have benefited a large number of families. The existence of sperm banks in the United States of America is meant to aid in prolonging a progeny.
Widows of deceased US soldiers in the Iraq war are pleased to successfully go through a medical procedure with a saved sperm donation from the husbands to get a baby. The ethical implication especially with regard to religion may view this as an attempt to clone man (Ian R Frekelton, &Kerry Anne Peterson 2006). Cloning of human beings has been restricted by the prohibition of human cloning act 2002, but there sections that provide for the creation of embryos like in the case of pregnancies from sperm banks where the procedure entails the fertilization of a human egg by a human sperm (Ian R Frekelton, &Kerry Anne Peterson 2006).
it may be right to prohibit the abuse of reproductive health especially with the fear that it increases unacceptable practices like cases of same sex marriage seeking to have kids through assisted reproductive health. Animal protection agencies have their goal established in ensuring that all animals have a right to live. Research in animal model thus violates the animal’s right to life especially in the event of death of the animal. These agencies are known to house animals presumed to be endangered in zoos with the hope that they at one point mate among themselves and increase in number.
A problem arises when there happens to be very little genetic diversity. Researchers are left to question whether it’s right to try saving animals by mating them among them selves even if this poses a risk of expressing traits like diseases that may further reduce their numbers into extinction. Medical research has the promise of increased diversity and selection pressure through artificial insemination and interspecies breeding (Leland Hartwell et al 2002)
Other researches in animal models other than drug trials include; the production of human proteins in the milk of animals like in the sheep, the procedure involves the insertion of the genes coding for the human proteins in the mammary glands of the animal and on transformation, the animal produces these proteins in its milk. These proteins are harvested and used for therapeutic purposes. Such a practice is done in the animal not because the animal may be vulnerable but because the procedure is not viable in other available models of trial.
With regard to drug discovery and testing, there cases where research has been associated with the loss of life. The drug thalidomide administered to expectant mothers in 1960 led to development of congenital disabilities. Vaccines like pertusis given to infants resulted into brain damage. Ethical issues surrounding such findings can not be neglected . Drugs are meant to save lives once discovered , when negative effects as such result the research is questionable. Researchers have severally argued that science changes dramatically and today’s invention may seem better and out do the mistakes previously done.
It may not be right to overlook the fears in the past but they should not be strongly held to the extend that they make it impossible for any new invention or trial (Marion et al 2005) Drug discoveries and testing have been ethically questioned in the recent past. A case is implicated of an ethno botanist working with the native people of Peru in medicinal plants, the ethno botanist is known to have disclosed information regarding the medicinal value of some trees in the forest to some pharmaceutical company .
He hoped that any research undertaking on this information will directly compensate the natives of Peru. Unfortunately researches went ahead to analyze the genes responsible for the medicinal traits in the plants and at the moment drugs are being synthesized from the plants. Scientists believe that they do not owe the ethno botanist or the natives of Peru any form of compensation (Leland Hartwell et al 2002). There cases where the ethical justification of a research finding as a wrong doing may be fully be accepted.
Cases of genetic doping resulting in to enhanced abilities in human beings are feared that they may not only be limited to situations like sports but people may use them to achieve traits hat may pose as a risk to the world as in the case of terrorism. Other than this sometimes the procedures involved in the research sampling of material are painful and dangerous. Obtaining of embryonic cells for instance involves the penetration of the womb a procedure that is painful and risks damaging the fetus (Claudio Marcello et al 2005)
Most controversies in research relate to data privacy, who should access the data other than the subject and the researcher, especially for human subjects where an investigation may require additional data from a third party like a relative whose consent may not be easily obtained unless he/she knows the out come of the first undertaking. Pressure on research by the ethical implications has been responded to variably. The fight from animal activists has seen the shift from trials in animals to plants .
Production of recombinant dugs is possible in plants . Biotechnology makes it possible to produce edible vaccines in food crops . This is meant to not only increase the field of practice but to change the practice from animals to plants. These vaccines are equally effective and safe in the sense that it’s not possible to pass diseases from plants to animals since the two do not bear close resemblance as it is in the case of animals that can mimick diseases in human beings (Leland Hartwell et al 2000)
Currently research has made it possible to identify new drugs like diabetes has recombinant insulin, hepatitis B has a vaccine, gene therapy has saved lives especially in the case of severe combined immune deficiency (ADASCID) through replacement therapy, HIV/AIDS has got drugs with regard to the genetics of the virus and the drug machinery that arrests the replication of the virus alongside boosting the immunity of the body. Good ethics should not amount into fears that may hinder research. Ethics should protect the vulnerable where necessary and ensure that research is not abused .
Medical research meant to achieve a higher therapeutic index in a drug or save a life is beneficial provided its done within the limits of professional guidelines. Ethical regulations and the benefit accrued in a medical research should always be weighed critically and the fears done away with to achieve the expected benefit, References: Claudia Marcello Tambourin &Tobjorn Tansjo. 2005. Genetic technology and sport ethical questions Rout ledge Marion et al. 2005. Dimensions of the Health Policy, Oxford University press Tamara K. et al 2004.
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