BIOETHICS
Overview
- Field of study that examines the moral, social,
and philosophical aspects of biomedical and
life science research, healthcare, and medical
technology.
-Involves the analysis of ethical principles,
such as autonomy, beneficence, non-
maleficence, and justice, to address complex
dilemmas emerging from medical
advancements (Beauchamp & Childress, 2019)
ETHICS
-The moral principles, values and rules that
guide human behavior and decision -making.
-Distinguishing right from wrong
-Determining what is morally acceptable
Key Elements
Values: Personal beliefs and principles that
influence ethical decisions. Ethics vary in terms
of value
Moral Principles: Fundamental rules; honesty,
fairness and respect. Expect from everyone
that is considered as ethical
Social Norms: Shared expectations within a
community. Vary to what society a person
belongs to.
HISTORICAL DEVELOPMENT
Ancient Roots
Has ancient origins in various cultures and
medical traditions, with ethical considerations
dating back to ancient civilizations such as
Egypt, India, and Greece.
Hippocrates (460-370 BCE)
Father of medicine
Hippocratic Oath (cornerstone of medical
ethics) : emphasizing the importance of patient
well- being confidentiality, and ethical conduct.
Modern Foundations (mid- 20th century saw
the formalization of bioethics as a field of
study)
Nuremberg Code (1964)- Develop ethical
guidelines in response to the unethical medical
experiments during WW2
Declaration of Helsinki (1964)- Outline ethical
principles for medical research involving
human subjects
Formation of Bioethics Centers- Hastings
Center (1969) and President’s Commission
(1983) Key institution in the growth of bioethics
KEY PRINCIPLES IN BIOETHICS
Autonomy- respect for an individual’s right to
make informed decisions about their
own healthcare
Beneficence - duty to do good and act in the
best interests oof the patient
Non- Maleficence- Obligation to do no harm
Justice- fair and equitable distribution of
healthcare resources
Veracity- principle of truthfulness and
honesty in healthcare
Confidentiality- keeps personal medical
information confidential and not to
disclose it without patient’s consent
NOTABLE BIOETHICS VIOLATIONS
Professional Ethics
Stem Cell Case (2005-2006)
-Dr. Hwang Woo-Suk claim that his team
succeeded in creating human embryonic stem
cells through cloning.
- Allegations that this paper was based on
fabricated data.
-As a result: the papers were editorially
retracted, lost his position, the government
ended its financial and legal support of his
research.
Patient Ethics
James Wilson (1999) the patient is not well-
informed about the clinical trial and the extent
of the adverse reactions involving gene therapy
that led to the death of 18 years old Jesse
Gelsinger.
Consequences of Violating Bioethics
• Loss of credibility
• Professional Sanctions
• Lawsuits and criminal charges
• Loss of funding and accreditation
• Public outcry and reputation damage
• Retractions of findings
• Research blacklisting
• Ethical violations can lead to harm,
suffering, or even death of patients,
which is profound consequences
• Reevaluations of ethics guidelines
Principle of non- contradiction
• Crucial in navigating ethical dilemmas in
bioethics, ensuring consistency and
coherence in moral reasoning
• Bioethical principles should not
contradict each other within a given
ethical framework.
ARTIFICIAL ORGANS • Genetically modified pigs are housed in
pristine conditions and regularly
DILEMMA checked for infections
DO WE HAVE ALTERNATIVES?
Shortage of hearts, lives, and lungs suitable for
transplant. Decellurating Organs
• Decellularization involves thoroughly
Challenges in Tissue Engineering breaking down and eliminating all
cells, extracting the cellular elements
• Cells form organs inside the human from biological tissue, and retaining
body solely the extracellular matrix (ECM).
• They need
o Support to grow
STEM CELLS
o Supply of nutrients Overview
o Removal of waste - Stem cells are undifferentiated cells
o Protection against immune with the remarkable ability to transform
rejection into various specialized cell types.
- Two key characteristics:
Blood Type Compatibility o Self- renewal; allowing them to
Blood Can receive Can donate divide and produce identical
type from to daughter cells, maintaining a pool
Type A A, O A, AB of undifferentiated stem cells.
Type B B, O B, AB o Differentiation; the process
Type AB A, B, AB, O AB through which they become
Type O O A, B, AB, O specialized cells with specific
• A, B, AB, and O are the main blood functions, what makes stem cells
types remarkable and crucial for
• Rh factors (+ or -) is another important development, tissue repair, and
consideration regeneration
• Rh+ individuals can receive Rh+ or R- HISTORY
blood 1998- researchers successfully extract stem
• Rh- individuals should ideally receive cells from human embryos, marking a pivotal
Rh- blood moment in stem cell research.
• In emergencies, O- blood is often used 1999- First successful human transplant of
because it can be given to individuals insulin-making cells from cadavers
with any blood type. demonstrates the potential therapeutic
SOLUTION applications of stem cells
2001- President George W. Bush imposes
• Xenotransplantation- transportation of restrictions on federal funding for embryonic
organs from one species to another stem cell research, sparkling debates on
o A pig organ to a human ethical and scientific fronts.
2002- Juvenile Diabetes Research
Why pigs? Foundation International launches a $20
• Pigs can provide the organs that we million fundraising efforts to support stem
need cells research, highlighting the growing
• They are of the right size, and we have interest in private funding for such endeavors
an infrastructure to grow them in large 2004- Harvard researchers achieve a
numbers significant breakthrough by growing ste cells
• A pig’s organ can buy time for a patient from embryos using private funding,
waiting for a human organ showcasing the importance of diverse
But… funding sources.
• The human immune system does not A ballot measure for a $ 3 billion bond to
take kindly to the presence of a pig support stem cell research reflex and support
organ for advancing this field.
• Human leukocyte antigen (HLA) Possibilities of Stem Cells
• Pigs also have another antigen called • Regenerating damaged or diseased
galactose alpha 1-3 galactose (alpha tissues and organs
gal) • Disease modeling
• Human have longer lives • Personalize medicine
• Bridge organ • Addressing individual variations for
What about spread of diseases? enhanced treatment outcomes
• Pig genomes also contain the remnants • Treatment of: leukemia, neurological
of viruses that stowed away millions of disorders, diabetes management,
years ago. cancer
• Improved quality life
• Tissue regeneration
 • Longevity research o Embryo Culture
• Immune system enhancement o Embryo transfer
• Artificial organs and tissues
Stem Cells Characteristics Intra-cytoplasmic Sperm Injection
• Blank cells (unspecialized)
• Capable of dividing and renewing At what point is this fetus?
themselves for long periods of time D 7-14 Uterine Implantation
(proliferation and renewal) D 14 Three distinct layers form
• Have the potential to give rise to • Formation of 3 germ layer
specialized cell types (differentiation) marks at the end of
Kinds of Stem Cells pluripotent stem cell stage
Stem Cells Description Examples • Embryo development begins
types with the ectoderm,
Totipotent- Can develop Cells from mesoderm, and endoderm
can form the into a new early 1-3 D 14- Beginning of future nervous system
embryo and individual days 21
placenta D 21- Facial features start taking shape,
Pluripotent- Cells can Some cells 24 marking the beginning of facia
(embryonic form any of blastocyst development
cell) can just (over 200) 5- 14 days W 3-8 Key organs and body systems
form the cell types begin to form during this critical
embryo period
Multi-potent Cells 14 days W 5-8+ Transition to fetus
(adult stem differentiated, *there’s no consensus on a specific timepoint
cells) but can forms
number of Adult Stem Cells
other tissues • Undifferentiated cells found among
specialized or differentiated cells in a
Types of Stem Cells tissue or organ after birth
1. Embryonic Stem Cells (ESCs) • May be found in: skins, fat, cells, bone
a. Source- derived from the inner marrow, brain, many other organs &
cell mass of a five to six days old tissues.
embryo Stem Cells in the Adult brain
b. Characteristics- exhibit a ‘tabula • they still working for us now
rasa’ state How do cells know what to become?
2. Embryonic Germ Cells • The central dogma of biology: DNA to
a. Source- derived from the part of a RNA to proteins
human embryo or fetus that will • All cells in an individual have the same
ultimately produce eggs or sperm set of genes
(gametes) • Genes are segments of DNA that carry
b. Function- Pluripotent stem cells instructions for building proteins
with the potential to differentiate • The type of proteins produced
into various cell types influences a cell’s function and fate
3. Adult Stem Cells • Cells receive signals from their
a. Location- found among environment that guide their
specialized or differentiated development
organ tissue or organ after birth Signals to Stem Cells
b. Characteristics- limited • Matrix Molecules
differentiation, capable of specific • Soluble Factors
Pluripotent Stem Cells- process greater
• Self- renewal
potential to differentiate into any type of cell
• Other cells
Multipotent stem cells- Limited in their
capacity to differentiate into specific cell types • Differentiative

Embryonic Stem cells are mainly from in vitro Central Dogma

fertilization (IVF) DNA-RNA-PROTEIN

In Vitro Fertilization
Induce(pinilit) Pluripotent Stem Cells
• Assisted reproductive technology (ART)
that involves fertilizing egg with sperm • These stem cells are created or induce
outside the body, in vitro, and then in the laboratory
implanting the fertilized embryo into the • Unlike embryonic stem cells, which are
uterus. naturally found in embryos, IPCs are
• Process Overview generated by reprogramming adult cells
o Stimulation of ovaries • Induces the adult cells to regain
o Egg retrieval pluripotency, meaning they regain the
o Fertilization
 ability to differentiate into various cell • Fundamental disagreements about
types, similar to embryonic stem cells when life begins contribute to ethical
dilemmas
• Balancing scientific progress with the
moral responsibility to respect and
protect human life.
Pros iPS cell technology
• Eliminates the need for embryos in the
generation of pluripotent stem cells
• Can be created from a patient’s own
cells, reducing the risk of rejection in
therapeutic applications
• Valuable tool for studying diseases in a
controlled environment
• Can be directed to become specific cell
types needed for specific therapies
Cons iPS cell technology
• iPSCs derived from a patient with a
genetic defect will retain the same
genetic defect abnormalities
• Potential for genetic mutations or
abnormal cell behavior
• Have the potential to form tumors,
raising concerns about their safety for
clinical applications
• Can be complex and costly
Bone Marrow
• Soft and spongy tissue inside bones that
plays a crucial role in the body’s blood
and immune system
• Houses hematopoietic stem cells
(HSCs) a type of multipotent stem cell
• HSC’s give rise to various blood cells,
including red blood cells, white blood
cells, and platelets
• Treat patients diagnosed with leukemia,
aplastic anemia, and lymphomas
• Need for greater histocompatibility

Umbilical Cord Stem Cells

• Adult stem cells of infant origin, obtained
from the umbilical cord tissue
• Collection is less invasive compared to
procedures like bone marrow extraction
• Shows enhanced compatibility,
minimizing the risk of rejection in
transplants
• Used in the treatment of diseases such
as leukemia, blood disorders, and
immune system disorders.

Technical Challenges
• Cell differentiation control
• Genetic stability
• Immunocompatibility issues
• Tissue integration
• Ethical considerations
• Scalability and production efficiency
• Long- term safety and efficacy
• Transitioning from preclinical success
to successful clinical applications

Why the controversy over stem cells?

• Controversy often centers around the
use of embryonic stem cells, derived
from early-stage embryos