BIOETHICS

Universal Declaration on Bioethics and Human Rights Benefit and Harm

Drs. Uki Dwiputranto, Grad. Dip. Sc., M.Sc

Aims:
Human Rights Relationship between rights and responsibilities Compare individual and Collective Rights Implementation on Ethical Issues

World War II (e.g. genocidal horror)

1948

Universal Declaration of Human Rights

Free and equal in dignity and rights irrespective of race, religion,politics

Enable people to support their familys basic needs, good quality of life and wellbeing (food, health, education, security, etc)

Rights to life, liberty, security.., adequate standard of living, health care. Freedom of thought, expression, .. and access to information from independent media.

Human Rights

Rights confer new powers and freedom. So, it must be exercised responsibly with due respect for issues of ethics and justice.

Human Responsibilities

To ensure the rights and general welfare of others.

The typical emphasis in WESTERN NATIONS has been on rights and freedom for the individual (=individualism)

In many EASTERN NATIONS there has been excessive emphasis on duties and responsibilities to society and state (=collectivism)

Each value system can learn and benefit from the other, to reach a common middle ground which doesnt sideline either individual human rights or collective human responsibilities

Human responsibilities at the global level include concepts of SOCIAL JUSTICE (economic issue), and ECOLOGICAL STEWARDSHIP (environmental issue).

Scienc e
Dilemma

Technology

Foundation for humanitys response to the ever increasing dilemmas and controversies related with science and technology application.

Universal Declaration on Bioethics and Human Rights (03 October 2005)

Implementation on Ethical Issues..?

1. Introduction of Bioethics 2. Ethics & Culture 3. Bioethics in Medical Education 4. Doctor-Patient Relationship

BHL-1

Beneficence

Four Basic Moral Principles

Non-maleficence Autonomy Justice

Public and institutional policies are also developed from reasoned choices about appropriate benefits relative to costs and risks (Benefit vs Harm). Judgment about the most suitable medical treatment. Judgment about ethical acceptibility of research involving human subjects.

Example: in submitting a research protocol involving human subjects to an institutional review board (IRB) for approval.

IRB then offer a reasoned assessment If approved

An investigator is expected to array the risk to subject and probable benefits to both subjects and society, and to explain why the probable benefits outweigh the risk.

The investigator is expected to describe the risk and probable benefits to potential subjects

Informed decision on research participation

Various informal strategies have evolved to help make decisions about benefits and costs/ risks (benefits vs harm).
Expert judgments based on the most reliable data that can be assembled and analogical reasoning based on precedents.

To establish new policies on the basis of policies that have already proved their value.

Analysis Tool

It was six men of Indostan, To learning much inclined, Who went to see the Elephant (Though all of them were blind), That each by observation Might satisfy his mind. The First approach'd the Elephant, And happening to fall Against his broad and sturdy side, At once began to bawl: "God bless me! but the Elephant Is very like a wall!" The Second, feeling of the tusk, Cried, -"Ho! what have we here So very round and smooth and sharp? To me 'tis mighty clear, This wonder of an Elephant Is very like a spear!" The Third approach'd the animal, And happening to take The squirming trunk within his hands, Thus boldly up and spake: "I see," -quoth he- "the Elephant Is very like a snake!"

3 5 4 1

6 2

The Fourth reached out an eager hand, And felt about the knee: "What most this wondrous beast is like Is mighty plain," -quoth he,"'Tis clear enough the Elephant Is very like a tree!" The Fifth, who chanced to touch the ear, Said- "E'en the blindest man Can tell what this resembles most; Deny the fact who can, This marvel of an Elephant Is very like a fan!"

The Sixth no sooner had begun About the beast to grope, Then, seizing on the swinging tail That fell within his scope, "I see," -quoth he,- "the Elephant Is very like a rope!" And so these men of Indostan Disputed loud and long, Each in his own opinion Exceeding stiff and strong, Though each was partly in the right, And all were in the wrong!

The Ethical Matrix

The Ethical Matrix is a versatile tool for analysing ethical issues. It is intended to help people make ethical decisions, particularly about new technologies. It is an aid to rational thought and democratic deliberation, not a substitute for them. The three principles of respect for wellbeing, autonomy and justice form the columns of the matrix. The rows consist of the interest groups caught up with the issue in question. These might include different groups of people, such as consumers and food producers, and also non-humans, such as farm animals or the environment.
http://www.nottingham.ac.uk/bioethics/theory_pages/matrix.htm http://www.foodethicscouncil.org/ourwork/tools/ethicalmatrix/uses

This example involves a hormone called bovine somatotrophin (bST), which increases milk yield when injected subcutaneous into dairy cattle. The hormone, which is produced by recombinant DNA technology (genetic engineering) in cultures of the bacterium E. coli, was the first GM product to be used (in the USA) in animal agriculture. By injecting cows every two weeks with bST, farmers can expect an average increase in yields of 12-15%; and, although slight changes in nutrient content may result, the overall concentrations of nutrients in bulked milk are probably unaffected. However, because higher metabolic demands may lead to increased rates of illness, there is a risk that the welfare of injected cattle will be diminished. The treatment also leads to an increase in the milk concentration of insulin-like growth factor 1 (IGF-1), which is a potent mitogen (i.e. it stimulates cell division). If the increased milk concentration of IGF-1 was physiologically significant and if it were to remain biologically active at the level of the gut mucosa (a claim which is contested by some scientists), it might pose a public health threat to people consuming the milk or dairy products.

The cows are injected every two weeks with bST Farmers can expect an average increase in yields of 12-15%

Figure 2 shows how the use of an ethical matrix can help to summarise the ethical issues raised by this technology in a systematic way that is based on the principles that comprise the common morality. The Ethical analysis of bsT use in dairy cattle (Mepham, 2005)

2 (two) situations : 1. Current situation (the status quo)

2. Expected result from the introduction of a new technology

Content of the cells:

Facts. Values (more important than facts). Possible asymmetrics b/w + and scores.

A more detail description of ways in which the different principles are specified for each of the four identified interest groups.

Dairy farmers
Wellbeing: satisfactory incomes and working conditions for farmers and farm workers: ('satisfactory' is obviously debatable, but it is a better word than 'adequate', which might imply 'just enough to meet bare necessities') Autonomy: allowing farmers to use their skills and judgement in making managerial decisions, e.g. in choosing a farming system Fairness: farmers and farm workers receiving a fair price for their work and produce, and being treated fairly by trade laws and practices

Consumers
Wellbeing: protection from food poisoning (and harmful agents e.g. residues of veterinary drugs); this also refers to the quality of life citizens enjoy as a consequence of a productive and profitable farming industry Autonomy: a good choice of foods, which are appropriately labelled, together with adequate knowledge to make wise food choices; this principle also encompasses the citizen's democratic choice of how agriculture should be practised Fairness: an adequate supply of affordable food for all, ensuring that no one goes hungry of poverty

Dairy cows
Wellbeing: prevention of animal suffering; improving animal health; avoiding risks to animal welfare Autonomy: ability to express normal patterns of instinctive behaviour, e.g. grazing and mating Fairness: treated with respect for their intrinsic value as sentient beings rather than just as useful possessions (instrumentally)

The Biota
Wellbeing: protection of wildlife from harm (e.g. bypollution), with remedial measures taken when harm has been caused Autonomy: protection of biodiversity and preservation of threatened species (and rare breeds) Fairness: ensuring sustainability of life-supporting systems (e.g. soil and water) by responsible use of non-renewable (e.g. fossil fuels) and renewable (e.g. wood) resources; cutting greenhouse gas emissions

Summary:
 the ethical acceptability of bST use for those who have licensed it (e.g. the USA) would probably cite the need to respect farmers' freedom to innovate; and the economic benefits to the manufacturers of bST, the economies of countries producing it, the farmers using it, and, were prices to fall, consumers of dairy products.  Moreover, if its use led to reduced cow numbers it might result in marginally reduced emissions of methane.  This case also rests on perceptions that the welfare of treated cows is not affected significantly (or that increased disease can be effectively treated) and that there are no risks to human safety, so that labelling is unnecessary.  Job losses in the dairy industry would not be seen as an ethical issue, being merely a feature of market economies, in which competition guarantees efficient production;

 the ethical case of those who have banned bST use (e.g. the EU) would probably focus on respects in which it appears to infringe commonly accepted ethical principles.  They would point to authoritative reports suggesting that bST use substantially increases the risk of pain and disease in dairy cows, and that it might present a risk to human safety through ingestion of increased IGF-1 in milk.  Moreover, they might consider that bST use would reduce farmers' autonomy; undermine consumer choice if milk products from treated cattle were not labelled; jeopardise public health if rejection of dairy products followed the licensing of bST (because milk is a valuable source of dietary nutrients); and increase local pollution through the intensification of dairying.

Life is something we are all in together in harmony