Chapter 3: Are Modern Biomedical Practices Ethical?
Chapter 3 Preface
In recent years, society has witnessed an explosion of medical and biotechnological advances. Medical procedures that were innovative only a few decades ago—such as organ transplants and in-vitro fertilization—now seem ordinary and commonplace. More recently, scientists have been making significant discoveries in areas that once were relegated to the world of science fiction, including cloning and genetic engineering.
However, many of these biomedical advances raise serious ethical questions. For example, successes in cloning animals have sparked such controversy over the imminent possibility of cloning humans that the U.S. government has placed a moratorium on federally funded research into human cloning. In ordering the ban, President Bill Clinton asserted, “Any discovery that touches upon human creation is not simply a matter of scientific inquiry. It is a matter of morality and spirituality as well.”
Opponents of human cloning fear that the procedure will be used in unethical ways. They argue, for instance, that a clone might be produced to serve as an “organ bank” for an individual in need of a transplant. According to Kevin T. Fitzgerald, a professor in molecular genetics, “Cloning a human being solely for the purpose of supplying organs or tissue makes it, at a minimum, a mere instrument for manipulation and negates the human identity of the clone.” Other critics maintain that the negation of human identity will be a...
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Cloning Is Ethical
About the author: Ronald Bailey is a writer and television producer in Washington, D.C., and a contributing editor to Reason magazine.
Cloning human cells could one day save your life and the lives of the people you love. Yet Congress seems hellbent on stopping the medical advances that cloning can make possible. Congress is responding to polls that show most Americans are opposed to the cloning of human beings. But carelessly crafted legislation would restrict not only research leading to the birth of cloned people but research that could find cures for cancer, genetic diseases such as cystic fibrosis, and damaged hearts, livers, and brains. . . .
Society’s Reaction to a Cloning Breakthrough
In February 1997, the Roslin Institute in Scotland, an obscure farm animal research facility, announced that it had succeeded in cloning a sheep from an adult, differentiated cell. The cloned sheep, Dolly, made headlines around the world and launched a fierce debate over the potential uses for this new technology. The breakthrough showed for the first time that genetic information encoded in the DNA of an adult cell could be “reset” and made young again. Once reset, the cells with rejuvenated DNA could produce all of the cells needed to grow a complete organism. “[S]uperficially, it’s a step toward immortality,” explained Ronald James, whose company, PPL Therapeutics, paid for the cloning research. “And if you take a step...
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Human Stem Cell Research Is Ethical
About the author: Lawrence S.B. Goldstein is an investigator for the Howard Hughes Medical Institute and a professor in the division of cellular and molecular medicine and the department of pharmacology at the University of California in San Diego.
Why should we use federal funds for human pluripotent stem cell research? Ask [former pro football player] Walter Payton and 12,000 other Americans who are waiting for liver transplants. If they are fortunate, new livers will be found and they may live; if not, they will die. [Editor’s note:Walter Payton died of liver cancer on November 1, 1999.]
Ask my friend Doug, who has a 7-year-old son with diabetes. Every night he and his wife are awake in the wee hours, monitoring their son’s blood, worrying that they have missed the balance and that their beloved child will slip into a coma.
Ask the children of millions more like them, for whom insulin is a treatment but not a cure, because crucial cells in the pancreas are still missing. These children are always in danger, and they live under the constant shadow of premature death or disability.
The Need for Research
New hope for these desperately ill people has come from the recent discovery of “human pluripotent stem cells,” the primordial cells from which all the tissues and organs of the body develop. However, a serious debate has erupted on Capitol Hill about whether federal...
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Allowing the Sale of Human Organs Could Be Ethical
About the author: Formerly the governor of Delaware, Pete du Pont is the policy chairman for the National Center for Policy Analysis, a public policy research institute headquartered in Dallas, Texas.
There are currently about 45,000 people waiting for a human organ transplant. About 3,000 of them will die on that waiting list because a suitable transplant organ will not become available in time.
The short supply of organs has recently led to some overt attempts to ration them in a way that would be more beneficial to society. For example, the United Network for Organ Sharing has altered its guidelines for those needing a liver transplant so that those with acute liver problems get priority. Those with a chronic liver condition like hepatitis or cirrhosis (which could be the result of alcohol abuse) cannot rise above the second level in priority status.
The legislature in the state of Washington recently passed a measure—which the governor vetoed for being too vague—that would prohibit those on Death Row from receiving “lifesaving health care procedures” such as an organ transplant.
Now the Cleveland Clinic is being accused of removing organs before some patients are legally dead.
Instead of looking for new ways to ration organs or take them prematurely, we should ask how we can increase the supply of organs so that doctors are not forced to decide who lives and who...
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Cloning Is Unethical
About the author: A physician and biochemist, Leon R. Kass is the Addie Clark Harding Professor in the Committee on Social Thought and the College of the University of Chicago. He is the coauthor of The Ethics of Human Cloning and the author of Toward a More Natural Science: Biology and Human Affairs.
Editor’s Note: The following viewpoint was originally presented as testimony before the National Bioethics Advisory Commission, which was directed by President Bill Clinton to review the implications of cloning humans. In June 1997, the commission recommended that research into human cloning be banned for three to five years.
I am deeply grateful for the opportunity to present some of my thoughts about The Ethics of Human Cloning, by which I mean precisely the production of cloned human beings.
This topic has occupied me off and on for over 30 years; it was the subject of one of my first publications in bioethics 25 years ago. Since that time, we have in some sense been softened up to the idea of human cloning through movies, cartoons, jokes, and intermittent commentary in the mass media, occasionally serious, more often lighthearted. We have become accustomed to new practices in human reproduction—in vitro fertilization, embryo manipulation, and surrogate pregnancy—and, in animal biotechnology, to transgenic animals and a burgeoning science of genetic engineering....
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Human Stem Cell Research Is Unethical
About the author: The Center for Bioethics and Human Dignity, located in Bannockburn, Illinois, studies and addresses contemporary bioethical challenges facing modern society.
Recent scientific advances in human stem cell research have brought into fresh focus the dignity and status of the human embryo. These advances have prompted a decision by the Department of Health and Human Services (HHS) and the National Institutes of Health (NIH) to fund stem cell research which is dependent upon the destruction of human embryos. Moreover, the National Bioethics Advisory Commission (NBAC) is calling for a modification of the current ban against federally funded human embryo research in order to permit direct federal funding for the destructive harvesting of stem cells from human embryos. These developments require that the legal, ethical, and scientific issues associated with this research be critically addressed and articulated. Our careful consideration of these issues leads to the conclusion that human stem cell research requiring the destruction of human embryos is objectionable on legal, ethical, and scientific grounds. Moreover, destruction of human embryonic life is unnecessary for medical progress, as alternative methods of obtaining human stem cells and of repairing and regenerating human tissue exist and continue to be developed.
Stem Cell Research Violates Existing Laws
In November 1998, two...
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Allowing the Sale of Human Organs Would Not Be Ethical
About the author: Physician Atul Gawande writes a regular column on science and policy for Slate, an on-line magazine.
Letting people peddle their kidneys might save lives, but the ethical price is too high.
Some people clearly are itching to do it. Consider this classified ad from Ruth Sparrow, a 55-year-old woman who was $20,000 short for a needed gallbladder operation, which ran in the May 17, 1997, St. Petersburg Times under “medical supplies”: “KIDNEY—Runs good, Taking offers. $30,000/obo.”
Someone must have called the newspaper, because it pulled the ad after three days, noting that organ selling is against federal law. That didn’t stop John Curtis, though. The 63-year-old immigrant from England managed to slip this ad into the same newspaper on May 10, 1998: “BRITISH MADE Kidney shaped item; will swap for 45' motor/sailboat.” When it came out that he was selling one of his kidneys, the newspaper pulled his ad, too.
The Argument for Allowing Organ Selling
Awful, right? Not at all, some say. Organ selling is gaining a respectable fan club. Recently, the Cato Institute posted an article on its Web site backing organ markets, and former Delaware Gov. Pete du Pont, policy chairman of the National Center for Policy Analysis, has endorsed the idea. Its most sophisticated defense, however, comes from University of Chicago law Professor Richard...
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Organ Donation from Anencephalic Infants Is Unethical
About the author: Paul C. Fox is a medical doctor in Farmington, Pennsylvania.
Not so many years ago death was a simple enough concept. If a person’s heart ceased to beat for any great length of time he was dead, and that was that. Then along came medical technology, and suddenly what had been simple became complicated. Now a person’s heart can be stopped completely for hours, and yet, thanks to the heart-lung machine, that person’s brain will survive undamaged. The person is dead by the old definition, yet obviously not really dead. On the other hand—again thanks to medical technology—a person’s brain can be irreparably destroyed, even though the heart may be kept beating for many hours. The person is still alive by the old definition, yet most of us instinctively feel that he is somehow not really living.
When Does Death Occur?
The altered perception of what constitutes life and death underlies the ethical dilemmas surrounding organ transplantation today. Of course, there is no controversy if, for example, a living person voluntarily donates a kidney to a relative who needs one. No one has to die in order for the transplant to be performed. This is not the case, however, with transplantations of such vital organs as the heart, the lungs, and the liver, where the donor must necessarily be dead before the transplantation can take place. Yet since, even with the best available medical...
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