Chapter 2: Are Technological Advances in Medicine Beneficial?
Chapter 2 Preface
In an effort to eradicate such seemingly incurable diseases as Parkinson’s, Alzheimer’s, and some forms of cancer, scientists have begun to study human pluripotent stem cells, which are thought to be the primordial cells from which a human is created. Stem cells, derived from fertilized eggs just before they would have implanted in the uterus, have the power to develop into any type of cell in the body. Because the cells have the ability to divide indefinitely outside the human body without the signs of age that afflict other cells, scientists speculate that the cells may be able to grow tissue for human organ transplants and recreate genes to combat inherited diseases.
Stem cell research has caused much controversy because scientists obtain the cells from aborted fetuses and unused embryos created at in vitro fertilization clinics. Opponents of stem cell research maintain that the practice is open to unethical practices, such as the deliberate destruction of unborn children for research purposes. According to Congressman Bob Schaffer, “Killing preborn babies for tissue harvest is never justifiable. It is something no civilized nation should condone, much less fund with the tax dollars of conscientious, disapproving Americans.”
Others contend that stem cell research is an invaluable tool for finding remedies for such degenerative ailments as heart and kidney disease. They argue that the embryos would never have become humans anyway, as...
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Research Involving Human Subjects Is Vital to Medicine
We’ve all taken medication. It may have been in the form of over-the-counter cough medicine, or prescription pills to treat chronic conditions such as diabetes. But how did researchers discover if the medicine is effective, if it’s safe, and if there are any potential side effects?
Testing and evaluating drugs is serious business, and clinical trials are right at the center of the process, according to Dorothy Cirelli, chief of the Patient Recruitment and Referral Center at the National Institutes of Health (NIH), U.S. Department of Health and Human Services (HHS). “Medical advances would not occur without clinical trials,” she said.
Well known as a world leader in medical research, NIH developed the first treatment for the human immunodeficiency virus (HIV), as well as innovative therapies for breast cancer, leukemia and lymphoma. For over a century, the agency has conducted clinical studies that explore the nature of illnesses. Clinical studies are currently underway for nearly every kind of cancer, HIV, cardiovascular disease, diabetes, obesity, and many other conditions—common and rare.
There are several types of clinical trials. By far the largest number are those that test new drugs. Prevention studies look at drugs or lifestyle changes that may help prevent disease. Diagnostic studies look at ways of detecting or finding out more about disease. Treatment studies may monitor new drugs or evaluate new combinations of...
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Research Involving Human Subjects Is Prone to Abuse
Late 1993 was marked by revelations that hundreds of nonconsenting Americans had been used in radiation tests that began in the 1940s and continued much longer. The full facts of these experiments are not yet known. Earlier in the year, the National Academy of Sciences blew the lid off World War II chemical weapons experiments involving 60,000 American GIs, including at least 4,000 used in gas-chamber experiments that left many permanently disabled. For nearly 50 years, the victims kept their secret, having been told that if they revealed the military experiments, they could be charged with treason.
These examples and others like them—the Pentagon’s hallucinogen experiments (1950–1975) and the Tuskegee syphilis experiments (1932–1972)—suggest that researchers can all too easily find themselves on the wrong side of ethical boundaries. It may be, however, that as scientific capabilities change, the boundaries themselves need to be redrawn. Consider some current cases.
Questionable Experiments Involving Children
At the National Institutes of Health (NIH), healthy short children are injected with a genetically engineered growth hormone. The 40 or so children already involved are not deficient in the hormone. They are simply short. Their parents consent to the experiment, and the children themselves affirm their assent. And 156 times every year until they reach their adult height, they get injections that are not...
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Selling Human Organs Is Ethical
When the practice of buying kidneys from live vendors first came to light some years ago, it aroused such horror that all professional associations denounced it and nearly all countries have now made it illegal. Such political and professional unanimity may seem to leave no room for further debate, but we nevertheless think it important to reopen the discussion.
The well-known shortage of kidneys for transplantation causes much suffering and death. Dialysis is a wretched experience for most patients, and is rationed in most places and simply unavailable to the majority of patients in most developing countries. Since most potential kidney vendors will never become unpaid donors, either during life or posthumously, the prohibition of sales must be presumed to exclude kidneys that would otherwise be available. It is therefore essential to make sure that there is adequate justification for the resulting harm.
Most people will recognise in themselves the feelings of outrage and disgust that led to an outright ban on kidney sales, and such feelings typically have a force that seems to their possessors to need no further justification. Nevertheless, if we are to deny treatment to the suffering and dying we need better reasons than our own feelings of disgust.
In this viewpoint we outline our reasons for thinking that the arguments commonly offered for prohibiting organ sales do not work, and therefore that the debate should be reopened....
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Selling Human Organs Is Unethical
The sale of human organs remains illegal in the United States. The National Organ Transplant Act of 1984 makes it unlawful for any person to “acquire, receive, or otherwise transfer any human organ for valuable consideration for use in human transplantation if the transfer affects interstate commerce.” A shortage of transplantable organs remains a problem in the United States, and throughout the world as well. Many proposals, such as changing the definition of brain death from “whole brain” to neocortical brain death, have been offered as ways to provide greater opportunities for organ harvesting. For more than a decade, some have suggested that commercializing the organ procurement system would help to alleviate the shortage of transplantable organs by serving as an incentive for people to “donate” organs. Some also suggest that paying for organs would further the cause of justice for living donors by properly compensating them. Jack Kevorkian calls purely altruistic organ donation a “delusion of hypocrisy.” He sees unfairness in prohibiting people from selling their organs, as surgeons are rewarded handsomely for their efforts in removing and transplanting organs while those who are the source of the organs are expected to behave altruistically.
Is our prohibition of the selling of human organs merely a sentimental custom that ought to be abandoned for the sake of increasing the supply of transplantable organs and eliminating the tragedy...
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Animal Transplants May Solve the Organ Shortage
There is something deeply ingrained in the human psyche about the fear and revulsion inspired by the image of a creature that is half-man, half-beast. From the Minotaur to A Midsummer Night’s Dream, the animal-human chimaera has been a grotesque spectacle relegated, thankfully, to the pages of mythology.
But could this always be the case? Now that the government has laid down the ground rules for the first organ transplants from animal to humans, it seems perfectly likely that the day will arrive when a man could be truly said to be a pig at heart. The first human patients to receive pig hearts could do so as early as 2000, though this optimistic timetable is just as likely to slip into the early years of the new millennium.
Many people will be understandably revolted by the idea of men or women walking around with pigs’ hearts. The notion of the heart being the seat of emotional strength and fallibility goes back many centuries. The bravery of Richard I emanated from his lion heart, wicked witches throughout the ages were said to be heartless, and Cilla Black made her fame in the Sixties from asking whether anyone with a heart could not help but fall in love.
But this irrational fear of losing your heart to a pig, so to speak, cannot possibly justify the rejection of xenotransplantation, when animal organs and tissues are used in human patients. There is, nevertheless, a definite “yuk factor” associated with...
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Animal Transplants Will Not Solve the Organ Shortage
Imagine a world where anyone who needs a new heart, liver, or kidney can get it, a world in which there is no waiting list for an organ transplant or a problem with rejection. If this sounds too good to be true, it’s because it is. Nevertheless, that is the picture the proponents of xenotransplants—the transplanting of animal organs into humans—want you to believe. They maintain that there is an unlimited supply of fresh organs, available to anyone in need. What they don’t tell you is the downside of xenotransplants—the cost to the animals whose organs are used and to the humans who pay for it financially and ethically.
The Food and Drug Administration Xenotransplant Advisory Subcommittee has recommended the approval of “limited” human clinical trials for xenotransplantation. With the chronic shortage of human donor organs—the list of patients waiting for transplants is more than twice the number of organs available every year—the medical community has looked for a new source, and thinks it has found it in animals.
Imagine a world with a new kind of factory farming, where animal organs are “harvested” for hospitals and clinics, where genetically engineered pigs (now favored over non-human primates) only weeks old are taken away from their mothers and raised in antiseptic surroundings. Obviously, the medical community takes little interest in the animals’ welfare. The sole value animals have is to be genetically altered...
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Fetal Stem Cell Research May Improve Medicine
Why should we use federal funds for human pluripotent stem cell research? Ask 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.
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.
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 recently erupted on Capitol Hill about whether federal funds should be used to support further research in this area. At issue is whether the merits of public funding and the dreadful burden of disease balance concerns about the origin of these special cells.
The Limitations of Organ Donation
To understand the need for research with human pluripotent stem cells, one need look no further than many common diseases such as cancer, heart disease...
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Fetal Stem Cell Research Is Unethical
It’s an ugly twist on an old science fiction theme: Would you use the body parts of an innocent baby so that you could live a happier life?
Would you support a system of incentives to kill other babies, and process them like meat at a packing plant, for the benefit of a frightened Baby Boom generation terrified of Alzheimer’s disease and death?
Of course not. The suggestion is monstrous and dehumanizing. By comparison, it makes what the Serbs and Albanians are doing to each other look like a gentle game.
But the science fiction scenario doesn’t generate the terrifying passions of old Balkan blood feuds.
Instead, it’s calculated, without anger, and practiced by reasonable men and women in white lab coats.
It’s about pure reason, efficiency and scientific rationalism. It’s what a culture can do when it loses its soul. If you don’t believe me, ask a Jew about the Nazi concentration camps.
A Science Fiction Nightmare
So get horrified. Because it’s not science fiction. It’s happening now, in our country.
I read about it in the Chicago Tribune on June 27, 1999, in a fascinating story by science writer Ronald Kotulak under the headline “Stem cells opening path to brain repair.’’
It began with an anecdote about a woman with Parkinson’s disease. Her name is Dr. Jacqueline Winterkorn. The drugs she was taking to fight the disease...
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Chapter 2 Periodical Bibliography
Ron Brown “A Free Market in Human Organs,” Freedom Daily, February 1996.
Barbara “Xenograft Technology: A New Frontier in Claxon-McKinney Medicine,” Pediatric Nursing, September 2000.
Judith A. DePalma and Ricard Townsend “Ethical Issues in Organ Donation and Transplantation: Are We Helping a Few at the Expense of Many?” Critical Care Nursing Quarterly, May 1, 1996.
John J. Fung “Transplanting Animal Organs into Humans Is Feasible,” USA Today, November 1999.
Diane M. Gianelli “Stem Cell Research Focus of Ethical Dilemma,” American Medical News, December 21, 1998.
Jonathan Hughes “Xenografting: Ethical Issues,” Journal of Medical Ethics, February 1998.
Paul Likoudis “Dead Baby Parts Business Booming,” Wanderer, September 30, 1999.
Jonathan D. Moreno “The Dilemmas of Experimenting on People,” Technology Review, July 1997.
Nancy Scheper-Hughes “Postmodern Cannibalism,” Whole Earth, Summer 2000.
Harold Y. Vanderpool “Xenotransplantation: Progress and Promise,” Western Journal of Medicine, November 1999.
Robert J. White “Human Embryo Research,” America, September 14, 1996.
Susan Wills “A New Growth Industry in Baby Body Parts,” National Right to Life News, November 1999.
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