Moral & Ethical Issues wrt Biomedical

Engineering Muhammad Salman.

Assistant Professor,Mechatronics & Control Engineering Department.

UET Lahore Campus.

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Morality & Ethics: A Definition of Terms• In around 6th century, the Greeks were successful in reducing many

primitive speculations, attitudes and views on various subjects to some type of order or system and integrating them into a general body of wisdom called “Philosophy”.• They reviewed and compared variety of customs, laws and institutions that

prevailed in different societies that surrounded them and this part of Philosophy is called “Ethics”.

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Morality & Ethics• The term “Ethics” comes from the Greek word ethos, meaning “custom”.• On the other hand, the Latin word for custom is “mos”, and its plural,

mores, is the equivalent of the Greek ethos and the root of the words moral and morality. • Although both terms (ethics and morality) are often used interchangeably,

there is a distinction between them that should be clearly understood.

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Morality & Ethics

• Philosophers consider “ethics” as a particular study and use morality to refer to its subject matter.• Some morals in our society are:

• Telling the truth• Paying one’s debt• Honoring one’s parents• Respecting the rights and property of others

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Morality & Ethics

• Most of us follow these rules of conduct and adjust our lifestyles in accordance with the principles they represent.• Many even sacrifice life itself rather than diverge from them, applying

them not only to their own conduct, but also to the behavior of others.

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Morality & Ethics

• Individuals committing “Criminal Acts” (defined by the society) are often “outlawed” and in many cases, severely punished.• Morality represents the codes of conduct of a society, but ethics is the

study of right and wrong, of good and evil in human conduct.• Ethics is not concerned with providing any judgments or specific rules for

human behavior.

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Three Questions: Morality & Ethics

• Consider the following three questions in the light of definitions of morality and ethics.

1. Should badly deformed infants be kept alive?2. Should treatment be stopped to allow a terminally ill patient to die?3. Should humans be used in experiments?

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Three Questions: Morality & Ethics

• Are these three questions related with morality or ethics?

• In the light of the definitions just provided, all three of these inquiries are questions of moral judgments.

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Redefining Death

• Medical field has played a very important role in providing better health conditions to common people.• For example, in the United States today, the average life expectancy

for males is 74.3 years and for females is 76 years, whereas in 1900 the average life expectancy for both genders was only 47 years.

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Redefining Death

• Infant mortality has been significantly reduced in developed nations where technology is an integral part of the culture.

• Premature births no longer constitute a threat to life because of the artificial environment that medical technology can provide.

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Redefining Death

• Today, technology has not only helped individuals avoid early death but has also been effective in delaying the inevitable.

• Pacemakers, artificial kidneys and a variety of other medical devices have enabled individuals to add many more productive years to their lives.

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Redefining Death• Approved criteria for a certified medical death of the patient includes the

following fours steps:1. The patient must be unreceptive and unresponsive, that is in a state of

irreversible coma.2. The patient must have no movements of breathing when the mechanical

respirator is turned off.3. The patient must not demonstrate any reflexes.4. The patient must have a flat EEG for at least 24 hours, indicating no electrical

brain activity..

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The Terminally ILL Patient & Euthanasia

• In enabling medical science to prolong life, modern technology has in many cases made dying slower and more undignified.

• The term “Euthanasia” is derived from two Greek words meaning “good” and “death”. The ancient Greeks assembled elderly and sick people at an annual function to consume a poisonous potion. Even Aristotle advocated euthanasia.

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Types of Euthanasia

• In today’s society, euthanasia is a practice to be followed when life is merely being prolonged by machines.

• There are two types of Euthanasia:• Active Euthanasia• Passive Euthanasia

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Euthanasia

• In Nazi Germany, for example the mercy killing was initially practiced to end the suffering of the terminally ill. • Eventually, the practice spread, so that even persons with slightest

deviation from the norm (e.g., the mentally ill, minority groups such as Jews and others) were terminated which is ethically not good.

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Human Experimentation• Medical research holds a very important position in our modern society. To

determine the effectiveness and value of drugs, these new drugs and medical devices eventually are used on humans.• Clinical researchers responsible for the well being of their patients must

face the moral issues involved in testing new equipment and procedures.

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Human Experimentation

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Human Experimentation

• Project Mk-Ultra was the code name for a CIA mind-control research program, run by the office of Scientific Intelligence. • Several types of drugs and other methodologies to manipulate

individual mental states and to alter brain function were used in a surreptitious way.

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North Korean & Nazi Experimentation• In world war II Nazi’s used laboratories equipped respectively for

poison gas, suffocation gas in which humans were the subjects which were locked in gas chambers and poisonous gas was injected through a tube, while “scientists” observe from above through glass.

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Definition & Purpose of Experimentation• Experiments involving human subjects have been classified as:• Therapeutic Experiment• Non-therapeutic Experiment

• A therapeutic experiment is one that may have direct benefit for the patient, but the goal of non-therapeutic research is to provide additional knowledge without direct benefit to human.

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Definition & Purpose of Experimentation• There have been numerous examples of therapeutic research

projects.• The use of Radiotherapy to inhibit the progress of cancer or tumor.• The use of pacemakers to provide the necessary electrical stimulus for proper

heart function.• The use of artificial kidneys.

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Definition & Purpose of Experimentation

• Non-therapeutic research is an important aspect of medical progress.• Experiments designed to study the impact of infection from the hepatitis

virus or the malarial parasite had significant effects on the advancement of medical science and the ultimate development of appropriate medical procedures for the benefit of all humans.

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Informed Consent

• It is the most important moral issue in human experimentation.• It is the principal condition that must be satisfied for human

experimentation to be considered both lawful and ethical. All adults have the legal capacity to give medical consent (unless denied through some legal process).

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Jarvik-7, The Artificial Heart

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Conclusion wrt Pakistan & Islam

• A very debatable topic.• Highly qualified professionals and religious scholars should sit

together and should make SOP’s for human experimentation in the light of teachings of Islam. • FDA should have very strict rules for experimentation of drugs on

human subjects.

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Conclusion wrt Pakistan & Islam

• Awareness must be developed in common people about the importance of donating vital body organs.• Consensus should be developed with the help of religious scholars to

accept organ transplant from other humans.

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Thank You

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