today: what ethical considerations are needed when using humans as research subjects? upcoming: peer...
TRANSCRIPT
Today: What ethical considerations are needed when using humans as research subjects?
Upcoming: Peer review exercise
Many early medical experiments were carried out on humans, and mostly without regulation.
Dr. William Beaumont experiments on the stomach of Alexis St. Martin in 1820's
http://www.corbisimages.com/Enlargement/Enlargement.aspx?id=BE041437&ext=1
Rules outlining a code of conduct for the use of humans in experiments were not made official until the 1947
Dr. William Beaumont experiments on Alexis St. Martin in 1820'shttp://www.corbisimages.com/Enlargement/Enlargement.aspx?id=BE041437&ext=1
One of the most serious issues is obtaining the consent of the subjects.
Dr. William Beaumont experiments on Alexis St. Martin in 1820'shttp://www.corbisimages.com/Enlargement/Enlargement.aspx?id=BE041437&ext=1
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Tuskegee Syphilis Study:•412 infected and 204 uninfected men were studied.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Tuskegee Syphilis Study:•412 infected and 204 uninfected men were studied.
•Infected subjects were not given treatment, but were told they were being treated.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Tuskegee Syphilis Study:•412 infected and 204 uninfected men were studied.
•Infected subjects were not given treatment, but were told they were being treated.
•Started in 1932 to understand the course of syphilis infections in African Americans.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Tuskegee Syphilis Study:•412 infected and 204 uninfected men were studied.
•Infected subjects were not given treatment, but were told they were being treated.
•Started in 1932 to understand the course of syphilis infections in African Americans.
•In 1940's penicillin was shown to be an effective treatment, but infected subjects were not treated.
•Reviewed in 1969 and not terminated until public outcry in 1973
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Institutions receiving federal support must have an Institutional Review Board that oversees human research projects.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Have they been coerced?Is payment coercion?
http://www.flickr.com/photos/adrian/5030705/
Coercion may come from doctors or family members
http://www.flickr.com/photos/adrian/5030705/
•Doctors may get paid per patient•Uninsured may enter studies to receive treatment
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Patients who are not mentally competent to give consent can be used in studies if their guardian consents.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Prisoners are at special risk of coercion, and research on prisoners must focus on issues related to prison, incarceration, etc. (in most cases)
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Prisoners are at special risk of coercion, and research on prisoners must focus on issues related to prison, incarceration, etc. (in most cases)
Prisoners, or a representative for the prisoners, must be on the IRB.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Children: Parents/guardians must give consent and the risks must be minimal.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Children: Parents/guardians, and if possible the subject, must give consent and the risks must be minimal.
If the subject may benefit directly, greater risks can be justified.
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Children: Parents/guardians, and if possible the subject, must give consent and the risks must be minimal.
...Many drugs are used in children without testing them on children
Scientific Integrity: an Introductory Text with Cases, 2nd ed. (2000) Marcina, F. L. ASM Press, Washington, D.C.
Subjects must give informed consent:
Is the subject competent to consent?
Have they been coerced?Is payment coercion?
Does informing the subject bias the outcome?
Use of stem cells shows promise to cure various diseases by replacing damaged cells
From Campbell's “Biology”
… but no diseases have ever been treated with human stem cells
From Campbell's “Biology”
Embryonic Stem Cells
vs.
Adult Stem Cells
From Campbell's “Biology”
Use of embryonic stem cells has generated controversy… Why?
From Campbell's “Biology”
What is life? When does it begin?
From Campbell's “Biology”
Fertilization and cell division without implantation is common
From Campbell's “Biology”
Use of embryonic stem cells has generated controversy… Why?
From Campbell's “Biology”
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