Lecture 2: Ethics in Medical Biotechnology Medical Biotechnology, BIOL456 Fall 2016 Sulaiman Al-Hashmi

Ethics What is ethics? the branch of knowledge that deals with moral principles What is Bioethics? The ethics of medical and biological research Study of ethical principles and values that guide behavior and policy in biomedicine

Ethical concerns Human health! Extensive use of humans Biomedical research Drug trials May cause some physical, mental, emotional, and genetic disabilities

Bioethics network Requires collaboration among: Pharmaceuticals Law Medicine Stem cell research Biotechnology Politics Sociology Genetics Environmental toxicology Public health

Major Ethical issues Embryonic stem cell research Gene Therapy Cloning Embryo screening Organ transplantation Vaccines DNA Fingerprint Xenotransplantation

Human Cloning Creation of a genetically identical copy Types: Does not follow the natural process Types: Therapeutic cloning Cloning cells from an adult for use in medicine and research, Reproductive cloning Making cloned humans Replacement cloning Replacement of damaged or dysfunctional body parts through transplantation

Organ transplantation Kidney Liver Pancreas Cornea Heart Lung Thymus Intestine Heart valves Blood vessels Skin

Organ transplantation

Organ transplantation Organ dysfunction Suffering Life quality Work Social life Multi-cellular Living and cadaver Surgical procedure

Ethical concerns in Organ tx. Religious Living donor Cadaver Brain death! Moral Close relatives Stranger Social perspective

Donor safety Recipient safety Commercialization Procedure Post tx. Organ function Disease transmission HLA match Commercialization Living donor Brain death (life ending)

Embryo screening Pre-implantation genetic diagnosis (PIGD) To know about the genetic of the fetus Avoids pregnancy termination Fetal diseases! Future treatment for the disease!! PIGD can’t be considered a diagnostic tool. Can be used to determine the gender of the embryo Male Female

Xenotransplantation Transplantation of cells, tissues, or organs from one species to another Do we need it? Human organ shortage Complications High rejection, improving Transmission diseases Religion

Human embryonic stem cells

Embryos donated by patients For research purposes with informed consent of the donors IVF, only extra can be used for research ESCs can be differentiated into all types of body cells and organs Can be used to treat different disease But: Destroy a starting life Ending pre-mature embryos Uncontrolled process!

Gene Therapy Genes are located on chromosomes If genes altered Carry specific sequences of bases Encode instructions on how to make proteins so that the body functions properly If genes altered The encoded proteins will not be able to carry out their normal functions Genetic disorders can result

Genetic engineering can be conducted in two modification ways Genetic alteration can be corrected by gene therapy within an individual’s cells and biological tissues to treat disease Genetic engineering can be conducted in two modification ways Somatic Germ-line With somatic engineering, it modifies only somatic cells such as liver, muscle, or blood cells. Only affect the individual being treated and does not affect future generations.

Somatic engineering techniques available for human use To treat diseases Others types of issues Muscle-strengthening procedure may help patients through genetic therapy by altering the cells to cure the person’s sickness. The same procedure may applied for genetic enhancement purposes for people seeking greater muscle efficiency

Genetic enhancement goes beyond genetic therapy Enhancing human characters rather than repairing or curing human diseases and conditions. This opens the door in making radical changes in humankind One single gene in a human body can perform multiple roles Thus, adjusting one gene may have more consequences than originally intended

Insertion of a functional gene Alteration Removal of genes Concerns: Techniques Virus as a vector to transport the genetic materials Gene complexity

A genetic network shows 10 proposed “key driver” genes that may have especially great influence in both type 2 diabetes and cardiovascular disease Liiu lab/Brown University

Genetic testing Psychological If positive for a ‘bad’ mutation: Burden of knowing you have the predisposition, particularly if no treatment is available Genetic determinism: possible overestimation of likelihood of actually becoming afflicted The situation with Huntington’s is not typical If negative: Evidence of ‘survivor guilt’ in some cases Possible over-confidence E.g., thinking you won’t get breast cancer because your test for BRCA1 & 2 came out OK

More Risks of Being Tested Practical Employment Life insurance Health Insurance (more important in US) Is it fair for companies to take genetic information into account when making hiring decisions or decisions about whether to insure a person?

Synthetic Biology The design of new biological parts and systems that do not already exist in the natural world Re-design existing biological systems to perform specific tasks Animal model for some diseases HIV models New species May transformed to other animal and come back to human Food Fruits

Vaccines Vaccine typically contains an agent that resembles a disease-causing microorganism in the body Often made from weakened or killed forms of the microbe or its toxins. The agent stimulates the body’s immune system to recognize the agent as foreign, destroy it, and recall it The immune system can more easily recognize and destroy any of these microbes that later come across

Carry part of the microbes Not always working May have side effects Vaccine industry may cover the safety and efficiency of vaccines financial benefits Examples:

Nanomedicine Nano-scale science is used for many applications from pharmaceuticals to consumer products Studies objects 1-100 nm in size Silver nanoparticles are naturally anti-microbial and are incorporated into many consumer products Socks, gym clothes, and Band-Aids to fight bacteria growth Silver nanoparticles do not discriminate between harmful and harmless bacteria May harm the environment by killing beneficial microbes

Target cancer cells Nanofibers Deliver drugs directly to the nuclei of cancer cells Nanofibers Special materials Wound dressings Surgical textiles Materials used in implants Artificial organ components