Friday, February 15, 2013

MEDICAL SCIENCES AND HEALTH CARE: LEGAL & ETHICAL MATTER ARISING


MEDICAL SCIENCES AND HEALTH CARE: LEGAL AND ETHICAL MATTER ARISING.

As long as science and  technology keep progressing with outstanding impact on man- a development that will always re-define life and social behavior, so will there be more questions on human moral values, ethical conducts, and the legality of new ways of life man adopt.

There is no doubt, man has undertaken a long and deep scientific journey in the past hundred years, worthy of mention is, the medical advancement that has gone beyond what man could imagine decades ago.

With a little understanding of human anatomy (study of the structure and relationship between or among  body parts) back then; today, we have answers to “what and where” questions on anatomy, because of the significant improvement over yesteryear examination method of dissection of (cadavers: dead human body) to several complex techniques of X-rays, Ultra-sound, Magnetic Resonance Imaging (MRI), Nuclear Magnetic Resonance Imaging (NMRI), and Magnetic Resonance Tomography (MRT); all are medical imaging procedures using radiology to examine internal body structures in details.
Also with unclear, vague, and perhaps obscured information on human physiology pioneered by Hippocrates of Kos (460- 370 B.C.E) to Aristotle (384-322 B.C.E), who established the relationship between the structure and function to Claudius Galen (circa, 129-200/216) who started animal dissection to study physiology back then; today, we can say with confidence that we have distinct and defined answers to several “how” questions on body function, thanks to medical imaging procedures.

Similarly, with doubtful or perhaps unreliable information on diseases and illnesses in terms of: causes, prognosis, care, and cure years back, today, our knowledge has become profound and unlimited.
Above all, our knowledge of medication procedure has become copious and bountiful, because of significant leap in: pharmacology (the study of drugs and their administration); pharmacodynamics (the study of how body responds to drugs); and pharmacokinetics (the absorption, distribution, metabolism, and excretion of drugs from the body).

In fact, this body of knowledge including pathology, psychology has made quality health care delivery simpler, cheaper, easier, better; more important, make humans enjoy meaningful and quality life than several generation before.
Notwithstanding this feat, human has continued to live with moral burden, troubled conscience, un-answered ethical and legal questions, regardless of Bio-Ethic studies, which have resulted in crafting  sound ethical codes and conducts in addition to medical laws for health care providers-unfortunately, man is still far from where he should be morally, therefore  aggravating the conflict between him and the society.

Oftentimes, individual’s medical needs do becloud sound judgment coupled with greed and love for money by health care providers and medical industrial complex that always push ethical and moral values to background.
A careful consideration of some issues over the years will shed light on how far, how good, how bad or even how worse, we have gone in pursuit of happiness when seeking medical help.

ON-GOING MEDICAL & SCIENTIFICAL ISSUES

STEM CELL:  there is no medical issue that has generated so much controversy more than stem cell. Stem cell is a biological process found in all mutli-cellular organisms that has the ability to divide, mitosis (separate chromosomes into two identical sets), and differentiate.
In mammals, there are two types of stem cells: the Embryonic Stem cells (ES cells) and the Progenitor Cell. The embryonic stem originates or develops from inner cell mass, which comes into existence 4-5 days of post-fertilization, it has between 50 and 150 cells that ultimately creates the structure of fetus (life); the first stage of human development before implantation at the uterus. The fetus produces by ES is also known as pluriblast- a cell with potentials to differentiate from less specialized cells to more specialized cells.

Progenitor cell- a replenish cell-that reproduce to repair, replenish worn out or damaged tissues in human body, mostly in grown up or adults.

The Controversy of Stem Cell Engineering

The controversy stem has generated over the years is, will it be proper to extract stem cell from: unbiblical cord, bone marrow, adipose tissues (i.e. body fat or fat depot) and blood as renewable sources to replace (damaged) cells, treat diseases, conditions, and disabilities in others?
Is it proper to extract Stem Cells from the mentioned sources for keep and later use for people with medical problems? There is no doubt, we will continue to have supporters, which includes but not limited to: scientists, liberals, pharmaceutical companies, medical care providers, pressure groups, political parties; on the other hand, non-supporter leagues will come from religious organizations, movements and brotherhood, political parties,  conservatives, legal experts.

Stem Cell activists will always argue the gains and benefits this therapy will offer humankind now and in the future; considering some of the exciting, but interesting discoveries so far. For instance, Medical Research Council for Regenerative Medicine, University of Edinburgh, U.K discovered a “key protein” Tcf 15 in a recent study-a trigger in differentiation process; the break-through gives a better insight into stem cell potentials to differentiate, the success made Sally Lowell, said stem cell holds promise for more future discoveries.
The study is similar to other valuable stem cell studies being conducted around the globe such as: Amyotrophic Lateral Sclerosis (ALM) study by Yang (Ted) Teng and his team of Harvard Medical School, findings from the study showed there will be cure for AML through stem cells use in the near future. More exciting, but interesting is the Olfactory Ensheathing cells joint study by Welcome-Trust MRC under Professor Robin Franklin of Medical Research Council (MRC), U.K.; the discovery in the study showed that certain nose cells can cure Spinal Cord Injuries (SCIs) because these cells can be used to regenerate axons-the signal carriers-in the Central Nervous System (CNS); more recently, Stem cell and Type 1 Diabetes study conducted by Dr.IIia Banakh and Professor Len Harrison of Institute of Molecular Medicine, Australia provided hope on a possible future cure for Type 1 Diabetes.  

The Australian medical team discovered a cell from the adult stem cell of pancreas that turned to “insulin-producing cell,” which in turns “secrete insulin in response to glucose.” The study concludes that “the potential to regenerate insulin-producing is present in all of us,” which means with stem cells therapy in place in the future, “people with type 1 diabetes will be able to regenerate their own insulin-producing cell.”

To state the obvious, today’s medical trouble caused by degenerative cell, nerve and bone, which result in Parkinson Disease, Alzheimer, Cancer, Multiple Sclerosis, Diabetes, Spinal Cord Injuries, Heart Diseases, and Motor Neuron Diseases may someday be gone as this procedure’s goal is to use not-yet-grown-or-less-specialized cells create new cells to replace those wasted in degenerative diseases.

No doubt, stem cell holds some degree of optimism for the future, but the questions regarding stem cells are: where will the cells be sourced-from parents, children, and relatives or from stem cell banks? Should the frozen embryonic stem cell be seen as life, or a mere bio-active medical material for treatment? What will be the relationship between stem cell donor and the receiver? Should there be monetary transaction between the donor, receiver, and the third party of this procedure? If yes, to what extent?
On the other hand, opponents of stem cell research have continued to say: life begins at conception, which takes place 4-5 days after sexual intercourse; even though, the conception theory is reasonable, inviolable and sacrosanct.

But stem cell supporters hold sperm and woman egg are already living organisms before fusion; one of their arguments is, should men who masturbate be punished for wasting their semen? Or should women be condemned for undergoing monthly cycles-after all, un-used and non-fertilized eggs are wasted?

These are questions without answers as the two parties keep presenting reasons for and against stem cells research; supporters and non-supporters keep increasing by the day. In fact, the recent US presidential elections showed how scientific matters, social issues, religious thoughts, shaped debates, electoral maps, and results. There is no doubt, these issues will linger for a long time to come.

                                               

                                                        CLONING.
CLONING: another trouble, another debate. Cloning is the biologic process of duplicating materials to produce same result with exact look, this genetic representation of individual can be accomplished in three ways:

1.    Recombinant DNA technology or DNA cloning

2.    Reproductive Cloning, and

3.    Therapeutic Cloning.

Like stem cell debate, opponents of cloning see the scientific process as nothing, but a negation to natural biological method of reproduction; more so, opponents have come up with social, moral, legal, and more important, medical problems- perpetuation of disorder or defect from genetically faulty individual-cloning will bring, if allowed or adopted as a medical procedure.

Nanotech is a smallest tag, bio-compatible RFID transponder, a hand-free or hand-held ergonomic reader and writeable software to identify, to trace issues for medical solution. The transponder contains electronic chips that can be planted in humans, animals, even plants or other objects to gather scientific data for analysis for human use.
It allows scientists to create, explore, manipulate, and measure materials in nanometer (one billionth of a meter); these materials can be chemical, physical or biological properties. Since the introduction of this technology in early 80s, we have had four types of nanotech:

1.    Passive, which includes dispersed and products nanotech

2.    Active, which includes: bio-active and physic-chemical material of drugs, bio-devises, transistor and amplifiers

3.    System nanotech

4.    Molecular nanotech.

What are the ethical and legal problems associated with nanotech? The science of nanotech has been quite phenomenal, it has helped in providing sound and detailed information on difficult subjects, also helped penetrate into difficult zones.
Nanotech has been very useful in space research, sea/ocean bed exploration because many of the research tools are fitted with nanotech to help obtain, explore, monitor and transmit binary information to earth stations for super-computers’ analysis.

More so, nanotech has been so helpful in gathering information on single or unicellular organisms such as: slime mould, algae, fungi, parasite, archaea, etc.. which in turn has helped in drug development and manufacturing for diseases’ management and control.
Also, nanotech has helped in the monitoring and management of wild-life, especially, the endangered species. Animals have been fitted with electronic chips to monitor their movement, social life, poachers/predators and document findings for further use.

Regardless, does it mean or suggest nanotech has no ethical or moral concerns? Certainly not! Are there ethical problems or moral burden, when a man or woman is fitted with amplifier to monitor what goes around such an individual? At what point is individual fitted with nanotech’s privacy infringed? What is the border line between private information and public information from someone with nanotech? Even, when nanotech is removed from the body, will the body be same as pre-nanotech? Who owns the information accessed by nanotech- the source or nanotech owners? How long will nanotech information/data be kept before discarded? Should there be monetary reward for nanotech participants?

                                        In Vitro Fertilization

In Vitro Fertilization popularly called IVF is the process of fertilization by manually combining egg and sperm in a laboratory dish, the process of fertilizing the female partner matured egg by male partner sperm in the IVF lab for the transfer of embryo into uterus.
In several cases, this medical procedure is performed on females that cannot conceived through biological process, what is done is, matured egg is extracted from a female through surgery, while male sperm is sourced or obtained through ejaculation, then fertilization takes place before the transfer into uterus. The moral questions the procedure raise are: at what point is the embryo transfer into the uterus? What compensates for bond between the fetus and the mother before the transfer? If egg is loaned (from relatives such as  mother, sister, aunt, niece) bought, or sourced from Egg Bank-who is the biological mother-the egg donor or the fetus carrier? 

 Surrogate Mothers

Arrangement where a woman or a couple hires another woman, to carry and to deliver a fertilized egg.
Surrogacy is of two types:

1.    Genetic Mother/Traditional surrogate

2.    Gestational Surrogate

Genetic or Traditional Surrogate-the baby carrier may be or not genetically related to the child she carries, on the other hand, gestational surrogate mother is un-related to the fetus; rather she is substituting for the actual or biological mother during the nine-month gestation.

                                         Civil Union

As civil union o gay marriage is becoming more popular in the western hemisphere, there are possibilities that partners in this union may seek the help of surrogate mothers in the future to help carry and deliver babies, even help nurse babies up to six year.
The question is who owns the baby-surrogate or civil union partners?
What are the ethical, moral, and legal problems the explained medical procedures will have on human society now and in the future? What are the implication of new medical procedures on the family and society at large?

Will these medical procedures create more complex medical situation, or correct the on-going troubles?

As science and technology keep moving forward with noticeable improvement, also there will be behavioral changes that will create more ethical and moral questions. Will there be answers to these questions?  Probably so, possibly not; however, only time will tell.





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