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NOTES:
Bioethics.
BSET-366.
Sources:
NOTE: these notes are made by a student mostly by class lectures.
Google search, HEC Website & Wikipedia.

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Bioethics:
The term Bioethics is derived from two words bio (life) & ethos (behavior). To study the
behavior of human life comes under the umbrella of bioethics. Ethics is a science of moral in
human conduct. Till 1970s the term bioethics was not used but then a scientist Van Rensselaer
used the term bioethics for the first time in 1971.

History of Bioethics:

It was all started from the 6th BC when the experiments were conducted on the prisoners who
were given the rotten meat.

In 5th century BC Hippocratic Oath was presented by a Greek scientist Hippocrates. He is

famous as the father of medicine. The Hippocratic Oath is written in Greek .The Hippocratic
Oath is an oath historically taken by doctors and other healthcare professionals swearing to practice
medicine ethically.

Some of the main Postulates of the Hippocratic Oath are:

1. I will prescribe regimens for the good of my patients according to my ability and my judgment
and never do harm to anyone.

2. I will not give a lethal drug to anyone if I am asked,

3. I will preserve the purity of my life and my arts.

From 1845 to 1849 a research was conducted by a scientist Marion Sims (the father of
gynecology) who performed his studies on African women suffering from prolapsed uterus
disease. He conducted his experiments without giving them anesthesia and many of them died.
About 34 surgeries were conducted on each individual.

In 1900 there was a scientist Walter reed he gave germs of yellow fever to 22 subjects & he
exploited them financially.

From 1932 to 1972 (Tuskegee) study was conducted on the disease syphilis & the subjects
were 400 black share coppers they were given the injections of syphilis disease but they were
told by the researchers that they are giving them vaccination for the cure of disease

In 1943 some experiments were conducted on 16 mentally disabled people they were kept In
the refrigerators at 30 degree Fahrenheit for 120 hours.

The scientific community then decided to make rules and regulations to stop the violation of
ethical issues.

1947 Nuremberg Code:

The Nuremberg code includes such principles as informed consent and; properly
formulated scientific experimentation; and beneficence towards experiment participants.

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(Informed consent is a legal procedure to ensure that a patient or client knows all of the risks and costs
involved in a treatment.)

Helsinki Declaration:

1964 in this declaration it was decided that the interest of science and society should never
take precedence over the well being of subjects

In 1979 Belmont report was presented and three basic principles were decided in that report

1. Respect for person.

Respect for persons incorporates at least two ethical convictions: first, that individual
should be treated as autonomous agents, and second, that persons with diminished
autonomy are entitled to protection.

2. Principle Of beneficence.
Persons are treated in an ethical manner not only by respecting their decisions and
protecting them from harm, but also by making efforts to secure their well-being. Such
treatment falls under the principle of beneficence

3. Justice.
whenever research supported by public funds leads to the development of therapeutic
devices and procedures, justice demands both that these not provide advantages only to
those who can afford them and that such research should not unduly involve persons from
groups unlikely to be among the beneficiaries of subsequent applications of the research.

In 1991 CIOMS (Council for International Organization of Medical Sciences) Guide lines was
introduced by W H O and four principles were there:

4. Respect for person.

5. Principle Of beneficence should be established.
6. Justice.
7. Non-malfeasance. (Not harming patient or research volunteer)

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Bioethics is applied in for areas:

1. Education.
2. Research.
3. Clinical.
4. Policy making.

Education:
Bioethics is taught to postgraduates and undergraduates as a subject in their course.
Research:
For research purposes there is a committee known as Research Ethics Committee in almost
every university and research institute which checks the ethical bases of study and give its
decision about the study i.e. whether to it allow it or not.
Clinical:
In hospitals there is a committee Known as Clinical or Hospital Ethics Committee. The
committee has two functions:
1. When a researcher is going to conduct a study on a patient he should take the patient in
confidence and get the approval of Hospital Ethics Committee.
2. In case if the patient is get harmed by the researcher & if he or she report his complaint
to H E C then H E C will have take the action against the particular researcher.
Policy making:
In policy making H E C is going make policy based on priority setting and resource allocation.
For example if there are 20 bed available in the hospital emergency room and nineteen of them
are given to 19 patients & only one bed is left and two more patient arrive then H E C is going to
give the priority to the patient who more is serious. Likewise in resource allocation H E C is
going to decide which department is more deserving for the funds and it will it be given the
priority over others.

CONCLUSION:
1. To study the behavior of human life comes under the umbrella of bioethics.

2. It was all started from the 6th BC when the experiments were conducted on the prisoners
who were given the rotten meat.

3. In 5th century BC Hippocratic Oath was presented by a Greek scientist Hippocrates.

4. The Nuremberg code 1974 includes such principles as informed consent and; properly
formulated scientific experimentation; and beneficence towards experiment participants.
5. In 1964 according to Helsinki declaration it was decided that the interest of science and
society should never take precedence over the well being of subjects

6. In 1991 CIOMS (Council for International Organization of Medical Sciences) Guide lines
was introduced by W H O.

Branches of Bioethics:
There are three major branches of ethics:

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1. Meta ethics:
Meta ethics is an ethical field that seeks to understand attitudes and judgments.
In Meta ethics the focus is on how we understand and knows about what is right and
what is wrong.
2. Normative ethics:
In normative ethics we decide what to do, what not to do and what we ought to do.
3. Virtue ethics:
Virtue ethics describe the character of moral agent as a deriving force for ethical
behavior rather than rules.

Philosophical definition of virtue:

Doing the right thing, for the right person, at the right time, for the right reason.

Some isms:
1. Hedonism:
The basic concept of hedonism is that we have to maximize pleasure and minimize pain.
2. Consequentilism:
The basic principle that we have to do whatever has the best consequences.
3. Deontology or Kantianism:
It is the philosophy of Immanuel Catt and it says that you should do your duty, having a
good will.
4. Utilitarianism:
It is based on the thoughts of Jeremy Bentham and he believes on the greatest good for
the greatest number of people. It has got two more types:
A). Act utilitarianism:
It is based on the selection of particular action under particular circumstances.
B). Rule Utilitarianism:
To follow the rule in a particular situation no matter what are the circumstances.

Conflict of Interest:

The term ‘conflict of interests’ refers to situations where a conflict arises between public
duty and private interest, which could influence the performance of official duties and
responsibilities. Such conflict generally involves opposing principles or incompatible
wishes or needs. Conflict of interest is behavior not a condition. A conflict of interest is a
set of circumstances that creates a risk that professional judgments or action regarding
a primary interest will be unduly influenced by a secondary interest.
Conflict of interests can involve pecuniary interests (i.e. financial interests or other
material benefits or costs) or non-pecuniary interests. They can involve the interests of
the public official, members of the official’s immediate family or relatives (where these
interests are known), business partners or associates, or friends. Enmity as well as
friendship can give rise to an actual or perceived conflict of interests.

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Relationship to medical research

The influence of the pharmaceutical industry on medical research has been a major
cause for concern. In 2009 a study found that "a number of academic institutions" do
not have clear guidelines for relationships between Institutional Review Boards and
industry.
Drug laboratories are controlling all the health sciences issues. Only 15% expenditure is
spent on drug making and 85% is left which is spent on advertising.
Financial benefits cause the conflict of interest. For example drug x is more effective
then drug y, but by product marketing drug x is promoted by a particular company that is
producing that drug, then it will be conflict of interest.
Types of conflicts of interests
The following are the most common forms of conflicts of interests:

 Self-dealing, in which an official who controls an organization causes it to enter

into a transaction with the official, or with another organization that benefits the
official. The official is on both sides of the "deal."
 Outside employment, in which the interests of one job contradict another.
 Family interests, in which a spouse, child, or other close relative is employed (or
applies for employment) or where goods or services are purchased from such a
relative or a firm controlled by a relative. For this reason, many employment
applications ask if one is related to a current employee. If this is the case, the
relative could then recuse from any hiring decisions. Abuse of this type of conflict of
interest is callednepotism.
 Gifts from friends who also do business with the person receiving the gifts. (Such
gifts may include non-tangible things of value such as transportation and lodging.)
 Pump and dump, in which a stock broker who owns a security artificially inflates
the price by "upgrading" it or spreading rumors, sells the security and adds short
position, then "downgrades" the security or spreads negative rumors to push the
price down.

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Research:
Research can be defined as the search for knowledge, or as any systematic
investigation, with an open mind, to establish novel facts, solve new or existing
problems, prove new ideas, or develop new theories, usually using a scientific method.
Research has been defined in a number of different ways.
A broad definition of research is given by Martin Shuttleworth - "In the broadest sense of
the word, the definition of research includes any gathering of data, information and facts
for the advancement of knowledge."
Another definition of research is given by Creswell who states - "Research is a process
of steps used to collect and analyze information to increase our understanding of a topic
or issue”.
The Merriam-Webster Online Dictionary defines research in more detail as "a studious
inquiry or examination; especially : investigation or experimentation aimed at the
discovery and interpretation of facts, revision of accepted theories or laws in the light of
new facts, or practical application of such new or revised theories or laws".

Steps in conducting research

The major steps in conducting research are:

 Identification of research problem

 Literature review
 Specifying the purpose of research
 Data collection
 Analyzing and interpreting the data
 Reporting and evaluating research
The steps generally represent the overall process, however they should be viewed as
an ever-changing process rather than a fixed set of steps [6]. Most researches begin with
a general statement of the problem, or rather, the purpose for engaging in the study [7].
The literature review identifies flaws or holes in previous research which provides
justification for the study. The purpose of the research identifies a specific hypothesis.
The researcher(s) collects data to test the hypothesis. The researcher(s) then analyzes
and interprets the data via a variety of statistical methods, engaging in what is known
as Empirical research. The results of the data analysis in confirming or failing to reject
the Null hypothesis are then reported and evaluated. At the end the researcher may
discuss avenues for further research.

Scientific research
Generally, research is understood to follow a certain structural process. Though step
order may vary depending on the subject matter and researcher, the following steps are
usually part of most formal research, both basic and applied:

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1. Observations and Formation of the topic: Consistst of the subject area of ones
interest and following that subject area to conduct subject related research. The
subject area should not be randomly chosen since it requires reading a vast
amount of literature on the topic to determine the gap in the literature the
researcher intends to narrow. A keen interest in the chosen subject area is
advisable. The research will have to be justified by linking its importance to
already existing knowledge about the topic.
2. Hypothesis: A testable prediction which designates the relationship between two
or more variables.
3. Conceptual definition: Description of a concept by relating it to other concepts.
4. Operational definition: Details in regards to defining the variables and how they
will be measured/assessed in the study.
5. Gathering of data: Consists of identifying a population and selecting samples,
gathering information from and/or about these samples by using specific
research instruments. The instruments used for data collection must be valid and
reliable.
6. Analysis of data: Involves breaking down the individual pieces of data in order to
draw conclusions about it.
7. Data Interpretation: This can be represented through tables, figures and pictures,
and then described in words.
8. Test, revising of hypothesis
9. Conclusion, reiteration if necessary
What Is A Null Hypothesis?
For this to work you’re going to have to imagine that you are a scientist. Now in order to
get that Nobel Prize you’re gonna have to come up with something pretty damn brilliant.
So let’s say you have some rather exciting ideas about why you seem to lose socks at
an astonishing rate. Maybe, you hypothesise, aliens are beaming down to steal one
sock out of every pair you own.
In order to test whether your hypothesis is true or not, you have to carry out some
research to see if you can back it up. So you set up a hi-tech alien detection system and
record whether times of alien activity are correlated with when your socks go missing.
However, when you get your results, it’s possible that any relationship that appears in
your data was produced by random chance. In order to back up your hypothesis you
need to compare the results against the opposite situation: that the loss of socks is not
due to alien burglary. This is your null hypothesis – the assertion that the things you
were testing (i.e. rates of alien activity and sock loss) are not related and your results
are the product of random chance events.

Null hypothesis. The null hypothesis, denoted by H0, is usually the hypothesis that
sample observations result purely from chance.

Alternative hypothesis. The alternative hypothesis, denoted by H1 or Ha, is the

hypothesis that sample observations are influenced by some non-random cause.

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Research methods
. This process takes three main forms (although, as previously discussed, the
boundaries between them may be obscure.):

 Exploratory research, which structures and identifies new problems

 Constructive research, which develops solutions to a problem
 Empirical research, which tests the feasibility of a solution using empirical
evidence

Research can also fall into two distinct types:

Primary research
Original findings
Secondary research
Summary, collation and/or synthesis of existing research
In social sciences and later in other disciplines, the following two research
methods can be applied, depending on the properties of the subject matter and
on the objective of the research:
Research Designs:
Phenomenological:
We study the living experience of others and we see how world appears
to other people.
In that case the output is from single researcher.
1. Narrative:
We use to collect data by story tellings.
2. Grounded Theory:
Same as phenomenological design, but the final output is a combine
theory of two or more researchers which becomes a near fact.
Ethnographic:
It is concerned with the study and analysis of people and their behavior in
their own environment.
3. Case study:
We use to analyse cases; that is we become more specific about a
particular situation, or case, and it similar to ethnographic design.

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Qualitative research
Understanding of human behavior and the reasons that govern such behavior.
This type of research looks to describe a population without attempting to
quantifiably measure variables or look to potential relationships between
variables. It is viewed as more restrictive in testing hypotheses because it is
extremely expensive and time consuming, and typically limited to a single set of
research subjects. Qualitative research is often used as a method of exploratory
research as a basis for later quantitative research hypotheses.

Qualitative research methods:

1. In Depth Interviews:
They are in-depth interviews mostly followed in phenomenological design.in
depth interviews mostly involve questioners.
2. Focus Group Discussion:
We make groups of individuals and conduct in depth interviews.
3. Unobtrusive method:
They are applied in qualitative research to analyze the behavior of individuals
through inspections.
4. Narrative Analysis:
It is based on narrative design; we study the behavior through story telling.
5. Memory work:
We analyze the incidents of past, it could be done either by conducting
interviews or gathering information through historical records like news paper,
articles etc.
6. Ethnography:
It is the study of cultural values by observations.
7. Participatory action research:
We analyze the cultural values through practices performed by the individuals
belonging to a particular culture

Quantitative research
Systematic empirical investigation of quantitative properties and phenomena and
their relationships. Asking a narrow question and collecting numerical data to
analyze utilizingstatistical methods. The quantitative research designs are
experimental, correlational, and survey (or descriptive).[10] Statistics derived from
quantitative research can be used to establish the existence of associative or
causal relationships between variables.

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Quantitative research methods

It can be based on observations and experimentations.

Observational Study:
This type of research draws a conclusion by comparing subjects against a control
group, in cases where the researcher has no control over the experiment. We
merely observe what is happening or what has happened in the past and the
conclusion is based on observations, involving no human intervension.

Examples of Observational Study:

CASE CONTROL STUDY:
A case control study is a method extensively used by the medical profession, as
an easy and quick way of comparing treatments, or investigating the causes of
disease.
The case control study uses groups of patients stricken with a disease, and
compares them with a control group of patients not suffering symptoms. Medical
records and interviews are used to try to build up a historical picture of the
patient’s life, allowing cross-reference between patients and statistical analysis.
Any trends can then be highlighted and action can be taken.
Possibly the most famous case control study using this method was a study into
whether bicycle helmets reduce the chance of cyclists receiving bad head injuries
in an accident. Obviously, the researcher could not use standard experimentation
and compare a control group of non-helmet wearers with helmet wearers,
measuring the chances of head injury, as this would be unethical. A case study
control was utilized, and the researchers looked at medical records, comparing
the number of head injury sufferers wearing helmets against those without. This
generated a statistical result, showing that wearing a cycle helmet made it 88%
less likely that head injury would be suffered in an accident.
COHORT STUDY:
A cohort study is a research program investigating a particular group with a
certain trait, and observes over a period of time. Some examples of cohorts may
be people who have taken a certain medication, or have a medical condition.
Outside medicine, it may be a population of animals that has lived near a certain
pollutant or a sociological study of poverty.
There are two main sub-types of cohort study, the retrospective and the
prospective cohort study. The major difference between the two is that the
retrospective looks at phenomena that have already happened, whilst the
prospective type starts from the present.

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RETROSPECTIVE COHORT STUDY

The retrospective case study is historical in nature.
For example, it might compare the incidence of bowel cancer over time in
vegetarians and meat eaters, by comparing the medical histories. It is a lot easier
than the prospective, but there is no control, and confounding variables can be a
problem, as the researcher cannot easily assess the lifestyle of the subject.
A retrospective study is a very cheap and effective way of studying health risks or
the effects of exposure to pollutants and toxins.
PROSPECTIVE COHORT STUDY
In a prospective cohort study, the effects of a certain variable are plotted over
time, and the study becomes an ongoing process. To maintain validity, all of the
subjects must be initially free of the condition tested for.
For example, an investigation, over time, into the effects of smoking upon lung
cancer must ensure that all of the subjects are free of the disease. It is also
possible to subgroup and try to control variables, such as weight, occupation type
or social status.

CROSS SECTIONAL STUDY

The cross sectional study looks at a different aspect than the standard
longitudinal study.
The longitudinal study uses time as the main variable, and tries to make an in
depth study of how a small sample changes and fluctuates over time.

A cross sectional study, on the other hand, takes a snapshot of a population at a

certain time, allowing conclusions about phenomena across a wide population to
be drawn.

An example of a cross-sectional study would be a medical study looking at the

incidence of breast cancer in a population. The researcher can look at a wide
range of ages, ethnicities and social backgrounds. If a significant number of
women from a certain social background are found to have the disease, then the
researcher can investigate further.
Experimental Study
It manipulates on variables to determine how the manipulation influences other
variables, mostly involving human interventions

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Example
RANDOMIZED CONTROLLED TRIALS

Randomized controlled trials are one of the most efficient ways of reducing the
influence of external variables.
by Martyn Shuttleworth (2009)
In any research program, especially those using human subjects, these external
factors can skew the results wildly and attempts by researchers to isolate and
neutralize the influence of these variables can be counter-productive and magnify
them. Any experiment that relies upon selecting subjects and placing them into
groups is always at risk if the researcher is biased or simply incorrect. The
researcher may fail to take into account all of the potential confounding variables,
causing severe validity issues. http://www.experiment-resources.com/research-designs.html

Plagiarism
Definition:

According to oxford dictionary plagiarism is defined as “ talking and using the thoughts, writings
and inventions of another person as one’s own’

Various forms of plagiarism:

1. Verbatim copying.

2. Near verbatim copying.

3. Self plagiarism.

1. Verbatim Copying:

It is copying the elements of another author’s paper, such as equations or illustrations that are
not common knowledge, or purposely paraphrasing (i.e. a restatement of a text, passage, or work giving
the meaning in another form) sentences without citing the source.

2. Near verbatim copying:

It is copying the portions of another author’s paper or copying from reports by citing the source
but not clearly differentiating what text has been copied (e.g. not applying the quotation marks
correctly), or not citing the source correctly.

3. Self plagiarism:

Wikipedia describes self plagiarism as “the re use of significant, identical, or nearly identical
portions of one’s own work without acknowledging that one is doing so or without citing the
original work”.

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Explanation by Wikipedia:

According to Wikipedia; “the unauthorized use or close imitation of the language and thoughts of
another author and the representation of them, as one’s own original work.” Unlike cases of
forgery, in which the authenticity of writing, document, or some other kind of object itself is a
question, plagiarism is concerned with the issues of false attribution. Within academia
plagiarism by students, professors or researchers is considered academic dishonestly or
academic fraud and offenders are subject to academic censure.

What is not plagiarism?

With some text, plagiarism is not a concern because content is not creative. Here are some examples where
attribution is generally not required for plagiarism concerns,

1. Use of common expressions and idioms, including those that are common in various
sub-cultures such as academic ones.
2. Phrases that are the simplest and most obvious way to present information. Sentences
such as "John Smith was born on 2 February 1900" lack sufficient creativity to require
attribution.
3. Simple, non-creative lists of information, such as a list of song titles on an album, or
actors appearing in a film. If creativity has gone into producing a list by selecting which
facts are included, or in which order they are listed, then reproducing the list without
attributing it to its source may constitute plagiarism.
4. Mathematical and scientific formulae which are part of the general background
knowledge of a field.
5. Simple logical deductions.

Responsibility of the Institutions & Organizations:

All institutions and organizations are responsible to apprise their students, teachers,
researchers and staff of the definition, implications and resulting punishments in case, after
due investigation, they are found guilty of plagiarism.

Penalties for Plagiarism:

The punishments for Plagiarism have been divided into two separate categories, i.e. those
for "Teachers, Researchers and Staff" and those for the "Students". The penalties for
plagiarism should not only take into account the severity and recurrence of the offence, but
also the intellectual standing of the offender. This entails a gradual increase in punitive
action with minimum punishment for a first time offence by a student who copies a home
work assignment to a maximum punishment for a teacher/researcher/staff who attempts to
present plagiarized material; as his own, in a conference or journal.

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Penalties for Teachers, Researchers and Staff:

(i) Major Penalty:

In cases where most of the paper (or key results) have been exactly copied from any published
work of other people without giving the reference to the original work, then (a) a major penalty of
dismissal from service needs to be prescribed, along with (b) the offender may be “Black
Listed” and may NOT be eligible for employment in any academic / research organization, and
(c) the notification of “Black Listing” of the author(s) may be published in the print media or may
be publicized on different websites at the discretion of the Vice-Chancellor / Rector / Head of the
organization.

(ii) Moderate Penalty:

In case where some paragraphs including some key results have been copied without citation,
then a moderate penalty involving any one or both of the following needs to be imposed (a)
demotion to the next lower grade, (b) the notification of “Black Listing” of the author(s) which
may be published in the print media or may be publicized on different websites at the discretion
of the Vice-Chancellor / Rector / Head of the organization.

(iii) Minor Penalty:

In case a few paragraphs have been copied from an external source without giving reference of
that work, then minor penalties need to be prescribed for a specified period involving any one
or more of the following: (a) warning, (b) freezing of all research grants, (c) the
promotions/annual increments of the offender may be stopped, for a specified period and (d)

Penalties for Students:

(i) Major Penalty:

The degree of a student may be withdrawn if AT ANY TIME it is proven that he or she has
presented Plagiarized work in his / her MS, MPhil or PhD dissertation.

The notification of the plagiarism by the author(s) may be published in the print media or
may be publicized on different websites at the discretion of the Vice Chancellor / Rector /
Head of the Organization.

(ii) Moderate Penalty:

The offender may be relegated to a lower class. The offender may be given a failure grade
in the subject. The offender may be fined an amount as deemed appropriate.

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(iii) Minor Penalty:

The offender may be given a written warning if the offence is minor and is committed for the
first time.

Penalty for Wrong Reporting / False Allegation:

If the case of Plagiarism is not proved and it is confirmed that a false allegation was lodged,
the Vice Chancellor / Rector / Head of the Organization will inform the complainant’s
Organization and will recommend disciplinary action against the complainant, to be taken by
his / her parent organization.

Appeal:

As the penalties are severe, the affected person(s) will have the right to appeal to the
Chairman Vice Chancellor / Rector / Head of the Organization for a review of the findings or
may submit a mercy petition within 30 days from the date of notification. Such appeals /
petitions will be disposed off within 60 days of receipt, by following the laid down procedures
regarding such appeals.

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Stem Cell Research

Start of life:

Life starts from conception when sperm fuses with ovule. Sperm and ovary cannot live alone. A
cell is considered alive if there is metabolism, growth and reproduction. Some people say that
life stars after 24 hours of conception that is zygote formation (Blastomere). Zygote has a
potential of a complete human being. Medically zygote is biologically considered to be alive.
Zygote reproduction is 16 cell stages that is 14 days after conception. Two cell stage of zygote
is called blastomere. Pregnancy starts after 10 days of conception. Medically once the
blastocyct is implanted in to the uterus it is call pregnancy. After 3 days (16 cell stage) morula is
produced & after five days 5 days it is converted to blastocyct (14 days). We can take stem cells
for 14 days because after that they are differentiated into organs. Primitive streak appears after
14 days of conception. This primitive streak develops into nervous system & life starts.
According to Islamic point of view the life stats after 40 days of conception because the embryo
can be distinguished at that stage, that is we can say that it is human embryo. After 10 weeks of
conception we can identify the gender.

End of life:

Life support system technology uses a device called ventilator that provides oxygen and export
carbon dioxide. At the end of life we use ventilators it is a new technology and used mostly in
cases when a birth of baby occurs before estimated period. Ventilators are use at terminal
stages the life is ended, that is death occurs we the heart beat is stopped this is an old concept.
According to the new concept the life is ended when the Brain death occurs. One of the biggest
ethical issues about the usage of ventilators is that for how long patient would be supported by
the ventilator. If someone is in vegetative stage and go into coma stage it is known as
comatose. Terri schiavo was a young lady in 1990 she went into coma by car accident and was
living on ventilation and she went into vegetative stage. For some period of time she was
supported by her husband but then he said he is not going to support her any more but her
parents said that he has to support her, so her husband filed a case in the court to remove her
ventilator. The case was there till 2001. According to some people she was under futile
treatment while the others said that she is not under futile treatment. The opinion of the doctors
was the she is under non-futile treatment and she can survive for at least one day without
ventilators, and her husband said that that she is under futile treatment because cannot survive
any longer without ventilators. Eventually the doctors removed the ventilators in 2001 and she
survived, so doctors put her in the ventilator again. But in 2005 G.W Bush ordered to remove
her ventilator and she was died. After that incident it established that when brain death occurs,
the person is died.

Euthanasia:

It means mercy killing. It is legal in 20 western countries. The term is derived from the Greek
word ‘Eu’
Means ‘good’ and ‘thanatos’ means ‘death’. So it means ending someone life in painless
manner, or “Deliberate action undertaken with the express intention of ending a life to relief
suffering”.

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Types of Euthanasia:
1. Active Euthanasia;
It means doing some action to end one’s life, for example if someone injects
poison to end his/her life.
2. Passive Euthanasia:
If a person refuses to take necessary actions that could save his/her life then it is
known as passive euthanasia. For example if someone rejects to take dialysis
that could save his/her life.
3. Physician Assisted suicide:
it involves the assistance of physician to end someone’s life.
Active and passive euthanasia can be done voluntary (patient’s will) or
involuntary (without patient’s will)

HUMAN CLONING:
Cloning is used to produce identical genetic copy of a living organism. Cloning is Greek
word which has been used for centuries, coning means (twig) terminal end of large woody plant.
Cloning is used in plants for centuries. The concept of cloning was there in invertebrates (like
earth worms) it is a natural phenomenon from which the cloning was started artificially. Identical
twins are from two parents and clones are from a single parent, this is the main difference
between identical twins and cloning. Cloning is an identical genetic copy of an existing life form.
Fro cloning first of al we take the unfertilized egg, the in the second stage we enucleate
it. In third stage we take the somatic cell apart from reproductive cell, after that we extract the
nucleus from the somatic cell and insert it into the unfertilized egg of the surrogate mother. Then
this modified cell is given a minute electric charge, before implanting into the womb of surrogate
mother. The clones are 99.5% identical and 0.5% genes are stored in the mitochondria. In
vertebrates the cloning was started in 1952 by Robert Bricks and Thomas king. They tried to
clone a frog and were not succeeded and therefore concluded that cloning is impossible in
vertebrates. John Guader in 1970 cloned the frog and proved that cloning is possible in
vertebrates. In 1997 the concept was raised that mammals cannot be cloned but in 1997 Dolly
Sheep was cloned by Scottish scientist Dr. EL Wilmot & Dr. Ian Rosin, after that pigs, sheeps,
cows, rodents and mute were cloned. Mule are the hybrids of horse and donkey, they are sterile
giving the concept that sterile couples can have babies through cloning. Korean team started
human cloning in 1998 but failed, the Australians started cloning of humans in 2001 but after 6
cell stage it was stopped. Clones facilitate in genetic engineering of animals. PPL Therapeutic
Biotech Company cloned a sheep “poly” having capability of producing milk, containing proteins
to treat Heamophilia patients.

Ethical Issues:
1. Failure rate of cloning is 90%.
2. Wide range of abnormalities.
3. Large offspring syndrome LOS.
4. Life span of clone is very short.
5. Family and reproductive issues.
6. Confusing personnel identity.
7. Homosexuality will become legal.
8. It is already banned in more than 45 countries.
9. Dr Wilmot didn’t defended cloning, in the US congress he said “it is un ethical because
the failure rate is high”.

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THERAPEUTIC CLONING:
` it is also known as stem cell cloning. In therapeutic cloning we perform growth till
blastocyct stage (14 days). Then we extract the cell mass from blastocyct stage i.e. we extract
16 cells then cells have the ability to grow. It can be done to clone the entire human, by using
his/her healthy cells, and then using the healthy cells of a newly formed clone to treat the
unhealthy person. We call it therapeutic cloning because we use it to cure disease. Blosatosyst
stage is also called blank cell or blank microchip. Sometimes it is also referred to as body repair
machine.
Totipotent:
The morula stage cells are the totipotent cells also known as germ/stem cells because they
produce both germ cells and stem cells.
Pluripotent:
Produce only stem cells ectoderm (producing GIT etc), endoderm (all epidermal cells, CNS etc)
and mesoderm (muscles, bones, urinogenital tract).
Multipotent:
These are the cells that can be differentiated in many types of cells but having the common
origin like blood cells.
Unipotent:
Produce only one type of cells like epidermal cells.

In stem cell research our object is to extract pluripotent cells (blastocyct stage).
Adults have multipotent, pluripotent or unipotent cells. Supporters of stem cells research say
that we can cure many diseases through stem cell research & it is quite helpful for
transplantation, they say they do it with a good will.
Ethical issues:
1. Death of embryo.
2. Embryo is a divine creation.
3. Moral status of embryo is violated.
4. De value of human life.
5. Obtaining large number of eggs is invasive.
6. Social oppression.
7. Eggs market.
8. Embryos have intrinsic value.
Solution:
We can take bone marrow cells to avoid these issues.

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IN-VITRO FERTILIZATION
it is technique to help women to achieve pregnancy. Also know as Assisted reproduction (AR),
Intra uterine Insemination (IUI), Gamete Intra fallopian Tube Transfer (GIFTT), Testicular Sperm
Extraction (TSE), Embryo Cryopreservation (EC), Assisted Hatching (AH), Frozen Embryo
Transfer (FET), Surrogacy, Embryo Donation (ED) are the alternate names for In-vitro
fertilization.
The basic components of pregnancy are eggs which are finite. Follicle Stimulating Hormone
(FSH)is produced in the brain and control ovaries, if too much FSH is released it means more
eggs are produced withdrawing ovaries. After withdrawing of ovaries from eggs, the maturation
of eggs will be started, after maturation the released eggs are grown in follicle (small cyst) , and
eventually at the end one or two cells will survive the rest of them will die. Mature eggs in follicle
releases steroidal or estrogen hormones and when the level of estrogen increases, then the
brain will release Luteinizing Hormone (LH) to start the process of ovulation (fusion of sperm
and ovary to form embryo). If a patient has deficiency of these hormones then we gave him
drugs but if there is problem in ovulation then we go ahead and perform in-vitro fertilization.
Fertility drugs are given to the patient for e.g. clomid tablets. It helps in the increase of embryo
survival rate
Eggs can be extracted by two ways;
1. Through needle (without anesthesia).
2. Laparoscopy (by making small incision in the abdomen to extract eggs through fallopian
tube).
Mature eggs are extracted and sperms are inserted in it and then we wait for its growth. Some
cells will have sperms and others will not. The produced embryo will be inserted in the uterus.
On 25th july 1978 Lewis Brown was born by using IVF & he is the first test tube baby.
Ethical Issues:
1. Large numbers of embryos are transferred, only one or two cells grow.
2. The extra eggs are either free-zed used for research or they can be donated to someone.
3. Fertility of embryo through surrogacy is a major issue.
4. Multiple pregnancy is dangerous for physical and mental health of mother.
5. Population burden.
6. In divorce case the issue of orphan embryo arises.

ABORTION

The life of baby is dependent on her mother (US concept) so it is up to her whether to allow it or
not
Ethical Issues:
1. If the baby is grown for let say 6 months and it is found that the blood group doesn’t
match with her mother, in that case if the baby is aborted then the life of mother can be
saved, but if the life of mother is taken then the baby will die, so it is an ethical issue.
2. In case if the baby is found to have any abnormality or disease in future, then the ethical
issue is that whether to allow it or not.

Ethical Issues in Research

1. Therapeutic misconception (meaning not taking informed consent it is severe in post
disaster situation).
2. Privacy & confidentiality.
3. Study Design.
4. Independent Ethical Review.
5. Respect for Autonomy & Dignity.
6. Social Value of Research (research should be beneficial for the society).

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7. Scientific validity of Research.

8. Fair “Subjects” Selection. (Subjects should be selected without any preferences).
9. Risk and Benefit Ratio.
10. Standard of Care.
11. Socio Economic Deprivation.
12. Placebo.
13. Sharing of Result. (the results should be shared with the participants)
14. Veracity issues.
15. Sample storage.
16. Conflict of Interest.
17. Impact of research.
18. Fulfillment of rights and duties. (E.g. permitting withdrawal from research).

CHIMERA
It is a new technique where we take two embryos from four parents and fuse them
together; the individual which is formed that way is composed of cells with different embryonic
origins, and referred to as chimera. Chimera in plants occurs through grafting. In USA in 2004
they decided to fuse the embryo of human and chimpanzee to produce “Humanzae”, but it was
banned. In 2001 human neuron cells were inserted in mouse, that mouse was then used for the
research of human neuronal disease (Alzheimer & Parkinson). “Geep” was produced by
crossing sheep and goat. In 1953 a woman Mrs. MCK was born, containing 60% O blood group
and 40% A blood group, because two zygotes were fused during her birth process. Walls from
pig’s heart were inserted in human heart by using one of the applications of chimera. Quail brain
cells were inserted in chick. 1966 Chimeric mouse was produced by crossing two different mice.

Ethical Issues:
1. Un-natural way of reproduction.
2. Moral confusion.
3. It is contrary to human dignity.
4. Violation of integrity of species is involved.

Three parent baby

This is specifically used to cure mitochondrial genetic disease. This process is practiced in
animals only.
98% genetic material is from original and only 2% is from surrogate. Also other genetic disease
can be cured. Ethical issue is the death of original embryos.

Animal rights
Animal right is an idea that “Most basic interest of non-human beings should be afforded the
same consideration as the similar interest of human beings”
Why animal rights shouldn’t be there;
Divine Hierarchy:
The concept was given by Aristotle who said “Animals are classified as high level and low level
animals, and high level animals (humans) have the right to use them”
Another concept is that since animals have no duty so they have got no rights. According to
another philosopher Nicolas Malebranche “animals eat without pleasure cry without pain, grow
without knowing, desire nothing, fear nothing, and know nothing”.
For animal rights we follow two approaches:
1. Utilitarian, developed by peter singer (“animals are equal to human beings they feel
pleasure and suffer pain”).

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2. Contractualist, developed by Tom Regan (“Animals have inherent moral value that might
be less than humans”) he further defended his argument by saying that it just like
embryo have less right then baby, baby have less right then adult, and adult have less
right then Comatose.
There are two types of values:
1. Intrinsic value. (“Animals have their own rights for their own self”)
2. Instrumental Value. (“Animals have instrumental value we can use their rights for
someone else”).

Accepting Animal Rights means;

1. No experiments on animals.
2. No breeding and killing for food.
3. No use for cloths or medicine.
4. No use for hard labor.
5. No selected breeding other than for animal breeding.
6. No hunting.
7. No zoos.
Animal rights No Animal Rights
Animals have similar level of biological Animals do not think.
complexity, similar to human beings
(meaning microbes have no rights).
Animals are conscious and aware that Animals are not conscious in reality.
they exist.
Animals know what is happening to them. Animals are biological robots.
Perform some, and dislike other works. Put on earth to serve human.
Live as to give themselves the best quality of They are not members of social community.
life.
Can plane their lives. Lacking capacity of moral judgment, and
cannot enter into a social contract.

Animal Usage:
1. Transport.
2. Labor.
3. Food.
4. Textile.
5. Zoos (entertainment).
6. Research (13 million each year, including 90% rodents, mouse & rats etc).
7. We use animals because they have short life span.
8. Help to understand how our body works.
9. To find cure or treatment for disease.
10. Test new drugs for safety.
11. Animals may also have the benefit of research.
12. Finally we have no other choice of testing our drugs.

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Animals for research:

Rats & Rodents;
Diphtheria vaccine, Typhoid vaccine, fewer vaccine, me seals vaccine and cancer research
vaccines.
Cattles:
Small pox, organ transplantation, arthritis disease, Osteoporosis, HFM (Head, Foot &
Mouth) disease
Rabbits:
Rabies vaccine, cataract disease, Cholesterol Studies, ageing effect, drug metabolism
research
Dogs:
Insulin, cardiovascular research, digestion research, respiratory research, and anemia
therapy
Frogs, Fish, Reptiles & Birds;
Tetanus vaccines, Malaria research, Edema treatment (Diuretic drugs), cells chemistry
research and liver cancer research.
Non human Primates (Monkeys):
Polio vaccine, rubella vaccine, hepatitis vaccine, anesthesia disease research, me seal
research, AIDS research
Risk Benefit Ratio:
It the benefit ratio is high then research is considered to be ethical otherwise un-ethical.
Ethical Issues:
1. Aesthetics.
2. Hunting.
3. Animal fighting.
4. Animal zoos.
5. Artificial Insemination.
6. Cutting fro ears, tails, and horns fro rapid growth.
7. Vasectomy (removing protected reproductive organs from animals).
8. Heavy milk production.
9. Large growth.
10. Castration (removing reproductive organs without anesthesia).
11. Slamming of animals.
12. Giving CO2 in large cage.
13. Large size animals are hanged.
14. Those that survive are kept in narrow cages.
15. Chicks after hatching, they kill the male chicks by grinding to make animal feed, or they
are kept in plastic bags.
16. The beaks of female chicks are removed without anesthesia for their rapid growth; they
spend their live in cage without fresh water and light source.

Organ Donation/Organ Transplantation

It is the donation or transplantation of biological organs or tissues from living or dead person to
a living recipient. From dead person we can take organ within 24 hours of Excision. Cornea was
transplanted for the first time in 1905, then in 1954 kidneys were transplanted, Pancreases in
1966, heart in 1967, hands in 1998 and in 2008 a baby was born from a transplanted ovary.
TYPES;
1. Auto graft:
It means grafting of tissues in same person, e.g. Coronary Artery Bypass Surgery
CABG, plastic surgery and hair transplant.

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2. Allograft:
It is the transplantation within one species between two genetically non identical
members of same species.
3. Xeno-grafting:
It the transplantation between two different species like anima to man.
4. Split Transplantation:
In this type one organ is divided between two or more recipient.
5. Artificial Organ Transplantation:
Stems cells are treated with various growth factors which then develops into a specific
organ that could be transplanted then e.g. trachea was transplanted in 2011.
Cases in transplantation;
Opt In:
Anyone who has not given consent is a donor.
Opt Out;
Anyone who has not refused is a donor
Ethical Issues:
1. Definition of death.
2. When and how consent should be given.
3. Socio-Economic Disparity.
4. Organ trafficking.
5. Organ theft.
6. Commercialization.
7. Rejection by surrogate.
8. Organ shortage.
9. Distribution of organ.
10. Donor’s safety.
11. Xeno Transplantation.

Avoiding issues:
1. Animal organs.
2. Artificial transplantation.
3. Stem Cells.
4. Adult Abortion.

Human Genome Project

It was started in 1990 in USA. Attempt to analyze all human genomes. It was ended I 2003.it
was concluded that there are 25 to 30,000 genes in a human genome. Exact number is 23,000
genes, 3 billion base pairs. They are stored in data bases by using improved tools for data
analysis. Similarity, behavior and disease were studied by HGP.

Ethical Issue;
1. Who owns HGP?
2. Genetic test.
3. Fetus Genetic test.
4. Gender determination.

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Role of Ethics In Biotechnology:

Biotechnology is basically the field of life sciences that is involved with the studies of and
manipulation of living organisms, and development of new technologies for human benefit, so
biotechnology is basically the area of life sciences which offers new emerging technologies
based on living organisms. Today biotechnology is divided into four major categories namely;
industrial, medical, agricultural and marine biotechnology. The field of biotechnology has shown
significant amount of improvement in area of agriculture, medicine and industry. Genetically
modified crops has been developed by the use of agriculture biotechnology and the new drugs
and medicines have been introduced utilizing the technologies of medical biotechnology and
likewise “transgenic animals” are produced by industrial biotechnologists to enhance the yield of
commercial products.

Besides providing these marvelous benefits to mankind, this field like other developing
fields has raised some serious issues. Some of the ethical issues are as follows;

In the field of agricultural biotechnology genetically modified crops are cultivated by the
support of agrichemical industries, and these foods containing GM ingredients are not labeled to
indicate their origin, and the reason is that if a food is found to include chemicals that are toxin
or causing allergy, it is not marketed. Certain companies sold GM foods to the farmers that did
not produced viable seeds, forcing farmers to purchase new seeds each year. Due these vary
reasons there is an uncertainty among people about the cultivation and the use of GM crops.

In the area of health care and medical biotechnology, experiments and clinical trials are
conducted on participants to develop new treatments for disease. Participation in the clinical
trials of recombinant DNA drugs, or of gene therapy requires informed consent. A case in 1999
provoked re-evaluation of the adequacy of informed consent protocols, in which 19 years old
Jesse Gelsinger participated in an experiment of gene therapy to have his “Orithine
Transcarbamylase Deficiency” treated (the mentioned disorder causes the accumulation of
ammonia in the body and damages the brain) mostly affected individuals under this particular
condition die within the early days of their birth, but survivors can usually control the symptoms
with proper diet and drugs. Jesse had been doing that but died five days after receiving the
gene therapy treatment. His death was tragic fro the researchers.

There are several other issues like, test tube babies, production of pest resistant crops &
formation of transgenic animals rising serious questions about the ethical bases of these
procedures and experiments, and also about the possible consequences of these experiments,
so the researcher are now looking forward to solve these issues and practice biotechnology
ethically.

References:

http://www.bbc.co.uk/ethics/guide/
http://en.wikipedia.org/wiki/Bioethics
http://www.eubios.info/Papers/AGBIO.htm
http://www.actionbioscience.org/biotech/kolehmainen.html

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