Bioethics

Author(s): Lawrence Koehler

Source: Bios, Vol. 68, No. 3 (Sep., 1997), pp. 137-141
Published by: Beta Beta Beta Biological Society
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 Bios 137

THE EXECUTIVES' CORNER

Bioethics
BYLAWRENCEKOEHLER,PhD
Professor of Biology, Central Michigan University, Mt. Pleasant, MI
48859

Ethical concerns increasingly command the attention of biologists

and those in medical research and practice. Bioethics is a discipline
generally considered to deal with the study of value questions aris-
ing in biological research,biomedical research, and in the practice of
medicine. Bioethical concerns are not new or unique to our society.
Some of these concerns are expressed in the Hippocratic Oath, of
uncertain origin, but probably developed by a group of physicians in
Ancient Greece in the Fourth Century B.C. (Edelstein 1967). This
Oath requires that a physician "do no harm"in the practice of medi-
cine. Even though some scholars believe the Hippocratic Oath pro-
motes paternalism and contains many vague phrases, it has been
used by physicians as a summary of their sense of ethical obligations
for a number of years.
In modern times, one of the first major codes of medical ethics in
the Anglo-Saxon world appeared in the eighteenth century, as John
Gregorywrote Lectures on the Duties and Qualification of a Physi-
cian (Gregory1817). This ethical code was based on the philosoph-
ical thought of the day in Scotland, and was not based extensively on
the Hippocratic Oath. Probablythe most influential development of
this period was the result of Percival's Medical Ethics (Percival,
1803). The American Medical Association (AMA)developed its first
Code of Medical Ethics in 1847 (American Medical Association
1847). The AMA Code has been revised a number of times during the
last 150 years to reflect the current attitudes of society and of our
evolving technology (American Medical Association 1992).
As biologists we are faced with decisions involving ethical con-
siderations nearly on a daily basis. For a student, some of the ethical
considerations may be whether to cheat on an exam, to write your
own term paper, to get a paper from a friend, or to find a report on
the Internet and submit it as your work. Consideration may arise
while working on a research project (e.g., could you alter the data
just a little maybe just deleting a few measurements to make the data
fit the hypothesis a little better).For biologists, honesty and integrity
are important concerns. Certainly one can "cheat" a little and may
not always get caught, but we all know that is wrong. When a person
does an action they know to be wrong, they are harming themselves
and their own self esteem (perhaps even reducing the value of their

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138 Bios

education), but when one cheats as a biologist they are also doing
harm to science and to their discipline as biologists.
I believe that most biologists and scientists do not intentionally
commit fraud in their scientific endeavors, however it is evident that
the number of reported cases of fraud in science has increased in
recent years. Even though these cases implicate a very small percent
of the members of the scientific community, they tend to degrade the
confidence that the general public has in science.
Scientific fraud (misconduct) can be divided into two broad cat-
egories for consideration. The first I will call scientific negligence
and will consider this to be those instances where scientists have
provided erroneous information, but have not set out with the intent
to defraud. The scientist has no premeditated plans to be dishonest,
but the researcher is human and having human faults, may have
poorly designed the experiment (e.g., lack of necessary controls)
which may be the cause of the faulty information. A biologist devel-
oping a career is often under pressure to publish (we sometimes use
the expression "publish or perish") and to publish quickly, thus the
experiment may not have been repeated adequately.
The second category of scientific fraud I will call deliberate dis-
honesty and will include those instances in which a scientist does
acts he or she knows are wrong, generally for self-interest. Included
are acts such as forged or fabricated data, falsified or invented re-
sults, plagiarism, hoaxes, and other malicious acts. In recent years,
we have observed a number of such acts of deliberate dishonesty in
the scientific literature. As a result of these reports, the U.S. Gov-
ernment has held numerous hearings concerned with fraud in sci-
ence and who should "police" the actions of scientists.
Many news reports have recently focused on ethical concerns in
science and medicine. There is an increase in the number of publi-
cations devoted to bioethical issues, as well as a number of sites on
the World Wide Web where resources are available on topics con-
cerning bioethics. Why the increasing concern for bioethics? Are
there really any new concerns or just new applications of previously
expressed concerns? Perhaps the increased interest is a result of the
development of new technologies in research and medicine which
allow us to "manipulate" the processes of life; or perhaps the con-
cern is because of a number of high profile cases of scientific fraud
in the news. Perhaps we also are more aware of the value of scientific
knowledge to researchers and to society.
Do our concerns arise from a consideration of right vs wrong or
from a fear of the application of the scientific information? Not many
years ago, there was great concern for the modification of the genome
of a microorganism. Fear of the possibility of making a super bug
seemed to be one of the major concerns, while others were con-
cerned with the concept of introducing genetic material from one

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 Bios 139

species into another unrelated species. This marked the beginning of

producing genetically engineered organisms (transgenic organisms).
Today the first of these concerns seems to have been alleviated for
most people and many useful applications of genetically engineered
organisms have occurred. Many are still troubled with the ability to
modify an organism's genome by the introduction of genes from
another organism. When in vitro fertilization of a human oocyte was
first proposed, many were strongly opposed, again for fear of pro-
ducing many malformed babies. Now in vitro fertilization and even
sperm injection into an oocyte are commonly practiced without any
known increase in the percent of developmental anomalies.
A vast number of bioethical concerns are presented in the scien-
tific literature and by the popular news media nearly on a daily
basis. I will briefly mention a few of these concerns.
Authorship of scientific papers. Whose names should be on a
paper? As a student, you may do a research project under the super-
vision of a faculty member. Should their name be on the paper?
Should the faculty member or the student be the first author? How
many authors should a paper have? Some have as many as ten or
fifteen authors and one wonders if each made a significant contri-
bution to the research, or are resumes being enhanced? Many uni-
versities are developing guidelines concerning Intellectual Property
Rights to address some of the issues involving authorship of pub-
lished work and patent rights.
Autonomy. In therapeutic medicine one assumes that the "interest
of the patient" should be the primary consideration, but who decides
what is in the best interest of the patient? In other words, when does
the patient's autonomy take precedence? Does the patient decide on
the course of treatment or the physician? If a patient desires a treat-
ment that the physician believes is not appropriate, what is the re-
sponsibility of the physician to provide the treatment?
Right to Die. Does a patient have the right to decide when they
should die? If they do have this right, does the physician have an
obligation to assist them to achieve this action? A number of states
have had bills introduced which would legalize physician assisted
suicide by allowing the physician to write a prescription for a lethal
medication for a terminally ill patient.
Reproductive technologies. Biologists have developed a number
of methods to control the reproductive potential of animals includ-
ing humans. We have seen these techniques used to improve the
quality of our dairy cattle and to select the sex of the offspring in
cattle, thus increasing our milk and meat supply. We also see this
technology used to enhance the reproductive abilities of endangered
species of mammals. This technology can be used to promote family
planning and to give humans reproductive freedom. These tech-
niques are used to overcome cases of infertility in humans, to store

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140 Bios

sperm in sperm banks, or to preserve frozen fertilized eggs in liquid

nitrogen for later use. In the future, if we combine our knowledge of
genetics with our techniques of in vitro fertilization and transfer of
genetic material into an oocyte, we may have the potential to deter-
mine the traits of our offspring before implantation. There are many
major concerns with the use of technology to modify genes and
reproductive potential of humans, and that biological research is
providing the technology before society is able to adequately con-
sider the ramifications of the applications of the technology.
Cloning. Recently a sheep was cloned when a cell from the mam-
mary gland of a 6 year old ewe was cultured. When a nucleus was
removed from a cell of the culture and was transferred into an
enucleated unfertilized oocyte. Upon implantation of this egg into a
surrogate mother, a normal lamb was born which had the genetic
traits of the ewe from which the nucleus was obtained (Wilmut et al.
1997). This research certainly gives biologists a better understanding
of the role of the nucleus in development, which has been discussed
for years in developmental biology. The concern is that we now have
the potential to clone humans. Many reports in the current news
media present the ethical concerns and fears with application of this
ability. Questions asked include, just because we can, should we
clone a human? For what purpose would one clone a human? It
brings us to think about what it is to be a "human being" and to be
a genetically unique being. If we clone humans, then each human
will no longer be genetically unique. Would this be good or bad, and
why? What is the value of a "human life"?
Organ Transplantation. This is seemingly a straight forward pro-
cess in which one person (the donor) is providing a better life for
another person (the recipient) by providing an organ to that person
to replace a defective organ. The most common transplant is of a
kidney, where the donor has two functional organs and can function
normally with only one. So what is the problem with donating one
kidney to a relative or friend? Most people feel that this is a very
appropriate action, provided there is no coercion to make the dona-
tion. Now, how about selling a kidney to the highest bidder? Most
are entirely against the selling of organs or human body parts for
transplantation. Why? Recently the successful transplantation of a
portion of the liver from one person to another was performed and
both recovered very well. Many organ transplants occur when per-
sons are involved in fatal accidents, and their organs are still useful
and functional. There is a need for many more persons to designate
the use of their organs for transplantation and to let their relatives
know of their decisions before the accidents. A problem does occur
in the determination of the time of death and conflict arises between
the maintenance of the "organs" and the treatment of the patient
who is the potential donor. I will also mention xenotransplantation

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 Bios 141

in which organs are transplantedinto animals of another genus (e.g.,

the transplantation of a pig heart into a human). The organs of a
variety of animals can potentially be transplanted into humans,
sometimes on a temporarybasis, until a human replacement is avail-
able and if the immune system can be controlled to prevent rejection
on a long term basis. We must ask if it is morally right to transplant
organs of other animals into a human to maintain or prolong life.
Why is it right or wrong? Should biologists proceed with the devel-
opment of mechanical replacements, (e.g., artificial hearts)?
Bioethical considerations draw from the literaturein the biological
sciences, health professions, philosophy, religion, law, social sci-
ences, and from the currentnews media. Many people have concerns
with the use of biological and medical technology based on their
cultural and/or religious backgrounds.
The bioethical concerns are many and the list of issues is growing
daily. There are many issues that each of us, as biologists, must think
about and issues that will influence our decisions in our daily life as
well as in the development of our careers. Many colleges and uni-
versities currently offer bioethics courses, in departments of biology
or philosophy, that are designed to raise the awareness of the issues
and to give biologists and persons entering into health related pro-
fessions an opportunity to consider the concerns. Since the concerns
are becoming more complex, there are many scientists who are con-
sidering careers in which they will study the bioethical and medical
ethical decisions in our culture. Graduateprogramsin bioethics exist
at a number of universities. For a list of some of these programs,
point your browser to http://www.med.upenn.edu/Tbioethic/ and
follow the prompts.
The ability to think about issues of bioethics and to show respect
for all human life and the value of life sets us apart from the other
animals.

Literature Cited
American Medical Association (1848) Code or Medical Ethics: Adopted by the Ameri-
can Medical Association at Philadelphia. May, 1847 and by the New York Acad-
emy of Medicine in October, 1847. New York: H. Ludwig.
American Medical Association (1992) Council on Ethical and Judicial Affairs. Current
Opinions of the Council on Ethical and Judicial Affairs. Chicago: American Medi-
cal Association.
Edelstein, Ludwig (1967) "The Hippocratic Oath: Text, Translation and Interpreta-
tion." In Ancient Medicine: Selected Papers of Ludwig Edelstein. edited by Owsei
Temkin and C. Lilian Temkin, 3-64. Baltimore: Johns Hopkins Press.
Gregory, John (1817) Lectures on the Duties and Qualifications of a Physician. Phila-
delphia: M. Carey & Son.
Percival, Thomas (1927) Percival's Medical Ethics. 1803. Reprint. Edited by Chauncey
D. Leake. Baltimore: Williams & Wilkins.
Wilmut, I., A. E. Schnieke, J. McWhir, A. J. Kinde, & K. H. S. Campbell (1997) Viable
offspring derived from fetal and adult mammalian cells. Nature 385:810-813.

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