Medical Ethics: Cloning - Coursework Example

The American Heritage Dictionary defines cloning as to produce or grow a cell, group of cells, or organism from a single original cell and to make identical copies of a DNA sequence (1). Human cloning means the practice of creating or attempting to create human being by transferring the nucleus from a human cell from whatever source into a human egg cell from which the nucleus has been removed for the purpose of, or to implant, the resulting product to initiate a pregnancy that could result in a birth of a human being. There are several types of cloning procedures that have been practiced for quite some time, such as molecular cloning, cellular cloning, and different types of embryo cloning. Embryo cloning can be of three forms, namely blastomere separation, blastocyst division, and nuclear transfer. Dolly, the sheep cloned by Roslin Institute, was created by using a variant of nuclear transfer called somatic cell nuclear transfer technique (2). Briefly this procedure involves the nucleus of a mature, but unfertilized egg (recipient cell) being removed and replaced with a nucleus obtained from a specialized cell (donor cell) of an adult organism. This nucleus comes from a cell that has been forced into quiescent state to prevent it from replicating its DNA or dividing. The donor cell is arrested in an inactive state by culturing it with very few nutrients. The donor and the recipient cells are then fused together using a series of electrical pulses, which also simulate the activation signal that occur normally in fertilization, initiating embryonic development. The fused ‘embryo’ is then cultured in laboratory for about a week and is then transferred to a foster mother. It is not an embryo in its true form since it does not involve a fusion of an egg and a sperm. Since almost all the hereditary material of a cell is contained in the nucleus, the renucleated egg and the individual into whom that egg develops are genetically identical to the organism that was the source of the transferred nucleus. Societies around the world have indicated their belief that the early cloning experiments will breach a natural barrier that is moral in character. People object human cloning on the moral grounds that claim that no human being should be unnecessarily harmed, either during experimentation or by expectations after birth. Is it not a moral crime to bring children into being without the prospect of adequate physical or psychological support? Every two out of three Americans consider human cloning to be morally unacceptable. Ethical standards should define what ought to be done and what ought not to be done. The most urgent ethical issues about human cloning arise in the context and process that may lead to birth of first human clone. This is because early human experiments may lead to number of miscarriages, may be hundreds of abortions would be necessary, still births, or congenital defective births. The ethical considerations of human cloning are rooted in the potential risk to human beings and to the potential human beings. Many question the identity and individuality of the new born. One is attempting to protect a future potential person against harms that might be inflicted by their very existence. It is not ethical to spend billions of dollars in ‘making a baby’, one is not sure if it will survive or not. This money can come in handy to feed millions of children going to bed without food in continental Africa, most of who will not be alive to see the next day. If lesbians, gays and sterile parents need children, they can always adopt. Wouldn’t it be a bizarre prospect of a woman possibly giving birth to genetically identical copy of herself, her husband, or even her mother or father or son? Many people are repulsed by the prospect of mother-daughter or father-son twins! Many people fear if human cloning would be a miracle in disguise or an ominous new way to play God. Is man playing God? If everyone will try to re-produce their lost beloved ones, what happens to the nature’s law of death after birth? Will this planet survive the mass production of human beings; it is already over-populated? People fear the narcissistic attitude of those who will clone themselves and that humanity’s worst instinct will prey on these synthetic humans. Society fears that cloning would produce humanoids or androids; soulless replicas of human beings that could be used as slaves. But it should be noted here that people are confused with the popular meaning of cloning and the context of biology. (Brain cannot be cloned or duplicated from a DNA blueprint.) Thanks to science-fiction books and films. People fear that dictators will be cloned (movie Sleeper and Boys From Brazil), fully grown clones will have no emotions and they will be murderous zombies (movie Invasion of the Body Snatchers), and the scientist who clones a mammal will be killed by his own creation (movie Jurassic Park and Island of Dr. Moreau). Many in the general public in western nations identified the most important problem of cloning as whether a clone would have a soul, parents, dignity, autonomy, be able to choose their own destiny, parenthood or society in a world that includes clones. Some with little knowledge of mutation and aging believe that clones would appear normal at birth, but would reveal defects upon maturity. I personally believe that an entire human should not be cloned. However, cloning of human in parts may be beneficial to mankind. For example, it can be considered as a research tool to understand how genes can be switched off and on, growing new skin for burns patients, culturing bone marrow to treat cancers like leukemia, manipulating genes to cure sickle cell anemia and, may be treating infertility. If we stick to the definition of cloning as defined by American Heritage Dictionary, I am fine (1). I find entire human cloning as offensive, disgusting, grotesque, repulsive, and uncalled for. It is unethical because the procedures required to obtain oocyte and the transfer of the clone to uterus of foster mother-to-be is not without hazard. Survival of a species depends on genetic heterogeneity and Charles Darwin would have called it ‘unnatural evolution of man’. If some call it a true therapeutic, I think it as neither genuine medicine nor a scientific progress. Medicine should cure a defect or alleviate pathology, not just construct or replace an entire human being. A clone does not arise from a natural, religious, and social conception. There is no love involved in its making; it is just a scientific goal. If a father replaces a dead son, lost in a battle with his clone, will he look at him as same heroic, daring person or will his mind force him to think so? If so, is it fair to the cloned child? Cloning should not be an option to adoption; adoption has been and will be accepted by all. Homosexuals should adopt children if they want some. If things are scientifically possible, it may not always be morally admissible. Humans are moving ever closer to a posture of making babies, rather than having babies. Cloning, to me, represents a remarkable test of human restraint, wisdom and institutional development, but should not defy moral, ethical, social, and religious features of 21st century biotechnology. An essential element of good research is that it be done in an ethical manner, with careful planning and procedures to protect the individuals who participate. Studies should be designed and monitored to protect the physical and psychological well-being of participants. An example would be if the confidentiality of a participant were not respected, especially during studies examining such sensitive issues as STDs (including HIV/AIDS), domestic violence, or sexual behavior and preferences. Such disclosure could expose participants to social stigma, job loss, or even violence and death (3). Research participants expect and deserve respect, beneficence, and justice. In the United States, these principles were articulated in 1976 by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (4). People who volunteer for research should be treated as autonomous agents – people who have self-rule. And people who have diminished self-rule due to age, marital status, mental or physical impairment, lack of education, incarceration, or financial instability are entitled to additional precautions. Beneficence is a term that typically describes acts of kindness or charity, but is used in a stronger sense when guiding the ethical design of research. In the context of research on humans, "beneficence" is a strict obligation to maximize possible benefits and to minimize possible harm to participants. Justice weighs such questions as who will benefit from the research and who will bear its burdens. Scientists are called upon to design studies that distribute equally the risks and benefits that participation in the research would bring. Justice mandates that research not be done on disadvantaged or vulnerable people in order to benefit the privileged. The Tuskegee Syphilis Study Tuskegee Syphilis Study of 1928 is one of the most horrendous and notorious examples of research carried out in disregard of basic ethical principles of moral conduct. It is an example of prolonged and knowing violations of the right of a vulnerable group of research participants. The study was carried out by the US Public Health Service (PHS). Tuskegee institute was chosen because it had a history of service to African Americans. The aim of the study was to examine the natural history of untreated syphilis, the title I assume would have been something to this effect: ‘A prospective study on the effects of UNTREATED latent syphilis on living subjects’. Over 400 black men with syphilis and about 200 men without syphilis, who served as control, were the subjects. During the study, the men were told they were being treated for “Bad Blood”. At the time of the project, the African Americans had almost no access to medical care, for some this was the first medical examination. The subjects were promised free health examinations, food and transport. Burial stipends were promised to family members in exchange of autopsies on the study participants (5). The unethical part of the study was that none of the participants were recruited by informed consent; none were told that they were infected with syphilis. They were either not treated or were treated at a level that was judged to be insufficient to cure the disease. The spinal taps were misinformed as “special free treatment”. During the study, the participants were not only denied treatment but PHS prevented other agencies from supplying treatment. The PHS began to administer penicillin to patients with syphilis in 1943, but this study subjects were excluded until 1970. The director of the Venereal Diseases unit of the PHS from 1943-1948 remarked the following about the study: “The men’s status did not warrant ethical debate. They were subjects, not patients; clinical material, not sick people” (p. 179) (5) The Jewish Chronic Disease Hospital Study of 1963 In 1963, studies were undertaken at New Yorks Jewish Chronic Disease Hospital to understand whether the bodys inability to reject cancer cells was due to cancer or debilitation or in other words to develop information on the human transplant rejection process.  The rational of the study was based on previous studies that indicated that healthy persons reject cancer cells faster, and the researchers supposedly believed that the debilitated patients would also reject the cancers but at a substantially slower rate when compared to healthy participants. Patients with widespread cancer also reject homografts, however, rejection is delayed substantially when compared with healthy individuals. These studies involved the injection of foreign, live cancer cells into 22 senile patients who were hospitalized with various chronic debilitating diseases.  Patients were not informed that they would receive cancer cells because the researchers felt it would unnecessarily frighten them.  Researchers defended this view by saying that the cancer cells were going to be rejected anyways. Unethical issues of the study were that oral consent was taken, but not documented. The study had not been presented to the hospitals research committee and that the physicians responsible for the patients care had not been consulted. The researches assumed that the cancerous cells would be rejected in all individuals, without any proof thereof. Two of the physicians responsible for the research were put on probation for a year. Three years later, despite these sanctions, one of the researchers was elected president of the American Association for Cancer Research. The ethical principles of respect for persons, beneficence, and justice were violated in this case (6) Use of consent form is essential when human beings are involved in the research. This tells the individual, what really he/she is getting into. By voluntarily signing the form, the researchers are satisfied that the participant is mentally competent. Just because the to-be-participant is available and vulnerable either by reason of infirmity or because they are already residing in an hospital, should not naturally make them subjects or participants. The consent forms make this view clear. Consent form protects the vulnerable from unethical research. These forms also tell the participant that they can refuse such treatments, and that there is subtle suggestion that treatment would be withdrawn or terminated if consent was not obliging. A good consent form should provide for the participant’s autonomy, benefits, justice and that they will be compensated or not for any injury. The purpose of the study tells the participant what is being studied, what the study is designed to discover or establish and why the participant was selected. Who will use, disclose or receive the data, should also be made clear to the participants. It should clearly mention the duration of the study and if it has any washout period and follow up periods. Also it should clearly mention what is experimental in this study, the purpose(s) of the procedures, how often each procedure will be done and how long it is expected to take, if there is any invasive procedure, how much blood will be drawn or if tissue samples will be sent outside the said facility. List of all the risks of the treatment or the invasive procedures should be clearly mentioned to the participants. The form should notify if the protocol includes gene transfer, or if the samples in study will be used for genetic testing or if future research on samples will include genetic testing. The participant should know if the test results will be available to them or not. The discomforts and inconveniences reasonably expected should be informed including the inconvenience of travel. Guarantee or promises of benefits from the research should be clearly mentioned in the form. It should be clearly stated if the participant will be paid for participating in the research study, including the amount of payment, if any, and the schedule of payment. A statement of any anticipated prorated payments to the participant must also be made. The Experimental Subject’s Bill of Rights should be on the form and be read to the participant. (7) It is essential to safeguard his/her past, present and future from autonomy, confidentiality and general well being point of view. The participant should be self satisfied that his/her contribution to medicine is going to be used for the benefit of mankind, if not theirs alone. Works Cited 1. "cloning." The American Heritage® Science Dictionary. Houghton Mifflin Company. 11 May 2010. 2. Campbell KH, Alberio R, Choi I, Fisher P, Kelly RD, Lee JH, Maalouf W.Cloning: eight years after Dolly. Reprod Domest Anim. 2005 Aug;40(4):256-68. 3. Guenter D, Esparza J, Macklin R. Ethical considerations in international HIV vaccine trials: summary of a consultative process conducted by the Joint United Nations Programme on HIV/AIDS (UNAIDS). J Med Ethics. 2000;26(1):38. 4. National Commission for the Protection of Human Subjects of Research. Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. U.S. Department of Health, Education, and Welfare, Office of the Secretary, 1978. Web. 5. Jones, J.. Bad blood: The Tuskegee syphilis experiment: A tragedy of race and medicine. NY: The Free Press. 1981. Print 6. Katz, J. Experimentation with Human Beings. New York: Russell Sage Foundation. 1972. Print 7. Human Subject’s Research. Medical – Consent. Web. 11 Apr 2010. Read More