Medical and Scientific Advance and Their Ethics.

General information:

● Medical advances -a significant breakthrough that results in an improvement of the

diagnosis, treatment, and prevention of disease.

● Scientific advances- generation or discovery of knowledge that advances the

understanding of science. It is the process of discovering new concepts and ideas that
lead to the development of new technologies and scientific theories.

● Example: Vaccinations, Anesthesia, Epidemiology (the study of patterns and cause of

disease in a population ), germ theory ( concept that germ causes diseases ), insulin, gene
therapy(introducing genetic material in cell to prevent or treat diseases), 3D printing,
telephones, photography, AI, organ transplants, Medical imaging etc…

● Importance:
- A significant turning point in the way diseases are diagnosed, treated, or
prevented has the potential to extend and save lives.
- Reduces the financial burden of disease and protects healthcare systems.
- increased accessibility of medical technology give patients the chance to treat
diseases at their onset, giving them a higher chance of successful recovery.
- provide more personalised care, convenient.
- Solve practical problems, Make informed decisions,Increase our fundamental
knowledge

● Ethical issues posed by:

- Genetic modification, xenotransplantation ( transferring cells, tissues, organs to different
species),organ transplant.

❖ Issues include: human right violation, animal right violation, increased

commercialisation, need to supply ratio, risk of failure, playing with spiritual
beliefs etc…

- AI

❖ Privacy, surveillance, bias, discrimination, Replacement of human works etc..

Facts: ( 10 - 15)
-Nearly 1,000 clinical trials testing gene therapies are ongoing, and the pace of clinical
development is likely to accelerate. (Looking forward 25 years: the future of medicine | Nature
Medicine)

-A number of deplorable abuses of human subjects in research, medical interventions without

informed consent, experimentation in concentration camps in World War II, along with salutary
advances in medicine and medical technology and societal changes, led to the rapid evolution of
bioethics. (Principles of Clinical Ethics and Their Application to Practice - PMC (nih.gov) )

- In modern times, Beauchamp and Childress' book on Principles of Biomedical Ethics is a

classic for its exposition of these 4 principles and their application, while also discussing
alternative approaches.

❖ The principle of beneficence is the obligation of physician to act for the benefit of the
patient and supports a number of moral rules to protect and defend the right of others,
prevent harm, remove conditions that will cause harm, help persons with disabilities, and
rescue persons in danger.
❖ Nonmaleficence is the obligation of a physician not to harm the patient.
❖ The philosophical underpinning for autonomy, as interpreted by philosophers Immanuel
Kant (1724–1804) and John Stuart Mill (1806–1873), and accepted as an ethical
principle, is that all persons have intrinsic and unconditional worth, and therefore, should
have the power to make rational decisions and moral choices, and each should be allowed
to exercise his or her capacity for self-determination .

( Principles of Clinical Ethics and Their Application to Practice - PMC (nih.gov))

- Using gene therapy, researchers were able to introduce a healthy copy of a disease-causing
gene and restore immune system function in children with a rare genetic disorder called severe
combined immunodeficiency, or SCID. In another study, researchers safely delivered gene
therapy to the brain to treat a debilitating neurological disease for which there are no effective
treatments.
- Scientists developed a device to decode brain activity into words in real time, allowing a person
with paralysis to communicate in complete sentences. Another system quickly translates brain
signals for imagined handwriting into text.

(2021 Research Highlights — Human Health Advances | National Institutes of Health (NIH))
-

Data/statistic: ( 15 -20)
-In recent decades, advances in technology and medicine have increased the life expectancy and
general health of people around the world. ( Global health - Statistics & Facts | Statista)

-Since 1900 the global average life expectancy has more than doubled and is now above 70
years.( Life Expectancy - Our World in Data)

-Also in 2019, the non-imaging diagnostics segment recorded 12.2% revenue growth, while the
therapeutic devices segment’s growth rate climbed to 12.5%. (EY, 2020).

-Around 39% of senior executives in MedTech companies consider supply chain technology
systems as a critical component of their operations. (Brandon Gaille, 2020)

- At least 85% of health executives acknowledge that technology has become an inextricable part
of the human experience and - Around 71% of health executives believe robotics will enable the
next generation of services in the physical world. (Accenture, 2020)

- At least 35% of consumers are willing to share data with medical device manufacturers.
Furthermore, 40% of patients are willing to share personal data for medical research. (Wolters
Kluwer, 2019)

- In general, 56% of consumers will share their personal and health data to help with disease
prevention, 45% to help the environment, 42% to help their community, 37% to help with
problems such as crimes, and 35% to increase transparency. (EY, 2020)
-A huge majority (88%) of medical technology executives rated advances in technology as a top
challenge, followed by policy and regulatory activity, and changes in consumer attitudes,
behaviours, and spending (63%). (Deloitte, 2020)

- Meanwhile, 70% of healthcare consumers are concerned about data privacy and commercial
tracking associated with their online activities, behaviours, location, and interests. (Accenture,
2020)

( 55 Interesting Medical Technology Statistics: 2023 Data on Companies & Usage -

Financesonline.com )

Research reports: ( 5-7)

- Unethical practices within medical research and publication – An exploratory study

(Unethical practices within medical research and publication – An exploratory study |

International Journal for Educational Integrity | Full Text (biomedcentral.com))

- Bio-Ethics and One Health: A Case Study Approach to Building Reflexive Govern

( Bio-Ethics and One Health: A Case Study Approach to Building Reflexive Governance
- PMC (nih.gov))

- Medical Ethics

(Medical Ethics | IntechOpen)

- The Ethics of Human Cloning and Stem Cell Research

( The Ethics of Human Cloning and Stem Cell Research - Markkula Center for Applied
Ethics (scu.edu))

Case study:(5-7)

- Sherley v. Sebelius : In 2008, The Department of Health and Human Services and the
National Institute of Health was sued after President Obama took away some of the more
 strict guidelines and rules on stem cell research that President George Bush had put into
place. It was decided in court that the NIH was following proper guidelines regarding
stem cell research and the Supreme Court rejected to hear an appeal. Stem cell research is
extremely controversial for many in the medical field because of the conflict of two very
separate beliefs.

- Tuskegee Syphilis Study:The Tuskegee Syphilis Study is an infamous clinical study

conducted by the U.S. Public Health Service to study the progression of untreated
syphilis in poor black men in Alabama. This experiment took place between 1932 and
1972 and tricked participants into thinking they were receiving free health care from the
government. The participants were unaware they would be infected with syphilis and left
untreated. After a leak to the press, the experiments stopped, the Office for Human
Research Protections was established, and federal laws were put in place that required
Institutional Review Boards for studies that involve human subjects.

(Five Historical Medical Ethic Cases - Minority Nurse)

- Dr.Sugandhan Selvendran vs The Registrar : Dr.Sugandhan was accused of unethical

acts agains which he has files a petition. According to code of medical ethic its not okay
for a physician to use himself/herself for any form of advertising, however, Dr.sugandhan
is accused of doing so in a site named “practo”.

(Dr.Sugandhan Selvendran v. The Registrar | Madras High Court | Judgment | Law |

CaseMine)

Testimonials: ( 5-7)
-Although it is difficult to pinpoint an exact value, it is safe to estimate that more than 250
patients have been treated with gene therapies for monogenic diseases for which there previously
were no treatment options. Add in the patients who have received CAR-T therapy, and that
number rises into the thousands. This is an enormous success, and it represents the beginning of
a fundamental shift in medicine away from treating symptoms of disease and toward treating
disease at its genetic roots. (Feng Zhang)

- “An ounce of prevention is worth a pound of cure.” (Benjamin Franklin )

- Any way you look at it, there are a number of concerns when it comes to medical
biotechnology, and as we continue to make advancements, these ethical considerations will have
to be made.( western governors university ).

-“Every human being of adult years and sound mind has a right to determine what shall be done
with his own body”(Justice Cardozo in 1914 )

(https://idp.nature.com/authorize?response_type=cookie&client_id=grover&redirect_uri=https
%3A%2F%2Fwww.nature.com%2Farticles%2Fs41591-019-0693-y)

Content related vocabulary:

Genetically Modified Organisms- A genetically modified organism (GMO) is an animal, plant,

or microbe whose DNA has been altered using genetic engineering techniques.

Stem cell - cells in the body that have the potential to develop into ‘specialised’ cell types.

Medical technology - refers to the products, services, or solutions used to diagnose, treat, or
improve a person’s health and wellbeing.

Articfical intelligence - the theory and development of computer systems able to perform tasks
normally requiring human intelligence.

Gene- a unit of heredity which is transferred from a parent to offspring and is held to determine
some characteristic of the offspring.

Customer privacy- protecting the personal information that customers supply to their financial service
providers
SOURCES TO BE REFERRED:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118276/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1084045/
3. https://www.wgu.edu/blog/medical-biotechnology-advancements-ethics1811.html#close
4. https://www.sciencedirect.com/topics/social-sciences/medical-ethics
5. https://www.sciencefocus.com/the-human-body/forbidden-medicine-what-do-we-do-when-
medical-breakthroughs-are-unethical
6. https://www.sandiego.edu/law/centers/chlpb/advances.php
7. https://www.aamc.org/news/5-medical-advances-will-change-patient-care

MEDICAL ADVANCES
● This is an example of an evidence created.

SCIENTIFIC ADVANCES
● This is another example

ETHICS OF MEDICINE AND SCIENTIFIC RESEARCH

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