Fetal research and organ transplant, Psychopharmacology, Psychosurgery and behaviour control

Sunday Asuke

Community Medicine and Primary Health care

Bingham University

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8/19/2021

Introduction

• Rapid development of Science and Technology creates the era of new biotechnological advances.
• Every aspect of human life is directly affected by the development of science and technology.
• People search answers and solutions for issues and problems they suffer.
• Ultimate answers and solutions may create controversial facts.
• In that case , ethics appears.

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Introduction -2

• Seeking solutions for degenerative diseases. Parkinson's Disease Multiple Sclerosis Myocardial Infarction etc….
• Embryo Research ,mainly “Stem cell therapy” could alleviate or even cure some of these diseases.
• But unfortunately, harvesting of stem cells destroys the embryo, which has the ability to develop into a perfect animal

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Ethical Issues for Gene Therapy and Genetic Engineering

• Safety (non-maleficence)
• Efficacy (beneficence)
• Informed consent (autonomy)
• Allocation of resources (justice)

(Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology 144,168-172 (1997)

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History of Human Embryonic Stem Cell Research

• 1954 – John Enders received a Nobel prize in Medicine for growing polio virus in human embryonic kidney cells
• In 1998, James Thomson (University of Wisconsin-Madison) isolated cells from the inner cell mass of the early embryo, and developed the first human embryonic stem cell lines.
• In 1998, John Gearhart (Johns Hopkins University) derived human embryonic germ cells from cells in fetal gonadal tissue (primordial germ cells).
• Pluripotent stem cell “lines” were developed from both sources

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Organ donation

• For some patients , e.g. those with liver failure, no treatment can save the organ
• The only option is a transplant to save their life
• Organs can be taken from living donors, such as a family member, or those who are recently deceased and registered to donate their organs
• Tissues such as Heart, lungs, two kidneys, pancreas, liver and small bowel can be donated
• Others are skin, bone, heart valves, tendons and cartilage can also be used – hand & face transplant

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Presumed consent debate

• In England in order to be an organ donor you have to sign up to the organ donor register.
• This is called opt-in
• In Spain the system is opt-out

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STEM CELL (DEFINITION)

• A cell that has the ability to continuously divide and differentiate (develop) into various other kind(s) of cells/tissues.
• Stem cells are primitive cells with the capacity to divide and give rise to more identical stem cells or to specialize and form specific cells or somatic tissues. (Wert and Mummery,2003)
• First isolated in 1998.

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Totipotent stem cells

• Has the potential to give rise to any and all human cells.
• Pluripotent stem cells- can give rise to all tissue types but cannot give rise to an entire organism.
• Multi potent stem cells-give rise to limited range of cells within a tissue type. Much more differentiated.
• Adult stem cells- used to replace cells that have died or lost function.
• It renews it self and can specialize to yield all cell types present in the tissue from which it originated

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Cloning

• A clone is, “ a group of cells or an individual organism or group of organisms derived from a single cell. Thus a bacterial colony is a clone, as are identical twin human beings.”
• Types of Cloning
• Reproductive Cloning: The generation of a new animal that has the same nuclear DNA as a previously existing animal
• Therapeutic cloning-Uses the process of nuclear somatic transfer to create an embryo.

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Major ethical issues in Human cloning

• Clones are worse in terms of wellbeing, especially psychological wellbeing.
• There are safety concerns, especially an increased risk of serious genetic malformation, cancer and shortened lifespan.
• Threatening the stability of the family.
• Can diminish our respect for human life
• Freedom to make personal reproductive choices.
• Freedom of scientific enquiry.

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Major ethical issues in Human cloning-2

• Achieving a sense of immortality.
• Eugenic selection.
• Social utility- cloning socially important people
• Treatment of infertility.
• Replacement of a loved dead relative.
• Insurance

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Possible Uses of Stem Cell Technology

• Replaceable tissues/organs
• Repair of defective cell types
• Delivery of genetic therapies
• Delivery of chemotherapeutic agents

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Psychopharmacology

• Is the study of how drugs affect behavior.
• If a drug changes your perception, or the way you feel or think, the drug exerts effects on your brain and nervous system

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Psychopharmacology-2

• We call drugs that change the way you think or feel psychoactive or psychotropic drugs, and almost everyone has used a psychoactive drug at some point (e.g., caffeine counts)

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Neurotransmitters used for psychopharmacological treatment and drugs of abuse

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Controversial Issues related to�Juveniles and Psychopharmacology�

• Many psychotropic drugs used for treating psychiatric disorders have been tested in adults
• However, only few have been tested for safety or efficacy with children or adolescents
• Less is known about the safety and efficacy in young populations who use these drugs typically prescribed for treating anxiety, depression, or other psychiatric disorders
• Some scientists, fear that drugs that alter neuronal activity in the developing brain could have significant consequences

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Ethical Issues related to�Juveniles and Psychopharmacology�

• There is an obvious need for clinical trials in children and adolescents to test the safety and effectiveness of many of these drugs
• who decides what children and adolescents will participate in these clinical trials, who can give consent, who receives reimbursements, etc.?

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Elderly and Psychopharmacology

• A population that has not typically been included in clinical trials to determine the safety or effectiveness of psychotropic drugs is the elderly.
• Currently, there is very little high-quality evidence to guide prescribing for older people
• The elderly person can get dizzy from too much of a drug and fall (breaking bones).
• There is also evidence that psychotropic medications can reduce bone density
• Current awareness about some of the issues facing pharmacotherapy in older populations, reveals that it is a complex area with many medical and ethical questions.

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psychosurgery

• Control or alteration of human behavior by the deliberate use of technology
• lobotomy is the technical process of cutting into or across a lobe of the brain, especially in order to modify or eliminate some functions associated with a mental disorder.
• It involves a surgical removal or destruction of a brain tissue for the purpose of altering behavior, moods, or mental states

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Psychosurgery-2

• CINGULOTRACTOMY is a procedure used to treat depressive-anxiety states, obsessional neuroses that have not responded to other treatments.
• THALAMOTOMY is a procedure in which parts of the thalamus are surgically severed or destroyed.
• AMYGDALATOMY is a procedure in which the parts of the amygdaloid body are destroyed in a carefully controlled manner
• It is a type of chemo-technology in which chemical drugs are used for behavior control (various kinds of mood and thought disorders)

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Ethical issues in Psychosurgery

• We all have a duty to preserve our lives
• We also have to risk them in such situations as in agreeing to abide by the outcome of a random procedure to decide who will get medical aid and who should not
• The principles of justice would rule out the distribution of resources based on social worth.
• Whatever benefits are available, must be of value to all and open to all.

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Thank you for listening

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