Medical Ethics Lecture 8

Medical Ethics - Lecture 8

• Fictional Scenario: A 2044 scenario presented an ethical dilemma regarding the addition of "Krypton" to the water supply in 2006, intended to strengthen teeth.
• Adverse Effects: Initial small-scale trials were successful, but later, a "Krypton-Associated Pancreatic Disease" (KAPD) emerged. KAPD caused severe damage to pancreatic cells, leading to malnutrition, diabetes, and gastrointestinal issues.
• Affected Population: Primarily affected 16-17 year olds (1 in 100).
• Resolution: The government removed "Krypton" from the water supply after realizing the harmful effects.

Ethical Considerations

• Animal Research: The use of frozen pig pancreatic cells ("Pork One") raised ethical questions about animal research, particularly regarding the ethics of using tissue frozen for 50 years.
• Alternative Models: The discussion highlighted the need to consider alternative research models, such as human cells or human clinical trials, when possible.

Ethical Questions and Polls

• Pig Cell Research: A majority of students agreed that using pig cells was ethically acceptable for research.
• Alternative Approaches: The discussion explored alternative approaches (like using human pancreas cells, live pigs or even prisoners for research). Human pancreas, however, self-digests rapidly after removal.

Human Fatalities

• KAPD: The scenario evolved to include human fatalities related to KAPD by 2024.
• Genetic Mutations: Samples from deceased patients showed genetic mutations in the MHC (Major Histocompatibility Complex) gene as a key aspect of the disease.
• Autoimmune Destruction: Increased MHC expression led to autoimmune destruction of pancreatic cells and brain damage.

Genetic Screening

• Implications: A screening program for 12-year-olds was initiated to identify defective MHC genes.
• Disease Progression Prevention: Treatment was proposed to prevent disease progression.
• Parental Consent: A poll question highlighted the debate around genetic screening, with the majority agreeing that parental consent should be required.

Brain-Related Effects

• Locked-In Syndrome: The scenario noted the observation of "Locked-in Syndrome" in patients due to damage to the brain's reticular formation, with no recovery reported.
• Life Support: Discussion centered around the ethical question of whether life support should be continued indefinitely for patients in locked-in syndrome or if a time limit should be considered.
• Treatments: The scenario discussed potential treatments, acknowledging the hurdles or difficulties like crossing the blood-brain barrier posed by drug therapy or targeting genetic DNA.

###Key Takeaways

• Ethical Dilemmas: The lecture highlighted inherent ethical dilemmas in medical sciences.
• Students' Roles: Students were encouraged to critically assess ethical issues, ask clarifying questions and consider the broader implications of their future medical practices.
• Exam Exclusion: The fictional scenario would not be on the exam.