Segregation of Bioethics in Medical Research

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In German concentration camps, Jewish prisoners or captured soldiers of the Soviet Union would be put into chambers of low pressure to study the effects of aviation in the stratosphere on young men to learn how pilots can survive in high altitudes. (USA, 2000). Other unethical Nazi experiments included testing deadly drugs on healthy people, infecting them with plagues and conducting dissections to understand the mechanism of the body to produce antidotes exclusive for the German population. (Tyson, 2000).

Along with unethical experiments conducted in Nazi Germany, Japanese medical research centre Unit 731 is also infamously known for its notorious, lethal human experimentations. Shiro Ishii, leader of the biological warfare research centre formed Unit 731 after he got impressed by the successful German use of chlorine gas at the second battle of Ypres. (Harris, 1994). A Chinese province, Manchuria, was once sprayed with cholera by Japanese airplanes so physicians could later examine bodies of the dead and the sick. Instead of being tried on war crimes in the Nuremberg Trials, researchers of Unit 731 were granted immunity by the US in exchange of the information gathered through human experimentations. (Harris, 1994)

Unethical medical experimentation and research has still been an ongoing issue post World War Two. U.S. Public Health Service conducted the Tuskegee Study of Untreated Syphilis in the negro male population between 1932 and 1972. The disease is caused by bacterial infection which spreads by sexual contact. (Thomas & Crouse, 1997). The research was unethical as the men were unaware that data could only be obtained through their autopsies, hence they were left to degenerate and face mortality. Another unethical medical experimentation was executed by a pharmaceutical company called Distillers that tested their drug thalidomide, Distaval on pregnant Australian women in 1960 through trials in several Australian hospitals. Pregnant Australian women were used as guinea pigs to determine the effect of thalidomide on foetuses. In 1961, malformed babies were born in Australia. An executive of the pharmaceutical company confirmed in 1962 that “no tests were carried out in pregnant animals before Distaval was marketed”. (Mckenzie, n.d.)

The history is full of instances where bioethics was segregated from medical research as “scientific results” were valued more than morals and human rights. In the Nuremberg Trials, Taylor also pointed out that the Nazi physicians must be strictly punished as they had sworn to “do no harm” and abide by the Hippocratic Oath. (Evelyne Shuster, 1997). Interestingly, an anonymous survey conducted in Adelaide in 2017 shows that 62.26% of the sample population believe that it is not ethical to use information gained from unethical experiments, as seen in Figure 2. (Ansari, 2017)[pic 4]

Figure 2: using data derived from unethical experiments (Ansari, 2017)

A comment on the survey that recurred several times was that “using information gained from unethical experiments causes medical dignity to fall and encourages such immoral activities”. (Ansari, 2017)

Current Bioethical Issues

In a globalising age of technological developments, cosmetic surgery and integrative medicine, bioethics is much relevant than ever before. (Sokol, 2008). However, with advancements and revolutions in science comes innominate ethical issues. Current bioethical issues revolve around the development of new technologies such as cloning and genetic engineering. Older issues that continues to remain a controversial topic is the legalisation of euthanasia. With advancement in medical research, it is important to understand whether bioethics remains integrated or gets segregated.

There are two types of cloning – therapeutic or reproductive. Therapeutic cloning involves duplicating human cells to create tissues and organs by first creating stem cells. Stem cells are derived from a three to five days old human embryo, an unborn offspring. Reproductive cloning is to produce human clones with the exact genes of a parent, meaning that the clone would be biologically and physically identical to the adult cloned. (Enescu Aurelia MD, 2011). Due to the low success rate in reproductive cloning and the opposing religious views on the morality of cloning, it has been banned in 23 countries which shows that bioethics still plays an important role. Figure 3 shows that 62.26% of the sample population that participated in an Adelaide survey, deem cloning as unethical. (Ansari, 2017).

Figure 3: Opinions on human cloning (Ansari, 2017)[pic 5]

An anonymous respondent commented “humans should not play God”, showing how bioethics and religion are intertwined and complement each other. (Ansari, 2017).

Similar responses were gained when asked about human genetic engineering, where the majority of the respondents deemed this medical advancement as unethical because developing a perfect human race would “eliminate the flaws in humanity”. (Ansari, 2017).

Most of the participants also believe that euthanasia; a painless method of ending one’s life when no cure is available; should be legalised, as seen in Figure 4. (Ansari, 2017).[pic 6]

Figure 4: Legalising euthanasia (Ansari, 2017)

Tara Mapes, a postgraduate in Humanities and Philosophy, believes that it is “hypocritical of the government to delegalize euthanasia when they encourage freedom of choice and human rights”. (Mapes, 2017).

Euthanasia is clearly a heavily debated topic as it contradicts the Hippocratic Oath which instructs physicians to “not give a drug that is deadly to anyone if asked”. (Gordon, 1996).

Current issues in medical research have had a big influence of bioethics, hence most nations prohibit the use of these advanced medical technologies such as cloning and genetic engineering. Euthanasia, however is considered ethical by most of the survey participants as “it relives the pain of a person” (Ansari, 2017), yet it is banned in all but eight countries, excluding some U.S. states and Northern Territory in Australia. Religion is one of the main contributors in the banning of euthanasia, as most “religions forbid mercy-killing”. (Mapes, 2017).

Conclusion

Bioethics assists medical researchers to conduct ethically and in accordance with basic human morals. However, medical history is full of unethical experimentations, which resulted in the creation of ethical guidelines such as The Nuremberg Code, The Declaration of Helsinki and The Belmont