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Applying ethical frameworks to medical dilemmas, including patient rights and genetic engineering.
Imagine you have the power to delete a hereditary disease from your future child's DNA—but doing so might also change their personality or physical traits. Where do you draw the line between 'healing' and 'designing' a human being?
In the world of medicine, decisions aren't just about science; they are about values. To navigate complex dilemmas, bioethicists use the Four Pillars. First is Autonomy, the principle that patients have the right to make their own healthcare decisions. Second is Beneficence, the duty to act in the patient's best interest. Third is Non-maleficence, often summarized as 'First, do no harm.' Finally, Justice ensures that medical resources and treatments are distributed fairly across society. These pillars often conflict—for example, when a patient's autonomous choice to refuse treatment conflicts with a doctor's duty of beneficence.
1. A conscious, adult patient refuses a life-saving blood transfusion due to personal beliefs. 2. The doctor identifies the conflict: Autonomy (the patient's choice) vs. Beneficence (saving the patient's life). 3. In modern bioethics, the patient's Autonomy generally takes precedence, provided they are of sound mind.
Quick Check
Which pillar is most concerned with the fair distribution of a limited supply of vaccines?
Answer
Justice
CRISPR-Cas9 is a revolutionary tool that allows scientists to 'cut and paste' DNA sequences. While it offers the potential to cure diseases like sickle cell anemia, it raises massive ethical red flags. We distinguish between Somatic editing (fixing cells in an existing person) and Germline editing (changing embryos). Germline changes are heritable, meaning they affect all future generations. This creates a 'consent gap'—we are making choices for people who haven't been born yet. Furthermore, if only the wealthy can afford genetic 'enhancements,' we risk creating a biological class divide.
Consider two uses of CRISPR: 1. Therapy: Editing a gene to prevent a child from developing a fatal heart condition. (High Beneficence). 2. Enhancement: Editing a gene to increase a child's natural athletic endurance or IQ. (Potential violation of Justice and unknown Non-maleficence risks).
Quick Check
Why is germline editing considered more ethically complex than somatic editing?
Answer
Because germline edits are passed down to future generations who cannot give consent to the changes.
Two patients need one liver. Patient A is 20 years old with a 90% chance of a 60-year survival (). Patient B is 70 years old with a 70% chance of a 10-year survival (). 1. Calculate for A: . 2. Calculate for B: . 3. A Utilitarian framework chooses Patient A to maximize total 'life-years' saved, though an Egalitarian framework might suggest a lottery to ensure 'Justice' as fairness.
A doctor accidentally prescribes a medication that causes a severe allergic reaction. Which pillar was primarily failed?
If a researcher uses CRISPR to change the eye color of an embryo, this is an example of:
The calculation is a tool used primarily by Egalitarian ethical frameworks.
Review Tomorrow
In 24 hours, try to list the four pillars of bioethics from memory and define the difference between somatic and germline editing.
Practice Activity
Research the 'Tuskegee Syphilis Study' and identify which of the four pillars were violated during that historical event.