|
Register | Sign In |
|
QuickSearch
Thread ▼ Details |
Member (Idle past 2520 days) Posts: 2965 From: Los Angeles, CA USA Joined: |
|
Thread Info
|
|
|
Author | Topic: Playing God with Neanderthals | |||||||||||||||||||
Perdition Member (Idle past 3266 days) Posts: 1593 From: Wisconsin Joined: |
But surely if the patient is terminally ill the concept of risk (re:life) is somewhat mute? That's sort of the 'House' philosophy. If they're dead anyway, and this might help them, that would seem to be a better course. I would agree.
|
|||||||||||||||||||
Taq Member Posts: 10084 Joined: Member Rating: 5.1 |
But surely if the patient is terminally ill the concept of risk (re:life) is somewhat mute? You still run the risk of increasing pain and suffering as well as taking away time that the patient has very little left of. All of these factors are weighed when testing highly experimental drugs in terminally ill patients.
Isn't it 'better' to perform the trial on a living being capable of engaging in a conversation on the pros and cons, rather than forcing the test on a living being that is incapable of understanding what is going on, much less give consent. That is certainly worth discussing. For non-humans we do not look at it in terms of consent since none can be given. Instead, the use of animals is justified by the knowledge that can be gained in the experiments. Those justifications are reviewed by various independent committees usually called Institutional Review Boards (IRB's). At least in the US, an IRB is required to have at leats one person from the community on the board with voting power. We have a pastor from a local church on our IRB. The IRB reviews the animal protocols for adherence to regulations as well as judging whether or not the suffering and/or death of the animals is justified by the knowledge that the experiments will uncover. They also look at the experimental protocols to see if suffering is kept to a minimum. This same IRB also reviews experiments that involve humans. Do you think this should be approached differently? If so, how?
|
|||||||||||||||||||
Dr Adequate Member (Idle past 312 days) Posts: 16113 Joined: |
Don't know if you are familiar with Dr Who (UK sci-fi TV series), but they have a race called the Daleks who were created for ethnic cleansing ... then decided that only Dalek's ahd any worth and so set out to destroy all other life in the Universe. Kind of an extreme response to worth=similarity, but extremes often expose issues within a premise. Well, of course it depends what similarities we choose. But there will normally be some. It is certainly true that I could in principle afford rights arbitrarily --- randomly granting them to John, Henry, and Peter while withholding them from James, Tony, and Bill --- but in practice people will grant rights to members of a natural class (by which I mean one defined by a simple criterion). These will necessarily have something in common, which is what makes them members of a natural class. Then if I think that I should have these rights (and again, though in principle I might not, in practice I will) then they must all have something in common with me that makes them and me all members of this class. Edited by Dr Adequate, : No reason given.
|
|||||||||||||||||||
Peter Member (Idle past 1507 days) Posts: 2161 From: Cambridgeshire, UK. Joined: |
So it all becomes a question of where in our hierarchy of attributes we start our comparison, and how deep we go before we stop ... ?
|
|||||||||||||||||||
Peter Member (Idle past 1507 days) Posts: 2161 From: Cambridgeshire, UK. Joined: |
Taq writes: But surely if the patient is terminally ill the concept of risk (re:life) is somewhat mute? You still run the risk of increasing pain and suffering as well as taking away time that the patient has very little left of. All of these factors are weighed when testing highly experimental drugs in terminally ill patients.
Isn't it 'better' to perform the trial on a living being capable of engaging in a conversation on the pros and cons, rather than forcing the test on a living being that is incapable of understanding what is going on, much less give consent. That is certainly worth discussing. For non-humans we do not look at it in terms of consent since none can be given. Instead, the use of animals is justified by the knowledge that can be gained in the experiments. Those justifications are reviewed by various independent committees usually called Institutional Review Boards (IRB's). At least in the US, an IRB is required to have at leats one person from the community on the board with voting power. We have a pastor from a local church on our IRB. The IRB reviews the animal protocols for adherence to regulations as well as judging whether or not the suffering and/or death of the animals is justified by the knowledge that the experiments will uncover. They also look at the experimental protocols to see if suffering is kept to a minimum. This same IRB also reviews experiments that involve humans. Do you think this should be approached differently? If so, how? If there is an acceptance that suffering may occur (which appears to be the case from your description) then that could, I would have thought, be discussed with individuals who stand a chance of benefitting. So long as everyone (relative included) enters into it with eyes wide open why would there be a problem? I can understand in instances where the aim is to relieve non-terminal suffering that the situation may be a different, but when considering terminal conditions I don't understand why there would be an objection. Unless it comes back to the squeemishness of experimenting on people in general. I've never been one for 'animal rights' in the sense of protesting experimentation or becoming vegan, but it still seems somehow wrong to me to favour experimenting on a creature that cannot give consent (but may at some level understand what is happening to it, and certainly suffer as a consequence) over human testing on consenting subjects. The bias (possibly wrong word) away from human testing seems somehow counter-intuitive to me.
|
|||||||||||||||||||
Taq Member Posts: 10084 Joined: Member Rating: 5.1 |
If there is an acceptance that suffering may occur (which appears to be the case from your description) then that could, I would have thought, be discussed with individuals who stand a chance of benefitting. So long as everyone (relative included) enters into it with eyes wide open why would there be a problem? Like I said above, there is the Hippocratic Oath to consider. The first rule of Doctor Club is "do no harm". The second rule of Doctor Club . . . well, you get the idea. Secondly, terminally ill patients are not as objective about the risks. I am not saying that this type of testing should not occur. In fact, this type of testing has been done and is being done in very limited clinical trials. What I am saying is that you have to be very, very careful in how these trials are conducted and in how you get consent to run these experiments. If at all possible, these types of studies should be avoided. From my understanding, a drug has to at least show promise in animal studies before it can be considered for these types of clinical trials in terminally ill patients, even if that drug has unknown or even known toxicity in animal or human models.
I've never been one for 'animal rights' in the sense of protesting experimentation or becoming vegan, but it still seems somehow wrong to me to favour experimenting on a creature that cannot give consent (but may at some level understand what is happening to it, and certainly suffer as a consequence) over human testing on consenting subjects. The bias (possibly wrong word) away from human testing seems somehow counter-intuitive to me. Bias is the right word. There is a bias towards non-primate species in animal testing. What sane, non-terminally ill human would consent to a study that might kill them or cause permanent damage? I think it is immoral to even ask people to participate in such a study, especially when the good data can be acquired through animal studies. There are even experiments where the subject is expected to suffer and/or die, such as finding the right dose of antibiotics for fighting massive infections.
|
|||||||||||||||||||
Peter Member (Idle past 1507 days) Posts: 2161 From: Cambridgeshire, UK. Joined: |
Taq writes: If there is an acceptance that suffering may occur (which appears to be the case from your description) then that could, I would have thought, be discussed with individuals who stand a chance of benefitting. So long as everyone (relative included) enters into it with eyes wide open why would there be a problem? Like I said above, there is the Hippocratic Oath to consider. The first rule of Doctor Club is "do no harm". The second rule of Doctor Club . . . well, you get the idea. Secondly, terminally ill patients are not as objective about the risks. I am not saying that this type of testing should not occur. In fact, this type of testing has been done and is being done in very limited clinical trials. What I am saying is that you have to be very, very careful in how these trials are conducted and in how you get consent to run these experiments. If at all possible, these types of studies should be avoided. From my understanding, a drug has to at least show promise in animal studies before it can be considered for these types of clinical trials in terminally ill patients, even if that drug has unknown or even known toxicity in animal or human models.
I've never been one for 'animal rights' in the sense of protesting experimentation or becoming vegan, but it still seems somehow wrong to me to favour experimenting on a creature that cannot give consent (but may at some level understand what is happening to it, and certainly suffer as a consequence) over human testing on consenting subjects. The bias (possibly wrong word) away from human testing seems somehow counter-intuitive to me. Bias is the right word. There is a bias towards non-primate species in animal testing. What sane, non-terminally ill human would consent to a study that might kill them or cause permanent damage? I think it is immoral to even ask people to participate in such a study, especially when the good data can be acquired through animal studies. There are even experiments where the subject is expected to suffer and/or die, such as finding the right dose of antibiotics for fighting massive infections. Human trials happen that Do cause permanent injury and death though ... and all the pre-testing gives the subjects a false sense of security. There's also financial inducement in some of those trials (in the UK anyhow) -- which is probably just as much a way of skewing the informedness of the consent as being terminally ill. I do see the point though ...
|
|||||||||||||||||||
Taq Member Posts: 10084 Joined: Member Rating: 5.1 |
Human trials happen that Do cause permanent injury and death though ... and all the pre-testing gives the subjects a false sense of security. If the process of getting consent is done properly then no subject should have a false sense of security. Also, no drug is approved for clinical trials if there is a known side effect that does cause permanent injury or death compared to the current standard of treatment. When such side effects are observed in larger pools of subjects a trial is immediately halted.
There's also financial inducement in some of those trials (in the UK anyhow) -- which is probably just as much a way of skewing the informedness of the consent as being terminally ill. That is a big no-no in the US. Subjects are paid for their time, but the pay is below levels that would be considered as an enticement. For our own trials we usually calculate around $12/hr for travel and time spent with the study coordinator. We are also careful in screening possible subjects to judge whether or not this small amount of reimbursement would sway their consent.
I do see the point though ... I have had to sit through the training so it is nice to shovel this on someone else for a change.
|
|||||||||||||||||||
Dr Adequate Member (Idle past 312 days) Posts: 16113 Joined: |
So it all becomes a question of where in our hierarchy of attributes we start our comparison, and how deep we go before we stop ... ? Quite so. Note again that I am being descriptive and not prescriptive. There would be something deeply circular about being prescriptive about how to construct ethical systems; and if someone constructed a system in which, for example, lawnmowers enjoyed a higher status than people, then there would be little to say to him except that I have different premises.
|
|
|
Do Nothing Button
Copyright 2001-2023 by EvC Forum, All Rights Reserved
Version 4.2
Innovative software from Qwixotic © 2024