The Disappearance of the True Athlete

Every time the Olympics come around, I get caught up in the excitement of the gold medals, the world records, and the inspiring performances that accompany them. When I was younger, I remember being awed by the gymnasts who persevered through injuries to win gold medals or the runners that won by sheer determination. And then there were always those athletes whose success came with seemingly no effort at all. Whatever the style, I always aspired to someday be like them. But that was when I was younger, before the debate of performance-enhancing drugs took as much of the attention as the Olympics themselves (or perhaps before I became completely aware of it). These drugs have taken some of the prestige away from the Olympics, for the once inspiring comebacks or talents of athletes are now overshadowed by the possible involvement of steroids. When I first learned about drugs that could enhance human performance, I was shocked that anyone could take these drugs and still feel proud of their victories. Not only was it biologically unethical to alter the body’s hormone levels or muscle composition, but it was morally wrong to cheat. I couldn’t believe that anyone who had taken such an easy route to victory could stand, smiling, with their medal. But as I learned more about the issue, I realized there was more to the debate than just the clear steroid users and the clean athletes. There were still training methods and other drugs that began to enter the ethical debate as well. And then there were always the athletes taking human growth hormone or other similar drugs for “medical reasons.” Where was the line between medical purpose and physical prowess? Should drugs that can be used as performance enhancing ever be legally prescribed to anyone?

In January, The New York Times published an article about amphetamines, another drug that became popular in baseball. As a stimulant, it artificially increased the performance of infielders and hitters especially, allowing them to react that split second faster to the speeding line drive or fastball. It was placed on the banned substances list along with human growth hormone and anabolic steroids. However, many players have been granted usage of stimulants like amphetamines in order to treat attention deficit disorder. In between the years 2006 and 2007, this number increased from 28 to 103. It seems wrong to deny someone the use of a medical treatment, but it also seems wrong that a medical treatment can give someone such an advantage. By allowing athletes to use stimulants for a relatively minor medical problem such as attention deficit disorder, it may not be long until more serious drugs such as steroids are permitted. With medical reasons as a ready-made excuse, we may find ourselves even farther away from solving the drug problem in sports. We need to draw the line somewhere to protect the honest hard-working athletes who can bring real glory to their countries and fans.

Relevant Site:

http://www.nytimes.com/2009/01/10/sports/baseball/10doping.html

Clinical Trials Involving Children: Are They Unethical?

The conflicts surrounding clinical trials on children have continued to grow over the past few years.  On April 8, 2005 a clinical trial called Children’s Environmental Exposure Research Study (CHEERS) was shut down.  This clinical trial was originally intended to estimate how much pesticide a child under the age of three would absorb into his/her system if his/her parents were to spray his/her room with it. The families would receive money and other gifts (such as a video camera) for taking part in the trial.  The Environmental Protection Agency (EPA) shut down CHEERS after receiving continuous complaints from the public.

 

All clinical trials involving humans must follow certain sets of ethical guidelines.  It is impossible to avoid all risks during the process of a clinical trial.  The key is to try to minimize the negative effects and maximize the positive effects.  Everything must be done in the researcher’s power to have the lowest risk to benefit ratio.  The potential benefits to an individual or society should be maximized and outweigh the risks.  It is also important to test and analyze how children react in a clinical trial that is actually testing something they are or may be exposed to.  Also following ethical guidelines must be the payment a research subject and his or her family receives.  Payments in forms of small amount of money may be given, but it must be in proportion to the clinical trial and may not be an excessive amount.

 

This experiment broke all of these rules.  This clinical trial had planned on spraying infants’ rooms with pesticide, but there were no pests to be sprayed.  The risk vs. benefit ratio had now turned strictly to risk.  If no pests were present, then the children were being put in harm for no appropriate reason or logical benefit.  This goes against what is asked of all researchers: do no harm.  Along with having no possible positive outcomes, this clinical trial also violated laws against bribing.   The video camera would have been beyond what was appropriate for the experiment. This clinical trial does not meet strict government standards and was, in my opinion, unethical.   As Barbara Boxer (Democratic Senator from California) said about CHEERS: "a reprehensible idea that never should have made it out of the boardroom".

 

Resources relevant to my post:

http://www.healthy.net/scr/news.asp?Id=9514

http://www.epa.gov/cheers/

http://www.naturalnews.com/019192.html

http://clinicalresearch.nih.gov/ethics_guides.html#6

 

 

When what you see is no longer real

In the past summer, when I jokingly told my mom that I wanted to do cosmetic plastic surgery, she responded, “Sure you can, but after that you don’t come back to our place; go to whoever you look like most instead.” I was at first shocked for her lack of humor, but then I started wondering if she opposed plastic surgery to such a degree. After all, people are more open and accepting about plastic surgery now than ever. A few years ago, people, mostly women, would travel from China to Korea purely for the Koreans’ advanced plastic surgery technology. Now the route of travel is reversed: the cosmetic plastic surgery industry in major China cities developed so fast that some Koreans would come to China to have their face remolded.

Back to the conversation between my mom and me. It made me wonder: how much do people care if a beautiful face is not natural? And can the person who got plastic surgery performed be regarded as the same person before the surgery? Someone reading a fashion magazine may not care if the featured models have got plastic surgery performed, but it’s harder to say so when it comes to husband and wife relationship. I once read an article in Chinese that reported a man filing lawsuit against his wife because only after their first child was born did he find out that his wife’s beautiful features were man-made rather than naturally born. The news is disturbing for the question it raised: is the wife a different person before she had plastic surgery? Not many people would agree with this notion: a few changes on her face are not adequate to change her identity. However, the difference hidden in her genome is strong enough to make her another person to her husband. He soon divorced her.

This is an interesting situation because suddenly the “reality” is not so “real”. Cosmetic surgery can indeed perfect one’s outside features, but when it comes to the humans’ reproductive needs, it no longer functions. People want their offspring to have advantage in the race of evolution, and an inherited beautiful feature is indeed an advantage considering the operation of cosmetic surgery costs money and contains risks. A few years ago people can look at their lovers’ childhood photo to look for any potential discrepancies, but now with the help of Photoshop, they have to find a more comprehensive way to decide for themselves.

Another Gene Therapy Death?

As I searched the internet for bioethics articles, I came across an article claiming that human immortality would be a possibility in 20 years and another which claimed that the human brain would be replicated within 10 years. I was formulating a plan to attack the ethics of converting myself into an ironman of sorts when I came across a much more serious article by the renowned Arthur Caplan.

Caplan’s article is a defense of gene therapy in light of Jolee Mohr’s sudden death during a gene therapy trial. While the article raises the routine question about the possible benefits weighed against the risks in this trial, I was struck by the informed consent piece of the article. Mohr’s husband “says his wife did not understand that she had agreed to be in a safety study of gene therapy, which was not intended to benefit her in any way” but she had signed a 15 page informed consent form. Caplan, later in the article, questions whether the consent forms should be so complex.

In gene therapy studies it is imperative that the patient knows exactly what they are getting themselves into. Therefore, rather than having scientific-ridden, intricate novels detailing an experiment for patients to comprehend, there should be simplified forms which give an overview which informs without being overbearing. One might argue that the physician should just explain the trial to the patient but when doctors are making money for recruiting patients into the study they could go to any lengths to convince their patients to take part in the study. In addition, many of these research trials are being approved by for-profit boards, making it easier for ethically questionable and higher risk trials to get through.

Though it isn’t clear if Mohr’s normal arthritis drug HUMIRA or the gene therapy trial is to blame for her death the main point of the article is to emphasis the need to better protect trial participants. When people volunteer to participate in trials for the betterment of humanity it is essential that they be protected from all unnecessary risks. Ethics boards should be diligent and physicians should not be paid for recruiting their patients into research trials. While gene therapy is a worthy investment moving forward, the focus on monetary gains must take a backseat to the health of the patients which should easily surpass the other factors as the number one priority.

Relevant site:
http://www.bioethics.net/articles.php?viewCat=2&articleId=202

"Savior Siblings" and Their Effect on Families

The right to make decisions regarding your own body is an intrinsic human right; whether deciding to participate in experimental studies or undergo surgery, each person has to the right to be in charge of those decisions. What happens then, when the situation becomes more complex, when deciding not to undergo surgery would cost a family member his or her health, and possibly his or her life.

Parents with sick and dying children have begun recently turning to a new, controversial method to find donor matches, in vitro fertilization. Parents “select an embryo free from serious genetic disease and simultaneously select for a tissue match” (M Spriggs). This is done because family members, and especially siblings, are the best chance of finding a genetic match to the sick child. Once a genetic match is found, treatments such as organ donations or blood transfusions become available as options. This issue was recently brought to the attention of the public through the movie adaptation of Jodi Picoult’s novel, My Sister’s Keeper. In the movie, 11-year-old Anna sues her parent’s for medical emancipation in order to stop a planned kidney surgery. This represents one major ethical consideration; why is it fair to the healthy child to constantly undergo surgery? Surgery itself is a risk, complications occur all the time even in simple surgeries. Children such as Anna also miss school when undergoing surgeries and are also precluded from activities such as participation in sports after select surgeries.

When you balance this with the fact that without these life-saving operations their sick family member could potentially die, a Catch 22 situation arises. It isn’t the child’s fault he or she is sickened with cancer or some other affliction and needs surgery, but it isn’t the other child’s fault either. Looking further into Anna’s hypothetical story, the reason she even filed the lawsuit was on behalf of her sister Kate. Kate was tired of the surgeries that only temporarily helped her live, and most importantly was done with watching her little sister selflessly sacrifice herself and her body whenever Kate needed more operations. Children such as Kate also deserve a voice in these situations, because among other considerations, it is hard to watch a sibling go through surgery specifically because he or she is sick.

In a desperate situation, parents want to do everything they can to help heal their children, but is it right to help heal one child by sacrificing another’s health, especially when generally neither child gets a say in the matter? The structure of the situation presents problems for all involved. The whole family dynamics shift once a “savior sibling” is born. Most of the time the focus rests of the new child and the parents, but the rest of the family is also affected and must be considered before a drastic measure such as this is undertaken.

Resources relevant to my post:
Picoult, Jodi. My Sister's Keeper. Simon and Schuster Adult Group, 2005. Print.
Spriggs, M. "Is conceiving a child to benefit another against the interests of the new child?" Journal of Medical Ethics (2005). Journal of Medical Ethics. Web. 27 Sept. 2009. .

The Use of Data

At the mention of human experimentation, one can often experience an immediate shiver shoot down one’s spine. The concept of experimentation, in one sense, should be relieving. Our society has harnessed science as a way to alter nature--improving and extending lives on the way. However, when I read the title to WRI 167: The Ethics of Human Experimentation, my mind jumped to a very ominous and sinister place. After reading numerous books regarding the Holocaust and Nazi experimentation, particularly Night by Eli Wiesel, linking research and human torture came too easily for me.

I bring this topic up because of the recent debate on whether using the data discovered from the German experiments is ethically sound. I firmly believe that the only thing worse than what these victims have been through would be if after these atrocities, the world accepted the trials as valuable. With the use of the data from the World War II “experiments”, the scientific community would be acknowledging the horrific crimes as positive in some way. To use data from their research is to establish redeeming qualities from the horrors of the Holocaust. It is to belittle the agonizing experience of the victims.

In recent historical studies, it has been determined that the Nazi doctors did not simply succumb to the authority of Adolf Hilter’s party, but in fact, these doctors were “active and responsible agents committed to hygienic theories with roots in Social Darwinism” (Post 42). These doctors were subhuman-- lacking any thread of moral decency or compassion. Once their research is distinguished as in any way worthwhile, the scientific world is losing a vital and necessary idea--the idea that the patients’ individual well-being is the most important thing.

These “patients” were murdered and brutally exploited. With the modern world giving positive distinction to the trials, we are simply reopening the victims’ wounds. Science must have a heart, or else the Earth will come significantly closer to another Holocaust. We must hold tightly onto the Nuremberg Code, the Declaration of Helsinki, and the Belmont Report by rejecting all findings that deviate from these honor systems.

Resources relevant to my post:
http://www.ushmm.org/research/doctors/Nuremberg_Code.htm
http://www.jewishvirtuallibrary.org/jsource/Judaism/naziexp.html
Stephen G Post, The Echo of Nuremberg: Nazi data and ethics
(Case Western Reserve University, Ohio, USA)