SJW 生物科技對社會之影響

大綱 從『傳統醫德』走向『生命倫理』 基因改造作物 (Genentic Modified Organism) 基因轉殖動物與異種移植 (Transgenic Animal & Xeno-transplantation) 基因篩檢及診斷 (Genetic Screening/Diagnosis)

大綱 基因治療：體細胞與生殖細胞 (Gene therapy:Somatic and Germ-line ) 幹細胞研究(Stem cell research) 動物及人類無性生殖 (Animal and Human Cloning)

Medical Ethics Systematic study of and popular debate on the moral problems raised by medical practice. The standard of professional competence and conduct which the medical profession expexts of it members. (Boyd , The new dictionary of medical ethics , 1977)

Bioethics A science of survival in the ecological science ,an interdisciplinary study aimed at ensuring the preservation of the biosphere. The growing interest in the ethical issues arising from the health care and the arising from the health care and the biomedical science. biomedical science. ~Van Rensseelaer Potter 1970~ ~Helga Kuhse & Peter Singer 1998~

The Ethics Industry? Medical Ethics Clinical Ethics Nursing Ethics Psychiatric Ethics Health Care Ethics

The Ethics Industry? Biomedical Ethics Environmental Ethics Animal Welfare Animal Welfare Bioethics How medicine has saved the life of moral philosophy ?

基因改造作物 Genetic Modified Organism

1953 Double Helix DNA 2001 Human Gene Sequence Watson and Crick ,the molecular structure of nucleic acids. Copying mechanism for genetic materal,clue to chemistry of herediary. What is it to be a human? Is there a perfect form of humanity? Can it be achieved by human choice? Eugenics,genetic engineering and gerntic control.

Bio—genetic Progress 1986基因轉植羊polly含人類凝血因子 1990基因轉植豬Genie 1990基因治療四歲先天免疫機能障礙(ADA defect)小女孩 1997年無性生殖複製(cloning)羊Dolly、鼠、豬、牛、羊？

Bio—genetic Progress 2000人類基因序列圖譜完成 2001第一例基因轉植猴ANDi 2001-9台灣第一頭複製牛畜寶早夭 2002-4台灣第一頭基因轉植複製豬酷比

基因改造作物 Genetic Modified Organism

Environmentalists say there has not been enough assessment of the risks of accidental releases of GMOs into the environment

基因改造作物 Genetic Modified Organism 過敏原/抗藥性/基因污染風險、安全性與效益 商業控制、壟斷 民眾的認知及選擇的權利 人與植物、自然生態的關係 人有權力隨心所欲地去改造植物嗎?

基因轉殖動物Transgenic Animal 異種移植Xenotransplatation 動物複製Animal Cloning

Rare pig breed cloned Scientists see a role for pig clones as organ suppliers for human transplants

Xenopus embryos: valuable even when they fail

Five Little Piggies Photo:PA/PPL Therapeutics

These five piglets,Gene Pig

Animal Cloning Hellow Dolly Poto:PA

Diagram of plant cloning through tissue culture propagation

Gurdon’s experiment to clone frog

Diagram of the nuclear transfer procedure the first cloned mammals

More Little Piggies Photo:Matt Gentry , AP / The Roanke Times

Moving on Photo : AP / Kyodo

New Lease on Life?

Copycat

Who’s She? The Cat’s Mother?

First cloned kitten-but it got an exact copycat Friday February 15 , 2002 Photo : PA

Australian scientist proposes recipe for cloning extinct

基因轉殖動物、異種移植與動物複製 Transgenic、Xenotransplataion & Animal Cloning 組織組織/器官遺傳工程(Tissue/Organ Engineering) 動物實驗與人體試驗的倫理 動物病毒入侵人類動物病毒入侵人類(風險與安全) 人與動物的關係 人有權力隨心所欲地去改造動物嗎?

基因篩檢及診斷 Genetic Screening & Diagnosis

The Purposes of Genetic testing To confirm a clinical diagnosis. To detect a genetic predisposition to a disease so that preventive measures can be taken or to help a patient prepare for the future. To give parents the option of terminating a pregnancy or beginning treatment as early as possible. To contributes to our understanding of the mechanisms of disease.

Genetic testing and Screening In the neonatal period Prenatal when couples are considering marriage or reproduction when a person, on the basis of family history,recognizes that he or she has a higher-than average risk of developing a genetic disease

Characteristics of genetic information that create the ethical and legal responsibility The implications of genetic information are simultaneously individual and familial; Genetic information is often relevant to future disease; And genetic testing often identifies disorders for which there are no effective treatments or preventive measures.

Common Ethical Issues of Genetic Testing Informed consent/Confidentiality The potential for psychological distress and social harm The resulting discrimination Conflict of personal privacy and family interest (the duty to warn?) Freedom and coercion in genetic testing The access to the services

基因篩檢及診斷 Genetic Screening & Diagnosis 基因資訊的獲得 基因資訊帶來的負擔 基因診斷結果的告知 對個人與家庭、家族的影響 基因隱私的保障 基因歧視、就學、就業、保險 基因決定論、社會正義議題

基因治療：體細胞與生殖細胞 Gene therapy: Somatic and Germ line

內容取材 1. 台灣ELSI研究中心演講 2. 台大醫院蔡甫昌醫生有關ELSI演講及生物科技與生命倫理課程相關教材

Monkey business Photo : PA/Oregon regional primate research centre

英國Clothier Committee 「基因治療倫理」1992年 指導「基因治療倫理」思考的兩個基本原則: 1.人類與生俱來天性中擁有必須以合乎倫理的方式去探 索、鑽研、追求、應用科學研究的義務。 2.當對知識的追求與對病人利益的保護發生了無法避免的 衝突與緊張時，對病人利益的保護必須勝出。

HUGO-ELSI Committee Statement on the Principled Conduct of Genetics Research (1996) 承認人類基因體是全體人類共享遺產 (common heritage)的一部分。 遵從有關人權之國際規範。 尊重參與者之價值、傳統、文化及個人完整性。 接受並且維護人性尊嚴及自由

基因治療：體細胞與生殖細胞 Gene therapy: Somatic and Germ-line 體細胞治療： 新創醫學應用的倫理：尊重自主、不傷害、善益、正義 生殖細胞治療： 醫源傷害、改變人種、未來世代的禍福、同意與埋怨、生殖自由權限、設計家寶寶、基因超市家寶寶、基因超市

幹細胞研究 Stem cell research

Source : NIH

Source :NIH

Source : NIH

幹細胞研究幹細胞研究 Stem cell research 幹細胞、胚胎、胎兒的道德地位 不同來源幹細胞之倫理意涵 劃時代突破性的醫療福祉劃時代突破性的醫療福祉VS 殺害人類胚胎與踐踏人性尊嚴

人類胚胎是不是人? (胎兒呢?) 如果人類胚胎不是人，是否研究者可以無限制地對無數的胚胎進行研究最後棄置它們? 用來實驗的胚胎、幹細胞來源為何? 從墮胎之胎兒身上、人工生殖治療後剩餘的胚胎、刻意創造的胚胎、或經體細胞核轉殖製造而取得有什麼差別?

人類胚胎是不是人? (胎兒呢?) 如果人類胚胎是人，什麼時候開始算是? 科學家是否因此不應該對人類胚胎進行研究而最終棄置它們? 因此放棄人類生殖細胞、幹細胞研究可能帶來的種種好處嗎? 墮胎、裝置子宮內避孕器、RU-486根本就是殺人的行為？

The Equation of human stem cell research ethics

人類無性生殖 Human Cloning

Severion Antionary Photo : Massino Sambucetti , AP

人類無性生殖 Human Cloning Human Cloning 生殖自由與福利 vs. 違反人性尊嚴 醫源傷害 vs. 意欲福祉 「人」為「目的」抑或「手段」 違反自然與容許科技使用界限 基因多樣性、人為演化 野心家利用、無窮災難 (滑波理論)

Summary and Conclusion

Concluding Remark Consensus morality has to be reached otherwise the law will be unenforceable!! How are we to promote human welfare without undermining human dignity? How are we to respect diverse values and yet still search to achieve overlapping consensus? This is a touchstone and immediate challenge that tests humanity and democratic maturity of our society.

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