Ethical issues involved in application of Science Technology

Ethical issues involved in application of Science & Technology vis a vis Human Rights Dr. Diganta Biswas, Assistant Professor, School of Law, Christ University, Bangalore.

ETHICS AND ETHICAL ISSUES Ethics is a code of thinking and behaviour governed by a combination of personal, moral, legal, and social standards of what is right. Although the definition of "right" varies with situations and cultures, its meaning in the context of a community intervention involves a number of guiding principles. Basically, ethics means the basic concepts and fundamental principles of decent human conduct. It includes study of universal values such as the essential equality of all men and women, human or natural rights, obedience to the law of land, concern for health and safety and, increasingly, also for the natural environment. It also includesa system or set of moral principles; the rules of conduct governing a particular class of human actions or a particular group, culture, etc, the branch of philo sophy dealing with values relating to human conduct, with respect to the rightness and wrongness of actions and the goodness and badness of motives and ends, and moral principles, as of an individual. ETHICAL ISSUE is a problem or situation that requires a person or organisation to choose between alternatives that must be evaluated as right (ethical) or wrong (unethical). 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 2

Ethics in science has increasingly become an important issue in democratic societies, especially subsequent to the rise of the modern life sciences. After important discoveries in the field of biology ethical reflection of scientific work and its results has come into focus. Naturally, the complex of bioethics, understood as medical ethics, is prominently represented. Furthermore closely related topics, like environmental ethics, animal ethics are also taking up much space. Societal acceptability of scientific research requires sound ethical reflection. The complexity of modern sciences and the rapid progress in research and development require that up-to-date information is available in order to make such reflection possible. Moreover, the Indian society is characterized by a rich plurality of ethical, legal and cultural traditions. This plurality, all the more, calls for an intensive exchange on normative aspects of science. 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 3

Ethical issues involved in the application of Science & Technology ISSUES UNDER PUBLIC HEALTHCARE SYSTEM ü Health Ø Reproductive Health q Abortion q Adoption of children by altruistic reproductive techniques q use of embryonic cells MISCELLANEOUS üApplication of bio- technology in agriculture üCloning ü Human-animal hybrids ü Privacy ü Personal genetic testing/personalized medicine ü Low-quality and counterfeit pharmaceuticals Ø Treatment ü Adaptation to climate change • Gene therapy ü Hacking into medical devices • Stem cell research ü Low-quality and counterfeit pharmaceuticals • Dementia ü Driverless (zip)cars ü Ensuring access to wireless and spectrum 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 4

Ethical issues and Public Health care system Ethical issues in healthcare common. Nearly every decision that’s made has ethical implications for patients, for providers and for healthcare leaders. The most important issues are as under- a. Balancing care quality and efficiency: There is a challenge in respect to balancing quality and safety with efficiency. Today it is really a question whether the right values are driving our focus in our healthcare system, ” or “Should efficiency be the driver? ” b. Building and sustaining the healthcare workforce of the future: To take care of this population, to manage chronic illnesses, coordinate care and provide many other services. The real threats to keeping the people we train in practice is having an ethical practice environment where they can actually practice with integrity, and where they are not constantly barraged with morally distressing situations that burn them out. ” 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 5

c. Improving access to care: Most ethicists believe that access to basic care is a hallmark of a civilized society. But, it is unfortunate that today, providing everyone with access to basic medical care remains a concern. d. Addressing end-of-life issues: End-of-life issues will also grow in importance as the population ages. The entire decision-making process, as well as the financing that pays for end-of-life care, will be up for discussion as these issues affect more people. e. Allocating limited medications and donor organs: One of the most important problem is the allocation of medicines and shortage of donor organs. There are just not enough livers or deceased donor organs to meet the need. Here is where continued research, as well as more donations, require. 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 6

HEALTH CARE ETHICS What is health care ethics? Health care ethics is a thoughtful exploration of how to act well and make morally good choices, based on beliefs and values about life, health, suffering, and death. Some common ethical questions: Generally, ethics questions arise when the right thing to do is not clear or when people disagree about what is best for a person who is ill. Some examples of common ethical questions include: Ø When should life-sustaining treatments like breathing machines or feeding tubes be started, continued, or stopped? 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 7

Ø What should family members and health care professionals do if a patient refuses treatment that promises to be medically helpful? Ø Who should make health care decisions for patients when they are unable to communicate or decide for themselves? Ø What should patients do when they do not understand what professionals are saying and feel they are not offered the opportunity to participate in their own health care decisions? 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 8

Ethical Dimensions of Reproductive Health Care Reproductive rights are basic human rights. They result from working out the implications of the basic rights of human persons in the specific field of reproductive and sexual health. In their most compact form, reproductive rights entail three basic components: v The freedom to decide whether, when and how many children to have v The right to modern family planning information and modern family planning methods v The right to control one’s own sexuality The ethical issues associated with reproductive healthcare as under. Confidentiality, Truth-Telling, Boundary Issues, Community and Personal Values, Paying for Care, Referrals to Distant, Specialized Providers 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 9

CONFIDENTIALITY: One of the essential concerns in managing ethics tensions in rural settings is the need for confidentiality. This becomes especially important for patients with reproductive health issues in rural settings, given their limited care options, unique community values, and overlapping patient- clinician relationships. Confidentiality can be difficult to maintain in a small community, where the people who work at the clinic are relatives, friends, and neighbours. However, in order to “do no harm, ” confidentiality is vital. TRUTH-TELLING: Overlapping relationships, community and personal values, and clinician stress all share a common core ethics issue: truth-telling. Questions, such as: how much of the truth is revealed to the patient and when; to what extent should information be placed in the medical record; and so on. on, are all part of the scope of truth-telling. It is important for the clinician to establish the habit of being honest and objective about medical diagnoses and treatments when talking with patients. in order to ensure informed consent, provide appropriate medical care, and protect the community’s public health, the truth needs to be told. 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 10

BOUNDARY ISSUES: When working with patients regarding sexual or reproductive health diagnoses and treatment decisions, ethics tensions may be increased by differing community and personal values, and by overlapping relationships. Such conflicts can put the clinician in a difficult position regarding how he or she offers recommendations. COMMUNITY AND PERSONAL VALUES: Ethics tensions are heightened when personal values and the community’s culture are part of the clinical decision-making process. 4, 5 Decisions that are impacted by social and/or personal stigma increase the provider’s difficulty in decision-making, and complicate patient- clinician relationships. PAYING FOR HEALTH CARE: When confidentiality is necessary because of personal and/or community values, arranging payment for rendered care must also be discrete. The business side of practice can be ethically complex and requires great care, adding to clinician stress. 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 11

REFERRALS TO DISTANT, SPECIALIZED PROVIDERS: Because rural areas often have limited access to specialized clinicians and resources, referrals to distant hospitals are common. Hence, travel issue raises both financial and personal ethics issues for the community, clinician, and patient. The ethics tensions in making these referrals add to the complexity of decisions that need to be made and add to clinician stress. RURAL CHARACTERISTICS THAT INTENSIFY ETHICS ISSUES: In rural settings, the ethics concerns that are commonly involved in reproductive health care heightened by the specific characteristics of rural settings. These characteristics are- Ø�Availability and/or limited access to care and services Ø�Overlapping relationships between patients and clinicians � Ø Community and personal values Ø Clinician stress 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 12

Other ethical issues concerning reproductive health- ØViolence against women Ø contraception Ø ethical considerations in sterilization Ø induced abortion for non-medical reasons Ø sex selection Ø surrogate motherhood Ø preventing iatrogenic multiple pregnancy Ø ethical guidelines regarding the procedure of collection of cord blood 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 13

a 9/10/2021 DR. DIGANTA BISWAS, ASSISTANT PROFESSOR, SCHOOL OF LAW, CHRIST UNIVERSITY, BANGALORE. 14