Transcript five little pig

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.
~Van Rensseelaer Potter 1970~
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.
~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.