Transcript Ethics in Conservation Medicine

Ethics in
Conservation
Medicine
October 3, 2012
What are ethics?
 “the
discipline dealing with what is good
and bad and with moral duty and
obligation”
 “a set of moral principles or a theory or
system of moral values”
-Merriam-Webster Dictionary
Morals
“About morals, I know only that what is
moral is what you feel good after and what
is immoral is what you feel bad after.”
-Ernest Hemingway, Death in the Afternoon
Determinants of Ethics
 Personal
moral values
 Personal responsibility
 Religion
 Culture
 Societal norms
 Professional code of conduct
 Laws, rules, regulations
Areas of Ethics
 Meta-ethics:
ethical theory, ideas of right
and wrong (focus on meaning)
 Normative
ethics: studies how to take an
ethical action (focus on actions)
 Applied
ethics: how to achieve an ethical
outcome (focus on outcome)
What is ethical?
 How
to determine right and wrong
 People are most comfortable with
dichotomous issue
 Often many sides to one issue
 Universal ethics: everyone agrees:
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Don’t lie, don’t steal, don’t kill
 But…
Complicated Ethics
 Thou
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shalt not kill
Death penalty?
Abortion?
Human euthanasia?
Self defense?
Animals?
Defining Ethics in the Sciences
 Driven
by professional values
 Concerns for values at different levels:
individual, patients, profession, society,
scientific community
 Mapping values helps define professional
values
 Identification of most troubling issues
Professional Value Mapping:
Veterinarians
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Self oriented:
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Patient oriented:
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Client’s monetary gain
Satisfaction
Knowledge/Science/Theory Oriented:
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Alleviation of pain and suffering
Promotion of patient health
Client oriented:
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Monetary gain
Personal satisfaction
Recognition
Scientific aspects of disease
Promotion of basic research
Society oriented:
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Public health
Individual human health
Animal control
Enforcement of Ethics in
Research
 Cannot
rely on ethical code alone
 Numerous determinants of individual
ethics
 Some people are amoral or immoral
 Regulations introduced to safeguard the
rights of humans and animals
Ethical Review Boards
 Before
20th century, human and animal
research ethics left to individual
researcher conscience
 Professional codes of conduct
 Laws and customs of society
 Elaborate rules and regulations
developed: IACUC (animals) and IRB
(humans)
IACUC
 Institutional
Animal Care and Use Committee
 Self regulating body required of all federally
funded research institutions to review and
regulate animal research
 Covers vertebrate animals
 IACUC reports to Office of Laboratory Animal
Welfare (OLAW) at the NIH
IACUC History
 1963
– veterinarians form Animal Care
Panel and publish The Guide for the Care
and Use of Laboratory Animals
 1966 – Animal Welfare Act – USDA
 1971 – AWA revised – animal care
committee used for compliance
 1979 – Public Health Service required
institutional committees
 1986 – IACUC formally used – regulated
by PHS policy
IACUC Requirements
 Committee
of at least 5 people
 Inspections of animal facilities every 6 mo
 Review research protocols
 Evaluate institutional animal care
 Report to OLAW at NIH yearly
 Maintain OLAW assurance
 Report noncompliance to OLAW
 Take institutional action to correct
compliance issues
IACUC at Tufts
2
committees for 3 campuses
(Boston/Grafton and Medford)
 Division of Teaching and Research
Resources (DTRR) – Grafton Campus
 Division of Laboratory Animal Medicine
(DLAM) – Boston campus
Tufts Research involving Animals
IACUC Protocols
 New
protocols reviewed monthly
 Species and number with rationale
 Details of all procedures
 Details of anesthesia, pain relief,
euthanasia
 Efforts to minimize discomfort or distress
 Assurance that research does not
duplicate previous experiments
 Assurance no non-animal model exists
IRB
 Institutional
Review Board
 Committee that reviews and approves
research protocols involving human
subjects
 FDA and DHHS Office for Human
Research Protections regulate IRBs
IRB History
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18th century BC - evidence of restrictions on
human use in experiments
1600s - laws pertaining to specific activities
1946 – Nuremberg Code – permissible
medical experiments after WWII
1964 – Declaration of Helsinki from World
Medical Association – governs research ethics
and designs for human subjects
1966 – Public Health Service requires IRBs for
federally funded research
IRB Requirements
 At
least 5 members of different professions
 Scientists and non-scientists
 Review research protocols involving
human subjects
 Ensure safety and safeguard the rights
and wellbeing of trial subjects
 Ensure informed consent
IRB at Tufts
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Provides guidance on consent forms, research
training, research guidelines, laws, institutional
policies
TUHS (Tufts Medical Center and Tufts University Health
Sciences) IRB
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Tufts Medical Center
Floating Hospital for Children
New England Eye Center
Tufts School of Medicine
Tufts School of Dental Medicine
Cummings School of Veterinary Medicine
Department of Agriculture Human Nutrition Research
Center on Aging
Friedman School of Nutrition
Tufts Institutional Review Board
HIPAA
 Health
Insurance Portability and
Accountability Act
 Includes privacy rules for health
information
 Gives patients right to privacy of personal
health info
 Rule is balanced to permit disclosure
when needed for patient care
IRB Protocols
 Reviewed
monthly
 Details of all procedures
 Informed consent forms
 HIPAA forms
IRB Forms
Environment
 Humans
and animals protected, what
about the rest of nature?
 1970 – first Earth day
 Dec 2, 1970 – EPA established
Ecological Ethics
 Values
are given to non-human as well as
human nature
 A view not restricted to treatment of
humans
 Ethics focused on maintaining health of
the natural world
What are the values of
conservation medicine?
Discussion of Articles
Advocacy, Ecology, and Environmental
Ethics
Ecological Medicine Values
Biodiversity value
 Intrinsic
value – an inherent or essential
value that is not dependent on good to
humans
 Demand
value – value based on
perceived usefulness
Ecosystem Services
 Water
purification
 Air purification
 Carbon cycle
 Waste decomposition
 Seed dispersal
 Recreation
 How
do these services affect conservation
medicine ethics?
Ethical Example: Logging
A
logging company has approval to clear
an old growth forest to convert to paper
products. Is this ethical?
Ethical Example: Logging
A
logging company has approval to clear
an old growth forest to convert to paper
products. Is this ethical?
 Two sides: in favor of logging or not
 Is one side ethical, the other not?
 Driven by different values, thus different
ethics:
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Value of the trees, intrinsic vs demand
Jobs, profit
Conservation Medicine Ethical
Dilemmas
Taxonomic Chauvinism
 Parasites
represent majority of species
 Play important ecological
 Many at high risk of extinction
 Often overlooked in conservation
medicine research and education
 Large vertebrates receive more attention
and more funding
 Ethical considerations?