Mains Practice Questions

Approach

• Write about what you understand by bioethics.
• Discuss the issues related to bioethics in India.
• Conclude suitably.

Introduction

Bioethics

• Ethical issues concerned with the biological aspects of life and how and when it starts is included in Bioethics.
• It is the branch of the ethics which consists of the analysis of specific, controversial moral issues such as abortion, animal rights, or euthanasia. It helps to use knowledge of moral principles to present dilemmas.
• The four common principles of Bioethics are:
  
  • Nonmaleficence: One should avoid causing harm. The healthcare professional should not harm the patient. All treatment involves some harm, even if minimal, but the harm should not be disproportionate to the benefits of treatment.
  • Justice: Benefits and risks should be fairly distributed. The notion that patients in similar positions should be treated in a similar manner.
  • Beneficence: One should take positive steps to help others. The healthcare professional should act in a way that benefits the patient
  • Autonomy: One should respect the right of individuals to make their own decisions by respecting the decision making capacities of autonomous persons; enabling individuals to make reasoned informed choices.

Body

Issues related to bioethics in India

• Euthanasia: In India, euthanasia/ “mercy –killing” of terminally ill patients has been a controversial bioethical issue. Proponents of Physician-Assisted Suicide (PAS) feel that an individual's right to autonomy automatically entitles him to choose a painless death.
  
  • The opponents feel that a physician's role in the death of an individual violates the central tenet of the medical profession - a Life versus dignity. We allow Passive Euthanasia but we don't allow Active Euthanasia.
• Stem Cell Research: The immense potential that has been shown by stem cells in the treatment of “degenerative, incurable and irreversible” diseases such as diabetes, heart disease, spinal cord injuries, Parkinson's, Alzheimer's disease has brought them into the spotlight. The debate around stem cells as therapy includes socio, political, cultural and ethical issues. The concerns related to designer babies has raised serious bio-ethical issues.
• There was a public outcry over the delivery of Human Papillomavirus (HPV) vaccine administered to girls in Andhra Pradesh by an international foundation. The tribal department of the state had come out with an order that girls’ parents need not be contacted for consent and that principals of the tribal schools may provide consent. It is not ethical to administer the vaccine to minor girls without their parents’ informed consent.
• Relaxed norms for clinical trials: Government had come up with stringent regulations regarding clinical trials in 2013. Since 2014, these regulations are being gradually relaxed. Drug Controller General of India (DCGI) has decided to waive off Phase III clinical trials except where it is specifically necessary if the drug has been approved in US, Australia, Japan, Canada or Europe, because of the bio-ethical issues involved.
• Abortion: The social, cultural, religious, legal and political context of abortion is complex. This is complicated by advances in medical technology. A range of prenatal diagnostic technologies and the emergence of preconception and genetics-based technologies more recently have made it possible to know the status of the foetus in terms of sex or other ”abnormalities”. This has encouraged women and their families to seek selective abortions including sex-based ones also.

Conclusion

Each situation is quite unique and complex. And, we have to negotiate with many factors before we really come with a final solution.The Bioethicist in the modern age should be sensitive to all these factors that play important roles in shaping Ethical values and principles in modern societies.