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To understand the meaning of Bioethics, we can first identify the two parts that make the word. “Ethics” is the identification, study, and resolution or mitigation of conflicts among competing values or goals, namely moral values. “Bio” contextualizes the topic, referring to the health-related sciences. It is a relatively young field of learning, drawing on many established academic disciplines, like philosophy, jurisprudence, sociology, life sciences, and others. The field of bioethics includes topics such as international collaborative clinical research in developing countries, organ transplants and xenotransplantation, aging and the human lifespan, AIDS, genomics, and stem cell research.
In the current days, bioethics has an ever-growing influence, generating new discussions in the most varied topics, due to new potentialities in medicine. The use of automated technologies, like machine learning, the adoption of new antibiotics, and the topic of vaccination are some of the most relevant themes for academics in the area.
The use of Aduhelm, the first FDA-approved drug for Alzheimer’s disease in 18 years, is controversial. The new drug, developed by Biogen, targets a possible cause of the disease, instead of the typical approach of symptom management. The bioethical debate is related to the nature of the approval, since it was under the Accelerated Approval Pathway. This choice to use this route was justified by the belief that the new drug can provide meaningful therapeutic benefit over existing treatments, despite remaining uncertainties regarding its efficacy in the clinic. There are also moral conflicts regarding informed consent in clinical trials, due to the nature of Alzheimer’s disease, and with drug pricing, presented at $56.000 per year per patient, which can be inaccessible for a large portion of those that may need it. It is important to weigh the risks and benefits involved in the decision to authorize new drugs. On one hand, it could improve the quality of life of millions of people affected by the disease. On the other hand, there are still some doubts regarding its efficiency and risks.
Artificial Intelligence (AI) is both a revolution and a risk for the medical field. The automated algorithms could provide tools for early diagnosis and adequate treatment of an immense number of pathologies. However, its failure could erode trust in health systems, as well as pose a threat to patient privacy, when considering cybersecurity. The trust of medical personnel and patients in AI is still very reduced, due to the lack of clinical trials, as well as the typical “black-box” model, caused by an absence of interpretability in the results. The adoption of AI in the medical field faces conceptual, technical, and humanistic challenges, with the latter being studied in bioethics. In order to guarantee a good application of this technology, effective strategies need to be planned.
References:
[1] Michigan State University.What is Bioethics?. https://bioethics.msu.edu/what-is-bioethics
[2] Benatar D. Bioethics and health and human rights: a critical view. J Med Ethics. 2006;32(1):17-20. doi:10.1136/jme.2005.011775
[3] Vera M., Cristina S. and Ivone D. Bioethics education and the development of nursing students’ moral competence. Nurse Education Today, Volume 95, 2020, 104601, ISSN 0260-6917
[4] Markkula Center for Applied Ethics. (2021, Jun 14). The Accelerated Approval of Aduhelm: An Ethical Analysis. https://www.scu.edu/ethics/healthcare-ethics-blog/the-accelerated-approval-of-aduhelm-an-ethical-analysis/
[5] Quinn TP, Senadeera M, Jacobs S, Coghlan S, Le V. Trust and medical AI: the challenges we face and the expertise needed to overcome them. J Am Med Inform Assoc. 2021 Mar 18;28(4):890-894. doi: 10.1093/jamia/ocaa268. PMID: 33340404; PMCID: PMC7973477
