In order to be considered “ethical-, medical practices must take into account four principles: autonomy, justice, beneficence, and non-maleficence. Autonomy requires that a patient has autonomy of thought, intention, and action when making decisions about their health care procedures and that they must be free of coercion. Justice is the concept that the burdens and benefits of treatments must be equally distributed. Beneficence means that treatment is provided with the intent of doing good for the patient. Non-maleficence requires that a procedure does not harm the patient involved or others in society.
As a result of progress in medical science, many novel technologies for treatment of diseases and human conditions have been developed. This has generated ethical dilemmas where the adverse effects of treatment have to be taken into account as well as the benefits.
A number of cases involving ethical issues have received much publicity. You may have seen the film based on the case of Henrietta Lacks. Henrietta Lacks had ovarian cancer from which she eventually died. The specialists treating her took a biopsy of her cancer cells and established the first cultured human cell line called HeLa. Since then, cultured cell lines have been an integral part of medical research. Scientists have subsequently been able to culture cells from most tissues of the body. Henrietta Lacks was not consulted about the use of her cells, raising the issue of the ethics behind the use of human tissue.
Many medical advances raise ethical issues. Some of these include the adverse effects of assistive reproductive technologies, high cost procedures like organs transplants that may consume health dollars, the rights of patients to die, conflicts between the wishes of patients and their relatives.
Attendance at this Zoom practical class is compulsory.
Before your Zoom Practical class:
• A video has been placed on the SLE346 web site in the ‘Resources Ethics Seminar’ folder that describes the different ethical frameworks. CRITICAL STEP: You must listen to this video before you attend your timetabled Seminar in Week 2.
During the Prac class:
• Please check STAR for what time your timetabled session will be held in Week 2 of trimester.
• This session will be conducted in Zoom and will involve as short presentation from the speaker on ethical dilemmas followed by a workshop.
• Groups of 5-6 students will be formed during this session.
• Each group will be assigned a specific ethical scenario and use an assigned ethical framework to prepare a debate.
• Each group will then give an oral presentation (debate) on their case in the second half of the seminar session.
• HURDLE REQUIRMENT: Each group leader has to hand in a bullet point summary of the main points of their case by the due date provided on the Dropbox to receive the mark for each member of his/her group for this Prac class.
Brief description of assessment task In week two, students will attend a Zoom session involving a presentation focused on ethical issues in precision medicine. Students are expected to review the online interactive lecture on ethical theories, before coming to the class and as preparation for this class. During the scheduled class students will break into groups (approx. 5) and prepare a brief oral presentation addressing an assigned ethics scenario related to the topic. Groups will present their findings and respond to peer questions. Dot points for the presentation should be submitted online.
Detail of student output Group oral presentation and individual summary document.
Grading and weighting (% total mark for unit) This assessment is worth 10% of total marks for this unit.
This task assesses your achievement of these Unit Learning Outcome(s) ULO3: Identify ethical challenges
ULO4: Define ethical dilemmas
ULO5: Process contextual information
This task assesses your achievement of these Graduate Learning Outcome(s) GLO1: Discipline knowledge and capabilities
GLO4: Critical thinking
How and when you will receive feedback on your work Oral feedback will be given on the day of the presentation and written feedback provided through CloudDeakin.
When and how to submit your work Presentations will be made in week two, with the dot point summary, due as advised on the Cloud Assignment Dropbox.
PRACTICALS 2 & 3 – PERNICIOUS ANAEMIA
*This practical takes place over two sessions.
**Hand in the practical report after the second session. See the Dropbox for due dates.
Pernicious anaemia is the end stage of chronic atrophic gastritis, an organ specific autoimmune disease affecting the stomach. The disease is characterised by gastric atrophy (wasting away of the stomach), infiltration of inflammatory cells into the stomach and production of auto-antibodies to various proteins, including intrinsic factor and the proton pump of parietal cells. Intrinsic factor is involved in the absorption of vitamin B12, which is required for the maturation of red blood cells, hence the anaemia associated with the disease. The parietal cells are found in the gastric glands, and their major function is to secrete hydrochloric acid, which is involved in the initial stages of digestion. The enzyme that is responsible for gastric acid secretion is the gastric HP+P/KP+P-ATPase, a proton pump, which consists of a 95 kDa subunit and a 60-90 kDa, glycosylated-ß-subunit. Auto-antibodies found in the serum from patients with pernicious anaemia react with either or both of the a and ß subunits of the gastric proton pump. This antibody response serves as a useful diagnostic tool for this disease.
In this exercise, you will be testing antibodies from patient serum samples to determine if any of them react with the gastric proton pump antibody, and hence would suggest a diagnosis of pernicious anaemia. You will be using two different methods to determine the presence of anti-proton pump antibodies in serum samples.
In Practical 2, you will separate proteins extracted from mouse stomachs by SDS-polyacrylamide gel electrophoresis, and transfer these proteins to a nitrocellulose membrane. In Practical 3, you will perform Western blotting on the gastric proteins using sera from patients who may or may not have pernicious anaemia. Also in Practical 3, you will stain a mouse stomach section with haematoxylin and eosin to become familiar with the structure and cell types within the stomach. The structure of the mouse stomach is similar to human, and human anti-proton pump antibodies cross react with the equivalent mouse protein.
In Practical 3, you will perform immuno-peroxidase staining of mouse stomach sections with the same sera from patients who may or may not have pernicious anaemia.
• To determine whether serum samples from two patients contain antibodies against the gastric proton pump by Western blotting and immuno-histochemistry, and suggest which patients have pernicious anaemia.