In 2016, a healthy male volunteer received an experimental drug that had never been tested in humans, lapsed into a coma, and died. There are a number of ethical questions raised by the episode, including whether it is appropriate to conduct first-in-human tests on a healthy volunteer who has no chance of medical benefit from the drug in question. At its core, paying healthy volunteers who stand no chance of medical benefit is a coercion that violates the ethical principle of nonmaleficence, “first do no harm.” Nevertheless, phase I testing is necessary for development of novel drugs that ultimately may enormously benefit the greater population. There are ways to address this essential tension between harm to an individual versus good to society. One way is to increase transparency in the testing design. Trials should provide more information regarding the evidence that a drug is safe, both to provide more information to a participant as well as to the public in the event of an adverse outcome. Requiring companies to release details of on whom the drug was tested and how much participants received is good science and good ethics. Drug companies should acknowledge that although uncommon, terrible outcomes will occur, and may result from testing any novel drug, regardless of anticipated safety. When a participant is injured during a phase I trial, there should be a clear process for compensation to the individual or survivors.
In this paper, I examine the ethical dilemma present in cases of Body Integrity Identity Disorder (BIID), a condition in which sufferers do not identify with one of their limbs and subsequently seek amputation. Many medical professionals and lay people alike feel there exists a moral requirement to refuse treatment in instances of BIID, as the curative procedure requires the removal of a “healthy” limb. I, however, resist the supposition of healthfulness of the undesirable limb in instances of BIID and indeed assert that an identity conflict poses a genuine medical condition with the undesirable limb as the source of ailment. Thus, I insist that amputation in the case of BIID is permissible, and further, that the medical establishment must fundamentally reexamine its conceptions of pain, illness, and health to honor a wider range of human experience.
1st Place – Rhetoric + Argumentation
The paper discusses the stance taken by a majority of the Muslim scholars regarding human cloning. It argues that the practice of human cloning should be permissible, through providing a critique on the prevailing arguments that exist in Muslim discourse against human cloning. The paper first argues that human cloning does not undermine God’s role nor does it weaken one’s belief in God. Second, it argues that human cloning does not necessarily result in the breakdown of lineage and kinship among society. Lastly, the paper explains that with further research, human cloning can be made safer and will not be as harmful as critics of human cloning deem it to be.
In the sphere of organ transplantation laws, Iran stands alone. Unlike all other nations, Iran allows its citizens to sell their “extra” kidney in exchange for cash, loans, and better health insurance. This market solution has largely eliminated kidney shortages persistent in countries with no market, and in turn, the Iranian market has allowed sick patients to undergo transplant surgery before they succumb to renal disease. Although these positive attributes may exist, many observers remain unconvinced and believe that the Iranian kidney market disrespects sellers and exploits those who live in poverty in Iran.
My paper serves as a case analysis of the Iranian market and concludes that the Iranian kidney market is not only permissible but also morally imperative. I first examine the consequences of potential markets and the Iranian market and find that while negative outcomes exist, these negative results are not caused by the commodification of kidneys. Rather, the Iranian kidney market produces tremendous good by eliminating organ shortages. Next, I consider whether the Iranian market is ethical while disregarding the consequences of the market. I conclude that the Iranian market enhances the autonomy of sellers. Not only can individuals sell kidneys as they desire, but also, the Iranian market is regulated such that a combination of non-profits, the government, and physicians foster informed consent practices that would otherwise be missing in a black market. Lastly, I recommend that other countries institute regulated kidney markets similar to those in Iran.
The F.D.A. recently granted approval to the genetic testing company 23andMe to offer screenings for three mutations of the BRCA1 and BRCA2 genes that increase one’s likelihood of developing breast cancer. This controversial decision creates a conflict between the fundamental bioethical principles of autonomy and beneficence/non-maleficence. In this paper, I argue that, while provision of these test results should not be banned, the F.D.A.’s decision insufficiently considers the risks posed by relatively unfettered access to these test results. Therefore, a guarantee of the opportunity to consult a professional throughout the process and an explicit recommendation to consumers to do so is needed.
2nd Place – Rhetoric + Argumentation
This case is a response to the 2017 Bioethics Bowl Competition’s Case 13. I will be competing this case in two weeks at the conference in Ogden, Utah along with my four teammates. The case is designed to answer all three questions broadly but more specifically focuses on question number 2 in bold. There are 15 total cases that we have prepared in preparation of the conference. The objective is to build an argumentative case around bioethical and philosophical principles. In this case I raise concerns about UN support and funding for transition opium production in Afghanistan to production of marijuana. I conclude that UN support for this transition would be unethical due to the real-world implications of their support.