Ethics

Introduction

In this section we will go through the ethical issues we are faced with, when we are talking about the use of medicaments curing lifestyle diseases. We are going to argument for an independent point of view based on different types of ethics.

The research and development of drugs that can cure lifestyle diseases are growing. Concurrently with the popularity and the convenience it offers, a lot of important questions rise: Can we make sure that there is no unwanted side affects? Will the use of such drugs make a society where nobody exercises? Will there be indirect coercion to be thin more than there is today? Will it be easier and more desirable to eat unhealthy instead of having a healthy living? Can people handle the freedom it provides?

Furthermore there are the whole aspects of ethic character: Is it cheating against the nature and other humans to eat what you want and not gain weight, or is it just the same as not eating sugary food? It is justifiable and sound to have a drug like that on the market - Should it be obtainable on prescription, or should it be possible to buy it over the counter? Is it okay to even make a drug like that after all? Should scientist have to be responsible for the way people use their inventions? What is most ethically to do and is it even possible to talk about ethics in the world that we live in today; these are some of the questions we will try to answer throughout this page.

We will focus on the arguments pro and against the use of medicine to cure lifestyle diseases, in our case obesity. We will compare the different sorts of ethics against each other. There will be a discussion divided into two sections – pro and against. First we will make a short introduction to normative ethic as the form we will be using.

Normative Ethic

We will use the normative ethics as the point of departure. It concerns itself with what it wrong and right. This kind of ethics can be classified into subgroups; consequence-based ethic, duty-based ethic, contract ethic and naturalistic ethic.

In consequence-based ethic the actions value is judged on the consequences it can have. The end justifies the means because it is the consequence and not the action itself that has value. An example of consequence-based ethic is the utilitarianism and the utility-based ethic of Bentham. According to utilitarianism the moral worth of an action is determined only by its resulting outcome although there is debate over how much consideration should be given to actual consequences. He introduces a method of calculating the value of pleasures and pains, which has come to be known as the hedonic calculus. Bentham says that the value of a pleasure or pain, considered by itself, can be measured according to its intensity, duration, certainty/uncertainty, purity, fruitfulness, propinquity/remoteness and prevalence.

The opposite goes for the duty-based ethic. Here does the end not justifies the means. The idea is that ethics is a moral law within our self. If an action is right or wrong, depends on a person’s disposition.
The contract ethic is built on a contract between an individual and the society. Ethic responsibility arise form of a contract. Ethic in this branch is seen as a social phenomenon. The individual’s freedom is protected by the contract. The contract ethic is based on justices. It operates with two principles of justices:
- Any person has the right to the most comprehensive and fundamental freedom, which is consistent with the freedom of others.
- Social and economically discrepancy is to be organized so that:

In naturalistic ethics, is the natural the right and the unnatural is wrong. Put in another way – to be reasonable is in our nature. The reason is what should dominate our choices but then again, our desires is also what control us and therefore natural.

Why is it Important to be Ethically Correct when you are a Scientist?

- or is it important to be ethically correct? When you are a scientist you work to some extent with descriptive ethics. You don’t concern yourself with what is right and what is wrong.

You work with challenges in the world. You research and develop products for todays and products that are selling. It is typically based on the perceptions and patterns of a certain group, without deciding if it is alright or not. For example when developing a drug, you do not take into consideration whether the people affected could be at fault for the illness themselves. In our research project, we have not studied people’s attitude towards the use of medicine targeted lifestyle diseases. However, we can observe that being obese is not perceived as a positive thing by a large group of people. When we develop the bacteria, we do not take into account whether the population believes in getting skinny the “easy way”. Many of the research projects in iGEM, are projects that expresses the saying ”just because you can”. There are many people in the world, and therefore there will always be a clientele for the use of your research. Everyone has their own opinions about what you should and should not do. People have the right to form and choose their own opinion of what they believe is right for themselves and their bodies.

It is difficult to be ethically correct when a researcher invents something. It is very easy to encounter people who cannot accept your research. You can soon get to discuss whether it is natural to use our scientific knowledge. You can also discuss whether or not it is human nature to use the tools given to man. Some would say that man's greatest tool is the intellect and the ability to adapt as Darwin says. Humans will always fight for their own survival, just like all other living creatures. Humans will always fight for the best mate, and you do that in nowadays by being good looking. Why should you not use all the tools available, and tools not yet found in the world, to create a better and more reproductive life?

However, it does have a downside to be making things "just because you can." It is important to think about the consequences. Do the consequences exceed the benefits? Does the hedonic calculus sum up to be positive? Let us briefly look at our iGEM product.

Intensity: The intensity is very high as the effect occurs soon after the bacteria are consumed.

Duration: Happiness lasts about as long as the product. You feel better mentally because you know that you do not need to have to deal with the guilt of eating sugar. Additionally, you will also be able to see it on the weight in the long run, because the calories that you would otherwise have consumed will not be converted into fat.

Certainty/uncertainty: With how much certainty occurs happiness? The effect will differ from person to person, just as it will with any other drugs.

Purity: How pure is the feeling of happiness? Happiness could possibly be mixed because, in theory, you can eat all the sugar you want to, without gaining weight. At the same time one must have a guilty conscience by over eating when you know that you should eat less and maybe even work out instead of consuming yoghurt to fight obesity.

Fruitfulness: How many other great things come with the action? There are many good side effects from ingesting inulin. It reduces your hunger, reduces the risk of diabetes, prevents bowel cancer and increases the satisfaction of what you eat.

Propinquity/remoteness: Does the consequence occur soon or sometime in the future? In our case, the consequence happens especially fast. It is a preventive drug, but when you consume our bacteria close to a sugary meal, and the bacteria converts the intake of sugar, it must be said to have a quick effect.

Prevalence: Assessment of all the points above on all persons affected by the action. The conclusion must be assessed that the consequence are beneficial for all of the affected, of the action from the six other sections. Therefore, it must be said from this happiness calculation that our bacteria is consequently, ethically correct, as they provide more happiness than pain.

Is There Such a Thing as "Ethically Correct"?

Meta ethics is about what ethics and morals are. Here you can involve issues of whether there can be no objective answers to ethical questions. Is it possible to objectively talk about what is good and bad morals?

In the medical world, you have the Hippocrates’s oath, describing what is correct to do when you are a scientist. It says, among other things:

“I will apply, for the benefit of the sick, all measures which are required”
“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”
“I will prevent disease whenever I can, for prevention is preferable to cure.”
“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”

This oath describes therefore that we must do everything in our power to help people to get well. And better yet, to prevent the disease. It is important to look at the world and keep in mind that you are not only curing a disease, but it also concerns a person with a family, someone living in a society with an economic balance. This must be cherished. That is why it is essential to help if you can, for example in the form of using synthetic biology to help prevent a disease, even if this is necessarily regarded as unnatural by some.

Should You Make a Cure for/Prevention of Obesity?

Before you make a product it is a good idea to do an impact analysis, not only for the individual but also for society as a whole.
The consequences dealing with our bacteria are both for and against.

Against:

One can argue that there could occur a greater overconsumption in the Western world as it to some degree would be possible to eat more without gaining weight. There will be no more appearance-related obstacles by eating, only the financial margin in the household. A natural reaction to this could be increasing of taxes on unhealthy foods because society ultimately cannot defend the production of so much more food to the individuals with the ever-increasing population.

Another problem is that even though it does not have adverse consequences to convert all of the "bad sugar" to inulin, they still have all the additives that are added to the manufactured food. Let us take the example of coke, which contains plenty of phosphorus that is extremely harmful to the body in large quantities.

In line with the above, this may result in more obesity because people are not informed well enough about the product. If the product is not promoted properly, it is possible that people will eat more unhealthy than they did previously, and therefore gain more weight, because there will typically be some fat consumed too.

There could arise a misuse of food, greater than seen today, where people either overeat or only eat things with sugar, which is degraded and thus used for energy, bordering on anorexia. The defence of overeating is that the inulin gives a greater feeling of satiety and fullness, which ultimately should give you less desire to overeat. You should be aware that the product is likely to reduce desire for food after the conversion of sugar to Inulin, which means that you can go for long periods without being hungry if you just consume a little sugar once in a while. It is a genuine concern that you fight the symptoms of obesity, but not the problem itself. In many cases the eating disorders, whether the case is of overeating or anorexia, are a reaction to mental instability. It could be a possibility to use the money you save on obesity, to assist with psychologists and therapy.

Without the right guidance for the product, people could also quit exercising, and eventually become indifferent to their lifestyle because they can "eat themselves slim". It is also conceivable that there was even more emphasis on living up to the ideals of beauty, as it with the product will be "easier" to stay thin. A downside to this, however, could be that it was more sought after to do it in other, and more unhealthy ways, than by exercising.

There will be a greater potential for fast food manufacturers. For example, people in the U.S. cannot necessarily afford to buy healthy and wholesome food, and therefore it is easier to buy unhealthy food. Our product promotes this attitude because by taking these bacteria, you would be able to cut down on the absorbing calories. This is both a good and a bad consequence. A bad side of this is that it makes it easier for people to stick with fast food, which also means that you do not get the vitamins you need, because they do not eat sufficiently varied, as most of their consumption is fast food. One can then from a political side consider whether any sanctions on sugary food could be a solution to America's obesity problem. This can obviously cause problems for our product, because people will no longer be able to afford to buy as much unhealthy foods, and our product would lose market share, as there is no need for it to the same extent. But in the end, this scenario will be the goal of our product - namely the elimination of obesity.

There are also side effects of the product, but the theoretical bad side effects are far outweighed by the positives.

These points clarifies that, with such an over the counter product on the market, it puts high demands on society and producers about informing consumers so that they have a sensible approach to the product and is aware of the pitfalls that are associated with this.

Ethical Arguments Against

The ethical counterarguments for our product are that it is unnatural when you consume something that prevents the body from absorbing anything it would otherwise have done. It is debatable whether there are unforeseen consequences or not. The theoretical consequences are, at most, increased gas in the intestines, which are not harmful to the consumer.

For:

People take up less of the unhealthy sugar and thereby prevent the part of the risk of being overweight. This reduces a variety of diseases related to obesity, and can save the state and families money on for example medications. It must be assumed that people are healthier when they are not overweight, and thus does not wear out to their bodies and organs to the same extent.

Those who have neither the money nor the time to buy healthy food still have a chance to look and appear healthy. This is of great importance mentally and it is typically easier to get a job and interact in society when you are not overweight. People are happier when they look good and they feel much better about themselves. It will affect many factors in a person's life and relationships with other people. The majority of bullying in schools is typically caused by obesity. Bullying at an early age lays the foundation for mental instability later in life. The fact that you remove a part of the reason for harassment will help prevent mental disorders.
The product has a lot of positive side effects that include healthier intestinal bacteria, increased satiety, increased feeling of fullness, easier weight loss and possible prevention of intestinal cancer.

There is a great economic benefit for companies that produce our product, as there is a market for it, especially in the United States. This is elaborated in the marketing part. At the same time, there is a lot of money to be saved for the hospitals and the state if the population overcomes the obesity epidemic. Instead, you can use the money in a more sensible place, namely by preventing obesity and by informing about better eating habits.

An article in "Ekstra Bladet" shows that obesity costs the Danish society up to 14.4 billion each year. This includes obesities lack of effort in the labor market. Obese people impact the environment through increased pollution. It is every seventh Dane who is overweight. There dies up to 1400 persons per year. This is equivalent to 2 percent of all deaths.

Ethical Arguments for

It is unnatural, but we live in an unnatural world. People today are already using diet products, they are on different diets and gets gastric bypass to become slim. Therefore, our product is natural, and possibly healthier choice for dieting and obesity prevention. It is natural for us to use the resources that are in the communities we live in.

We have an obligation to do something about problems when there are solutions to it. While it can be argued that you have an obligation to not be overweight if possible, and use the proper funds there are available on the market if you cannot make do with exercise and healthy eating. Obesity is incredibly expensive for the society and every year they suffer because of it. In the same way, it is also expensive for the individual is used for treating obesity-related diseases. You have as a citizen of a country a responsibility towards society that one does not burden the healthcare system, and that you get a job. It is undoubtedly harder to get a job if you are overweight and therefore these people may have a greater tendency to be and remain unemployed for long periods. You have the same responsibilities towards your family, namely to enter the job market and spend money on anything but medications. It is typically cheaper to prevent than to cure.

People have the right to choose a product that increases their chances of success. It is adults who have a responsibility for their own lives. There are many social consequences of living a life as obese, which outweigh the theoretical consequences of using our product.

Literature:
http://en.wikipedia.org/wiki/Utilitarianism#Classical_utilitarianism
Ekstra Bladet, 12. maj 2012