Translational Value of Animal Models in Research [Raboan Discussion Forum]

Wednesday, (23/08) Center for Bioethics and Medical Humanities (CBMH FK-KMK UGM) held Raboan Discussion Forum. The routine webinar was held in collaboration with International Medical University Malaysia. The speaker was Dr. Renu Agarwal and the moderator was Erlin Erlina, PhD. The raised topic is Translational Value of Animal Models in Research: Ethical Viewpoint.

Understanding how the human body functions, identifying diseases that affect humans, and developing effective treatment options are pivotal endeavors in medical and scientific research. To advance these goals, animal testing has played a significant role in various fields, including research and development (R&D), fundamental research, quality control (QC), production, and toxicity testing. Commonly used animals for these purposes include mice, rats, ectotherms, rabbits, and birds.

One of the most poignant stories related to animal testing is that of Laika, the first dog in space. Laika was sent into orbit aboard the Soviet spacecraft Sputnik 2 to study the prolonged effects of weightlessness on a living being. Unfortunately, her mission ended tragically as she succumbed to stress and overheating. This story sparking a debate on the ethical considerations surrounding animal testing.

This debate can be distilled into two primary viewpoints: those in favor of animal testing (pro-animal testing) and those against it (kontra animal testing).

Proponents of Animal Testing (Pro):
– Argue that human life has greater intrinsic value than animal life and that medical research saves countless human lives.
– Emphasize that legislation is in place to protect lab animals from cruelty or mistreatment.
– Point out that many animals are euthanized before experiencing significant suffering, making their sacrifice more humane.
– Highlight the irony that millions of animals are killed every year for food, questioning whether their deaths for medical research are a more worthy cause.

Opponents of Animal Testing (Kontra):
– Contend that animals have as much right to live as humans and that their lives should not be sacrificed for research purposes.
– Argue that strict controls have not always prevented some animals from being abused, even if such instances are rare.
– Assert that death for research is unnecessary, and alternative methods should be explored to replace animal testing.
– Express concerns about the suffering experienced by animals while they are confined and question our ability to accurately gauge when they do or don’t feel pain.

Despite the ethical divide, international guidelines acknowledge the role of animal testing in advancing medical knowledge and ensuring the safety and efficacy of medicines, vaccines, and surgical techniques. These guidelines stipulate that such testing must involve two different species of mammals. While contentious, it is an unavoidable reality in the pursuit of scientific progress.

The guiding principles underscore the need to regulate animal testing rather than abolishing it and emphasize the humane treatment of animals involved in experiments.

For scientific integrity, researchers must address internal and external validity in animal testing. Key questions include considering the relevance of the chosen animal species, designing experiments to eliminate bias, and outlining plans for data collection and analysis.

In conclusion, the debate over animal testing is complex and multifaceted, touching on ethical, scientific, and regulatory considerations. Striking a balance between advancing medical knowledge and respecting the welfare of animals remains a challenging and ongoing endeavor in the field of research.

Islamic Perspective on the Use of Tube Feeding [Raboan Discussion Forum]

Wednesday (16/08), Center for Bioethics and Medical Humanities, Faculty of Medicine, Public Health, and Nursing held a Raboan Discussion Forum titled “Tube Feeding in Dementia at the End of Life from an Islamic Perspective.” The event, which was held online, invited speakers, Dr. Hadil Lababidi from Erlangen University, Germany. Meanwhile, the discussion was led by Ns. Wahyu Dewi Sulistyarini, M.SN.

Dementia is an umbrella term for a disease of decreased cognitive ability. One type of disease in dementia is Alzheimer’s. People living with acute dementia will experience severe symptoms such as being confined to bed, wetting the bed, and having difficulty swallowing food.

Artificial Nutrition and Hydration (ANH) was created to help people living with dementia get food intake. ANH will be given through a gastronomic tube or nasogastric tube, so this process is often called Tube Feeding. ANH can cause several side effects, such as nausea, vomiting, diarrhea, and infection. Apart from that, it can also make patients stressed and uncomfortable and increase social isolation.

From an Islamic point of view, hunger and lack of nutrition is something that is opposed. However, continuous use of ANH should be avoided. Islam teaches that close relatives who care for dementia patients must respect the patient’s dignity and prevent the side effects of ANH.
There are several alternatives that can be used besides tube feeding, including Assisted Hand Feeding (AHF), Feeding Positions and Skills, and Modification of Food Texture.

Professionalism and Ethical Responsiveness for Medical Student [Raboan Discussion Forum]

Wednesday (09/08), Center for Medical Bioethics and Humanities, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University held Raboan: International Collaboration in collaboration with International Medical University Malaysia. The boldly held event raised the topic of Student Empowerment: Professionalism & Ethical Responsiveness, which was presented by Dr. Serena In from IMU Malaysia. Meanwhile, the moderator who led the discussion was Dr. Wika Hartanti MIH from CBMH FK-KMK UGM.

Professionalism is an important thing to be mastered by students, especially medical students. Professionalism and Ethical Responsiveness emphasize the commitment of physicians and healthcare professionals to excellence, patient well-being, and the health needs of society. For students to have professionalism and ethical responsiveness, such as integrity, accountability, respect, and professional commitment, it is necessary to involve various stakeholders in medical education and patient care.

Dr. Serena highlighted the competencies of good ethical education, including the ability to identify ethical issues, knowledge of aspects, self-reflection, and making ethical decisions in critical situations. Methods that can be taken include conducting open dialogues, simulations, case studies, and workshops in order to develop skills and understanding of complex ethical issues. So students can explore their attitudes, manage emotions, and engage with different perspectives.
Dr. Serena suggested that lecturers can encourage students to be aware of how ethical issues can be resolved in clinical practice. She also encourages students to dialogue and interact with others to determine whether students have ethical abilities in clinical practice.

Cultural Influence on Clinical Ethics [Raboan Discussion Forum]

Wednesday (02/08) Center for Bioethics and Medical Humanities held the Raboan Discussion Forum again. The webinar, which was held online, raised the topic of Cultural Influence on Clinical Ethics. The speaker was Peter Johannes Manoppo Bioethicist, General Surgeon. Meanwhile, the role of the moderator was Nathan Agwin Khenda, Ftr.

Culture influence is the influence of culture or tradition in clinical practice. The challenges that arise in the doctor-patient relationship occur because of differences in culture and language. One of the cultural influences of paternalism is when doctors make decisions without considering patient autonomy.

In applying clinical ethics, cultural context, relationships between groups, and medical ethical codes must be considered. Culture and tradition influence arguments, medical indications, and patient wishes.

The solution to overcoming cultural differences is forming bridging groups, such as nurses or patient families, who can help bridge the communication between doctors and patients. This can improve patient comfort, doctor’s analytical ability, and benefit both parties.

It is very important for doctors to have soft skills such as the ability to communicate and understand cultural differences. This can provide benefits for improving interaction and collaboration with local communities in efforts to improve health services in various contexts.