Nobel Laureate delivers ‘distinguished’ lecture on Bioethics in Medicine at SRHU
Nobel Laureate and eminent Biochemist Dr Aaron Ciechanover stressed on the significance of bioethics in medicine. Delivering the inaugural address as part of the Distinguished Lecture Series 30th -31st March 2023 initiated at Swami Rama Himalayan University, he highlighted the dilemma in respect of bioethics in medical profession. He informed that Israel is a relatively small country in terms of population with only 9 million but more than 30,000 cases of cancer of various types are reported every year. Sometimes patients come with terminal stages of cancer and it always remains a difficult task to inform the patient or his family that the patient is going to die. Morally speaking, this fact should not be hidden from the patients or the immediate families, but it has been a tough task. They come to the Hospital with hope and think that everything is fine, but when the MRI or other tests are being conducted, they are a little concerned but when it is found that the disease is incurable and that they will die, the entire life of the patient and his family takes a flip. For the doctors, it is a dilemma of how to deal with this and how to tell patients that they don’t have long to live. Here bioethics comes into picture. How to train the medical doctors to deal with this.
Dr Aaron Ciechanover said that when speaking about bioethics, he would like to remind the people about the Covid pandemic. The pandemic created other problems besides the deaths and the problems specific to Covid. The official death count is 5 million but the recount is around 20 million. Israel itself saw more than 14,000 deaths with such an advance medical system and such a small population. The world was not prepared for this pandemic. There were not enough ventilators to put every needy patients on ventilators in the world. There were not enough beds in hospitals, not enough doctors. Ventilators were not enough since one needed accompanying medical experts like cardiologists, pulmonologists etc. So an urgent need arose how to prioritise which people should be put on ventilators and which ones left to die. In Israel, in Italy or other countries some criteria was worked out and based on that criteria based on over 100 parameters, patients were chosen or rejected for treatment and hospitalisation. But the criteria was man which involved bioethics. Later studies revealed that 99 percent of the patients of age 65 years or more with Covid complications died despite ventilators and only the younger survived. Hence this led to what appears to be cruel act, not to admit elderly patients and let them die.
Dr Ciechanover said that Covid also led to neglect of other medical issues. Hospitals were emptied and many patients with other critical illnesses were asked to go home while a large number of hospitals were turned into Covid Hospitals. The response was led by public panic. Covid was stigmatised to an extent that everything else was ignored because everyone including the governments wanted to get rid of this problem at the earliest. Other critical patients had to suffer a lot and many of them might have died due to resulting neglect. Even issues like climate changes were neglected due to pandemic and many children lost formative years of education.
Dr Ciechanover further stated that because of lockdowns and cancellation of flights, people died in Africa because of hunger. New cancer drugs were also delayed by as much as 18 months and this also might have led to deaths of many patients. He also cited the response to vaccines. He said that there was lot of mistrust and misconception over the vaccines. In democracies, people can’t be forced to get vaccinated but the hesitation was also due to lack of trust in the governments and misinformation spread over social media. This, he said can be called as infodemic. He also felt that mistrust was also on account of racial and other kinds of discrimination. He mentioned a study conducted in US where it was seen that 27 percent of white population was hesitant and 16 percent was not at all interested in vaccination. On the other hand 32 percent of black population was hesitant and 40 percent simply unwilling to take vaccines. This mistrust was a result of a long long history of racial discrimination. Blacks do not have reasons to trust the whites. They have been used as experiment subjects without their knowledge for decades and cheated by doctors by a horrendous betrayal of medical oath. He cited experiments conducted on blacks with syphilis research conducted in US as an example. He said that there were good reasons behind the campaigns such as Black Lives matter.
He also referred to certain people like Dr Wakefield who had spread a lot of misconceptions about vaccinations in general. He had claimed that many of the problems were result of vaccines and it finally took billions of dollars and decade’s worth of studies to establish the safety of the vaccines.
The speech was followed by an interesting question and answer session. Some questions were related to his research on characterising the method that cells use to degrade and recycle proteins using ubiquitin, which got him the Nobel prize. He said that while he agreed that special diets can help to some extent in control of the diseases on in slowdown but added that he can’t really see any direct linkages between controlling protein degradation and nutrition. He agreed that that anti oxidants may have role to play but added that these days many rich people paid high amounts of money to get extra oxygen and oxidants to help treat cancer.
In response to another question, Dr Ciechanover said that environmental changes can create problems but he did not see any direct linkage between environmental changes and diseases such as cancer. Genes have far bigger role still behind these medical complications, he stressed. Dr Vijay Dhasmana, Vice Chancellor of SRHU gave the welcome address while Dr Vijendra Chauhan, Pro-VC proposed the vote on thanks. A large number of faculty members, students and distinguished guests were present on this occasion.
Dr Sunil Saini moderated the Question and Answer session.