Matthias Braun

Individualisierte Medizin: Ethische und gesellschaftliche Herausforderungen

ZusammenfassungDie Diskussionen um die sog. individualisierte Medizin, ihre Chancen, Möglichkeiten und Visionen prägen die aktuellen Debatten um die Zukunft von Medizin und Gesundheitssystem. Neben der prinzipiellen Nachfrage, was eigentlich Gegenstand einer solchen individualisierten Medizin sei, gibt es immer wieder auch ethische Bedenken und Rückfragen, die gegen die sog. individualisierte Medizin ins Feld geführt werden. Diese kritischen Rückfragen wie auch Herausforderungen und Chancen der individualisierten Medizin werden aus ethischer Perspektive beleuchtet. Dabei ist zu konstatieren, dass es in der individualisierten Medizin vorrangig darum geht, die aktuellen Entwicklungen in einem ethischen Assessment zu begleiten, es aber aktuell keine ethischen Argumente gibt, die per se gegen eine weitere Forschung in diesem Bereich sprechen.

Re-entering obesity prevention: a qualitative-empirical inquiry into the subjective aetiology of extreme obese adolescents

BackgroundWhile numerous studies highlight the relevance of socio-cultural factors influencing incidence and prevalence of obesity, only a few address how obese people perceive causes and prevention of or intervention for obesity. This study contributes to a more thorough understanding of subjective aetiologies and framing themes for a mainly understudied but promising field. Thus it may serve for the development of effective public health strategies to combat obesity.MethodsAutobiographically based in-depth interviews were conducted with 20 patients (adolescents and young adults) institutionalised in the obesity rehabilitation centre INSULA in Bischofswiesen (Germany). The data were analysed with Atlas.ti with regard to two main perspectives: (1) How the interviewees perceive ‘their’ obesity from a subjective point of view and (2) which conclusions they draw from their own ‘story’ concerning prevention/intervention strategies.ResultsThe interviewees did not indicate a clear starting point for their overweight. Nevertheless, certain life-events (e.g. divorce or illness of parents) were identified as catalysing weight gain. As a consequence of coping with distress, body weight rises rapidly and not continuously. Obesity was generally framed as a problem primarily located within the family and not in the wider environment. Corresponding to this, the family was identified as the main and most important addressee of preventive measures. The interviewees highlighted the importance of personal responsibility as a prerequisite for self-determined action against obesity, but denied any link between responsibility and guilt.ConclusionsThis study contributes substantially to a broader perspective on the prevention of obesity. First, more attention has to be paid to the interactions of medical aspects and the social dimension of obesity. Second, prevention efforts should be more aware of the relevance of subjective aetiology when it comes to the definition of reasonable and effective governance strategies in tackling obesity. Third, current assumptions concerning the importance of personal responsibility for obesity prevention might underestimate the relevance of self-determined action of the obese.

A primer to ‘bio-objects’: new challenges at the interface of science, technology and society

Biotechnological and life science innovations do not only lead to immense progress in diverse fields of natural science and technical research and thereby drive economic development, they also fundamentally affect the relationship between nature, technology and society. Taken this seriously, the ethical and societal assessment of emerging biotechnologies as for example synthetic biology is challenged not only to constrain on questions of biosafety and biosecurity but also to face the societal questions within the different fields as an interface problem of science and society. In order to map this vague and stirring field, we propose the concept of bio-objects to explore the reciprocal interaction at the interface of science and society serious as well to have the opportunity to detect possible junctions of societal discontent and unease before their appearance.

The synthetic biology puzzle: a qualitative study on public reflections towards a governance framework

Synthetic biology is currently one of the most debated emerging biotechnologies. The societal assessment of this technology is primarily based on contributions by scientists and policy makers, who focus mainly on technical challenges and possible risks. While public dialogue is given, it is yet rather limited. This study explores public debates concerning synthetic biology based on a focus group study with citizens from Austria and Germany and contextualises the analysed public views with content from policy reports and previous empirical studies on public engagement. The findings suggest that discussants favoured a gradual implementation process of synthetic biology, which is receptive to questions about the distribution of possible benefits. The discussed topics correspond in many ways with content from policy reports and former investigations, yet the emphasis of the discussions was different for many aspects.

Safe and Sound? Scientists’ Understandings of Public Engagement in Emerging Biotechnologies

Science communication is a widely debated issue, particularly in the field of biotechnology. However, the views on the interface between science and society held by scientists who work in the field of emerging biotechnologies are currently insufficiently explored. Therefore filling this gap is one of the urgent desiderata in the further development of a dialogue-oriented model of science-public interaction. Against this background, this article addresses two main questions: (1) How do the persons who work in the field of science perceive the public and its involvement in science? (2) What preferred modes of communication are stressed by those scientists? This research is based on a set of interviews with full professors from the field of biotechnology with a special focus on synthetic biology. The results show that scientists perceive the public as holding a primarily risk-focused view of science. On the one hand, different forms of science communication are thereby either seen as a chance to improve the public acceptance of science in general and one field of research in particular. On the other hand, the exchange with the public is seen as a duty because the whole of society is affected by scientific innovation. Yet, some of the stakeholders’ views discussed here conflict with debates on public engagement in technological innovation.

Mind the gaps!: Towards an ethical framework for genome editing

The use of CRISPR/Cas genome editing in agriculture and medicine develops in a state of vagueness regarding regulation, trust and responsible research. The precautionary principle could provide a way for handling these uncertainties when developing safe and socially acceptable applications.

Ways Out of the Patenting Prohibition? Human Parthenogenetic and Induced Pluripotent Stem Cells

Abstract According to the judgement of the European Court of Justice in 2014, human parthenogenetic stem cells are excluded from the patenting prohibition of procedures based on hESC by the European Biopatent Directive, because human parthenotes are not human embryos. This article is based on the thesis that in light of the technological advances in the field of stem cell research, the attribution of the term ‘human embryo’ to certain entities on a descriptive level as well as the attribution of a normative protection status to certain entities based on the criterion of totipotency, are becoming increasingly unclear. The example of human parthenotes in particular demonstrates that totipotency is not at all a necessary condition for the attribution of the term ‘human embryo’. Furthermore, the example of hiPSC and somatic cells particularly shows that totipotency is also not a sufficient condition for the attribution of a normative protection status to certain entities. Therefore, it is not a suitable criterion for distinguishing between human embryos worthy of protection and human non‐embryos not worthy of protection. Consequently, this conclusion has repercussions for the patenting question. The strict delineation between an ethically problematic commercial use of human embryos and the concomitant patenting prohibition of hESC‐based procedures and an ethically unproblematic commercial use of human non‐embryos and the therefore either unrestrictedly permitted (cf. human parthenotes) or even unregulated (cf. hiPSC) patenting of procedures based on these alleged alternatives becomes increasingly blurred.

Hybridisierungsdynamiken im Verständnis von und im Umgang mit ‚Leben’

Befürworter wie Kritiker der Synthetischen Biologie sind sich darin einig, dass das transformative Potential dieser Biotechnologie zu Verschiebungen in der Deutung kultureller Leitunterscheidungen – z.B. im Verständnis des Lebensbegriffs – führen und deshalb neue gesellschaftliche Aushandlungsprozesse im Umgang mit lebenswissenschaftlichen Innovationen provozieren wird. Der vorliegende Aufsatz untersucht solche Transformationen kultureller Orientierungsmuster, indem unter Rückgriff auf die hermeneutische Figur des kulturellen Unbehagens die den Produkten der Synthetischen Biologie anhaftenden Ambiguitäten erschlossen und mit Hilfe des von Bruno Latour vorgeschlagenen Theorierahmens als Phänomene der Hybridisierung erfasst werden. Das Konzept der ‚Bio-Objekte‘ bietet die Möglichkeit, die so identifizierten Herausforderungen für das Verständnis von ‚Leben‘ zu bearbeiten und konzeptionelle und handlungspraktische Implikationen emergierender Biotechnologien zu eruieren.