Understanding bioethics and the ethical dilemmas surrounding medical technologies and advances, should not only be reserved for future physicians and philosophers. This understanding is a fundamental aspect of our collective knowledge as teenagers living in a world growing increasingly complex. These discussions are taking place through healthcare policy, shaping personal health decisions, and posing fundamental questions about what it means to be human in the 21st century.
1.Designer Babies and Genetic Engineering
The idea of "designer babies" remains a potential subject for empirical investigation - thus representing a shift above from science fiction to fact. Through the use of gene-editing tools like CRISPR, it may be possible for parents to select the traits of their offspring soon enough, like eye color, intelligence, the ability to overcome certain diseases, and with it, as the author assesses, many consequential ethical dilemmas regarding equity, human enhancement, and normality. The issue received international attention in 2018, when a scientist in China claimed to have gene-edited two babies, ultimately provoking a highly publicized surprise from the scientific community.
2.Artificial Intelligence in Healthcare
With social media-driven systems increasingly interpreting disease and recommending treatments, considerations surrounding accountability, bias, and patient autonomy are increasingly salient. If AI algorithms are developed using biased or out-of-date data, it is likely that the result is the continued entrenchment of healthcare inequities, wherein AI systems could provide different levels of care that vary based on race, gender, or any other social determinant of health. In addition, if an AI system makes a diagnostic error, who is responsible for the error? Patients will also face existing questions concerning informed consent: how would a patient even know if AI was involved in their care?
3.Animal Testing for Medical Research
Over 100 million animals are used annually in medical research worldwide, which continues to raise ethical questions about the trade-off between scientific improvement and animal welfare. Ethical animal research seeks to follow the '3 Rs' - Reduction, Refinement, and Replacement - but the question remains whether the current positions are enough. Public opinion about animal testing is highly polarized, with roughly half in support of and half against animal testing in Western countries.
4.Euthanasia and Assisted Dying
The moral and ethical dilemma between the right to die with dignity and the sanctity of life has created perhaps bioethics' most emotionally contentious debate. Currently few countries and only some U.S. states allow assisted dying under specific conditions. Proponents emphasize personal autonomy and alleviating suffering, while the opposition is concerned with protecting vulnerable populations and trust in health care. The debate becomes more complicated when one considers teenagers, who are probably not in a legal position to reasonably arrive at such decisions.
5.Organ Transplant Ethics and Allocation
At present, there are more than 100,000 Americans on transplant waiting lists. The allocation process that distinguishes between patients in need of lifesaving transplants involves ethical considerations. The key issue for transplantation systems is how to ration scarce organs equitably while retaining public trust in the donation process. Public policies which give preference to certain patients with cardiac devices, and the practice of multiple listing, raise pertinent questions about equity. Transplantation systems need to balance medical standards with wider social considerations.
6.Teenage Pregnancy and Reproductive Rights
Adolescent pregnancy raises numerous ethical implications surrounding autonomy, consent, and protection. While caring for a pregnant adolescent, the health care provider will wrestle with many choices involving confidentiality when the adolescent has an unhealthy family system. In any given jurisdiction, the adolescent's right to reproductive health care services with parental consent will be a function of laws in that jurisdiction. Factors such as culture and context, poverty, and education impact adolescent pregnancy. Solutions must recognize individual rights and social determinants of health.
7.Mental Health Consent and Confidentiality for Minors
The Mental Healthcare Act imposes a requirement for parents to provide consent for the treatment of minors, creating ethical dilemmas when an adolescent seeks mental health care independently. Dilemmas may arise when an adolescent that is in a process of development, will often opt out of treatment when parental knowledge or involvement is needed, and wait until they are in a state of unwellness. The dilemmas emerge by attempting to balance the adolescent's right to develop autonomy with parental support and the protection of adolescents. There is an obligation for health care providers to assess and know the adolescent's capacity for autonomous decision making in the context of their development.
8.Vaccine Hesitancy and Adolescent Health
Vaccination hesitancy in adolescents brings distinct developmental, clinical, ethical and legal considerations. Adolescent vaccination hesitancy is different from hesitancy for younger children in that the adolescent's own beliefs and attitudes about vaccination typically have an influence on the adolescent's vaccination decisions. Adolescent vaccination uptake is positively associated with increased accurate knowledge of vaccine-preventable disease, and increased confidence in vaccines. In the context of COVID-19, the discussion about whether adolescents should be able to consent for vaccination against their parent's wishes intensified.
9.Genetic Privacy and Family Secrets
Genetic testing has a distinctive privacy consideration because one's DNA contains information about the family unit. Since 2018 and the Golden State Killer case, there is a heightened awareness that genetic privacy is not merely an individualistic concern. Genetic privacy policies and questions regarding consent also include possible genetic relatives of individuals. Because police used a genealogy website to find a suspect through distant relatives, we could have individuals like teenagers that are even more susceptible to genetic privacy; their genetic information may be utilized without consent by their family or members of their family. Many questions emerge in the landscape of genetic privacy: specifically who owns the genetic information and how do we reconcile individual will and rights with family rights?
10.Research Participation and Teenage Consent
Involving adolescents in medical research presents complex ethical issues of assent, consent and safeguarding. Even young children display nociceptive skills to comprehend the basic components of research elements, although children's cognition varies. The question for researchers is how to balance adolescents' wishes for privacy/autonomy and the acceptable parental participation. Trust is another dimension of choice that affects adolescents' decision making in research participation and the determination of risks.
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