Ethics
Who gets the COVID-19 vaccine first? Who do you give the new treatment option to? How do you test this new medicine to see if it works? These are some of the biggest questions in ethics. It was one of the first lessons we were given but the one that I cannot stop thinking about and relating to real life. Ethics, most simply, is looking for the right answer when faced with hard decisions. It can be thought about as a decision between life or death of another person, the right versus the wrong answer, and often has the words “should” or “ought” in the question. As a group we were introduced to ethics by talking about who we think should get a vaccine for a respiratory virus out of a group of people. The roles of these people included a woman who thinks she is six weeks pregnant (counts as 1 dose), two young adults who recently married, a senior citizen in a nursing home (who has fifteen grandchildren), an elementary school teacher, a grocery store cashier, identical twins who are thirteen years old (both have asthma), an experienced ICU nurse, a firefighter with diabetes, and a CEO of a large tech company.
My group decided that the people who took the highest priority would be the people doing essential work and activities such as, working in the ICU, teaching at the elementary school, and the grocery store cashier. The people with the lowest priority included those who could work from home, non-essential workers, and people who are young and in good health. As we decided who would get the highest priority we found that we had views that were both different and the same. Most people agreed that we should give the vaccine to people who were essential for society to function but we also had some differences. Some people had personal stories that made them want to give the vaccine to the senior citizen and children with asthma. Though this was not related to COVID-19 directly, our experience with COVID-19 influences how we think and decisions we make in regard to ethics. Ethics is a hard thing to consider because every person’s point of view is different and personal experiences influence how you feel about situations. When making ethical decisions it is important to keep in mind four things, respect, maximizing benefits and minimizing harm, justice, and critical perspectives. Our lesson on ethics leads me to think about so many things when thinking about my future in science, healthcare, medicine, and life.
From Jeanne Chowning's presentation: These are the four things to consider when thinking about ethics and questions that can help guide
FRED HUTCH NEWS HIGHLIGHT
The Paulovich Lab at Fred Hutch Cancer Research center is led by Dr. Amanda Paulovich. Recently this lab has been working on improving old testing methods for identifying proteins in breast cancer patients. For 30 years patients who tested with a high number of HER2 proteins received a drug called trastuzumab or Herceptin which stopped the growth of the proteins that were feeding breast cancer in the body. The test used to detect a protein called immunohistochemistry or IHC. This test has worked and the treatment has been successful for those who had high amounts of HER2 protein but the test was not as exact as possible. The test was more qualitative, so people with low numbers of HER2 protein were not positive therefore not receive the targeted therapy used for patients who tested positive. The new test that the Paulovich lab is working on is using a more precise method that is quantitative, called multiple reaction monitoring mass spectrometry (MRM-MS). This test will allow more people to be identified for receiving the new and improved drug. This new antibody-drug is known as an antibody-drug conjugate. This antibody-drug conjugate is a combination of the classic treatment, Herceptin, and an additional add on that Dr. Paulovich calls a warhead. The warhead is attached to the Herceptin to make for a really strong treatment. The Herceptin prevents the growth of HER2 protein and the warhead kills cancer in the body. The job of her and her lab is to help the drug producers identify more people who could benefit from this antibody-drug conjugate. This new drug will not be the solution for chemotherapy but makes treatment more accessible for more breast cancer patients. The testing being done in this lab is not limited to breast cancer either, if a new drug is produced that prevents the growth of a different protein it could be identified in this lab. The future of targeted therapies in cancer treatment is hopeful with more precise testing and stronger more effective drugs.
I chose to write about this article because it has a personal meaning to me. My mom was diagnosed with HER2 positive breast cancer this year and is receiving treatment for it right now at Seattle Cancer Care Alliance. 15 or 20 years ago there was not as much hope for survival as there is now because of the targeted therapies that scientists have been testing. This new way of identifying patients for this really effective treatment gives more improvement to the treatment that is already out there. The work that the drug labs and research labs are doing gives me hope for the future of breast cancer and other cancer research.
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