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Harrison KL, Geller G, Marshall P, Tilburt J, Mercer M, Brinich MA, Highland J, Farrell RM, Sharp RR. Ethical Discourse about the Modification of Food for Therapeutic Purposes: How Patients with Gastrointestinal Diseases View the Good, the Bad, and the Healthy. AJOB PRIMARY RESEARCH 2012; 3:12-20. [PMID: 22773953 PMCID: PMC3389757 DOI: 10.1080/21507716.2012.662574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND: Researchers have the potential to utilize genetic modification (GM) technologies to create a hybrid of "food" and "medicine" that may challenge traditional understandings of what is "natural". Moral and ethical concerns are likely to arise in any discussion of these therapeutic foods and will affect the integration of products into clinical care and daily life. This study examined how patients with chronic gastrointestinal (GI) diseases view probiotics as future bioengineered therapeutic foods. METHODS: A multi-site qualitative study consisting of focus groups with chronic GI diseases was conducted at Cleveland Clinic, Mayo Clinic, and Johns Hopkins University RESULTS: We conducted twenty-two focus groups with 136 patients with major GI diseases between March and August 2009. GI patients associated the term "natural" with concepts of diminished risk and morally "good"; conversely, patients associated the term "unnatural" with things that are "risky," "foreign", and morally "bad". Readily available unmodified probiotics were more commonly described as "natural" while genetically modified probiotics were more commonly labeled as "unnatural" and "risky". However, patients acknowledged that not all natural products are safe, nor are unnatural products always harmful. CONCLUSIONS: If GI patient perspectives are indicative of public perceptions of therapeutic foods, our findings suggest that the potential benefits and risks of clinical and public health initiatives employing therapeutic foods will be understood in moralistic terms. Bioethicists and others should be sensitive to the implicit normative appeals that are often embedded in the language of what is "natural" and "unnatural".
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Affiliation(s)
- Krista L. Harrison
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Gail Geller
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Patricia Marshall
- Department of Bioethics, Case Western Reserve University, Cleveland, OH, United States
- Center for Genetic Research Ethics and Law, Case Western Reserve University, Cleveland, OH, United States
| | - Jon Tilburt
- General Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - MaryBeth Mercer
- Department of Bioethics, Cleveland Clinic, Cleveland, OH, United States
| | | | - Janelle Highland
- Department of Bioethics, Cleveland Clinic, Cleveland, OH, United States
| | - Ruth M. Farrell
- Department of Bioethics, Cleveland Clinic, Cleveland, OH, United States
- Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, United States
- Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH, United States
| | - Richard R. Sharp
- Center for Genetic Research Ethics and Law, Case Western Reserve University, Cleveland, OH, United States
- Department of Bioethics, Cleveland Clinic, Cleveland, OH, United States
- Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, United States
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Abstract
“Dissecting Bioethics,” edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.The section is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people’s actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are therefore particularly appreciated.The themes covered in the section so far include dignity, naturalness, public interest, community, disability, autonomy, parity of reasoning, symbolic appeals, and toleration.All submitted papers are peer reviewed. To submit a paper or to discuss a suitable topic, contact Tuija Takala attuija.takala@helsinki.fi.
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