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Nobel Prize winner Prof. Chechenover on science and ethics in the times of Corona: new-old challenges

Prof. Aharon Chachanover lectured on the burning issue, mainly he warns about the danger of resistance to vaccines (video)

Research Professor Aharon Chachanover. Photo: Technion spokespeople
Research Professor Aharon Chachanover. Photo: Technion spokespeople

In line for the ventilator

The current period floods the ethical issues concerning the technological development. For example, the question of patient prioritization: should we give priority to a young person over an old person in the line for the ventilator? In Italy, for example, it was decided to save the young first; In Israel, on the other hand, a different decision was made - there will be no age discrimination, and if we reach a crisis where we are required to prioritize patients in line for the ventilator, the decision will be based on weighing a set of factors, including the patient's other background illnesses and the chances of his recovery.

As mentioned, the development of medicine raises complex ethical questions, and the answers are not found in the medical technology itself. For example, on whom does the decision regarding the priority of the soul fall? It is a fateful decision that sometimes means who lives and who dies. Such a decision has many aspects - legal, social, family, historical and of course medical-scientific, as well as aspects related to tradition. Therefore we must not leave this decision to either doctors or scientists; We, as a society, must use their advice, while providing them with guidelines; The decision forum must reflect the structure of society in its many facets.

Personalized medicine

The ethical issues are becoming more and more complex as medicine advances, as it becomes more precise and personalized. Personalized medicine means that the medical treatment will be adapted to the patient's genetic and biochemical profile and to the set of physical data. Therefore, personalized treatment will be better than "off the shelf treatment" or one size fits all medicine. This is a significant positive development, but it requires a deep perceptual change in the basic concepts of medicine and in decision-making. For example, if the doctor at Rambam Medical Center tells a patient that he has good and bad news - '"You didn't have a heart attack but you have a gene that increases the tendency to Alzheimer's" - what is the person supposed to do? Who should he share this information with? His wife, who in a few years he will have trouble recognizing? His employer, who may be fired? The insurance company that may refuse to renew his policy? Personalized medicine and the ability to correct genes, even in the embryonic stage, also completely change the definition of a patient (can the embryo or the fertilized egg be defined as "sick"?), of a disease (is hair color or body structure or level of intelligence, which in the future we will be able to predict And perhaps targeting them already at an early stage, can be considered a disease in the eyes of some people?) and of treatment (what is allowed and what is not allowed in editing genes - is it allowed to treat only the patient's own problem or also a future problem of his descendants?).

Dangerous myths

Madonna, before the vaccine, claimed to her 50 thousand followers that there is already a vaccine but only the rich receive it. Illustration:
Madonna, before the vaccine, claimed to her 50 thousand followers that there is already a vaccine but only the rich receive it. Illustration:

The corona epidemic not only illustrates the importance of modern medicine; Unfortunately, it also intensifies the infodemic phenomenon - the deliberate distribution of incorrect information. Madonna, with her 50 million followers, promotes the connection theory according to which there is already a vaccine for Corona but it is in the hands of the rich for their use only. As scientists and doctors it is difficult for us to influence such a large audience - after all, no scientist has 50 million followers. Another connection theory holds - contrary to the scientific findings - that certain drugs help corona patients. The plague overwhelms the hostility, in certain circles, to medical science in general and to vaccines in particular, and this even before we have a vaccine for Corona. In 1998, Andrew Wakefield began to spread the false claim about the existence of a causal link between vaccines and autism - a claim that misled millions and caused severe damage to public health. Despite a series of serious studies, which refuted the false myth and clarified that vaccines do not cause autism, many adults in the world do not vaccinate their children and do not intend to vaccinate against Corona when there is a vaccine.

Resistance to vaccines is especially common among young people, perhaps because the adults still remember the great plagues of the twentieth century and their successful eradication, which is the result of the development and improvement of vaccines. It also brings up again the problem of the discriminatory treatment of minorities in the US, among whom the opposition to vaccines is also widespread because they do not trust everything that comes from the government. All of us - scientists, doctors and members of the media - must work to make the correct scientific information accessible so that the general public understands the importance of vaccines in particular and the meanings of the personalized medicine revolution in general and their reliance on evidence-based science and clinical trials.

Research Prof. Aharon Chachanover, Nobel Prize laureate in chemistry

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