Glossary of Terms and Acronyms

This glossary offers some useful definitions of terms and acronyms that are used in the discussion of bioethical issues.

For ease of understanding this Glossary is divided into sections including:

General Terms and Concepts in Bioethics​

Autonomy, Competence and Informed Consent are fundamental concepts in Bioethics.

An individual’s ability to freely make their own decisions in accordance with their own values, without coercion, manipulation or deceit.
Thus, to act against someone’s wishes or to act without someone’s permission would be a violation of their autonomy. Patient autonomy is held as the primary ethical principle in health care decision making in New Zealand.

Beauchamp and Childress are seminal authors within the area of autonomy, competence and informed consent. They offer the following definition of competence:
“A patient or subject is competent to make a decision if he or she has the capacity to understand the material information, to make a judgement about the information in light of his or her values, to intend a certain outcome, and to freely communicate his or her wish to caregivers or investigators.” (1994, p 135)
Competence is a difficult thing to assess even in the simplest of adult cases, as it is a dynamic concept, varying in accordance with the specific situation. Buchanan and Brock (1989) point out that the statement that a particular individual “is”, or “is not”, competent is incomplete. Competence is always competence relating to some task – it is competence to do something.

An individual’s voluntary agreement to undergo a diagnostic, preventative or therapeutic procedure, or to participate in research, based on their knowledge and understanding of all relevant information.

Rights are entitlements. Rights are justified claims that individuals and groups can make upon others or upon society. As Beauchamp & Childress (1994, p69) point out, statements of rights provide vital protection of life, liberty, expression and property, a safe guard against oppression, unequal treatment, intolerance, arbitrary invasion of privacy and so on.

Claims that are justified by legal principles and rules.

Claims justified by moral principles and rules.

A positive right is a right to be provided with a particular good or service by others. (For example, in New Zealand, an adolescent has the positive legal right to obtain contraceptive advice from an appropriate heath care professional.)

An individual’s voluntary agreement to undergo a diagnostic, preventative or therapeutic procedure, or to participate in research, based on their knowledge and understanding of all relevant information.

Terms associated with reproductive technology

Blastomeres are the initial cells of the early embryo. For example, two to three days after fertilisation, the human embryo consists of eight blastomeres. At this early stage each of the cells is Totipotent.

Blastocyst is the stage approximately four days after fertilisation and after several cycles of cell division when the totipotent cells begin to specialize, forming a hollow sphere of cells. The blastocyst looks a little like an inverted diamond ring, with a layer of outer cells and inside the hollow sphere, a cluster of cells called the inner cell mass.
The outer layer of cells will go on to form the placenta, amniotic fluid and other supporting tissues needed for foetal development in the uterus.
It is cells from the ‘inner cell mass’ that can become any of the over 200 tissues that make up the human body. The cells of the inner cell mass are pluripotent.

Cloning is the process of creating copies of a biological entity including fragments of DNA, whole cells, or whole organisms.
Essential to any discussion regarding human cloning is the distinction between therapeutic and reproductive cloning.
Human Reproductive cloning wants to create complete individuals that will live and grow into adulthood much like any naturally conceived child.
In contrast, Therapeutic cloning seeks to produce single tissues or organs that may be used for analysis, treatment and healing.

The early stages of growth and differentiation between zygote and foetus. In humans, the embryo is the stage between zygote and the end of the eighth week after fertilisation.

A mature ovum or sperm. A gamete contains a single set of unpaired chromosomes necessary to form a new individual. Gametes may also be referred to as “germ line” cells as they contribute to the next generation. Gametes are formed through the specialised cell division called meiosis.

The stage between embryo and birth when the developing vertebrate exhibits recognisable features of the mature animal. In humans, the foetal stage is recognised as being from the end of the eighth week after fertilisation until birth.

The stage, approximately 14 days after fertilisation when the cells of the inner cell mass specialise and become committed to become cells that have a particular ‘bodily’ function. It is only after individuation that there is no longer a chance that the embryo will divide into monozygotic twins.

The female gamete also referred to as the egg, oocyte or female sex cell.

Cells of the developing embryo that have plural potential. It is these cells that are important in the stem cell debate. To use these cells destroys the embryo.

A body cell that contains the full complement of chromosomes
In animal studies using SCNT, researchers have taken a normal animal egg cell and removed the nucleus that contains the chromosomes, leaving behind the cytoplasm that contains nutrients and other energy-producing materials that are essential for embryo development. Next, a somatic cell – that is, any body cell other than an egg or a sperm cell – is placed next to the egg from which the nucleus had been removed, and the two are fused. The cell is stimulated electrically and may begin to divide into totipotent cells that will soon form a blastocyst. Cells from the inner cell mass of this blastocyst can then be used to develop pluripotent stem cell lines. Somatic cell nuclear transfer (SCNT) is Cloning.
Stem cells are cells that have the ability to divide continuously and to develop into various kinds of specialised tissue. Many scientists believe that with research, stem cells will be able to be used to treat a wide variety of serious injuries or diseases from spinal cord injury to cancer. However, ethical issues arise when we consider the various sources of stem cells that may be used for research or treatment purposes.
Totipotent cells are undifferentiated cells of the very early embryo, which have total potential. That is, given the right circumstances each cell has the potential to develop into a foetus. It is impossible at this stage to tell which cell will become what.
A term coined from Aldous Huxley’s 1932 book “Brave New World” in which Huxley anticipated developments in reproductive technology that saw human infants created in test-tubes. The term “test-tube baby” has become synonymous for a baby created via IVF (in vitro fertilisation), which actually involves petri dishes!
Zygote comes from zugoun ‘to join’, the zygote is the first cell of a new individual formed by the union of the ovum and sperm, and prior to the first cell division. The zygote contains the full complement of chromosomes required for an individual, having received half from the ovum and half from the sperm.

Terms associated with Biotechnology

Transplantation of living cells, tissues or organs within the same species, for example from human to human; dog to dog. The living tissue may be from a deceased donor (e.g. heart, liver or corneal transplant) or from a living donor (e.g. kidney, skin, bone marrow).
Transplantation of living cells, tissues, or organs, between from the member of one species to the member of a different species. For example, the transplantation of living tissue from a pig into a human. (The injection of pancreatic cells from a pig into humans with diabetes is an example of xenotransplantation.)

Terms associated with end of life issues

Assisted suicide is where a doctor or other person assists the terminally ill person to kill themselves.
The term is deriving from the Greek eu meaning good, and thanatos meaning death, the word euthanasia originally meant good death. That is, that an individual should “be enabled to die well” – a comfortable death, gentle and prepared for at the end of a fulfilled life. This compared with a bad death, Cacothanasia – hideous, tormented death, unexpected and unprepared for. Common usage of the term euthanasia has established a meaning associated with “mercy killing” – the intentional killing of someone who is terminally ill or in severe, incessant pain in order to spare them from further suffering. In this modern context, euthanasia carries with it a value judgement that, for the person who dies, death is actually a good thing.
Functionally bringing about a patient’s death through a direct means such as by administering a lethal injection. Active euthanasia may be either with or without the patient’s request.
Involves allowing the patient to die, not by directly killing them, but by withdrawing or omitting treatment.
Means that the intentional termination of the person’s life is done at their own request.

Those Acronyms!

(Established under New Zealand’s Human Assisted Reproductive Technology Act 2004.) Government appointed, members of ACART are required to undertake extensive public consultation and from this to formulate policy and advise the New Zealand Government. www.acart.health.govt.nz
(Established under New Zealand’s Human Assisted Reproductive Technology Act 2004.) Government appointed, members of ECART consider and determine applications for assisted reproductive procedures and human reproductive research in New Zealand. They also monitor and review approvals given and previously given. www.ecart.health.govt.nz
HART: Human Assisted Reproductive Technology
HART Act (2004): the Human Assisted Reproductive Technology Act is designed to regulate assisted reproductive technology and human reproductive research in New Zealand, including IVF and associated technologies, and research that uses or creates gametes or embryos. The Act imposes prohibitions on fundamentally unacceptable practices (including cloning) and established both the Advisory Committee on Assisted Reproductive Technology and the Ethics Committee on Assisted Reproductive Technology.link to HART Act
HFEA: Human Fertilisation and Embryology Authority – is the statutory body that regulates artificial reproductive technologies and research in the United Kingdom.
IV: In Vitro – “within the glass” that is, outside a living body. This compares with In Vivo – within a living body.

IVF: In Vitro Fertilisation – the joining of egg and sperm outside the body.

IVM: In Vitro Maturation – the removal of immature ovum from the female body and the subsequent maturing of these eggs in the laboratory. When necessary the IVM process is added prior to in vitro fertilisation.
ICSI: Inter-Cytoplasmic Sperm Injection. A procedure sometimes used during IVF where a single selected sperm is injected directly into the cytoplasm of the ovum to achieve fertilisation.
PGD: Pre-Implantation Genetic Diagnosis. (Sometimes referred to as ‘embryo biopsy’.) This procedure involves the removal of one (sometimes two) blastomere from the early embryo at the 8-cell stage. Genetic screening is then undertaken on this cell.
SCNT: Somatic Cell Nuclear Transfer. The process of removing the nucleus from an ovum and transferring a nucleus from a somatic cell into the cytoplasm that remains. SCNT is a form of cloning.
UNCROC: United Nations Convention on the Rights of the Child. The General Assembly of the United Nations adopted the United Nations Convention on the Rights of the Child (UNCROC) on the 20th of November 1989. It passed into force as an international law on 2nd September 1990 following its ratification by the requisite twenty states. Since then, the UNCROC has been ratified by all but two of the world’s governments, making it the most widely ratified human rights treaty in history. New Zealand ratified the UNCROC in 1993. The United Nations Convention on the Rights of the Child consists of fifty-four articles that can be divided into three main types of rights: provisions rights, protection rights and participation rights. UNCROC emphasises that children have a special need for protection but that they simultaneously have a special need to be regarded and treated as individuals.

References:

Beauchamp T.L. & Childress J.F. (1994) Principles of biomedical ethics.4th ed. New York: Oxford University Press.

Buchanan A.E. & Brock D.W. (1989) Deciding for others: The ethics of surrogate decision making. Cambridge: Cambridge University Press.

General terms and concepts in Bioethics

Autonomy, Competence and Informed Consent are fundamental concepts in Bioethics.
  • Autonomy
    • An individual’s ability to freely make their own decisions in accordance with their own values, without coercion, manipulation or deceit. Thus, to act against someone’s wishes or to act without someone’s permission would be a violation of their autonomy. Patient autonomy is held as the primary ethical principle in health care decision making in New Zealand.
  • Competence
    • Beauchamp and Childress are seminal authors within the area of autonomy, competence and informed consent. They offer the following definition of competence: “A patient or subject is competent to make a decision if he or she has the capacity to understand the material information, to make a judgement about the information in light of his or her values, to intend a certain outcome, and to freely communicate his or her wish to caregivers or investigators.” (1994, p 135) Competence is a difficult thing to assess even in the simplest of adult cases, as it is a dynamic concept, varying in accordance with the specific situation. Buchanan and Brock (1989) point out that the statement that a particular individual “is”, or “is not”, competent is incomplete. Competence is always competence relating to some task – it is competence to do something.
  • Informed Consent
    • An individual’s voluntary agreement to undergo a diagnostic, preventative or therapeutic procedure, or to participate in research, based on their knowledge and understanding of all relevant information.
  • Rights
    • Rights are entitlements. Rights are justified claims that individuals and groups can make upon others or upon society. As Beauchamp & Childress (1994, p69) point out, statements of rights provide vital protection of life, liberty, expression and property, a safe guard against oppression, unequal treatment, intolerance, arbitrary invasion of privacy and so on.
  • Legal rights
    • Claims that are justified by legal principles and rules.
  • Moral rights
    • Claims justified by moral principles and rules.
  • Positive right
    • A positive right is a right to be provided with a particular good or service by others. (For example, in New Zealand, an adolescent has the positive legal right to obtain contraceptive advice from an appropriate heath care professional.)
  • Negative right
    • In contrast, a negative right is a right to be free from some action taken by others. (For example, a competent adult has a negative right to forgo a recommended medical procedure.) So, an individual’s positive right entails another’s obligation to do something for that individual, whereas a negative right necessitates another’s obligation to refrain from doing something.

Terms associated with reproductive technology

  • Blastomere
    • Blastomeres are the initial cells of the early embryo. For example, two to three days after fertilisation, the human embryo consists of eight blastomeres. At this early stage each of the cells is Totipotent.
  • Blastocyst
    • Blastocyst is the stage approximately four days after fertilisation and after several cycles of cell division when the totipotent cells begin to specialize, forming a hollow sphere of cells. The blastocyst looks a little like an inverted diamond ring, with a layer of outer cells and inside the hollow sphere, a cluster of cells called the inner cell mass. The outer layer of cells will go on to form the placenta, amniotic fluid and other supporting tissues needed for foetal development in the uterus. It is cells from the ‘inner cell mass’ that can become any of the over 200 tissues that make up the human body. The cells of the inner cell mass are pluripotent.
  • Cloning
    • Cloning is the process of creating copies of a biological entity including fragments of DNA, whole cells, or whole organisms. Essential to any discussion regarding human cloning is the distinction between therapeutic and reproductive cloning. Human Reproductive cloning wants to create complete individuals that will live and grow into adulthood much like any naturally conceived child. In contrast, Therapeutic cloning seeks to produce single tissues or organs that may be used for analysis, treatment and healing.
  • Embryo
    • The early stages of growth and differentiation between zygote and foetus. In humans, the embryo is the stage between zygote and the end of the eighth week after fertilisation.
  • Gamete
    • A mature ovum or sperm. A gamete contains a single set of unpaired chromosomes necessary to form a new individual. Gametes may also be referred to as “germ line” cells as they contribute to the next generation. Gametes are formed through the specialised cell division called meiosis.
  • Foetus (also spelt fetus)
    • The stage between embryo and birth when the developing vertebrate exhibits recognisable features of the mature animal. In humans, the foetal stage is recognised as being from the end of the eighth week after fertilisation until birth.
  • Individuation
    • The stage, approximately 14 days after fertilisation when the cells of the inner cell mass specialise and become committed to become cells that have a particular ‘bodily’ function. It is only after individuation that there is no longer a chance that the embryo will divide into monozygotic twins.
  • Ovum
    • The female gamete also referred to as the egg, oocyte or female sex cell.
  • Pluripotent cells
    • Cells of the developing embryo that have plural potential. It is these cells that are important in the stem cell debate. To use these cells destroys the embryo.
  • Somatic Cell
    • A body cell that contains the full complement of chromosomes
  • Somatic Cell Nuclear Transfer (SCNT)
    • In animal studies using SCNT, researchers have taken a normal animal egg cell and removed the nucleus that contains the chromosomes, leaving behind the cytoplasm that contains nutrients and other energy-producing materials that are essential for embryo development. Next, a somatic cell – that is, any body cell other than an egg or a sperm cell – is placed next to the egg from which the nucleus had been removed, and the two are fused. The cell is stimulated electrically and may begin to divide into totipotent cells that will soon form a blastocyst. Cells from the inner cell mass of this blastocyst can then be used to develop pluripotent stem cell lines. Somatic cell nuclear transfer (SCNT) is Cloning.
  • Stem Cells
    • Stem cells are cells that have the ability to divide continuously and to develop into various kinds of specialised tissue. Many scientists believe that with research, stem cells will be able to be used to treat a wide variety of serious injuries or diseases from spinal cord injury to cancer. However, ethical issues arise when we consider the various sources of stem cells that may be used for research or treatment purposes.
  • Totipotent Cells
    • Totipotent cells are undifferentiated cells of the very early embryo, which have total potential. That is, given the right circumstances each cell has the potential to develop into a foetus. It is impossible at this stage to tell which cell will become what.
  • Test-tube baby
    • A term coined from Aldous Huxley’s 1932 book “Brave New World” in which Huxley anticipated developments in reproductive technology that saw human infants created in test-tubes. The term “test-tube baby” has become synonymous for a baby created via IVF (in vitro fertilisation), which actually involves petri dishes!
  • Zygote
    • Zygote comes from zugoun ‘to join’, the zygote is the first cell of a new individual formed by the union of the ovum and sperm, and prior to the first cell division. The zygote contains the full complement of chromosomes required for an individual, having received half from the ovum and half from the sperm.

Terms associated with biotechnology

  • Allotransplantation
    • Transplantation of living cells, tissues or organs within the same species, for example from human to human; dog to dog. The living tissue may be from a deceased donor (e.g. heart, liver or corneal transplant) or from a living donor (e.g. kidney, skin, bone marrow).
  • Xenotransplantation
    • Transplantation of living cells, tissues, or organs, between from the member of one species to the member of a different species. For example, the transplantation of living tissue from a pig into a human. (The injection of pancreatic cells from a pig into humans with diabetes is an example of xenotransplantation.)

Terms associated with end of life issues

  • Assisted Suicide
    • Assisted suicide is where a doctor or other person assists the terminally ill person to kill themselves.
  • Euthanasia
    • The term is deriving from the Greek eu meaning good, and thanatos meaning death, the word euthanasia originally meant good death. That is, that an individual should “be enabled to die well” – a comfortable death, gentle and prepared for at the end of a fulfilled life. This compared with a bad death, Cacothanasia – hideous, tormented death, unexpected and unprepared for. Common usage of the term euthanasia has established a meaning associated with “mercy killing” – the intentional killing of someone who is terminally ill or in severe, incessant pain in order to spare them from further suffering. In this modern context, euthanasia carries with it a value judgement that, for the person who dies, death is actually a good thing.
  • Active Euthanasia
    • Functionally bringing about a patient’s death through a direct means such as by administering a lethal injection. Active euthanasia may be either with or without the patient’s request.
  • Passive Euthanasia
    • Involves allowing the patient to die, not by directly killing them, but by withdrawing or omitting treatment.
  • Voluntary Euthanasia
    • Means that the intentional termination of the person’s life is done at their own request.

Those Acronyms!

  • ACART: Advisory Committee on Assisted Reproductive Technology. (Established under New Zealand’s Human Assisted Reproductive Technology Act 2004.) Government appointed, members of ACART are required to undertake extensive public consultation and from this to formulate policy and advise the New Zealand Government. www.acart.health.govt.nz
  • ECART: Ethics Committee on Assisted Reproductive Technology. (Established under New Zealand’s Human Assisted Reproductive Technology Act 2004.) Government appointed, members of ECART consider and determine applications for assisted reproductive procedures and human reproductive research in New Zealand. They also monitor and review approvals given and previously given. www.ecart.health.govt.nz
  • HART: Human Assisted Reproductive Technology
  • HART Act (2004): the Human Assisted Reproductive Technology Act is designed to regulate assisted reproductive technology and human reproductive research in New Zealand, including IVF and associated technologies, and research that uses or creates gametes or embryos. The Act imposes prohibitions on fundamentally unacceptable practices (including cloning) and established both the Advisory Committee on Assisted Reproductive Technology and the Ethics Committee on Assisted Reproductive Technology.link to HART Act
  • HFEA: Human Fertilisation and Embryology Authority – is the statutory body that regulates artificial reproductive technologies and research in the United Kingdom.
  • IV: In Vitro – “within the glass” that is, outside a living body. This compares with In Vivo – within a living body.
  • IVF: In Vitro Fertilisation – the joining of egg and sperm outside the body.
  • IVM: In Vitro Maturation – the removal of immature ovum from the female body and the subsequent maturing of these eggs in the laboratory. When necessary the IVM process is added prior to in vitro fertilisation.
  • ICSI: Inter-Cytoplasmic Sperm Injection. A procedure sometimes used during IVF where a single selected sperm is injected directly into the cytoplasm of the ovum to achieve fertilisation.
  • PGD: Pre-Implantation Genetic Diagnosis. (Sometimes referred to as ‘embryo biopsy’.) This procedure involves the removal of one (sometimes two) blastomere from the early embryo at the 8-cell stage. Genetic screening is then undertaken on this cell.
  • SCNT: Somatic Cell Nuclear Transfer. The process of removing the nucleus from an ovum and transferring a nucleus from a somatic cell into the cytoplasm that remains. SCNT is a form of cloning.
  • UNCROC: United Nations Convention on the Rights of the Child. The General Assembly of the United Nations adopted the United Nations Convention on the Rights of the Child (UNCROC) on the 20th of November 1989. It passed into force as an international law on 2nd September 1990 following its ratification by the requisite twenty states. Since then, the UNCROC has been ratified by all but two of the world’s governments, making it the most widely ratified human rights treaty in history. New Zealand ratified the UNCROC in 1993. The United Nations Convention on the Rights of the Child consists of fifty-four articles that can be divided into three main types of rights: provisions rights, protection rights and participation rights. UNCROC emphasises that children have a special need for protection but that they simultaneously have a special need to be regarded and treated as individuals.

References:

Beauchamp T.L. & Childress J.F. (1994) Principles of biomedical ethics.4th ed. New York: Oxford University Press. Buchanan A.E. & Brock D.W. (1989) Deciding for others: The ethics of surrogate decision making. Cambridge: Cambridge University Press.

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