7 May 2022


Moral and Ethical Decision Making

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Academic level: Master’s

Paper type: Coursework

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Moral and Ethical Decision Making

Healthcare is one of the institutions where technology had taken lead. With the emerging different kinds of diseases, technology had been put on the frontline to curb some of the challenges experienced in treatments. One such emerging technology is use of injected bioabsorbable hydrogel commonly referred to as SpaceOAR in prostate cancer patients. It is used to reduce the effects of radiations to tissues and organs of the patients. Prostate cancer is common with men and hence the technology is commonly used in men (Herfarth et al ., n.d).

Description of Technology

SpaceOAR is a procedure which involves the separation of the rectum from the prostate using an injectable hydrogel. The hydrogel is injected transperineally and not transrectal using hydrodissection to facilitate its placement in the space between the rectum and the prostate. The hydrogel is injected in a manner that it is able to keep the cancer cells in a high radiation field and not push them away. This procedure requires a lot of attention and care to prevent the stress that might be caused to the wall of the rectum. The transperineal procedure is used instead of a transrectum method because transrectum procedure might cause contamination from the bacteria found in the rectum. Transperineal procedure is performed before the administration of the hydrogel injection. 10ml of the hydrogel is administered in 8 to 10 seconds (Hatiboglu et al ., 2012).

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The distance between the rectum and the prostate is measured after and before the procedure. The hydrogel is meant to create space of less than 1cm. This space is maintained through the treatment. The hydrogel separates the rectum from the prostate in about 3 months giving the rectum and other tissues protection from the radiations. The hydrogel is eventually absorbed in a natural way in about six months.

Ethical concerns related to the Technology

SpaceOAR is an emerging technology and with the available literature, there are limited ethical, cultural and religious considerations attached to this treatment (Commonwealth of Australia, 2010). Some of the ethical considerations discussed are safety of the patient and the efficacy of the procedure (Herfarth et al ., n.d).

Safety of patient

Based on several studies, there are no serious safety issues or health complications associated to spaceOAR. Some of the effects of the procedure are infection brought about by the injection. In addition, the injection has been indicated to bring about allergic reactions for example reactions at the injected area which includes tenderness, redness, pressure on the rectum, discoloration and itching. Bleeding is also a possible especially if the gel was accidentally injected into the blood vessel rather than the fat around the rectum and prostate.


The technology should be able to give the results that have been attached to it. These results are protecting the rectal wall and other tissues from the effects of the radiations used in the treatment of prostate cancer in men.

Consent from the patient

Before the procedure is carried out on a patient, the physician involved should be given a go ahead by the patient him or herself. The permission is given after the physician explains clearly to the patient what the procedure entails; it is side effects and the benefits.

Defense of technology in line with ethical concerns

Based on various studies, spaceOAR has been proved to protect the rectal wall and other tissues from the adverse effects of radiations. With the side effects, antibiotics and prophylaxis are administered to counter the effects brought about. Lastly, the health system has designed consent forms that a patient is required to fill and sign before any procedure is conducted.


Australian Government: Department of Health and Ageing. (2010). Inert Liquid-To-Solid Gels for Prostate rectum Separation during Prostate Radiation Therapy. Horizon Scanning Technology Prioritizing Summary . 1-10

Hatiboglu, G., Pinkawa, M. et al ., (2012). Application Technique: Placement of a Prostate – Rectum Spacer in Men Undergoing Prostate Radiation Therapy. BJU International. 110(11b): 647-652

Uhl, M., Herfarth, K., Hatiboglu, G., & Song, D. (n.d). Space Creation, Maintenance and Absorption of a Polyethylene Glycol Based Prostate – Rectum Spacer. WhitePaper . 1-3

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