The University of Southampton

Tag: bioethics

From stealing organs to growing organs from pigs: the lengths humans will go to survive.

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As a registered organ donor before the opt-out system, I could not fathom why people would not want to donate their organs. It baffled me, and yet in 2019, I was in a debating competition where I had to oppose the idea of organ donation as an opt-out system – my point was simple. Surely the argument that this is a violation of a donor’s autonomy and implies given consent, would always triumph over the utilitarian view, that it should be the greatest good for the greatest number, right?

The original donor card required for the opt-in system.

In 2020, the UK introduced a new law, the ‘opt-out’ system. Many believed this diminished a donor’s autonomy, yet, by definition, there is still a choice in opting out. The new law made sense to me, when around 6,945 people are currently awaiting a transplant in England, I found it hard to understand the counter-argument.

Dr. Jon Dawson covered the ideas of organ donation and autonomy throughout his lectures. I saw a wide range of views in one group of students of a similar age and with the same privilege of higher education. Dr. Dawson put forward the Alder Hey case, where about 850 organs were being harvested after death without any form of consent from either the patients or guardians.

A video briefly describing the Alder Hey Scandal.

There was a large consensus that this was not okay from the class, the lack of adequate consent when removing organs and tissue from patients was barbaric, nonetheless arguments can be made that people uneducated in the opt-out system are therefore giving ill-formed consent.

This case made me think of the book Never Let Me Go by Kazuo Ishiguro, where clones are created for the purpose of organ donation, and once they have donated around three of their organs, their short lives are over. Although this dystopian novel seems far stretched, the premise behind it still stands. Especially as since 2015, advancements in tissue engineering has shown animals as a viable surrogate for growing organs.

In 2019, Hiromitsu Nakauchi had the first approved experiments to allow a human-animal hybrid to grow fully. This sounds like some werewolf science-fiction, Morbius esc (awful movie); however, this could be the key to the current organ shortage. In an ideal world, we could grow the organ required at the drop of a hat- but here is a scientific solution where we could grow organs within animals and harvest them without invasive surgery on humans, or an ethical debate of autonomy.

Now, PETA and animal rebellion may be opposed to this idea, but I think animals will forever hold a place in scientific research, so could this be a legal viable solution? What do you think?

Well, in January 2022, the first pig to human transplant was done; a genetically engineered pig’s heart was harvested and placed into a patient. Although this required a lot of medication and extra resources, the heart did work prolonging the patients life for two months. This was a major breakthrough- can we now combat our organ shortage through animals?

Whether genetically modified pigs or human-animal hybrids hold the future in organ donation, ethics must be considered- we can not return to being so desperate as to take organs without consent. The podcast below is an informal discussion on organ donations with the opinions of two biochemists discussing frankly the possible future of organs, ethics and consent for further insight into this medical and ethical minefield.

https://open.spotify.com/episode/4inRLDaXEcnROyTexaC3WQ?si=7988ff562cb04df4
STEM Sundays a podcast by Lara Etheridge and Yasmin Yardley discussing organ donations, ethics and movies.

Chimera Concerns

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World First:

The first human/animal chimera was a human/rabbit chimera documented in Cell Research 2003 where the scientists from Shanghai Second Medical University fused human skin cells with rabbit eggs and allowed them to develop in laboratory dishes for several days before their human embryonic stem cells were harvested. This raises many ethical issues, specifically with embryonic stem cell harvesting as many people see the destruction of the embryo to retrieve these cells to be ending a human life, and some scientists even argue the research is not necessary in the first place.

Primate Chimeras:

A simplified diagram of the processed used to produce the human/monkey chimera cells.

The negative reaction to the 2003 paper did not deter a team of researchers from China, Spain and the USA from creating the first human/monkey chimera in 2021, who injected human epithelial pluripotent stem cells (hEPSCs) into macaque blastocysts.

This video shows the growth of one of the chimeric embryos, with the human cells highlighted in orange where you can see them migrating and undergoing mitosis.

Images of the chimera cells under different staining

In over half of the injected embryos TD+ human cells were found within the embryonic disc which is responsible for detaching embryonic cells from the blastocyst walls and forms a trilaminar embryo- an important step in embryonic development.

Ethical Considerations:

As it stands at the embryonic stage of development there are already ethical concerns with regard to the harvesting of embryonic stem cells from these chimera embryos, as some consider this to be killing a living organism, however if these cells were allowed to grow and able to produce an adult organism the concerns become even more sinister- organ farming.

Growing human organs in animals for the sole purpose of transplanting them into awaiting human patients is a conflicted topic for many reasons. Jehovah’s Witnesses famously refuse blood transfusions, and many more would likely object to receiving an organ grown inside an animal. The possibility of growing human organs using the patient’s own cells may persuade more, but many would still object to receiving an organ grown inside of an animal. Furthermore, there are research limitations on primates due to their similarity with humans, but it is this very similarity which could make them one of the best candidates for organ farming.

On the other side of the fence, you could argue that harvesting organs from animals like monkeys and pigs is no different than farming any other sort of animal product, with the added benefit of saving lives. One of the considerations with chimera organ harvesting is which animals we create chimeras from. Monkeys are typically thought in the west to be too intelligent to eat, and many religions disallow the consumption of pork so would likely refuse organs from one too, however pigs and monkeys are typically viewed as the best vessels for growing human organs. If the animal used is already farmed en masse, how bad is it really?

According to the HRSA website, there are 104,234 people in the US on the national transplant waiting list as of 24/03/23, and 17 people die every day waiting for an organ transplant. over 42,000 organ transplants were performed in the US in 2022. If human/monkey chimera technology advanced to the point of transplanting mature organs into human recipients, it could help to alleviate the organ crisis we face in the world today.

Human/animal chimeras for organ harvesting could save thousands in the future, but is it worth sacrificing animals to play God?

Should Euthanasia be legal in the UK?

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Trigger Warning – this blog discusses terminal illness and suicide.

If anyone is affected by the topics in this blog, please ring the Samaritans helpline on 116 123.

In the lecture about bioethics and law, one of the areas we focused on was the Nazi’s during WWII and their mass murder or ‘euthanasia’ of people who they deemed ‘unsuitable’.

That made me think about euthanasia and the laws surrounding it. It is legal in Switzerland, and some other European countries and UK citizens often fly there to be euthanised.

My personal opinion is that euthanasia should be legalised in this country with strict legal restrictions and multiple approvals from medical professionals needed.

One of the reasons for my view is because my sister is a nurse who works in ICU in London. She has patients who are on life support machines and have no quality of life yet are kept alive. Some of these were born with such severe conditions, that they have never left the hospital, been able to talk or move, and are also blind and deaf. Is it not crueller to keep them alive, knowing there is no hope for recovery or improvement than to let their parents/medical professionals put them to rest?

In addition, last year my family had to put down our 13-year-old golden retriever. She had cancer and went through surgery and chemotherapy. Unfortunately, the tumour continued to grow, so we stopped treatment and until she became uncomfortable and unhappy. As hard as the decision was to put her down, it was in our home and was the most peaceful and graceful way to die that I could possibly imagine.

Why do we treat our animals with such love and allow them to be euthanised, as the ‘kindest thing’, yet we don’t treat humans with that same compassion? Especially if the human is able to consent?

In 2002, Diane Pretty was diagnosed with motor neurone disease – a chronic and terminal diagnosis. She did not want herself nor her family to suffer through the final stages of the disease. She wanted to end her life peacefully at home. Unfortunately, she was not granted this wish. She went to court to appeal to change the law; however, they did not grant her the right to die. Because of her condition, she had 24-hour care and was unable to commit suicide alone. She wished her husband could assist her with this, however this is illegal in the UK.

Video about the Diane Pretty case
Sharon Johnston and Sue Lawford

How can it be that someone who is able to commit suicide alone is not breaking the law, but someone who needs assistance is unable to? Surely this is discriminatory against those who are disabled.

Last year, Sharon Johnston, who was paralysed but mentally competent, decided that she no longer wanted to live. She therefore chose to be euthanised at Dignitas in Switzerland. Unable to travel alone, a retired NHS worker, Sue Lawford, took her to carry out Sharon’s wishes. Sharon was euthanised but, when Sue got back to the UK she was arrested and questioned on suspicion of attempted murder. She was investigated for six months before being cleared of charges.

It is an incredibly difficult and sensitive topic, and inevitably there will never be a unanimous opinion regarding it. There will undoubtedly be a grey area between assisted suicide, euthanasia, and manslaughter. This potentially puts doctors in a difficult position legally, especially if the patient is unable to consent for themselves. I’m unsure what precise restrictions and requirements should be put in place, but I firmly believe that people who have terminal illnesses or are suffering from incurable conditions should be able to have the choice to end their pain and suffering.  

News article about Sue and Sharon: https://www.bbc.co.uk/news/uk-wales-63599107

My death my decision, a movement that Sue Lawford is a member of: https://www.facebook.com/MyDeathMyDecision/