Xenotransplantation - ethics and regulation

Healthcare workers, researchers, and policy makers find themselves in challenging times, being required to make ( often prompt) decisions in the face of novel ethical dilemmas. Moral theory may assist with decision-making in complex areas of medicine such as the xenotransplantation of insulin-producing cells to reverse diabetes. Moral theory attempts to capture intuitions about whether an action is right or wrong and it may gives us a deeper understanding of moral claims as it gives us an account as to why an action is good or bad. We may opt to choose different ethical frameworks such as consequentialism, principlism or a duty-based approach, to assist with deciding a certain action in a particular scenario. The xenotransplantation of porcine insulin-producing cells is a potential solution to the shortage of human tissue. It is crucial for the advancement of xenotransplantation that the benefits to society outweigh the risks and whilst there is enormous potential to assist mankind, there are unique bioethical challenges and dilemmas. New treatment strategies should be regulated appropriately to minimize risks to patients, their relatives and the wider community. There are specific regulations ( such as those developed by the FDA) that provide a robust framework for the safe implementation of xenotransplantation and more generally applicable ones such as the Declaration of Helsinki. Xenotransplantation is either morally acceptable or not to an individual. Patients must ultimately decide as to whether they would accept a certain form of treatment or not, a decision which would take into account their religious beliefs and categorical objections. There is no point in developing a treatment option unless there is good patient support. To that end, a study was conducted to ascertain the acceptance of tissue from different animal sources, by diabetic patients in England and Australia. Interviews were conducted to ensure that patients' views were reflected in their answers. There were 316 English and 195 Australian questionnaire respondents and the vast majority would accept human (85%, 94%), porcine (68%, 85%) or non-human primate (67%, 82%) tissue, respectively. This study suggests that a large proportion of diabetic patients may accept a xenotransplantation product.