Tag: organ transplantation

Bioethics Blogs

Fetal tissue and commerce

You may have seen in the general press that Indiana University is asking a federal judge to declare unconstitutional that state’s law banning research on the remains of aborted fetuses.  I noticed an article in the Wall Street Journal (subscription required).  An open-access account can be found here.

I oppose abortion, but I can imagine for the sake of argument that, if one allows for abortion, that it might be claimed that the tissue of an aborted unborn human could ethically be donated for research.  It seems to me that such an argument would construe this donation to be similar to donation of organs for transplantation.  In this case, the mother would be speaking for her (newly-deceased) unborn to make the decision, since the aborted one would not have decision-making capacity.

For such an action to be remotely ethical, donation of tissue could not in any way influence the decision to have an abortion–as, indeed, federal restrictions on fetal tissue research currently require.  There should be no profit to the donor or the abortion provider in the process.  In light of the Planned Parenthood brouhaha over this subject, I might suggest that the researchers seeking the tissue for research be required to bear any costs for the preparation of the tissue.  And something like the dead donor rule for organ transplantation would have to apply.  But that’s probably a trivial point in this case.  Never mind that the dead donor rule itself is under attack these days.

I imagine it’s clear that I don’t find this argument very persuasive. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Organ donation for transplantation in children with cardiac arrest and dying person dignity

Premortem interventions before donation in circulatory arrest in children could have objective ethical problems 

(See our special reports about criterion of death and organs transplantation HERE)

Up until a few years ago, performing medical interventions in end-of-life situations had been proposed as actions centered on the best interests of the dying patient.

The growing demand for organs for transplantation has created a need to increase the number of organ donors (see HERE).

Since the number of brain-dead donors is currently insufficient to meet the needs of patients on the transplant waiting list, medical procedures have been developed in the last decade aimed at ensuring that the organs from donors in cardiac arrest are also suitable for successful solid organ transplantation (see HERE our article about the relation between excellent figures of organ donation and organ donors with cardiac arrest in Spain).

Nevertheless, in order to achieve sufficient organ viability in donors with cardiac arrest, a series of medical procedures need to be performed that have the main aim of reducing the warm ischaemia time to which these organs are subjected, in order to increase the chances of post-transplant success.

An article has recently been published in the Journal of Medical Ethics (1“Premortem interventions in dying children to optimise organ donation: an ethical analysis”, whose authors Joe Brierley and David Shaw analyze the ethical and legal aspects of premortem interventions performed in dying children, aimed at optimizing organ donation for transplantation following cardiac arrest.

Premortem interventions in pediatric patients for organ donation from an ethical perspective

This article examines the legislative aspects (specific to the United Kingdom), and also gives a description and analysis of the elements that, from an ethical perspective, might support – or contradict – the performance of premortem interventions in pediatric patients for organ donation.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Brain Death Conference in Cuba

The 7th International Symposium on Brain Death will be held in Havana, Cuba, from December 5 to 8, 2017.


Topics include:
•    Conceptual approach to human death
•    BD criteria in different countries
•    Ancillary tests in BD
•    Autonomic nervous system assessment in BD
•    BD in childhood
•    Anencephalic infants
•    End-of-life dilemmas: terminal patient, euthanasia, assisted suicide, 
•    Legal considerations surrounding BD
•    Philosophical, theological, sociological, historical and cultural considerations of human death
•    Organ transplantation

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

June 2017 Newsletter

Global Bioethics Initiative (GBI) is dedicated to fostering public awareness and understanding of bioethical issues, and to exploring solutions to bioethical challenges.
Through its events and activities, which include annual summer schools on global bioethics, GBI seeks to keep the international community, policy decision-makers, the media, and the general public aware of important bioethical issues which is essential for making informed decisions and fostering public debate. Using various platforms, we at GBI are able to promote our motto “Doing bioethics in real life!”.
GBI is an active member of the United Nations Academic Impact (UNAI) and enjoys a special consultative status with the United Nations Economic and Social Council, the UN’s central platform for debate, reflection, and innovative thinking on sustainable development. Check out our website here.
Global Bioethics Initiative (GBI) launches
its third edition Summer School Program

NYC (June 19-30), 2017New York, New York June 19, 2017: GBI starts its summer school program sponsored by Pace University, College of Health Professions and New York
Medical College. Lead by experts in the field of Bioethics, students and professionals will witness Bioethics in various forms such as film screenings, field trips, and lectures/seminars, ending with a completion ceremony. Topics addressed in the program are: embryonic stem cell research, cloning, gene therapy, end-of-life care, genetics, reproductive technologies, human subject research, organ transplantation and access to health care.

“I am absolutely confident you leave this program enriched, “said Dr. Bruce Gelb, President of GBI. You will find that what you learn over the coming days, will impact how you interact and engage with the world in many aspects of life.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

My Sister’s Keeper: An Assessment of Living Organ Donation among Minors

by Alex Fleming

The 2009 film My Sister’s Keeper, based on Jodi Picoult’s 2004 New York Times bestselling novel which bears the same name, is among other things, a controversial story about a young girl (Anna Fitzgerald) who sues her own parents in order to obtain legal rights to the use of her body. For as long as she can remember, Anna has unwillingly been providing blood and bone marrow to her older and critically ill sister, Kate. As the story unfolds, tension within the family arises as the 13 year-old Anna Fitzgerald becomes fully aware of her reason for existence, so to speak, which is to prevent the death of her older sister by providing a regular supply of blood and bone marrow, which she has done regularly for several years. Later on, as Kate’s condition worsens and her renal function begins to fail, the parents naturally turn to Anna to provide what could be a life-saving kidney transplant for her older sister. The climax of the story begins as Anna confidently and heroically refuses. The story raises a slew of bioethical issues which are beyond the scope of this essay; however, the story sheds light on a topic worthy of discussion: living organ donation among minors.

As the supply of organs suitable for transplantation decreases and the demand for them increases, the question of living organ donation among those yet of age has become a question of greater concern, primarily among those who point to the various ethical implications which such a procedure creates.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In Memoriam: John A. Robertson

by David Magnus, Ph.D.

Sadly, the field of bioethics lost one of its best this week. John Robertson, a law professor at the University of Texas and a major figure in law and bioethics, passed away on July 5th. John was an important scholar whose work spanned major contributions to scholarship on end of life, organ transplantation, and genetics, but he is best known for his work on reproductive technology. John’s articulation and defense of the importance of procreative liberty, though both his articles and his important book, Children of Choice, stands as an exemplar for scholarship in bioethics. I have used his work in my classes for over 20 years, because no one has better articulated the perspective he brought to bear on issues in reproductive technology.

In addition to his scholarly contributions, what I will miss most about John is that he was a tireless and enthusiastic mentor and advocate for younger scholars. Without his support, I doubt that my career would have turned out the way it has. First, if you are reading this blog, you are aware of the success of the American Journal of Bioethics. The journal owes a great deal of its success (and perhaps its continued existence) to John. When the journal was first launched, most leaders in the field expressed a great deal of skepticism about the need or value of another journal. John not only supported us and encouraged us, he made a major contribution to ensure our success. As the Chair of the ethics committee of the American Society for Reproductive Medicine, John was instrumental in promoting a position to accept uses of new technologies for sex selection (at least in the context of family balancing).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Global Bioethics Initiative (GBI) launches its third edition Summer School Program

Global Bioethics Initiative (GBI) launches its third edition Summer School Program

New York, New York June 19, 2017, GBI starts its summer school program sponsored by Pace University, College of Health Professions and New York Medical College. Lead by experts in the field of Bioethics, students and professionals will witness Bioethics in various forms such as film screenings, field trips, and lectures/seminars, ending with a completion ceremony. Topics addressed in the program are: embryonic stem cell research, cloning, gene therapy, end-of-life care, genetics, reproductive technologies, human subject research, organ transplantation and access to health care.

“I am absolutely confident you leave this program enriched,”said Dr. Bruce Gelb, President of GBI. “You will find that what you learn over the coming days, will impact how you interact and engage with the world in many aspects of life.”

“There is a lack of opportunities for undergraduate, graduate students and professionals to learn about practical bioethics and GBI summer school helps to fill this void,” said​ Ana Lita, Co-Founder and Executive Director of GBI.

GBI is a not-for-profit international educational organization founded in 2011, by Dr. Ana Lita. GBI keeps the international community, policy decision-makers, the media, and the public versed in bioethical concepts. GBI provides this level of knowledge through an annual summer school program, human rights advocacy, and public policy reviews. GBI is associated with the United Nations Department of Information (UNDPI) with special consultative status with the United Nations Economic and Social Council (ECOSOC).

Attendees are encouraged to join Dr. Harriet R. Feldman, Dr. Charles Debrovner, and Dr. Ana Lita for the program’s introductory cocktail reception on June 20th, from 6-9PM at Pace University’s Aniello Bianco Room, 1 Pace Plaza, New York, New York,  featuring the singer, Sarah Hayes and​ her Trio​.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Stem cell research. The two sides of the coin

Science facing market

The “heads” of stem cell research

Stem cells today represent a great hope for the future of regenerative medicine due to their ability to differentiate into cell lines of almost any tissue, making them a promising therapeutic option for many diseases.

These pluripotent cells are found in embryonic and also in adult tissues. Their isolation and culture in specific media may lead to the development of tissues that are useful in regenerative therapies for conditions such as heart disease, myelopathies, diabetes, nerve injuries, retinopathies, etc. After their isolation, they are injected directly into the tissues to be regenerated, so that the stem cells differentiate into cells of these same tissues.

A third way of obtaining pluripotent cells is that described by Yamanaka 10 years ago, a finding for which he was awarded the Nobel prize in Medicine. Starting from a differentiated adult cell, Yamanaka managed to find a way of “dedifferentiating” it so that it returned to its pluripotent state, to then “redifferentiate” it into a particular cell line with therapeutic utility. These are known as iPS or induced pluripotent stem cells.

Similarly, tissues that simulate the function of certain organs have been reproduced in vitro from stem cells, and could, in the future, be an alternative to current organ transplantation.

The current state of the clinical application of stem cells remains uncertain. Although successful outcomes have been reported in some fields, such as cardiology and haematology, many clinical trials and therapeutic applications have failed due to problems arising in the differentiation processes and the appearance of tumours.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Teaching Medical Anthropology by Ari Gandsman

In the decade since becoming a full time professor, medical anthropology has been one of my core courses. I have taught it seven times.  Although the basic structure of the course remains similar, emphases have shifted over time. Perhaps I can best highlight the evolution of the course through a discussion of readings I use since readings are the backbone of a syllabus.  Even though I generally do not follow texts closely since I see lectures as overlapping but also supplemental and complimentary to readings, I try to mirror topics that they will be reading about, often highlighting a general theoretical literature or approach while the students read a single illustration.

Starting from the beginning, my history of medical anthropology remains the same, focusing on when “medicine” was subsumed into broad and now antiquated anthropological categories of magic and witchcraft. I never stray far from Evans-Pritchard’s Witchcraft, Oracles & Magic Among The Azande, an apparent professional contractual obligation for meAlthough I have given them the entire ethnography [the abridged in print edition] to read twice in the past, I have more lately just given them a short excerpt, often “The Notion of Witchcraft Explains Unfortunate Events.” I once also used W.H. Rivers Medicine, Magic and Religion but, although fascinating and of historic importance, it proved esoteric for an undergraduate course.  When I first started teaching, I tried to include more on non-Western medical systems, including using ethnographies on Traditional Chinese Medicine or Tibetan medicine. More recent students may be disappointed that I do not delve further into non-Western medical systems, what many students with hazy ideas of the discipline may think a medical anthropology course should almost entirely consist of.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

The Future of Bioethics: Organ Transplantation, Genetic Testing, and Euthanasia

By Ana Lita

When you think of bioethics, some of the first hot-button topics you may consider are organ transplantation, fertility and genetic engineering, and end-of-life-care. The Global Bioethics Initiative serves as a platform to address many bioethical questions and engages in public debates to develop resolutions to present and emerging issues.

Dr. Ana Lita, founder of the Global Bioethics Initiative, discusses the various areas GBI addresses and highlights the organization’s contributors in their prospective fields. She acknowledges the valuable contribution of the current president of GBI, Dr. Bruce Gelb, in the field of organ transplantation. She also addresses the original co-founder of GBI, Dr. Charles Debrovner, and his lifelong passion in the field of fertility and genetic engineering. Lastly, Dr. Lita offers a brief insight into the future of Bioethics in these uncertain times.

ORGAN MARKETS AND THE ETHICS OF TRANSPLANTATION 

Recent developments in immunosuppressive drugs and improved surgical techniques have now made it much easier to successfully transplant organs from one human body to another. Unfortunately, these developments have led to the rise of black-markets in human organs. This underground market is where people who need kidneys to survive or to improve the quality of their lives, for example, purchasing such organs from impoverished persons in the developing world. In January 2017, scientists announced that they successfully created the first human-pig hybrid and a pig embryo with some human characteristics. Given the increasing need for transplant organs, should such markets be regulated and legalized?  Could the success of therapeutic cloning eliminate the need to consider this option?

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.