Xenotransplantation and public health: identifying the legal issues

Lebanese medical students' knowledge on and attitude toward xenotransplantation and its ethical issues: A cross-sectional study

INTRODUCTION

Xenotransplantation is the transplantation of animal parts into humans. This study's aim is to assess the Lebanese medical students' attitude toward xenotransplantation and their knowledge of its related ethical issues.

METHODS

A questionnaire was answered by 120 Lebanese medical students. Statistical analysis and ethical reflections were performed on the results.

RESULTS

Out of the 120 participants, 100 already knew about xenotransplantation, and 61.7% of the students believe that it is applied clinically. Only 25% trust that the animals need to be genetically modified for the organs to be eligible for transplantation. About 25.8% and 46.7% of the students, respectively, strongly agree that the patients' and physicians' beliefs play an important role in agreeing to the procedure. Students were likely to accept the animal organ for transplantation if the transplant could completely cure or improve the course of an untreatable disease (86.6% and 75.0%) or if the outcomes and risks were the same as with a human transplant with a shorter waiting period (71.7%). Students who agreed that animal rights and welfare/wellbeing should be respected tended to disagree with the statement that it is acceptable to use animals for human ends (p = .026).

CONCLUSION

Medical students proved to be knowledgeable on the ethical dilemmas related to xenotransplantation and showed a favorable attitude toward this procedure, which is crucial in its establishment as an absolute clinical reality in the near future and in the development and strengthening of research in this field.

Re-interpreting some common objections to three transgenic applications: GM foods, xenotransplantation and germ line gene modification (GLGM)

Concerns about safety to the individual, the wider community and the potential impact on the environment are typical consequentialist objections to transgenesis that feature prominently in public debates about its ethical acceptability. I consider some of these claims with respect to their motivation, validity and their overall influence on public policy using three well-discussed applications of transgenesis: GM foods, xenotransplantation and germ line gene modification (GLGM).

Legal enforcement of xenotransplantation public health safeguards

Xenotransplantation is any transplantation, implantation, or infusion of either live cells, tissues, or organs from a nonhuman animal source, or human bodily fluids, cells, tissues, or organs that have had ex vivo contact with live nonhuman animal cells, tissues, or organs into a human recipient. Most scientists agree that clinical xenotransplantation should not be performed in the absence of accompanying public health safeguards The science upon which that consensus is based has been extensively described in the literature. By and large the most compelling reason for public health safeguards is the possible introduction of new infectious agents into the human life cycle as a result of xenotransplantation.

The most frequent source of new infectious diseases in human populations is the transfer of agents, such as viruses, bacteria, or prions, from animals to man. Human diseases and infectious agents that are thought to have originated from animals include influenza, rabies, malaria, lassa fever, lyme disease, AIDS, yellow fever, tuberculosis, the human t-cell lymphotropic virus, the herpes B virus, the hantavirus, and even the bubonic and pneumonic plagues.

Animal spare parts? A Canadian public consultation on xenotransplantation

Xenotransplantation, or the use of animal cells, tissues and organs for humans, has been promoted as an important solution to the worldwide shortage of organs. While scientific studies continue to be done to address problems of rejection and the possibility of animal-to-human virus transfer, socio-ethical and legal questions have also been raised around informed consent, life-long monitoring, animal welfare and animal rights, and appropriate regulatory practices. Many calls have also been made to consult publics before policy decisions are made. This paper describes the Canadian public consultation process on xenotransplantation carried out by the Canadian Public Health Association in an arm's length process from Health Canada, the ministry overseeing government health policy and regulation. Focusing on six citizen for a conducted around the country patterned after the citizen jury deliberative approach, the paper describes the citizen panelists' recommendations to hold off on proceeding with clinical trials and the rationales behind this recommendation. The consultation process is discussed in the context of constructive technology assessment, a framework which argues for broader input into earlier stages of technology innovation, particularly at the technology design stage.