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Xin M, Li Q, Wang D, Wang Z. Organoids for Cancer Research: Advances and Challenges. Adv Biol (Weinh) 2024:e2400056. [PMID: 38977414 DOI: 10.1002/adbi.202400056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/04/2024] [Indexed: 07/10/2024]
Abstract
As 3D culture technology advances, new avenues have opened for the development of physiological human cancer models. These preclinical models provide efficient ways to translate basic cancer research into clinical tumor therapies. Recently, cancer organoids have emerged as a model to dissect the more complex tumor microenvironment. Incorporating cancer organoids into preclinical programs have the potential to increase the success rate of oncology drug development and recapitulate the most efficacious treatment regimens for cancer patients. In this review, four main types of cancer organoids are introduced, their applications, advantages, limitations, and prospects are discussed, as well as the recent application of single-cell RNA-sequencing (scRNA-seq) in exploring cancer organoids to advance this field.
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Affiliation(s)
- Miaomaio Xin
- Assisted Reproductive Center, Women's & Children's Hospital of Northwest, Xi'an, Shanxi Province, 710000, China
- University of South Bohemia in Ceske Budejovice, Vodnany, 38925, Czech Republic
| | - Qian Li
- Changsha Medical University, Changsha, Hunan Province, 410000, China
| | - Dongyang Wang
- Assisted Reproductive Center, Women's & Children's Hospital of Northwest, Xi'an, Shanxi Province, 710000, China
| | - Zheng Wang
- Medical Center of Hematology, the Second Affiliated Hospital, Army Medical University, Chongqing, Sichuan Province, 404100, China
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2
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Kataoka M, Lee TL, Sawai T. Human Brain Organoid Research and Applications: Where and How to Meet Legal Challenges? JOURNAL OF BIOETHICAL INQUIRY 2024:10.1007/s11673-024-10349-9. [PMID: 38969917 DOI: 10.1007/s11673-024-10349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/23/2024] [Indexed: 07/07/2024]
Abstract
An ethical and legal framework is needed to regulate the rapidly developing human brain organoid research field properly. However, considering the legal issues involved in human brain organoid research remains underdeveloped and scattered. This article reviews the legal issues of human brain organoid research, grouping them into the following five broad themes: (1) consciousness, (2) legal status, (3) consent, (4) ownership, and (5) transplantation. The issues in each topic include both the urgent (e.g., appropriate forms of consent) and the speculative (e.g., protection of conscious human brain organoids). Therefore, we have attempted to be as explicit as possible about the timescale within which each issue will be realized and to prioritize each. Examining these issues has revealed legal issues specific to human brain organoid research and issues common to research in other fields. Further discussion of human brain organoid research from a legal perspective is needed in the future, considering discussions in related fields.
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Affiliation(s)
- M Kataoka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan
| | - T-L Lee
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - T Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan.
- Institute for the Advanced Study of Human Biology, Kyoto University, Kyoto, Japan.
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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3
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Zondag AGM, Rozestraten R, Grimmelikhuijsen SG, Jongsma KR, van Solinge WW, Bots ML, Vernooij RWM, Haitjema S. The Effect of Artificial Intelligence on Patient-Physician Trust: Cross-Sectional Vignette Study. J Med Internet Res 2024; 26:e50853. [PMID: 38805702 PMCID: PMC11167322 DOI: 10.2196/50853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Clinical decision support systems (CDSSs) based on routine care data, using artificial intelligence (AI), are increasingly being developed. Previous studies focused largely on the technical aspects of using AI, but the acceptability of these technologies by patients remains unclear. OBJECTIVE We aimed to investigate whether patient-physician trust is affected when medical decision-making is supported by a CDSS. METHODS We conducted a vignette study among the patient panel (N=860) of the University Medical Center Utrecht, the Netherlands. Patients were randomly assigned into 4 groups-either the intervention or control groups of the high-risk or low-risk cases. In both the high-risk and low-risk case groups, a physician made a treatment decision with (intervention groups) or without (control groups) the support of a CDSS. Using a questionnaire with a 7-point Likert scale, with 1 indicating "strongly disagree" and 7 indicating "strongly agree," we collected data on patient-physician trust in 3 dimensions: competence, integrity, and benevolence. We assessed differences in patient-physician trust between the control and intervention groups per case using Mann-Whitney U tests and potential effect modification by the participant's sex, age, education level, general trust in health care, and general trust in technology using multivariate analyses of (co)variance. RESULTS In total, 398 patients participated. In the high-risk case, median perceived competence and integrity were lower in the intervention group compared to the control group but not statistically significant (5.8 vs 5.6; P=.16 and 6.3 vs 6.0; P=.06, respectively). However, the effect of a CDSS application on the perceived competence of the physician depended on the participant's sex (P=.03). Although no between-group differences were found in men, in women, the perception of the physician's competence and integrity was significantly lower in the intervention compared to the control group (P=.009 and P=.01, respectively). In the low-risk case, no differences in trust between the groups were found. However, increased trust in technology positively influenced the perceived benevolence and integrity in the low-risk case (P=.009 and P=.04, respectively). CONCLUSIONS We found that, in general, patient-physician trust was high. However, our findings indicate a potentially negative effect of AI applications on the patient-physician relationship, especially among women and in high-risk situations. Trust in technology, in general, might increase the likelihood of embracing the use of CDSSs by treating professionals.
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Affiliation(s)
- Anna G M Zondag
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Raoul Rozestraten
- Utrecht University School of Governance, Utrecht University, Utrecht, Netherlands
| | | | - Karin R Jongsma
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Wouter W van Solinge
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Robin W M Vernooij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia Haitjema
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Kataoka M, Gyngell C, Savulescu J, Sawai T. The Donation of Human Biological Material for Brain Organoid Research: The Problems of Consciousness and Consent. SCIENCE AND ENGINEERING ETHICS 2024; 30:3. [PMID: 38315257 PMCID: PMC10844458 DOI: 10.1007/s11948-024-00471-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/15/2024] [Indexed: 02/07/2024]
Abstract
Human brain organoids are three-dimensional masses of tissues derived from human stem cells that partially recapitulate the characteristics of the human brain. They have promising applications in many fields, from basic research to applied medicine. However, ethical concerns have been raised regarding the use of human brain organoids. These concerns primarily relate to the possibility that brain organoids may become conscious in the future. This possibility is associated with uncertainties about whether and in what sense brain organoids could have consciousness and what the moral significance of that would be. These uncertainties raise further concerns regarding consent from stem cell donors who may not be sufficiently informed to provide valid consent to the use of their donated cells in human brain organoid research. Furthermore, the possibility of harm to the brain organoids raises question about the scope of the donor's autonomy in consenting to research involving these entities. Donor consent does not establish the reasonableness of the risk and harms to the organoids, which ethical oversight must ensure by establishing some measures to mitigate them. To address these concerns, we provide three proposals for the consent procedure for human brain organoid research. First, it is vital to obtain project-specific consent rather than broad consent. Second, donors should be assured that appropriate measures will be taken to protect human brain organoids during research. Lastly, these assurances should be fulfilled through the implementation of precautionary measures. These proposals aim to enhance the ethical framework surrounding human brain organoid research.
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Affiliation(s)
- Masanori Kataoka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan
| | - Christopher Gyngell
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne Law School, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Julian Savulescu
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore
- Faculty of Philosophy, University of Oxford, Oxford, UK
| | - Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan.
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore.
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
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5
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Pichl A, Ranisch R, Altinok OA, Antonakaki M, Barnhart AJ, Bassil K, Boyd JL, Chinaia AA, Diner S, Gaillard M, Greely HT, Jowitt J, Kreitmair K, Lawrence D, Lee TN, McKeown A, Sachdev V, Schicktanz S, Sugarman J, Trettenbach K, Wiese L, Wolff H, Árnason G. Ethical, legal and social aspects of human cerebral organoids and their governance in Germany, the United Kingdom and the United States. Front Cell Dev Biol 2023; 11:1194706. [PMID: 38020890 PMCID: PMC10679683 DOI: 10.3389/fcell.2023.1194706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Human cerebral organoids (HCOs) are model systems that enable researchers to investigate the human brain in ways that had previously been impossible. The emergence of HCOs was accompanied by both expert and layperson discussions concerning the possibility of these novel entities developing sentience or consciousness. Such concerns are reflected in deliberations about how to handle and regulate their use. This perspective article resulted from an international and interdisciplinary research retreat "Ethical, Legal and Social Aspects of Human Cerebral Organoids and their Governance in Germany, the United Kingdom and the United States", which took place in Tübingen, Germany, in August 2022. The retreat focused on whether HCO research requires new ethical and regulatory approaches. It addressed epistemic issues around the detection and theorisation of consciousness, ethical concerns around moral status and research conduct, difficulties for legislation and guidelines managing these entities, and public engagement.
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Affiliation(s)
- Anja Pichl
- Faculty of Health Sciences Brandenburg, University of Potsdam, Germany
- Research Unit “Ethics of Genome Editing”, Institute of Ethics and History of Medicine, The University of Tübingen, Tübingen, Germany
| | - Robert Ranisch
- Faculty of Health Sciences Brandenburg, University of Potsdam, Germany
- Research Unit “Ethics of Genome Editing”, Institute of Ethics and History of Medicine, The University of Tübingen, Tübingen, Germany
| | - Ozan Altan Altinok
- Center for Ethics and Law in the Life Sciences, University of Hannover, Hannover, Germany
| | - Melpomeni Antonakaki
- Department of Science, Technology and Society, Technical University Munich, Munich, Germany
| | | | - Katherine Bassil
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - J. Lomax Boyd
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States
| | | | - Sarah Diner
- Institute for Medical Humanities, Medical Faculty, University of Bonn, Bonn, Germany
| | - Maxence Gaillard
- HYBRIDA Project, University of Oslo, Oslo, Norway and UCLouvain, Louvain-la-Neuve, Belgium
| | - Henry T. Greely
- Stanford Law School, Stanford University, Stanford, CA, United States
| | - Joshua Jowitt
- Newcastle Law School, Newcastle University, Newcastle, United Kingdom
| | - Karola Kreitmair
- Department of Medical History and Bioethics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - David Lawrence
- Durham Law School, Durham University, Durham, United Kingdom
| | - Tim Nicholas Lee
- Edinburgh Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
| | - Alex McKeown
- Department of Psychiatry, Wellcome Centre for Ethics and Humanities, University of Oxford, United Kingdom
| | - Vorathep Sachdev
- Edinburgh Infectious Diseases, University of Edinburgh, Edinburgh, United Kingdom
| | - Silke Schicktanz
- Institute of Medical Ethics and History of Medicine, University Medical Center Göttingen, Göttingen, Germany
| | - Jeremy Sugarman
- Berman Institute of Bioethics and Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Katharina Trettenbach
- Faculty of Health Sciences Brandenburg, University of Potsdam, Germany
- Research Unit “Ethics of Genome Editing”, Institute of Ethics and History of Medicine, The University of Tübingen, Tübingen, Germany
| | - Lara Wiese
- Institute for Social and Health Law, Ruhr University Bochum, Bochum, Germany
| | - Hannes Wolff
- Chair of Constitutional and Administrative Law, Public International Law, European and International Economic Law, Faculty of Law, University of Passau, Passau, Germany
| | - Garðar Árnason
- Research Unit “Ethics of Genome Editing”, Institute of Ethics and History of Medicine, The University of Tübingen, Tübingen, Germany
- School of Humanities and Social Sciences, University of Akureyri, Akureyri, Iceland
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Kataoka M, Gyngell C, Savulescu J, Sawai T. The Ethics of Human Brain Organoid Transplantation in Animals. NEUROETHICS-NETH 2023; 16:27. [PMID: 37809032 PMCID: PMC10550858 DOI: 10.1007/s12152-023-09532-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023]
Abstract
In this paper, we outline how one might conduct a comprehensive ethical evaluation of human brain organoid transplantation in animals. Thus far, ethical concerns regarding this type of research have been assumed to be similar to those associated with other transplants of human cells in animals, and have therefore not received significant attention. The focus has been only on the welfare, moral status, or mental capacities of the host animal. However, the transplantation of human brain organoids introduces several new ethical issues. Many of these are related to uncertainty regarding whether or not brain organoids might be conscious. While these concerns might not be immediately relevant, they warrant closer scrutiny. We discuss how various ethical issues are relevant to different stages of human brain organoid transplantation and can guide the ethical evaluation of research. Our examination would broaden the horizons of the debate on the transplantation of brain organoids.
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Affiliation(s)
- Masanori Kataoka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan
| | - Christopher Gyngell
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Melbourne Law School, The University of Melbourne, Melbourne, Australia
| | - Julian Savulescu
- Biomedical Ethics Research Group, Murdoch Children's Research Institute, Melbourne, Australia
- Faculty of Philosophy, The University of Oxford, Oxford, UK
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Higashi-Hiroshima, Japan
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
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7
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Kataoka M, Gyngell C, Savulescu J, Sawai T. The importance of accurate representation of human brain organoid research. Trends Biotechnol 2023; 41:985-987. [PMID: 36959082 DOI: 10.1016/j.tibtech.2023.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
Representations of brain organoids in the media are often negatively or positively exaggerated without appropriate discussion. Here, we examine two topics (the possibility of consciousness and medical applications) and call on scientists, ethicists, and the media to represent brain organoid research and its ethical issues more accurately.
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Affiliation(s)
- Masanori Kataoka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Christopher Gyngell
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Julian Savulescu
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore; Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Tsutomu Sawai
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan; Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
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8
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MacDuffie KE, Stein JL, Doherty D, Jayadev S, Girault JB, Emmons KA, Glass MR, Dempsey JC, Marrus N, Botteron KN, Dager SR, Estes AM, Piven J, Wilfond BS. Donor perspectives on informed consent and use of biospecimens for brain organoid research. Stem Cell Reports 2023; 18:1389-1393. [PMID: 37352851 PMCID: PMC10362497 DOI: 10.1016/j.stemcr.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/25/2023] Open
Abstract
Debates about the ethics of human brain organoids have proceeded without the input of individuals whose brains are being modeled. Interviews with donors of biospecimens for brain organoid research revealed overall enthusiasm for brain organoids as a tool for biomedical discovery, alongside a desire for ongoing engagement with research teams to learn the results of the research, to allow transfer of decision-making authority over time, and to ensure ethical boundaries are not crossed. Future work is needed to determine the most feasible and resource-efficient way to longitudinally engage donors participating in brain organoid research.
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Affiliation(s)
- Katherine E MacDuffie
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Jason L Stein
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Dan Doherty
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Suman Jayadev
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jessica B Girault
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Katherine A Emmons
- Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Madison Rose Glass
- Department of Genetics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jennifer C Dempsey
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Stephen R Dager
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Annette M Estes
- Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Benjamin S Wilfond
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, WA, USA
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9
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van Till SAL, Bunnik EM. Symbolic Value of Brain Organoids: Shifting the Focus from Consciousness to Sociocultural Perspectives on Resemblance. AJOB Neurosci 2023; 14:210-212. [PMID: 37097872 DOI: 10.1080/21507740.2023.2188307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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10
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Lavazza A, Chinaia AA. Human cerebral organoids: the ethical stance of scientists. Stem Cell Res Ther 2023; 14:59. [PMID: 37005693 PMCID: PMC10068143 DOI: 10.1186/s13287-023-03291-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 03/17/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Human cerebral organoids (HCOs) offer unprecedented opportunities to study the human brain in vitro, but they also raise important ethical concerns. Here we report the first systematic analysis of scientists' stance within the ethical debate. METHOD Twenty-one in-depth semi-structured interviews were analyzed through a constant comparative method to highlight how the ethical concerns filter in the laboratory. RESULTS The results suggest that the potential emergence of consciousness is not yet seen with concern. However, there are some features of HCO research that need to be better accounted for. Communication to the public, the use of terms such as "mini-brains", and informed consent appear to be the most pressing concerns of the scientific community. Nonetheless, respondents generally showed a positive attitude toward the ethical discussion, recognizing its value and the necessity of constant ethical scrutiny over scientific advancements. CONCLUSIONS This research paves the way for a better-informed dialogue between scientists and ethicists, highlighting the issues to be addressed whenever scholars of different backgrounds and interests meet.
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Affiliation(s)
- Andrea Lavazza
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza Botta 11, 27100, Pavia, Italy.
| | - Alice Andrea Chinaia
- MoMiLab, IMT School for Advanced Studies Lucca, Piazza S. Francesco 19, 55100, Lucca, Italy
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11
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Ravn T, Sørensen MP, Capulli E, Kavouras P, Pegoraro R, Picozzi M, Saugstrup LI, Spyrakou E, Stavridi V. Public perceptions and expectations: Disentangling the hope and hype of organoid research. Stem Cell Reports 2023; 18:841-852. [PMID: 37001517 PMCID: PMC10147824 DOI: 10.1016/j.stemcr.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 04/03/2023] Open
Abstract
Organoid technologies are rapidly advancing and hold great potential and hope for disease modeling and clinical translational research. Still, they raise a number of complex, ethical questions regarding their current and future use. Patient and public involvement is important in building public trust and helping to secure responsible conduct and valued innovations; nevertheless, research into patient and public perspectives on organoid technologies remains scarce. We report on a first public dialogue on organoid technologies through three cross-country deliberative workshops with a diverse group of stakeholders to identify their perceptions and concerns. Participants generally support organoid technologies on the condition that responsible governance, ethical oversight, and sound informed consent procedures are in place. Yet, a broad set of potential concerns are identified, primarily concerning commercialization, healthcare access, and cerebral organoids. Participants' insights and recommendations can help inform researchers and ethics and policy bodies toward supporting responsible and ethical organoid approaches.
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12
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Lensink MA, Jongsma KR, Boers SN, Bredenoord AL. Better governance starts with better words: why responsible human tissue research demands a change of language. BMC Med Ethics 2022; 23:90. [PMID: 36050689 PMCID: PMC9438266 DOI: 10.1186/s12910-022-00823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
The rise of precision medicine has led to an unprecedented focus on human biological material in biomedical research. In addition, rapid advances in stem cell technology, regenerative medicine and synthetic biology are leading to more complex human tissue structures and new applications with tremendous potential for medicine. While promising, these developments also raise several ethical and practical challenges which have been the subject of extensive academic debate. These debates have led to increasing calls for longitudinal governance arrangements between tissue providers and biobanks that go beyond the initial moment of obtaining consent, such as closer involvement of tissue providers in what happens to their tissue, and more active participatory approaches to the governance of biobanks. However, in spite of these calls, such measures are being adopted slowly in practice, and there remains a strong tendency to focus on the consent procedure as the tool for addressing the ethical challenges of contemporary biobanking. In this paper, we argue that one of the barriers to this transition is the dominant language pervading the field of human tissue research, in which the provision of tissue is phrased as a 'donation' or 'gift', and tissue providers are referred to as 'donors'. Because of the performative qualities of language, the effect of using 'donation' and 'donor' shapes a professional culture in which biobank participants are perceived as passive providers of tissue free from further considerations or entitlements. This hampers the kind of participatory approaches to governance that are deemed necessary to adequately address the ethical challenges currently faced in human tissue research. Rather than reinforcing this idea through language, we need to pave the way for the kind of participatory approaches to governance that are being extensively argued for by starting with the appropriate terminology.
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Affiliation(s)
- Michael A Lensink
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Karin R Jongsma
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Sarah N Boers
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Annelien L Bredenoord
- Department of Medical Humanities, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA, Utrecht, The Netherlands
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13
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de Jongh D, Massey EK, Bunnik EM. Organoids: a systematic review of ethical issues. Stem Cell Res Ther 2022; 13:337. [PMID: 35870991 PMCID: PMC9308907 DOI: 10.1186/s13287-022-02950-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/12/2022] [Indexed: 11/20/2022] Open
Abstract
Organoids are 3D structures grown from pluripotent stem cells derived from human tissue and serve as in vitro miniature models of human organs. Organoids are expected to revolutionize biomedical research and clinical care. However, organoids are not seen as morally neutral. For instance, tissue donors may perceive enduring personal connections with their organoids, setting higher bars for informed consent and patient participation. Also, several organoid sub-types, e.g., brain organoids and human-animal chimeric organoids, have raised controversy. This systematic review provides an overview of ethical discussions as conducted in the scientific literature on organoids. The review covers both research and clinical applications of organoid technology and discusses the topics informed consent, commercialization, personalized medicine, transplantation, brain organoids, chimeras, and gastruloids. It shows that further ethical research is needed especially on organoid transplantation, to help ensure the responsible development and clinical implementation of this technology in this field.
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Affiliation(s)
- Dide de Jongh
- Department of Nephrology and Transplantation, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Emma K. Massey
- Department of Nephrology and Transplantation, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Eline M. Bunnik
- Department of Medical Ethics, Philosophy and History of Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Ding L, Xiao Z, Gong X, Peng Y. Knowledge graphs of ethical concerns of cerebral organoids. Cell Prolif 2022; 55:e13239. [PMID: 35582763 PMCID: PMC9357362 DOI: 10.1111/cpr.13239] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/11/2022] [Accepted: 04/13/2022] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The rapid development of cerebral organoid technology and the gradual maturity of cerebral organoids highlight the necessity of foresighted research on relevant ethical concerns. We employed knowledge graphs and conducted statistical analysis with CiteSpace for a comprehensive analysis of the status quo of the research on the ethical concerns of cerebral organoids from a bibliometric perspective. MATERIALS AND METHODS We performed a statistical analysis of published papers on cerebral organoid ethics, keyword co-occurrence graph, literature co-citation and knowledge clustering graph to examine the status of the ethics research, internal relationship between technological development and ethical research, and ethical concerns of the academia. Finally, we used a keyword time zone graph and related statistics to analyze and predict the trends and popular topics of future cerebral organoids ethics research. RESULTS We demonstrated that although the ethical concerns of cerebral organoids have long been discussed, it was not until 2017 that the ethical issues began to receive more attention, when cerebral organoids were gradually mimicking the human brain more closely and increasingly being combined with chimera research. The recent key ethical concerns are primarily divided into three categories: concerns that are common in life sciences, specific to cerebral organoids, and present in cross-fields. These increasing ethical concerns are inherently related to the continual development of technology. The analysis pointed out that future research should focus on the ethical concerns of consciousness that are unique to cerebral organoids, ethical concerns of cross-fields, and construction and improvement of legislative and regulatory systems. CONCLUSIONS Although research on cerebral organoids can benefit the biomedicine field, the relevant ethical concerns are significant and have received increasing attention, which are inherently related to the continual development of technology. Future studies in ethics regarding cerebral organoid research should focus on the ethical concerns of consciousness, and cross-fields, as well as the improvement of regulatory systems.
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Affiliation(s)
- Lulu Ding
- Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Zhenyu Xiao
- School of Life Science, Beijing Institute of Technology, Beijing, China.,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China
| | - Xia Gong
- Institute of Zoology, Chinese Academy of Sciences, Beijing, China
| | - Yaojin Peng
- Institute of Zoology, Chinese Academy of Sciences, Beijing, China.,Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
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Zuk P, Stertz L, Walss-Bass C, Lázaro-Muñoz G. Research Comparing iPSC-Derived Neural Organoids to Ex Vivo Brain Tissue of Postmortem Donors: Identity After Life? AJOB Neurosci 2022; 13:111-113. [PMID: 35324409 DOI: 10.1080/21507740.2022.2048730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Laura Stertz
- University of Texas Health Science Center at Houston
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Boyd JL, Sugarman J. Toward Responsible Public Engagement in Neuroethics. AJOB Neurosci 2022; 13:103-106. [PMID: 35324403 DOI: 10.1080/21507740.2022.2048736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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MacDuffie KE. What Brain Organoid Research Can Gain From Engaging Biospecimen Donors. AJOB Neurosci 2022; 13:95-97. [PMID: 35324405 PMCID: PMC9707507 DOI: 10.1080/21507740.2022.2048734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bollinger J, May E, Mathews D, Donowitz M, Sugarman J. Patients' perspectives on the derivation and use of organoids. Stem Cell Reports 2021; 16:1874-1883. [PMID: 34329595 PMCID: PMC8365094 DOI: 10.1016/j.stemcr.2021.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 12/17/2022] Open
Abstract
Organoid research is enhancing understanding of human development and diseases as well as aiding in medication development and selection, raising hopes for even more future therapeutic options. Nevertheless, this work raises important ethical issues and there is a paucity of data regarding patients' perspectives on them. We report on 60 interviews with adult patients or parents of pediatric patients from diverse disease populations who receive medical care at a major academic research institution in the United States. Interviewees expressed broad support for organoid development and use. However, patients viewed brain organoids, and sometimes gonadal organoids, as morally distinct; and some organoid research poses moral concerns. Nonetheless, patients generally understood the potential value of such research and approved of it, provided it was aimed at good intent and conducted with ethical oversight and a robust consent process. These data should help inform conceptual and policy deliberations about appropriate organoid use.
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Affiliation(s)
- Juli Bollinger
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore, MD 21205, USA
| | - Elizabeth May
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore, MD 21205, USA
| | - Debra Mathews
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore, MD 21205, USA; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mark Donowitz
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeremy Sugarman
- Berman Institute of Bioethics, Johns Hopkins University, 1809 Ashland Avenue, Baltimore, MD 21205, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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