You are Dr. McPaperwork, the Chief of Staff of a regional hospital that serves a large metropolitan, suburban, and rural area. You have been approached by Dr. Thatcher, a researcher from a state university who holds both an MD and a PhD in biomedical engineering. Dr. Thatcher's research team has been doing research into transgenic (across species) organ transplantation, where pig organs can be placed into humans in situations where human organs are not available. This process is called xenotransplantation. Dr. Thatcher has had success at his research hospital at the university and wants to expand his testing to a larger setting, and he would like to use your hospital as the first public hospital because your hospital treats people of many different races and backgrounds and will give him a wide range of data for analysis.
Dr. Thatcher is hoping that xenostransplantation on a large scale will be able to alleviate the shortage of human organs, especially hearts and livers, and be able to save many lives. He also hopes that if the xenotransplantation testing is successful, that he will be able to use that success to attract funding for a transgenic project that involves using gene splicing on a cellular level using cells from chimpanzees, pigs, and other animals. Dr. Thatcher believes that cellular transgenesis can be used to treat diseases and also has the potential to enhance normal human capabilities.
With your support, Dr. Thatcher will apply to the National Institute of Health and the Food and Drug Administration for permission and funding to implement the first transgenic organ transplant center in the nation.
Do you give Dr. Thatcher your support?
Position One: Yes, Dr. Thatcher, sign me up!
After careful analysis and several meetings with the hospital's ethics board, you decide to lend your support to the research, in part because:
There is a long waiting list in your region for people who need organ transplants.
The overall cost of organ transplantation will be reduced by using animal organs, which can be readily available on-site, as opposed to having to transport human organs from one site to another.
Establishing the transgenic transplantation center will attract some of the best surgeons and researchers to your hospital, which will ensure that your patients receive outstanding care and will decrease your hospital's mortality rate.
You feel that research using animal organ and animal cells to treat human disease is more ethically acceptable than using stem cell research or pursuing the cloning of human organs.
Patients who are on the waiting list can give or refuse their consent to be part of the study, meaning that no one is coerced into participating in the program.
It would be personally and professionally rewarding to be part of such exciting developments in medicine, and help many people—which is why you got into medicine in the first place.
Position Two: No thank you, Dr. Thatcher.
After careful analysis and several meetings with the hospital's ethics board, you decide to withhold your support from the research, in part because:
You feel that not enough human trials have been performed to offer it on a larger scale.
You are worried that there will be a backlash against the hospital when the public finds out that animals are being raised to harvest organs for human use.
You are concerned that patients whose lives are in jeopardy will feel compelled to participate in the research even if they do not approve or do not fully understand what is happening.
You have serious concerns about Dr. Thatcher's future plans and do not wish to facilitate future research by participating in this research.
You are concerned that if the research does not work or has long-term detrimental side effects, that your doctors and your hospital will be held responsible.