Each year, about 120,000 Americans need organ transplants, yet the demand for donor organs far outweighs the supply. The solution: Bioprinting. A 3-D printer is used to dispense different cells, creating layers of cells that form tissue. So far, artificial organs are successfully functioning in animals. Mice, for instance, were able to conceive and give birth by means of prosthetic ovaries.
However, as this new industry emerges, so does the opportunity to capitalize on it. A company in China estimates that the market in America for artificial livers is approximately $3 billion annually. With that sort of potential for profits, larger companies have taken an interest in the future of bioprinting. Well-known companies are making significant progress printing skin for burns and ulcers. A company in Pennsylvania has developed a method to print skin directly onto the patient by spraying stem cells onto the area in need of new skin. Such interest by major companies is advancing this new technology.
From The Economist, “Printed human body parts could soon be available for transplant”
Excerpt from article:
But a lack of suitable donors, particularly as cars get safer and first-aid becomes more effective, means the supply of such organs is limited. Many people therefore die waiting for a transplant. That has led researchers to study the question of how to build organs from scratch.
In 1990, Congress approved the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The CARE Act funds support and medical treatment for individuals with HIV. However, under the Act every state had to certify that it had criminal laws that would prosecute individuals with HIV who knowingly exposed others to the disease, even if those exposed did not contract HIV. Individuals who are successfully prosecuted under these laws are listed as sex offenders. In one case in Iowa, a woman was prosecuted successfully even though she claimed that she informed the man that she was HIV positive. He claimed she did not tell him; however, two weeks prior to filing his complaint against her, he was convicted of domestic abuse for hitting her. She is now listed as a sex offender.
Currently, the federal government and advocates consider these HIV-specific laws to be draconian in light of modern scientific knowledge regarding HIV, which is “no longer the death sentence it once was.” Many of these HIV-specific laws do not require exposure in the form of sexual contact, and some even include exposure in the form of something as innocuous as spitting. HIV cannot be transmitted through saliva. Some states, including Iowa, are reconsidering and changing their HIV-specific laws in response to this change in public opinion.
The House placed its stamp of approval on the HIV Organ Policy Equity Act (HOPE), which passed the Senate in June of 2013. HOPE lifts the federal ban on the transplantation of HIV positive organs to HIV positive donees. The Department of Health and Human Services and the Organ Procurement Transplant Network are responsible for creating and implementing standards for research on the transplantation of HIV positive organs.
The Welsh government passed the Human Transplantation Act of 2013 this July, and as of 2015 the government will presume that every citizen has consented to donate their organs upon their deaths, unless they opted out of the program. The current system in the UK is described as a “voluntary,” opt-in program. However, the shortage of human organs motivated the Welsh government to institute the new legislation. The government hopes the Act will increase transplant rates by as much as 25%, and drive down the statistics on “preventable” deaths. Over the next two years, the government will launch a public information campaign to inform citizens of their rights under the opt-out program.
The Organ Procurement and Transplantation Network (OPTN) issued changes to its transplant policy for lung candidates under the age of 12 on June 11, 2013, after a meeting of the Executive Committee. The Secretary of the Department of Health and Human Services (HHS), Kathleen Sebelius, prompted the meeting in response to the controversy surrounding the case of Sarah Murnaghan. Sarah Murnaghan suffered from end-stage cystic fibrosis at 10 years old and was on the waiting list for pediatric donor lungs. On June 12 Sarah received a transplant, with adult donor lungs, in contravention of the former OPTN policy for children, but in accordance with the temporary restraining order (TRO), issued by Federal Judge Michael Baylson from the Eastern District of Pennsylvania, that stopped Sebelius from enforcing the policy.
Sarah’s mother, understandably, launched a media blitz after her daughter was denied an exception to the policy. However the public-relations onslaught and subsequent judicial intervention troubles some bioethicists. Members of the Executive Committee voiced serious medical and ethical concerns at the meeting. To resolve the matter, the Committee incorporated a review process into the policy for children. The process allows for an exception application for anyone under 12 years old, to request that the person be classified as an adolescent in order to receive either adult or adolescent lungs. Dr. Arthur Caplan, a renowned bioethicist, stated that in implementing the review system the OPTN is addressing the concerns raised by Justice Baylor, while simultaneously issuing a warning. Dr. Caplan believes it is inappropriate for bureaucrats and politicians to decide how organs are allocated based on the medical complexity of a case.
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In March, the Utah legislature passed, and Utah Governor Gary R. Herbert signed, a law that allows prisoners to register as organ donors. The notion of permitting prisoners to designate themselves as organ donors has occasioned challenging ethical questions, and Utah is the first state explicitly to allow prisoners to provide for organ donation at death.
In the ethical debate about prisoners donating organs, the potential for coercing prisoners into becoming donors has been balanced against the large number of people on the organ waiting list of the United Network of Organ Sharing. The state representative behind the Utah bill was inspired by the death of a man in prison for murder who wanted to become a donor at death but was not allowed to do that.