TISSUE ENGINEERING
from petri dish to patient
Scientists can also engineer tissues from allogeneic cells, or cells from another person. However, this also raises questions In a hypothetical situation, person A donates cells to a bank. The cells from person A are being developed into bladder. When Person B receives the bladder transplant, is person B still person B? Or has person B become a hybrid? How would person B feel if he or she had a part of person A inside of him or her? How would person A feel if his or her cells are present in another human? These questions are all questions to consider, but when considering that a life is on the line, that becomes the top priority, rather than an identity crisis that the patient will realize later on.
BIOMATERIALS: CELLS
As you read in the about section earlier, scientists have a wide variety of options of cells to choose from. Many scientists use stem cells to engineer tissues because of its versatility. Stem cells are undifferentiated cells that can be programmed to become specialized cells.
Stem cells can come from embryos (ESCs) and can differentiate to more specialized ones. Although people have differing opinions on when life actually starts, embryo usage for stem cells is still very controversial because one is taking away the potential for life to harvest cells to save another life.
However, scientists do not all have to use embryonic stem cells. With the discovery of induced pluripotent and mesenchymal stem cells, or iPSCs and MSCs, respectively, scientists do not have to harvest embryos for a stem cell source and can now aquire them from adults. The most beneficial aspect of iPSCs and MSCs is that there is no threat to life.
The issue of embryo usage is not solved: scientsts may continue to use ESCs as opposed to iPSCs and MSCs when creating a product, and may not even tell you about it. Read more about regulatory issues.
HUMAN RESEARCH
Dr. Paolo Macchiarini, shown at the right, demonstrates the powerful applications that tissue engineering brings to society in his research and the potential for scientific malpractice.
Macchiarini is renowned as a pioneering surgeon in the regenerative medicine field for conducting groundbreaking surgeries, such as Hannah Warren's trachea procedure.
However, the public is now scrutinizing him, even the Karolinska Institutet, the organization that selects the Nobel Laureates in medicine, for his unscrupulous activities involving research on human subjects.
Tissue engineering is a well-established but undeveloped field and is subject to abuses to achieve fame and publish papers. Human research is one of those abuses that a few, like Macchiarini, carry out to further their achievements in an unexplored field.
ETHICAL ISSUES
PRIORITY PATIENTS
When deciding the next prospective patient that receives an organ, should we value the young over the elderly, or vice versa?
Some argue that the youth should receive priority because young patients benefit the most from it. Others believe that other factors, like lifestyle choices, should be included in the screening process.
However, the more factors that are involved in the decision making process, the muddier the water gets. It is already hard for biases to not play a role in the process by incorporating age as a determining factor.
Fortunately, in the United States, the waiting list system is run on a "first come, first serve" basis. Candidates are screened for survivability, during and after the operation, and compatibility.
