Xenotransplantation - Nuffield Council on Bioethics

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Animal-to-Human Transplants : the ethics of xenotransplantation 8.16 From 1 April 1996, the Supra Regional Services Advisory Group will have additional responsibilities including “funding the service costs of new developments, in those services for which it is the purchaser, to enable full evaluation to take place”. This would allow the involvement of the Supra Regional Services Advisory Group in the provision of services, such as xenotransplantation, before they are established clinical services. 11 8.17 A mechanism such as the Supra Regional Services Advisory Group would allow the introduction and provision of xenotransplantation which, at the outset, will be a rare and expensive treatment, in a controlled way. The Working Party recommends that, if xenotransplantation becomes a treatment of choice, the introduction of the treatment into the NHS should be overseen by the Supra Regional Services Advisory Group. The Supra Regional Services Advisory Group would be concerned with administration and financing and thus its role would be distinct from that of the proposed Advisory Committee on <strong>Xenotransplantation</strong> responsible for establishing good practice in xenotransplantation (paragraph 6.41). 11 Supra Regional Services Advisory Group annual report (1994-5) p 3. The Group’s name will change to National Specialist Commissioning Advisory Group to reflect these additional responsibilities. 100
Personal and social effects of xenotransplantation Chapter 9 Personal and social effects of xenotransplantation 9.1 A health care system is part of a wider social order. Developments in health care cannot, therefore, be separated from their social context and the broader effects they may have. It is difficult to predict how social attitudes and institutions will respond to xenotransplantation, should it become introduced as a clinical treatment. It is important to consider what these responses might be, however, even if there is, inevitably, an element of speculation involved. In this chapter, therefore, the broader social implications of xenotransplantation are considered. Attitudes towards xenotransplantation 9.2 One view of xenotransplantation is that it represents yet another attempt by human beings to deny their own mortality. Susan Roberts wrote in her submission: “For whilst the improvement in medical techniques is an admirable challenge to face, we do appear to be driven by an overriding desire to fight death at all costs. Perhaps if we could come to terms with the forces of nature at work within our own lives, it would enable us to reach a position of equanimity with the rest of the planet.” This view reflects a more general ambivalence about ‘high-tech’ medicine that is sometimes thought not only to yield little benefit in terms of increased quality of life but also to undermine human dignity in death. 1 Survey respondents, for example, often express a preference for treatments that reduce pain or disability over those that add a little to the length of life. These reservations extend to human organ transplantation. There is also concern about the morality of practices associated with obtaining human organs for transplantation (paragraphs 2.6 - 2.10). Underlying these attitudes is a sense of the inherent limitations of modern medicine, and a recognition that death can be staved off a little but never defeated. In this context, xenotransplantation can be regarded as part of the quest to prolong life, in pursuit of which goal, human beings are prepared to abuse their relationship with other animals. 9.3 Transplantation does not have to be regarded, however, as a form of heroic intervention that strives to extend life at any cost, with little regard to the best interests of the patient. As discussed in Chapter 1, transplantation is increasingly a routine, and not especially expensive, form of treatment that offers significant 1 Calman M and Williams S (1992) Images of scientific medicine. Sociology of Health and Illness, 14:233-54. 101
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NUFFIELD COUNCIL ON BIOETHICS Anima
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Preface Preface Since the N
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Xenotransplantation</strong
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Xenotransplantation - Nuffield Council on Bioethics

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