Xenotransplantation - Nuffield Council on Bioethics
Xenotransplantation - Nuffield Council on Bioethics
Xenotransplantation - Nuffield Council on Bioethics
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Pers<strong>on</strong>al and social effects of xenotransplantati<strong>on</strong><br />
9.6 In trying to assess how people might adapt to xenotransplantati<strong>on</strong>, it is helpful to<br />
draw <strong>on</strong> research that has examined the pers<strong>on</strong>al impact of human organ<br />
transplantati<strong>on</strong>. 3 This research indicates that how well, or badly, some<strong>on</strong>e adapts<br />
to transplantati<strong>on</strong> can have a significant impact <strong>on</strong> physical recovery and <strong>on</strong> health.<br />
In particular, there may be a direct effect <strong>on</strong> the level of compliance with the<br />
demanding regime of immuno-suppressive drugs and other follow-up procedures<br />
needed by transplant recipients.<br />
9.7 The stresses of human organ transplantati<strong>on</strong> fall into two classes: those experienced<br />
before transplantati<strong>on</strong>, and those occurring afterwards. 4 The stresses before<br />
transplantati<strong>on</strong> include dealing with the effects of a severe illness, and coping with<br />
the l<strong>on</strong>g wait for a transplant and the uncertainty of a suitable organ or tissue<br />
becoming available whilst being close to death. 5 If xenotransplantati<strong>on</strong> succeeds in<br />
alleviating the shortage of organs for transplantati<strong>on</strong>, making transplantati<strong>on</strong> available<br />
more quickly and to more people, these stresses might be significantly reduced.<br />
9.8 Stresses occurring as a c<strong>on</strong>sequence of transplantati<strong>on</strong> include the general stresses of<br />
hospitalisati<strong>on</strong> and surgery. More specific stresses include coping with the fear of<br />
rejecti<strong>on</strong> of the transplant or with infecti<strong>on</strong>; with the intrusive nature of<br />
immunosuppressi<strong>on</strong> and follow-up treatment; and with a change in image of the<br />
body. 6 Different levels of significance are attached to different transplants: tissue<br />
transplantati<strong>on</strong>, for example is seen as much less significant than organ<br />
transplantati<strong>on</strong>. Heart transplantati<strong>on</strong> is seen as most significant, since so much<br />
symbolic importance is attached to that organ: “It is the seat of emoti<strong>on</strong>s (especially<br />
love) courage, enthusiasm and innermost thoughts.” 7 Transplant recipients report<br />
being affected by thoughts of organ d<strong>on</strong>ors and their families. For some, it is<br />
disturbing that they have inside them an organ from some<strong>on</strong>e who has died. 8<br />
9.9 There is evidence that transplantati<strong>on</strong> is particularly stressful for children and<br />
adolescents. 9 Young children may not understand why they are ill, and may<br />
perceive it as punishment. Self-image and the peer group are particularly important<br />
for adolescents, and this may lead to problems with adjusting to receiving a<br />
transplant, coping with scars and the physical side-effects of immunosuppressive<br />
drugs. Adolescents’ increased desire for independence may lead to resentment of the<br />
3<br />
Craven J and Rodin G M (1992) Psychiatric Aspects of Organ Transplantati<strong>on</strong>. New York: Oxford Medical<br />
Publicati<strong>on</strong>s.<br />
4<br />
Craven and Rodin (1992) Psychiatric Aspects of Organ Transplantati<strong>on</strong>, pp 90-7.<br />
5<br />
British Heart Foundati<strong>on</strong> (1995) Cardiac Transplantati<strong>on</strong>.<br />
6<br />
Craven and Rodin (1992) Psychiatric Aspects of Organ Transplantati<strong>on</strong>, pp 95-7.<br />
7<br />
Submissi<strong>on</strong> to the Working Party from the Working Group <strong>on</strong> Genetic Engineering in N<strong>on</strong>-human Life Forms of<br />
the Society, Religi<strong>on</strong> & Technology Project of the Church of Scotland.<br />
8<br />
Craven and Rodin (1992) Psychiatric Aspects of Organ Transplantati<strong>on</strong>, pp 169-71.<br />
9<br />
Craven and Rodin (1992) Psychiatric Aspects of Organ Transplantati<strong>on</strong>, pp 33-49.<br />
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