Ethics of bioprinting

Ethics of bioprinting is a sub-field of ethics concerning bioprinting. Some of the ethical issues surrounding bioprinting include equal access to treatment, clinical safety complications, and the enhancement of human body (Dodds 2015).[1][2]

3D printing was invented by Charles Hull in the mid 1980s.[3] 3D printing is a process in additive manufacturing which uses a digital design to produce a physical copy. This process is carried out by a specific printer, which uses several layers in order to complete the design. However, bioprinting uses the ways of 3D printing to create things such as organs, tissues, cells, blood vessels, prosthetics and a broad range of other things that can be used in the medical field.[4][5][6] The "Pioneers" of bioprinting include, Organovo, Tissue Engineering and Regenerative medicine Lab at Columbia University, Makoto Nakamura, to name a few. These pioneers have all helped to shape bioprinting into what it is. The ethics of bioprinting have been a topic of discussion as long as bioprinting has been popular. Ethics are moral principles that govern production, behavior, etc.[7]

Equal access to treatment

Bioprinting focuses on the individual care rather than developing a universal treatment plan for all patients. Personalized medicine is expensive and increases the disparity between the rich and poor. Since 3D printing is an individual treatment, the general public assumes that it may prevent people with financial issues from receiving care. However, bioprinting improves universal access to healthcare because it will eventually "bring down the time and cost" of treatment.[1] For example, prosthetic limbs and orthopedic surgery can be done in an efficient and inexpensive manner. People would not have to wait months for their prosthetics, which will ultimately decrease the medical expense. The bioprinter may be used to manufacture bone replacements and produce customized prosthetic limbs quickly. Also the printing of human organs, and tissues, are available with decreased time, only taking a few weeks to produce instead of a regular transplant. Currently in the United states the Transplant list is 115,000 people are awaiting a transplant, which can take nearly two years to obtain, while nearly 2 million people have lost a limb.[8][9] Those who were previously excluded from these medical advancements will now have access to them.

Safety

Any new treatment involving 3D printers is risky and patients must be well informed of the health implications. Doctors hope in the future to print organs in order to replace dysfunctional bio-structures. Similar to organ donations, the cells must match genetically otherwise the recipient’s body will reject the organ. The patient would have an autoimmune response and destroy the donated tissue. The individual’s stem cells must be used to manufacture the organ for the specific patient. In order to advance this technology the medical field must find a way to test and standardize organ production.

Human enhancement

Bioprinting may be used to increase human performance, strength, speed, or endurance. For instance, bioprinting may be used to manufacture enhanced bones and replace regular human bones that are stronger and more flexible. The 3D printer could also be used to increase muscle performance by making muscles more "resilient and less likely to become fatigued".[1] Lung capacity could also be improved by replacing it with an artificial lung that can increase oxygen efficiency in the blood. Human enhancement would have a dangerous but incredible impact on society; bioprinting could create a culture without disease or imperfection.

Legality and policies

Bioprinted items must require regulation. In the United States this is the job of FDA. The FDA must make sure that printed organs are handled a bit differently than human organs because while Bioprinting is a growing field, still little is known about it and what it does to the human body.[10] In bioprinting we face tradeoffs between restricted use and open use. Restricted use will allow bioprinting to only be done by trained professionals, where as, open use is more of a free for all. There are also trade offs between if it is ethical to mass produce organs or if it could make issues in transplant cases worse. The legality behind bioprinting is a means in which selling organs on the black market is deemed a problem but is the production and selling of bioprinted items also fall under that law.[11]

References

1. Dodds, S. (2015, February 11). 3D printing raises ethical issues in medicine. Retrieved from ABC Medicine.
2. Rhiannon Williams (29 January 2014). "3D printing human tissue and organs to 'spark ethics debate'". The Telegraph.
3. "What is 3D Printing? The definitive guide". 3D Hubs. Retrieved 2018-05-06.
4. "What is Bioprinting?". www.innovateus.net. Retrieved 2018-05-06.
5. "ExplainingTheFuture.com : Bioprinting". www.explainingthefuture.com. Retrieved 2018-05-06.
6. Lim, Alane (May 2, 2018). "What is Bioprinting?". thoughtco. Retrieved September 17, 2019.
7. University, Santa Clara. "What is Ethics? - Markkula Center for Applied Ethics". www.scu.edu. Retrieved 2018-05-06.
8. "Limb Loss Statistics - Amputee Coalition". Amputee Coalition. Retrieved 2018-05-06.
9. "Facts and Myths – American Transplant Foundation". www.americantransplantfoundation.org. Retrieved 2018-05-06.
10. Kelly, Elizabeth. "FDA Regulation of 3D Printed Organs and Associated Ethical Challenges" (PDF).
11. Vermeulen, Niki; Haddow, Gill; Seymour, Tirion; Faulkner-Jones, Alan; Shu, Wenmiao (2017-03-20). "3D bioprint me: a socioethical view of bioprinting human organs and tissues". Journal of Medical Ethics. 43 (9): medethics–2015–103347. doi:10.1136/medethics-2015-103347. ISSN 0306-6800. PMC 5827711. PMID 28320774.