Friday, September 25, 2015

Kidneys, Experiments, and Ethics

Kidney failure isn't always fatal these days. Hemodialysis or peritoneal dialysis can keep someone alive until a transplant donor shows up. Even so, kidney problems kill about a million folks each year.

It's not the leading cause of death for my 7,250,000,000-plus neighbors, but that's still a lot of deaths.

Scientists in Japan grew working kidneys in rats and pigs. We're years away from grow-your-own kidneys for patients: but I think that's coming.

Meanwhile, a scientist in England wants permission to collect people for genetic experiments. The Francis Crick Institute, Human Fertilization and Embryology Authority, and BBC News describe the proposal more discretely.
  1. Kidneys and Stem Cells
  2. Human Experimental Subjects: Disposable People

Doing the Right Thing: Eventually

America has changed since this was written:
"...'...We blowed out a cylinder-head.'

" 'Good gracious! anybody hurt?'

" 'No'm. Killed a [redacted].'

" 'Well, it's lucky; because sometimes people do get hurt....'..."
("The Adventures of Huckleberry Finn," Part 2 (1885), Chapter XXXII, Mark Twain; via
"Huckleberry Finn" is fiction, but I'm pretty sure that Mark Twain knew folks who shared Aunt Sally's belief that some folks weren't "people."

Aunt Sally was a nice enough person, with no more than the usual human failings. But she lived in a society which treated some people as if they were property.

Several decades later, Harper's Weekly explained differences between the presumably-superior "Anglo-Teutonic" race and many of my ancestors.

Many Americans eventually accepted the Irish and other folks "of low type." We've even had an Irish president.

These days some 'regular Americans' see folks from the Middle East threats to our country. I'm pretty sure we'll get over that, too. (September 18, 2015; July 6, 2014)
"Americans will always do the right thing — after exhausting all the alternatives."
Winston Churchill, 1980 or earlier

"Men and nations behave wisely when they have exhausted all other resources."
Abba Eban, March 1967

"You can depend on Americans to do the right thing when they have exhausted every other possibility."
Some Irishman

Remembering Tuskegee

The Hippocratic Oath has been rewritten — and ignored — quite a few times.

But the basic idea, that doctors should behave ethically, won't go away.

The World Medical Association put the Declaration of Geneva together in 1948, after embarrassments like Josef Mengele and Sigmund Rascher.

A few decades later, Irwin Schatz, Peter Buxtun, and other troublemakers finally ended the Tuskegee syphilis experiment.

Hepatitis studies at Willowbrook State School were also shut down around that time. Too many folks got squeamish over using mentally disabled children as lab animals.

Acknowledgement of Unit 731's alternatively-ethical human experiments is starting to trickle through official channels: after more than a half-century. I suppose 'better late than never' applies here.

There's still lively debate over whether anyone should use data from those experiments. Some of the arguments 'against' are ethical. Others point out that sloppy methodology makes the data useless. It's a thorny issue that I'll leave for another post.

Today I'll focus on why I think curiosity isn't a good reason for subjecting folks to occasionally-lethal experiments.

Love, Science, and Being Human

I've been over this before. Human beings are people; all of us, no matter who our ancestors are, where we live, what we look like, or how old we are. (Catechism of the Catholic Church, 357, 361, 369-370, 1700, 1730, 1929, 2273-2274, 2276-2279)

We're not all alike, and we're not supposed to be. But we have equal dignity. (Catechism, 33, 366, 1934-1938, 2232, 2393)

People are not property. (Catechism, 2373-2379, 2414)

I must respect local, regional, and national, authorities; and be a responsible, active, citizen. (Catechism, 1897-1904, 1913-1917)

That does not mean blindly following orders. (Catechism, 1905-1912, 2242)

Loving God, loving my neighbors, seeing everyone as my neighbor, and treating others as I'd like to be treated, is a high priority. (Matthew 5:43-44, 7:12, 22:36-40, Mark 12:28-31; Luke 6:31 10:25-27, 29-37; Catechism of the Catholic Church, 1789)

Learning how the universe works and using that knowledge to make new tools, is part of being human. It's what we're supposed to do. Science and technology are fine. Ignoring ethics isn't. (Catechism, 159, 2292-2296, 2375-2377, 2414)

I'm expected to love all neighbors, no exceptions: and follow the 'friends don't let friends drive drunk' principle. (September 6, 2015; March 15, 2015)

1. Kidneys and Stem Cells

(From Science Photo Library, via BBC News, used w/o permission.)
"Lab-grown kidneys work in animals"
Michelle Roberts, BBC News (September 22, 2015)

"Scientists say they are a step closer to growing fully functioning replacement kidneys, after promising results in animals.

"When transplanted into pigs and rats, the kidneys worked, passing urine just like natural ones.

"Getting the urine out has been a problem for earlier prototypes, causing them to balloon under the pressure.

"The Japanese team got round this by growing extra plumbing for the kidney to stop the backlog, PNAS reports.

"Although still years off human trials, the research helps guide the way towards the end goal of making organs for people, say experts...."
The Jikei University School of Medicine's Dr. Takashi Yokoo and others tested their technique on rats, then pigs — successfully. Rats and pigs aren't human, so as Michelle Roberts said: we're years from growing human kidneys.

But we already have folks "walking around with body parts which have been designed and built by doctors out of a patient's own cells." (BBC News (2012))

Kidneys are much more complex than the bladders mentioned in that 2012 article. But I'm pretty sure we'll add 'artificial' kidneys to the growing list of available replacement parts. I'm also pretty sure that we'll have ethical questions about the new tech. (February 13, 2015; August 29, 2014)

Stem Cells, Organ Transplants, and Ethics

I don't see problems with the Jikei University School research, but my guess is that some folks might.

They used stem cells and cloned pig fetuses in their research. Stem cells are undifferentiated cells. They'll become muscle tissue, nerves, or whatever, depending on which bit of genetic code gets used.

My bone marrow, adipose tissue, and blood, contains stem cells. Umbilical cord blood is another source for stem cells. Extracting stem cells from my tissues would probably hurt a bit, but wouldn't disable or kill me.

Using my stem cells for stem cell transplantation would be okay, just as organ transplants are ethically justified — usually. Killing someone and breaking the body down for parts wouldn't be. Not even if I didn't know the victim, and someone I liked needed the spare parts. (Catechism, 2296)

If this research leads to 'grow your own' kidneys for humans, someone will be the first patient: a human test subject.

Experimentation on humans is okay unless it involves "disproportionate or avoidable risks," or experiments are done without informed consent. (Catechism, 2295)

The rules aren't as strict for animals — but we can't 'do anything we like' to critters. We shouldn't anyway. (Catechism, 2416-2418)


2. Human Experimental Subjects: Disposable People

Medical research is a good idea. But ethics still apply. (March 6, 2015; February 13, 2015)
"UK scientists seek permission to edit the genes of human embryos"
Kate Kelland, Reuters (September 18, 2015)

"British scientists have applied for permission to edit the genes of human embryos in a series of experiments aimed at finding out more about the earliest stages of human development.

"Just months after Chinese scientists caused an international furor by saying they had genetically modified human embryos, Kathy Niakan, a stem cell scientist from London's Francis Crick Institute, has asked the British government's fertility regulator for a license to carry out similar experiments.

"In a statement about her application, which was made to the Human Fertilization and Embryology Authority (HFEA), Niakan said she had no intention of genetically altering embryos for use in human reproduction, but aimed to deepen scientific understanding of how a healthy human embryo develops.

" 'This knowledge may improve embryo development after in vitro fertilization (IVF) and might provide better clinical treatments for infertility,' she said in a statement, adding that any donated embryos would be used for research purposes only...."
Wanting to "deepen scientific understanding of how a healthy human embryo develops" is, I think, a good idea.

Growing or collecting people to be used "for research purposes only," on the other hand, is not a good idea. At all.

As I said earlier, I think human beings are people: all human beings. Even those who don't have my legal or social status.1

I'll admit to a bias, since a doctor used me for a scientific study without my parents' knowledge. The experiment was non-lethal, obviously, but probably contributed to several decades of somewhat-avoidable pain. (February 3, 2009)

The Crick Institute is following British law and customs, getting official permission to experiment on people. But 'legal' isn't necessarily 'right.'

Cultural Values, Rules, and Principles

There is no one 'correct' culture. We're not all alike. That's how it's supposed to be.

But cultural values which do not honor human dignity, freedom, and justice, are wrong — no matter how cherished those values are. (Catechism, 814, 1740, 1882-1883, 1901, 1915, 1928-1948, 1950-1960, 1957, 2524)

I've talked about positive law, rules we make up and change as our circumstances change; and natural law, unchanging principles, before. (August 31, 2014; August 29, 2014)

"For Research Purposes Only"

(From SPL/Science Photo Library, via BBC News, used w/o permission.)
"Scientists seek permission to genetically modify embryos"
BBC News (September 18, 2015)

"UK scientists are seeking permission to genetically modify human embryos for the first time.

"Researchers at The Francis Crick Institute in London want to use a controversial genetic technique to carry out research into infertility.

"The embryos would be destroyed after the research and not implanted into the womb....

"...Research leader, Dr Kathy Niakan, said the aim was to understand the genes that human embryos need to develop successfully.

" 'Importantly, in line with HFEA regulations, any donated embryos would be used for research purposes only,' she said.

" 'These embryos would be donated by informed consent and surplus to IVF treatment.'...

"...'UK scientists are poised to make a world-leading contribution to this exciting field,' she said.

" 'At the same time, we should be reassured to know that this work is being carried out under a robust regulatory scheme that ensures high scientific and ethical standards."
I suppose it's nice that folks at the Francis Crick Institute are going through proper channels, getting government approval before asking parents to donate their kids for these experiments.

But I do not think that a parent, informed or not, should hand a child over to killed. Not even if scientists might discover something useful — and boost England's international reputation a leader in human experimentation.

I understand that some residents of the UK don't like the Crick proposal. I think the British government will probably approve, anyway.

Genetics is an exciting study today, national pride is at stake, and we're not supposed to think of embryos as people. Not 'real' people.

Delaying recognition of a person's humanity until a fixed age is convenient, of course. But convenience does not justify classifying some folks as non-persons. (February 13, 2015)

Faith, Reason, and Ethics

It's not faith or reason: it's faith and reason. ("Fides et Ratio," John Paul II (September 14, 1998); Catechism, 35)

Thinking is not a sin. Neither is curiosity. (Catechism, 159, 283, 1778)

Learning how our genes work is okay. Killing people in the process is not: even if the victims are not, legally, people.

As a Catholic, I must believe that human life is sacred: all human life, including folks who are very young. (Catechism, 2258, 2270, 2273, 2276-2279)

Life and health are "precious gifts." Healing the sick is a good idea. But killing one person to get parts for another is wrong. So are experiments that cause someone's death. (Catechism, 2258, 2288-2296)

More, mostly about science, tech, and thinking:

1 Slavery finally became illegal in America and quite a few other nations, but human trafficking is still a problem. (January 18, 2015; August 31, 2014)

No matter what you call it, slavery is a bad idea, and we shouldn't do it. (Catechism, 2414)


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From time to time, a service that I use will display links to - odd - services and retailers.

I block a few of the more obvious dubious advertisers.

For example: psychic anything, numerology, mediums, and related practices are on the no-no list for Catholics. It has to do with the Church's stand on divination. I try to block those ads.

Sometime regrettable advertisements get through, anyway.

Bottom line? What that service displays reflects the local culture's norms, - not Catholic teaching.