[Editorial] Find space for new science, its ethical dilemmas

new science

 

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Context

Xenotransplantation.

What the editorial is about?

  • The need to deal with complex ethical questions that result from advances in science and technology.

How good India is in discussing the advances in modern science and their repercussions for public life?

  • In India, because of the election cycle, and because political events oscillate between their significance for an electoral democracy or their implications for an electoral autocracy, we spend little time discussing the advances of modern science and their repercussions for public life.
  • There have been such fascinating developments in science and in technology, such as in artificial intelligence, but these have merely been reported and then have quietly faded from public view.
  • In India, such advances in science and technology get adopted without even a boo.
  • They soon get normalized without their ethical implications even being debated.

The need to do discussions and debates

  • In the last four months, there have been various news reports regarding the direction of medical science towards an area labelled as Xenotransplantation.
  • The first case comes from a successful experiment, in September 2021, at a hospital in New York, where a medical team there attached a kidney from a gene-edited animal to a person declared brain dead to see if the animal kidney was able to do the job of processing waste and producing urine.
  • The second case is from the University of Maryland where a team of doctors used the heart of an animal, which had genetically modified features, as a replacement heart on a patient who had run out of available options.
  • The third case is the news report that a doctor in Germany, who has been working in the area of xenotransplants, plans to develop a farm to cultivate genetically-modified organs for such transplants. In his view, this will ease the pressure on the medical system.
  • In all three cases, the animal from which the tissue or organ had been taken was the pig. It is regarded by medical science as the animal whose organs are currently best suited for humans.

What is Xenotransplantation?

  • Xenotransplantation or heterologous transplant is the transplantation of living cells, tissues or organs from one species to another.
  • Such cells, tissues or organs are called xenografts or xenotransplants.
  • Human xenotransplantation offers a potential treatment for end-stage organ failure, a significant health problem in parts of the industrialized world.
  • It also raises many novel medical, legal and ethical issues.

Questions that Xenotransplantation raises

Ethical issues

  • At the very least there are three ethical issues that these medical advances raise for human societies.
  • In India, these developments carry an additional sting.
    1. Should we discuss them or, given that they involve community sensibilities, should we pretend they are not there?
    2. Do these ethical issues pertain only to the individual or do they also concern the community? Which gets precedence?
    3. Are we obliged to discuss them, because Article 51A of the Constitution requires us “to develop scientific temper”, or can we ignore them?

The Rights of animals

  • The animal rights movement has objected to these advances in medical science, of xenotransplantation because it ignores the rights of animals.
  • They are hostile to the idea of animal farms with genetically modified animals for the purpose of harvesting organs for humans requiring transplants.
  • Animals, they argue, also have rights and it is our moral responsibility to support these rights.
  • We must, therefore, not walk down the road of organ farms. Such thinking, they argue, stems from a philosophy of anthropocentrism which places human beings at the centre of nature and regards all other living creatures as having only value if they can be of use to humans.
  • Such anthropocentric thinking, they rightly declare, has been the basis of the ecological crises of climate change.
  • Mahatma Gandhi, they add, was opposed to the practice of vivisection.

Moral dilemmas

  • The animal rights perspective places on us the classic utilitarian dilemma of whether it is better to kill an animal and save a human being or to save an animal and let the human die.
  • Medical science is having to work though such moral dilemmas.
  • In India, where such questions do not even enter the portals of regulatory bodies, such as the Indian Council of Medical Research (ICMR).

Set of questions that are so incendiary in India

  • In a society where the pig is considered a dirty animal, where eating pork is considered disgusting, where those who deal with pigs are given low social status, where even asking such questions is taboo if global advances in medical research are moving towards a consensus on the suitability of a pig’s heart for patients suffering from terminal heart decline. The following questions are so incendiary in India.
    1. What should the medical fraternity do?
    2. What should the medical authorities recommend to the government?
    3. Imagine that such a patient is a Jain, or a Jew, or a Muslim or just a vegetarian. Should they be allowed to die since their belief system forbids them to have anything to do with a pig, or should they be offered a choice of life?

Conclusion

  • In election-obsessed India, there is hardly any time to discuss the advances of the modern sciences and the repercussions.
  • The is an immediate need to deal with complex ethical questions that result from advances in science and technology.

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