Your life or mine : how geoethics can resolve the conflict between public and private interests in xenotransplantation / Martine Rothblatt.

Format:

Book

Author/Creator:

Rothblatt, Martine Aliana, 1954-

Language:

English

Subjects (All):

Zoonoses.

Xenografts.

Procurement of organs, tissues, etc.

Xenografts--Moral and ethical aspects.

Transplantation of organs, tissues, etc--Complications.

Transplantation of organs, tissues, etc.

Procurement of organs, tissues, etc--Moral and ethical aspects.

Physical Description:

xii, 196 pages : illustrations ; 23 cm

Place of Publication:

Aldershot, Hants, England ; Burlington, VT : Ashgate, 2004.

Contents:

I Introduction: The Organ Shortage is a Major Problem That Defies Conventional Solutions 1

Mind the Gap 2

Measurements of Demand and Supply 2

Demand for Hearts, Lungs, Livers and Kidneys 3

Historical, Current and Prospective Supply of Vital Organs 5

Where Have All the Organs Gone? 9

Presumed Consent 9

Permanent Vegetative State (PVS) 11

Elective Ventilated Donors 12

Non-Heart-Beating Donors 12

Improved Allocation and Infrastructure 13

Selling Your Body: The Status of Marketplace Solutions to the Problem 16

Supply Side Economics Justification for Banning Organ Sales 18

Bioethical Reasons Such as Autonomy for Banning Organ Sales 21

Public Revulsion Reason for Banning Organ Sales 24

II Brave New Organs: The Status of Technological Solutions to the Problem 27

Some Assembly Required: Status of Wholly Artificial Organs 27

The 'Wholly' Grail: A Total (Not Partial) Artificial Heart 29

Cardiac Assistance Devices

Part of an Organ Covers Part of the Gap 31

Summary of Wholly Artificial Organ Technology 31

Human-Cyborg Relations: Status of Bio-Artificial Organs 32

Bio-Artificial Livers 32

Growing Your Own: Status of Wholly Bio-Engineered Organs 33

Organogenesis 33

Xenotransplantation 35

The Science of Xenotransplantation 36

First Stage of Failure: Hyperacute Rejection ("HAR") 37

First Stage of Xeno-Success: Transgenic Animals 38

Second Stage of Failure: Delayed Xenograft Rejection 39

Second Stage of Success: Anti-Pyrimidine Biosynthesis Drugs 40

Third and Fourth Stages of Failure: Acute Cellular and Chronic Rejection 40

Third and Fourth Stages of Success: Ever Better Immunosuppressives and Monitoring 41

Realtechnik and Realpolitik: Why Xenografts Will Win 42

III Look Before You Leap: Technological Risks of Xenotransplantation 47

Blood Sucking Host Hoppers: Zoonotic and Xenogeneic Bugs 48

Theoretical Likelihood of Xenogeneic Diseases 51

Practical Experience with Xenogeneic Infections 52

Scientist as Lawyer: Absence of Evidence is Not Evidence of Absence 53

Mi Casa Es Su Casa? Issues of Public Health Acceptability 55

The U.K. Approach 56

The U.S. Approach 57

Stasi Medicine?

How Surveillance Can Coexist with Human Rights 58

Consent, Informed or Presumed? 61

Community Consent 64

Life Trumps Autonomy? 66

IV Of Pigs and Men: Issues of Speciesism and Chimerism 71

Are All Animals Created Equal? 72

We Feel Your Pain 72

Agreeing to Disagree 73

Singer: Weigh Animals Like Humans 74

Regan: Don't Play the Weighing Game with Life 76

Frey: Humans Outweigh Animals by a Longshot 78

Leahy: Weigh it in Words 81

How Much Does Private Language Count? 82

Physiological Signs of Pain 82

Only Language Separates Us From Them 83

Giving Darwin Some Respect 85

Chimerism and Its Discontents 87

Piled High and Deep: The Realities of Pork 87

Transgressing the Pig Genome 89

Transgressing Humanity 91

Transgressive Psychology 94

Conclusion: No Revolution Likely on the Animal Pharm 95

V The Right to Life: Society's Obligation to Provide Health Care and Xenotransplantation 97

Ought Implies Kant 97

Berlin's Polarization and the Power of Negative Thinking 98

Dealing in John Rawls: Primary Goods in a Just Society 101

Don't Forget About the Health Benefits! 102

Doyal and Gough's Theory of Human Needs 103

Why Must My Rights Be Everyone's Rights? 105

Giving an Inch and Taking a Mile: Can Health Care Include Xenotransplantation? 108

No Religious Preference 109

VI Is Xenotransplantation Worth the Risk? 111

Truth or Consequences: Incommensurability of Negativities 112

Garbage In, Garbage Out: Inestimability of Probabilities 113

Antibiotics: Better Not Sorry Than Safe 115

We Tolerate the Risks for the Sake of the Benefits 119

Containing Pandora: Russian Doll Treatment of Recombinant DNA 122

The Asilomar Story 123

"Devil's Doctrine" Debunked 126

Science is Neither Above the Law Nor Apart from Society 127

Applying Asilomar to Xenotransplantation 129

The Precautionary Principle 131

Asilomar-Type Rules and Antibiotic-Type Risks on a Global Stage 134

A Little Bit of Risk is Not a Bad Thing 134

Risk Bearers of the World, Unite! 135

VII A Geoethical Solution to the Conflict Between Private and Public Interests in Xenotransplantation 139

Practical Implementation of Geoethical Xenotransplantation 142

Who Will Do What To Whom? 142

Problems with Minimal Competence Regimes 143

Maximal Competence Regime is More Realistic 144

Not Pie in the Sky 146

Financial Elements of a Global Xenotransplantation Control 150

Certification Costs are Minimal 151

Surveillance Costs are Basic Global Health Care Costs 151

The Xenograft Tax 153

Legal Pathways to a Global Xenotransplantation Control 156

Sentinel Organizations 157

Participation Sectors 158

Not the First Time the Rich Tax Themselves for Global Benefit 160.

Notes:

Includes bibliographical references (pages [167]-179) and index.

Includes bibliographical references and index.

ISBN:

0754623912

OCLC:

54966963