In 2008, according to The Wall Street Journal, there were more than 80,000 people on the waiting list for a kidney transplant in the U.S.. Of these, 5000 did not arrive alive at the end of the year (http://tiny.cc/76158, 08/01/2010). These data show that the shortage of transplant organs is a major health problem.
A solution could come from practice, still experimental xenotransplantation, the insertion into the body of a human tissue from non-human animals. However, the non-human tissues used contain microorganisms that could in theory change after transplantation and become pathogenic to humans. This phenomenon would generate a Xenozoonoses, that a new human disease caused by a pathogen of an animal-human. As the most accepted theory today for the origin of HIV whether you want to own a certain Xenozoonoses from ape to man, and that HIV infection has killed 25 million since the early eighties to the present The risk of a Xenozoonoses by xenotransplantation can not be underestimated, even if its a priori probability was estimated as very low.
If this problem has long been known in the scientific and bioethics literature on the subject (so that the bulk of biomedical research done today in the field takes care to limit this risk), an interesting article by R. Sparrow appeared alla fine del 2009 su Developing World Bioethics (9, 3:119-127) associa il rischio di xenozoonosi a problematiche di giustizia globale e di consenso informato.
In primo luogo, dato che il rischio di xenozoonosi riguarderebbe inevitabilmente l'intero pianeta a causa dell'alta mobilità della popolazione, la decisione se compiere o meno il primo xenotrapianto (il che comporterebbe di accettare il rischio di xenozoonosi) dovrebbe essere affidata alla comunità globale, in quanto gli interessi di tutte le nazioni del pianeta sarebbero coinvolti nei potenziali esiti della scelta. Tuttavia non esiste un forum politico globale democraticamente costituito in cui rappresentanti di tutte le nazioni del globo possano dibattere in modo informato l'argomento e deliberare. Do you see then who is entitled to express consent of humanity to this decision.
Secondly, and this is where the most interesting part of Sparrow, the risks and benefits of xenotransplantation would distribute asymmetrically in the general population: poor countries with health systems are inadequate are the main victims of any Xenozoonoses pandemic, while rich countries could defend themselves through drugs and timely public health measures. In contrast the benefits of the new therapy would fall almost entirely on the rich countries, given the enormous costs of xenotransplantation, which would require special breeding sterile donor animals, a continuous monitoring del ricevente dopo la donazione e immunosoppressione farmacologica vita natural durante. Quest'asimmetria renderebbe la pratica dello xenotrapianto ingiusta di per sé, stante l'attuale distribuzione delle risorse sanitarie.
La bioeticista Martine Rothblatt (Your Life or Mine, Ashgate 2004) ha proposto, per risolvere questo problema, che il consenso allo xenotrapianto sia un consenso ipotetico (si potrebbe cioè procedere allo xenotrapianto solo qualora fosse ragionevole credere che la pratica riceva un consenso maggioritario da parte di una comunità globale ben informata) e che il consenso vada dato a un pacchetto di misure sanitarie che comprenda, oltre allo xenotrapianto, servizi sanitari di base per i paesi poveri, necessari a monitorare il Xenozoonoses risk.
Sparrow replica Rothblatt that this consent would be morally null and void, because obtained by blackmail (basic health against xenotransplantation) that exploit the vulnerability of poor countries.
Sparrow concludes that the global consensus to xenotransplantation could be given only after it has been settled, whatever you want to introduce new therapy, the gap in global health resources.
This request is valid all the more so given that rich countries are responsible, as former colonizers, the current condition of the poor and that could remedy the wrongs done by sacrificing a very important portion of their purchasing power per qualche anno.
0 comments:
Post a Comment