So, the technology is here to grow human pancreas in pigs and potentially improve lives of millions of diabetics. The obstacles are mostly ethical/regulatory, apparently. Does this mean that we explicitly or implicitly value non-creating a donor pig life, however short it might be, over quite a few human QALY?
potentially improve lives of millions of diabetics
There aren’t a million type 1 diabetics in the world. I estimate 100k. Cloned pancreatic transplants are “potentially” useful to the much larger number of type 2 diabetics, but it’s not clear. Really, it’s not even clear how valuable they are to type 1 diabetics—it’s generally believed to be autoimmune, so the new pancreas probably wouldn’t last long.
Yes, of course we should answer these questions by allowing this research, but the pancreas seems a weird choice to start.
PS—the subtitle “We have excellent snack foods” seems like a weird choice to address to a Japanese.
Really, it’s not even clear how valuable they are to type 1 diabetics—it’s generally believed to be autoimmune, so the new pancreas probably wouldn’t last long.
Also, T1D is pretty well managed with modern insulin pumps and blood sensors and finger checks. I have had T1D for 15 years now, and the insulin-related technology and quality of life has really improved over that time. I wouldn’t take a transplant option unless it was grown from my own cells (to negate rejection issues) and the transplant itself had very low failure and complication rates (most of my pancreas is working fine, after all, and I don’t want to risk it).
In current pancreas transplants, you keep your old pancreas, for that very reason. Yes, surgery is bad for your health, but T1D is pretty bad, even if “well-controlled.” If the cloned islets aren’t destroyed in the same way, it’s almost certainly a win. It occurs to me that foreign islets might avoid the autoimmune problem, but it’s only worth it for the worst T1D cases.
Article makes it sound like Japan has unusually strict rules here - - quoting the article, “Japan currently has a ban on what’s called “in vivo” experiments, meaning “within the living.” Essentially, Japanese law forbids experiments that involve a whole, living creature, like these piglets. (“In vitro,” or “within the glass,” is permitted.)”
I think in the US, this would be a relatively easy sell to institutional review boards. It’s legal and widely considered ethical to raise pigs and then eat them. Is there an ethical issue posed here that doesn’t arise for pork?
So, the technology is here to grow human pancreas in pigs and potentially improve lives of millions of diabetics. The obstacles are mostly ethical/regulatory, apparently. Does this mean that we explicitly or implicitly value non-creating a donor pig life, however short it might be, over quite a few human QALY?
There aren’t a million type 1 diabetics in the world. I estimate 100k.
Cloned pancreatic transplants are “potentially” useful to the much larger number of type 2 diabetics, but it’s not clear. Really, it’s not even clear how valuable they are to type 1 diabetics—it’s generally believed to be autoimmune, so the new pancreas probably wouldn’t last long.
Yes, of course we should answer these questions by allowing this research, but the pancreas seems a weird choice to start.
PS—the subtitle “We have excellent snack foods” seems like a weird choice to address to a Japanese.
Also, T1D is pretty well managed with modern insulin pumps and blood sensors and finger checks. I have had T1D for 15 years now, and the insulin-related technology and quality of life has really improved over that time. I wouldn’t take a transplant option unless it was grown from my own cells (to negate rejection issues) and the transplant itself had very low failure and complication rates (most of my pancreas is working fine, after all, and I don’t want to risk it).
In current pancreas transplants, you keep your old pancreas, for that very reason. Yes, surgery is bad for your health, but T1D is pretty bad, even if “well-controlled.” If the cloned islets aren’t destroyed in the same way, it’s almost certainly a win. It occurs to me that foreign islets might avoid the autoimmune problem, but it’s only worth it for the worst T1D cases.
Article makes it sound like Japan has unusually strict rules here - - quoting the article, “Japan currently has a ban on what’s called “in vivo” experiments, meaning “within the living.” Essentially, Japanese law forbids experiments that involve a whole, living creature, like these piglets. (“In vitro,” or “within the glass,” is permitted.)”
I think in the US, this would be a relatively easy sell to institutional review boards. It’s legal and widely considered ethical to raise pigs and then eat them. Is there an ethical issue posed here that doesn’t arise for pork?
If it’s OK to eat a pig but throw away the pancreas, then it should be OK to implant the pancreas and eat the rest of the pig.
Although law doesn’t have to be as internally consistent as most ethical systems.
We explicitly value legal regulations over QALY in thousands of situations.