Thinking twice about "tissue engineering" [ethical issues]

There is no question that organ transplantation is difficult and expensive. Screening donors for transmissible disease and accurate matching of donor organs to recipients, so that there will be the best possible blood and tissue compatibility, as well as appropriate size, is extremely difficult. Fundamental problems remain: the supply is far exceeded by the demand, the costs of the procedures involved tend pragmatically to reduce access by less well-off and disenfranchised individuals and, as a result, nagging questions of social justice remain. It is fair to state that these considerations have played a strong role in the early development of the field now known as "tissue engineering." The author recommends taking a second look at the entire concept of tissue engineering. Before one goes too far down this path, it is worthwhile to think twice; to consider the implications and ask whether there are some things that should not be done simply because they appear to be possible. Topics considered include: autoreplants, alloreplants, xenografts, gene transplants and cloning.