Your Life or Mine: How Geoethics Can Resolve the Conflict Between Public and Private Interests in Xenotransplantation

Cover
Half Title
Dedication
Title Page
Copyright Page
Table of Contents
List of Tables and Figures
Preface
Acknowledgements
I Introduction: The Organ Shortage is a Major Problem That Defies Conventional Solutions
	Mind the Gap
		Measurements of Demand and Supply
		Demand for Hearts, Lungs, Livers and Kidneys
		Historical, Current and Prospective Supply of Vital Organs
	Where Have All the Organs Gone?
		Presumed Consent
		Permanent Vegetative State (PVS)
		Elective Ventilated Donors
		Non-Heart-Beating Donors
		Improved Allocation and Infrastructure
	Selling Your Body: The Status of Marketplace Solutions to the Problem
		Supply Side Economics Justification for Banning Organ Sales
		Bioethical Reasons Such as Autonomy for Banning Organ Sales
		Public Revulsion Reason for Banning Organ Sales
	Conclusion
II Brave New Organs: The Status of Technological Solutions to the Problem
	Introduction
	Some Assembly Required: Status of Wholly Artificial Organs
		The \'Wholly\' Grail: A Total (Not Partial) Artificial Heart
		Cardiac Assistance Devices - Part of an Organ Covers Part of the Gap
		Summary of Wholly Artificial Organ Technology
	Human-Cyborg Relations: Status of Bio-Artificial Organs
		Bio-Artificial Livers
	Growing Your Own: Status of Wholly Bio-Engineered Organs
		Organogenesis
		Xenotransplantation
	The Science of Xenotransplantation
		First Stage of Failure: Hyperacute Rejection (\"HAR\")
		First Stage of Xeno-Success: Transgenic Animals
		Second Stage of Failure: Delayed Xenograft Rejection
		Second Stage of Success: Anti-Pyrimidine Biosynthesis Drugs
		Third and Fourth Stages of Failure: Acute Cellular and Chronic Rejection
		Third and Fourth Stages of Success: Ever Better Immunosuppressives and Monitoring
	Realtechnik and Realpolitik: Why Xenografts Will Win
	Conclusion
III Look Before You Leap: Technological Risks of Xenotransplantation
	Introduction
	Blood Sucking Host Hoppers: Zoonotic and Xenogeneic Bugs
		Theoretical Likelihood of Xenogeneic Diseases
		Practical Experience with Xenogeneic Infections
		Scientist as Lawyer: Absence of Evidence is Not Evidence of Absence
	Mi Casa Es Su Casa? Issues of Public Health Acceptability
		The U.K. Approach
		The U.S. Approach
	Stasi Medicine? - How Surveillance Can Coexist with Human Rights
		Consent, Informed or Presumed?
		Community Consent
		Life Trumps Autonomy?
	Conclusion
IV Of Pigs and Men: Issues of Speciesism and Chimerism
	Introduction
	Are All Animals Created Equal?
		We Feel Your Pain
		Agreeing to Disagree
	Singer: Weigh Animals Like Humans
	Regan: Don\'t Play the Weighing Game with Life
	Frey: Humans Outweigh Animals by a Longshot
	Leahy: Weigh it in Words
		How Much Does Private Language Count?
		Physiological Signs of Pain
		Only Language Separates Us From Them
	Giving Darwin Some Respect
	Chimerism and Its Discontents
		Piled High and Deep: The Realities of Pork
		Transgressing the Pig Genome
		Transgressing Humanity
		Transgressive Psychology
	Conclusion: No Revolution Likely on the Animal Phann
V The Right to Life: Society\'s Obligation to Provide Health Care and Xenotransplantation
	Introduction
		Ought Implies Kant
		Berlin\'s Polarization and the Power of Negative Thinking
	Dealing in John Rawls: Primary Goods in a Just Society
		Don\'t Forget About the Health Benefits!
		Doyal and Gough\'s Theory of Human Needs
		Why Must My Rights Be Everyone\'s Rights?
	Giving an Inch and Taking a Mile: Can Health Care Include Xenotransplantation?
		No Religious Preference
	Conclusion
VI Is Xenotransplantation Worth the Risk?
	Introduction
		Truth or Consequences: Incommensurability of Negativities
		Garbage In, Garbage Out: Inestimability of Probabilities
		Antibiotics: Better Not Sorry Than Safe
		We Tolerate the Risks for the Sake of the Benefits
	Containing Pandora: Russian Doll Treatment of Recombinant DNA
		The Asilomar Story
		\"Devil\'s Doctrine\" Debunked
		Science is Neither Above the Law Nor Apart from Society
		Applying Asilomar to Xenotransplantation
		The Precautionary Principle
	Asilomar-Type Rules and Antibiotic-Type Risks on a Global Stage
		A Little Bit of Risk is Not a Bad Thing
		Risk Bearers of the World, Unite!
	Conclusion
VII A Geoethical Solution to the Conflict Between Private and Public Interests in Xenotransplantation
	Introduction
	Practical Implementation of Geoethical Xenotransplantation
		Who Will Do What To Whom?
		Problems with Minimal Competence Regimes
		Maximal Competence Regime is More Realistic
		Not Pie in the Sky
	Financial Elements of a Global Xenotransplantation Control
		Certification Costs are Minimal
		Surveillance Costs are Basic Global Health Care Costs
		The Xenograft Tax
	Legal Pathways to a Global Xenotransplantation Control
		Sentinel Organizations
		Participation Sectors
		Not the First Time the Rich Tax Themselves for Global Benefit
	Conclusion
VIII Summary
Bibliography
Index
Credits