2004, Vol.7, No.1

Korean Journal of Medical Ethics 2023 KCI Impact Factor : 1.21

pISSN : 2005-8284 / eISSN : 2234-3598
https://journal.kci.go.kr/medethics

The transplantation of animal tissue and organs (xenotransplantation) is touted as one of the future options for transplantation medicine. This technology implies many unsolved practical and ethical problems. The article summarizes those issues in xenotransplantation which require international efforts with special emphasis on safety regulations to prevent the transfer of pathogens from source animals to humans. The most important result is the call for international guidelines, norms for reporting and compatible information technology. Means of risk assessment, risk management and risk prevention are necessary as public health tools to reduce or eliminate the risk of infection. These are questions raised by patient monitoring and the implementation of archives, for example, or the economic aspects of xenotransplantation and the question of who is to bear the costs for international initiatives and public health safety mechanisms. The article discusses the medical and ethical problems involved in weighing chances and risks are classified and discussed. Additionally, parallels between the debate on handling HIV in the 1980 s and xenozooneses today point to possible scenarios for future debate.

In response to the shortage of human organs for transplantation, xenotransplantation is considered as one of the alternatives. In Korea, the xenotransplantation research began at 2002. But xenotransplantation raises a few of bioethical issues: the ethical legitimacy of xenotransplantation research, the ethics of animal experiments, and the problems of the clinical trial. In 2004 we administered a survey to find out the perceptions and attitudes of the researchers participated in xenotransplantation research toward some bioethical issues related to such research. We received 40 responses and analyzed the data. This survey showed that all of the respondents answered that xenotransplantation research is ethically legitimate. But 'very much legitimate'(43.6%) is little lower than 'some legitimate'(56.4%). In related to the ethics of animal experiments, this survey showed some meaningful results: the establishment of Animal Experiment Committee, the need to regular education about animal experiment guideline, the need and justness of transgenic animal and primates recipients etc. In relation to the clinical trial, this survey showed the researchers are very prudent and cautious. They agree to clinical test after 90% safety guaranteed in animal experiments. But they show a favourable response to xenotransplantation if the safety and effectiveness of xenotransplantation is guaranteed.

This study provides suggestions on how to improve and activate Hospital Ethics Committees (HECs) in Korea. First, we analyzed several HECs in the U.S. and Germany. Secondly, we compared these with several HECs in Korea. Finally, we developed suggestions on ways to improve the function of HECs in Korea. These suggestions concern the legalization of HECs; the standardization of HEC regulations; the development of an HEC model; the establishment of a community network through the use of the Internet; the assurance of financial support for HECs; and the encouragement of ethics for senior-level hospital staff. Among these suggestions, the most important concerns the standardization of HEC regulations.