John Paul II Institute for Marriage and Family, Melbourne, VIC, Australia.
Med J Aust. 2011 Mar 7;194(5):263-5. doi: 10.5694/j.1326-5377.2011.tb02961.x.
Trade in human tissue in Australia is prohibited by state law, and in ethical guidelines by the National Health and Medical Research Council: National statement on ethical conduct in human research; Organ and tissue donation by living donors: guidelines for ethical practice for health professionals. However, trade in human tissue products is a common practice especially for: reconstructive orthopaedic or plastic surgery; novel human tissue products such as a replacement trachea created by using human mesenchymal stem cells; biomedical research using cell lines, DNA and protein provided through biobanks. Cost pressures on these have forced consideration of commercial models to sustain their operations. Both the existing and novel activities require a robust framework to enable commercial uses of human tissue products while maintaining community acceptability of such practices, but to date no such framework exists. In this article, we propose a model ethical framework for ethical governance which identifies specific ethical issues such as: privacy; unique value of a person's tissue; commodification of the body; equity and benefit to the community; perverse incentives; and "attenuation" as a potentially useful concept to help deal with the broad range of subjective views relevant to whether it is acceptable to commercialise certain human tissue products.
澳大利亚的州法律禁止人体组织交易,国家卫生和医学研究委员会的伦理准则也禁止这一行为:《国家人类研究伦理行为声明》;《活体捐赠者的器官和组织捐赠:卫生专业人员伦理实践指南》。但是,人体组织产品的交易是一种常见的做法,特别是用于:整形或重建骨科手术;新型人体组织产品,如用人间质干细胞制造的替代气管;使用细胞系、DNA 和蛋白质进行的生物库支持的生物医学研究。这些方面的成本压力迫使人们考虑商业模型来维持其运营。现有的和新型的活动都需要一个强有力的框架来允许人体组织产品的商业用途,同时保持社区对这些做法的可接受性,但迄今为止,还没有这样的框架。在本文中,我们提出了一个用于伦理治理的模型伦理框架,该框架确定了一些具体的伦理问题,例如:隐私;一个人组织的独特价值;身体的商品化;社区的公平和利益;不正当激励;以及“衰减”作为一个潜在有用的概念,有助于处理与将某些人体组织产品商业化是否可接受相关的广泛的主观观点。