Personalized medicine is expensive and increases the disparity between the rich and poor. Since 3D printing is an individual treatment, the general public assumes that it may prevent people with financial issues from receiving care.
Three-dimensional printing technologies have the genuine potential to improve medical treatments for conditions ranging from bone cancer and arthritis to glaucoma and hearing loss. Already 3D bioprinting allows orthopaedic surgeons to print artificial bone from a scan of the patient, printing existing surgical materials to precisely the right shape to replace missing or damaged bone.
For example, the technique has been recently used to create skull implants for people with head trauma and a titanium heel pictured right to replace heel bone that had been eaten away by cancer. In the future, 3D printing technologies may be used together with advances in stem cell research to print living bone cells from patients' own cells or functioning organs for transplant such as kidneys or hearts.
The technology could enable doctors to tailor treatments to individual patients, rather than developing a treatment that works well for most patients with that condition.
Ethics of bioprinting 3D bioprinting also raises a number of ethical questions that will need to be considered as these technologies develop. Three ethical issues that are raised are: Until recently it has been thought that advances in personalised medicine go hand-in-hand with increasing disparities in health between rich and poor.
Should these treatments only be available to those who can pay the additional cost? If so, then those patients who lack financial resources may not receive effective treatments that others can access for a range of serious conditions.
Personalised medicine is most closely associated with research in Ethics of bioprinting and stem cell therapies. Advantages of personalising medicine are most obvious in cases where the condition affects patients in very different ways and standardised treatments offer imperfect benefits.
For example, conditions affecting the growing bones of children are among those where personalising treatments, if these can be adapted to the rapidly changing bodies of children, can make a very big difference in the child's comfort and capacity to participate in ordinary childhood activities and play.
Until recently, the cost and time required to provide a series of customised prostheses of different sizes for a child who has lost a leg to cancer, for example, has been prohibitive for many patients.
In cases like that of Ben Chandler, printers can also be used for implants, which might avoid the need to amputate the original limb, even where significant bone loss has occurred. The capacity to use 3D printing technology to substantially reduce the cost of prosthetics, or orthopaedic surgery to restore lost bone structures, means that this area of personalised medicine can avoid the criticism that personalised medicine inevitably increases the cost of health care and puts effective personalised treatments out of the reach of many patients.
A second ethical concern about any new treatment, including the use of 3D printing, is how we can test that the treatment is safe and effective before it is offered as a clinical treatment.
In the case of 3D printing to replace bone, the materials used — for example titanium — are those already used for orthopaedic surgery, and have been tested for safety over a long period and with many patients, so it is unlikely that there are new risks from the materials.
In the future, 3D printing may be used in combination with stem cell derived cell lines. This could lead to the development of printed functioning organs that can replace a patient's damaged organ, but without the risk or rejection associated with donor organs, because it uses that patient's own cells.
How can we know in advance that these treatments are safe? Unlike the case of developing a new drug, a stem cell therapy can't be tested on a sizable number of healthy people prior to being tested on patients and then, finally, being made available as a standard treatment.
The point of using a patient's own stem cells is to tailor the treatment quite specifically to that patient, and not to develop a treatment that can be tested on anybody else. Researchers combining 3D printing with personalised stem cell therapies beyond the experimental stage will need to develop new models for testing their treatments for safety and effectiveness.
Regulatory bodies that give approval for new treatments, such as Australia's Therapeutic Goods Administration TGAwill also need to establish new standards of testing for regulatory approval before these treatments can become readily available.
This means that even if researchers were ready to print a functioning prosthetic organ, it will be quite some time before patients with kidney disease should expect to be offered a 3D printed prosthetic kidney that uses their stem cells as a routine treatment.
Human enhancement The third issue is whether or not we should use 3D printing for human enhancement.8 days ago · Bioprinting is a prime example of technology affecting humanity and vice versa.
To fully harness the benefits of bioprinting, we need to have conversations now about when it is ethical and beneficial to use the technology and who really gains from it, both medically and economically. Applied ethics deals with moral questions concerning specific contested practices, say the engineering ethics, medical ethics, bioethics and environmental ethics.
Given the growth of 3D bioprinting, it is high time to think of ‘Bioprinting Ethics’. The primary goal of Experimental Eye Research is to publish original research papers on all aspects of experimental biology of the eye and ocular tissues that seek to define the mechanisms of normal function and/or disease.
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To the extent that 3D bioprinting gets put to such uses, the ethical concerns typically raised about the general issue of human enhancement will extend to it. The three most important such concerns are safety, fairness, and coercion. A survey of ethical issues related to bioprinting includes justice in access to healthcare, testing for safety, human enhancement, and stem cell research.
Bioprinting will likely affect equal access to healthcare because it provides avenues for personalized healthcare.