Discussed here fifteen days ago: https://news.ycombinator.com/item?id=29882912
Not a huge update but an interesting discussion of FDA approval; can the FDA actually stop or sanction experimental procedures like this?
Would have been interesting to hear what the feeling was like 2 weeks later (ie lethargic? walking alright? breathing well?) TFA only says he's alive "with his new heart beating soundly", which could mean a lot of things.
My dad took weeks(like more than 2 months) to back to being some what confidently ok'ish with things after his coronary artery bypass graft. He needed physiotherapy. His knees were weak and he needed a knee replacement only an year later. But in the after math of bypass surgery I had to hold his hand and make him walk, even feed and took him to rest room personally, I would even bathe him.
It took like ages to let him confidently use the toilet on his own. And I'd always keep the toilet door open 'Just in case'.
The Knee replacement a year later was obviously more brutal given the bypass was only an year back and we were peak in COVID times. He was infected, and I had sleep on the road as I caught it too(couldn't go home out of fear of infecting the family). Pretty much saw hell in bare form during that(weeks in anxiety, walking in COVID wards and suffering every single minute), and of course that recovery took months, as the drugs they gave him caused a huge spillover of issues.
It might just be that as a I child I felt more for my father.
But let me tell you major surgeries like bypass grafts, or knee replacements are nightmarish experiences, even more more so in the COVID times today.
P.S: This is in Bangalore, India.
I think two weeks after heart surgery is never fun... A few days ago I noted that recovering from having your sternum broken open takes 6-8 weeks to be able to resume daily basic activities under the best circumstances.
> A few days ago I noted that recovering from having your sternum broken open takes 6-8
Can also confirm. I received CPR which cracked some ribs. I had to sleep in a chair for the first 5 weeks because lying down flat and getting back up again was so painful. Sneezing and coughing were excruciating until I found the trick of 'hugging' oneself just before to reduce chest movement.
I was amazed at how soon I could pick up my baby after her 4 heart surgeries. Obviously, it was a bum scoop as opposed to picking her up under the arms (never had that luxury), and she was medicated, but literally 3-5 days after surgeries, we're back to having skin-skin. Maybe it's because their bones aren't as strong as an adults and there's more flex, but still, really took me by surprise. Even hours after surgeries, her diaper/nappy needed to be changed, so the nurses/I/we would carefully do it, but it was really eye-opening considering she just had major open heart surgery.
As a father of two little ones, my thoughts go out to you and your baby :)
Two weeks after the surgery he probably still has plastic hoses sucking fluid from his thorax and he can maybe sit up with assistance.
When I was in high school we video chatted with a heart surgeon while he was doing heart surgery. It was an insane, incredible thing to see.
The doctors want you walking (with help) as soon as possible after a heart transplant, unless something is horribly wrong.
Relevant: https://www.upmc.com/services/transplant/heart/process/after discusses the usual timeline after a heart transplant. tl;dr 2 weeks in he likely still feels like shit
This reminds me of the movie The Island where they cloned people as organ backups https://www.imdb.com/title/tt0399201/.
If you want to explore the concept further, I suggest you watch the movie "Never Let Me Go" (2010). The premise is very similar, apart from the fact there's no secret or conspiracy about it, children are just grown to become sacrificial organ donors, and since it's socially accepted, there's no way out of it.
Fair warning: it's pretty depressing.
I second this recommendation. And "The Island" is 100% the Hollywood / Michael Bay version of that story.
Based on a book by the same name. I haven't watched the film but I can recommend the book.
Speaking from a country with ongoing human organ harvesting, this is absolutely amazing, everyone involved in this deserves an enormous amount of praise.
I wonder how long it'll last, given the pig it came out of was probably already an adult, and pigs live far shorter lives than humans.
It's an important question, but the typical donated human organ only lasts ~10 years, which doesn't have much to do with the donor's age.
https://wexnermedical.osu.edu/blog/how-long-do-transplanted-...
Donors are usually 35-50 at time of donation, so way more than 10 years away from average life expectancy. The donated organs fail for other reasons.
There are many examples of donated organs living past 100 (years since donor's birth) even though the number of humans who live that long is quite rare.
https://www.dailymail.co.uk/health/article-3731752/The-woman...
https://www.bbc.com/future/article/20200625-the-woman-with-a...
Can’t they just keep replacing it every ten years?
It's difficult to do repeat surgeries in the chest.
Just install a window and some valves for easy replacement. Maybe you could even hot swap pig hearts.
If Apple can make magsafe for their laptops, then the medical industry can make magsafe for your heart - hot swappable hearts, a simple procedure! :P
Ok Tony Stark
Woosh
Don't get talk about people "feeling" the person from whom they received the transplant inside them? If so, how would a pig seem?
People talk about a lot of things. God, ghosts, karma. No evidence it isn't anything other than psychological.
> phycological
Let's leave the algae talk out of this!
Even if it is psychological, it's a valid question how people will respond. Really there are a lot of ways people might think about it. I imagine it might change some recipients views on pork. And I wouldn't be surprised if some reported a connection to the pig from which it came similar to human transplants. Whether it's objectively real or not
There is an Indian movie which beautifully explores this concept.
https://www.imdb.com/title/tt1773764/
Worth watching with subtitles if you do not understand the language.
That trailer seemed pretty bad
This is great news! I am very hopeful there is no reject in a year … hopeful for him and his family
I assumed “victim” referred to the pig, but I believe this is in reference to the fact that the heart recipient stabbed someone, leading to their death: https://nypost.com/2022/01/13/historic-pig-heart-recipient-w...
The article says; "Almost 22 years later the first ever xenotransplant has finally taken place."
They seem to have forgotten about this baboon-to-human heart transplant from 1984.
Yeah, that caught my eye. I did a little research and the first xenotransplant of any kind was somewhere about 1838 -- of a cornea from a pig (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684730/)
A podcast called Straight Talk MD talks about several different weird transplants like this in this episode: https://pca.st/episode/1628074d-b415-477b-b1f6-81c9d81fc261 (For Fame or Money? The Dark Side of Ten Amazing Medical Firsts on Straight Talk MD)
Of note is the disastrous synthetic heart in the 90’s. I was surprised that such a thing was attempted.
Optimally the synthetic kidney is more successful
https://pharmacy.ucsf.edu/news/2021/09/kidney-project-succes...
This is friggin crazy.
Is this compassionate use or experimentation on a dying patient for the future benefit of the rest of us? I’m fine with the latter, if consensual. But only if we call it what it is.
First generation transplants are always both. David would have died soon without this (he's quite likely to die soon with it too, unfortunately, if this goes anything like other first of a kind transplant receivers). Desperate people accept desperate measures, and the hope that it may teach us how to save others helps too.
It's a way to potentially prolong a terminally ill patients life with an experimental technique, potentially advancing medical science in doing so. I fail to see why this should be cast in a negative light.
That is what a clinical trial is. There is now other way. Although with organs-on-a-chip we are working on at least getting the animal testing stages confined to a minimum. Over time we may reduce the risk to first recipients of new tech using these new technologies. Perhaps even digital models may at somepoint start playing a role. But until we have digital models, this is what we have. And it does seem to work well in this case.
Yes. No matter what the treatment might be, someone always has to be the first human it's tried on.
Even if we did have good digital simulations, someone would still have to be the first human to get it "for real". That's just the nature of things. Someone has to be the first patient of a new heart surgeon. Someone has to be the first person to hire a newly-minted PE to design a bridge that might fail and kill thousands. And so on.
We mitigate these risks to the best of our ability by ensuring rigorous training of doctors and PEs, and stuff like animal testing and computer simulations, but someone still has to be first.
It sounds like this patient was well aware of the risks, and opted to get the procedure since otherwise his death would be a certainty.
It is quite clear since the first article on this topic that the recipient is very aware of the potential and risks. If I may say, he sounds like he geeks out about it. He had previously received a pig heart valve which kept him alive a long time. This probably affects his perceptions positively too.
From everything I read it was consensual. But that raises a larger moral question. Is it really consent if you're about to die? I think that almost anyone given the choice to either die or get a pig heart will choose the latter, there's a good chance you will die if you get the transplant but there is a 100% chance that you will die if you don't.
I don't think that is necessarily true - people reject potentially lifesaving treatments all the time for many different reasons. Yes, the desire to live is very strong in us, but it's not infinite.
Since it's consent to do the best option available and he wasn't put into the position of needing the help by the ones offering it I don't think it's much of a moral issue. Usually the moral problems come when less than ideal alternatives are proposed or people are forced into a situation where they otherwise wouldn't have had to choose. I.e. conflict of interest stuff from the ones proposing to get consent to try to help.
The guy would have died pretty soon without the procedure. If the choice is between dying for sure in a few weeks, or maybe dying in a few weeks but maybe not dying for another few years.... I'll take the 2nd option.
>for the future benefit of the rest of us
why does it need to be? What if Mr. Bennett just wants to live longer? What obligation does he have to you or me or anyone?
If the patient gets to hug his kids a year from now, he would probably consider it compassionate use.
He won’t. Although I’d love to be proven wrong. Similar experiments lasted weeks
I just want to say huge respect for Dr Mohammad who despite his faith decided to do what is right. It might not be well known but most muslims are raised with strong beliefs, even in educated countries (eg 85% in Pakistan support sharia).
God bless Dr mohammad
The recipient is a non-Muslim, so no Sharia-related problems in his case.
AFAIK it is not forbidden for a Muslim to touch pigs, only to eat them. Pigs and dogs are impure, but you can perform ablution afterwards. Muslims normally own hunting and guarding dogs. That would actually be a common problem for Coalition soldiers in Iraq when they tried to enter a village by stealth - lots of barking.
"This impureness nevertheless doesn't imply that one might not touch a pork, but that one might need to wash his hands and maybe even re-do the ablution to be able to pray after touching it."
https://islam.stackexchange.com/questions/48791/is-it-haram-...
I understand why pigs are “impure” (parasites in the meat), but why dogs?
Pigs are no more impure than dogs, fwiw. That belief is merely a result of having been raised in a culture that arbitrarily chooses to love dogs and cats and hate most other animals.
Dogs can be infested with parasites just as easily as pigs.
Well, but I don't think they eat dogs.
This rule was written in an age when rabies was a big problem. It has a lot of sense to avoid scavenger dogs and pigs in those places in the past. Now we have developed a solution to this problem but, as is included as part of a religion is a fossil rule that can't be changed. We have still many of this rules around.
Science welcomes change when we find a better way to do something. Is assumed that humans can be wrong and learn. Religion will fiercely oppose change because god can't be wrong by definition (and nobody has the authority to fix it). Ideology will oppose also changes that see as a menace, but can be more flexible.
In Judaism at least, and I'd assume the same translates to Islam, "impurity" is understood to mean "ritually impure". It doesn't necessarily mean there's a specific scientific reason to avoid the meat, just that God asked them not to partake.
Yeah, ritual impurity is forgotten in modern West and hard to describe to a modern non-religious person.
It is not the same as "being unhygienic", though it overlaps to some degree. (Faeces etc.)
An interesting example from Judaism is "Tzaraath", which means skin disease, but it could also afflict houses. Today we do not know for sure what it even meant. Mold infestation? Maybe.
https://en.wikipedia.org/wiki/Tzaraath#Affliction_of_housing
“Dogs are pets” is one of those cultural background assumptions that can be pretty jarring when you realize it’s not a universally held belief. There are pretty large chunks of the planet where dogs are mostly unwanted pests at best.
It’s not a religious thing, it’s a geographic thing. Wild dogs are a serious problem in some areas, and whether or not dogs are viewed as common pets varies wildly. To pick one example, a mere 16 million homes in India have a dog, and that is up a lot over the past decade. Compare that to the 63 million homes with dogs in the US, a much smaller country by population.
I don't know how many Muslims you're friends with but I wouldn't assume without some indication that this was difficult for him. There is a huge variety of beliefs in a population of over a billion adherents. Most of the ones I know have no issue with, for example, picking up a pack of bacon from the store as long as they're not the one expected to eat it.
Im sure it is morally justifiable to people of any religion, when performing the procedure is the only chance the patient has to continue living.
Porcine heart valves are largely accepted by Islamic scholars in situations where there are no alternatives available.
Abortion is largely accepted by Catholic scholars if there is, otherwise, a high risk of death. That doesn't mean all Catholic medical practitioners would carry out such an operation. I don't think the respect is misplaced.
That is absolutely false and made clear in the Catechism (though abortion is, fundamentally, not a matter of faith, but of ethics, contrary to popular misconception). Abortion understood as the intentional killing of the unborn child, even in the case of high risk of death, is always gravely morally illicit and falls under murder. Even in the given circumstance, it would violate the principle of double effect.
Now, what is morally licit is not abortion, but also by virtue of the principle of double effect, a procedure intended to save the mother's life that unintentionally and as a side effect results in the child's death. For example, it is morally licit to extract the affected tissue with the implanted embryo during an ectopic pregnancy. This extraction will result in the death of the child, but the death was neither intended nor was the death of the child the means by which the mother's life was saved nor is saving the life of the mother a lesser good than the life of the child (though in this case, both would very likely have perished if this condition had been allowed to continue). Note that the situation must be proportionally grave, meaning you could not licitly perform such a procedure if the risk to the mother was not proportional (like experiencing headaches because of the pregnancy). In those cases, proportional care is permissible.
> That is absolutely false and made clear in the Catechism (though abortion is, fundamentally, not a matter of faith, but of ethics, contrary to popular misconception).
A bit nit-picky, but while all authoritative documents (like the catechism) unequivocally condemns abortion, there is no shortage of Catholic scholars who are pro-abortion. Just like the Pontifical Commission on Birth Control. The scholars gave it the green light, but not even having “Pontifical” in the name made it remotely authoritative.
Yes, how wonderful that a medical doctor would make an exception over his superstition. Truly a man of science!
Is there a need to be condescending about his beliefs, especially when what we're hearing of them is based on conjecture?
> sharia
Can anybody offer some insight into what people mean by that? I know that in the 19th century, sharia was basically just a legal tradition, that drew on Islam (just as western legal traditions draw on Christianity, or eastern ones Confucianism). Is it more extreme these days?
No. Sharia means different things to different people. Think of someone who calls themselves a "practicing Catholic", and then think of what that might mean to a non-Catholic hearing that. Do they eat meat on Fridays? Do they attend church every day? Do they protest health clinics? There are practicing Catholics who do all of these things and none of them.
Unfortunately, the word has been seized on in western culture to refer to the legal beliefs of militant Islamism. But that's not at all what it means to most Muslims.
From the article: "[pigs] they can be genetically manipulated to produce organs less likely to be rejected on transplantation."
Is this true? How would these manipulations be carried out?
There's a sugar that most animals produce but humans don't[0]. These pigs have been genetically modified to not produce that sugar, the thought being that that's what's responsible for the xenotransplantation rejections[1].
[0] https://www.cdc.gov/ticks/alpha-gal/index.html [1] https://www.healio.com/news/primary-care/20201214/fda-oks-ge...
Doctor: "Now, most hearts couldn't withstand this voltage ... but I'm fairly certain your heart..."
Pig: "What was noise?"
Doctor: "The sound of progress, my friend."
This video is a good overview of the whole thing https://www.youtube.com/watch?v=0d8svvqX1c0
It is also becoming more common in drug research. It is fairly common to adapt animal genomes to be closer to that of humans so that the drugs will work in similar ways.
For a layman like me on medical matters, it seems very strange that a pig's heart is used. Would it more logical idea to use a primate, our closest "cousin"?
"While it is true that pigs are less compatible with humans than monkeys, they can be genetically manipulated to produce organs less likely to be rejected on transplantation. Pigs quickly grow to full size, produce larger litters and can be more easily reared by biotechnology companies."
They do cover this point.
That's pretty clearly explained in the article.
Pigs have a lot of physiological similarity to us (thus why fetal pig dissections are often done in high school/undergrad biology). Plus there are fewer ethical concerns around using an animal we already use for food.
I imagine there's also a consideration for ease of raising. These pigs had to be kept separate from others and tested frequently for disease because of having some aspects of their immune system weakened to reduce rejection risk. This would probably be easier to do ethically for pigs compared to primates.
Pigs are not too far off when it comes to the overall body. I believe the idea to use a pig's heart is one off availability (and maybe ethics). A ton of pigs are slaughtered each and every day, we already use several parts of a pig's body (which is a good thing, waste as little as possible). If we can successfully use it's heart for transplantation, even better. This means there is a good supply of hearts to be used.
Read the article.
Does the genetic modification mean immunosuppresents aren't required? If so, that sounds like a major step forward.
A good test. The guy is older and wanted to remain alive, despite the wishes of his family. And pigs are so close to humans anyway -- which is why I have the theory of why humans love bacon so much.
Best wishes to Mr. Bennett, and hope that whatever happens, it will be a good leap for humanity.
> And pigs are so close to humans anyway -- which is why I have the theory of why humans love bacon so much.
Are you claiming (most/many) humans are closet cannibals? I don’t agree with that.
Also, pigs aren’t particularly close to humans, genetically. In biological classification they even are in a different order (even-hoofed ungulates) than humans, who are primates.
⇒ I don’t think that theory makes sense.
Human Bacon, the final frontier. How long until you can buy Beyond Human burgers?
You may enjoy the first story in the compilation of Clarke stories called The Wind From The Sun:
Bitelabs, a startup purportedly launched to deliver celebrity salami, made that joke in 2014.
Hufu had a product in 2005: https://en.m.wikipedia.org/wiki/Hufu
I've said this before here and got downvoted for it, but bioethicists as a profession are responsible for more death than pretty much anything else I can quickly think of.
People are dying from heart disease all the time, very often in predictable conditions. Literally millions every year. Statistically this means we should hear about such failed procedures many many more times than we do now - there is literally no downside from doing this much more often, and a strict upside: a chance to live longer and a definite advance in medicine leading to other lives saved. Sure, it may mean more stress for a dying patient, but quite a few would prefer their death have some meaning. But they can't chose this because it's not "ethical".
Moderna had the mRNA vaccine for Covid ready in about 3 weeks. This means the tech was already there - I'd really like to see an argument where we had three major companies create mRNA vaccines, only one failed (harmlessly!) but we shouldn't have used this technology a few years early. mRNA tech is incredibly versatile - it should have applications from curing cold to curing cancer. But no, we needed a pandemic and 10 months of testing to start using it, because it wasn't "ethical".
We knew from month 1 that the young and healthy are not hit hard by Covid. Mortality in those groups was always comparable to flu, more or less. But we didn't do challenge trials. We wasted ... I have to take a break from typing, tbh, I'm overwhelmed. We wasted almost a year while literal millions died while wondering if Covid is transmitted by touch, aerosols or airborne when we could have fixed this in two weeks with a bunch of 25 year olds. We spent half a year before even realizing masks help, and we still don't know for sure how much and what's the difference between each kind. We had Omicron - we knew it was different, we had good reason to think it's not significantly worse from the start, but we still had a _lot_ of questions. But two years from the start of the pandemic we STILL didn't put a bunch of healthy volunteers through a completely harmless study to find out things early. Because it wouldn't have been "ethical".
This isn't ethics we're talking about. It's pure and unadulterated cowardice. We as a society shy away from doing things which we _know_ would save more lives in the aggregate because we'd have to risk causing much less harm, but harm which we'd be directly responsible for. Joe from the street would be excused from making these decisions, but when you deal with the people directly charged by the society from making these decision, it's just failure to do their job. And in a supermajority of case we're dealing with volunteers anyways.
If you feel like reading more about how stupid the whole system is: https://slatestarcodex.com/2017/08/29/my-irb-nightmare/
100% agree. I think the unsolved meta problem here is large-scale game theoretic stalemates where we all lose in grand ways, and yet nobody can bust out of their local incentives.
To do so successfully would require thousands of unacquainted people to coordinate changes (against their backdrop of incentives) simultaneously.
Governments are made for this but after a certain size and complexity, their people get stuck in the same frontier of stuck incentives.
A horribly-written but salient book about this is “Inadequate Equilibria: Where and How Civilizations Get Stuck”: https://www.amazon.com/gp/aw/d/B076Z64CPG
> only one failed (harmlessly!)
They (CureVac) failed because they started trials too late, and by then the Delta variant was going around and caused the numbers to not look as good as Pfizer and Moderna's. v If you look back, it's a real shame, because Pfizer's and Moderna's Delta numbers are no better than CureVac's.
[Also, speaking completely anecdotally, but I'm in that clinical trial and thus a recipient of 2 CureVac shots and 2 Moderna shots. I have yet to catch Covid despite taking nearly zero precautions and a lot of high risk contacts. And yes, I get tested constantly. There might be something more interesting yet to discover about this.]
Ethical protocols are useful to have to prevent genuinely bad stuff from happening but they are indeed over used to instead limit legal and political liability; which is not the type of "bad stuff" most people would care about but which is something that gets expensive quickly if you are a multi billion dollar corporation in the business of converting government funding into profit (aka. a Pharmaceutical company). The only bad outcome they really care about is of a financial nature.
When ethics devolves into morals and religion, it gets worse because in that case the "bad stuff" is somebody feeling offended/insulted and when that conflicts with potentially life saving new treatments; that in itself might be considered a bad thing (unethical?). Ethics has this way of contradicting itself.
When you weigh two bad outcomes, the rational thing to do (the least bad thing) might not be the ethical thing to do but some people (me) would still consider that the right thing to do. When letting people die that want to live (an important caveat) is more ethical than doing something to prevent that, something is very wrong. Also letting them die when they actually want to is considered unethical by some.
One word: inequality.
When people don't feel they are equals in society, the whole "for the benefit of all" sounds pretty cynical.
Also, some governments have a poor record for taking responsibility (e.g. looking after veterans), or making others take responsibility (DuPont), so the people who do come off worse don't necessarily expect to be taken care of.
I respectfully disagree. It is patient's right to refuse any medical procedure.
A mere suspicion, impression that doctors are not treating life and health of this particular patient with all sainctity will do a lot more harm than good.
I mean, life is precious, doctors should know this best and act like it is. Recklessness even in words will do a lot of harm. A lot of credit will be lost if standards slip even a little bit.
I know this very well because people around me are not vaccinated yet because they are suspicious of Sputnik-V. Yes, this is reality where I live. People are suspicious and refusing a life-saving procedure.
>It is patient's right to refuse any medical procedure.
The problem is not that they can't say "no", it's that they can't say "yes".
I don't think the OP disagrees with you.
The patients who don't get the experimental treatment didn't refuse the experimental treatment -- they were never offered it at all which is the problem.
The ethics and regulatory red tape kills any hope for such a treatment before patient consent is even a question.
This is risking another rant, but I'll hold. Keeping things short - authorities lied their asses off for the whole pandemic, and this is what (legitimately) destroyed trust. People are a lot less stupid than usually given credit for - sure, they can't always do the research themselves, but they do know to look around and orient them in complex situations. And it got pretty obvious pretty soon that the official message was not about the truth, but about getting the "correct" response. Which turned out to be a lot less precise and correct in practice. So yeah, now you get people mistrusting vaccines because you can't get them to trust anything.
The longer response would be that public institutions should be forbidden to use Simulacra Levels over 1 (https://www.lesswrong.com/posts/qDmnyEMtJkE9Wrpau/simulacra-...)
I find this to be a strange take.
>Moderna had the mRNA vaccine for Covid ready in about 3 weeks. This means the tech was already there
Not quite. While this line of research has been occurring for some time, it wasn't quite at that point yet. It wasn't developed and not being used because testing them would be considered unethical. It was developing technology, and Covid came at an opportune time in that things were close enough for researchers to rush things along.
>But no, we needed a pandemic and 10 months of testing to start using it, because it wasn't "ethical".
Yes, we did need testing before we started using it. It could make everyone sick for all we know. Or perhaps only a select few populations. Testing also allows guidance to be developed on what expect, and what doctors need to look out for. If it were to cause bleeding in people with a certain blood type, for example, then just giving it out would result in huge numbers of people rushing to already overworked ER rooms. Which could just worsen the health crisis we were trying to avoid. There are many good reasons to test treatments even when time is limited
>We as a society shy away from doing things which we _know_ would save more lives in the aggregate because we'd have to risk causing much less harm, but harm which we'd be directly responsible for.
Y I'll take this logic further and say why not do some DNA alteration experiments on babies? We may have to destroy the specimens after, but so what? A finite number of lives can lead to saving countless lives in the future. Think of the things we could learn about rare diseases, removing harmful genes, improving human health, etc. The millions, even billions of lives we could save and enrich. It's immoral NOT to do that, when the rewards are so great.
That's the line of thinking that doctors try to avoid, hence "do no harm". It doesn't matter how common sense it seems, some lines you just don't cross. Because if people do cross those lines, eventually some might use it to justify doing immoral things. There's certainly a lot of rigorous debate about medical ethics, but these decisions are the results of groups of doctors and ethicicts. I'm of the belief that the alternatives have indeed been considered in most cases and the best choice has been made.
I follow your arguments, but I just find them incredibly weak.
We're not talking about slippery slope here and "may have beens", we're talking about already having a soft form of worst case scenario, and _still_ not bringing out the big guns. Not doing challenge trials for Covid is just stupid, no matter how you try to push it.
"DNA alteration experiments on babies" - we do that, actually, and I'm seriously considering waiting on having a family until they become mainstream. It's a pretty cool tech, they had the first designer baby out last year. Just putting the scariest form you can think of in writing isn't an argument in itself, you know. You also have to say why it's a bad idea. Otherwise, no offense and please don't take it personally, but it's purely equivalent of somebody saying 200 years ago: "what's the next step, feeding MOLD to BABIES?". Turns out yes, feeding mold to babies is exactly what we're supposed to do. It's just progress - it looks weird until it's in the kitchen cabinet.
The mRNA vaccine not being ready - it's just incredibly improbable that you had three major corporations being able to "rush things along" and finish exactly at the same time. It's 10x to 100x more probable that they were already finished and stuck at some regulatory step.
And a final thought - please don't interpret my comments to say testing and regulation in general is bad. FDA is bad, and probably should be destroyed outright and something else, something much leaner, built instead. But some regulation and a lot of testing are of course necessary. It's just that currently 1. they've gone waaaay beyond what's needed and into pure bureaucracy and 2. the system is such that it ignores major slices of reality and focuses only on what's in front of their eyes, i.e. they don't do challenge trials because it's not ethical for the volunteers, but if they lead to 1% less death overall this means tens to hundreds of thousands saved - which they ignore.
Now I know that I will stop eating pork.
I'm a full on speciesist. let's do more of this. since we're already eating them I feel like this even a more reasonable usage of their lives. can we do kidneys next please? we can basically shut down most dialysis clinics after that.
They did so a pig to human kidney transplant recently however it was on a brain dead man as an initial test. Probably soon it be on a living patient. As a person on a kidney transplant waitlist, it given me some hope for the future.
https://medicalxpress.com/news/2022-01-pig-to-human-transpla...
Calm your horses. His body was donated to science by the family, I'm sure they knew what he wanted and did just that.
Why do you say it’s non-consensual? He donated his body to science.
Might as well then also get consent from cadavers to do autopsy lmao.
Don't we actually do that? By getting consent before death?
What's your source that states it was non consensual?
The next logical step is to breed pigs with organs that especially suit humans, maybe with some genetic engineering to optimise them. I really can't see anyone needing an organ complaining that they're GMO.
As long as we treat animals well while they're alive (and why wouldn't you, you want high quality low stress organs) then there's really no limit here, morally.
That's what they've done here, this are GMO pigs designed to be more compatible with human biology.
> The heart transplanted into Mr. Bennett came from a genetically altered pig provided by Revivicor, a regenerative medicine company based in Blacksburg, Va.
> The pig had 10 genetic modifications. Four genes were knocked out, or inactivated, including one that encodes a molecule that causes an aggressive human rejection response.
> A growth gene was also inactivated to prevent the pig’s heart from continuing to grow after it was implanted, said Dr. Mohiuddin,who, with Dr. Griffith, did much of the research leading up to the transplant.
> In addition, six human genes were inserted into the genome of the donor pig — modifications designed to make the porcine organs more tolerable to the human immune system.
https://www.nytimes.com/2022/01/10/health/heart-transplant-p...
Wow, great info. Very low-key and subtle, but the future is arriving slowly, one pig gene modification at a time!
I now wonder if this guy will have to pay licensing costs for the copyright on the genes the rest of his (admittedly freshly prolonged) life...
Depends on whether he's going to use his heart to create more GMO pigs.
I mean if you buy a book that's it. You don't get a license to redistribute, but you get an unlimited license to read and use the book for whatever. That's how copyright law works.
And then the next step is to do research showing that pigs that are happy, stress free, and eat a good diet produce organs that are better for transplant. If so, this might be one of the most ethical animal industries.
Maybe we could grow happy, stress free and well fed human beings. Then we wouldn't need so many transplants in the first place.
> You see where this is going, right?
Yes, a slippery-slope argument that all gene manipulation leads to eugenics.
Here's the counterpoint: The Nazis (and eugenicists / race-scientists in general) used the authority of science, but didn't actually do good science (and slipped in a lot of stuff that was pure ideology); so actual science is automatically different.
Or they could take a page from the semiconductor industry and replace human hearts with 128 genetically modified mouse hearts in an array.
The problems of aging would creep on them later, but it isn't as if happy, stress free and well fed people stay healthy forever.
Aging is a process that affects everyone, the only thing that you can influence a bit is speed thereof.
Ah, but the human is more economically productive than the pig, particularly when taken as a cohort, and healthcare and happiness are expensive - and there is therefore a point of diminishing returns for increased happiness and health.
It makes more sense to allow a certain portion of your population to die of preventable causes than to make them all happy, as the current net goal is economic productivity, not human happiness. This is demonstrated aptly by the lack of socialised healthcare in much of the world, and where it does exist, the relative paucity of resources provided.
So, while I agree in spirit with what you posit, capitalism and the value axis it brings has to die first.
It would be better if you got to keep the meat rather than letting it go to waste. Then you could indulge in autophagy by proxy.
Prions don't appear from thin air - and you can already get deadly prions eating meat, the reason why you don't is the same why you don't get all kinds of deadly diseases from meat - it's (usually) well regulated and any outbreaks are immediately culled. A pig genetically modified to be "more like a human" wouldn't spontaniously get deadly prions.
Apparently they have recently granted permission for these (type of) pigs to be sold for meat so those who suffer with alpha-gal syndrome (and are thus allergic to regular meat) can eat it. So I’m guessing by not.
Pigs are already similar enough to humans that there are major risks from parasites; I don't think the small modifications we've seen so far would significantly increase prion risk.
The pig kidney and heart recently transplanted have already been genetically engineered. So far it's only to avoid rejection, but other modifications are likely on the roadmap.
In TFA that's actually what they describe - the pig was genetically engineered to reduce rejection and to control the growth of the heart to stay human-sized.
> As long as we treat animals well while they're alive (and why wouldn't you, you want high quality low stress organs) then there's really no limit here, morally.
We have a really, really, horrible history of treating animals. It's obvious we wouldn't treat them well.
As long as we treat humans well while they're alive (and why wouldn't you, you want high quality low stress organs) then there's really no limit here, morally.
Wouldn’t you need to kill the animal in the prime of its life, causing a moral issue?
Pigs reach slaughter weight at about 6 months[0] and the lifetime of a domestic pig is 15 to 20 years. Their breeding age is 8+ months. So we kill them before they reach the prime of their life most of the time. Killing them at their prime might be less of a moral issue than what we do currently.
[0]https://modernfarmer.com/2016/05/raising-pigs/#:~:text=Most%....
It's not zero cost morality wise to kill anything at any point in their lifetime; from bacteria, to worms, to flies, to pigs each has its own weight on a person's conscience be it nil or hefty. I mean that. But a pig is not human so it's acceptable to me.
I don't think life length is an issue, the pig doesn't know how long it will live so there doesn't seem much scope for suffering.
It comes back to the question if never being born at all is better than some (domesticated) life at all.
Food animals are killed in adolescence for far less noble reasons.
I'm a vegetarian.
Grow me a goddamned lung pig.
I understand your view and agree with what you’ve said, however, the primary point was that there are moral implications if you intervene in another life so it is not a moral freebie.
I'm vegetarian and have no issue with using animals for medical purposes like this. It's one thing to kill for pleasure as in fur, cosmetics and food, but quite another to kill an animal to save a human life. I am pretty sure even most vegans would be happy to accept an animal death to save their own life, even a pet.
Similarly, I guess, I was vegan but I had to stop that diet as it caused severe health problems for me.
Once you kill the pig for its heart and kidneys, you might as well eat it. Better than letting the nutritional value of the meat go to waste.
That wouldn't be a lot of pigs, true, and a pork chop of that origin would be pretty expensive.
Nothing in an animal for slaughter goes to waste, they're too expensive for that.
I mean the value of various parts like organ meat varies by what it's used for, but eventually everything is used up. A lot of offal ends up in animal feed, for example. And their hooves end up in keratine supplements for the gymbros.
These are genetically altered pigs with human genes inserted, though. I can see some people being uneasy about consuming them, either from moral or pragmatic (possible pathogenicity) point of view.
Perhaps I'm somewhat of an atypical veg, but I am okay with that - although I personally wouldn't as I no longer like meat.
I also would not ban meat consumption if I was a dictator, but I would enforce extremely high ethical standards, carbon neutrality and proper management of agricultural effluent. I suspect that would make a pork chop pretty expensive too.
The adage "use the whole buffalo" has never really died out in terms of meat processing. There's a lot of good product in an animal and you can find buyers for all of it. There's the obvious stuff like hotdogs, sure, but even stuff like the blood is also important. Fetal bovine serum, a supplement for cell culture media, for example comes from the slaughterhouse and is extremely important for biomedical research.
And the next step would be to eat the humans who've had an animal transplant, sounds all good and logical to me.
That is such a ridiculous comment, I had a mighty chuckle.
If you replace a human organ by organ with one from a pig, is he still the original human? Ship of piggus.
Ask the speciesist ;)
His victim's family (yes, really) doesn't like that he was the first to get a heart transplant. https://nypost.com/2022/01/13/historic-pig-heart-recipient-w...
PETA doesn't like that anyone got a pig heart transplant. https://www.peta.org/media/news-releases/first-heart-transpl...
>“The key principle in medicine is to treat anyone who is sick, regardless of who they are,” said Arthur Caplan, a bioethics professor at New York University. “We are not in the business of sorting sinners from saints. Crime is a legal matter.”
This is so simple and newspapers trying to make it into a matter for debate is actually compromising that.
> This is so simple and newspapers trying to make it into a matter for debate is actually compromising that.
Even if one were to consider moral character when allocating organs in general: the researchers needed someone who was sick and likely to die, ineligible for human organ transplant (here, because of severity of condition), and not so sick that there was no chance of success or useful data.
So, we're already picking someone who doesn't meet the normal rules.
And, of course, considering moral character when allocating organs probably isn't a great idea.
Yeah, the Post complaint (echoed elsewhere) is basically a call for having a social credit score that can say “you’re not a good person, so we’re not going to let the doctors save you.”
There was an episode of Star Trek Voyager that had this system in place, ep 7x5 Critical Care
Naturally it was corrupt
That's not a moral judgment: that's a judgment about whether you're likely to not wreck the new organ and have a good outcome.
That is not a universal statement[0]. They may get lower priority in many cases, but MELD[1] or a similar model is used to determine who gets priority for liver transplant.
[0] https://www.hopkinsmedicine.org/news/articles/destigmatizing...
[1] https://en.wikipedia.org/wiki/Model_for_End-Stage_Liver_Dise...
I’m all for providing telemedicine to those who choose not to be vaccinated against COVID (compared to those who medically can it be vaccinated). But letting them into health care facilities? Nah, get your shots and come back.
This is not same.
The non vaccinated are actively choosing to be a danger to people around them.
It is like actively carrying concealed unlicensed gun which can silently and anynomously fire at people.
That's different because there's no moral judgement in that position. If you refuse treatment for a condition, even a preventative one, then there's no moral imperative to offer a different treatment later. Doctors did their best to save you, but you didn't do your part. That's on you.
It probably happens more than you think. Organs are doled out based on a rating system as evaluated by a small review board
In the case of ties, the question of who “deserves” the organ is relevant to the board members. Uncomfortable but true.
Also doesn’t really apply here as this guy had a last ditch experimental operation. The family in the article just wanted revenge.
Yes, most of the time that’s true, and just about everything you mentioned can be boiled down to a single number.
Genuine ties do happen though, and at the end of the day the board is human.
Considering a person's criminal record is not the same as considering their moral character.
>Considering a person's criminal record is not the same as considering their moral character.
Although some might argue that there was a certain correlation between the two.
https://www.nbcnews.com/news/crime-courts/anthony-stokes-tee...
"The New York Post (NY Post) is a conservative[8] daily tabloid newspaper published in New York City. The Post also operates NYPost.com, the celebrity gossip site PageSix.com, and the entertainment site Decider.com."
The NY Times and Washington Post also had silly articles that presented this as a serious debate.
What was the purpose of posting this?
I try to avoid NY Post, but sometimes forget. Still, it's a true story afaik.
Most posters who use the phrases "newsflash" or "wake up" are not posting in good faith.
It is even simpler than that.
Someone who has served their time in prison and is now released is considered to have paid their debt to society.
You may think, as I do, that this man served nowhere near what he should have for the crime he committed. However, the law has been followed and he is no longer in prison.
If the people the New York Post is targeting think that he should still be punished, then he should still be in prison. The problem is that the type of people clamor for these people to stay in prison also are at the forefront of refusing to pony up the money to pay for that prison.
I do not want to sound like a person who would deny ex-prisoners medical care (I wouldn't), but legal disabilities even today do not end with your release from prison.
For example, felons in the US are banned from owning guns even after they served their time.
Do you consider that good or bad?
> For example, felons in the US are banned from owning guns even after they served their time.
I'm not a big fan of that, but I would prefer that it reflect the harm done from the crime and the statistics surrounding recidivism.
A simple drug possession offense should not warrant banning you from voting or guns when you are done. If you were convicted of an armed robbery, maybe the guns should be banned.
I really don't like the idea that once you're done with the justice system it continues to punish you. Once you are done with it, you should be done--especially if the crime was "victimless" (ie. something like drug possession where the only harm would be to yourself).
This becomes a significant issue in, for example, sex offenders. Some places have so many restrictions on sex offenders that, for all intents and purposes, they cannot comply with probation and cannot function in society. Well, if you're going to do that, at least be honest that you are simply "executing them on the cheap and out of sight" and either keep them in prison or execute them explicitly.
This is one of the problems with low-level drug convictions--the "felony" conviction becomes a poor man's "social discredit" system. And most of us from Western democracies understand pretty solidly why "social credit" systems are pernicious.
My experience has been that the kind of people that want longer prison sentences for folks like this are more than willing to tolerate higher taxes to pay for them.
Let’s not pretend that the budget of prisons has any bearing on a man that was dutifully convicted and sentenced by a judge.
The bigger issue IMO is that the killer never paid any of the monetary judgement against him to the victims family.
Well, the Zeitgeist of the social networks is "destroy the sinner mercilessly and crush him into dust" plus "whoever does not take part in that crushing or even advocates for mercy is suspicious himself". And too many journalists are on their social network accounts every waking hour, so it seeps through.
I suspect that quite a lot of people would support denial of medical care to sinners. For example, the sentiment of "triage against the unvaxxed" seems to be pretty strong.
(For the record, I am fully vaxed but do not support mistreatment of people who believe in conspiracy theories.)
What you see on social networks is a reflection of who you choose to follow and engage with. I use social networks to engage with people who actually make those decisions and they do not encourage any of that.
Denying medical care is made either by individual health care professsionals or, in cases that require more consideration, health services ethics commity. I’d be surprised is anyone stating what you said would keep their medical license, let alone would be allowed to sit in a commitee.
> The key principle in medicine is to treat anyone who is sick, regardless of who they are.
The victims family is saying “Our principle is that people who stab Ed should not get a heart, therefore David should not get a heart.” The doctor is saying “Our principle is that we don’t use the patient’s past violence or convictions to determine whether they should get a heart or not, so the stabbing doesn’t disqualify David.”
Neither party can offer a valid argument as to why their principle is true, because both of their principles are normative.
The weird thing about saying "Do not save those who took another's life" is that you are saying, "The person took a life. That's bad. We should punish them for the bad thing." Then saying, "Let's take their life to punish them." (not saving a life you could being essentially the same as life taking, to me, here).
To me, you are undermining your view that life-taking is bad, by engaging in it yourselves. To me, this is a paradox. You seem to be standing up for your belief in the badness of life-taking, by doing something against those who do it, then you do something which goes against the very thing that you are trying to protect--which, to me, makes it seems like you are merely pretending to protect.
So, to me, their moral claim (?) that they are somehow "better" than this life-taker, and therefore have a right to say/do this life-save withholding, is completely undermined by their action of said withholding (or proposal to do it).
On the other hand, my ape-brain very much endorses the logic of revenge and sees no problem with an eye for a eye. It will teach people a lesson, let them know they can't mess with us, and let them know there are consequences if they try. Hopefully, my ape brain says, that will make us safer and rest easier, in future.
But the logical/rational part of me trying (but maybe failing) to consider this from an ethical or moral point of view, says, "Nah, that doesn't work."
Well put. Apart from the lengthy threads here regularly on how flawed the very notion of free will that's necessary to even justify this focus on vengeance, I absolutely agree with you that if you're going to argue for vengeance and have a moral leg to stand on you better at least not argue for such an outcome.
I like to point to this page from Franquin's Idées Noires (finally in English as "Die Laughing", only a few decades late) [1], which makes much the same point as you. (The whole book is very much worth it if you like dark humour - it's a crime it took so long for it to get translated to English given how many other languages it's been translated to decades ago)
Translated the speech bubbles are roughly:
"The law is clear: Every person who voluntarily kills another will have their head cut off. Let the executioner do their job."
"Over here, my friend."
"And so a good deed done..."
"Sorry, but the law is clear: Everyone who voluntarily kills another..."
[1] https://i.pinimg.com/474x/c5/3c/45/c53c451e1fea4fd04ea6cf674...
Wow, the positive comments here are really, nice. Thank you! Yes I was rather proud of that as well, I thought it deserved a bit of love--so thank you for sharing! :)
It's nice to get that here after slugging it out with someone who's seemingly misinterpreting what you're saying, so thank you for that support :) xx
Well it makes sense to me. Your reading is a little bit uncharitable. Seems almost like you didn't make any effort to understand it, and just rather pretend that it's stupid...Sigh. But I suppose I could have helped you by saying the other part which I think about this:
That's why the legal system is so important. We need a way to do these things, that's not about individuals getting revenge. So...you kill Alice, then society takes it up with you, through their legal/punitive officers--rather than Alice's family.
But even so...that doesn't fully resolve it for me, the paradox I see there.
But at the same time, I get your point of view. I mean, what that means we can't punish anyone? Because we don't want to seem bad, by pushing back against the bad people? Are you saying we just turn the other cheek? That's crazy.
Yeah, I get that...But I think it's important...You do some crime, and I say, "I have to get back at you". But no, I'm the one that has to be moral. Individuals have to be moral. The state doesn't have to be moral in the same way. But we can't let that spill over to individuals otherwise everything collapses.
I mean, I'm not saying I can resolve this right here--and your strong reaction to what I said, indicates that I have raised a complex, subtle point that's not easy to resolve. People face stuff like that, it's difficult, so they react strongly, or emphatically, like you did.
So I think we need the state, the organs of the state, to be able to enact this violence on our part (take their money, their freedom, their life--maybe? I'm not sure about the last one). Then we can afford to be moral and live up to that, and that's good overall. It's not perfect but then what other options do we have?
Note that graderjs is not saying that there could not be other morally justifiable reasons for calling for the death of someone.
What they were saying is specifically that arguing that someone who takes a life should be punished in a life ending way because of the severity of taking a life is undermining that argument's own central claim of the severity of taking a life by at the same time arguing for ending a life.
Your analogies are flawed for two reasons:
1. there are other justifications for punishments that may (or may not) be valid. One argument may be that it is preventative, for example.
2. in neither example would most people argue that we're imposing a particularly extreme sentence because the action was particularly extreme, and this is central to the argument made by graderjs.
In the case of the theft example, if anything we'd tend to argue a fine is not a very serious punishment. In the case of kidnap, we argue for serious sentences because of the seriousness of the crime, but a prison sentence would not be seen by most people as equally cruel as the uncertainty and fear and trauma imposed on both the victim and their loved ones, and most people would argue that the prison sentence is not just a response to the seriousness of the crime committed.
Some people might nevertheless find it hypocritical to argue for prison sentence on the basis of the seriousness of kidnapping, and its their right. But that in itself does not make a prison sentence unjustifiable even if you agree with them, because you may have many other arguments, such as e.g. risk of reoffending, or signal effect to others.
The point is in other words not that a given punishment can't be justified, but that if you choose to argue that something is particularly severe and then in the same breath argues for inflicting that same thing on someone because of that perceived severity, you're undermining that argument.
Fines and jail sentences are imposed by courts. It would be weird for a grocery store clerk to overcharge a convicted thief after they served their sentence.
The stabbing victim was wheelchair bound and later died from a stroke directly related to the stabbing.
Confining a person is bad. But we imprison someone who did that. Thereby, to show that freedom taking is bad, we engage in it. To me, this is a paradox.
r/im14andthisisdeep
When evaluating principles, the trick is to extrapolate from each principles what society would be like if they were followed.
The first one “Our principle is that people who stab Ed should not get a heart, therefore David should not get a heart.” means that there is no rehabilitation for ex-cons, that doctors have the power to condemn people to death based on their past by refusing a life saving procedure and that in the case of new research like this one, doctors cannot have access to the best candidate.
Extrapolating the second principle means living in a society where the judicial system decides the punishment and people pay their due afterward, potentially reducing recividism. It means that when doing an experimental procedure that requires very specific candidates, the doctors have to pass on an ideal candidate delaying discovery.
> Neither party can offer a valid argument as to why their principle is true, because both of their principles are normative.
Can you offer a valid argument for the truth of your own principle, that it is impossible to offer a valid argument for the truth of any normative principle? I think your own position is a normative principle, and hence your position is self-refuting.
To call an argument "valid" is to make a normative claim; it is to claim that a rational agent ought to accept it. To call an argument invalid is to claim that a rational agent ought not accept it. Rationality has as much oughtness as morality does, and hence is a normative discipline just as morality is.
> Idk, it could just be a claim that the argument can be expressed in a logical system, combined with the normative axiom that rational agents should only trust arguments that can be validly expressed in such a formal system.
The term "valid" has both formal and informal senses. I agree some of its formal senses are non-normative, but I think its informal uses have a strong normative element. The original comment to which I was responding wasn't very clear about in what sense it was intending the term, but when people aren't clear, it is not unfair to assume they mean a term informally rather than in some specific formal sense.
> Regardless this seems to be missing the forest for the trees. Nobody has put forth any arguments for either position that are emperical in nature. Is there really a practical difference between impossible and possible but nobody knows how?
What is the proper role of empiricism in human knowledge, including moral knowledge? You seem to be making some assumptions here which you are not making explicit.
If one accepts moral sense theory – that moral intuitions are a form of empirical knowledge – then we can have direct empirical knowledge of the truth or falsehood of moral propositions.
If one accepts pragmatism – that beliefs can be justified by the pragmatic benefits of believing them, and that pragmatically justified beliefs can constitute genuine cases of knowledge – then empirical evidence can be used to establish the pragmatic benefits of a moral belief, and hence (indirectly) to establish its truth.
One may believe that some axioms are self-evidently true, and that one's knowledge of the truth of those axioms is innate rather than empirical – in which case, if one accepts that for non-moral axioms, how about accepting it for moral axioms as well?
The practical/empirical argument would essentially be to extrapolate out what the world will become like if we spread X or Y normative belief/practice.
You can argue that one will lead to a preferable world than the other.
Of course, we may have different preferences, so we may not agree even if we agree on that extrapolation. But often basic human preferences like not wanting to be the victim of unprovoked public violence do align.
You are saying that, a valid deductive argument with a normative conclusion must either have a normative premise, or else rely on a logic whose inference rules permit normative statements to be inferred from non-normative ones.
I agree with you there. But you haven't explained how this (obviously true) statement is relevant to the original discussion, about the morality of providing life-saving medical treatment to perpetrators of serious crimes.
> Neither party can offer a valid argument as to why their principle is true, because both of their principles are normative.
The majority of ethicists agree that normative statements can express true statements.
But the positive/normative distinction is also not important here: medical ethics is a prescriptive and lexical ethics, one that you must follow if you are to practice medicine. It's not interested in what any individual does thinks should or shouldn't be the case: you do no harm and you always render treatment in accordance with your means.
> What do you think is a good candidate for such a statement?
Here's an intuitive one: "you shouldn't kick puppies." Most people think that expresses a true statement (not that "most people" is itself indicative of truth value).
In terms of my own ethics: "act only in a way that you can will be universal law." Of course, not everybody agrees with that one, but I think it's an awfully good candidate.
We can talk about if and how those proceed from axioms, but I suspect that'll be a long thread :-)
> What is the meaning of “lexical ethics”?
Sorry: lex is in lex, legis, "law." Medical ethics don't concern themselves with normal moral objects or even moral laws in the deontological sense; they are literally a book of rules that doctors (broadly) are not allowed to disagree with.
So yes, I think it's correct to read the doctors' responses as a positive claim: they're pointing out that it's a category error to appeal to their (potentially true!) moral beliefs.
Not particularly! There are ethicists who believe all sorts of silly things, if you think "self-defeating" or "undermining" qualifies as "silly." For example, there are plenty of ethicists who think that moral statements are really just preference statements, putting "killing is bad" on the same epistemic level as "I don't like peanuts on my sundaes."
This all works out because it isn't actually contrary to their self-interest: academic philosophy doesn't care whether your position undermines some grounding claim, because there's no universal consensus around that grounding claim to begin with. You'll find plenty of moral philosophers who think that morality is a purely preferential mental phenomenon; they don't mind admitting that because there's still plenty of interesting work to be done if that's the case.
>The doctor is saying “Our principle is that we don’t use the patient’s past violence or convictions to determine whether they should get a heart or not, so the stabbing doesn’t disqualify David.”
>Neither party can offer a valid argument as to why their principle is true, because both of their principles are normative.
I'm pretty sure someone mentioned that the Dr's pov is that the doctors don't punish crime. Someone else does that. If they have a crime worthy of death, someone else determines that and administers that punishment. The Dr's stay out of that conversation.
Exactly. If the law was changed to allow judges to impose "denial of transplants" as a punishment, then one might consider that a good or bad thing, but in that case it would be the courts not the doctors who makes the determination, and the legislative who'd be ultimately responsible for the rule existing.
As long as there is no such law, it's not for doctors to impose such restrictions.
The first argument is a slippery slope. What crimes disqualify you from getting a heart? How much repentance do you have to go through the get qualified back? Who judges that?
The guy should have got the death penalty for attempted and arguably successful murder (the victim later died of a stroke directly attributable to the wounds he received from the stabbing). 10 years for stabbing a guy multiple times to the point of putting him in a wheel chair is a slap on the wrist.
Funny how a lot of problems work themselves out when swift justice is delivered. This whole thread doesn’t exist in that alternative, more just world.
People who commit crimes should not get a heart can be transformed to Only people who have not committed crimes should get replacement hearts. The problem is, who hasn't committed crimes? Which crimes count? Who decides?
That question makes the more-topical issue When the ER fills up, should unvaccinated people be treated by administering carbon monoxide in the hospital parking garage? look trivial to resolve, in comparison.
We deny people waiting for organ transplants medical treatment regularly. there simply aren't enough organs to go around. In the case that people are already having life saving organs withheld from them, it makes sense to prioritize.
I think people have the ethical issue in this case backwards: the reason this guy got this transplant is because it was an experiment. We effectively used an ex-con as a guinea pig. (Personally, I'm fine with that, he was fully aware and consented, it was his only chance.)
If this guy had died due to the experimental heart failing, we'd probably be seeing a bunch of op-eds about our moral failure to prevent exploitation of a vulnerable (ex-)prison population.
In the vaccination example: it is based on triage. Which is based on predicted outcome and resources available.
If you have one hospital bed and two COVID patients that are looking like they will die if they don’t get admitted you treat the one with the greater chance of survival. Being vaccinated is predictive of a higher survival rate…
I mean one of those principles generalize, the other does not. I would argue making medical decisions based on ad-hoc principles is unjust.
Is there a limit to this impartiality? Should we have saved Hitlers life with a breakthrough transplant?
If he follows the same protocol and gets considered under the same criteria, yes.
Doctors making moral judgements and withholding treatments based on their patients lifestyle has a pretty ugly history.
I would suggest the following limit, unless the state has already sentenced to death.
We have a justice system to make these calls. Let the doctors treat everyone and the justice system decide who lives and dies.
This. All these arguments over ethics miss the point. Doctors shouldn't be placed in the position of making morale decisions. Their job is to render care and given the grave consequences of malpractice, we should always expect them to do so to their fullest abilities. FULL STOP.
Let the legal profession handle how to deal with criminals. Punishment and medical care have no place existing together.
What happens if you decide to not transplant because of their past but it turned out they were wrongfully convicted?
To the top of the transplant list immediately pushing others down or “ohh.. awkward. we’ll treat you fairly from now on”?
> Is there a limit to this impartiality?
No.
> Should we have saved Hitlers life with a breakthrough transplant?
Yes.
It really is not complicated: Doctors are not in the business of judging their patients.
> Doctors judge, at least in their own mind and that influences survival decisions.
That isn't intentional or desirable though. It's a flaw. Doctors are people and people are imperfect.
I have some bad news from you about where anesthesia data came from...
But are they wrong?
Pretty much always, yes.
Side-comment that doesn't apply in this case, but worth mentioning: "regardless of who they are" seems like a shitty blanket principle to have. For example, hospitals are overstuffed with COVID patients means regular patients die as a result. In many cases, "The overwhelming majority of the patients had COVID-19, and 98% of those needing acute critical care were unvaccinated." This means people who choose to not take the vaccine are causing others to die. So the unvaccinated should be thrown out when a patient in need comes and no beds are available.
https://www.project-syndicate.org/commentary/health-care-pri...
It's a slippery slope.. I think the uneducated are less likely to be vaccinated and it doesn't seem right to refuse service to someone because they believed something that was incorrect. Say there were people with mental handicaps that fell in this camp, it would be even worse.
And where do you draw the line for who gets help for stuff unrelated to covid? Having a do no harm type moral code seems like the best way to navigate and avoid the minefield of deciding who deserves care in what circumstances.
The problem is that it's not as simple as that, everyone knows fire will hurt you. Our country is polarized and the truth is under attack. A large part of the population doesn't trust vaccines, they are not all idiots. They are victims of circumstance and don't know any better. I don't think it makes sense to equate them to suicidal people that are wandering around in forest fires.
Even simpler: By refusing treatment based on choices stemming from mistrust of the system you are validating that mistrust.
Counterpoint: it's not the uneducated that don't vaccinate, it's the cynical - and the "educated" are often ignorant of all the ways it's reasonable to be cynical because they haven't been screwed over as much.
At the end of the day, understanding the benefit of a vaccine requires trusting information, and I think that information, and trust, has been compromised. You could equally hate on anyone deciding that smoking was bad for you, not long ago, because of how thoroughly compromised the "science" around it was.
Why are so many vocal advocates for the covid vaccine such demons? Is the rhetoric surrounding the covid vaccine so toxic that it turns otherwise normal people into people who are so hate filled, or are such hate filled people simply predisposed to being influenced by such rhetoric?
It's your standard us vs them scenario. Humans love us vs them scenarios, we're a tribal bunch
The vaccine narrative is collapsing, and people are desperate for answers and to find someone responsible. They were promised high immunity from infection and close to 100% immunity from hospitalization/death. Real-world stats paint a completely different picture and people are desperate.
> The unvaccinated are literally causing people to die besides themselves. There is nothing hate-filled about that.
As a soon to be triple vaccinated healthy adult I wish we could soon admit that we do this for our own good and to not be away from work.
By now it is very clear that about the only thing the current vaccine does against Omicron is lessen the consequences for the individuals who take the vaccine.
I still recommend it but it won't save anyones life except those who take the vaccine.
what are you talking about? Are you under the impression the vaccines prevent transmission of COVID?
at best, the vaccines reduce your personal chance of hospitalization and death.
for those at risk from COVID, take the vaccine. But pretending you're assisting your community by doing so is ridiculous and unfounded in data. "Fully vaccinated" people appear MORE likely to catch and spread Omicron 90 days post-vaccination.
Source: https://www.medrxiv.org/content/10.1101/2021.12.20.21267966v...
The unvaccinated are harmless, full stop.
> hospitals are overstuffed with COVID patients means regular patients die as a result
as a result of what? Failure to isolate COVID patients?
No, it really shouldn't. I'll be the first to say that unvaccinated people are morally bad, and their actions are harmful to wider society.
But, and this is a really important but, the way to punish that behavior isn't to deny them care in the hospital. For a variety of reasons, not the least of which is that not every unvaccinated person is unvaccinated by choice. But more generally because applying any sort of moral standard to who lives and who dies in an emergency gets incredibly murky incredibly quickly.
If you want to punish people for failing to get vaccinated, I'm all for it. But do so outside of a hospital.
Read the article. Sadden he took such drastic actions & that it led to someone’s suffering for so many years until their eventual death, but he served his time in jail. Isn’t that how we repay criminal debts in society? Not a very good argument to deny anyone life saving care after they served their sentencing(or because for their past actions for that matter). If the family believed the sentencing wasn’t accurate that’s a different matter
Glad Doctors don’t discriminate based on past actions of an individual. Would be a very dystopian society if we did.
I don't understand what people are arguing, he didn't even get a real heart that could've potentially gone to "a more deserving person". He literally got something that no one else would've gotten. The only reason they agreed to do this experiment on him is because he was about to die and he agreed to be part of an extremely risky surgery that he very likely would've never wake up from.
I could see him being all over the press being annoying for the victim's family, but I don't see this as him being rewarded with anything. What he got is one of the worst option, though the fact that he's survived this far makes it better in hindsight. Then again 2 weeks means nothing, let's see if it actually lasts.
> If the family believed the sentencing wasn’t accurate that’s a different matter.
It probably depends on what you mean by 'accurate'. They almost certainly do not believe this person has repayed a debt to the victim, the victim's family or society in general. Phrasing the issue as one of repaying a debt is problematical when it is beyond the means of the perpetrator to make amends.
Note that this is not an argument for the doctors doing anything different. All else aside, it is in the best interests of society as a whole that they should select the most medically-suitable candidate available for this research.
Considering the situation, a very important medical experiment but over a socially sensitive patient, would it help to keep the guy anonymous ?
There isn't even a consensus on what prison is actually for, so this discussion is doomed to be ambiguous and fruitless. Is it punitive, is it rehabilitation, is it about separating danger from the rest of society, or is it some kind of morale debt collection?
I understand the family though. The unfairness is heavy.
The unfairness of a terminally ill person that's not eligible for a regular heart transplant receiving an experimental treatment that might just as well kill him, but in the long run might save many more? Or is it the unfairness of never being able to escape ones past?
The social implication can be as incredible as we all imagine, it's still unbearable for the family involved.
Ugh PETA, always have to butt in just to keep themselves relevant.
For the first one, I can totally understand what the victim's family must be going through, but doctors aren't (and shouldn't) be in the business of making moral judgements on who should and shouldn't get to live. There is an established process in place for organ transplants (time on the wait list, viability of the transfer) and that's all that needs to be followed.
He's still serving his sentence, right? At least he's being useful as a guinea pig. Maybe it's selfish, but at least it's data that will help the next person.
Frankly, I could care less what the family thinks. If they feel so strongly, then they should advocate for some legislative change. Most families would kill if given the option, and also the luxury of having someone else do it for them.
Doesn't sound like it, it was 24 years ago according to the article, and they had a ten year sentence.
Right, he injured someone and shortened that person's life, but the justice system didn't know about that last part until long after he was sentenced. So it's not surprising that he's been out for a long time.
I mean it doesn't affect the time they did.
34 years
> Ugh PETA, always have to butt in just to keep themselves relevant.
This is literally what they are all about. It's like complaining that the IOC keeps whining about athlete doping just to try to stay relevant.
I originally downvoted you but then removed the downvote since what you write is correct and not trollish.
That said I have though about it more than once, simulation in the head style and a world were PETA wins turns in to a uglier world in most cases.
Note: this is specifically about PETA, some other animal rights/welfare organizations are somewhat reasonable.
[deleted because I didn't articulate this well]
Punishing someone for a crime is the responsibility of the justice system. You are saying hospital administrators should basically be able to hand out death sentences at their discretion, which is a bizarre line of thought.
> to me it honestly seems pretty reasonable if hospitals were to lower the priority of people who've been convicted of serious, deliberate violent offenses (where "serious" can be rigorously defined based on charges/sentences), given the very limited supply and high demand. Perhaps even restrict it to cases where the victim died, like this one.
Why would anyone want to add complexity to triage would be my knee jerk wonder, it’s supposed to be a quick process
Would the hospital need to wait for the legal system to get back to them before treatment can begin? How would you know if the patient has committed a crime without waiting?
How would you ever remove human bias from such a system? This is a non-starter.
For the record, my original comment before I deleted it was exclusively referring to cases of deliberate violent crimes, with a caveat that it should probably be restricted to just homicide.
I see many answers arguing that doctors treat everyone the same regardless of their criminal past. That's ethically right, and the victim's family doesn't have to like it either. PETA doesn't have to like it either. My grandmother doesn't have to like it either. Maybe the victim's family would've been happy that he got the transplant if that had caused him to die; maybe PETA would be happy if pigs got transplants from humans. Thankfully it doesn't really matter what the victim's family or PETA thinks of it.
I was in jail with someone who had been given a life sentence. He needed a kidney transplant. He said there had been a lot of talk about giving a kidney to someone who was going to die in prison. He got the kidney transplant while he was locked up, and then he was later exonerated of the crime in an appeal.
I'm glad that he wasn't refused the kidney transplant simply because he was incarcerated, although I'm sure it happens.
The idea that a prior criminal record - even a violent one - should disqualify you from medical care is just vile.
And in any case: seems like the man served his time.
It’s The Post, kind of their thing.
This is why we’ll never have a rehabilitative justice system. We don’t deserve it.
He was convicted in 1988 and sentenced to 10 years behind bars, probably served less so it’s likely that he’s been a free man for 25+ years.
It’s been over 30 years since the incident. Give the man a break.
Some want vengeance in place of justice.
I think it's more that justice means something different to different people. I think that vengeance can be justice.
I of course think that example is not just. However I think there a certain crimes like mass murder are beyond being forgivable. It's where I think the only just thing is vengance.
Also justice can't be objective. Put n people in a room and ask them what is just and you'll get n different answers.
This comment is a great example of why social media doesn't work. Factual, cited, but totally irrelevant to anything around the technology. It's the top comment because it brings up the controversial elements that spur more comments, and it's in a positive feedback cycle from there.
Why are these points of view (especially the first) worth noting? They are quoted saying the heart 'should have gone to someone more deserving'. Yes, the precious, rare pig heart. It would be more fitting to look on this guy as a Guinea pig, so if he is a bad guy to you, who better to use?
I’m not familiar with the details of this case, but I can imagine that the time and expertise of physicians capable of doing the surgery is scarce. What do you say to the claim that, “The time and resources including the surgeons and the pig heart should be put to use helping a more deserving person.”
I already said: First time surgery that might not work is an experiment as much as a treatment. Hypothetically dialling the risk level up - just a matter of degree, still - we'd find ourselves regarding this operation as his sacrifice for the greater good.
> I already said: First time surgery that might not work is an experiment as much as a treatment.
I don’t think changing the name of what happened from “treatment” to “experiment” tells me anything new. If another person with a roughly identical health status but without the violent history is also willing to accept the pig heart, then the decision must be made to use the scarce resources to treat Ed or the “non-violent” person.
> we'd find ourselves regarding this operation as his sacrifice for the greater good.
I agree that people may be talking about the transplant and Ed differently had he died on the table.
I’m surprised to see such irrelevant and sensationalized information being pushed to the top of the comment section of a hn post. Does a crime that happened 34 years ago, and a sentence served for said crime, hold any at all relevance to the medical breakthrough posted here? Does a questionably-ethical nonprofit’s viewpoint matter on said medical breakthrough? No to either.
> was charged with intent to murder and openly carrying a concealed weapon, among other charges.
I know what a concealed weapon is, but what is 'openly carrying a concealed weapon'?
I'm carrying a concealed weapon right now. (It's a S&W .380 M&P.) I have a card in my wallet that makes this completely legal in the state where I live, and in 35 other states. I'm always amazed at the culture clash between the anti-gun lobby (including the press), and people who choose to exercise an important constitutional right.
A gun is just a tool. It can be used for both good and bad purposes.
Also, the NY Post article says; "To some families, it’s an outrage that a person convicted of a violent crime would be awarded an organ others so desperately need. But doctors often disagree and there are no laws prohibiting someone with a criminal history from receiving a transplant."
Elsewhere in the same article, it says; "A jury found him guilty of battery and carrying a concealed weapon but acquitted him of of intent to murder. Washington County Circuit Judge Daniel Moylan called the stabbing a case of “extreme violence” and sentenced him to 10 years behind bars."
The facts of the crime are not given, but apparently a jury did not believe he intended to kill, and since the victim did not die right away, there was no killing to prosecute.
That's great, but none of it answers the question.
Given your expertise, maybe you know, what is 'openly carrying a concealed weapon'?
In particular, ‘openly’
There is "open carry" and "concealed carry", but I've never heard the usage you are asking about. I suppose that if one had a knife sheathed and attached to their belt, but was wearing a jacket that concealed the knife, that might qualify.
I know of people who were legally openly carrying a firearm and got convicted of carrying a concealed weapon because of a jacket. The laws vary by state, so such a thing is possible in some states.
Believe it or not, in some jurisdictions you can have a ccdw license and are fine to carry concealed, but it is illegal to carry said weapon openly.
I don't like the wording of that charge(if it even really exists), but that's all I can come up with.
The knife had a fake mustache and googly eyes glued on as he waved it around, so people didn't realize it was a weapon.
"...and a tremendous waste of resources that could be used to fund research that might actually help humans."
Hey PETA, source?
PETA hates anything that makes animals useful to humans. It could solve world peace and they’d be arguing that surely there’s a better way.
I don't think peta would consider it "world peace" yet.
No.
Why do animals need to be useful to humans to justify their existence to you?
if there's one thing peta knows inside and out it's being a tremendous waste of resources
..but, this does help humans? (Or at least one so far).
Well they are literally named "People for the Ethical Treatment of Animals." It shouldn't be surprising that they are not in favor of killing animals for replacement body parts.
I'm not either, but at least this was a case where the personally arguably "needed" it. Usually we treat animals like garbage just for fun.
Not to invalidate that person and family's feelings, but it was from 1988, not recently.
Dude looks more like 77 than 57. Life-long stress, I'm guessing.
My understanding is that given this was the first time this was tried, there was a strong possibility that the patient would not survive. Instead, the manner of their death would inform the doctors for the next person they tried it on.
Given that their chance of survival is so slim, choosing to use a person for whom such small odds give more information to science, rather than do moral good by helping this person survive, seemed a reasonable tradeoff.
Is this too cynical a read on the choice they made?
Reading all the responses to this on social media is both sad and mildly entertaining. The level of hypocrisy combined with fever and sensitivity everyone has been worked up into over the past few years, when anything even slightly complicated or nuanced comes up everyone is jumping almost panicked to figure out the "right" position is.
Excuse my"rough language" but I find PETA people stupid, aburd and straight up dangerous. Those bastards want to leave a human being to die because they care about an animal. Fuck you.
Look. I am a Muslim. That means, by religious scriptures, we are programmed to avoid pork. why? Simply because "god told us to avoid pork". No other thing. Abstain from eating pork and people follow that.
Now, when it comes to saving a life, those religious considerations do not stand because a life is at stake. Same for " consuming wine is prohibited" but if alcohol is necessary as a medicine, its allowed because the intention is not to get drunk but to get treated. That is important.
Now, when it comes to using a pig heart as a replacement, I am pretty sure no resonable person, from any religion would have problems with because the end goal is to save a human life.
These PETA people are keeping themselves relevant by being the dissenting voice that nobody has to listen. Yeah, if PETA or their supporters are reading this, again, fuck you. Let us save lives and your organization can watch us do it.
Wow, this is one triggered ego! "I'm more important than animals because I said so!!!". Hilarious watching you throw this little tantrum.
yeah.. pretty much. i did not say "I'm more important than animals because I said so!!!". i said "humanity is more important than animals". there is a difference. if you can't see that then the joke is on you
> PETA doesn't like [...] anyone
FTFY. PETA is a shit organization.
Haven’t you learned anything from M.A.S.H.?
Would M.A.S.H. teach me to put the peta link first?
Just kidding, I think I know what you mean.
I think the main problem is not the life saving but the good publicity the guy gets. I'm not going to publicly agree or disagree with either article right now, though - I'm conflicted about each of them.
a pig deserves a pig's heart
A literal pig.
Is it now cannibalism if he eats bacon?
I have a cow valve and I say yes.
pass me the steak.
This is why I'm here. Thank you.
Did he become a vegetarian?
What if he had kids now?
They transplanted a heart, not testes.
I am not a vegan but this is unethical
Sounds like you should be a vegan! If this is unethical to you, why eat animals?
How? Is inserting animal parts into your body via your mouth fine but not via a hole in your chest? Both sustain life, both mean the pig lives relatively comfortably as a domestic animal for a while. Surely that's better than never been born at all.
Anyone care to emphasize why this opinion should be down voted so heavily ?
It's ok to now breed animals for parts; However if someone questions the ethics of that, it's bad? Ridiculous...
Because they aren't questioning the ethics of this, they're stating their opinion on it without giving any reasoning why they feel that way.
> Anyone care to emphasize why this opinion should be down voted so heavily
Because they don’t say anything. They announced their belief and wandered off. Post could do with a “because” and another sentence or two
Can’t speak for everyone ofc but that was my reasoning. Nothing to do with the opinion my side, standard downvote behaviour for contentless comments
Do you require an explanation for why that might not be the correct thing to do?
Nope. I'll vote how I feel like voting. You may do likewise :)
If a single downvote matters, it doesn't matter
It's a typical reddit-level-effort comment. These and annoying puns get automatic downvotes from me. Maybe a bit shortsighted, but I solely use HN for highbrow intellectual discussion, debate, and insight. The only reason I'm so protective of this kind of discussion is that HN is literally the only venue left.
If you agree it's okay to breed animals for nourishment ("not a vegan") then why would it not be okay to breed them for organs?
If you're not a vegan and you're against this you're letting your squeamishness override your ethics. If an animal is worth killing for the convenience and taste of a meal, it's worth killing to save a human being with a transplant.
Your objection sounds like squeamishness, and in that case I'd avoid looking at medical procedures in general.
I bet you'd take one tho if your other option was certain death. Or if your child needed it and it was the only option.
How come?
Maybe I can add some nuance as a vegan (I'm vegan btw, and I use Arch btw). I think that it's amazing that this is possible, but where it seems unethical to me is that there still are many other ways we could route heart transplants from willing humans. I think the only way I'd find this ethical is if the pig died from natural causes. But that probably complicates using the heart. If a pig is killed for food and then the heart is used for this, it still wouldn't be ethical to me, because it's plainly not ethical to kill another being for one's benefit in a situation that is not purely for survival (everyone's favorite deserted island). A heart transplant is a situation of survival, but again - we should continue to explore human donors first.
> The patient, David Bennett, a 57-year-old Maryland handyman, knew there was no guarantee the experiment would work but he was dying, ineligible for a human heart transplant and had no other option, his son told The Associated Press.
> There’s a huge shortage of human organs donated for transplant, driving scientists to try to figure out how to use animal organs instead.
> Dr. Bartley Griffith, who performed the surgery, said the patient’s condition — heart failure and an irregular heartbeat — made him ineligible for a human heart transplant or a heart pump.
- https://apnews.com/article/pig-heart-transplant-6651614cb9d7...
I'm curious how you'd extract a human heart from a willing human donor without killing the donor. I'm also curious how you'd similarly prepare the human donor in any way to meaningfully reduce the chances of rejection, like genetic modification.
Organ donors
The last time I checked, we were already recruiting organ donors at the DMV. How do you suppose we go about increasing the (currently small) number without resorting to unethical means?
Am I reading this wrong? Isn't this how you'd do it?
> As of 2018, the most common procedure is to take a functioning heart, with or without both lungs, from a recently deceased organ donor (brain death is the standard) and implant it into the patient. [1]
The point is that there's a gigantic gap between supply and demand, and a lot if not most of the supply goes to waste because you can't stockpile hearts. They need to be harvested from a compatible donor and very quickly transplanted. The odds of finding a compatible match are not great.
There simply are not enough compatible donors to meet the demand. With an emphasis on "compatible"
I disagree. This brings us back to tribal times; kill the animal or starve, or in this case, kill the animal or die of a heart attack.
Maybe you could at least address the points I gave instead of plainly ignoring them and repeating the same argument? I already addressed this - we aren't in tribal times. We can even grow organs in the lab. We can also coordinate complex routes to securing organ donations. There are so many available options. And again, if a heart from a pig that died naturally could be found, I'd be all for it. I think it adds a more to control than already a trans species heart, but that'd be my ideal.
So there's a shortage of human organs in general (especially heart and lungs), which means we need to get them from somewhere.
Using complex routes to secure organ donations isn't a great option, because the viability of organs decrease as time goes on, so there is an effective limit on how far they can travel. It also doesn't help people who are currently ineligible for organ transplants, because their current scarcity means that only prime candidates can get them (otherwise it would be wasteful).
We could change the organ donation system from opt-in to opt-out, but I get the impression that wouldn't be as ethical from a vegan point of view. That also doesn't help the afformentioned distance problems.
Lab grown organs could be a great solution that would actually be better than animal organs, but they're not a viable option yet.
Basically, if we had good options other than xenotransplantation, I would probably agree that it's unethical to use their organs. However, we don't have better options right now (especially ones that can scale to treat everyone that needs an organ), so in my opinion, xenotransplants are better than nothing.
(Also as a side note, a pig that died from natural causes wouldn't be viable for organ transplantation. The pig needs to be physiologically alive for the organs to be viable, and it needs to be genetically modified to not have animal proteins that the immune system can detect).
There is a shortage of organs. There are not enough. Lab grown is not an option yet.
As a vegan what is your view on testing drugs on animals and do you refuse to use those medicines?
I was hospitalised for a month and didn't ask any questions, because I couldn't - I was dying. But if I had more capacity I would have requested vegan options. Once I came to I did refused any non vegan hospital food - which meant I only ate plain boiled potatoes.
So I was grateful for the medicines I received then that may have been tested on animals or may have had animal ingredients. But I still advocate and prefer medicines to not be tested on animals and to not contain animal ingredients. I think we have a vast amount of untapped technology that could avoid that.
I don’t get what tidal wave of angry finger pointing you are talking about. All I see is curious people discussing the topic in a civilized manner.
> "I try to do the best I can to minimize the unethical treatment of others," and it's a tidal wave of angry finger pointing and fallacious appeals to nature.
Maybe because the vegans people have met, are the obnoxious ones that want to push their eating disorder on everyone else, so they just point out the hypocrisy when appropriate.
Animals eat each other alive in the wild, they kill on a whim for the pettiest of reasons.
Dying at the hands of another animal is as natural a cause as you can get. Because we're human we don't treat animals badly while alive, that where our ethics come in.
Obviously if there enough hearts to go around no one would be looking at pigs.
We generally consider killing something to be treating it badly.
Both can be true. Everyone considers sweatshop child abuse to be bad, but we still buy things that people know were produced in those conditions. We have a clear conscience because we just don't think about it too much.
>can the FDA actually stop or sanction experimental procedures like this?
They explicitly permitted this operation, by means of https://www.fda.gov/news-events/public-health-focus/expanded...
Sometimes called “compassionate use”, expanded access is a potential pathway for a patient with an immediately life-threatening condition or serious disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Yes, the FDA will insert itself to regulate medicine wherever it can. For example, the FDA has been pushing to regulate diagnostic tests as medical devices.
It’s funny how Americans surrender medical autonomy to the government but draw a strict line in the sand in other issues
I have a weird muscle disease that is treated with just taking over the counter L-Carnitine. The issue, vitamins and supplements are not regulated. So, I will try to take a new brand and after a few days my symptoms will come back because the pills don't have the L-Carnitine like it says and there is no one to make sure it does. It will cost me four to seven days of pain, and no one is held responsible.
My best guess is one in a thousand actually needs them so the 999 have a placebo effect and the 1 suffers. I told my neurologist, and he couldn't even prescribe them for me because that isn't a thing. So now I buy all I can find that works and hope they don't stop making it.
I don't know if this helps you, but in case it does: They are regulated in Australia. Products that conform will have an AUST R or AUST L number on the packaging.
I learnt this at a talk I went to about 10 years ago. At the time, in the speakers opinion (who from memory was involved in surveillance testing of these products), some countries did regulate stuff like vitamin supplements, but Australia was the only country that "did it properly". And a major component of this was that their regulations covered ingredients and the supply chains.
A quick search turned up this article: https://www.tga.gov.au/blogs/tga-topics/how-are-vitamins-reg...
Finally, a word of caution given by the speaker: many companies/suppliers try to trick consumers online by selling cheaper versions with identical labelling but no AUST number and shipped directly from overseas so it technically counted as a consumer "importing" on their own. Idk if this loop hole still exists.
That sounds severe enough I'd consider it worthwhile to pay a lab to run spectroscopy on a range of supplements just in case, or consider hiring a lab to synthesize a batch I _know_ will meet my needs. The first option is probably a lot less pricey than you'd expect.
Do you have any proof the supplements don’t have l-carnitine? You should get a lawyer if so, that is an easy case against the supplement maker imo.
The whole supplements industry is like this. The best you can do is get one that’s USP certified.
> So, I will try to take a new brand and after a few days my symptoms will come back because the pills don't have the L-Carnitine like it says and there is no one to make sure it does.
Unlikely. What's more likely is that something else interferes with the absorption.
Anyway, don't just take my word at face value, have a sample tested: liquid chromatography can give you an answer quickly. Also, don't buy on amazon where cheap fakes and inventory comingling make the problem unsolvable.
Grab a monster energy drink: content in L-Carnitine is guaranteed,
Have you considered skipping the shady middleman altogether and just ordering the pure stuff directly from a manufacturer?
I had to spend thousands to go through a dozen medications for medical issues. Eventually turned to supplements in part because it was much easier to experiment.
I have a couple meds and treatments I’ve been begging doctors to try, but they aren’t aware of them so refuse to consider.
Go onto any support forum and you’ll find countless tales of doctors not listening or not knowing current info on a condition.
You'll also find tons of people who swear by their home "witches brew" medication. People who are just feeling a placebo. Or people who think they have the forum's banner illness but actually have something totally different and much more benign. They heal over time naturally, but attribute it to gum root jelly concentrate.
I've been there a few times before. And while inevitably monkeys popping random pills will find something, separating the signal from the noise takes time and studies. The things that doctors pay attention too.
Disclaimer: Yes there are out of touch doctors and yes random medicating has lead to amazing discoveries.
If there are two brands exposed to the same market rules and one cost half the price there is a fair possibility that will contain less amount of the expensive active stuff and more of the cheaper ingredients. Technically is still carnitine, but one can have 90% of carnitine and the other just a 60%.
> For example, the FDA has been pushing to regulate diagnostic tests as medical devices.
I assume you mean COVID home tests and things like that? Call me strange, but if I buy such a thing then I'd like to make sure it's held to some standard of accuracy and safety. I do not have the resources or knowledge to find this out myself. Most people don't, and you can't just rely on "internet reviews" or the like.
Someone has to do this, and while the FDA and government authority may not be perfect, they're the best we've got, and we can at least somewhat hold them accountable through the democratic process (which also isn't perfect, but better than anything else we've got).
I'm surprised by the popular take on this. Hasn't HN spent the last 3 years lamenting how the FAA ceded too much regulatory power to industry?
... because this is where it starts. The answer to "there are regulatory inefficiencies" is not "get rid of regulations" or "allow industry to self-regulate."
Right? Like why shouldn't they regulate diagnostic tests? Do you expect the free market to do it?
> regulate diagnostic tests
If only there hadn't been a major high profile collapse of a fraudulent diagnostic test company recently.
The hostility towards FDA on HN is incredible. I wouldn't trust some VC funded startup bros with anything related to medicine at all without having passed every single regulatory board tangentially related to whatever they are doing, even more so after Theranos.
> it simply needs to get better at its job
The issue here (and with regulators in general) is that in general "being better at their job" means going into more depth to determine whether an approval is warranted, which means expending more resources on investigation. I don't know that I've ever seen any overlap between the people who think the regulators do a bad job at regulating and people who think we should be funding the regulators more thoroughly.
All that not to mention that when a regulator like the FDA starts going into more depth in its investigations of an industry, that industry's firms start spending more money on either complying with or deceiving the regulator, risking a downward spiral of wasted resources.
But the FDA isn't executing 100 people (or corporations) per year. FDA isn't even indiscriminately halting progress. Your argument has no premise.
The FDA regulates with cause and investigates all new medical products before they can be brought to market. They don't willy nilly approve some and nix others.
Why? Because citizens want an expert-staffed and functional regulatory body, but aren't willing to pay the tax necessary to fund it, at parity with private sector salaries.
The root of all government problems is "We trust you to make decisions that impact a large amount of monetary value, but also pay you less than the amount of money flowing through you, and also pay you less than private industry would be willing to."
Which... sets up an interesting dynamic.
There are a lot of selfless saints out there. But there are also a lot, not. And so internal processes and regulations pile on top, in an attempt to curb the worst of corruption.
Can we make the system better? Eh... maybe? But it's important to remember that a lot of features that look insane are actually reactive solutions to problems inherent in the system.
The market for counterfeit and unregulated chargers and electronics on Amazon/Alibaba (most all of which are UL marked) and fires related to the above suggests that the UL doesn't really have any teeth.
It's possible that medical approvals would be less prone to this sidestepping of independent regulators, since much of the spending is proxied by insurance companies looking to maximize profits and minimize BS spending, but I have very little confidence that such a system would function.
Getting regulation "just right" is a complicated process, people differ in their risk tolerance, and it isn't clear to me at all that "more powers to X" is always the right answer.
The fda is responsible for keeping hearing aids at insane prices my entire life. They serve as the gatekeepers for a cartel of once manufacturers, now IP holders (pure rent seekers,) who have successfully used the US government to exploit one of the most overlooked and vulnerable classes of people. Almost everyone loses hearing when they're older.
When you live with hearing loss, it leads to social isolation and embarrassing situations, depression, and all the usual attendant disasters in people's lives.
The hearing cartel has used their wealth to create a pseudomedicine so as to brand their salespeople as doctors, and infested almost every state with bureacrats who determine policy and direct licensing and enforcement.
Hearing aids that are priced at $5000 or more are produced at scale for less than $5 per unit. It'd be trivial to turn most modern headphones into hearing aid equivalent technology, but there is a regulatory moat surrounding real time audio enhancement that will cause the fda to shut down any attempt to augment regular hearing, let alone allow the hearing impaired the ability to operate what amounts to a stereo equalizer.
The fda does engage in legitimate business, but that's insufficient to justify the costs paid by people who get screwed when the FDA is exploited for profit.
I currently pay for "hearing aids as a service" and lose $200 a month for the privilege of hearing. I pay what amounts to extortion money for my disability. Because my loss is classified profound, none of the Obama era loosening of hearing aid restrictions help. It's lip service that acknowledges the problem but leaves 95% of it unsolved.
Libertarian shmibertarian, I think I'm entitled to not get specially fucked because my ears don't work. I think it's sick that I feel grateful that I can afford hearing as a service when it should be something covered by insurance, or something I can buy for the same cost as premium earbuds.
Government shouldn't be involved in hearing aids, except in the consumer protection arena. The fda has no business enabling the exploitation of disabled and vulnerable people, but hearing aids are just one area they happily strong-arm the public on behalf of cartels and industry lobbies.
> Pretty typically libertarian—freedom as long as nothing gets more dangerous. Kind of like rebellious children.
Or, as this guy[1] put it, like house cats. “convinced of their fierce independence while utterly dependent on a system they don’t appreciate or understand.”
As a former Libertarian who luckily grew out of that phase, I love this analogy.
1: https://twitter.com/jspauldingphoto/status/14615069981183303...
HN had a huge sophomoric Randian streak years ago.. It seems to be maturing as I assume the users age.
Incredible, thank you for the live example of this mindset.
This is the epitome of survivorship bias. The Moderna vaccine could have just as well made a lot of people very very sick. There are countless examples of problematic medicines and vaccines which didn't get the scrutiny the COVID vaccines got (and continue to get) simply because not enough people were relevant for the studies and statistics are subsequently weaker.
We should all appreciate it went through the regulatory process (accelerated) to confirm it does not before injecting millions of people with it.
Regulations are written in blood, then the blood darkens and people forget why we have regulations.
Too often it seems it's blood of the lobbyist who slipped and fell on ice while carrying a suitcase full of benjamins.
Your quip is an easy one to make but there is very clearly no shortage of entities who peddle goods and services seeking, often successfully, to influence lawmaker so those goods and services are legally required despite the benefit to society being marginal if even measurable.
You can look up any and all regulations online. Then you can read the transcripts of public comments regarding the regulations. You can find relevant court cases online. What else do you need?
Nobody does that now, for the most part, why would they do it if there were a hyperlink attached to the regulations themselves? Who actually reads the text of regulations in the general population? I have zero data, but I'm willing to bet it's virtually no one. Specialists with a vested interest sure do, and they will probably already know relevant cases or thought processes.
Edit: This was written in a very US-centric way, because it is in response to something originally about the FDA.
Well, they are? You just need to look them up. It seems you expect others to drip or force feed you these regulations or something.
If there was indeed a way to pull back the scope and power granted to the government I think a lot of us Americans would love to hear about it. The way it is, it seems like the US government is an unstoppable machine that will grow until it destroys itself.
I don’t think the American governments biggest problem is it’s scope and power: I think it’s biggest problem is inefficiency due to corruption (regulatory capture, etc). It seems to me that the biggest obstacle to fixing this is that many Americans see this as an inevitable character of government rather than something specific to their system, and thus spend their time trying to reduce government (ironically making it even less effective by hobbling it with silly restrictions) rather than fixing it into a well functioning system.
The two are interrelated — regulatory capture doesn’t make sense if there’s no power to capture. So one must first grow the size and power of government through other means, then capture/influence that power. This cycle has been going on for a long time.
One of the amendments is supposed to shield you from tyranny. But, going down a less risky path, I'd vote (no pun) for migration. My parents migrated away from a country that trades in humans to this day, in full view of the gov, and i can't be thankful enough.
Is that a recent push? I used to work for a company producing a diagnostic test, and it was being regulated as you said.
But what is the issue with that? Failures in diagnosis kill people very regularly. It should be regulated.
All you need is a conservative talking head to kickstart resistance to that as well, they just have to figure out a way of making money out of it.
>> to regulate diagnostic tests as medical devices.
Like MIR machines? Like blood labs? Like home pregnancy tests? Without the FDA's regulation of medicine we would quickly be back to snake oil and cocaine in everything. It is bad enough that drugs stores are allowed to sell water as a "homeopathic remedy". The snake oil people are out there waiting for deregulation.
>It’s funny how Americans surrender medical autonomy to the government but draw a strict line in the sand in other issues
If they knew the extent of it they probably wouldn't.
I don't know where you're from but I'm sure the people there show equal apathy on some subjects.
> It’s funny how Americans surrender medical autonomy to the government but draw a strict line in the sand in other issues
You're implying that all ~332 million Americans are a homogenous and single-minded mass. Please stop generalizing, it's not a good look.
Some of us realize it's straight up politics, but we have no power. It's not a choice, but a reality we live with.
That's actually why we're against it. Once they have the power it's basically impossible to recall it. There were many lines in the sand in the past and they keep being crossed.
Everyone who isn’t an HCP “surrenders” medical autonomy since not everyone pretends to know better than the experts.
HCPs love the idea of declaring autonomy as outdated, or problematic, or even better, an HCP behavior itself. Dream on.
It's funny how susceptible Americans are to medical misinformation. The FDA is a necessity.
Private companies also rely on the state for liability reasons as we just now saw with the vaccines. I believe overall this is a good idea to have high expectations for medical procedures as it does not inhibit progress.