Subject(s)
Embryo Research/ethics , Embryo Research/legislation & jurisprudence , Embryo, Mammalian , Internationality , Societies, Scientific , Stem Cell Research/ethics , Stem Cell Research/legislation & jurisprudence , Tissue Culture Techniques , Embryo, Mammalian/cytology , Embryo, Mammalian/embryology , Female , Gene Editing/ethics , Gene Editing/legislation & jurisprudence , Guidelines as Topic , Humans , Male , Mitochondrial Replacement Therapy , Ovum/cytology , Ovum/metabolism , Spermatozoa/cytology , Spermatozoa/metabolism , Time Factors , Tissue Culture Techniques/ethics , Tissue Culture Techniques/methods , Twins/genetics , United StatesABSTRACT
Organoids are three-dimensional multicellular structures grown in vitro from stem cells and which recapitulate some organ function. They are derivatives of living tissue that can be stored in biobanks for a multitude of research purposes. Biobank research on organoids derived from patients is highly promising for precision medicine, which aims to target treatment to individual patients. The dominant approach for protecting the interests of biobank participants emphasizes broad consent in combination with privacy protection and ex ante (predictive) ethics review. In this paradigm, participants are positioned as passive donors; however, organoid biobanking for precision medicine purposes raises challenges that we believe cannot be adequately addressed without more ongoing involvement of patient-participants. In this Spotlight, we argue why a shift from passive donation towards more active involvement is particularly crucial for biobank research on organoids aimed at precision medicine, and suggest some approaches appropriate to this context.
Subject(s)
Organoids/cytology , Precision Medicine/ethics , Precision Medicine/methods , Biological Specimen Banks/ethics , Community Participation , Directed Tissue Donation/ethics , Directed Tissue Donation/trends , Health Services Needs and Demand , Humans , Tissue Culture Techniques/ethics , Tissue Culture Techniques/methodsABSTRACT
The ability to generate human tissues in vitro from stem cells has raised enormous expectations among the biomedical research community, patients, and the general public. These organoids enable studies of normal development and disease and allow the testing of compounds directly on human tissue. Organoids hold the promise to influence the entire innovation cycle in biomedical research. They affect fields that have been subjects of intense ethical debate, ranging from animal experiments and the use of embryonic or fetal human tissues to precision medicine, organoid transplantation, and gene therapy. However, organoid research also raises additional ethical questions that require reexamination and potential recalibration of ethical and legal policies. In this Review, we describe the current state of research and discuss the ethical implications of organoid technology.