Organoids: a systematic review of ethical issues
Dide de Jongh, Emma K. Massey, Ekaterine Berishvili, Laura Mar Fonseca, Fanny Lebreton, Kevin Bellofatto, Juliette Bignard, Jochen Seißler, Leila Wolf-van Buerck, Mohsen Honarpisheh, Yichen Zhang, Yutian Lei, Monika Pehl, Antonia Follenzi, Cristina Olgasi, Alessia Cucci, Chiara Borsotti, Simone Assanelli, Lorenzo Piemonti, Antonio Citro, Silvia Pellegrini, Cataldo Pignatelli, Francesco Campo, Olivier Thaunat, Antonia Cronin, Devi Mey, Chiara Parisotto, Giovanna Rossi, Patrick Kugelmeier, Petra Wolint, Markus Mühlemann, Karolina Pal-Kutas, Marco Cavallaro, Julia Götz, Jeanette Müller, Eline M. Bunnik
Abstract
Organoids are 3D structures grown from pluripotent stem cells derived from human tissue and serve as in vitro miniature models of human organs. Organoids are expected to revolutionize biomedical research and clinical care. However, organoids are not seen as morally neutral. For instance, tissue donors may perceive enduring personal connections with their organoids, setting higher bars for informed consent and patient participation. Also, several organoid sub-types, e.g., brain organoids and human-animal chimeric organoids, have raised controversy. This systematic review provides an overview of ethical discussions as conducted in the scientific literature on organoids. The review covers both research and clinical applications of organoid technology and discusses the topics informed consent, commercialization, personalized medicine, transplantation, brain organoids, chimeras, and gastruloids. It shows that further ethical research is needed especially on organoid transplantation, to help ensure the responsible development and clinical implementation of this technology in this field.