Universiteit Leiden

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The man who sewed a new man together

Organ transplantation is often subject to ethical, economic and political discussions. In the Honours Class Organ Transplantation, students take part in these discussions to get a better understanding of the many different views on transplantation.

‘Newton once said: I’m standing on the shoulders of giants. But who are these giants in transplantation?’ Mike Bos (chair of the Ethical Committee of the Eurotransplant Foundation) starts his guest lecture with a short history of transplantation. ‘In Mary Shelley’s novel Frankenstein is not the monster, he is the scientist who wanted to create a new man by sowing body parts together.’ It became an inspiration for the first attempts at human transplants. A notable milestone was the first recorded human transplant in 1933 in Ukraine. A kidney from a sixty year old dead man was transplanted to a twenty six year old woman, and functioned for a couple of days.

Taxi driver

The general ethical rule is that you can only take organs from a person after his death, explains Bos. ‘But when is someone actually dead?’ Two centuries ago this was clear: ‘when someone was heavily burned, the body decomposed or when head and body were severed.’ Nowadays someone can be declared brain dead if there is unconsciousness, no reflex responses, no breathing and dead is confirmed with an EEG scan. ‘But there’s always the problem if the family really understands this ‘brain dead’’.

The lecture by Bos is about the ethical discussions that dominated the issue on transplantation recently. ‘Who would prefer to give a donor organ to a thirty-two year old mother with three children, rather than a sixty year old taxi driver?’ Most students agree on their preference for the young mother. However, one of the students does not. ‘What if this taxi driver was my grand pa?’ It shows how complicated these discussions are.

Different backgrounds

For this Honours Class, students with different disciplinary backgrounds were selected. ‘This leads to us having many more different views on the topic than we usually have in our classes. Which is very interesting’, one of the organisers of the class Cees van Kooten (professor Experimental Nephrology and Transplant Immunology) elaborates. It does mean that students do not always have a medical background, which can be challenging for the lecturers. ‘But with the ethical discussions of today’s lecture, this is not a problem. Everybody has an opinion about that aspect of transplantation.’

Each class has been prepared by two students and a lecturer. ‘This always gives more interesting perspectives than if only the lecturer prepares something’, explains Van Kooten. Today the preparation was done by students Yiran (Psychology) and Wouter (Medicine). In their part of the lesson they organized a debate and let people vote on tough ethical choices. ‘Organ donation has to be made mandatory if the number of available organs keeps declining.’ Everyone takes part in the discussion actively.

Culture

‘My fellow student of today (Chinese psychology student Yiran) has a different background than me with regards to field of study as well as culture. That was very interesting’, Wouter mentions after the course. He is very passionate about transplantation. ‘I knew immediately that I wanted to follow this course. I also signed up for the summer school on this topic.’ Yiran is less concerned with the medical aspects of transplantation. She was especially interested in the ethical part. ‘My opinion on this topic developed a lot during the course’, she says with a smile.

(IJT / Photography: Andre van Haasteren)

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