A deliberative public engagement study on heritable human genome editing among South Africans: Study results.

This paper reports the results of a public engagement study on heritable human genome editing (HHGE) carried out in South Africa, which was conducted in accordance with a study protocol that was published in this journal in 2021. This study is novel as it is the first public engagement study on HHGE in Africa. It used a deliberative public engagement (DPE) methodology, entailing inter alia that measures were put in place to ensure that potential participants became informed about HHGE, and that deliberations between the participants were facilitated with the aim of seeking consensus. A diverse group of 30 persons was selected to participate in the DPE study, which took place via Zoom over three consecutive weekday evenings. The main results are: Provided that HHGE is safe and effective, an overwhelming majority of participants supported allowing the use of HHGE to prevent genetic health conditions and for immunity against TB and HIV/Aids, while significant majorities opposed allowing HHGE for enhancement. The dominant paradigm during the deliberations was balancing health benefits (and associated improvements in quality of life) with unforeseen health risks (such as loss of natural immunity). The seriousness of a health condition emerged as the determining factor for the policy choice of whether to allow an application of HHGE. More generally, equal access to HHGE qua healthcare service featured as an important value, and it was uncontested that the South African government should allocate resources to promote scientific research into HHGE. These results are aligned with the policy principles for regulating HHGE in South Africa suggested by Thaldar et al. They call for urgent revision of South African ethics guidelines that currently prohibit research on HHGE, and for dedicated HHGE legal regulations that provide a clear and comprehensive legal pathway for researchers who intend to conduct HHGE research and clinical trials.

This is my kidney, I should be able to do with it what I want: towards a legal framework for organ transplants in South Africa.

In 2010 illegal kidney transplants performed in South African hospitals were exposed. Living donors (actually sellers) from Brazil and Romania were flown into South Africa where a kidney was harvested from each and transplanted into Israeli patients. The media reports that followed indicated an outcry against the sale of human kidneys. But by analysing the whole transplantation process from the point of view of each person involved in the transplantation, namely the recipient, the donor, the doctor and the black market in the background the feeling is created that a process of payment for a kidney seems fairer than the current way of procuring organs either legally or illegally.

Commercialization of human organs for transplantation: a view from South Africa.

The Human Tissue Act 65 of 1983 regulates all aspects regarding organ transplants. This Act was last amended in 1989. Since then medical science has developed tremendously and to such an extent that organ transplants today are almost routine operations in many hospitals. Unfortunately the current methods of procuring human organs are not supplying the demand. A new approach, the commercialization of human organs for transplantation is a possibility with the potential to supply one hundred per cent of the demand for organs. There are however many arguments against the commercialization of human organs, but not one of these arguments is without criticism. Ethical aspects concerning commercialization of human organs also need to be investigated, in order to reach a conclusion that it is not unethical and is worth being investigated.