{"id":3177,"date":"2017-06-10T16:27:44","date_gmt":"2017-06-10T15:27:44","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=3177"},"modified":"2017-06-10T16:27:44","modified_gmt":"2017-06-10T15:27:44","slug":"no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/","title":{"rendered":"No Pain, All Gain: The Case for Farming Organs in Brainless Humans"},"content":{"rendered":"

Guest post by Ruth Stirton, University of Sussex (@RuthStirton) and David Lawrence, Newcastle University (@Biojammer)<\/strong><\/em><\/p>\n

It is widely acknowledged that there is a nationwide shortage of organs for transplantation purposes.\u00a0 In 2016, 400 people died whilst on the organ waiting list<\/a><\/span>.<\/a>\u00a0 Asking for donors is not working fast enough.\u00a0 We should explore all avenues to alleviate this problem, which must include considering options that appear distasteful.\u00a0 As the world gets safer, and fewer young people die in circumstances conducive to the donation of their organs, there is only so much that increased efficiency in collection (through improved procedures and storage) can do to increase the number of human organs available for transplantation. Xenotransplantation \u2013 the transplantation of animal organs into humans \u2013 gives us the possibility of saving lives that we would certainly lose otherwise.<\/p>\n

There are major scientific hurdles in the way of transplanting whole animal organs into humans, including significant potential problems with incompatibility and consequent rejection.\u00a0 There is, however, useful similarity between human and pig cells, which means that using pigs as the source of organs is the most likely to be viable.\u00a0 Assuming, for the moment, that we can solve the scientific challenges with doing so, the bigger issue is the question of whether we should<\/em> engage in xenotransplantation.<\/p>\n

A significant challenge to this practice is that it is probably unethical to use an animal in this way for the benefit of humans. Pigs in particular have a relatively high level of sentience and consciousness, which should not be dismissed lightly.\u00a0 Some would argue that animals with certain levels of sentience and consciousness \u2013 perhaps those capable of understanding what is happening to them \u2013 have moral worth and are entitled to respect and protection, and to be treated with dignity.\u00a0 It is inappropriate to simply use them for the benefit of humanity.\u00a0 Arguably, the level of protection ought to correlate to the level of understanding (or personhood), and thus the pig deserves a greater level of protection than the sea cucumber.\u00a0 The problem here is that the sea cucumber is not sufficiently similar to the human to be of use to us when we’re thinking about organs for transplantation purposes.\u00a0 The useful animals are those closest to us, which are by definition those animals with more complex brains and neural networks, and which consequently attract higher moral value.<\/p>\n

The moral objection to using animals in this way arises because of their levels of cognition.\u00a0 This moral objection would disappear if we could prevent the animals ever developing the capacity for consciousness: they would never become entities capable of being harmed.\u00a0 If we were able to genetically engineer a brainless pig, leaving only the minimal neural circuits necessary to maintain heart and lung function, \u00a0it could act as organic vessel for growing organs for transplantation.\u00a0 The objection based on the use of a conscious animal disappears, since this entity \u2013 it\u2019s not clear the extent to which is it possible to call it an animal \u2013 would have no consciousness.\u00a0 It is correspondingly difficult to ground an objection in the undignified treatment of the entity.\u00a0 Arguments relying on dignity imply that there is a conscious entity that is entitled to be treated with respect.\u00a0 Since this engineered pig has no capacity to possess consciousness or even cognition at all, it is difficult to argue that it is capable of possessing any dignity in this sense, that can or should be protected.\u00a0 Since the sentience and consciousness has been prevented, the vessel is more akin to an agricultural field than it is to a \u2018normal\u2019 pig.\u00a0 There is no sense in which we would object to a ploughed field being sown with crops.\u00a0 It is equally difficult to see how we could object to this vessel made of organic matter which happens to be shaped like a pig being used to grow organs.<\/p>\n

This brings us to another scientific hurdle.\u00a0 While pig organs are likely to be the most compatible with the human body, they are not necessarily ideal, and many people may not be able to handle non-human organs.\u00a0 The next stage is to use the organic vessel as a host to grow human organs from induced pluripotent stem cells.\u00a0 The iPSCs have no consciousness or sentience that attracts moral value.\u00a0 Nor does the organic vessel.\u00a0 It is simply a complex collection of organic matter, grown in a machine that happens to be made of similar materials, that is more compatible with the protection of human life.\u00a0 If organs were grown from iPSCs that were HLA tissue typed to the individual patient then organs would be perfectly matched and rejection would be even less likely to occur.\u00a0 Experimentation into chimeric organisms that can do just this are underway and are increasingly successful, albeit in sentient creatures.<\/p>\n

However, this process is still less than perfect.\u00a0 Using a vessel that originated from pig matter is not the ideal growing medium for human organs.\u00a0 It would be much more likely to be successful if the vessel came from human tissue matter.\u00a0 We can apply the same reasoning as for our pig vessel, with an escalation.\u00a0 The respect and moral value that human beings attract is due to their capacity for consciousness and feelings \u2013 the elements of personhood.\u00a0 We nurture consciousness and intelligence, and we protect the ability to develop consciousness once an entity with the capacity to develop consciousness comes into being.\u00a0 If we were able to genetically engineer brainless humans, then the reasons behind these protections no longer apply.\u00a0 The object \u2013 it is not possible to call it a human being since it has no consciousness \u2013 has no capacity for consciousness, nor did it have the potential for capacity for consciousness since it would not have been created except in these circumstances.\u00a0 It is at best, similarly to the vessel of pig origin, a collection of organic matter that happens to be shaped like a member of the species Homo sapiens<\/em>.\u00a0 The organs grown within this vessel would be the most compatible with patients, and would help to alleviate the organ shortage crisis.<\/p>\n

In relation to both types of vessel there are challenges to be overcome with the growing phase.\u00a0 They would have to be grown using ectogenesis, outside of the womb.\u00a0 A living \u2018mother\u2019, whether pig or human, would be caused a great deal of pain and suffering through gestating a brainless foetus.\u00a0 Furthermore, pregnancy itself is not without its physical risks, irrespective of any mental anguish that might be suffered.\u00a0 Ultimately, it is not necessary to use human persons to host the organ growth vessels since the development of the Biobag<\/a><\/span>, an external womb that has been used to continue gestating premature lambs.\u00a0 It is within the realms of possibility that organic matter of human origin could be grown within the Biobag, and this would also avoid some of the criticisms levelled at ectogenesis regarding parental bonds.<\/p>\n

The transplantable organ shortage is critical.\u00a0 It is imperative to find new means of procuring organs in the context of an ageing population.\u00a0 It is important to continue to encourage the population to sign up to donation registers, and to pursue research into how chimeras \u2013 human\/animal hybrids \u2013 can reduce immunological rejection rates.\u00a0 But we must recognise that our initial distaste may be preventing us from implementing other solutions that may be more effective and more efficient.\u00a0 There is no good reason to ascribe any particular value to meat that has never \u2013 and could never have \u2013 suffered, regardless of its appearance or genetic origin.\u00a0 If we can do an immense good, by reducing suffering and saving the lives of the 400 people a year who die in the UK waiting for a transplant, all whilst not causing any harm or disrespect to another creature, is it right that some sense of discomfort should prevent us from doing so?\u00a0 We say no, discomfort is not a good enough reason.\u00a0 Further, if we were to follow this path, it is imperative to do it in the way that has the most chance of success, the creation of genuine human organs which will avoid all the scientific issues of xenotransplantation.\u00a0 It is not enough to grown organs in brainless animals. \u00a0 We should go further and grow human organs in organic vessels of human origin.<\/p>\n

We do not suggest that this is the only solution or even the right one. However, the organic vessel of human origin serves to illustrate that even those methods we may have dismissed out of hand are no longer necessarily repugnant nor even morally problematic.<\/p>\n","protected":false},"excerpt":{"rendered":"

Guest post by Ruth Stirton, University of Sussex (@RuthStirton) and David Lawrence, Newcastle University (@Biojammer) It is widely acknowledged that there is a nationwide shortage of organs for transplantation purposes.\u00a0 In 2016, 400 people died whilst on the organ waiting list.\u00a0 Asking for donors is not working fast enough.\u00a0 We should explore all avenues to […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[963,2147,2153,591,2144,328,576,1544,472,7970,407],"tags":[1856,317],"class_list":["post-3177","post","type-post","status-publish","format-standard","hentry","category-curios","category-genetic-jiggerypokery","category-guest-post","category-life-and-death","category-organ-donation","category-philosophy","category-the-art-of-medicine","category-the-nhs","category-thinking-aloud","category-transplantation","category-wtf","tag-enhancement","tag-research"],"yoast_head":"\nNo Pain, All Gain: The Case for Farming Organs in Brainless Humans - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"No Pain, All Gain: The Case for Farming Organs in Brainless Humans - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"Guest post by Ruth Stirton, University of Sussex (@RuthStirton) and David Lawrence, Newcastle University (@Biojammer) It is widely acknowledged that there is a nationwide shortage of organs for transplantation purposes.\u00a0 In 2016, 400 people died whilst on the organ waiting list.\u00a0 Asking for donors is not working fast enough.\u00a0 We should explore all avenues to [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2017-06-10T15:27:44+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"No Pain, All Gain: The Case for Farming Organs in Brainless Humans\",\"datePublished\":\"2017-06-10T15:27:44+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/\"},\"wordCount\":1432,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"keywords\":[\"Enhancement\",\"Research\"],\"articleSection\":[\"Curios\",\"Genetic jiggerypokery\",\"Guest Post\",\"Life and Death\",\"Organ donation\",\"Philosophy\",\"The Art of Medicine\",\"The NHS\",\"Thinking Aloud\",\"Transplantation\",\"WTF?\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/\",\"name\":\"No Pain, All Gain: The Case for Farming Organs in Brainless Humans - Journal of Medical Ethics blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\"},\"datePublished\":\"2017-06-10T15:27:44+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2017\\\/06\\\/10\\\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"No Pain, All Gain: The Case for Farming Organs in Brainless Humans\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"name\":\"Journal of Medical Ethics blog\",\"description\":\"A blog to discuss the ethics of medicine in its many guises and formats.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\",\"name\":\"Journal of Medical Ethics blog\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"width\":200,\"height\":50,\"caption\":\"Journal of Medical Ethics blog\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"No Pain, All Gain: The Case for Farming Organs in Brainless Humans - Journal of Medical Ethics blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/","og_locale":"en_US","og_type":"article","og_title":"No Pain, All Gain: The Case for Farming Organs in Brainless Humans - Journal of Medical Ethics blog","og_description":"Guest post by Ruth Stirton, University of Sussex (@RuthStirton) and David Lawrence, Newcastle University (@Biojammer) It is widely acknowledged that there is a nationwide shortage of organs for transplantation purposes.\u00a0 In 2016, 400 people died whilst on the organ waiting list.\u00a0 Asking for donors is not working fast enough.\u00a0 We should explore all avenues to [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/","og_site_name":"Journal of Medical Ethics blog","article_published_time":"2017-06-10T15:27:44+00:00","author":"BMJ","twitter_card":"summary_large_image","twitter_misc":{"Written by":"BMJ","Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"No Pain, All Gain: The Case for Farming Organs in Brainless Humans","datePublished":"2017-06-10T15:27:44+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/"},"wordCount":1432,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"keywords":["Enhancement","Research"],"articleSection":["Curios","Genetic jiggerypokery","Guest Post","Life and Death","Organ donation","Philosophy","The Art of Medicine","The NHS","Thinking Aloud","Transplantation","WTF?"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/","name":"No Pain, All Gain: The Case for Farming Organs in Brainless Humans - Journal of Medical Ethics blog","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website"},"datePublished":"2017-06-10T15:27:44+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2017\/06\/10\/no-pain-all-gain-the-case-for-farming-organs-in-brainless-humans\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/medical-ethics\/"},{"@type":"ListItem","position":2,"name":"No Pain, All Gain: The Case for Farming Organs in Brainless Humans"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","name":"Journal of Medical Ethics blog","description":"A blog to discuss the ethics of medicine in its many guises and formats.","publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/medical-ethics\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization","name":"Journal of Medical Ethics blog","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","contentUrl":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","width":200,"height":50,"caption":"Journal of Medical Ethics blog"},"image":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/medical-ethics\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/3177","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/comments?post=3177"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/3177\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/media?parent=3177"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/categories?post=3177"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/tags?post=3177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}