Personalized 3D printed scaffolds: The ethical aspects. 2023

Manon van Daal, and Anne-Floor J de Kanter, and Annelien L Bredenoord, and Nienke de Graeff
Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address: m.vandaal@umcutrecht.nl.

Personalized 3D printed scaffolds are a new generation of implants for tissue engineering and regenerative medicine purposes. Scaffolds support cell growth, providing an artificial extracellular matrix for tissue repair and regeneration and can biodegrade once cells have assumed their physiological and structural roles. The ethical challenges and opportunities of these implants should be mapped in parallel with the life cycle of the scaffold to assist their development and implementation in a responsible, safe, and ethically sound manner. This article provides an overview of these relevant ethical aspects. We identified nine themes which were linked to three stages of the life cycle of the scaffold: the development process, clinical testing, and the implementation process. The described ethical issues are related to good research and clinical practices, such as privacy issues concerning digitalization, first-in-human trials, responsibility and commercialization. At the same time, this article also creates awareness for underexplored ethical issues, such as irreversibility, embodiment and the ontological status of these scaffolds. Moreover, it exemplifies how to include gender in the ethical assessment of new technologies. These issues are important for responsible development and implementation of personalized 3D printed scaffolds and in need of more attention within the additive manufacturing and tissue engineering field. Moreover, the insights of this review reveal unresolved qualitative empirical and normative questions that could further deepen the understanding and co-creation of the ethical implications of this new generation of implants.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D054457 Tissue Scaffolds Cell growth support structures composed of BIOCOMPATIBLE MATERIALS. They are specially designed solid support matrices for cell attachment in TISSUE ENGINEERING and GUIDED TISSUE REGENERATION uses. Tissue Scaffolding,Scaffold, Tissue,Scaffolding, Tissue,Scaffoldings, Tissue,Scaffolds, Tissue,Tissue Scaffold,Tissue Scaffoldings
D023822 Tissue Engineering Generating tissue in vitro for clinical applications, such as replacing wounded tissues or impaired organs. The use of TISSUE SCAFFOLDING enables the generation of complex multi-layered tissues and tissue structures. Engineering, Tissue
D066330 Printing, Three-Dimensional Process for making, building or constructing a physical object from a three-dimensional digital model by laying down many successive thin layers of building material. 3-D Printing,3-Dimensional Printing,3D Printing,Three-Dimensional Printing,3 D Printing,3 Dimensional Printing,3-D Printings,3-Dimensional Printings,3D Printings,Printing, 3-D,Printing, 3-Dimensional,Printing, 3D,Printing, Three Dimensional,Printings, 3-D,Printings, 3-Dimensional,Printings, 3D,Printings, Three-Dimensional,Three Dimensional Printing,Three-Dimensional Printings

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