Analytical study on articular cartilage tissue engineering research : its ethico-legal aspects from Islamic perspective

Abstract

Degenerative joint disease has no known cure. Although this medical condition affects mostly the ageing population, joint injuries at a young age may accelerate the degeneration process. The existing pharmacological and surgical treatments alleviate symptomatic pain and help patients to remain active. Unfortunately, there is no single treatment that is able to address the root cause of the disease thoroughly. As an alternative, tissue engineering and regenerative medicine (TERM) method offer numerous options to treat joint diseases. There are growing demands for tissue-engineered medical products (TEMPs) worldwide, including Malaysia. However, based on a scoping review, scientific development and clinical translation activities for TEMPs are not progressing as they should be. These multitude limitations perhaps stemmed from many challenges in TERM practices ranging from scientific and technical issues, economic recession, social perplexities, as well as ethical and legal issues. This study aims to formulate an ethical and legal framework to facilitate both scientific and social progress of articular cartilage tissue engineering (ACTE) research in Malaysian context. A survey on the worldwide trend of ACTE research was conducted using a systematic search and through content analysis in formulating the framework. This ethical and legal framework is addressed from the Islamic perspective. A framework, with the benefits being weighed up against possible risks and harmful effects, should be the basis of the practices of ACTE research. Since both ethics and scientific knowledge play a role to determine the permissibility of ACTE research, this study uses both scientific as well as ethical and legal literature, so the two disciplines are bridged. It is so because the concerns made by the bioethicists in this matter are worthy. While scientific endeavours done by the researchers to improve the scientific knowledge in ACTE is also worthy, these two concerns are thus complementary, not contradictory to each other. Although the monitoring by responsible bodies such as governments, legislators, and scientific organisations is essential, it equally is the responsibility of a competent TERM professional to be morally aware when confronted with issues related to ACTE research. More intellectual and engaging deliberation on ACTE research should enter the domain of ongoing moral, ethical and legal education. The end goal of this effort is towards establishing a holistic healthcare management model for patients in the future.