Medical futurology is no excuse for the UK's organ failures

A mouse with a human liver is extraordinary indeed, but we should do better with what science has provided.

We can create a mouse with a human liver. So, no longer any need to face up to the tricky subject of organ donation, right? Wrong. One of the dangers of such achievements is that we begin to think that a solution to the organ crisis is just around the corner.

The Japanese mouse-human chimera involved taking adult stem cells from human skin and chemically inducing them to return to their “pluripotent” state, where they can become any kind of cell. Further treatment guided them to take the form of liver cells, which were then grafted into the mouse. There, they connected to the blood vessels and formed into a functioning human liver.

The work built on an idea first put forward by the US geneticists Tim Townes and Thomas Ryan in 2000. They spotted that knocking out certain genes and inserting genetic material from an afflicted patient allowed you to rear an animal whose heart, liver, pancreas or blood or skin cells were human – that were genetically matched to the recipient and were in every way perfect for transplantation.

By coincidence, Townes and Ryan submitted their patent application on the day after Sally Slater was discharged from a hospital in Newcastle. Slater, aged six, had undergone an emergency heart transplant after a virus attacked her cardiac tissue. Her donor was a recently deceased, middle-aged woman whose family came forward to help after Slater’s father issued an emotional appeal through the national media.

Every year in the UK, a hundred or so families go the other way and overrule the wishes of a deceased relative who had wanted to donate his or her organs. In the decade that it might take for the Japanese success to make any headway into patient treatment, more than a thousand families could dash the hopes of the desperately ill. That’s in this country alone, where more than 7,000 people are waiting for transplants. A thousand of them will die this year because of a lack of organs. Slater, now a thriving 19-year-old with a 62-year-old heart, has been vocal and active in drawing attention to the shortfall, encouraging more people to sign up for organ donation.

Things might get a little better after the 2 July decision by the Welsh Assembly to adopt “presumed consent” for organ donation. After 2015, people in Wales who don’t want their organs recycled will have to sign the opt-out register. Somewhat perversely, organs from Wales will be available to patients in the rest of the UK, which remains opt-in after a 2008 review concluded that opt-out was unlikely to increase the number of donated organs and risked reducing their availability IN THE FRAME by undermining trust in the medical profession.

Britain has one of the highest refusal rates in Europe, with half of all families denying organs if the deceased’s wishes are not known. In some ways this is understandable. It is only 45 years since the first UK liver transplant and 30 since our first heart-and-lung transplant. That is a very short time, in human terms, in which to contemplate changes to our death rituals.

Nonetheless, we should do better with what science has provided – regardless of what is coming. A mouse with a human liver is extraordinary indeed. But scientists have also made great strides in learning how to perform transplants, how to suppress the immune system’s rejection of foreign tissue and how to care for those who have gone through such traumatic procedures.

It would be a terrible shame if the advances of stem-cell research were to provide any further excuse for refusing to save a life.

Japanese scientists have grown human liver cells in mice. Photograph: Getty Images

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 15 July 2013 issue of the New Statesman, The New Machiavelli

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The UK press’s timid reaction to Brexit is in marked contrast to the satire unleashed on Trump

For the BBC, it seems, to question leaving the EU is to be unpatriotic.

Faced with arguably their biggest political-cum-constitutional ­crisis in half a century, the press on either side of the pond has reacted very differently. Confronting a president who, unlike many predecessors, does not merely covertly dislike the press but rages against its supposed mendacity as a purveyor of “fake news”, the fourth estate in the US has had a pretty successful first 150-odd days of the Trump era. The Washington Post has recovered its Watergate mojo – the bloodhound tenacity that brought down Richard Nixon. The Post’s investigations into links between the Kremlin and Donald Trump’s associates and appointees have yielded the scalp of the former security adviser Michael Flynn and led to Attorney General Jeff Sessions recusing himself from all inquiries into Trump-Russia contacts. Few imagine the story will end there.

Meanwhile, the New York Times has cast off its image as “the grey lady” and come out in sharper colours. Commenting on the James Comey memo in an editorial, the Times raised the possibility that Trump was trying to “obstruct justice”, and called on Washington lawmakers to “uphold the constitution”. Trump’s denunciations of the Times as “failing” have acted as commercial “rocket fuel” for the paper, according to its CEO, Mark Thompson: it gained an “astonishing” 308,000 net digital news subscriptions in the first quarter of 2017.

US-based broadcast organisations such as CNN and ABC, once considered slick or bland, have reacted to Trump’s bullying in forthright style. Political satire is thriving, led by Saturday Night Live, with its devastating impersonations of the president by Alec Baldwin and of his press secretary Sean Spicer by the brilliant Melissa McCarthy.

British press reaction to Brexit – an epic constitutional, political and economic mess-up that probably includes a mind-bogglingly destructive self-ejection from a single market and customs union that took decades to construct, a move pushed through by a far-right faction of the Tory party – has been much more muted. The situation is complicated by the cheerleading for Brexit by most of the British tabloids and the Daily Telegraph. There are stirrings of resistance, but even after an election in which Theresa May spectacularly failed to secure a mandate for her hard Brexit, there is a sense, though the criticism of her has been intense, of the media pussy-footing around a government in disarray – not properly interrogating those who still seem to promise that, in relation to Europe, we can have our cake and eat it.

This is especially the case with the BBC, a state broadcaster that proudly proclaims its independence from the government of the day, protected by the famous “arm’s-length” principle. In the case of Brexit, the BBC invoked its concept of “balance” to give equal airtime and weight to Leavers and Remainers. Fair enough, you might say, but according to the economist Simon Wren-Lewis, it ignored a “near-unanimous view among economists that Brexit would hurt the UK economy in the longer term”.

A similar view of “balance” in the past led the BBC to equate views of ­non-scientific climate contrarians, often linked to the fossil-fuel lobby, with those of leading climate scientists. Many BBC Remainer insiders still feel incensed by what they regard as BBC betrayal over Brexit. Although the referendum of 23 June 2016 said nothing about leaving the single market or the customs union, the Today presenter Justin Webb, in a recent interview with Stuart Rose, put it like this: “Staying in the single market, staying in the customs union – [Leave voters would say] you might as well not be leaving. That fundamental position is a matter of democracy.” For the BBC, it seems, to question Brexit is somehow to be unpatriotic.

You might think that an independent, pro-democratic press would question the attempted use of the arcane and archaic “royal prerogative” to enable the ­bypassing of parliament when it came to triggering Article 50, signalling the UK’s departure from the EU. But when the campaigner Gina Miller’s challenge to the government was upheld by the high court, the three ruling judges were attacked on the front page of the Daily Mail as “enemies of the people”. Thomas Jefferson wrote that he would rather have “newspapers without a government” than “a government without newspapers”. It’s a fair guess he wasn’t thinking of newspapers that would brand the judiciary as “enemies of the people”.

It does seem significant that the United States has a written constitution, encapsulating the separation and balance of powers, and explicitly designed by the Founding Fathers to protect the young republic against tyranny. When James Madison drafted the First Amendment he was clear that freedom of the press should be guaranteed to a much higher degree in the republic than it had been in the colonising power, where for centuries, after all, British monarchs and prime ministers have had no qualms about censoring an unruly media.

By contrast, the United Kingdom remains a hybrid of monarchy and democracy, with no explicit protection of press freedom other than the one provided by the common law. The national impulse to bend the knee before the sovereign, to obey and not question authority, remains strangely powerful in Britain, the land of Henry VIII as well as of George Orwell. That the United Kingdom has slipped 11 places in the World Press Freedom Index in the past four years, down to 40th, has rightly occasioned outrage. Yet, even more awkwardly, the United States is three places lower still, at 43rd. Freedom of the press may not be doing quite as well as we imagine in either country.

Harry Eyres is the author of Horace and Me: Life Lessons from an Ancient Poet (2013)

This article first appeared in the 20 July 2017 issue of the New Statesman, The new world disorder