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

Photo: Getty
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The vitriol aimed at Hillary Clinton shows the fragility of women's half-won freedom

The more I understand about the way the world treats women, the more I feel the terror of it coming for me.

I’m worried about my age. I’m 36. There’s a line between my eyebrows that’s been making itself known for about the last six years. Every time I see a picture of myself, I automatically seek out the crease. One nick of Botox could probably get rid of it. Has my skin lost its smoothness and glow?

My bathroom shelf has gone from “busy” to “cluttered” lately with things designed to plump, purify and resurface. It’s all very pleasant, but there’s something desperate I know at the bottom of it: I don’t want to look my age.

You might think that being a feminist would help when it comes to doing battle with the beauty myth, but I don’t know if it has. The more I understand about the way the world treats women – and especially older women – the more I feel the terror of it coming for me. Look at the reaction to Hillary Clinton’s book. Too soon. Can’t she go quietly. Why won’t she own her mistakes.

Well Bernie Sanders put a book out the week after the presidential election – an election Clinton has said Sanders did not fully back her in –  and no one said “too soon” about that. (Side note: when it comes to not owning mistakes, Sanders’s Our Revolution deserves a category all to itself, being as how the entire thing was written under the erroneous impression that Clinton, not Trump, would be president.) Al Gore parlayed his loss into a ceaseless tour of activism with An Inconvenient Truth, and everyone seems fine with that. John McCain – Christ, everyone loves John McCain now.

But Hillary? Something about Hillary just makes people want to tell her to STFU. As Mrs Merton might have asked: “What is it that repulses you so much about the first female candidate for US president?” Too emotional, too robotic, too radical, too conservative, too feminist, too patriarchal – Hillary has been called all these things, and all it really means is she’s too female.

How many women can dance on the head of pin? None, that’s the point: give them a millimetre of space to stand in and shake your head sadly as one by one they fall off. Oh dear. Not this woman. Maybe the next one.

It’s in that last bit that that confidence racket being worked on women really tells: maybe the next one. And maybe the next one could be you! If you do everything right, condemn all the mistakes of the women before you (and condemn the women themselves too), then maybe you’ll be the one standing tippy-toe on the miniscule territory that women are permitted. I’m angry with the men who engage in Clinton-bashing. With the women, it’s something else. Sadness. Pity, maybe. You think they’ll let it be you. You think you’ve found the Right Kind of Feminism. But you haven’t and you never will, because it doesn’t exist.

Still, who wouldn’t want to be the Right Kind of Feminist when there are so many ready lessons on what happens to the Wrong Kind of Feminist. The wrong kind of feminist, now, is the kind of feminist who thinks men have no right to lease women by the fuck (the “sex worker exclusionary radical feminist”, or SWERF) or the kind of feminist who thinks gender is a repressive social construct (rechristened the “trans exclusionary radical feminist”, or TERF).

Hillary Clinton, who has said that prostitution is “demeaning to women” – because it absolutely is demeaning to treat sexual access to women as a tradeable commodity – got attacked from the left as a SWERF. Her pre-election promises suggest that she would probably have continued the Obama administration’s sloppy reinterpretation of sex discrimination protections as gender identity protections, so not a TERF. Even so, one of the charges against her from those who considered her not radical enough was that she was a “rich, white, cis lady.” Linger over that. Savour its absurdity. Because what it means is: I won’t be excited about a woman presidential candidate who was born female.

This year was the 50th anniversary of the partial decriminalisation of homosexuality, and of the Abortion Act. One of these was met with seasons of celebratory programming; one, barely mentioned at all. (I took part in a radio documentary about “men’s emotional experiences of abortion”, where I made the apparently radical point that abortion is actually something that principally affects women.) No surprise that the landmark benefiting women was the one that got ignored. Because women don’t get to have history.

That urge to shuffle women off the stage – troublesome women, complicated women, brilliant women – means that female achievements are wiped of all significance as soon as they’re made. The second wave was “problematic”, so better not to expose yourself to Dworkin, Raymond, Lorde, Millett, the Combahee River Collective, Firestone or de Beauvoir (except for that one line that everyone misquotes as if it means that sex is of no significance). Call them SWERFs and TERFs and leave the books unread. Hillary Clinton “wasn’t perfect”, so don’t listen to anything she has to say based on her vast and unique experience of government and politics: just deride, deride, deride.

Maybe, if you’re a woman, you’ll be able to deride her hard enough to show you deserve what she didn’t. But you’ll still have feminine obsolescence yawning in your future. Even if you can’t admit it – because, as Katrine Marçal has pointed out in Who Cooked Adam Smith’s Dinner?, our entire economy is predicated on discounting women’s work – you’ll need the politics of women who analysed and understood their situation as women. You’ll still be a woman, like the women who came before us, to whom we owe the impossible debt of our half-won freedom.

In the summer of 2016, a radio interviewer asked me whether women should be grateful to Clinton. At the time, I said no: we should be respectful, but what I wanted was a future where women could take their place in the world for granted. What nonsense. We should be laying down armfuls of flowers for our foremothers every day.

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.