This transcript has been edited for clarity.
Recently, a 20-year-old young woman underwent the first ear transplant, which is very exciting. Her own cells were used in a printer — kind of a dot printer, if you will — and layer by layer, they built up a living artificial ear that could accept circulation from her own body.
She had been born with a condition where her ears didn't develop. It was a wonderful cosmetic breakthrough, the first that I'm aware of using bioprinted organs to supplement or repair a body part. More of this is on the way.
I think we're going to see bioprinting start to move into the production of skin, or perhaps blood vessels. If you can think of things in the body that are simple fluids, not too complicated, or sheets of tissue, that's exactly where bioprinting is.
It's not yet quite to the point where we could see somebody print out a functioning heart. That's too complicated in terms of getting everything right so that it would work — although someday, but not soon. Same thing with a functional liver. Think about blood components, skin, or maybe the lining of the intestine.
There are areas where bioprinting, I think, holds much in store for the future of repair of damaged organs or birth defects. That's very exciting. I don't have much ethical objection about those uses. They sound wonderful. Things that we didn't know how to repair or couldn't do very well cosmetically, now we're seeing the bioprinter suddenly jump in and start to be used to manufacture body parts.
There is a weirder future coming. I haven't seen anybody write about it or comment on it, but I know it's coming. A person who can have an ear made to replace one that didn't develop when you were born is a person who could say, "I'm a big fan of Mr Spock on Star Trek." For those who don't know, Spock had very pointy, big ears.
They might say, "When I go to a convention, I want to get big, pointy ears. I want my ears modified so that I'll be a real Star Trek fan. I'll not only show up at the conventions, the meetings, and buy memorabilia, but also I'm going to make myself look more like Spock."
Where might that end? People could certainly say, "If you're making me an ear, why don't you make me green ears because that'll be cool. It'll match my hair color or other aesthetic, fashion, or cosmetic alterations that are in the offering."
A bioprinter that can make a human-like ear can make all kinds of ears. Some people would say, "Oh, that would be cool. I have tattoos, I have piercings. Now, I'd like to see some of this technology used to alter my body appearance, to alter my presentation to others, to make me part of a group, a club, a gang, an association, or whatever it is."
It's going to be up to us to say, "Here are the limits. This is what we will do. This is what we won't do." We wouldn't remove an organ to let you look different because that would be harm and danger and not worth it, so to speak, the aesthetic risk or to violate medical ethics to harm somebody — to remove something they didn't need removed and that was normal, just to replace it.
At the same time, someone may say, "I have birth defects or I suffered an injury. As long as we're doing this, can't we do something different?" That's going to be a place where professional societies, associations, and doctors are going to have to step in and say, "This is what we will do for money. This is what we won't do."
It's a very interesting line. When most of us think about the future of improvement or enhancement, we tend to think about drugs. We tend to think about steroids or growth hormone or things that people take to make themselves stronger or faster or grow taller. Bioprinting is absolutely an area where we're going to have debates and disputes about how to apply it, how far to take it, and where it ought to go.
It's one thing to repair a missing ear. It's a very different thing to say, "I want to change all my facial features, remove what I have, and rebuild them. They work very well, but I just don't want to look the way I look now."
I don't know where that debate will end, but I am absolutely certain it's coming.
I'm Art Caplan at the Division of Medical Ethics at New York University's Grossman School of Medicine. Thanks for watching.
Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.
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Cite this: Arthur L. Caplan. Will 'Bioprinting' Body Parts Lead To Crazy Cosmetic Requests? - Medscape - Jul 20, 2022.