Those who followed Euronews this week would have heard of the development of cells to replace blood. This means that, in the hopefully near future, we would be able to produce blood ‘synthetically’ and solve the problem of blood banks, which are always calling for blood donations.

Granted that one is removing an altruistic form of behaviour known only in humans; and granted perhaps that some Maltese workers would not be able to take the day off because they want to donate blood, the true problem with blood banking is that it has to work on the basis of a ‘bank’; once blood moves out it has to be replaced.

If we can synthesise biological tissue in the laboratory then we can solve many problems where resources are scarce. Imagine having all the blood available in case of disaster situations.

We have already experienced this on the levels of pharmaceutical drugs. Most drugs today are synthetic. What this actually means often is that the natural product is taken and modified in a way either to make it more available to the body or to reduce its side effects. Many drugs can also be produced almost completely synthetically.

However doom-day people always exist; this does not mean we should not heed the ethics and the danger of knowledge. Just as people often continue to speak of ‘natural’ drugs (we often hear the word ‘herbal’ – as if by herbal we mean that it can do no harm), there may come a day when these blessings for some are seen as a tragedy for others and some people may request ‘normal’ blood rather than synthetic blood; even worse, some hospital may boast of giving natural blood only.

Of course there are compelling reasons why not to give natural blood besides the availability – blood can transmit microbes and diseases not yet understood, even though it is screened. But before the advent of AIDS, we used to screen blood as well. Yet we did not know it existed and some who receive transfusion got the illness. There is also however the problem of rejection. If we can have a synthetic blood which avoids rejection, imagine the reduced costs in tests for compatibility etc.

However, science does legitimately elicit fears. Some may say that new biological entities can be invented somewhere in a garage and used for biological warfare. With people like Gaddafi still roaming and threatening the world, funding for this malicious use is readily found. Yet should this be a reason why not to allow science to progress?

The European Union has already issued several reports on the possible use and precautions of such a technology. This is not the only testimony of the fear this technology is eliciting. Scientific American recently also carried an essay on this ‘ability to make life from scratch, with the potential consequences both good and bad’. The essay goes on to explain how what happened just ten years ago in gene sequencing is already the stone-age for the advancements genetics has made. We can now insert synthetic gene sequences into cells which will make these cells produce a different kind of protein which they usually would produce. It is like having the software of a computer creating its own hardware.

The essay however points out many important areas of application – from creating micro-organisms which degrade the toxic waste products we are throwing into the environment to organisms which can create biofuel and also to organisms which can ‘strategically’ attack cancer cells. Of course the downside is the bioterrorism mentioned.

It is good to anticipate problems which may happen. At present the biology is so advanced that terrorists will probably have no idea of how to access it. In time however one must also devise policing methods to minimize risks and maximize benefits. For the time-being, the production of blood sounds enticing…at least to me.

Pierre Mallia is Associate Professor in Family Medicine, Patients’ Rights and Bioethics at the University of Malta; he is also Ethics Advisor to the Medical Council of Malta. He is also former president of the Malta College of

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