As bioethicists rushed to defend the need for xenotransplantation, they were mum on the ethics of creating a new category of animal farming: A standing reserve of genetically modified animals bred as repositories of organs for human use.
JAN DUTKIEWICZ: Humans and pigs share 98 percent of the same genes. Most of those similarities don’t matter—we share genes with a lot of animals. But a small number of specific similarities do: They make it possible to use porcine tissue for human ends. And with recent developments in gene editing technology, knocking down a few pesky genes that would otherwise cause the human immune system to reject foreign organs allows for the use of entire pig organs in human patients.
This process is called xenotransplantation, and on January 7 it saw a breakthrough when a team at the University of Maryland Medical Center in Baltimore successfully completed the first ever transplant of a genetically modified pig’s heart into a terminally ill human patient.
Celebration of this momentous occasion was quickly eclipsed by ethical debate about the procedure… As bioethicists rushed to defend this particular procedure, and the need for xenotransplantation more broadly, they were mum on the ethics of creating a new category of animal farming: a standing reserve of genetically modified animals bred as repositories of organs for human use…
Modern bioethics rests on four basic principles to determine whether a procedure is ethical: autonomy, justice, beneficence, and nonmaleficence. In short, this means that a medical procedure is considered to be ethical if the patient agrees to it of their own free will, they do not receive preferential treatment, and the procedure is conducted in good faith, meaning that doctors intend to help rather than harm their patient…
The transplant may be a watershed moment for a branch of medicine long plagued by supply issues. At any given moment, well over 100,000 people in the United States with severe organ disease languish on waiting lists for transplants. Those transplants require either living donors (kidney and liver donations can come from a live donor) or more likely dead donors (for hearts). Demand usually outstrips supply, and 17 people on average die every day waiting for organs that don’t arrive on time. This makes the prospect of a reliable and renewable source of organs appealing. The most renowned bioethicists in the country have gone so far as to claim, “There is no question that using pigs as organ sources is the future.”
There’s just one hitch: the pigs themselves. Assuming that pigs are the future of xenotransplantation assumes that there is no ethical problem with creating a new form of animal farming predicated on genetic modification and on-demand slaughter for spare parts. And yet a surprising number of medical professionals, bioethicisists, and the media covering xenotransplantation have been mum on the subject.
This attitude is best encapsulated by a comment the pathbreaking bioethicist Arthur Caplan made in an interview with The New York Times, while defending Bennett’s right to the surgery. “To be clear, he didn’t take a human organ from anybody,” Caplan told the Times. “Nobody died because this guy got a pig heart”… Xenotransplantation hinges on this foundational but silent assumption: that the lives of the animals used to produce organs do not matter, or at least that they matter much less than the human lives they might save. Scientific progress has long relied on the same assumption…
Ethically speaking, the use of animals for medical purposes is thorny. While eating animals prioritizes humans’ gustatory pleasure (your love for bacon) above animals’ interest in not experiencing pain or being killed, leading many ethicists to consider it unethical except in particular contexts, the medical question changes the stakes, weighing the life and suffering of both currently existing and future humans against the life and suffering of animals. If a medicine can save many humans, is it not worth killing some lab mice or beagles to get there? If pigs’ hearts can save people dying on organ waiting lists, is it not worth killing some pigs and baboons?…
On principle we accept the desirability of medical advances that will potentially save human lives. This is anthropocentrism—the view that humans have moral primacy above all other beings—and because we are human, it comes naturally to us. The problem with a pig organ transplant, however, is that it doesn’t rely on a simple ethical decision of whether any given pig’s life is worth less than that of any given human who needs a heart. Rather, it calls for the creation of a new type of farming and a new political economy of animal use.
The heart transplanted into Bennett was provided by a Virginia company called United Therapeutics, which is in the process of patenting its proprietary xenoheart, to be grown inside a population of pigs genetically modified specifically to create human-compatible organs. The issue here is less that a corporation is genetically engineering animals and patenting a new technology (although of course that matters) but rather that embracing xenotransplantation involves embracing the commodification, modification, and slaughter of animals on an unknown scale. This makes it a systemic question about the role of animals in our society…
In the wake of Bennett’s surgery, there will now be many questions, including about the ethics of genetic modification of animals and of future human clinical trials, about regulatory and policy frameworks for xenotransplantation, and about who gets these still experimental heart transplants. But there is one that should not be ignored: How can we work toward a medical system that doesn’t have to rely on the suffering and death of animals so that humans can thrive?…
Many, including many bioethicists, will shrug off this concern for animals as maudlin or perhaps even misanthropic, but if we take the bio in bioethics to mean concern with all of life and not simply human life, then the question of animal ethics becomes central to the morality of the entire enterprise. It should make us question our assumed supremacy over animals and seek alternatives that allow both humans and nonhumans to thrive. SOURCE…
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