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Authors: Françoise Baylis, University Research Professor, Philosophy, Dalhousie University and Andrew Fenton, Associate Professor, Philosophy, Dalhousie University
At the end of 2021, 57-year-old David Bennett Sr. was bedridden and was suffering from irreversible heart failure. He was not eligible for a human heart transplant or an implanted mechanical heart pump due to his underlying health condition, allegedly having a “history of ignoring medical advice”.
There was certain death on the horizon, and this fatal prognosis made Bennett a candidate for an unprecedented, experimental surgical procedure that involves transplanting a heart from a genetically modified pig.
A pig-to-human heart transplant – or organ transplant – was approved by the US Food and Drug Administration for humanitarian reasons on New Year’s Eve 2021 and the surgery was performed on January 7, 2022.
Initial reports following the experimental surgery indicated that the genetically modified, humanized pig heart was functioning well and infection was not a problem.
Bennett died on March 8 – at the time, “no clear cause” of death has been established. Now, it has been reported that the pig’s heart was infected with a virus called porcine cytomegalovirus and that this virus may have contributed to Bennett’s death.
Although the cause of death remains unclear, infection has been implicated in previous xenotransplant failures that included a baboon as recipient.
Ask more than bid
There is an ongoing chronic shortage of suitable human organs for life-saving transplantation. In fact, many Canadian transplant candidates die while waiting for organ donation.
Attempts to increase the limited supply of human organs have included changes to consent rules: the transition to a withdrawal system, the introduction of direct live donation and chains initiated by deceased donors, and, in some countries, the introduction of monetary compensation.
However, patients die on transplant waiting lists. For this reason, there is an ever-increasing interest in organ transplantation – an ethically controversial practice.
Non-human primates and pigs
In 1984, a baby monkey’s heart was transplanted into Baby Fae, an infant born with a fatal heart defect called hypoplastic left heart syndrome. Baby Fei lived for three weeks, but eventually died of heart failure caused by rejection of a transplanted baboon’s heart.
Prior to this, there had been three experimental non-human heart transplants, the oldest in 1964 using a chimpanzee heart.
Recent efforts in organ transplantation have involved transplanting pig kidneys into brain-dead humans. However, the most dramatic recent example remains the first Bennett heart transplant in humans using a genetically modified pig heart.
For some, using pig hearts for transplants may be more ethical than using hearts from non-human primates because pigs are already used in medicine: pig heart valves, corneas, and skin, for example, are used in various treatments.
Or it could be that pigs prefer “organ donors” because they are already used for food. When it comes to food animals—those that humans consume—people can be biased against a strictly subjective view of the animal. This is referred to as the ‘meat paradox’, in which people view food animals as ‘things and thus avoid the discomfort of knowing the suffering behind consumer goods’.
The third reason to prefer killing pigs for the benefit of humans rather than killing non-human primates is that pigs are biologically less similar to humans.
Giving priority to people
Moral value—the value given to others in ways that affect how we treat them—is not specific to species. Rather, it is associated with specific abilities such as the ability to think, choose, experience pain, communicate, and socialize.
Since the human zygote lacks such abilities, not many believe they have the same moral value as a two-year-old human, and there is nothing distinctly irrational about this belief. Although the zygote may have the potential to reach a similar level of development as a two-year-old baby, it is not yet comparable. Their common human identity is off topic.
Sometimes, humans may choose to prioritize the interests of their companion animals without doing something clearly wrong. For example, it does not make sense to spend money on pet care, even if this money could be dedicated to helping our fellow human beings. This choice may reflect a shared social relationship and the emotional connections that come with it. It may also reflect a sense of duty to non-human animals that depend on the care provided by humans.
Having said that, there are clearly times when it is appropriate to prioritize the interests of humans over other animals; It’s just that this perspective shouldn’t be the default. In any case, it’s not clear, nor is it easy to determine whether Bennett’s unusual organ transplant falls into this category.
In Canada, support for animal-based research rests on a commitment to prevent – or at least reduce – unnecessary suffering. The problem with this position is that current animal welfare considerations do not usually support strong limitations on the scientific use of animals.
Notably, there is pressure to reduce, but not eliminate, the use of animals in research that is likely to have severe impacts on well-being. Also, common animal welfare considerations do not prohibit the killing of animals, they only restrict how they are killed.
Part of the problem here is that there are no objective ethical principles governing animal use in science. The three Rs, prevalent in structured animal use in science, emphasize the replacement of conscious animals (animals capable of feeling pain and pleasure) where possible, reducing the number of conscious animals used in studies to a “minimum” and revising their experiences in use to reduce suffering.
As such, the three rupees seem to assume something like a principled commitment not to offend – to avoid unnecessary harm. However, the continued reliance on harmful animal-based research that almost always ends in killing animals belies this claim, given the significant problems known to extrapolate the research findings.
Given the ethical challenges in animal-based research in general and the ethical challenges more specifically with animal-to-human organ transplantation, there is good reason to look for other strategies to increase the supply of organs for transplantation.
Andrew Fenton is a member of the (Canadian) Association for the Humanities and currently serves on a subcommittee of the Canadian Council on Animal Welfare (Review of the Basic Ethics Document) and a committee on non-human primate research for the National Anti-Anatomy Society.
Francoise Baylis does not work for, consult with, own or receive funding from any company or organization, and has not disclosed any relevant affiliations after her academic appointment.
This article has been republished from The Conversation under a Creative Commons license. Disclosure information is available on the original website. Read the original article: https://theconversation.com/pig-human-transplants-may-be-a-misguided https://theconversation.com/pig-human-transpl