by Dr. L. Syd M Johnson
As the availability of transplantable human organs continues to be a challenge, medical researchers have turned to taking the organs of individuals from other sentient species—especially from pigs. But what about the ethics for humans and animals of xenotransplantation?
In her article, Dr. L. Syd M Johnson, a philosopher, bioethicist, neuroethicist, and associate professor of Bioethics and Humanities, discusses the ethical tensions that arise in using the organs of other species.
Johnson begins with an overview of the history of xenotransplantation (XTx).
She then discusses the risks of zoonotic disease transmission, which are relevant both for individual patients, and as a public health risk.
As Johnson notes, someone who receives a xenotransplant is “potentially at risk for infection with infectious agents already known to be transmissible from animals to humans as well as with infectious agents which may become transmissible only through xenotransplantation and which may not be readily identified with current diagnostic tools. Infected xenograft recipients could then potentially transmit these infectious agents to their contacts and subsequently to the public at large.”
She says, “The risk of unleashing a new infectious disease on the world changes the stakes of XTx considerably, highlighting an important difference between allotransplantation and xenotransplantation.”
Johnson also discusses the importance of the rights of human research subjects, as anyone who received a xenotransplant would “be considered research subjects.” They and their close contacts (such as family members) might find their lives disrupted by research protocols, such as lifelong monitoring and strictures on their personal lives. Privacy and confidentiality could also be an issue.
Children who received xenotransplants, she notes, would, via their parents’ consent, be committed to “lifelong surveillance” and potential limitations on their future opportunities. As Johnson highlights, adult research participants would be required to waive their right to withdraw from research and surveillance. “Could parents/guardians waive that right for their children?”
Johnson also discusses the ethics of using nonhuman animals as sources of organs. As Johnson notes:
“The breeding, confinement, and slaughter of pigs for meat can cause significant suffering and harm, but it is also clear that the breeding, confinement, and killing of pigs to grow organs for XTx, or NHPs [nonhuman primates] for pig-to-primate XTx experiments, can result in different but no less harmful physical and psychological suffering.”
Johnson describes xenotransplantation as “the wrong solution to an urgent problem.”
Johnson, L. Syd M. “Existing Ethical Tensions in Xenotransplantation.” Cambridge Quarterly of Healthcare Ethics 31, no. 3 (6 June 2022): 355-67.
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