Mandy Nguyen
vox.com
Originally posted 30 NOV 24
In 2022, surgeons transplanted the first genetically engineered pig heart into a human. Fifty-seven-year-old David Bennett, a patient with heart failure, survived almost two months with a pig heart beating in his chest, one of five people who have received pig organs as a part of an experimental procedure called xenotransplantation — the transplanting of living cells, tissues, or organs from one species to another.
Some scientists view these pig organs transplants as potentially lifesaving for many like Bennett.
In the US alone, more than 100,000 people are waiting for an organ transplant, and almost 20 people die every day because they can’t get one in time. But a major challenge remains in making xenotransplantation work: scientists haven’t figured out how to get a human body to accept a pig organ for very long. None of the five patients who received these pig organs have survived beyond two months, though researchers believe they’re making progress toward overcoming rejection and eventually moving to clinical trials.
This push to make pig organs viable for humans also comes with enormous ethical implications — from concerns surrounding the use of humans in an experimental procedure that they’re highly unlikely to survive, to the impacts on animals who are supplying the organs themselves. At first glance, the pursuit can feel like hubris. I wanted to better understand these questions, so I spoke with bioethicist L. Syd Johnson, author of a 2022 paper on the ethics of xenotransplantation, for Unexplainable, a Vox podcast that explores unanswered scientific questions. A portion of our conversation, edited for clarity, is included below.
Here are some thoughts:
The article explores the ethical complexities surrounding xenotransplantation, the experimental process of transplanting animal organs, particularly from genetically engineered pigs, into humans. This procedure is viewed as a potential solution to the critical shortage of human donor organs, with over 100,000 people in the U.S. waiting for transplants. However, its experimental nature raises significant challenges, including the body’s rejection of animal organs and the risk of zoonotic disease transmission. Ethical concerns extend to the welfare of the pigs, which are genetically modified and bred solely for organ harvesting. These animals are subjected to invasive procedures and kept in artificial environments, raising questions about the morality of such treatment of sentient beings.
Additionally, the process of obtaining informed consent from patients facing imminent death presents challenges. These patients may not fully grasp the experimental nature of the procedure or the low likelihood of its success, complicating the concept of voluntary and informed decision-making. The environmental impact is another concern, as scaling up xenotransplantation could exacerbate the harms associated with factory farming, such as resource intensiveness and ecological strain. Critics also question whether the significant resources invested in this technology might be better allocated toward preventive healthcare, lab-grown human organs, or therapies aimed at reducing organ failure.
These ethical issues are intertwined with broader questions of equity, sustainability, and opportunity costs. As xenotransplantation progresses, it risks deepening inequalities, as advanced procedures may be accessible only to wealthier individuals. Furthermore, the potential public health risks, such as zoonotic disease transmission, require careful consideration against the procedure’s potential benefits. Ultimately, the discussion calls for a reflective examination of the balance between innovation and ethical responsibility, ensuring that advancements in biotechnology align with principles of justice, compassion, and sustainability.
