A Calculated Taboo Break

Tens of thousands of animals are just kept and killed — to serve as a warehouse of spare parts for humans. Is that morally defensible? Absolutely. And it’s more common than many think.

It doesn’t take much to be a pig. Swine-inspired characteristics come to mind quickly when one demeans people. But pigs are clean, intelligent — and their organs are relatively similar to human ones. One swine has, at least provisionally, become a lucky charm for a 57-year-old American man who received its heart last week. In an eight-hour operation at the University of Maryland, he received the organ of a genetically modified pig as a transplant.

A pig heart beating in the chest of a human? That may cause some observers’ hearts to sink. After all, reservations about breaking such a barrier are great; the news might provoke rejection on ethical or moral grounds. But hasn’t breaking taboos long become a daily part of medicine and advanced so far that it was only a matter of time until a pig heart would be used in a transplant? As recently as September, a patient in New York received a kidney transplant from a pig.

In the 1960s, Monkey Hearts Were Already Being Transferred to Humans

It is worth taking a closer look at the moral aspects of this pioneering work in medicine. Transplanting animal organs into humans — a process called xenotransplantation in medical jargon — has been an ambitious project in medicine for decades. Attempts were made as early as the 1960s to use baboon kidneys; in the 1980s, “Baby Fae” received a baboon heart. The child, who had been born with a severe cardiac defect, died three weeks after the transplant. Until now, all experimental therapies have failed to prevent the foreign organ from being rejected after a short time; a reaction that can also occur after the transplantation of human organs. In the current case, experts tried to prevent this reaction by modifying multiple genes in the pig that would have made the human immune system more likely to reject the transplant.

Animals as warehouses for spare human parts, which, on top of that, are being genetically modified? Before the cries of outrage break loose, it is helpful to know that such moves are already common, even if on a smaller scale. Cardiac valves from pigs have been used for years in cardiology when human ones are failing. Millions of diabetics injected themselves with insulin from the pancreases of pigs and cattle until a genetically engineered hormone, which is easier for the human body to take up and easier to produce, brought some therapeutic relief.

The Heart Is the Seat of Love and Emotion — But It Is Just a Pressure Pump

But the cultural dimension plays a special role when transplanting a heart. Although the heart is, from a mechanical-reductionist perspective, just a pressure pump, the organ is considered the seat of love, emotion and temperament. Obviously, a person’s character and personality do not change if he or she receives a pig heart transplant. But the image raises strange connotations because for every sentient being, the heart is, well, a matter of the heart. Unlike heart valves or insulin that originate from animals, too, in the case of a complete heart, we are also dealing with a functioning organ, not just parts of one.

Whoever feels disgusted that animals are only being held, bred, genetically engineered and killed for medical purposes should not forget about industrial livestock farming. Millions of animals worldwide are held, bred — some also genetically engineered — and killed for human consumption. The medical use of animals is many times rarer. The need for organ transplants is calculated in the hundreds of thousands, whereas animals used for food products number in the millions and billions.

Animal well-being, human well-being — moral judgment should not be taken lightly, nor is it a question of dimension. Who, after all, completely avoids all animal products, does not eat them, does not use leather, down or feathers? Moreover, millions of pounds of meat from livestock are fed every year to pets that are just so cute.

And a therapeutic use? That would be a matter of great ethical good. The success of animal organ transplants remains questionable, however. American doctors can be accused, in the short term, of being motivated by fame and the novelty of experimenting to see what’s possible. If such calculated barrier-breaking proves useful, this may be acceptable as a welcome side effect, but it is in no way guaranteed. It is still unclear how long the patient with the pig heart will survive. Despite an arsenal of medications that are supposed to prevent the organ from being rejected, it is possible that his body will reject the foreign organ from a foreign species. The discomfort over a pig heart in a human chest remains. If it all goes well despite the risks, the patient may, in any case, always be told, you are one lucky pig.