Pig heart transplant sparks controversy

On the 7th of January 2022, 57-year-old David Bennett received a transplant of a genetically modified pig’s heart, the first operation of its kind. In the following days, the transplant was widely hailed a ‘success’ by news outlets, with reporters and medical professionals alike praising it as a huge step forward for organ transplantation. However, as the story unfolded, animal rights organisations responded and news of the recipient’s background broke, questions were raised over the ethical minefield that is the use of animal organs for human transplants. Is this transplant 2022’s first great medical advancement or its first unethical experiment?

“It was either die, or do this transplant”

– David Bennett, as reported by the BBC

The Transplant

David Bennett, the transplant recipient, had arrhythmia and was attached to a heart-lung bypass machine pre-surgery. He was deemed ineligible to be placed on the human transplant waitlist, as he was too sick and would be unlikely to survive the surgery. He was out of options until an experimental procedure using a genetically modified pig’s heart was suggested by one of his doctors, as a last-ditch attempt to save his life.

“I know it’s a shot in the dark, but it’s my last choice”

– David Bennett, as reported by the BBC

Transplanting an animal organ into a human, officially known as xenotransplantation, has never successfully been done, although previous attempts have been made. In 1994 a baboon’s heart was transplanted into a baby girl, who died 21 days later, while in October 2021 a pig’s kidney was successfully transplanted into a human, although the recipient was already brain dead. But with 17 people dying every day in the United States while waiting for organ transplants, many are wondering, what’s there to lose?

It’s a ‘no’ from the animal activists

In the wake of the news of this transplant, widespread outrage from the animal rights community followed. Both PETA and Animal Aid, a UK-based animal rights group, condemned the use of an animal’s organ, declaring the operation ‘unethical‘ and ‘a waste of resources‘ . They argue that breeding and raising animals just to be killed for human use is wrong, especially as it is unknown how painful and harmful the procedure to genetically modify the heart is. This is of particular concern as pigs are believed to be highly sentient and intelligent beings, so much so that, according to another animal rights group, they are the fifth most intelligent animal. This leaves us to question whether is it ethical to breed and kill animals in the name of potentially saving human life?

A religious dilemma

Questions have also been raised over the religious ramifications of using an animal organ, particularly pig organs, for transplantation. In many religions, including in Judaism and Islam, it is forbidden to breed or consume pigs. As xenotransplantation is a novel concept, there is no precedent for it within religious organisations, with many people wondering if accepting an animal organ for transplantation would be permitted.

In response a senior rabbi and member of the UK’s Moral and Ethical Advisory group, Dr Moshe Freedman, declared that being a recipient of a pig’s heart is acceptable, as it is for the preservation of human life and does not violate Jewish dietary laws. Several Islamic organisations have responded similarly.

“But I wish, in my opinion, it had gone to a deserving recipient”

– Leslie Shumaker Downey,   as reported by the Washington Post

To pick and choose

In the wake of the reveal of the recipient’s identity, it was reported that Bennett is a convicted criminal who received a ten year sentence after stabbing a man in 1988. This raised questions as to whether Bennett was a suitable choice for such a ground-breaking procedure. The victim’s sister, Leslie Shumaker Downey, criticised the hailing of her brother’s attacker as a hero, wishing the transplant had been performed on “a deserving recipient”.

However, many others argue that Bennett’s history is irrelevant. Medical ethics is built on the foundation that everybody is entitled to equal and fair medical treatment, regardless of background. Convicted criminals, including those currently serving a sentence in prison, cannot legally be excluded from the organ transplant waitlist. Furthermore, a criminal conviction cannot be used as a factor to argue in favour of a person being placed further down the list. Bennett’s conviction was not a factor in his ineligibility for the waitlist, and should not be a factor that excludes him from receiving experimental medical treatment.

This novel surgery may pave the way for new treatments and could one day save the lives of thousands of people, but so far it has only raised more questions than it has answered.