There are approximately 120,000 Americans on the organ transplant waiting list, about as many people as live in Charleston, South Carolina and Hartford, Connecticut. Many of these people’s lives will ultimately be saved, after long and harrowing waits—as former Vice President Dick Cheney’s was. But others on the list will die before their turn comes up and a suitable donor is found.
These tragic deaths are putting increasing pressure on organ transplant ethics. Some “jump the queue” and travel to China to buy organs—many of which come from executed political prisoners. Others pay destitute people in developing countries for a kidney; this exploitation of the desperate poor became so rampant that Pakistan outlawed live organ donations to non-relatives and the Philippines banned organ transplant surgeries for non-citizens. Here in the U.S., public intellectuals such as Sally Satel of the American Enterprise Institute—who received a kidney from a live donor—argue for changing the law to permit organ sales. Of course, people in Satel’s socioeconomic class would never be the sellers.
Meanwhile, many bioethicists argue that we should eliminate the “dead donor rule” that requires donors of vital organs to be deceased before procurement. If these advocates get their way, doctors will be allowed to euthanize seriously incapacitated patients by means of organ harvesting.
Fortunately, organ transplant medicine remains a highly ethical enterprise (although some believe that using brain death to determine readiness for organ procurement is highly questionable). But the waiting lists continue to grow, a fact measured in sleepless nights of desperation and the tragedy of avoidable deaths. This is why the news that scientists have made progress in genetically altering pigs to use in human organ transplantation is so exciting.
Specifically, scientists are learning to alter pig organs to avoid tissue rejection when the organs are transplanted and, more recently, have used a gene-editing technique to help prevent interspecies infections. From the New York Times story:
In a striking advance that helps open the door to organ transplants from animals, researchers have created gene-edited piglets cleansed of viruses that might cause disease in humans.
The experiments, reported on Thursday in the journal Science, may make it possible one day to transplant livers, hearts and other organs from pigs into humans, a hope that experts had all but given up.
Some might feel squeamish at having an animal organ implanted into their bodies. But if the choice is between death and receiving a pig kidney, most would take the kidney. And why not? Animal body parts are already transplanted into humans—for example, pig heart valves. If it is acceptable to receive part of an animal organ to save human life, why not the entire thing?
Still, some would certainly object. Utilitarian bioethicists such as Peter Singer might claim that killing pigs for their organs—while sparing cognitively disabled humans—would amount to unethical “speciesism,” because it would treat humans as having greater value than pigs, based solely on their humanity. Singer rejects human exceptionalism, arguing that an individual—whether animal or human—earns the moral status of “person” based on the individual’s mental capacities. “Non-persons”—again, whether human or animal—have lesser value and may be used for the benefit of persons. In this view, since pigs have greater mental capacities than people with, say, the capacities of a Terri Schiavo, cognitively disabled humans should be used as organ sources before pigs. (Singer has specifically argued that people in a persistent vegetative state should have been used in creating the hepatitis vaccine instead of chimpanzees.) If we ever accept such a philosophy, it will mark the end of universal human rights, since human non-persons could be exploited and killed for the benefit of persons.
The loudest wailing over pig-organ “donation” will undoubtedly come from animal rights activists. Animal rights ideology (which must be distinguished from animal welfare) holds that the capacity to suffer—sometimes called “painience”—is the proper measure of moral value. Since both animals and humans experience pain, they are morally equal. Hence, raising and killing pigs for their organs would be equivalent to killing racial minorities for the same purpose.
That is nonsense. Racism is an invidious evil because it treats intrinsic equals—e.g., human beings—as if they were unequal. But there is a hierarchy of moral worth, with humans at the apex. Not only are pigs not our moral equals, but they cannot possess rights, since they are inherently incapable of assuming duties. It would not be wrong to raise these animals to save human lives. Assuming the safety issue is solved, it would be immoral not to.
This does not mean that the “grim good” of using pig organs would have to be a permanent policy. We must hope that an even more ethical means of supplying organs will be developed, one that would obviate the need to use sentient animals. Scientists have already learned how to change our skin cells into stem cells, and from there into particular organ tissue. Research is advancing on using these “induced pluripotent stem cells” to repair damaged hearts and lungs, with hope that some day this technology might even be harnessed to grow new organs from a patient’s own flesh.
Should that hoped-for day arrive, there will be no further moral justification for using pigs for organs—any more than it is currently justifiable to hunt whales for their oil. Then we could stop the pig organ harvest and resume arguing about the ethics of eating bacon.