Questions about xenotransplantation in ethical and religious literature
Ramiza Sharifova1, Boris Yaremin1, Abdel Hadi Al Breizat2, Michael Kaabak1.
1Transplantation Scientific Group, Reaviz Medical University, Moscow, Russian Federation; 2Jordanian Center of Organ Transplant Directorate, Ministry Of Health, Amman, Jordan
Transplantation allows you to confidently save the lives of previously doomed patients. The shortage of organ donors not only limits this undeniable achievement, but also raises a series of new ethical questions.We analyzed 102 sources of ethical and religious literature for 2000-2022 in order to isolate the main issues that arise around xenotransplantation. The main ones are the following.
Is it ethical to put humanity at risk by saving one person? The alleged xenotransplantation will lead to the creation of patients in whose bodies animal tissues and organs will live, a kind of xenochimer. A patient with animal organs may be more susceptible to the corresponding infections of these animals. In the body of such a xenochimeric patient, not only the virome inherent in humans will be present, but also in this animal. This transformation can pose a threat to the life of not only him alone, but the whole of humanity. Can we save one patient at the cost of risk to humanity?
Is it ethical to limit the civil rights of a xeno-recipient? This question follows from the previous one. Since the xenochimera poses an increased risk to others due to the possibility of the formation of new infectious threats in his body, it is expected to obtain an irrevocable obligation from this patient before transplantation. Such obligations are called the Ulysses Pact. Undoubtedly, the xeno-recipient will save his life at the cost of his civil rights and freedoms. Is it ethical?
Will xenotransplantation create another reason for discrimination? Apparently, humanity will not get rid of the principles of discrimination based on race, nationality, and gender for a long time. Won't xenotransplantation create a precedent when xenorecipients become the object of discrimination for fear of infection, prejudice, disgust?
Can the creation of xenochimeras be considered an unacceptable interference in the Divine plan from a religious point of view? According to the book of Genesis, animals and man were created on different days of creation and thus refer to different stages of the realization of the Divine plan. Nowhere in the Pentateuch, which postulates the predominance of man in relation to creation, is there any mention of the possibility of creating mixed chimeric organisms of man and animals. To what extent does such intervention in human nature meet the requirements of religious ethics?
Is it ethical to use higher animals for xenotransplantation? If any tools manage to minimize the risk of using monkey organs, the ethical problem will remain - to what extent does a person have a moral right to kill rather complexly organized living creatures with complex nervous activity in order to save the life of their species?
We believe that the emerging issues cannot be an obstacle to performing xenotransplantation. However, finding answers to them will increase the understanding and acceptance of this life-saving type of treatment by people of different cultures and beliefs.
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