Dr. Bartley P. Griffith surgically transplanted the pig heart into the terminal heart disease patient David Bennett. (Image supplied by the University of Maryland School of Medicine)
News of a successful organ transplant transferring a pig’s heart into a human is a fine example of the advances made in medicine and science.
It also raises important questions covering bioethics, religion, law, and governance.
Xenotransplants are procedures involving the transfer of an organ from one species into the body of a different one.
Since research in this specialist medical field started, there has been a level of controversy. Some claim it is abhorrent, while others see the capacity for an effective healthcare program.
Saving human life is paramount in Islam. The religion teaches followers to respect life since the soul enters the embryo’s body until our last breath. It is a religious and professional duty to save a person’s life whenever possible and appropriate.
Islam also mandates that humans deal with animals with care, tenderness, and respect while forbidding cruelty. Based on the principle of EHSAN (charity), Muslims must avoid the suffering of animals.
The teaching further forbids causing psychological harm to animals, such as slaughtering one in front of another. There are, of course, well-known strict processes related to killing animals. Hunting for food is allowed but never for recreational activities.
The Islamic faith mandates the upholding of animal rights and has created a balance between protecting animals against a human’s right to benefit from them. There are also clear directions for helping animals aside from being a food source.
The crucial term here is balance, a balance of rights, benefits, risks, and potential harms of using animals for medical purposes.
There are two Islamic rules to justify xenotransplantation in life-saving situations. The first is that “necessities allow prohibitions,” while the second indicates that “necessities are estimated according to the need.”
When there is a need and all other possible solutions have been exhausted, then – from a medical ethics point of view – it is justifiable and acceptable to prevent harm and preserve life through such a procedure using a pig’s organs.
An example of “necessities permit prohibitions” is the permission of abortion within a specific timeframe and when the pregnancy threatens the mother’s life.
In short, Islamic ruling deems strict prohibition of eating the animal, but not for other potential needs.
Using animals in laboratory research and animal experiments is viewed by the public as necessary and acceptable, but using animals to harvest organs for humans remains taboo.
Choosing pigs over other animals for these types of procedures is based on the similarity of the animal’s organs with those in humans. The pigs used for organ donations are bred and raised in unique controlled environments. In medicine, blood thinners and heart valves include pig products.
The entire world was stunned by the successful xenotransplant breakthrough conducted by clinicians from the University of Maryland medicine school, and the campus’s medical center.
Everyone agrees that this was a hazardous surgery, and before proceeding, the medical team must exhaust all possible approved treatments.
After eliminating all possibilities and following ethical practice in such a radical experiment, the doctor must fully inform the patient of the facts related to this kind of treatment. All risks and estimated success and failure rates are known, including a full spectrum of criteria ranging from immediate death to monitoring a functional person living with a pig’s heart.
Like any other patient receiving surgery, the person must acquire capacity, apprehend, and discuss all provided information to consent properly.
In this breakthrough, ten modified genes allowed the pig’s heart not to be rejected by the human body. Decades of lab experiments were performed to reach this level of scientific confidence in gene editing.
The radical experiment was justified because the patient would have died without the xenotransplant and had no other options to receive a human heart or live on mechanical heart support.
There are several benefits for xenotransplants, including increasing the organ pool, transplant surgery that will not cover emergency medical operations, and better organ quality than non-heart-beating donors.
With the collaboration between science and medicine, xenotransplants might end the suffering of thousands of patients awaiting an organ and increase the organ pool along with non-heart-beating donors and living donors.
With all the pros of using pig organs in life-saving operations, we still lack a lot of knowledge about the long-term success rates of xenotransplants and potential future complications that might arise for the patient.
The most important thing is to enact a regulatory framework that can respect the teachings found in different religions to guide ethical xenotransplants.
The article first appeared in Al-Arabiya