PubMed2003
Xenotransplantation is a question of "ethics between man and animal". Because those affected in different ways by xenotransplantation (patients, relatives, medical doctors, laypeople) have different perceptions, "foreign" perspectives must be consciously considered next to one's own perspective in the ethical judgement. As xenotransplantation is still at the stage of preclinical research, this special opportunity for an early public ethical discussion should be taken. According to biblical teaching, man is responsible for his fellows before God, therefore every decision of a patient (or a doctor) in favour of a xenotransplantation made without consideration of the social environment or the society as a whole cannot be ethically justified. From the Jewish-Christian point of view, the "innate value of man's fellow creatures" should be considered. What happens to the animals used for research into transplantation may not simply "vanish" before the vision of a successful xenotransplantation. What man's responsibility to creatures should prevent commonly happens: animals are exploited as instruments or treated as objects to reach human goals, they are perceived only as their utility value. We humans, with God's biblical mandate for our fellow creatures, must remember that the unavoidable weighing up between the (proposed) welfare of man and the welfare of animals should not be decided to the detriment of the animals too easily. The effects of medical technological possibilities on the conception of man and on our value system show themselves in a special way in xenotransplantation. Are the hopes set in xenotransplantation an expression of a mechanistic understanding of the human body and a conception of man that blends out the mortality and imperfection of human life? Focussing on human-ethical aspects leads to the neglect of the animal-ethical aspects by some Protestant ethicists. However, it is necessary to forego at least extremely severe animal experiments and so also to do without the possible gain of knowledge, i.e. to consciously limit research interests for ethical reasons. The tendency towards the reduction of animal experiments should not be reverted by research into xenotransplantation. The ethical evaluation of xenotransplantation should also consider whether economic interests are placed above the welfare of humans and animals, thus supporting questionable research processes. Justice and partisanship for the disadvantaged is a central aspect of biblical tradition. The problem in deciding what is fair in xenotransplantation is multifaceted: How can fair allocation of organs be ensured when both animal and human organs are available at the same time? What effects will this medical technology have on the distribution of the (limited) resources on the national health system? And finally: can such a cost-intensive technology helping only a few be justified in the light of the lack of basic medical care in the poor regions of the earth? A technology which many experts warn will result in the opposite of the original goal, i.e. reduction of the lack of organs.