Transplants Using Animal Organs Are Research, Not Lifesaving Efforts, According to Ethicist

This transcript has been edited for clarity. 

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at New York University (NYU) Grossman School of Medicine in New York City. 

Sadly, a patient who received a pig kidney about 7 or 8 weeks before his death passed away at the Massachusetts General Hospital at the age of 62. 

Richard Slayman was a volunteer. He was dying because he had exhausted his options for dialysis. He was not a candidate, being deemed too sick, for a human kidney transplant, so he wasn't somebody that was going to be listed. Massachusetts General Hospital basically asked the US Food and Drug Administration if they could try and save this gentleman using the pig kidney as a last-ditch effort to try and save his life.

There's certainly a future, I believe, for genetically engineered animal organs as a source to replace inadequate supplies of human organs. I certainly want to encourage patients, providers, everybody we come in contact with at church or civic organizations or mosques or synagogues, wherever, to sign up to be an organ donor. 

It is a very necessary thing. It's a very important thing. It's much in need of reinforcement by doctors and healthcare providers as a reminder that it's something that people should be thinking about, and something they can contribute to the community and really save lives and improve the quality of life for many, many people. 

All that said, we don't have enough organs — and we're not going to have enough organs — to transplant for those in need next week, next month, or even the rest of this year. Thus, we get to the genetically engineered pigs. We do some of that work at NYU. Obviously, it's going on in other places. 

One of the questions is, what's the right way to proceed at this point? Should we offer it to nearly dead individuals, people dying of heart failure and kidney failure, saying maybe we could put a pig heart or a pig kidney into you? Should we try to organize this a little bit differently — more as research or as a clinical trial than an emergency rescue, which I think carries a promise that's hard to deliver on? We're going to do this as a last-ditch effort to save your life. It's hard to imagine people saying no to that.

We are at the earliest stages of trying to figure out if this is going to work. If we use an engineered pig organ, will it be accepted? Will it be rejected? People are very sick when they get these organs, so are they healthy enough to survive even if the pig organ works? 

It's better to have protocols that are agreed upon by the centers that can do this in the earliest stages of pioneering this procedure. Then people know they're coming in as experimental subjects — not so much to get themselves rescued but as a way to contribute, as part of their dying, to what we know, what we understand, to make learning possible, and to go forward with this alternative source of organs from the pig. 

Now, there are obviously people out there who still say, I don't like the use of pigs. They're intelligent, sentient creatures, and I don't want that avenue pursued. I'm going to dismiss that objection here in the transplant space. I think sacrificing pigs live a healthy, nonsuffering existence. They're taken well care of before organs are removed from them and before they're killed because they don't want any diseases or stresses in these animals. This is not factory farming. 

I think that moral tradeoff makes sense. There are plenty of areas where it doesn't make sense to use animals in the way that we do, but I think this one is a defensible area. Still, moving forward with the idea that maybe we can save you, maybe we could rescue you, I think, is tough. 

The person who died at Mass General, Mr Slayman, did say, and his family said later, that they were proud that he could contribute to knowledge. They were proud that maybe the doctors learned and that the next patients would benefit from his, if you will, altruistic sacrifice. 

Maybe Mr Slayman knew something that some of us don't really want to concede: At the earliest stages of a new therapy, it's hard to promise that you're going to get rescued and that your life will go on. You can't really expect that. It's very much research. It's very much experimentation. It has to be offered to and accepted by individuals as such. That's the only ethical way to proceed. 

I'm Art Caplan, at the Division of Medical Ethics at New York University Grossman School of Medicine. Thanks for watching.