Xenotransplantation

An aid to ethical discernment

prepared by a working group on behalf of the Church Office of the Evangelical Church in Germany and the Secretariat of the German Bishops' Conference

Joint Texts No.13, 1998

Xenotransplantation

An aid to ethical discernment

2. Aspects of cultural history

It is not unproblematic to use animals as an organ resource. A look at history and at other cultures will be elucidating. In all cultures, the relationship between animals and humans is of central significance - with corresponding consequences on how humans deal with nature and how they see themselves. What is decisive in this context is the hierarchy of forms of existence and their specific ethical and legal contents. Are humans entitled to decide on the fate of "inferior" forms of existence to maintain themselves and produce offspring? What are their limitations? What are the conditions humans have to meet? Even though the issues vary, there is an intrinsic connection between eating animals, conducting animal experiments, deriving medicine from animals and transplanting animal organs into humans.

In view of the present state of modern western medicine, the European development with its Greco-Roman and Jewish-Christian roots is of fundamental significance. In acknowledgement of the fact that in Western countries the population is multicultural, which is also reflected in the diversity of cultures among patients, nurses and doctors, it is also paramount to respect other cultures and their traditions.

The relationship and the bond between humans and animals have found expression in all cultures in both a realistic and a symbolic form. Various buzz words that are also of relevance in the context of xenotransplantation are veneration of animals, animal offerings, animal fetishism, zoophily, chimeras and transformations from humans to animals and vice versa, for these have always been associated with health and disease, therapy, prevention and prophylaxis.

The Bible gives praise to the beauty of nature in its different guises, plants and animals are considered a model for human beings, and animal offerings play an important role. The invitation in Gen. 1, 28 to subdue the earth and to have dominion over every living thing that moves is by no means a justification for exploiting and destroying nature, rather it is a call on humans to become responsible caretakers and stewards of nature. The right to use animals and the duty to look after their maintenance and care create a tension and a challenge to humans that is of indispensable significance.

Various arguments on the necessity and the justification for animal experiments that are also of relevance for xenotransplantation have pervaded European modern history. The nineteenth century marks the birth of the antivivisectionist movement. The eighteenth-century physiologist and medical doctor Albrecht von Haller legitimized "cruel" tests on living animals by referring to their usefulness for human beings. Debates of this nature were already going on during the seventeenth century and even before, and in these - in keeping with the spirit of renaissance - reference was made to models and examples from the ancient world.

Legal stipulations to protect animals vary within the European countries. The Animal Welfare Act of the German Reich in 1933 marked an important milestone by stipulating the obligation to protect animals in Germany. This development has been continued by further decisions up to the present and found remarkable expression in Article 1 of the present German Animal Welfare Act where "the responsibility of human beings for their fellow creatures" is stated.

This development is reflected in the medical oaths and declarations of past and present. The Hippocratic oath from the fourth or fifth century B. C. does not mention any relationship to animals, however, the rejection of perineal lithotomy (to take out bladder stones) is a manifestation of the Hippocratic doctor's reserves against any type of surgery that could also be applied to animals. At the same time, this oath cannot claim to be representative of antiquity; doctors of that era also followed other theological and philosophical doctrines. Apart from that this oath advocates leaving surgery to "men who are practitioners of this work". During the Middle Ages, the Hippocratic tradition of general surgical restraint was continued on the basis of theological and religious arguments that contradicted the idea of shedding blood in medicine. According to the worldwide accepted Helsinki Declaration of 1964 and the Tokyo Declaration of 1975, animal experiments are legitimate and are considered a necessary precondition for conducting experiments on both healthy and sick humans. There are no explicit statements on xenotransplantation contained in these texts on ethics in research, but there are some specific words on how to deal with animals: "the welfare of animals used for research must be respected". The history of xenotransplants as such sets in at the beginning of the twentieth century with kidney transplants, but its true advancement did not come about until the 1960s.




 


 

extended search