The Ethics of Xenotransplantation --
An Annotated Bibliography
Keith A. Billman
May 1998
A. Books -- General Animal Rights Background and Introduction to Vivisection
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Adams, Carol. Neither Man nor Beast: Feminism and the Defense of Animals.
New York: Continuum, 1994. Adams takes the following as her givens: oppression
is a reality; species is a social construction the same as gender and race;
environmental exploitation takes place through social domination of the
bodies of some people by other people; feminism does not solely address
men/women relationships, but also how gender becomes a marker of the oppression
of animals. Her goal is to "equip us to recognize what we as humans do
to other animals, especially through the institution of corpse eating."
Her starting point is not that of animal rights theory, but on "exposing
the ideology that ontologizes animals as usable" by exploring the result
of a "human-animal dualism that is embedded within a racist patriarchy."
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Regan, Tom. The Case for Animal Rights. Los Angeles: University
of California Press, 1983. Regan seeks to "articulate and defend, at greater
length and in greater depth than others....what it means to ascribe rights
to animals, why we should recognize their rights, and what are some of
the principal implications of doing so." In some sense, while making the
case for animal rights, Regan also makes the case for the rights of human
beings. To be "for animals" is not to be "against humanity." Against the
background of animal rights, that is, that animals have "inherent value,"
not value as having utility to others, Regan argues that one of the implications
of this view is vegetarianism. One of the other main implications is "the
total elimination of the harmful use of animals in research" (i.e. toxicity
tests). For most, this volume has replaced Singer's Animal Liberation
as the "Bible" of the animal rights movement.
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Singer, Peter. Animal Liberation. New York: Avon Books, 1975; revised
edition, 1990. The start of the animal rights movement, this book "is about
the tyranny of human over nonhuman animals." Singer states that animals
should be treated as ends, not means to human ends. The basic moral principle
of equal consideration of interests should not be restricted to members
of our own species. Singer coins the word "speciesism." This principle
should also be demanded by reason, not emotion. Singer recounts numerous
examples of the abuses of animals at the hands of scientific researchers
(vivisection) and calls for an end to these practices, as well as vegetarianism.
B. Articles
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Allan, Jonathan. "Baboons, Safety in Xenotransplantation," ProMED-mail
post (1998). Allan writes about the recent U.S. Public Health Service
meeting in which newly revised guidelines for xenotransplantation were
presented. Allan points out, however, that these guidelines have not dealt
with the issue of species differences in regard to infectious disease risks,
i.e. baboons and pigs are treated the same and that based on current technologies
it is virtually impossible to provide "clean animals" for use in humans.
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Bach, F.H.; Fishman, J.A.; et al. "Uncertainty in Xenotransplantation:
Individual Benefit versus Collective Risk," Nature Medicine 4 (1998)
141-4. The authors address the dramatic tradeoff of individual benefit
against societal risk involved in clinical xenotransplantation. The article
discusses the ethical considerations which guide the paper and the risks
associated with xenotransplantation. A three-tiered approach to policy
development and decisions is explored, which includes the societal level,
the level of institutions performing the xenografts and lastly at the level
of individual patient immunization.
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Callahan, Rick. "Hog Intestines Used to Rebuild Knees," Associated Press
Wire (March 9, 1998). The author describes the repair of 38 year old
James McDonald's knee, where the anterior cruciate ligament (the web of
fibrous tissue that binds the knee together) was replaced with refined
hog intestines. The man is the first person to receive an implant of small-intestinal
submucosa, or SIS, a paper-thin material derived from hogs' small intestines
that has shown promise in regenerating damaged tissues. SIS, however, contains
no individual hog cells, all but eliminating the threat that human patients
could be infected with hog-borne diseases.
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Collins, Huntly. "Animal-to-human Procedure Discussed at Science Conference,"
Philadelphia Inquirer Feb. 18, 1998. The American Association for
the Advancement of Science met and speakers included California AIDS activist
Jeff Getty, who received bone marrow from a baboon and the surgeon who
oversaw the controversial experiment. They are trying to head off a proposed
movement by some scientists to temporarily halt animal-to-human transplants.
The two major hurdles to xenotransplants include rejection of the animal
organ by the patient's immune system and that an animal virus might be
introduced into the patient and then be spread to others.
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Drawbaugh, Kevin. "Animal to Human Transplants Raise Concerns," Reuters
March 6, 1996. This article deals with the fears of xenotransplantation
allowing dangerous animal diseases to cross species and spread through
human populations. It tells why there is interest in xenotransplants, mainly
the lack of available human donor organs. The article quotes pharmaceuticals
analyst Peter Laing, who predicts pig-to-human kidney transplants by the
year 2000 and that they will be more common than human-to-human procedures
by 2002.
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Francione, Gary L. "Xenografts and Animal Rights," Transplantation Proceedings
22 (1990) 1044-6. Francione touches on the moral status of the nonhuman
animals involved in xenografts. He believes that xenografts crystallize
the basic moral issue in a rather dramatic way. He states one can arguably
trace a direct benefit that results from the exploitation of the nonhuman
animal. He feels there are three reasons why the animal rights community
will intensify resistance to such procedures. First, more people are rejecting
the "balancing" approach as an appropriate way to resolve moral issues.
Second, the concept of animal rights is becoming increasingly accepted
as the morally appropriate alternative to the balancing approach. Third,
various groups, including, but not limited to the animal rights movement,
have begun to question the "objectivity" of science and see it as a "political"
activity.
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Henderson, C.W. "Xenotransplantation: Cows, Pigs may Offer Transplant Hope,"
Cancer Weekly Feb. 12, 1998. This article deals with genetically
engineered animals whose organs appear human to the immune system. Cells
are encased in a plastic net that keeps out anti-bodies and are filtered
out of the blood. A device known as cellular replacement by immunoisolatory
biocapsule (CRIB) encases the cell in a porous membrane that lets in nutrients
like oxygen, but filters out antibodies.
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Hoke, Franklin. "As Cross-Species Transplantations Forge Ahead, Some Scientists
Call for Caution and Restraint," The Scientist 9 (1995) 1. The author
discusses a brief history of xenotransplantations and the reasons to proceed
with the procedure. He discusses the disease risks and the appropriate
safeguard systems which could be put into place, which would include a
centralized resource which provides oversight.
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MacPherson, Kitta and Silverman, Edward. "Weighing Risks of Pig Transplants,"
New Jersey Online Mar. 15, 1998. This article covers a wide range
of the various aspects of xenotransplantation, including minimizing risks
and the involvement of corporations in the technological aspect of xenotransplants
being involved in the ethical decision making process. Particular technology
includes freeze-dried arteries which mean they are virus-free. This article
also covers why pigs are the best choice for transplants, as they are "easy
to raise, mature quickly, produce large litters and have organs comparable
in size to humans."
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Marketletter Feb. 23, 1998. The article discusses the U.S. FDA rejection
of calls for a moratorium on clinical trials of xenotransplantation "until
ethical issues associated with the transfer of organs from animals to humans
are resolved." The FDA decided to proceed cautiously with strictly controlled
and supervised studies.
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Recer, Paul. "Patient: Animal Organs not Accepted," Associated Press,
Feb. 14, 1998. This article discusses Jeff Getty, an AIDS patient, who
said his health improved markedly after he received an experimental transplant
of baboon bone marrow, but that the public was horrified at the idea. The
transplant was an attempt to place within his body a partial immune system
that is resistant to the virus.
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Trew, Andrew. "Xenotransplantation: Anglo-American Update," Cleveland
Clinic Department of Bioethics Contemporary Issues 1997. Trew notes
the novel medical, legal and ethical issues raised by xenotransplantation.
The medical concerns center on organ rejection and the risk of infection.
The ethical concerns include: potential risks to the general public, risks
of cross-over infections from animals to patients, how informed consent
is possible with indeterminate risks, issues of justice and availability
of procedures, animal welfare issues and other psychological and social
issues. Legal issues include: debate about ownership of transgenic animals
and long-term effects of introducing artificially created species into
the natural world.
C. Book Reviews
Carol Adams, Neither Man nor Beast: Feminism and the Defense of Animals:
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L. Vance, Choice 32 (1995) 1636, states that previously Adams had
introduced the idea that the "eating of meat and the oppression of women
are intimately connected." This volume continues this idea with the feeling
that the patriarchal mind sees both women and animals only in terms of
usefulness. Vance notes that Adams argues that by "eating meat women are
complicit in their own oppression." Vance feels this collection of essays
is welcome, since most were previously inaccessible. Vance describes Adams'
thinking as "brilliant and original," and that though geared toward an
academic audience, general readers with animal rights interests will be
intrigued.
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Carolyn Craft, Library Journal 120 (1995) 107, feels Adams "continues
her ecofeminist analysis of the relationship between objectification, experimentation
and consumption." Adams provides a radical critique of "Christian humanocentric
theology" which supports both human/animal dualism as well as man/woman
dualism. Adams advocates activism and Craft recommends the book for informed
lay readers.
Tom Regan, The Case for Animal Rights:
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Library Journal 109 (1984) 428, states that Regan makes a strong
case for the concept "that an animal life, like a human life, has inherent
value" and that this means animals have certain rights. Regan avoids hysterical
treatment of the subject and should be read, even if one disagrees with
his premise, if only as a further reflection on individual human rights.
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Leslie Armour, Library Journal 108 (1903) 1879, notes this book
is a heavier argument in support of vegetarianism. Animals have fundamental
rights which are independent of utilitarian considerations. Armour notes
the book's strength lies "in the detail of the arguments for and against"
and "that no sensible person should venture into the animal rights issue
without consulting this book."
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Choice 21 (1984) 992, sees Regan's book as "unquestionably the best
work yet to appear in its field in originality, thoroughness and rigor."
The three sections of the book include: the argument that animals are conscious/enjoy
a mental life, the defense of a general ethical theory - the rights view,
and the obligations of humans toward animals. Regan argues against meat
eating, hunting, trapping and the "many uses of animals in science." The
book is recommended without qualification for use at all levels.
Peter Singer, Animal Liberation:
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Timothy Daum, Library Journal 100 (1975) 2231-2, mentions that Singer
notes that while humans have started to overcome racism and sexism, they
still ignore the problem of speciesism or the domination of one group over
another. Singer "mounts a blistering indictment of the so-called humane
use of animals in scientific research." Singer examines the historical,
social and philosophical bases which permit destruction of over one and
a half million animals each year in the U.S. The book is "thoroughly documented,
well balanced, and unfortunately often revolting." It is the study of humans
as the ultimate repressors.
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Library Journal 101 (1976) 667, notes that Singer presents "strong
arguments against the use of animals in science and attacks procedures
followed in laboratories and academic institutions of subjecting animals
to "painful, injurious and ultimately lethal" experiments that frequently
result in "findings inapplicable to human beings." The presentation is
controversial, not hysterical.
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Sharon Russell and Charles S. Nicholl, Proceedings of the Society for
Experimental Biology and Medicine 211 (1996) 109-138, not that the
book is frequently referred to as the "bible" of the animal rights movement.
Russell and Nicholl accuse Singer of "mischaracterizing the various studies"
and quotes "selectively and out of context." They feel he distorts and
trivializes research projects, and that his utilitarian arguments are not
convincing.