2001-10-04
Det var jag som undrade över organdonation, det viktigaste i den frågan ur mitt perspektiv, just nu, är vad katoliker säger angående att ta organ från djur och transplantera de i människor, exempelvis ett grishjärta eller dylikt till en människa.
med vänliga hälsningar
Elin
Hej
Jag frågade Erwin Bischofberger Jesuitpater och professor i medicinsk etik vid Karolinska Institutet i Stockholm.
Det finns inga officiella uttalanden från Kyrkans läroämbete.
Ur etisk synvinkel är det dock ingen skillnad mellan att ge människor insulin som genom genetisk programmering framställts från gris - vilket görs idag - och att ge ett organ från en gris till en människa.
Dock är risken är mycket stor att dödliga virus sprids till människan från djuret. Det är s.k. retrovirus. HIV t.ex. är ett sådant virus. Dessa virus är nödvändiga för djuren men skadliga för människan. Dessa problem har ännu inte lösts.
Infektionsrisken är också mycket stor.
Här är material från Pontifical Academy for Life
ZENIT ROME, NOV. 24, 2001
Animal-to-Human Organ Transplants: OK Within Bounds
Procedure Could Help Remedy a Life-and-Death Shortage
ROME, NOV. 24, 2001 (Zenit.org).
- Does the Church approve the transplant of animal organs for humans? On Sept. 26 the Pontifical Academy for Life answered with a qualified "yes."
The Academy published a study on some scientific and ethical considerations related to the possibility of xenotransplants -- a term used when speaking of transplants between species.
Growing waiting lists for organ transplants are putting ever-greater pressure on medical authorities to find solutions. So far, campaigns to increase organ donations have had only limited success.
Xenotransplantation is still taking its first steps. In the United States a few years ago a child born with a malformed heart survived for a short period of time with a baboon heart. At the University of Pittsburgh, a couple of men received livers taken from baboons; these patients lived for several weeks.
There are major medical problems to be overcome, principally rejection by the immune system and the danger of cross-species infections. Genetic engineers are trying to get around the first problem by genetically modifying pigs so the organs taken from them will have some human genes.
Then there is the matter of infections. Opinions differ as to whether transplanting animal organs into humans could result in the outbreak of an animal virus in the human species.
Shortly after the Vatican document was released, the New York Times on Oct. 2 published a debate over the possibility of organ transplants from pigs to humans.
Jonathan S. Allan, of the Southwest Foundation for Biomedical Research, explained that animal cells are being used in some trials. Researchers are injecting fetal pig cells into the brains of patients with Parkinson's disease, Huntington's disease, epilepsy and stroke.
Allan, who is opposed to proceeding with cross-species transplants, pointed out that some scientists are uncomfortable with the trials, given the lack of information on whether viruses can be transmitted from pigs to humans. Some researchers think the AIDS epidemic started when HIV jumped from a monkey to a human, so the potential for problems exists.
As an alternative, Allan proposes developing better artificial organs, or looking for ways to regenerate our own organs.
On the other side of the issue, Dr. David K. Cooper, immunologist at Massachusetts General Hospital, spoke of the grave shortage of donor organs. Some 50,000 of the 70,000 people in the United States who are awaiting transplants will not get them this year.
Moreover, continued Cooper, the quality of donor pig organs will certainly be better than those from human cadavers. "Brain injury and brain death can stress organs, particularly the heart," he explained.
As to the question of infections, Cooper is optimistic that the dangers can be avoided.
Ethical implications
The first part of the document published by the Pontifical Academy for Life presents a roundup of the scientific aspects of xenotransplants. The second part goes on to examine some anthropological and ethical implications.
Three questions are identified at the start of the second section: whether it is licit for man to intervene in creation by means of cross-species transplants; the ethical implications of using animals in this way; and the possible impact for the human identity of those who receive animal parts.
As to the first question, the authors refer to the story of creation as related in Genesis, in which there is a clear hierarchy in creation, with the human person being placed at the summit of all created beings.
This does not give humans the right to abuse other creatures in a capricious way. It does mean however that there is a natural order in which it is licit for us to make use of what is created to help us in our lives, explains the Academy.
As to the second question, the document admits that animals have a value that we should recognize and respect. At the same time, God has placed them at our service. Using animals as a source of organs does not contravene the order of creation, the Academy states. On the contrary, it is a reasonable use of the power God has given us over creation.
The document notes that some people today consider that humans and animals possess the same degree of dignity. The use of animals, they argue, constitutes speciesism, a kind of tyranny.
The Academy notes that man was created in God's image and that therefore the human person has a superior dignity to that of other creatures. Sacrificing the lives of animals to provide organs for humans is licit as it satisfies a legitimate human good.
On the third question, the human identity of those who receive xenotransplants, the Academy notes that this theme is complex, both philosophically and scientifically.
Not all organs express our human identity in same way, notes the document. Some organs, such as the brain or the reproductive organs, have a strong personal value, and it would not be licit to utilize animal transplants. Others play a more functional role, and their replacement by animal organs does not present a problem.
Other questions
The Pontifical Academy highlights a number of other ethical questions related to xenotransplants.
--Health risks. There must be a careful evaluation of both the grade of risks involved and level of damage that can result from xenotransplants. We should avoid the extremes of a total opposition to experiments, or going ahead without sufficient precautions.
--Genetic changes to animals. By introducing human genes in animals, some hope to overcome the rejection of transplanted organs. This is morally acceptable, according to the Academy, provided that the genetic identity of the animals is not destroyed. Care must also be taken in order to avoid undesirable consequences for the environment.
--Informed consent. Before proceeding with the transplant of animal organs, the human patient should be given a full explanation of the factors involved.
--Resources. Some question the high cost of xenotransplants. The Academy contends that the use of such resources is justified, given that patients' lives are at stake.
--Patents. As to whether companies should be allowed to take out patents on animal organs genetically modified for transplants, the Academy concludes that the definitive answer is beyond the scope of the document. The document does assert however that every person should have access to the medical attention he needs, without discrimination or obstacles created due to the costs of the treatment involved.
John Paul II, in his address to the 18th International Congress of the Transplantation Society on Aug. 29, 2000, made reference to organ transplants from animals.
He mentioned what Pius XII said in 1956. Pius XII specified that the transplanted organ must not impair the integrity of the psychological or genetic identity of the person receiving it. Moreover, evidence must show that the transplant has a possibility of success and that it does not expose the recipient to inordinate risk, Pius XII indicated.
The debate on this question shows the Church's openness to scientific progress -- so long as it is oriented toward the integral good of the human person.
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