Vatican document on animal-human organ transplants highlights profound moral and ethical questions
One of the more unusual and attention-grabbing headlines doing the rounds this week was the news that the Vatican has released a formal document stating that the Catholic Church has no objection to Catholics receiving organ transplants from animals. The excitement – or at least the inventive headlines – related to a lengthy and distinctively complex 90-page text published by the Pontifical Academy of Life on the emerging science of xenotransplantation – the transplanting of organs or tissues from one species to another.
Normally such erudite pronouncements escape the mainstream media but the statement that: “Catholic theology does not have preclusions, on a religious or ritual basis, in using any animal as a source of organs, tissues or cells for transplantation to human beings” was sufficient for someone to spot a headline. This triggered a gaggle of similar stories but evidently few people sought out the original document, published on Tuesday and entitled Prospects for Xenotransplantation: Scientific Aspects and Ethical Considerations. Had they have done so they might have reflected quite differently on what the panel of international experts who created it were actually saying – which was that this emerging science is raising all sorts of complex and untested moral and ethical dilemmas so it’s probably best that we set down some clear ethical guidelines now rather than later – with the Vatican stressing the “importance” of achieving “substantial convergence of international legislation as soon as possible.”
At a basic level what the media picked up on was perfectly correct, that Catholic theology “on religious or ritual basis” has no particular objection in using animals as a source of materials for transplantation. Traditionally, the Catholic position is that the human body is not determined by matter, and is but a temporary vessel for the passage of our immortal soul through this imperfect and briefly experienced world. As such it has historically been the view of Catholic theologians that whatever exists in this world can be utilised – or even exploited – in the service of the human person.
“Be fruitful and multiply, and fill the earth and subdue it.” (Gen 1: 28)
It was a view that developed early on – Thomas Aquinas (who himself had been influenced heavily by the ancient Greek philosopher Aristotle) developed a predominantly hierarchical (or in academic terms, anthropocentric) view of the world, seeing humans as being the most spiritual, sublime and rational of all the species so therefore sat at the top of creation. Consequently, all other living creatures were less perfect, and less deserving of God’s (and humankind’s) attention, therefore their purpose must be to serve the human good as they can never achieve the perfection – and give Glory to God – in the way that the human person does.
In partial defence of Aquinas, he did also argue for the benevolent treatment of animals, but he was reticent that this was not out of any love, concern, charity or friendship per se for God’s ‘lesser’ creatures, but out of a questionably pragmatic view that treating animals well was wise as it would enhance their benefit to humans.
The legacy of Aquinian theology, or Thomism as it’s known, prevailed in Catholic theology down the centuries and has really only been challenged in very recent times. In particular the Catechism of the Catholic Church – which devotes four paragraphs to non-human animals make the case for animals having a distinct dignity that commands human kindness and sensitive stewardship and – in a direct contradiction of Aquinas – the Catechism states unambiguously “one can love animals.” (CCC 2418).
This foundational shift in Catholic thinking was embraced by Pope Francis I, and found its most challenging expression in his influential encyclical Laudato Si’. Drawing inspiration from St Francis’s well-known Canticle of Creatures, Pope Francis states that animals “have an intrinsic value independent of their usefulness” (140). Actually Francis goes even further, arguing that caring for other creatures (he rarely uses the word ‘animals’) is central to what it means to be a human being.
With the basics of the background theology out of the way it’s worth examining what the latest document from the Pontifical Council for Life actually grapples with – because the ethical and moral issues raised by this rapidly-emerging science should be a concern to all of us. Xenotransplantation has been around since the 1960s, pushing at the very limits of what it means to be human and creating numerous lurid and challenging headlines in the process. Who could forget ‘Baby Fea’ – Stephanie Fae Beauclair was an American infant born in 1984 with hypoplastic left heart syndrome. On October 26th, 1984, she became the first infant subject of a xenotransplant procedure and the first successful infant heart transplant, receiving the heart of a baboon – surviving until November 15th.
In the 1990s baboon livers were transplanted into two human patients, who survived for 70 days in one case and 26 days in the other.
In 2022 57-year old David Bennett of Baltimore, who had terminal heart disease, hit the headlines after receiving a heart transplant from a genetically-modified pig. Mr Bennett underwent the surgery on January 7th, and doctors say in the weeks afterwards he spent time with his family, watched the Super Bowl and spoke about wanting to get home to his dog, Lucky – sadly he died on March 8th.
Naturally, scientists have been desperate to push this technology further – after all if it became possible to breed pigs that could supply viable donor hearts to extend human life significantly (and other animal organs and tissues too), wouldn’t that be a remarkable achievement, and coincidentally even an endorsement of the Thomistic view of the purpose of creation?
Well, maybe – or at least that’s what the latest Vatican document is actually saying. The ethical and moral issues surrounding this medical science are legion and it’s well worth reading the Vatican document to see just how significant the problems are. On one side of the argument it’s easy to say that the discovery that animals can be potential life-saving donors to humans is a glorious extension of their pre-destined subservience and service to the anthropomorphic superiority – and closeness to God – of the human person. That’s OK as far as it goes but what happens when we start genetically modifying these poor creatures (as we have to) to suit our desperation to cling to mortal life a little longer? Is that in accord with God’s purpose for either the poor animal – or the human person?
Whilst our human nature weeps at the impending death of an innocent infant, or the terminal decline of a loved one, how does our obsession to clinging to life fit with God’s purpose, and are we in fact playing God by breaching the human/animal species barrier in artificially extending a life when God seems clearly to have intended otherwise? Media vita in morte sumus.
If the question of extending a human life beyond the likely intentions of God is one theological conundrum, a far deeper problem – and one that is a central focus of this latest Vatican document – is the profoundly challenging and disturbing question of the physical interaction between the human person and the donor animal. After all, if Aquinas was prepared to argue that we must be kind to animals purely to avoid inheriting their primitivism and becoming like them, then it’s not unreasonable to ask what becomes of the physical composition of the human person when their body is suddenly serviced by the pulsations of – for instance – a pig’s heart? This may sound facile, but it’s a perfectly rational question that even the Vatican is asking: “Any ethical appraisal of xenotransplantation must ultimately address the question of whether the “introduction of a foreign organ into the human body modifies a person’s identity and the rich meaning of the human body?” And if the answer is affirmative, one must ask up to what point is such modification acceptable. (10)
“We can therefore conclude that, in general, the implantation of a foreign organ into a human body finds an ethical limit in the degree of change that it may entail in the identity of the person who receives it.(11)
At the core of the Vatican argument is that any transplants that might materially alter the recipient’s personality are probably NOT morally licit, but equally any transplants that even have a purely symbolic significance to the recipient must be subject to ethical scrutiny. Given this, the objections of some religious groups – such as the Mormons – to even blood transfusions on the grounds that they might alter the personality of the recipient – seem suddenly slightly less than irrational.
As a result of technological advances in Xenotransplantation the question we are all now confronting is to define where the line rests between God’s intentions for the human person and the artificial continuance of life, as well to what extent it is morally acceptable to manipulate and modify God’s other species in the pursuit of the (perhaps un-natural) extension of human life?
It might surprise many to know that exactly this question was in the mind of Pope John Paul II almost a quarter of a century ago, when he was addressing the 18th International Congress of the Transplant Society. John Paul said he would uphold the moral legitimacy of xenotransplantation, but only if “the transplanted organ does not affect the psychological or genetic identity of the person who receives it” and “that there exists the proven biological possibility of carrying out such a transplant with success, without exposing the recipient to excessive risks”.
No-one knows quite how the sector is going to balance morally the genetic manipulation of species to create reliable animal donors with a guarantee of no psychological or physiological impact on the human person, or even if they actually have any serious impulse to do so. It’s with this concern in mind that the Pontifical Academy for Life has spoken out, and has called for an ethical and legislative framework to be put in place now before this technology develops any further. In conclusion the document emphasises: “the importance and desirability that a substantial convergence of international legislation in this area should be achieved as soon as possible, by means of a genuine coordination at the different levels. On the one hand such legislation must provide rules for the continuation of scientific research, guaranteeing its validity and safety; on the other hand it must watch over the health of the citizens involved and the potential risks (especially infective) connected with xenotransplantation.”
The message is clear – any theological concept of global stewardship calls for responsible care, and a fundamental commitment to the good of the human person. It also reminds us that we need to alter our inherited thinking that God provided this planet and the resources within it for our sole benefit and subjugation – but rather that we are but one component in a divine construct that we are still a very long way from understanding, let alone controlling for the common good of all and everything within it.
Link to Vatican document: Prospects for Xenotransplantation: Scientific Aspects and Ethical Considerations
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Joseph Kelly is a Catholic writer and public theologian