Brain death and xenotransplantation research
OK, so researchers have genetically modified pigs and then transplanted their hearts into brain dead human bodies. Yesterday’s dystopian science fiction has become today’s human interest story. One of the most shocking things about these experiments is how little shock they generated. Nothing in biotech shocks us anymore, especially nothing to do with the exploitation of dead bodies. We’ve gotten used it. Dead bodies have long been used for medical education, transplantation, research and commerce. We plastinate dead bodies, dissect them, put them on display in museums, and throw them in the trash when we’re done.
It takes work to generate moral outrage about the use of dead bodies for biomedical research.
To the extent that controversies arise, they generally turn on issues of consent, disclosure, and profit sharing. Nobody argued that Henrietta Lacks’ cells should not be used for research, only that she deserved a share of the profits.
Still, some taboos remain. We prohibit the buying and selling of certain body parts and regulate the ways that sex can be bought and sold. We forbid cannibalism.
We analyzed controversies about the enormously popular anatomical exhibits of chemically transformed (“plastinated”) corpses. One Rabbi compared it to the Nazi use of the skin of murdered Jews to make lampshades. The President of Venezuela banned the exhibit, claiming that is was “a really clear sign of the huge moral decomposition that is hitting our planet.” Neil Ward suggested the goal was to “knock the body off its pedestal as cradle of the soul.” Farr Curlin worried that “plastinated body exhibits are one expression of deeper cultural shifts toward treating our bodies as mere stuff to be controlled and altered according to our own or others’ whims.” The most outrageous suggestion came from philosopher Geoff Rees, who claimed that the exhibit did not go nearly far enough. If we really wanted to educate the public, he said, we should display not plastinated corpses but the bodies of carefully dissected brain dead people so that the museum-going public could see hearts pumping and stomachs digesting.
Rees' proposal raises eyebrows. The concept of brain death, though widely accepted and legally endorsed, remains intuitively troubling. Brain death was developed to bridge the gap between biological realities and utilitarian goals. We needed organs for transplantation. We didn’t want to take them from living people. So we found a way to categorize some living people as legally dead. In doing so, we had to work hard to ignore the fact that these “dead” bodies could stay warm, maintain blood pressure, go through puberty and gestate babies. They may be legally dead but they are biologically alive. We instinctually recognize the ways that the use of the warm bodies of people who meet neurological criteria for death seems different than the use of bodies when death has been defined by other criteria. That seeming difference flows from our intuition that brain death is different from traditional death in morally relevant ways.
We need more organs for transplant. Using genetically modified organs from animals could relieve the current shortage. Eventually, we may be able to grow organs in the lab without needing human or animal donors. Then, we may no longer need the legal fiction that allows us to classify irreversible cessation of brain function as death. And we will look back with wonder at the ways that we willed ourselves to believe that such people were actually dead.