Ethics, Virtues and Xenotransplantation

Image by Alexa from Pixabay

This article (published as George AJT, Ethics, Virtues and Xenotransplantation, Perfusion OnlineFirst) looks at the ethics of xenotransplantation in light of recent cases of cardiac xenotransplantation of pig hearts into patients. It looks at the ethics of xenotransplantation from a number of perspectives, including the use of virtue ethics as a lens to understand the ethical issues. A full reference will follow once published in Perfusion.


Early in 2022 the first pig to human cardiac xenotransplant was performed. The graft initially performed well, and rejection was well controlled. However, the graft failed, and the patient died 60 days after the procedure. The ethical issues relating to xenotransplantation include the risk/benefit to the individual, the risk of porcine-derived infectious agents crossing into humans, animal welfare and rights, issues of human and animal identity and concerns relating to fair allocation of organs and appropriate use of resources.

These ethical issues are often addressed using emotional arguments, or through consequentialist or deontological lens. An alternative is to use approaches based on virtue ethics to understand the moral purpose (telos) of the research and the virtues (character traits) needed to be a good research clinician. In this review we will consider the virtues of justice, courage, temperance and practical wisdom, as well as the role of clinical curiosity, and their application to xenotransplantation. This provides an alternative approach for the clinical academic and others involved in the research to reflect on their practice.