Discipling your church for a world in sexual crisis
By / Mar 10

On this episode, we feature a webinar hosted by Jason Thacker on discipling your church for a world in sexual crisis. Thacker talks to Dean Inserra, Katie McCoy, and Andrew Walker about a biblical sexual ethic and how to communicate it with truth and grace in a secularized society. 

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Explainer: The “three-parent baby” IVF technique you should know about
By / Mar 10

Over the past decade, scientists have developed a technique called mitochondrial replacement therapy (MRT), which allows for the creation of babies with three genetic parents. MRT was originally developed to prevent the transmission of certain genetic diseases from parent to child. Yet as MIT Technology Review notes, “new evidence suggests it doesn’t always work—and could create babies at risk of severe diseases.” It was also discovered that MRT has been used as a way to treat infertility.

Whether or not this technology has the potential to prevent the transmission of certain genetic diseases or to help overcome infertility, the technology raises serious and significant bioethical and theological concerns. Here is what Christians should know about this controversial IVF technique. 

What is mitochondrial replacement therapy (MRT)?

The process of creating babies with three genetic parents involves replacing the faulty mitochondrial DNA of the egg with healthy mitochondrial DNA from a donor, a technique, known as mitochondrial replacement therapy (MRT). Mitochondria are the energy-producing organelles within cells, and their dysfunction can lead to serious health problems for the baby. By using MRT to replace the faulty mitochondria, the child could theoretically be protected from mitochondrial diseases.

But the techique is not as sucessful as it once appearred. MIT Technology Review found two cases in which babies conceived with the procedure have shown what scientists call “reversion.” In both cases, notes Jessica Hamzelou, the proportion of mitochondrial genes from the child’s mother has increased over time, from less than 1% in both embryos to around 50% in one baby and 72% in another. “These mitochondrial diseases have devastating consequences,” as Björn Heindryckx at Ghent University in Belgium told MIT Technology Review. “We should not continue with this.”

Where is the technique currently legal?

Australia and the United Kingdom are the only nations that have explicitly authorized MRT. However, it has been used in IVF clinics in other countries, such as Greece and Ukraine.

The procedure is currently disallowed in the U.S. because Congress has, since 2015, included a provision in the federal budget that forbids altering the genomes of human embryos intended for pregnancies.

What are the concerns about MRT?

While this technique may sound promising, it raises numerous ethical and medical concerns.

One of the most significant bioethical concerns about this technique is that MRT involves the manipulation of genetic material, which could alter and affect the genetic makeup of future generations. This could have dangerous consequences, particularly in cases where the genetic changes are passed down through multiple generations. The reason is that mitochondria are not merely energy-producing organelles; they also play a role in a wide range of cellular processes. By replacing a woman’s defective mitochondria with healthy mitochondria from a donor, there is a risk of disrupting these cellular processes and causing unintended health problems. The long-term effects of MRT are not yet fully understood, and the safety of the procedure has not yet been established.

However, the research needed to make the technique viable and safe is itself unethical. Christians believe in the inherent value and dignity of all human life at every stage of development—including the embryonic stage. MRT requires the creation and destruction of human beings in the embryonic stage solely for research purposes. This killing of human beings for the purposes of research is an unjustifiable violation of the sanctity of life. 

Genetic modification may also lead to an increased acceptance of eugenics. Eugenics is the idea of improving the genetic quality of the human population through selective breeding or genetic engineering. While MRT is not directly related to eugenics, it does involve selecting and manipulating genetic material to achieve a desired outcome. This could potentially lead to a slippery slope where parents feel pressure to select certain traits in their children, or where certain traits are seen as more desirable than others. This could lead to a further devaluation of human life and a focus on genetic perfection rather than the inherent value of every human being made in God’s image.

Finally, there are concerns about the impact of MRT on family relationships. The creation of a child with genetic material from three different individuals raises questions about parentage and identity. This could lead to legal and social issues, such as disputes over custody and inheritance rights. MRT could further undermine the traditional understanding of the biological family unit (i.e., one biological mother and one biological father) and could have negative consequences for the emotional and psychological well-being of children created through this technology.

While the technique has ​the remote potential to offer hope to some couples at risk of passing on genetic disorders, both the known ethical concerns and the unforeseeable and unmanageable effects on future generations make it a reproductive technology that Christians should reject and oppose. 

Explainer: What you should know about Canada’s medical assistance in dying law
By / Mar 3

Last month, the government of Canada introduced legislation to extend the temporary exclusion of eligibility for medical assistance in dying (MAID) where a person’s sole medical condition is a mental illness until March 17, 2024. The legislation (Bill C-39) passed the House of Commons and has been introduced in the Senate.

Here is what you should know about Canada’s law that allows for voluntary euthanasia.

What is Canada’s MAID law?

MAID is the acronym for Canada’s medical assistance in dying law. The laws allows physicians and nurse practitioners (in provinces where this is allowed) to help a person commit suicide by either directly administering a substance that will end their life or prescribing such as substance so that it can be self-administered.

The law provides exemptions from the criminal law concerning suicide and provides protection from liability to pharmacists and pharmacy technicians/assistants, healthcare providers who help physicians or nurse practitioners, and family members or other people who have been asked to participate. They are able to assist in the suicide process without being charged under criminal law as long as they follow the legal requirements. 

This legal right to voluntary euthanasia has been in effect since March 17, 2021. Prior to that, the Supreme Court of Canada had ruled that a prohibition on medical assistance in dying violated the Canadian Charter of Rights and Freedoms.

What should Christians think about medically assisted suicide?

Medically assisted suicide is a form of euthanasia, the intentional act of taking a human life for the purpose of relieving pain and suffering. Christians should reject euthanasia because it denies the inherent dignity that God has given human beings and seeks to take the place of God in determining the end of life.

While those seeking MAID and those participating in the practice may want to eliminate suffering, what they are doing is actually undermining the objective value of life. Although the Bible does not speak about euthanasia directly, it teaches that we must regard life as belonging to God and approach issues of suffering with a critical and biblically-based approach. As Mary Wurster has written, “The value of human life in all its forms and at all stages is the central theme of the gospel, for it is the very purpose of Christ’s birth, death, and resurrection. To fail to respect human life at any point mocks the very essence of Christ’s mission to humanity.”

See also: How would you counsel someone interested in assisted suicide?

How many people are being legally euthanized under Canada’s MAID law?

In the five years since the law was adopted, there have been 31,664 medically assisted suicides. As the Canadian government notes, “annual growth in MAID provision continues to increase steadily each year.” In 2021, the total number of MAID deaths increased by 32.4% (2021 over 2020), compared to 34.3% (2020 over 2019) and 26.4% (2019 over 2018).

In 2021 there were 10,064 MAID related suicides, an average of 28 per day. MAID suicides account for 3.3% of all deaths in Canada. Across Canada, fewer than seven deaths were from self-administered MAID.

What is the reason people in Canada choose MAID?

According to the Canadian government, the most commonly cited intolerable physical or psychological suffering reported by individuals receiving MAID in 2021 was the loss of ability to engage in meaningful activities (86.3%), followed closely by the loss of ability to perform activities of daily living (83.4%).

Who is eligible for medically assisted suicide under MAID?

To qualify under MAID, a person wanting to take their own life must satisfy all the following criteria:

  • Be eligible for government-funded health insurance in Canada.
  • Be 18 years of age or older and have decision-making capacity.
  • Have made a voluntary request for MAID that was not a result of external pressure.
  • Give informed consent to receive MAID after having received all information needed to make this decision, including a medical diagnosis, available forms of treatment, and options to relieve suffering (including palliative care).
  • Have a “grievous and irremediable condition,” meaning they have a serious illness, disease, or disability (excluding a mental illness until March 17, 2023), be in an advanced state of decline that cannot be reversed, and experience unbearable physical or mental suffering from an illness, disease, disability, or state of decline that cannot be relieved under conditions that the person considers acceptable.

Does a person have to have a terminal illness to qualify for medically assisted suicide?

No. The diagnosis has to be considered “serious” but not necessarily “terminal” (i.e., a condition that cannot be cured and is likely to lead to someone’s death).

Does a person with a mental illness qualify for medically assisted suicide?

If the sole underlying medical condition is a mental illness, they are not currently eligible for MAID. However, this exclusion is only in effect until next March, at which time it will be automatically repealed.

This exclusion also only applies to conditions that are primarily within the domain of psychiatry, such as depression and personality disorders, and does not include neurocognitive and neurodevelopmental disorders, or other conditions that may affect cognitive abilities. For instance, a person who has dementia, Alzheimer’s, Huntington’s, or Parkinson’s are all able to receive medical assistance in their suicide. In 2021, 12.4% of MAID deaths were for neurological conditions.

Are medical practitioners able to refuse to participate in Canada’s MAID law?

The MAID law does not itself compel doctors or physician assistants to participate in the medical killing of another person. However, various Canadian provinces have issued guidelines that “strongly encourage” medical practitioners who are unwilling to provide MAID to refer their patients to other institutions or providers.

Some provinces violate the conscience rights of doctors and physician assistants by requiring transfer of care or referral  to a medical provider who will participate in the suicide. For example in the province of Ontario, objecting providers must make an “effective referral” to an available, accessible physician or agency willing to facilitate a request for assisted dying. 

An interview with Jason Thacker about “The Digital Public Square”
By / Mar 3

On this episode, Brent Leatherwood and Lindsay Nicolet talk to Jason Thacker about his new book, “The Digital Public Square,” and how Christian ethics apply in a technological society. They discuss the importance of Christians engaging various technological tools with wisdom and the motivation to love God and love our neighbors. 

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Toward a public theology for a digital age
By / Feb 21

A few years ago, I read an insightful article by Shira Ovide of the New York Times on the splintering of the internet and the complexities surrounding digital governance around the world. 1Shira Ovide, “The Internet Is Splintering,” New York Times, February 17, 2021, https://www.nytimes.com/2021/02/17/technology/the-internet-is -splintering .html. She writes about how most countries around the world have their own car safety regulations and tax codes, but currently there is widespread debate over how online expression should be governed. She highlights how technology companies—many based in the Western world—are essentially governing speech and free expression online, which leads to major controversies and dissension as many countries want to retain that power for themselves.

One of the most salient points she makes in the piece concerns the promises of how technology was going to usher in a new world order. She writes, “The utopian idea of the internet was that it would help tear down national boundaries, but technology watchers have been warning for decades that it could instead build those barriers even higher.” Not only are those barriers being built higher around the world, but technological power is also being exerted by powerful governments and leaders to control and manipulate people created in God’s very image. 2For more on the widespread use of technology to suppress human rights and free expression around the world, see chapter 11 by Olivia Enos in this work.

Over the last few years, we have even seen numerous companies shut down the internet to quell protests and dissension among their own people, like that in Iran, Belarus, China, and Cuba. These stories represent a much larger question that is being debated about how technology companies like Meta, Twitter, and many others should do business around the world, especially in areas where there is significant disagreement over the basic freedoms we enjoy in America. 

But even in the United States, we have significant differences and major disagreements on the role of the government and third-party technology companies concerning issues like content moderation, free expression, and online governance. These complexities and differences are present even though we have some level of a shared culture and agreement on many basic human freedoms—even though that agreement seems to be fraying with each passing day.

An opportunity for Christian engagement

Technology policy expert Klon Kitchen, who serves at the American Enterprise Institute as a Resident Fellow, wrote a brilliant essay at National Affairs about the realities we face in this technological age. He states that “all governments must [now] acknowledge and adapt to the fact that they no longer wield exclusive power and influence on the global stage.” 3Klon Kitchen, “The New Superpowers: How and Why the Tech Industry Is Shaping the International System,” National Affairs, no. 49 (Fall 2021), https://nationalaffairs .com/the-new-superpowers-how-and-why-the-tech-industry-is-shaping-the-international-system. The rise of a technology industry operating transnationally with enormous power over public discourse presents a unique challenge to our society but also an opportunity for Christians to engage with these companies as we have historically done with governments, standing for human dignity and religious freedom around the world. The Christian church has a rich heritage of public theology and navigating church/state relations, drawn in large part directly from the scriptural calling to honor the leaders God has placed in charge, hold the government accountable to their calling to stand for justice, and honor the God-given freedoms of all as created in God’s image (Rom 13:1–6). 

While the rise of these transnational entities in the digital age may present unique challenges on issues like online governance, it also presents a unique opportunity for Christians to engage the technology industry with a robust public theology built upon an unchanging understanding of human dignity and freedom derived from Scripture. It is far too easy in our technological society to see other human beings as simply problems to be solved or as pawns in the pursuit of power. But a Christian understanding of humanity and the nature of society is rooted in the dignity of all people that transcends our national allegiances and even the technological order itself we spoke of earlier.

As Christians engage on these important ethical issues, we must do so from a position of principled pluralism—recognizing the inherent dignity of all people and with a clear moral vision of a common good grounded in God’s Word.

Grounded in these two truths, we can model for our society how to have these debates from a convictional, yet grace-filled perspective. In a society that prizes efficiency, speed, and at times public contempt for our political and social “enemies,” we should seek to prioritize the dignity of all, including those who disagree with us on these important issues. We can do so by recognizing that our battle is not against flesh and blood but against the cosmic powers of darkness (Eph 6:12). That means that we engage from a position of hope and grace, knowing that we are to seek the right changes in the right way (Rom 3:8).

A second and vital requirement is understanding the basic tenets of the debates at hand, rather than simply dropping into these complex debates or speaking to issues without a full understanding of the gravity of the situation. Just as we seek to gain insight and expertise in other areas of life—especially engagement with government—to honestly engage, we must do the same with the technology industry and the complex issues they face doing business around the world. This is one of the many reasons this volume consists of two corresponding chapters speaking to the domestic and international issues of technology policy as well as a host of important issues in the digital public square. 

It does not serve well the message of the gospel, much less our society, to engage on issues without knowledge or awareness of the issues at stake, even if our society seems to reward hot-takes on social media over true action oriented toward lasting change. Even with the immense complexity of these debates, one thing is clear: the dignity of our neighbor is at stake around the world, especially under repressive authoritarian regimes. We must keep that truth central in this debate over digital governance. Even though these issues may at times seem to be simply about tweets, posts, and even the contours of content moderation, these are simply expressions of how human beings, created in God’s image, are able to communicate, express themselves, and do life in an ever-increasing digital society.

Adapted from The Digital Public Square: Christian Ethics in a Technological Society, edited by Jason Thacker, and published by B&H Academic.

  • 1
    Shira Ovide, “The Internet Is Splintering,” New York Times, February 17, 2021, https://www.nytimes.com/2021/02/17/technology/the-internet-is -splintering .html.
  • 2
    For more on the widespread use of technology to suppress human rights and free expression around the world, see chapter 11 by Olivia Enos in this work.
  • 3
    Klon Kitchen, “The New Superpowers: How and Why the Tech Industry Is Shaping the International System,” National Affairs, no. 49 (Fall 2021), https://nationalaffairs .com/the-new-superpowers-how-and-why-the-tech-industry-is-shaping-the-international-system.

3 top technology issues to watch in 2023
By / Feb 13

Since 2020, I have sought to write about some of the top technology issues to be aware of and how we as Christians can address them in light of the Christian moral tradition rooted in the love of God and love of neighbor. There have been a couple prevailing themes over the years centered on the ways that technology is shaping us as people—namely our understanding of ourselves and those around us—and how we as a society are to think through the power it holds in our lives.

Already, it seems 2023 is going to be an interesting year as we deal with an onslaught of emerging technologies like advanced AI systems and virtual reality, as well as continue to navigate pressing challenges of digital privacy and the role of faith in the digital public square.

Artificial Intelligence and ChatGPT

Back in 2020, there was already social buzz about AI and how it was shaping our society. I published my first book, The Age of AI: Artificial Intelligence and the Future of Humanity, with the goal of thinking about how some of these technologies might affect our understanding of human dignity and our common life together. As 2022 came to a close, there was a major release of a ChatGPT (chatbot) from OpenAI that caught the attention of our wider culture and confirmed that AI is (and will continue to be) a major part of our lives, especially in education and business. 

The introduction of advanced AI systems like these in recent years has fundamentally challenged much of what we have assumed about the uniqueness of humanity. These systems are now performing tasks that only humans could in past generations.

In an age like ours, we all need to be reminded that the value and dignity of humans isn’t rooted in what we do but who we are as those uniquely made in the image of our Creator.

AI systems like ChatGPT have deeply concerning elements but also afford the opportunity for educators and students to evaluate with fresh eyes the purpose and design of education. Education is not simply about information transfer but whole-person transformation. These types of tools require that administrators, professors, and students alike learn about how these systems work, their advantages and limitations, and how we might seek to prioritize the transformation of their students above a simple letter grade. 

Similar to the classroom, these tools may have limited use in local church ministry but must be thought through with the utmost care and wisdom. They may be used to aid one in research, writing reflection questions, or even rudimentary copy for church functions. However, one must keep in mind their limitations as well as be on guard for the temptation to simply pass off the output as their own work. 

Current limitations with these systems are myriad and must be taken into account as one thinks through the ethical ramifications of their use. They are limited by data sets and human supervision used in training the system; are widely known to falsify information, misapply concepts, or even alter their answers based on the political and social views of their creators; and rarely account for nuance and complexity, leading to, at best, the production of entry level and/or basic material. 

Privacy rights and children

A second issue we should be aware of is one that will inevitably be perennial. With the ubiquity of technology and our growing dependence on it, there is the vast and growing concern over personal privacy and how this data will be used by individuals, governments, and especially the technology industry.

We live in a data-saturated world, and there can be a lot of money made by harvesting troves of data and creating predictive products or optimizing our interactions with our daily technology use. Governments around the world are beginning to or have already regulated the flow of data and who has access to it, often focusing on a supposed right to privacy—a term that has competing definitions and proposed safeguards.

Christians, specifically, need to think deeply about what a right to privacy is and what it is not. 

In 2023, four American states—Colorado, Connecticut, Utah, and Virginia—will follow a similar pattern to California’s groundbreaking privacy law, the California Consumer Privacy Act (CCPA) which went into effect in January of 2020, and begin implementing new General Data Protection Regulation (GDPR) on data collection and use. These new state laws share many of the same types of protections as the CCPA and GDPR of the European Union. 

This year, there will be increasing pressure across the board for federal legislation focused on privacy as it specifically relates to children, as is seen with the bipartisan Kids Online Safety Act (KOSA) and more broadly with other proposals. 

Regardless of where these policies end up, the framing of privacy soley in terms of moral autonomy and personal consent often makes it easy to overlook data privacy as such a central concern to Christian ethics.

Instead, Christians need to be the ones asking the hard questions about how we as a society want to protect and guard the rights of the individual but in ways that also promote the common good.

Virtual reality and augmented reality

One of the technologies that was discussed significantly in 2022 and will likely continue to be in 2023 is virtual reality (VR) and augmented reality (AR). In recent years, we have seen a surge of new VR devices and an increasing number of wearable devices such as smart glasses. As the devices become more commonplace in our society and societal norms continue to shift, it seems likely that they will grow in prominence in our lives.

Some of the pressing ethical questions about their use are not as straightforward as ethical issues in technology, but a host of new challenges will arise, especially in light of the new mediums and means of connection that VR has created. 

Aside from the more common concerns of data privacy, including the use of advanced biometric data such as eye-tracking and more, there are also novel challenges to long-standing understandings of free speech and religious freedom in these digital spaces. These developments are often spoken of in terms of the wisdom of VR churches and gatherings. However, I think the more pressing questions will be over how religious groups who may hold to culturally controversial beliefs—especially on topics like sexuality, gender—will be treated in these digital environments. 

These spaces are not truly public because they are often hosted or even created by technology companies themselves. This represents a new angle on the continued debate over free speech, content moderation, and the nature of faith in the public square.

Overall, 2023 will be a year where Christians are continually pressed to think about how we will live out our faith in the public square amid an increasingly secular culture. One of the temptations when faced with complex or challenging ethical questions with technology is to rush to a position of full adoption or rejection. 

Wisdom, which is at the core of the Christian moral tradition, calls us to slow down and think deeply about the nature of these tools, and discern if their many uses can help us better love God and love our neighbors as ourselves.

ERLC’s Jason Thacker Releases ‘The Digital Public Square: Christian Ethics in a Technological Society’ with B&H Academic
By / Feb 2

NASHVILLE, Tenn., Feb. 2, 2023—Jason Thacker, director of the research institute and chair of research in technology ethics for the Ethics & Religious Liberty Commission of the Southern Baptist Convention, released a new volume titled, “The Digital Public Square: Christian Ethics in a Technological Society,” published by B&H Academic.

This volume is among the first to focus on questions of digital governance, content moderation and the role of social media in society from a distinctly Chrisitan perspective. It is a part of a long-term research project launched by the ERLC that explores the intersection of Christian ethics and the increasingly digital public square.  

“Social media and emerging technologies have challenged some of our most basic understandings of truth, faith, and even the idea of a public square,” said Thacker. “Today we face immense ethical and social challenges such as the proper role of government, corporate responsibility, and personal accountability in light of the ways that technology is shaping us and the public square. The Christian moral tradition is not only sufficient for the immense task before us but also reframes these debates in light of God’s unchanging character, the Christian concept of human dignity, and a vision of social transformation and the common good rooted in the gospel message.”

Thacker assembled a team of 12 contributors to aid the church in applying the Christian moral teachings to topics including: 

  • Censorship;
  • Technology policy; 
  • Free speech;
  • Conspiracy theories;
  • Sexual ethics;
  • Hate speech;
  • Religious freedom;
  • Digital authoritarianism;
  • Tribalism;
  • Discipleship; and
  • Christian witness. 

Contributors such as David French, Patricia Shaw, Keith Plummer, and Brooke Medina cast a distinctly Christian vision of a digital public theology to promote the common good throughout our society and around the world.

The Digital Public Square project was launched by Thacker and the ERLC in September 2021 and is a multi-year initiative in technology ethics. The ERLC released the first ever faith-based statement of principles on artificial intelligence in April 2019.

“For years now, the ERLC has produced a number of thought-provoking resources about technology and the ways it is both challenging and changing us,” said Brent Leatherwood, ERLC president. “This newest resource continues that work to help our churches understand the complexities of our increasingly online world. While it can be tempting to think the Bible doesn’t have a lot to say about emerging technology, Jason Thacker and the incredible team of thinkers he’s put together in this volume reveal how, in fact, Christian ethics offer the best possible guide for successfully engaging the digital public square.”

For more on this volume and the other resources from the Digital Public Square research project, visit jasonthacker.com/books.

March for Life 2023, South Carolina’s 6-week abortion law, and Stand for Life
By / Jan 13

In this episode, Lindsay and Brent discuss the South Carolina Supreme Court striking down the state’s 6-week abortion ban. They also talk about the pro-life organization and the March for Life happening next week.

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  • Sexual Ethics Resource Page | Do you ever feel overwhelmed by the constant stream of entertainment and messages that challenge the Bible’s teachings on sexual ethics? It often feels like we’re walking through uncharted territory. But no matter what we face in our ever-shifting culture, God’s design for human sexuality has never changed. The ERLC’s new sexual ethics resource page is full of helpful articles, videos, and explainers that will equip you to navigate these important issues with truth and grace. Get these free resources at ERLC.com/sexualethics.

ERLC’s Jason Thacker co-edits ‘Essentials in Christian Ethics’ series by B&H Academic
By / Nov 15

Nashville, Tenn., Nov. 15, 2022— Southern Baptist ethicist Jason Thacker of the Ethics & Religious Liberty Commission and renowned, moral philosopher C. Ben Mitchell recently contracted with B&H Academic to edit a new eight-volume series entitled Essentials in Christian Ethics, set to begin release next year.

The first in the series of short, introductory level volumes features the work of theologian and ethicist David VanDrunen of Westminster Seminary California on the topic of natural law and the moral order, which will be released in November 2023.

With the Essentials in Christian Ethics series, Mitchell and Thacker hope to help equip the next generation to see the centrality of ethics in the Christian life, especially in the training of future leaders for the church. Volumes will begin releasing in 2023 and continue through 2026.

“Ethics is not merely an academic discipline, but intricately woven into the very fabric of the Christian life as we all seek to apply God’s word to the society in which we have been placed and live in light of those truths, no matter the circumstances we face today,” said Thacker.

Current volumes under contract include: 

  • Natural Law Ethics with Van Drunen;
  • Biblical Ethics with Jacob Shatzer of Union University;
  • Metaethics with J.P. Moreland and David Horner of Biola University;
  • Political Philosophy with Bryan Baise of Boyce College;
  • Bioethics with C. Ben Mitchell;
  • Just War and the Ethics of Contemporary Warfare with Paul D. Miller of Georgetown University.

About Jason Thacker: Thacker serves as the director of the ERLC’s Research Institute and chair of research in technology ethics where he leads the Digital Public Square research project. He also teaches at Boyce College in Louisville, Ky. and is the author of multiple works on Christian ethics and public theology. He is currently pursuing a Ph.D. in Christian ethics, public theology, and philosophy from The Southern Baptist Theological Seminary.

About C. Ben Mitchell: Mitchell earned a Ph.D. with a concentration in medical ethics from the University of Tennessee. He held the Graves Chair of Moral Philosophy at Union University for more than a decade before his retirement in 2020. Mitchell previously taught bioethics and contemporary culture at Trinity Graduate School and Trinity Evangelical Divinity School.

What are the ethical issues with pig-to-human transplants?
By / Sep 29

Pig-to-human transplants sounds like science fiction, but actual occurrences of this experimental treatment were in medical news earlier this year. The field is known as xenotransplantation and refers to any sort of cross-species transplant. While there have been documented attempts at xenotransplantation as far back as the 17th century, with advancements in medicine and science in the modern era, xenotransplantation has become a reality with clinical trials of solid organs (e.g., kidneys; hearts) likely to take place soon. Christians should think carefully through the ethical issues this aspect of the medical world brings to the forefront.  

Why are pigs being used in humans?

The demand for human organs for transplant always outpaces their supply. In the United States alone there are over 100,000 persons waiting on an organ. The vast majority of these are waiting on a kidney, where the median wait time is about 3.5 years. Many patients will die from end-stage organ failure or other complications before they ever receive a transplant. To help mitigate this disparity, alternative sources of organs have been experimented with for decades. 

One alternative source that has shown a lot of promise in pre-clinical trial studies is genetically-altering pigs in order to make their organs more compatible for human use. Other animals have been considered, and xenotransplants have been attempted with them. A famous case—known as Baby Fae—took place in 1984. An infant only days old with a severe heart abnormality received a baboon heart. The child would die three weeks post-transplant from organ rejection. Since then, the primary model for solid organ xenotransplantation has shifted from primates to pigs for several reasons, including the large litter size of pigs, the size of pig organs that are roughly compatible with humans, the lesser risk of infectious disease transfer, and many persons seem to have less issue with using pigs than primates—though the use of pigs is still contested.

What are the latest advancements in xenotransplantation? 

Xenotransplantation has been primarily in pre-clinical trial stages for years. Researchers have been doing genetic alterations on the pig genome to make the organs more compatible with humans. Without these modifications of the pig genome then, even with immunosuppressant medication, it is likely that hyperacute rejection would soon occur—a process in which the body thinks something is foreign and attacks it. In addition to genetic modifications, work has been ongoing on novel immunosuppressant therapy as well as experiments that place the genetically-altered pig organs into other mammals, such as baboons, to see how they respond. 

In the fall of 2021, New York University (NYU), under the leadership of Robert Montgomery, transplanted a pig kidney into a human recipient that had been declared deceased by brain death criteria. Then they did it again about two months later.1Montgomery RA, Stern JM, Lonze BE, et al. Results of Two Cases of Pig-to-Human Kidney Xenotransplantation. N Engl J Med. 2022;386(20):1889-1898. Shortly after the first transplant at NYU, Jayme Locke and her team at the University of Alabama at Birmingham (UAB) transplanted two kidneys from a genetically-altered pig into a brain-dead human.2Porrett PM, Orandi BJ, Kumar V, et al. First clinical-grade porcine kidney xenotransplant using a human decedent model. Am J Transplant. 2022;22(4):1037-1053. Both research teams reported that the kidneys seemed to function fairly well, and there was no sign of hyperacute rejection. 

While the kidney transplants in brain-dead humans were a step forward for xenotransplantation, a giant leap would follow. The University of Maryland Medical Center (UMMC) would stun the transplant community when they announced in early January 2022 that they had successfully transplanted a pig heart into a living human.3Kotz D. UM Medicine Performs Historic Xenotransplantation. https://www.umaryland.edu/news/archived-news/january-2022/um-medicine-performs-historic-xenotransplantation.php. Published 2022. Updated January 11, 2022. Accessed January 12, 2022. The patient—David Bennett, Sr.—was reportedly not a candidate for a human heart. UMMC had a longstanding research program into pig heart transplantation and researchers at UMMC asked the U.S. Food and Drug Administration for emergency authorization to allow them to transplant a pig heart into Bennett. He would live for over 8 weeks4Rothblatt M. Commentary on achievement of first life-saving xenoheart transplant. Xenotransplantation. 2022:e12746. before dying from what some have suspected to be a virus that was transferred to him from the pig heart.

What are the ethical issues involved in xenotransplantation for Christians to be aware of?

While allotransplantation (human-to-human transplants) has been written on from a Christian perspective for decades (Helmut Thielicke, Paul Ramsey, and Gilbert Meilaender to name a few), Christian writings on xenotransplantation are sparse. The Catholic Church’s Pontifical Academy for Life has developed perhaps the most comprehensive theological viewpoint on the subject that would likely resonate with many Protestant Christians. Additional symposia and focus groups have been conducted with academic theologians and clergypersons alike,5Hurst DJ, Padilla LA, Cooper DKC, Paris W. Factors influencing attitudes toward xenotransplantation clinical trials: a report of focus group studies. Xenotransplantation. 2021:e12684. 6Paris W, Seidler RJH, FitzGerald K, Padela AI, Cozzi E, Cooper DKC. Jewish, Christian and Muslim theological perspectives about xenotransplantation. Xenotransplantation. 2018;25(3):e12400.and there has been a small number of empirical studies looking at how religious persons view xenotransplantation. 

From my perspective, the most glaring ethical issues with xenotransplantation that we need to think through from a theological perspective are 1) the use of animals as a supply of organs, and 2) the potential risk of infectious disease and how this may impact those who receive a pig organ and the wider public. Each of these two items has many subpoints that will be explained.

The proper use of animals for the benefit of humans has long been the subject of deliberation. In the Genesis creation account, God states, “Let us make man in our image, after our likeness. And let them have dominion over the fish of the sea and over the birds of the heavens and over the livestock and over all the earth and over every creeping thing that creeps on the earth” (Gen. 1:26, ESV). From this account, it seems unquestionable that God gives humankind dominion over other living things, yet what this dominion entails has been subject to interpretation. 

Scripture reveals that God allows animals to be used for the benefit of humans in a variety of ways, including as food (Gen. 9:3), clothing (Gen. 3:21), and for labor that benefits humankind (Exo. 23:12). The term stewardship is often used when Christians think through their relationship to the created world, including animals (i.e., God has appointed humans as stewards over his creation). While in the garden of Eden prior to sin entering the human realm, Adam’s role in the garden is “to work it and keep it” (Gen. 2:15). A conventional interpretation of this implies that humans (Adam, in particular) are given a leadership role over God’s created role to prepare it, guard it, and protect it. King David tells us that all of creation is God’s: “The earth is the LORD’s and the fullness thereof, the world and those who dwell therein” (Psa. 24:1). All of creation is the Lord’s, and he has given a leadership role over his creation to humans, a delegation of authority to steward the world, its resources, and the living creatures within. 

How should we think about xenotransplantation? 

With these items in mind, how then do we regard xenotransplantation? I will emphatically note that Christian liberty instructs that we can disagree over the conclusions we draw from what it means to be stewards of God’s created world. Yet, I think there is a convincing argument that as God has granted dominion over the created world to humans, and as humans are meant to steward those resources well, then xenotransplantation may fit within this framework if we maintain certain parameters.

First, Christian doctrine affirms that humans are the only beings created in God’s image and, by bearing that image, they occupy a place of importance in the created order that animals do not. Humans are the ultimate work of creation. As the pinnacle of creation, some have taken this to mean that humankind can do anything they please with other created entities (e.g., the environment, animals). This would be a misinterpretation of what it means to be a steward of the resources God has given to humankind. Surely abuses have occurred in the past and present in the name of so-called exercising dominion, but acting in God’s image means—in part—that we are to mirror his goodness for creation. Christians can differ in how we apply certain aspects of dominion, such as what sound environmental policy might entail, but seeing the created world as merely at the disposal of humans and to be used in any conceivable way would be mistaken. 

While we must not make the mistake of seeing the created as ours to be exploited, one purpose of the created world is for the use—even the flourishing—of humanity. I am sensitive to those who have hesitations about explicitly breeding a genetically altered species of pigs solely for the purpose of using their organs to meet human needs. Yet, we similarly breed species of animals for other purposes: for sport, for work, for food, for companionship. These activities, it could be argued, are for human flourishing. Hence, if we deem it acceptable to promote the use of animals for these purposes, then it does not seem that using an animal for xenotransplantation is entirely dissimilar. This is not to say we still do not try to promote such activities within the confines of what is ethical (e.g., try to reduce animal suffering; reduce the number of animals needed if possible), but there does not seem to be anything explicitly unethical about the use of animals for the purpose of xenotransplantation if we accept the use of animals for certain other purposes. 

Second, one risk of xenotransplantation that has been known for decades is xenozoonotic infection. That is, the risk that the nonhuman organ may contain an infectious disease, such as a virus, that could infect the human that receives the nonhuman organ. It is then plausible that such an infection could spread to other close contacts and become a public health concern. As it was recently reported that the pig heart transplanted into the patient at UMMC was infected with a pig virus, this is a serious issue. Steps have been taken to reduce the risk of a xenozoonotic infection being transferred from a pig to a human, such as research protocols aimed at supplying pathogen-free porcine specimens (i.e., in how they’re raised/prepared), as well as developing highly sensitive molecular diagnostic panels to screen xenotransplant material for a wide range of infectious agents immediately prior to the transplant procedure. 

However, even with this mitigation the risk still exists, and the true level of this risk is uncertain. Every day, we accept some level of risk for ourselves and those around us. We drive our cars and are accepting risk. If we have passengers—children, especially—we are accepting a risk for them, as they cannot consent to that risk. I bring up the aspect of “risk” because as Christians we are called to love our neighbors. Jesus speaks of the greatest commandments being to love him and love our neighbor. Accepting a nonhuman organ carries the risk of becoming infected with a pig virus and then possibly exposing others (our neighbor) to that risk—a risk they did not consent to accept. From an ethical perspective, even apart from the question of how Christians might view xenotransplantation, the risk of infectious disease is likely the most looming ethics issue facing this new therapy. In one sense, putting our neighbor at some risk is unavoidable in this world. More work certainly needs to be done to ensure that the pigs used for xenotransplantation are pathogen-free, which would undoubtedly ease the minds of many.  

In short, xenotransplantation does present ethical challenges, but none seem outright insurmountable. The largest ethical issue facing xenotransplantation is the risk of potential infectious disease and what this may entail. For instance, some proposals call for xenograft recipients to be monitored for infectious diseases for the remainder of their lives. This seems difficult for both the study sponsor and the graft recipient to realize. The constant risk of spreading an infectious disease to loved ones (at least until the scientific community can be certain their source pigs are indeed pathogen-free) is a glaring issue and one that Christians may not want to assume currently. 

Acknowledgment: I want to thank long-time friend Scott James, MD for reading an early draft of this article and offering many helpful comments. 

Potential conflicts of interest: DJH is a paid consultant to a working group on ethical and social viewpoints of xenotransplantation at NYU. 

  • 1
    Montgomery RA, Stern JM, Lonze BE, et al. Results of Two Cases of Pig-to-Human Kidney Xenotransplantation. N Engl J Med. 2022;386(20):1889-1898.
  • 2
    Porrett PM, Orandi BJ, Kumar V, et al. First clinical-grade porcine kidney xenotransplant using a human decedent model. Am J Transplant. 2022;22(4):1037-1053.
  • 3
    Kotz D. UM Medicine Performs Historic Xenotransplantation. https://www.umaryland.edu/news/archived-news/january-2022/um-medicine-performs-historic-xenotransplantation.php. Published 2022. Updated January 11, 2022. Accessed January 12, 2022.
  • 4
    Rothblatt M. Commentary on achievement of first life-saving xenoheart transplant. Xenotransplantation. 2022:e12746.
  • 5
    Hurst DJ, Padilla LA, Cooper DKC, Paris W. Factors influencing attitudes toward xenotransplantation clinical trials: a report of focus group studies. Xenotransplantation. 2021:e12684.
  • 6
    Paris W, Seidler RJH, FitzGerald K, Padela AI, Cozzi E, Cooper DKC. Jewish, Christian and Muslim theological perspectives about xenotransplantation. Xenotransplantation. 2018;25(3):e12400.