Abstract
Porcine-derived medical products represent an effective solution for a wide range of human suffering, yet this may contradict Muslim and Jewish religious prohibitions against consuming pig. The present study evaluated the level to which Muslim and Jewish participants are knowledgeable about the conditions permitting porcine-based treatments and explored their attitudes toward the permissibility of these treatments. A questionnaire that presented fifteen medical uses of porcine-derived products was completed by 809 Muslims and 714 Jews. Neither Muslim nor Jewish participants are knowledgeable about the religious rulings of their religions which permit the use of pig for life saving. Participants of both groups objected to the view that porcine-derived materials should be permitted. The findings imply that the attitude toward porcine-derived materials for medical use is contingent upon the knowledge or lack thereof that individuals have regarding the permissibility of such use. We offer useful recommendations to improve the informed consent process before conducting porcine-based treatments.
Similar content being viewed by others
References
Abdulla, A., M. Hossain, and C. Barla. 2019. Toward comprehensive medicine: Listening to spiritual and religious needs of patients. Gerontology and Geriatric Medicine 5: 2333721419843703.
Bokek-Cohen, Y., & Ravitsky, V. 2017. Cultural and personal considerations in informed consent for fecal microbiota transplantation. American Journal of Bioethics, 17(5): 55–57.
Bokek-Cohen, Y. 2021. Sperm donors versus long-term mates: A comparison of preferences of heterosexual and lesbian women. Human Fertility, 1-13.
Bokek-Cohen, Y., Abu-Rakia, R., Azuri, P. & Tarabeih, M. 2020. The view of the three monotheistic religions toward cadaveric organ donation. Omega: Journal of Death & Dying, 85(2): 429-444.
Babos, M.B., J.D. Perry, S.A. Reed, et al. 2021. Animal-derived medications: Cultural considerations and available alternatives. Journal of Osteopathic Medicine 121(4): 361–370.
Bona, M.D., D. Canova, R. Rumiati, et al. 2004. Understanding of and attitudes to xenotransplantation: A survey among Italian university students. Xenotransplantation 11(2): 133–140.
Bhamra, N., K. Jolly, A. Darr, D.J. Bowyer, and S.K. Ahmed. 2021. Intra-operative use of biological products—Are we aware of their derivatives? International Journal of Clinical Practice 75(10): e14633.
Byrne, B.M. 2010. Structural equation modelling with AMOS: Basic concepts, applications, and programming, 2nd ed. New York: Routledge.
Cozzi, E., and D.K. Cooper. 2018. Jewish, Christian and Muslim theological perspectives about xenotransplantation. Xenotransplantation 25(3): e12400.
Curlin, F.A., C.J. Roach, R. Gorawara-Bhat, J.D. Lantos, and H.M. Chin. 2005. When patients choose faith over medicine: Physician perspectives on religiously related conflict in the medical encounter. Archives of Internal Medicine 165(1): 88–91.
Easterbrook, C., and G. Maddern. 2008. Porcine and bovine surgical products: Jewish, Muslim, and Hindu perspectives. Archives of Surgery 143(4): 366–370.
Ebner, K., J. Ostheimer, and J. Sautermeister. 2020. The role of religious beliefs for the acceptance of xenotransplantation. Exploring dimensions of xenotransplantation in the field of hospital chaplaincy. Xenotransplantation 27(4): e12579.
Enoch, S., H. Shaaban, and K.W. Dunn. 2005. Informed consent should be obtained from patients to use products (skin substitutes) and dressings containing biological material. Journal of Medical Ethics 31(1): 2–6.
Eriksson, A., J. Burcharth, and J. Rosenberg. 2013. Animal derived products may conflict with religious patients’ beliefs. BMC Medical Ethics 14(1): 48.
Godehardt, A.W., and R.R. Tönjes. 2020. Xenotransplantation of decellularized pig heart valves—Regulatory aspects in Europe. Xenotransplantation 27(3): e12609.
Gold, E.R., and W.A. Adams. 2002. Reconciling private benefit and public risks in biotechnology: xenotransplantation as a case study in consent. Health Law Journal 10: 31–75.
Goyal, D., A. Goyal, and M. Brittberg. 2013. Consideration of religious sentiments while selecting a biological product for knee arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy 21(7): 1577–1586.
Hagelin, J. 2004. Public opinion surveys about xenotransplantation. Xenotransplantation 11(6): 551–558.
Hagelin, J., J. Hau, S.J. Schapiro, M.A. Suleman, and H.E. Carlsson. 2001. Religious beliefs and opinions on clinical xenotransplantation: A survey of university students from Kenya, Sweden and Texas, Clinical Transplantation 16(4): 314
Hurst, D.J., L.A Padilla, D.K.C. Cooper, and W. Paris. 2021. Factors influencing attitudes toward xenotransplantation clinical trials: A report of focus group studies. Xenotransplantation 28(4): e12684.
Jenkins, E.D., M. Yip, L. Melman, M.M. Frisella, and B.D. Matthews. 2010. Informed consent: Cultural and religious issues associated with the use of allogeneic and xenogeneic mesh products. Journal of the American College of Surgeons 210(4): 402–410.
Jolly, K., A. Darr, A. Aslanidou, D. Bowyer, and S. Ahmed. 2019. The intra-operative use of biological products: A multi-centre regional patient perspective of a potential consenting conundrum. Clinical Otolaryngology 44(5): 831–835.
Karim, H.M.R., and T.H. Khan. 2018. Religious belief as determinant of animal derived medications in health care: how much is fairly good? Anaesthesia, Pain & Intensive Care 22(2): 151–154.
Kranenburg, L.W., C. Kerssens, J.N. Ijzermans, W. Zuidema, W. Weimar, and J.J. Busschbach. 2005. Reluctant acceptance of xenotransplantation in kidney patients on the waiting list for transplantation. Social Science & Medicine 61(8): 1828–1834.
Loike, J.D., and A. Kadish. 2018. Ethical rejections of xenotransplantation? The potential and challenges of using human-pig chimeras to create organs for transplantation. EMBO Reports 19(8): e46337.
Manji, R.A., A.H. Menkis, B. Ekser, and D.K.C. Cooper. 2012. Porcine bioprosthetic heart valves: The next generation. American Heart Journal 164(2): 177–185.
Padela, A.I., S.W. Furber, M.A. Kholwadia, and E. Moosa. 2014. Dire necessity and transformation: Entry-points for modern science in Islamic bioethical assessment of porcine products in vaccines. Bioethics 28(2): 59–66.
Padela, A.I., and R. Duivenbode. 2018. The ethics of organ donation, donation after circulatory determination of death, and xenotransplantation from an Islamic perspective. Xenotransplantation 25(3): 1–12.
Padilla, L.A., D. Hurst, R. Lopez, V. Kumar, D.K. Cooper, and W. Paris. 2020. Attitudes to clinical pig kidney xenotransplantation among medical providers and patients. Kidney 360 1(7): 10-34067.
Paris, W., R.J.H. Seidler, K. FitzGerald, A.I. Padela, E. Cozzi, and D.K. Cooper. 2018. Jewish, Christian and Muslim theological perspectives about xenotransplantation. Xenotransplantation 25(3): e12400.
Rodger, D. 2021. Why we should stop using animal-derived products on patients without their consent. Journal of Medical Ethics. ePub ahead of print, June 8. https://doi.org/10.1136/medethics-2021-107371.
Rodger, D., and B.P. Blackshaw. 2019. Using animal-derived constituents in anaesthesia and surgery: The case for disclosing to patients. BMC Medical Ethics 20(1): 1–9.
Sattar, S.P., M.S. Ahmed, J. Madison, et al. 2004a. Patient and physician attitudes to using medications with religiously forbidden ingredients. Annals of Pharmacotherapy 38(11): 1830–1835.
Sattar, S.P., M.S. Ahmed, F. Majeed, and F. Petty. 2004b. Inert medication ingredients causing nonadherence due to religious beliefs. Annals of Pharmacotherapy 38(4): 621–624.
Shiwani, M.H. 2020. The use of porcine mesh implants in the repair of abdominal wall hernia: an Islamic perspective for an informed consent. Journal of the British Islamic Medical Association 4: 30–37.
Sommaggio, R., M. Uribe-Herranz, M. Marquina, and C. Costa. 2016. Xenotransplantation of pig chondrocytes: Therapeutic potential and barriers for cartilage repair. European Cells & Materials 32: 24–39.
Sykes, M., A. d’Apice, and M. Sandrin. 2003. Position paper of the ethics committee of the international xenotransplantation association. Xenotransplantation 10(3): 194–203.
Van den Branden, S., and B. Broeckaert. 2011. The ongoing charity of organ donation: contemporary English Sunni fatwas on organ donation and blood transfusion. Bioethics 25(3): 167–175.
Vissamsetti B., M. Payne, and S. Payne. 2012. Inadvertent prescription of gelatin-containing oral medication: Its acceptability to patients. Postgraduate Medicine Journal 88(1043): 499–502.
Acknowledgements
The authors wish to express their sincere gratitude to the anonymous reviewers for their helpful comments and suggestions. We are also grateful to the Academic College of Israel in Ramat-Gan for the research grant that enabled this study.
Funding
This work was supported by the Academic College of Israel in Ramat-Gan under Grant number 24484057
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest statement
No potential competing interest was reported by the authors.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The appendix citation in the text has been changed to read ‘(see appendix A in the Supplementary Information for the study questionnaire).
Supplementary information
ESM 1
(DOCX 27.1 kb)
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Bokek-Cohen, Y., Tarabeih, M. The Use of Porcine-Derived Materials for Medical Purposes: What do Muslim and Jewish Individuals Know and Opine About It?. Bioethical Inquiry 19, 599–612 (2022). https://doi.org/10.1007/s11673-022-10203-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11673-022-10203-w