Keywords: decision making, participatory governance, health policy, public participation, public policy, risks, risk management, USA, United States, rights, ethics, xenotransplantation, XTP, healthcare, transplantation, transplants, regulation, pig endogenous retroviruses, PERVs
Reinventing the pig: the negotiation of risks and rights in the USA xenotransplantation debate
Xenotransplantation (XTP) involves the transplantation of cells, tissues and organs from non-human mammals (usually pigs) to humans. Because XTP could produce considerable public health gains, advocates want to proceed to human clinical trials as soon as possible. However, XTP also raises complex regulatory issues, since virtually all scientists agree that there is a risk of pig endogenous retroviruses (PERVs) crossing the species barrier and infecting patients, their contacts and potentially the community. This tension between individual benefit and potential public risk mandates that the public should be consulted on this issue. This paper analyses the XTP debate in the USA in order to evaluate the implications of the shift from expert-driven health policy to more participatory governance of health and risk.