Feline Renal Transplantation: The Ethics
Chronic kidney disease (CKD) is very common in cats, especially those over 7-years-old. Kidney transplantation is sometimes used to treat CKD, and it usually involves the transfer of a single kidney from a healthy cat. However, this procedure is controversial because it is difficult to predict potential harmful effects on both donors and recipients. As CKD becomes more common and demands for kidney transplantation increase, it is important for everyone, and especially for veterinarians and lawmakers, to consider related ethical issues.
In an article in “The Veterinary Journal,” the author focuses on two concepts to assess the morality of kidney transplantation in cats. The first is “harm versus benefit”; the second is “cat-likeness,” or the degree to which a cat may be defined as one. He then discusses ethical implications for veterinarians and lawmakers, key decision-makers of kidney transplantations. The author points out that although kidney transplantation can alleviate CKD, it can also lead to side-effects such as pain, transplant rejections, and infections. In addition, the procedure may or may not extend a cat’s life significantly. Other factors, such as the guardian’s capacity to pay for post-operative care, can affect a cat’s quality of life over the long run. In a sense, the veterinarian must “gamble” and evaluate the potential harms and benefits of each case individually.
There is a gamble for donor cats, too. The removal of a kidney would likely cause suffering and shorten lifespan. However, donor cats, who often come from shelters, may sometimes be adopted by the guardian of recipient cats. In this case, a cat that may not otherwise find a home could find one. Still at issue is whether a donor cat thus adopted would live comfortably in the long run, instead of being neglected or euthanized. Apart from these gambles, another potential concern about kidney transplantation is whether it makes cats “abnormal.” The addition of a kidney may enhance a cat’s bodily function, making it “beyond natural,” and the loss of a kidney may make a cat “impaired.” However, the author asserts that these arguments have “limited force.”. An added kidney substitutes an original kidney, restoring overall kidney function; the loss of a kidney usually has little impact on overall kidney function. In both cases, “cat-likeness” is generally unaffected.
The author proposes that lawmakers ban kidney transplantations, except in cases where no cat is harmed overall (for example, if kidneys can be obtained from a deceased cat). Even when transplantation is allowed, veterinarians and guardians are still advised to consider any broader harmful effects on cats, and lawmakers are advised to establish suitable protective measures for such cases. For animal advocates, the article is sure to generate a great deal of discussion—discussion that is worth having.