The Impact of International Bioethics on the Sanctity of Life Ethics and
the Ability of Ob Gyn's to Practise According to Conscience - Part II
THE FUTURE OF OBSTETRICS AND GYNAECOLOGY: The Fundamental Right To
Practice and be Trained According to Conscience: An International Meeting
of Catholic Obstetricians and Gynaecologist
Organised by the World Federation of Catholic Medical Associations
(FIAMC)
and by MaterCare International (MCI)
Sponsored by the Pontifical Council for the Health Pastoral Care
ROME, June 17th-20th, 2001
Reproduced with permission
Dianne N. Irving, M.A., Ph.D.
*
The first part of this paper addresses topics
that are covered in other essays by Prof. Irving
that are available on the Project site. The full
text of the paper is available at
LifeIssues. [Administrator]
"A small error in the
beginning leads to a multitude of errors in the
end."
Thomas Aquinas, De Ente Et Essentia;
Aristotle, De Coelo
F. Erroneous "Personhood" Theories used by
Bioethics
ObGyn's might keep in mind that the key to
understanding any philosophical or theological
ethical theory is to identify its philosophical or
theological "anthropology"-- or definition of
"a human being" or "person". Different
anthropologies lead to different ethical theories.
Some anthropologies match reality; others don't.
Bioethics tries to claim that its theory really
has no "anthropology", i.e., the "personhood" issue.
Bioethics is "just" about "ethics". However, almost
all bioethics arguments do incorporate a "delayed
personhood" claim,45
whether or not they know or admit it -- especially
within the context of debates over abortion, the use
of abortifacients, human and fetal research,
cloning, stem cell research, euthanasia, etc. That
is, most deny the accurate human embryology, or make
up their own, to argue that at fertilization there
is no human being -- or at least no human "person"
-- there yet. "Whatever" is there has only a
"reduced moral status" at best (the language used
from the National Commission onward). Only some time
period after fertilization, e.g., implantation (5-7
days post-fertilization), 14-days (with the
formation of the primitive streak), or "brain birth"
46 (with the formation of the cortex or
neocortex), etc. (depending on the theory), is there
a real "person" with rights present. Before that
biological marker there are only "stem cells", or
"pre-embryos"
47 present.
Virtually all of the arguments for "delayed
personhood" use erroneous science on which to ground
their philosophical "personhood" claims, hence
rendering those claims automatically invalid per se.
Regardless, these false claims have had enormous
influence in public policy making worldwide --
especially the "brain-birth" myths (addressed with
"preference" utilitarianism, below), and the
"pre-embryo" myth of McCormick and Grobstein. It is
worth reviewing even briefly this influence, as it
helps to explain at least to some extent the sources
of such immense pressures against Catholic ObGyn's
in their daily practice. While many may be aware of
McCormick's influence in moral theology, few seem to
be aware of his penetrating work in a totally
different field -- "secular bioethics".
Early in the 1970's, Richard McCormick, S. J.,
had argued that defective newborns could be allowed
to die. Applying the "Catholic" moral theology
distinction of the Principle of Double Effect,
McCormick concluded that the term "extraordinary"
was large enough to justify the omission of
life-sustaining treatments on the basis of expected diminished quality of life, defined in
terms of the potential for human relationship.48 McCormick had also agreed with the May 1979
DHEW Ethics Advisory Board recommended approval of
federal funding of research on the safety and
efficacy of IVF research and embryo transfer in the
treatment of infertility -- departing from the
Vatican's position against any technologically
assisted pregnancies, even in lawfully married
couples.49 Now, following similar work by Andre
Hellegers (founder of The Kennedy Institute of
Ethics at Georgetown University), McCormick
seriously questioned the "moral status" of
early human embryos (or, "pre-embryos" as he
referred to them), as did several others within the
Catholic Health Association.51 Furthermore, McCormick reluctantly agreed
that since some abortions are acceptable, then some
fetal research would also be acceptable. He had
reasoned that children have a moral obligation
to participate in non-therapeutic experimentation
where there is no discernible risk or undue
discomfort, and therefore their parents may give
proxy consent for their children's participation in
such research that would not benefit them
personally. He grounded this moral obligation in social justice -- i.e., "to contribute to the
benefit of the human community." The same moral
obligation, argued McCormick, can now be extended to
the fetus.52
Paul Ramsey also had qualms about the
"moral status" of the early embryo, accepting the
McCormick/Grobstein "pre-embryo", and therefore also
reluctantly sanctioned fetal research.53
Thus these writers, as many others, claimed that
morally relevant characteristics were not present in
the early developing embryo until "segmentation", or
the attainment of "individuality" about 14-days or
even later during human development.
54
Regardless of the biological marker used, what
these arguments have in common is a claim for some
sort of a "delay" -- in "personhood", or even
"humanhood" -- after fertilization.
Philosophically, such a claim is per se a
claim about "anthropology", and historically a very
weak and indefensible one at that. It requires that
the soul and the body are two separate and
independently existing substances. But think about
it. If there is a real split or gap between
the "mind" (or "soul") entity, and the "body" (or
"matter") entity -- which is required if there is
any "delay" in "personhood" -- then one simply
cannot successfully explain any causal
interaction whatsoever between these two
separate entities, either before or even after
"uniting". Nor is there any scientific data to
verify such a "split", nor such a "delay".55
A lengthy response is not practical here, but
solid arguments to refute such "delays" have been
advanced for many years. Briefly, e.g., if, the
"rational soul" contains virtually the other
powers of the soul; if there is no split among the
several powers of the soul; if there is no split
between the soul and the body; if the body and soul
must exist together as one single substance
(as both Aristotle and St. Thomas have insisted!);
and if there is scientific evidence that the
"vegetative" power of the human rational soul is
present immediately at fertilization (which there
is) -- i.e., the immediate production of explicitly
human proteins and enzymes, the development of
specifically human tissues and organs -- then
the whole rational soul must be immediately present
at fertilization.56
Personhood must begin when the human being begins.
There is no carrot or frog produced -- and we know
that empirically!
It is long past time for us to recognize,
acknowledge, and deal with the concrete reality that
the earliest human embryo is indeed deserving of
exactly the same respect, dignity and legal
protections as all human persons -- simply even by
virtue of his or her inherent humanity which we all
share in common (the basis of natural law
philosophical ethics), and as stated explicitly in
many Church documents.57
This information is critical for the correct
formation of conscience.
To choose not to acknowledge or deal with this
information has already led to the acceptance, now
almost habitual, of a two-tiered caste of human
beings -- some of whom are "persons" and some of
whom are not -- as exemplified in these bioethics
"delayed personhood" debates. This "delayed
personhood" mental construct has also long since
been transferred to bioethics issues
involving adult human beings, e.g., in issues
concerning the mentally ill, euthanasia, etc. If
nothing else the Nazi "science", rationalizations,
propaganda, and experiments, and the on-going
scourge of slavery, should have taught us about the
inevitable real life consequences of such a "caste".
The unheralded words of the single dissenting
National Commissioner Louisell ring ominously clear:
"American society is itself at risk -- the risk of
losing its dedication to the proposition that 'all
men are created equal.' We may have to learn once
again that when the bell tolls for the lost rights
of any human being, even the politically
weakest, it tolls for all."
58
III. INTERNATIONAL BIOETHICS' ATTACK ON THE
"SANCTITY OF LIFE ETHIC":
Although bioethics is unquestionably
predominantly a "utilitarian" ethical theory, there
are in fact many different kinds of
"utilitarianism". Probably the most common in
bioethics today is "preference" utilitarianism, a
deconstruction of the classical utilitarianism of
Bentham and Mill. While it would be a mistake to
paint all "preference" utilitarians the same, as
each proponent differs somewhat in their "theory", a
small sampling of some of the most articulate in the
field could serve to indicate, in general, some of
the main dogmas they hold in common -- which dogmas
the Catholic ObGyn meets daily face to face.
In "preference" utilitarianism an action is
ethically correct if it satisfies the "preferences"
(or, another variety, "best interests") of those
affectedand has the best consequences for
the greatest number of "people". Modern
utilitarianism, Bernard Williams explains, is
supposed to be a system neutral [!] between
the preferences that "people" actually have -- a
"preference" being a reflection of the state of mind
of the agent, and not to be judged by some standard
of reasonableness other than whether it accords with
the best moral theory. Therefore, all preferences go
into the melting pot, with no preference to count
for more than any other; there must be "equal
consideration of interests", as Singer puts it.59
But of course ultimately, these individual
"interests" will be weighed unequally against the
total "good" or consequences for society as a whole
-- a point about any utilitarian theory that is
often overlooked or underestimated.
Of interest is the definition of "people" or
"person" used in preference utilitarianism.
"Persons" are those who have preferences, interests,
desires, etc. For these utilitarians, not all human
beings are "persons", while some animals
are
"persons". Preference utilitarians especially need
to attack those who hold the "sanctity of life
ethic" (which states that only human beings are
"persons"), as simply prejudiced and racists tenets
of "speciecism". As Oderberg explains the origins of
this attack: "The charge was made famous by Peter
Singer and is leveled by virtually all the followers
of Singerian bioethics".
60
They prefer instead a "quality of life" ethic. One
way that "preference utilitarianism" attacks the
"sanctity of life ethic" is by literally
deconstructing or redefining it -- usually by means
of "soft", meandering, but very clever "thought
experiments" and "logical dialogues" that "evaluate"
the "pros" and "cons" of the "sanctity of life
ethic" -- to support a "quality of life" position.
A. Jonathan Glover:
One of the major theoreticians of "preference
utilitarianism" for many decades has been Oxford
philosopher/bioethicist/eugenicist Jonathan Glover.
In his 1977 book,61
Glover literally redefines the "sanctity of life
ethic" by means of redefining its major premise.
Once that major premise is corrupted, of course,
then all conclusions which flow from it will be
corrupted as well.
The "sanctity of life ethic" is generally
correctly stated as: "It is always a morally evil
act to intentionally and directly kill an innocent
human being." From that major premise it follows,
e.g., that since human embryos and fetuses are
innocent human beings, and since human disabled and
terminally ill adults are also innocent human
beings, to intentionally and directly kill them
would be morally evil actions per se --
regardless of any "personhood" status, circumstances
or intentions.
But Glover doesn't hold those actions to be "morally
evil
per se"; besides, that would impede the
advancement of global "positive eugenics" and
genetic engineering which he, and most preference
utilitarians, strongly advocate. So he redefines the
major premise of the "sanctity of life ethic" as
follows: "It is always intrinsically wrong to
destroy a life that is worth living."
63 Such a life would not be "mere biological
life", but rather, as Glover vaguely describes it,
the
quality of life of one who consciously
possesses preferences, plans, projects, desires,
feelings, memories, a sense of identity, etc. --
what later came to be grouped together in bioethics
and labeled "rational attributes" and/or
"sentience". Only a "person" possesses a life that
is worth living. Since unborn, born, and human
children, as well as many ill or disabled adult
human beings do not have this "quality of life",
they do not have a "life that is worth living".
Therefore, they are "non-persons" -- and therefore
the direct and intentional killing of these human
non-persons would not necessarily be a morally evil
act. Voila! The "sanctity of life ethic" now
is
the "quality of life ethic"!
B. R. M. Hare:
Glover, in turn, was the academic mentor of
Oxford philosopher/eugenicist R. M. Hare. For Hare,
the early human embryo, fetus and even young child
are also not "persons". They are not "real people";
they are just "possible people" -- and therefore
have no serious "interests" or "preferences" to be
respected. We do, however, have "some" duties"
toward "them". Thus, applying a sort of mathematical
trigonometry to the problem, his international
public population policy proposals go like this:
"The maximum duty that is imposed is to do the best
impartially for all the 'possible people' there
might be by having an optimal family planning or
population policy, which means necessarily excluding
some possible people." Indeed. Hare asserts that the
best policy will be the one which produces that set
of people, of all "possible sets" of people,
which will have in sum the best life, i.e., the best
possible set of future possible people."
64 Hare's bioethics interests lie largely in
translating the Gloverian theory of "preference"
utilitarianism into national (i.e., British) and
global population public policies. One of Hare's
most prominent students at Oxford was Peter Singer.
C. Peter Singer:
Most bioethicists today -- to one degree or
another -- agree that a "person" is to be defined in
terms of such "rational attributes" or "sentience".
What are really "morally relevant" are "quality of
life" characteristics, "preferences", or
"interests". So too argues Peter Singer, currently
the Ira W. DeCamp Professor of Bioethics at
Princeton University's Center for Human Values.
Like Glover and Hare before him, Singer -- the
founder and first President of the International Bioethics
Institute at the U. N., and the
founder of "animal rights" -- argues that the higher
primates, e.g., dogs, pigs, apes, monkeys -- even
prawns -- are persons, because they exercise
"rational attributes" and/or "sentience". However,
some human beings, even normal human infants,
as well as disabled and ill human adults, are not
persons.65
American philosopher/bioethicist Richard Frey,
pushing Singer's logic, actually published an
article in a major international bioethics textbook
that, since many adult human beings are not persons
(e.g., Parkinson's patients, the mentally ill and
retarded, the frail elderly, etc.), and since many
of the higher primates are persons, then these adult
human non-persons should be substituted in purely
experimental research in place of the higher
primates who are persons.66
Recently, Singer applied his form of "preference
utilitarianism" to bestiality. He concluded that
bestiality can be an "ethically correct" action, as
long as it is not cruel, if it satisfies the
preferences (e.g., sexual pleasure)
of those
affected (i.e., the human person and the
animal),
and if it has the best consequences
for the greatest number of people involved (i.e.,
the total amount of "pleasure" experienced in the
world would be increased).
67 And, of course, since Singer defines many
animals as "people", then "the greatest number of
people" for Singer would include some human beings
and some animals. Therefore, bestiality can indeed
be "ethical". This is surely "theory" run amok!
D. Others:
American bioethicst and "preference" utilitarian
philosopher Peter Suber also attacks the "sanctity
of life ethic", which always entails a different
definition of "person": "The 'life' that has
sanctity for SL ["sanctity of life ethic"] is
biological vitality, perhaps with a spiritual glow,
but not the complex of powers and interests that we
collectively call the person."68
This dogma then allows Suber to argue for the range
of other bioethics positions already noted --
including abortion, euthanasia, and eugenics. He too
is impatient with those who would fail to consider
"the degree or kind of suffering, deterioration,
dependency, or development they manifest, and
regardless of the imminence of death, the burden on
others, and the wishes of the subject to live or
die." Suber prefers a "combined" quality of life"
ethics.69
United Nations consultant/bioethicist/biologist
Darryl Macer (Japan) also defines a "person" similar
to Glover, Hare, and Singer: "A person is generally
referred to as someone who is rational, capable of
free choices, and is a coherent, continuing and
autonomous centre of sensations, experiences,
emotions, volitions and actions; these are what may
be called the characters of a person."70
Macer, like so many others in the field,
conveniently continues to ground his "embryology"
and "personhood" concepts at least in part on the
amazingly flawed but influential bioethics
book by Australian theologian Fr. Norman Ford, When Did I Begin?.71
Ford himself, unabashedly and without
cross-verification, used and applied the same
erroneous "human embryology" -- as well as the same
"moral" conclusions that follow from it -- that
McCormick and Grobstein used to fashion their
scientifically erroneous concept of a "pre-embryo".
Macer argues that the life of a 1-cell embryo is not
sacrosanct, and has never been, even in theological
circles. "It is clear that the biological qualities
of personhood are not present at conception; what is
present is something we call the embryo, ... but it
does not manifest the activities of a human person.
It is a potential human person, at the biological
level at least, rather than a human person with
potential." Ultimately, Macer leans toward the
socially acceptable concept of the "gradual"
attainment of "personhood" and "brain birth",72
and is a strong proponent of global birth control.73
However, although a living human embryo or fetus
does not qualify as a "person" for Macer, their
manipulation (or destruction) can be useful for
purposes of "positive eugenics" -- for a "healthy
"society". Macer clearly articulates the
international bioethics case for "positive
eugenics."74 But as with all utilitarian theories, there
is virtually no "ethical" consideration given to the
"means used" to achieve this eugenics agenda. Nor
would they need to. The reality of the person
of the individual human being at fertilization has
been disposed of -- "scientifically", conceptually,
and linguistically. It simply remains to be
concretized in all international law.
Or ponder the contemporary thoughts of one of
bioethics' founders, "Christian bioethicist"
Tristram Engelhardt: "Persons in the strict sense
are moral agents who are self-conscious, rational,
and capable of free choice and of having interests.
This includes not only normal adult humans, but
possibly extraterrestrials with similar powers."75
Obviously, "personhood" has been and still is
used as a linguistic device for various unethical
purposes. It has been used in the medical arena as a
justification for abortion, the use of
abortifacients, international population policies,
euthanasia, and a multitude of related bioethics
issues -- and often for eugenic purposes. Indeed,
many of the leading "savants" who pioneered the
early formation of the field of bioethics were quite
outspoken eugenicists. This has not changed; it is
merely getting more vocal and more universal.
For example, sounding much like Hare (above),
bioethicist Dan Wikler, as representative of the
World Health Organization, recently declared that:
"The state of a nation's gene pool should be
subject to government policies rather than left to
the whim of individuals. ... The completion of
the human genome project would also make it possible
to promote some genetic qualities such as
intelligence and lower the incidence of others. ...
It may be conceivably required by justice itself"
["justice", as in Rawls!]76
Of course, the "gene pool" must also be
determined by means of abortion, the use of
abortifacients, infanticide, IVF, pre-natal
selection, surrogate mothers, human embryo and fetal
research, human cloning, human chimera research,
human embryonic and human fetal "stem cell"
research, euthanasia, physician-assisted suicide,
etc. These are the usual "bioethics" issues,
accomplished via "absolute autonomy" (at least for
now) and the other bioethics principles as
originally defined. These are not just "issues",
but also the "tools" required to advance a global
eugenics agenda -- just read their works, and listen
to their lectures. And it is the Catholic ObGyn who
is standing in the way!
IV. ERRONEOUS SCIENCE IN HUMAN STEM CELL AND
HUMAN CLONING RESEARCH:
Finally, one of the most hotly debated issues
right now is human embryonic and fetal stem cell
research, which, researchers claim, can cure many
diseases, as well as advance scientific knowledge in
early human embryonic development. Here too it is
difficult to correctly form one's conscience because
these debates, as with the earlier debates on
abortion, the use of abortifacients, etc., are
replete with similar false and confusing human
embryology and genetics. And although some ObGyn's
are not particularly concerned about these "medical
research" issues, you should consider that sooner or
later you will be expected to apply "fruits" of such
research in your own practice of medicine and on
your own patients.
A. "Human Embryonic Stem Cell" Research:
1. The new "pre-embryo": "just 'pluripotent'
'stem cells'":
Once bioethicists were forced to discard the
scientifically erroneous term "pre-embryo", there
was a need to find some term to take its place --
some term that could still "scientifically" justify
the use of the early human embryo in research and in
"therapy".
Among the more "creative" attempts that have
emerged, perhaps the most influential has been to
redefine the early human embryo as "just stem
cells". For example, in his 1999 testimony before
the U.S. Senate subcommittee hearings on stem cell
research, then-Director of the National Institutes
of Health, Harold Varmus, actually defined the early
human embryo from fertilization to the end of the
blastocyst stage as "just stem cells"!
77 The concrete reality of the early human
embryo, a whole human organism, simply
"vanished"! The NIH Guidelines on stem cell research
then proceeded to define all of the "stem
cells" derived from frozen IVF-produced human
embryos as "just pluripotent", rather than
acknowledging that many of these stem cells are
"totipotent".78
2. Separated "stem cells" could become embryos:
It has also not been explained in these debates
that most of IVF-produced human embryos are used
immediately or frozen down at very early stages,
usually between the 4-8-cell stage79 (long before any differentiation into an
inner and outer cell layer takes place), rather than
at the 5-7 day blastocyst stage (when the embryo
consists of at least 30-150 cells, and has
differentiated into an inner and outer cell layer).
Thus most of the "stem cells" retrieved from these
early-stage frozen IVF-produced human embryos would
actually be totipotent, not pluripotent.
Oddly, most of the debate centers on the older
blastocyst-stage frozen embryos, all of whose "stem
cells" (derived from the inner cell mass) are
referred to as "pluripotent". But most IVF transfers
do not use blastocyst-stage embryos; and most frozen
embryos do not have inner cell masses!
Nor has it been explained that the term "human
embryonic stem cells" can properly refer to those
cells only while they are still a part of and intact
within the whole embryo. Once these "stem cells" --
or even groups of "stem cells" -- are separated from
the whole embryo, they can be "totipotent",80
and therefore quite capable of "healing" themselves
(called "regulation) and becoming new whole living
human embryos themselves -- per se.
81 That is, they would no longer be "stem
cells"; they would be living human beings.
Substantial change would have taken place, much as
like happens in human cloning, resulting in the
formation of a new living human embryo/being. So to
use such so-called "stem cells" would constitute
human embryo research per se.
We know this biological fact about regulation even
from
natural monozygotic twinning82 -- a form of asexual reproduction called
"fission", "blastomere separation", or "blastocyst
splitting". In fact, "twinning", sometimes called
"embryo multiplication", is a form of cloning,
83
in which copies or replicas of human genetic
organisms are produced. The method is even being
seriously considered by IVF researchers and
clinicians themselves for "multiplying" human
embryos from single embryos produced by older
infertile women who have difficulty maturing viable
oocytes during IVF "therapy".
84 And surely, neither the IVF clinician nor the
woman think that what is being implanted in the
woman's uterus is just a "stem cell"!
B. "Fetal Stem Cell" Research:
Another misleading scientific term used in these
debates is "fetal stem cells". These cells are
generally retrieved from aborted embryos aged
5-9 weeks. Since the embryonic period extends from
fertilization to the end of 8 weeks,85
the majority of these cells are "embryonic", not
"fetal". These cells are also not "somatic cells",
but rather the primitive sex cells, the
immature human germ line cells. They are still
diploid, and therefore can be cloned using any
cloning technique (including somatic cell nuclear
transfer). They can be matured in vitro to produce
the sex gametes (sperms and oocytes) and then used
in artificial fertilization.86
Since they are germ line (sex) cells, they can be
manipulated using DNA-recombinant gene transfer, and
thereby transmit "foreign" genes down through the
generations (eugenics).87
V. CONCLUSIONS:
As Catholic ObGyn's continue to insist on your
right to be trained and practice in medicine
according to your consciences, I hope you will
consider how critical it is to develop a well-formed
conscience -- one that is grounded in reality. Part
of that reality is the accurate objective scientific
information that the immediate product of
fertilization and of cloning is a new, living
innocent human being. These are the objective
empirical facts of human embryology and human
genetics which lead to the conclusions of the Moral
Law that they should be treated as persons even at
their earliest stages of development. This is the
"sanctity of life ethic", and is the starting point
for all further considerations in medicine and
research.
I hope you will also consider that another part
of reality is the existence of malignant global
structures of bioethics which purposefully use
erroneous science and an idiosyncratic and very
problematic normative "ethics" to redefine the
"human being" and "human person" in order to achieve
their own medical and research agendas, often
eugenic in purpose. Theirs is the "quality of life
ethic", which necessarily comes to far different
ethical conclusions in medicine and research.
Until and unless we all come to deal effectively
with these concrete realities, the pressures on and
discriminations against Catholic ObGyn's and related
health care workers to be trained and practice
according to conscience will continue to escalate.
... [T]here has emerged a
phenomenon unknown to antiquity that permeates our
modern society so completely that its ubiquity
scarcely leaves us any room to see it at all: the
prohibition of questioning ... We are confronted
here with persons who know that, and why, their
opinions cannot stand up under critical analysis
and who therefore make the prohibition of the
examination of their premises part of their
dogma ... The questions of the "individual man" are
cut off by the ukase of the speculator who will
not permit his construct to be disturbed. [Eric
Voegelin Science, Politics and Gnosticism (1968) ]
Notes
45. For a long and detailed
philosophical and scientific analysis of the
"delayed personhood" arguments of 28 current
bioethicists see my 400-page Doctoral Dissertation,
A Philosophical and Scientific Analysis of the
Nature of the Early Human Embryo (Department of
Philosophy, Georgetown University, Washington, D. C:
University Microfilms, 1991). A very short summary
of the dissertation can be found in Dianne N.
Irving, "Science, Philosophy and Expertise: An
Evaluation of the Arguments on 'Personhood'", Linacre Quarterly
(Feb. 1993), 60(1):18-46.
46. A short list of
bioethicists who argue for "personhood" at "brain
birth" (or beyond) includes: Jonathan Glover, What Sort of People Should There Be? (New York:
Pelican Books, 1984); Glover, Causing Death and
Saving Lives (New York: Pelican Books, 1977);
Clifford Grobstein, "The Early Development of Human
Embryos", Journal of Medicine and Philosophy (1985),10:213-236; Grobstein,
Science and the
Unborn (New York: Basic Books, 1988), p. 61;
Joseph Fletcher, Humanhood: Essays in Biomedical
Ethics (New York: Prometheus Books, 1979), and
in Jonsen (1998), pp. 46-47; Tris Engelhardt, The
Foundations of Bioethics (New York: Oxford
University Press, 1985), p. 111; John Robertson,
"Extracorporeal Embryos and the Abortion Debate", Journal of Contemporary Health Law and Policy
(1986), 2;53;53-70; Robertson, "Symbolic Issues in
Embryo Research", The Hastings Center Report
(1995, Jan./Feb.), 37-38; Robertson, "The Case of
the Switched Embryos", The Hastings Center Report
(1995), 25:6:13-24; Michael Tooley, "Abortion and
Infanticide", in The Rights and Wrongs of
Abortion, M. Cohen et al (eds.) (New Jersey:
Princeton University Press, 1974), pp. 59 and 64;
Peter Singer and Helga Kuhse, "The Ethics of Embryo
Research", Law, Medicine and Health Care (1987), 14:13-14; Kuhse and Singer, "For Sometimes
Letting - and Helping - Die", Law, Medicine and
Health Care (1986), 3:40:149-153; Kuhse and
Singer, Should The Baby Live? The Problem of
Handicapped Infants (Oxford University Press,
1985), p. 138; Singer, "Taking Life: Abortion", in
Practical Ethics (London: Cambridge University
Press, 1981), pp. 122-123; Singer and Kuhse, Stephen
Buckle, Karen Dawson, Pascal Kasimba (eds.), Embryo Experimentation
(New York: Cambridge
University Press, 1990); R. M. Hare, "When Does
Potentiality Count? A Comment on Lockwood,"
Bioethics (1988), 2:3:214; Michael Lockwood, "When
Does Life Begin?", in Michael Lockwood (ed.), Moral Dilemmas in Modern Medicine (New York:
Oxford University Press, 1985), p.10; Hans-Martin
Sass, "Brain Life and Brain Death: A Proposal for
Normative Agreement," Journal of Medicine and
Philosophy (1989), 14:45-59; Michael Lockwood,
"Warnock versus Powell (and Harradine): When Does
Potentiality Count?" Bioethics (1988),
2:3:187-213; see Robert Edwards, Donald MacKay,
Bernard B. Haring, D. Wells, in D. Gareth Jones,
"Brain Birth and Personal Identity", Journal of
Medical Ethics (1989), 15:4; Goldenring,
"Development of the Fetal Brain," New England
Journal of Medicine (1982), 307:564; Thomasine
Kushner, "Having a Life Versus Being Alive," Journal of Medical Ethics (1984), 10:5-8; M. C.
Shea, "Embryonic Life and Human Life," Journal of
Medical Ethics (1985), 11:205-209; Richard G.
Frey, "The Ethics of the Search for Benefits: Animal
Experimentation in Medicine", in Raanan Gillon
(ed.), Principles of Health Care Ethics (New
York: John Wiley & Sons, 1994), pp. 1067-1075.
47. The term "pre-embryo" has
been explicitly rejected by the International
Nomina Embryologica, as noted earlier by one of
its committee members in his text: "The ill-defined
and inaccurate term pre-embryo, which includes the
embryonic disc, is said either to end with the
appearance of the primitive streak or ... to include
neurulation. The term is not used in this book."
[O'Rahilly and Muller (1994), p. 55] Unlike some
other scientific fields, the field of human
embryology is professionally required to follow the
standard "Carnegie Stages", terminology and
definitions as determined by this international
committee composed of expert human embryologists
from around the world. The "arbitrary" use of terms
and definitions are not professionally accepted.
48. Richard A. McCormick, S.
J., "To Save or Let Die," Journal of the American
Medical Association (1974), 229:172-176. See
also, John C. Fletcher, "Abortion, Euthanasia and
Care of the Defective Newborn", New England
Journal of Medicine (1975); 292:75-79; H.
Tristram Engelhardt, Jr., "Ethical Issues in Aiding
the Death of Young Children," in Martin Kohl (ed.),
Beneficent Euthanasia (Buffalo, N.Y.:
Prometheus Books, 1975), pp. 180-192; John Robertson
and Norman Fost, "Passive Euthanasia of Defective
Newborn Infants," Journal of Pediatrics 88
(1976), 88:883-192; John Robertson, "Involuntary
Euthanasia of Defective Newborns: A Legal Analysis,"
Stanford Law Review (1975), 27:213-269;
Albert R. Jonsen and Michael J. Garland (eds.), Ethics of Newborn Intensive Care (Berkeley:
Institute for Government Studies, 1976), pp. 33 and
190; Albert Jonsen, William Tooley, Roderick Phibbs,
and Michael Garland, "Critical Issues in Newborn
Intensive Care: A Conference Report and Policy
Proposal," Pediatrics (1975), 55:756-768;
Barbara Culliton, "Intensive Care for Newborns: Are
There Times to Pull the Plug?", Science
(1975), 188:133-134; Paul Ramsey, "An Ingathering of
Other Reasons for Neonatal Infanticide," in Ethics at the Edges of Life: Medical and Legal
Intersections (New Haven: Yale University Press,
1978), pp., 228-267, 250; Darrel W. Amundsen,
"Medicine and the Birth of Defective Children:
Approaches of the Ancient World," in Richard M.
McMillan, H. Tristram Engelhardt, Jr., and Stuart F.
Spicker (eds.), Euthanasia and the Newborn:
Conflicts Regarding Saving Lives (Dordrecht/Boston: D. Reidel Publishing Company,
1987), pp. 3-22; Maria W. Piers, Infanticide (New
York: Norton, 1978); Clement A. Smith, "Neonatal
Medicine and Quality of Life: An Historical
Perspective", in Jonsen and Garland (eds.), Ethics of Newborn Intensive Care, p. 33;
Alexander Schaffere, Diseases of the Newborn
(Philadelphia: Saunders, 1960); William Silverman,
"The Lesson of Retrolental Fibroplasia," Scientific American
(1977), 236:100-107; Paul A.
Freund, "Mongoloids and 'Mercy Killing'" in Reiser
et al, Ethics in Medicine, pp. 536-538; James
M. Gustafson, "Mongolism, Parental Desires and the
Right to Live," Perspectives in Biology and
Medicine (1973), 16:4:529-557; Raymond S. Duff
and A. G. M. Campbell "Moral and Ethical Dilemmas in
the Special-Care Nursery," New England Journal of
Medicine (1973), 289:890-984; President's
Commission on Ethical Problems in Medicine and
Biomedical and Behavioral Research, Deciding to
"Forego Life-Sustaining Treatment: A Report on the
Ethical and Legal Issues in Treatment Decisions
(Washington, D.C.: U.S. Government Printing Office,
1982), Chapter 6; Cindy Bouillon-Jensen,
"Infanticide," in Warren T. Reich (ed.), Encyclopedia of Bioethics (2nd ed.) (New York:
Simon and Schuster Macmillan, 1995), pp. 1200-1205;
Martin S. Pernick, The Black Stork: Eugenics and
the Death of "Defective" Babies in American Medicine
and Motion Pictures (New York: Oxford University
Press, 1996)
49. See discussions on the
impact of the work of Richard McCormick on the
development of bioethics in the current NBAC
commissioned paper by John C. Fletcher,
"Deliberating Incrementally on Human Pluripotential
Stem Cell Research", Sept. 1999, p. E-11 and
several others; also in Jonsen, pp. 52-56, 100, 106,
154-155, 247, 259, 291, 293, 310-311
50. Andre E. Hellegers, "Fetal
Development", Theological Studies (1970), 31:3-9;
Hellegers, "Fetal Development", in Thomas A. Mappes
and Jane S. Zembatty (eds.), Biomedical Ethics
(New York: Macmillan, 1981).
51. See, e.g., Richard
McCormick, S. J., "Who or What is the Preembryo?",
Kennedy Institute of Ethics Journal 1:1
(1991). In this paper McCormick draws heavily on the
work of frog embryologist Clifford Grobstein, as
well as from "an unpublished study of a research
group of the Catholic Health Association entitled
'The Status and Use of the Human Preembryo' ...".
(p. 14). The influence of the McCormick/Grobstein
term "pre-embryo" was (and still is) widespread even
among Catholic scholars. In addition to the works of
McCormick and Grobstein, see acceptance of the term
"pre-embryo" also in the work of other Catholic
writers: Andre E. Hellegers, "Fetal Development," in
Thomas A. Mappes and Jane S. Zembatty (eds.), Biomedical Ethics, (New York: Macmillan, 1981);
Hellegers, "Fetal Development", Theological
Studies (1970), 31:3-9; Charles E. Curran,
"Abortion: Contemporary Debate in Philosophical and
Religious Ethics", in W. T. Reich (ed.), Encyclopedia of Bioethics 1 (London: The Free
Press, 1978), pp. 17-26; Kevin Wildes, "Book Review:
Human Life: Its Beginning and Development"
(L'Harmattan, Paris: International Federation of
Catholic Universities, 1988); Carlos Bedate and
Robert Cefalo, "The Zygote: To Be or Not Be a
Person", Journal of Medicine and Philosophy (1989), 14:6:641; Robert C. Cefalo, "Book Review:
Embryo Experimentation, Peter Singer et al (eds.);
'Eggs, Embryos and Ethics'", Hastings Center
Report (1991), 21:5:41; Mario Moussa and Thomas
A. Shannon, "The Search for the New Pineal Gland:
Brain Life and Personhood", The Hastings Center
Report (1992), 22:3:30-37; Carol Tauer, The
Moral Status of the Prenatal Human (Doctoral
Dissertation in Philosophy; Kennedy Institute of
Ethics, Georgetown University, Washington, D.C.:
Georgetown University, 1981) (Sister Tauer's
dissertation mentor was Richard McCormick; she later
went on to become the ethics co-chair of the NIH
Human Embryo Research Panel 1994); C. Tauer, "The
Tradition of Probabilism and the Moral Status of the
Early Embryo", in Patricia B. Jung and Thomas A.
Shannon, Abortion and Catholicism (New York:
Crossroad, 1988), pp. 54-84; Lisa S. Cahill,
"Abortion, Autonomy, and Community", in Jung and
Shannon, Abortion and Catholicism (1988), pp. 85-98;
Joseph F. Donceel, "A Liberal Catholic's View", in
Jung and Shannon, Abortion and Catholicism (1988), pp. 48-53; H. Tristram Engelhardt,
The
Foundations of Bioethics (New York: Oxford
University Press, 1985), p. 111; William A. Wallace,
"Nature and Human Nature as the Norm in Medical
Ethics", in Edmund D. Pellegrino, John P. Langan and
John Collins Harvey (eds.), Catholic Perspectives
on Medical Morals (Dordrecht: Kluwer Academic
Publishing, 1989), pp. 23-53; Norman Ford, When
Did I Begin? (New York: Cambridge University
Press, 1988), p. 298; Antoine Suarez, "Hydatidiform
Moles and Teratomas Confirm the Human Identity of
the Preimplantation Embryo", Journal of Medicine
and Philosophy (1990), 15:627-635; Thomas J.
Bole, III, "Metaphysical Accounts of the Zygote as a
Person and the Veto Power of Facts", Journal of
Medicine and Philosophy (1989), 14:647-653;
Bole, "Zygotes, Souls, Substances, and Persons", Journal of Medicine and Philosophy (1990),
15:637-652.
52. See Richard McCormick's
testimony in The National Commission for the
Protection of Human Subjects of Biomedical and
Behavioral Research; Report and Recommendations;
Research on the Fetus; U.S. Department of
Health, Education and Welfare, 1975, pp. 34-35;
McCormick, How Brave a New World?
(Washington, D.C.: Georgetown University Press), p.
76; McCormick, "Proxy Consent in the Experimentation
Situation", Perspectives in Biology and Medicine
(1974), 18:2-20
53. See Paul Ramsey's testimony
in The National Commission for the Protection of
Human Subjects of Biomedical and Behavioral
Research; Report and Recommendations; Research on
the Fetus; U.S. Department of Health, Education
and Welfare, 1975, pp. 35-36.
54. For further analysis of the
use of the erroneous term "pre-embryo" in the work
of both McCormick and Grobstein (and others) see:
Dianne N. Irving, A Philosophical and Scientific
Analysis of the Nature of the Early Human Embryo
(Doctoral Dissertation; Department of Philosophy,
Georgetown University, Washington, D.C.; University
Microfilms, 1991), esp. Chapter 3 (the Dissertation
includes an analysis of the works of 28 other
bioethicists who also argue for "delayed personhood"
based on different "biological marker events"
throughout prenatal development - and beyond. Most
of these bioethicists were referenced in the NIH
Human Embryo Research Panel meetings and report).
See also: Irving, "Science, Philosophy and
Expertise: An Evaluation of the Arguments on
'Personhood'", Linacre Quarterly (Feb. 1993),
60(1):18-46; Irving, "When Does a Human Being Begin?
'Scientific' Myths and Scientific Facts", International Journal of Sociology and Social Policy
(1999), 19:3/4:22-47; Ward C. Kischer and Dianne N.
Irving, The Human Development Hoax: Time To Tell
The Truth! (1997, distributed by American Life
League).
The use of the term "pre-embryo" has been quite
widespread for decades - nationally and
internationally. In addition to the Catholic
scholars who accepted the use of the term
"pre-embryo" as noted above, a partial list of
secular bioethics writers who also accepted the use
of the term in these debates includes: Paul Ramsey,
"Reference Points in Deciding About Abortion" in J.
T. Noonan (ed.), The Morality of Abortion
(Cambridge, MA: Harvard University Press, 1970), pp.
60-100, esp. p. 75; John Robertson, "Extracorporeal
Embryos and the Abortion Debate", Journal of
Contemporary Health Law and Policy (1986),
2;53;53-70; Robertson, "Symbolic Issues in Embryo
Research", The Hastings Center Report (1995,
Jan./Feb.), 37-38; Robertson, "The Case of the
Switched Embryos", The Hastings Center Report
(1995), 25:6:13-24; Howard W. Jones, "And Just What
is a Preembryo?", Fertility and Sterility
52:189-91; Jones and C. Schroder, "The Process of
Human Fertilization: Implications for Moral Status",
Fertility and Sterility (August 1987),
48:2:192; Clifford Grobstein, "The Early Development
of Human Embryos", Journal of Medicine and
Philosophy (1985), 10:213-236; also, Science
and the Unborn (New York: Basic Books, 1988), p.
61; Michael Tooley, "Abortion and Infanticide", in
The Rights and Wrongs of Abortion, M. Cohen
et al (eds.) (New Jersey: Princeton University
Press, 1974), pp. 59 and 64; Peter Singer and Helga
Kuhse, "The Ethics of Embryo Research", Law,
Medicine and Health Care (1987),14:13-14; Kuhse
and Singer, "For Sometimes Letting - and Helping -
Die", Law, Medicine and Health Care (1986),
3:40:149-153; Kuhse and Singer, Should The Baby
Live? The Problem of Handicapped Infants (Oxford
University Press, 1985), p.138; Singer, "Taking
Life: Abortion", in Practical Ethics (London:
Cambridge University Press, 1981), pp. 122-123;
Peter Singer, Helga Kuhse, Stephen Buckle, Karen
Dawson, Pascal Kasimba (eds.), Embryo
Experimentation (New York: Cambridge University
Press, 1990); R. M. Hare, "When Does Potentiality
Count? A Comment on Lockwood," Bioethics (1988), 2:3:214; Michael Lockwood, "When Does Life
Begin?", in Michael Lockwood (ed.), Moral
Dilemma's in Modern Medicine (New York: Oxford
University Press, 1985), p. 10; Hans-Martin Sass,
"Brain Life and Brain Death: A Proposal for
Normative Agreement," Journal of Medicine and
Philosophy (1989), 14:45-59; Michael Lockwood,
"Warnock Versus Powell (and Harradine): When Does
Potentiality Count?" Bioethics (1988),
2:3:187-213.
See also the use of the term "pre-embryo" in many
national and international documents (a small
sample): Ethics Advisory Board (1979) Report and
Conclusions: HEW Support of Research Involving
Human In Vitro Fertilization and Embryo Transfer,
Washington, D.C.: United States Department of
Health, Education and Welfare, p. 101; National
Institutes of Health Human Embryo Research Panel
Meetings (Washington, D.C.: NIH, 1994), Feb. 2
meeting, pp. 27, 31, 50-80, 85-87, 104-106; in the
Feb. 3, 1994 meeting, pp. 6-55; April 11 meeting,
pp. 23-41, 9-22. See also, Dame Mary Warnock, Report of the Committee of Inquiry into Human
Fertilization and Embryology, (London: Her
Majesty's Stationary Office, 1984), pp. 27 and 63;
Commonwealth of Australia, Select Senate Committee
on the Human Embryo Experimentation Bill, (Canberra,
Australia: Official Hansard Report, Commonwealth
Government Printer, 1986); Parliamentary Assembly of
the Council of Europe, On the Use of Human
Embryos and Foetuses for Diagnostic, Therapeutic,
Scientific, Industrial and Commercial Purposes,
Recommendation 1046, 1986; and On the Use of
Human Embryos and Foetuses in Scientific Research,
Recommendation 1000, 1989; Ethics Committee of the
American Fertility Society (AFS), "Ethical
Considerations of the New Reproductive
Technologies", Fertility and Sterility
(1986), 46:27S. See also Jonsen (1998), esp.
Chapters 4 and 12.
55. In historical terms, this
is referred to as the "chorismos" (or, "separation")
problem in philosophy, originated by Plato in his
famous "Theory of Forms". For discussions of Plato's
quite extensive chorismos problems, see: Etienne
Gilson, Being and Some Philosophers (Toronto:
Pontifical Institute of Mediaeval Studies, 1949);
Frederick Copleston, A History of Philosophy (New
York: Image Books, 1993), Vol. 1, pp. 167 ff;
Leonard J. Eslick, "The Material Substrate in
Plato", in Ernan McMullin (ed.), The Concept of
Matter in Greek and Medieval Philosophy
(Indiana: University of Notre Dame Press, 1963);
Frederick Wilhelmsen, Man's Knowledge of Reality
(New Jersey: Prentice-Hall, Inc., 1956), esp. Chaps.
2 and 3. Descartes tried to give an explanation of
interaction, but miserably failed and was literally
laughed out of the academy. See Descartes' efforts
in his Meditations (especially his Sixth
Meditation), in J. Cottingham, R. Stoothoff, D.
Murdoch (trans.), The Philosophical Writings of
Descartes (Cambridge: Cambridge University
Press, 1989). See also, Frederick Copleston, A
History of Philosophy (New York: Image
Books/Doubleday, 1994), Vol. 4, pp. 120 ff; Paul
Edwards, The Encyclopedia of Philosophy (New
York: Macmillan Publishing Co., Inc. and The Free
Press, 1972), Vols. 1 and 2, pp. 353-354.
56. For extensive philosophical
and scientific analyses of these positions, see
references in note 54, supra.
57. The Church has consistently
taught that to intentionally and directly kill an
innocent human being at any stage of development is
inherently evil - regardless of the "personhood"
status. E.g., Declaration on Procured Abortion:
"In the course of history, the Fathers of the
Church, her Pastors and her Doctors have taught the
same doctrine -- the various opinions on the
infusion of the spiritual soul did not introduce any
doubt about the illicitness of abortion ... This
condemnation was in fact unanimous [II.6]. ... The
tradition of the Church has always held that human
life must be protected and favored from the
beginning, just as at the various stages of its
development [II.6]. E.g., Donum Vitae: "From
the moment of conception, the life of every human
being is to be respected in an absolute way ...
[Intro. 5]. ... At the second Vatican Council, the
Church for her part presented once again to modern
man her constant and certain doctrine according to
which: 'Life, once conceived, must be protected with
the utmost care; abortion and infanticide are
abominable crimes.' More recently, the Charter of
the Rights of the Family, published by the Holy
See, confirmed that 'human life must be absolutely
respected and protected from the moment of
conception.' ... The Congregation recalls the
teachings found in the Declaration on Procured
Abortion: 'From the time that the ovum is
fertilized, a new life is begun which is neither
that of the father nor of the mother; it is rather
the life of a new human being with his own growth.
It would never be made human if it were not human
already. To this perpetual evidence ... modern
genetic science brings valuable confirmation.' ...
This teaching remains valid and is further confirmed
... by recent findings of human biological science
which recognize that in the zygote resulting from
fertilization the biological identity of a new human
individual is already constituted. ... Certainly no
experimental datum can be in itself sufficient to
bring us to the recognition of a spiritual soul;
nevertheless, the conclusions of science regarding
the human embryo provide a valuable indication for
discerning by the use of reason a personal presence
at the moment of this first appearance of a human
life; how could a human individual not be a human
person? ... [S]ince the embryo must be treated as a
person, it must also be defended in its integrity,
tended and cared for, to the extent possible, in the
same way as any other human being as far as medical
assistance is concerned." [I.1]
58. The National Commission for
the Protection of Human Subjects of Biomedical and
Behavioral Research; Report and Recommendations;
Research on the Fetus; U.S. Department of
Health, Education and Welfare, 1975; "Dissenting
Statement of Commissioner David W. Louisell" (p.
77-82).
59. See David S. Oderberg, Moral Theory: A Non-Consequentialist Approach
(Oxford: Blackwell Publishers Inc., 2000), pp.
167-168. See also definition of "preference
utilitarianism" at:
http://www.utilitarianism.com/prefutil.htm.
60. Ibid., Oderberg
(2000), p. 174.
61. Jonathan Glover, Causing
Death and Saving Lives: The Moral Problems of
Abortion, Infanticide, Suicide, Euthanasia, Capital
Punishment, War, and Other Life-or-Death Choices
(New York: Penguin Books, 1977).
62. See, e.g., Jonathan Glover,
What Sort of People Should there Be? (New
York: Penguin Books, 1984): "[T]he central issue is
about changing human nature. I want to argue for
greater willingness to consider policies that would
do this, so it seems important to meet conservatism
about human nature on its strongest ground (p. 16).
... [O]n the way we will be forced to do some fresh
thinking about what autonomy is, and why we value
it. ... Changes in society and in human nature can
be expected to involve changes in values (p. 19).
... There is a widespread view that any project for
the genetic improvement of the human race ought to
be ruled out: that there are fundamental objections
of principle. The aim of this discussion is to sort
out some of the main objections. It will be argued
that [such] resistance is based on a complex of
different values and reasons, none of which is, when
examined, adequate to rule out in principle this use
of genetic engineering." (p. 25). Glover also
considers human cloning, and human/animal
cross-breeding as well.
63. Op. cit., Glover, Causing Death and Saving Lives (1977), pp.
50-59.
64. R. M. Hare, "When Does
Potentiality Count? A Comment on Lockwood", Bioethics (1988), 2:3:214.
65. Peter Singer, Practical
Ethics (London: Cambridge University Press,
1985), pp. 118, 123; see also, Helga Kuhse and Peter
Singer, "For Sometimes Letting - and Helping - Die,"
Law, Medicine and Health Care (1986),
3:4:149-153; Kuhse and Singer, Should the Baby
Live? The Problem of Handicapped Infants (Oxford: Oxford University Press, 1985), p. 138.
66. R. G. Frey, "The Ethics of
the Search For Benefits: Animal Experimentation in
Medicine", in Raanan Gillon (ed.), Principles of
Health Care Ethics (New York: John Wiley & Sons,
1994), pp. 1067-1075. Frey is now a Senior Scholar
at The Hastings Center.
67. Peter Singer,
"Heavy Petting", Nerve.com.
68. Peter Suber,
"Against the Sanctity of Life" [Philosophy
Dept., Earlham College, Indiana - Quaker]
69. Ibid., Suber: "But
in general the QL ["quality of life"] view is easy
to state. It is the view that the value of a life
varies with its quality. That value might be
absolute, infinite, or maximum, but only if
circumstances permitted it; other circumstances can
reduce that value. The value of a life is
contingent. It follows directly that not all lives
have equal value. Hence, QL denies both the equality
condition and the unqualified ultimity condition of
SL ["sanctity of life" view]. ... The positive
approach requires that a life possess some positive
features or set of features to be worth living, such
as dignity, autonomy, and rationality, while the
negative approach requires that a life simply lack
certain negative features to be worth living, such
as extreme pain, hopeless deterioration, and
irreversible incapacity to give or withhold consent.
The positions can be combined to hold that a life is
worth living only if certain positive features are
present and certain negative features absent."
70. Darryl R. J. Macer, Shaping
Genes: Ethics, Law and Science of Using New
Genetic Technology in Medicine and Agriculture,
(Eubios Ethics Institute, Japan, 1990), Chapter on
"Status
of the Embryo".
71. Norman Ford, When Did I
Begin? (New York: Cambridge University Press,
1988).
72. Ibid., Macer (1990):
"The current attitude of society is that there is a
steady and gradual unfolding of life and a gradual
assumption of rights by the embryo. ... From the
reasoned argument based on biological knowledge, and
ethical principles it is possible to draw different
lines in the status of the embryo at fertilisation,
implantation, formation of the cerebral cortex, and
viability. An early embryo is a body in preparation
at least, and the likelihood of homicide increases
with the age of the individual. ... There are
sufficient doubts over the commencement of human
personhood until the cerebral cortex begins to
function, not to consider the embryo a person until
at least 8 weeks and possibly up to 24 weeks."
73. Ibid., Macer (1990):
"When the earth is crowded, and so many resources
used, we should not overfill it. There is a limit to
the land. We need to control the desire to have many
children, and what is more important allow choice to
those who want birth control, and use reason and
common sense, and the techniques that we have been
given in our technology to practise sensible birth
control." (In Chapter on
"Human Reproduction").
74. Ibid., Macer (1990):
"One of the aims of eugenics today is the
"application of societal measures at improving
physical and mental attributes of future
generations" (Eugenics Society 1988). This is
not in itself dissimilar from most peoples'
attitude. It is held by many that it is in the
interests of the state to reduce the incidence of
genetic disease (Mason & McCall-Smith 1983)."
(Chapter on
"Selective Breeding") ... In favour of genetic
engineering is utilitarian thinking. Although there
will be risks for individuals the goal of the
application of these techniques will be to aid human
beings, in reducing genetic disease and its affects,
and possibly improving the human race (Brody 1981).
We are rational beings and we should take advantage
of the chances used to apply our rationality to the
control of something so important as the generation
of children, and to agriculture and environmental
modification. We have allowed many people that have
genetic disease to live, and so have exposed the
human race to genetic decay, for example diseases
like diabetes are increasing. This is seen as a bad
affect on the human gene pool, and something to
counter." (Chapter on
"Genetic Engineering")
75. H. Tristram Engelhardt,
"Viability and the Use of the Fetus", in Tom L.
Beauchamp and Terry P. Pinkard (eds.), Ethics and
Public Policy: An Introduction to Ethics
(Englewood Cliffs, NJ: Prentice-Hall, Inc., 1983,
pp. 299-230; reprinted from W. B. Bondeson, H.
Tristram Engelhardt, Jr., S. F. Spicker, and Daniel
Winship (eds.), Abortion and the Status of the
Fetus (Dordrecht, Holland: Reidel Publishing
Company, 1982).
See also Engelhardt's further reflections on the
"personhood" of human pre-born and young children:
"... It is for these reasons that the value of
zygotes, embryos, and fetuses is to be primarily
understood in terms of the values they have for
actual persons. Zygotes, fetuses, and embryos do not
have the rich inward life of adult mammals. ...
However, one must remember that the sentience of a
zygote, embryo, or fetus is much less than that of
an adult mammal. One might even develop a suggestion
of the natural theologian Charles Hartshorne so as
to argue that from the perspective of the Deity the
intrinsic value of a human fetus will be less than
that of an adult normal member of some other
mammalian species. (pp. 112-113). ... One also owns
what one produces. One might think here of both
animals and young children. Insofar as they are the
products of the ingenuity or energies of persons,
they can be possessions. There are, however, special
obligations to animals by virtue of the morality of
beneficence that do not exist with regard to things.
Such considerations, as well as the fact that young
children will become persons, limit the extent to
which parents have ownership rights over their young
children. However these limits will be very weak
with regard to ownership rights in human zygotes,
embryos, and fetuses that will not be allowed to
develop into persons, or with regard to lower
vertebrates, where there is very little sentience.
For example, it would appear very plausible that
plants, microbes, and human zygotes can be fashioned
as products, and be bought and sold as if they were
simply things. In contrast, strong claims of
ownership would cease, as children become persons
and sui juris, self-possessing. This latter moral
issue also arises with regard to normal adult
non-human higher primates. It is much more plausible
to suspect that higher non-human primates are in
possession of themselves than to suspect that such
is the case with even one-year-old human infants. At
the point that an entity becomes self-conscious, the
morality of mutual respect would alienate the
property rights of the parents over the children or
other animals (129-130). ... These reflections can
be encapsulated in what one may term the principle
of ownership. This principle will be central to
understanding the roles of public and private
funding in health care, as well as the rights of
physicians to exempt themselves from the constraints
of national health services. Owning private
property, insofar as such private ownership exists,
will always permit patients merely to buy around the
established system. So, too, having the right to own
one's talents will permit physicians to sell around
the constraints of the system. This can be
tendentiously summarized as the basic right of
persons to the black market." (emphases added)
Engelhardt, The Foundations of Bioethics (New
York: Oxford University Press, 1986), pp. 133-134.
76. See, Victoria Button,
"Control Gene Pool, Says Ethicist", The Age
[theage.com.au], October 13, 2000.
77. Quoting from Dr. Harold
Varmus' Senate
testimony: "Totipotent stem cells - such as the
product of fertilization of an ovum and its progeny
- are stem cells that have total potency, which
means that they have the ability to form an entire
mature organism, e.g., a human being, although only
if placed in a woman's uterus. In contrast, human
pluripotent stem cells, which are under discussion
today, do not have total potency, and hence cannot
form an entire organism under any known condition.
But pluripotent stem cells can give rise to all of
the different types of specialized cells in the
body." (emphases added)
78. "For purposes of these
Guidelines, 'human pluripotent stem cells' are cells
that are self-replicating, are derived from human
embryos or human fetal tissue, and are known to
develop into cells and tissues of the three primary
germ layers. ... NIH research funded under these
Guidelines will involve human pluripotent stem cells
derived 1) from human fetal tissue; or 2) from human
embryos that are the result of in vitro
fertilization, are in excess of clinical need, and
have not reached the state at which the mesoderm is
formed." (p. 7) (emphases added) [http://www.nih.gov/news/stemcell/stemcellguidelines.htm]
79. "Successful transfer of
four- to eight-cell embryos ... to the uterus after
thawing is now a common practice (Fugger et al.,
1991) ..." (Moore and Persaud, p. 39); "After
thawing four-cell embryos, some cells may not
survive, leaving one-, two-, or three-cell embryos
[in Prof. Dr. Mithhat Erenus,
"Embryo Multiplication"
] "The oocytes are
allowed to mature to the second meiotic metaphase
and then fertilized with previously capacitated
sperm, allowed to develop, and then inserted into
the uterus at the 2- to 4-cell stage (or later)."
(Larsen 1998, p. 18); "The embryos are usually
allowed to develop to the two-to-eight-cell stage
before they are considered ready to implant into the
uterus. ... Embryos other than those used during the
initial procedure are stored for future use if the
first embryo transfer proves unsuccessful." (Carlson
1999, p. 35).
80. " ... (2) the fertilized
egg, which has not yet divided, is now known as a
zygote; (3) the egg begins to divide and is now
known as an embryo; at this point each blastomere,
or cell, within the embryo, is capable of developing
into an identical embryo." [Geoffrey Sher, Virginia
Davis, and Jean Stoess, In Vitro Fertilization:
The A.R.T. of Making Babies (copyright 1998 by
authors; information by contacting Facts On File,
Inc., 11 Penn Plaza, New York, NY 10001), pp. 20]
"The embryo enters the uterine cavity after half a
week, ... . Each cell (blastomere) is considered to
be still totipotent (capable, on isolation, of
forming a complete embryo), and separations of these
early cells is believed to account for one-third of
cases of monozygotic twinning." [ O'Rahilly and
Muller (1994), p. 23]
Even NIH, in its recent stem cell research report,
acknowledges that some of these "stem cells" are
totipotent and can revert to whole embryos: "If
these cells separate, genetically identical embryos
result, the basis of identical twinning." ([National
Institutes of Health, "Stem Cells: Scientific
Progress and Future Research Directions; (Ruth
Kirschstein and Lana R. Skirboll),
Appendix A: Early Development, p. A-3)
81. For more details, please
see my recent report, Analysis: Parts I and II:
Stem Cells That Become Embryos: Implications for the
NIH Guidelines on Stem cell Research, the NIH Stem
cell Report, Informed Consent, and Patient Safety in
Clinical Trials (July 22, 2001), written as a
Fellow of the Linacre Institute, a Consultant for
the Catholic Medical Association (USA), and a
Consultant for the International Federation of
Catholic Medical Associations (FIAMC), on issues
relating to human embryology and human embryo
research. See also my analyses for The University
Faculty for Life: "University Faculty for Life:
Submission of Concern to the Canadian CIHR Re the
'Human Stem Cell Research Recommendations 2001'";
written as UFL Board Member on behalf of UFL;
submitted to Dr. Alan Bernstein, President, Canadian
Institutes of Health Research Working Group on Stem
Cell Research, Ottawa, Ontario, Canada, on June 3,
2001; "University Faculty for Life: Submission of
Concern to the British House of Lords Re the 'Human
Fertilisation and Embryology (Research Purposes)
Regulations 2001'"; and, "University Faculty for
Life: Letter of Concern to Sen. Brownback and
Congressman Weldon Re the 'Human Cloning Bill
2001'".
See also: "Early mammalian embryogenesis is
considered to be a highly regulative process.
Regulation is the ability of an embryo or an organ
primordium to produce a normal structure if parts
have been removed or added. At the cellular level,
it means that the fates of cells in a regulative
system are not irretrievably fixed and that the
cells can still respond to environmental cues. ...
Of the experimental techniques used to demonstrate
regulative properties of early embryos, the simplest
is to separate the blastomeres of early
cleavage-stage embryos and determine whether each
one can give rise to an entire embryo. This method
has been used to demonstrate that single
blastomeres, from two- and sometimes four-cell
embryos can form normal embryos, ... .
... Another means of demonstrating the regulative
properties of early mammalian embryos is to
dissociate mouse embryos into separate blastomeres
and then to combine the blastomeres of two or three
embryos. The combined blastomeres soon aggregate and
reorganize to become a single large embryo, which
then goes on to become a normal-appearing
tetraparental or hexaparental mouse.... Blastomere
removal and addition experiments have convincingly
demonstrated the regulative nature (i.e., the strong
tendency for the system to be restored to wholeness)
of early mammalian embryos. Such knowledge is
important in understanding the reason exposure of
early human embryos to unfavorable environmental
influences typically results in either death or a
normal embryo." [Carlson (1999), pp. 44-49.]
82. "... Some types of twinning
represent a natural experiment that demonstrates the
highly regulative nature of early human embryos, ...
Monozygotic twinning: If the splitting occurred
during cleavage - for example, if the two
blastomeres produced by the first cleavage division
become separated - the monozygotic twin blastomeres
will implant separately, like dizygotic twin
blastomeres, and will not share fetal membranes.
Alternatively, if the twins are formed by splitting
of the inner cell mass within the blastocyst, they
will occupy the same chorion but will be enclosed by
separate amnions and will use separate placentae,
each placenta developing around the connecting stalk
of its respective embryo. Finally, if the twins are
formed by splitting of a bilaminar germ disc, they
will occupy the same amnion." [Larsen (1998), p.
325]. "Monozygotic twins and some triplets, on the
other hand, are the product of one fertilized egg.
They arise by the subdivision and splitting of a
single embryo. Although monozygotic twins could ...
arise by the splitting of a two-cell embryo, it is
commonly accepted that most arise by the subdivision
of the inner cell mass in a blastocyst. Because the
majority of monozygotic twins are perfectly normal,
the early human embryo can obviously be subdivided
and each component regulated to form a normal
embryo." [Carlson (1999), pp. 44-49].
83. "The term 'clones'
indicates genetic identity and so can describe
genetically identical molecules (DNA clones),
genetically identical cells or genetically identical
organisms. Animal clones occur naturally as a result
of sexual reproduction. For example, genetically
identical twins are clones who happened to have
received exactly the same set of genetic
instructions from two donor individuals, a mother
and a father. A form of animal cloning can also
occur as a result of artificial manipulation to
bring about a type of asexual reproduction. The
genetic manipulation in this case uses nuclear
transfer technology: a nucleus is removed from a
donor cell then transplanted into an oocyte whose
own nucleus has previously been removed. The
resulting 'renucleated' oocyte can give rise to an
individual who will carry the nuclear genome of only
one donor individual, unlike genetically identical
twins. The individual providing the donor nucleus
and the individual that develops from the
'renucleated' oocyte are usually described as
"clones", but it should be noted that they share
only the same nuclear DNA; they do not share the
same mitochondrial DNA, unlike genetically identical
twins." [Tom Strachan and Andrew P. Read, Human
Molecular Genetics 2 (New York: John Wiley &
Sons, Inc, 1999), pp. 508-509] "Clone describes a
large number of cells or molecules identical with a
single ancestral cell or molecule." [Benjamin Lewin,
Genes VII (New York: Oxford University Press, 2000),
p. 955)]
84. "Some couples, however, may
have only one or two embryos available for
replacement. In such cases, patients may benefit
from embryo multiplication, as discussed in the
study by Massey and co-workers. ... In humans,
removal of less than half of the cells from an
embryo have been documented. No adverse effects were
reported when an eighth to a quarter of the
blastomeres were removed from an embryo on day 3
after insemination. ... Further evidence supporting
the viability and growth of partial human embryos is
provided by cryopreservation. After thawing
four-cell embryos, some cells may not survive,
leaving one-, two-, or three-cell embryos. These
partial embryos survive and go to term, but at a
lower rate than whole embryos." [in Prof. Dr.
Mithhat Erenus,
"Embryo Multiplication" ]
"Now, a new method of actually producing identical
twins looms near. Called "blastomere separation"
(the separation of a two- to eight-cell blastomere
into two identical demi-embryos), it is potentially
one method of helping infertile couples have
children through in vitro fertilization (IVF)." [in
The Twins Foundation,
"New Ways to Produce Identical Twins - A Continuing
Controversy"]
"Because early embryonic cells are totipotent, the
possibility of splitting or separating the
blastomeres of early preimplantation embryos to
increase the number of embryos that are available
for IVF treatment of infertility is being discussed.
Because embryo splitting could lead to two or more
embryos with the same genome, the term "cloning" has
been used to describe this practice. ... Splitting
one embryo into two or more embryos could serve the
needs of infertile couples in several ways. For
couples who can produce only one or two embryos,
splitting embryos could increase the number of
embryos available for transfer in a single IVF
cycle. Because the IVF pregnancy rate increases with
the number of embryos transferred, it is thought
that embryo splitting when only one or two embryos
are produced may result in a pregnancy that would
not otherwise have occurred. For couples who produce
more than enough embryos for one cycle of transfer,
splitting one or more embryos may provide sufficient
embryos for subsequent transfers without having to
go through another retrieval cycle, thus lessening
the physical burdens and costs of IVF treatment for
infertility. In addition, this technique may have
application in preimplantation genetic diagnosis."
[in American Society of Reproductive Medicine,
"Embryo Splitting for Infertility Treatment"].
85. "Prenatal life is
conveniently divided into two phases: the embryonic
and the fetal. The embryonic period proper during
which the vast majority of the named structures of
the body appear, occupies the first 8 postovulatory
weeks." [O'Rahilly and Müller (1994), p. 55]; "After
the eighth week of pregnancy the period of
organogenesis (embryonic period) is largely
completed, and the fetal period begins." [Carlson
(1999), p. 447]; "The first 8 weeks constitute the
embryonic period. The remainder of gestation
constitutes the fetal period." [Larsen (1998), p.
317].
86. "Like all normal somatic
(non-germ- cells), the primordial germ cells contain
23 pairs of chromosomes, or a total of 46." [Carlson
(1999), p. 2]; "In a mitotic division, each germ
cell produces two diploid progeny that are
genetically equal." [Larsen (1998), p. 4].
"A subset of the diploid body cells constitute the
germ line. These give rise to specialized diploid
cells in the ovary and testis that can divide by
meiosis to produce haploid gametes (sperm and egg).
... The other cells of the body, apart form the
germline, are known as somatic cells ... most
somatic cells are diploid ...". [Tom Strachan and
Andrew Read, Human Molecular Genetics: Second
Edition (New York: Wiley-Liss, 1999), p. 28].
"Gametogenesis is the production of germ cells
(gametes), i.e., spermatozoa and oocytes. These
cells are produced in the gonads, i.e., the testes
and ovaries respectively. The gametes are believed
to arise by successive divisions from a distinct
line of cells (the germ plasm), and the cells that
are not directly concerned with gametogenesis are
termed somatic. ... The reduction of chromosomal
number from 46 (the diploid number) to 23 (the
haploid number) is accomplished by a cellular
division termed meiosis. ... Primordial germ cells
... are difficult to recognize in very young human
embryos. Claims for them have been made as early as
in the blastocyst, and they are believed to be
segregated at latest by 2 weeks and possibly much
earlier." [O'Rahilly and Muller (1994), pp. 13-14].
"Meiosis is a special type of cell division that
involves two meiotic cell divisions; it takes place
in germ cells only. Diploid germ cells give rise to
haploid gametes (sperms and oocytes) [after puberty
and beyond, that is]. [Moore and Persaud (1998), p.
18].
87. "From the ethical point of
view, an important consideration is to what extent
technologies developed in an attempt to engineer the
human germline could subsequently be used not to
treat disease but in genetic enhancement. There are
powerful arguments as to why germline gene therapy
is pointless. There are serious concerns, therefore,
that a hidden motive for germline gene therapy is to
enable research to be done on germline manipulation
with the ultimate aim of germline-based genetic
enhancement. The latter could result in positive
eugenics programs, whereby planned genetic
modification of the germline could involve
artificial selection for genes that are thought to
confer advantageous traits." [Strachan and Read
(1999), pp. 539-541].
The use of germ-line gene "therapy" by U.S.
scientists has recently been published, producing
genetically altered human infants. See, Dr. David
Whitehouse, "Genetically altered babies born:
Mitochondria contain genes outside the cell's
nucleus",
BBC News Online.