April 03, 2009
The stem cell issue-2: The ethics
Yesterday, I discussed the science involved in stem cell research. Today I want to discuss the ethics.
The ethical problems associated with stem cell research occur because although the fertilized eggs were not created for the purposes of research but to help infertile couples, since the method of in vitro fertilization for the treatment of infertility has not been perfected, more fertilized eggs are created than can be used to actually generate pregnancies, and the question of what to do with these extra frozen stored embryos is problematic.
If the extra ones are not needed for future implantation in a womb, then the options are to destroy them, preserve them forever, or use them for research. Those favoring stem cell research argue that preserving them forever is not realistic, that they will have to be thrown away eventually, and that using them for research is better than destroying them without any benefit being obtained, even though the resulting blastocyst must be destroyed in order to produce the stem cell lines,
Those opposed to stem cell research (and abortion) have a simple and clear argument: Life begins at the instant when an egg is fertilized, and no human action is permissible thereafter to prevent that egg from being eventually born. So once an egg is fertilized, whether in the uterus or outside, then we have a human life and using a blastocyst for research is effectively destroying life. This is a secular argument, even though many, or even the majority, of those who support it may have religious reasons for their stand, such as the idea that god inserts the soul at the moment of conception when the egg is fertilized. They argue that if such a position requires the preservation of unused embryos indefinitely, then we should do so, however impractical that might be.
Those who support a woman's right to terminate a pregnancy and/or the use of embryonic stem cells for research have more difficulty in justifying their position because drawing a clear line as to when 'life' begins or a clump of cells becomes 'human' is hard. One thing they are agreed upon is that a human being is much more than a fertilized egg or a bunch of cells such as a blastocyst. But where does one draw the line?
One line is that until such time as the fetus can exist independently outside the womb, it is not a human being. Right now that time corresponds roughly to the third trimester of the pregnancy. But as technology improves, that is likely to shift to earlier times. Others argue that any organism (human or otherwise) must have some higher level of capacity, such as a brain, before its life becomes worthy of protection from harm. After all, when it comes to question of death, society seems to have decided that when the brain stops functioning one is effectively dead and one no longer needs to take steps to keep the body alive. And as the Terry Schiavo case tragically illustrated, what we mean by a functioning brain is more than just brain stem functions that maintain basic body processes and some reflexes. It means that the part of the brain, such as memory and cognition, that gives us our personality and makes us who we are must be functioning. Once a person has reached the stage of being in what is known as a 'persistent vegetative state', that person is considered to be effectively dead.
In this debate, both sides usually ignore the need for consistency across species. Why should only human life be so valued? What makes us superior and worthy of special consideration? If life is precious and life begins with a fertilized egg or with higher brain function, then what about the lives of other species? After all, we kill animals, even though they are fully functioning living things with a level of brain function that we would undoubtedly value if a human had it. We even think nothing of eating them after killing them. Why should we have one standard for humans and another for nonhuman animals?
One can take a speciesist position and simply assert as a given that human beings are superior to others and so we have a right to do what we like to other animal forms while treating human life as sacrosanct. But that is hard to justify on general moral or ethical grounds. There is no clear marker that justifies treating humans as special, unless you throw in ideas such as that humans have a soul and other animals do not. This is an argument based on a particular religious viewpoint and should have no place in determining public policy, which should always be based on secular arguments.
In my opinion, the position taken by ethicists such as Peter Singer is the most consistent moral and ethical one, that does not give humans special privileges. They take a utilitarian position, that what one should seek is the minimization of suffering. Since suffering involves sentience, this requires that an organism must have at least some primitive brain function and the development of a nervous system before it can be said to have the possibility of suffering. So it would be acceptable to destroy any system of cells (whether from a human or non-human animal) as long as it has not yet reached the stage where it has the ability to suffer, or it has passed that stage at the end of life.
Even if we do not achieve the high level of consistency that it requires of us, the utilitarian argument that says that what we should aim for is a net reduction of global suffering seems to me to be a workable ethical principle on which to base decisions like these. Hence it is ethically allowable to use embryonic stem cells from a blastocyst (before the cells themselves have reached the capacity to suffer) in order to do research to reduce the suffering of actual living organisms.
Of course, this raises other potential problems that are sure to come down the road. Is it ethical, for example, to deliberately produce blastocysts purely for the purpose of research, as opposed to using those that are the by-products of infertility treatments? If, for example, one wanted to study the early development of a disease that had a genetic basis, would it be ethical to take an egg and sperm from people who have that disease and create a fertilized egg purely in order to study the early onset of that disease or to develop treatments for it?
These are very tough questions but ones that are going to come at us thick and fast in the near future as science and technology inexorably advance.
POST SCRIPT: God will decide if and when and how the world will end
Two days ago, I suggested that religious people make unreliable allies in the battle to save the environment because of their belief in god's plan. Right on cue, we have a member of the US Congress during hearings last week on cap-and-trade policies to reduce carbon emissions, quoting the Bible (Genesis 8:21,22 and Matthew 24:31) to support his belief that the future of the Earth is part of god's plan. Yes, god has our back, based on what he supposedly told Noah after the flood. So don't worry, burn those fossil fuels because Jesus has it covered!