Catholic bishops condemn France’s first ‘bebe medicament’

Last month, doctors in France announced the arrival of the country’s first so-called ‘saviour sibling’. Born to parents of Turkish origin, Umut Talha (Turkish for ‘our hope’) was conceived through in vitro fertilisation (IVF) using preimplantation genetic diagnosis (PGD). This technique, in conjunction with Human Leukocyte Antigen (HLA) typing, commonly known as ‘tissue-typing’, has enabled families to have a child – a ‘saviour sibling’ – that is capable of donating life-saving tissue (usually umbilical cord material) to an existing sick sibling. Umut’s parents approached the hospital in Clamart a year ago requesting tissue-typing PGD. Their two existing children had beta thalassaemia, an inherited blood disorder that requires monthly blood transfusions.

An embryo was screened and genetically selected from an original group of twelve embryos to ensure that it was both free of the disorder and a tissue match for one of the existing siblings. The resulting saviour sibling, Umut, did not have thalassaemia, and cells from his discarded umbilical cord will be used to cure his older sister, now aged two, and her monthly blood transfusions will be discontinued. Umut’s parents plan to return to Clamart to undergo the same procedure to cure their other child, Umut’s four-year-old brother.  

Saviour sibling selection is nothing new. Adam Nash, reported to be the world’s first saviour sibling, was born over a decade ago in the US. Cells from his discarded umbilical cord were used to cure his sister, Molly Nash (aged six at the time) who had Fanconi anaemia, a hereditary condition that weakens the immune system and usually causes death by the age of 7. Here in the UK, the Human Fertilisation and Embryology Authority (HFEA) permits saviour sibling selection, and perhaps the most well-known case is that of the Hashmis. In 2002, the couple was given the go-ahead to create a saviour sibling for their son, Zain, who also suffered from beta thalassaemia. And in 2003, Christina Curkowskyj, who also had Fanconi anaemia, became Australia’s first child to receive a life-saving transplant from the umbilical cord blood of her saviour sibling, Thomas. Cases of tissue-typing PGD both in combination with, and in isolation from disease testing PGD, have drawn considerable media attention and public interest. ‘My Sister’s Keeper’, the 2004 novel written by New York Times Best Selling author Jodi Picoult attests to this very fact. The novel was later turned into a film adaptation.

France’s standing bioethics laws allow for cases like Umut’s. Tissue-typing PGD has been theoretically permissible in France since 2004; however, the issue remains controversial. More than six years later, the timing of the birth of France’s first saviour sibling could prove to be significant: the very law that allows for cases like Umut’s is currently being revised.

Stephen Wilkinson outlines a fundamental assumption which he terms ‘Schematic Political Liberalism’. This is the view that the State is obliged not to prohibit a given activity unless it can provide compelling reasons for doing so. For example, we should not ban the use of PGD and other forms of selective reproduction unless this is accompanied by adequate ethical justification and moral reasoning, in much the same way as it would be wrong to prohibit smoking or gambling unless there were justifiable reasons for doing so. This is not to say that we should allow anything and everything. A very restrictive set of government policies could be justifiable, provided there are good arguments to support these policies. Tissue-typing PGD allows for the creation of a life free from disease, and also allows a sick child’s life to be saved. There would be very few people who would argue it is better to create a life that is affected by disease, or that a sick child should not be saved. It is therefore up to detractors of tissue-typing PGD to show there are morally adequate reasons for banning this type of selective reproduction, and that these outweigh the reasons that support the creation of saviour siblings.

One group of detractors is, unsurprisingly, the Catholic Church. Archbishop Pierre d’Ornellas of Rennes, joined by the other bishops of his ecclesiastical province, issued this statement several days following the birth of Umut:

To cure a brother in humanity honours man. Many people dedicate their lives to this. To support parents in their suffering who have a seriously sick child is a duty of society. We understand their anguish and their hope in medicine. However, to legalise the use of the most vulnerable human being to cure is unworthy of man. To conceive a child to use him – even if it is to cure – is not respectful of his dignity.

Claims that tissue-typing PGD is morally objectionable because it involves instrumentalising children are often raised in public debates about the ethics of particular forms of selective reproduction. Many detractors of tissue-typing PGD, like Archbishop Pierre d’Ornellas, have argued that saviour sibling selection wrongfully mistreats the ‘most vulnerable human beings’, and that children should be respected for themselves and wanted for their own sakes, and not for what they can do for others. The creation of a saviour sibling, these bioconservatives claim, would be disrespectful of the (future) child’s dignity. The basis for arguments of instrumentalisation comes from various perspectives; more often than not, however, these claims rely upon philosopher Immanuel Kant’s universal prescription:

Act that you use humanity, whether in your own person, or in the person of any other, always at the same time as an end, never simply as a means.

However, closer analysis of the Kantian view suggests there is nothing to prohibit the treatment of people as means, but rather there is something morally objectionable to the treatment of people solely or simply as means. And thus, even if we follow Kant’s famous dictum, creating a child is not morally objectionable, even if it is a ‘means to an end’, provided that this child is respected as a human being. It would be morally reprehensible to, for example, create a saviour sibling and then to discard the child once it had ‘served its purpose’. However, this is clearly not the case with Umut, or any of the other thousands of saviour siblings that have come into existence, and so this objection fails as an ethical argument and a fortiori as a case for legal prohibition. Given that these parents go to such lengths to save their sick child suggests they are loving and caring parents, and that they will love and care for their new baby. Umut’s parents stated they would have had him regardless of whether or not he was a tissue match for his sibling. Moreover, in the Curkowskyj case, Christina’s parents had another daughter (this was their fourth child) several years after the birth of Christina’s saviour sibling, Thomas. One would imagine that, had they wanted Thomas purely to save the life of their sick daughter, Christina’s parents would have stopped having children once Thomas had been born and Christina’s life had been saved.

As long as the saviour sibling is loved as an individual, and not only because he or she can save his or her sibling, the outcome is a win-win situation. It is hard to argue with creating new (disease-free) life that can also save another life as long as both those lives are respected and loved.

It seems, however, that Archbishop Pierre d’Ornellas opposes tissue-typing PGD even when the resulting saviour sibling is not used solely as a means for a cure; rather, the fact that a child is used for any means is morally objectionable, or so it would seem according to his statement. Very few people (if any) would suggest that the motives of a woman who wants to have a child because her lifelong dream is to be a mother and raise a family are morally objectionable. Yet one could argue that she is viewing her future child as a means of achieving her own happiness and fulfilling her goals of motherhood, even if these are not the sole reasons for her wanting to have a child. It would hardly seem fair to deny her reproductive liberty provided, of course, she was able to care for and love the child.  

There are many other (perhaps less benign) reasons that have been put forward for wanting to have a child. These include ‘completing a family’, providing a playmate for an existing child, pleasing grandparents, improving the state of a marriage, the financial and psychological benefits that grown children provide for aging parents, filling the bedrooms within a newly purchased house, and even to produce an heir. These reasons all involve parents viewing their children as means in one way or another, even if they are not viewed as solely being means. Whilst Archbishop Pierre d’Ornellas (or you and I for that matter) might not view these as being particularly good reasons for conceiving a child, his objection, which is based upon the idea of wrongful instrumentalisation, would seem excessively restrictive as it would unsuccessfully single out embryo selection for saviour sibling purposes; rather, it would count against many instances (if not the majority of cases) of reproduction. Unless there was an empirical way of ranking the ‘wrongness’ of these reasons from ‘most morally objectionable’ to ‘least morally objectionable’ and of determining where the line should be drawn (which is highly unlikely), it would seem unreasonable to prohibit reproduction for some reasons, but not for others.

So does this mean there are no ethical justifications for prohibiting tissue-typing PGD? Not necessarily. Other objections have been raised by bioconservatives that have not been discussed here. These include arguments relating to safety concerns and issues of harms and benefits for saviour siblings, and potential harms of tissue-typing PGD to society at large (for example, arguments concerning enhancement and the slippery slope principle, and the allocation and distribution of resources), although I must admit that many of these objections, at least from a philosophical approach, seem problematic to me. Moreover, although I have focussed on umbilical cord blood donation, there are objections regarding organ donation after birth, and issues of exploitation and coercion and non-renewable solid organ donation (such as kidneys). What can be said, however, is that the argument provided by Archbishop Pierre d’Ornellas is flawed, and that objections based upon ideas of wrongful instrumentalisation do not successfully demonstrate that France’s standing bioethics laws which allow for cases like Umut’s should be changed. It is up to bioconservatives and prohibitionists to develop adequate ethical justification for the prohibition of tissue-typing PGD, and to demonstrate that these justifications outweigh, not only the creation of a child unaffected by disease, but also the reasons for wanting to save the life of an existing sick child.

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44 Responses to Catholic bishops condemn France’s first ‘bebe medicament’

  • S.Newark says:

    The Argument for use is a presumption. Science is not infallible. Science is as flawed as any other method of thought.

  • ann says:

    I have not read the Archbishop's full comment, but there is a very glaring aspect to these "savior sibling" process which ensures the Catholic church will never endorse it (and in my opinion, rightfully so). The sibling is "screened" out of 12 other embryos, and considering the Catholic church believes that life begins at conception, that means that 11 children were sacrificed to create the "savior" and to "save" the other. There is no way the Catholic church can condone such a procedure. It is not a "win, win" situation for all of those involved. 11 children who should have been loved were discarded because they did not serve the parents purpose. It is a rather sad situation.

  • David says:

    What a ridiculous comment by ann – how many women produce 12 eggs during each "normal" menstrual cycle? It is rare to harvest as many as 12 eggs and it is very wrong to say 11 children are "discarded". I can only imagine that these comments come from a position of ignorance. I think it is important to understand the mechanics of IVF, in terms of PGD. Would you condemn a woman, accusing her of manslaughter by negligence for failing to become pregnant at each menstrual cycle? In the simplest of terms, during the PGD-IVF process, a woman is given drugs to down-regulate then further drugs to superovulate so that she produces as many eggs as possible: these are eggs that would normally be "sacrificed" during subsequent menstrual cycles. Sperm from the father is used to fertilise each of these eggs in-vitro. Many will not fertilise, some will not develop, some will develop abnormally and if lucky some will develop into blastocysts and maybe beyond. Some embryos will not develop sufficiently and will "self-destruct", for want of a better expression, prior to reimplantation. Following reimplantation, as with the "normal" process of impregnation, there is no guarantee that a pregnancy will develop. The difference between "standard" IVF and PGD-IVF is that 1 cell is removed from a cluster of 8 cells and tested for the disease and if required, HLA-matching for a possible stem cell transplant for a sibling. There is no engineering or alteration, purely selection – something that mother-nature prides itself on.
    I fully support the personal choice being available to undergo PGD-IVF or not. My 11-year-old daughter died a horrible painful death due to an inherited genetic disorder and my 3-year-old son has the same condition. We tried PGD and were unsuccessful but my wife got pregnant naturally and we will have to wait for another 5 or 6 weeks to find out if he has the same condition and if he is an HLA-match for his older brother. The cord blood would have been thrown away anyway. Our new baby was wanted for himself and will be loved in his own right. Where's the problem if the waste product from his birth can save his brother's life? If anybody saw the suffering our little girl went through, I think their opinion may differ. Walk a mile in our shoes then……………….
    In any event, I fail to understand the Church's objection – God has given us the intelligence and ability to develop new treatments, procedures, technologies and drugs – why should we not use what is available to prevent unnecessary suffering?
    "Life begins at conception"?????? How many embryos do actually self-terminate? Under "normal" circumstances, not every one develops into a pregnancy!!!

    • Alexander says:

      Ann's comment was spot on and she is correct on the Catholic position. There is no need to debate the subject because it's common sense. It is what it is…. Another Selective/destructive form of eugenics (Someone must die for the strength of another)…When will it stop?

  • ann says:

    What a stupid ridiculous comment by David – the article did not say that they chose 12 eggs, it was that they chose from 12 embryos – each egg was fertilized. Each fertilized egg is a new life. The difference between a person deciding to discard these embryos and a miscarriage is the same as the difference between a person dying through murder and natural death. Yes, the end is the same in both situations, but the difference is the willful influence of outside source that ends the life. The church is not going to change its belief in life beginning at conception, so they can not and will not change their position on this situation.

  • ann says:

    *I meant to just say "what a ridiculous comment…" I originally typed the first sentence to obviously mirror the previous post, but remembered it wrong and wrote "stupid" then forgot to erase it when i put the "ridiculous" in to correct it. I know it's minor, but I just didn't want it to seem as though I want to escalate insults. My bad.

  • David says:

    I didn't actually read the article. I was simply replying to your post. I'm not stupid and my comments were not stupid. I stand by what I said. However, you are right that embryos are fertilised eggs but never in a million years would all 12 be viable. I know from experience that lots can happen to these embryos and they are NOT "a new life". Just because an egg fertilises, this does not mean it will successfully become a baby!!! A cluster of 6 or 8 cells does not constitute human life. As I said in my other thread, generally, the embryos fail to develop or "self-destruct" – it is not often a choice to discard and if any are discarded, these are usually embryos that fail to develop – they are not "a life" that is ended!!! That is such a ridiculous concept.
    Clearly, the people that formulate these opinions have never had a child with a killer disease and certainly never been in my position, watching one child die a horrible death then facing the same prospect with a second child. This condition has killed several of our very dear friends this year.

  • ann says:

    I really did not intend to call you stupid in my post. The point is that each of us had, at one point in our lives, been 6 or 8 cells. If someone had decided to throw those cells away, then that life would have been cut short. The position of the Church is not because those in the hierarchy have never had a child with a terminal illness. It is because of the belief that life begins at conception – which is is not a ridiculous concept for anyone who celebrates the Annunciation (when Jesus was conceived). It is the belief that every life is precious regardless of it's point in development. We can agree to disagree, I just want clarify what is at the heart of the Church's position.

    I am sorry for the deaths within your family and friends – my husband was killed three months ago, and to say it is difficult is a horrible understatement.

  • Joann says:

    Ann is right. The ends do not justify the means.

  • David says:

    I'm sorry, Joann – I have to disagree. Ann is not right, she has simply expressed her opinion, as I have expressed mine. We are entitled to an opinion – doesn't make it right or wrong!

    • Alexander says:

      Sorry David you are wrong. This is a right or wrong issue, just because you have an opinion doesn't erase the absolute truth from the equation.

      • David says:

        Have you watched your 11-year-old daughter die a horrible, painful death and then have nightmares that the same will happen to your 3-year-old son???? I think I know the answer to that one. Sitting there in your ivory tower, casting judgement on people. You make me sick. Walk a mile in my shoes. Sanctimonious………………….

        • Alexander says:

          No David I haven't, and I thank God that I haven't. To the same effect….Two of my children were aborted from a woman who didn't love me (That woman happened to be my wife) I had no say in her decision, and if I could of had her arrested for murdering my children … I would of ( I also feel I could of done a lot more to save my children) . No matter what stage of life that a child is, from an Embryo to its first heart beat and so on, you can never be the deciding factor in if that child lives or dies. It is God's, not the mother's/father's/doctor's etc…

          • Alexander says:

            typo (That woman happened to be my ex-wife)

          • David says:

            Abortion is a totally different thing. Let's not change the discussion. I too disagree with abortion. We were given the option to abort our little boy when we found out he had the condition that killed his sister. We chose not to. We chose life. A foetus or a baby is very different to a cluster of 6 or 8 cells!!!

  • Trung Nguyen says:

    Ann and David: You may have noticed in my above post (although you may not have because, as you said David, you hadn’t read it but rather you were replying to Ann’s comment) that I delibrately avoided discussing the moral status of the human embryo. This is because the point of my post was to focus upon the objections put forward by Archbishop Pierre d’Ornellas which centred around the idea of wrongful instrumentalisation, and not of concerns about the moral status of the human embryo and the destruction of embryos. I stated in my last paragraph that there are many other objections to tissue-typing PGD that I have not chosen to address here, and one of these objections could very well be the objection you put forward, Ann, which is that life begins at conception. However, a discussion focussing on the moral status of the embryo is one that is beyond the scope of what I have argued. Moreover, disagreements about when human life begins appear intractable, and basing arguments upon a particular view of the status of the embryo would lead straight to an argumentative deadlock, as we can see has already happened between the people who have posted comments. This is why I have chosen to explore an alternative objection, namely one that focuses on the idea of wrongful instrumentalisation and does not rely on contentious assumptions about the status of the embryo. Even if you are right, and that life does begin at conception, it does not detract from my argument which is that objections about wrongful instrumentalisation are flawed and do not successfully demonstrate tissue-typing PGD should be banned. Whether or not life begins at conception (and whether or not arguments concerning the moral status of the embryo are morally justifiable reasons for the prohibition of tissue-typing PGD) is a different issue altogether, and one that is beyond the scope of what I have discussed above.

    Joann: In my post above, I have argued that, in certain cases, the creation of a saviour sibling is morally permissible, even if it is a ‘means to an end’. I am not sure if you read what I wrote, but if you did, I would be interested in your response to the argument I presented.

    Alexander: Once again, I am not sure if you read what I wrote, but, if you have a response to the actual argument I put forward (i.e. that objections based upon ideas of wrongful instrumentalisation do not successfully demonstrate that tissue-typing PGD should be prohibited) then I would be very interested to hear it.

    My post was intended to be an ethical analysis of saviour siblings and selective reproduction in the context of France’s first saviour sibling and the possible revision of bioethics laws in France that allow for cases like this. But I suspect some of the comments provided have been fuelled by emotional responses on both sides rather than sound rational ethical reasoning.

  • Vishnu Chari says:

    hey trungy! nice piece,

    i agree with you for the most part, creating a child that can help save its older siblings is a wonderful medical creation, and that if its possible to perform in a safe and humane way, it should be. I wonder how this computes to the poor people of the world who have sick children, i presume this technique is exorbitantly expensive, doesn't that lead to futher ethical questions of the commercialization of health/care. If only the rich can afford to have saviour siblings, will that not increase the socio-economic tension already rising to the surface in places like England & France?

    From a religious stand point, such unnaturalness poses questions that most religious leaders would be very uncomfortable with. If the fate of a child could be changed by having a sibling that can cure him of disease, i, personally, think that god would want us to do what ever we can to help, but i think many people, who aren't so open to medical people "playing god" would rather not mess with fate. However, i also think that they'd rather not suffer the trial/trauma of losing a child. Education and enlightenment will see more widespread acceptance of this technique.

    PS : ( ann and david need to get a room : )

    • Matt Sharp says:

      "If only the rich can afford to have saviour siblings, will that not increase the socio-economic tension already rising to the surface in places like England & France?"

      I'm presuming that this sort of medical intervention would be available on the NHS (feel free to correct me anyone). I'm also presuming that it could be cost-effective for the NHS to do this, at least if the saviour sibling is born and can help cure the child before his disease gets serious and needs constant medical care. Certainly, the actual costs of doing molecular biology have been falling dramatically over the past few years so I can't imagine the PGD is itself expensive.

  • ann says:

    I appreciate your response to the comments posted, though by only discussing a portion of the Archbishops argument without considering the wider context of the Church teaching misleads the reader to think that his stance is based on poor reason.

    You said that "wrongful instrumentation" was not part of this particular situation considering the couple loved the "savior sibling" just as much as the other children. Yet, the other 11 siblings that were created and then set aside were not loved as they should have been because they were not the "right instruments". The question of whether or not the embryo is a human life is a fundamental part of the argument, thus neglecting that aspect and then claiming that it is "beyond the scope" of the article is not a legitimate option.

    It is the job of the Archbishop to speak up on such things to not only let Catholics know, but also to let others be aware that moral questions arise with such things. I doubt he expected the State to side with the Church's position, but I applaud him for standing up.

    Please let me know how that is not "sound rational ethical reasoning."

    • Matt Sharp says:

      The embryo is human, and it is a life. Ergo it is a human life. The question is whether being a human life is in itself morally relevant. Now, to be considered sound and rational reasoning, this should be backed up by arguments that don't in any way refer to the Bible or God or religion. Otherwise it just turns into a debate about those things. What usually seems to happens in these arguments is this:

      person 1: Being a human life is not in itself morally relevant. Skin, hair, muscle, heart etc cells count as human life. But they're not morally relevant.
      person 2: But the embryo has the potential to develop into a sentient, intelligent, human being. Those cells do not.
      person 1: Why is having 'potential' to develop characteristics morally relevant? A child is a potential adult; that doesn't mean we grant it permission to vote or buy alcohol, or drive etc. A first year medical student is a potential doctor. That doesn't mean he is granted permission to perform brain surgery.

      and so on…

      • ann says:

        The point is that the Archbishop is viewing the issue from the perspective that every embryo is a new human life. The "person 1" and "person 2" you present will obviously not agree with this issue, not because of a flaw in their reasoning, but because of a difference in their philosophy; One philosophy being that there is a God who made man with an intrinsic dignity. Including this in one's reasoning does not make it less sound or less rational since there is no way for one to complete confirm or deny that aspect simply through reason. If there is a God in the form that Christians believe, then the reasoning is completely sound. If there is no God, or the God is different from what Christians believe, then the reasoning is still sound, it is just the premise that is flawed, which would lead the reason to the wrong conclusion.
        Presenting the Archbishop as being wrong with his argument because the "savior sibling" is loved is not a flaw in reason, but a disconnect between philosophies of human life. The author should have recognized this rather than leaving it out of the conversation.
        Also, granted, you do not treat a med student as a "potential doctor" or allow a child to vote, but if you were to end the life of either, it would still be a life cut short. If one person murders a young adult, and another person murders an old man, they are both receive the same murder charge.

        • Matt Sharp says:

          The argument from the Archbishop that the author was responding to made no mention of God. The author was responding to one particular claim from the Archbishop: that the saviour sibling is being used as a means rather than an end.

          I don't believe the author was trying to completely discredit every belief that the Archbishop holds. It was merely a response to the one particular statement. That's why there's no talk of God, or the rights of the embryo. Of course they're related to the overall, but they are *not* directly being argued against. Consider that an atheist could have put forward exactly the same argument that the Archbishop is quoted as saying. Christianity and God are not the point here.

          Yes, if you killed the medical student or the child, it would be murder. But it wouldn't be the murder *of a doctor* or the murder *of an adult*. Similarly, if an embryo is only a potential person, then killing it wouldn't be the killing *of a person*.

          • ann says:

            The problem lies in the author's definition of "the most vulnerable human beings" versus the Archbishops definition. From the author's writing, the term is directed only towards the child whom is born. According to the Church, and thus the Archbishop, a human being is created when he/she is conceived, meaning when he/she is an embryo. With that, the procedure does use "the most vulnerable human beings" as tools and does not respect the dignity of the individual – as is evidenced by the 11 discarded embryos.

            It is not that the author is expected to discuss every area of disagreement, it is recognizing the actual meaning of statement being quoted and arguing along those lines. Maybe the Archbishop should have been more direct with the wording, but the difference in definition plays a large role of the validity of the argument.

            Along the lines of the difference in definitions, I trust you realize that your argument of the embryo not having equal dignity because it is a "potential life" similar to a "potential doctor" is not convincing to a person who contends that life begins at conception. By this definition, the embryo is already a human life. There is no chance that as the embryo ages, it will turn out to be a dog or cat. Unless there is an agreement in definition, it will remain one of those "agree to disagree" moments.

          • Matt Sharp says:

            Ann, you may well have a point, though if the Archbishop wanted to refer to any embryos, he should have mentioned it (or perhaps he did, and the quote provided is used out of context).

            If you are correct, then the argument Trung makes is not against the view of the Archbishop, but it's still valid in terms of a counterargument to those who *do* argue the point holding the position Trung believes the Archbishop has.

            Just to clarify: I believe human *life* does begin at conception. But as I said above, every human cell in the human body is a human *life*: each cell is human, and it is alive. What matters to me is personhood, or at the very least sentience. Now, when a growing foetus can be said to be sentient is debatable. But it's not sentient from the moment of conception. And when something can be considered a person is also debatable. But, to me personhood does not come into existence until *at least* several months after birth, if not longer. We could argue about what it means to be a person. But I don't think that actually matters to you, because you believe that having a high moral status begins at conception, regardless of whether it is sentient or a person.

            I don't really see the point in arguing about this point anymore. I'm not going to attempt to change your mind, because it's obviously based on a religious foundation. Though I do think without religious convictions it's very hard to make a case for moral status beginning at conception without relying entirely on the potentiality argument.

          • Peter Wicks says:

            @Matt..I don't think we should refrain from discussing our moral attitudes with people just because theirs is "based on a religious foundation". At least they should make that explicit, and then we can start to talk abbot evidence and why we believe what we believe. You have pointed out an obvious flaw in Ann's reasoning, namely her failure to distinguish between when human life begins (on which you both seem to agree, as do I) and whether that is morally relevant. I hope she responds by explaining *why* she thinks this is morally relevant. Then we will be able to assess whether this is indeed a disagreement about religion, or whether she has some other reason to think that it is wrong to use human life instrumentally even when the human life concerned is neither sentient nor a person.

            It's perhaps also worth pointing out that the author does not even rely on the embryo not being a person, he merely points out that the embryo is not being used *solely* instrumentally. It's a good argument, although as I pointed out in an earlier comment it rather assumes that we are all disciples of Kant (Kantadelphians perhaps?).

            On a more emotional note I'm inclined to share David's disgust at the attitude of some moral realists (religious or otherwise) who are so blinded by their opinions that they lose any sense of empathy for human suffering. Ultimately this is why I favour utilitarianism as an ethical framework: not because I believe it is "right" in any absolute sense, but because it best reflects the (in my opinion) honourable desire to maximize human well-being and minimize human suffering (such as David's).

          • David says:

            I just wanted to thank Peter for not losing sight (as others seem to have done) of the suffering that could be prevented with treatments such as this.

  • Dan says:

    I am a Christian myself, and also believe all life is sacred, however firstly i am no theologian and hence can not speak on behalf of the church or its beliefs, however i feel i have insist we must stop referring to the discarded embryos as 'children' or 'siblings'. Ontologically, these are separate nouns with separate definitions, and whilst i do also believe a fetus is sacred, how early in its time line it is considered such is still publically and personally open for debate.

    Based on the logic expressed by a number of people who have posted above, does that make IVF immoral as multiple embryos must be grown? I shudder to think of all those couples who have a burning desire to have kids "and love" them being rebuked and admonished despite the existence of viable options that are available today.

    And i apologise Trung as i have also steered the topic away from the one you intended 😛

  • Peter Wicks says:

    Perhaps it would be useful to have a definition of "sound rational ethical reasoning".

  • Irene says:

    I've read the column and have been following the comments and want to throw this out there, and ask for clearification.

    Does tissue-typing have to be done prior to the "embryo" being placed in the uterus, or is it possible to do tissue typing while the fetus is in the womb (at no harm to the fetus)? Though I understand that siblings and blood relatives usually are the best matches, is it possible for other children's umbilical chords to carry cures to the diseases that are mentioned above?

    If the answers to my questions is, yes tissue typing can be done while the child is in the womb, and that yes, other umbilical chords could be carriers of cures for the blood diseases, then my next question is why not do something like Organ Donation, and allow parents to volunteer to let the umbilical chords of their child (after the child is born) to be used for cures?

    Though I realize that this solution requires us to have more faith in mankind, and that other problems may arise like having a black maket on umbilical chords. I think this would be a better solution than getting into debates about the morality and ethics with IVF itself.

    My heart goes out to those who have someone or know someone who is suffering from a disease that isn't easily cured. I feel bad for parents who are unable to conceive. However there is much debate over the morality and ethics with IVF itself, and until that debate is resolved, any thing coming from IVF cannot be debated as if it stand alone.

    It is irrational to argue a point of ethics by ignoring an aspect of the technology that is being used that itself can be considered unethical. It could be considered very Machiavellian.

    In citicizing the Bishop on his position against PGN, even if he doesn't go into all the thought behind why it's wrong (the Church has been consistent in it's belief of when life begins and that anything besides natural conception and natual family planning is immoral) is irresponsible.

    • David says:

      In reply to your questions, Irene, testing for the disease and tissue typing can be either be done before or after reimplantation. It is inmportant to note that the testing after reimplantation (CVS or amnio) do carry a risk of miscarriage so there is a risk to the embryo / foetus. Matched sibling donors are the best for transplant and other family members cannot generally be used (often there is a dangerous mismatch or in the case of parents, a half-match, which is the riskiest form of transplant). Stem cells from the cord blood of an unrelated baby can be a good source of stem cells for transplant, if there is a suitable HLA-match but again there are no guarantees. The condition that killed my daughter and could kill my son is rare and complicated; due to chromosome fragility, transplants are very dangerous and carry serious complications. Although there is no guarantee, a matched sibling donor is the best chance of survival and reduced suffering. There is no facility in the UK – no cord blood bank: Cord blood can be collected and stored for a specific recipient (sibling) but there is no "general" bank. We know this because we have offered to donate our new baby's cord blood if it is not a match for our son but the law states that it must only be used for him, nobody else!

  • Peter Wicks says:

    I still think it would be useful to have a definition of the term "sound rational ethical reasoning". One thing I noticed in the author's response to Ann was the comment that disagreements about when human life begins "appear intractable". He then seems to draw a contrast between this "intractable" issue and the question as to whether the procedure constitutes "wrongful instrumentation". In his original post he appealed to Kant as some kind of authority on the issue, based on the (somewhat implausible from my perspective) claim that arguments such as those made by the Archbishop "more often than not…rely on" the prescription from Kant that he then quotes. Certainly I'm not aware of any evidence that the Archbishop was relying on Kant's prescription, so why judge his argument against it?

    The truth, as I've pointed out repeatedly on this blog, is that no ethical issue is "tractable" if by that we mean that we can somehow logically deduce our moral positions on the basis of pure reason and evidence. Moral positions are choices. Joann and Alexander may prefer to believe that this is an issue of absolute right and wrong, but they have no more evidence for this than Christians (of any denomination) have for claiming that Jesus rose from the dead or that the Bible is the
    Word of God. And nor does the author have any sound basis for claiming that arguments about "wrongful instrumentation" are any more tractable than arguments about where human life begins.

  • ann says:

    Matt & Peter: I think a part of the disconnect between views in the question of person hood lies in the question of the soul. Through the Catholic prospective, the union of the body and the soul is what creates the person – although signs of death can be witnessed through the body (heart stops, brain waves cease, etc), another aspect to death is that the soul is no longer present in the body. Likewise, life begins when a new soul is present. There is obviously no way for science to "study the soul" because it is outside of it's scope of limitations. Thus, there is no reason not to believe that the soul is present with conception, but we do have reason to believe it is the case if one believes in Jewish and Christian scriptures. So yes, while the embryos are not sentient beings, it is believed that they are persons because it is the earliest union of a body and soul. This body/soul aspect is the intrinsic difference between the embryonic cells and skin cells – which is why the Church does not condone embryonic stem cell research, but has no qualms with adult stem cell research.

    To be honest, I really do not have an argument from the materialist perspective because there are a lot of moral issues that rely on the God premise. On this topic, and many others, I really can't make up a reason for atheists to come to the same conclusions as a Christian. I think it is important though to recognize the differences between the two beliefs rather than pretending that their definition of morality are the same. My only intent with all these responses was to clarify why the Archbishop made those comments, and why it is not bad reasoning.

    I'm sorry for writing so much – I'm sure you're all probably tired of reading from me.

  • Peter Wicks says:

    Ann many thanks for this – on the contrary I think this is precisely the kind of debate we should be having on this blog, even if it's a bit out of scope of Trung Nguyen's original post.

    I agree that we're using the word "person" in two different ways. The secular meaning of the word that Matt and I are using basically has to do with function: does the embryo/infant have the capacity to have interests, that is to say to make up his or her mind about things. I'm simplifying a bit but that's the jist, and it's generally considered that this capacity does not develop until some time – at least a few months as Matt said – after birth.

    If instead you want to use the word "person" to mean a union of body and soul, where "soul" is seen as meaning something different from "mind", then of course you are relying on a belief system that atheists generally don't share. Once this is clarified – and this is precisely the point I was making in response to Matt – we can then talk about evidence and why we believe what we believe. You say that the soul is "outside the scope of [science's] limitations". To me that is basically another way of saying there is no evidence supporting it's existence. (If there was, then it could most certainly be studied using the scientific method.) So the question is then why you believe in it. I was raised as a Christian as well (not Catholic but that's not relevant for the present discussion), but in a sense I never really believed it, essentially because of the lack of evidence. But it took me some time to overcome my fear of damnation (and parental disapproval) and stick up for my genuine beliefs…and even longer to clarify my values, once I no longer had the Bible or a priest (Archbishop even) to tell me what they should be. But others have different motivations, and I am curious to know more about yours.

    • Irene says:


      I'm having trouble with your belief that a sentient life doesn't begin until at least a few months after birth. Sentient is difined as "having the power of perception by the senses; conscious." We are all born with a conscious, it just needs to be developed. As far as preception goes, ultrasounds have shown that inside the womb fetus' respond to their parents voices and that during partial birth abortions it has been documented that the fetus at least seems to be in pain. You seem to be taking it a step further by putting the stipulation that as a scularist a person has to be able to think for themselves to beconsidered a "person." I know many adults who are unable to think for themselves.

      As far as evidence for a soul, and the inability for science to actually prove it's existence, science hasn't been able to prove it doesn't exist. Science can't explain why two identical twins have completely different personalities. Though science can give the chemical response to what happens when we're "in love", it can't explain why even when the chemical responses are present we aren't necessarily "in love". Though science can explain our "fight or flight" response, it can't answer how even when our mind is telling us to run to preserve our own life, people still make the decision to stay and lay down their own life for another. Science has it's limitations (just look at the advancement of science itself over the last 100 years); I don't know why you would dismiss the possibility of something existing just because science can't explain it, especially when the proof of it's existence is in front of our eyes, even if some people want to dismiss it as fanciful thinking.

  • ann says:

    The tricky thing with the concept of the soul and God is that I don't think there is some unquestionable evidence – if that were the case then having faith would not be necessary, and it would further the myth that man can know everything. What I do find very telling, and what is a large part of my basis of belief is the idea that "God is love" because love is the common thread within human life which is present regardless of country/class/race/place in history. I believe it gives people the most satisfaction in life (as opposed to power, money, etc) because it is what authentically satisfies the human person. If we are made in God's image, and "God is love," then it makes sense that we are made to love. Just how you can not convince someone of the reality of love through argument, you can not convince a person of the reality of God simply through argument. In both cases, the free will plays an important role in one's openness to the subject.
    Through the materialist lenses, one claims that we can study love through the chemical process within the brain, but there is a difference between watching how the body manifests it, and what "it" actually is. If a person were to say that they can recreate the chemical process of love in a person's brain to create the "sensation," it would obviously not be the same thing as love.

    I know this kind of "love" talk often strikes people as saccharine-sweet, but it is not without the understanding that with love also comes sacrifice and sorrow.

    I acknowledge this is way off from the original topic, but as you may have guessed, I have difficulty not responding to a question. I appreciate your patience.

  • Peter Wicks says:

    OK we're indeed straying way off topic here, so I won't make a long reply here (if anyone wants to continue this conversation on my website, just click on my name at the top of this comment). Some quick comments though, in response to both Ann and Irene:

    1. I didn't say sentient life begins a few months after birth, I said personhood does. I agree sentience begins earlier (although Irene I notice you're using the argument from potentiality, in which case we might as well say that sentience and personhood all begin at the Big Bang).

    2. Faith is always necessary. As Hume and Wittgenstein have shown (and in spite of Descartes' "I think therefore I am") it is possible to doubt everything, even our own existence. Belief is always a choice.

    3. Ann a secular version of your distinction between the mechanics of love and the "thing itself" would be the Platonic realm of ideals. Love is then an ideal, which is from time to time manifested, imperfectly, in the real physical world.

    4. You don't have to believe in God to want, and actively strive, to create a world in which love is manifested more frequently.

    Peace to all.

  • David says:

    I'm going to stop posting on this forum because it is very upsetting. The disease that killed my daughter and could kill my son has also killed many of our close friends. There have been over a dozen, just this year.
    The final thing I wanted to say is that even though I am a Scientist, I am very spiritual (there is no reason the two cannot go hand in hand) – I know that we all have a spirit / soul that cannot be explained by science. I actually felt my daughter's spirit leave her body hours before the machine was switched off and she was pronounced "clinically" dead. I also know that one single cell does not have a soul, neither do 6 or 8 cells in a cluster that are tested during PGD-IVF. Furthermore, what is important is personal belief and values – the way we live our lives and how we treat others. My unborn son will be loved so much, just like my other children, whether his cord blood is a match for his brother or not – this would be a bonus NOT his "raison d'etre".
    Please do not lose sight of the fact that religion is man-made: there are so many different Churches that cannot agree, it is unreal – wars are fought in the name of religion – I know that I will join my daughter in heaven one day even though I never set foot in a Church.

  • Peter Wicks says:

    From my perspective David's comments are a good reminder that ethical questions involve real human suffering (and also real human pleasure). I also believe that religion is man-made – certainly there is no convincing evidence to suggest otherwise. As David says, the important thing is how we live our lives and treat others. That is of course what ethics is all about, and it seems to me that the desire to maximise pleasure and minimise suffering should be our guide in determining our moral positions, both on specific issues and in general. Many of us are emotionally attached to our beliefs, even when there is no evidence to support them, but if that means taking moral stances that weaken our ability or willingness to maximise pleasure and minimise suffering then we must be prepared to question those beliefs. In the mean time there is much to debate about utilitarianism, but I haven't come across any ethical system that is better.

  • casas says:

    Thank you very much, it pleases the details.

  • Samuel says:

    “Zygote”, “embryo”, “foetus”, “child”, “adult” are simply the various developmental stages of biological life. If every human being has a right to life by virtue of them being extant, then to screen one embryo in favour of another has to be viewed as a clear bias that can only be justified on the grounds of an arbitrary value judgment in favour of one stage against another. The position held by the Catholic Church is correct and valid if we hold to the view that all life is equal in value.

  • Theo says:

    I agree with David, and we must be reasonable. There is no need to allow a sentinent being to suffer when there are technologies that can prevent it. Likewise, it is irrational, and, one may say, cruel, to deny such procedures to someone that needs them.

    The bishops' argument, which says both that "lives should be saved" and that "this baby must suffer from its disease", is quite hypocritical.

    And whether embryos count or not as people is a long discussion. 11 people were not "sacrificed" in order to save another. Embryos don't have consciousnes, and before the 24 week they can't even feel pain, as they cortexes still aren't connected to their peripheral nervous system. Besides, an ejaculation has more cells than those embyos.

    That said, the church has nothing to do with science. France is a secular State and the bishops cannot go beyond the religious sphere (which they always do). Religious doctors and scientists have as well the moral duty of not letting their beliefs influence their practice, which is objective. This is a fact, it is not open to debate.

    Religion is not the problem, but stubborn belief is. Also in France, some days ago, a child died of malnutrion because her parents were vegan and denied animal-based food. Someone who consistently puts more value on ideas than on quality of life certainly has a mental disorder.

    • Peter Wicks says:

      Great comment, especially the last sentence! I think it summarizes very well why I like utilitarianism so much. By temperament I *love* ideas, but these days I am sufficiently "mentally ordered" to put quality of life first (well most of the time anyway!), and this for me is exactly what utilitarianism instructs us to do.

    • Matt Sharp says:

      I agree with most of what you're saying, other than the implication that children can't be healthy on a vegan diet (which frankly has nothing to do with this topic). If the child died, it was not because it was fed a vegan diet, but because it was fed a *nutritionally inadequate* vegan diet. Just like millions of parents feed their children nutritionally inadequate omnivorous diets, leading to obesity and diabetes. The only difference is that veganism requires a bit more attention to be nutritionally adequate.

      • Theo says:

        Thanks to both. The point was not veganism, but to present an example of non-religious inflexibility of thought that leads to acquirement of "nocive" priorities – in that case, the couple thought, implicitly, that a) "preventing animal suffering" was more important than b) "preventing their child's death". The thing goes deeper (but it has nothing to do with the topic;you can check the news archive in, I think): they also stopped visiting doctors and treated their children only by books. The legist declared death due to extreme malnutrition.

        Personally, I belive things and ideas (such vegan diet and alternative medicine) are not intrinsically good or bad. The problem is always with the people that use them. And ideals themselves likewise not wrong, but we must have priorities, and priorities change according to the circumstance.


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