By Julian Savulescu
Reneuron has today announced the first transfer of stem cells in the UK to treat stroke. This follows quickly from Geron’s recent trial in spinal cord injury.
This is a historic moment which may be viewed in the same way as the first attempts to use antibiotics. Stem cells offer the door to entirely new form of medical treatment called regenerative medicine. When cells (the building blocks) or tissues of the body are damaged, they are generally not replaced. The dead tissue is replaced by scar that holds the rest of the organ together. So when a person has a stroke (or heart attack) a blood vessel to an area of brain is typically blocked and that area of the brain dies, being replaced by a scar that is functionless. Stem cell therapy offers the hope of replacing that dead or damaged tissue and cells with functioning new cells, in this case nerve cells. This trial is the very first stage to see if the transfer can be done safely.
Regenerative medicine is one of the most exciting areas of medical research and many scientists will be looking expectantly to the Geron and Reneuron trials. There will be one major hurdle, though, even if these trials are safe and show the treatment to be effective. Stem cells can come from a variety of sources but one of the major sources are from embryos. The derivation of embryonic stem cells from embryos results in their destruction.
It is not clear from the press release or Reneuron’s website (http://www.reneuron.com/news__events/news/document_260_237.php) whether or not their stem cells have been derived from embryos. Their press release states, “The ReN001 cells that are being used in the initial clinical trial are taken from the existing manufactured cell banks that will form the basis of the eventual marketed product.”
Whether or not the stem cells used in Reneuron’s research were or were not derived from human embryos, there is an interesting question which arises now or will arise in the future for the field of regenerative medicine: if stem cell therapies were originally derived from the destruction of embryos, should they be used? Such research has previously been described by its opponents as cannabalizing human beings.
How should we view stem therapies which are based on the destruction of human embryos? Is it wrong to destroy human embryos to derive life saving medical treatments?
The Moral Status of the Human Embryo: Solving the Stem Cell Puzzle
In March 2006, a 21 year old Cleveland man, Christopher Challancin, was driving home from a party with his 17 year old girlfriend, Jessica Karos. She was 4 months pregnant. They began to argue about her ability to care for their child. Challancin, who had been drinking, became angry. He began to weave high speed through traffic and crashed. Karos was left paralysed. The baby died. Challancin was unhurt. Because he killed the baby, he was charged with homicide.
In 2005, Alison Miller and Todd Parrish sued their fertility clinic in Chicago. They had been having IVF treatment back in 2002 and stored 9 embryos. One of these was “mistakenly” discarded. The clinic apologised and offered the couple a free cycle of IVF. They sued for the “wrongful death” of their embryo.
Every year, about 100 000 fetuses are aborted in the UK. No one is charged over these deaths. Thousands of embryos are also destroyed. The law on UK requires their destruction after 10 years. How can killing a fetus at once be homicide and yet no crime at all?
How can the destruction of embryos be required by law and widely practised but also, in some places, the crime of wrongful death? How can one act – killing early human life – be both right and wrong? This is the puzzle of social practice involving early human life.
One solution has been proposed by the Christian Right, the Catholic Church, “pro-life” movements and conservative politicians. That solution is to give the embryo, from the moment of creation, a full right to life.
That strategy certainly resolves the conflict. Killing embryos is always wrong. But it leaves us with no abortion (even after rape or when the woman’s life is at stake), no effective contraception (the commonest effective methods – IUD and pill – destroy embryos), no IVF and no effective control over our own reproduction. Many conservative religious and political leaders joyfully embrace these consequences, and seek to impose their values on society, because they are convinced they are right. This is the sort of disrespect of liberty and intolerance of which we so righteously accuse countries like Iran.
The kinds of Christian values which claim that the embryo has a full right to life account poorly for ordinary English life and conflict with accepted practices, regardless of whether a few good men disagree. Good men can be wrong.
There are other values which can account for our polar opposite moral norms, attitudes, practices and laws. This is a value to controlling our reproduction, in deciding how many children we will have and when to have them. “Go forth and multiply” – but there is a limit. Early human life has value when it is a part of plan to have a child. The reason why Challancin was wrong to kill his girlfriend’s baby was because she wanted to have that baby. Challancin is more like a drunk driver who recklessly kills an innocent child than a doctor who performs an abortion. Destruction of embryos is a moral crime when parents wanted them. It should have been Miller and Parrish who decided the fate of their embryos, not the Chicago clinic.
Here is the solution to the puzzle of our conflicting attitudes: embryos have special moral value when they are part of a plan to have a child, or at least desired by the people who made them. Embryos do not have special moral value when they are not desired by the people who formed them.
Creating embryos for research or medical treatment, either by cloning or by IVF, does not destroy any embryo that is a part of anyone’s plan to have a family. It does not deny the world of a child that would otherwise have existed. It is morally equivalent to engaging in sex using contraception. Both create and destroy embryos, the difference being research is to save lives, but sex is just for fun.
Opposing embryo research represents a backdoor assault on hard won reproductive liberty. It holds embryos as sacred and commits us to a world of vast overpopulation and unbearable family size. Women should not be compelled to bear 10 children or be abstinent.
The two missing pieces in the puzzle of early human life are the value of reproductive liberty and the conditional moral status of early life. Once we solve the puzzle, rational opposition to creating embryos for research melts away.
(Adapted from an opinion piece written for The Age several years ago.)
Professor Julian Savulescu University of Oxford
Does the plan argument really solve the couple who sued the IVF clinic for accidently destroying their embryo? They had a plan to use an embryo, to start a family…. But why did it have to be that particular embryo over any other? Their plan had 8 alternate ways of being achieved (fewer possibilities exist if they wanted multiple children).
The moral value of the embryo seems to turn on a person’s whim. Why is it that the moral value of embryos are determined by personal subjective whims, but not fully actualized adults? What if I’m a really indecisive person? I have 9 embryos, and I think, I don’t want them. Then I change my mind. Then I change it again. Would it have been wrong between the time I’ve changed my mind to destroy one of the embryos?
Say I have a plan, I want to have a baby, but I can’t get pregnant. So I turn my attention to the discarded embryos. Anyone of those embryos can be part of my plan to build a family. Do they all now have moral worth? Would it be wrong to destroy them simply because they’re 10 years old. Their age seems to indicate that they are not wanted by their biological donors, but now I want them.
Why would biological connection to the parents/donors give them the moral right to decide their moral worth? Does the fertility clinic, which had a significant role on forming the embryo, be able to decide the moral worth? Why not? what about surrogates?
What if I had a baby and the baby is severely disabled, and that was not part of my plan for life? Can I euthanize it? What if it were a boy, which was not part of my plan…
Julian,
Perhaps you could clarify whether you are arguing that the plans for embryos imbue them with an intrinsic or an extrinsic moral value. it is , I think, reasonably easy to argue for an extrinsic value in different circumstances. In this respect the IVF embryos and the research embryos could both be seen as having this, each simply being extrinsically valuable in a different way. However, it is surely intrinsic value that is at issue here. While the subjective plans/desires of actual moral agents might be seen as changing extrinsic value, I find it difficult to see how this would play out regarding intrinsic value one way or the other.
Hi Julian. I think your argument very interesting. But I have some doubts. Having a part in anyone’s plan of to have a family is certainly a reason for not destroying embryos. A group of embryonic cells can persist of having a part in one’s plan of having a family, even if some of those cells would be detached for other purposes, like research. Some cells within a group can even be discarded if a sufficiently number remains capable of being used for developing embryos for posterior implantation. The detached embryos hence can be ceased of having a part in some plan of having a family without prejudice to the plan. They only have a special value, then, by reference to the plans of their entitled holders (usually a couple formed by a man and a woman). Now, it is different in the case of the newborn, which has some special value in itself independently of the plans of her parents. I conclude following your argument that laboratory embryos cannot have any special value in themselves; but newborns have it. A further problem concerns the case of intrauterine embryos and fetuses. Would embryos or fetuses inside a womb have a value in itself? Having in mind the case of your cited fact that abortions are not criminalized (even if they are considered criminal, the fact is that they usually are not), if we follow your argument, fetuses are not beings with any value in itself, except the special value they can have (but not necessarily have) if the woman (or the couple) wants it for the sake of her plan of having a family. Only newborns, hence, can have an independent value from the special value or interests of their progenitors. I don’t know if you agree with the “in itself value” thesis. Anyway, newborn and people in general have some independent values. Nevertheless, I suppose that you will agree that beings capable of suffering can have independent interests (and, hence, with some independent value or interest on account of other’s values and interests). Now, in this case, fetuses (like Jessica Karo’s) could be seen as having an independent interest respectively Jessica’s or Christopher Challancin’s actual plans. Nevertheless, I’m inclined to think that even fetuses are outside the scope of the set of beings with respectable interests for their own sake, but I don’t have a clear argument for this (I only intuitively suspect that the fact of birth makes that difference). I’m also not sure that the capability of felling pain is what makes all difference (fetuses can fell pain, like newborns). Neverthelless, in vitro embryos are certainly outside the scope of beings capable of having any individual or independent interests. What do you think?
Julian,
assuming that the idea is about moral status (non-instrumental reasons/values), I recall that a very similar notion was suggested by Philip E. Devine in the course of the 1970’s abortion ethics debates (a chapter in Feinberg’s The Problem of Abortion, as I recall), but then applied all across the board. That is, moral status is generally a sort of social fact, made up of being recognized by others in a certain way. Devine applied this to fetuses and concluded that birth is, in fact, a very significant event, morally speaking, since it is there that the fetus/baby becomes directly accessible to the cognition of others. For good reasons, he abandoned this idea quite rapidly. Now, it seems to me that your notion of being a part of someone’s plan is very similar to Devine’s idea of being recognized. But, I assume, you are not willing to apply this notion of moral status all across the board (right?). But why then assume that it applies in the case of embryos? If it is not a condition for having moral status in other cases, why in that case?
Dear Julian,
I live in a Secular Country (Brazil) with a strong influence of Catholic Church. In fact, the Catholic Church tries to assign an intrinsic value to the Human Being which supposedly starts at the very moment of conception. In that instant, there’s an “infusion of the Soul”. Then the embryo becomes a Person, who has dignity per se.
In a post-metaphysical thinking that respects multiculturalism, this idea cannot be a General Ethical Principle.
An embryo is neither a person, nor a human being. Those categories are intersubjective constructions and as such they rise from intelligent communicative interaction. Personhood is not “natural”, it is constructed. Dignity is not inate, it is claimed.
I think an embryo in its early days is not even an individual, as it can be split without losing its main characteristics…
I suppose that the change from “object” to “subject “ is not abrupt, it is a continuous process. The embryo starts as part of someone’s plan and can reach the status of a person (with his own plans). The social construction of person and dignity (a plan to Good Life) is made at the public sphere by that person’s own iniciative.
That is my two cents on the subject. But I know I am far from solving the puzzle…
What about post-natal infants who have not yet become persons capable of forming their own plans and who are unwanted by their parents (or anybody else). On what basis would Julian oppose “disposing of them?”
Hi Peter what should we take from the overall discussion when it is clear from our discussions that even as well informed as Julian is, he and others still makes the same fundamental error of thinking there is some sort of Pro-Life party line against all abortions?
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