By Richard M. Doerflinger
"We don't live in a world of moral absolutes," ethicist Arthur Caplan assured members of Congress at a recent hearing. Dr. Caplan's comforting words were music to the ears of those trying to find a way to rescind or evade the ban on federal funding of destructive embryo experiments which has been in effect since 1995. But it was also clear from that hearing that they will not advance their agenda without a fight.
The December 2 hearing was conducted by Senators Arlen Specter (R-Pa.) and Thomas Harkin (D-Ia.), chairman and ranking minority member respectively of the Senate subcommittee with jurisdiction over the Labor/Health and Human Services appropriations bill. Ostensibly it was held to study the implications of new advances in "embryonic stem cell research."
Those advances have been heralded in the press as promising an endless supply of "magic cells" to treat many human diseases, so it was not surprising that the hearing room was filled with reporters and the proceedings broadcast live on C-SPAN2.
In fact the hearing was a showcase for a new campaign against a pro-life policy which for years has prevented federal funds from being used to create and destroy early human life in the laboratory.
The hearing's direction was clear before any testimony was even heard. Sen. Specter praised the wonderful progress to be expected from embryonic cells - - likening them to a possible "fountain of youth." Sen. Harkin declared that it would be "morally wrong" not to fund the experiments in question, adding that the current ban on funding harmful embryo research does not apply to them.
To realize how wrong Senator Harkin was, one must know something about the experiments, which have attracted enormous favorable media attention, and about how current law would apply.
Three Ways to Manipulate Life
The three experiments attracting the subcommittee's interest have one thing in common:
they all claim to produce embryonic "stem cells."
Stem cells are fast-growing cells which, in the words of National Institutes of Health director Harold Varmus, are not "committed" to developing into one particular type of cell such as nerve or muscle. Instead they can be "pluripotent" - - able to produce a variety of cell types depending on what is needed by the body. Adult bone marrow contains stem cells which can produce different kinds of blood cells, but the early embryo contains especially useful stem cells which can potentially produce almost any kind of tissue in the human body.
The allure of these early cells is that they grow rapidly, can apparently be cultured to establish long-lived "cell lines," and may be able to develop into a wide variety of human cells and tissues. In theory, tissues grown from these cells could someday be transplanted into adults to replace sick or damaged tissue and to treat various diseases. Dr. Varmus, clearly enthusiastic about the prospect of funding such research, testified that it has "the potential to revolutionize the practice of medicine."
But each experiment has a different means to the goal of obtaining embryonic stem cells. Each, in its own way, raises ethical problems.
At the December 2 hearing, James Thomson of the University of Wisconsin at Madison described his approach to obtaining stem cells. He obtained so-called "spare" human embryos from in vitro fertilization clinics. He grew them for several days until they reached the "blastocyst" stage, when the developing embryo has hundreds of cells which are beginning to assume different functions in the new human organism. Thomson and his colleagues dissected these new human beings to harvest their inner cell masses, and then grew them in a tissue culture to develop lines of stem cells. In all, their experiment destroyed 36 human embryos to obtain five cultures of living tissue.
The approach taken by Michael West of Advanced Cell Technology in Worcester, Massachusetts, was more bizarre. He used "somatic cell nuclear transfer," the cloning technique used to create "Dolly" the sheep. The technique works like this:
A human body cell is deprived of certain nutrients to put its nucleus into a relatively inert stage. It no longer develops as one particular type of body cell but is ready to be reprogrammed. The nucleus is then transferred into an egg whose own nucleus has been removed, and the resulting cell is stimulated to produce a developing embryo with the same genetic makeup as the individual who donated the body cell. West's experiment produces a genetically matched embryo who is then destroyed to obtain stem cells.
NRL News has warned against plans to perform such cloning for research purposes harmful or fatal to the embryo in the past (see "Use Cloning to Create Human Guinea Pigs?" NRL News, 4/14/98, p. 11). Such experiments create new human life in the laboratory for the express purpose of destroying that life in order to gain knowledge or medical benefits.
The bizarre new twist to West's experiment, however, is that instead of human eggs he used unfertilized eggs obtained from cows to make his embryos.
This aspect of the experiment has excited media comment about the implications of mixing species to produce a creature that is half human, half cow.
But West's goal is not to make animal/human hybrids. He wants to produce tissue that is "fully human." By producing tissue whose genetic makeup is exactly matched to that of each individual patient who needs replacement tissue, the procedure is intended to eliminate the problem of tissue rejection.
That is why West contemplates using a body cell from each would-be transplant recipient to clone custom-made embryos, rather than using donated embryos as Thomson has done.
One obvious question here is how one can achieve such an exact genetic match with each human patient if one starts with a cow egg. West claims that while cows' eggs contain a tiny bit of genetic material outside their nucleus, this material is quickly taken over by the genes from the human nucleus inserted into each egg. In other words, the cow's egg is hijacked to make a human embryo, which is then destroyed for the useful cells it develops.
The ominous implications of West's experiment go beyond concerns about mixing humans and animals. One of the last practical barriers to mass production of identical human embryos for destructive experiments was the fact that it required donated human eggs, which are difficult to obtain in large quantities. But if eggs can be obtained in large numbers from other species, there may be almost no limit to the number of identical human embryos who can be produced by cloning for such lethal experiments.
Creating and destroying human life in the laboratory on a regular basis could actually become the standard way to treat a broad array of human diseases. Each time a patient requires replacement tissue, his or her body cells (along with eggs taken from a cow or other species) would be used to create genetically matched human embryos who are grown and then dissected for their stem cells.
Saving each human life - - if this ever proved to be possible - - would demand countless deaths in the lab.
A third way to obtain stem cells was described at the hearing by Dr. John Gearhart of Johns Hopkins University. He has harvested "primordial germ cells" - - fetal cells that later develop into sperm and egg cells - - from abortion victims seven to nine weeks old. These cells are then cultured to produce stem cell lines.
It is not entirely clear whether this experiment produces any human embryos. Although Gearhart was not trying to create embryos, he reports that some of the cell clusters in his culture form "complex structures closely resembling an embryo during early development."
Even if this ambiguity could be cleared up, an important moral issue remains: the use of cells taken from elective abortion victims.
Legal and Moral Evasions
Efforts to provide federal funding for these experiments faces an obstacle: it is not clear that any of them can be funded under current federal standards on embryo research.
Since 1995, each Labor/Health and Human Services appropriations bill has contained a provision (the Dickey-Wicker Amendment) that bans federal funding of experiments on human embryos. Congress enacted the ban to head off the National Institutes of Health's plans to fund such experiments, based on 1994 recommendations made by the NIH Human Embryo Research Panel.
The current law prevents funding of any experiment in which human embryos are created for research purposes, or in which embryos already in existence are subjected to significant risk of harm or death. The ban applies to early organisms that are created by fertilization, cloning, or other means using one or more human gametes (egg or sperm) or human diploid cells (such as body cells).
A separate law, enacted in 1993, sets guidelines for using tissue from abortion victims in federally funded research. For example, such tissue cannot be used for human transplantation research if the "timing, method or procedures" for an abortion are influenced by research needs. (These guidelines were drafted by abortion supporters in Congress as a "compromise" solution.
Pro-life groups see the guidelines as inadequate, since they still allow the exploiting of abortion victims and could legitimize abortion as a source for "useful" tissue.)
Under current law, the Thomson and West experiments clearly cannot be funded, because both involve the destruction of live human embryos. The West experiment, in addition, involves specially creating embryos for the sole purpose of destructive research, which even President Clinton has said should never be done with federal funds. Whether funding for Dr. Gearhart's research would be lawful could depend on whether any early embryos actually begin to develop in his culture of embryonic stem cells.
But supporters of the research are testing a series of arguments by which they hope to evade the current law or have it changed:
1. "It's only stem cells." This claim was made by Sen. Harkin at the December 2 hearing. Current law only bans harmful experiments on "organisms," he observed, and stem cells obtained from embryos are not "organisms." After consulting the dictionary, he actually polled all the witnesses at the hearing, asking each whether a stem cell is an "organism."
Testifying on behalf of the National Conference of Catholic Bishops, I agreed with all other witnesses that the answer to this question is "no." A stem cell may be very versatile, but it is still a part of a human being, not a whole human organism in its own right. But I went on to point out that while my heart is not an organism either, I am an organism - - and if you rip out my heart during an experiment I'll die. That is what the Thomson and West experiments do to human embryos.
A distinct question, of course, is whether federal funds could be used to develop and use these stem cells after the embryos have already been destroyed to provide the cells. But if Congress applies here the policy reflected in current law on fetal tissue taken from abortions, the tissue could not be used. Why? Because the "timing, method or procedures" for destroying the embryos is directly influenced by the effort to obtain tissue.
2. "They're not really human embryos." At the hearing, ethicist Arthur Caplan tried to defend Dr. West's experiment by claiming that what he has produced by joining a human nucleus and a cow's egg is not a human embryo.
But Dr. West himself flatly disagreed. Anxious to show that he is not in the business of making half-humans, half-cows, he testified that the goal of his experiment is "the production of a blastocyst-staged embryo genetically identical to the [human] patient" which can then be destroyed for its "fully-human stem cells." In any case, the current funding ban covers cases where only one of the cells used to make an embryo is of human origin.
A different version of this argument has been offered by President Clinton's National Bioethics Advisory Commission (NBAC), which commented on Dr. West's experiment in a November 20 letter to the President. Simply put, NBAC has made up its own definition of "human embryo" much narrower than the one found in current law.
According to NBAC, a human embryo is an early organism "that has the potential, if transferred to a uterus, to develop in the normal course of events into a living human being." In current regulations, of course, embryos are considered not potential but actual human beings - - they are covered by the rules on protection of human subjects.
But NBAC apparently thinks that only live-born infants are "human beings." This idea is also found in the commission's earlier report on human cloning, which proposed that Congress should ban cloning of a "human being" by requiring that any embryo produced by cloning is destroyed or aborted instead of being allowed to survive to birth.
In his testimony, Dr. West denounced any effort to clone a "human being" (in NBAC's sense of the word). He also suggested that a cow's egg used in his "therapeutic cloning" experiment could "potentially be engineered to be defective in producing a fetus," so that there would be no danger of his experiment resulting in a live infant.
This is an amazing statement. Once one has defined an "embryo" as an organism that can become a live-born child, one can simply engineer lethal defects into the embryo so it would perish long before birth - - and then claim that it was never an embryo at all!
In my testimony I pointed out that this is a strange and narrow view of what constitutes an embryo. "In many circumstances - - especially those involving laboratory manipulation of new life - - embryos are created in such a fatally damaged condition that they will not survive to live birth. This does not mean that they were never embryos. One might as well say that an infant born with a fatal disease, who will not survive to adulthood, was never an infant."
It would be one thing to develop ways to produce useful stem cells without having to create and destroy embryos at all. What may be planned here instead is to produce embryos that are deliberately pre-programmed to develop horrible defects and die at a certain stage. That would make the ethical problems worse, not better.
3. "We need to control abuses." Dr. Caplan was among those arguing that the experiments could be more easily monitored to prevent abuses if federal funds were provided. "If we let it just stay private, not only will it be slow, it will be hidden, secret," he said.
But as I pointed out in response, some of these experiments are the abuses. Some of them, even if done with private funds, would violate laws against destructive embryo experiments in at least nine states. (Sen. Specter was visibly surprised when I observed that the Thomson experiment, which he seems to favor subsidizing, would be a felony in his home state of Pennsylvania.)
4. "But think of the medical benefits!" NIH director Varmus promoted this research as "an unprecedented scientific breakthrough," and Senators Specter and Harkin were clearly impatient with any ethical consideration that could slow the wheels of progress. The parallel here to the exaggerated claims for fetal tissue transplants a decade ago is uncanny.
Now as then, proponents insist there is a long list of diseases that could be cured if only opponents were not so picky about the source of the wonder-working tissue. People seem to forget that the federal government has been funding research into fetal tissue transplants from abortion victims for at least five years now, with no news that the tissue has been successful in curing any disease. At the December 2 hearing, new advances in regenerating blood vessels in the human heart and in replacing blood cells in leukemia victims - - advances which did not require exploiting human embryos to obtain their stem cells - - received little notice.
5. "The embryos would just go to waste anyway." This argument, used by supporters of embryo research in 1994, is now being recycled to defend the Thomson experiment, which uses "spare" human embryos from in vitro fertilization clinics whose parents no longer want them. These embryos would be indefinitely frozen or simply discarded in any case, the argument goes, so where's the harm? (This argument had particular appeal for Senators Specter and Harkin as well as Dr. Caplan.)
The "harm," of course, is that the federal government itself, acting on behalf of all taxpayers, would be moving into this situation to directly attack human life. That some private party plans to mistreat an early human being does not make it moral for the government to step in and do its own mistreating.
Congress recognized this principle in 1985, when it clarified federal law on fetal research to make sure that unborn children intended for abortion are treated by federal researchers with the same respect as unborn children intended for live birth.
The argument that "they'll die anyway" is found throughout the history of medical atrocities on human beings. It was used by German doctors to justify experiments on death camp inmates. It is used today by Jack Kevorkian to propose lethal experiments on euthanasia clients and death-row prisoners.
The last time members of Congress tried to use it to fund deadly experiments on "spare" embryos, in 1996, they were soundly defeated in the House of Representatives, 256 to 167. But with these new reports of "promising" embryonic stem cell research, we can expect new efforts to revive the argument in the upcoming Congress.
Perhaps the broadest threat to human dignity comes from the attitude voiced by Dr. Caplan: "We don't live in a world of moral absolutes." The Nuremberg Code and other declarations on human experimentation do speak of absolutes, to make sure that defenseless human subjects are never reduced to mere objects to advance benefits for others.
In a world of moral absolutes, a society will channel its resources toward the many promising alternatives to the exploiting of human embryos - - including the use of stem cells from other sources, and new advances in replacing and regenerating human tissue that do not require use of embryos at all. Without those absolutes, people can be treated as things if that is judged useful for medical progress.
We have no reason to believe that this demeaning view of human life will ultimately confine itself to only one small class of human life. The renewed debate on human embryo research is about whether human dignity still has meaning for any of us.
Mr. Doerflinger is associate director for policy development at the Secretariat for Pro-Life Activities, National Conference of Catholic Bishops.