IN SUPPORT OF MEDICAL RESEARCH AND TREATMENTS INVOLVING THE USE OF EMBRYONIC STEM CELL

PAPER OUTLINE (8 Minute Presentation): PHI7550 Argumentative Paper FOR OUTLINE

PAPER FINAL FORM: PHI7550 Argumentative Paper FOR FINAL

THESIS Using hESC for medical research and treatment should be supported on the basis that it is a vehicle of Christian agape compassion, and does not deny the dignity and rights of human individual beings.

BACKGROUND: THE SCIENCE

Before we can engage in a discussion on the moral acceptability of hESCR, we will need to overview some entry-level terms regarding the science. Stem Cells are cells containing two defining characteristics: self-renewal and potency. Self-renewal means these cells are able to go through numerous cycles of mitotic cellular division and still maintain an undifferentiated state (which allows further division). In addition to self-renewal, SC’s must exhibit potency, which is defined as the ability of a cell to differentiate, or specialized, into certain cell types. The degree of cell types determines the potency of SC’s. Four are noted: Totipotent (can differentiate into all cell types, embryonic & extra embryonic), Pluripotent (derived from Totipotent cells after initial cellular divisions, and can differentiate into all cells of the three germ layers), Multipotent (can differentiate into cells of its cellular family), and Unipotent (differentiate into same cell type, but self-renewal). In addition to understanding what a stem cell is, it is necessary to explain the basics of embryogenesis. Two main categories of stem cells exist: Embryonic (hESC) and Adult (ASC). Upon the fusion of genetic material from the oocyte egg and sperm (Fertilization), a 46 chromosome single-celled organism is created (zygote). This zygote then begins to experience cellular division, and forms a sphere of 16 totipotent cells (Cleavage). After 4-6 days, the Blastocyst is formed, which produces a ball with an outer layer of trophoblast cells, and an inner cell mass of Pluripotent cells. After 14 days from conception, the embryo implants into the mother’s uterus, and signals are sent to initiate genetic formation of the embryo’s basic forms as encoded in its genetic blueprint. The embryo then proceeds into a fetus, which proceeds into an infant, and so on. hESCR desires to extract the Pluripotent inner cell mass prior to its division into the three germ layers, and utilize it to create regenerative treatments by guiding the cellular differentiation.

In addition to hESCR, we should name two other important technological innovations. The first involves In Vitro fertilization (IVF). This involves a process whereas a female’s egg is fertilized with a man’s sperm in vitro, or in a dish outside of the mother’s fallopian tube. The fertilized egg is then inserted into the woman in hopes or implanting. The process uses many fertilized eggs, and the leftover are frozen. In addition to IVF, somatic cell nuclear transfer (SCNT) is relevant to the issue of hESCR. This is the process of embryonic cloning, such as the cloned sheep Dolly, whereas an ovum is taken, removed of its nucleus (de-nucleated), and inserted with the nucleus of the somatic body with the desired genes. This fusing it then zapped into gear, and an embryo with the genetic material of the donor is formed into a cloned embryo. hESCR utilizes either donated embryos from the IVF process, or embryos created for therapeutic cloning via SCNT.

The issue in question is then whether either process, which attempts to extract the Pluripotent SC’s from the inner cellular mass (and destroys the embryo in the process), should be ethically opposed. It is the opinion of this paper that it should not be opposed, but embraced.  For the sake of brevity, we will not address the issue of ASC’s, as they are not widely contested to. We will also accept that persons have a right to life, and that murdering human beings is to be ethically opposed. This paper will argue that on the basis of the Christian Moral Imperative of compassion and healing, as well as the reality individual human beings are formed person not until after implantation in the uterus, hESC does not violate human dignity, but rather affirms it by actualizing agape love.

PART 1: CHRISTIAN MORAL IMPERATIVE

From the start, an assumption may be fairly made: both sides of the argument likely have as their interest the desire to reduce suffering and induce compassion. I do not deny that the goal should indeed be honoring the life of human beings and their dignity. The difference, however, is that I believe one view in particular not only honors the life of human beings by not murdering them, but honors the dignity of those suffering from disease. Before we enter into a discussion on why hESCR does not murder human beings, we should lay the groundwork on why we have the incentive, as Christians, to pursue hESCR. If the motivation is reflective of our Christian virtues, and the process of hESCR does not harm human beings, then our moral obligation should take the form of embracing and utilizing such research and treatment.

It is clear from the testimony of Scripture that Christians have a moral obligation to reduce suffering and pursue healing. I will refer to this obligation as Agape love (Christian love for others). It is made evidently clear in Jesus’ personal example and healings. “He saw a great multitude; and He was moved with compassion for them, and healed their sick,” (Mt 14:14). It is also evident in the responsibility charged to the disciples to pursue healing (Mk 16:15, Lk 9:1, Mt 10:6). The act of healing, whether spiritual or physical, is in accordance with our love not simply for each other, but for our neighbors, which thus encompass everyone (Lk 10:29-37). It may then be said that supporting scientific endeavors that have as their goal the alleviation of suffering and healing give expression of our compassion/agape love. In addition, it shows us as good stewards of the gifts that God has given us, for we utilize our special position as ‘Created Cocreators,’ to create imaginative ways to actualize our duty of agape love.[1]

From our moral obligation to pursue agape love comes the reality of hESCR. Doctors are in wide agreement that hESCR has major potential to lead to breakthroughs that reduce suffering and provide healing. Dr. Zerhouni, Director of the National Institute of Health, has said that “Embryonic stem cell research holds great promise for treating, curing, and improving our understanding of disease, as well as revealing important basic mechanisms involved in cell differentiation and development.”[2] These opinions are shared by “Dr. Tabak, director of the Dental Institute; by Dr. Volkow, director of the National Institute of Drug Abuse; by Dr. Collins of the Human Genome Institute; [and] by Dr. Neiderhuber, director of the Cancer Institute;” among many other leaders of their medical fields.[3]

For the reason of agape love, and the great potential of hESC, Christians should pursue hESCR. It has been estimated that over 400,000 embryos lie frozen and unused, rendering such a wide source of already existing hESCs. At the moment, it would seem irresponsible to allow such embyros to be wasted away, while human beings suffer. This adds urgency to the element of our agape love and Christian virtue. As Eric Juengst and Michael Fossel explain,

If ethicists or the public would restrict the uses of embryonic stem cells, then they must then bear responsibility for those patients they have chosen not to try to save by this means. Currently, patients die regularly because transplantable organs are unavailable. There is no moral culpability in this: physicians are powerless. If stem cell research can provide the power to address this need, however, the claims of those patients becomes compelling.[4]

PART 2: HUMAN LIFE VS. A HUMAN BEING

I am sure that even the opponents of hESCR would agree that we should pursue medical treatments that bring about the alleviation of suffering, have great potential, and materialize our agape obligation. Where they object is that hESCR destroys individuals to help individuals. No doubt, this would appear a blatant contradiction, and would render hESCR as a vehicle of propagating what it seeks to ensure (saving lives). However, it may be demonstrated that pursuing hESCR performs no such hypocrisy.

I am in agreement with my Christian brothers that “you shall not murder” (Ex 20:13). We may agree that human beings are worthy of a right to life and dignity. However, is Richard Doerflinger and others correct when they simply state that “intentional destruction of innocent human life at any stage is inherently evil, and no good consequence can mitigate that evil,”?[5] Does hESCR perform such an evil? Before we can determine if an individual is being destroyed, we must determine what an individual is. For this reason, we must explore the difference between human life and a human being.

The importance of determining whether robbing one of a right to life and dignity has been performed is grounded on whether a human being has been wronged. This is grounded on an understanding that a human life is not the same as a human person. As prestigious bioengineer, professor, and CEO of  BioTime explains, embryology is clear that upon conception, a human individual is certainly not presence. Human life may begin at conception, but the presence of an individual may be questioned on the grounds that

Quite often a single fertilized egg splits to make twins. Since they come from a single fertilized egg, they share all the same genes… Certainly in the case of these twins, no one can assert that they were individual human beings at conception.[6]

The process of human life becoming an individual human person may be known as developmentalism, and makes an important distinction regarding the moral status of a Blastocyst. If a human being is worthy of dignity on the basis of it being an individual person, then the lack of the presence of an individual would render human life valuable simply on the issue of its nature. But human nature isn’t simply worthy of human dignity, individuals are. Peters, Lebacqz, and Bennett expand on this moral status of the Blastocyst, where they explain that

At 12 to 14 days the in vivo embryo adheres to the mother’s uterine wall. The primitive streak, which marks the location of the future backbone, appears, and the central nervous system first begins to develop. At this point, twinning can no longer occur. All three of these characteristics may be morally relevant: the rudiments of the nervous system necessary for sentience, the adherence to the uterine wall necessary for any future development, and the shutting off of the possibility of twinning. Prior to 14 days, the embryo cannot (strictly speaking) be treated as a morally protectable individual, since twinning might occur. Prior to 14 days, it is not sentient. And ex vivo or without adhering to the uterine wall, it has no potential for future development as a person.[7]

One cannot have personal dignity and rights unless one is in fact an individual. An abstract nature does not contain dignity, for only persons can have dignity. Otherwise, there would be no real tangible object meriting such. The question then of when human life becomes a human individual is of the utmost moral importance, and it is observable that human individual beings occur at implantation (14 days). Prior to this period, human life in its initial Blastocyst stage can become multiple people. It is not until the embryo plants itself into the uterine wall that individuals are solidified, and separate persons are destined to continue with the growth of bodies. It would appear nature provides a clearly observable mark of when individual persons are decided, which then circumvents the usual charge of arbitrary methods of determining personhood. As Dr. West explains, that an individual being

occurs at about fourteen days after fertilization. Up to this point there has been no movement toward building a human body. The cells in preimplantation embryos contain no body cells of any kind, not even any cells on their way to becoming body cells. They are blank embryonic and immortal stem cells… the primitive streak is therefore a very useful line drawn in the dust on the ground from which we are made, drawn not by arbitrary human convention but by nature itself.[8]

To this, someone such as John Breck, an Orthodox theologian, may counter “life begins at conception, when a sperm unites with an ovum to produce a genetically unique, living being.”[9] The emphasis is usually placed on the unique genome after fertilization, whereas the 46 chromosomes are evident enough to render one an individual. They may argue that the potential is present, and that this unique individual simply needs time to grow. However, this simply equates to a call to protect unique genomes and not unique persons. For unique genomes, and life, are not equivalent to individuals. The focus on ‘genetically unique individuals’ prior to implantation may be rejected on three grounds: (1) Embyro Wastage, (2) Twinning, and (3) Chimerism. It is first noticed that the process of becoming pregnant is a terribly inefficient affair. The number of naturally fertilized eggs that “are flushed from the mother’s body before they can adhere to the uterine wall range from 50 percent to 80 percent.”[10] It would seem odd that such wide-ranging waste of individuals would occur, and in the least should call those against hESCR to have funerals whenever this naturally occurs. In addition, the issue of twinning becomes again important:

In the early embryo, each cell is totipotent–that is, each cell can make not only any tissue in the body, it can also make an entire person. In the first few days, the agglomeration of cells can divide into twins, quadruplets, octuplets, or in principle even into 16 individual embryos. All of these would have the same genetic code, even if they become separate individuals… Further, during these early stages, which can last up to 12 or 14 days, these divided embryos can recombine. Twins can become a single person again… The result of the twinning process, of course, is that two or more babies can be born with identical genomes. Yet each is clearly an individual.[11]

It would seem odd to argue that there exists here genetic uniqueness, when identical genomes can not only be shared through twinning, but that such can then fuse into an individual. Finally, the issue of chimerism firmly rebukes the idea of unique individuals on the grounds of conceived genomes.

A chimera is a single individual with two or more genomes. Within the mother’s body, in vivo, frequently two or more eggs can be fertilized at the same time… during the first few days of embryonic development… this pair of zygotes can combine to form a single embryo. If brought to term, the resulting baby is a chimera, a single person with two genetic codes. If the two fertilized ova are of the same gender, then the baby girl or baby boy grow up… If, however, a male and female combine, then the resulting baby may be a hermaphrodite possessing both male and female characteristics.[12]

For these reasons, we are led to agree with Dutney and Andrew, where they state that it is “not until the woman is pregnant can we be confident that an embryo… is becoming a human being. And it is becoming a human precisely by implanting in the mother’s uterus. In that process, and not before, a human being is conceived.” If human beings are worthy of dignity, and a human being is different from human life, and it may be naturally observed that a human individual occurs upon implantation, dignity and a right to life must occur at implantation as well.

Thus, hESCR is morally permissible, for it does not violate human beings dignity and right to life, for it does not murder human beings. These individuals have yet to be actualized naturally in the uterus, and prior to the 14th day where individuals are observed, there can be no murder for no individuals are being harmed.

PART 3: ENSOULMENT & DIGNITY

The argument of the moral status of the Blastocyst, and the difference of human life and a human being, are further reinforced when one ponders the nature of the individual eternal soul. Let us assume human souls are unique, singular, and eternal. Clearly there is theological disagreement on what humans are made of (soul, spirit, body, etc), but allow us to assume that human beings are of a moral status. Human beings are made in the imago dei, and unlike animals, human beings are capable of moral judgment (and guilt), reason, and eternal existence after divine judgment. Jesus came to save and call into repentance humans, and not animals, so let us assume he came to save the essence of the human, and we call this unique eternal essence the soul. It could then be said that human beings are worthy of special dignity because they have a single individual unique eternal soul, grounded in their imago dei. If such were not worthy of dignity and worth, it would make little sense why God would go to the compassionate merciful extreme of incarnated sacrificial rescue. As such, it is morally relevant to observe where the soul is most likely to occur, which is known as Ensoulment, and may aid in figuring out when an individual (whose intrinsically identifiable with their soul) is created.

To this, we turn again to the issue of Embryo Wastage, Twinning, and Chimerism. If Ensoulment occurred upon the implantation on the 14th day when human beings are formed, it would provide a good explanation of embryo wastage. As Benedict A. Ashley and Kevin D. O’Rourke observe, “probably many of these imperfectly fertilized ova were never prepared for ensoulment.”[13] Second, the issue of twinning brings about problems for a traditional view that souls are created upon conception and fusion of the oocytes: does the initial embryo have a single soul? If so, does this soul split when the embryo splits, giving twins half a soul? And if two souls were instead created upon twinning, what would happen to the twinned souls if the cells were to fuse back into one embryo prior implantation? Perhaps you yourself are the product of twin fusion. Such difficulties make the observation that Ensoulment occurs upon implantation that much more viable. Finally, chimerism argues in favor of Ensoulment at implantation, where Peters explains that in such incidents,

a genetic test is likely to reveal two genomes, one with XY chromosome and the other with XX. In other words, here is an individual with not one but two genomes. Does this person have two souls? … The attempt to link individual humanity with a unique genome simply unravels at this point.[14]

As argued, it would appear the Blastocyst is unlikely to have a soul given the various difficulties, and that the moment where human life becomes an individual human being seems likely the moment Ensoulment occurs. This would alleviate some additional theological difficulties brought by pondering what would occur if Jesus, upon the incarnation, if he would had ‘twinned’. We may then argue that Ensoulment likely occurs at implantation. As Peters concludes, “If the immortal soul is connected to an individual person, then ensoulment would have to be dated at day 14 and not at conception. Further, it is misleading to tie human individuality so closely to our genetic code.”[15]

Thus, the moment where human beings attain special dignity on the basis of when they attain an individual soul, likely occurs when they become individuals at implantation.

PART 4: CMI, LIFE VS. A BEING, AND FROM DESTINED TO DEATH TO ONGOING LIFE

We may then review the argument as follows:

1.     Christians have a Moral Obligation to Reduce Suffering and pursue Healing for Human Beings.

2.     Human Beings are worthy of healing and protection on the basis of their dignity as individual persons.

3.     Human Beings are worthy of healing and protection on the basis of their Souls (imago dei).

4.     Human Life via hESCR will likely lead to the ability to reduce suffering and provide healing for Human Beings, while murdering no individuals in the process. (Breath of Life to breath in favor of Human Beings)

5.     Thus, Christians should be in favor of pursuing hESC research and using hESC treatments.

We acknowledge that after implantation, it would be wrong to abort or harvest a fetus for medical technological advancement, for at this time human individual beings are observable. This view then adheres to a principle of seeking the healing and dignity of both persons in the womb, and out of the womb, by actualizing agape love through medical research and treatment. Furthermore, it most honors the life of the Blastocyst, for one can argue “the blastocyst ex vivo is destined for death. By continuing its existence as a line of stem cells, one in fact prevents that death and gives it a form of ongoing life. To ‘respect’ it, in other words, may mean precisely to keep it ‘alive’ in the form of stem cells.”[16] We would then be wise to conclude, alongside Peters Lebacqz, and Bennett, that what “we find in the petri dish up to 14 days is a GIFT OF NATURE that could prompt a giant leap forward in human health and well-being.”[17]

Therefore, society, and Christians especially, should be in favor of permitting medical research and treatments that utilize the God-given gift of human stem cells.


[1] “created cocreator” term coined by Philip Hefner in The Human Factor (Minneapolis, MN: Fortress Press, 1993

[2] Senator Specter, “Senator Spector Speaks on the Senate Floor Regarding Stem Cell Research,” Monday, July 17, 2006.

[3] Senator Specter

[4] Eric Juengst and Michael Fossel, “The Ethics of Embryonic Stem Cells–Now and Forever, Cells without End,” JAMA 284.24 (2000): 3180-84

[5] Richard Doerflinger, “The Policy and Politics of Embryonic Stem Cell Research,” National Catholic Bioethics Quarterly 1.2 (Summer 2001): 143

[6] Michael D. West, The Immortal Cell: One Scientist’s Quest to Solve the Mystery of Human Aging (New York: Random House/Doubleday, 2003), 213-214

[7] Peters 81

[8] West 214-215)

[9] John Breck, The Sacred Gift of Life (Crestwood, NY: St. Vladimir’s Seminary Press, 1998)

[10] Peters 120

[11] Peters 121

[12] Peters 121

[13] Benedict M. Ashley, O.P., and Kevin D. O’Rourke, O.P., Health Care Ethics: A Theological Analysis, 4th ed. (Washington, DC: Georgetown University Press, 1997), 235

[14] Peters 121-122

[15] Peters 56

[16] Peters 149

[17] Peters 81

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