NIH and human embryo research revisited:
What is wrong with this picture?
Dianne N. Irving, M.A., Ph.D.
Professor of Philosophy
Dominican House of Studies
Washington, D.C. 20017
I. Introduction
The rapid advance of medical technology has left a plethora of profound ethical,
social and political issues unresolved. No longer restricted to the archaic
deliberations within the halls of academia, Americans in general are finding
themselves increasingly affected by these technical medical issues and the
corresponding academic "theories" and public policy recommendations constructed
by academia - especially within bioethics. Without the technical and academic
expertise they perceive necessary to respond cogently to these issues, most
people remain in a state of persistent ethical ambiguity, confused by the
increasing number of ethical decisions they are being required to make on
a daily basis, and motivated more by emotion than by sound reasoning.
Questions abound. Are there really troubling medical experiments with human
beings taking place? Are there no realistically effective controls on all
of this "new reproductive technology"? Will my children or grandchildren
end up in some scientist's petri dish? Will I or my children be able to get
insurance if we carry a "bad" gene? Do we have a social duty to forego our
own individual ethical decisions about these medical technologies in deference
to some larger social gain for the betterment of our society in general?
Could we ever countenance a national policy, such as in China and other Third
World countries, where families with more than one child must be aborted,
or children with the wrong sex or with disabling genes must be eliminated?
Recently, a couple (who are dwarfs) told their genetic counselor that if
their fetus was "normal", they would want to have it aborted, because they
preferred a child more like them. And consider a recent poll in which close
to 30% of the respondents replied that they would abort their child if they
knew in advance it would be obese. Now that we supposedly have identified
the gene for obesity, would that mean that we could or should abort these
affected human embryos?
Despite these and other questions and confusions, perhaps some minimal clarity
and objectivity can and should be brought to at least one issue which is
fundamental to all of the above concerns, e.g., the on-going and still unresolved
debate on human embryo research. The question to be considered is the following.
Should any living human embryos be allowed to be used in purely destructive
experimental research, including those which are left over from in vitro
fertilization (IVF) "treatments" ("surplus" human embryos), those created
specifically only for research purposes, those produced by parthenogenesis,
etc.?
II. The recent response of the NIH Human Embryo Research Panel
Consider the recent NIH Human Embryo Research Panel's recommendations on
the use of living human embryos for experimental research. Great benefits
can be attained, they claim, e.g., the curing of diseases, the treatment
of infertility, and the pure advancement of scientific knowledge. As the
advocates of human embryo research complain, who would be so insensitive
as to reject human embryo research, when so much good can be realized? They
vigorously tout the claim that when so many people agree with the "carefully
considered and scientifically grounded" recommendations of the NIH Panel,
only ignorant, uneducated, unsophisticated people who linger among the shadows
of the irrational and misinformed "far right" could possibly find them
objectionable.
However, contrary to these obviously biased and clever complaints, those
who do object to this research are not radical, irrational, right-wing, ignorant
and uneducated bigots. Nor is this issue one of "balancing one group's belief
system against another group's belief system". Nor is this simplistically
about religion or pro-life zealots or anti-scientific research mentalities.
To the contrary, it can be demonstrated that these NIH recommendations are
simply not grounded in or based on sound science, guided by sound moral
reasoning, or constitutive of sound public policy.
III. What is wrong with this picture?
The fundamental issue here concerns basic human rights - especially the right
to life, on which all the other human rights depend. And those who have taken
a stand against this human embryo research come from all religious,
non-religious, grass roots, cultural, academic, professional, and political
persuasions. There have been over 53,000 letters of protest against the NIH
Recommendations (including many from overseas), compared with only 1,300
letters of support. Most of this research has already been rejected by every
other country, and violates many of our own state laws. The United States
would be the first and only country in the world to sanction most of this
research.
Furthermore, these NIH recommendations are in fact the product of a small
but clever and powerful group of academic and political elites - particularly
in the fields of bioethics, the hard sciences and the social sciences. After
over 30 years of unchallenged educational efforts and publications, they
have crafted and fabricated a working set of "ethical principles" and bogus
theories of "human nature" on which to ground their "ethical" positions -
positions which have heavily influenced the formulation of public policy
for many years now. Unfortunately, in the present case (as in several others)
they have also exploited the current epidemic of infertility and childlessness,
as well as the difficult problems associated with genetic imperfections,
using these affected patients and their family members to lobby in favor
of human embryo research in order to advance their own research agendas.
(Over 75% of infertility is caused by scar tissues formed from abortions,
the use of contraceptives and sexually transmitted diseases; some is caused
by the in vitro infertility "treatment" itself). What is wrong with this
picture?
Many have probably registered a bit of uneasiness in response to some of
the discussions and reports concerning the NIH's recommendations - quite
aside from their individual political affiliations or positions on abortion.
This same uneasiness and caution describes my own reaction in a slightly
different but related situation only a few years ago upon finishing the first
part of my analysis for my dissertation on the philosophical and scientific
arguments on the nature of the early human embryo and the ethics of human
embryo research.
I had originally intended to argue that "personhood" (or the moral status
of the early human embryo) began about 14-days - given the 25 years of scientific
and philosophical arguments so popular in the academic bioethics literature
at the time. I had retrieved the mountains-high stacks of articles and books
on the subject, and had selected just 23 "representative" arguments on "delayed
personhood" - arranging them in chronological order along the continuum of
the biological growth and development of the human being - from fertilization
through birth and early childhood. But my focus was on the supposedly gray
area between fertilization and 14 days.
I analyzed these arguments according to three criteria (no religion or theology):
scientific accuracy; historical philosophical accuracy and defensibility;
and logic. After literally years of verifying these criteria, I reluctantly
concluded that in virtually all 23 arguments, the science used was incorrect;
the philosophy used was historically inaccurate or embarrassingly indefensible;
and that none of the conclusions followed logically from their major and
minor premises. The statistical chances of this happening are, frankly, zero.
Half-way through the dissertation, then, I sat back and asked myself - "What
is wrong with this picture?"
IV. Political evolution of the issue
In order to begin to unravel the present "picture", consider how the recent
situation concerning human embryo research came about. For over 20 years
a ban, or moratorium, had been placed on the use of federal funds for fetal
tissue transplant research and IVF research. One common misconception is
that all fetal research had been banned. However, the moratorium banned only
fetal tissue transplant research, and not all other types of fetal research,
which have been going on for years in both private and federally funded labs
(including NIH, which has a central retrieval and distribution center in
Seattle, Washington, which has supplied live human embryos and human fetuses
to researchers for over 30 years.) Under the moratorium, IVF research was
conditioned on approval by an Ethics Advisory Board. Because this Board was
never appointed, the moratorium also precluded federally funded IVF research
(which would have required the use of early human embryos) as well. However,
human embryo research was not even articulated as part of the original
restriction on IVF research - another common misconception.
President Clinton, upon his election, lifted the moratorium on fetal tissue
transplant research by signing into law the NIH Revitalization Act of 1993.
It was through this Act, by a very clever move, that IVF research was - by
default -Congressionally sanctioned. As proponent Joseph Palca, writing in
the Hastings Center Report, so effusively and unabashedly stated: "With lobbying
support from the American Fertility Society, and the willing cooperation
of Senator Kennedy and Representative Waxman, they hit on the strategy of
simply eliminating the requirement that the EAB approve IVF research projects.
Language doing that was "slipped into the NIH Revitalization Act of
1993....attracting very little attention".
V. The recent NIH Recommendations
Immediately NIH set up their Human Embryo Research Panel to address the "profound
moral and ethical issues" connected with the use of living human embryos
in destructive experimental research. After almost 9 months of "public" hearings,
the Panel concluded as ethically acceptable much of the proposed research.
Human embryos could be acquired by: producing them specifically for research
purposes by IVF; using those left over from IVF treatment (so-called "surplus"
human embryos) with the informed consent of the donor ; embryo flushing;
parthenogenesis; and production with sperm from anonymous male donors. Ova
could be obtained from: the donation of ovaries from female cadavers if they
had given previous consent, or if their next of kin agreed (without transfer);
women undergoing IVF treatment; and, women undergoing regularly scheduled
pelvic surgery.
Several categories of research were found to be acceptable, including ("but
not limited to") studies on: IVF pregnancy rates; contraceptives; parthenogenesis
(without transfer); embryonic stem cell cultures (only with "surplus" IVF
embryos, without transfer); nuclear transplantation (without transfer); the
verification of important scientific data; and, those concerning preimplantation
genetic diagnosis (with and without transfer).
Needing further review ("for now") included: studies using human embryos
after 15 days until the closure of the neural tube (about 18 days); cloning
(without transfer); the use of oocytes from aborted female fetuses, which
are matured, and then fertilized and used (without transfer); nuclear
transplantation (without transfer); and, the development of stem cells using
embryos fertilized specifically for this purpose. Unacceptable ("for now")
included: cloning (with transfer); preimplantation genetic diagnosis for
sex selection (except for sex-linked diseases); fertilization of fetal oocytes
(with transfer); nuclear cloning (with transfer); the use of human embryos
after the closing of the neural tube (after 18 days); the formation of
human/human and human/non-human chimeras (with or without transfer);
cross-species fertilization, except those which have already been used for
some time, e.g., those involving chimeras formed with hamster sperm and human
ova to test for sperm fertility [no mention of those already used to produce
"transgenic mice" or other human/non-human chimeras, e.g., those used in
AIDS research]; the transfer of human embryos for extrauterine or abdominal
pregnancies [not mentioned, e.g., male pregnancies; or transfer into gorillas,
chimpanzees, etc.]; and, the transfer of human embryos into non-human animals
for gestation [no mention of the transfer of non-human embryos into humans
for gestation].
VI. Analysis of the NIH Recommendations
But, as enticing and exciting as all of this sounds to the proponents of
human embryo research, what are some of the serious problems involved with
this agenda, problems about which the vast majority of the American people
and their elected representatives seem to be unaware, and problems which
the proponents of this research continue to successfully ignore? Let me point
out just a few considerations.
1. It is important to understand that research now considered unacceptable
or needing further review can be immediately sanctioned by Dr. Varmus anyway
at his own discretion, including those studies in the unacceptable and needing
further review categories, and including that single and limited category
which President Clinton just recently wanted banned because of the "profound
moral and ethical problems" connected with them (i.e., human embryos produced
solely for research using federal funds). Clinton's statement was deceptive,
as it would not include human embryos produced solely for research using
private funds, or "surplus" human embryos from IVF, parthenogenesis, etc.
Furthermore, Dr. Varmus can override any objection, even the President's
and Congress', at will.
2. As the Panel itself frankly admits, the 14-day marker research limit is
purely arbitrary. Indeed, several of the panelists insisted that in order
to scientifically validate many of these presently proposed studies, eventually
the marker will have to be gradually erased all together so that the researcher
can determine the actual success or failure of his or her earlier interventions.
3. The legal status of this Panel is in question. It is alleged that the
Panel violates several provisions of the Federal Advisory Committee Act.
4. The composition of the Panel's membership has met with strong objections.
In their minutes the Panel admits itself that it was purposefully stacked
only with members who would approve of this research.
Many of the members have participated in similar commissions before, aggressively
taking partisan positions and even defining per se the "ethical principles"
which were used a priori in the earlier commissions' considerations as well
as the present NIH Panel's recommendations.
For example, several members served on the National Commission which, as
recently admitted by one of its members, basically made up the "bioethics
principles" of autonomy, beneficence and justice, later used as the very
basis of the conclusions and recommendations of the President's Commission,
the NIH Fetal Tissue Transplant Conference, the OPRR regulations for the
use of human subjects in research, the recent CIOMS/WHO International Guidelines
on the Use of Human Subjects in Research (especially addressing epidemiology
research and research in Third World countries) -indeed this present NIH
Panel's Recommendations.
Many of the members have also been involved publicly for years in national
and international abortion, euthanasia, and eugenics organizations and
industries.
Other possible conflicts of interests involve 10 of the 19 members of this
Panel who have themselves already received over $21 million from NIH from
1989 to the present to conduct research similar to that human embryo research
presently under their review.
And amazingly, there is not even one human embryologist on this NIH Human
Embryo Research Panel, raising questions about the kind of "human embryology"
they used (in fact they were using amphibian embryology rather than human
embryology) which obviously could have skewed their discussions and conclusions.
5. This incorrect "human embryology" was in fact the basis for the Panel's
so-called "balanced" claim that the moral status of the early human embryo
is less than that of born children and adults. If NIH cannot empirically
sustain and defend that grounding "human embryology", then they cannot sustain
and defend their subsequent philosophical claim about the "reduced moral
status" of the early human embryo which is derived from that incorrect "human
embryology". If they cannot sustain their claim about the "reduced moral
status" of the early human embryo - which is their self-proclaimed basis
for their many recommendations on human embryo research - then it would seem
that all of their recommendations are per se groundless, arbitrary and invalid.
6. There are in fact several major objections to NIH's "balanced" claim that
the moral status of the early human embryo is less than that of born children
and adults:
a) The opinions they are really balancing are not those of the popular citizenry,
but of those academics whose "theories" on human nature and delayed personhood
have been bandied about unchallenged in bioethics for years. To imply that
these bioethicists' "theories" are representative of the pluralistic opinions
of the American public is disingenuous in the least. They are not even
representative of the majority of bioethicists working in the field.
b) Even the claim that moral and ethical rightness or wrongness is determined
by consensus, by "balancing" opinions, or by balancing the risks/benefits
is not a neutral ethical claim at all. In fact, there is no such thing as
a "neutral ethics". Their position is clearly based on a normative utilitarian
ethical theory, which is riddled with theoretical and practical problems
- and only one ethical theory among many other ethical theories. Why should
utilitarianism be afforded such exalted status over and above any other ethical
theory - especially in a "pluralistic" society?
c) Why were bioethics principles fabricated? And if they don't work, as admitted
now even by their creators and by so many practitioners in the field, then
why are they still being invoked as the basis of ethical evaluations - especially
in the formulation of public policy - such as in this NIH Panel's
recommendations?
d) Ideas have consequences, especially when applied to millions of people.
Why is there no discussion concerning any harm that is and will be caused
by the application of these inaccurate, indefensible and impractical theories
and ideas? And who is going to be legally accountable for the concrete harm
that is and will be caused? It is simply not true that one idea or theory
is just as good as another idea or theory. Some match reality, and some do
not. Some can be defended, and some cannot. Some cause harm, and some do
not.
e) The NIH's claim about the "moral status" of the early human embryo, as
I have indicated, is really based on journal articles and books produced
in the last 25 years primarily in the field of bioethics. Many of the papers
which I analyzed in my dissertation are actually referenced by the present
NIH Panel to support their claim about the moral status of the embryo in
their Recommendations (one of the most influential being that of Clifford
Grobstein and Richard McCormick, S.J.). None of these arguments can be sustained
scientifically, philosophically or even logically.
f) On a further rather amusing note, the "human embryology" chart and the
list of "scientific terms" which the NIH Panel uses in the Appendix of their
recommendations are not referenced by a single scientific text book, but
rather by an Australian bioethics book, written by authors who all have argued
for infanticide in the bioethics literature for many years, and who have
used the very same incorrect science, philosophy and logic in their own
publications. These authors are Peter Singer, a philosopher; Helga Kuhse,
an "ethicist"; Steven Buckle, a philosopher; Pascal Kasimba, a lawyer; and
Karen Dawson, who is a geneticist, but who is not a human embryologist or
even a developmental biologist, and who sometimes even argues against several
of the scientific statements of her co-authors. Even this Australian bioethics
book does not give any scientific references for its own "human embryology"
chart or for its own list of "scientific terms" - all of which NIH uses in
the Appendix of its own human embryo research recommendations.
Why would NIH, supposedly one of the greatest scientific research institutions
in the world, with immediate access to almost infinite scientific resources
and experts, decide to use only an Australian bioethics book, which itself
has no scientific references, to reference its own "human embryology" chart,
its own "scientific definitions", and several of its other major recommendations?
What Is Wrong With This Picture?
7. Why have many academic scholars, who have tried for years to correct the
scientific and philosophical inaccuracies and misconceptions in the popular
and academic press been precluded from publishing those corrections?
VII. Protections of the basic human rights of research subjects
Regardless of the great benefits obtainable by creating and then destroying
some human beings in order to help other human beings, or to advance scientific
knowledge, national and international declarations and precedents have
unambiguously stated that the means used to those laudatory ends may not
include the harm or death of human subjects. For example, the Nuremberg Code
states that regardless of goods yielded to society, research using human
subjects must conform to certain ethical and legal concepts, primary among
which are the use of qualified scientists and correct scientific information,
the human subject's informed consent, and a minimal level of personal risk
to the subject. The Declaration of Helsinki states: "In research on man,
the interests of science and society should never take precedence over
considerations related to the well-being of the subject." Even the NIH's
OPRR regulations ensure that unborn children, whose parents intend to abort
them, are as equally protected from research harm if they survive the abortion
as are those children intended for live birth. And where in our Constitution
or Bill of Rights is there a guarantee of the rights of some human beings,
or even the government, to purposefully create other human beings to be destroyed
or donated for "the greater good of society or of science"?
Despite the catastrophe of the Nazi medical experiments with "sub-humans"
(who were going to die anyway and so they might as well get some good out
of them), shadows of that rationale keep emerging, even in our own society,
from time to time. Consider the Willowbrook experiments, in which mentally
retarded children were purposefully infected with infectious diseases in
order to study the diseases to prevent later populations from infections.
Or the Tuskeegee experiments, in which black males suffering with syphilis
were not administered penicillin, in order to observe the progression of
the disease. Elderly male nursing home patients were injected with cancer
viruses to see if they would form antibodies. Mentally retarded children
in state institutions were fed feces to study hepatitis. And most recently,
consider the radiation experiments sponsored by the United States Government
from 1945-1973 performed on thousands of unsuspecting patients, service personnel
and urban populations. All of these experiments were performed without the
informed consent of the human subjects experimented on.
It is interesting that many of such breeches of research ethics took place
in experiments involving vulnerable populations of human beings, whose
"personhood", perhaps, was considered to be less than adequate. It is also
interesting that much of it was federally funded, and justified "for the
greater good of society", for the advancement of scientific knowledge or
for national security reasons.
VIII. Conclusions
Considering the above facts and analysis, even from a scientific or ethical
perspective these human embryo experiments are unacceptable. The basic science
that is used to determine the "moral status" of these early human embryos
is grossly incorrect. There is absolutely no question whatsoever, scientifically,
objectively, that the life of every human being begins at fertilization.
There is no question philosophically that any attempt to split a human being
from a human person is both theoretically and practically indefensible.
Personhood begins when the human being begins - at fertilization.
Therefore, any experiment which would require the intentional destruction
of innocent human beings - even if for the greater good of society, or for
the advancement of scientific knowledge, or for the national security - is
automatically unethical. Great benefits do not justify unethical means.
And finally, given the questionable status of the famous "bioethics principles",
as well as the questionable makeup of this NIH Panel and its inherent conflict
of interests - and given the Panel's indefensible theory of the moral status
of the early human embryo, a theory which is selectively utilitarian and
grounded on unscientific bioethics books and literature - none of their
Recommendations can be defended, and so are invalid.
But that does not mean that these experiments have not or will not take place.
They already have taken place, and they will continue, unless our collective
basic common sense is restored and the inherent value and dignity of every
human being is acknowledged and protected - regardless of its quality of
life - and until everyone becomes informatively and actively involved in
this critical human rights dialogue.
References
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