9:30a.m. – 11:00a.m.
National Press Club
A discussion including:
Ronald Cole-Turner, H. Parker Sharp Professor of Theology and Ethics, Pittsburgh Theological Seminary
Kevin FitzGerald, Dr. David Lauler Chair in Catholic Health Care Ethics at the Center for Clinical Bioethics and Research Associate Professor, Georgetown University Medical Center
Brent Waters, Director of The Center for Ethics and Values and Assistant Professor, Garrett-Evangelical Theological Seminary
Laurie Zoloth, Director of Jewish Studies and Associate Professor, San Francisco State University
Melissa Rogers, the Pew Forum on Religion and Public Life
MELISSA ROGERS: We're glad you're here with us this morning. My name is Melissa Rogers and I am executive director of the Pew Forum on Religion & Public Life.
The Pew Forum serves as a town hall and a clearinghouse for information on issues at the intersection of religion and public affairs. We seek to promote a deeper understanding of the ways in which religion shapes the ideas and institutions of American society, and we strive to serve as a true forum rather than an advocate on issues. The Pew Forum is supported by The Pew Charitable Trusts, and we're very grateful for that support.
The Forum is fortunate to have as its co-chairs two national leaders in the discussion on religion and public life: E.J. Dionne, a senior fellow at the Brookings Institution and columnist at the Washington Post, and Jean Bethke Elshtain, a professor of social and political ethics at the University of Chicago. Unfortunately both of them have to unavoidably be absent today and they do send their regrets.
We're very grateful this morning to take up a very serious and fundamental bioethical issue: the moral status of the human embryo. Certainly ever since President Bush's decision-making process and ultimate decision on federal funding for stem-cell research, this issue has not been one that has been confined to the labs; it has a discussion that happens around the water coolers, and it's not one that's been confined to the erudite thinkers that we have with us this morning from various religions traditions, but also one that has happened in the pews more and more, and in other religious communities and circles.
It seems that we confront these issue almost weekly, if not daily, and this morning was no departure from that. I know that many of you noticed in the Washington Post this morning that there were two articles - one I believe carried on the front page - of a bioethical nature. The first dealt with a screening of embryos before implantation to identify a rare gene that, if present in a human, tends to create the Alzheimer's disease before mid-life, about 40 years old. This screening has allowed a woman to give birth to a baby girl who will not carry this gene and thus not be at risk for this specific disease. At the same time, the article notes that, quite tragically, the woman who gave birth to this healthy baby is herself a carrier of the gene and thus likely to develop the disease in the next ten years. And so that is also an important part of the consideration of the issue, but as I was talking with Dr. Zoloth this morning, she noted that another important aspect of this is that we don't know what kind of research will develop over the next ten years that might be able to assist this particular woman.
Another article described an issue that we have all learned a lot about the past year, and that's cloning. The article in the Post this morning describes the proposal that was made yesterday by the U.S. delegate to the U.N. for a global and comprehensive ban on human cloning and all experimentation involving human embryos. The article noted that while there seems to be widespread agreement at this time that babies should not be created through cloning, there's much less agreement on restricting or banning the creation of cloned embryos for research purposes. So these are just a sampling of the current, pressing issues at hand on this topic; science presses forward, and ethics must be factored in.
As Kevin FitzGerald and Ronald Cole-Turner have so helpfully led us to understand, underlying these issues is the fundamental question of the moral status of the human embryo. Religions traditions are deeply concerned with questions of life - the purpose of life, the meaning of life - and so it's not surprising at all that we hear religious voices raised in this debate. We look forward this morning to hearing from a diversity of voices about religious perspectives on bioethical issues and specifically on the moral status of the human embryo.
At the same time, we may touch on the perennial question that's raised with respect to religion in the public square, and that is, how should religious perspectives engage the wider public on these issues? More specifically, in what terms should religious perspectives and fundamental religious beliefs be expressed on issues of public policy, and what weight should they carry in a pluralistic country such as our own?
We have, thankfully, a very talented and experienced group to help us with these questions. I'm going to call on each of them to make a brief presentation, and then turn to all of you for participation in the discussion. Just from looking around the room, I know that many of you are experts on these issues, and we look forward to your comments and questions. I should say at the outset that many of these people are accustomed to having a much lengthier time than the very short amount of time that we have given them to comment, so they're going to do their very best to stay within the limits, and we know that we will have a very robust exchange afterwards, and allow them to make many more comments at that time.
Let me call first on Dr. and Fr. Kevin FitzGerald. Kevin FitzGerald is the Dr. David Lauler Chair in Catholic Healthcare Ethics at the Center for Clinical Bioethics at Georgetown University. And I should say that Kevin has been so very helpful to us in our thinking about these issues, and we've been very grateful for his generous assistance.
And we're also very grateful to Georgetown University because the grant for the Pew Forum is made to Georgetown University, and Georgetown has been a very important partner in our endeavors.
Dr. FitzGerald is research associate professor in the department of oncology at GU medical center. He has a PhD in molecular genetics, and a PhD in bioethics from Georgetown University. He is the author of numerous scholarly and popular works, and you can tell from his background, as well as the other panelists, that they are very uniquely qualified to speak to these issues. So let me call on Kevin FitzGerald first to join us, and then I'll recognize each of our speakers in turn.
DR. KEVIN FITZGERALD: Thank you, Melissa, and thank you all this morning for this opportunity to come and enter into this discussion with you on this incredibly complex and yet important topic. As Melissa mentioned, it is in the papers every day, and it will continue to be that way on the news, and all sorts of advances will occur. But one of the consequences of these advances is that it is challenging the very concepts that we have of the entities involved, and the entities in this particular instance are human beings. What does it mean to be a human being? What does it mean to be an embryo? After all, perhaps five or six years ago that answer would have seemed a lot simpler than it does today. Certainly five or six years ago someone might have said, well, an embryo is simple: fusion of sperm and egg. Of course, that would have left out Dolly. Now as some people say, maybe Dolly was never an embryo. Well, then, was she ever a fetus? And if not, is she a sheep? And you see where we certainly run into all kinds of conundrums because of the advances in technology.
And so now we have the idea, what is an embryo? What does somatic cell nuclear transfer mean? What about parthenotes? Are they embryos, where you stimulate an egg without adding any more genetic material? All these raise questions, and it is in how we begin to frame those questions that I think is the most important challenge for us today. Now let's look at some of the things we do know. One of the things we do know is that at one time, all of us here gathered in this room were embryos. All of us were fertilized, two-cell, four-cell, eight-cell embryos. If the embryos had been destroyed, we would not be here.
How do we put all this information together? How do we integrate this scientific information, especially in our pluralistic and democratic society? That is one of the issues, as Melissa mentioned, that is very much a challenge to us today.
In that regard, there's an interesting debate going on, and that debate is, where do we put the burden of proof? Interestingly enough, if you look at some of the eclectic groups that have been brought together, of experts or people involved in this debate, to come up with some kind of approach for proceeding, often times they will say, well, yes, the embryo has some moral status, but yet there must be a way to justify research on embryos ethically, and they usually use two reasons for doing that. One is there are no good alternatives to embryo research, and the second is the great potential benefits that are going to come from embryo research; meaning, of course, once you do the research you develop all kinds of products, and those products will then help to save the lives of millions of people.
Well, this raises another issue that I think does not get the important attention it needs in this debate, and that is the question of who is going to benefit. We already know of many examples of cases around the world where people have diseases that we can treat now, and they don't benefit because they don't have access to those treatments. We also know that 11,000 children die everyday from a lack of clean water, and yet oftentimes you hear in this debate how much this is going to be good for our children. Which children are those?
And there was one last article in today's paper, which I figured might not have been as high-profile, but I find very interesting. Many of you are familiar with Lyme Disease, and there was a vaccine that was made to try and prevent Lyme Disease. Did you know that vaccine will no longer be produced by the company who makes it, not because it isn't working -- the FDA looked at that; doesn't seem to have any problems at all -- but because it isn't profitable. Now is that the basis on which we are going to decide who is going to receive this care and who isn't, especially when the arguments that are made over and over again, that one reason for doing this controversial research is the benefit of the millions?
And so, as I've just tried to show in a few minutes, I think this is an extremely complex issue, not only from the scientific end, but also from the social and ethical end. Thank you very much.
MS. ROGERS: Thank you for that wonderful introduction to the issues in a very short time. Next we're pleased to have joining us in the discussion, Dr. Ronald Cole-Turner. Dr. Cole-Turner is the H. Parker Sharpe Professor of Theology and Ethics at the Pittsburgh Theological Seminary. This is a position that relates theology and ethics to developments in science and technology. Ron was very kind, when we first started the Pew Forum, to stop by and chat with us, and was just such a wealth of information about this topic. We really appreciated that, and he has been also helpful to us in helping us see where the important issues are in this debate.
Dr. Cole-Turner serves on advisory board on the Program of Dialogue on Science, Ethics, and Religion of the American Association for the Advancement of Science. He is an ordained minister in The United Church of Christ, and he is author of numerous books on bioethics, and has won numerous awards for teaching and scholarship. So we're very grateful that he could join us as well this morning.
DR. RONALD COLE-TURNER: Well, thank you to Melissa and to the Pew Forum, and thank you to all of you for being here. Recent developments that you are very much familiar with - developments in human stem cell research, human cloning as was announced in a preliminary way by the ACT Corporation - all of these developments have underneath them the profound question of the human embryo. On the one hand, great potential benefits lie in these areas of research; on the other hand, this great question that is posed right at the starting gate: is it right to engage in research that involves the human embryo? And that is the focus of our attention today.
One of the first questions we are faced with, though, when we raise the question of the human embryo, is how precisely we define this thing, this entity. What is it exactly? Does it matter where it's located? Is it an embryo if it is located in utero, but something else if it is located in a petri dish or perhaps in frozen storage in a reproductive clinic? Does it matter for what purpose it is created and if that purpose either defines it toward actually becoming a live human being or defines it toward being an instrument of research? Does the purpose of its creation have anything to do with its definition? Does the means of its creation have anything to do with its definition?
These are all very difficult questions that we simply need to sort out, and I point to them because the deeper issue that I want to get to is the question of how we regard the embryo -- first of all, how do we define it, but how do we regard it. But you see the problem is if we can't define it very clearly, or, more precisely, if our definition is always a work in progress, always governed by the latest technology and what the latest technology will allow us to do in creating embryos, then it becomes very difficult to say how we should regard it theologically or religiously, and how we should regard it morally. Consequently, it is simply a fact, I believe, that within Christianity there is no deep, longstanding, orthodox or dogmatic position on the human embryo for the simple fact that the concept didn't exist until fairly recently.
Now it's true that different Christian traditions have perspectives on this, and some Christian traditions have very clear perspectives on that, but in fact, there is no deep, long-term tradition. Rather, the whole idea of the embryo is a dynamic concept, and the best that any of the faith traditions can do is to regard it as kind of a moving target, and we do our best to try to make sense of what it means given the new scientific and technological culture in which we find ourselves.
That being said - that there is no long-term dogma - it is the case, of course, that at least some within Christianity, say, well, we don't know exactly what it is in the dogmatic sense, but we know how we should regard it, we know how we should treat it. And for some, at least, the answer to that question is treat it as a human being. Accord to it the respect of human life. In fact, some will draw upon a very interesting passage in Christian Scriptures, the 25th chapter of Matthew, in which Jesus says to his followers: Show acts of kindness as opposed acts of rejection to the least among us, the most vulnerable, the weakest. And some will say, of all human beings, of all entities that fall within the category of human, who are the least, who are the most vulnerable, who are the least protected if not the human embryo. "Inasmuch as you do it to the least of these," Jesus says to his followers, "you do it to me." In other words, how we regard the embryo, the least protected, is how we regard humanity itself as embraced by God in Christ, at least according to some Christians.
Other Christians look at that and say, that doesn't quite fit; that doesn't make sense. Imagine you're looking at an embryo in a dish. There it is in front of you: a dot the size of a dot over an i. Imagine for a moment that you're holding a baby, and imagine a bizarre thought experiment in which you have to make a choice in a flash: do I save the baby, or do I save the embryo? I don't know very many human beings who would throw the baby out and save the embryo. Instinctively, intuitively, human beings recognize a value in a fully developed baby that we don't recognized in a human embryo.
Now one has to be careful about instinctive or intuitive groundings of ethical value, but for a fair number of Christians that intuition is what informs the decision that the embryo is to be regarded as valuable. Save them both if possible, but not as being on the same level of value, not accorded the same level or respect.
And consequently, when it comes to questions of embryo research, it becomes then an open question, it becomes a possibility that can be entertained. Is it legitimate ever to sacrifice embryos for the sake of medical and scientific progress? At least a fair number of Christians -- myself included -- would say at least that's an open question. There's not a priori objection to that.
All of this, of course, relates to what is going on in national politics and in the question of federal funding of embryo research. As all of you know, I'm sure, there is a ban on any federal funds being used for embryo research, and this has been raised in terms of the question of whether that extends to stem cells. And again, as all of you know in the speech on August 9th, President Bush said that the federal funds may be used for stem-cell research for stem cells derived from embryos prior to August 9. A morally peculiar distinction, one that could be argued certainly, but not on grounds that are quite as obvious as some of us would like.
The real problem, though, is not whether the stem cell lines that fall under the Bush policy for access to federal funds are adequate for scientific or medical purposes. The real problem we face is that federal funding, and the whole question of federal role in this, is limited to the matter of federal budget. There is no limitation, there's no federal oversight, there's no federal role, in matters of privately funded research. Basically we have a situation where you can do very little, almost nothing, in the area of embryo research -- including now stem cells - with federal funding, but you can do pretty much anything you want in the United States if you have private funding. I think that's a problematic situation, and I think that's one that we ought to try to change. As a matter of policy, I do not think it is adequate to have, as federal policy, a situation in which publicly funded is highly limited and privately funded is not limited at all.
I think the religious groups that have been so much at odds with each other - particularly the groups within Christianity that have struggled over this issue and have conflicted with each other - really owe it to the public good and to the development of science under a sane policy, to come together and to recognize a common, pragmatic interest. Whether we are among those Christian groups that object to embryo research categorically, or among those Christian groups and individuals who would permit a certain amount of embryo research, we have a common, pragmatic interest, I believe, in limiting the amount of embryo research, and putting it on a sane and public policy basis. We have a pragmatic interest, first of all, in limiting it: limiting who can do it, and limiting the number of embryos being used. But secondly, we have a common, pragmatic interest in moving all research, publicly-funded or privately-funded, out into public.
One of the problems of the research that was reported in late November is that it was done in a private corporation with minimal public input. A small group of bioethicists were involved in consulting. But the American people, much less the people of the world, were not consulted on a matter so important as to whether human cloned embryos should be created. I think we need to bring all research, publicly or privately funded, into public scrutiny.
The third reason why we have to come together and support this is that by putting embryo research in public, it opens the possibility of a public conversation on where we are going with this research. We look at short-term benefits, treatments of diseases -- all well and good. What we really need to be engaged in is a conversation about where this research will take us in ten, twenty, thirty, fifty years, a hundred years. Will it extend the human life span? Will it usher in an era of regenerative medicine in which the human body can be regenerated at will? Will it utterly transform the meaning of our humanity? You and I need to be participants in the conversation about that, but right now it occurs in private labs under private funding, and unless we have an opportunity to move this out into the public situation, we have no opportunity for engaging in the conversation.
The human embryo, as I see it, must be recognized as the icon or the window of our own destiny. See the embryo in a dish not as an isolated, individual entity, but as a way in which human nature itself is malleable and modifiable by technological action. We need a situation in which that is out in front of us, and people globally can participate in a conversation about the wisdom of the long-term changes that we are already beginning to implement today. Thank you.
MS. ROGERS: Thank you so much. So many interesting points, especially that one about bringing all the research into greater public viewing. I know as a normal person outside of this debate, it's been staggering to read the papers and see what is happening that very little is known about. And so that is something that, I think, is a good point of discussion later on for all of us.
Let me next introduce Dr. Laurie Zoloth. She is professor of ethics and director of the program in Jewish studies at San Francisco State University. She is the immediate past president of the American Society for Bioethics and Humanities. She has also served on numerous prestigious boards, and has been awarded so many grants to explore bioethical issues - I would just have to go on forever if I told you all the awards that everyone on this panel has won. So you'll have to take it on faith, as it were, the diversity of awards that each of them have received. Her PhD is in social ethics, and she has an MA in Jewish studies from the Graduate Theological Union, and MIT Press has recently published her book on stem cells. This book - there's a copy on display outside - includes substantive discussions of religion, policy and ethics. We're very pleased that Dr. Zoloth could join us today.
DR. LAURIE ZOLOTH: She didn't mention the children - five children - that at one time were embryos. (Laughter.)
I want to begin with a couple of things from secular bioethics because that's the reason we're here. And I want to say that in secular bioethics we can agree on three things, and I think that everybody on the panel might agree with these as well.
Basic science is an open question, and as such, is a kind of free speech. It should be free, essentially, from the manipulations and silencing of either state authorities or from church power, and I won't tease too much about Galileo today, Kevin. Secondly, health care research is a public good, and as Ron Cole-Turner said, it needs to be freely witnessed, freely discussed, and freely argued about in a democracy without secrecy and without deception, hence the role of a fourth estate. And third, medicine is a moral gesture. It is made as a moral gesture in response to a world of suffering, so it's not a neutral gesture. And I want to add, though, to the next part which is a caveat from Jewish studies, that I'm not a rabbi. I'm a scholar in the field, and I'm only one Jewish view. So you know, to be a real Jewish scholar I would be disagreed with.
I want to begin with the least important thing of six points I want to make as commitments from Jewish ethics. So the final point - the least important and least riveting for Jewish sources and Jewish texts - is the moral status of the human embryo. It is largely important for Jews only as interlocutors for the gravitas of the Catholic tradition. And I think the gravitas of the Catholic tradition has brought us to attention about the moral status of the human embryo. When Kevin says something like, "All of us were embryos," it is undoubtedly true that all of us were embryos, but most embryos, larger than 90 percent of embryos, are not persons and will never be persons. This is an Aristotelian concept, one that Maimonides and others like too: the thing X, the potential thing X is the potential thing X. So a potential thing isn't the thing; it's a potential thing, and that's been a key distinction, both of moral philosophy and actually imbedded in many religious traditions.
We can see this play out, especially in Jewish law, because while not all embryos will be us, all of us will be corpses. And yet we don't treat each other like corpses, even though undoubtedly we will be corpses with an absolute certainty not enjoyed by any embryo. And in the laws of Jewish tradition about the goses, even the nearly dying person is not the dead person, it's a goses. So that is a very important principle within our tradition that we can bring to the discourse.
Within Jewish law there are seven discourses or seven texts that we might turn to, that tell us the moral status of the human embryo in Jewish law. In Jewish tradition, it is not equivalent to the moral status of a living human ensouled person. The embryo, which for research purposes is made outside of a human womb, is made artificially, is prior to the 40-day discussion. After 40 days in Islam, in early Christianity and in Judaism, the embryo was regarded as the unformed, like water; that's the status that it contains. It's prior to implantation; it's biologically an unstable situation at five days. It is - important to Jewish law - smaller than a barley corn, thus falling in another distinction, and it is not discussed or prohibited in texts and therefore stands outside of classic Rabbinic discourse. So even interrupting pregnancy is not seen as the killing of an ensouled person. And finally, an important point for this, killing for defensible reasons is not murder, even in abortion.
So those are the reasons around moral status, the clusters of reasons that I'm just going to leave that, bracket it for more discussion later, and go to the five points that I think are important contributions that Jewish ethics might make to this discourse.
One is the principle of justice: Tzedakah. Our priority in thinking about this problem is the moral status of the human community rather than the moral status of the human embryo. Who are we are human persons? Are we a moral community? What is our commitment to justice in the world? Are we helping the vulnerable, and who do we mean by vulnerable? In Jewish law, this would not be the human embryo; it would be the born persons to whom we have obligations, to whom we have duties and who have duties back to us. There's access to basic and decent healthcare, a universal healthcare system that might embrace and nest all healthcare research. There needs to be an allocation of healthcare funding for this research and other, that's fair in how we talk about it and the substance of the work that we do, and innovations for maximum benefit of a larger polity are supported. This research might be interesting to us within the Jewish tradition because it holds the potential for research that teaches the body to heal itself, a different kind of medicine and a different kind of science.
The second commitment might be the commitment to discernment, to judgment. Discernment is the way we are human. We are meant to be namers of the world, namers of new things in the natural world. We are law receivers and judges of human events in histories using judgment and laws, so hence the commitment to public discourse.
The third commitment is one that is an overriding one in Jewish law, pikuach nefesh: the duty to heal and save a life. This duty to heal is as important as the duties within Catholic moral tradition. It is a paramount duty overriding other duties, even other powerful moral appeals. In fact, one is obliged to heal and obliged to save, even one is to break the laws of Shabbat. There are many texts talking about this. And again, the moral status of the researcher here, as a healer, as one with a duty to heal, is one that concerns Jewish law and Jewish texts.
Fourthly, Jews are seen and see themselves as guardians, shomer, of the world in a world that is incomplete. Creation is not complete in Jewish moral tradition, and in fact our task as Jews is to complete an unredeemed and unfinished world. The work of creation is interrupted, and there are classic Rabbinic texts that talk about this - why is it that the world is so unfinished; why didn't God make it so that wheat comes up and it grows, and it stops at stalks? Why not little loaves of challah on the end of the stalks? There's a long discussion about this. The world is deliberately unfinished so the work of the human intercedes in the work of creation. Nature is not sacred. To change nature, to shape nature, to circumcise our sons is not a violation of the sacred order; it is the completion of order. Humans are needed to make a natural world habitable and just and humane.
And finally, the notion of readership. Jews see themselves as readers, readers of the text, readers of the natural world. The ability to interpret the complicated and multi-vocal texts is the work of being a studier or a reader, which is perhaps who we see ourselves most profoundly. All must be learned in order to teach. Even the texts on Rabbinic magic that describe the dangers of using magic tell us that responsibly, magic should be learned in order to be taught; perhaps not to be performed, but always in order to be taught. Learning and study of the texts of the law, and the texts of the phenomenological world is the task of human persons. We are readers, and in the postmodern sense of course, a reader of the text is a writer of the text, writers of the word and writers of the world itself.
Now, is the Jewish holiday of Purim, just passed - I almost came in costume but refrained - and like in Purim, we understand the world as unrevealed, needing to be read, something hidden and unredeemed yet. Perhaps we're brought to this place in this understanding to bring into being and to interpret the new possibilities of science. Perhaps we are here, now, the human community, knowing and learning about this extraordinary phenomenon, about the malleability and plasticity of the human embryonic stem cells, to bring into being new ways to understand the creation of families and faith of blastocysts. I'll say just a little bit about this.
We have learned in the last few years of the remarkable mutability and plasticity of the human family and the way we can bring children into being. It was not that long ago that it was a shocking thing, when Edwards and Steptoe brought an in vitro-fertilized embryo into the world and she became a little girl and we all got to know that little girl and watch her grow over the last several years. And in fact, now it's almost a commonplace thing to have an in vitro fertilization child as a member of your religious or faith community. There are alternative ways of creating babies rather than the one narrative of a mother and a father and sexual reproduction within a marriage leading to the one narrative that produces the one child. That's the foundational narrative of many of our religious traditions, but we all have come to understand it is no longer the only possible narrative leading to the creation of an embryo and a child.
Now we are beginning to understand that we can read the text in another creative way. It not only has a multiplicity of beginnings, it might be true that it has a multiplicity of endings, that the embryo can be lost, can die, can not be productive. The embryo can implant and become a human child, or the embryo has the potential to be many other things, things that we didn't yet know about and we're only learning about. This potential means that it could be a bank of stem cells, it could be nudged towards parthenogenesis, and we don't know yet the answer. Hence, the question of the end of that story or the development of the narrative itself is the open question, which brings me back to the beginning: Should the open question be stopped, or should the query, the opening questions of science, be allowed to continue?
Thanks a lot.
MS. ROGERS: Thank you for those very insightful remarks. I appreciate Dr. Zoloth's statement that she is one of many in her tradition, and I know from doing all these Pew Forum events that there is a great diversity of viewpoints within particular religious traditions, and it is always important to recognize that. And I'm sure we'll hear more from you all later about your particular perspectives on these issues.
Let me call, finally, on Dr. Brent Waters. We're very pleased that Dr. Waters could join us. He is assistant professor of Christian ethics and director of the Center for Ethics and Values at Garrett Evangelical Theological Seminary in Illinois. He is also an ordained minister, and he has earned his Doctor of Philosophy from Oxford University. He has published extensively in the field of bioethics, and he is past president of the Society of Christian Ethics. So he is also someone who knows a lot about this, and we're anxious to hear from you, Dr. Waters.
DR. WATERS: I presume the topic of this forum can also be posed as a question, otherwise we wouldn't be here today. What is the moral status of the human embryo? Now this is not a new question, although our ancestors may have phrased it differently. Philosophers and theologians, for instance, have pondered the perennially vexing issue of when a human body becomes animated with something we may call a soul. Although this is not a new question, we are asking it within a novel set of circumstances now.
Unlike previous generations, we may now create embryos for the sole purpose of conducting scientific experiments, and perhaps in the near future, developing therapies to treat various diseases and illnesses. It is important that we come to terms with the sheer novelty of this capability, for it seemingly requires us to strip away the procreative context in which we have traditionally thought about our moral responsibilities in relation to the embryo. The notion of a parental relationship in light of this capability, for example, is now rendered irrelevant.
In deliberating on the moral status of an abstract embryo - by which I mean literally abstracted from this procreative context - I think we are endeavoring to establish a threshold along the following lines: When an embryo reaches a certain point of development, for example perhaps 14 days as in U.K law, in which it manifests certain characteristics such as the so-called primitive streak, it is granted a moral status that it did not possess previously. Prior to reaching this point, it would be permissible to do such things as harvest stem cells or clone an embryo, but upon reaching the point where a moral status is obtained, these same acts would then be forbidden.
Procedures overseeing compliance with these restrictions would thereby insure ethical research protocols. Yet, establishing the moral status of an embryo per se would not produce a universal set of rules guiding how they should be used or treated. The restrictions noted previously, for instance, would presumably not apply to embryos created or implanted in a womb. Curiously, we would abstract the human embryo from a procreative context in order to deliberate on its moral status in a more objective and rational matter, only to discover that the context of the laboratory, or a woman's body, might determine the fate of a particular embryo. The practical effect of attempting to determine the moral status of an abstract object is that this status - or, better, the object's value - will be assigned by whoever owns it. In other words, the owner of the embryo will assign the status or the moral value. Individuals producing an embryo for the purpose of obtaining a child will assign it a kind of value that affords it a great range of protections, while those creating an embryo for the purpose of conducting medical research will assign it a value of affording few, if any, protections.
The very way the question is posed presupposes that it will be answered in such a way that the assigned moral status of the embryo will not prevent medical research from proceeding, but also not impinging on our reproductive rights and interests. Thus, we would be able, for example, to maintain the dubious distinction between so-called reproductive and therapeutic cloning. But what is most troubling is that in trying to preserve some semblance of respect for an embryo within the laboratory by assigning it an objective moral status, we may ironically propel ourselves down a road where we will come increasingly to perceive the human body as a collection of biological and medical commodities whose value will be determined largely by shifting markets.
In response to this prospect I want to suggest exploring an alternative or at least parallel question: Is the human embryo my neighbor? The reason I believe this question may offer a more promising starting point for our moral deliberation is that it is much more difficult to think about neighbors in an abstract manner. We cannot contemplate a neighbor in isolation, but only in relationship to other neighbors. We really cannot even imagine what it would be like to be human in the absence of neighbors, for they are the ubiquitous characteristic of our lives and of our common life. We have neighbors near and far. We have neighbors we know and neighbors we have never met. We have neighbors who are our friends and neighbors who are our enemies. Moreover, in encountering neighbors whom we do not know, we presume, or at least should presume, that we share a bond by the sheer fact that we both exist, however qualitatively different that existence might be. And, speaking as a Christian theologian, I must remind myself constantly that we are commanded by God to love our neighbors.
I realize that it may be objected that my alternative question is too fanciful to be of much real use. We cannot seriously consider the embryo to be a neighbor because we cannot interact or form a relationship with it. In other words, how do you consider this dot in the petri dish to be a neighbor? Yet I would remind us that being a good neighbor does not always require reciprocity or even interaction. We can help or protect nameless and vulnerable neighbors and even assist neighbors we have never met, as recently demonstrated by the outpouring of aid that was given to the victims of New York City.
I'm also aware that this alternative question will certainly not make our moral deliberation any easier. I do not think that regarding the embryo as my neighbor suggests any obvious ways it should be treated, in light of our new technological potential. How indeed do we simultaneously exhibit love for neighbors, some of whom are in desperate need of healing and more efficacious medical treatments, and some of whom are in the most weak and vulnerable stages of their development as human beings? And even more perplexing, how do we exhibit this love in the practical details of the policy decisions we will be required to make?
If we choose to go down the road of a research project that many assure us will lead to unprecedented advances in medicine and healthcare, I think I would prefer to make that journey in the company of embryos I regard as neighbors instead of abstract objects, to which I must assign, and rather arbitrarily, a value or a moral status.
MS. ROGERS: Thank you very much. That's a very helpful way to lead us through the questions here.
I want to thank each of the panelists, and perhaps kick off a couple of questions myself. Then, what I'd like to do is ask each of you who have a question to, if you would, raise your hand and wait until the mike comes to you to fire off your question, because we are recording this session. It's very helpful to us if you can wait until the mike comes to you, state your name and your affiliation, if any, before asking your question of the panel.
The President has recently established this Council on Bioethics and has named its membership in the last few months. I'm somewhat acquainted with their work. I wonder if those of you who wish to could tell us what progress, if any, you think they are making, or what recommendations you would make to them in terms of addressing this fundamental question. Do you see as part of their task addressing this fundamental question, and if so, do you have any sort of wise words for them in terms of helping the nation launch into this important discussion?
DR. ZOLOTH: What is fundamentally interesting about this panel is the level of disagreement that has been displayed. My colleague, Brent Waters, thinks that an embryo is a neighbor, and he's entitled - and I'm respectful of the decency and the authenticity of that position. But it is undoubtedly true - and I would imagine that if I were a Catholic or the kind of Protestant theologian that my colleague Brent Waters is, I would defend that as well. I think that's a respectable position and one that should be honored in a pluralistic and democratic and free society.
However, I don't think that the embryo is my neighbor. I'm not permitted to think that way by the interpretive community of which I am a part, the Jewish community. Neighborliness, obligation to the neighbor, begins at birth. And that commitment to my neighbor, my commitment to heal is as absolute as another's commitment to protection of the sanctity of life.
Those two commitments, as you can see, are on a collision course and need to be both honored and respected in a pluralistic and democratic society. The respect for and the toleration for irreconcilable moral differences and religious faith distinctions needs to be honored. That's why, I think, to debate the moral status of the human embryo is a fundamental faith tradition and a faith commitment. To debate how a free society should proceed with research is a fundamentally political question; how one honors and defends quite discreet differences within a free society.
It is this collision of commitments, I think, to which the nation needs to turn its attention, rather than trying to convince me as a traditional and observant Jew that I'm just wrong about my ideas about what an embryo is, that my texts teach me incorrectly, or me trying to argue that Kevin's texts or Brent's texts are incorrect. It's just an insoluble difference, and one that we've seen lead to the abortion wars of the last 20 years. I would hate to see basic science and the civic discourse continually enmeshed in what I think is an intellectually interesting but ultimately politically fruitless and despairing set of wars.
MS. ROGERS: Dr. Cole-Turner.
DR. COLE-TURNER: On the question of the Bioethics Council, I think we could trust that council to do very careful, very thoughtful work, and not only deliberate within itself but to have a teaching role for the whole society. There's no doubt that they will undertake their work with integrity and with great skill.
My problem with the Council is how it arises in the first place in national life. I mean, we have an election, the National Bioethics Advisory Commission goes out of existence, the Bioethics Council takes its place. We really can do better as a nation in docketing our national bioethics conversation, our national bioethics deliberation. It needs to be well-established as a recognized role of the federal government; well-established in both the legislative and the executive branches that we have a conversation that is consequential in terms of regulation, in terms of oversight, and in terms of staying power administration to administration so that there is consistency, so that the poor scientists don't have to wait for the results of a national election to know whether their research is going to be funded and know whether they can do their work in the United States or, as one of the prominent scientists recently said, "I'm going to the UK so I can get my work done."
This is a terrible way for a democratic society to engage in the difficult task of science policy. I think we really can do better than that. Again, it's not a criticism of the Council, but a criticism of the infrastructure that undergirds the very emergence of this kind of a structure within national life.
DR. FITZGERALD: I agree with Ron, and actually with Laurie too, that on the one hand I don't think there is anything that I can say to the members of the Council to guide them in their deliberations as they are ongoing at the moment, and they are obviously very competent, capable people. But pulling it back into a larger picture I think is where we might be able to see some of the potential benefit, not only from their deliberations but how we might move ahead in the future, as Ron and Laurie suggested. There isn't going to be some wonderful consensus to which we all ascribe in the near future, especially I'm sure on the moral status of the embryo. I agree. That's the situation.
What do we do in the meantime is the question. And it is a very important question because what we are deliberating about now is just the tip of the iceberg. Now we're talking about the beginning of life. Years past, one of the emphases was on the end of life, care at the end of life. That is still a very important topic in our society. Soon we are going to be talking about human life per se. What does it mean to be human, whether you're born or not? What happens when the genetic technology is available and safe to do genetic interventions on people? The discussions we're having now will help us as we move into that time period because they will lay some groundwork, not necessarily for forming some kind of authoritative consensus, but for beginning a process of deliberation and discernment, a process which is strong in all our religious traditions, because that is how community progresses; that is how community flourishes.
So for me, the important aspect is not necessarily saying that we're going to find the answers. What I'm hoping we do is find the right questions. What I'm hoping that this council can do, and that our gathering and our discussions can do, is to help us formulate the proper questions to pursue.
There are all kinds of ambiguities here. There is all kinds of equivocation. One of the questions, as I mentioned before, is what is an embryo? Now, people use statistics to say that 75 to 90 percent of embryos never make it. What if, in our definition of an embryo, most of those wouldn't be defined as embryos? Why? Because they just don't have the genetic constitution to ever develop, even though they might have 46 chromosomes. We know that a fusion of sperm and egg can lead to something that has 46 chromosomes that will eventually become a hydatidiform mole, a growth. Was that ever an embryo? Did it switch at some point and suddenly decide not to be an embryo? Are there all sorts of evidences that would indicate to us that our concepts here are no longer adequate to this discussion and therefore we do need to take this step back as a society, as a democratic and pluralistic society, and say, wait a minute, what is it we're talking about?
Later on when we start doing genetic interventions we're really going to have some questions. If we put a gene into you that allows you to glow green under ultraviolet light, are you still human because now you have this foreign jellyfish gene in you? Is the bunny still a bunny? These are some of the questions. And how many of those genes can we put in and then you stop being human?
The technology is there. This is the challenge in front of us, and this is why I think, in one sense, yes, the process is not all it could be. But hopefully it's another stepping stone on the way to a process that is better.
DR. WATERS: Very briefly, my hope is that what the new council can do is to provide a framework that would enable us to have a public moral debate where we really can bring the convictions and put it on the public table, rather than simply focusing on the procedures and not allowing the different moral voices to really be heard; not for the sense of stopping the debate or creating the logjam, but to really try to create, if not at least a greater sense of understanding, maybe perhaps even the ability to coin a public moral vocabulary. Whether the Council will achieve this -- given my tradition I'd probably say fat chance, but nonetheless we should try.
DR. ZOLOTH: Just a brief thing: When we talk about this, it's very tempting to leap to the most terrifying, green-bunnied future. (Laughter.) And I want to warn us away from that because that's a way that I think the American public gets terrified: Genes, they'll come and they'll kill us and it will be science fiction and clones of Nazis or something. And I think that it's a diversion, frankly. It's a diversion that keeps us away from the careful kind of scholarship that's needed right now to look really carefully on exactly what's being asked of us.
Let's step back a bit and talk about IVF. There are fears of unregulated clinical trials, in the private sector clinical trials, unwitnessed by IRBs and the usual panoply of ethicists around. But in the in vitro fertilization clinics that operate around this country now, every embryo that is not a successful baby is considered something that can be discarded, something that can be bought and sold and frozen and killed and anything you want to do to it. It is a medical experiment. It's just an unwitnessed and unregulated one.
So I don't want to make a distinction between IVF, good, defensible, this is a good thing, and suddenly we're doing something new to embryos. The entire field of fertility is grounded on our previous unspoken-of assumption that manipulation of human genetic material, however special and extraordinary it is, up until 14 days can be done. And that's been an unwritten and unwitnessed law. So there's not a sudden change in the use of human embryonic material. It is just that we're asking public questions.
So actually what we're doing, Kevin, is instead of asking the questions of the green-bunnied future, of the genetic terror future, we're looking back actually. I would say looking back at the 11 million children, at the infant diarrhea, at the catastrophe of unjust healthcare systems, to turn backward at this moment and put our attention on where we are now; we are located now in relation to American healthcare and American research on fertility. These would be questions to really try to resolve first, I think, before we start panicking about things that may never come to pass.
DR. FITZGERALD: Okay, that's right.
I don't raise the example of the green bunny as some kind of specter of doom. I mean, I do molecular biology. I think molecular biology is very cool.
However, what I also think molecular biology does is challenge us to rethink some of the ways we view ourselves and view nature and view our lives. I agree with you completely. I agree that we need to look at the social justice issues. Part of my concern about this debate is the fact that we are so quickly skipping over some of these parts, and they're being used to justify going ahead with research which is considered ethically controversial and contentious. Whether or not you hold my position or your position, nobody disagrees that this is not ethically contentious and controversial in our society. And if the justification to go ahead is to say, well, all these millions of people will be cured, well, I'm a scientist, and I can tell you, it may not happen. It may well not happen. In fact, if you talk to the scientists, if you talk to Jamie Thompson, if you talk to John Gearhart, they will tell you the research itself is not to lead to specific therapeutic interventions, it's to lead to more research that will allow us to transcend this cellular biology level.
I have to give my caveat here, or my revelation of my bias. I'm a molecular biologist. I think doing cellular biology is just crude and working on such a gross level - that the real solutions are the molecular biology solutions. But, they see the research as leading to that, and that's what they want to do. They're scientists. I understand that. Of course they want to do it; that's their work. But is the work of society to decide what science research benefits society and what might not and when the scientific research should occur? That's the discussion that I want, and that's the discussion that I would argue we all need in even that larger context, because there is a lot more. I know it is coming, and it will happen. The genetic intervention stuff will be there, that I can tell you. Now how much it will do, I don't know.
DR. ZOLOTH: But actually, Kevin, something really interesting: Do you want society - and that's a complicated word; the state, the church, who would that be - to stop basic research, and on what grounds? Does that not make you just a tad worried about the power of the state to stop the scientific inquiry?
It does me.
DR. FITZGERALD: They already do. I'm a cancer researcher, and the best research I could do, literally, scientifically speaking, would be to take this group of people, divide you in half, use half as a control group - you lucked out - and the other half, I give you cancer. I give it to you. Why? Because then I can understand best how cancer comes about. That is the best science. That is the best scientific experiment I can possibly formulate. It's a double-blind study. It would be perfect.
Fortunately, our society says you can't do that.
DR. ZOLOTH: Of course we can't allow any clinical trials on human persons, but that's a different question than the question of basic research. Except, of course - clever people who might know this -- if, like Kevin, you think the embryo is a human subject, then that's a different issue. But let's not make the quick rhetorical switch to our poor audience members without making, lifting up the distinction between human subjects application, which will need a second kind of a discussion from a panel like this.
MS. ROGERS: Okay.
Now the audience has their revenge. Ask your questions at this point.
Q: I'm in the control group. I feel much more at ease being in the control group. I'm Moe Woltering from the American Life League.
I'd like to direct this discussion back to the moral status of the embryo. Practically all of the panelists referred to the human embryo in the framework of body and soul composition or distinction. This goes back, as some of the panelists even mentioned, to the Aristotelian framework holomorphic approach.
But that doesn't have to be our exclusive philosophical approach to the human embryo or the human person, and so I'd like to ask Father FitzGerald first, and then any of the other panelists, to comment on something borrowed from phenomenology, and that would be that the body expresses the person, and that the embryo - we have a living, human body, and most importantly for theology the body -- for example, at the very beginning of the human embryo's life, we know what sex it is. That's very important in that the body expresses the person and the person comes in two forms, either male or female. So if you could just comment on that, how it might help contribute to our understanding of the moral status of the human embryo.
MS. ROGERS: Thank you.
DR. FITZGERALD: Well, boy, talk about setting up the Catholic, that's great. (Laughter.) Okay, so, yeah, let's do phenomenology. No, if I can, let me move it into a slightly larger context. There are, as many of you I'm sure are familiar, many different sorts of strains of thought within philosophy. Aristotelian-Thomistic sort of thought is one. Another would be phenomenology. There are many other types.
The point, I think, is that one of the challenges -- and I think this is a challenge that is certainly acknowledged by the Catholic church, both by the church as its constituent members and the church as its hierarchy - that we really are confronted with is this scientific revolution. This requires, in the words of Cardinal Frances George in Chicago, "a new theology of the body." We have to rethink this. Why? Because our old Aristotelian concepts might not serve us as adequately as we would like.
Now, it may be a combination or a variety of different things. We can use phenomenological insight. We can use the idea that in epistemology, in other words, how we know things, we know things in different ways but we know the one reality. So therefore, one can get at an understanding of an embryo many different ways. One can understand it scientifically, theologically, philosophically, but all of those are only pieces of the larger truth, all these different things. This is indeed one of the things we have to do, and it's not just within the Catholic Church. I think this scientific information challenges all of us. I think it challenges every religious tradition. Every religious tradition with whom I've had any encounter has agreed.
So, I agree certainly with the question that we need to look at these different things, because there are other ways and when one looks in other ways, you're going to get different insight into this. Again, I don't think anybody disagrees that a lot of this is still quite confusing. A lot of this is still uncertain. A lot of this is unclear. Now, certainly from my tradition and the Catholic tradition, the idea is in this uncertainty, if you don't know what it is, don't kill it. And the idea there is again we do want to look toward the weakest of our community, we do want to look toward being inclusive, we do want to bring all in regardless of religious tradition, geographic location, socioeconomic status, or stage in development.
So, again, that's the position, that's the tradition, that's the perspective we're taking. That doesn't mean, in the secular dialogue, some of those insights aren't helpful. As Laurie said, this is part of the reason for the dialogue is to hear the insights from the Jewish tradition, to hear what they have to say to help inform this discussion and social deliberation. So, yes, absolutely, we have to think outside the old Aristotelian box, all right? And we have to start looking at all the sorts of information and wisdom and insight that we have to help inform us at this time, because I think they still are very challenging times.
DR. COLE-TURNER: I think from the perspective of Protestantism, you raise the question of the soul and the body. This is something that Protestants have debated. Actually, there is a feud that goes back to the very earliest moments of the emergence of Protestantism in the 1520's, 1530's. One of the divisions that goes back to that era between Lutherism and reformed branches of Protestantism is over this particular question of the soul and the body and how are you to understand the relationship between the two?
Noting that, I guess the conclusion that you would take from that is that this is an area in which there is a division and a great deal of murkiness, indeed, in Protestant theology. Protestants have never been very clear. So, asking now, particularly in the light of revolutions in scientific understanding, first of all, and then new technological possibilities in terms of what can be created, it breaks the old rules of biology, asking now for a clear-headed interpretation of soul and body that is clear enough, compelling enough, and has enough command within Protestantism -- that's something we just are not in a position to offer. I wish we were, but we don't have that. We don't have a clear teaching to offer to this. What we do offer, I think, is a history of debate and a history of discussion of these issues, but again, no particular dogma that says, at conception or at its technological surrogate moment you have an embryo and there is a soul present.
Again, even before understanding what an embryo was, Protestants debated that kind of premise all the way back to the very beginning. It's no wonder that we're all over the place when it comes to understanding embryo research. You have two Protestant denominations, the Presbyterian Church and the United Church of Christ, both this last summer, voting resolutions that are very permissive, very encouraging to embryo research; much more permissive, let's say, than the position that President Bush took on August 9. On the other hand, you have the United Methodist Church, and certainly the Southern Baptist Convention and other Protestant denominations that have taken quite the opposite point of view, maybe agreeing with the president, maybe even taking a more conservative view than the president. So Protestantism is really just all over the place on this, sadly so.
MS. ROGERS: Yes, Dr. Waters.
DR. WATERS: Yes, just for the point that wherever two Protestants are gathered you'll have one or more opinions. I'm trying increasingly not to think in terms of the distinction between body and soul, but more or less to try to think, again, as a Christian theologian, the embryo as simply an embodied creature, and what does that mean?
The reason why I think we need to at least approach this research very cautiously and very slowly is I don't like reinforce a perception which I think is already rampant in the kind of society we live in, that ultimately biology, or the human biology itself, becomes simply a malleable resource, because I think down the road that may lead to all sorts of unforeseen consequences we may not want to deal with. In other words, what I'm saying is if you proceed down the road too quickly, you build up a momentum that you may not be able to stop. It's not a slippery-slope argument. It's just simply saying there is a technological imperative that may be driving us that we may want to question.
DR. ZOLOTH: Just a brief thing, the question - again, the complexity and the length of the Jewish arguments about this are fairly profound and technical, but the critical thing that I think is raised by the thoughtful question that our colleague put to us is the notion of respect for the extraordinary miracle of which we are participants, whatever our stand is. If in the Jewish tradition the majority of respondents do not consider the human blastocyst at five days a fully ensouled person - it's personhood that is the key piece, which is a complicated relationship between one's self, one's being, one's soul, one's nefesh, one's body. It's a multileveled and complex discourse.
But what's really at stake here is how we regard our participation in this miracle as neighbors. So how do neighbors do research is the more interesting question, I think, for us. So I think, as a neighbor doing the research, human gametes are terribly important. A long Jewish tradition of care and consideration of human sperm, the way that ovacytes are collected, how women bring their eggs into the world, and what happens after menstrual flow, long debates about that, to recognize the incredible difference of gamete human tissue, the reproductive process, the necessity for spiritual attention, faith attention, to the reproductive process at all stages, even well before embryos are formed as unique human creatures.
The entire activity of human reproduction is a special and intensely important and meaningful human activity; the meaningful activity one might even argue. Because of that, the distinctions start well before, between regular old human tissue, fingernails and hair, and the kind of tissue that sperm and eggs are. So it's well before that period. Given that attention and respectful nature of that concern, that's a different sort of question than the beginning of life and the beginning of our responsibilities as neighbors to this life and to this life process.
Q: Can I just ask you a quick question? Could you explain the Jewish understanding of nefesh and why that wouldn't include human embryo?
DR. ZOLOTH: Well, it's just one part of the human's self. The nefesh is the life-breath or life-soul of a person. There is one text where they have a debate about, you know, is the embryo within the human body, is it ensouled, is it not? If it doesn't have a nefesh, would it just be like so much flesh or so much tissue? No, it must have a soul.
But there is a long debate, and unlike Protestants who seem somewhat concerned when there are disagreements, the Jewish textual sources expect disagreements, especially about this essential mystery.
Q: Hi, Bob Barnett. I'm a physician ethicist associated with the Center at Georgetown.
Reverend Cole-Turner made, I think, an important distinction to start with, and that is the difference between defining the embryo and regarding the embryo. This question is directed primarily at Laurie and Kevin.
Laurie gives the Jewish tradition as one which recognizes the uncertainty of the embryo, or at least a different moral status, and moves on from there and makes decisions on other grounds. Kevin takes one of the traditional Roman Catholic positions, and because the uncertainty assigns personhood special respect from the time of conception; as I think you both have pointed out, really an unresolvable dilemma in how to deal with that.
I guess one of my final comments would be that maybe a Jesuit who glows like a jellyfish may still be human. (Laughter.) In other words, is there more than one pathway to being human? Is the traditionally defined embryo only one of those pathways? And if we accept that there's a different pathway other than what we think of traditional conception as being the only pathway; if you bring in the issue of parthenogenesis, for instance, how does this influence the discussion, where does that take us?
MS. ROGERS: Yes, and the people who answer the question have to define parthenogenesis first, for those of us who are lay people.
DR. FITZGERALD: All right, I'll define parthenogenesis.
Parthenogenesis is the situation where an egg, without any genetic contribution from a sperm, is activated. In certain species this can happen -- in certain reptiles and things like that this can happen under physiological conditions, such that the egg begins to divide as if, or as an embryo; so in either way. I try to be very careful here, all right? Because in the case of a reptile, there is the possibility that a parthenogenetically activated egg can grow up to be a new reptile. Therefore, according to our understandings or our traditional concepts of the word embryo, that reptile at one point was an embryo. Therefore, parthenogenesis must work as a means of reproduction in that reptilian species.
Now, as far as I know, there has been no evidence that parthenogenesis can work in higher mammals. It has never been successfully done. Part of the reason is we have different molecular regulatory mechanisms at work in our chromosomes than do reptiles. These molecular mechanisms, they're not in the DNA sequence, so you can have 46 chromosomes in a parthenogenote, or whatever they called it. You can have 46 chromosomes there and not necessarily have something which is going to continue to develop, as we traditionally think of human development.
Now who knows? Next week they come along and they say, see, we parthenogenetically activated this egg and voila, we've got a fetus. That's what science has been doing to us. But right now there's no evidence to indicate that, and in fact there is evidence to indicate that in fact it may never be the case unless you take care of this epigenetic, this molecular regulatory deficiency.
Okay? Is that clear, I hope? All right, sort of, right, good. That's about as good as we're going to get.
Now, is there more than one way of being human? Well, there's certainly more than one way of being human, Bob. In other words, we all know, around the room here we can see many different ways of being human. I think the question is going to come down to our understanding and perhaps even, not that it's ever going to happen precisely, but our definition of what it means to be human.
One of the things I like to do with groups to whom I speak is to ask them to picture in their mind a human being, so that some alien might telepathically come to understand what it means to be human -- because pictures are worth 1,000 words, we don't have time for 1,000 words - and then ask them the question, who thought of somebody of the opposite gender? Who thought of somebody of a different racial background? Who thought of somebody who was blind, or deaf, or missing a limb? Are they not human? Where do we draw our lines currently on what it means to be human?
Again, part of this scientific and medical research has challenged us in that direction. So before we can answer the question, are there different ways of getting to that point, I think we have to ask ourselves, what is that point? What are we going to consider to be human?
Again, that's why I raised this earlier. Right now we're at the tip of the iceberg. Right now we're going back and forth on when does human life as an individual or a developing human being, as we understand currently human being, which of course is not in and of itself a univocal concept? How do we deal with this issue is going to be very important in how we deal with the other issues that are coming down the line.
So I can't answer your question, in a sense to say, are there more than one ways, since it's hard to say what do we mean by human being? And could there be more than one way? Certainly, certainly. I mean, we don't a priori rule out anything.
DR. ZOLOTH: Moral status is relative to temporality, to time, cross development, to moral location, inside a room or not, and to power relationships. Those are premises, I think, that undergird my response. Is there more than one way to be human is not a new question, surprisingly enough. In the Talmud there is an interesting discussion about, what if a monster birth happens; what if somehow a human got inside of a cow and was born, and what if some other entity got inside of a human womb and was born, and if the creature itself had a tail and claws?
And the rabbis of the Talmud debate this theoretical question, as they do many and they have a debate. And in fact, if such an entity is born from a woman's womb, one ought to cut off the tail and file those claws and raise the child as a Jew. That text is an important one for disability activists, of course, to assert the essential humanness of that which we nurture and love. I think that that's going to be our challenge in the years ahead that we face, bit by bit understanding the ability to nurture and love that which is born to us, that which is given to us. That, I think, undergirds the response.
We won't ever know, I hope, if a parthenote can be a human person, because if someone asks me as an ethicist, I'd say, guess what, let's not test that in the human subjects because of my high level of protection against human subjects. There are going to be some questions about the kind of tissue that we can create in a lab that we will hopefully never know what could become of that, in terms of its human fate.
This would all be interesting and tantalizing and very cool things to talk about, in the technical sense -- very cool in the technical sense, but it's a very different discussion for a Jew who is thinking about healing as an absolute duty, again, written against this otherwise interesting textual argument. If we were just discussing abortion it could stay within a faith community discourse, and we could come up with sincere differences between us. But as soon as we enter the arena of the potential for human healing, the potential for stem cells to do the kind of things that John Gearhart is displaying them doing in his lab, healing spinal cord injuries, making little rats walk again. That idea that there is a possibility for human healing, even at the first stages of research, that drives the debate in a somewhat different direction, I think, and overlays all of the otherwise very fascinating discussions.
The different ways to be human, as Kevin said, I think will be fundamentally a mystery to us. As I've said before in this debate, for me the interesting thing is, can we start the discussion of the mystery without worshiping it falsely? And, again, just to refer briefly to the Talmud, there is a long and intricate discussion about the use of magic and alchemy. One of my favorite discussions: Can you do alchemy? Can you make cucumbers, magic ones? Is that permitted or is it not? After long debates they realize the danger of magic isn't the making of magic or the practice or the learning of it. It's making the terrible error of thinking that that's God, of worshiping the magic, of saying that the stars are where God is, the natural world is where God is. So, the tension between the doing of the work and the worship of the work is an interesting religious question, I think.
DR. COLE-TURNER: Just a quick, additional comment on that.
Kevin has very nicely pointed us to the question of the future, of human destiny, of the long-term implications of what we're doing. We hear so much about the evils of cloning, particularly reproductive cloning. It seems to me we need to begin to think very carefully about the rhetorical level of what's going on around us in denouncing certain things like this. It really gets back to the question of how do we refine and how do we regard human life? I guess, despite efforts to ban cloning, I'm of the opinion that human reproductive cloning is inevitable, given enough time. Pick your timeframe, but given enough time, it's inevitable.
Will the cloned children of the future read the bioethics literature of 2002 and read about the evils of cloning, the repugnance that greets cloning, and will they see that as a rejection, not simply of cloning but of the cloned, of humanity that comes into existence by these technological means? I think we really need to be very, very careful and more circumspect in our use of rhetoric that denounces technologies that we don't like, because we may end up denouncing and rejecting human beings. All of our religious traditions, without exception, call upon us to accept, with unconditional love, any human life, no matter how it comes into existence.
MS. ROGERS: It's obviously a very explosive issue, and one that will be debated in Congress in not too long.
Q: Hi, I'm Ed Dohr, with Americans for Religious Liberty. There is a perspective that hasn't been brought out yet today, and that is, in defining personhood, what is a human person, there are three problem areas; three or four that come up. One, when does a human person cease? Our society is coming up on brain death as the point at which it ceases.
When in the course of evolution could we regard our ancestors as persons? Anthropologists will argue about this forever and never come up with an answer, but it's in there someplace.
And then the question of moving from a fertilized egg to a baby, at what point do you become a person? A brief was filed in the Supreme Court, in the Webster case a dozen years ago, by a number of Nobel Laureate biologists and others who said that they agreed with the point of view expressed by Isaac Asimov, that you can do without just about anything - eyes, ears, nose, limbs. You can replace a heart. You can replace the lungs, liver and other stuff. The one thing you can't replace without ceasing to exist is the cerebral cortex. So maybe cerebral cortical development is relevant to the debate of when personhood begins, and when is the cerebral cortex wired up and functioning continuously. Again, it's fairly late in pregnancy, like after 28 weeks. This is a perspective that probably needs to be talked about in this debate.
MS. ROGERS: I know we have a number of scholars on death and dying issues, too, that you prefaced your comments with, so I'll let whoever wants to bite on that go.
DR. FITZGERALD: Well, let me just raise a couple of issues on that regard.
It is very interesting, and it's certainly part of the scientific impetus to follow a somewhat reductionistic sort of reasoning, to say can we bring this down to a more basic level? Of course, this is part of that whole thing between molecular and cellular biologists, right? We want to reduce everything down to the molecules; they stay at a much more complex and difficult level.
Can we use that same sort of reductionistic thinking in starting to wrestle with some of these issues? You bring up a perfect example of this idea, what really makes us human? Some people will argue, well, it's obviously our brains, right? Well, maybe, maybe not.
Last February, about a year ago, Irv Weissman out in Stanford and a company called Stem Cell, Inc., did a little experiment. He took some human neural stem cells -- so brain stem cells -- and he put them into the developing brain of a mouse, to see if those cells would integrate with the mouse brain cells. Lo and behold, they did. Fascinating. That next summer -- so this past summer -- others did a similar experiment with a monkey, putting the brain cells into the monkey.
Now, that raises some interesting questions. I'm sure there are many judges that don't get much sleep at night thinking of the possibility of someone taking a lot of human neural stem cells, perhaps a majority, and putting them into the brain of a developing monkey. Now you have a monkey that's brain is primarily human cells. Is it a human brain? If we take that monkey and destroy it in lab research, is that murder?
Now, okay, this may sound kind of crazy, but when you get into the legal realm, who knows?
But on the same token, if you were to take - and this is research that is being done, has been done for quite awhile with dogs - if you were to take the brain of someone and transplant it into a different body, who would that be? And would it be the same person, even if we say the brain is what makes the person? I've talked to some neurologists on this aspect, and they -- some of them say no, it wouldn't be the same person, we are not just our brains, the way we are not just our genes or our chromosomes or our cells. What are we? Hard to say.
There is a lot of mystery involved, as Laurie mentioned. But I think we have to be very careful whenever we get into that reductionistic kind of thinking to listen to the alarm bells that are going off in our head. In the process of breaking ourselves down into our component parts, we lose who we are.
MS. ROGERS: We're quickly running out of time, what I'd like to do now is just collect a few questions from the audience and then let each person make some final remarks at this point. So I want to make sure we accommodate this lady who has been waiting, and if there are others who would like to, we'll get a couple of more over here. Then we'll let each panelist make final remarks.
Q: I'm Frances Kissling from Catholics for a Free Choice.
I wanted to explore the concept of uncertainty. I missed Kevin's initial presentation, so this may well have been dealt with. In relation to the moral status of the embryo, if there is some agreement, or at least if there is one line of thought, that the moral status is uncertain, that personhood is uncertain, that we have not yet determined that; and then the following principle that, Kevin, you articulated was that in cases of uncertainty we should not act - we should act as if certainty were there, and that in this case to assume a moral status, the equivalent of human personhood. I wonder, both in terms of your own thinking, or your own understanding of Catholic thinking on this, as well as others on the panel, if uncertainty requires or obligates us to act in the most conservative way, or do any other values in this specific case of moral status of the embryo need to be weighed? Or is uncertainty the absolute value that trumps the uncertainty of the status of the fetus, the possibility that it might be a person, that trumps any and all other values at stake in terms of how to treat the embryo?
MS. ROGERS: Thank you, and if I could collect the questions and then go down the row for each of you. You can answer each of the questions in your final comments, as best as you can. I know that's hard.
If we could get mikes over here, and we'll collect these three questions right here and let the panelists take it from there.
Q: Okay, Jonathan Imbody from Christian Medical Association. My question is for Doctors Cole-Turner and Fitzgerald.
Dr. Cole-Turner, you held up both hands, and you had a little thing in one hand and a big baby in the other. You were saying instinctively you give more value to the big thing than the little thing. So I wondered if each of you could talk a little bit about assigning value based on physical characteristics versus value based on the essential nature of a being.
Q: Al Milliken, Washington Independent Writers. If it turns out God does consider every embryo fully human, not just potentially, how would a just, holy, loving God respond to a political decision like George W. Bush made in August? You know, how could he be pleased with such a thing? How would he make his will known? What would it take to shake people up into what his role is?
I'm just curious too, as far as those who are talking about the freedom, and scientists just getting their work done. Once an embryo develops into a clone that would develop the characteristics that we've seen in sheep and cats and other beings, as far as having the enlarged hearts, enlarged livers, deformities, defects. Who takes responsibility for that? Is it the scientist? Is it the donor? Is it the taxpayer?
MS. ROGERS: Okay, and this lady in the second row.
Q: Hi, good morning, my name is Diane Withline. I'm with Georgetown University. I would like the panel to comment on this story in the news today about the mother in the family that has a gene for early onset Alzheimer's.
MS. ROGERS: We'll start with Dr. Waters at the end and work our way in this direction, please.
DR. WATERS: Answers to the four questions: yes, no, no, maybe. (Laughter.)
MS. ROGERS: Oh, that's a great, succinct answer.
DR. WATERS: What do we do in the face of uncertainty?
I think if you're going to err you err on the side of doing as little damage as possible, as just a practical rule of thumb. I realize that that begs the question of who is it you think you're damaging.
I don't have to answer question two because it was directed to my colleague at the end of the table.
MS. ROGERS: Yes, you can be selective, except for the ones that were clearly addressed to you.
DR. WATERS: I do think it's a fascinating question you two have to deal with -- does size matter on this.
God's response to Bush's decision? (Pause, scattered laughter.) It's a fascinating question. You stand before God in judgment and say what did you decide about this embryo strain. Will it be asked?
I think within the realm of political necessity, Bush did about as well as one could expect. Is it a good moral response? No. But it's better than some, and I think that there is, at least from my viewpoint, a certain wisdom in saying let's proceed slowly here.
Finally, what concerns me about this whole debate - and purposely over the last few years I just quit using the word person - because I think what it is is we somehow get the assumption that if we can just define what a person is then all else will follow, when it becomes obvious what you can do to non-persons as opposed to persons. I'm just not convinced that's the case. What concerns me is that increasingly when we think of persons we think of a certain kind of autonomy so that all human relationships become some form of contract. Rather, what I'm more interested in, in the light of this technology, is what does it mean to have certain responsibilities and commitments to involuntary forms of human association. In other words, I guess my concern is with the technology we're developing now, it may begin to produce social and political ways of thought that may not serve us very well down the road.
MS. ROGERS: Thank you. Dr. Zoloth?
DR. ZOLOTH: Moral uncertainty is a complicated juncture for us, and in the face of moral uncertainty over the moral status of a five-day old human embryo, which for Jews is not such an uncertain moment, for in vitro, for artificially created embryos at five days - for that, there is more uncertainty than not, but I'll warrant that socially there might be some. And there is an overwhelming possibility for beneficence, the beneficent act of healing. Healing itself is a commanded act. That creates a different set of assumptions. So, while Catholics might be more concerned with non-maleficence, I think Judaism would be more concerned with beneficence. I think that's - that's just, again, a fundamental religious difference about how one acts and to whom one is obligated.
Secondly, value based on physical characteristics, of course. The actual, tangible discourse of Jewish bioethics is case-based reasoning. In case-based reasoning, the essential but undefinable nature of a thing is only mediated and taken up through the physicality and tangibility of the thing itself. So it does really matter about size, and it does really matter about the actual, tangible, physical embodied thing that we are discussing.
It is not irrelevant that Ron Cole-Turner's baby is squealing happy, comes from a particular mother and a particular father in a particular family in a particular location to whom I have an absolute duty, and that the human - the five-day-old stem cell, which may turn out to be one thing or may turn out to be another or may not have the potential to arrive at 46 chromes is smaller than a barley coin, in the Jewish textual tradition. That does matter to us. The actual world needs to be read, and that's why we'd answer differently there.
About God's will on George Bush's decision. I respected George Bush at that moment as a man who had prayed and struggled and consulted and acted within the discourse of politics to which he had been well trained. I thought that it was a skillful political and a thoughtful moral discussion on his part. Far from me to understand what God intends at any moment.
Science needs, though, to be responsible for that which it does, and in the discourse of science, I want to say very carefully scientists themselves are also men and women of decency, morality and sanity. Much of the time in this discourse we portray them as maniacs, mad scientist maniacs, with no moral compass whatsoever, the moral compass held firmly in the grip of bioethicists, and it is just not the case. Scientists, too, struggle. Responsible scientists struggle as men and women of faith and commitment and civic sensibilities with these issue, and yes, that is why I think the American scientific community has turned away from reproductive cloning because of its potential for the enormity of harm, the harm to human subjects that it would involve, and the potential for human grief. While it might be theoretically possible, in essence possible, in the tangible, material world it is terribly dangerous, an impermissible scientific experiment, and in fact creates, as Brent said quite clearly, some difficult and impermissible ideology about the relationships of parents to children. So that's why I think there has been that response.
Finally, planned plantation diagnosis has been around now for more than a decade. It's not that they changed the genetic structure of the tiny embryo. It is that they chose the one without it. That's what I think is a fairly - there's a tragic choice before us.
We can create many embryos, and we can choose which one we choose to embrace and implant. We can't do anything about the ones that have the genetic defects except destroy them, quite frankly. So it's important to know exactly what was done and what wasn't done, and the birth of a child with the potential for more health than another is, again in the Jewish tradition, a thing to be celebrated. We are at a stage where it does involve some tragic choices.
DR. COLE-TURNER: First of all, the question of uncertainty, I agree very much with what Dr. Zoloth just said about degrees of uncertainty. In the brand of Protestantism that I represent there isn't too high a degree of uncertainty here. We look at the embryo and we say it's just not the equivalent.
We're pretty sure about that. It's not absolute. Let's talk. Let's think about this. Let's debate. The starting point is to assume that the answer is no.
I think that's important because, yes, there is something appropriate about going from uncertainty to a conservative stance. It's kind of a precautionary principle, which is operative, as you know, in other parts of the world and in terms of assessing technology. But a precautionary principle would apply to the human life over the life span? Yes, let's be precautionary. Let's be conservative. So, if you have a really high degree of uncertainty, if you really think that this could be, then yes, it would follow, I think, pretty automatically, that you should accord it the protections of what it might be. In my case, though, I'm pretty clear that it does not, and so lead to the opposite conclusion.
A question was posed about the baby versus the embryo and whether I was looking at the physical characteristics as opposed to the essential nature. At one level of course that's true. You look at a baby and you think, oh, just an instinctive human response to this beautiful new life. It's doing this, and everybody responds. It just entered a very deep, visceral level to that promise of life. Whereas you look at embryo, and you squint and you're not sure if you're seeing it. Okay, I'll buy that part of it, but the question actually suggests that there is a distinction between physical characteristic and essential nature, and that's frankly where I guess I would disagree with the intent of the question.
The physical and the essential are one and the same. We are embodied at every moment in our life span. The embryo is important, but it is just that. It's just that embryo. It's that single cell, or dividing cluster of cells. It's just that. It's not the fully developed human baby. In fact, I would go so far as to say that I think people would have the instinctive response that I'm suggesting even if that newborn they were holding were profoundly compromised, in terms of its health, even to the point, let's say, of being an encephalic. Would you not respond to it with a greater sense of its value, its inclusion within the human community, as opposed to the human embryo? Some might begin to quibble at that point, but again, I'm suggesting that the human intuition is to accord more value to what is fully developed, as opposed to what is not developed at all.
God's response to George Bush? Again, I agree with what the President did in a number of respects. The seriousness with which he approached the issue, the carefulness with which he heard various opinions, and the fact that he did in fact go forward with research within limits. That formula I agree with, go forward with research, within limits. I think he put the limit at the wrong place, but I agree with the general principle.
I don't claim to know about how God responds to this, but I guess I would agree with the questioner that there is an ultimate theological, ultimate religious significance to these questions. We will reap what we sow here, and these little steps, these baby steps of today's science, will have enormous implications, which brings us really to the last question.
On the Alzheimer's question, no, unless there is something really bizarre going on here, this was not a matter of adding or subtracting genes. That would be what is ordinarily called germline modification. What was reported was merely pre-implantation selection, selection of an embryo that didn't have a particular genetic anomaly that would have created a problem.
The more audacious proposal, that of modifying or altering genes, that is seriously advocated by a number of people, as the next huge step in - well, I was going to say health care. It's not really health care. It's human self-directed evolution. It's being debated currently, and I could list some resources for that debate. It's a step though that I think needs to be aired very much in public before anybody would dare to go ahead with it. But I assure you that someone in time will think that they're ready to go ahead with that technology and propel us into a whole new level of human technological self-modification.
MS. ROGERS: Thank you.
DR. FITZGERALD: Okay, let's see how I can do here.
The uncertainty with which I was referring to earlier is scientific uncertainty. There's a great deal of scientific uncertainty. We don't know what an embryo is. It's very difficult to get a definition of an embryo now, and because there is scientific uncertainty, that, I believe one can argue, leads to greater moral certainty, because the claims of people one way or another scientifically are not clear. Therefore, I think one can take the -- what you would call the safer, or what we'd call in Catholic moral theology, but also if one takes a proportionalist argument within Catholic moral theology, which, in fact, many Catholic moral theologians have taken and do argue for not going ahead with the research, even from a proportionalist. So it's not necessarily saying only take the safest approach. But because there is the scientific uncertainty, I think the moral is more certain.
As to the value of physical characteristics, exactly. Physical characteristics are one way in which we know who we are as human beings, in which we know our nature. Embodiment is important to us in who we are. In fact, it's so important that many theologians argue that after we die, and hopefully go to heaven, we will still in some way be embodied, because that is who we are as human beings.
So, yes, it's important, but it is one way that we know ourselves, not the only way we know ourselves. I mean, one can try and reduce love to physical characteristics. One can talk about the pheromones, and one can talk about the way in which the hypothalamus is activated and all that sort of thing. Is that love? So, I think it's important, again, to try and be aware of reductionistic thinking that says we are only our physical characteristics. I think we are much more than that, and there are other ways which we can get at that information as to who we are, and I think we need to do that.
As to God's interpretation of Bush's decision? Ask God. (Scattered laughter.) You know, when I have a question you just usually ask and see what God has to say.
I can say that one of the difficulties that I have had, and I think even within the Catholic tradition that we have had, is something that Ron brought up before. In the decision there is nothing there for regulation over the private sector. Therefore, any of the research that was done with public funding, even if one might consider it moral, could then be used by researchers in the private sector to go ahead and do whatever kind of embryo research they want to do. So in one sense, to me, it exacerbates the situation, because it will allow public funding to be done to do the basic science, or some of the tissue culture work, and then private industry can just piggyback on that. So it actually makes things worse from that perspective.
Who takes responsibility for the mistakes? Excellent question. Well, if we're all neighbors, we all do. We all take responsibility for the mistakes.
That includes the scientists and the scientific community, and I agree with Laurie. Scientists aren't evil. I hope not. Otherwise, I'm severely schizophrenic, but that's another whole topic. They aren't. I mean, you meet and talk to scientists, they are good people. But they are also scientists, and they say what you would expect scientists to say. That's why we need scientists in the public discourse, not only so we can hear from them, but so that they can hear from other people who have other perspectives and are steeped in other sorts of cultures.
So in this specific instance, actually it's even more interesting what Yuri Verlinsky did in this Alzheimer's case. I don't believe he tested the embryos. I believe he tested the eggs. There is a way you can use this genetic diagnosis to test the eggs - not the embryos - and therefore see if an egg carries the particular gene or not. It involves testing the polar bodies and all that. But it is not testing embryos. That's different. Now there is also some ethical issues involved in that.
Finally, I hope I haven't come across as too negative on all this, because I don't think I really am. These discussions point out to me a great deal of common ground. Laurie went through some of the major points she sees in Jewish bioethics - justice rooted in a moral community, discernment is the human thing to do, the duty to heal, being guardians of an incomplete world, being readers of the texts. I can tell you, all these are extremely important in the Catholic tradition. All these are very important to us, and all of them get taken in by what we would consider to be a paramount duty - and I'm not saying this is different than Laurie, but we would put it in this terminology - the duty to love. The duty is to love everyone, from start to finish.
MS. ROGERS: Thank you for that conclusion.
I want to thank all of you for staying. You've stayed and it has been a marvelous conversation, and you're very good to be with us throughout the entire conversation. I want to thank a distinguished panel for very insightful remarks. I'd also like to thank our staff, particularly Staci Simmons, who is in the back of the room, who planned this event almost exclusively, and I would like to thank her. (Applause.)
I would also like to thank the other members of our staff - Amy Sullivan, Heather Morton and Kirsten Hunter, as well as interns Kelly Hansen and Natalie Moreno. Special thanks go to intern Lily Houseman, who is a student at Georgetown, and who helped with the planning of this event.
We thank you very much and hope to see you again soon.