Scoreboard Bioethics

Editors Note: This article appeared in Salvo 32, Spring 2015 edition and is used by permission.

Everyone Loves When It's Wrong

If you visit stemcellresearch.org, a website co-partnered with the Center for Bioethics & Human Dignity, you’ll notice a scoreboard at the bottom of the home page showing a tally of diseases successfully treated with adult stem cells (including induced pluripotent stem cells, or iPSCs) versus embryonic stem cells. The current tallies are: Adult, 73; Embryonic, 0. But that second number is about to change.

One recent report on a human embryonic stem cell (hESC) trial touted success in restoring human vision for two conditions.[1] This success may turn the zero into a 1 or 2, and other trials now underway may eventually produce a higher number. Does that then undermine the value of the scoreboard? Is hESC research ethically problematic simply because it has not worked, or is there another reason?

The principal objection to hESC research is not that it is inefficient, virtually uncontrollable, and known to induce tumors in animal models. While true, these facts are not ethically dispositive. The deeper fault line is that between research that does not harm the human research subject, and research that uses such subjects as raw material. Human embryo research has destroyed thousands, possibly millions, of human embryos. Each attempt to derive hESCs requires the destruction of at least one human embryo, and usually many more. It is patently not beneficial for the embryos involved and, until recently, has been of questionable value to the potential beneficiaries, patients with serious diseases such as Type 1 diabetes, Lou Gehrig’s disease, and ALD (adrenoleukodystrophy, the disease featured in the movie Lorenzo’s Oil).

Using embryos in this way is a straightforward case of instrumentalism, treating the human person as an instrument, or means, to achieve a goal that benefits another person. Although “the end doesn’t justify the means” is a familiar saying, apparently the values behind it are not. The principle of not using human beings for non-beneficial (to them) purposes requires that embryos never be destroyed intentionally, for any reason.

The defensive response is that these embryos somehow are not human persons, whether because they were created in a lab, are leftover from IVF and would die anyhow, or are smaller than a dot and therefore insignificant. This makes moral status dependent upon method of conception, location (womb or Petri dish), or size. But in a liberal democracy, the most vulnerable members of society merit greater protection, not less. It is hard to imagine a more vulnerable human being than an embryo destined for destruction.

But how should we respond to the genuine need for therapy and cures? The individuals with these diseases are here and suffering among us now; don’t their lives matter too? One of the lead researchers in a new hESC diabetes trial has two children with Type 1 diabetes; that has spurred him to persist for more than two decades.[2] It seems callous to call the effort unethical.

Yet unethical it is. It is never ethical to take the life of one human being—even one microscopically small—for the hypothetical or actual benefit of another human being. That was a major conclusion of the Nuremberg trials of the doctors and lawyers who abetted and conducted gruesome experiments on human beings, and it is the principle behind the codes governing research on human subjects.

So even if the scoreboard changes to 100:100, the ethical response to human embryo destructive research is an emphatic and principled “no.”

 

Notes

[1] Rob Stein, “Embryonic Stem Cells Restore Vision in Preliminary Human Test,” NPR News (Oct. 14, 2014): npr.org/blogs/health/2014/10/14/346174070/embryonic-stem-cells-restore-vision-in-preliminary-human-test; Stephen D. Schwartz et al., “Human embryonic stem cell-derived retinal pigment epithelium in patients with age-related macular degeneration and Stargardt’s macular dystrophy,” The Lancet (Oct. 15, 2014): thelancet.com/journals/lancet/article/PIIS0140-6736(14)61376-3/abstract.

[2] B. D. Colen, “Giant leap against diabetes,” Harvard Gazette (Oct. 9, 2014): news.harvard.edu/gazette/story/2014/10/giant-leap-against-diabetes. 

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