There are points of agreement in the research debate.
Most people agree that it would be unethical to kill an innocent child or adult or research purposes, regardless of the potential benefit.
Also, most would agree that it would be unethical to destroy en embryo even in the moment of conception if the benefit is non-existant or trivial (say, to make Coca-Cola taste sweeter).
So, in the graph below, I plotted these point on a graph, and drew a line between them separating destructive research that is definitely unethical based on the above two premises from research that is not ruled out by these premises alone.
But wait, it's hard to imagine a scenario where we would be willing to perfrom on adolescents, and not adults. In fact, most people wouldn't be willing to perfrom this research on infants, so let's move the sticks...
Ok, so now our range of area of debate is bounded by conception and birth on the development access, and no benefit and save the world on the benefit access.
My position, and that of the Catholic Church, is that there is no more lines to draw. Or rather, there is a vertical line on the y-axis -- it is unethical to destroy any human life for research puroposes, regardless of the potential benefit.
In my opinion, this is the most coherent position that has been articulated. In short, I have not seen a convincing argument for why that line (or whatever shape) should be anything other than a vertical line on the Y-axis.
8 comments:
But, but, but...
You're treating all these issues as certainties. They're not - they're probabilistic.
it is unethical to destroy any human life for research purposes, regardless of the potential benefit.
Destroy is such a pejorative term, isn't it? Well, we know not every fetus is going to make it to birth - are we destroying a life, or shifting a probability? If this amounts to the same thing, does this mean those researchers in Great Britain who killed the handful of people on a clinical trial of that dandy new anti-inflammatory last year should be charged with murder?
From a completely utilitarian perspective, the act of destroying a newly implanted blastocyst is equivalent to cutting off a hangnail.
In addition to not accounting for the probabilistic nature of potential harm, you (and the Catholic church) are also discounting the factor that seems persuasive to most sane people - the degree to which the subject is "alive." A blastocyst is only as alive as my dermal cells, after all - the only difference between the two being the potential for a future being we would consider "alive" in the human sense. That potential is only realized through gradual accretion. (And in some cases, arguably never realized at all [identified examples self-censored])
If you disagree on the basis of potential for life alone, and that potential for "human" life is the deciding factor, consider this:
When attempting to conceive a child, my wife underwent fertility treatments. As part of this process, our doctor extracted an agreement that, should a pregnancy of more than triplets result, we would agree to have a "pruning" down to no more than two fetuses (we took precautions, of course, but again – this is a probabilistic enterprise). Our doc had been responsible for some very sick babies, you see, and has grown tired of the guilt, and the looks she gets from the docs staffing the newborn ICU.
Is this ethical? Had we not agreed, my daughter wouldn't have been born.
Of course, that potential works down the other tail as well. Odd, I suppose, that I find it unethical to perform invasive experimentation on people in persistent vegetative states, but the idea that fertility research and treatments result in both pre and post implantation abortions bothers me no a whit. (If there is such thing as a pre-implantation abortion – even calling it a termination seems inaccurate).
The line drawn by you, and the Catholic church, is far more arbitrary than it seems.
Last argument, of course, is that debates on abortion always contain an element of religious belief – we vary in our beliefs about what constitutes sovereign life.
What’s your position on living wills? Or the Schiavo case?
Sorry, I haven't had time to respond.
First, you would also have to acknowledge that the y-axis has a probabalistic aspect as well. We don't know for sure that this research would cure this disease any more than we know the embryo would develop into a wonderful adult hiuman being (or a degenerate criminal).
Second, I would be fine with relabeling the X-axis "probabilty of developing into a functioning adult" if you prefer. From my perspective, it wouldn't change my analysis. And it would cover cases like using death row inmaates or PVS patients for research.
Third, I submit that the agreement you describe is unethical. Your daughter is a good consequence of that agreement, but that does not itself make it ethical. My real beef would be with the PICU and NICU doctors who give dirty looks over doing their jobs. To use your logic, are they saying these children shouldn't exist?
Although I acknowledge the y-axis is probabilistic, the implications are different. Medical research that involves risk of harm to fetuses has, and will continue, to save lives. For example – we know relatively little about teratogenic effects of many medications on humans. Though exposing fetuses in controlled clinical trials is unlikely to gain much support, data is collected on individuals who are in treatment, with doctors left to determine whether or not the risks of non-treatment outweigh the risk to the developing fetus.
By your calculus, none of this treatment would occur. Unfortunately, the probabilistic nature of withholding treatment also results in a proportion of those mothers dying, or experiencing grave enough health effects that the fetus will also perish. The individual judgment of physicians in these cases is somewhat arbitrary. Should we grant the same rights to developing fetuses as we do mothers?
I’m curious about your statement about PVS clients and death-row inmates. Would you condone clinical trials being done on these patients? Even if the trials would not be anticipated to result in any direct benefit to the patient? I admit, the argument against using death-row inmates for medical research is less straightforward, but there is ample support for the contention that the social costs of such research are both substantial and demonstrable.
The same argument can be made about the death penalty altogether, though that’s another topic.
I strongly disagree with your assessment of the ethics involved in the case of fertility treatments. When women are administered Pergonal or Metrodin, they are monitored to assess the number of follicles developing that might release an egg (on administration of an HCG shot). Again, this is a probabilistic exercise, and sometimes the unfortunate limits of probabilistic assessment (including the limits of ultrasound technology and lapses in judgment) will result in implantation of as many as eight offspring. The odds that such a pregnancy could be carried to term are slim, and odds that all children will survive are virtually nonexistent, and the odds that all children will survive without grave health problems is very nearly zero.
The docs at the PICU and NICU are, in fact, saying that in some cases, these children should not exist. Knowing nurses and docs who work in these units, I can tell you they are well aware of the formidable resources that are spent protecting the life of a children who are unlikely to survive, or who will be gravely disabled.
Given that the amount of healthcare dollars is finite, far more lives could be saved, and vastly more people positively influenced, if a proportion of that money were funneled to primary health care. Assuming a fixed pot of healthcare dollars, what you propose would result in 1) an absolute decline in number of babies born, and 2) a shifting of healthcare dollars away from other areas, almost certainly resulting in an absolute decline of the number of children reaching adulthood.
Last, although the probability that any single research project which entails risk (or certainty) of fetal harm will result in actual benefits to people is certainly debatable, the aggregate probability that this area of research will result in positive outcomes is indistinguishable from 100%. So, we can be sure that some potential people who would’ve grown up to be functional adults will not, but we can also be sure that their deaths will result in some potential people growing up into functional adults who otherwise would not. The numbers are almost certainly on my side.
PS. Two things we haven’t even addressed are opportunity cost (for example, utilizing post-abortion fetal material; zero additional moral cost) and the impact religious belief has on your calculus. There are many of us who see no moral quandary at all, at least in the case of very early fetal development. Though I might be open to an argument about the social costs associated with devaluing life, I’d insist that before we look here, we turn our efforts to the more egregious examples of such (war, poverty, foster children, starvation, environmental hazards, the death penalty, handguns, drugs…)
Regarding your last point, I would say they are intertwined -- we will not build a society that seriously addresses war, poverty, and inequality so long as view some members of the human races as expendable for the benefit of others.
I would not support using either death row inmantes or PVS patients for clinical research -- I was saying that if we were to change the X-axis to be probabilistic, than the same chart could be used to capture a wider variety of ethical issues.
I think it's worth noting that other than my mention that my position is the same as the Catholic Church's I have not referenced religion at all in my arguments, but you have in both of yours.
You have also failed to make a positive case of where to draw the line (or any other shape) in a place other than where I initially proposed.
I agree with you that all cases of exploitive treatment for some at the expense of others are intertwined. Somehow I doubt, however, that it is possible to create a society where some aspect of this doesn’t occur. I’d argue it’s an unavoidable aspect of competition, and the idea that a society without competition is either possible, or desirable, strikes me as ludicrous. We should mitigate exploitation where it occurs, but focusing our efforts on this issue, when there so many other more egregious instances, seems at best inefficient.
I referenced religion in both my responses, because religious beliefs are inextricably intertwined in beliefs about what constitutes human life during the period of prenatal development. If we are to remove religion from the discussion, then that makes my point about the lunacy of equating in any way a blastocyst (potential human) and a case where human potential is realized (in a biological sense). My mention of religion involves my perception that religious belief, not rational belief, is what underlies your position. Otherwise, how can you possibly argue that a multicellular (small n) organism, regardless of DNA, can be considered at all human?
My stance is that it is impossible to impose a rule-based system on a situation with so many dynamic variables. This is why we maintain institutional review boards (though we all know they’re far from perfect). What you are attempting to do is remove all of the ambiguity from an inherently ambiguous situation. What I am trying to do is point out instances in which this obviously makes no sense.
Which reminds me – you really haven’t addressed any of my points. What you’ve done is ignore them, and then pronounce your position as being stronger. Your position is much easier to describe, of course, but the mechanism you use to describe it (your graph) is fundamentally flawed. What you ask cannot be done – you cannot build an argument for a hard-and-fast rule in this situation. Any point you choose to place your line at is, in some sense, arbitrary. Including the one you, and the Catholic church, selected.
PS. Amniocentesis must drive you positively bonkers.
BTW – I finally got around following you link. Seeing as religion has reared it’s divinely hideous head, I thought I’d mention the flaw in this statement.
An action is either contrary to God's will, or it isn't.
This implies you can conceptualize God’s will. Douglas Adams does a nice (famous) spoof on this, of course: 42. The problem is you don’t know the question.
If we are to answer a complex question from a bottom-up perspective, we are functioning much like a neural net. We make associations based on what works, and the organization behind the problem is gradually revealed. Back in the day when I was hearing about such things, I remember the application of Chaos theory calculations to human interaction and weather prediction. My recollection is that, so far as the weather is concerned, we know almost all of the pertinent variables. There’s one, however, we’ve not been able to identify. My understanding, however, is that this variable (even if composite) also functions in a potentially predictable manner (predictability diminishing as a function of time). If we’re clever enough, can gather enough data for a long enough period of time, and have clever programmers and really powerful computers, we can improve our ability to anticipate this variable over increasing lengths of time.
Last I heard, application of this process to human dynamics yielded the ability to anticipate the directional code of a communication between two people up to eight lags ahead (eight coded communications). That’s pretty good, really. Not all that practical, perhaps, but quite a bit better than most people can do.
But it’s hardly the same as saying you understand what’s going on. That, I’m afraid, is the problem with trying to know the mind of God (granting there is one, with all the usual assumptions and all that). You can come up with a set of rules to attempt to predict the higher-order organized schema (Thou Shall Not Kill, for example – a nice, clean rule), but even us mere mortals can come up with a bunch of exceptions to that one [as socially practiced these days – thou shall not kill, unless in war, or defending yourself, or defending someone else (unless less lethal force is sufficient), or if you live in Texas and work in corrections etc.].
My point – this is one of those moments. Trying to come up with all the caveats and exceptions, as part of a dynamic decision-making process, is the best we can do. Your graph is artificial, and inaccurately portrays the problem space, in much the same way as a commandment.
That’s why we support religious leaders, philosophers, and bioethicists. Awkward, but the best us mere mortals are capable of, at the moment.
John, I agree with you to the extent that if you crack the breach even a little (saying that whatever you have upon conception is even a little less than human), you make for situations when the good can clearly outweigh the bad.
I even constructed some statistical analogies (discrimination analysis), but I've no time to figure out how to present that just now.
Unfortunately, I don't think I can convince myself that a zygote has achieved full personhood, and though I don't like the idea of harvesting them, I could envision situations where the good outweighs the bad.
K
You might be interested in an ongoing conversation happening at Mirror of Justice, a Catholic legal blog, over the struggles we Catholics are having in articulating our position on protecting embryos in the public square.
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