Embryos Stem Cells, Morality and Public Policy: Difficult Connections

• Author: Richard W. Momeyer
• Pages: 93-104

Page 93

I am going to examine two questions in this paper. The first question is about the moral status of embryos¹, specifically embryos created in the process of in vitro fertilization (hereinafter "IVF") treatments that are "surplus" and destined to be destroyed. The particular moral question I am interested in is the propriety of developing these embryos ex-utero to the point where it is feasible to destroy them by extracting undifferentiated embryonic stem cells that are totipotent and capable of becoming both immortal and potentially valuable therapeutic agents for very damaged human beings. The second question I shall explore is a political/public policy one on the desirability of federal funding (through the National Institute of Health, hereinafter "NIH") of research on undifferentiated embryonic stem (hereinafter "ES") cells extracted from embryos destined for destruction.

These are separate but connected issues, and they are at least connected in this manner: if there is a compelling reason to believe that experimentation on or medical use of embryos is indefensible, then this is a compelling reason to forbid the encouragement of such research by the main funding mechanism, namely, NIH grants. Conversely, if there is no good reason to accord embryos a moral status, which should give us the least concern as to how they are used, this is a powerful reason to go forward, even very aggressively, with NIH funding of ES research. Of course, if it turns out that the moral status of embryos is contentious, indeterminate, and/or uncertain, what we should do morally and politically becomes very complicated.

As those of us who have followed the public discussion on these matters and President Bush's reasoning and decision-making on funding ES research will know, the closest thing we have to a consensus on the question of the moral status of the embryo is that it is a very contentious matter. As such, it provides grist for the issue I really want to discuss inPage 94 part two of this paper, which is not so simple as the moral status of embryos. Rather, I want to consider how, in a pluralistic and democratic society, we should go about setting public policy where the morality of what is being proposed is in serious contention. ES research is a nearly ideal case study for this most difficult question.

So for the first question: what is the moral status of an embryo? There are three kinds of positions on the moral status of the embryo that are worth considering:

1. The embryo should be thought of as having full moral status. It has a full, unique human genome and the potential, in the normal course of events, to become a child and then an adult human being. In these most important respects it is already a unique human life and should be treated with the respect due any human being. Failure to show full respect for embryonic life threatens to de-value all human life.

2. A second position is that the embryo has some moral status as human life, but not full moral standing. Full moral standing comes as the result of a gradual process of development culminating with birth. Legally, this is where protection traditionally begins, and morally it is the appropriate place for full moral status.

3. The embryo-the pre-implantation embryo--should be thought of as having no moral standing at all. The embryo satisfies none of the reasonable criteria for having intrinsic moral status: it has no personhood, no consciousness, no self-consciousness, no sentience, and no interests. It is an object that may have great value, but no moral value in itself.

Personally, I think this third view is the most nearly correct one. And if I were King, or better, Emperor, it is the view that I would implement as public policy. But I am not, for better or worse, Emperor; I am a citizen of a nominally democratic, proximately just, and increasingly diverse country. As such, I shall argue in the second part of this paper against implementing my view as public policy, and I shall argue against implementing the contrary of my view as public policy.

First, however, let us pause for a moment to review some technical biological information essential to an informed discussion of these matters. Consider the following: IVF is, of course, in vitro fertilization, the process by which sperm and egg are joined together in a petri dish in a laboratory. This is done in fertility clinics as part of the process whereby infertile couples might attain a conceptus suitable for implantation in a woman's, usually the egg donor's, womb. Eggs are harvested from a donor after powerful drugs stimulate super-ovulation, and many more eggs are attained and fertilized than can be implanted. After selection of which embryosPage 95 will be used during implantation attempts, the "surplus" is frozen, often with the expectation of future use if the present attempt at impregnation fails.

Not all of these surplus embryos find a use in attempts at achieving a successful pregnancy. Typically, they are disposed of no later than five years after being stored. We now know that these embryos might have other highly valuable uses. Not many years ago, James Thomson, at the University of Wisconsin, succeeded in extracting embryonic stem cells from thawed out embryos that had been allowed to develop for less than a week.² The process of extracting these cells destroys the embryo.³Thomson got these cells to further divide and to stay alive by placing them on a "feeder bed" of mouse cells that provided nutrients.⁴ The wonder of these embryonic stem cells is that they are undifferentiated, totipotent, and immortal. This means that they do not yet have an identity as a specific type of tissue cell, that they can, in principle, be stimulated to become any kind of human cell. And as long as they remain viable, undifferentiated cell cultures can live indefinitely, allowing for their experimental use in any number of attempts to urge development as specific cell types.⁵ The value of stimulating ES cells to become differentiated cells is that we might be able to produce pancreatic cells with which to cure diabetes; neuronal cells with which to cure Parkinson's and Alzheimer's; and so on.⁶The potential for revolutionary medical advances is mind-boggling.

Now a very quick, superficial bit of embryology.⁷ Conception begins when a sperm penetrates an ovum; this might take several hours.⁸ It takes anywhere from 6 to 24 hours for the sperm and the ovum each to release half their chromosomes and line them up with each other to create a fertilized egg, conceptus, a zygote, a blastocyst, a pre-embryo.⁹ It takes 6-8 days for this egg to reach and implant itself in a woman's uterine wall, thereby achieving pregnancy for the woman and genuine embryo status for itself.¹⁰ Only one-third or one-fourth of all embryos conceived in utero get Page 96 to this point. ¹¹. A hallmark of the gastrulating embryo is evident at about 14 days.¹² This is the "primitive streak," a dark line down the embryo that consists of three distinct levels of cells that will eventually differentiate into every distinct cell type in a human body.¹³ About a week later, the top most layer of these cells differentiates into neuronal cells that will in time become the brain and spinal cord.¹⁴ By approximately eight weeks, cell differentiation and organogenesis that generates all the major tissue and organ systems of the human body has occurred, and the embryo is transformed into a fetus.¹⁵ There are normally thirty-two more weeks of fetal development ahead, but for present purposes that need not concern us.

Theorists have argued heatedly for a very long time about what forms of human life deserve moral status, deserve, that is, regard for a life-form's interests that obligates moral agent's to take these interests into consideration when acting. One theory or another has urged every stage of...