Vatican Favors Implanting Diseased Embryos
Ronald Bailey | March 1, 2006, 12:43pm
That is the logical conclusion of the deliberations held this week at the Vatican during an international congress devoted to "the human embryo prior to implantation, scientific aspects and bioethical considerations." Among other questions, the conference delved into the issue of the moral status of IVF embryos discarded by would-be parents because pre-implantation genetic diagnosis (PGD) detected genetic defects.
The Associated Press began the story this way:
Scientists told a Vatican conference Tuesday that screening embryos for disease before implanting them in in-vitro fertilization posed grave ethical problems that could ultimately result in parents choosing the type of children they want.
Presumably, parents who use PGD want children who will not suffer from dread genetic diseases such as Fanconi's anemia, cystic fibrosis, Down's syndrome, muscular dystrophy and so forth. That's a laudable moral goal.
In another story, the Associated Press also reported that according to Pope Benedict XVI,
embryos developed for in vitro fertilization deserve the same right to life as fetuses, children and adults and that that right extends to embryos even before they are transferred into a woman's womb.
But a naturally produced embryo's "right to life" is empirically pretty tenuous. As I pointed out in my column "Is Heaven Populated Chiefly by the Souls of Embryos?" a while back:
John Opitz, a professor of pediatrics, human genetics, and obstetrics and gynecology at the University of Utah, testified before the President's Council on Bioethics that between 60 and 80 percent of all naturally conceived embryos are simply flushed out in women's normal menstrual flows unnoticed. This is not miscarriage we're talking about. The women and their husbands or partners never even know that conception has taken place; the embryos disappear from their wombs in their menstrual flows.
In fact, according to Opitz, embryologists estimate that the rate of natural loss for embryos that have developed for seven days or more is 60 percent. The total rate of natural loss of human embryos increases to at least 80 percent if one counts from the moment of conception. About half of the embryos lost are abnormal, but half are not, and had they implanted they would probably have developed into healthy babies.
I think that it's pretty hard to assert that human beings should be more careful of embryos than is Nature or, for believers, Nature's God.
thoreau | March 1, 2006, 1:16pm | #
I know this thread will quickly develop into people talking past each other with arguments based on very different premises, nonetheless....
Let's explore the implications of a stance that fertilized eggs at any stage should be protected:
If we operate under the assumption that all fertilized eggs have the same moral status as babies, or at least close enough, are medical researchers under an ethical imperative to seek a remedy for the natural loss of fertilized eggs during the menstrual cycle?
For instance, advances in health care have done much to reduce miscarriages of implanted eggs, as well as fatalities during childbirth and infant mortality shortly after childbirth. Many of those advances simply amount to better sterlization, sanitation, nutrition, and basic medical care. I won't claim that they are complex fruits of scientific inquiry, but they are nonetheless major lifesaving advances.
Now that those problems have been solved, would it be more ethical for the medical research community to turn its attention to saving those fertilized eggs that are not yet planted, or would it be acceptable for researchers to write them off and focus on diseases affecting those already born?
I realize that this isn't entirely an either/or scenario. Medical research advances on many different fronts at once with an army of researchers in the public, private, and academic sectors tackling a huge array of problems. No individual researcher should be faulted for working on cancer rather than corn syrup, or blindness rather than infant mortality.
But, if the entire scientific establishment ignores a problem that kills millions of people around the globe, from every nation and social stratum, is that a sign of moral blindness on our part?
Let's make this a little more concrete: Say that you're the dean of a Catholic university with a good medical school and strong basic science program. You're proud of the many faculty members studying AIDS, cancer, corn syrup, blindness, mental illness, antibiotic resistant bacteria, and numerous other medical problems. But, you notice that your faculty are almost completely ignoring something that kills at least half of all fertilized eggs/unborn children/insert preferred term here.
Should you direct your faculty to pay more attention to this problem?
thoreau | March 1, 2006, 2:16pm | #
Thinking more about the issue of fertilized eggs not implanting....
No individual researcher should be considered obligated to change fields, of course. But let's say you're interviewing faculty candidates. You have two scientists before you. Each gives a sales pitch.
Scientist #1: "Since receiving my Ph.D. in physics I have conducted work on tumor-induced angiogenesis. Cancer is an obvious health problem afflicting millions of Americans in all age groups, and so cancer therapies are a research area of obvious importance. My work focuses on understanding and disabling the mechanisms by which tumors recruit blood vessels to gain nourishment. The hope is that if we can halt this process we can prevent tumors from growing and thereby save millions of lives." And then I go into a spiel about the technical details and why my work is promising.
Scientist #2: "Since receiving my Ph.D. I've been studying the factors affecting implantation of fertilized eggs. More than half of all fertilized eggs fail to implant in the uterus, and are lost during the normal menstrual cycle. This translates to the deaths of millions of unborn children every year. My goal is to identify the factors that determine whether or not implantation will be successful, and develop therapies that boost the chance of successful implantation. We could potentially save more than a million babies every year." And then he goes into the technical details and why the work is promising.
Assume that both candidates display the same level of technical competence, the same deep understanding of their field, the same record of publication, the same teaching background, etc.
Now, your job is to hire the person whose work is most worthy of departmental resources. As the dean of sciences at a Catholic university, your mission is to hire the scientists who can best advance the school's goal of produce life-saving cures while training the next generation of scientists.
Should a Catholic university flip a coin, or is one of the two research programs obviously more compelling than the other?
We can either explore the implications of crimethinks views in a different context, or we can just belittle them.
Stevo Darkly | March 1, 2006, 7:46pm | #
I was going to try to avoid getting involved in another embryoglio today. But thoreau raised some interesting questions.
My thoughts: Even within the context of Catholic teaching, I don't think there is a particular moral imperative to save embryos from .... let's call it "natural prenatal embryo loss" (NPEL). I think, for the same reason that there is no moral imperative to "save" people from eventually dying of old age. Eventually, we all do, and there's no moral failure in that.
Even under RCC teaching, which is pretty strict on this stuff, you're under no obligation to pursue "extraordinary means" to prevent someone from dying a natural death of old age or a disease that can't currently be cured.
(But if you deliberately whack an innocent person, even in pursuit of good ends --
that the RCC comes down hard on.)
This is pretty sensible, and compatible with libertarian thought. Nobody can lay claim a right to having an infinite amount of resources devoted to keeping himself alive. And likewise, there's a limit to our obligation to spend resources on keeping someone alive.
Where you draw the line, I don't know. How much are
you willing to spend to keep someone you love from dying? That may be a matter for individual conscience and the individual case.
But I think that, at present, a massive program to prevent NPEL would qualify as "extraordinary means."
If it ever (
can it ever?) becomes practical and affordable to catch all those lost embryos in a bucket and raise them,
then maybe we'd have an obligation to do so. One of the biggest obstacles I can envision -- how the hell could we possibly detect the loss of an embryo under these circumstances in time to do anything about it? Some kind of "nano-ambulance/monitor" that floats around in the womb, detects an embryo's failure to implant, and then gloms it and flies it off to a hospital?
Presumably the mother would in most cases just give the thing up for adoption -- that might be the "default option" -- although she wouldn't have to. Since I'm an anarchist, I can't and don't advocate a State coercing women to participate in this process. Personally, as a creature of my own time I think it's bizarre situation, but in the future it might be recognized as the moral thing to do. I can see women of the future volunteering if it's not too intrusive, and possibly subject to non-statist social pressure to do it ... from a woman's own socially conditioned conscience, and the consensus of the people around her whose opinion she cares about. It all depends on what people's attitudes toward embryos are when this becomes possible. I can't really imagine it.
I personally file this under "we can cross that bridge when we come to it."
Although I can see a 22nd version of, say, a Catholic hospital, with buildings full of recovered embryos. Maybe they'll just be frozen indefinitely. Or maybe they'll be raised in artificial wombs ... educated in militant RCC schools ... eventually growing to fervent RCCC adulthood ... many of them swelling the ranks of the Knights of Columbus (that's the 22nd century Catholic defensive militia force) ... Like the "clone army" in Star Wars! (Only they won't be cloned and won't really be an army.)
And thousands of them will volunteer for the Vatican's mission to Tau Ceti, there to found the colony of St. Brendan ...
Yes, that's the future of mankind -- a galaxy full of genuflecting papists, ever increasing in number and influence! "This cathedral has now become the ultimate power in the universe!" "Bishop Vader, release him!" Bwahahaha vobiscum!
(Sorry.)
Stevo Darkly | March 1, 2006, 10:44pm | #
thoreau, good questions.
I don't rightly know.
The answer to the first one might be fairly look-up-able by someone already more knowledgeable about Catholic doctrine than I. (coughcoughcoughcrimethinkcoughcough)
In thinking about this stuff, I do have a few half-formed thoughts.
1) The depth of the moral obligation to take action to prevent someone else's death (which, again, is distinct from the obligation not to take action that would actively cause a death) is difficult to gauge. Another example came to me while I was eating dinner. What is the depth of my obligation to prevent children from starving to death in Ethiopia? Give everything I own? Reduce my position to just barely above starving myself? Something short of that? Where?
2) Is my moral obligation to help keep one of my relatives from starving to death any stronger than my moral obligation to help keep a stranger in Ethiopia from starving to death? I think it is, but why? I can think of a few answers, but they are all very pragmatic ones more than abstract principles -- "rule utilitarianism," I guess. Which needn't mean they're wrong. (The rule is something like "People will be more effective at taking care of other people if they focus first on the people they love or feel connected to," BTW.)
3) While the question of, "Is this affecting a stranger, or a loved one?" might not be relevant to the duty not to kill an innocent, from the above it does appear to be relevant to "How much obligation do I have to help someone else?"
4) I'm also getting a vague idea that "the moral obligation to provide assistance" may be something close to "the market demand for providing assistance." I may not have phrased that right; I'm still thinking about it.
5) How much do we know about
why some embryos fail to implant and are flushed out? Ron's citation says that about half of such embryos are abnormal. Does that mean that about half of them might bear inherent defects that make them unlikely to survive even if they successfully implanted? If so, that would push even a much easier effort to "help them implant" into the realm of "extraordinary means" again, because it would probably be ultimately futile.
Also, of the other half that are apparently healthy, and would "probably" develop into healthy babies -- how sure are we of that? Maybe the implantation process acts as a kind of filter of nonviable from viable embryos -- one that's more sensitive than our own present means of detecting embryonic defects. A 60-80 loss of potential additions to the species for no particular reason seems pretty inefficient. Maybe that's just the way it is, but I would've expected more of evolution than such sloppy waste.
Those aren't really answers, just thoughts I'm throwing out there. And the last one may be kind of a tangent that doesn't address your "what if they
could be saved?" question.
Reason on Facebook
Reason on Twitter
Reason on YouTube
Reason RSS
