E. Albert Reece, a Seventh-day Adventist physician who now serves as Vice President and Dean of the School of Medicine at the University of Maryland, is the one who proposed the answer.
Delivered on Thursday evening, January 10, at Loma Linda University, his presentation was the first of what will be nine weekly lectures on "The Moral Status of the Human Embryo." I hope to post a report like this one for all nine.
This is the "Jack W. Provonsha Lecture Series" for 2008. It is organized by the LLU Center for Christian Bioethics. Doctor Provonsha was a minister, physician and ethicist who taught at LLU for many years. Mark Carr is the Director of the Center and Dawn Gordon is the Manager. Thanks to them, the series is off to a good start!
Thousands of human embryos are discarded each year because they are no longer needed in fertility clinics. Can patient care progress without looking to them for stem cells? Although this a factual question, it emerges from intense ethical controversy.
Beginning with what he called "Stem Cells 101," Reece indicated that very early in human pregnancy when the new life is a microscopic cluster of cells, scientists can coax them into becoming many different kinds of tissues that can be helpful in treating patients. They gradually become more specialized, moving from "totipotent," to "pluripotent" and "multipotent" and presumably on to "unipotent," or nearly so, when they are of little therapeutic value.
The trouble is that, although reliable surveys show that their number is declining, many Roman Catholics and Protestants object on moral grounds to acquiring stem cells from human embryos because doing do kills them and, they hold, wounds society. This is why George W. Bush restricted financial support from the federal government to research on the so-called "Presidential Lines" that were on hand when his administration took over.
But these lines are few in number and some of them have been contaminated. Many hope that the next President will reverse Bush's policy so that the federal government can join private financiers, individual states like California and New York and other nations in providing funding.
Meanwhile a number of researchers who are looking to other sources in order to circumvent the ethical controversies are having some success. Stem cells acquired from adults can be "reversed engineered," to use a term I incorporate from other discussions, to function in important ways like those from embryos. Although this is a promising alternative, Reece asserted that embryonic stem cells remain "the gold standard."
Not looking to them has several "opportunity costs," he stated. Over time more patients are likely to suffer and die and the financial expenses of caring for them will soar. Also, more indirect "human costs," that are real even though they are less able to be quantified, will ripple through society. We need informed and responsible ethical positions, he stated.
Reece held that the conclusions toward which a group of Seventh-day Adventist specialists have been moving is "subtle, balanced and middle of the road." This emerging stance holds that attempts to acquire stem cells from other sources should continue but that acquiring them from embryos should be limited to techniques that neither harms nor kills them.
This startled some in the audience because many all over the world have taken it for granted that acquiring stem cells from embryos inevitably compromises their well-being. How could it be otherwise?
Reece countered that it increasingly appears that very early on scientists can remove one cell from the developing cluster without harming the others. Indeed, in a dramatic flourish, he read to the audience from the Internet a report in the Washington Post for January 10, which was published just a few hours before he began his Loma Linda lecture, that scientists "have created several lines without harming embryos." How could anyone be more up-to-date than that?
So far my reactions to these remarkable events are mixed. On the one hand, I admire the tenacity and ingenuity of the scientists who are doing everything they can to get around the ethical debates and the restrictions by President Bush they prompted. On the other hand, their impressive and successful efforts, which may not have occurred were it not for the ethical controversies, strike me as only postponing the larger and more basic question: What are we ethically permitted to do with our thousands of frozen embryos, or "pre-embryos" as many prefer to call them?
So far we have three primary alternatives. One is to discard them. Another is to find couples who are able and willing to adopt them. And a third is to "store them indefinitely." A fourth alternative gives me pause. This is to refuse to discard any frozen embryos but to allow them to be transferred to another fertility clinic where that will.
There is some precedence even for this, however. For many years some physicians who have declined for ethical reasons to do certain procedures have referred their patients to other competent doctors who will. Some physicians who will not perform abortions do this with clear consciences, for example.
Using the terms in their most literal meaning, I find it helpful to distinguish between "possible" human persons and "potential" ones even though we often use these words interchangeably. I reserve the term "potential" for (1) ova that (2) have been fertilized by sperm and (3) have successfully implanted in a human uterus or, perhaps eventually, its artificial substitute.
By themselves sperm and ova are "possible" but not "potential" persons because they lack the inherent power to continue through the pregnancy. I would say the same thing about a fertilized ovum that has not successffully implanted. It, too, is a "possible" but not a "potential" human person.
This is why I have no unconditional moral objection to IUDs or other contraceptive measures that hamper implantation. And this is why I have no categorical objection to acquiring stem cells from microscopic pre-embryos before they have implanted. But the discussion continues!