[Originally titled, "The woman and the physician facing abortion: The role of correct science in the formation of conscience and the moral decision making process", and published in the Proceedings of the Scientific Congress, "The Guadalupan Appeal: The Dignity and Status of the Human Embryo", Mexico City, Mexico, October 28, 1999, Libreria Editrice Vaticana; Linacre Quarterly (Nov.Dec. 2000); slightly updated and edited here for clarity; footnote references provide a mini-historical summary of how the issue has evolved since the "birth" of secular bioethics by the U.S. Congress in 1978. No room for more current references, but for those please see Irving, "Playing God by manipulating man: Facts and frauds of human cloning" (October 4, 2003), at: http://www.lifeissues.net/writers/irv/irv_22manipulatingman1.html. -- DNI]
"Consider the young teenagers or college students in today's society -- let's say they are all basically good and decent people -- male and female -- and all come from loving, caring, practicing Catholic families. We'll call one of them Margaret. For whatever reason, Margaret suspects that she might be pregnant, and being the honest and diligent person she is, she sincerely begins to try to inform her conscience so that she can make a morally right decision about whether or not to seek out "emergency contraceptives". She starts this process by seeking the advice of others whose counseling, knowledge and work she respects and trusts."
One of the most urgent yet least discussed dilemmas concerning the woman, the physician, and a host of others facing abortion and counseling today is access to the correct basic scientific information regarding the human embryo -- scientific information which demonstrates empirically that in sexual human reproduction normally every human being begins at the beginning of the process of fertilization as a single-cell embryo, the penetrated oocyte.1 Without this correct scientific information we are all precluded from providing sound advice in counseling, forming our consciences correctly2 or making morally correct decisions3 about abortion, human embryo research, human embryonic stem cell research, cloning, formation of interspecies chimeras, germ-line DNA recombinant gene research and therapy, and other related current medical and scientific issues.4 The use of the correct science is indeed the starting point for thinking about all of this.5
One philosopher's favorite dictum would seem quite appropriate here: "A small error in the beginning leads to a multitude of errors at the end" (paraphrased).6 Nowhere is this more fundamental than here. Any error in the science will have a rippling effect on the philosophical anthropology,7 ethics,8 sociology, politics, law, and theology -- degrading our knowledge and understanding of the real dignity and status of the human embryo. To complicate the matter further, also facing us is the fact that the human embryo is per se a multi-faceted creature, and thus must be studied from the perspective of several different academic disciplines simultaneously.9 Even one's choice of philosophical schools to use (e.g., rationalist, empiricist, idealist, realist, existentialist, etc.) alone can be problematic, as each defines "being" differently (and therefore "human being" and "material being" differently),10 and uses different starting points and criteria of truth -- hence arriving at different conclusions about reality.
This is not, however, to be taken as an excuse for claiming that we can never know "reality", that all philosophies are relative, or simply "different ways of looking at the same reality". Rather, it would be more to the point to say that some philosophies match reality and some don't; some philosophies are actually looking at quite different realities or cosmologies than others; and some philosophers are right and some philosophers are wrong -- not a particularly "politically correct" statement, but true nonetheless.
A realist philosopher's starting point for doing philosophy at all is a posteriori (outside the mind), i.e., in our experiences of material things (or natural philosophy)11, rather than starting with purely subjective ideas in the mind. Thus all concepts are originally derived inductively, and must correspond with or match the material things outside our minds which caused those concepts in order to be judged as true.
This is so as well for St. Thomas' philosophy (on whose holistic philosophical anthropology, among others, many of the Church's teachings and documents are philosophically based),12 including his philosophical anthropology. For him a "human person" is defined as one single whole multi-faceted composite substance of 3 different principles or causes: immaterial form (the rational soul, which always contains virtually the sensitive and vegetative powers), "undesignated matter" (the human body), and esse (the act of existing of this one human substance).13 The name of "person", St. Thomas states, does not refer to the rational soul alone, nor to the whole soul alone, but to the entire subsistens -- that is, the soul (form), body (matter), and act of existing (esse) all together as one whole existing human substance.14 Thus the whole existing human substance is one person for St. Thomas -- no splits, either within the soul itself, or between the whole soul and the body. Further, every human person is simultaneously a human being, and vice versa, since it is through the whole rational soul that a human body is specifically human, and animated (i.e., alive, existing).
But because of its multi-faceted composition, in studying each one of these several facets of a human person it is necessary and essential to use the content of different academic "sciences" and therefore different epistemologies or methods, in the process. Thus the question as to when a human person begins is a philosophical (or using a different discipline, a theological) question -- and a realist philosopher would begin by deriving his or her philosophical concept of "person" inductively from the correct natural philosophy, which in turn is derived from the correct basic sciences. The question as to when the physical material dimension of a human being begins is a strictly scientific question, and it is the basic science of human embryology which properly studies this question, because it alone has the proper subject matter and epistemology to do so.
Today, however, the very content or subject matter of the basic sciences has been corrupted,15 in turn leading to the use of the wrong epistemologies or methods, in turn leading to the wrong "scientific" conclusions about whether or not the human embryo or fetus are in fact human beings, and when these human beings begin their lives as individual persons.
To know that the human embryo is indeed a personal human being16 is central to forming our consciences, and therefore to knowing what actions are right or wrong in a specific situation. While conscience is the subjective norm in philosophical natural law theory, it must be a correctly formed conscience -- one in accord with objective reality and objective truth17 -- starting with and including this objective scientific truth. Thus any scientific error in this regard precludes us from forming our consciences correctly.
An erroneous conscience literally enslaves us, and erodes our freedom.18 Much of the error is usually referred to as "culpable" ignorance -- things we can do something about, and therefore for which we are responsible and accountable. But what I am pointing to is "inculpable" ignorance -- things we really can't do anything about -- such as access to the correct basic scientific information about the human embryo in order to inform our consciences correctly.
The moral decision making process itself is also therefore corrupted. Although the moral and theological virtues are critical in the moral decision making process,19 the intellectual virtues are the starting point for this process.20 Yet they too seem to be frequently neglected in these discussions -- especially the intellectual virtue of "science".21 Given that it is the intellectual virtues which in general help us attain correct information as to what the good (end) is that we should desire, the intellectual virtue of scientia also helps us to think well, e.g., to know our material reality correctly -- including at least what the physical material dimension of a human embryo is and when it begins to exist. Thus knowing that correct scientific information is part of the very starting point of the moral decision making process facing the mother, the physician and a multitude of others. This right starting point, in turn, is essential for rightly deliberating about the means to our good (end), choosing those means, willing them, and performing such actions as are necessary to reach our proper human end or goal. So any scientific error in the beginning of this moral decision making process also precludes us from making morally correct decisions in the end.
Even given the very best of scenarios, it is next to impossible these days for anyone to acquire the proper and correct basic scientific information about when the physical dimension of the human embryo or fetus begins to exist -- a situation due mostly to the inordinate influence of the scientific fraud so prominent in the secular (and even "prolife") bioethics22 and related literatures -- a real cacophony of chaos -- which has been silently foisted upon the rest of us and now pervades our entire societies. And it is not just "the woman" who is a victim.
Consider the young teenagers or college students in today's society -- let's say they are all basically good and decent people -- male and female -- and all come from loving, caring, practicing Catholic families. We'll call one of them Margaret. For whatever reason, Margaret suspects that she might be pregnant, and being the honest and diligent person she is, she sincerely begins to try to inform her conscience so that she can make a morally right decision about whether or not to seek out "emergency contraceptives".23 She starts this process by seeking the advice of others whose counseling, knowledge and work she respects and trusts.
Based on recent "scientific" articles and documentaries in the media24, her parents are convinced that whatever is there is "just a bunch of loosely connected cells that don't know how many people they will be yet", so it is really "OK" and prudent to take those "morning-after" pills. Her grandparents reluctantly concur, embarrassed that they are not up on the most recent cutting edge scientific advancements which prove that it is just a "piece of the mother's tissues". Her boy friend is convinced that it is just simply a "neutral blob". And her big sister teaches her that in terms of evolution it is probably still just a mouse, a fish, or a frog. Even her family lawyer assures her that it is just a piece of her own tissues, a part of her body, her own personal property that has "symbolic value" only25 -- and, she reminds Margaret that abortion is legal now. The only viable issue left is "choice".
The health clinic nurse in her high school instructs Margaret that pregnancy doesn't even begin until "conception", i.e., which takes place, she explains, when the "egg" implants into the uterus (5-7 days post-fertilization).26 And if a condom was used she could not even get pregnant. Just to make sure, the nurse had slipped her a fresh supply of "morning-after" pills -- for emergency use only, of course. Her local pharmacist assures her that "morning-after" pills are only contraceptive, and definitely never abortifacient -- or so the pharmaceutical companies had assured him27. Even her sociology professor assures her that ridiculous claims that this could be a real human being are just remnants of a passe cultural or obsessive religious cult "belief system".
In her high school library Margaret nervously scans the pages of the various medical textbooks, and the numerous pamphlets from Planned Parenthood -- no sign anywhere that what she might be carrying now inside of her is a real human being yet. Same with the one medical textbook she grabbed from the shelf in the medical school library down the street.28 She checks the internet and pulls up the web site for the National Institutes of Health (NIH), clicking into the page where information is provided to the researchers and the public about human embryonic stem cell research. There she finds the official testimony of the Director of NIH to the United States Senate: these early "entities" are only totipotent stem cells, not a human being; a human being doesn't even exist until after birth and young adulthood.29 The Senators and their staff race off to spread the good news to other Congressmen and their staffs, and even hold several press conferences to "educate" the public.
Further checking at the Kennedy Institute of Bioethics Library at Georgetown University in Washington, D.C. -- the only source of "ethical" information feeding into the National Library of Medicine and NIH for researchers and interested others from around the world -- confirms that not only is there is no human being there, there is no human person there yet either. It is just a "potential person" -- so all the bioethics and philosophy articles seemed to say.30 "Phew -- where are those pills?" Margaret sighs. Oh, no -- they are all mixed up in her pocket now with the ones for sexually transmitted diseases (which she also recently contracted).31
Margaret seeks the advise of her family physician, who quickly confirms to her all of the above.32 "Not to worry," he advises her, as he helps her sort out the pills. "That's all absolutely correct scientific information -- the very latest from our professional medical associations!" "Besides," he smiles reassuringly, "these 'morning-after' pills are essential for 'emergency contraception'. After all," he reminds her, "you do want to be able to go on to college next fall, don't you? Trust me," he winks, as he urges her to quickly take those "morning-after" pills, before it is too late -- although she could still elect for an abortion later if it is.
The most comforting of all, as always, is her pastor. He assures her that there is nothing there but a "pre-embryo",33 -- or even one of those tiny "pre-zygotes" -- hardly a human person with an immortal soul! "Right now all that is there is just a sort of 'vegetable', with a vegetable soul," he explains to her. "The rational soul can't be infused by God until the matter is 'appropriately organized' -- about 14-days after fertilization. After that, twinning cannot take place, he asserts, so then God is sure, and finally agrees to slip the rational soul right in there and create a real live human person. How else would theologians ever be certain about how many souls there were there to baptize?," he quips with amusement. "Besides," he advises her, getting serious, "theologians tell us that only the cells from the inner layer of this 'pre-embryo-thing' become the later fetus and adult human being, not the cells from the outer cell layer. The cells from the outer cell layer are the ones that are all discarded after birth. That's why it is perfectly fine to use those 'morning-after' pills," he assures her. "They would only attack the outer cell layer, not the inner cell layer from which the real human being will later arise. No," he concludes pensively, "a real person would not be so totally disconnected and confused. This 'pre-embryo' or 'pre-zygote'-thing' must just be sort of like a 'being-on-the-way'34 -- just a potential human person. So, Margaret, either the 'morning-after' pills, or later even abortion, would be morally acceptable -- given the proportionate circumstances and intentions, of course".35 Thanks to modern science," her spiritual advisor advises, "we pastors can be much more pastoral these days. Why even the Church recognizes this "pre-embryo" thing in Donum vitae, so even the Church is finally "getting with it," he mumbles. "No guilt, my child. Go in peace."
Finally, assured by every kind of personal friend, family, and professional expert from whom she could possibly seek advice, Margaret is truly convinced that this "thing" inside of her is essentially insignificant and has no inherent or real value. The only "choice" left for her to make is whether she takes the "morning-after" pills now, or waits a while and give her legal "informed consent" for an abortion. "How silly of me," she reproaches herself. "And to think, I had actually almost decided to call him Baby John!" Margaret takes the pills. The deed is done. Her conscience is quite clear. No guilt36.
This scenario would be funny if it were not repeated a million times a week around the world. Virtually all of the basic "scientific" facts of human embryology provided to all of these victims are false. Contrary to reports in the media, and contrary to such "scientific" claims in the literatures of Planned Parenthood, the pharmaceutical industry, medical and research professional organizations, governmental institutions, bioethics textbooks and journals, laws, regulations, international guidelines, and pastoral and theological "debates", the early human embryo is not "just a bunch of loosely connected and confused cells that don't know how many people they will be yet", "a neutral blob", "a piece of the mother's tissues", a "seed-on-the-way", a "fish-on-the-way"37 -- or a "pre-embryo". None of these claims have any bases in the objective scientific facts of human embryology. There is no such thing as a "pre-embryo", and the term itself is specifically rejected by human embryologists, as well as by the international nomenclature committee on human embryology.38
Furthermore, if fertilization has already taken place, the "morning-after" pill, or "emergency contraception", could possibly be abortifacient if ovulation and fertilization have already taken place.39
Every individual human being produced via normal sexual reproduction begins as a human embryo at fertilization40 -- when normal pregnancy actually begins41 -- or in in vitro fertilization, with the initial fusion of the sperm and the oocyte. This is not just a "faith position", a "personal opinion", or a "pro-life radical's" misguided fantasy. This is an objective scientific fact -- Biology 101 -- agreed to by every human embryologist around the world. Like 2 + 2 = 4.
At fertilization the matter is "appropriately organized",42 and this single-cell human embryo -- in vivo or in vitro -- is an already existing human being,43 with his or her own unique genetic composition (from both the mother and the father), genetically already a girl or a boy.44 Immediately this tiny human being directs his or her own growth and development.45 The embryo grows continuously from a single-cell embryo, to the 12-16 cell morula stage, to the 5-6 day blastocyst stage, and on. The whole embryonic blastocyst is the human embryo (the human being), not just the cells from the inner cell layer.46
Specifically human proteins and enzymes are produced,47 and later specifically human tissues and organs are formed -- long before some isolated "pure rational soul" might be "infused" to try to direct such operations and functions. All biologists know empirically that function does follow being (or form).48 Therefore these specifically human functions and activities could only be produced by a human agent, a human being (i.e., who must possess a human rational form -- which form itself cannot be divided, or exist separately from the body). We also know empirically that carrot and frog enzymes, proteins, tissues and organs are not produced, and that carrots and frogs do not produce specifically human enzymes and proteins, organs and tissues!
If there is a human being there, which the correct basic science surely demonstrates, we can reason directly from these correct objective scientific facts to the realist philosophical conclusion that there must be simultaneously a human person present as well -- whole soul, body and esse in ONE single composite human being. There is no such thing as a pure "rational soul" alone; the rational soul must always contain virtually the sensitive and vegetative powers, and must always exist in one composite with the material body. If the vegetative powers are empirically observable, which they are, then the sensitive and rational powers must also be present as well.49
Probably the most influential argument for "delayed personhood" has been the "individuality" argument of McCormick and Grobstein that grounds their concept of a "pre-embryo"50 . There may be a human being present at fertilization, they claim, but it is just a "genetic" individual, not a "developmental" individual, i.e., a person. Only a "developmental" individual can be a person, i.e., when the rational soul can then be infused. They base this "developmental individuality" claim on their following interpretation of "human embryology": These early entities, they claim, are just a "loose collection of cells" which "have not yet made up their minds as to how many individuals they will become". There are two essentially independent and separate layers in the blastocyst, they state, but only the inner cell layer (embryoblast) is the source of cells for the real future fetus and future adult human being. The cells of the outer cell layer (trophoblast) are the only ones discarded after birth as the placenta, etc, and none of these cells ever become part of the future embryo or fetus, etc. Also, twinning can still take place before 14-days, they claim, producing more than one individual. So there is no developmental individual there yet -- which means that there is no human person there yet. At 14-days the primitive streak begins to form, and twinning cannot take place any more. It is only then that there is finally a "developmental" individual present, and therefore a person there. So for McCormick and Grobstein, the developing human embryo up to the 14-day biological marker is not a person yet, but instead is a "pre-embryo".
In sum, the "pre-embryo" is "human", and a genetic individual, so therefore it deserves "respect". But the "pre-embryo" is not a developmental individual yet, and therefore not a human person yet - it is just a "potential person". So it does not deserve the same respect as that due a real human person. Therefore it can be used in experimental human embryo research, cloning, some abortifacients are allowed, etc. -- for "proportionate reasons", of course.
However, this "human embryology" is erroneous and seriously misconstrued. No human embryologist would agree with such an interpretation. For example, the cells of the early human embryo are not so "loosely connected", but in fact are biologically all part of one and the very same whole individual human organism. Nor are they so psychologically "confused" and "undecided". And to cast the early blastocyst as essentially consisting of two separate, disconnected and isolated cell layers is empirically incorrect. There is constant and continuous interaction between and among the cells and tissues of the developing human being at any one time right from the beginning.51 Nor it is true that only the cells from the outer cell layer of the blastocyst are discarded after birth. Many of the tissues discarded after birth are derived from the inner embryoblast cell layer.52 And cells from the outer trophoblast cell layer do become part of the embryo (e.g., the blood cells derived from the chorion, which originates from the outer trophoblast layer of the blastocyst). Nor are the cells of these two layers necessarily naturally "fated" to be one kind of cell or another.53
Furthermore, the dramatic experiments with Dolly the sheep, and those using adult stem cells in both medical research and therapy (including humans) have clearly demonstrated that the "fate" of any cell in the human body is capable of being artificially diverted, converted, and "de-programmed" back to even the single-cell embryonic zygote stage. As reported in a recent article on adult stem cell research using mice:
In a bizarre experiment that demonstrates the surprising plasticity of the body's cells, scientists have converted mice's brain cells into blood cells ... [U]ntil now, the stem cells were thought to be committed to their own organ type and unable to cross over. ... A team of Italian and Canadian scientists, led by Angelo L. Vescovi ... in Milan, has now found that the neural stem cells can metamorphose into the blood-making stem cells of the bone marrow. ... The conversion of neural stem cells into blood cells is particularly surprising because brain and blood come from different germ layers created in the early embryo. ... The brain develops from the ectoderm and blood from the mesoderm. Dr. Vescovi's work defies the widely held assumption that cells in the three lineages are permanently committed to their fate. ... Dr. McKay said the new result showed that differentiation, the commitment of a cell to a specific fate, is not irreversible.54
These startling current experiments continue to be rapidly reported, and surely cast profound doubt on any further claims such as McCormick's and Grobstein's that the two cell layers of the blastocyst are so "isolated" and so permanently "fated",55 -- either naturally or artificially.
Furthermore, twinning can take place after 14-days and the formation of the primitive streak,56 as in Siamese twins and in fetus-in-fetu twins (which can form many weeks, indeed months, after the 14-day marker). And about one third of monozygotic twins are formed before the 14-day marker.57 Would they not be persons -- then, or now? No need to baptize them either? And what about twins who form after the 14-day marker -- are they also not persons either?
Why the phenomenon of "twinning" has taken on such gargantuan proportions is surely an enigma -- especially among theologians. The response in biological terms is rather simple. In monozygotic twinning, the first twin begins to exist at normal sexual fertilization -- in vivo or in vitro. Since the twinning process itself is an asexual process of reproduction, the second twin begins to exist at fission, when the cells of the original embryo are split off -- naturally or mechanically. Because the cells of this early embryo are "totipotent", the embryo has a built-in mechanism of repair and survival in the event of such injury. Thus under normal conditions, the first "twin" begins at fertilization as a human being (human person), and the second twin begins at fission (when the "matter is appropriately organized) as a human being (human person). It is really no more complicated than that.58
If McCormick and Grobstein (and all those who follow them) ground their "philosophical" (or theological) concept of "pre-embryo" on so much erroneous "human embryology", then the very concept of the "pre-embryo" itself is rendered completely and totally invalid -- as well as their justification for using live human embryos in any experimental research.
I would seriously suggest that in these arguments of McCormick and Grobstein -- as well as in all of the other arguments for "delayed personhood" -- certain kinds of philosophical, theological or political concepts have simply been imposed on the empirical human embryological data, and if the data don't fit these preconceived concepts, then the empirical data are simply changed and manipulated accordingly. Considering the evidence, it would seem that a lot of documents, regulations, laws, professional codes, pharmaceutical licenses and literatures, national and international guidelines, standard medical treatments, IVF procedures and patient information literatures, pastoral directives, and bioethics textbooks and journals need to be cleaned up!
If we, as individuals in our personal lives, and as experts in our various professional fields, are so systematically precluded from knowing correctly these basic human embryological facts, this surely renders us schizophrenic between our lived experiences and our abilities to think and act well. The basic objective scientific truth is that these tiny vulnerable helpless defenseless human embryos are indeed real live human beings, and therefore real live human persons.
Without knowledge of this objective truth, how can we possibly form our consciences correctly or make good moral decisions in the face of abortion or human embryo research? How are advisors to counsel and minister to us truthfully and objectively? How are we to make, or help others make, these very complex and difficult choices? How can societies come to grips with this simple objective reality, or legal systems interpret the "common good" correctly,59 or vigorously protect all of its citizens? How are we to recognize this tiny human being as our neighbor -- someone to love not just for his or her own sake, but also for the sake of God -- Who Himself created this tiny child in His own image and likeness, from whence comes this child's true dignity and status?60 He has commanded us to "choose life". But how are we to usher in the "culture of life", when we cannot even define "human life" correctly ourselves, and therefore know how to think and act correctly towards this life? We have ample historical examples of the kinds of devastations that flow from the de-constructions and re-definitions of vulnerable "human beings" -- deceiving us with an arbitrary and fabricated two-tier caste of humanity to be eagerly relished as "objectively true".61
Nowhere is the need to evangelize greater in our contemporary technological society than in the basic sciences -- not only for the personal conversions of these scientists, but also to appeal to them to at least remain intellectually honest in their chosen fields of science, regardless of outside political or economic pressures.62 Margaret, her parents and grandparents, her sister, her boy friend, media professionals of all types, physicians, nurses, all health care workers, pharmacists -- teachers and professors in the lower schools, high schools, colleges, graduate, medical, nursing and dental schools -- social workers and sociologists, lawyers, judges, public policy makers, Congressmen, institutional leaders, librarians, bioethicists, philosophers, parish priests, nuns, theologians -- and even other bench researchers in the same or different fields of science -- all depend on their intellectual honesty. So does Baby John. A small error in the beginning has certainly led to a multitude of errors in the end.