Why on earth would we want to "Recapture the soul of bioethics"???

Dianne N. Irving
Copyright May 26, 2009
Reproduced with Permission

It continues to be exceedingly embarrassing to have to point out fundamentally gross historical and theoretical errors in much of what passes as "scholarly" Catholic literature these days. But given that such mistakes can have exceedingly far-reaching and destructive and deadly consequences, it needs to be done.

Consider a recent article entitled, "Making sense out of bioethics: Recapturing the soul of bioethics" (Father Tadeusz Pacholczyk, National Catholic Bioethics Center). One truly and genuinely has to wonder where this author has been for the last 30 years. Bioethics is not Catholic ethics - and any feeble attempt to "convert" secular bioethics to Catholic medical ethics is a total exercise in futility and wishful thinking. Rather, bioethics is the newest of dozens of different kinds of ethics. It was created out of thin air in 1978 by 11 politically appointed people (most of whom had no academic degrees in philosophy or ethics), by mandate of the U.S. Congress with their Belmont Report. It never did have a "soul" - at least not the kind that Catholics talk about. The concern is that Catholics will not "convert" bioethics; rather, bioethics will "convert" the Catholics. The worst possible thing would be to "recapture" bioethics unethical ethical norms!

Yet we are "instructed" in the article that, "Modern bioethics seems to be going through a kind of identity crisis. ... Rather than examining and rejecting certain poor choices that may have been made in prior years, and trying to regain lost ground, bioethicists today unwittingly continue to grease the slippery slopes by their lack of courage in disavowing some of the unethical practices they have aided and abetted in the past."

Identity crisis? Excuse me, but perhaps a trip to the Kennedy Institute of Ethics Library or to the Hastings Center might be in order. Modern bioethics is not going through any identity crisis whatsoever, and has always deliberately greased such "slippery slopes" - from their very beginning. And they would hardly characterize their past as "making poor choices". Those "choices", they would point out, were duly based on the bioethics principles created out of thin air in the Belmont Report: autonomy, justice and beneficence (non-maleficence was later dropped) - "for the greater good". Note also that the definitions of those bioethics principles were very odd and strange indeed - very utilitarian, with a "twist". And as for greasing slippery slopes, the bioethics literature over the past 30 years is replete with articles, books, journals, etc., plying such ware. Not new! A trip to the library is in order.

With this new "bioethics" and its ethical "norms" came the very foundation for IVF (addressed in this NCBC article) and other ARTs, human embryo and human fetal research, human cloning, human embryonic stem cell research, all manner of genetic engineering (including OAR, ANT, iPS and other genetic research), etc. Likewise, the scientifically erroneous definition of "cloning" only in terms of SCNT - as Fr. Tad defines it in this article (and in others) - was created out of thin air by these very same bioethicists. Search the PubMed literature and you will find thousands of articles explaining dozens of different kinds of cloning techniques - chief among which is "twinning" (or, blastomere separation, blastocyst splitting, embryo multiplication, or however else you want to camouflage the language). And note that "twinning" is the long-established preferred cloning method used in IVF and other ART centers for "infertility treatments" and in their laboratories for creating "research embryos". Lots of dots to connect there.

As one of the few with a Ph.D. concentration in secular bioethics from the Kennedy Institute of Ethics at Georgetown University, and as a member of the first formal graduating class in bioethics (we were called the First Generationers), we too found bioethics compellingly erroneous - principles and all. This finally prompted me to write a very long analysis and evaluation of bioethics - both its theory and its practice. This article, with quite extensive historical references, has been out there for a long time now, and many other writers have also commented in depth on the disaster that bioethics is. For this very in-depth analysis of bioethics, see Irving, "What is 'bioethics'?" (June 3, 2000), UFL Proceedings of the Conference 2000, in Joseph W. Koterski (ed.), Life and Learning X: Proceedings of the Tenth University Faculty For Life Conference (Washington, D.C.: University Faculty For Life, 2002), pp. 1-84, at: http://www.lifeissues.net/writers/irv/irv_36whatisbioethics01.html. For a shorter version of it, see Irving, "The bioethics mess", Crisis Magazine, Vol. 19, No. 5, May 2001, at: http://www.lifeissues.net/writers/irv/irv_37bioethicsmess.html.

The NCBC article ends by again reminding us that, "Bioethics is an exceedingly important discipline for the future of our society, addressing critical issues in science and life. This discipline cannot afford to compromise its integrity as new controversies arise, ...". The historical fact is that bioethics never did have any integrity and can hardly be blended with Catholic medical ethics. In another article, I tried to compare secular bioethics with Catholic medical ethics so that Catholics would not be blind-sided by this new "ethical" theory:

Consider for a moment the strikingly different conclusions they reach. Secular bioethics considers the following as ethical: contraception; the use of abortifacients; prenatal diagnosis with the intent to abort defective babies; human embryo and human fetal research; abortion; human cloning; the formation of human chimeras (cross-breeding with other species); "brain death"; purely experimental high risk research with the mentally ill; euthanasia; physician-assisted suicide; living wills documenting consent to just about anything; and, withholding and withdrawing food and hydration as extraordinary means. In contrast, Roman Catholic medical ethics, as expressed in the National Conference of Catholic Bishops' Ethical and Religious Directives for Catholic Health Care Services, considers all of these unethical - with the possible exception of the use of "brain death" criteria (and some Catholic theologians are now becoming concerned about that as well). Probably the only issues on which they both agree is that the use of extraordinary means, e.g., a ventilator, is not morally required if a treatment is medically futile, and that even high doses of pain medication may be given if medically appropriate. How is it that these two ethical systems lead to such opposite and contradictory conclusions? It is because their conclusions flow necessarily from very different ethical principles, or premises. [Irving, "Which ethics for the 21st century? A comparison of 'secular bioethics' and Roman Catholic medical ethics" (March 14, 1999), Linacre Quarterly, at: http://www.lifeissues.net/writers/irv/irv_02ethics1.html; see also Irving, "Which ethics for science and public policy?", Accountability in Research 1993, 3(2-3):77-99, at: http://www.lifeissues.net/writers/irv/irv_42whichethics1.html.

But because the new bioethics is, as we grad students used to say, "federal ethics", it spread rapidly around the world. It is now concretized in almost a thousand Bioethics Centers now (check out the latest numbers with the KIE Library) - and I assure you, by "bioethics" they do not mean "Catholic medical ethics" in any way, shape or form. It is also now concretized in thousands of laws, regulations and treaties around the world - soul-less or not.

Yet so many Catholic scholars seem to think there is little difference between bioethics and Catholic medical ethics. I wonder why? It is logically and theoretically impossible to merge the ethical norms of bioethics with those of Catholic medical ethics. And such myths are hardly to be considered "education". So what's up???


by Father Tadeusz Pacholczyk, Director of Education at The National Catholic Bioethics Center

May 2009

Making Sense Out of Bioethics: Recapturing the Soul of Bioethics

Modern bioethics seems to be going through a kind of identity crisis. With ethicists available for hire, drug companies and biotech firms have easy access to "experts" who can provide them with the veneer of respectability if they decide to head in the direction of unethical science.

Erwin Chargaff, a pioneer in the field of biochemistry, once quipped that, "Bioethics didn't become an issue until ethics started being breached. Bioethics is an excuse to allow everything that is unethical." One common approach to allowing the unethical is to claim that, "We have already made certain choices, and now we really must move on to the next step - we must yield to the inexorable progress of science."

Rather than examining and rejecting certain poor choices that may have been made in prior years, and trying to regain lost ground, bioethicists today unwittingly continue to grease the slippery slopes by their lack of courage in disavowing some of the unethical practices they have aided and abetted in the past.

Today, for example, we see enormous pressure on the public to support embryo-destructive stem cell research. Where do the embryonic humans come from that are to be destroyed for this research? They come from in vitro fertilization (IVF), a practice very few bioethicists have been willing to confront or challenge. IVF has become a kind of "sacred cow" that few outside the Catholic Church are willing to question. Yet it requires very little ethical reflection to see, for example, how making "extra" embryos during IVF and freezing them is a grave moral problem.

Relatively few countries (among them Italy and Germany) have legal restrictions regarding IVF. In Italy, it is illegal to freeze embryos, and whenever you do IVF, you are not permitted to make more than three embryos at a time, all of which must be implanted into the woman. Germany has a similar law, and the country has almost no frozen embryos as a result. Such a law is a straightforward attempt to limit some of the collateral damage from IVF, and any reasonable person can see the benefit of enacting such legislation.

But in the United States, we face what has been termed the "wild west of infertility," where few regulations of any kind exist and close to half a million frozen embryos are trapped in liquid nitrogen tanks in fertility clinics. As couples get older and no longer intend to implant their own embryos, researchers begin to clamor for those embryos to use in their research experiments. Bioethicists and politicians then further muddy the waters by suggesting that "they are all going to be thrown away anyway," which is neither true nor morally relevant. Even when somebody else will perform the dastardly deed of destroying a group of humans (discarding them as medical waste), that does not suddenly make it OK for me to choose to destroy them with my own hands.

Here we have a perfect opportunity for some serious introspection about the mistakes of the past, an opportune moment to limit some of the collateral damage from IVF through laws like Italy's and Germany's. Yet one finds very few bioethicists willing to step up to the plate to tackle such an unpopular topic.

As the biotechnology juggernaut forges ahead with minimal ethical oversight, additional concerns quickly arise. Embryonic humans who will be sacrificed for research can be created not only by IVF but also by cloning (SCNT: somatic cell nuclear transfer). But in order to clone, you need women's eggs. Currently, women can be paid significant sums of money to "donate" their eggs to infertile couples who will use them for IVF.

However, if they donate their eggs to science, for purposes of research cloning, they generally cannot receive payment except for incidental costs like travel expenses to get to the clinic. Hence, when donating eggs for fertility treatments, a woman can earn as much as $20,000 or even $30,000. If she donates her eggs to science for research purposes, on the other hand, she receives nothing.

An article in March of 2007 in the New England Journal of Medicine refers to the "central contradiction" of this situation: "...in the United States, we already allow women to 'donate' their eggs for profit. We allow them to undergo the same procedure and to undertake what is arguably a far more emotional endeavor - passing their genes to a child they will never know. How can we conclude that providing eggs for reproduction is less exploitative or dangerous than providing them for research? We can't."

The outcome of this line of thinking is that a growing number of bioethicists are recommending policy changes so that women can also be paid when their eggs are harvested for research. This assures "that science can go forward." A proper ethical analysis of this question, however, would mean promoting exactly the opposite position, namely, that women (and men) should never be paid for their egg or sperm, as we insist they not be paid for organ donations. This is done to prevent the human body from becoming "commodified" by powerful economic and market forces, and to stave off the prospect of trafficking in human parts.

Additionally, there are known risks associated with harvesting a woman's eggs. Five women are reported to have died as a result of egg harvesting in the United Kingdom, and between 0.5 to 5% may typically have side effects of some kind, ranging from respiratory distress to renal failure. Providing payment for eggs is essentially a form of coercion, encouraging women to be reckless with their own bodies. Here again, we encounter a unique opportunity to insist on a thoroughly ethical approach for the future, by banning the sale of human gametes and acknowledging that past practices have not been ethical. Yet few bioethicists seem willing to broach the topic.

Bioethics is an exceedingly important discipline for the future of our society, addressing critical issues in science and life. This discipline cannot afford to compromise its integrity as new controversies arise, selling its soul to the highest bidder or playing to powerful special-interest groups like universities or biotech companies.

Only by rejecting the demands of expediency and courageously acknowledging past mistakes can it regain the kind of principled moral foundation and credibility it needs to effectively assist scientists, medical professionals, and researchers in the future.

Father Tadeusz Pacholczyk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, MA, and serves as the Director of Education at The National Catholic Bioethics Center in Philadelphia. See http://www.ncbcenter.org.