A One-Act Play: "Crippled Consciences and the Human Embryo"

Continuation: Dr. Human Embryology

Dr. Human Embryology: With pleasure, Mr. Chairman.11 There are two basic categories of cells in the human organism: somatic ("body") cells, and germ line ("sex") cells.12 During very early human embryonic development, primitive germ line cells are initially totipotent,13 and they are diploid, i.e., they each have "46" chromosomes" (and thus they too can be cloned). So before fertilization can take place, the number of chromosomes in each germ line cell must be cut in half through the process known as gametogenesis -- which can ultimately take decades to accomplish. The final effect of gametogenesis is the production of haploid "sex gametes", the sperm and the oocyte, which have only "23" chromosomes in each cell (although the oocyte's chromosomes are not halved until it is fertilized). Once gametogenesis has taken place, then fertilization is at least scientifically possible. During the process of fertilization, the sperm and the oocyte fuse, and each ceases to exist as such. Rather, a new single-cell human being is produced. This is a sexual method of human reproduction, but there are also a-sexual methods of human reproduction that are involved in our debates here this evening, and need to be distinguished.

Sexual reproduction (e.g., in fertilization) and a-sexual reproduction (e.g., in cloning) involve several different, even opposite, biological processes. I like to use the analogy of the "zipper". Think of the process of sexual reproduction roughly as predominantly a sort of "zipping up", and that of a-sexual reproduction as predominantly a sort of "zipping down".

For example, in sexual reproduction, this new single-cell human being contains all of the genetic information it will ever need. No genetic information is lost or gained during growth and development; this information is only turned on or turned off, depending on what products are needed. This process is called "methylation", and the more specialized or differentiated a cell becomes the more methylation of the DNA has taken place.14 The products formed by means of the genetic information in each cell then cascade15 down throughout the life of the organism. This is "zipping up". Scientifically, empirically, we know that immediately at fertilization species-specific human proteins and enzymes are produced, and species-specific human16 tissues and organs will be formed. We also know empirically that carrot, corn, frog, or monkey proteins, enzymes, tissues, or organs, are not produced.

In a-sexual reproduction, such as cloning,17 many of these processes operate in reverse. One begins with a specialized or differentiated cell, in which some or even most of the DNA in that cell has been "silenced", and then the methylation bars on that DNA are incrementally removed -- eventually resulting in, e.g., a new, single-cell zygote, an organism, an embryo, a human being.18 This is "zipping down", and roughly what happened with the production of Dolly the sheep. As distinguished human molecular geneticists have documented:

Animal clones occur naturally as a result of [i.e., derived from] sexual reproduction. For example, genetically identical twins are clones who happened to have received exactly the same set of genetic instructions from two donor individuals, a mother and a father. A form of animal cloning can also occur as a result of artificial manipulation to bring about a type of asexual reproduction. The genetic manipulation in this case uses nuclear transfer technology: a nucleus is removed from a donor cell then transplanted into an oocyte whose own nucleus has previously been removed. The resulting 'renucleated' oocyte can give rise to an individual who will carry the nuclear genome of only one donor individual, unlike genetically identical twins. The individual providing the donor nucleus and the individual that develops from the 'renucleated' oocyte are usually described as "clones", but it should be noted that they share only the same nuclear DNA; they do not share the same mitochondrial DNA, unlike genetically identical twins. ... Wilmut et al (1997) reported successful cloning of an adult sheep. For the first time, an adult nucleus had been reprogrammed to become totipotent once more, just like the genetic material in the fertilized oocyte from which the donor cell had ultimately developed. ... Successful cloning of adult animals has forced us to accept that genome modifications once considered irreversible can be reversed and that the genomes of adult cells can be reprogrammed by factors in the oocyte to make them totipotent once again. [Tom Strachan and Andrew P. Read, Human Molecular Genetics 2 (New York: John Wiley & Sons, Inc, 1999), pp. 508-509] (emphases added)

Narrator: There is utter silence in the dark meeting room. Even Well-Formed Conscience stops banging on the outside of the heavy locked doors to try to listen. But rapidly Dr. "Science" regains his usual scornful composure.

Dr. "Science": This is all very interesting, Dr. Human Embryology, but there is still one major scientific problem that you have not confronted: i.e., the empirical fact that these little "pre-embryos" can form twins until 14-days, and that two of them can fuse to become one human being. That proves that these "pre-embryos" can't possibly be "developmentally individual" yet!

Dr. Human Embryology: Not a problem, if you understand the basic human embryology. The quickest way to explain what is going on in both of your examples is to understand the biological process called "regulation". Regulation is operative in both "zipping up" and "zipping down". In "zipping up", as in sexual reproduction (fertilization), regulation concerns various processes of differentiation; but it also becomes involved when an injury has occurred to the organism. Here, regulation is the ability of an embryo or an organ primordium to "heal" a normal structure if parts have been removed or added.19 In "zipping down", as in a-sexual reproduction such as twinning, regulation could possibly revert separated totipotent embryonic cells back to new living human embryos, i.e., new living human beings. Indeed, this is what happens with human twinning in vivo.20

I know, Dr. "Science" -- you want to know when each twin is to be considered as an "individual", right? Well, please consider twinning from the standpoint of regulation. A normal human embryo is produced sexually via fertilization (in vivo or in vitro). Scientifically we know that this embryo produced at fertilization has already been determined scientifically to be an individual -- both "genetically" and "developmentally". He or she is a new human being. The embryo grows developmentally in total continuity with itself, and is composed initially of totipotent cells. If cells of the embryo are damaged, the embryo could die, or regulation could set in to "heal" the embryo and restore it to wholeness. On the other hand, if these totipotent cells are actually separated from the whole embryo, then these separated cells too could just die, or regulation could possibly set in and revert these totipotent cells to new human embryos. So the first twin is the original human embryo produced sexually and begins to exist as an individual at fertilization. The second twin is the new human embryo produced a-sexually and begins to exist as an individual when regulation is completed. Thus there is not only a "genetic" continuum involved between twins, but also a "developmental" continuum, from fertilization on. Finally, twinning can take place after the arbitrary 14-day marker event.21 And so there is no "Pre-embryo" -- other than in someone's mind, as a sort of "thought experiment".

Now please consider the fusion of two early human embryos to form a single chimera from the standpoint of regulation.22 If two human embryos fuse together to make one organism, that organism is not a human being. It would have 92 chromosomes -- whatever kind of animal that makes it! Both original embryos have died. If this chimeric organism undergoes regulation, ejects all excess chromosomes, and reduces the number and proper mixture (male and female) of chromosomes to "46", then it could theoretically result in the formation of a new human embryo. But that embryo would not be the same individual as either of the original embryos that fused. However, assuming that this process would even be possible in humans, there would still be both a "genetic" and a "developmental" continuum in this new human chimera from fertilization on.

Most of the "scientific" data used by the proponents of the "Pre-embryo" and its various "substitutes" (of which there are many!) is elementarily erroneous science; they selectively use bits and pieces of "data" on which is superimposed very specific ideologies; they leave out, or don't themselves understand, any of the more sophisticated understanding of the biological processes involved; and the term has been formally rejected by the appropriate international scientific experts in the field. There is no such thing as a "pre-embryo -- or any of its various "substitutes".

Crippled Conscience (slightly upset): Does this mean, Dr. Gyno, that my "morning-after" pills might sometimes be abortifacient?23

Dr. Gyno: Nonsense, my dear Crippled Conscience. Even if there is no such thing as a "Pre-embryo", at least we do know for certain that the early human embryo is not a human being until it gradually evolves into one during gestation -- sort of like a tiny "human-being-on-the-way", right Master Bioethics? That's what the famous "biogenetic law" so states.

Dr. Human Embryology: Unfortunately, Dr. Gyno, there is no such thing as a "human-being-on-the-way" either; the "biogenetics law" too has long been rejected by scientists. Quoting from O'Rahilly and Muller:

"Recapitulation, the So-Called Biogenetic Law. The theory that successive stages of individual development (ontogeny) correspond with ("recapitulate") successive adult ancestors in the line of evolutionary descent (phylogeny) became popular in the nineteenth century as the so-called biogenetic law. This theory of recapitulation, however, has had a "regrettable influence on the progress of embryology" (G. de Beer). ... According to the "laws" of von Baer, general characters (e.g., brain, notochord) appear in development earlier than special characters (e.g., limbs, hair). Furthermore, during its development an animal departs more and more from the form of other animals. Indeed, the early stages in the development of an animal are not like the adult stages of other forms but resemble only the early stages of those animals. The pharyngeal clefts of vertebrate embryos, for example, are neither gills nor slits. Although a fish elaborates this region into gill slits, in reptiles, birds, and mammals it is converted into such structures as the tonsils and the thymus." [O'Rahilly and Muller 2001, p. 16].

Crippled Conscience: I am totally confused now. How can one thing go by so many different names? And I just don't see why it matters how one scientifically defines a human being, or when it begins to exist. What difference does it make, ethically? Bioethics has already assured us that these are "pre-embryos" and not persons, and that it is ethical to use and destroy these little blobs or cells for "the greater good".24 What's ethical is ethical. That's what we're really here to vote on tonight!

Master Bioethics: Precisely, Crippled Conscience. And that should be quick and easy to do. Forget all these scientific facts.25 After all, we bioethicists have already decided for you what is ethical. Our ethical principles, you know, are ethics -- they are brand new, and perfectly fitted for promoting the rapid progress being made in all of these "converging nano/bio/info/cogno technologies" these days26 -- for that matter, in all areas of human endeavor -- globally!27 The possibilities are endless! This ethical theory was all sorted out by us back in 1978 at a quiet meeting in Belmont, when we wrote our Belmont Report as appointed members of the National Commission.28 With that famous Report of ours, "bioethics" was formally "born".29 The U. S. Congress actually mandated that we identify what is ethical in their 1974 National Research Act.30 So we did just that! Of course, we incorporated all of this sophisticated and enlightened "pre-embryo" science in subsequent documents, regulations, laws and guidelines over the years.31 And our ethical theory is neutral -- perfect for public policy decision making in any pluralistic, multicultural, democratic society! Don't worry your little conscience about any of this.

Prof. Philos: Excuse me, Master Bioethics, but your nouvelle theory of ethics is not "ethics-per-se", nor is it in any way "neutral" for use in public policy. There are dozens of different kinds of ethical theories throughout all of human history; and there is certainly no such thing as a "neutral ethics".32 Even your bioethics Founders and textbooks clearly state this.33 It would seem that you are imposing your non-neutral normative ethics on the rest of us!

Jaded Judge: Perhaps the Master can tell us more about this new bioethics theory. It sounds rather invigoratingly new, and we all could surely use a change! What ethical principles do you use to determine what is ethical, Master Bioethics?

Master Bioethics: Well, Your Honor, we decided that there would be three ethical principles -- we just combined bits and pieces of those ethical theories used by Kant and Mill, mixed them around a bit, and came up with "autonomy", "justice" and "beneficence" -- otherwise known as "principilism" or "the Georgetown mantra". These three ethical principles are very democratic. They are prima facie -- no one principle can outweigh either of the others!34

Prof. Philos: But if each of these ethical principles are prima facie, Master Bioethics, then what happens when one of these principles comes into conflict with either of the other two principles? For example, how to we consistently respect the "autonomous" demands for medical treatment of a patient, while at the same time respect the medical expertise of the physician who needs to "do good" for his or her patient (or at least "do no harm"), and the "just" cost of the patient's medical treatment to society -- all at the same time? It is impossible. Isn't that why many of your own Founders have recently admitted that after 25 years of application these bioethics principles simply don't work in the real world?35

Master Bioethics: Well, we keep trying.

Prof. Philos: What I am most curious to know, Master Bioethics, is precisely how you are defining "autonomy", "justice" and "beneficence" in your Belmont Report? You know how fussy we philosophers are about "definitions"! In my reading of The Belmont Report, those terms have rather "strange" definitions -- and therefore, of course, could lead to "strange" ethical conclusions.

Master Bioethics: There is nothing strange about them. We all agreed that "autonomy" should be defined as "absolute choice by human beings who are actively exercising their rationality". Why, most bioethicists so define "autonomy" -- e.g., Peter Singer, the founder and first president of the International Bioethics Institute himself!

Prof. Philos: But wouldn't that mean that non-autonomous human beings who are not capable of actively exercising their rationality -- e.g., even adult human beings who are mentally ill, the mentally retarded, the emotionally ill and depressed, alcoholics and drug addicts, the physically disabled, the comatose, etc. -- are not persons?36 This, again, creates two subclasses of humanity -- one composed of human beings, and the other composed of human persons -- and we've already been there before! And how can you theoretically defend the mixing and blending together of the ethical theories of two totally opposite philosophers?37 Wouldn't that be self-contradictory? That doesn't seem very "rational" to me.

Master Bioethics: Indeed, you are correct, Prof. Philos. I can see you like to "push the logic"! Not to ignore your questions, but to continue, "justice" is defined as "fairness" -- as in John Rawls' Theory of Justice. Of course, "fairness" is then defined as "the fair distribution of the risks and benefits of participation in purely experimental research for the greater good of society" -- which participation is, as we stated in our Belmont Report, a strong moral obligation and duty for every citizen in society. And "beneficence" is defined, of course, mostly in terms of that "greater good" -- you know, the "common good".

Prof. Philos: Those are unique definitions, for sure. But tell me, Master Bioethics, by what process did you eleven selected committee members arrive at such enlightening definitions of what is "ethical"?

Master Bioethics: By consensus, of course -- just as with our "scientific definitions". We want to be strictly democratic. Our "bioethics" and "science" is now used exclusively by literally thousands of bioethics experts around the world.

Perplexed Parliamentarian: I am curious, Master Bioethics. Just what makes one an "expert" in bioethics?

Prof. Philos: I can answer that question, Mr. Parliamentarian. Only a handful of "professional" bioethics experts have academic degrees in the discipline, and even for those few who do, there is no uniform or standardized curriculum. Most professors of bioethics don't know the historical or the philosophical roots of the subject matter they teach; the courses vary from institution to institution; there are no local, state, or national boards of examination; and there are no real professional standards. There is not even a professional code of ethics for bioethicists.38

Jaded Judge: Master Bioethics, I am worried now. It puts me in mind of an old legal colleague of mine who was a legal consultant for the National Commission. He remarked to me one day that he was fearful for the future: "What one fears", he said, "is that the [National] Commission may become the mechanism whereby the speculations of the ethicists become the law of the land. It is already far too easy for abstract notions of right and wrong to emerge as deontological rules which begin their public life as 'guidelines' but culminate in the force of law."

Perplexed Parliamentarian: The more I think about bioethics, Master Bioethics, the more perplexed I get. I seem to recall too that even many of your Founders lately have expressed deep concern about this bioethics theory -- one of them even went so far as to refer to it as an "ailing patient" whose "diagnosis is serious, if not terminal". Well, aside from these minor problems, what are some of the ethical conclusions that bioethicists come to concerning today's urgent bioethics issues?

Master Bioethics: Yes, well ...... we have made great progress over these last 35 years. For example, by deducing from our ethical principles we would conclude that the following are "ethical": designer babies; 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 and "back-breeding" with other human and animal species); human embryonic stem cell research; "brain birth; 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.41 We are quite certain about these ethical conclusions.

Prof. Philos: In contrast, I would suggest a very different ethics, one that has withstood the test of centuries, and is grounded in our empirical experience of human nature, our common natural and supernatural goals, and which goods we all hold in common (a different definition of "the common good") by virtue of that common human nature. It would come to quite different ethical conclusions. I am referring to philosophical natural law ethics. In fact, that ethics would conclude that all of those actions are unethical, because they would lead to serious harm to people, and impede them from ever reaching their common goals as human beings. You see, different scientific definitions of "a human being" and when a human being begins to exist lead necessarily to different philosophical "anthropologies". Different anthropologies lead necessarily to different philosophical "ethics" -- and therefore to different ethical conclusions.42

Mr. Chairman: Well, this is all much too deep for me. We have a practical job to complete here tonight -- to decide on the legislative language to be used in these proposed bills on human cloning and human embryonic stem cell research. I want some solid suggestions now.

Dr. "Science": I would suggest that we make this bill a "ban" on all human cloning using the somatic cell nuclear transfer (SCNT) technique. That technique, as you know, would produce a human clone with the exact genetic information as is in the donor cell.

Dr. Human Embryology: Objection, Mr. Chairman. A human being cloned using the SCNT cloning technique would not be an "exact genetic copy of the donor cell". The mitochondrial DNA of the donor cell is not transferred, and the mitochondrial DNA of the recipient cell is retained in the product. If you so scientifically mis-define the SCNT human cloning technique itself, then the bill will not apply to the real SCNT technique at all -- isn't that correct, Your Honor?

Jaded Judge: As a matter of fact, that is the case. The bill would only apply to those activities that are specifically articulated in the language of the bill.

Dr. Human Embryology: And what about all of the other cloning techniques that can and could be used to clone human beings? Why aren't they specifically articulated in the bill, Dr. "Science"?

Master Bioethics: There are no other cloning techniques. What are you talking about?

Dr. Human Embryology: Come now, there are quite a number of other kinds of cloning techniques. For example, there are cloning techniques such as: germ line cell nuclear transfer;43 "twinning" (blastomere separation and blastocyst splitting)44 -- which is the most genetically exact kind of cloning technique;45 the formation of chimeras (now by using pronuclei, or back-breeding to new human embryos); and many other kinds of "de-methylation" experimental techniques. As the Jaded Judge explained, if these cloning techniques are not included in the language of the bill, then they too will not be banned. In fact, a bill with such erroneous science and linguistic loopholes would effectively ban no human cloning at all.46

Perplexed Parliamentarian: But let's be practical, Dr. Human Embryology. First we need to get some bill passed, and then later we can come back and refine it. What difference does it make, as long as we can at least limit the evil bill proposed by some of the other Parliamentarians?

Jaded Judge: It makes a big difference, Perplexed Parliamentarian. Once this erroneous science gets passed into law, it is simply reduced to stare decisis -- legal precedent.47 The Courts would then only have a legal duty to apply this erroneous science to any and all further related legislation. These scientific flaws may never be revisited for correction.

Prof. Philos: And I wonder, Perplexed Parliamentarian, can any and all "means" be used to reduce or limit the evil in some other bill, or only morally licit means? Does knowingly using this false science and these linguistic loopholes in this bill constitute morally licit means or not? This bill would legally guarantee that any and all human cloning techniques would be legally protected. These "means" would ensure that untold numbers of innocent living human beings would be able to be cloned and used in destructive experimental research. How can that be "ethically" or "legally" acceptable?

Mr. Chairman: Well, I think we have debated these issues long enough. It is time to roll up our sleeves now and actually write this bill so that it can be submitted to the full Parliament tomorrow. Let's unlock the doors, take a short break, and come back here to go to work in exactly 5 minutes.

Narrator: The weary and bedraggled committee members slowly begin to collect their piles of papers, stuff them in their briefcases, and singly file out of the dark meeting room into the corridor, the various points of their heated discussions weighing heavily on them. The silence is deadening. Five minutes later, the Chairman wanders back through the doors, relocks them, and shuffles over to the head of the long committee table. He looks up to discover that the meeting room is quite empty! Everyone else has simply disappeared, except for Well-Formed Conscience, who is now patiently sitting across the table. The Chairman's eyes begin to get a little twinkle in them.

Mr. Chairman: "Well, it's about time you got here, Well-Formed Conscience! It's late -- let's get to work!"

Next Page: Endnotes:
1, 2, 3, 4