Quid Sit Veritas?
The Odyssey of One Human Embryologist As A Modern Diogenes


The New England Journal of Medicine publishes routinely on the subject of abortion, in vitro fertilization, fetal tissue research and other socio-legal issues, as well as social policies. A cursory review of the table of contents of The New England Journal of Medicine over the past several years will confirm these facts. Following this rejection I next sent the manuscript to Perspectives in Biology and Medicine. Again, the manuscript lay on the desk of the Editor, Richard Landau, for approximately six weeks. I eventually was able to talk to him on the telephone at which time he admitted the manuscript had not been sent out for review and told me "two's enough". I inquired of him what that meant since I knew of only one article in his Journal published on abortion and that was by Rivers Singleton, Jr. I reminded him of several errors that Singleton had made in that paper, which I was trying to correct on the basis of factual and scientific knowledge in human embryology. Landau informed me that there was another manuscript that had been accepted for publication and would be published within the next several issues of the Journal. Further, in the course of the conversation he said: "You should know that I am pro-abortion. Violently so!" Recognizing the futility of any further discussion I simply requested the return of the manuscript copies. I also discovered that Clifford Grobstein was, at that time, a member of the editorial board of Perspectives in Biology and Medicine. The second manuscript Landau referred to, that eventually was published in his Journal, indeed, concerned abortion and the abortion controversy and was a very pro-abortion article in which the author, Robert T. Muller, a psychologist, justified abortion on the basis that our society executes convicted criminals and therefore the paradigm for killing was already embedded in our society (1991. In Defense of Abortion: Issues of Pragmatism Regarding the Institutionalization of Killing. Perspectives in Biology and Medicine, 34:315-325). This is at best a bizarre way to look at the justification for abortion. But, Muller was prophetic! On April 13, 1991, Judge Michael J. Noonan delivered a wholly odious opinion in the State of New Jersey vs. Alexander Loce et al. It seems Loce and friends were found guilty of trespassing while protesting around and about an abortion clinic in the effort to prevent the abortion of an embryo, which he had fathered. Noonan's decision included: "Roe v. Wade is still the law of the land and this court is bound by it. Therefore, I find that the 8 week fetus (sic) in this case was a living human being that was legally executed (sic) pursuant to the United States Supreme Court decision in Roe v. Wade." Is this what we now should be teaching in classes of Human Embryology? Incidentally, the judge erred in identifying the 8 week embryo as a fetus.

Noonan was simply amplifying what the Supreme Court had already decided. Brennan, for example, has publicly stated his position on the death penalty for born adults: "the best way in which we choose who will die reveals the depth of moral commitment among the living." (Are not the embryo and the fetus living?) Blackmun, when interviewed on 3 December, 1993, by Ted Koppel on the death penalty, said his concerns, with regard to equal protection, are: "the disturbing statistics that come in when one considers race"! Moral posturing by the likes of Justices Brennan and Blackmun are out of character. Obviously, Blackmun is not concerned when considering age, e.g. up to 24 weeks after conception. It is apparent that these two Justices would drown if caught in the shallow waters of moral outrage.

I then sent the manuscript to BioScience, the official publication of the American Institute of Biological Sciences. Again, it was rejected without review. The Editor, Julie Anne Miller, included a comment in the cover letter stating that a resumed copy contained reviewer comments. In fact, there were three comments, only, written on the manuscript, two of which were corrected typos, and did not constitute a bonafide review. The third comment concerned my correction of the fact that Singleton in his article in Perspectives had inferred that the human embryo displayed gill slits and a tail. In my manuscript I corrected that by indicating that gill slits never appear in humans, and the embryos never display a tail, but that, unfortunately, the caudal area is referred to as a tail process. The so-called reviewer for BioScience had written after that sentence "snide, again". After receiving the manuscript back from Dr. Miller and BioScience, I wrote to her that one comment written in a phrase on one copy of my manuscript did not constitute a bonafide review. I requested a copy of a review commentary and that not being available I requested that the manuscript be reconsidered and this time sent out for a real review. I never received a reply from her. Following this I retitled the manuscript to: "In Defense of Human Development" and submitted it to Issues in Science and Technology, then to Policy Review. Again, it was summarily rejected in both cases. Next, the manuscript went to Pharos, which is the official publication of the Alpha Omega Alpha Honor Medical Society. Their reply, another rejection, included the following comments: "We have had this paper for a much long a time than in the case with other manuscripts. The delay in our getting back to you reflects the fact that there was considerable debate among the various members of the Editorial Board to whom we sent the paper regarding its suitability for publication. Everyone agreed that the paper was well written and it obviously deals with a topic of importance in our current society. Taking into account the pros and cons, however, I regret to say that we have come out on the side of not accepting the paper."

To date, not a single major publication, lay or scientific, has published any article correcting the plethora of false statements about human development which have burdened the literature for the past 15 or more years. I next sent the manuscript to the Western Journal of Medicine. The letter of rejection included the following statement: "It is the policy of the Western Journal of Medicine to send (to the author) any available comments from the board's reviewers. This is intended to assist authors to rework manuscripts before submitting them to another publication." Rubber stamped in bold black letters at the bottom of this letter were the words "No comments received". This Journal resumed my manuscript with the letter of rejection within 10 days.

I also sent the manuscript to Human Life Review, but again it was resumed with a brief cover letter indicating that it was essentially "inappropriate" for publication in Human Life Review, but one year later an article appeared on abortion with a somewhat romanticized approach. Thus, in all, this manuscript, essentially, was rejected, in one form or another, a total of eighteen (18) times.

A Second Manuscript

While I was struggling to get this manuscript published a paper appeared in The Kennedy Institute of Ethics Journal. It was the lead article in the very first issue of this Journal, authored by Richard A. McCormick, a Jesuit priest. The title of the article was "Who or What is the Pre-Embryo?" In this article the Reverend McCormick called for a reconsideration of the time for ensoulment based upon Grobstein's so-called stage of developmental individuality. In essence, this "stage" was described as that point after which the embryonic mass could no longer divide and form a copy or multiple copies (twins or multiple identical individuals). This would be a time from 5 to 6 days and perhaps up to 14 days post-fertilization. The fallacy of this definition lies in the facts that monoygotic twins occur in only 10 of every 2700 live births, and at least 30% of all monozygotic twins (arising from one fertilized oocyte), occur within the first two or three mitotic cell divisions post-fertilization. Still further, the origin of monoygotic twinning is not known. It does not appear to be familial in origin, and therefore, is not predictable. Therefore, if ensoulment were to be withheld until after the inner cell mass stage, assuming that one could indeed tell at that stage that twinning had occurred, it would be withheld for approximately every 385 individuals until 1 had been determined. It seems this would constitute a major problem in ethics, especially for any religion or church.

The editorial Statement of The Kennedy Institute of Ethics Journal states that it "publishes opinion and analysis dealing with social, ethical, and public policy aspects of bioethics and related areas of 'applied' ethics. It presents varied points of view and encourages open debate of critical issues." Encouraged by this lofty and noble objective I wrote a reply to McCormick's article and submitted it to the Journal.

The story of the preembryo

In this article I reviewed all of the previous and contemporary textbooks used in human embryology, none of which used the tem pre-embryo. It appears that this term, per se, was conceived by Clifford Grobstein in a 1979 article from Scientific American. It is most unfortunate that the newest, fifth edition (1993), of Keith Moore's textbook The Developing Human uses the term pre-embryo. However, Moore uses the term in a contradictory way. In subsequent correspondence which I have had with Keith Moore protesting the use of this term in his text, he replied that he understood the objection and offered to remove it for the next subsequent printing of that text. There has never been a historical record of the use of that term. Indeed, the renowned dean of human embryology, Bradley Patten, used the term embryo for every stage subsequent to the fertilized ovum (zygote). Further, the author of a new textbook Human Embryology And Teratology, Ronan O'Rahilly, indexes the term pre-embryo but this is what he states in his text in a footnote: "The ill defined and inaccurate term pre-embryo which includes the embryonic disk is said either to end with the appearance of the permanent streak or (in the Nomina Embryologica) to include neurulation. The term is not used in this book." While it is true that the current issue of Nomina Embryologica, the taxonomy of language for human embryology, does not per se use the term pre-embryo, it does use as a heading pre-embryonic period. Pre-embryonic period implies a period of the pre-embryo. Because Keith Moore is currently a member of the nomenclature committee for the American Association of Anatomists, and a member of the committee on nomenclature for human embryology, I wrote to him in protest about the inclusion of the term pre-embryo in the third edition of Nomina Embryological His reply to me was: "The term pre-embryo does not appear in the third edition of Nomina Embryological This is at best disingenuous because, as stated above, there is no difference between the terms pre-embryonic and pre-embryo. In correspondence with Dr. O'Rahilly inquiring as to how this term found its way into Nomina Embryologica, Dr. O'Rahilly replied that he did not know and that even though he was a member of the International Anatomical Nomenclature Embryology subcommittee and a human embryologist, he was never solicited for his opinion. Then, how did "pre-embryonic" become incorporated into the current Nomina Embryologica nomenclature? Perhaps, a statement at the beginning of the manual (page ix) may provide a clue: "1985 Twelfth International Congress of anatomists in London: Discussions at this and thereafter led to the present . . . Nomina Embryologica"! Looking at the list of members of the last committee for Nomina Embryologica this membership was comprised of individuals the world over. It may be that very few of these individuals were human embryologists. Indeed, Moore's text is the first one to include the term pre-embryo. However, predating this is a book advertised "for course consideration: Embryo Experimentation, (subtitled): Ethical, Legal and Social Issues" (1992, Cambridge University Press). It is edited by six faculty members from the Monash University Centre for Human Bioethics (Australia). Interestingly, the senior editor, Peter Singer has authored other books including, Practical Ethics, Marx, and Should the Baby Live? This book uses the term pre-embryo liberally, and advocates continuing "human pre-embryo research". Included are recommended guidelines on embryo experimentation. How can one avoid the feeling that the fox is running the chicken coop? Political correctness, deceit and fraud have found their way into the science of human embryology.

The term pre-embryo in on the verge of having wide popular acceptance. On a February 4th, 1994 CNN broadcast of Sonya Live, which discussed genetic testing of in vitro fertilized embryos, Dr. William Gibbons, a Gynecologic surgeon from Eastern Virginia Medical College in Norfolk Virginia, defended the term pre-embryo and freely (and without interruption) defined early stages of human development using such terms as trophoblast, etc.

But, when a bioethecist, Dr. Dianne Irving, protested, declaring the term pre-embryo a myth and attempting to use the identical terminology in her rebuttal as Dr. Gibbons had used, she was abruptly interrupted by Sonya, who declared such scientific terms as unsuitable for her listening audience.

Currently, the National Institutes of Health are holding hearings on proposals involving in vitro fertilization of donor ova. Of course, a significant amount of testimony is centering on the unethical and immoral use of zygotes, which some witnesses regard as allowable based on the early developmental stages as not constituting the new individual, thus, a preembryo.

More Rejection, Then FinaLly Acceptance

In spite of the stated objective to publish articles on both sides of an issue, The Kennedy Institute for Ethics Journal rejected my manuscript without review. I protested to the Editor, Renee Shapiro, and subsequently she apparently did seek a kind of review which, again, as in the instance of BioScience, came back with a handwritten comment on a manuscript copy that I was "fossilized". The scientific data in this manuscript was not reviewed and not commented upon. I then sent this manuscript to Cross Currents, the official organ of the Association for Religion and Intellectual Life (ARIL), College of New Rochelle (New York). Again, the manuscript was rejected without review and without comments.

Finally, I sent both manuscripts to The Linacre Quarterly, the editor of which is John P. Mullooly, M.D. The Linacre Quarterly accepted both and eventually they were published. The first one, "In Defense of Human Development" appeared in the November 1992 issue, volume 59, number 4, pages 58-76. The second manuscript: "Human Development and Reconsideration of Ensolement" appeared in the February 1993 issue, volume 60, number 1 pages 57-63.

The problems of publishing the truth about human development are not just manifest in the difficulties related here. They can also be observed in some subsequent events, for example, in attempting to deliver the history of these rejections at a recent conference sponsored by the Journal of the American Medical Association which took place in Chicago in September, 1993. When I was informed that there was to be a conference sponsored by the JAMA in Chicago in September of 1993 on Peer Review, which would be the perfect forum to relate the problems described above, I wrote to the organizer of that conference, Dr. Drummond Rennie, but, at the same time I called the Chicago office of the JAMA and made an inquiry about the meeting. I was told by Cheryl Manno, the person assigned to collate the abstracts and send them out for review that "We are still sending abstracts out for review." I then asked, if that is the case may I fax to her an abstract of the paper I would like to deliver from the podium. She said yes. I wrote the abstract and faxed it that afternoon and she confirmed by telephone the next morning that she indeed had received the abstract. The abstract I faxed was essentially the history of rejections including biased statements by some editors of the article on the misuse and false statements of the known science of human embryology within the abortion controversy. I waited several days and received a reply of my original letter to Drummond Rennie, the organizer of the conference, who said in the letter that the program had already been established and to allow me on the program would mean bumping someone off. I found Rennie's letter to be disconcerting since I had been told that abstracts were still being sent out for review.* (*Even more disconcerting is the fact that Dr. Rennie has recently been appointed to a newly formed commission on Research Integrity by HHS Secretary Donna Shalala.)

I wrote him back indicating that I had been told that the program had not yet been put together and asked him to reconsider. He replied and again refused my request, but did not reply to my claim that I had been told the program had not yet been established. It was interesting to me in the meantime to have received a flyer on the program to see the various sessions scheduled for the program and the names of the session chairmen. It was no small observation to me to see that the session to which my abstract would have been sent and in which I would have delivered my presentation was chaired by none other than Marcia Angell, the Executive Editor of the New England Journal of Medicine. If the abstract I faxed to the JAMA office had, indeed, been sent to review, it would seem logical that Dr. Angell would have reviewed it.

The First Casualty Of The Cultural War

I believe Patrick Buchanan is right when he stated at the Republican National Convention in 1992 that "our society is engaged in a cultural war". I also believe that the first and most significant casualty of this war has been, and continues to be the human embryo and human fetus. This casualty is not dead but severely wounded. Only total care and treatment with every resource in the armamentarium of truth can bring this wounded soldier back to full and vibrant life.

Human embryology is a subject which is fast becoming incorporated into daily communication, but in a distorted "New Wave" form. It is not well understood by the lay public because the truth has not been given to them. But it is not just the lay public which has trouble interpreting the facts or science of human development. One can find this kind of problem within medical students (as well as physicians, e.g. Holly Galland). For example, a third year medical student called in to an afternoon radio talk show on KNST, Tucson Arizona, on April 17, 1993 in which he made the following statement: "In the emergency room, we pronounce a person dead when the heart stops beating, I would like to propose we just reverse that, that life begins when the heart starts beating." Clearly, there is a problem here, not just in communication, but in education, particularly that of medical students.

Human embryology and medical education

The College of Medicine at the University of Arizona, and many other medical schools, does not offer a credit achieving course in human embryology to the medical students. It never has. When it had been proposed in the past to do this, the curriculum committee rejected the proposal on the basis that it would provide one more course with a potential failing mark for the medical student, which they were loath to do. We now know the importance of knowledge about human embryology and it's relevancy in such profound elective social pursuits such as in vitro fertilization, abortion, fetal tissue research, human embryo research, in utero fetal surgery and fetal farming. It should be incumbent upon every medical school in this country to provide a thoroughly grounded course in human embryology to medical students. It should further be the mission of every school or college of medicine in the United States to provide a service of education concerning human development with the lay public through seminars, public lectures and forums and through published communications by appropriate news services. Only in this way are we going to alert the lay public to the gravity of the condition of our wounded casualty in this cultural war. It is not an easy task particularly when the ground work has been laid to obviate many of the scientific facts known about human embryology for the sake of political correctness (PC) and expediency. One such example of PC lies in the fact that many medical schools, the University of Arizona included, no longer require their graduates to take the Hippocratic Oath. Rather, a modified Hippocratic oath or a substitute oath is given to the graduates, or at least offered as an alternative to the traditional Hippocratic Oath. One of these alternatives is called the Oath of Lasagna. In this oath the reference to abortion has been removed, which is incorporated in the Hippocratic Oath. In the Oath of Lasgna it is stated "It may also be within my power to take a life, this awesome responsibility must be faced with great humbleness and awareness of my own frailty." This is more politically correct and in tune with our times, apparently, although in direct contradiction to everything that is taught in medical school to the student. It seems paradoxical in view of the fact that the prevailing concept taught in medicine today is that the human fetus is a second patient.

This is where science has been clearly separated from the law. The "second patient" is recognized medically from the point of diagnosis of pregnancy, but the court (Roe v. Wade) only recognizes it at 24 weeks post-fertilization. Why is this so? The legal "choice" pundits say the rights of the mother cannot be superseded. Why? Why are not the rights of the mother and that of the conceived at least equivalent? After all, the mother is no longer living for one, but for two, and a good mother will, no doubt, sacrifice habits and conduct to effect proper care of the "second patient". Some states have already prosecuted pregnant alcoholic or cocaine addicted mothers for abuse in cases where there have been compromising effects (which are permanent) on the fetus or newborn. The Supreme Court decisions, indirectly, do not support the states' caveats.

The embryo and early fetus are exceedingly small, cannot protest or produce an outwardly recognizable sign that they are in danger, and, therefore, cannot signal to third parties that something is threatening or wrong. In the final distillation of the Court's (and other's) decision can be found the answer to WHY?: It is a matter of arrogance!, a characterization to which the court (and others) would be loathe to admit.

Quid Sit Veritas?

This chronicle is a revelation of the attempts to bring scientific knowledge of human development before the public, which has been exposed (and still is) to an excess of misrepresentations. Generally, it has been the case that the truths within science have been sought and revealed by those who know the subject best. Sadly, this has not been true in the case of human development. Political imperatives have allowed other than human embryologists to speak for human embryology and to gain credibility through acceptance by the media.

Science in its purest form is the pursuit of truth, and repeated confirmations, over time, can produce absolute truths. But, truth is often obscured by relevancy. To be politically correct in our present time one often is driven to qualify the truth and declare that there are no absolutes. In the absence of absolutes, quality and status become arbitrary, and value can be redefined at will. The consequence of this to human embryology is that the value of the human embryo is now being reduced to the surgeon's instrument and the research bench.

Nevertheless, no amount of revisionism can obscure the fact that one of the great absolute truths is that LIFE has been a gift, provided in virtual perpetuity in the form of a continuum renewed through a system called reproduction, which is the essence of life.

"All truths pass through three stages. First, they are ridiculed; second, they are violently opposed; third, they are accepted as being self evident." --Arthur Schopenauer (Philosopher)

A Brief Journey Through the Home of Human Embryology: Human Anatomy

I have been a long time member of the American Association of Anatomists. Through the years of their annual meetings their programs often have included sessions on the History of Anatomy. In the spring of 1994 I conceived the idea to organize a Symposium on The History of Human Embryology, and attended the annual meeting in Anaheim, California in order to propose such a Symposium to the incoming President, Charles Slonecker. I met with Slonecker and issued my verbal proposal on the basis that Human Embryology was in danger of losing its base in Human Anatomy because the language of Human Embryology was being preempted by Developmental Biology. A case in point is the "pre-embryo", conceived specifically for the human embryo by an amphibian embryologist, Clifford Grobstein. Slonecker agreed the term was at least "unfortunate".

He was sympathetic but wanted to make sure the proposed symposium would not be used as a political forum. I assured him it would not be, that my interest was in reclaiming the correct and true science.

Slonecker advised me to write him the proposal (for the next year's April meeting) by summer (sometime before the end of July) and include the topics I would plan. He would submit the proposal to the Executive committee for a decision.

I did that, and had tentatively obtained speakers in three areas:

1. the history of early embryology

2. a comparison of the characteristics of human embryology, obtained through traditional studies, with in vitro fertilization procedures, and

3. the history of development of the brain and nervous system, including the validity of studies involving electroencephalograms on fetuses, (or, as some have claimed, on embryos) and the concepts of "sentience" and "brain birth".

I also had intended to find another speaker on the history of the fetus as a "second patient".

This was submitted to Slonecker in early July, and despite a follow up letter requesting a reply, I never received any response from Slonecker. In mid-October I requested intercession from a friend of mine who was an officer of the Association. Slonecker then called and simply said he would submit my proposal. But, by that time the Symposia had already been selected and their schedule published and distributed to the Association.

Needless to say, it seemed there had not been any intention to accept my proposal and it further appeared that the gravity of the situation with human embryology never realty registered with Slonecker. As expected, a letter of denial followed shortly thereafter.

One may explain this sequence of events in procedural terms according to the traditional workings of a scientific society. On the other hand, it ought to be clear that the problems of exhibiting the truth concerning human embryology are significantly compounded by the pusillanimous regard to a profound component of the moral crisis in our culture, even within the structure of the very body (American Association of Anatomists) which ought to set right the heart of the problem: the true science!

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