A New Wave Dialectic:(1)
The Reinvention Of Human Embryology
And A Futuristic Social Policy For Humankind


Status: preembryos are pre-persons?

"What should be the status of the developing entity of the pre-embryonic stage? I prefer the following tentative approach to this important and difficult question. By virtue of its earlier developmental activation, the pre-embryo has potential to become a person in the full sense. This means that it has among its alternative futures possible maturation into a person. It is, in this sense, a preperson and this must be taken into account in its treatment and status."

Heros are often artificially made by erecting straw men, then knocking them down in public view. Unfortunately, this is what Grobstein is doing by promoting this false concept of a "pre-embryo", then lamenting: "what should be done with it?" As many human embryologists, as Grobstein may have supporters, will claim there is no such stage as the "pre-embryo" The basic reason is that such artificial stages are significant only to the extant political discourse. It is of o value to human development because all of development from fertilization to birth (and beyond) is a continuum. As such, it is supreme evidence of the fait accompli begun by initial contact of the sperm and ovum. Most importantly, under normal conditions the continuum of development is not subject to any intrinsic arbitration!

"What might such a status entail? First, since we should and do attach very high value to persons (in part because the category includes each of us as a self) and pre-persons are the only source of persons, every feasible opportunity and priority should be provided to pre-persons to continue their development to personhood. However, this does not require and does not mean that pre-persons are automatically and immediately persons. Rather, it means that appropriate formulation of the status and rights of pre-persons is a task of high priority, taking into account the status and rights of the mother."

It would seem that once a straw man is constructed it can arbitrarily be given a heart, a brain and courage, at some arbitrary future time. Thus, the straw man is now a "pre-person".

"Second, pre-persons, as genetic individuals, are members of the kinship network of both of their parents. In the absence of the genetic parents as decision makers at a critical time, an agreed-upon procedure for surrogate custodianship should exist within each human community, whether it is applied to a particular subgroup (family) or to a larger community having a reliably stable consensus within it."

It is interesting that Grobstein admits to the derivation and subsequent decision making, of "pre-persons" through both parents. In fact, an equal consideration of a genetic father's vested interest in the fate of embryos and fetuses (Grobstein's pre-person) was submitted to the Supreme Court for adjudication in 1993. The court refused to hear the case.

There is another, ominous aspect to this concept of Grobstein. Some states do not require consent from both parents for a pregnant minor to get an abortion. Who then would constitute the "community" and who would become the "custodian"? Read on!

"Third, if acceptable custodianship based on kinship has not been provided for a given pre-embryo, it should become the responsibility of a designated public authority, which may appoint a trustee to make suitable decisions on behalf of the pre-person, with priority given as indicated in the precelling first principle.

Fourth, if all possibilities for providing continued development to personhood have been exhausted, a pre-person may be made available for other purposes (my emphasis) approved under rules to be formulated and monitored by a publicly responsible oversight body."

This is perhaps the most odious statement made, yet. In pre-World War II Nazi Germany, the mentally defective, Pastors, Priests, Gypsies & others were declared "non persons" and routinely executed. It is the "Second Holocaust" which is rarely written about, and included more than lO,OOO,OOO people.21 Is there a parallel here with the infamous Nazi medical experiments in the WW II concentration camps? Jews, Russian POWS, Polish inmates and even some Germans were considered "nonpersons" and thereby useful in yielding information presumed beneficial for soldiers in the field or for the good of science.

The fact that we have, on the one hand Nazi authority, and on the other, federally sanctioned guidelines by the Ethics Committee of the American Fertility Society, experimenting on "nonpersons" makes no difference. In both cases the objectives were and are driven by an abject denial of moral imperative.

"Fifth, it is assumed that such pre-persons will be maintained in an optimal frozen state pending disposition -- but that they will not be so maintained for periods longer than one year unless accumulating experience indicates otherwise. Careful records should be maintained for all individual pre-embryos so as to allow modification of the one-year preliminary recommendation in response to cumulative experience.

These principles are intended to apply to pre-embryos as pre-persons, the developmental stage most often dealt with in clinical centers providing in-vitro fertilization and related techniques for treating subfertile couples. This set of applications does not, however, exhaust the growing possibilities for beneficial intervention during development in utero, whether the benefit be to the mother or the offspring. There is, therefore, growing need for greater scientific understanding of both embryonic and fetal development to support these clinical possibilities.

Preembryos are now embryos

Thus, the first point made earlier with respect to the status of pre-embryos is equally valid for embryos -- it is essential both to protect their potential as prepersons and to better understand the nature and properties of such potential. We need therefore to define the status of embryos so that their pre-personhood is appropriately respected, while allowing knowledge about them to be effectively expanded."

This seems contradictory. Grobstein says that "it is essential both to protect their potential as pre-persons and to better understand the nature . . . of such potential."

Which has priority? The best way to protect the "potential of pre-persons" is to permit no intervention so they can be born!

Further, Grobstein equates pre-embryo with pre-person and states "the status of pre-embryos is equally valid for embryos"; that is, "pre-persons are not" according to Grobstein, "automatically and immediately persons"!

This is the very concept placed before the NIH advisory panel on Human Embryo research in the spring of 1994. As we read on we shall see how Grobstein claims the entire embryonic period (his definition up to 7 weeks P-F) may be subjected to human embryo research.

"The embryonic period can be defined as beginning with the appearance of the head-to-tail body axis and extending to the onset of bodily movement at six to seven weeks. The main body axis is first recognized by appearance of the so-called primitive streak in the cup-shaped layer of cells which, ten to fourteen days after fertilization represents the nascent embryo. Shortly thereafter, in line with and ahead of the primitive streak the neural folds appear as the first visibly precursor of the central nervous system and the brain. "

Grobstein is reinventing human embryology. An traditional teaching in human embryology has heretofore taught that the embryonic period ends and the fetal period begins on or about the ninth week of development post-fertilization, based on 3 things occurring at that time: 1) more rapid development of the face, 2) completion of the formation of all major organ fields, and 3) the onset of differentiation of the reproductive structures.

A new definition for the transition of embryo to fetus

" . . . By six to seven weeks, neuromuscular connections have been established in the neck region sufficient to support primitive turning movements of the head. This is a reasonable marker for the transition from primary organogenesis of the embryo to fetal growth and maturation, which continues on to birth and beyond."

Simply, not so. Turning of the head is not a reasonable marker for transition from embryo to fetus. First, it is in direct contradiction to what has been previously accepted and taught. Second, there is the vague inference here that turning the head may suggest such psychological traits as query, curiosity or willful response. There is o evidence for such veiled inferences. In fact at 5 to 6 weeks, limbs and/or head may move in response to two stimuli: 1) chemical, effecting a change in tissue balance of 02 and C02, and 2) mechanical, including that produced by a surgeon's probe. A consortium of sarcomeres (contractile units) in differentiating voluntary muscle is probably not necessary for this kind of movement, because many cells contain microfilaments, which represent primitive contractile systems.

Grobstein's not-so-veiled inferences are "The New Wave" of science.

"Movement, particularly when it seems purposeful, has significant impact on observers; accordingly, at the much later time of quickening, this was a traditional clinical sign of advancing pregnancy and fetal well-being. Today, embryonic movement is visible to ultrasonography as early as six to seven weeks of gestation and affords welcome testimony about fetal welfare. Moreover, movements imply a significant level of maturation, including the presence of receptors, neural transmitters, and effectors such as muscles. Thus movement as behavior, even when rudimentary, becomes a potential form of communication and thus an indicator of an internal state that may later include the beginnings of sensation, awareness, and comfort -- all assumed to require at least minimal brain function."

There is nothing really incorrect in what is said here. However, Grobstein has probably justified Bernard Nathanson's claims in his production of "The Silent Scream"!

However, it should be said that Grobstein's use of the word "purposeful" is a rather long reach, and has no scientific support. In fact, applying this even to the newborn is suspect.

"With these developments, concern legitimately rises about influences and treatments that may evoke pain or other significant discomfort. Very much more knowledge about these matters is needed to deal intelligently and humanely with the "rights" of quasi-persons during their course to full subjective existence.

Added value through added signals

Recapitulating, although the human developmental course is gradual and cumulative, there are several fundamental horizons that are recognizable as major transitions. These include, in addition to fertilization, embryonic axis formation and onset of behavior as indicated by bodily movement. Each signals a new level of organization and integration, which can justify assignment of added value with regard to realized function and imminent social potential."

Each does signal a new level of organization and integration. But it does not follow that "added value" means value to the political or social structure of the society in which the embryo is developing. This is specious and arbitrary, because "added value" may apply to any stage, including newborn (which in the past were subjected to infanticide in some cultures) or adult (decreased value of which is prompting aided death by Kervorkian).

Because of the continuum character of development, stages or ever new levels of differentiation are important only in a taxonomic way to human embryologists and obstetricians.

". . . even at birth full independence as a person is still some years ahead. Nonetheless, in most contemporary societies full protection as a person is mandated for any newborn. Yet, the fetus, particularly in its early stages, is a far cry from a normal newborn, and no general consensus has been achieved on when in fetal life in utero a person definitely exists. There is, however, consensus that any fetus capable of survival after delivery ("viable") is a person from the time of delivery."

Grobstein finally admits that not even birth confers full "personhood" upon an individual. Thus, assigning this socio-legal quality at any time is simply arbitrary.

The only consensus that viability and personhood are linked is that of a majority of the Supreme Court arrived at in 1973 in Roe v. Wade.

" . . . What seems dear is that there is no moment or single step when, or by which, a person in the full sense suddenly exists. Rather, a human being in the full sense gradually emerges through a series of steps, with no way of progressing immediately from a pre-person to a person. Nonetheless, each step makes a contribution, and we do not yet fully understand all of the steps or exactly how each contributes. Some steps can be clarified by study of other species, but no other species undergoes the full changes that are so diagnostic of humanity."

He contradicts himself, because this means that not even his arbitrary stage of "developmental individuality" confers personhood, nor does birth, nor does puberty.

". . . Clearly needed is wider awareness that essentially ideological considerations are pinching off an important area of biomedical research -- an area involving critical aspects of reproduction and development."

"Family of value issues"

To summarize the problem in the context of this book experience has taught us that a number of ethical issues regularly arise in the conduct of scientific research. At the primary level this book presents much about misrepresentation of data, the responsibilities of authorship, and the conflicts of interest that may arise when scientists function in centers of national policy or in corporate board rooms. These indeed are important issues and call for careful attention.

But there is another family of value issues that has plagued the interaction of science with society for centuries, perhaps as long as the two have existed.

I believe it is not by accident that Grobstein uses the phrase "family of value issues". This is a thinly veiled attempt to establish some sense of credibility, not to mention ethical and moral value to his gratuitous tone by offering a contorted syntaxical phraseology of "family values". Traditional family values are the bed rock of societal stability. He knows that; therefore, he makes a rather lame attempt to invoke this concept.

"It has to do with the product of science rather than its methods or even its objectives. To attach value to scientific knowledge often means to detach value from what was previously thought to be reliable knowledge."

Therefore, the end, indeed, would justify the means.

" . . . The firm belief that a complete person begins at conception and that, consequently,both contraception and abortion are moral equivalents to murder rests on supposed knowledge from which value now has to be detached. The much more difficult present reality that a person emerges gradually in complicated ways from a single cell is knowledge to which value now has to be firmly attached. Neither the substance of this relatively new knowledge nor the evidence that supports it is easily communicated throughout the body politic. Nonetheless, it must somehow become part of the scientific and technological literacy, which we are all urged to share more widely with the general community."

Development does not stop at birth The fundamental processes of embryology are continued even into old age and death This is so because all of life is a continuum. Therefore, the human, the person, the individual are all identical in the conceptual sense. Hence, the value of life is established at the initial contact of sperm and ovum and cannot be "detached" because of a self-serving or arbitrary reinvention of human embryology.

References

1 New Wave is used as opposed to New Age because the former connotes: a movement or trend, as in art, literature, or politics, that breaks with traditional concepts; whereas the latter connotes: a social movement embodying American Indian traditions, holism, concern for nature, astrology, vegetarianism, etc. [Back]

2 Syllabus: The Supreme Court of The United States, Roe et al. v. Wade, District Attorney of Dallas County, No. 70-18, decided January 22, 1973. [Back]

3 AMICI CURIAE Brief of 167 Distinguished Scientists and Physicians, Including 11 Nobel Laureates, In Support of Applellees. In The Supreme Court of The United States, October Term, 1988, Re: William L. Webster, et al. v. Reproductive Health Services, et al. [Back]

4 Proc. Amer. Philosp. Soc., 101:357-370, 1957. [Back]

5 Solomon, Susan., personal communication. [Back]

6 Grobstein, Clifford. 1988. Science and The Unborn: Choosing Human Futures. Basic Books, Inc., New York. [Back]

7 Grobstein, Clifford. 1979. External Human Fertilization. Scientific American, 240:57-67. [Back]

8 Moore, KeithL. 1988. Before We Are Born. p.71. W.B.Saunders Co., Philadelphia. [Back]

9 Moore, Keith L. 1993. The Developing Human. 5th edition. W.B. Saunders Co., Philadelphia. [Back]

10 Grobstein, Clifford. 1993. The Status and Uses of Early Human Developmental Stages. in Ethical Issues In Research, ed. Darwin Cheney, The University Publishing Group, Inc., Frederick, Maryland. [Back]

11 I. Strömberg, M. Bygdeman and P. Almqvist. 1992. J. Comp. Neurol., 315:445. [Back]

12 Lindvall, et al., 1992. Annals of Neurolology, 31: 155-173. [Back]

13 Grobstein, C. 1989. Psychology Today, September Issue, pp. 43-46. [Back]

14 Singleton, Rivers, Jr. 1989. Persp. Biol. Med., 32:174-179. [Back]

15 Sagan, C. and A. Drugan. 1990. Parade, The Sunday Paper Magazine, April 22, pp. 4-8. [Back]

16 Kolberg, R. 1993. Science (Research News), 262:652-653. [Back]

17 Moore, K.L. 1988. The Developing Human, 4th ed., p. 125, W.B. Saunders Co., Philadelphia. [Back]

18 Carlson, Bruce. 1994. Human Development and Developmental Biology, Mosby Books, New York. [Back]

19 Larsen, William J. 1993. Human Embryology, Churchill Livingstone, New York. [Back]

20 O'Rahilly, R and F. Muller, Human Embryology and Teratology, page 55, Wiley-Liss, New York. [Back]

21 O'Malley, W.J. 1986. America, June 14, 492-494. [Back]

1, 2,