My god-daughter (albeit as her Confirmation sponsor) is an intern this summer at the President’s Council on Bioethics. I am very proud of her accomplishments. I told Genna honestly, she was far smarter than I ever was. Her gifted mind delights me even as I am saddened by my inability to keep up with her as she travels into new frontiers of knowledge and ideas.
Although my appreciation of medical ethics and moral theology may be a bit dated, I wanted to respond to a recent post on her Blog. Quoting Dr. William Hurlbut on the notion that science and religious truth are complimentary (which is Catholic Thomism 101), she praises his evident genius and poetic ability for self-expression. This is well enough, and I take no exception here, but I do have serious personal reservations about his proposals. Following is an abbreviated version of a post dated July 8, 2007 from her Blog:
…Dr. William Hurlbut, a professor at Stanford University in California and a tireless researcher in the area of alternate sources of pluripotent stem cells. Most recently this includes altered nuclear transfer (ANT). He is one of the masterminds behind the Council’s latest “white paper”, Alternative Sources of Pluripotent Stem Cells. (Like a good intern, I have a copy on my desk, well-marked up and nearly memorized.) FYI, the four alternatives that the paper suggests are (and I am taking this from the paper):
According to the first proposal, pluripotent human stem cells are to be derived from early IVF embryos (roughly 4-8 cells) that have spontaneously died (as evidenced by the irreversible cessation of cell division) but some of whose blastomeresii appear normal and healthy….
According to the second proposal, pluripotent stem cells are to be derived from blastomeres obtained by biopsy of an early human embryo….
The third approach comprises a variety of proposals for engineering “biological artifacts” possessing some of the developmental capacities of natural embryogenesis (but lacking the organismal character of human embryos) and containing cells from which pluripotent stem cell lines can be derived. Crucial to this approach is demonstrating both (a) that the developing entity is truly not a human embryo and (b) that the cells derived from it are in fact normal human pluripotent cells. In addition, one must show that creating such biological artifacts does not itself introduce other ethical problems. One such proposal (”Altered Nuclear Transfer”) was presented at the Council’s December 3, 2004, meeting by Council Member Dr. William Hurlbut.
The fourth proposal involves reprogramming human somatic cells, perhaps with the aid of special cytoplasmic factors obtained from oocytes (or from pluripotent embryonic stem cells), so as to “dedifferentiate” them back into pluripotent stem cells. Crucial to this approach is discovering a way to reverse cell differentiation all the way to pluripotency, but not (as in cloning) even further back to totipotency.
I know Fr. Joe disagrees with Dr. H’s proposed solution to the problem – and believe me, I am cautious and have reservations of my own – but I also have done a great deal of reading of Dr. H’s articles, etc. and spoken with him myself, and can attest to the fact that he is an altogether honorable, upright, and decent person who would not rush into something without carefully weighing all sides and considering all the facts. After I finish my current research project for the Council, I plan to investigate this third approach quite seriously and decide for myself when I am satisfied with my own level of understanding. Until then, I will have to parry arguments with a “wait and let me study a bit before I answer”.
Reading the “white paper” only confirms my apprehension. As she said, speaking for myself, I do have problems with Dr. Hurlbut’s ideas.
A mouse is not a man. This seems obvious to most of us and yet I suspect the exceptionally brilliant and the most mentally challenged sometimes forget this fact. A mouse is conscious in an instinctive way, but it is not self-conscious. It has a memory but not much in the way of a mind. A mouse will never read or write a book. It will neither compose nor perform music— not a symphony, not even a two minute rap song. The mouse can steal cheese, but he cannot make cheese for himself. His life is short and as vermin his existence is granted little or no value. Nevertheless, scientists today are performing experiments upon mice in regard to embryos, DNA mutations and stem cells that are regarded as precursors, both in terms of genetics and ethics, to the eventual manipulation of human genetic material and the origins of life. The prospect makes me shudder. All life is dependent upon God, but men more than mice are imbued with mystery. Men have souls that cannot be ascertained by the physical senses, neither measured nor manipulated by scalpel or hypodermic. The presumption is that at conception a human being is present and no science will ever be able to prove otherwise. No mechanistic description of early human development or even a mutation to forestall what nature and the God of nature intends necessarily means that a man is not present— a being with a supernatural destiny, even if his “specific” natural trajectory is made defective or abridged from that of other men. Potency, both active and passive, is present. Going back to a few microscopic cells, the person is whole, cannot be defined by his parts, and shares his humanity with the species of man. No matter whether brain-dead and ninety years old, or freshly conceived and in a petri-dish, we have a human being. While the use of human gametes and especially egg cells holds its own moral problems, the very sovereignty of God may be challenged. Altering the DNA to create a time bomb in the embryo does not negate the fact that like any natural miscarriage, we may still be dealing with a human person who is entitled not to be treated as a means to an ends or as a commodity. Cloning a monstrosity that mimics an embryo might still leave us with a human being— although grossly deformed and defective. I am very fearful that Dr. Hurlbut and his colleagues, despite their pro-life sympathies and good intentions, may have given us a new form of homicide.
It is hard to come to terms with the possibility that I might not always be of the same mind with several highly regarded and orthodox philosophers and theologians about certain important questions. Ideas are very important to me and there are some notions that help define my own sense of identity and outlook upon life. There are also ideas for which I would hopefully fight and even lay down my life. Many of the founding fathers of our nation were of this sort, philosophers who defined the rights of man and who were willing to sacrifice everything in the practical realization of their ideas about natural law, the quality of life, and the value or good of happiness and liberty. I do not have a lot of degrees after my name. My skills as a philosopher are amateurish, my depths as a scientist go no further than a hobby, and although a priest, I would never count myself a true learned theologian.
When first given a bare-bones explanation of Dr. Hurlbut’s work by a friend, I vaguely recalled from the news a suggestion about the creation of a non-embryo entity from which stem cells might be harvested. But I was busy with parish business and the matter did not register more than a quick blip on my personal radar. I had forgotten the name of the doctor who had put the strategy forward and figured that any idea about which Dr. Grisez and my old friend Dr. May would sign off was probably worthwhile. However, now that it was spelled out to me, personal alarms started ringing. I feverishly began to explore the matter further. I became deeply and increasingly troubled and fearful that this new research might further divide the pro-life movement.
Those sympathetic to Dr. Hurlbut’s work would find themselves with the majority of ethicists and theologians in the conservative camp. Unfortunately, the more I read, the more reservations and queasiness I feel about it. We have been down this road before. The so-called majority report about contraception was rejected by Pope Paul VI. It is my hunch, despite a number of enthusiastic Vatican experts, that the Holy See might also reject Dr. Hurlbut’s strategy to harvest stem cells from an embryo-like mutation. On the level of faith, could we be setting the stage for dissent from Catholic teaching about the sacredness of life from the very first moment of conception and as expressed in EVANGELIUM VITAE and VERITATIS SPLENDOR and future ecclesiastical declarations? On the level of science, are we playing with possible cooperation with a form of medical research which might one day be regarded by the Church as a new form of murder?
It is one thing to enlist a major Catholic philosopher like Dr. Germaine Grisez and a faithful Catholic moral theologian like Dr. William May regarding animal research into Altered Nuclear Transfer; it is quite another to contend that ethical concerns no longer apply to human research and application. Dr. Rudolf Jaenisch had some success in extracting stem-cells from a product that was no longer a normal mouse embryo. What he produced could never develop into a fully developed mouse. However, even had it remained unquestionably a mouse embryo, there still would have been no moral problems with its destruction and the extraction of embryonic stem-cells. The sore point was where the research was heading. The research is by its very nature a precursor to human experimentation and purportedly to avoid the outright destruction of human embryos that would otherwise have the potential to grow into fully formed human beings. Given that Dr. Hurlbut has strong Christian pro-life sympathies, there is something noble about his desire to find a way around the moral impasse that makes research into embryonic stem-cells so very problematic. However, I am uncertain that all the hurdles have been successfully jumped. Further, there may be important differences between a scientific, philosophical or generic Christian, i.e. Protestant view about life’s beginnings and that held by Catholics as a matter of accepted faith.
Along with other pro-life advocates, including Dr. Hurlbut, I have been increasingly distressed with the stance of various secular scientists, easily manipulated politicians and Hollywood celebrities who have labeled us as insensitive and backward for our opposition to harvesting stem-cells from human embryos.
Part of the dilemma is that critics reject the humanity or personhood of embryonic human beings. Of course, there may be some pragmatists, who like certain Nazi biological scientists, want to pursue research regardless of life issues or moral reservations. Possible benefits from stem-cells, not yet realized, fuel a utilitarian approach. Emotions often cloud clear reasoning with lobby groups upset about the late President Reagan’s final days, Christopher Reeves paralysis and death, and Michael J. Fox’s continued cerebral-motor degradation. When a human face is given of those who might have benefited from such research, it is indeed quite compelling. Nevertheless, if we regard embryonic life as human and personal then I would contend there is no way to make the ends here justify the means.
When Senator Kerry ran for president he attacked the prohibitions that President Bush had put in place in regard to federal funding for embryonic stem-cell research and the use of only pre-existing embryonic stem-cell lines. Although a Catholic, Kerry took a radical pro-abortion stance. His position in favor of embryonic stem-cell research flowed from this stance. He derided the other side of the issue as those who would place ideology over science. Of course, a thoughtful person might realize that science in and of itself does not tell us what we should do; only what we might be able to do. Science is good but like any good it can be abused.
While there have been federal restrictions in funds, a great deal of private money and many scientists have pursued embryonic research. Ethical questions aside, this work has not faced legal injunction and major corporations have sought to tackle the research in the hope that they might be the first to develop cures for such problems as paralysis, Alzheimer’s, Parkinson’s, etc. Despite all this work there is not yet one cure for anything!
Nevertheless, certain pro-life researchers have also foreseen possible medical advances in embryonic stem-cell research and have desperately sought alternative ways of procuring these stem-cells, other than destroying human embryos.
It is here that Dr. William Hurlbut from Stanford emerges on the scene with his Altered Nuclear Transfer approach. Various representatives at the Vatican and even important Catholic “orthodox” moral theologians and philosophers here in the U.S. have endorsed research, albeit in animals if not humans. The idea here was to utilize embryo-like stem-cells from a mutated source (a tumor), but not a true human embryo.
Politically, the Hurlbut proposal may give credence to the arguments of our opponents while it divides the pro-life community which has stressed the very real successes of adult stem-cell therapies. Dr. Hurlbut and the OAR contribution of Dr. Grompe are rehashing proposals about the potential curative possibilities of embryonic stem-cells while the normative way they are harvested is still by killing human embryos. When we talk about a morally licit means of acquiring embryonic stem-cells, we are speaking to a small pro-life ghetto. Most researchers are going to ignore what seems to be a lot of bother about nothing.
When challenged by such people as Dr. David Stevens of the Christian Medical Association, the supporters of Dr. Hurlbut have insisted that certain doctors, theologians and ethicists are suffering from confusion about the technology. While polite, what they are essentially saying is that if you disagree with ACT-OAR then you are too stupid to understand. The truth is that there are some serious disagreements about the nature and beginnings of human life.
Back in 2004, Dr. Hurlbut and his colleagues suggested that pluripotent stem cells might be extracted from something other than a human embryo. As a pro-life non-denominational (Protestant) Christian, neither the use of current stem-cell lines nor the creation of embryos through in vitro fertilization was deemed satisfactory.
ANT calls for the removal of a cell from the body, like a skin cell, and the DNA in the cellular nucleus is manipulated so as to control whatever operation of genes it can sustain. The nucleus already present in a human egg cell (oocyte) is removed; it is fused to the nucleus of an adult stem cell. Whatever alterations that have been made in the adult stem cell nucleus will now direct the gene expression and growth activity of the hybrid. This new ANT cell could now produce pluripotent (embryonic-like) stem-cells genetically akin to the adult cell that was used.
When I first heard about this, my initial thought was that it sounded like traditional cloning. Such research had already been condemned by the Holy See as unethical. The twist here was that adult cells would themselves be altered before fusion. But would we not still be dealing with an embryo of sorts?
It was first proposed that the gene in charge of growth in the embryo could be suppressed. Since the entity could not grow to be a fetus it was argued that it was more like a teratoma tumor than a true embryonic human being. When I read this, my next mental connection was with the children of miscarriages. Many of them had genetic errors that made full maturation impossible. The Church, however, had regarded such as lost children, no matter how early in the pregnancy. It seemed to me that Dr. Hurlbut and his fellow researchers might contend that there was no true embryo and human being in these cases as well. I became increasingly anxious about what I was hearing and the possible repercussions from a mechanistic theory of “developmental trajectory”. I was not the only one worried. Dr. David Stevens, executive director of the Christian Medical Association stated: “Just because scientists have created a genetic time bomb in the embryo does not change its essential human nature” (cited by Joan Frawley Desmond’s article). Would we not be simply creating disabled or defective embryos?
Since the initial proposal and the release of “a white paper” from the President’s Council on Bioethics that detailed four stances; the proposal from Dr. Hurlbut has merged with that of Dr. Markus Grompe. Oocte-Assisted Reprogramming is now at the heart of this ANT proposal. It proposes taking any body cell (probably skin or liver) and reprogramming it to return the adult cell to a pluripotent stage. Such cells could be used in the treatment of donors themselves, avoiding any concern about immune rejection. It would also remove the need for conventional cloning. It was to this notion and within the current range of animal research that Dr. William May, Archbishop Levada, Dr. Germain Grisez, John Haas and others have signed off.
David Schindler and Adrian Walker, both professors at the John Paul II Institute voiced serious concerns and opposition in a series of articles in COMMUNIO to this line of research. What exactly is the nature of this creation from Hurlbut’s ANT?
DAVID L. SCHINDLER
The new so-called middle-ground approach remains problematic and I find myself agreeing with Professor David Schindler: the Hurlbut solution is inherently flawed by a mechanistic consideration of nascient human life that betrays the pro-life cause and is incompatible with Catholic theology. [Obviously, this is a verdict not shared by the current majority of Catholic ethicists and moral theologians.]
Professor Schindler questioned Hurlbut’s philosophical underpinnings and charged him with a mechanistic view of the human being in his denial that he was creating a true embryo. Schindler said that Hurlbut brushed aside the “integrity of the human being as born not manufactured and as naturally apt in his or her bodiliness for the expression of gift.” Professor Schindler contended that there can be no “technological solution” to the moral impasse because “there is no unqualifiedly technological solution to any human problem.”
Professor Schindler is correct that you cannot consider the human body merely in a mechanical or physical way apart from moral consideration of the human person. Hurlbut would attempt to escape a moral dilemma by the supposed creation of a tertium quid, an entity that is not an animal or non-human, but human while not strictly a human person. Is such research literally to play God? Is it not advancing a dominion over nature that negates that which is given as naturally good? It is difficult not to detect a certain hubris in this, given that it undermines the basic premises of the natural law and substitutes human whim. Professor Schindler describes this folly as a “mechanistic philosophy” arising from an “absent God.”
He concludes that the “signatories have failed to show conclusively that OAR (Grompe’s addition to Hurlbut’s idea) does not present us equally with a species of the evil of homicide; that OAR is not the cloning of defective humans.” Of course, even if there is no true human embryo, the use of human eggs presents its own problems. He says proponents ignore the “special significance of the finality of the human body’s sexual/reproductive organs, by virtue of their being bound up so directly with the origins of life.”
I share Professor Schindler’s frustration, particularly as critics are charged with not understanding the science. My return is that the signatories themselves may not understand the science and how elements of it are inconsistent with Aristotelian/Thomistic philosophy and fundamental Catholic theology.
If this procedure (OAR) should produce an embryo or anything arguably an embryo, then I suspect the proposal would quickly forfeit its many supporters.
Professor Grompe, himself, acknowledges that the Vatican may very well rule against the proposal. Would orthodox Catholic ethicists, theologians and scientists then back off, or would they dissent and continue the work and support of Grompe and Hurlbut? I feel that this negative verdict is a certainty, but I may be wrong. A utilitarian approach would permit evil for a potential good, like killing human embryos in an effort to fight certain diseases. This is, however, immoral.
Politically, efforts to get funding for Hurlbut’s ideas have forced moderate and conservative opponents of embryonic stem cells to reconsider their opposition. If adult stem cells will not work just as well, then why go to all the trouble to do what Hurlbut wants. It is a pro-life gamble that could quickly backfire.
“Veritatis Splendor and the Foundations of Bioethics: Notes Towards an Assessment of Altered Nuclear Transfer and Embryonic (Pluripotent) Stem Cell Research,” COMMUNIO 32 (Spring 2005).
Dr. Schindler makes a distinction between active and passive potency. Next he gives us the analogy of an acorn which has the active potency to become a tree. However, would it be any less an acorn if it failed to become a tree because of a serious defect? The acorn only has a passive potency to become a desk and requires intervention. However, did it not still come from an acorn? Moving to bioethics, the ANT argument is that, due to manipulation, the entity created is sub-human in that it does not present those characteristics we associate with humanity. The question still remains, as it does with the acorn, is a non-human entity created or is it a human entity grossly disabled? Dr. Schindler states: “…the nature of an organism is not determined in the first instance by its capacity to progress to a more mature stage of development: being an organism is not synonymous with (progressively) manifesting organismal traits” (p. 196).
Dr. Schindler next takes exception to something similar to what we used to call process theology and philosophy. Thinkers spoke about beings and things as in a process of becoming. He contends that the nature of an organism is that of an “all-at-once” character prior to any development. This wholeness at the beginning is not exhausted by, or strictly defined by, a temporal process and the growth of parts. Dr. Schindler is insisting upon transcendence intrinsic to the human person from the very beginning. This is something that Dr. Hurlbut dismisses with his notion of coordinated trajectory.
Dr. Schindler demands that we respect how mystery is part of the very fabric and design of an organism. It is mystery and not a mechanistic appreciation of a being that must be respected. He writes, “Mystery expresses the non-determininistic (not exhaustively mechanical) being and causal agency proper to an organism…” (p. 197). Dr. Schindler is literally reminding us not to try to play God. He states: “Empirical-experimental knowledge, in a word, is intrinsically limited because and insofar as the causal agency constitutive of an organism, as a whole and in its parts, is not exhaustively mechanical” (p. 198).
Dr. Schindler states: “The difficulty, then, is that ANT, failing to take account of the ontological mystery proper to organic life, is just so far incapable of providing any principled or reasonable means of checking the tendencies of the dominant scientific culture as these bear on (human) organic life at these most subtle and fragile moments. First of all, the principle that ANT offers for distinguishing a human organism from a sub-human entity,…yields no criterion adequate for sustaining such a distinction. Secondly, ANT provides no principled criterion for noticing the intrinsic limits imposed by nature herself on experimental knowledge—i.e., on the manipulation of pluripotent stem cells—and the (potentially) serious implications of such intrinsic limits” (p. 198-199).
Dr. Schindler is quite right that we must see the creature in light of the diffusive goodness and “esse” of God himself as the Creator. We must ponder the theological significance of creation. “The existence and nature of organic life as gift can be fully grasped only in the pondering of such questions” (p. 200). The ANT proposal brings up serious questions about BEING and GOD. ACT would manipulate beings “at their origin, in their original being and acting” (p. 200). He concludes by citing Veritatis Splendor, noting that we have to understand the body as gift.
Just as Dr. Hurlbut and his colleagues have argued that Dr. Schindler just does not understand, Schindler turns the tables on him in critical fashion: “Christians who would face the ethical problems posed by contemporary biotechnology, given its radical capacities now to manipulate life in its most fragile beginnings, no longer have the luxury of leaving such ponderings to ‘specialists’” (p. 201).
“A Response to the Joint Statement, ‘Production of Pluripotent Stem Cells by Oocyte Assisted Reprogramming’,” COMMUNIO 32 (Summer 2005).
Dr. Schindler chastises the 35 pro-life scholars who signed off on ANT-OAR proposal, saying that they are “begging a series of questions, and so by importing a number of assumptions, regarding the origin and nature of human life and, at least implicitly, also regarding the meaning of nature, of creation, and of Christian faith itself, and of the implications of these for (scientific) reason” (p. 369).
1. The criterion assumed in the OAR proposal for determining the (ontological) identity of the product of the procedure—whether it is a stem cell or a one-celled human embryo made to resemble a stem cell—is flawed.
The OAR proposal is for the fusion of an oocyte with the nucleus moved with a somatic cell nucleus. Dr. Schindler contends that this “mimics conception” (p. 371). The problem is that this so-called “epigenetic reprogramming” might actually be the modification of an artificially derived human conceptus. “Epigenetics can determine only the phenotypical manifestations of the cell whose identity is at issue, not its (ontological) identity as such” (p. 371). Such modification does not negate the entity from being a human organism. He goes on to say: “…the assertion that OAR enables us to create pluripotent stem cells without creating an embryo is certainly true only if the mechanistic philosophy mediating this claim is certainly true, which it is not” (p. 372). Noting Pope John Paul II’s encyclical, EVANGELIUM VITAE, he says that OAR fails the test: “…what is at stake is so important that, from the standpoint of moral obligation, the mere probability that a human person is involved would suffice to justify an absolutely clear prohibition” (p. 374/EV #60).
2. The proponents of OAR miss the ontological subtleties of the beginning of human life. Recognition of ontological dependence and mystery is necessary for judging rightly the original fact and not merely the value (or dignity) of the human embryo.
The origins of human life cannot be reduced to a “scientific-empirical question,” even in regard to the ANT-OAR positivism that disregards gift and mystery to play God over life in a mechanistic mindset and intervention. Dr. Schindler states: “…determination of the presence of life in its most subtle beginnings is precisely not obvious in the manner of a positivistic fact, but always involves philosophical mediation (even if only unconsciously). Apprehending life in its most subtle beginnings involves a cognitional act that is not only empirical but also (at least implicitly) metaphysical in nature, an act which, rightly exercised, recognizes the mystery characteristic of the organism in its very givenness” (p. 375).
Returning to his argument about dependent being, he explains: “…the organism in its actual wholeness is ontologically prior to the organism in the coordinated action of its parts, even as the coordinated action of its parts is simultaneously-subordinated necessary for that actual wholeness. This mutual if asymmetrical dependence of whole and parts, as constitutive, implies that the being and indeed the existing nature of an organism is in the first instance dependent, hence received: given to itself and not self-generated. The organism is not an absolute first cause of itself as a whole or in its parts. Because the being of the organism as such is first given, this givenness remains the inner and abiding condition of its acting….God gives the organism to itself and so creates an originality that by definition we cannot know or control exhaustively, an originality that we therefore should not attempt or claim to know or control exhaustively” (p. 375). Proponents of OAR seem to claim some knowledge of human life’s origins, although from a scientific perspective. But the philosophy and theology is weak.
OAR fails to perceive the mystery of human origins and seeks to define the human being in strictly scientific terms. This derides human dignity and actually factors into the “depersonalization” of the embryo. He says that OAR has brought us “to the question of the meaning of embryonic life in the mysterious subtlety of its origin or original nature, an origin which, involving as it does ontological dependence, remains effective within the embryo as a whole and in all of its parts for the duration of its existence” (p. 376).
3. Dr. Schindler claims that while adult stem cell research depends upon a more natural and “organismic causality,” the scientific method in regard to OAR pluripotent stem cell research where cells are manipulated in an in vitro environment “in and from their origins” works against nature.
4. OAR appears to treat the body as “pre-moral,” that is, in an objectifying way as merely a quarry for “parts”.
He asks: “Is this reduction of the oocyte to a mechanism for harvesting parts consistent with the Church’s theology of the body, for example, with the finality of the gametes as implied in John Paul II’s notion of the “nuptial body”? Has the oocyte not become in OAR rather an instance of the ‘premoral’ body rejected in Veritatis splendor (see n. 48)? Does not OAR eo ipso do violence to the human body at the source and original place of its (mysterious) procreative capacities?”
5. The signatories of the Joint Statement are known pro-lifers, but in their haste because of political restraints, they may have put their names to a proposal that may “present us equally with a species of the evil of homicide,” given that OAR may be “the cloning of defective humans”.
When it comes to such a subject, I may only be a hack with a gut feeling that something is terribly wrong. But the public academic debate seems to substantiate my concerns. I will defer to Dr. Schindler and others in making the case against Dr. Hurlbut’s proposal. Here are important links: (note that Dr. Schindler’s articles are at COMMUNIO)