These various particular cases for discontinuity (and
these are not the only ones that have been propounded
over the years) are not mutually exclusive. Indeed, many
of them point to more than one particular element of early
human development as finally decisive of moral standing.
But they share the belief that moral status accrues only
at some later stage of the developing human organism.
Their claim, in the broadest terms, is that in its earliest
stages a human embryo is not yet simply a human being
or a human person, and that it need not be treated as
though it were.104
Human development, they contend, is
an essential element in any understanding of human life,
and an organism at the earliest stages of that process
is not to be treated the same as one much farther along.105
There are developmental differences, and these differences
matter, in ways to be determined by human choice and understanding,
as well as by a grasp of the biological facts.106
Critics of this view contend that while it is certainly
true that human beings at different stages of development
are not to be treated the same (as children are not given
the responsibilities of adults), the crucial treatment
here at issue is destructive treatment. No human being,
at any stage, they argue, should simply be destroyed for
research, and the “use” of an embryo for research,
no matter how valuable one deems the research to be, could
not amount to treatment of that embryo as “deserving
some degree of respect.” The degree of respect granted
in destroying the embryo would be zero, they contend.107
Nonetheless, the case for developing moral status, as
articulated by a great number of participants in the policy
debates of the past several years, often results in an
expression of what has sometimes been termed the “special
respect” approach to human embryos: an embryo in
its earliest stages is not accorded the full moral standing
of a human person, but it is nonetheless regarded as deserving
some degree of respect and is treated as more than a mere
object or collection of somatic cells in tissue culture.
In practice, adherents of this view tend to accept the
use of early human embryos in medically valuable research
under some circumstances, but they seek to apply some
scrutiny to the reasons for which embryos will be used,
the circumstances under which those embryos are obtained,
and other relevant factors. Several bodies advising the
federal government on human embryo research over the years
have expressed this view, to varying degrees. The Ethics
Advisory Board to the Department of Health, Education
and Welfare concluded in 1979 that the early human embryo
deserves “profound respect” as a form of developing
human life (though not necessarily “the full legal
and moral rights attributed to persons”).108
The NIH Human Embryo Research Panel agreed in 1994 that
“the preimplantation human embryo warrants serious
moral consideration as a developing form of human life,”
though the panel argued that this did not mean that research
should be prohibited.109
In 1999, the National Bioethics Advisory Commission (NBAC)
cited broad agreement in society that “human embryos
deserve respect as a form of human life,”110
but, like its predecessors, did not recognize the embryo
as having the full rights of a human person. The special
respect position has been held by its advocates to be
consistent with a range of possible particular policies
on embryo research, including fairly restrictive ones,
and indeed could be held consistent even with an outright
restriction on the destruction of human embryos.v
111
To consider the embryo “inviolable” (and therefore
not a mere utility to be instrumentally used), it is not
necessary to presuppose its moral equality with a child,
an adult or even a later stage gestating fetus. There
may be increasing moral obligations (and natural sentiments)
associated with a deepening relationality that extend
moral duty without in any way implicitly eroding an imperative
of protection at earlier stages of developing life. Most
of those who have articulated the special respect position
in the public debate have, however, tended to then argue
that some research on embryos should be permitted within
certain boundaries, even if they have not always agreed
on the permissible extent or the appropriate boundaries.
B. Special Cases and Exceptions
Some arguments in favor of permitting and funding embryo
research, grounded in the “special respect”
approach, do not in fact explicitly (or exclusively) rely
on arguments about discontinuity or a biologically grounded
view of developing moral status. Instead, or in addition,
they rely upon questions of embryo viability and potential,
and they are aimed at exploring unique circumstances to
address and perhaps resolve questions of the moral standing
of certain particular human embryos.
1. IVF “Spares.”
Much of the debate surrounding embryonic stem cell research
has focused on the use of cryogenically preserved IVF
embryos, left over from assisted reproduction procedures
and stored, perhaps indefinitely, in the freezers of IVF
clinics. One recent study suggests there are hundreds
of thousands of such embryos in the United States alone,
though only a very small percentage of them (less than
3 percent, approximately 3,000 or more) has ever been
donated for research.112
Although all were produced with reproductive intent and
were stored for further reproductive efforts should the
first attempt fail, most of these frozen embryos may never
be claimed by the original egg and sperm donors for use
in assisted reproduction procedures. They are almost certain
to remain frozen and, eventually, to die without developing
further. Although there have been some efforts to build
interest in adopting such embryos, such adoption, some
commentators argue, is very unlikely to become a large-scale
phenomenon or to affect the fate of most of these stored
embryos. 113
Under the present funding policy, if these frozen embryos
were donated for research and embryonic stem cells were
derived from them, research on the resulting cells would
not be eligible for federal funding. Many observers argue
that it should be: Since these particular embryos are
almost certainly destined to die without ever developing,
it would be appropriate to at least redeem some possible
good from their existence and unavoidable demise.114
Some people have pushed the point further. Since the vast
majority of the (huge number of) cryopreserved embryos
will almost certainly not be adopted, and since many may
not be viable even if they were to be transferred to a
woman’s uterus, a few observers have argued that,
practically speaking, the frozen embryos are virtually
all already lost.115
To be sure, they are not already dead, but they are in
a so-called “terminal situation” from which
no rescue is practically possible. In view of this situation,
one commentator proposes extending to these embryos the
principle that sometimes, he argues, permits the killing
of innocents. That is, killing may be morally permissible
in cases where the person will soon die for other unavoidable
reasons and where there is another person who can somehow
be rescued through or as a result of such a normally impermissible
act of killing (thus, as he puts it, “nothing more
is lost”). He admits that the case of cryopreserved
embryos stretches the application of the “nothing
is lost” principle beyond its previous uses, because
the embryos in question are alive and at risk of death
only because of human choices and designs specifically
directed toward them. The principle is also stretched
because the lives that might someday be saved through
today’s embryo deaths are quite remote. The potential
lives saved are those of unspecified future persons with
diseases that might be treated by therapies that as yet
do not exist and may or may not exist in the future. However,
against the weight of all these ifs, which some find formidable,
there is the present fact that (like the embryos used
to create stem cell lines derived before August 9th of
2001) the cryopreserved embryos are already here, with
little or no prospect of rescue—they are, in this
observer’s description, already lost.116
Presumably, if destruction of “spare embryos”
for human embryonic stem cell research were generally
agreed to be permissible through this “nothing is
lost” principle, it could be federally funded, subject
to such routine secondary considerations as the need for
free and informed consent by donors.
Yet this argument, not surprisingly, has met with opposition.
Some critics have claimed that it employs circular moral
reasoning. The embryos, they argue, are in a “terminal
situation” because of human choice and design; thus
to then decide that, since they are going to die anyway,
they may as well be put to good use is to ignore the moral
implications of the original decision to create and freeze
them. Critics argue, moreover, that when thinking about
our responsibilities to those who are soon to die, we
would normally say that it makes a considerable moral
difference whether we simply accept their dying or whether
we positively embrace it as our aim.117Yet
some proponents of using IVF spares argue that the present
situation is best understood as a forced choice between
two regrettable alternatives for the final disposition
of stored embryos (whether donated for research or abandoned).
One choice may then be justified as the lesser evil. Even
if one deems the original decisions leading to the creation
and storage of these embryos questionable, the embryos
exist, and the earlier decisions cannot be undone.118
Some have also worried about the possibility of a “slippery
slope,” by which the uses of “spare”
IVF embryos under this justification might open the door
to their wider use in experiments in natural embryogenesis,
toxicological studies or chimerizations, or perhaps their
development in an artificial (or natural) endometrium,119
(though the reasonableness of “slippery slope”
arguments is often disputed).120
Other critics point out that the “nothing is lost”
principle is not permitted to govern decisions regarding
lethal experiments on the terminally ill, on death-row
inmates, or even on fetuses slated for abortion.121
A further issue involves the question of whether accepting
the “nothing is lost” principle for already
existing embryos condones in principle the use of future
excess embryos, or whether the principle actually requires
efforts to prevent the creation or storage of “excess”
embryos in the future.122
Further, this application of the principle
relates only to embryos originally created for the purpose
of reproduction but not transferred to initiate a pregnancy.
Should their use in research be accepted, however, it
is not clear that it would be possible to differentiate
between embryos created originally for reproduction and
extra embryos created with an eye to research uses, since
the process of producing them would be identical (though
consideration of the extra risks involved for the woman
egg donor could act as a counter against any large-scale
embryo-creation-for-research).123
Other observers, however, begin from the presence of cryogenically
preserved embryos but extend further the argument justifying
their use in research. They argue that there is good reason
to use embryos for research, not only because a situation
some judge tragic already exists but because donating
embryos is an act of beneficence and using them is a social
obligation incurred by their gift.124
This approach would have us start by recognizing that,
in the current situation, there is a set of embryos (in
IVF clinics) none of which will ever enter a uterus, or
even a (still hypothetical) artificial uterus.125
These embryos, in one commentator’s term, are “unenabled”
and have no potential for full development. Since there
is no possible way for such embryos to develop, there
is no “possible person” to whom any “unenabled”
embryo corresponds; therefore using them in research involves
no loss of possible life.126
Critics of this approach argue that in effect it allows
the moral standing of any given embryo to be decided simply
by those responsible for it. Thus, whether a given embryo
has moral standing depends only on whether it has a practical
prospect of developing, as evidenced by whether it will
be transferred to a uterus. But whether it enters a uterus
depends on human choices, so the moral standing of a given
embryo depends on human choices. If we choose to withhold
essential enabling conditions for an embryo’s development,
these critics argue, then that embryo will lack not moral
standing but merely the opportunity to develop. Its intrinsic
nature, including its own potential to develop (given
needed conditions), has not changed.127
Nonetheless, in the view of a number of commentators,
the fact that so many frozen embryos already exist (even
if only a small percentage of them are donated for research)
changes the balance of duties and respect owed to any
single ex vivo embryo. Several observers have argued that
the presence of these frozen embryos, with little or no
chance of attaining birth, creates special circumstances
in which the use of embryos in research (whether destroying
them in the course of research or allowing them to die
and subsequently using them)128
is independent of any final judgment regarding the moral
standing or worth of the ordinary human embryo, as such.129
2. Natural Embryo Loss.
Some authors tie their moral arguments regarding the
use of embryos in research to the fact of the high rate
of embryo loss under natural conditions of sexual intercourse
and unassisted reproduction. They argue that directed
destruction of ex vivo embryos for the purpose of research
would not result in greater embryonic loss than occurs
in this natural process and would result in far greater
benefits for humanity.130
The rate of natural embryo loss after conception in unassisted
human reproduction (taking in losses both before and after
implantation), though not accurately known, is thought
to be high, some suggest as high as 80 percent.131
Moreover, the fact of natural loss is now fairly well
known, so that persons who engage in unprotected intercourse,
whether seeking to reproduce or not, are knowingly bringing
about the conception of many embryos that will die. We
generally do not regard this embryo loss as unacceptably
tragic, and we do not engage in great efforts to avert
it or to find ways to diminish it (beyond research to
prevent miscarriage, for instance). For this reason, these
commentators argue, using artificially created embryos
for purposes of research would not destroy a greater portion
of those embryos than ordinarily die in natural unassisted
reproduction.132
Moreover, they suggest, the high rate of natural embryo
loss should call into question the views of those who
believe that early-stage human embryos merit equal treatment
with human children and adults. If so many die in the
natural course of things, why do we not treat natural
procreation as a great fountain of tragedy and carnage?
The natural rate of embryo loss, and most people’s
failure to mourn its consequences, they suggest, should
teach us something about the limited significance of human
embryos in the earliest stages. One observer adds that
the same logic should diminish our concerns about creating
extra human embryos for research, as long as sufficient
embryos are created for implantation to keep the chances
of survival for any given embryo as good as the chances
in natural reproduction.133
Another argues further that human embryonic stem cell
research might actually raise the probability of longer
survival for all humans, including embryonic ones, and
is therefore a case of permissible taking of life, even
on the assumption that the embryos are persons.134
Opponents of this view, however, have argued that natural
deaths of embryos and the deaths caused by intentional
efforts to destroy ex vivo embryos for research are not
morally equivalent. There are many things that happen
naturally that we are not therefore justified in doing
deliberately. Indeed, the rate of natural loss of live-born
human beings is 100 percent, but that does not justify
their killing. And, they argue, even if one were permitted
to analogize the deaths of frozen embryos in vitro to
the embryonic wastage in vivo, in neither case were the
embryos lost destined or created for anything other than
their procreative end. In contrast, they argue, using
embryos for research bears no relation to their natural
direction or trajectory. Critics also argue that the character
of our reaction to the natural embryonic death does not
justify our practice of destructive embryo research. For
they believe that a creature’s moral worth is not
dependent on the emotional reaction of others to its death.135
The absence of moral sentiment does not imply an absence
of moral obligation (nor a right of adverse intervention
in a naturally developing human life). Moreover, critics
contend, it is not clear how many of these “natural
losses” were in fact failures of the fertilization
process, so that there was never a unified, integrated
organism in the first place, and thus never the loss of
a human embryo. It is also unclear, they argue, how much
of the supposedly “natural” loss rate is actually
due to contingent and changeable factors, such as environmental
pollution, pesticides, or endometrial problems, and so
is not simply an unavoidable fact of embryonic existence.136
3. Prediction of Non-Viability of Embryos.
Some people, hoping to get around the moral dilemma of
destroying even “unenabled” embryos, seek
to identify a subset of embryos that might reasonably
be regarded in advance as non-viable. One proposal has
involved the possibility that cloned human embryos, created
by somatic cell nuclear transfer, may prove to be non-viable
or unable to develop beyond a certain point (biological
evidence that this may be the case is presented by Rudolph
Jaenisch in Appendix N) or may even, by their nature and
origins, simply not constitute the equivalent of human
embryos. If this turns out to be true, it is further argued,
it might be possible to use them without arousing some
of the ethical dilemmas that accompany the use of otherwise
potentially viable human embryos.137
Others point to a possible sub-group of those embryos
currently frozen in storage as potentially non-viable.
Although those embryos are not yet dead and, if thawed,
would still exhibit some cellular function, some would
be unlikely to survive even were transfer attempted. Since
IVF procedures usually produce more embryos than can be
transferred at one time, goes the argument, the clinicians
choose for transfer those among the available embryos
that look “the best” and seem most likely
to survive and develop—so that those that are frozen
are those deemed less likely to develop. Moreover, by
applying similar judgment to the unimplanted embryos,
we might identify those that would be least likely to
survive even under the most favorable circumstances. These
embryos might then reasonably be regarded as non-viable
and therefore available for research since their use will
not disrupt a potential life.138
There has not been much direct reaction to this view in
the ongoing ethical debates. Yet some observers have noted,
in other contexts, that the techniques used to identify
which IVF embryos are more or less likely to develop successfully—estimates
based usually on visual assessment of the embryos—have
never been proven effective or even tested to ascertain
their validity.139
Moreover, some argue, the true viability of cloned human
embryos or of cryogenically stored embryos could not be
determined in advance without attempting to implant them.140
4. Creation of Non-Viable Embryo-Like Artifacts.
Others, seeking to bypass altogether the issue of viability,
propose the possibility of creating a biological entity
that cannot rightly be called a living organism, yet that
has the generic organic powers necessary to produce embryonic
stem cells. They suggest that somatic cell nuclear transfer,
or a similar technique, could be used to create an entity
that lacks, by design, the qualities and capabilities
essential to be designated a human life in process. By
intentional alteration of the somatic cell nuclear components
or the cytoplasm of the oocyte into which they are transferred,
researchers may be able to construct an “artifact”
that is biologically (and morally) more akin to cells
in tissue culture, but could still provide a source of
functional human embryonic stem cells.141
Proponents of this innovation aim to shift the ethical
debate from the question of whether or when a human embryo
should be considered a human being to the question of
which organized structures and potentials constitute the
minimal criteria for considering an entity to be
a human embryo.142
Absent all the essential elements (including a full complement
of chromosomes, proper genetic sequence and chromatin
configuration, and cytoplasmic structures and transcription
factors), advocates of this proposal argue, there can
be no integrated whole, no organism, and hence no human
embryo. By technically constructing biological entities
lacking these essential elements yet bearing the partial
organic potential often found in failures of fertilization,
they suggest it may be possible to procure embryonic stem
cells without producing an organismal or embryonic entity
that can meaningfully be designated a being with moral
standing.143
Proponents argue that there is a natural biological precedent
for such an entity lacking the qualities and characteristics
of an organism yet capable of generating cells with the
character of embryonic stem cells. Teratomas are germ
cell tumors that generate all three germ layers as well
as more advanced cells, tissues, and partial limb and
organ primordia. Yet these chaotic, disorganized, and
nonfunctional masses lack entirely the structure and dynamic
character of an organism. Likewise, failures of fertilization
due to abnormal complements or chromatin configurations
(imprinting) of the chromosomes may still proceed along
partial trajectories of organic growth without being meaningfully
designated as organismal entities.
These natural examples of “partial generative potential”
(described by some as ‘pseudo-embryos’), together
with other observations of early embryonic process, have
led to a diverse array of suggestions for ways that embryonic
stem cells may be produced without raising the moral issues
involved in the creation and destruction of human embryos.
These suggestions include the use of aneuploidies, polyploidies,
viable cells from embryos in arrested development, parthenotes,
and chimeras of human nuclear material and animal oocytes.
Each presents its own particular technical challenges
and raises unique and unfamiliar moral considerations.
The scientific prospects for such projects remain largely
unexplored in humans, though some animal work has shown
promise, and proponents argue that they are within the
reach of current technology.144
The crucial principle in all such efforts, proponents
argue, is the preemptive nature of the intervention: undertaken
at a stage before the transition to organismal status.
They contend that just as we have learned that neither
genes, nor cells, nor even whole organs define the locus
of human moral standing, in this era of developmental
biology we will come to recognize that cells and tissues
with “partial generative potential” may be
used for medical benefit without a violation of human
life or dignity. Moreover, they argue, the moral distinctions
essential to discern and define the categories of organism,
embryo, and human being will be critical to progress in
scientific research involving embryonic stem cells, chimeras,
and laboratory studies of fertilization and early embryogenesis.
These advances in developmental biology, they contend,
will depend on clarifying these categories and defining
the moral boundaries in a way that at once defends human
dignity while clearing the path for scientific progress.145
This proposal has drawn criticism on several fronts. First,
critics suggest, it would require significant research
to ensure that the procedure reliably produced the desired
sort of “non-embryonic” entity yet also still
yielded normal human embryonic stem cells, and such research
might itself be morally problematic. Second, this proposal
raises a series of further scientific and ethical questions,
including those regarding the minimal degree of “partial
generative potential” for an entity to be considered
an organism, and for an entity to be considered a human
embryo. They point further to the risk of creating entities
that are so ambiguous as to leave their moral standing
in serious doubt, at least for those people who believe
that the early stages of human life have at least some
moral worth. Finally, proposals to use human oocytes raise
moral concern regarding the source of supply, in this
case as in the larger arena of in vitro fertilization
and experimentation.146
Although this approach has never been tested in humans,
animal experiments suggest it has potential, and it has
begun to play a part in the debates over the moral standing
of human embryos and the permissibility of embryo research
more generally.
V. Societal Significance and Public
Responsibility
While the bulk of the public debate surrounding embryonic
stem cell research has been directed to the question of
the moral standing of human embryos, some commentators
have raised a number of other crucial and serious concerns.
They have argued that the debate suffers from focusing
too narrowly on questions of the standing of human embryos,
when other issues—including the duties and responsibilities
of those who engage in embryonic stem cell research, the
implications of such uses of nascent life for our society
(rather than just for the embryos themselves), the significance
of the public debate, and a series of other issues—also
bear heavily on the subject, and may illuminate it in
ways at least as significant.147
Some authors, including some who do not believe that human
embryos should simply be treated as inviolable persons,
have argued that the instrumentalization of human embryos—the
seeds of the next generation—might tend to coarsen
the sensibilities of our society toward future generations,
and toward human life in general, quite apart from the
effects on the embryos themselves.148
Others also argue that by setting down the path laid out
by human embryonic stem cell research, we open the way
for other, and more troubling, techniques and developments.
Since human suffering and disease will never come to an
end, they suggest, the resort to extreme and potentially
exploitative methods is unlikely to find a logical stopping
point. Today, they argue, scientists want to use only
the earliest embryos; but what will happen when it turns
out that later-stage embryos are even more valuable in
developing treatments for disease?149
Critics of this view have generally argued that it fails
to offer a sufficient ground for impeding the promise
and potential of medical treatments that might result
from embryonic stem cell work. These critics see medical
research as a central moral duty, and they argue that
a society that prevents such research undermines not only
medical progress, but the moral progress of the community
as a whole. While instrumentalization and moral coarsening
are real worries, these critics argue, long-term fears
of a “slippery slope” do not justify renouncing
the potential of today’s research. Future difficulties,
they say, can be faced if and when they arrive in earnest.150
Other observers have raised concerns related to the ethical
and policy debate itself, rather than to the specifics
of one technique or another, or of one funding policy
or another. Some, for instance, have argued that what
is needed in the human embryonic stem cell research debate
is not only an exchange of views about the substantive
issues (though that is surely crucial) but also some sense
of the appropriate democratic process for deliberation
and for establishing appropriate public policy on such
a profoundly contentious matter. The embryonic stem cell
debate, it is argued, offers a valuable opportunity to
think through the ways in which the American polity debates
the most contentious moral issues.151
Some even suggest that such matters should be removed
from the political process altogether, and left in the
hands of a regulatory body specifically charged with monitoring
and decision-making authority.152
Other observers worry that the promise of embryonic stem
cell research to bring swift or immediate cures to those
who are now ailing has been oversold. They point out that,
two decades ago, similar claims of rapid cures were made
on behalf of fetal tissue transplantation research, but
have not as yet been realized (though, of course, the
danger of unfulfilled hope always looms over medical research).
Such talk, some observers have argued, tends to raise
false hopes, and thus does a genuine disservice to the
sick and disabled.153
Worse, some regard it as cruel and immoral to exploit
the hopes and fears of the desperately ill and their families,
especially when—as several scientists in the field
have remarked—it is not very likely that stem cell
based remedies will be available for most people now suffering
from the potentially targeted diseases. This moral concern
is tied directly to the longstanding bioethical principle
of truth-telling, which obliges physicians to inform their
patients honestly about their condition and prognosis
and encourages researchers to be truthful in their assessments
of the potential for new treatments and cures, whether
or not what they have to say is what patients and their
loved ones want to hear. “It is misleading to suggest
that stem cells will bring cures,” one writer observes,
“particularly cures for patients now coping with
the serious diseases the research targets.”154
A related concern, raised by some of the same commentators,
involves what has been termed “the disproportionate
emphasis on stem cell research in contemporary health
politics.”155
The prominence of this debate in American politics, they
argue, may tend to distract us from the fact that many
Americans, and even more people elsewhere, lack very basic
healthcare and have no access to those medical tools and
techniques that already exist and that raise no profound
controversy.156
The concern for justice, and for the
proper setting of priorities, they argue, requires us
to see this line of research in its proper perspective.
Because federal resources for research are limited, decisions
must be made about which areas should receive high (and
low) priority, and decisions must be made about how much
to devote to research and how much to devote to programs
that provide proven health care to patients. These commentators
suggest that this view does not mean that stem cell research
should not be funded, but only that we must keep in mind
that funds are also needed for many other approaches to
fighting suffering and disease.157
Critics of this view, however, respond that an excessive
preoccupation with existing health care needs
can jeopardize new medical research and medical progress,
and that today’s “basic medicine” was
once experimental research.158
Meanwhile, others have argued that the debate has been
too narrow in another way. Any federal policy, they suggest,
must take note not only of the potential promise of embryonic
stem cell science, but also possible alternatives to such
research, alternatives less morally troubling to many
Americans. Many opponents of public funding for human
embryonic stem cell research, for instance, have argued
that more attention should be paid, and more resources
devoted, to adult stem cell research, which raises
few of the moral difficulties present in the embryonic
stem cell debates159
(though, for some, it still does raise a number of ethical
difficulties).160
Such work, they contend, might even make embryonic stem
cell research (or, at the very least, publicly funded
embryonic stem cell research)161
unnecessary, if it proves sufficiently useful.vi
In response, however, others point out that adult stem
cell research already receives about ten times the amount
of federal funding apportioned to human embryonic stem
cell research. Critics also argue that embryonic stem
cells may possess unique advantages over adult stem cells,
just as (in some circumstances) the opposite may be the
case, and that therefore both avenues, as well as research
using stem cells derived from fetal tissue, should be
pursued simultaneously.162
And they contend that opponents of embryonic stem cell
research have oversold the promise of adult stem cells
so that the public might come to see embryonic stem cell
research as unnecessary.163
In the next chapter, we examine some of the scientific
facts regarding adult and embryonic stem cells, but in
the context of the ethical and political debates, the
distinctions between them have been quite important and
prominent.
In these ways, the controversial possibility of scientific
alternatives, as well as concerns about the health of
American culture and democracy, the honesty of a political
debate that touches on the hopes and fears of many who
are suffering, and the bigger picture of health-care politics
all impinge upon the question of federal funding of human
embryonic stem cell research.
VI. Conclusion
Participants in the public debate surrounding human embryonic
stem cell research and the administration’s funding
policy have addressed themselves to many complicated and
difficult ethical matters: the character of the moral
question at issue; the nature, object, ethical assumptions,
and premises of the policy itself; the vexing question
of what is owed to the early human embryo; and a number
of other related concerns. As we have seen, strong and
powerfully argued views have been presented on various
sides of each of these questions. For now, neither side
to the debate seems close to fully persuading the other
of the truth it thinks it sees. But the rich and growing
ethical debates do suggest the possibility of progress
toward greater understanding of the issues, and toward
more informed public decisionmaking, as all parties to
the deliberation appreciate better just what is at stake,
not only for them or their opponents, but indeed for all
of us.
_________________
Footnotes
i. Only
“the now,” created by an act of speaking,
defines the difference between past and future (tenses
and deeds).
ii. Lori
Andrews detailed both these ongoing efforts and existing
legislation in the states in her presentation at the Council’s
July 2003 meeting and in the accompanying paper. (See
Appendix E.)
iii. Readers
may find it helpful to consult Notes on Early Human Development
(Appendix A).
iv. Also,
several traditional religious views of the embryo (among
some Jews and some Muslims, for instance) have attributed
humanity to the embryo only after a particular point in
its development, for example the 40th day.
v. This
is partly due to the fact that “special respect,”
and “intermediate moral status,”
are rather vague terms, and embrace a very wide range
of degrees of “specialness” and “intermediacy.”
vi. In
1999, the National Bioethics Advisory Commission stated
that, “In our judgment, the derivation of stem cells
from embryos remaining following infertility treatments
is justifiable only if no less morally problematic alternatives
are available for advancing the research,” though
the commission did not conclude that adult stem cells
were sufficiently shown to offer such an alternative.
(National Bioethics Advisory Commission, Ethical Issues
in Human Stem Cell Research, Washington, D.C.: Government
Printing Office, 1999, p. 53.)
_________________
Endnotes
1. “Press Conference
by President Bush and Italian Prime Minister Berlusconi,”
as made available by the White House Press Office, July
23, 2001.
2. See, for instance,
Weissman, I. L., “Stem Cells—Scientific, Medical
and Political Issues,” New England Journal of Medicine 346(20): 1576-1579 (2002).
3. See, for instance,
Green, R., “Determining Moral Status,” American Journal of
Bioethics 2(1): 28-29 (2002).
4. See, for instance,
Orr, R., “The Moral Status of the Embryonal Stem
Cell: Inherent or Imputed?” American Journal of
Bioethics 2(1): 57-59 (2002).
5. See, for instance,
Doerflinger, R., “Ditching Religion and Reality,”
American Journal of
Bioethics 2(1): 31 (2002).
6. See, for instance,
Latham, S., “Ethics and Politics,” American Journal of
Bioethics 2(1): 46 (2002).
7. See, for instance,
Marquis, D., “Stem cell research: The Failure of
Bioethics,” Free Inquiry 22(1): Winter
2002.
8. See, for instance,
the presentation of Richard Doerflinger before the Council
on June 12, 2003. A transcript of that presentation is
available on the Council website at www.bioethics.gov.
9. See, for instance,
FitzGerald, K., “Questions Concerning the Current
Stem Cell Debate,” American Journal of
Bioethics
2(1): 50-51 (2002).
10. See, for instance,
Haseltine, W., “Regenerative Medicine: A Future
Healing Art,” Brookings Review, Winter 2003.
11. See, for instance,
Stolberg, S., “Scientists Urge Bigger Supply of
Stem Cells,” The New York Times, September 11, 2001,
p. A1.
12. See, for instance,
Perry, D., “Patients’ Voices: The Powerful
Sound in the Stem Cell Debate,” Science
287: 5457, 1423; and the presentation of Irving Weissman
before the Council on February 13, 2002, available on
the Council website at www.bioethics.gov.
13. This point was
taken up by the Council in its report Human Cloning and Human Dignity: An Ethical Inquiry (July 2002),
Chapter 6, pp. 167-168.
14. One useful description
of this approach to the issue is Zoloth, L., “Jordan’s
Banks, A View from the First Years of Human Embryonic
Stem Cell Research,” American Journal of
Bioethics
2(1): 7 (2002).
15. Callahan, D.,
What Price Better Health: The Hazards of the Research
Imperative. Los Angeles, CA.: University of California
Press, 2003; also see Daniel Callahan’s presentation
before the Council on July 24, 2003, available on the
Council’s website at www.bioethics.gov.
16. FitzGerald, K.,
op. cit., pp. 50-51.
17. For examples,
see Weiss, R., “Legal Barriers to Human Cloning
May Not Hold Up,” The Washington Post, May 23, 2001.
18. See, for instance,
Elias, P., “States, Feds May Clash over Cloning
Rules,” Genomics and Genetics Weekly, April
12, 2002, p. 24.
19. This, for instance,
was the line of reasoning of the American Bar Association
when, in August of 2002, it issued a resolution supporting
limited therapeutic research using cloned human embryos.
The report of the ABA’s Section of Individual Rights
and Responsibilities (available from the ABA) lays out
the case.
20. See, for instance,
Russo, E., “Policy Questions and Some Answers,”
The Scientist, April 15, 2003.
21. R. Alta Charo,
of the University of Wisconsin Law School, quoted in Coyle,
M., “The Clone Zone,” The National Law Journal,
May 15, 2002.
22. Alan Meisel of
the University of Pittsburgh School of Law, quoted in
Coyle, M., “The Clone Zone,” The National Law Journal, May 15, 2002.
23. Berkowitz, P.,
“The Meaning of Federal Funding,” a paper
commissioned by the President’s Council on Bioethics
and included as Appendix F of this report.
24. See: Maher
v. Roe 432 U.S. 464 (1977); Harris v. McRae
448 U.S. 297 (1980); Rust v. Sullivan 500 U.S.
173 (1991).
25. Berkowitz, P.,
“The Meaning of Federal Funding,” a paper
commissioned by the President’s Council on Bioethics,
and included as Appendix F of this report. See also Khushf,
G., and Best, R., “Stem Cells and the Man on the
Moon: Should We Go There from Here?” American Journal of
Bioethics 2(1): 38 (2002).
26. FitzGerald, K.,
op. cit., pp. 50-51.
27. Doerflinger,
R., op. cit., p. 31.
28. Childress, J.,
“Federal Policy Toward Embryonic Stem cell research,”
American Journal of
Bioethics 2(1): 34 (2002).
29. Kahn, J., “Missing
the mark on stem cells,” Bioethics Examiner
5:3, Fall 2001, p. 1.
30. Murray, T., “Hard
Cell,” The American Prospect, September
24, 2001.
31. See, for instance,
Lefkowitz, J., “The Facts on Stem Cells,”
The Washington Post, October 30, 2003, p. A23; and Bush,
G.W., “Stem Cell Science and the Preservation of
Life,” The New York Times, August 12, 2001, p. D13.
32. “How many
lines,” The Washington Post, August 31, 2001, p.
A22.
33. Daley, G., “Cloning
and Stem Cells—Handicapping the Political and Scientific
Debates,” New England Journal of Medicine 349(3):
211-212 (2003).
34. Kennedy, D.,
“Stem Cells: Still Here, Still Waiting,” Science
300: 865 (2003).
35. See, for instance,
Brickley, P., “Scientists Seek Passports to Freer
Environments,” The Scientist 15:36 (2001).
36. See, for instance,
Weissman, I., “Stem Cells—Scientific, Medical
and Political Issues,” New England Journal of Medicine
346(20): 1578-1579 (2002).
37. See, for instance,
Weise, E., “USA’s Stem Cell Scientists Fear
a Research Brain-Drain,” USA Today, May
12, 2003, p. 6D.
38. Clark, J., “Squandering
Our Technological Future,” The New York Times, August
30, 2001, p. A19. See also the presentation of Thomas
Okarma, President and CEO of Geron Corporation, before
the Council on September 4, 2003. The full transcript
of Okarma’s presentation may be found on the Council’s
website at www.bioethics.gov.
39. Robertson, J.,
“Crossing the Ethical Chasm: Embryo Status and Moral
Complicity,” American Journal of
Bioethics 2(1):
33 (2002).
40. See, for instance,
Pizzo, P., “Remove Obstacles to Stem cell research,”
San Jose Mercury-News, June 19, 2003; and Holden,
C. and Vogel, G., “‘Show Us the Cells’
U.S. Researchers Say,” Science 297: 923 (2002).
41. The most notable
discussion of safety concerns has been Dawson, L., et
al., “Safety Issues in Cell-Based Intervention Trials”
Fertility and Sterility 80: 5, 1077-1085, 2003. We
must note, however, that the assessment of the subject
presented in that article relies upon the assumption that
“all of [the approved] lines were derived using
mouse feeder layers.” (p. 1078). In his presentation
before the Council on September 4, 2003, NIH Director
Elias Zerhouni flatly contradicted this assertion, telling
the Council that “there are at least those, which
is about 16 lines, I believe, that have not been exposed
to either mouse or human cell—human feeder cell
lines.” (The transcript of Zerhouni’s presentation
is available on the Council’s website at www.bioethics.gov.)
Those eligible unexposed lines, however, are
not presently among the lines available to researchers,
and it cannot be known in advance if or when they might
become available or whether they will prove useable. In
addition, the FDA has stated that even in the case of
those lines that were developed with mouse feeders, “FDA
does not intend that the agency’s regulation of
xenotransplantation will preclude the use of these hES
cell lines.” (Food and Drug Administration, “Guidance
for Industry - Source Animal, Product, Preclinical, and
Clinical Issues Concerning Use of Xenotransplantation
Products in Humans,” April 3, 2003.) FDA Commissioner
Mark McClellan also made that clear in his presentation
before the Council, available at the Council’s website.
42. Faden, et al.,
“Public Stem Cell Banks: Considerations of Justice
in Stem Cell Research and Therapy” Hastings Center Report 33:6 (2003).
43. See, for instance, Capron, A.,
“Stem Cell Politics: The New Shape to the Road Ahead,”
American Journal of
Bioethics 2(1): 35-36 (2002).
44. Robertson, J.,
op. cit., pp. 33-34.
45. See, for instance,
the testimony of HHS Secretary Tommy Thompson before the
Senate Health, Education, Labor and Pensions Committee,
September 5, 2001; and Lefkowitz, J., “The Facts
on Stem Cells,” The Washington Post, October 30,
2003, p. A23.
46. Brownstein, R.,
“Bush Won’t Budge on Stem Cell Position, Health
Secretary Says,” Los Angeles Times, August
13, 2001, p. A9.
47. This comment
was made by Council Member Gilbert Meilaender in Council
discussion on September 4, 2003. A transcript of that
discussion is available on the Council’s website
at www.bioethics.gov.
48. See, for instance,
FitzGerald, K., op. cit., pp. 50-51.
49. Khushf, G., and
Best, R., op. cit., p. 38.
50. See, for instance,
the discussion of the Council in its September 4, 2003
meeting, particularly the argument elucidated by Council
Member Michael Sandel. A transcript of that session is
available on the Council website at www.bioethics.gov.
51. See, for instance,
Stolberg, S., op. cit.
52. See,
for instance, Robertson, J., “Ethics and Policy
in Embryonic Stem cell research,” Kennedy Institute
of Ethics Journal 9(2): 109-136 (1999); Spike, J.
“Bush and Stem cell research: An Ethically Confused
Policy,” American Journal of Bioethics 2(1):
46 (2003); and Capron, A., op. cit., p. 36.
53. The statement
was made by bioethicist Glen McGee, in reference to the
Clinton-era proposed NIH rules on funding, quoted in Spanogle,
J., “Transforming Life,” The Baylor Line,
Winter 2000, p. 30.
54. The remark was
made by Bishop Joseph A. Fiorenza, President of the U.S.
Conference of Catholic Bishops, in a news release (“Catholic
Bishops Criticize Bush Policy on Embryo Research,”
made available by the United States Conference of Catholic
Bishops, August 9, 2001).
55. This argument
arose in the course of Council discussion on September
4, 2003 (see particularly the comments of Council Members
Michael Sandel and Charles Krauthammer in that discussion).
A transcript of that session is available on the Council’s
website at www.bioethics.gov.
56. Ibid., see particularly
the comments of Council Members Mary Ann Glendon and Gilbert
Meilaender in that discussion.
57. For these guidelines,
see Appendix D.
58. Ibid., see particularly
the comments of Council Member William Hurlbut in that
discussion.
59. Some reasons
to regard public funding of activities in a light different
from mere permission are proposed in Khushf, G., and Best,
R., op. cit., p. 38.
60. “Remarks
by the President on Stem Cell Research,” as made
available by the White House Press Office, August 9, 2001.
61. “President’s Phone
Call to March for Life Participants,” as made available
by the White House Press Office, January 22, 2002.
62. See Council discussion
on September 4, 2003, especially comments by Council Members
Charles Krauthammer, Francis Fukuyama, Gilbert Meilaender,
and Leon Kass. A transcript of that session is available
on the Council’s website at www.bioethics.gov.
63. Bush, G.W., “Stem
Cell Science and the Preservation of Life,” The New York Times, August 12, 2001, p. D13.
64. “Remarks by the President
on Stem Cell Research,” as made available by the
White House Press Office, August 9, 2001.
65. See, for instance, Council discussion
on September 4, 2003 (particularly the comments of Council
member Michael Sandel and invited guest Peter Berkowitz
in that discussion). A transcript of that session is available
on the Council’s website at www.bioethics.gov.
66. “Remarks by the President
on Stem Cell Research,” as made available by the
White House Press Office, August 9, 2001.
67. See, for instance, Council discussion
on September 4, 2003 (particularly the comments of Council
Members Charles Krauthammer and James Wilson in that discussion).
A transcript of that session is available on the Council’s
website at www.bioethics.gov.
68. For instance, in discussing research
on cloned human embryos, President Bush said, “Research
cloning would contradict the most fundamental principle
of medical ethics, that no human life should be exploited
or extinguished for the benefit of another. Yet a law
permitting research cloning, while forbidding the birth
of a cloned child, would require the destruction of nascent
human life.” (“Remarks by the President on
Human Cloning Legislation,” as made available by
the White House Press Office, April 10, 2002); and in
explaining his stem cell funding policy, the President
wrote: “While it is unethical to end life in medical
research, it is ethical to benefit from research where
life and death decisions have already been made.”
(Bush, G.W., “Stem Cell Science and the Preservation
of Life,” The New York Times, August 12, 2001, p.
D13.)
69. As noted previously,
in August of 2001 Health and Human Services Secretary
Tommy Thompson told reporters that “neither unexpected
scientific breakthroughs nor unanticipated research problems
would cause Bush to reconsider.” (See, Brownstein,
R., “Bush Won’t Budge on Stem Cell Position,
Health Secretary Says,” Los Angeles Times,
August 13, 2001, p. A9).
70. One useful account of these issues
is Cohen, E., “Of Embryos and Empire,”
The New Atlantis 2: 3-16 (2003).
71. See, for instance,
London, A., “Embryos, Stem Cells, and the ‘Strategic’
Element of Public Moral Reasoning,” American Journal of
Bioethics 2(1): 56 (2002).
72. For examples
of this way of proceeding—both in arguments supporting
embryo research, and arguments opposing it—see,
among numerous other sources, the Council’s July
2002 report, Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6.
73. See, for instance,
McCartney, J., “Embryonic Stem cell research and
Respect for Human Life: Philosophical and Legal Reflections,”
Albany Law Review 65: 597-624 (2002).
74. See, for instance,
Orr, R., op. cit., pp. 57-58.
75. See, for instance,
Steinberg, D., “Can Moral Worthiness Be Seen Using
a Microscope?” American Journal of
Bioethics 2(1):
49 (2002).
76. See, for instance,
Green, R., op. cit., p. 20.
77. See, for instance,
Doerflinger, R., op. cit., pp. 31-33; Orr, R., op. cit.,
pp. 57-58; and the personal statements of Council Members
William Hurlbut and Robert George and Alfonso Gómez-Lobo,
in the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, among others.
78. See, for instance,
Orr, R., op. cit., pp. 57-58.
79. See, for instance,
the personal statement of Council Member William Hurlbut,
in the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry.
80. See, for instance,
Sullivan, D., “The Conception View of Personhood:
A Review,” Ethics and Medicine 19(1): 11-33 (Spring
2003).
81. A form of this
argument was presented by some Members of the Council
in the Council’s July, 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, chapter 6, and
in several of the personal statements appended to that
report.
82. See, for instance,
Steinberg, D., op. cit., p. 49.
83. See, for instance,
the transcript of Council discussion on October 17, 2003,
especially the comments of Council Member Elizabeth Blackburn.
The full transcript is available on the Council’s
website at www.bioethics.gov. Also see Green, R., op. cit., pp. 20-30.
84. See, for instance,
Lanza, R., et al., “The Ethical Validity of Using
Nuclear Transfer in Human Transplantation,” Journal
of the American Medical Association, 284(24): 3175-3179
(2000). Also, see the views expressed by some Members
of this Council in our July 2002 report Human Cloning
and Human Dignity: An Ethical Inquiry, chapter 6,
and in the personal statements of Council Members Elizabeth
Blackburn, Michael Gazzaniga, and Janet Rowley.
85. See, for instance,
the transcript of Council discussion on April 25, 2002,
especially the comments of Council Member Daniel Foster.
The full transcript is available on the Council’s
website at www.bioethics.gov.
86. See, for instance,
the position articulated in “Position Number Two”
of the “Moral Case for Cloning for Biomedical Research”
presented by some Members of the Council in the Council’s
July, 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6; and the personal statement
of Council Member Michael Gazzaniga, appended to that
report.
87. See, for instance,
the comments of Council Member Michael Gazzaniga (and
response from other Members) during Council discussion
on February 14, 2002. The full transcript is available
on the Council’s website at www.bioethics.gov.
88. See, for instance,
Orr, R., op. cit., pp. 57-59; Callahan, S., “Zygotes
and Blastocysts: Human enough to protect,” Commonweal,
June 14, 2002; the position articulated by several Members
of this Council in our July 2002 report Human Cloning
and Human Dignity: An Ethical Inquiry, Chapter 6;
and the personal statements of Council Members Robert
George and Alfonso Gómez-Lobo, and William Hurlbut
in that same report.
89. See, for instance,
Steinberg, D., op. cit., pp. 49-50; and Green, R., op. cit., p. 20.
90. See, for instance,
Meyer, M. J., and Nelson, L. J., “Respecting What
We Destroy: Reflections on Human Embryo Research,”
Hastings Center Report 31(1): 16-23 (2001).
91. See, for instance,
Strong, C., “The Moral Status of Preembryos, Embryos,
Fetuses, and Infants,” The Journal of Medicine
and Philosophy 22(5): 457-478 (1997).
92. Pearson, H.,
“Your Destiny, from Day One,” Nature 418:
14-15 (2002).
93. See, for instance,
McCartney, J., op. cit., pp. 601-602; Brogaard,
B., “The moral status of the human embryo: the twinning
argument,” Free Inquiry Winter 2002; Meyer,
M. J., op. cit., p. 18. The question of twinning—pro
and con—was also taken up by the Council in its
July 2002 report, Human Cloning and Human Dignity:
An Ethical Inquiry, Chapter 6.
94. See, for instance,
Green , R., op. cit., pp. 21-22; Lanza, R., op. cit.,
p. 3177.
95. See, for instance,
Ashley, B., and Moraczewski, A., “Cloning, Aquinas,
and the Embryonic Person,” National Catholic
Bioethics Quarterly 1(2): 189-201 (2001); Orr, R.,
op. cit., p. 58; Marquis, D., op. cit.;
and Lori Andrews quoted in Green, R., op. cit.,
p. 22. The question of twinning—pro and con—was
also taken up by the Council in its July 2002 report,
Human Cloning and Human Dignity: An Ethical Inquiry,
Chapter 6, and in the personal statement of Council Member
William Hurlbut, attached to that report.
96. See, for instance,
National Bioethics Advisory Commission, Ethical Issues
in Human Stem cell research, Washington, D.C.: Government
Printing Office, 1999, p. 7; and the position articulated
by several Members of this Council in our July 2002 report
Human Cloning and Human Dignity: An Ethical Inquiry,
Chapter 6, among many others.
97. See, for instance,
Lanza, R., op. cit., p. 3177.
98. See, for instance,
Strong, C., op. cit., p. 467.
99. See, for instance,
the views expressed by some Members of this Council in
our July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6, and in the personal statement
of Council Members Robert George and Alfonso Gómez-Lobo.
100. See, for instance,
the personal statement of Council Member William Hurlbut,
in the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry.
101. See, for instance,
Wilson, J., “On Abortion,” Commentary
January 1994; and the position articulated by several
Members of this Council in our July 2002 report Human
Cloning and Human Dignity: An Ethical Inquiry, Chapter
6.
102. See, for instance,
Green, R., op. cit., pp. 20-30; and the position articulated
by several Members of this Council in our July 2002 report
Human Cloning and Human Dignity: An Ethical Inquiry, Chapter
6.
103. See, for instance,
the views expressed by some Members of this Council in
our July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6, and in the personal statement
of Council Members Robert George and Alfonso Gómez-Lobo.
104. See, for instance,
National Institutes of Health, Report of the Human
Embryo Research Panel, Bethesda, MD.: NIH, 1994;
and the position articulated by several Members of this
Council in our July 2002 report Human Cloning and Human
Dignity: An Ethical Inquiry, Chapter 6.
105. See, for instance,
McGee, G., “The Idolatry of Absolutizing in the
Stem Cell Debate,” American Journal of
Bioethics
2(1): 53-54 (2002).
106. See, for instance,
Green, R., op. cit., p. 20.
107. See, for instance,
the views expressed by some Members of this Council in
our July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6, and in the personal statements
of Council Members Gilbert Meilaender, William Hurlbut,
Robert George and Alfonso Gómez-Lobo.
108. “Report
of the Ethics Advisory Board,” 44 Fed. Reg.
35,033-35,058 (June 18, 1979) at 35,056.
109. NIH, op.
cit., Report of the Human Embryo Research Panel,
p. 2.
110. National Bioethics
Advisory Commission (NBAC), Ethical Issues in Human Stem
Cell Research Bethesda, MD.: Vol. I, p. ii; cf. p. 2 (September
1999).
111. See, for instance,
Lebacqz, K., “On the Elusive Nature of Respect,”
in Holland, S., Lebacqz K., and Zoloth, L., eds., The
Human Embryonic Stem Cell Debate, Cambridge, MA.: MIT
Press, 2001, pp. 149-162; and the personal statement of
Council Member Rebecca Dresser, appended to the Council’s
July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry.
112. Hoffman, D.I.,
et al., “Cryopreserved Embryos in the United States
and Their Availability for Research,” Fertility and Sterility 79: 1063-1069 (2003).
113. See, for instance,
Spike, J., op. cit., p. 45.
114. See, for instance,
the testimony of Michael West before the Labor, HHS, and
Education Subcommittee of the Senate Appropriations Committee,
December 4, 2001, among others.
115. Outka, G.,
“The Ethics of Stem cell research,” a paper
presented to the Council for its April 2002 meeting, and
available on the Council website at www.bioethics.gov.
A slightly revised version appeared in the Kennedy
Institute of Ethics Journal, 12:2, pp. 175-213.
116. Ibid.
117. See, for instance,
“The Stem Cell Sell,” Commonweal, August 17,
2001; Meilaender, G., “Spare Embryos,” The Weekly Standardl, August 26, 2002; and Council discussion
of Gene Outka’s paper, in its April 2002 meeting,
a transcript of which is available on the Council website
at www.bioethics.gov.
118. See, for instance,
McCartney, J, op. cit., p. 615.
119. Council Member
William Hurlbut, in Council communication.
120. See, for instance,
the comments of Council Member James Wilson during Council
discussion on April 25, 2002. The full transcript is available
on the Council’s website at www.bioethics.gov.
121. A federal law,
42 U.S.C. § 289, is directed specifically against
any such lethal experimentation on these populations.
122. This concern
is raised in Outka, G., “The Ethics of Stem Cell
Research,” a paper presented to the Council for
its April 2002 meeting, and available on the Council website
at www.bioethics.gov. Also see the Council discussion
of that paper, available on the Council website; and see
Meilaender, G., op. cit.
123. See, for instance,
the transcript of Council discussion on April 25, 2002,
available on the Council’s website at www.bioethics.gov.
124. Guenin, L.
M., “Morals and Primordials,” Science
292: 1659-1660 (2001).
125. Spike, J.,
op. cit., p. 45.
126. Guenin, L.,
op. cit.
127. See, for instance,
Orr, R., op. cit., p. 58.
128. Mahowald, M.
and Mahowald A., “Embryonic Stem Cell Retrieval
and a Possible Ethical Bypass,” American Journal of
Bioethics 2(1): 42-43 (2002).
129. See, for instance,
Zoloth, L., op. cit., pp. 4-5.
130. See, for instance,
Harris, J., “The ethical use of human embryonic
stem cells in research and therapy,” in Burley,
J. and Harris, J., eds., A Companion to Genetics:
Philosophy and the Genetic Revolution, Oxford: Basil
Blackwell, 2001; and Savulescu, J., “The Embryonic
Stem Cell Lottery and the Cannibalization of Human Beings,”
Bioethics 16(6): 508-529 (2002).
131. This subject
was discussed in a Council session on January 16, 2003.
When asked, in the course of a presentation before the
Council, about the rate of natural embryo loss, Dr. John
Opitz (Professor of Pediatrics, Human Genetics, and Obstetrics/Gynecology,
School of Medicine, University of Utah) responded: “Estimates
range all the way from 60 percent to 80 percent of the
very earliest stages, cleavage stages, for example, that
are lost.” The transcript of this session is available
on the Council website at www.bioethics.gov.
132. Spike, J.,
op. cit., p. 45.
133. Harris, J.,
“Stem Cells, Sex & Procreation,” a paper
presented to the American Philosophical Society, March
29, 2003.
134. Savulescu,
J., op. cit., pp. 508-529.
135. See, for instance,
Orr, R., op. cit., pp. 57-59.
136. See, for instance,
Council discussion in its January 2003 meeting, a transcript
of which is available on the Council website at www.bioethics.gov.
137. See, for instance,
the comments of Rudolph Jaenisch before the Council in
its July 2003 meeting, and Dr. Jaenisch’s accompanying
paper (included in Appendix N of this report). See also
the personal statement of Council Member Paul McHugh,
appended to the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry.
138. See, for instance,
Zoloth, L., op. cit., pp. 4-5.
139. See, for instance,
Mandavilli, A., “Fertility’s New Frontier
Takes Shape in the Test Tube,” Nature Medicine
9: 1095 (2003).
140. See, for instance,
Council discussion with Rudolph Jaenisch at the Council’s
July 2003 meeting, and discussion taken up in the Council’s
July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6.
141. See, for instance,
the personal statement of Council Member William Hurlbut,
in the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry; the transcripts
of Council discussions on June 20, 2002 and July 24, 2003,
available on the Council’s website at www.bioethics.gov;
and Weiss, R., “Can Scientists Bypass Stem Cells’
Moral Minefield?” The Washington Post, December
14, 1998, p. A3.
142. See, for instance,
the transcript of Council discussion on July 24, 2003,
available on the Council’s website at www.bioethics.gov.
143. See, for instance,
the transcript of Council discussion on June 20, 2002,
available on the Council’s website at www.bioethics.gov.
144. See remarks
by Professor Rudolph Jaenisch before the Council’s
July 24, 2003 meeting. A transcript of that session is
available on the Council’s website at www.bioethics.gov.
145. See, for instance,
the personal statement of Council Member William Hurlbut,
in the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry.
146. See, for instance,
a number of arguments raised in Weiss, R., “Can
Scientists Bypass Stem Cells’ Moral Minefield?”
The Washington Post, December 14, 1998, p. A3; and the
transcript of Council discussion on June 20, 2002, available
on the Council’s website at www.bioethics.gov.
147. Lauritzen,
P., “Report on the Ethics of Stem cell research,”
a commissioned paper prepared at the request of the Council
and included in Appendix G of this report. See also the
Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6.
148. See, for instance,
Kass, L., “The Meaning of Life - In the Laboratory,”
The Public Interest, Winter 2002. Also see the
Council’s July 2002 report Human Cloning and
Human Dignity: An Ethical Inquiry, Chapter 6.
149. This case is
articulated by several Members of the Council in the Council’s
July 2002 report Human Cloning and Human Dignity: An
Ethical Inquiry, Chapter 6. See also, “Biotechnology:
A House Divided,” The Public Interest,
Winter 2003.
150. This case is
articulated, for instance, by several Members of the Council
in the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapter 6.
151. Strong, C.,
“Those Divisive Stem Cells: Dealing with Our Most
Contentious Issues,” American Journal of
Bioethics
2(1): 39-40 (2002).
152. See, for instance,
the Council’s July 2002 report Human Cloning and Human Dignity: An Ethical Inquiry, Chapters 6 and 8, available
on the Council’s website at www.bioethics.gov.
153. See, for instance,
Dresser, R., “Embryonic Stem Cells: Expanding the
Analysis,” American Journal of
Bioethics 2(1): 40-41
(2002); and FitzGerald, K., op. cit., pp. 50-51.
154. Dresser, R.,
op. cit., p. 41.
155. Ibid.
156. See also FitzGerald,
K., op. cit., pp. 50-51.
157. Dresser, R.,
op. cit., p. 41.
158. See, for example,
the discussion and presentations at the Council’s
July 2003 meeting, available on the Council’s website
at www.bioethics.gov.
159. See, for instance,
Orr, R., op. cit., pp. 57-58; “A review of
the National Institute of Health’s Guidelines for
Research Using Human Pluripotent Stem Cells,” Issues
in Law and Medicine 3(17): 293; and the testimony
of Representative David Weldon before the Technology and
Space Subcommittee of the Senate Commerce, Science and
Transportation Committee, January 29, 2003.
160. Lauritzen,
P., “Report on the Ethics of Stem cell research,”
a commissioned paper prepared at the request of the Council
and included in Appendix G of this report.
161. See, for instance,
Oldham, R., “Stem Cells: Private Sector Can Do It
Better,” The Wall Street Journal, August
28, 2001, p. A14.
162. See, for example,
the discussion and presentations at the Council’s
April 2002 meeting, available on the Council’s website
at www.bioethics.gov; and Verfaillie, C., “Multipotent
Adult Progenitor Cells: An Update,” a commissioned
paper prepared at the request of the Council and included
in Appendix J of this report.
163. See, for example,
the discussion and presentations at the Council’s
July 2003 meeting, available on the Council’s website
at www.bioethics.gov.