The ethics of the public debate

The centre of the stem cell debate is disagreement over whether embryonic humans should be used for destructive research. The disagreement can most easily be understood when we consider different ways of defining the embryo.

1.The biological definition

Eminent embryologist Ronan O’Rahilly has no doubt that in biological terms we are dealing with a human being from the time of fertilisation. ‘Although life is a continuous process, fertilisation … is a critical landmark because, under ordinary circumstances, a new, genetically distinct human organism is formed when the chromosomes of the male and female pronuclei blend in the oocyte (egg).’  From the time it is created, the embryo is a unified, unique, dynamic, self-directed whole, not just a collection of cells. There is evidence that organisation exists from the first cell division.  Opponents of human ES cell research reason that if a human being exists from the time of fertilisation, it is unethical. This is because the harvesting of the stem cells destroys the blastocyst.

From the time it is created, the embryo is a unified, unique, dynamic, self-directed whole

While the foremost promoters of this position in Australia tend to be the churches, it is not a religious divide. Other groups such as those interested in human rights also oppose ES cell research and the Greens are often on board on grounds of their opposition to manipulating the human gene pool.

Destructive research on human embryos contravenes years of human rights declarations, which since World War II have been designed to protect the welfare of human research subjects. The Council of Europe Biomedicine Convention from 1997 specifically prohibits destructive research on human embryos and the creation of human embryos for research. It also prohibits human reproductive cloning. The United Nations released a statement on cloning in 2005 that opposed all forms of human cloning.

Opponents of destructive research on human embryos do not think they are risking the loss of any medical therapies. They regard the success of adult stem cell research and the discovery of IPS cells as evidence that regenerative medicine can develop without using ES cells. Generally it is suggested that the excess embryos in IVF clinics be adopted by infertile couples or allowed to die undisturbed. Opponents would also like to see a tightening of safeguards to prevent further accumulation of excess human embryos. Use of the ‘spare’ embryos has meant that a market for human embryos has developed which has, predictably, led to legislation allowing the creation of more embryos for destructive research. So, if there is no doubt biologically that the human embryo is just that, human, from the time it is created, how is their destruction justified?  

The answer lies in the philosophical definition.

2.  The philosophical definition

Protagonists of destructive embryo research have suggested that protection is only due to human persons, and that personhood is not achieved merely on biological grounds. The idea of personhood was first introduced into the beginning of life, ironically, by a Christian, Rev Joseph Fletcher, an Episcopalian minister who in the 1950s was looking for a way to allow abortion, which many Christians at that time saw as an act of compassion - a long story which we will have to leave for another time. The concept of personhood has been around for a long time, and arguments vary widely as to when personhood begins.

Grounds have been put forward for the commencement of personhood at various points including implantation, when the one-week old embryo has attached to the mother; birth; and several weeks after birth, a position espoused by philosopher Peter Singer. The latter argument justifies infanticide on the grounds of newborns being non-persons. Alternative theories argue that there are certain attributes, which must be possessed by the developing embryo before it can be called a person.

The argument that has influenced many countries’ treatment of human embryos was that put forward by the United Kingdom’s Warnock Report (1984) which, while acknowledging that embryonic humans should have a special status, decided to avoid answering the question of when life or personhood began. Instead it discussed how the embryo should be treated.  The Warnock Committee approved research up to 14 days (the time when the primitive streak was visible in the embryo), since ‘this marks the beginning of individual development’. Proponents of ES cell research point to other social policies that imply the same notion (that the nascent human does not deserve protection): access to elective abortion, the use of post-conception contraceptives and the destructive research already occurring in IVF clinics. The high rate of natural embryo implantation failure is also used in support of this position.

some have argued that it is unethical NOT to use the embryos for research

It is also argued that the surplus frozen embryos are going to die anyway, so we might as well get some benefit from them before that happens. This position relies on the philosophical theory of consequentialism - that it is only the consequences of our actions, not the actions themselves, which determine right from wrong. By suggesting that the moral interests of the surplus embryos are trumped by the needs of the sick who would benefit from possible therapies developed, some have argued that it is unethical NOT to use the embryos for research.

3.  The middle position

In the initial Australian public debate on stem cells in 2002, the most common view in the community was a variation of this, ie that ES cell research is ethical so long as only surplus embryos are used and informed consent is obtained from those for whom the embryos were created. While the loss of the embryos was seen as regrettable, the benefits of the research justified their use.  

Note that there are several unspoken assumptions in this argument. The first is that the ends can justify the means, especially if the ends are great health benefits (consequentialism again), the second is that there are no ethical problems in destroying embryos on purpose rather than just letting them die, and there is even a suggestion that those who raise ethical questions may lack compassion in denying many who are suffering debilitating or life-threatening illnesses the chance of a cure. But saying you might as well use unwanted embryos for research depends on the idea that the human embryo is not a human person, deserving of protection. 

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