Unitarian Universalist Church of the Palouse
UUCP Sermons

Sunday, July 11, 2004


[7/11/04] The Ethics of Using and Changing Life

by Brian Morton
July 11, 2004

Music

Hymn 207: This World Was Given as a Garden. Hymn 107: The Leaf Unfurls. Hymn 128: For All That Is Our Life. Closing Song: Shalom Havareem.

Story for all Ages

The Pied Piper of Hamelin

Opening Words

Our Opening words are from President Bush interrupting Prime Time TV to speak to the nation about Human Embryonic Stem Cell Research 1 month before Sept 11

"Good evening. I appreciate you giving me a few minutes of your time tonight so I can discuss with you a complex and difficult issue, an issue that is one of the most profound of our time.

The issue of research involving stem cells derived from human embryos is increasingly the subject of a national debate and dinner table discussions. The issue is confronted every day in laboratories as scientists ponder the ethical ramifications of their work. It is agonized over by parents and many couples as they try to have children, or to save children already born.

The issue is debated within the church, with people of different faiths, even many of the same faith coming to different conclusions. Many people are finding that the more they know about stem cell research, the less certain they are about the right ethical and moral conclusions."

Sermon: The Ethics of Using and Changing Life

It's not often that I get a chance to agree with President Bush, but I too think that human embryonic stem cell research is a complex, difficult but profound topic that ought to be talked about in our churches.

A few months ago we had a speaker who explained to us much of the science behind Somatic Cell Nuclear Transfer Cloning, a technique that is also common in Embryonic Stem Cell Research, but he said only a little about the ethical dilemmas involved. Since I have done some work on bio-ethics, I was asked to speak to the church about the ethical side of some of these issues.

Bio-Ethics is literally Greek for the customs a society has for using life.

What counts as using life well, as using life rightly?

In bio-technology what is possible, and what is economically feasible or tempting changes so rapidly that usually we need to do a lot of ethical reflection just to keep pace with the changing technology. Lets think about some examples: Bio-technology came a long way in the 20th century. Here's a short list of 20th century innovations. IQ Testing, Blood Banks, Electroshock Therapy, Insulin Injections, Penicillin, LSD, vaccines for polio, and other diseases, Birth Control, improved abortion technology, Organ transplants, In vitro fertilization, and many other reproductive technologies, and more recently the Cloning of Mammals. More general developments in our understanding of the human brain, or the role of genetics, and of diet have had equally huge impacts that we cannot summarize in simple breakthroughs. We have had tragically disastrous innovations, like Thalidomide or cigarettes, and we have had triumphs like the World Health Organization's worldwide eradication of smallpox in 1979.

Just thinking carefully about one of these, say IQ Testing, would take a whole sermon or more. IQ testing did a lot of good for our society, but it was also misused, intentionally sometimes, and accidentally in other cases. Intelligence testing has been around since 1905, but still the Supreme Court is debating its role in death penalty sentencing. And most bio-tech developments are like this, with some clear advantages, several avenues for potential abuse intentional and accidental, and often raising new questions or re-raising old questions with a further twist.

Sometimes the philosophical implications are even more profound. For example, because of advances in our understanding of how breathing, heart function and brain function interrelate in death, every state in the US has changed its legal definition of death from cardiac oriented definitions of death to brain-function oriented definitions of death since the 1970's. Death literally does not mean the same thing it did 40 years ago in the United States, and indeed most of the world.

The 21st century will almost certainly have a similar list of society transforming bio-technology breakthroughs, and serious ethical reflection on them is likely to be just as important and controversial. Its hard to see too far ahead, but in the next 20 years we will almost certainly be facing advances in: lifespan extension, behavior control of children via drugs, enhancing rather than therapeutic medicine such as cosmetic surgery or sports enhancements, memory boosting and suppression techniques, human cloning, Human Embryonic Stem Cell technologies, sex selection technologies, and increased use and complexity of genetically modified agricultural products. Even more radical genetic engineering technologies might become available this quickly. Likewise, new wrinkles on older technologies will probably keep coming to light. For example, California just heard a case trying to decide the inheritance rights of a child conceived from frozen sperm after the father's death, a technology that is now decades old.

Bio-ethics problems frequently come back to the same themes again and again, where do we want our society to be going? What does it mean to be a person? How much intervention is appropriate in reproduction? How much do we trust humanity? How much do we fear human arrogance? And most basically, which uses of life are appropriate ones, and which are misuses?

The work that I have done is on Human Embryonic Stem Cell research, so I'm going to focus on it, but in reality it is just one example of much broader issues of personhood, sacrifice, and societal change.

Human Embryonic Stem Cell Research has a lot of potential to perhaps someday provide cures many diseases such as diabetes or Alzheimer's or Parkinson's, but at the moment the only ways currently known to culture human embryonic stem cells all involve destroying a fetus, embryo or pre-embryo. So the first set of worries about HESCR (although not the only one) involve questions of personhood.

Just like in the abortion debate, many people object to HESC because they see it as destroying very young children in an attempt to get medical benefits for the rest of us. That is basically the current position of the Catholic Church.

On the other hand, because the medical benefits of HESC are potentially so large, many people who oppose abortion will nonetheless allow HESC in some cases. There are basically two ways to get this kind of argument to work

One way involves thinking about overdetermination and complicity. This gets complex quickly, but the basic idea is that if the embryos are going to be killed anyway, they might at least help save people's lives in the process. This is why Bush's official position is that abortion is wrong, but that federal dollars can be used to fund stem cell research based on existing stem cell lines, where the embryos have already been killed, but cannot be used to fund killing new embryos to create new stem cell lines.

The second argument for opposing abortion, but still supporting HESCR is say that embryos are persons, but that even adult persons are sometimes sacrificed in warfare if the benefits are high enough, and thus it is morally permissible to sacrifice embryos in the "war against disease," even if the embryos are full moral persons.

A lot of my work has focused on the sacrifice argument, and it's a theme I'll come back too, but many aspects of it are pretty disingenuous. The "War against Disease" isn't really very similar to other kinds of warfare, and many of the safeguards we put in place to prevent immoral sacrifices in other contexts are not often applied to sacrificing embryos in HESCR.

I could talk a lot more about those arguments, but my guess is that most UU's probably aren't very tempted to think of embryos as persons.

UU's have covenanted to affirm and promote the "inherent worth and dignity of every person," but the UUA takes no general position on what counts as a person, or whether personhood is absolute or a matter of degrees.

It is worth thinking seriously about whether or not embryos are persons and thus protected by our most solemn covenant...

And how we can know whether they are persons or not...

And to what extent we can be certain about whether they are persons or not...

But I leave that as an exercise for each individual conscience.

Instead, let's look at some of the moral issues surrounding embryonic stem cell research, when we are not assuming that the embryos are persons.

Issues of sacrifice and of societal direction remain even if human embryos are not persons.

One position on the question of moral worth is called Gradualism, and is popular among bio-ethicists and was the foundation of the legal compromise at the heart of the famous Roe vs. Wade decision. Gradualism, suggests that there is no magic line between being a person and not being a person, but rather than a being acquires slowly more moral worth the more it acquires the features central to personhood. Thus a pre-born being gradually becomes more and more like an adult human in moral worth as it passes important developmental landmarks, like individuation, sentience, gender differentiation, social interaction, viability etc. Gradualists think that pre-born beings are more morally important the more developed they are.

Likewise, In Jewish law, the pre-born is often considered to be "as water" before the 40th day of the pregnancy, but to be "the thigh of the mother" afterwards so that harming an fetus is considered comparable in moral seriousness to maiming the mother; not as serious as taking a life, but pretty serious nonetheless. Thus, gradualists and Jews often allow harvesting stem cells from very young pre-born beings, such as excess fertility clinic embryos, which are typically frozen after only a few days of development, but disallow fetal gonadal harvesting techniques, which involve destroying much older and more developed pre-born beings.

Essentially the way these arguments go, is that that even if embryos are not full persons they still might be valuable enough that we should not sacrifice them lightly, and there are several other ways to argue the same point.

Perhaps embryos have "symbolic personhood" and thus like corpses or flags deserve some modicum of respect. Certainly embryos are at least symbols of our hopes for the future.

Perhaps "potential personhood" is quite valuable even if embryos do not have full actual personhood yet.

Perhaps all living things whether they are persons or not deserve not to be sacrificed lightly: thus

Some people oppose ESCR for much the same reasons as they oppose killing or torturing lab rats or other animals for the sake of science. Moral Vegetarians often oppose ESCR on the same grounds as they oppose killing animals for food. Wiccans sometimes oppose ESCR for the same reasons as they oppose animal sacrifice in religious rituals.

Even if embryos aren't very valuable at all, some people argue that we should delay sacrificing them, until we have exhausted the possibilities of Adult SCR, especially bone marrow work, which might allow us to extract stem cell lines without having to destroy embryos.

Of course, what we hope to gain in ESCR is pretty morally significant as well, so many people think that human embryos are quite valuable, but are still worth sacrificing for the sake of possible serious medical advances. Even advocates of this position ought to put some safeguards in place to minimize sacrifice, especially needless sacrifice, or premature sacrifice.

Once we've thought about personhood, and sacrifice, there is still the third big issue of where we are going as a society.

So for example one worry that has been raised about HESCR, is that even if successful it is most likely to produce expensive treatments that will enhance the well being of the already fairly well-off, especially folk who are both well-off and elderly.

Maybe our society should focus on extending medical care to those with sub-standard medical care, rather than focusing on improving the high quality of care available to those who can afford it.

Likewise in HESCR the young and powerless are sacrificed for the benefit of the old, often especially the old and rich. So there are potential justice worries surrounding HESCR, related to both class issues and age issues. Another worry is that HESCR is a step further in the direction of turning human life into a commodity.

Can humans be bought and sold like slaves or animals as long as they are unborn?

Can human cells be patented? Human tissues? Human organs? Whole human organisms?

Because governments have been shy about public funding of HESCR, much of it is being done by private venture capital bio-tech firms, thus opening weird questions about what kinds of knowledge and techniques can be owned privately. Likewise, big business and big money are not well known for adhering to restrictions put in place by ethicists, so there is good reason to worry that even many of the minimal restrictions on Bio-tech that are all ready in place may not be well followed.

Indeed the thought of powerful bio-tech research in the hands of big-money corporations used to cutting corners is enough to give one nightmares of modern re-plays of the Hamelin myth.

Who will own the fruits of this research? Worries about commodification and the economics of bio-techology are another common theme in HESCR ethics.

Finally, bio-tech forces us to confront the possibilities of a future in which humanity and human nature are profoundly changed, and those are dizzying possibilities.

We have already changed the meaning of death once in the last few decades, what if new technology changes it further? What if we have to re-define human or person? What if the people living a decades from now are so different than us that they are barely recognizable as humans?

Already we can transplant blood and organs, surgically alter many aspects of our own bodies, and chemically alter even more. Humans are already artificial, re-making ourselves as we want to be rather than as we were born. Body piercing, tattoos, cosmetic surgeries, and transgender surgeries are already viable, as are such neurochemical alterations as LSD, and Prozac.

Philosophers and science-fiction writers sometimes speak of a future of "post-humanity" in which technology is used to alter people further and further away from the old fashioned standards of human nature.

Bio-tech forces us to confront our freedom, which always involves angst. We may soon be able to choose to alter things that in the past have always been dictates of fate and birth. Likewise in seeing our freedom it is easy to fear our own arrogance and hubris.

When we have advanced genetic screens that allow us to choose among a large variety of embryos for implantation how will we choose? When we can genetically manipulate embryos how will we alter them? When tissue and organ replacement is cheap how will we use it?

It is easy to imagine many bio-tech nightmares like Hamelin's fate, in which we make mistakes, or use the technologies for evil: people engineered for obedience, reproduction in the hands of a private monopoly, agriculture transformed into a cash crop monoculture business to put even the 20th century to shame, a whole generation of babies accidentally born with a subtle genetic error that doesn't show itself until too late. Etc.

Even the good scenarios can just be so different from our world that they are frightening. How will society adapt if average life spans continue to increase at an exponential rate and tops 130 by the end of the century? What if the gaps in lifespan between the rich and poor keep pace? What if medical immortality is within the life-horizon of the young people alive today?

UU's are called on to have a certain optimism, and faith in humanity, that despite our power and failings, it will all work out and we will succeed more often than we fail.

Nonetheless, Stem Cell research of any kind brings us one step closer to being able to alter fundamental biological facts, and thus raises a host of worries about post-human futures.

I've been using HESCR as an example, but it is just one of many similar bio-ethics issues. If ESCR doesn't worry you along these lines, then just wait, the next bio-ethics problem will push things further.

So what thinking about ESCR is really for, is to try to examine the fundamental problems of bio-ethics. How should we use life? Or to put it another way: Is life a tool? Is a human life a tool? And I think the answer must be both Yes and No!

We are called on to use life for good But also to enjoy life and to value it. Life is a gift from the ultimate. Life must in some sense be more than a tool!

In the end I have no clear answers, about HESCR or the related problems. But I hope that every UU can feel the moral tensions, and agree with at least the minimal point of each side of the ESCR debate.

On the one hand: all life is a gift that we are called to use to build a common good.

On the other hand: all life, human embryos or otherwise, must be somehow more than just a tool to be exploited economically, more than just a commodity, more than just a raw material, more than just a sacrifice.

I don't know the best way to balance these two insights, but in HESC and many other issues in Bio-ethics, I think that is the task before our society.

I've had my say; lets have some responses.

Closing Words

Closing words come from the end of the Bush Speech mentioned earlier: "As we go forward, I hope we will always be guided by both intellect and heart, by both our capabilities and our conscience. I have made this decision with great care, and I pray it is the right one."



 
 
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