The Ramazzini Institute
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The Pew Forum Asks
What is the Moral Status of the Human Embryo?

     On February 27, a group of Roman Catholic, Jewish and Protestant theologians, at Washington’s National Press Club in a briefing sponsored by the Pew Forum on Religion and Public Life, debated a hard question: What is the moral status of the human embryo? To answer this, they asked a prior, and equally hard question: What is a human? The meeting seemed to be timed to influence legislation that would be guided by President George W. Bush’s new Council on Bioethics, the most recent in the series of eight similar “White House” advisory bodies appointed since 1974.
    That evening, the British government announced it’s new cloning research policy. British regulators have already issued the first licenses to extract and experiment with cells from donated embryos, and authorized the use of these cells for cloning. A national stem cell bank is being constructed.
     Three weeks later, the Washington Post headlined a “break with the right”, when Orthodox Jewish leaders issued their own opinion.¹
     Leon R. Kass, a philosopher-physician of The University of Chicago, and chair of President Bush’s Council on Bioethics appears to be attempting political impartiality in the choice of finding “intelligent people with open minds” to join him on the Council ². He is himself a fellow of the conservative American Enterprise Institute. Among those named by the President to the panel of 17 experts is not only conservative newspaper columnist and physician, Charles Krauthammer, a possible beneficiary of stem cell research to repair his spinal cord injury, but also another Chicago faculty member Janet D. Rowley. Rowley, one of the nation’s most distinguished professors of medicine and cell biology, previously served on former President Jimmy Carter’s National Cancer Advisory Board. Kass is joined on the Council by conservative public policy guru James Q. Wilson, still another Chicago alumnus and coauthor with Kass of The Ethics of Human Cloning (AEI Press, 1998).
    The political makeup of the Council, however, appears to be relatively meaningless. Ideological [and even theological] labels have little value in understanding a deliberative process in which analysis of the issues is taking unexpected directions, leaving stereotyped positions fallen at the wayside.
     Those who attended the briefing in Washington were given a short background paper written for the Forum by John H. Evans, Institute for Advanced Study, Princeton ³. The debate about cloning by religious groups, Evans concludes, “considers a broader range of values and concerns than a secular debate would be.” Without question, the dialogue at the Press Club displayed a broad array of opinion expressed by a small, but nationally-recognized, set of authorities: Ronald Cole-Turner of Pittsburgh Theological Seminary, Kevin FitzGerald of Georgetown University, Brent Waters of Garrett-Evangelical Theological Seminary, Laurie Zoloth of San Francisco State University, and moderator Melissa Rogers, Executive Director of the Pew Forum. Yet there was a studied effort not to be dogmatic and insensitive to the established views of the very different groups represented.
     At stake are rules to limit the methods and direction of the ‘hottest’ field of biomedical research. FitzGerald argued, without contradiction from his colleagues, that scientific research is always subject to the limitations society chooses to impose, supplementing protections already in place to limit what research may be done on humans and animals. Undecided in the minds of the panel is the stringency of control and the value of specific measures.
     The fate of research on what some do and others don’t call a human embryo seemed tied to settling first what each meant by a human. In the face of disagreement, Professor Zoloth asked, “could there be more than one way to be human?”
     Conventional wisdom leads to the conclusion that within the framework of each set of religious beliefs the question has already been answered. The dialogue seemed to establish that no such set-in-concrete beliefs exist, at least among the theologians at the Press Club meeting.
     FitzGerald mentioned that Francis Cardinal George of Chicago, has
indicated that one of the challenges before the Roman Catholic Church is to articulate a theology of the body that more fully integrates advances in scientific knowledge. Another source within the Church told GEE! that there are several efforts to develop this new line of theology, and that this possible departure from past doctrine has been brought to the attention of Pope John Paul II.
     The dynamic nature of these inquiries, according to FitzGerald, who is both a theologian and a molecular biologist, stems from the observation that “most certainly our concepts of human nature are informed by more that just scientific knowledge and information. As we struggle to integrate new biological information into our ideas about human nature, and due to the importance we place on the value of human beings, it is reasonable to take a general stance of ‘if you do not know whether or not it is a human being, don't kill it to find out.’ "
     Orthodox Jewry, often perceived in the same corner as Roman Catholics and fundamentalist Protestants on associated issues of reproduction, previously declared their position on stem cell research. The Union of Orthodox Jewish Congregations and the associated Rabbinical Council of America wrote President Bush in July of last year, expressing their belief that stem cell research using existing embryos that would otherwise be discarded is “appropriate”. They said that it is another matter “to create embryos ab initio for the sole purpose of conducting this form of research.”
     On March 12^th , the Union and the Council, weighing the “life-saving potential” of cloning research with the need to be “vigilant against any erosion of the value that society accords to human life,” concluded that “cloning for therapeutic purposes… ought to be pursued,” but opposed cloning for reproductive purposes. They said that: “our tradition states that an embryo in vitro does not enjoy the full status of human-hood.” A strong recommendation for strict guidelines and a special oversight body to enforce them was made.
     Paralleling the Roman Catholic exploration of a ‘theology of the body’ are two papers integrating the advances in molecular biology with talmudic tradition, published online by the Institute for Public Affairs of the Union and written by physician Daniel Eisenberg and Rabbi Michael J. Broyde http://www.ou.org/public/Publib/cloning.htm

[1] Cooperman, A 2 Jewish Groups Back Therapeutic Cloning: Orthodox Leaders Break With Right. Washington Post, March 13, 2002.

[3] Evans, JH. Cloning Adams Rib: A Primer on Religious Responses to Cloning. Pew Forum publication on www.pewforum.org. February 2002.

Moral Questions
What Is The Role Of The Ethicist?

     The circle of professions within which we preserve life is expanding with the increased number of physicians, lawyers, social workers, and those trained in philosophy who now practice medical ethics or bioethics. The ethicist is being regarded as a practitioner in a specialty of medicine. Yet if it is a specialty of medicine, it is not regulated professionally or by law like specialties of medicine such as cardiology or internal medicine. Admission to its professional organizations, none of which (interestingly) have a professional code of ethics, has few if any restrictions. It is, however, a discipline-in-the-making as professional and public expectations for virtue in public affairs rise to ever-higher levels. In the United States, besides the traditional medical school professorships in medical ethics, academic centers have been established to serve a growing employment market for ethicists. In conjunction with departments of philosophy and law, specialists are being trained in the counseling arts, law, and social sciences essential to the administration of codes of ethics (which increasingly take the form of laws and regulations for the protection of patients, research subjects, and practitioners).
     For many, the rise of this new professional has become still another excuse for ignoring the obligation of each practitioner to understand the moral or immoral or amoral content of his or her own decisions. Admittedly, the case can be made that for most choices the ethical choice is clear. Society could not function at any level in its hierarchy without the bulk of our acts being consistent with some form of ethical behavior, whether by reason, education, imitation, regulation, or altruistic instinct. Most choices we make are relatively simple or require little examination. The complex situations with which we are continually confronted, while fewer, almost never yield simple choices, even when the medical judgments and the ethical questions are clear. Increasingly, referrals are made to ethicists specializing in the problems of medicine in much the same way patients or problems are referred to a medical specialty. This is a hazardous practice.
     An ethicist can provide dialectical skills to help us maintain objectivity in our perception of the choices, to loosen the bonds of our emotions. The ethicist is seldom qualified to make the "right" decision for us, but should be able to challenge our ideas and motives, ask questions, impart understandings, make critical distinctions, and impose internal coherence and external applicability on our perceptions as a system.
     None of us can understand everything, making the most effective process of ethical choice, as moral philosopher Bernard Gert notes, an interdisciplinary team effort. Rarely are the requisite arts and sciences coupled in one person. Even the best-known medical ethicist, Hippocrates, sought help from outside his profession.
     Born in 460 B.C., Hippocrates was a physician (who integrated environmental perspectives in his work) and a philosopher (who sought to understand how medicine ought to be practiced). The code of ethics ascribed to him, embodied in the Hippocratic Oath, included the admonition that "whatever, in connection with my professional practice, or not in connection with it, I see or hear, in the life of men, which ought not be spoken of abroad, I will not divulge, reckoning that all such should be kept secret"
     The word ought implies a moral judgment to be made by the physician, not for the physician by an ethicist, regarding the confidentiality of patient information divulged under the cloak of the patient-physician relationship. Then, as now, physicians continuously make moral judgments in the practice of medicine through action or inaction, with knowledge or ignorance, willingly or not. Responsibility cannot be delegated, except when the physician fails to function qua physician, because of the high moral content of choices made in the normal practice of medicine. To help him make such judgments, Hippocrates sought the guidance of a popular school of ethicists, the Sophists. His contemporary, Socrates (born 469 B.C. ), is said (by Plato) to have admonished him, "You are going to commit your soul to the care of a man whom you call a Sophist. And yet I hardly think that you know what a Sophist is; and, if not, then you do not know whether (that) to which you commit yourself be good or evil."
     This guidance is as useful today as it was 25 centuries ago to Hippocrates. But the warning about sophists needs to be addressed not only to the practitioner as an individual who must make a choice, but also to the community that would judge that choice. Assignment of primary responsibility for review of the judgment made, then as now, resided in the community of physicians. "He who judges rightly will judge of the physician as a physician," enjoined Socrates. A generation later, a student in the Academy of Plato, Aristotle, clarified the advice: "The physician ought to be called to account by physicians." This did not mean, for Aristotle, as it does not for ourselves, that the physician is accountable only to the community of physicians. He or she is responsible to the whole community as well. But the train of responsibility starts with our peers and with those who are best able to understand the technical and scientific issues that are always part of the moral question in the practice of any profession, not just medicine.