This brings us to the third framework: the medical benefits framework. Few people doubt that hES
cell research offers tremendous promise for medical advance. For many, this
promise serves as the framing consideration within which all other concerns
related to stem cell research must be considered. In contrast to the other two,
this framework begins by developing a positive vision for the future and then
works back to the present situation asking: in what way can biomedical science
help us actively bring about that future?
Here the orienting bioethical principle is “beneficence,”
or “doing good.” This principle holds that we are morally obligated to pursue
the good. Stem cell research appears to be a way of doing good; human embryonic
stem cells have the potential for regenerating human organs and other tissue,
if not immediately at least in the future. Moreover, the promise of regenerative
medicine is currently based upon a theory with considerable experimental
corroboration; the promise of stem cell medicine is realistic. Relief of human
suffering, the lengthening of lives with improved health, and overall advances
in human flourishing are taken as compelling by those who advocate from this
framework. These considerations are used to frame all other concerns.
The ancient Greek, Hypocrites, said, “benefit and do not
harm.” This is the first formulation of both beneficence and nonmaleficence.
Those who advocate the medical benefits framework embrace both. However, they
understand these two principles as standing in a particular relationship to one
another. Beneficence takes precedence. Beneficence provides an orienting vision
that calls us to actively engage in pursuit of human betterment. Of course this
vision cannot be pursued by any means. Indeed, some means may come into
conflict with the vision itself. Here the principle of nonmaleficence can make
such conflicts visible. In doing so it serves to focus attention back onto the
positive ethical vision.
This ordering of beneficence and nonmaleficence
is exemplified by Jesus’ parable of the Good Samaritan (Luke
-37). The actions of the priest and Levite in Jesus’ story were oriented by the
principle of nonmaleficence: they did not do any
additional harm to the already beaten and suffering man on the side of the
road. They simply passed by on the other side. The actions of the Samaritan, by
contrast, were oriented by beneficence: he pursued an opportunity to be of
help. The Samaritan went out of his way to provide medical services and nurse
the suffering man back to health. This tells us why so many Christian hospitals
are named “Good Samaritan Hospital.”
Christians who vigorously support stem cell research out of
a medical benefits framework are sharply critical of those who would shut it
down. The number of persons now living and yet to be born whose lives could be
saved or improved by regenerative medicine number in the millions, perhaps
hundreds of millions. Any delays in the progress of this research could be
measured in the numbers of persons who will not benefit from stem cell
research. As those who operate in the embryo protection framework call
supporters of stem cell research to account for the moral status of the embryo,
in a similar way those who operate within the medical benefits framework call
those oppose stem cell research to account for lives lost by not pursuing this
research. For those who hold the medical benefits framework, to retard or
prevent stem cell research from going forward, even on the basis of the ethical
principle of nonmaleficence, risks “passing by on the
other side.” It risks failure to love one’s neighbors.
