Ronald Cole-Turner

I want to invite you to think with me briefly now about research on human embryos, including research using stem cells derived from human embryos. We want to ask about the limits of this research. In particular I want you to join me in thinking about six questions:

1. Why, first of all, should there be limits on this research?

2. Who sets the limits?

3. Where should we not set the limits?

4. Where should we set them?

5. How should we enforce them? and, revisiting the first question, we’ll rephrase it to ask,

6. Why, finally, should we set limits on this research?

A. So why, first of all, should there be limits on embryo and embryonic stem cell research? 

Moral limits to what is permissible and impermissible must be established if we are to assign practical meaning to what we say we believe. This is particularly true and especially difficult if we hold that the human embryo has "relative value." By "relative value" I mean we believe that the human embryo holds more value that human cells but less value than a human person. Just how much more and how much less, of course, needs to be determined. But the principle I want to assert here is that when it comes to how we regard the human embryo, there should be a correlation between the ontological status, the moral value, and the practical limits of what we allow ourselves to do with embryos. In simpler terms, what we do with embryos should be based on what we believe them to be. Now if we assign to them merely the value of human cells, then there are effectively no limits to what we may do with them, aside from informed consent. Or if on the other end of the spectrum we assign to them the full value of a human person, then we may do nothing with them that we cannot do to a person, which means effectively that we may only treat them therapeutically, not experimentally. These positions at the ends of the spectrum - the value merely of cells or the value fully of a person - lead rather straightforwardly to clear limits. It is the positions in the middle (and I would suggest that there are many positions in the middle, many versions of relative value) that require us to work hard in translating our assessment of status into practical limits.

Furthermore, I would say there is a social or cultural reason why there must be limits in embryo and embryonic stem cell research. That is because many of us are suspicious about our human capacity to moderate our collective behavior. We are doubtful that we will in fact be able to agree on limits here and then abide by them. And if we cannot or will not, what then? Let the research go on, effectively without limits? Or should we try to stop it before it stops, or at least slow it down? If it’s a car that won’t steer, are best off hiding the keys? This is not far off from what Bill Joy suggests in his widely discussed article, "Why the Future Doesn’t Need Us." According to Joy, uncontrollable knowledge should be declared forbidden knowledge. Really the question of limits is not so much a question about embryos or about technology but about human beings in our complex political, economic, and technological systems. Are these systems capable of defining and enforcing limits? If not, then the point of our conversation today is merely to comfort ourselves with illusions of safety. Now in fact I want to believe that we do have minimally sufficient ability here, and the will to exercise it. But I have to confess a deep uneasiness in assuming that this is the case.

B. Who sets the limits? 

The process should be participatory and not the decree of one individual, not even the President of the United States. It must come from a forum or panel - perhaps the new Bioethics Council - with recognized competence and political integrity. It must in fact be a process, because as science moves forward, the precise limits must be clarified and modified to reflect technical capabilities. Finally, and perhaps most difficult of all, the process of setting limits should aim at being international. We might for instance work for an international directive to which the laws of participating nations would conform. But the overall point here is that if the limits are not set by the right process, they will not be respected or observed and therefore will not be effective, and we will be fooling ourselves by trying to set them.

C. Where should we not set the limits? 

One place we should not set a limit between what we may and may not do with embryos and embryonic stem cells is in the line between privately funded and publicly funded research. The limit there works like this: federally funded research may not done on embryos at all, while privately funded research may do practically anything that it wants.

Another place where we should not put the limit is on the distinction between research and reproductive medicine. At the moment, there is an enormous conceptual and practical gap between what reproductive medicine does with embryos and what scientists usually believe they can do. I don’t think that’s the right place to set the limit, and that in fact we ought to work to bring reproduction and research under common values and practical procedures.

Nor should we not set a limit by the calendar, specifically by August 9, 2001. President Bush has approved the use of federal funds for research on stem cell lines derived from embryos before August 9, but not after. His reason of course is that funding for cells derived after that date may be an incentive for more embryos to be destroyed. This limit rests upon the desire to avoid complicity in an act thought to be evil. Whether it truly avoids complicity is doubted, for example by many Catholic theologians. But it also fails the test I suggested earlier, that our practical policy about embryos and the limits we set on what we do with them be founded upon how we regard them. An embryo in a petri dish destroyed before August 9 is not morally different from an embryo destroyed after August 9, and what we may do with them is not made moral by the calendar.

And I want to ask whether or not we should set certain limits to research on embryos based on how the embryo is brought into being. Now the biggest distinction here is between embryos conceived in vivo and those created in vitro. Are these any different from each other morally speaking? Do we owe them different levels of respect and are there different limits to what we may do with them? My inclination is to say yes. But I want to call our attention now to the distinctions that lie in how created embryos are created. Until now, of course, this is down by in vitro fertilization, with some slight variations thereon. But even here we have to ask: Is there a morally significant difference between an embryo created by in vitro fertilization in a reproductive clinic and one created in a university research lab? I cannot find a difference - help me if I am wrong - and so I cannot find a basis for setting a practical limit here, as I have already suggested. But what of embryos created by embryo splitting or by nuclear transfer, the two types of cloning, the first like identical twins but forced in a dish, the second like Dolly. What do we think of when we think of such embryos? Are they different from embryos created by in vitro fertilization, different perhaps because their achievement may pave the way to reproductive cloning? My sense is that many people see cloned embryos as different from in vitro embryos and as more objectionable, but that no one has offered satisfactory explanation as to why this is the case. The question - and this is very much a question on my part - is whether we should draw a practical limit here.

D. So, then, where should we set the limits to research?

What I am about to offer is my own opinion, which I agree at the outset is merely a contribution to a participatory process on a global level, one voice out of six billion. Furthermore I would say that the burden of meeting the conditions and the limit of research rests upon those who advocate research. If the social mechanisms do not yet exist, advocates of research should be the first to help build them. That said, I suggest the following limits or conditions, in addition to the usual requirements of informed consent and local institutional review, all of which must be met by any project of embryo research, including derivations of human embryonic stem cells.

1. Research is in vitro only; nothing is to be implanted.

2. For fourteen developmental days only.

3. Only under federal license that requires prior review, full public disclosure of all aspects of the protocol, and full reporting at its conclusion.

4. Only with the number of embryos necessary for the research objective.

5. Only for research in the fundamental science of human embryology that cannot be done with embryos of other species, or for research that promises to lead to compelling medical advance.

6. Only if the funding, intellectual property, and commercial factors are so determined so that no person, corporation, or nation profits financially from the donation, research upon, or destruction of a human embryo.

Let me say again that in my proposal, all these conditions must be met by every research protocol, regardless of how it is funded or where it is located. Those who wish to proceed with this research, and those who support it enthusiastically, should work to make it possible for us to achieve these limits.

Two additional comments are in order. These limits are specified for research. We must, I believe, bring reproductive medicine under similar constraints, even while recognizing that patient families are involved and the aim is quite different.

Second, we must clarify quickly whether these limits apply to (and thus permit) research involving embryos specifically created for research. I believe the answer to this is yes. But does it also extend to embryos created by splitting or nuclear transfer? I am not offering an opinion on that, but I cannot yet find a compelling reason to exclude them from research.

E. How should we enforce these limits? 

Let me say that I am very serious about this and believe that whatever limits are established should be enforced with such legal and professional sanctions that no serious researcher would think for a moment about violating them. If we can define the limits and do so internationally, then enforcement, I believe, will be the relatively easy part, at least when it comes to research. When it comes to reproductive medicine, for instance to enforcing a ban on reproductive cloning, I am far more pessimistic.

But we should think of enforcement, however, not merely as external constraint but as internal moral compass, and so I think it is essential that the moral resources of our society work to build the moral sensitivity and wisdom of those who are engaging in this research, of young people headed into technical careers, and of directors of research at major firms. My point here is for the church not so much to be countercultural but a transformer of culture, particularly in this case the culture of research. We should work to inspire a clear awareness of what is not to be done together with a compelling vision of the good that may be done.

F. So come back with me then to the first question, rephrased a little bit so that now we ask, Why, finally, should we set limits on this research?

I suggested near the beginning that if we cannot set limits, we should not proceed. But I think that what hangs in the balance here is not just near term human embryo research and embryonic stem cell research, but far more profound and audacious applications of technologies that are only now in early stages of development. I have in mind here the modification of human genetic inheritance, in ways that will affect every cell of the human body and which may be passed to offspring forever. I have in mind here reproductive cloning. I have in mind here pre-implantation genetic diagnosis, something that is already being done. In each of these, with the exception of cloning, there are quite possibly great benefits, but there are assuredly great risks. And in each of these, there is the human embryo in vitro, out of the womb and in the dish, in front of us, in our hands, under the microscope, accessible to our prodding and poking, our genetic modifications. This is a new fact of our moral universe. Human biological nature out there, exposed, the object of our study and our technology. The tiny dot in the dish symbolizes the vulnerability of our destiny, vulnerable not to the threats of nature but to all the promises and threats of what technology can do to our nature. That is what the in vitro embryo represents - not a person but our future. In that sense it is far more than a person. It is the future of us all, the point of access to the technological modification of the future of human nature. Because that is what the in vitro research embryo represents, we must learn to see it with new eyes, as the locus of our future, and treat it with new respect appropriate to the future of our humanity.