Research on Human Embryos :How Our Theology Shapes Our Attitude
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Research on Human Embryos:
How Our Theology Shapes Our Attitude by Audrey Jarvis
Some background; the Interchurch Bioethics Council represents the Anglican, Methodist and Presbyterian churches of New Zealand. It was created first in 2000 as the Interchurch Commission on Genetic Engineering, in order to present a submission to the Royal Commission on Genetic Modification in New Zealand. We than realized that the ethical, spiritual and cultural issues raised by biotechnology were only to get bigger and that we were well placed to have a voice in these matters. And so we took a slightly different name and have been active since. We have nine members, with between them expertise in medicine, science, ethics, theology, education and cultural issues.
I chose tonight to talk about the use of human embryos for research. This is a major topic, and has been particularly studied during the past 18 months. It is an important topic for two reasons: there is the possibility of huge potential benefit from the research and application of the knowledge to be gained: but there are major ethical questions to be addressed.
I chose this topic also because it shows how the theological beliefs that we hold play a major part in determining our attitudes to difficult ethical questions.
In considering embryonic research, these are the 3 questions which first need answering:
1. Are there situations in which it is acceptable to use human embryos for research?
2. If so, where should these embryos come from?
3. Should there be restrictions on the type of research to be done?
It helps in thinking about the status of the embryo or the importance of an embryo to look at the milestones in its development and what they mean.
The fertilized egg produces 2 identical cells and by day 4, a cluster of cells The number of cells continues to increase and at 5 to 7 days the mass of cells has an internal cavity and this stage of the embryo is termed a blastocyst, a milestone in the development of the embryo.
This outer layer of cells when implanted into the uterus will eventually become the placenta. The inner cell mass, or ICM is still undifferentiated and it is from a few of these cells that the future individual arises. At nine weeks the developing human being is termed a foetus. So at 0-8 weeks it is termed the embryo.
Blastocyst in utero –totipotent, has everything it needs to become a human being
Blastocyst in the laboratory is potentially totipotent, cannot become a human being outside the human environment. This is seen as a very significant difference between a blastocyst in utero, which is on its way to becoming a person, and a blastocyst which cannot develop in its present circumstance develop into a human being.
The cells here in the centre of the blastocyst, the inner cell mass (ICM) are able to differentiate into any of the types of cell which are found in the body. It is possible in the laboratory to take cells from here and grow them, and they are called embryonic stem cells. The ICM and embryonic stem cells derived from the ICM cannot become a human being because they don’t have the cells that will become the placenta, and they are not in the uterus, but they can differentiate into any of the cell types that are found in the human body but cannot become a human being. Having said that, there is still a lot to be learnt about how to develop just the cells that are wanted.
Another milestone. At 15-16 days the primitive streak appears –this is the beginning of the nervous system and in New Zealand it is illegal to allow an embryo to develop in the laboratory beyond 14 days—in fact in any country which does allow research on human embryos 14 days is the generally agreed cut-off point.
Why does anyone want to use human embryos for research? To study growth and development of the human being. To find ways of treating diseases, including cancer, which involves the abnormal and uncontrolled growth of cells. To study infertility, and to hope therefore to find ways of treating infertility and to improve the rate of successful pregnancies in IVF. To find ways of detecting and preventing inherited diseases.
I have talked about stem cells, and they have been held up in the media as the cure-all of the future, perhaps as penicillin was the magic bullet in the 1940s. The hope is that by putting stem cells into people whose cells are not functioning, e.g. cells which will develop into brain cells into people suffering from Parkinsons disease, a cure will be effected. Another example on which research and clinical trials are currently being undertaken is that of repair of a damaged spinal cord. Undoubtedly there is promise in some of these areas, but we have to be realistic about the speed with which all this will occur. I would like to quote Prof Richard Faull, who carries out research on brain cells and diseases of the brain. He said at a seminar last month that the hype and media statements are unrealistic and that there are enormous challenges ahead. He said that in Parkinsons treatment trials, which gave mixed results, 4 aborted fetuses were required to treat one patient and he, I quote, ‘couldn’t go down this line’.
The significant point about all this research is that whether to develop stem cells or to carry out other work, the process requires that the embryos will be destroyed.
We go back to the first question I listed. Are there some situations in which research on gametes or embryos should be allowed?
The answer to this will depend largely on the spiritual value or status which we give to human embryos. The embryo can be seen as a potential human being or it can be regarded as a tissue or group of cells which has no intrinsic value.
At one end of the spectrum (quoting from Prof Edwin Hui, a well known ethicist, Professor of Biomedical Ethics, Christianity and Chinese Culture at Regents College Canada) is the belief that the soul is present at conception . This is a position I have met a number of times, often with definite statements but without any clear reasons as to why this belief is held. I therefore found it helpful and challenging to hear the reasons stated by Professor Hui. In his belief, personhood is constituted by a covenant of love initiated by God and expressed in the marriage covenant. The use of assisted reproductive technologies (ART) forces God to accept a child when he has not given that gift of life. Thus the argument that the soul is present at conception, and therefore the embryo must be completely protected as a human being, is based on relationship and God’s purpose.
This position leads to a rejection of any ART including IVF for infertile couples, and of course any research on human embryos.
There are some obvious difficulties with these arguments, e.g. why is a longed-for loved child created by IVF not a gift of God, but an unwanted child born naturally but not in a loving context is a gift of God? And in rejecting any technologies related to the reproductive process as unnatural, do we then have to reject all medical intervention in illness?
Additionally, it is not clear how the theological principles enunciated by Hui are to be applied in pluralistic societies, such as we increasingly have in New Zealand. The ethical principles outlined are based on theological principles. There is a major gap between those who hold to these principles and those for whom they are not significant. and it is not clear how Christians holding these ideals are to function in an alien environment or how those who are not Christian are to cope with the restrictions placed on them by these rules. We might say we see this in a small way in Easter Trading. It is easier to see that the gain from Easter Trading is ephemeral and comparatively minor. This would not necessarily apply to benefits which might accrue from medical technology.
Further along the spectrum, there are other beliefs relating to the concept of personhood. Ersonhood may be seen as the acquiring of a soul (still difficult to define) or of individuality. Personhood is believed to be acquired at different times in different cultures. If the embryo is protected only when it has acquired personhood, research may be acceptable until this stage. If the embryo before implantation, when it can differentiate into different types of cells but cannot become a human being without being implanted in the mother’s uterus, is only a bunch of cells, then it might well be an appropriate subject for research.
At the other end of the spectrum, another way of looking at research on an embryo is directed by the belief that creativity is fundamental to human existence, our gifts are given to us by God and we have a responsibility to use our gifts to extend knowledge and to make decisions for good.Compassion is a Christian virtue. In this context the potential for healing and scientific advance in reproductive and other medicine may be more important than the harm done to an embryo which has not yet reached the status of personhood.
We may then make a decision on the idea that good to the community is greater than the harm to the embryo.
There are particular beliefs shared by Maori, and I emphasise that there is no one Maori belief, which refer to whakapapa (genealogy) mauri (life principle) wairua (spirit)…tika (correct) tikanga (custom or practice)
Having looked at these different beliefs and positions, if we have decided that there are some situations in which research on human embryos is permissible, the next question is ‘where should these embryos come from?’
1. The first possibility is to use embryos created for IVF, (the process used to create embryos in a test-tube to assist infertile couples to have children). These embryos may not be stored for more than 10 years. So if the embryos are going to be destroyed anyway at 10 years so why not make good use of them for research?
2. Another option is the creation of embryos specifically for research. This does seem to make an embryo a commodity. However, there is a narrative argument that an IVF embryo was created to become a child and was loved and valued c.f. an embryo created for research was never on that path. It was never intended to become a child so it was always just a collection of cells.
3. SCNT (somatic cell nuclear transfer). This is a little different. It involves making an embryo without using an egg and sperm. Against is the slippery slope argument re reproductive cloning, which is illegal in most countries. Also we would still be creating an embryo for research.
So our third question was if we approve embryonic research, and if we decide where the embryos may come from, are there any restrictions on the type of research which should be allowed, is some research more appropriate than others?
This raises the question of informed consent. Both parents have an input into what happens to an embryo. The parents could have the opportunity to deny some sorts of research or specify areas of research e.g. someone who does not support abortion may agree to research into how to raise fertility rates but not agree to research related to the termination of a pregnancy.
One point which I have not made up to now is that there is work being done on using stem cells as a tool in therapy e.g. using stem cells to repair a damaged spine, which uses adult stem cells and therefore sidesteps some of the ethical issues I have mentioned. However, not all research on embryos is directed to stem cell research and the basic ethical questions still remain.
The ICBC acts on the assumption that in deciding to respond to an ethically difficult situation, the way forward is to consider the theological issues, the core values which we hold, the balance of benefit and harm, the questions of justice. By ‘we’ I mean the people we call our constituency, the members of the three churches by which we were appointed. We research the issues, including what is being done in other countries and communities, add input from our own various areas of expertise and work by consensus.
We have a website which can be reached through the CASI (churches agency on social issues) at www.casi.org.nz.
Research on Human Embryos:
How Our Theology Shapes Our Attitude by Audrey Jarvis
Some background; the Interchurch Bioethics Council represents the Anglican, Methodist and Presbyterian churches of New Zealand. It was created first in 2000 as the Interchurch Commission on Genetic Engineering, in order to present a submission to the Royal Commission on Genetic Modification in New Zealand. We than realized that the ethical, spiritual and cultural issues raised by biotechnology were only to get bigger and that we were well placed to have a voice in these matters. And so we took a slightly different name and have been active since. We have nine members, with between them expertise in medicine, science, ethics, theology, education and cultural issues.
I chose tonight to talk about the use of human embryos for research. This is a major topic, and has been particularly studied during the past 18 months. It is an important topic for two reasons: there is the possibility of huge potential benefit from the research and application of the knowledge to be gained: but there are major ethical questions to be addressed.
I chose this topic also because it shows how the theological beliefs that we hold play a major part in determining our attitudes to difficult ethical questions.
In considering embryonic research, these are the 3 questions which first need answering:
1. Are there situations in which it is acceptable to use human embryos for research?
2. If so, where should these embryos come from?
3. Should there be restrictions on the type of research to be done?
It helps in thinking about the status of the embryo or the importance of an embryo to look at the milestones in its development and what they mean.
The fertilized egg produces 2 identical cells and by day 4, a cluster of cells The number of cells continues to increase and at 5 to 7 days the mass of cells has an internal cavity and this stage of the embryo is termed a blastocyst, a milestone in the development of the embryo.
This outer layer of cells when implanted into the uterus will eventually become the placenta. The inner cell mass, or ICM is still undifferentiated and it is from a few of these cells that the future individual arises. At nine weeks the developing human being is termed a foetus. So at 0-8 weeks it is termed the embryo.
Blastocyst in utero –totipotent, has everything it needs to become a human being
Blastocyst in the laboratory is potentially totipotent, cannot become a human being outside the human environment. This is seen as a very significant difference between a blastocyst in utero, which is on its way to becoming a person, and a blastocyst which cannot develop in its present circumstance develop into a human being.
The cells here in the centre of the blastocyst, the inner cell mass (ICM) are able to differentiate into any of the types of cell which are found in the body. It is possible in the laboratory to take cells from here and grow them, and they are called embryonic stem cells. The ICM and embryonic stem cells derived from the ICM cannot become a human being because they don’t have the cells that will become the placenta, and they are not in the uterus, but they can differentiate into any of the cell types that are found in the human body but cannot become a human being. Having said that, there is still a lot to be learnt about how to develop just the cells that are wanted.
Another milestone. At 15-16 days the primitive streak appears –this is the beginning of the nervous system and in New Zealand it is illegal to allow an embryo to develop in the laboratory beyond 14 days—in fact in any country which does allow research on human embryos 14 days is the generally agreed cut-off point.
Why does anyone want to use human embryos for research? To study growth and development of the human being. To find ways of treating diseases, including cancer, which involves the abnormal and uncontrolled growth of cells. To study infertility, and to hope therefore to find ways of treating infertility and to improve the rate of successful pregnancies in IVF. To find ways of detecting and preventing inherited diseases.
I have talked about stem cells, and they have been held up in the media as the cure-all of the future, perhaps as penicillin was the magic bullet in the 1940s. The hope is that by putting stem cells into people whose cells are not functioning, e.g. cells which will develop into brain cells into people suffering from Parkinsons disease, a cure will be effected. Another example on which research and clinical trials are currently being undertaken is that of repair of a damaged spinal cord. Undoubtedly there is promise in some of these areas, but we have to be realistic about the speed with which all this will occur. I would like to quote Prof Richard Faull, who carries out research on brain cells and diseases of the brain. He said at a seminar last month that the hype and media statements are unrealistic and that there are enormous challenges ahead. He said that in Parkinsons treatment trials, which gave mixed results, 4 aborted fetuses were required to treat one patient and he, I quote, ‘couldn’t go down this line’.
The significant point about all this research is that whether to develop stem cells or to carry out other work, the process requires that the embryos will be destroyed.
We go back to the first question I listed. Are there some situations in which research on gametes or embryos should be allowed?
The answer to this will depend largely on the spiritual value or status which we give to human embryos. The embryo can be seen as a potential human being or it can be regarded as a tissue or group of cells which has no intrinsic value.
At one end of the spectrum (quoting from Prof Edwin Hui, a well known ethicist, Professor of Biomedical Ethics, Christianity and Chinese Culture at Regents College Canada) is the belief that the soul is present at conception . This is a position I have met a number of times, often with definite statements but without any clear reasons as to why this belief is held. I therefore found it helpful and challenging to hear the reasons stated by Professor Hui. In his belief, personhood is constituted by a covenant of love initiated by God and expressed in the marriage covenant. The use of assisted reproductive technologies (ART) forces God to accept a child when he has not given that gift of life. Thus the argument that the soul is present at conception, and therefore the embryo must be completely protected as a human being, is based on relationship and God’s purpose.
This position leads to a rejection of any ART including IVF for infertile couples, and of course any research on human embryos.
There are some obvious difficulties with these arguments, e.g. why is a longed-for loved child created by IVF not a gift of God, but an unwanted child born naturally but not in a loving context is a gift of God? And in rejecting any technologies related to the reproductive process as unnatural, do we then have to reject all medical intervention in illness?
Additionally, it is not clear how the theological principles enunciated by Hui are to be applied in pluralistic societies, such as we increasingly have in New Zealand. The ethical principles outlined are based on theological principles. There is a major gap between those who hold to these principles and those for whom they are not significant. and it is not clear how Christians holding these ideals are to function in an alien environment or how those who are not Christian are to cope with the restrictions placed on them by these rules. We might say we see this in a small way in Easter Trading. It is easier to see that the gain from Easter Trading is ephemeral and comparatively minor. This would not necessarily apply to benefits which might accrue from medical technology.
Further along the spectrum, there are other beliefs relating to the concept of personhood. Ersonhood may be seen as the acquiring of a soul (still difficult to define) or of individuality. Personhood is believed to be acquired at different times in different cultures. If the embryo is protected only when it has acquired personhood, research may be acceptable until this stage. If the embryo before implantation, when it can differentiate into different types of cells but cannot become a human being without being implanted in the mother’s uterus, is only a bunch of cells, then it might well be an appropriate subject for research.
At the other end of the spectrum, another way of looking at research on an embryo is directed by the belief that creativity is fundamental to human existence, our gifts are given to us by God and we have a responsibility to use our gifts to extend knowledge and to make decisions for good.Compassion is a Christian virtue. In this context the potential for healing and scientific advance in reproductive and other medicine may be more important than the harm done to an embryo which has not yet reached the status of personhood.
We may then make a decision on the idea that good to the community is greater than the harm to the embryo.
There are particular beliefs shared by Maori, and I emphasise that there is no one Maori belief, which refer to whakapapa (genealogy) mauri (life principle) wairua (spirit)…tika (correct) tikanga (custom or practice)
Having looked at these different beliefs and positions, if we have decided that there are some situations in which research on human embryos is permissible, the next question is ‘where should these embryos come from?’
1. The first possibility is to use embryos created for IVF, (the process used to create embryos in a test-tube to assist infertile couples to have children). These embryos may not be stored for more than 10 years. So if the embryos are going to be destroyed anyway at 10 years so why not make good use of them for research?
2. Another option is the creation of embryos specifically for research. This does seem to make an embryo a commodity. However, there is a narrative argument that an IVF embryo was created to become a child and was loved and valued c.f. an embryo created for research was never on that path. It was never intended to become a child so it was always just a collection of cells.
3. SCNT (somatic cell nuclear transfer). This is a little different. It involves making an embryo without using an egg and sperm. Against is the slippery slope argument re reproductive cloning, which is illegal in most countries. Also we would still be creating an embryo for research.
So our third question was if we approve embryonic research, and if we decide where the embryos may come from, are there any restrictions on the type of research which should be allowed, is some research more appropriate than others?
This raises the question of informed consent. Both parents have an input into what happens to an embryo. The parents could have the opportunity to deny some sorts of research or specify areas of research e.g. someone who does not support abortion may agree to research into how to raise fertility rates but not agree to research related to the termination of a pregnancy.
One point which I have not made up to now is that there is work being done on using stem cells as a tool in therapy e.g. using stem cells to repair a damaged spine, which uses adult stem cells and therefore sidesteps some of the ethical issues I have mentioned. However, not all research on embryos is directed to stem cell research and the basic ethical questions still remain.
The ICBC acts on the assumption that in deciding to respond to an ethically difficult situation, the way forward is to consider the theological issues, the core values which we hold, the balance of benefit and harm, the questions of justice. By ‘we’ I mean the people we call our constituency, the members of the three churches by which we were appointed. We research the issues, including what is being done in other countries and communities, add input from our own various areas of expertise and work by consensus.
We have a website which can be reached through the CASI (churches agency on social issues) at www.casi.org.nz.
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