Where Do You Stand? Perspectives on the Ethics of Stem Cell Research

[1] President Bush’s recent decision regarding the government funding of stem cell research illustrated the dilemma we face rather than resolving it. Allowing research to go forward on existing lines of embryonic stem cells acknowledges the concern of many that we pursue the promising possibilities of therapeutic benefits resulting from this research. At the same time, his decision to go no further than this echoes the conviction of others that even pre-implanted embryos are human life deserving our protection and respect. Scientists and hopeful beneficiaries were disappointed by the restrictions but at least saw an opening. Many opponents were disappointed that any research was permitted but fastened on to the prohibitive dimension of the President’s decision as support for their cause.

[2] The question, “Where do you stand?” is not simply a question of your ethical convictions on this matter. It is also a question about your location, the vantage point from which you look at this question.

[3] Certainly people with Parkinson’s disease, families with loved ones in the grip of Alzheimer’s disease, and others beset with end-stage kidney disease, certain forms of cancer, or liver failure are likely to see the promise of embryonic stem cell research as a virtual godsend. Even if it is too late for them or for their loved ones, their experience with these fatal and debilitating diseases evokes a compassionate advocacy for this work to go forward. Just as surely, the scientists who have these diseases in their cross hairs are eager to forge ahead, whether out of an authentic vocational drive to combat disease and death or the thrill of the hunt and the glory of the prize…or both. From this vantage point the road ahead seems clear.

[4] Yet there are also folks, including some whose lives have been touched by dread diseases or who are in the healing arts, who stand in a different location, on what they might call the higher ground of the sanctity of human life. For them the destruction of embryonic life for the advance of medicine is a Faustian bargain. In many, if not the overwhelming majority of instances, this belief in the inviolable sanctity of life in all its phases is driven by religious convictions employed in the interpretation of the scientific data of human genesis. From this vantage point the road ahead is a dead end.

[5] For both camps, pro and con, then, there is yet another location to consider, one that is raised when we invoke the sanctity of life principle in this debate. Where do you locate yourself on the question of when life begins? This is the centuries old question so central to the endless debate over abortion. The varieties of answers given throughout the tradition of Christian moral reflection represent a broad spectrum to say the least. Indeed, so varied has been the array of religious and philosophical positions on the matter that Roe v. Wade concluded that abortion must remain a matter of personal choice until the time of viability when the state then had a legitimate interest in that fetal life. However, when it comes to matters of public policy in research with embryos, which does not involve a woman’s right to privacy in any obvious way, the moral/legal status of nascent life in its various stages gains renewed attention.

[6] Are religiously driven convictions that life begins at conception an imposition on the workings of secular government or do they represent a genuine expression of at least a major segment of the body politic? What are the alternatives? For some proponents, embryonic stem cell research is not a compromise of the sanctity of human life, because embryonic life does not have the moral status of personal human existence whatever its potential. For still others, even conceding the fact that embryonic life is human life deserving of respect, our normal moral obligations to extend protection to nascent life are overridden by the urgency of addressing the suffering of those who might benefit from embryonic stem cell research now and in future generations. Some may even say that this is the true way to respect the sanctity of life.

[7] Where does the Evangelical Lutheran Church in America locate itself in the midst of this debate? First of all, it is fair to say that our people look at this from the various vantage points we can discern in the general population. However, we do have a common place from which to begin our moral deliberation. The document, A Social Statement on Abortion, adopted by the Churchwide Assembly in 1991, operates with the following conviction, “Human life in all phases of its development is God-given and, therefore, has intrinsic value, worth, and dignity.” One could readily infer from this statement a moral prohibition of research with embryonic stem cells.

[8] However, the social statement on abortion does not make absolute prohibitions; it recognizes some dire circumstances in which abortion is a responsible albeit tragic choice. Thus, we have to deal with the question of whether or not the fetal tissue involved in such cases might not be donated to stem cell research and if not, why not? Is this morally different from donating organs of those who are brain dead and about to be taken off futile life supports?

[9] The social statement does not deal with the moral status of pre-implanted embryos such as those discarded in the process of in vitro fertilization. This gets us closer to the heart of the issue at present since the existing 60 embryonic stem cell lines are drawn from excess embryos created in the in vitro fertilization process. There is no church consensus on this as yet. The “life in all phases of its development” phrase in the abortion statement could be construed to mean life begins at conception and thereby settle the issue. However, an endnote on embryology tells us that 40-75% of the zygotes resulting from conception in normal intercourse spontaneously fail to implant. Do the unused embryos of the in vitro process simply mimic nature, albeit with intentionality, thereby placing them in a morally different category from implanted embryos? Furthermore, the document also states that, “Although abortion raises significant moral issues at any stage of fetal development, the closer the life in the womb comes to full term the more serious such issues become.” Does the morally “less significant” (?) status of pre-implanted embryos make them more susceptible to use in research for therapeutic benefit? (Interestingly enough, here in Ohio where we have a law against research on aborted fetal tissue, the question of pre-implanted embryos and stem cell research is now open for debate.)

[10] These questions will obviously be a part our moral deliberation as a Christian community. However, I believe, for openers, that the thrust of our social statement on abortion is the protection of life except under the most tragic circumstances. This stance and the theological and ethical rationale that underlies it would seem to place us in opposition to the use of embryos for stem cell research with the burden of proof falling on the lowering of that barrier. At the level of public policy advocacy, I should think we would at least want to see research restricted to pre-implanted embryos that are the excess of in vitro fertilization procedures and a ban on creating such embryos for the sole purpose of research.

[11] We will want to advocate for the research with stem cells from umbilical cords and adult sources. However, we should be aware that that is not the easy way out. At present, though the jury is still out, scientists see differences in adult stem cells and embryonic stem cells that seem to favor the latter in their potential for a variety of therapeutic applications. Adult stem cell research may not show results any time soon that will relieve the pressure to work with embryonic tissue.

[12] Finally, there is another vantage point from which to view the matter. It is the vantage point of justice. With over 43 million people without health insurance, how do we set priorities in the allocation of funds spent in medicine? Will the benefits of this stem cell research continue to be unevenly shared as with other benefits of medical science? It is vexatious to consider saying “no” to any pursuit that we think will relieve suffering or cure disease. However, given the system we have chosen for the delivery of healthcare, we do, de facto. It is within this larger context that we must also consider the relative value of a controversial issue such as stem cell research.