Tag Archives: Bioethics

Discerning Bio-advances with a Catholic Lens

At no time in history has the line separating good and evil been so blurred. It is especially so in the fields of science and medicine where the lines are vanishing while the right to conscience is being legislated away.

When evil poses as ‘care’

Discovery, relieving suffering, finding cures…these were once understood as absolute goods. However, when ending suffering means ending lives on both ends, and curing diseases happens through experimentation on embryos and designer genes, and when discovery means playing God, then evil masquerades as good.

“The Catholic Church has a vitally important role in helping people distinguish between morally appropriate and inappropriate uses of biotechnology and medicine,” Father Tadeusz Pacholczyk, Ph.D., Director of Education at the National Catholic Bioethics Center, explained in an interview with Legatus. He noted that many people are grateful for the way the Church articulates well-defined positions on moral questions.

Church guidance at forefront

Although the Church may reflect for some time to identify important considerations and guiding principles in the biosciences, Fr. Pacholczyk said that even with this slow and deliberative process, the Church stays well ahead of the curve. “For example, by the time of the successful cloning of Dolly the sheep in 1996,” he said, “the Catholic Church had already been reflecting on the question of human cloning for many years, and concluded, nine years prior to Dolly, that human cloning would be morally unacceptable in an important document called Donum Vitae (On the Gift of Life).”

When the first test tube baby was born in 1978, the serious moral concerns raised by the procedure had already been spelled out 22 years earlier, by Pope Pius XII, in his 1956 Allocution to the Second World Congress on Fertility and Human Sterility. The Pope concluded: “As regards experiments of human artificial fecundation ‘in vitro,’ let it be sufficient to observe that they must be rejected as immoral and absolutely unlawful.” The Church’s stance was explained in greater detail later in Donum Vitae, as well as in various other statements and addresses, according to Fr. Pacholczyk.

“The Church is one of the last remaining voices in our culture to remind us of the most basic truths about sexuality, how new human life must be procreated in the warmth of the marital embrace and in the protective hearth of the maternal womb, not in the icy, impersonal world of the research laboratory, or the manipulative setting of a Petri dish,” he said.

Science often unheeded

Charles LiMandri, a Legate with the San Diego Chapter, is the President and Chief Counsel of the Freedom of Conscience Defense Fund, (FCDF) a nonprofit law firm that defends constitutional liberties, conscience rights and the sanctity of human life. He and his wife Barbara are also the parents of five children. According to him, the culture has gotten extremely aggressive, pushing a liberal agenda in which science is often ignored in the case of gender issues, or used in immoral ways such as with experimentation on embryos.

“A lack of respect for the sanctity of life and separating the procreative from unitive aspect of sexuality has fueled many unethical practices,” LiMandri said. “Once it is just about pleasure rather than cooperating with God’s natural law, it really is a slippery slope.”

Courts bully Catholics

According to LiMandri, the far left uses the courts as the least representative form of government to take away the right of Catholics to follow Catholic teaching. “Many of these appointed judges can use the force of law to make Catholics, Christians and other individuals follow their liberal agenda, with the threat of serious repercussions,” he said. “The opposition will stop at nothing to force the Christian community to accept their agenda carte blanche.”

LiMandri writes about many of these issues at Alumni for Catholic USD, a page he started to promote the truth after his Catholic alma mater, the University of San Diego held a drag queen contest.

Inspired into bioethics, genetics by JPII

Marilyn E. Coors, Ph.D., a Legate in the Denver Chapter, is an associate professor of ethics in genetics at the University of Colorado Health Sciences Center. When she and her husband Peter sent the youngest of their 6 children to school, Coors returned to school also, receiving a masters in cytogenetics and another in ethics and religion, a Ph.D. in bioethics and a post-doctoral fellowship in bioethics and human medical genetics.

“It was a quote from JPII, that we should infiltrate the bastions of science with the word of God, that became my inspiration while I was going to school,” Coors said. According to her, the field of bioethics is changing quickly and posing many challenges.

“Genetic science and technology have advanced tremendously from the first decoding of the human genome in 2001 to 17 years later being able to edit it in specific ways,” Coors said. “The Church, through teachings of JPII and Pope Benedict, endorses the use of genetics to treat and cure disease, but editing genes has significant concerns for both science and religion.”

Mushrooming bio-quandaries

Everything from bioterrorism that could impact the environment, to gene editing in order to hardwire babies for desirable traits, has serious moral implications, according to Coors. She also pointed out that for humans, editing genes at the embryonic level, which involves fertilizing eggs in test tubes, is illicit.

Experimentation on human gene editing is just beginning. This past July, experiments were done on embryos to edit out the fatal gene for cardiomyopathy, then they were destroyed. Coors pointed out that a potential risk with this kind of technology is that insurance companies will refuse to cover conditions that could have been edited out.

Have a personal advocate

Bobby Schindler, president of the Terri Schiavo Life & Hope Network, became involved in bioethics and defending personal rights after witnessing firsthand the harm that judges, political figures and bioethicists can have on vulnerable people like his sister Terri who had her lifesustaining nutrition removed by a judge. “I realized that my vocation was advocating for medically vulnerable persons,” he said. “Before that, I assumed that physicians would want to care for disabled people like my sister rather than fatally starve and dehydrate them. It opened my eyes.”

Schindler is in the second year of a masters program in bioethics at the University of Mary to expand on years of practical experience advocating for his sister and more than 2,500 medically vulnerable patients and their families. “Ethics committees and the courts are imposing their values and medical determinations on whether a patient receives medical treatment, rather than the directives of family members,” he said.

Medical decisions are often made based on cost, Schindler said.

“Simply put, the heath provider is making medical decisions with their best interest in mind—which is cost containment dictated with the accountants more in mind than God— rather than the patient’s best interest,” he said. According to him, the physician’s principle to “do no harm” has come to be re-interpreted as to hasten death for patients.

“Ultimately, there’s no silver-bullet solution to the bioethical challenges we face,” he said. “The best protection for each and every one of us is to have heroic advocates in our lives who will fight for our basic care.”

PATTI MAGUIRE ARMSTRONG, who wrote the newly published book, Legatus @ 30, is an award-winning author and Catholic journalist, TV and radio commentator, and mother of 10.

Catholic Bioethics Resources

Ethical and Religious Directives for Catholic Health Care Services, 5th edition
United States Conference of Catholic Bishops (2009)

Dignitas personae (Instruction on Certain Bioethical Questions)
Congregation for the Doctrine of the Faith (June 20, 2008)

Address to an International Conference on Organ Donation
Pope John Paul II (August, 2009)

Fides et ratio (Faith and Reason)
Pope John Paul II (September 14, 1998)

Evangelium vitae (The Gospel of Life)
Pope John Paul II (March 25, 1995)

Veritatis splendor (The Splendor of Truth)
Pope John Paul II (August 6, 1993)

Donum vitae (The Gift of Life)
Congregation for the Doctrine of the Faith (February 22, 1987)

Declaration on Euthanasia
Congregation for the Doctrine of the Faith (May 5, 1980)

Redemptor hominis (The Redeemer of Man)
Pope John Paul II (March 4, 1979)

Humanae vitae (Of Human Life)
Pope Paul VI (July 25, 1968)

Address to the First International Congress on the Histopathology of the Nervous System
Pope Pius XII (September 13, 1952)

Is a soul conscious after death?

A distinguished group of Catholic bioethicists had gathered in a conference room of a Washington, D.C., hotel to discuss the topic of brain death. When my turn came for a presentation, I was in for a shock.

Edward J. Furton

Within 10 minutes, the room grew uneasy. There were quizzical looks and the shuffling of papers. One of the attendees became angry and began to shout. His words were at first unintelligible — they included complex Latin quotations — but it became clear that he was objecting to my statement that the intellective soul survives the death of the body.

The discussion continued for weeks afterwards via email. To my surprise, I discovered that the majority of these distinguished thinkers did not know that the soul continues in conscious existence after separation from the body. One influential figure told me that at death, the soul went into a deep unconscious state and lacked all awareness. Another said that the soul ceased to exist at all until it was reunited with the resurrected body. Yet the Church teaches that at death there is a “particular judgment” that either unites the soul with the life of Christ in heaven (often through purgatory) or condemns it to eternal damnation (Catechism of the Catholic Church, #1021). This event precedes the “last judgment” and the resurrection of the dead (CCC #1038).

Death is the separation of the soul from the body, but the soul does not lose consciousness — or cease to exist — when it undergoes that separation. The soul is fully aware of the particular judgment. This is not to deny in any way that the soul is the substantial form of the body. The two form a composite union, but the soul has its own principle of existence, given to it by God. As a spiritual entity, the soul doesn’t need the body to exist or to engage in thought. The soul has an “intellective memory” that survives death and can also have new thoughts through God’s direct infusion of ideas into the mind.

These are interesting philosophical inquiries, but they also have some measure of empirical support from a remarkable phenomenon within the field of medicine. Some patients who are dead by standard medical criteria report after resuscitation that they were aware of efforts to revive their bodies and are able to describe specific events that occurred then. Thus a patient might say, “I saw a nurse wearing a red cap enter the room, give the physician a syringe, and then leave.” But during that time the patient had no heartbeat, no brain function, and no signs of life, but lay on the operating table dead.

Revived patients who experience these events often describe a feeling of looking down on the room from above, but the question of location is really not important. What matters from an evidentiary point of view is the accuracy of their accounts. If the soul ceased to exist at death, or fell into a state of complete unconsciousness, it would not be able to know anything. But in these cases, the patient is able to describe details about events connected to the resuscitation that could not possibly have been known unless he or she were somehow still aware.

One of the most comprehensive surveys of this phenomenon is titled “AWARE” (Parnia et al., Resuscitation 85.12, Dec. 2014, 1799-1805). The study shows that 40% of patients who survived cardiac arrest were aware during the time that they were clinically dead. If death is the separation of the soul from the body, as the Church teaches, then these cases should not surprise us. The person has indeed died because the soul has separated from the body, but a successful resuscitation causes the soul to return life to the body. The particular judgment does not take place because death had not been finalized.

Of course, we live in an age of materialism. Those who hold that there is no life after death tell us that these experiences are the result of chemical imbalances in the brain or some other purely material cause. Yet that view cannot explain the factual nature of the accounts. Hallucinations caused by chemical imbalances don’t produce accurate reports.

Given that Church teachings on the nature of the soul are not matters of faith but are evident to reason, such studies provide an important type of empirical evidence. I have met physicians who have experienced this phenomenon, but they are uneasy speaking about it. They fear ridicule from their colleagues. At least they aren’t likely to be shouted at in Latin!

EDWARD J. FURTON, PH.D., is a staff ethicist and the director of publications for the National Catholic Bioethics Center.

CRISPR: A new challenge to the Culture of Life?

The journal Science named “CRISPR” the “breakthrough of the year” for 2015. What is CRISPR, and what challenges could it pose to building a Culture of Life?

John F. Brehany, PH.D, S.T.L.

“CRISPR” is an acronym for a new biotech tool scientists developed in 2012-2013 by harnessing two features that Strep bacteria use to fight viruses: first, an ability to reliably identify specific strands of DNA, and second, an ability to use enzymes to cut such strands at precise points. CRISPR is the most powerful gene editing tool yet, theoretically able to accurately identify, cut, and replace more than one gene at a time in DNA — including human DNA.

Over 30 years ago, in developing ethical and procedural proposals to begin genetic engineering, scientists distinguished between using genetic engineering for therapy and for enhancing human traits. An additional distinction was drawn between inducing genetic changes in individuals (somatic cell) and creating genetic changes that could be passed down to future generations (germ line). Somatic cell gene therapy was widely embraced in principle — including by Pope St. John Paul II in 1983 — while germ line genetic engineering was outlawed by a number of countries and taken off the table in the United States.

Yet few human diseases have been successfully treated with somatic cell gene therapy, in part due to the challenge of delivering replacement genes with precision. Scientists tried everything from disabled retroviruses to “gene guns” shooting gold particles coated with DNA. Now CRISPR appears to overcome this hurdle — well enough, some argue, to safely introduce changes into the human germ line.

Indeed, CRISPR hit the headlines in early 2015 when Chinese researchers tested it on human embryos. While many in the scientific community greeted news of this unethical experiment with angst and even outrage, influential scientists, journals, and bioethicists called for additional research and discussion.

Last December, the National Academies of Science of the U.S., the U.K., and China held a summit about CRISPR in Washington, D.C. Their closing statement favored use of CRISPR in somatic cell therapies and research into human germ line applications, but stopped short of endorsing clinical applications to the human germ line — for the time being. Meanwhile, CRISPR’s impact is being felt outside of laboratories and conferences. I met late last fall with a financial analyst who told me that CRISPR was the hot new topic at venture capital meetings.

Catholics are called to be leaven, salt, and light in a fallen world. Catholics can and should be leaders in the ethical debate and the scientific development of CRISPR. If indeed practical (reliability and safety) obstacles to significant genetic engineering are soon to be overcome, it’s more important than ever to be clear on issues of principle.

Some issues of principle are clear. The potential abuse of technology does not rule out legitimate use — and there are clear ethical and practical uses of CRISPR. For example, it can be used to quickly create lab animals to study diseases, to control rather than change genes (for example, to “turn on” some genes to grow heart muscles after a heart attack), and to enhance the effectiveness of ethical stem-cell therapies.

Some moral harms are clearly and widely rejected. Eugenics is almost universally condemned, as is employing technology to exacerbate social disparities. And Catholics should faithfully apply John Paul II’s clear teachings regarding respect for the dignity of every human life (including at the embryonic stage) in research and treatment.

However, some ethical issues raised by CRISPR have not yet been comprehensively examined or defined by the Church. What if gene editing or control can be used to promote human health in new or better ways, for example, by replacing vaccines in providing immunity? Questions like these require new and careful discernment.

Finally, Catholics need to bring an enhanced level of prudence to respond to the enhanced powers this new technology provides. There is no doubt that CRISPR will fuel substantial personal and cultural temptations. It’s being celebrated as a scientific game-changer. Some scientists will be tempted to fight against limits on their work, and ordinary people will be tempted to use technology to meet deeply felt human needs or to advance their children with the continuous growth of the reproductive technology industry.

Catholics need to be aware of what CRISPR is and how it can affect science and society. We should encourage greater regulation of research, particularly research on human embryos. We should also renew our efforts to form students in the Church’s moral vision of the human person, science and society.

JOHN F. BREHANY, PH.D., S.T.L. is the National Catholic Bioethics Center’s director of institutional relations.

The Church at the forefront

Dr. John Haas: Despite the NCBC’s long history, few Catholics know it exists . . .

John Haas

John Haas

I recently had the pleasure of addressing three different Legatus chapters in one week. The topic was the role of the Catholic Church today in the major public policy debates in the area of bioethics.

One cannot discuss the Church’s role in this contentious area without discussing The National Catholic Bioethics Center (NCBC) of which I serve as president. After one of these Legatus presentations I was chided by a woman for not having made our work and services better known. “Why are we just finding out about you now!?” she wanted to know.

I explained that we do our utmost to make our work known, including writing a regular column for Legatus magazine! However, she has a point. Simply publishing articles with our ethicists’ bylines tells little about the Center’s work.

The Catholic Church is often perceived as being behind the times. However, invariably, the Church is ahead of the times. After all, the father of modern genetics was an Augustinian friar named Gregor Mendel, and it was a Catholic canon named Nicolaus Copernicus who had proposed the theory that the earth revolves around the sun.

NCBC is another indication that the Church is ahead of the times. Before anyone was even talking about bioethics, the Catholic Hospital Association established a “think tank” in 1972 to reflect on the ethical issues arising from developments in medicine and the life sciences. The Association wanted to be prepared to address the ethical issues they knew would arrive in medicine. It was initially named the Pope John XXIII Medical Moral Research and Education Center to honor the man who took the Church boldly into the contemporary world. The name was changed years later. The NCBC is formally committed to doing all of its work in conformity with the magisterial teachings of the Catholic Church.

The Center was forward-looking from the beginning and was established before abortion was “legalized” in this country, before HIV/AIDS had come on the scene, before a stem cell was ever isolated, before fertility clinics were engendering human embryos in Petri dishes and freezing hundreds of thousands of “spare ones” in liquid nitrogen.

The Center’s first president, Fr. Albert Moraczewski, OP, embodied the Catholic tradition of embracing science and religion in his very person. Father Albert had taught pharmacology at Baylor Medical School before discovering his call to the priesthood. He went on to become a Dominican priest, theologian and bioethicist.

The NCBC is the largest Catholic publisher in the area of bioethics. It has a four-page monthly publication, Ethics & Medics, and a scholarly journal, The National Catholic Bioethics Quarterly. This publication has been awarded first prize for scholarly excellence six times from the Catholic Press Association.

Then there is education. The Center’s six ethicists travel the world giving presentations on bioethics and the Catholic moral tradition. At the request of a number of bishops, the Center established a National Catholic Certification Program in Bioethics, which is an online educational program requiring completion of weekly assignments, two onsite meetings and a research paper. There are now hundreds of certified health care professionals, hospital administrators, health care attorneys, chaplains, and conscientious Catholics.

One of the Center’s most impressive educational endeavors is a bioethics workshop that takes place every other year. We invite all bishops from Canada, the U.S., Mexico, Central America and the Caribbean. In attendance at our February workshop were over 140 bishops, two apostolic nuncios, and the Prefect of the Congregation for the Doctrine of the Faith. It is the largest gathering of bishops apart from their own annual meetings and has been addressed by Supreme Court justices, curial cardinals, scientists, philosophers, and, on two occasions, Cardinal Ratzinger.

One of the NCBC’s most valued services is a 24-hour, seven-days-a-week consultation service to assist individuals facing difficult (often life-and-death) ethical decisions, who seek guidance from the Catholic moral tradition. In fact, it was this service the good lady from Legatus wished she had known about.

The Center is here to serve you with the Church’s teachings. Never hesitate to contact us if you need help. The NCBC also offers individual memberships, which provide all its print publications and consultation services. Contact us to see if we can be of assistance. Visit ncbcenter.org or call (215) 877-2660.

JOHN M. HAAS, PH.D., is president of the National Catholic Bioethics Center and founding president of the International Institute for Culture. He is a member of the Pontifical Academy for Life and serves on its Directive Council.

Three controversial bioethical questions

Christian Brugger explores the complex world of bioethics in the 21st century . . .

Christian Brugger

Christian Brugger1

Imagine you’re an official with the Vatican’s Congregation for the Doctrine of the Faith, and you receive a memo from the Holy Father asking for your ethical opinion on three innovations in the field of bioethics.

The first concerns a variation of in vitro fertilization (IVF) to help patients potentially to overcome the debilitating effects of mitochondrial DNA (m-DNA) disease. But in order to gain these benefits, IVF embryos need to be created using the biological material from three parents. The second technique uses stem cells from human fingernails and toenails to help amputees grow new limbs, and the third involves growing human organs inside a pig.

Your initial response is a combination of fascination and repugnance. But you don’t want to jump to any conclusions because of the “yuck factor.” Nor do you want to naively approve morally objectionable techniques. Realizing that not all bioethical techniques are created equal, you critique each using principles of Catholic morality.

Three parent” embryos. Because it uses a form of IVF, you already know it’s ethically objectionable. IVF transmutes the begetting of new human life from the context of self-giving in marital intercourse to the making of an object by a laboratory technique.

But you suspect the grounds for objection stretch even wider. The technique can be performed in two ways. In the first, a woman who suffers from m-DNA disease has one of her oocytes (eggs) engineered to remove all infected m-DNA. That m-DNA exists only in her egg’s cytoplasm, not in its nucleus. Another egg, from a donor, with an uninfected cytoplasm is needed. Two eggs: one with “good” cytoplasm, one with a “good” nucleus are combined, and the resulting egg is fertilized with male sperm. A human being comes into existence who allegedly doesn’t suffer from m-DNA disease.

There are several problems with this. First, we don’t know if this would cure the disease. Moreover, transferring an egg nucleus is complicated and would take many trials to perfect. Further, we could not possibly be sure of the long-term effects on human development. Thus it would subject embryos — human beings — to the risk of grave developmental harm. Finally, the genetic composition of the embryo derives from “three parents.” This fact is part of the embryo’s identity and so will be an important part of the future adult’s self-understanding. Parentage confusion from this technique has been greatly minimized by some bioethicists, but shouldn’t be dismissed.

Since human dignity is violated in this situation, you decide to advise the Holy Father to oppose the technique and to back forms of research that do not destroy human beings or subject them to unreasonable risk of physical and psychological harm.

Nail stem cells. The cells used in the second type of research are adult stem cells harvested from human fingernails and toenails. You know that adult stem cell research is — in principle — morally unproblematic, so you examine the research with interest. You learn that in both mice and humans, the regeneration of an amputated digit involves the activity of stem cells found in the nails.

Studies have shown that if an amputation removes the nail stem cells, no regeneration of the corresponding digit occurs. If the nail stem cells remain, regrowth can occur. The technique’s principle requires learning how nail stem cells are biochemically signaled to regenerate limbs. If that can be understood more fully, then researchers might be able to artificially signal the cells from amputees to grow them new limbs. You decide to advise the Holy Father to cautiously support further research into the matter.

Pig incubators. The third technology involves injecting a human stem cell into a pig embryo that’s been genetically engineered not to develop a certain kind of internal organ (e.g., a pancreas). The embryo is then transferred into the uterus of a female pig to develop to birth; the developing pig develops with a human organ!

The technique at first sounds benign, sort of like using a pig’s body as a kind of incubator to grow human organs. But you learn that the human stem cell injected into the pig embryo does not merely develop into a human organ. Human cells incorporate randomly and in unknown proportions throughout the developing organism.

In other words, the technique produces a human-pig chimera, which may even generate human rather than porcine sperm and possess a significant percentage of human brain matter. Although organs might be prompted to grow, the problematic nature of creating human-non-human organisms leads you to recommend against supporting further research using this technique.

CHRISTIAN BRUGGER, PH.D., is the J. Francis Cardinal Stafford Chair of Moral Theology at St. John Vianney Theological Seminary in Denver, Colo.

Odd things said about embryos

Ted Furton writes that about 50% of children conceived do not implant and thus die . . .

Ted Furton

One of our failures as human beings is the inability to conceive of God in his full greatness. This is not really surprising, given that we have finite minds. But one would hope that we might at least imitate the wisdom of Socrates who said, “All I know is that I know nothing.”

When it comes to theology, we apparently know a lot more than we should. God has arranged the world as it is, but we sometimes put ourselves in the position of telling God how we might improve upon his work. We ought, instead, to appreciate the mysteries that nature poses to our minds.

Complaints against God concerning bioethics cover a wide range of topics, but one of the areas that is regularly troublesome concerns the apparently ruthless way in which nature treats the embryo. It’s well known in scientific circles that an extraordinary number of embryos perish shortly after conception. According to studies, as many as 50% or more of human embryos do not implant in the uterus or otherwise die. This is often perceived as a horrible “blotch” on the face of God, and yet, those are the facts.

Some see this as proof that there cannot be a Divine Being. Others say that, if we Catholics were serious about human life, we would see this loss as one of the greatest tragedies of our time and work tirelessly to prevent it from happening. I’ve heard some say, in so many words, that “until you can explain how God could allow this to happen, I will never be a Christian.”

Apparently God is not living up to our standards. And yet, is it all that surprising that the Supreme Being would show his power in terrible and frightening ways? We like to think of God as a purely benevolent being whom we hope will one day judge us lightly, but that benevolence also has a fearsome side. The world is filled with enormous suffering. Compared against that backdrop, the high loss rate among embryos is but another and rather minor example.

As Catholics, we hold that at death the soul continues to exist in the presence of God. The body, perfected by God’s grace, will eventually rejoin the soul at the final judgment. With confidence in God’s great mercy and love of innocence, we rightly hope that these tiny embryos, who barely have any experience of earthly life at all, will join the ranks of those who stand in eternal chorus praising God.

Although some might find God’s decision to allow this loss of life incomprehensible, to be a person is an inestimable blessing — even if we live for only a moment. In view of our final destination, where is the harm? Let’s suppose that these embryos are minimally aware and so experience some measure of suffering at death. To be brought into being out of nothingness, and to exist as a person, is to be given a supreme gift. Given our eternal destiny, where is death’s sting?

Where life can be saved, it falls to us to try. But the high rate of loss among embryos reminds us that the things of this world, including our own earthly lives, are passing. These embryos, in a sense, have been given a great gift at little cost. It is as if they have been specifically made for heaven.

Still, some say that it’s more reasonable to suppose that what exists at this early stage is a “pre-embryo” or a “potential person.” Such a hypothesis thereby resolves the “moral alarm” that embryo-loss causes because these are simply not “persons.” Others say there cannot be a person from conception because of the possibility of twinning. How could one person become two people? Until the possibility of twinning has passed (somewhere around 14 days post-conception), we shouldn’t talk about an embryo as a person.

This view, however, doesn’t conform to the empirical data. Late-stage twinning (after 12 days) typically results in conjoined twins. Here the bodies of two individuals have not yet managed to fully separate, yet no one doubts that they are two unique persons. If personhood were impossible before the possibility of twinning had passed, how could these be two persons when their bodies have not successfully completed the process?

The more plausible view is to say that there is indeed a person from the moment of conception, but that when twinning occurs, a second soul is infused. The bodily matter, at that point, is shared temporarily between the two persons. One person does not become two people, but one set of bodily materials houses two souls until the separation of twinning is complete. Thus a person does exist from conception, and a second person appears later as a twin.

So it appears … but I wouldn’t want to tell God how to conduct his business.

Edward J. Furton, PH.D., is the director of publications for the National Catholic Bioethics Center.

Threats to the integrity of the medical profession

Patrick Lee writes that secularism and materialism have distorted the medical profession . . .

Dr. Patrick Lee

Medicine is a noble profession dedicated to helping patients maintain or restore their health and life. Health and life are intrinsic goods of the human person. Thus the medical profession is defined not by its provision of some commodity, but by its mission to contribute to human flourishing. But our culture threatens this truth, both in specific policies and in pervasive attitudes.

Next August a regulation from the Department of Health and Human Services is slated to mandate health insurance providers to cover “contraceptive” devices — including many that are sometimes abortifacient. This is a particularly egregious example of governmental intrusion to classify procedures as health care which are in fact the diametrical opposite of that.

Physician-assisted suicide is now legal in three states and there are organized movements to bring it to others. Physicians are being pressured to kill the severely disabled, the dying and the suffering — and to help create a culture that tells them their lives are not worth living. And regarding the beginning of life, physicians are under intense pressure to cooperate with contraception, sterilization and abortion.

Yet these recent overt threats are later symptoms — perhaps lethal in themselves — of the progression of an underlying, more extensive disease. They stem from ideas that permeate our culture (especially in medical schools) that block any coherent view of the true mission of the medical profession. The chief of these influential ideas are materialism and secularism.

The basic premise underlying the truth that medicine is a distinct and noble profession is that the human person is of incalculable dignity — each person is irreplaceable, inherently valuable and should be treated with reverence. And so the patient enters a sacred trust with his physician. The physician doesn’t just have a job, but a mission to cooperate actively with a patient to help the whole person with respect to his health.

Since health is only one of many intrinsic goods of the person, the person seeking health care is the ultimate authority in deciding whether or not to accept the physician’s recommendations. Therefore, paternalism — making all the decisions for the patient — is wrong. Yet the patient’s rightful autonomy does not mean that the physician is obliged to do whatever the patient demands. The physician is committed to the patient’s true well-being, and the physician is also a real moral agent with moral responsibility for his actions. Thus, the physician is not just a functionary or a technician hired to produce a specific product or result. The physician (and the whole health-care team) should cooperate with the patient to serve his overall well-being with respect to health.

Materialism denies that the human being has a spiritual aspect. Secularism is the view that religion is a mere distraction and even harmful. Secularism also often leads to the view that there is no objective meaning and value in the universe — and that we ourselves endow it with whatever meaning and value we choose. Health-care professionals need not themselves be materialists or secularists for their outlook on patients to be profoundly influenced by these views. Such views permeate our culture and there is often an assumption that even if one does not personally hold them, one’s actions must be guided by them in the public domain. Hence there is often a tendency to lose sight of the patient as a whole person and to view him as a mere machine. Then, instead of trying to help a person decide how best to fulfill his particular responsibilities, the medical challenges become viewed as mere technical problems to be fixed.

It is often rightly said that a physician needs to treat the whole person. But it doesn’t mean that the physician must try to solve issues outside his expertise. Rather, it means that the physician should remember that he’s treating health issues that will fit within the whole set of responsibilities and vocation of a person of inestimable worth.

Materialism and secularism together create an environment which obscures the actual nature of the people in need of health care. To the extent that human beings are viewed as mere complex machines (materialism), health-care professionals will find it virtually impossible to treat patients with reverence. And to the extent that reality is viewed as lacking any inherent meaning and value (secularism), health care will be reduced to mere mechanics, and then health-care professionals will be fair game for bureaucrats insisting that destructive and lethal procedures must be part of their training and practice.

In truth, we are created in the image of God, and we are sacred. Health-care professionals need to remind themselves of that, need to be vocal about their beliefs and need to strive to treat their patients with reverence and awe, begging God for his guidance and grace in their important mission.

Patrick Lee, Ph.D., is the John N. and Jamie D. McAleer Professor of Bioethics and the director of the Institute of Bioethics at Franciscan University of Steubenville.

The womb and reproductive technologies

Medical advances have led to the possibility of a uterus transplant, but is it ethical ?

Jennifer Kimball

Jennifer Kimball

Classical and theological discourse has always held a unique and deeply significant respect for the womb. Indeed, it’s the place where the human person first experiences communion with another, where the child is nourished and grows under the care of maternal union, where the developing person is most vulnerable and depends upon another in all things.

There’s a cultural norm in Catholic morality which implies a regard for the womb, but this norm has yet to be fully articulated in Church teaching. Its absence can be understood when looking at the Church’s early understanding of human embryology. In the 13th century, Thomas Aquinas thought that human life began only from the man’s sperm, his “seed.” The woman’s participation in conception was thought to be passive. It’s interesting to note, however, that the woman’s “seed” is mentioned much earlier (Gen 3:15).

The womb, or uterus, is part of the female reproductive system, yet outside of the generative capacity of the system itself. The womb doesn’t participate in conception, but it’s where a new life grows and develops.

By design, the womb doesn’t serve the physical integrity of the woman, such as the kidney or liver, but exists to serve another — actually drawing, to a small degree, from the physical good of the woman, demanding her gift of self.

Given that the womb exists for another and bears a deeper relational significance not yet fully articulated by the Church, Catholic bioethicists may need to address future issues such as womb donation and the gestation of embryos in artificial/mechanical wombs. In delving into these questions, we contribute significantly to current debates such as early embryonic transplants to save the life of the fetus. Are artificial wombs intrinsically wrong? Suppose a pregnant woman needs radiation therapy to prevent her death from cancer (and the unborn baby’s death as well). Would it be immoral to move the unborn child from the mother’s womb to an artificial uterus to protect its life?

In 2006, the review board for New York’s Downtown Hospital granted approval for Dr. Giuseppe Del Priore to perform the United States’ first human uterus transplant. The first known attempt was performed in Saudi Arabia in 2000. It was removed after 99 days due to clotting of the blood, even after two successful menstrual cycles. Upon hearing of the N.Y. board’s approval, barren women were lining up to receive a new uterus. With many cases of endometriosis and scarring of the uterus, conception can still occur in the fallopian tubes and travel the four to six days to the uterus. The problem with these illnesses, however, is not necessarily the lack of conception, but that the womb becomes inhospitable to the embryo, causing a failed attachment and the resultant death of the embryo. Given that medicine has sought a nonconventional therapy in the form of transplants, we must ask if it’s ethical.

The Church teaches that “ethically, not all organs can be donated. The brain and the gonads may not be transplanted because they ensure the personal and procreative identity respectively. These are organs which embody the characteristic uniqueness of the person, which medicine is bound to protect” (Pontifical Council for Pastoral Assistance, Charter for Health Care Workers, 1995, #88).

The uterus, though part of the reproductive system, does not comprise generational or personal identity of the donor such as with the ovaries, testes or brain. This may suggest that to donate this organ for the sake of another’s conceived children may be licit in Church teaching, though the need for such a transplant may only be realized as a result of advances in reproductive medicine and technology.

With a uteral transplant, a woman’s uterus is removed and then placed in another woman’s body in the hope that the woman and her husband may conceive a child. In formulating an ethical regard for transferring a heterologous (foreign) uterus into the body of another woman, will we need to consider marital or sexual ethics?

A child gestating in the donated womb within its biological mother is not foreign to the father nor is it generated without his participation. It also seems reasonable to say that the transplantation of the uterus, though part of the reproductive system, is not a sexual act in any fashion. It’s a medical procedure that provides an actual good for both the fulfillment of the marriage and the gestation of their children.

A woman’s becoming pregnant after such a transfer remains to be established as a result of the natural marital union. The gestation of the couple’s child, however, comes about through the gift of another though it remains personal to the mother and to her body.

I believe that, as technology progresses, the Church may rule that it’s permissible to transplant a womb in order to save another — and to gestate and nurture a human life.

Jennifer Kimball is executive director of the Culture of Life Foundation, a non-profit policy think tank based in Washington, D.C. She earned a bachelor’s degree and a Licentiate in Bioethics from the Pontifical Athenaeum Regina Apostolorum School of Bioethics in Rome.

Death in a test tube

Dignitas Personae takes on bioethical concerns including freezing human egg cells. . . 

Fr. Alfred Cioffi

Fr. Alfred Cioffi

The Vatican examines the treatment of human embryos in its bioethics document Dignitas Personae, released late last year. The document takes on a myriad of bioethical concerns including freezing oocytes (immature ova or egg cells), the reduction of embryos and preimplantation diagnosis. Though none of these procedures is new, they have drawn the Vatican’s attention and that of Catholics around the world.

Freezing oocytes

Sperm banks have been freezing and thawing sperm (cryopreservation) for over 40 years. Freezing and thawing eggs (oocytes or ova), however, has been more difficult, mostly due to their much higher water content which tends to expand and contract during the process, thus destroying the cell. But earlier this decade, scientists began reporting success in cryo-preserving human eggs to the point that there are now also egg banks.

Theoretically, freezing human eggs is not intrinsically evil since there are some clinical settings in which a woman might benefit from such a technique (for example, to evaluate some aspect of her fertility that is otherwise impossible to ascertain). That is why, in making its moral evaluation, Dignitas Personae (DP) focuses on the intention for freezing a human egg. If the purpose is for in vitro fertilization (IVF), then the procedure is morally tainted. “In this regard it needs to be stated that cryopreservation of oocytes for the purpose of being used in artificial procreation is to be considered morally unacceptable” (DP #20). Emphasis in the original.

In June, New York’s stem cell board agreed to use public funds to pay women who donate their eggs for research. However, there are serious risks involved: Ovarian hyperstimulation and egg retrieval are dangerous and can be fatal. They can only be justified for extremely grave reasons. Women are often exploited for their eggs through financial incentives, which is the case in New York.

Embryo reduction

In a normal IVF procedure, typically three to four embryos (blastocysts) are inserted into the woman’s uterus; on average, only one implants. The other two or three are discarded by her body. There are times, however, when two, three, four or even more of the embryos implant. Because the woman or couple only wanted one child, they are offered the choice to terminate the “excess” embryos. In order to make an informed choice, the embryos or fetuses in her womb are tested for genetic defects and for gender. They can then select to abort the ones that might be carrying some genetic defect or are the “wrong” gender.

To intentionally kill a human being, no matter how early in development, is a grave moral evil. When this is done on the basis of the intentional selection of inheritable traits, it’s called “eugenics” and has serious consequences for all of society. “From the ethical point of view, embryo reduction is an intentional selective abortion. It is in fact the deliberate and direct elimination of one or more innocent human beings in the initial phase of their existence and as such it always constitutes a grave moral disorder” (DP #21). Emphasis in the original.

Preimplantation diagnosis

Preimplantation diagnosis (PID) is a type of prenatal diagnosis involving the three-to-four-day-old embryo before implantation (thus, PID is associated with IVF). Typically at the eight-cell stage, while the embryo is still growing in a Petri dish in a lab incubator, a single cell is plucked out and sent for genetic testing (karyotyping) and gender determination. The results can be used to choose for or against implanting that particular embryo.

This is another form of eugenics. In addition, there are further grave considerations for condemning PID: First, since each cell has the capacity to develop into a whole new embryo, extracting one cell (which could in fact be creating a new human being who will then be destroyed during the genetic analysis), another abortion will have occurred.

Second, there is no solid evidence yet that extracting a cell at this stage does not cause significant damage to the early embryo. To find out with certainty would require even more human embryo experimentation, which would be a gross violation of human rights.

Third, PID genetic testing is not accurate science, leading to the real possibility that many “normal” embryos will be killed due to false positive results (that is, that they indicate anomalies where there are none). Also, lethal selection based on gender is a grave intrinsic evil which should be self-evidently abominable.

“Preimplantation diagnosis, connected as it is with artificial fertilization — which is itself always intrinsically illicit, is directed toward the qualitative selection and consequent destruction of embryos, which constitutes an act of abortion” (DP #22). Emphasis in the original.

All three procedures — egg freezing, embryo reduction and preimplantation diagnosis — are closely associated with IVF, which has drastically negative consequences for human embryos, the parents who choose this method, the medical profession and society at large. Hence, it is imperative for people of influence (and all people of good will) to speak up against the IVF industry and its associated technologies, which is leading the contemporary developed world into eugenics. What makes the nefariousness of this eugenics even more urgently condemnable is the fact that IVF gives the appearance of being pro-life, but is not.

Rev. Alfred Cioffi, STD, Ph.D., is a staff ethicist for the National Catholic Bioethics Center.

The Vatican and human dignity

Three principles govern Dignitatas Personae‘s moral analysis of human embryos and their conception

Dr. Edward Furton

Dr. Edward Furton

The Vatican examines new reproductive techniques and the treatment of human embryos in its latest bioethics document Dignitas Personae. Generally, the Church teaches that the techniques of medicine may only assist the procreative act and may not replace it. Here the rule of thumb is that conception should take place within the body, not outside. A corresponding rule governs the treatment of human embryos who ought to be conceived through the marital act, not engendered in vitro by a laboratory technician.

More broadly, Dignitas Personae (DP) lays out three principles that govern its moral analysis in this area: “The right to life and to physical integrity of every human being from conception to natural death; the unity of marriage, which means reciprocal respect for the right within marriage to become a father or mother only together with the other spouse; and the specifically human values of sexuality, which require that the procreation of a human person be brought about as the fruit of the conjugal act” (#12).

Any medical technique which conforms to the third principle enunciated above is morally acceptable, for conception will necessarily take place through the immediate sexual act of the married couple. Thus the removal of obstacles to the natural process of fertilization, such as surgery for endometriosis or the unblocking of the fallopian tubes, is morally licit because it assists the marital act. In vitro fertilization, in contrast, takes place without the marital act; hence, it is clearly an act of replacement.

Not only does in vitro fertilization replace the marital act, it also allows for the violation of the first and second principles set forth above. All in vitro fertilization separates conception from the immediate act of sexual union between the spouses, but it can be further deformed when the gametes (the sperm and the ovum) are not taken from the married couple themselves. A married man can use the ovum of any woman, or a married woman can use the sperm of any man, to engender a child in a Petri dish. Indeed, there is no requirement that one even be married. Sperm and ova are offered for sale and can be purchased by anyone. An unmarried man or woman could buy these materials on the market, pay a technician to have them combined in vitro, and then implant the embryo into a surrogate “mother.” This would engender a child without any genetic connection whatsoever to the producer. Obviously, this treats human life as a commodity.

In vitro fertilization also kills many embryonic human beings through neglect or intentional destruction. DP notes that fertility clinics consider the number of embryos destroyed to be inconsequential compared to its rate of success in achieving births. The clinic is mainly interested in “obtaining better results in terms of the percentage of babies born who begin the process, but does not manifest a concrete interest in the right to life of each individual embryo” (#14).

DP also points out the profoundly troubling fact that couples are now “using artificial means of procreation in order to engage in genetic selection of their offspring” (#15). This is eugenics, the use of techniques of animal husbandry to produce the fittest offspring. Eugenics has often been forced on an unwilling population by the power of the state (i.e., China’s infamous “one-child” policy). But in the U.S., we have a consumer-driven model where individual parents select the traits (including gender) they want to see in their children. A single cell can be removed from an early stage embryo produced in vitro, and if that cell shows undesirable traits, the embryo is destroyed. The parents search through their embryos until the suitable genetic traits are found. This embryo is then implanted and brought to term.

These practices reveal two deeply troubling attitudes animating the use of modern reproductive technologies: a base utilitarian approach toward the production of human life and a disregard for the inviolable dignity of every human being. The first is exemplified by techniques better suited to the production of livestock. The second shows itself in the willingness to countenance a staggering loss of human life, a rate that would not be permitted in any other field of medicine, and which demonstrates that all claims about “respecting” embryonic life are without merit.

Leaving human procreation in the hands of laboratory technicians represents a serious danger to our future. If technicians are to be given the authority to control and manipulate the origin of the human being, they will not only have power over the life or death of the embryo, but also the power to decide what life will be allowed to come into this world. They will decide which traits are most desirable, which racial characteristics are preferable, which sex should predominate in numbers. They will stand before us as gatekeepers, advising parents on what is possible, what is moral and what is ideal. We will no longer rely on the workings of nature to decide our offspring in its own mysterious way. Some have already assumed these gargantuan tasks to themselves, claiming an authority superior to nature, and pretending to walk among us as if they were gods.

Dr. Edward J. Furton is the director of publications for the National Catholic Bioethics Center.