Tag Archives: Bioethics

Discerning neuroethics amid new challenges in bioethics

The field of neuroethics is relatively new, having been formally inaugurated at a conference only in 2002. Neuroethics was created because of new questions and concerns arising out of the rapidly developing fields of neuroscience and neurotechnology. Scientists have been making significant progress in observing previously unobservable operations of the brain. And technologies with the potential to heal, interact with, and perhaps even control elements of the human brain and behavior are rapidly becoming available.

Scientists have long understood that there is a connection between the normal and injured brain, and distinctive human behaviors. One of the first insights into this connection came in the strange case of Phineas Gage, an American railroad worker who was terribly injured in 1848. When Gage used an iron rod to tap down a charge of gunpowder, a premature explosion shot the rod through his cheek and out the top of his head, passing through his left frontal lobe. Gage survived the accident, but his personality underwent a total change. Gage went from being a quiet, even-tempered man to a being a rude man who often indulged in profanities. Since then scientists have sought to better understand the structure and functioning of the brain.

From the late 20th century, cutting -edge technologies have begun fulfilling these aspirations. The use of functional magnetic resonance imaging (fMRI) — using magnetic waves as a kind of “radar” to track the electrical impulses of neurons in the brain — is among the most important. fMRI has been used to learn whether patients in profound states of unconsciousness (a.k.a. PVS) have any awareness (short answer: “probably yes”). fMRI also has been used to locate a part of the brain which appears to be active when people make moral judgments, and then to experiment with disrupting the neurons to see if it changes people’s ability to make those moral judgments. A more recent experiment with animals involves seeding their brains with “neural dust” — hundreds of sensors the size of a grain of rice to monitor brain activity. With emerging nanotechnology, scientists hope to shrink these sensors to a microscopic size and use them to stimulate the brain in various ways to obtain some desired result.

What should Catholics be thinking and doing as the fields of neuroscience and neuroethics develop? They should find ways to become engaged, affirming the good work being done, identifying the potential for abuse, and seeking to keep all of the knowledge and power gained within a framework of Christian anthropology. Advancing a Christian anthropology at this time is critical because trends in neuroscience can support some approaches to the human person which are potentially harmful, such as thinking that humans are essentially machines or objects, or that the soul is nothing but complex matter.

Apart from integrating neuroscience and neuroethics with the Church’s understanding of the dignity of the human person, and with the main tenets of the moral tradition, Catholics should be engaged as new opportunities and issues arise. For example, Catholics should be encouraged to enter these fields, to better understand and help human persons. St. Augustine famously said that “A good and true Christian should realize that truth belongs to his Lord, wherever it is found, gathering and acknowledging it even in pagan literature, but rejecting superstitious vanities . . .” Catholics should feel free to participate in well- designed, safe, and ethical research projects. They should learn the science and skills necessary to use neuroscience for legitimate ends, and then prioritize applications related to healing significant illness and injuries, such as epilepsy, strokes, and significant states of unconsciousness.
The challenges to life and human dignity are not going to diminish. But we can help to improve the field of neuroethics so that neuroscience and neurotechnology contribute to human flourishing in the orders of Creation and Redemption.

JOHN F. BREHANY, PH.D., STL, is director of institutional relations at the National Catholic Bioethics Center (Philadelphia) and past executive director of the Catholic Medical Association.

Catholics have a ‘way’ with faith and reason

Each year, the center for Bioethics and Human Dignity names a recipient of the Ramsey Award. Paul Ramsey, a Methodist, was an admired ethicist who wrote on theoretical and practical matters, including just-war theory, fetal research, and the patient as person. Although the CBHD is Protestant in origin and outlook, the vast majority of its award recipients have been Catholics. The winner in 2017 was David Albert Jones, the Director of the Anscombe Center in Oxford. Our own Father Albert Moraczewski, OP, former president of The National Catholic Bioethics Center, received the honor in 2008. Why are members of the Catholic faith receiving this prize in disproportionate numbers?

Edward J. Furton, M.A., PH.D.

There are many elements that make the Catholic faith unique, beginning with unity under the papacy, a long apostolic tradition handed down from Christ, our sacraments, and especially the sacrifice of the Mass. As Catholics, we see our faith as one, true, holy, and apostolic faith. Yet these elements do not explain the outsized influence Catholics have in bioethics. Protestants, in fact, consider these things just as contentiously as they did at the time of the Reformation.

The key is our openness to reason. Catholics have long held that faith works with reason, not that it eradicates reason. The great thinkers of our tradition have willingly absorbed the knowledge of philosophy, science, and the wider culture in a manner unlike any other religious faith. And many nonCatholic thinkers have made important contributions to ethics and moral philosophy in a similar manner — and we have embraced these truths.

The apostle Paul taught that God’s existence can be known through the things that are made [Rom 1:20] and that there is a moral law written into the heart of all human beings [Rom 2:15].

Catholics see St. Paul’s words as references to natural theology and natural law morality, that is, to that body of religious truth that is available to all human beings through the exercise of reason. A rational understanding of God and the moral order is not limited to Christians, but can be discovered by any thoughtful person who cares to objectively examine the evidence given in nature. This is not always an easy task, and many people have fallen into preconceived patterns of thinking, making it very difficult for them to see the moral order of the world as it exists around them.

But in principle, the Catholic defense of the power of reason to know certain theological and moral truths, even without revelation, gains us access to a much wider sphere of influence than does the Protestant reliance on Scripture alone. We are able to appeal to what is good and evil in human action without appeals to scriptural authority. This enables us not only to learn widely from others, but to engage in moral discussion with virtually anyone regardless of their views on religion.

After a conference hosted by the CBHD near Chicago, I chanced to share a taxicab with a physician who was headed to South America to do medical work for the poor without pay. This was to be his twoweek “vacation.” We got to talking about Thomas Aquinas and Catholicism. I pointed out to him the paradox of the Ramsey Awards. He nodded and agreed. “You Catholics have been doing this work in medical ethics for a lot longer than we have. We need your knowledge, but you need our enthusiasm.”

The harmony that exists among the Christian denominations of today is quite remarkable. We work across denominational lines because we share many concerns about the direction of our shared culture. We are happy to share the wisdom of our tradition with other Christians even as they inspire us with their evangelical zeal. Perhaps we can establish a Pope Saint John Paul II Award for the Evangelization of Culture and regularly award it to Protestants. A fitting return!

EDWARD J. FURTON, PH.D., is Director of Publications for the National Catholic Bioethics Center (Philadelphia), and among its team of seven ethicists. He’s editor-in-chief of NCBC’s awardwinning National Catholic Bioethics Quarterly and Ethics & Medics.

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.