Tag Archives: Dr. Stephen Napier

Gene therapy and enhancement

Stephen Napier says the Vatican is concerned about the use of  gene therapy technology . . .

Dr. Stephen Napier

Dr. Stephen Napier

Despite scientific advances in gene therapy and enhancement, the 2008 Vatican document Dignitas Personae (DP) expresses concern for the use of these technologies. First, let’s look at what these terms mean. Numerous diseases have a genetic base, either causing or pre-disposing one to disease. Gene therapy aims to address such abnormalities by modifying the gene/genetic complement that is functioning abnormally.

Although gene therapy trials have not had significant success to date, science is making progress, and the risk-benefit ratio for this research is slowly changing. DP recognizes that gene therapy may progress more rapidly and, with cautious foresight, considers that gene research might not be used only to cure disease, but to enhance our capacities or abilities.

To consider adequately the ethical issues, DP makes some needed distinctions. First, there are two kinds of gene-therapy: somatic cell therapy which “seeks to eliminate or reduce genetic defects on the level of … cells which make up the tissue and organs of the body,” and germ-line therapy which “aims instead at correcting genetic defects present in [sperm and eggs] with the purpose of transmitting the therapeutic effects to the offspring of the individual” (# 25). Second, there is an intuitive distinction between therapy and enhancement. As is commonly understood, therapy refers to procedures or practices that aim to cure a pathology or disease. Enhancement (in this context) refers to procedures that aim to improve the capacities or abilities of the person by modifying his or her genome.

The ethical issues, then, are that gene therapy seeks to adjust our genetic complement, and the risks of doing so are as yet uncertain. Furthermore, such research on the embryo requires the embryo be engendered through IVF, itself an immoral practice. And lastly, seeking enhancements manifests an attitude of domination of man over man.

Regarding body-cell therapy, DP renders a positive judgment, saying that “such actions seek to restore the normal genetic configuration of the patient or to counter damage caused by genetic anomalies or those related to other pathologies” (#26). The document gives germline (sex cell) therapy a more cautious judgment because the modifications affect one’s offspring. These risks are unknown. “Because the risks connected to any genetic manipulation are considerable … it is not morally permissible to act in a way that may cause possible harm to the resulting progeny” (# 26).

Germ-line modification would be done for the sake of future children. For example, the decision to eliminate the gene that causes sickle cell anemia would theoretically produce future children free of this disease. But it might also have serious side-effects. The gene for controlling this type of anemia also protects children against malaria. Efforts at germ-line engineering seek to take control of our genetic patrimony, but we do not yet have the wisdom to do this successfully. Once changes are made in the germ line, they may be very difficult to reverse.

With regard to genetic enhancement technologies, one would modify a gene (or have one added) that would confer greater abilities or capacities to a particular individual. Parents who enjoy athletics might wish to have a child who is a speedy runner.

Such a plan is highly unlikely to succeed because many of our capacities are poly-genetic (they involve a group of genes manifesting complex interactions with one another) and our most meaningful traits and abilities are not genetically determined but are learned and formed through practice, upbringing, formal learning and environment.

When the President’s Council on Bioethics discussed enhancement technologies, it did not address genetic enhancement, saying that in such cases the relationships and interactions among these genes (and between one’s genes and the environment) are certain to be enormously complex. Isolating all the relevant genetic variants and knowing how to work with them to produce the desired result will therefore prove immensely difficult.

Nevertheless, in the event that such advances are made, DP renders the following judgment: “Such manipulation would promote a eugenic mentality and would lead to indirect social stigma with regard to people who lack certain qualities, while privileging qualities that happen to be appreciated by a certain culture or society; such qualities do not constitute what is specifically human” (# 27).

The document goes on to point out that seeking enhancements violates both the principles of justice and charity. Justice is violated because the equality of all humans would be compromised in a culture that had an enhanced and unenhanced class — or one in which certain capacities were favored and lacking them meant lacking full moral status.

Seeking enhancement violates charity in that at some level seeking to modify oneself manifests a disgust with oneself, a rejection of the finite nature of man. Implicitly, man takes on a domineering role, seeking to rule and control his nature and life. Such is the height of hubris and is contrary to the self-love required to respect every human being, even ourselves.

In rendering a negative judgment on these kinds of interventions, DP says that they imply “an unjust domination of man over man” and urges us to “an attitude of care for people and of education in accepting human life in its concrete historical finite nature” (# 27).

Stephen Napier, Ph.D., is a staff ethicist at the National Catholic Bioethics Center. He serves on the University of Pennsylvania’s Institutional Review Board.

Frozen embryo adoption

Certain moral questions like embryo adoption are still open to further debate . . .

Despite scientific evidence and detailed Church teaching, certain moral questions are still open to further theological reflection. The National Catholic Bioethics Center offers the following exchange between two of its ethicists on whether the 2008 Vatican document The Dignity of the Person (DP) allows for the adoption of frozen embryos left over from in vitro fertilization procedures.

Dr. Stephen Napier

Dr. Stephen Napier says YES

“It has also been proposed, solely in order to allow human beings to be born who are otherwise condemned to destruction, that there could be a form of prenatal adoption. This proposal, praiseworthy with regard to the intention of respecting and defending human life, presents however various problems” (DP #19).

Some have taken this note to reject embryo adoption. I do not think that is correct. The U.S. Conference of Catholic Bishops says, “The document raises cautions or problems about these new issues but does not formally make a definitive judgment against them.” Also, the president of the Pontifical Academy for Life, Archbishop Rino Fisichella, has said that embryo adoption is still an open question. If the USCCB and the Pontifical Academy for Life got it wrong, the Vatican would have corrected them publicly. But there has not been any correction, so the question on embryo adoption remains open.

Embryo adoption is clearly an act by which a young human being is saved. The fact that the woman must gestate the child in order to save the child does not change the moral quality of the action. Childhood adoption, after all, is not only permissible but is encouraged by the Church. Adopting a child that happens to be younger, and thus requires implantation in a mother’s womb, means only that the woman must sacrifice more, thus growing in charity. Those who say that embryo adoption achieves procreation apart from the marital union misunderstand the obvious fact that the child already exists! The child has already been procreated.

The Church says that the child has a right to be gestated by his or her own parents. But who violates that right? Clearly, the parents who went through IVF and abandoned him or her to life in a freezer. In fact, the embryo-adopting couple cannot violate this right.

Adopting an embryo is a way to love a child in a very vulnerable state. Additionally, it gives witness to the inherent dignity of all human beings no matter how small.

 

Dr. John Haas

Dr. John M. Haas says NO

“The proposal that these embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable for the same reasons which make artificial heterologous procreation illicit as well as any form of surrogate motherhood; this practice would also lead to other problems of a medical, psychological and legal nature” (DP #19).

The Holy See acknowledges the good motivation of those proposing pre-natal adoption of frozen embryos but states that not even an infertile couple may have them implanted for the various reasons already stated: that in vitro fertilization, artificial heterologous procreation and surrogate mothering (a woman who is not the mother allows the “renting” out of her womb for gestation) are wrong. In such cases, embryos are manipulated and subjected to the decisions and actions of others that do not respect the inviolability of their personhood.

First of all, some frozen embryos will be chosen to live while others will be allowed to die. What will be the criteria used as to which will live and which will die? Would just boy embryos be chosen? Just Asians? Caucasians? These are arbitrary criteria used to decide who will have a chance at life and who will not.

Second, the “thawing” process itself will result in the deaths of some embryos. And then, after they have been thawed, the surviving embryos will be judged as to which will have the greatest chance of survival. Again, arbitrary judgments will be made as to which will be given a chance to live and which not. And how are the ones not chosen for implantation discarded?

Third, single women have advanced the same arguments for rescuing the embryos by offering their bodies to gestate them even though they do not have husbands. This would deny the child the good of an integral family.

Finally, husbands and wives give the procreative powers of their bodies to one another as a gift to be open to the engendering of new life between them. As St. Paul said, “The wife’s body does not belong to her alone but to her husband. In the same way, the husband’s body does not belong to him alone but to his wife” (1 Cor 7:4). To place someone else’s child into the body of the wife would violate the integrity of the marital union unique to that husband and wife.

As regrettable as it is, “it needs to be recognized that the thousands of abandoned embryos represent a situation of injustice which in fact cannot be resolved” (DP #19)

John M. Haas 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. Stephen Napier is a staff ethicist at the National Catholic Bioethics Center. He serves on the University of Pennsylvania’s Institutional Review Board.