Spare Embryo

...The circumstances of their lives destined them to suffer from and perhaps die of complications resulting from syphilis...

...Given that certain choices have been made, these spare embryos are destined to die, but our relation to their dying is not a matter for moral indifference...

...They are destined to die by our will and choice...

...Neither, on the other hand, do I seek to relieve the conscience of anyone who may be bothered by the similarities in argument...

...In those cases, these commissioners suggested, one cannot impose any additional risk of harm or further diminish the life prospects of these potential research subjects...

...Many were fated to die...

...Is not being used once enough...

...Not that we should feel free to use them, but, rather, that, as Hans Jonas once argued with respect to the terminally ill, we should spare them "the gratuitousness of service to an unrelated cause...

...Here, then, are three examples of reasoning that is structurally similar to the reasoning often used to defend the mediating position that permits research only on "spare" embryos...

...We have met it before...

...We cannot pretend that they simply are dying—as if that were a natural fact independent of our will and choice...

...Are there reasons to question the appeal of this approach...

...The compromise—research on spare embryos but no others— has its appeal...

...Having agreed on that, the commission also had to consider possible research on the fetus still living in the womb but intended for abortion (that is, destined to die) or on the child still living outside the womb after abortion but nonviable (and, hence, destined to die...

...They are destined to die, and the only question is how...

...Hence, they could not really be harmed if subjected to experiments that would never have been carried out on people not destined to die...

...When prisoners arrived at a concentration camp such as Auschwitz, "selections" were made that determined the life prospects of those prisoners...

...For, as Paul Ramsey also put it, "the moral history of mankind is more important than its medical history...

...He permitted funding for research on embryonic stem cell lines only if the evil deed of embryo destruction had already been done but not for cell lines derived from embryos destroyed in the future—thereby seeking to permit some research to go forward without providing an incentive for further destruction of embryos...

...They are destined to die anyway...

...The issue of embryo research is not precisely the same as fetal research, of course, but the insight into our ready recourse to the quasi-religious language of finding some redeeming good in what we do is illuminating...

...These embryos have already been used once in the service of someone else's project...

...Perhaps even, we may hypothesize, they have been justly used in that project...

...We need to think again about the spare-embryo argument...

...It is one thing for us to acquiesce in their death...

...They are going to die...

...Consider the following three examples: In the mid-1970s Congress established a National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research...

...They may simply die, or they may be used as research subjects in the course of their dying...

...Reducing all moral evils to harm, we blind ourselves to issues of dignity and justice—as if, for example, we would not wrong a permanently unconscious person by selling tickets for others to observe him...

...Why not proceed...

...The very form of the argument— "he'll die anyway...

...This is a fascinating thought, depending, as it does, on the intuition that an evil is done here and is in need of redemption...

...No harm, no foul" may work well enough for officiating basketball, but it does not work well for sorting through our moral obligations...

...What follows...

...Why not, then, gain useful medical knowledge and thereby wrest some good from tragic circumstances...

...More than a quarter century ago, writing about the ethics of fetal research, Paul Ramsey contemplated similar claims about the need to gain at least some good from the deaths of aborted fetuses...

...But perhaps we ought to worry about it more than we do...

...If one felt Hippocratic twinges of conscience, one could usually reassure oneself that, since all of these people were condemned to death in any case, one was not really harming them...

...In this instance, however, because they are destined (as a result of someone's choice) to die soon anyway, we can— without further diminishing their life prospects or imposing upon them additional risk of harm—use them as research subjects in ways that we would never use fetuses or infants who were not destined to die...

...We need to slow down, think again, and draw back, lest we train ourselves to think in ways that diminish us as a people...

...Then we say that, since they're destined to die anyway, we might as well gain some good from that tragedy...

...The fact that we cannot start over and immediately construct our IVF practices in a morally better and more regulated manner does not mean that we need proceed farther down the road on which we are traveling...

...This commission, which proved to be fairly influential, examined and issued reports on a number of difficult topics in the ethics of human experimentation...

...Taliaferro Clark, but with, it is clear, wider reference to the motives of the researchers generally): "The fate of syphilitic blacks in Macon County was sealed (at least for the immediate future) regardless of whether an experiment went forward...

...For approximately forty years officials of the U.S...

...Public Health officials were not in a position to change those circumstances...

...The views expressed here are his own and do not represent the council...

...But, of course, there is no reason why we should not tackle our problems one at a time...

...I do not say that those who argue for research on spare embryos should be equated with the Tuskegee researchers, or the Nazi doctors, or even moralists who were willing to apply exactly analogous reasoning not (let us note) to five-day-old blas-tocysts but to well-developed fetuses and newborn but nonviable infants...

...it is quite another for us to embrace their death as our aim, to seize upon it as an advantageous opportunity to use them yet again for our purposes...

...for the pedigree of this sort of reasoning is actually more mixed and troubling than we usually realize...

...A second example may be yet more troubling...

...By virtue of decisions others had made, these victims had no life prospects...

...We should notice, just for starters, that the form of the argument essentially baptizes the current practice of in vitro fertilization in this country—a practice that is, we might note, almost entirely unregulated...

...Perhaps the most well-known instance of research gone horribly awry in this country is the Tuskegee syphilis experiment...

...Because spare embryos are destined to be discarded in any case—because, that is, the decision of those with legal authority over the embryos has been to discard them—they have no future life prospects...

...the only question is how...

...This position proscribes (at least for federal funding) any research on stem cells derived from embryos produced solely for research purposes, while permitting research on stem cells derived from embryos that were produced but are no longer needed for use in infertility treatments...

...This compromise approach is not without appeal, and it has a distinguished pedigree...

...As a tactic, of course, this is intended to stifle opposition to embryo research by requiring its opponents to bear the burden of arguing for rolling back practices now widely used...

...Looked at in this light, the argument seems inherently corrupting...

...I simply ponder these examples as a way of wondering whether we need to slow down the train of this conversation and think again...

...Why not, one might wonder, gain some useful knowledge from their dying...

...In Bad Blood: The Tuskegee Syphilis Experiment, James H. Jones describes such a mode of reasoning (referring in particular to the view of Dr...

...Certainly, at least, the IVF project uses embryos in ways that are oriented toward their natural reproductive end...

...It may be moral progress simply to stop, even if we cannot for now turn back...

...What follows...

...The argument simply accepts, for example, the routine creation of spare embryos...

...Discussing the way in which doctors at Auschwitz were "hungry for surgical experience," Robert Jay Lifton writes: "In the absence of ethical restraint, one could arrange exactly the kind of surgical experience one sought, on exactly the appropriate kinds of 'cases' at exactly the time one wanted...

...Initially appealing as it may be, offering it seems a chance to move forward with research while still drawing a significant moral line, it begins to lose its force the longer we ponder it and the harder we press on it...

...It is instructive, however, to remind ourselves that several of the commissioners argued that "equal respect" could mean something quite different for a fetus-to-be-aborted or for a still living but nonviable child outside the womb after abortion...

...In the latter case, so the argument went, we do not treat them unequally or respect their lives less...

...On the contrary, we apply exactly the same principle ("no additional risk of harm") that we apply to other research subjects...

...Collectively guilt-laden, we go on . . . to other potential harms and wrongs in order to avoid acknowledging the first...

...Not that we should feel free to use them, but rather that, having condemned them to their fate, we should refrain from the added indignity of regarding them as handy research material...

...The commission eventually recommended that these possible research subjects be given equal treatment...

...The commission recommended that research on stem cells derived from spare embryos remaining after infertility treatments be eligible for federal funding but that, at least for the present, such funding not be permitted for research on stem cells derived from embryos that had been produced solely for research purposes...

...No doubt this practice eases the burden on those who seek IVF to overcome infertility, but there is no reason why their burden should necessarily be of greater moral concern than the production of spare embryos destined to be discarded...

...It was, for example, specifically endorsed by the National Bioethics Advisory Commission in its 1999 report on "Ethical Issues in Human Stem Cell Research...

...We are determined to wrest by our scientific good works" some benefit from the deeds that engender guilt in us...

...must die...

...I am not here referring to a different sort of compromise struck by President Bush in his speech of August 2001...

...Why does the fact that they are destined to die, by human will and choice, make them available for our continued use...

...A third example is, if anything, more thought-provoking still...

...attractive...

...The justification is striking...

...If so, that only means that here, as in so many other areas of research, we accept and honor necessary moral limits...

...Increasing the store of knowledge seemed the only way to profit from the suffering there...

...Nevertheless, appealing as this mediating position is in certain respects, we should not too quickly endorse it...

...First we decide that they "No harm, no foul" may work well enough for officiating basketball, but it does not work well enough for sorting through our moral obligations...

...At the very least, it seems less crass than simply endorsing embryo research without limits...

...But, still, they have been produced and used in an attempt to satisfy the desires of others...

...They too should not be subjected to research that imposed more than minimal risk or any additional risk to their well-being...

...We miss some of the complexity of the case, however, if we forget that the poverty, illiteracy, and race of these men meant that, even if the research were not undertaken, they almost surely would not have gotten treatment...

...With certain safeguards, the commission was prepared to approve research on the fetus in utero and on the possibly viable infant outside the uterus, but if the research was not aimed at benefiting the research subject himself or herself, the commission required that it impose "minimal or no risk" or "no additional risk" to the well-being of the fetus or infant...

...The first of its reports, issued in 1975, was "Research on the Fetus...

...This is a thoughtful compromise and in certain ways Gilbert Meilaender is a member of the President's Council on Bioethics...

...I think there are...

...BY GILBERT MEILAENDER In our ongoing national debate about the use of human embryonic stem cells for research, there is one compromise position that reappears with regularity and attracts relatively wide support...

...Public Health Service used impoverished, uneducated black men in Macon County, Alabama, as subjects in a project designed to study the effects of untreated syphilis...

...Moreover, the fact that these are spare embryos remaining after infertility treatments may actually turn the argument in quite a different direction...

...It is crucial (and terrifying) to remember that the doctors of whom Lifton writes were, in many cases, ordinary people—like us—who supposed themselves to be advancing the mission of medicine...

...Sometimes, of course, it will be tempting to think that we should at least seize the opportunity to redeem their loss by using them to seek good for others...

...The subjects were left untreated even after penicillin was known to be effective in the treatment of patients with syphilis...

...Bombs away," as a student of mine once put it...

...He suggested that only a religious commentary could adequately explain the need to find a salvific or redemptive purpose in research upon condemned and dying human subjects...

...It seems unlikely that our society will—very soon—decide to rein in and rethink its IVF practices, and proponents of embryo research sometimes act as if one cannot oppose it without demanding far-reaching IVF regulation...

...Why not, therefore, at least gain from their plight knowledge that might benefit future sufferers...

...Perhaps this means—though it's hard to say for sure—that the pace of medical progress must be slower than it could be...

...Why, if they are no longer needed or wanted for reproductive purposes, should we suppose that they are still available for our use, still a handy resource for other purposes entirely unrelated to their well-being or their natural end...

...But for others it may demonstrate a praiseworthy inclination to "shudder" just a bit in the face of a routinized use of nascent human life that any full-fledged program of embryo research would certainly involve...

...Carrying out their research would neither diminish the life prospects of these men nor impose upon them any additional risk of harm...

...we might as well get some good from his dying"—seduces us into supposing that all moral evils must be forms of "harm...

...Perhaps some support the compromise solely for strategic rea-sons—as a first step but not, they hope, the last step in embryo research...

...Nothing is lost and something potentially of medical significance is gained...