The Ethics of Embryology
[Rachel's Introduction: Health and safety regulation is now an accepted (although often criticised) feature of modern life, as is a version of the "precautionary principle
" which obliges those proposing some technological innovation to provide reasonable scientific evidence that it will not cause great or irreversible harm to individuals or the environment.]
Should deaf parents be prohibited from using reproductive technology to have a child with genes for deafness? Should an infertile couple be prohibited from using artificial sperm and eggs to have a child of their own? Should scientists be permitted to create hybrid embryos (animal eggs with human genetic nuclei) for research into human diseases? These are some of the highly controversial questions raised by the Human Fertilisation and Embryology Bill currently being debated in the UK Parliament.
They illustrate just how rapidly medical research has developed since the original Human Fertilisation and Embryology Act of 1990. That Act allowed the strictly regulated use of human embryos in reproductive research related to infertility treatment -- research, that is, which might give other embryos in the future a better chance of developing safely. But before the decade had ended, embryos were beginning to be used in a different way, as a source of stem cells in research into what came to be called regenerative medicine -- potential therapies using stem cell technology to repair or re-grow bodily organs damaged by illness, accident or ageing. If this research is successful, many currently incurable conditions might become treatable by stimulating the body to heal itself: the shortage of donor organs might no longer be a problem, cancer and degenerative diseases might be held at bay, and the human lifespan itself might be healthily extended.
With these enormous potential benefits in prospect, shouldn't scientists just be allowed to get on with regenerative medicine research unrestricted by regulations, and shouldn't personal decisions about the use of reproductive technologies, such as those involving deaf or infertile couples, be left to the individuals concerned and their own doctors? Why should Parliament be involved in regulating and deciding about such matters? An obvious answer, of course, is that in a parliamentary democracy, parliamentary representatives need to heed the views of their constituents, and that many of their constituents belong to or share the views of significant scientific, religious, disability or other pressure groups, whose arguments for or against the use of particular aspects of reproductive or regenerative medicine research are often polarised and politicised. Parliamentary regulation of research can sometimes seem like a way of achieving the least socially damaging compromise between warring sections of public opinion. Underlying these political debates however, there are ethical questions and quandaries which many members of the public who do not hold such polarised or politicised views nevertheless find morally troubling.
These questions and quandaries are concerned on the one hand with safety and on the other with solidarity. Health and safety regulation is now an accepted (although often criticised) feature of modern life, as is a version of the "precautionary principle" which obliges those proposing some technological innovation to provide reasonable scientific evidence that it will not cause great or irreversible harm to individuals or the environment. Developments and occasional disasters in the 20th century chemicals and nuclear power industries ensured that a need for regulation in these contexts was generally recognised, and a similar need is now recognised in relation to genetic technologies. An important reason for this is that "genetic engineering," unlike conventional engineering, deals with materials which have a life of their own, and can respond to modification in many unpredictable and potentially unsafe ways. Public concerns about the potential harms as well as benefits of genetic modifications have been fed by a long literary tradition, typified by Mary Wollstonecraft Shelley's Frankenstein, but also by the use and misuse of eugenics in the early twentieth century, especially in Nazi Germany.
If safety concerns raise troubling and divisive ethical questions, so too do those concerned with solidarity. In the 20th century, solidarity, or the recognition in practice of each individual's equal dignity, regardless of class, race, gender, wealth or poverty, was increasingly reflected in national and international declarations, conventions and legislation regarding rights, responsibilities, opportunities and unfair discrimination. Moreover, part of the impetus for this came from the recognition that the very opposite of solidarity had been all too evident in the same century. Even an activity as ostensibly humanitarian as medical research had been part of this: reputable doctors, in the USA and other countries as well as Nazi Germany, were discovered to have conducted harmful research without consent, especially on people who were racially, socially or psychologically disadvantaged.
Much of the perceived need for, and implementation of, regulation in medical research arose from such revelations, and in particular the insistence, in medical treatment as well as research, on informed consent. But the problem again, as in concerns with safety, is one of proportion. If solidarity is the recognition in practice of each individual's equal dignity, are the individuals concerned only human individuals, or are members of other species, especially those closest to humans, to be included? And are the human individuals concerned only human persons, defined by characteristics such as rationality, self-consciousness or moral agency, or do they include beings of the human species, from the earliest stages of human life?
Animals and now human embryos are regularly experimented upon in scientific and medical research in ways in which it would be considered totally unethical to experiment upon any being of the human species from the womb onwards. Intuitively, many of us are prepared to defend this. A favourite argument in support of this in the case of embryos, is that if there was a fire in a laboratory and you had the opportunity to save either a tray of a hundred human embryos or one child, whatever your beliefs about the moral status of embryos, you would still save the child. But the problem with this argument is that in experimenting upon embryos, or for that matter animals, the alternatives are far less clear cut.
By experimenting on the embryo or the animal, you might eventually come upon a cure which will save the life of one child, or indeed many children. But then again you might not. Everyone must hope that research in regenerative medicine will be successful. But there are no guarantees. There are no final, knock-down ethical arguments against those who claim that in using animals we are blinded by "speciesism," or against those who argue that in using embryos we are offending against human life and dignity. But there are also no final, knock- down ethical arguments to silence those who ask: "If a child, or many children, might be saved by such research, how can you justify not doing that research?" Ethics does not necessarily provide answers. Sometimes it just makes the questions more difficult.
Kenneth Boyd is Professor of Medical Ethics at the University of Edinburgh