Biological Ethics
Table of contents
Chapter 18. Experimentation on human foetuses
N. López Moratalla
a) The meaning of "human life
"Qualities" of human life
Scientific knowledge makes it clear and beyond any doubt that the beginning of the existence of each living being takes place with the fusion of the gametes of its progenitors, at which point its genetic programme is constituted. Therefore, the same principles set out for the ethics of scientific experimentation on humans have the same validity and Degree of requirement in all that refers to experimentation in the embryonic or foetal phase of life. The existence of specific aspects in this research is the reason for dealing with them separately.
Research into prenatal diagnosis and intrauterine treatment is of great importance, and indeed considerable progress is expected in the near future. However, some biomedical practices with foetuses suggest that these advances in the field of science can easily turn into terrible setbacks in the field of humanity. The step backwards means, first of all, arrogating to oneself the power to decide on the life of an unborn child, simply because it is an "unwanted" life, knowing that it is a human life that therefore demands all respect.
There have been numerous efforts to introduce the abortifacient and contraceptive internship , firstly, and later "in vitro" fertilisation, in order to desensitise consciences and erase the value of "human life" by establishing different "qualities". Added to these efforts are those of scientists - for whom every value can be sacrificed for the sake of scientific progress - eager to have the most suitable material for their work and, moreover, cheap; it cannot be ignored that having a monkey embryo, taking into account the breeding of its progenitors and the leave birth rate, is very expensive.
This aberrant attitude is easily ignited when it is admitted that there may be human lives that are not so worthy of being lived for reasons of biological race, of belonging to poor or uneducated peoples, of age, or of illness. If this is admitted, we are one step away from accepting that the condition of being human would not be in oneself, in man, but would be given to him by others and would depend, therefore, on his generosity. Just as there would be human lives unworthy of being lived, because they are not useful from the point of view of socio-economic profitability, an unwanted, unplanned child becomes an "undesirable"; and not only because it is an intruder who disturbs family peace and the mother's psychic balance and therefore deserves not to be born, but because, it is even said, it is not a human life. This is what Giséle Halini, the French feminist who promoted the legalisation of abortion, said: "this life - that of the child to be born - becomes life only because of the desire that I, a woman, have for it. On the contrary, it will never be life against my own will, but a jumble of malignant cells, which will burn in my betrayed body". To be a person or a tumour would thus depend on the mother's wish.
In 1973, the Washington Post published a comparison between abortion and slavery - "Two cases of disregard for human life" - outline , carried out by an American organisation for the protection of the right to life. The parallel is both chilling and revealing:
"Slavery (1857)
Even if he or she has a heart and a brain, and is biologically considered human, a slave is not a "person" in the eyes of the law. The US Supreme Court decision makes this clear.
A man of the black race only receives his legal personality when he is liberated; before that we need not worry about him, for he has no rights before the law.
If you think slavery is wrong, no one is forcing you to own a slave, but don't impose your morality on others.
A man has the right to do what he wants with his property.
Isn't slavery more humane? After all, doesn't the black man have the right to be protected? Isn't it better to be a slave than to be thrown into a cruel world without preparation or experience? (A statement made by a person who is already free).
"Abortion" (1973)
Even if it possesses a heart and a brain, and is biologically considered human, the unborn child is not "a person" in the eyes of the law. The US Supreme Court has made this clear.
A child only acquires legal personality at birth; before that, we should not worry about him or her, as he or she has no rights before the law.
If you think abortion is wrong, no one is forcing you to do it, but don't impose your morality on others.
A woman has the right to do what she wants with her own body.
Isn't abortion more humane? After all, don't all children have the right to be "wanted" and loved? Isn't it better that a child is never born before it has to face a cruel world alone and unloved? (Claim made by a person who has already been born).
Will the unborn child become today's "Dred Scott" or will our nation use its great resources to respect every human life, whether black or white, poor or rich, male or female, unborn child or octogenarian?
A question immediately arises: if so, where to put the "quality control" barrier? It is astonishing to see a court acquit Dr Leonard Arthur, accused of killing, by administering drugs, a child born mongoloid and therefore not accepted by his parents, while more than one American hospital is ordered to pay heavy compensation to the parents of children born with congenital anomalies, undetected because of the doctors' negligence. The time may be near when a child will take legal action against its parents because they allowed it to be born with a physical defect.
Beginning of human life
The quality of human life is not dissociated from biological life, just as there is no such thing as a human life and a humanised life, which is worthy of respect because it is useful, healthy and does not hinder others. Every human being has a single life, which began at the moment of conception, during which he is a perfect unity of body and spirit, and hence his dignity, whatever the biological conditions he is going through or in which he finds himself. It is as obvious as "nobody distinguishes, for example," comments A. del Amo, "with regard to dogs, between life and canine life; a dog zygote is either a dog or it is nothing, and the same would be true for any other species". However, the interests of the advocates of abortive or contraceptive practices and the use of early embryos, from "in vitro" fertilisation for experimentation, have been granting human quality as appropriate: 14 days after conception after nidation, or after the beginning of the brain development -three months-, or simply when, exposed to unnatural conditions, that is, outside the uterus before gestation is completed, it becomes viable according to the advances of the techniques available at that time. Thus Hoult1 stated that human life goes through the following general cycle: (a) in utero, the embryo or foetus has a protoplasmic "animation", dependent on the energy of its mother, (b) after a viable birth, the human individual has, in addition to the protoplasmic, another organismic one in which it begins to depend on itself and is therefore independent; (c) after brain death, in the body, the protoplasmic one remains, but no longer independent - unless artificially maintained - and some time after death, protoplasmic death occurs. Protoplasmic life originated, says Hoult, 3 billion years ago and has continued uninterrupted through repeated cell divisions that mediate human heredity. No other quality of life is attributed to an embryo or foetus than protoplasmic life, linked to the protoplasmic life of its mother through its energetic dependence. Claims like this subject are totally unfounded, especially if it is a question, as in this case, of seeking grounds for claiming ownership of the embryo and the freedom of use of the embryo by scientific laboratories. There is no doubt, nor has there ever been, that in nature animals, even those that sometimes form colonies or societies, appear as individuals with their own unique life; after the death of multicellular organisms some of their cells remain living substance for a time, but they have lost the functional unity that manifests individuality. As F. Ponz2 points out, "from the moment the egg is fertilised and the zygote is formed, and the life of the new being begins, until death occurs, there is a manifest continuity in the individual, whatever the intermediate states may be. At any moment this individual is identifiable with the one it was before or with the one it will be later. A morphologically coherent corporeality is visible in the animal at all times, with parts, limbs and organs physically united to form a body. The functions of all these parts make sense in order for the whole organism to live. And in all its activity, spontaneous or provoked, whether it is confined to a small part or is rather general, the action is proper to the animal as one, as a whole.
... On the physiological level, this unity of the individual is appreciated as functional unity, and implies organisation: hierarchisation and ordering of functions, so that the most elementary give rise to coherent activities of a higher order, these are coordinated among themselves to develop functions of a higher rank and so on until, by integration of all of them, unitary animal life is achieved. Functional unity requires operative subordination, correlation between parts and partial functions, control of all activities in the service of this unitary, harmonious and balanced living". And this functional unity, this organisation exists as soon as the individual has two cells: the specific interactions between the membranes of these cells maintain it.
The claim to relate the beginning of human life to any particular phase is also scientifically unfounded. For some in particular it would be at development brain. There is no stage at which the transition from being something else to being human life takes place. Fertilisation initiates a unique and irreversible process in which genes are expressed from agreement with the strict programme of the embryonic development . As G. López3 , this continuous programme also includes the brain development : "the suggestive chapter of Neuroembryology offers multiple demonstrative data that this programming and direction of the development of the nervous system is a fact. Morphological study reveals that the first signs of nervous system differentiation begin in the ectodermal cells of the average line above the notochord. The cells of the notochord change and become more elongated, forming the neural plate, in which it is already possible to differentiate, in the third week, what will become the medulla from what will form the encephalon. Later, the plate transforms into the nerve canal, which continues to show the simultaneous development of medulla and encephalon, with the appearance of the encephalic vesicles at the end of the first month. All the nerve Structures continue to grow in a programmed integral development , with reciprocal molecular interconnections, development and axon growth, etc. (...); the nervous system develops as a unit, and at any point of the embryonic Structures of the nerve centres, the cells have activity - nerve activity - at a very early stage. Neurons tend towards each other, and interconnections of high specificity are established. The embryonic nerve cell, when it has not yet reached true neuronal morphology, presents extensions, called advancing filaments, which progress in many directions as if exploring the environment. They are dynamic Structures that advance and retreat in minutes to establish differential connections with the surfaces of other neurons, and thus prepare for axonal growth until they constitute the fibre network of the central nervous system.
On the other hand, everything indicates that in the first months and even years of extrauterine life, profound changes take place in the nervous system, but the important thing is that the development is done without interruption, and the functional sensory and motor capacities gradually appear. The nervous system is the same, controlled by the same potentiality Genetics, both in the first days of the embryonic development , and after a few months or after birth. To point to a moment of radical change, in order to say that this is the beginning of human life, would be arbitrary and incompatible with the most elementary knowledge of neurobiology".
The current polemic between "developmentalists" and "conceptionists" is nothing more than a pseudo polemic, a philosophism introduced into the scientific world by non-scientific interests. It is not a question of debatable opinions because of a lack of certainty in the experimental data . Experimental science proved a long time ago that fertilisation produces a new individual whose programme of development and life is different from that of its parents. This is already the beginning of its life; this programme marks the development of its whole organism and the programme of development of the nervous system as well as that of the other systems is perfectly situated in it.
(b) Early detection of anomalies
Many biological techniques and intrauterine examinations are currently used for the prenatal diagnosis of congenital diseases, often with the aim of early identification of embryos or foetuses that are defective and their immediate elimination by abortion. Direct or indirect participation in these techniques or experiments for this purpose is flawed in its origin and as such is ethically inadmissible. Likewise, any experimentation with the risk of damaging the integrity of the foetus or worsening its condition is illicit, unless it is an extreme attempt to save it from certain death. evaluation Careful consideration of the negative consequences of the use of a diagnostic - or therapeutic - technique is all the more necessary, given the greater fragility of an organism when its life is in its infancy.
congress It is not in any way a question of slowing down, or placing obstacles in the way of scientific progress, but of detecting with authenticity what could be a "latent form of induced abortion", and of assessing with responsibility whether the risk coefficient is compensated by a real urgency of diagnosis and by the importance of the results achievable in favour of the conceived child, as John Paul II pointed out to the participants in the International Medical Meeting on "Prenatal Diagnosis and Surgical Treatment of Congenital Malformations": "the bearer of such an anomaly, in fact, does not thereby lose the prerogatives proper to a human being, to whom the respect to which every patient is entitled must be accorded".
(c) The use of human foetuses in research
Over time, in countries where abortion has been legalised, this aberration has been joined by the use of human foetuses, both dead and alive, as material for research after the abortive internship . Obviously, any participation in such experiments is unlawful, as it amounts to direct murder or cooperation in murder.
In 1975, the journal "Pediatrics"4 published what the researchers of the "Task Force on Pediatric Research" have elaborated as "Code of Ethics for the use of foetuses and foetal material in the research". In addition to the incongruity of giving absolute value to the scientific research , in such a way that any action is justified if it is used to develop science, it is also incongruous that this code should arise among paediatricians, when, not long ago, Perinatology was born as a branch of paediatrics that assumes the human foetus as a patient.
In the introduction to the code, the following is stated:
1) "The research on foetuses and newborns is of utmost importance in contributing to the health and well-being of the entire population. Such research, motivated by human interest, should be continued and encouraged, subject to appropriate and clearly defined safeguards.
The American Academy of Pediatrics recognises that through research on previable fetuses, new knowledge can be gained that will ultimately benefit viable children. The American Academy of Pediatrics also recognises that some of these areas of research, while not risking the health and well-being of fetuses, do not directly benefit the individual fetus. In such cases, express parental permission must be obtained. The whole previable foetus offers an important opportunity, which cannot be obtained in any other way, to perform valuable programs of study on the transfer of substances across the human placenta, the reaction of the immature foetus to drugs, and on the endocrinological development of the foetus and placenta.
Foetal viability means the ability of the foetus to survive after spontaneous delivery (given therapeutic services) to the point of sustaining a heartbeat and breathing independently - not artificially. If the foetus has this capacity, it is viable and therefore a preterm baby".
The incongruity, both from an ethical and scientific point of view, of making a distinction between a pre-viable foetus - with no right to have its life respected - and an immature child, is obvious. Moreover, the decision about the viability of a particular foetus is left to the subjective judgement of the doctor and the objectivity of the capacity of the technique at that moment to bring that foetus to life outside its natural environment, the mother's womb. Thus the code adds: "because of the rapid changes taking place on the medical knowledge , the definition of viability should be regularly reviewed in order to be in conformity with these changes".
The determination of viability involves a subjective judgement and goal of the physician attending or examining the product of conception and must be a physician and not a researcher wishing to use the foetal tissue for research.
In general, despite all other circumstances, a beating heart is not test sufficient for viability. At least one additional necessary condition is the possibility that the lungs can be filled with air. Without this precondition, no currently available mechanism for initiating or maintaining respiration can prolong life, and in this case, even if the heart is beating, the foetus or "abortus" is not viable.
"Abortus" means a foetus expelled whole, before it is viable, either spontaneously or as result of a medical or surgical intervention. The term does not apply to foetal material from the placenta, which is macerated at the time of expulsion, or to cells, tissue or organs removed from a dead foetus".
2) The second point of this statement of principles in the above-mentioned introduction states: purpose "Research affecting the foetus in utero or the pregnant woman may be undertaken for the benefit of a specific foetus or for the health of the mother, as part of a procedure to terminate a pregnancy, and to evaluate or improve methods of prenatal diagnosis, methods to prevent premature birth, or methods of intervention to counteract the effects of an abnormality Genetics, or congenital injury, or to ascertain the safety or efficiency of drugs that a pregnant woman might need."
That is to say, in a foetus lodged in the uterus - and therefore viable, since it is in its environment - it is possible, according to this code, to undertake any subject of research, including that of "perfecting" the techniques conducive to taking its life.
The four points set out in the code are transcribed below: they are in themselves illustrative of how far one can go and has gone when Technology and/or Science are separated from Ethics.
1) "research of the foetus in utero: research and tests may be carried out with the intention of benefiting the mother, the unborn child or both. For other research and testing, explicit consent must be obtained.
2) research of the viable foetus: When the foetus is viable, the ethical obligation is to maintain its life as long as possible. It is neither ethical nor legal to conduct experiments that are incompatible with the treatment necessary to prolong the life of the foetus. It is known that in many cases the techniques used to help a foetus in distress may be so new that, at some Degree, they may be considered experimental.
3) research of the pre-viable foetus in utero, when abortion has been decided or in "abortus". This research is permissible provided that: a) the programs of study animals, if provided for, have been completed; b) the mother and father have legal capacity and have given their consent, except in the case where the consent of the father is not necessary because his identity or location cannot be ascertained prudently; c) the related persons on the research have no part in: 1) any decision on the timing, method or procedures used to terminate the pregnancy and 2) the assessment of the viability of the foetus at term; d) such research shall be performed only at Departments directly under the authority of a medical institution and with the express authorisation of committee for human experimentation; e) before permitting such research the committee for human experimentation shall ascertain: 1) the validity of the research; 2) that the information required cannot be obtained in any other way and 3) that the investigators possess the necessary capability, experience and integrity; f) that dissection of the dead foetus or experiments on the foetus or foetal material are not performed at the conference room operating or delivery site; g) that no offer of money for the foetuses or foetal material takes place; h) that the relevant institution retains a complete certificate or report .
4) research of dead or aborted foetuses. agreement This research is permissible provided that the conditions of paragraph 3 (b or h) are respected and the research is carried out in accordance with the applicable state or local law regulating autopsies".
It is deeply ironic to claim a "dignified" use of human foetuses, from which the first right - the right to life - on which all human fulfilment rests, has been "unworthily" taken away; it is morally worthless to claim more restrictive conditions for using a foetus than for taking its life. However much it "hurts the sensibilities", it is not comparable that some cosmetic industries use foetal material for the elaboration of their products, with the performance of an abortion. The use for commercial purposes, such as the use in the medical internship for tissue transplants, for example, will be a cooperation to this evil, the seriousness of which has to be judged according to the ethical principles of such a cooperation. The French Ministry of Health has prepared a draft law in this respect:
This law," comments Valtueña5 , "seeks above all to prevent the commercialisation of human foetal tissues or their abusive use. In this sense, a paradigmatic case is that which has occurred in the USA, where a young father, with irreversible renal insufficiency, determined not to undergo any more dialysis and with an exceptional group hystic found that his wife had become pregnant for the sole purpose of sacrificing the foetus at an advanced age in order to transplant the father's kidneys.
It is clear that there is only one step from the subject use of the foetus to its sale, pure and simple, which some people are prepared to take. This is what the French legislation wants to avoid, as well as the association International Against the Exploitation of Human Foetuses, whose president, Ch. Jacquinot, has declared the following: "We believe it is necessary to make a distinction between dead foetuses and foetuses removed intact by caesarean section, and also between the interventions of doctors pursuing a therapeutic purpose goal and those of researchers who have a purely scientific purpose. The association considers that organ harvesting for the purpose of research may be carried out on foetal cadavers, subject to parental consent and provided that the death of the foetus was neither deliberately provoked nor hasty, and that it has been verified by two doctors who do not belong to the team using the organ harvested. The association recommends to the Parliament to prohibit any use of anatomically intact human embryos or foetuses".
Anatomically intact or not, they will die of asphyxia due to lack of oxygen, minutes after being removed from the mother's womb, and it is just as much an abortion when it is labelled therapeutic as when it is labelled scientific. But, as can be seen, it is not a question of preventing homicide but of "preventing the commercialisation of foetal tissue or its abusive use".
Since a human embryo or foetus is a human person, its corpse "whether voluntarily aborted or not must be respected like the mortal remains of other human beings.... Also in the case of dead foetuses, as in the case of adult corpses, any commercial internship is illicit and must be prohibited"6.
One last comment on the Code: if abortion has been decided upon, the pain caused to the foetus does not seem to be considered any more - since its life has no value whatsoever. For humanitarian reasons, all animal experimentation codes - cf. chapter 15 - require the use of anaesthetics at employment and strictly prohibit unnecessary harm. However, in human experimentation, the medical evidence that the foetus shows signs of pain sensation at the end of three months has been forgotten. The research states7 that, at 13 weeks and average gestation, all the neurological Structures necessary for organic pain sensation already exists, and the foetus responds to unpleasant stimuli by withdrawing. According to the known data fetuses develop sensory Structures and in the same way begin to respond to stimuli. For example, at the end of the 5th week, a light tap on the foetus' mouth causes it to contract its lips; in the 10th week, the palms of the hands are sensitive to touch; and in the 11th week, the face, fingers and toes are also sensitive to touch. At 13 weeks and average these responses are sufficiently elaborated and show that the foetus is already making efforts to avoid negative stimuli.
Once again it is clear that there is a big difference between what is right by nature and what is legal. Neither the decriminalisation of abortion nor the authorisation of experiments on embryos removes responsibility for these actions. It is similar to what happened in Nuremberg when the Nazi criminals were tried; for those who argue that what is ethically lawful and just comes down to what is legal, those men were innocent, because all they had done was to abide by the laws of the Third Reich with absolute perfection; but everyone knows that what these men committed were real crimes.
d) "Production" of human embryos
The initiators of the application of "in vitro" fertilisation to human reproduction, Edwards and Steptoe (cf. chapter 23) began to cultivate the embryos obtained also without the intention of transferring them to the uterus of a woman who could be suitably prepared by hormone treatment fill in for gestation. The goal of their work was not only to try, by means of artificial fertilisation, to provide a solution to the desire of sterile couples to have a child, but also to make human embryos available for experimentation from which "innumerable benefits" would be obtained: immunological contraception, the use of embryonic tissue for transplants, the programs of study on cancer, the possibility of choosing the sex of future children, the early diagnosis of congenital anomalies, the possibility of cloning, etc. In 1983, these experiments were denounced by the British National Medical Association ( high school ). A new stage was then added to the technique: freezing the embryo in liquid nitrogen at -190°C and then thawing it, thus offering the "advantage" of creating an embryo bank for "human embryo trafficking". Alarm at this and the danger of monstrous alterations to these embryos has led the high school of Doctors of Great Britain to warn all its members to avoid any subject of partnership with these researchers.
"Human embryos obtained "in vitro" are human beings and subjects of rights: their dignity and their right to life must be respected from the first moment of their existence. It is immoral to produce human embryos destined to be exploited as "biological material" available... Methods of observation or experimentation which cause harm or impose serious and disproportionate risks to embryos obtained "in vitro" are morally illicit for the same reason. Every human being must be respected for his or her own sake and cannot be reduced to a purely instrumental value for the benefit of others"8.
Some laboratories are currently investigating complementary techniques for artificial reproduction, ovarian culture and training of artificial placentas, in order to obtain the development embryo outside the womb, with the aim of increasing the availability of human beings at the service of experimentation.
Obviously, any direct or indirect participation in this subject of works, or any partnership in this "traffic", either in the purchase or in the sale of foetal material obtained by these systems, is illicit. Lending oneself to this would amount to cooperation.
There is absolutely nothing to justify this massive disposition of human life. The attempt is made to convince that these human lives thus begun are a product of science that has created life from an egg and a sperm independently of the parents, during the few days of the process of laboratory. This is an argument that no one with a minimum of biological knowledge of the processes involved in reproduction would subscribe to. Those first days of the existence of a new being, spent in a laboratory, what they do show scientifically is that this life is different and independent up to that point from that of its parents9.
Notes
(1) HOULT, R.L. "The meaning of human life". Nature, 316, 480, 1985.
(2) PONZ, F. "Homeostasis, Automatism and Freedom". lecture of the Opening of the 1979-80 academic year at the University of Navarra.
(3) LOPEZ GARCIA, G.: "Comienzo de la vida del ser humano". Rev. Med. Univ. Navarra, 29, 227-232, 1985.
(4) HODES, M.L. et al. "AAP code of ethics for the use of fetuses and fetal material for research". Pediatrics, 56, 304-305, 1975.
(5) VALTUEÑA, J.A., Janus, 566, 19, 1983.
(6) RATZINGER, J. "Respect for nascent human life and the dignity of procreation". Document of the Congregation for the Doctrine of the Faith. I, 4, 1987.
(7) "Foetal Pain and Abortion: the Medical Evidence". Americans United for Life. In NC News Service. Chicago, 9.VIII.84.
(8) RATZINGER, J. "Respect for nascent human life and the dignity of procreation". Document of the Congregation for the Doctrine of the Faith. I, 5.
(9) Since 1985, the journal Nature has reflected the controversy on the subjects: "When does life begun?" and "Embryo research". Some letters can be found in: 314, 492, 1985; 320, 208, 1986; 314, 666, 1985; 316, 480, 1985; 313, 618, 1985; 313, 728, 1985; 314, 11, 1985; 314, 127, 1985.