By MARK WAYMACK

Embryonic stem cells are on the cutting edge of today’s human tissue engineering, yet they are controversial. An ongoing debate over federal funding for research in this field has highlighted the ethical problems involved. “There are a lot of ‘Sophie’s Choices’ in this,” said Alan Russell, a molecular biologist who heads the University of Pittsburgh’s chemical engineering department.

Many abortion foes, contending that un-implanted embryos are every bit as human as a fetus, have opposed funding. President Bush has expressed his personal opposition to this type of research and has asked Health and Human Services Secretary Tommy Thompson -- an abortion foe but, as Wisconsin governor, a supporter of embryonic stem-cell research -- to review federal guidelines. Biotechnology experts worry that without such research, U.S. biotech companies might fall behind those in other countries, notably Britain, that allow embryonic stem-cell experiments.

Medical researchers now argue that these cells hold the promise for highly effective treatments for many diseases that afflict us. The list of medical conditions that their use might help includes diabetes, Parkinson’s and Alzheimer’s diseases, perhaps leukemia, even spinal cord injuries. Many researchers, physicians, patients and politicians are clamoring for greater support for such research. But there are others, as well, who argue that such practices should not be supported since they are the equivalent of murder. How have we become so divided?

Embryonic stem cells are, without a doubt, remarkable. After the ovum is fertilized it begins to divide. One cell becomes two, then four, then eight, 16, and so on. At these early stages, each cell is virtually identical to the others. But by the time the fetus emerges into our world, he or she has changed dramatically. From that small, one cell start, he or she has emerged as a being of millions of cells, and those cells are specialized in their structure and function. Brain cells are different from liver cells, which are different from skin cells, which are different from muscle cells, and so on. And putting muscle cells into a brain will not change them into new brain cells. Those cells in the early embryo, what we call the embryonic stem cells, are special in that they carry the capacity to become all the different kinds of cells in the body.

Researchers can take those embryonic stem cells and culture large quantities of them. What they hope to learn to do well is to then transplant those stem cells into an individual’s diseased organ -- the pancreas, the lungs, the liver, the bone marrow, the brain -- and have the healthy stem cells proliferate, specialize into the needed function and thus take over the role of the diseased cells.

Clinical trials thus far have not been very successful; but there is reason to believe that with diligent work the technique will become more effective.

Some researchers want to push ahead for the fame of success or for financial profit. Many who lobby for advancing research argue on the grounds of moral obligation. Do we not have an obligation to give succor? To aid those in need? Did not Christ heal and admonish us to heal? Most of us accept a responsibility to care for others, including those in medical need. Traditionally religious organizations have been active in providing health care, seeing it as a moral obligation. If then, we see a promising avenue of medical research, an avenue that could possibly provide comfort, relief and even cure for perhaps millions of people, do we not have a moral obligation to pursue it?

For many, the issue is not that straightforward. The problems revolve around the moral status of the embryo and, consequently, our obligations to the embryo.

If one sees the embryo as simply a collection of undifferentiated cells, then there would be no moral problem with using these stem cells for our own benefit. Consider, for example, how skin is routinely cultured into large sheets to be used for skin grafts for severely burned patients. Few of us think of those skin cells, growing into living, pliable sheets of skin, as having any special moral status. The burn surgeon trims the edges of the graft to fit the wound and throws away the trimmings, and no one gives those cells a second thought. “It seems difficult to deny that relieving widespread suffering is morally better than destroying embryos at no gain,” says Louis Guenin of Harvard Medical School, who also argues that up to day 14, a fertilized egg can become twins, so no human identity exists before this time.

But many think differently. Under the right circumstances, that small collection of undifferentiated cells has the possibility to be born as a unique human being. For some, this means that the embryo deserves special respect. It does not necessarily mean that the embryo has a full-fledged right to life. For being special need not mean the same thing as being a bearer of full moral rights. For these thinkers, we should be respectful toward the embryos we use. We should not use them casually. But, given that the primary source for embryonic stem cells is the frozen leftovers from in vitro fertilization, leftovers that will be destroyed anyway, why not allow something good to come from them? From this point of view, embryonic stem cell research and use may require guidelines and oversight, but the compelling obligation to help those individuals who are sick, and who are fully fledged bearers of moral rights and objects of our moral concern, can easily override respect for the embryo.

However, if we think of the embryo as a person, as a human being with a right to life, then harvesting embryonic stem cells would be a deliberate killing of another human being. And that, of course, is morally wrong. Well, it is usually morally wrong.

Even if we presume that the early embryo counts as an individual with full moral standing, the answer may still be complicated. We have, as can be seen, conflicting moral obligations. An obligation to help and an obligation not to kill. An obligation to do good versus an obligation to do right, so to speak. But which takes precedence?

Most of us do not take the injunction not to kill as an absolute. We might allow the killing of an aggressor if that is the only way to defend our own lives. We might find justification for killing the enemy in a morally just war. In what way can an embryo in a petri dish be said to be an aggressor? And if the embryo is not an aggressor, but an innocent bystander, there must be very special circumstances to justify overriding the prohibition against murder.

Finally, even if one regards the destruction of the embryo for our own medical benefit as an immoral murder, one must still confront a different consideration. Embryonic stem-cell research is already being conducted in the United States. Private research money can be, and is being, spent in this activity. It thus proceeds with little public oversight. An argument for allowing federal money to be used would be as a strategy to gain federal oversight and thus perhaps lessen some of the moral evils that might happen otherwise.

Should we dirty our hands to try to prevent greater evil? Or should we stand aside and uphold our moral rectitude even though that might lead to more harm to embryos than otherwise? The debate, then, revolves around two key issues: 1) the moral status of the embryo, and 2) the conflicting moral obligations to help others (to do good) versus the moral obligation not to murder (to do right). We will need patience, attentiveness and wisdom as we seek a consensus.

Mark Waymack is associate professor of philosophy and co-director of graduate programs in health care ethics at Loyola University Chicago.

National Catholic Reporter, July 27, 2001

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