In 2006, I was contacted by a Dr. Edward E. Furton, Editor of The National Catholic Bioethics Quarterly, inviting me to write an article for his journal, based on my experience with trying to obtain legislation mandating labeling of commercial products to indicate whether they contain materials from aborted humans. I presented to him a first draft. He recommended some changes, which I implemented. The revised manuscript was read by a reviewer, who suggested further (minor) modification. Those were implemented and the re-revised manuscript sent to Dr. Furton, from whom I got no reply. On my inquiring about the matter, he told me that someone very important and who could not be named had objected to the manuscript being published, so his hands are tied. As things have not changed basically in the years since (if anything, the situation became worse), I decided to present the paper here. This is the final, revised version, which was burried in the Editor’s office.
Basic premises
Two scientifically established facts will help setting the premises for the discussion that follows: First, an embryo is never a part of the body of the mother, as proved by in vitro fertilization combined with surrogate motherhood. In that situation, the biological mother never has the baby inside herself and the function of sustaining the life of the child until birth is fulfilled by the surrogate mother. The latter, however, receives and carries a child with whom she has no genetic relationship, stipulated by contract to be someone else’s.
Second, from conception to death the human organism passes through stages of variable autonomy. It is in a state of full dependency before birth, which is then gradually reduced until full autonomy is achieved. The quality of human being does not change with the autonomy level. The autonomy is reduced again in old age and can be lost completely after an accident. If the loss is reversible, the organism is in the same condition as before birth. Between conception and implantation the organism is essentially autonomous. Interestingly, the cells formed in that stage, after the first division, are differentiated and oriented, a discovery that prompted the comments: “Your world was shaped in the first 24 hours after conception” and “(t)he mammalian body plan starts being laid down from the moment of conception.” [1]
The use of embryonic and fetal materials and the opposition to it.
Tissues from aborted humans are used in the production of vaccines, currently on the market, against various infectious diseases and for isolation of stem cells, intended for the development of treatments of degenerative diseases or the repair of injured organs. The embryonic stem cell applications are mostly in the research stage, but further development (clinical testing) has been reported.[2] On the other hand, the use of vaccines involving the application of tissues from aborted humans is widespread.
It can be expected that people who reject abortion should reject also the use of materials obtained from the aborted child. Indeed, there are special grounds for opposing the latter activity, in addition to those adduced for the former. Abortion at all stages, from the morning-after pill to partial-birth abortion is the result of a decision of one of the participants. The embryonic-materials-in-medicine activity, however, forces participation (complicity) on unwilling but uninformed members of the society. It also conveys a message that abortion may be a source of benefits for the population at large.
In the debate on abortion, the pro-lifers have often been accused of wanting to control other people.[3] The goal of petitions, marches, and speeches is to convince others (the legislators, the courts, and the women having abortions) to desist. In the debate on the use of products of abortion, the protesters can speak for themselves, as intended beneficiaries. To maintain moral consistency (and credibility), they have to reject the benefits thus offered.
The opposition to the use of remains of victims of abortion has been expressed by individuals and by organized pro life groups. Also, the attitude of randomly selected members of the Catholic Church toward the matter was tested by presenting persons exiting from Mass at a number of churches, with the question: “Would you use a medicine produced using materials from an aborted baby?” Among those that stopped to answer, the answer was most often negative.[4]
A formalization of the refusal was undertaken by pro-life activists in the Diocese of Pittsburgh, PA,[5] and like-minded people elsewhere, by the circulation of the following pledge:
It has been the custom of civilized societies to protect the defenseless and especially the young. It has been a characteristic of barbarian societies not to have such restraints. It is alarming that at this time in our society, killing of the youngest, that is the unborn, is contemplated for the purpose of improving the health of the old. I consider that depriving a human being entirely of the experience of life for such a purpose is not only morally abhorrent, but demeans the beneficiary. In addition, to destroy a human life for the benefit of another human life lacks the fundamental qualities of humanity. Therefore, I bind myself with the 2 PLEDGE that follows:
Never, under any circumstance, will I accept any medicine, drug, remedy, or treatment whose creation, development, or research sacrificed a human life, particularly the unborn. The definition of “human life” includes any cell or group of cells which can develop as a human being, whether generated naturally or artificially, or by any procedure or technique that may be invented or discovered. I will not use any product which involves materials, results, or knowledge gathered by harmful experimentation on nonconsenting humans. This pledge shall also be binding on any guardian who might be in charge of my care in case of enfeeblement of body, mind, or spirit.
It is notable that the rejection of “tainted” medicine, drug, remedy, or treatment in this pledge is absolute and all-encompassing. For lack of a better word, we will refer to it as the absolutist position. A more nuanced position (flexible rejection), and a position accepting the use of such products, will be examined below.
As used here, flexibility does not imply a relativistic attitude, but the recognition that exceptional circumstances in which an absolute rejection could have negative consequences exist. Flexible rejection has been discussed in connection with vaccines. It was noted that the use of products based on cell lines harvested from aborted humans constitutes indirect (mediate) and remote material cooperation with the evil act of abortion.[6] It was concluded that such cooperation is illicit, except when facing the danger of spreading an epidemic, as for examples German measles. Even then, every effort should be made to develop and procure alternative, morally acceptable vaccines.[6]
Flexible rejection is a prudent approach of striking a balance between the moral concern and the risk of exposing oneself and others to significant risks to their health. The holders of the absolutist position are less than comfortable, however, with that approach. One key problem is that “grave inconvenience” is a soft concept, open to interpretation, rather than quantifiable. Indeed, an objection to replacing the aborted fetal tissue-developed vaccines with morally acceptable alternatives currently available was based by some on the existence of allergic reaction to the latter in some individuals. To paraphrase Thomas More (on stage):[7] “Why, Richard, it profits a man nothing to give his soul for the whole world . . . But for” avoiding allergies! The absolutist may also argue that a flexible position applied at the time could have concluded that eating flesh from animals sacrificed to Roman gods would have been preferable to accepting martyrdom, especially for children. In both cases, Christians were offered a choice: sacrifice to Roman gods or be killed; take the “tainted” medicine (vaccine) or risk coming down with a more or less grave disease (but sometimes only an allergy). Note that the present paper is not intended to advocate either position, but to present them to the reader. The absolutist position is given in more detail, because the other position has been well explained before.[6]
Another objection is that the exceptions blur the demarcation between right and wrong and once the process is started, the acceptability criterion will slide lower with time.
“Loss is perceived most clearly at the beginning; after habit becomes implanted, one beholds the anomalous situation of apathy mounting as the moral crisis deepens.”[8]
In the flexible rejection argument, the remoteness of collaboration with the evil of abortion does not refer to distance in time between abortion and use of the product, but by the position of the action in the chain of events (abortion, tissue harvesting, manufacture, marketing, and use). Also, there is no remoteness in the cooperation of the user (patient) with the evil act of marketing of products coming from abortion. In the extreme case when such products are used to avoid grave consequences, the user has the “duty to take recourse to alternative vaccines (if they exist), putting pressure on the political authorities and health systems so that other vaccines without moral problems become available,” and to “oppose by all means (in writing, through the various associations, mass media, etc.) the vaccines which do not yet have morally acceptable alternatives, creating pressure so that alternative vaccines are prepared, which are not connected with the abortion of a human foetus, and requesting rigorous legal control of the pharmaceutical industry producers.”[ 6] The absolutists accept that to avoid exposing others to a deadly epidemic some one-time deviation from his norm may be necessary, but notice that acceptance, even temporary, of any objectionable remedy diminishes the perceived urgency of the request for alternatives and affects negatively the credibility of the requester. The fact is that there are parents who refuse to vaccinate their children.
The utilitarian position
Not unexpectedly, there is a segment of the population that considers that combating disease, any disease, cannot be subordinated to other considerations. Their position reflects an epicurean philosophy, defining good and virtue only in relation to the well-being of the body. Of those people, a part are pro abortion and another part use a distorted interpretation of the remoteness of collaboration with evil: if the unborn human has been killed anyway, it is better to put the remains to the noble use of combating disease than to discard them. By the internal logic of the latter argument, the user of embryonic materials-derived medicine does no harm, so he is morally justified. This interpretation is unacceptable to all those who advocate rejection of products based on the destruction of the unborn. If one can use vaccines made using aborted humans because the tissues were harvested some years ago and frozen, so no further harm is done by using them at this time or later, then the tissues taken from today’s abortions can be used in a few years time, and so on. There can be no objection to any use after a waiting period, because the user will always come in after the abortionist has done the harm. Now, one either accepts the use of embryonic materials entirely, or draws a line somewhere. To be logically consistent, that line has to be drawn at the beginning.
In the utilitarian compromise, “(t)he human embryo has a special status, and we owe a measure of respect to the embryo . . . We also owe a measure of respect to the millions of people living with these devastating illnesses and the millions who have yet to show signs of them. This is the balance we must make.” [9] To the people who oppose the use of embryonic materials, such a tradeoff is unacceptable. From the basic premise expressed at the beginning of this paper, it follows that if “the potential medical benefits for (the) desperately ill outweigh any ethical reservations about embryo cell research,”[10] then the plight of the desperately hungry fully justifies cannibalism. The utilitarian argument (it makes no sense to discard the tissue of the already aborted babies) could be applied as well: As the bodies of executed criminals are similarly available, the states that have the death penalty could pass laws mandating means of execution that do not spoil the flesh. There is, however, a level of respect accorded by a civilized society to the remains of the condemned. We should demand a similar respect for the remains of the innocent.[11]
We note, however, that sale of organs from prisoners condemned to death is practiced by the government of People Republic of China (PRC).[12] In view of the large number of executions conducted in the PRC (more than in the rest of the world combined[13]), this seems a lucrative business. Embezzlement is there a capital crime. One can suspect that there are other reasons for executions, which the government does not publicize, and also that the authorities are not very scrupulous about free consent of the “donors.” People from USA, UK, and Israel were reported to have received transplants that way.[12]
Whereas the Epicurean seeks the satisfaction of the body, the Christian accepts, ideally seeks, selfmortification to help in salvation of the soul.[14] One can, then, ask why should Christians try to cure themselves from disease, that is, from suffering, at all? The answer was, I think, given by St. Paul: “You must know that your body is a temple of the Holy Spirit, who is within – the Spirit you have received from God.” [15] One cannot offer a proper sacrifice in a sanctuary that is filthy or on a shaky and crumbling altar. Also, one needs the strength to do the work expected of a Christian, including acts of charity. It is not acceptable to make oneself an object of charity by neglect. But one cannot risk imbuing the Holy Sacrifice with chlorine vapors for the sake of a clean altar.
It is most unsettling, however, to hear the epicurean arguments from people coming out of Catholic churches after Mass.[16] They don’t think that man should ever deprive himself of the medical benefits that science could provide. St. Paul’s exhortation: “(B)rothers, I beg you through the mercy of God to offer your bodies as a living sacrifice to God,” [17] is either not known, or considered unimportant. This is unfortunate, because sacrifice is central and essential to the Christian faith.
Trying to understand the causes of this phenomenon, one must start with the influence of the secular culture, which emphasizes gratification of earthly desires and excludes any concern for spiritual matters. Counteracting its influence requires a rigorous, unrelenting effort. As it is, an adequate presentation of personal sacrifice is weak or absent, both in the general catechesis (e.g., homilies) and in the catechesis of children. Physical well-being is given an exaggerated importance; indeed, corporal acts of charity, especially at social level, are stressed, often to the exclusion of the spiritual. The root causes of these manifestations are beyond the scope of this paper, but I will mention that the sacrifice is downplayed rather often even in the celebration of the Mass and catechesis, both in church and in the classroom, seldom, if ever, mentions the existence of an alternative to heaven.
An interesting dichotomy of positions, absolutist on stem cell research and utilitarian on vaccines, was sometimes encountered by the author.[18]
An argument often repeated by the advocates of the use of embryonic materials is the existence of leftover embryos in fertility clinics. The matter has been debated and reported by the President’s Council on Bioethics (PCBE).[19] The objectors perceive the problem as the generation of too many embryos, crying for strict regulation of fertility clinics. But that is a subject to be broached elsewhere.
Searching for ethically acceptable sources of stem cells, the PCBE report cites a study in which 8-24- cell embryos were destroyed and shown to be good sources of stem cells.[20] It then continues: “This work would have to be reproduced and refined before we could be certain that embryos at such an early stage are indeed a dependable source of stem cells.” [19] The remark introduces another feature of the use objectors’ position: Work of research, development, or production ethical per se, but predicated upon unethical research will necessarily give unacceptable products.
Actions taken in response to the use of embryonic and fetal materials in research and manufacture
It is immediately apparent that the refusal to use (purchase) certain products is ineffective in the absence of information on which products are to be refused. That information, available to the manufacturers, needs to be provided to the distributors and users of the products as well. The companies can be asked to reveal the materials used in the research, development, and manufacture of a product (without divulging techniques or other proprietary data). That approach is not expected to be productive, however, because the disclosure will be perceived as limiting the market. It remains, therefore, to force disclosure through legislation.
The best way to achieve general and immediate access to data is through appropriate labeling of the products sold. Labeling is a widely used method of consumer protection. It warns of cholesterol in food, sulfites in wines, dangerous voltage in appliances, etc. Not long ago, it was revealed that manufacturers of cosmetics were testing the irritating effects of hair sprays by applying them to the eyes of rabbits. Following protests from animal protection advocates, the producers have begun writing on the label whether the development of the product sold involved harmful testing on animals or not.
Legislation mandating labeling of pharmaceuticals to disclose existence of materials taken from aborted humans has been passed in Australia (amendment to the Therapeutic Goods Act).[21] In the US, petitions asking for such legislation at federal level have been circulated in the states of New York, Pennsylvania, New Jersey, Colorado, and – to a limited extent – Virginia.[22],[23]
The labels should indicate whether materials from nonconsenting humans, or experimentation on nonconsenting humans, was involved at any stage in the research, development, and manufacture of the product. Thus, not only the unborn babies from the moment of conception, but the subjects who cannot make a free choice in willing body parts or consenting to experiments conducted on themselves (e.g., prisoners in the PRC) are covered. Whether the development of the product was predicated on research involving such subjects (see previous section) should also be shown.
It is noteworthy that tissues from spontaneously aborted fetuses, technically also in the class of humans incapable of free consent, are covered in the request for labeling as well. First, in the present situation, excluding them would open vast opportunities for cheating. Second, labeling does not forbid use. The companies using materials from miscarried, rather than aborted, fetuses will be most happy to state so on the label. It is also noteworthy that labeling is a satisfactory measure for both groups identified above, opposing the use of materials from abortion in pharmaceutical and consumer products.
The product labeling will not deprive those who have no moral qualms about using such products of using them. Indeed, a number of such people admitted that the desire of use objectors and the approach taken are fair. Some pro abortion activists, however, have contended to the author that simply mentioning opposition to the use of byproducts of abortions can somehow be a limiting factor on abortions.
Criticism of the approach was expressed by some anti abortion advocates, who maintain that only legislation banning altogether such products and the research leading to them is acceptable.[18],[24] It was stated that “it might appear as though we are condoning the use of these products as long as they are labeled.”[24] This statement is logically equivalent, however, to saying that opposing partial birth abortion means condoning other abortions and the requests for parental notification laws show acceptance of abortions for teenagers as long as the parents are notified.
Granting that a total ban would be preferable, obtaining such legislation at federal level is, at this time, most unlikely. Even if the state laws or constitutional amendments restricting or eliminating abortion stand, there is no chance to have such legislation passed in New York or California. The pharmaceutical products being items of interstate commerce, they cannot be regulated or restricted by states. At federal level, the only political fight fought in this area so far has been for denying public funding, an action even more limited than labeling. Even if blocking federal subsidies is successful and the states that chose to finance such activity (California, New Jersey, Massachusetts) reverse themselves, work on embryonic and fetal tissues with private money, or paid for by governments in foreign countries, will not be affected. The morally unacceptable products will still be offered, in increasing numbers, to the U.S. consumers, who will have no means to distinguish them from the unobjectionable alternatives.
The law we request can, however, have far-reaching consequences: it will show the existence of a market for ethically unobjectionable treatments and will, therefore, stimulate investment of capital in adult and umbilical cord stem cells. (The successful treatments so far have used the patients’ own stem cells.)
Turning to vaccines, both ethically acceptable and unacceptable versions exist on the world market in most cases.[21] Pressing for legislation to ban the latter would be futile. Demanding clear information on which is which will allow the objectors to choose only the former products and will stimulate the firms using “clean” technologies to apply them to vaccines they don’t make yet, knowing that there is a market for them. The same effect is expected on the firms that currently produce acceptable vaccines but do not market them in the US. Then, in the free market competition between products bought by all and products bought by some and rejected by others, the purveyors of vaccines made using aborted fetal tissues may well be squeezed out or have to change their processes.
It is notable, however, that none of the pro life critics is on the record with demanding a ban of all use of embryonic materials in research. It was argued that the embryonic stem cell path will prove unproductive anyway and only adult stem cells will ultimately be used.[18] As for vaccines, some leave them out of consideration at this time,[24] whereas others have stated that bringing up the matter of vaccines would jeopardize the health of children,[18] positions directly opposed to that of the Pontifical Academy for Life.[6] We are thus finding a position of rejecting unethical treatments as long as they are unsuccessful and accepting them as soon as proved useful.
Embryonic and fetal materials as a regular commodity
A request for labeling legislation at state level, in New York State, was met with the objection that there are not enough products of this kind on the market and one cannot regulate a commodity unless it is in sufficiently widespread use.[24] In other words, one cannot legislate preventively, but only post facto. Such an approach defeats the whole purpose of the action. Besides, preventive legislation in US history started with the Bill of Rights. When the Constitution was written, the press was free in America, as proven by the spirited debate between federalists and anti-federalists. Yet, the injunction against the abridgment of the freedom of the press by the government was put in the first amendment. Waiting for the government to curtail the freedom of the press before acting would have been folly. The authors of the Constitution anticipated a possible danger and acted preventively.
Notably, we are already post facto in the matter of vaccines existing on the market, but the vaccines were omitted from discussion.[24] As for stem cell activities, it will be very difficult, if not impossible, to control them post facto, for the following reasons: Requesting information on the label of a marketed product is common enough. What has been put on labels so far, however, is information that can be checked by analysis of the product (e.g., cholesterol content). By contrast, what is sought on the label is the history of the product (what it was started from). One cannot report this history unless it has been traced from the beginning, so legislation that mandates tracking the production process from the beginning must be in place by then.
At this time it is possible to keep track of things. Work on embryonic stem cells is conducted mostly in small firms, funded by venture capital and concentrating on just one type of product The products and technologies can easily be identified. We can expect that after an active, marketable product is made, a Pfizer, Merck, or Eli Lilly will buy the start-up and incorporate it into its structure. The need to maximize the investment will require that the products and techniques of the acquired unit be used as much as possible throughout the company. A good scientist and a good lawyer might find that incorporation of some stem cell materials or techniques into an existing process with the patent close to expiration might lead to something eligible for a new patent and seventeen more years of exclusivity.
To use an analogy, there is a Talmudic injunction for Jewish people against using linen and wool in the same garment. That requirement is easy to fulfill when the manufacturer still has linen and wool as yarns on different spools. If the request is made after a fabrics mixing linen and wool have been woven, it becomes much hader to satisfy it.
References and Notes
[1]. H. Pearson, Nature, 2002, 418, 14.
[2]. StemCells Inc., Press Release, Palo Alto, Jan. 05, 2005; available at [email protected]
[3]. Cf. the typical slogan at pro abortion rallies: “Keep your rosaries out of my ovaries.” Also, the former New York Governor Mario Cuomo used to argue that legal abortion is needed to protect victims of rape or incest (without ever mentioning what percentage of abortion were in that class) and accused pro life advocates of lacking compassion
[4]. The test was conducted by the author at 11 churches on Long Island, NY, asking 10-12 persons in each place this specific question. About three quarters responded in the affirmative, unambiguously. The polling was unscientific, but is still informative.
[5]. The circulation was facilitated, without any recommendation (1995-2000), by the Secretariat for Pastoral and Social Concerns, Diocese of Pittsburgh, PA, Susan Rauscher, Director.
[6]. Pontifical Academy for Life: Moral Reflections on Vaccines Prepared from Cells Derived from Aborted Human Foetuses, 5 June 2005; available at: www.academiavita.or , under PAV Documents.
[7]. Robert Bolt, A Man for All Seasons, Act 2; Vintage Books, New York, 1962
[8]. Richard M. Weaver, Ideas have consequences, The University of Chicago Press, Chicago, 1948; reprinted, 1984, p. 10.
[9]. Health Minister Lord Hunt, in the House of Lords, Jan. 2001, in defense of the proposed modification of the Human Fertilization and Embryology Act of 1990 to allow for cloning of human embryos in the UK. The measure was later approved.
[10]. Rick Weiss, Washington Post, Aug. 23, 2000; p. A01
[11]. Dan Fărcaşiu, presentation to the Students for Life organization at St. John’s University, Jamaica, Queens, NY, Spring 2001.
[12]. Richard Spencer, Daily Telegraph (London), Dec. 20, 2005
[13]. Alan Paul, The Wall Street Journal, March 17, 2006.
[14]. One should go no farther than to Pope Paul VI, who used to wear a hair shirt under his clothes.
[15]. 1 Corinthians, 6, 19
[16]. At 11 churches where the author has directly participated in gathering signatures on the petitions after Masses, there were some people who stopped to argue from the utilitarian position, while others turned around and left. On the other hand, the existence of people who call themselves Catholics and “pro choice” is generally known.
[17]. Romans, 12, 1.
[18]. For example, in pronouncements to parish Respect Life coordinators in the Diocese of Rockville Centre, NY, by the diocesan Respect Life Office (Madelaine Willi and Mary Bossart, Co-Directors), before 2005.
[19]. President’s Council on Bioethics, White Paper: Alternative Sources of Pluripotent Stem Cells; Washington, D.C., May 2005: www.bioethics/gov/reports/white_paper/index/htm
[20] N. Strelchenko et al, Reproductive BioMedicine Online, 2004, 9 (6), 623, cited in Ref. [19].
[21]. Information gathered by Children of God for Life, Debra L. Vinnedge, Executive Director, and available at www.cogforlife.org
[22]. With minor local variations, the petition reads:
WHEREAS tissues procured through abortion are used for development of medicine by private companies and research on such materials is promoted by some U.S. states and foreign countries;
WHEREAS many people do not accept medical treatment or products developed in such ways for any purpose;
WE REQUEST that legislation be enacted to require a clear labeling of any pharmaceutical or consumer products, to identify conspicuously and legibly those which involved research or experimentation on human beings (excluding consent given by an adult for himself/herself) created naturally or artificially, at any point in their development from conception, or which used results and information from such experiments. Likewise, no import license should be granted if this requirement is not satisfied.
[23]. In a statement released after the submission of the original manuscript, the US Catholic Medical Association has also recommended labeling of vaccines derived from cell lines connected with acts of procured abortion: http://www.cathmed.org/publications/cma_vaccine_statement_may06.pdf
[24]. Long Island Coalition for Life, Life News, 32 (12) 5; www.ProLifeLI.org
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