Bioethical debate is coming out of the deep freeze. The Clinton administration, reversing policies from the Reagan-Bush years, has moved to thaw federal funds for scientific research on living human embryos, inviting a blizzard of conservative protest.
How the new Republican Congress, the Clinton White House, and scientists resolve the dispute over embryo research may spell out the means of resolving future bioethical issues for years to come.
In addition, research on human embryos is developing as an important struggle in defining America's values. The right-to-life community forecasts a bleak future for the dignity of human life if embryo experimentation proceeds. Yet, embryo-research advocates envision breakthroughs in the treatment of a host of ailments if scientists are permitted to explore how human embryos grow and develop.
Harold Varmus, director of the National Institutes of Health (nih), says, "Advances [from embryo research] could spare enormous human suffering and help countless Americans." Embryo research could lead to improved treatment of genetic disorders, birth defects, infertility, and cancer.
However, Randall K. O'Bannon, director of research for the National Right to Life Educational Trust Fund, says, "We strongly oppose the recommendations of the NIH human embryo research panel, which claim that human embryo research is acceptable." He calls research on human embryos "irresponsible manipulation and destruction of human life [ignoring] the unique character of each individual human being."
For the prolife movement, this fight over federal funding of embryo research may become a decisive testing ground of their national strength. Prolifers are in a multifront battle, which involves fetal-tissue testing and physician-assisted suicide, as well as abortion and embryo research. (See "Christians Use Courts to Fight Assisted-Suicide Measure").
Until 1994, a ban on federal funding of human embryo research kept public debate of the issue on the back burner. A federal panel's vote to allow federal funds for such research suddenly turned up the heat on that debate.
The NIH committee has recommended federal funding of research on human embryos up to 14 days after fertilization. The recommendations, awaiting final approval by director Varmus, confine research to fertilized eggs that have never been implanted in a woman's uterus for procreation (known as "preimplantation ex utero" embryos). A common source of such embryos is the leftovers from medical clinics that harvest eggs from women, fertilize them with human sperm, and then introduce the embryos into women's wombs.
In early December, within hours of the committee's vote in favor of embryo research, President Clinton forestalled some criticism by ordering that no federal funds be spent on creating human embryos solely for use in research labs.
"I do not believe that federal funds should be used to support the creation of human embryos for research purposes," Clinton said. He also said he planned to establish a bioethics advisory commission to deliberate further on these issues.
The panel had recommended that, under limited circumstances, researchers should be able to "create" and discard embryos solely for research purposes, a recommendation that drew fire from liberals and conservatives alike.
White House Press Secretary Dee Dee Myers said the President's statement "should be interpreted very narrowly" and does not rule out research on spare embryos from in-vitro-fertilization (IVF) clinics, which the panel advocates.
STACKED PANEL? Embryo research opponents have taken their criticism beyond intellectual and moral arguments by alleging that the federal panel has been biased. Also, critics hope to shift the debate into Congress, where the new Republican majority could pose a formidable obstacle.
U.S. Representative Bob Dornan (R-Calif.) calls the embryo panel's recommendations "spooky and Frankensteinesque" and is spearheading a legislative effort to derail them. A September letter signed by Dornan and 27 other representatives urges the NIH's Varmus to reject the recommendations. Among the other signers are new House Speaker Newt Gingrich (R-Ga.), Henry Hyde (R-Ill.), and Chris Smith (R-N.J.).
Critics fault the makeup of the panel, pointing out that many of the members have received nih grants in the past and stand to gain from supporting federal funding for human-embryo research.
According to Judie Brown, president of the American Life League (all), 11 panel members received a total of $20 million in nih grants between 1987 and 1993. "Obviously, these panel members, cognizant of the nih's expressed desire to fund ivf and human-embryo research, and in the debt of the nih for a substantial amount of their income and career path recognition and advancement, would have their judgment colored by this considerable restraint on their independence."
Baptists for Life claims the panel violates the Federal Advisory Committee Act, which requires that panels be balanced and should not be inappropriately influenced by special interests.
Varmus, in a letter to Dornan and other representatives, insists "expertise and disciplinary balance were the principal criteria we used in selecting panel members." He says no disqualifying conflict-of-interest evidence has been discovered for any member. "No one was considered to have interests or relationships that would significantly affect … the member's duty to participate impartially."
Dornan is seeking congressional hearings on what he calls the unbalanced nature of the panel. "These people have set up a so-called ethics committee as watchdogs on themselves," Dornan says.
On a different front, the International Foundation for Genetic Research/Michael Fund of Pittsburgh, a pro-life genetic research agency, filed a lawsuit against Varmus, the 19 panel members, and Donna Shalala, secretary of the Department of Health and Human Services.
In spite of the public's resistance, federal funding of human embryo research of some kind in the United States may become irresistible, although some health-care professionals are deeply uncomfortable with it. Speaking for the 9,500-member Christian Medical and Dental Society (CMDS), executive director David Stevens says, "Our doctors adhere to the principles articulated in the Hippocratic oath to 'do no harm' to any human being—whether in the first few days of life or the last."
ILL-PREPARED OPPOSITION? Because there has been little public debate on the issue, few Christians have had to craft carefully their positions on the morality of embryo research.
Nigel Cameron, chair of the board of the Center for Bioethics and Human Dignity and a professor at Trinity Evangelical Divinity School, says that a preoccupation with the abortion debate has left many pro-life evangelicals ill prepared to engage in public debate over other biomedical ethics issues.
"Evangelicals in this country simply have not had the kind of serious interdisciplinary discussion they should have been having over the last ten years on these issues," Cameron says. "So we just respond in a sort of knee-jerk way."
Some of the early skirmishes in the fight over human-embryo research underscore Cameron's point. Steven Muller, president emeritus of Johns Hopkins University and chair of the 19-member federal panel that drafted the recommendations, says, "By a huge majority, the public has no idea what ex-utero or preimplantation human-embryo research means or what it involves. But it does, to most people, sound terrible."
Muller says the "extremely high level of public ignorance invites exploitation by those who for moral reasons object to human-embryo research in any form."
CMDS's Stevens says the panel's response to criticism demonstrates its "arrogance." He says, "The paramount issue here is the moral worth of the individual and the sanctity of human life—not technical knowledge about stages of human development."
Still, a lack of knowledge about embryo research may keep critics from being taken seriously. Among the 50,000 letters and postcards objecting to the embryo recommendations are 20,000 concerning fetal-tissue research, which the embryo panel's report does not address. (The term fetus typically applies to the developing child after the eighth week of growth.)
Panel member Ronald Green, director of the Ethics Institute at Dartmouth College, told the Washington Post that many of the letters he has received "contain gruesome depictions of the decapitation of midterm fetuses—and this has nothing whatsoever to do with what we're talking about."
OBJECTIONS TO RESEARCH:Whatever the level of preparedness, opposition to the panel's report has been vigorous and varied.
This winter, 26 scholars in ethics, theology, medicine, and law issued a statement saying the federal panel's argument "is morally repugnant, entails grave injustice to innocent human beings, and constitutes an assault upon the foundational ideas of human dignity and rights essential to a free and decent society.
"The recommendation, if adopted, will be a fateful step for humanity from which it may be impossible to turn back," continues the statement. Duke University ethicist Stanley Hauerwas, Harvard University law professor Mary Ann Glendon, Richard John Neuhaus of the Institute on Religion and Public Life, and David Singer of the American Jewish Committee were among those who signed the document, published in the journal "First Things."
In recent months, editorial writers around the country have vigorously debated embryo research. The Washington Post pointed out that one does not have to be against abortion to oppose the creation of embryos for research. "It is not necessary to be against abortion rights, or to believe human life literally begins at conception, to be deeply alarmed by the notion of scientists' purposely causing conceptions in a context entirely divorced from even the potential of reproduction." Other metropolitan dailies, including the "Chicago Tribune" and the "Chicago Sun-Times," have published editorials denouncing the panel's recommendations in their entirety.
Panel member Green, explaining the group's underlying assumptions, says the panel believes the preimplantation human embryo "merits respect as a developing form of human life."
"But we also concluded that the embryo's claims upon us are not so great as to outweigh those of infants, children, or adults who can suffer harm if research does not go forward within a framework of stringent guidelines."
CMDS's Stevens says, "These premises deny the innate worth and moral significance of each individual human life.
"According to the panel's reasoning, humanness is not inherent," Stevens says. "Rather, humanity is a status conferred by an elite governmental group, at some unspecified point in development."
A SLIPPERY SLOPE? Opponents compare the argument that human embryo research is justified because of its potential benefits to humanity to arguments for Nazi-era eugenic experimentation. "Doing good things does not justify wrong actions," says Stevens.
"Within the pages of [NIH] recommendations are plans that will allegedly eradicate genetic diseases, cancer, and the like from society by eliminating tiny, less-than-human fertilized eggs who are found to be flawed in any number of ways," says all's Brown. "In other words, the genetics of today is the eugenics of tomorrow."
A broad cross section of organizations has denounced human-embryo research, including the Family Research Council, Focus on the Family, Concerned Women for America, the Christian Coalition, American Family Association, and several pro-life Catholic, Jewish, and libertarian organizations. Research advocates assert that the embryo panel recommendations will not take medical ethics onto a slippery slope from which it cannot recover.
The panel rules out research on an embryo after it is 14 days old. After that, a so-called primitive streak appears. This streak is the first sign of the nervous system. Before this point, there is no neural tissue.
Yet, the panel leaves the door open to experimentation up to 18 days after fertilization in order to study the factors that control the closing of the neural tube and to determine whether the appearance of the primitive streak can be reliably identified.
The panel also rejects embryo cloning; the buying or selling of egg, sperm, and embryos; and research involving fertilization of immature eggs taken from aborted fetuses.
In arguing for federal support, proponents caution that ongoing private research on human embryos in the United States is not subject to scientific review or government regulation.
Brigid Hogan of Vanderbilt University and cochair of the committee told the New York Times, "A lot of it is being done by people who do not have a background in modern molecular genetics and developmental biology."
Some clinics advertise in college newspapers, offering women thousands of dollars to donate their eggs; many subjects are not fully informed of the potential health risks of taking fertility drugs that help them produce more than one egg at a time.
"If NIH funding could be allowed, the guidelines would set both the ethical and scientific tone for research in other places," Hogan says. Research on human embryos is allowed in Canada, Spain, Sweden, and the United Kingdom.
Among the groups that have voiced support for the proposals are the American Medical Association, the American Fertility Society, the American College of Obstetricians and Gynecologists, and the Society for the Advancement of Women's Health Research.
In 1994, the door to federal funding of human-embryo research was opened when Congress nullified a provision that required all proposed in vitro fertilization-related research to go through the Ethics Advisory Board (EAB). The board, created in the mid-1970s, has been inactive since 1980 when its charter lapsed. This inactivity resulted in a de facto ban on federal funding of ivf and embryo research.
Before its charter lapsed, the eab ruled in favor of IVF-related research, provided the research was designed primarily to improve methods of embryo transfer, the introduction of a preimplantation embryo into the uterus or fallopian tube, and to attain scientific information not reasonably attainable by other means. That report was never acted upon.
Copyright (c) 1995 CHRISTIANITY TODAY, Inc./CHRISTIANITY TODAYMagazine
