Transcript Stem Cells: What is Ethically Possible and What Does

Stem Cells:
Teaching the Ethical
Issues
Pluripotent Cells in a Pluralistic
Democracy
Ask yourself:
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What is a right act and what makes it so?
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A question in bioethics : is research on
human stem cells is a right act and what
makes it so?
Background-
Ethical problems in:
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Origins of cells moral status issues
Process and means human subject issues
Telos/ends social impact issues
Start with agreements in a
contentious time!
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We are at a crossroads in world history
Science research is like free speech
But some limits or guidelines are needed.
Science is always witnessed speech
Be careful—attend to safety concerns
Be good—do not take bribes
Do no harm—don’t deceive or hurt
Tell the truth
Try not to make errors
Controversial because History haunts
research
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Ethics of memory—our duty to remember
science misdeeds
Informed consent is what stands against
the power science and the state
Codes , norms and regulation protect
science
Controversial because it touches on
essential human concerns
Blood
 Sex
 Animals
 Power
 Fate
This is what is meant by “playing God’
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Controversial because issues also
engage Religious Thought
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Conception
Suffering
Healing
Death
Resurrection
A special American Challenge:
Moral Status
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We will not agree, for this is a religious
question with significant differences and a
history of dissent
We will not agree, for Americans historically
disagree about moral status issues
Pragmatism evolved from failure to find a
coherent ideology (no null position)
Moral status and other liminalities
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What is a slave?
What is an immigrant?
What is a woman?
What is a dying person?
What is a minimally conscious person?
Medicine always challenges and
reframes suffering
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Anesthesia introduced to controversy
Vaccines introduced to controversy
We really differ on some things
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Arguments against stem cell research
1. To destroy an embryo is murder
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Once the sperm and egg meet and form a
new DNA, the entire self has a blueprint
and a plan. Our bodies begin at the
moment that our DNA is assembled.
2. Dignity toward the most
vulnerable
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Our dignity requires this intactness is
identity. This moral status means that most
of all, destroying human embryos is always
wrong, but also that any deliberate
approach to the DNA of any creature is
wrong as well.
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Touching or changing the DNA alters the
essence of being and creation itself
3. Nature is fixed.
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Nature—human nature and the nature of
the green and living world—is fixed, for it
has borders that cannot be broached
without violation.
Species boundaries are particularly
important to keep intact.
4. Nature is normative
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Nature is normative, (meaning it suggests rules and
laws) and morally good, if left free
It will express itself in a primal harmony that our
use, and our machines, threatens.
There is an order to nature that is inherently wise
and self-correcting
Gaia theory, Natural Law
5.Suffering is the main thing that
defines our species
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Suffering and its noble acceptance is the
great teacher of our need and of our love.
Without suffering, we would become
soulless.
6. Slopes are slippery
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Very slippery—if we begin to create or use
a technology, there will be no way to stop it
from being used for ever larger and
progressively more trivial or common
purposes.
7. Dual Use is Inevitable
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Evil people will turn what you make for
good—even great good—into bad uses.
Such technology will give unprecedented
power which could enslave us.
The history of our species included
genocidal actions.
8. Mistakes are inevitable
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Mongoose in Hawaii, Sparrows in North
America, etc.
9. Playing God
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New technologies are really an effort to live
forever
Death defines us, and this technology is
intended to—and might—lead to
immortality.
10. You cannot trust scientists
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They lie (Korea)
They engage is false advertising (cold
fusion)
They exaggerate
In every science fiction story, they are
rather crazy
11.The Marketplace will distort science
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The mix of marketplace and science is troubling
The very success implied -widespread
applications—should alert us.
Even good scientists will be tempted by profits
promised by Big Pharma.
Conflicts of interest will alter the integrity of science
12. An Unfair World
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How will the goods created be distributed?
We should only be working on social
solutions not hi-tech ones
Classes of haves and have-nots will
worsen.
What can be said about these
challenges?
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3 things we know are true
1. All of these claims have some real
validity
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First, all of them are more than trivially correct, and
any sensible person could agree with many of these
statements.
Trouble begins here is their extremity when taken to
their logical conclusion. (yes, slopes are slippery,
but they are not impossibly slippery, just to give one
example)
3. All of these claims are faith based
All of these are profoundly religious statements.
They are statements of faith, world view and
eschatology, not of moral arguments.
As such, they will not—cannot—be entirely agreed
upon in a pluralistic democracy.
Like many faith claims in our world, they are
eschatological in nature
2. These claims create new political
alliances
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Second, not every one makes every claim;
some emerge politically from the left, some
from the right.
Argument I: Utilitarian
That the more we learn about this
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
The better able we are to relieve
human suffering
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
Argument II: We Have Duties
As in Kantian Moral Imperatives
As in Religious Commands
The ethical question of stem cell research
also is a deontological question
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If I have a duty to heal the suffering other,
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Is it warranted to block the moral action of
healing to avoid the destruction of a
blastocyst?
Northwestern University Feinberg School of
Medicine, Center for Bioethics, Science and
Society
They are long standing differences
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When does human life begin?
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Aristotle: when menstrual blood congeals -40
days
Judaism—40 d, quickening, showing, birth
Islam-when bones knit., 120 days
Buddhist—life like a flame
Hindu—developmental
Christian traditions until 1859- 40 days
. Which is most natural?
III. Which is most natural?
Major Ethical Problem
Moral
status
Duty to
Heal
Make to
destroy
Tx of
donors
nature
$$$
Secular
Judaism
x
Islam
x
x
Buddhist
justice
Hype
mistakes
Free
Inquiry
x
x
x
x
x
x
x
x
Hindu
Lib Prot
x
x
x
x
x
Fem/Sp
Ev Prot
x
x
R Cath
x
x
x
x
x
x
x
x
x
x
x
Moral Status
UnEnable
De
Novo
Like any
Other
Secular
x
x
Judaism
x
Islam
x
Buddh
Hindu
Hum
Life
Very
Small
person
Ev Prot
x
x
R Cath
x
x
Lib Prot
Fem/Sp
Other
Faiths
Spec
Entity
Has
Inheren
Dignity
x
x
x
x
x
x
x
x
x
Worthy
Of
Respec
Not
For $
x
x
x
No
gene
alter
Most
Vulner
Among
us
x
x
Justification
Expand
Human
Know
For
other
uses
Secular
x
x
Judaism
x
Islam
x
Buddh
Hindu
Unde
r
No
circ
Really!
not
Even
IVF
Ev Prot
x
x
R Cath
x
x
Lib Prot
Fem/Sp
For
Enhance
Heal
Via
Med
Res.
Heal
When
proven
x
x
x
x
x
x
x
x
x
Heal
Severe
diseas
e
To
save
life
x
x
x
Other
Wise
Fatal
Infan
t
x
x
What is the right act, what makes it
so? Some ways to figure it out?
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Utility—how it will turn out?
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Virtues—what it makes of us as a society?
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Duties –what have we promised to do?
Healing defines Humanity
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The teacher/ philosopher Emmanuel
Levinas gives an idea:
Our duty to one another is the constant
subject of a good life—in teaching, medical
research or science.
End with agreements in a
contentious time!
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

.
We are at a crossroads in world history
Science research is like free speech
But some limits or guidelines are needed.
Science is always witnessed speech
Be careful—attend to safety concerns
Be good—do not take bribes
Do no harm—don’t deceive or hurt
Tell the truth
Try not to make errors
But don’t forget disagreements are
important! Remember Socrates!
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Justice as foundational—Fair play, good
rules, foul lines
Observation of everything—test and watch
Public funding means public debate and
oversight
And TEACHING happens in the middle of
the public square
Thanks to:
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Northwestern University: John Kessler, Douglas Losordo,
Holly Falk-Krzesinski, Dean Grosshandler, Latonia Trimuel
Leroy Walters, Baruch Brody, Jon Moreno
Al Jonson, Karen Lebacqz, Mike Mendiola, Ernle Young, Ted
Peters
Suzanne Holland, Dena Davis, John Lantos, Shimon Glick,
Noam Zohar, Robert Gibbs, Elliott Dorff,
Roger Pederson, Ron McKay, Doug Melton, Len Zon, David
Anderson, Larry Goldstein, Irv Weisman, John Gearhart, Tom
Okarma, Seth Morrison, Stephen, Desidario, Brigid Hogan
Emmanuel Levinas