Making Sense of Bioethics: Column 022: Recapturing the Soul of Bioethics
Modern bioethics seems to be going through a kind of identity crisis. With ethicists available for hire, drug companies, biotech firms, and lawmakers have easy access to “experts” who can provide them with the veneer of respectability if they decide to head in the direction of unethical science. Erwin Chargaff, a pioneer in the field of biochemistry, once provocatively quipped that, “Bioethics didn't become an issue until ethics started being breached. Bioethics is an excuse to allow everything that is unethical.” Rather than examining and rejecting certain poor choices that may have been made in the past, and trying to regain lost ground, many “experts” and “authorities” today unwittingly continue to grease the slippery slopes by their hesitancy to disavow even the most egregiously unethical practices.
Today, for example, we see enormous pressure on the public to support embryo-destructive stem cell research. The embryos that are destroyed for stem cell research come from in vitro fertilization (IVF), a practice very few bioethicists have been willing to confront or challenge. IVF has become a kind of “sacred cow” that few outside the Catholic Church seem willing to question. Yet it requires only the most minimal ethical reflection to see how making “extra” embryos during IVF and freezing them is a grave moral problem. In the United States, we conspicuously face what has been termed the “wild west of infertility,” where few legal regulations of any kind exist and where nearly half a million frozen embryos have thus far become trapped in liquid nitrogen tanks in fertility clinics, with more being added each day. This generates a desire among scientists to “use” those embryos for research experiments. Here we find a perfect opportunity for some serious introspection about the mistakes of the past, a chance to limit some of the grave collateral damage that routinely occurs from IVF, by enacting regulatory legislation to forbid the production of extra embryos (as has been done, for example, in Italy and Germany). Yet one encounters very few bioethicists willing to step up to the plate to tackle such an unpopular topic.
In an environment of weakening ethics, researchers can be expected to push the envelope still further. Embryos to be destroyed for stem cell research can be obtained not only by IVF but also by the technique of cloning. In order to clone, however, you must start with a supply of women’s eggs. Currently, women can receive significant sums of money, even tens of thousands of dollars, to “donate” their eggs to infertile couples. However, if they donate their eggs to scientists, for purposes of research cloning, they generally cannot receive payment except for incidental costs like travel expenses to get to the clinic. An article in March of 2007 in the New England Journal of Medicine refers to the “central contradiction” of this situation:
…in the United States, we already allow women to ‘donate’ their eggs for profit. We allow them to undergo the same procedure and to undertake what is arguably a far more emotional endeavor — passing their genes to a child they will never know. How can we conclude that providing eggs for reproduction is less exploitative or dangerous than providing them for research? We can't.
A growing number of bioethicists are thus recommending that women be paid to harvest their eggs for research. A proper ethical analysis of this question, however, would mean promoting exactly the opposite position, namely, that women (and men) should never be paid for their eggs (or sperm), as we insist they not be paid for organ donations. This is done to prevent the human body from becoming “commodified” by powerful economic and market forces, and to stave off the prospect of trafficking in human parts. Paying women for their eggs is essentially a form of coercion, encouraging women to be reckless with their bodies. Donating eggs is never a risk-free proposal. Serious side effects can occur, ranging from respiratory distress to renal failure, and several women have died in recent years from the process of superovulation. Here again, we encounter a unique opportunity to insist on a thoroughly ethical approach for the future, by banning the sale of human sex cells and acknowledging that past practices have not been ethical. Yet few bioethicists seem willing to broach the topic.
Bioethics is an exceedingly important discipline for the future of our society, addressing critical issues in science and life. Such a discipline cannot afford to compromise its integrity as new controversies arise, selling its soul to the highest bidder or playing to powerful special-interest groups like universities or biotech companies. Only by rejecting the demands of expediency and courageously acknowledging past mistakes can it regain the kind of principled moral foundation and credibility it needs to effectively assist scientists, medical professionals, and the broader public in the future.
Copyright © 2020, The National Catholic Bioethics Center, Philadelphia, PA. All rights reserved.
