To read about F's and my London trip, start here and click "newer post" to continue the story.

Saturday, February 09, 2008

I'm posting here a comment that I made on the bioethics blog I've posted about before. The post I commented on was about using embryonic stem cells to research Huntington disease. The poster indicated that she thought President Bush objects to this research because he imagines that babies are being stuffed into test tubes. In a comment responding to me she says that this was hyperbole but she still thinks he doesn't understand the development of a blastocyst. I left this comment for approval but I'm posting it here too because it occurs to me that on my very own blog I've never spelled out my thinking about this issue.

Ricki, I'm not sure he is not aware of the extent of development of a blastocyst, either.

Many people, me included, consider that life - that is, human life worthy of respect and protection - begins at conception. To explain this as briefly as possible, when I wanted to reach a conclusion about this, I thought that I needed to find a bright line between life/not life. I can't see acknowledging that an individual is a living human but that his life is without value if his death would be convenient for another individual. Fetal development occurs on a continuum. If one picks out an event such as the heart beginning to beat, (a) it doesn't immediately start beating the way a mature heart does, and (b) different individuals will hit that milestone at different times; you can't say "X happens at Y weeks" and cover every individual. You can see this by looking at premature babies. Some born at 30 weeks aren't ready and can't be saved, others do very well and later have no averse effects. So the trimester divisions don't make much sense either if you're looking for life/not life or viability. Birth isn't really a bright line either, which was confirmed for me when my daughter was born 3 weeks before her due date. That would have been 3 weeks that she was a human, when if I hadn't gone into labor early she would have been an amorphous clump of cells (bit of hyperbole there.) But going back all the way to ova and sperm, each gamete has the potential to become an infinite variety of humans depending on which gamete it finds to join with; or nothing at all if conception doesn't happen to occur. Once conception occurs, a unique individual exists who did not exist before. So there is my bright line. Some people think implantation is the magic moment, which makes a certain amount of sense because it's known that many, perhaps most, embryos don't implant, so it looks like "nature" views them as throwaways. I see that but it's not compelling to me. So for me, conception is it.

The point is, you absolutely do not have to agree with me. I will not think you are stupid or misinformed if you do not. On the other hand, the fact that I have this view that most likely differs from yours doesn't make me stupid or misinformed. If I skimmed your article and thought, "she doesn't care about helping sick people, she just wants any excuse to keep abortion legal" I would be wronging you, for one thing, but also denying myself an opportunity to check my conclusions and make sure they are still valid; something we should all do from time to time.

Sometimes when I read things that bioethicists write I think that their function is to find a way to rationalize whatever a doctor or scientist wants to do. I'm sure that's not fair but it's how they come across sometimes.

I remember that several years ago a woman whose father had Parkinson's wanted to be inseminated by him so that there would be a fetus closely related to him for a fetal tissue implant. This was turned down. For those of us who object to the harvesting of fetuses for their tissue on principle, it's a no-brainer anyway. For those who don't, it's hard to see what the objection is except that it seems icky. You bet it is, it's icky as hell, and it's the next logical step if we dehumanize unborn humans to this extent. One isn't supposed to say "nazi" because it's an overused cliche. So I'll mention the Japanese "doctors" who experimented on American POWs during WWII: to find out how much blood loss they could endure if it was replaced with seawater, for instance, or how much of their livers could be removed without killing them. Dehumanizing these people in the interest of learning things. What's the point in doing medical research, if people's lives don't matter anyway?

I think some people are distracted by the fact that the ESC and fetal tissue experiments are carried out in nice, clean labs by people with advanced degrees who wear white lab coats. How can you connect experiments on POWs with this? How can you extrapolate from attempts to research disease, to doctors like Mengele? Going back to what I posted earlier about "To Build a Fire", maybe this points out the importance of imagination, without which one can't see the big picture. You can't put blinders on and focus only on the need to do something about a specific disease without counting the cost. You can't look at what is happening in one isolated lab in 2008. You have to look at these things in the context of how they have been done before (i.e. what humans are capable of, which is why those of us who contemplate this weren't shocked by that woman who wanted to conceive her father's child) and therefore what they could lead to without meaningful regulations and guidelines. This is the only difference between doctors in Germany and Japan in the last century, and doctors here today. To be clear about what I'm saying here: all doctors in Germany and Japan were not engaged in these horrific things. Only a few were. But there's nothing, no "bright line", to really say that German or Japanese doctors in the 1940's were qualitatively different from doctors now to the extent that everything our doctors want to do is automatically ethical and defensible. You can't assume that intelligence and an advanced degree imply a well-developed conscience or that each individual researcher fully understands that "we can" does not imply "we should".

So these are my thoughts. As always, feel free to disagree.

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