[Paleopsych] CHE: The Thoughtful Distinction Between Embryo and Human

[Premise Checker]

The Thoughtful Distinction Between Embryo and Human
The Chronicle of Higher Education, 5.4.8
http://chronicle.com/weekly/v51/i31/31b01001.htm

    By MICHAEL S. GAZZANIGA

    Central to many of the bioethical issues of our time is the question,
    When should society confer moral status on an embryo? When should we
    call an embryo or a fetus one of us? The fertilized egg represents the
    starting point for the soon-to-be dividing entity that will grow into
    a fetus and finally into a baby. It is a given that a fertilized egg
    is the beginning of the life of an individual. It is also a given that
    it is not the beginning of life, since both the egg and the sperm,
    prior to uniting, represent life just as any living plant or creature
    represents life.

    Yet is it right to attribute the same moral status to that human
    embryo that one attributes to a newborn baby or, for that matter, to
    any living human? Bioethicists continue to wrestle with the question.
    The implications of determining the beginning of moral status are
    far-reaching, affecting abortion, in vitro fertilization, biomedical
    cloning, and stem-cell research. The rational world is waiting for
    resolution of this debate.

    This issue shows us how the field of neuroethics goes beyond that of
    classic bioethics. When ethical dilemmas involve the nervous system,
    either directly or indirectly, those trained in the field of
    neuroscience have something to say. They can peek under the lid, as it
    were, and help all of us to understand what the actual biological
    state is and is not. Is a brain present? Is it functioning in any
    meaningful way?

    Neuroscientists study the organ that makes us uniquely human -- the
    brain, that which enables a conscious life. They are constantly
    seeking knowledge about what areas of the brain sustain mental
    thought, parts of mental thought, or no thought. So at first glance,
    it might seem that neuroethicists could determine the moral status of
    an embryo or fetus based on the presence of the sort of biological
    material that can support mental life and the sort that cannot -- in
    other words, whether the embryo has a brain that functions at a level
    that supports mental activity. Modern brain science is prepared to
    answer this question, but while the neurobiology may be clear,
    neuroethics runs into problems when it tries to impose rational,
    scientific facts on moral and ethical issues.

    The fertilized egg is a clump of cells with no brain; the processes
    that begin to generate a nervous system do not begin until after the
    14th day. No sustainable or complex nervous system is in place until
    approximately six months of gestation.

    The fact that it is clear that a human brain isn't viable until Week
    23, and only then with the aid of modern medical support, seems to
    have no impact on the debate. This is where neuro "logic" loses out.
    Moral arguments get mixed in with biology, and the result is a stew of
    passions, beliefs, and stubborn, illogical opinion.

    Based on the specific question being asked, I myself have different
    answers about when moral status should be conferred on a fetus. For
    instance, regarding the use of embryos for biomedical research, I find
    the 14-day cutoff employed by researchers to be a completely
    acceptable practice. However, in judging a fetus "one of us," and
    granting it the moral and legal rights of a human being, I put the age
    much later, at 23 weeks, when life is sustainable and the fetus could,
    with a little help from a neonatal unit, survive and develop into a
    thinking human being with a normal brain. This is the same age at
    which the U.S. Supreme Court has ruled that the fetus becomes
    protected from abortion.

    Obviously there is a point of view that life begins at conception. The
    continuity argument is that a fertilized egg will go on to become a
    person and therefore deserves the rights of an individual because it
    is unquestionably where a particular individual's life begins. If one
    is not willing to parse the subsequent events of development, then
    this becomes one of those arguments you can't argue with. Either you
    believe it or you don't.

    While those who argue this point try to suggest that anyone who values
    the sanctity of human life must see things this way, the fact is that
    this just isn't so. This view comes, to a large extent, from the Roman
    Catholic Church, the American religious right, and even many atheists
    and agnostics. On the other side, Jews, Muslims, Hindus, many
    Christians, and other atheists and agnostics do not believe it.
    Certain Jews and Muslims believe that the embryo deserves to be
    assigned the moral status of a "human" after 40 days of development.
    Many Catholics believe the same, and many have written to me
    expressing those views based on their own reading of church history.

    When we examine the issue of brain death -- that is, when life ends
    -- it also begins to become clear that something else is at work here:
    our own brain's need to form beliefs. If we examine how a common set
    of accepted rational, scientific facts can lead to different moral
    judgments, we see the need to consider what factors influence these
    varying conclusions, and we can begin to extricate certain
    neuroethical issues from the arbitrary contexts in which they may
    initially have been considered.

    Different cultures view brain death differently. Brain death is
    declared medically when a patient is in an irreversible coma as a
    result of brain injury -- from a stroke, for example -- and has no
    brain-stem response, leading to a flat EEG (that is, no sign of brain
    activity on an electroencephalography recording), and no ability to
    breathe independently.

    A survey published in the journal Neurology in 2000 compared worldwide
    standards and regulations for declaring brain death. The concept of
    brain death is accepted worldwide: Even in the most religious
    societies, no one argues that human life continues to exist when the
    brain is irreversibly unable to function. What differs is the
    procedure for determining brain death. And these societal differences
    reveal how bioethical practices and laws can vary so wildly, for
    reasons that have nothing to do with science but instead are based on
    politics, religion, or, in most cases, the differing personal beliefs
    of a task force.

    For instance, China has no standards, while Hong Kong has well-defined
    criteria -- left over, no doubt, from its having been under British
    rule. The Republic of Georgia requires that a doctor with five years
    of neuroscience practice determine brain death; this is not so in
    Russia. Iran requires the greatest number of observations -- at 12,
    24, and 36 hours -- with three physicians; and in the United States,
    several states have adapted the Uniform Definition of Death Act,
    including New York and New Jersey, both of which have a
    religious-objections loophole.

    The example of brain death illustrates how rules and regulations on
    bioethical issues can be formed and influenced by beliefs that have
    nothing to do with the accepted scientific facts. No one debates that
    a line has been crossed when the loss of brain function is such that
    life ceases. What we differ on isn't even where that line should be
    drawn -- most countries have similar definitions of brain death. What
    differs is largely who makes the call and what tests are used
    -- differences, basically, in how you know when you get there, not
    where "there" is.

    So, too, we all seem to be in agreement that there must be a point at
    which moral status should be conferred on an embryo or fetus. However,
    we seem to have a harder time defining that point, regardless of the
    facts.

    Why? As Sir Bertrand Russell said, "In an instant of time, nothing
    exists." In other words, everything is the product of the interaction
    of atoms and molecules, so by definition, everything is a dynamic
    process. This raises the potentiality argument, the view that since an
    embryo or fetus could become an adult, it must always be granted
    equivalent moral status to a postnatal human being.

    During a discussion of stem-cell research that took place while I was
    serving on President Bush's bioethics council, I made an analogy
    comparing embryos created for stem-cell research to a Home Depot. You
    don't walk into a Home Depot and see 30 houses. You see materials that
    need architects, carpenters, electricians, and plumbers to create a
    house. An egg and a sperm are not a human. A fertilized embryo is not
    a human -- it needs a uterus, and at least six months of gestation and
    development, growth and neuron formation, and cell duplication to
    become a human. To give an embryo created for biomedical research the
    same status even as one created for in vitro fertilization, let alone
    one created naturally, is patently absurd. When a Home Depot burns
    down, the headline in the paper is not "30 Houses Burn Down." It is
    "Home Depot Burned Down."

    Many other compelling arguments about the course of the natural
    reproductive process should cause one to doubt that something magical
    happens at conception. It turns out that twinning commonly occurs in
    the first 14 days. One person becomes two persons. Even more bizarre,
    chimeras are formed. This happens when an egg that has split to form
    twins fuses back into one egg again. In such circumstances, it is hard
    to ascribe the sense of what is happening to the uniqueness of the
    "individual" or "soul" that is supposedly being formed at the instant
    of conception.

    The debate over the ethics of stem-cell research involves arguments
    that weigh the relative importance of relieving human suffering,
    freely conducting research, and protecting human embryos. The logic
    and thinking are complicated and often confused. For example, from my
    point of view, there is no conflict or weighing of goods between the
    embryo and stem-cell research. I assign no moral status to the
    14-day-old embryo. If I did, the weighing of goods would begin, and
    moral judgments would follow. One is quickly placed in the middle of
    well-known dilemmas posed by philosophers and ethicists alike. It
    comes down to the question, Is it a moral good to sacrifice one life
    if more lives will thereby be spared? Does the mother of five hiding
    from the Gestapo have the moral duty or right to smother the crying
    baby so the whole family will not be caught and shot?

    Current policy on stem-cell research is based on the attempt to weigh
    the value of a potential human life (in the case of biomedical
    cloning, an embryo created for biological research) against the value
    of the potential of research to save lives. This is a wrongheaded
    equation. For research on spare IVF embryos, as well as for embryos
    made for biomedical cloning, the need to harvest stem cells at 14 days
    raises the question of the moral status of the embryo. Both these
    cases raise another ethical factor to weigh, that of intention.

    Two kinds of embryos are used for human biomedical research: spare
    embryos from IVF procedures, and embryos created by "somatic cell
    nuclear transfer." In SCNT an egg is removed from a female, the DNA is
    removed from it, and a cell from another individual is placed into the
    egg and allowed to grow. The South Koreans have shown that this can
    work in humans. They let such an entity develop to 14 days and then
    harvested stem cells from it. If the entity had been reimplanted in a
    woman's uterus, it is possible a fully formed baby might have
    developed. This process was used to produce the cloned sheep Dolly.

    In biomedical research using SCNT, a cloned embryo is created in a
    petri dish for the purpose of harvesting stem cells for studies and,
    ultimately -- if research that has recently been thwarted is
    successful -- for use in the treatment of such diseases as
    Parkinson's. There is never an intention to create a human being. Does
    this clump of cells deserve the protections of a human being?
    Stem-cell researchers adhere to a cutoff of 14 days, before which they
    do not consider life to have begun. The embryo has not begun to
    develop a nervous system, the biological structure that sustains and
    interprets the world in order to generate, maintain, and modify the
    very concept of human dignity.

    An intention argument can also be made for spare embryos created from
    IVF. Parents undergoing fertility treatment may create many embryos,
    so as to ensure that one viable embryo takes hold when implanted. It
    is not the intention of the parents that every embryo created be a
    child. After natural sexual intercourse, an estimated 60 to 80 percent
    of all embryos generated through the union of egg and sperm
    spontaneously abort -- many without our knowledge. So if we use IVF to
    create embryos and then implant only a select few, aren't we doing
    what nature does? We have simply replaced nature's techniques with
    modern scientific techniques for selecting the strongest embryos.

    Do extrauterine embryos deserve the moral status of a human being? Do
    they even deserve to be considered the same as implanted embryos? I
    say not. It seems to me that the intentions of parents or donors to
    either create a human baby or not create a human baby must have some
    role in the potentiality argument. In other words, if we create cells
    for research purposes, and never intend to create a human, or if a
    parent creates embryos so that one can "take," do we have a moral
    responsibility to grow those other embryos into human beings? Of
    course not.

    Intention is an interesting ethical concept that we seem to understand
    intrinsically. We see it everywhere; save for cases of recklessness
    and negligence, intention is a clear marker of guilt in our legal
    system. Crimes are weighed, guilt is determined, and punishment is
    meted out based on intention: Charges of manslaughter and murder in
    the third, second, and first degrees are all determined by the level
    of intention of the killer. The same goes for determining whether
    crimes are misdemeanors or felonies.

    Is intention, which appears to be a guiding principle of ethics,
    hard-wired into our brains? Research on the "theory of mind" suggests
    that it is. In fact, intention may be one of the defining
    characteristics of the human species. A crucial part of being human is
    to have a theory about the intentions of others in relation to
    oneself. If I have a theory about how I relate to you and you to me, a
    huge part of it is based on what I view our intentions toward each
    other to be.

    Knowing this -- that our brains are wired to form intentions -- should
    become the context, then, for looking at any intention argument. While
    I happen to agree with the logic of the intention argument vis-à-vis
    stem-cell research, intention arguments are inherently nonsensical.
    When you think about the neuroscience, it is important to understand
    we are wired to form these personal beliefs -- these "theories of
    mind."

    When one has an intention about another person, or thing, or animal,
    it is a state of personal belief. The person or thing or animal sits
    separate and apart from that belief. Does a clump of cells take on a
    different character if I have no intention ever to let it develop?
    Does it take on a different character if I do intend to have it
    develop, say by reimplanting it into a woman's uterus? I think not. It
    is the same clump of cells no matter what my personal intentions are
    for it. The cells are what they are and should be evaluated on their
    own terms, not mine. This, ultimately, is why we should set aside our
    personal beliefs and accept that a clump of cells is decidedly not a
    human being. Your parents may have intended for you to become a
    doctor. Should you feel lessened by the fact that you became a
    professor instead?

    Clearly, I believe that a fertilized egg, a clump of cells with no
    brain, is hardly deserving of the same moral status we confer on the
    newborn child or the functioning adult. Mere possession of the genetic
    material for a future human being does not make a human being. The
    developing embryo that becomes a fetus that becomes a baby is the
    product of a dynamic interaction with its environment in the womb, its
    postnatal experiences, and a host of other factors. A purely genetic
    description of the human species does not describe a human being. A
    human being represents a whole other level of organization, as
    distinct from a simple embryo as an embryo is distinct from an egg and
    sperm. It is the dynamics between genes and environment that make a
    human being. Indeed, most of us are willing to grant this special
    status to a developing entity long before it is born, but surely not
    before the entity even has a brain.

    Fixing the beginning of life is a tricky issue that, like most, if not
    all, neuroethical issues, should depend on the context. There is not a
    single answer. My life and your life began at conception. But when my
    life began and when life begins are different questions. A 14-day-old
    embryo created for research is not, and should not be granted the
    moral status of, a human being. Embryos are not individuals. As a
    father, I may react to a sonogram image of a nine-week-old embryo and
    see a future child; as a neuroscientist, I know that that creature
    cannot survive outside the womb for another 14 weeks. In neuroethics,
    context is everything. And it is our brains that allow us to analyze,
    reason, form theories, and adapt to all contexts.

    Michael S. Gazzaniga is a professor of cognitive neuroscience and
    director of the Center for Cognitive Neuroscience at Dartmouth
    College. This essay is adapted from his book The Ethical Brain, to be
    published this month by Dana Press.