July 13, 2009
Who's an Embryo? St. Francis of Genomia at the NIH
Those who follow Big Lizards religiously (have you all put on your phylacteries before reading?) know that we're big on Dr. Francis Collins, M.D., Ph.D., the evangelical Christian who headed up the Human Genome Project -- and especially on his book the Language of God: A Scientist Presents Evidence for Belief. In fact, we've spoken in favor of his ideas (and highly recommended his book) in the following Lizardian posts, from the oldest (August 28th, 2006) to today:
- Jury Nullification Or Nullifying the Jury?
- I appear to have become a Nazi...
- Expelled: No Intelligence Offered - part 1 (Win Ben Stein's Monkey Trial!)
- Expelled: No Intelligence Offered - part 2 (Ben in the Dock)
- The Nuclear Winter of Conservative Discontent
- The Membrane Connecting Science, Morality, and Aesthetics - More Thoughts
- Who's an Embryo? St. Francis of Genomia at the NIH
But who is Francis Collins? This post is going to be long, so I'll tuck the rest away behind the Slither on...
Collins' main thrust in his first book (he is secretive about the subject of his second, but he had to resign from his government position at the National Institutes of Health -- NIH -- to write it) is that there is no essential conflict between Christian faith and evolution by natural selection (hence, "evolutionary biology"). Collins uses the term "BioLogos" for the particular branch of theistic evolution he supports, the "wind up the universe and let it run" thesis: God created the universe and all its physical laws and constants, set the initial conditions, and then allowed it to evolve naturally.
Being omniscient and omnipotent, God deliberately set everything up so that moral human beings (and perhaps other sentient, moral creatures elsewhere) would eventually evolve; so in that sense, you could call it a version of creationism. But it's quite distinct from the Biblical creationism that ruled the creationist roost until a series of legal setbacks in the 1980s, and also from "Intelligent Design," the current method of back-dooring creationism into the public schools by not using certain words -- e.g., "God," "Lord," "Creator" -- and using code words instead ("Designer"): BioLogos requires no direct intervention or manipulation, no "fine tuning," to run its course; in Collins' view, God got it right at the first time and doesn't need mid-course corrections.
So it likely comes as no surprise that we soundly applaud, and even jump up and cheer a bit (in a dignified way, you understand), President Barack H. Obama's announcement last Wednesday appointing Collins to head up the NIH, subject to Senate confirmation. This will put Collins in control (along with the Advisory Committee to the Director) of all federal funding for medical, biomedical, and health-care research, both direct -- "intramural research" at the NIH's main campus in Bethesda, MD -- and indirect, by funding "extramural research" conducted by private universities, hospitals, and other medical research facilities outside government.
I myself am also unsurprised that some more absolutist members of the evangelical community are upset by the appointment; they fret that he will not be as -- all right, I'll say it -- not as doctrinaire as they themselves would be, particularly regarding stem-cell research:
President Obama's nomination of Francis Collins to be director of the National Institutes of Health has resulted in pro-life advocates expressing concerns about the views regarding unborn life held by the world-renowned scientist and evangelical Christian....
In announcing his intention to nominate Collins, the president described him as "one of the top scientists in the world," adding "his groundbreaking work has changed the very ways we consider our health and examine disease...."
Since Obama announced Collins' nomination July 8, some evangelical and pro-life spokesmen have taken issue with the nominee's comments about embryonic stem cell research and cloning.
A Southern Baptist philosophy professor at Union University said Collins needs to make his views clear before he takes over as director of the National Institutes of Health (NIH), which oversees federal funding of embryonic stem cell research (ESCR). Extraction of stem cells from an embryo requires the destruction of a tiny human being less than a week old.
Whoa, stop right there; that is not, strictly speaking, true, as we have discussed here. There is already a procedure for extracting stem cells from human embryos non-destructively, utilizing the same procedure used in preimplantation genetic diagnosis (PGD) to extract cells from living embryos to test for various genetic diseases... extractions that leave the embryo intact and still growing normally.
Besides non-destructive ESCR, there are also other types of stem cells, of course; they can be found in somatic (bodily) cells of various types: uterine cells, placental cells, amneotic fluid cells, testicular cells, dental cells, mammary cells, and so forth. Many of these latter have already been used extensively in medical therapies; embryonic stem cells have barely been used so far, but they still show tremendous promise.
President George W. Bush had issued an executive order (EO 13435) on June 20, 2007 that specifically funded:
[R]esearch on the isolation, derivation, production, and testing of stem cells that are capable of producing all or almost all of the cell types of the developing body and may result in improved understanding of or treatments for diseases and other adverse health conditions, but are derived without creating a human embryo for research purposes or destroying, discarding, or subjecting to harm a human embryo or fetus.
We posted on that, too... in a post noting that one of Obama's earliest EOs (March 9th) after assuming office was to revoke EO 12435, killing the requirement to fund non-destructive stem-cell research, even as he lifted the federal-funding ban on destructive ESCR. (Anything you need to know, you can learn from Big Lizards.) The natural conclusion most drew was that Obama supported destructive ESCR and was uninterested in or even hostile to non-destructive stem-cell research, either embryonic or somatic... both of which positions comport with his ultra-liberal base.
Federal stem-cell research funding policy is still governed by President Obama's EO 13505, according to the NIH website; I doubt that NIH's "final regulations," issued last Monday, July 6th, 2009, differ from this, since federal agencies are bound by relevant executive orders.
But it's important to note that Obama did not order a ban on future funding of non-destructive stem-cell research; he just revoked Bush's EO that ordered NIH to actively seek out opportunities to fund such research. Bush asked NIH to conduct research in non-destructive stem-cell therapies; but it seems Obama would not particularly care if all that research withered on the vine.
(There is also a federal law, the Dickey-Wicker Amendment, preventing NIH or any other federal agency from directly funding the killing of embryos to create new lines. But once such lines are created privately, under Obama's EO 13505, they are fair game for federal funding.)
Still and all, the technique for non-destructive ESCR, somatic cell nucleus transfer, exists; it simply is not necessarily federally funded, now that the Obamacle presides. So the statement in the Townhall.com article above is at a mimum misleading, and might even be called fraudulent -- unless it "stems" from simple ignorance, which itself is not very reassuring. But we continue with the attack on Collins:
Collins was mistaken or misleading in comments about Obama's position on federally funded embryonic stem cell research, said Justin Barnard, associate professor of philosophy and director of the Carl F.H. Henry Institute for Intellectual Discipleship at Union University in Jackson, Tenn.
At Obama's direction, NIH issued final regulations July 6 governing federal funding of stem cell research. In a May interview Collins said Obama's position "is not very radical" because Obama basically said "what Bush said in August of 2001" when the former president announced his policy. But that is not the case, Barnard says. The new NIH guidelines allow research not only on lines that were in existence when Obama made his announcement but new stem cell lines, Barnard wrote in a July 13 commentary for Public Discourse. Obama's position in fact is a "dramatic shift" from Bush's, Barnard said.
In these and other comments, Collins "is less than clear" regarding "the metaphysics and moral value of human life," Barnard wrote.
Perry Mason for the defense...
"Less than clear" is a term that can be equally applied to Barnard's attack: Is he saying that Collins supports the creation of new stem-cell lines from existing human embryos, or from other kinds of stem cells? And even if the former, does he mean embryos created for the purpose of research -- or embryos that were already created for reproductive purposes (in vitrio fertilization), remain unused, and are already slated to be destroyed? Barnard's deliberately vague wording leaves his accusation a complete muddle.
He does make one charge very explicitly in his Public Discourse article. First, a little background from Collins himself, quoted by Barnard:
Basically, what the president’s executive order said and what the NIH in its draft guidelines has now made more clear is that federal funds will be allowable, assuming these draft guidelines get finalized, for stem cell lines that were developed from leftover embryos from in vitro fertilization clinics. And in a way, this is not very radical because that’s what Bush said in August of 2001 when he became the first president to authorize federal funds for embryonic stem cell research. Remember, it wasn’t allowed at all before his statement. But he said only lines that were developed before 9 p.m. on Aug. 9, 2001, could be used, which obviously seems like a bit of an arbitrary deadline.
Now Obama is saying, what about the 700 lines that have been developed since then, which are actually scientifically more useful? The early lines had problems. These new lines will now be allowed as well. Remember, though, that just means the funds will be allowed for the study of those lines, not for creating new ones. That is prevented by the Dickey-Wicker amendment, which people expect will probably remain there unless Congress decides to take it away. My bet is that they probably won’t, and I’m not sure that it’s necessary for them to do so in terms of supporting research. The use of private funds to develop new lines might be sufficient.
Barnard then pounces, flattening a very difficult, complex question into an easy soundbite of utter moral certitude, an "eternal verity":
Collins’s comments here are remarkable on several different levels. To begin, it is unclear whether Collins has any moral qualms about the wanton destruction of innocent human life given his apparent optimism about the sufficiency of private funds for the doing the federal government’s dirty work. [There's that weasel-word "unclear" again! -- the Mgt.] But even if one supposes that he’s not happy about it, his analysis of the difference between the Bush administration policy and the new Obama guidelines is mistaken at best, misleading at worst. For the August 9, 2001 deadline under the Bush administration was imposed precisely to take away the incentive for private entities to engage in more embryo destruction. Of course, as Collins’s remarks make clear, this did not prevent private entities from doing so. And apparently, they did so at least 700 times. (Of course, who knows how many embryos it actually took to get the 700 lines to which Collins refers!) And if the Obama guidelines were written so as to allow funding for these 700 lines and only these 700 lines, they would, in that respect, be similar to the Bush guidelines. But the new Obama guidelines do not limit the use of NIH funds exclusively to these existing, additional 700 lines.
Knowing this, Collins chose his words carefully when he said, “Remember, though, that just means the funds will be allowed for the study of those lines, not for creating new ones.” By the letter of the law, what Collins here claims is true. The new NIH guidelines do not permit the use of federal funds for creating new human embryonic stem cell lines. This is because, as Collins points out, such activity is prohibited by the Dickey amendment. Moreover, the guidelines do allow for the study of those 700 lines that have been produced since August 9, 2001. What Collins does not say, however, is that the new NIH guidelines also allow for federal funds to be used in studying new human embryonic stem cell lines that are created (by private entities, of course) beyond the 700 currently in existence. This represents a dramatic shift in policy from the previous Bush administration regulations. And Collins is doing nothing more than engaging in rhetorical subterfuge to suggest otherwise.
Collins in the dock...
This really boils down to one philosophical question: Do we admit the reality that:
- In vitrio fertilization will continue
- Excess embryos (beyond those that are implanted in a womb) will continue to be created, and
- Those excess embryos will either be destroyed outright or frozen in suspended animation for eternity (or until someone pulls the plug)?
If so, then neither Obama's EO or the new NIH policy provides an "incentive" to create embryos for purposes of research; the incentive already exists (via fertility therapy) to create far more embryos than could ever safely be implanted, and far more than could ever be used in research anyway -- a point that Barnard himself glosses over. (Just as he imputes pejorative motives and moral beliefs to Collins that Barnard could not possibly know unless he's a telepath.) The embryos are there and will continue to be there, with or without federal funding.
If we accept that such lines will be created willy nilly, entirely privately -- as Barnard himself admits -- then the only question is whether we allow federal funding to research those new lines... or only to research the old, degraded lines created the exact same way, but prior to 9 PM, August 8th, 2001.
This is certainly not the black-and-white issue that Barnard pretends; it's both more nuanced and more profound. But Barnard demands utter conformity to the most restrictive possible moral interpretation, or he launches a crusade against the heretic.
He has chosen his target well. Barnard knows that such high-level, future funding decisions are generally made by the Director of the NIH in conjunction with his Advisory Council; and he knows that director is going to be Francis Collins; there is no serious senatorial opposition to the appointment.
So what are Collins' thoughts on ESCR -- destructive and non-destructive -- and other kinds of stem-cell research? Fortunately, we have the answer to that question in his own words, from a series of interviews he gave, excerpts of which have been collated by a Christian blog.
First, on the precise moral question above, from an interview in Salon (the interviewer's questions are in blue):
Geneticists are sometimes accused of "playing God," especially when it comes to genetic engineering. And there are various thorny bioethical issues. What's your position on stem cell research?
Stem cells have been discussed for 10 years, and yet I fear that much of that discussion has been more heat than light. First of all, I believe that the product of a sperm and an egg, which is the first cell that goes on to develop a human being, deserves considerable moral consequences. This is an entity that ultimately becomes a human. So I would be opposed to the idea of creating embryos by mixing sperm and eggs together and then experimenting on the outcome of that, purely to understand research questions. On the other hand, there are hundreds of thousands of such embryos in freezers at in vitro fertilization clinics. In the process of in vitro fertilization, you almost invariably end up with more embryos than you can reimplant safely. The plausibility of those ever being reimplanted in the future -- more than a few of them -- is extremely low. Is it more ethical to leave them in those freezers forever or throw them away? Or is it more ethical to come up with some sort of use for those embryos that could help people? I think that's not been widely discussed.
So your position is that they should be used for research if they already exist and they're never going to be used to create a human life?
I think that's the more ethical stance. And I say this as a private citizen and not as a representative of the U.S. government, even though I'm employed by the federal government at the National Institutes of Health. Now let me say, there's another aspect of this topic that I think is even more confusing -- a different approach which is more promising medically. It's this thing called somatic cell nuclear transfer, which is where you take a cell from a living person -- a skin cell, for instance. You take out its nucleus, which is where the DNA is, and you insert that nucleus into the environment of an egg cell, which has lost its nucleus. Now think about this. We have a skin cell, and we have an egg cell with no nucleus. Neither of those would be things that anybody would argue has moral status. Then you give a zap of electricity and you wait a couple of days. And that environment convinces that skin cell that it can go back in time and it can become anything it wants to be. That is an enormously powerful opportunity because the cell would then be received by that same person who happened to need, say, neurons for their Parkinson's disease or pancreas cells for their diabetes without a transplant rejection.
Isn't this the process that is otherwise known as cloning?
Yeah, it's called cloning, which is a very unfortunate term because it conjures up the idea that you're trying to create a copy of that human being. And at this point, you're doing nothing of the sort. You're trying to create a cell line that could be used to substitute for something that a person desperately needs. It would only become a cloned person if you then intentionally decided to take those cells and reimplant them in the uterus of a recipient woman. And that, obviously, is something that we should not and must not and probably should legislate against. But until you get to that point, it's not clear to me that you're dealing with something that deserves to be called an embryo or deserves to be given moral status.
Let an urgent point not be forgot...
This is a much more sophisticated response than Barnard's; Barnard wants to anwers this... but the only way he can do so is to deny there is any moral distinction between the union of a human egg and human sperm -- and the union of a denucleated human egg and a human skin-cell nucleus.
His thesis appears to be that anything that could conceivably grow into a human being -- even if that would require future intervention by doctors, and even if it has never been demonstrated in the lab yet -- is a human being. But of course, once egg and skin-cell nucleus are combined but before electricity is added, I can still say it "could conceivably grow into a human being"... assuming "future intervention by doctors," including the spark. Does that mean such a union is already a human being?
In fact, I can still say the same after two cells have been extracted but before they are combined. This oddball definition not only entirely removes the necessity of sperm, its structure disturbingly reminds me of Roe v. Wade's test of whether a foetus can survive outside the womb: In both cases, the test of human personhood depends upon the state of medical technology du jour:
Nobody ever has cloned a human being; we don't even know if it would ever be possible to grow such a "cloned" embryo into a human.
- So if we're not actually able to clone human beings in 2009, then a cell created by somatic cell nucleus transfer is not a human person by Barnard's thesis.
- But if ten years later, we are able to clone humans, then those same, exact cells from 2009 magically transmaugrify into human beings by 2019 -- even though they are utterly identical in every respect to what they were ten years ago, having been kept on ice all that time.
(If an old growth spotted owl leaves its old-growth tree, flies a few feet away, and nests in a young tree, it becomes a member of a whole new species!)
I'm with Collins on this: I consider such a definition preposterous and unscientific. We must have a definition of "human person" that doesn't change with every advance in medical science, one that seeks a deeper element of humanity than superficial morphological characteristics -- what I refer to as a "movable verity," rather than an "eternal verity," because it's robust enough to remain consistent even as technology changes around it.
When, for example, does the soul enter a human body?
- If you believe that occurs sometime after conception, then is the developing embryo still a human being even before being ensouled?
- And even if you believe that occurs "precisely" at conception, then when "precisely" do you define conception itself to have taken place? (a) When the soon-to-be successful sperm starts to penetrate the egg's cellular wall? (b) When it works its way fully inside the egg? (c) When it contacts the egg nucleus? (d) When it combines chemically? Or (e) when it first divides into a blastocyst? Conception is a continuum, like everything else in biology -- conception, gestation, birth, and even death.
- Finally, no matter how one defines conception in the normal circumstance -- does the soul also enter into a cloned cell at the moment of transfering the nucelus of a non-sperm cell into the egg, even though no combining of DNA occurs?
- Does it occur after the electrical charge is applied?
- Or does it not occur at all, since there is no bisexual reproduction taking place in any event?
Is a human body a person, absent a soul?
These are not easy questions; but without answering them, we cannot decide "who's an embryo" -- and what isn't.
Shouldn't we then, just for safety's sake, accept the Barnard thesis that anything that could conceivably grow into a human is therefore automatically a human person from the moment of its creation, no matter how? Shouldn't that be the default presumption?
Not necessarily... because such a presumption is not cost-free in the realm of human life. Making that presumption will inevitably kill people -- people already living, breathing, thinking, and feeling.
Collins understands, as Barnard gives no evidence of understanding, that ESCR comprises more than just the rights of human embryos; it also includes the rights of those already born and suffering, even dying, from potentially curable diseases. As often happens in law, the two rights must be weighed against each other in individual cases and a just decision reached. From part 2 of an interview of Collins for a PBS television show titled Think Tank:
So I think one thing we ought to do is, sort of, tone down the rhetoric and try to get our scientific facts straight. So stem cells-- there's lots of different kinds of stem cells. The kind that I think many people are most concerned about are the ones that are derived from a human embryo which is produced by a sperm and an egg coming together. The way you and I got here.
There are hundreds of thousands of those embryos currently frozen away in in vitro fertilization clinics. And it is absolutely unrealistic to imagine that anything will happen to those other than they're eventually getting discarded. So as much as I think human embryos deserve moral status, it is hard to see why it's more ethical to throw them away than to take some that are destined for discarding and do something that might help somebody.
Reality and the limits of dogma...
Morality is never a lightswitch; it's never either all-the-way on or all-the-way off. Morality always exists on a continuum, because human life and the human condition exist on a continuum (recall my example of conception above). That's why each case must be judged individually -- under general guidelines.
(It's a terrible and dangerous error to try to write too much specificity into a guideline; that's how you end up with "zero tolerance" drug laws that expel a girl from high school for taking Mydol for her menstrual cramps.)
Even if one believes that a human zygote (fertilized egg) is a human being, not even the most ardent pro-lifer argues that a zygote can feel the pain of its own destruction; that capacity clearly comes much later in ontogeny. But a person suffering from Cystic Fibrosis certainly does feel the pain as that disease destroys him by inches until he finally dies an agonizing, suffocating death. Is it black-and-white that each zygote is morally equal, on a one-to-one basis, to every already-born person?
I see a whopping huge moral distinction between killing a zygote to save a teenager -- and killing a newborn baby to save that same teenager. Perhaps it's just sentimentality; but sentiment is as much a part of humanity as rigorous logic. Sentimentally, I attach far more value to a newborn, or even to a seven month old foetus, than to a human zygote... let alone to a cell produced by somatic cell nucleus transfer, a.k.a. "therapeutic cloning."
Professor Justin Barnard sees no moral distinction whatsoever. Early in his Public Discourse article, he refers to the destruction of human embryos as "the wanton destruction of innocent human life;" then towards the end, he adds the following tendentious codicil:
[T]he embryo produced by cloning enjoys the same moral status, whatever one judges that to be, as the embryo produced the old-fashioned way.
Since we know what Barnard "judges that to be," he must see no moral distinction at all between a skin-cell nucleus stuck into a denucleated egg cell and given a spark of electricity -- and a teenager dying of CF.
I consider that position vile and thuggish if he holds it merely for political purposes, and monstrous if he holds it honestly. (A lack of hypocrisy doesn't necessarily ameliorate a grotesque idea; I'm sure that many advocates of eugenics were quite sincere in wanting to eliminate inferior humans.)
But why can't we just use the stem-cell lines for which even George W. Bush approved federal funding, those generated before 9 PM, August 9th, 2001? Simple: Because they are old, degraded, and no longer work very well. In the interview linked above, Ben Wattenberg asks whether Collins agrees with the Bush decision to restrict federal funding for ESCR to those lines that already existed. Collins responds:
But as a scientist -- I would say we are currently not making as much progress as we could if we had access to more of these stem cell lines. The ones that are currently available for federal funding is a very limited set and they clearly have flaws that make them hard to use. But you know what? I think that kind of stem cell research is actually not the part that's going to be most interesting.
The part that's really showing the most promise is to take a skin cell from you or me and convince that cell, which has the complete genome, to go back in time and become capable of making a liver cell or a brain cell or a blood -- cell if you need it to. That reprogramming. That's called somatic cell nuclear transfer in the current mode. And yet people still refer to those products as an embryo. Well, there's no sperm and egg involved here.
And that's where I think we've really gotten muddled. That the distinction between these various types of biology has been all murkified. And people are beginning to argue in very irrational ways based on a lack of understanding what the science says. If we could back off from all of the, sort of, hard edged rhetoric and really say, okay, what is science teaching us, I suspect that the moral dilemmas are not nearly as rough as people think they are.
Finally, I think this response in a third interview for Christianity Today sums up and clarifies Collins' beliefs (which Barnard claims are "less than clear"), not only as to ESCR but human cloning as well (see p. 5):
[E]ven if the safety issues were solved, would human reproductive cloning be an acceptable practice? It wouldn't be for me. I believe that human beings have come into this world by having a mother and a father. To undertake a different pathway of creating a human being is a profound departure from the normal state of things. I have yet to hear a compelling argument for why we need to do that.
It is a classic example of a collision between two very important principles. One is the sanctity of human life and the other is our strong mandate as human beings to alleviate suffering and to treat terrible diseases like diabetes, Parkinson's, and spinal-cord injury. The very promising embryonic stem-cell research might potentially provide remarkable cures for those disorders. We don't know that, but it might. And at the same time, many people feel, I think justifiably, this type of research is taking liberties with the notion of the sanctity of human life, by manipulating cells derived from a human embryo.
It's rare that we get a presidential nominee to an important scientific (or legal) position who has thought as deeply and consistently about the great moral dilemmas as Francis Collins has. It's even rarer that after such thought, he remains so close to what I would call the best conservative principles of individualism, respect for human life and dignity, and ethical scientific inquiry. (And it's especially dumbfounding that a president who would call himself "the One We Have Been Waiting For" would make such an appointment. One would think that the One would be more apt to attempt to use somatic cell nucleus transfer to appoint an exact clone of himself to head up NIH.)
But for heaven's sake, let's grab this one while we can. Let's not make a big stink just because Francis Collins' evangelical Christian position on stem cells is an angstrom apart from that of the most dogmatic true believer, such as Professor Barnard. For God's sake, Obama could have named Peter Singer!
Collins is an amazingly good choice for NIH Director. He will be sensitive to human-life issues, a strong advocate for scientific inquiry, and not only not hostile to, but actually embracing of issues of faith, religion, and morals in federal funding of biomedical and health-care research.
Cross-posted in Hot Air's rogues' gallery...
Hatched by Dafydd on this day, July 13, 2009, at the time of 10:02 PM
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