Christmas and Medical Ethics (December 2004)

The conception of Jesus Christ

The early Christians were marked out for their opposition to abortion. They respected foetal life in a Roman world that saw little wrong with the practice. That respect has been dominant in the West until recently. Fundamental to this Christian understanding of life in the womb has been the accounts of Jesus' birth. From these it is clear that the incarnation (his coming in the flesh as a real man) began not with Christmas, but with his conception. As we say in the Creed: "He was conceived ... ."

Jesus reveals true man as well as true God. The inescapable conclusion, then, is that life in the womb is human from conception and so worthy of respect and protection from conception. What is in the womb is not blob of tissue but a human being - as Jesus was a human being in the womb of Mary. True, it is an embryonic human being and not an adolescent, adult or senile human being. But protection is demanded because here is the beginning of a creation that is in God's image. The primeval biblical prohibition against killing was based on humans, alone of the animal kingdom, being "in the image of God" (Genesis 9.6). Also the Bible teaches that human life is "given". It is not "achieved" by reaching certain standards of skill or competence. Our God is a "giver" - a God of grace. Job said, when bereaved, "The Lord gave and the Lord has taken away" (Job 1.21).

But in today's world many are denying just that. They are saying that "achievements", in terms of physical, psychological and mental development determine what it means to be "human". This, of course, is the route taken by the Nazis in the first half of the 20th century. It gave rise to their eugenics, experimentations and, of course, the holocaust. However, the eventual horror of it all, by the end of the Second World War, then gave rise to a rediscovery of a sense of natural law - namely that some things are so immoral there can be no arguments for them. Such an ethical consciousness is hinted at in Romans 2.14-15. And Christians were in the fore in this rediscovery which then gave rise to the UN Declaration of Human Rights in 1948 and, very significantly, the Medical Code of Ethics, the Declaration of Geneva, from the second General Assembly of the World Medical Association in 1948. This required the new doctor to say:

"I solemnly pledge myself to consecrate my life to the service of humanity ... I will practise my profession with conscience and dignity; the health and life of my patient will be my first consideration ... I will maintain the utmost respect for human life, from the time of its conception, even under threat. I will not use my medical knowledge contrary to the laws of humanity."

But that has all now changed - witness the issue for us in Newcastle. This came to a head with the licensing by the Human Fertilization and Embryology Authority (HFEA) earlier this year for scientists at Newcastle's Centre for Life to carry out "therapeutic cloning". This was only the second official cloning project in the world. Last month (November 2004), however, a legal challenge was raised to the granting of the licence. But a number of business people want the challenge to fail as the project is hailed as "the key building block for the future of the regional economy". Others are offering hopes of miracle cures. But these are not yet in sight. Critics say these offers of hope are being used as "emotional manipulation".

The beginning of life

The heart of the ethical debate over embryo research and cloning relates to whether conception is the beginning of life or not. This debate has led people to reject the Geneva Declaration of 1948. This is due, I suggest, to regression from a Christian world view (in Europe in particular) and liberal churchmen in high places who seem to prefer the world's ethic to a biblical ethic. It was noticeable that the chairman of the House of Lords Select Committee on Stem Cell research was the Bishop of Oxford, Richard Harries known for his liberalism on human sexuality. He argued in the debate in the Lords in 2000 that he did not believe human life needed to be protected from the moment of conception. His arguments prevailed. The "fourteen day" rule has again been adopted.

But what are the facts? Embryologists seem to agree that "Human development begins at fertilization" and "Although life is a continuous process, fertilization is a critical landmark because, under ordinary circumstances, a new genetically distinct human organism is thereby formed" - to quote two textbooks.

Following normal sexual intercourse a new individual gets half his/her chromosomes from the nucleus of the sperm cell and half from the nucleus of the egg cell. The new organism that is produced is then genetically distinct from all other human beings and has started its own distinctive development. However, modern techniques have supplemented this natural process. One is where a sperm and egg unite in a laboratory dish and not in a woman's body. This is "in vitro fertilization" (IVF). But another is where no sperm is needed. Rather an egg has its nucleus removed which is then replaced by a nucleus from another type of cell - a body or "somatic" cell. The egg is then stimulated by an electrical charge and a living human being (or zygote) is created. This is cloning, with the body cell supplying the necessary chromosomes. Both IVF and cloning currently involve the creation of spare or redundant embryos.

But the new organisms produced both by fertilization and cloning are quite distinct entities. One bioethicist, William Saunders writes*:

"From its first moment, supplied with its complete set of chromosomes, each new zygote directs its own integral functioning and development. It proceeds, unless death intervenes, through every stage of human development until one day it reaches the adult stage ... but it will never undergo a change in its basic nature. It will never grow up to be a cow or a fish. It is a human being from the first moment of its existence. As Paul Ramsey has noted, 'The embryo's subsequent development may be described as a process of becoming what he already is from the moment of conception.'"

Moral Slippage

So how have we allowed the creation of spare embryos to be discarded and treated like commodities in IVF treatments? How are we allowing some to be used for scientific experiments? One answer is that word games have been played. People now speak of a "pre-embryo" for an embryo prior to implantation in the womb. You can then argue it is not human until fourteen days of life and so it need not be protected. "Certainly," writes Saunders, "the embryo at this point is 'pre-implantation,' and certainly implantation is a highly significant event. If the embryo does not implant, it will die; if it implants, it will receive nutrition and a suitable environment in which to live, grow and develop (every human being at every stage of life similarly requires nutrition and a suitable environment). But the critical question is: Does implantation effect a change in the nature of the thing that implants? It is clear from the basic facts of embryology that it does not." The term pre-embryo was introduced in 1986 largely for public policy reasons as Lee Silver, a Princeton biology Professor and advocate of all the new biotechnologies, tells us in his Remaking Eden (1997):

"The term pre-embryo has been embraced wholeheartedly by IVF practitioners for reasons that are political, not scientific. The new term is used to provide the illusion that there is something profoundly different between a six-day-old embryo and a sixteen-day-old embryo. The term is useful in the political arena - where decisions are made about whether to allow early embryo experimentation - as well as in the confines of a doctor's [surgery] where it can be used to allay moral concerns that might be expressed by IVF patients."

Similarly, another word game has been played with cloning. After opinion polls found that people did not want any kind of "cloning", some decided to rename the procedure and call it "somatic [from the Greek word for body] cell nuclear transfer". This is mischievous. [See Saunders' arguments in The Human Embryo Debate in Human Dignity in the Biotech Century (2004)]

July 2004

In the US there is activity to halt the slide. Some are saying that in IVF treatments no more embryos are to be formed than the number of children patients are willing to parent. And last July, 2,165 US Christian medical professionals opposed to embryonic stem cell research wrote to President Bush. They pointed out that the earliest possible hope for any clinical applications from the research was 10-15 years away if ever. On the other hand, non-embryonic adult stem cells are ethically obtainable from multiple sources in human beings. In the last three years this work has shown significant progress and is already providing hope and therapy for patients suffering from heart muscle injury, diabetes and brain damage from stroke. It has realistic promise for treating other diseases on the horizon. Yet the media is giving little attention to this work. And sadly Europe has frustrated the US attempt at the end of November to check cloning world-wide through the UN. Surely we need to pray for God's mercy.

Christmas and Medical Ethics by David Holloway
December 2004

The conception of Jesus Christ The early Christians were marked out for their opposition to abortion. They respected foetal life in a Roman world that saw little wrong with the practice. That respect has been dominant in the West until recently. Fundamental to this Christian understanding of life in the womb has been the accounts of Jesus' birth. From these it is clear that the incarnation (his coming in the flesh as a real man) began not with Christmas, but with his conception. As we say in the Creed: "He was conceived ... ." Jesus reveals true man as well as true God. The inescapable conclusion, then, is that life in the womb is human from conception and so worthy of respect and protection from conception. What is in the womb is not blob of tissue but a human being - as Jesus was a human being in the womb of Mary. True, it is an embryonic human being and not an adolescent, adult or senile human being. But protection is demanded because here is the beginning of a creation that is in God's image. The primeval biblical prohibition against killing was based on humans, alone of the animal kingdom, being "in the image of God" (Genesis 9.6). Also the Bible teaches that human life is "given". It is not "achieved" by reaching certain standards of skill or competence. Our God is a "giver" - a God of grace. Job said, when bereaved, "The Lord gave and the Lord has taken away" (Job 1.21). But in today's world many are denying just that. They are saying that "achievements", in terms of physical, psychological and mental development determine what it means to be "human". This, of course, is the route taken by the Nazis in the first half of the 20th century. It gave rise to their eugenics, experimentations and, of course, the holocaust. However, the eventual horror of it all, by the end of the Second World War, then gave rise to a rediscovery of a sense of natural law - namely that some things are so immoral there can be no arguments for them. Such an ethical consciousness is hinted at in Romans 2.14-15. And Christians were in the fore in this rediscovery which then gave rise to the UN Declaration of Human Rights in 1948 and, very significantly, the Medical Code of Ethics, the Declaration of Geneva, from the second General Assembly of the World Medical Association in 1948. This required the new doctor to say: "I solemnly pledge myself to consecrate my life to the service of humanity ... I will practise my profession with conscience and dignity; the health and life of my patient will be my first consideration ... I will maintain the utmost respect for human life, from the time of its conception, even under threat. I will not use my medical knowledge contrary to the laws of humanity." But that has all now changed - witness the issue for us in Newcastle. This came to a head with the licensing by the Human Fertilization and Embryology Authority (HFEA) earlier this year for scientists at Newcastle's Centre for Life to carry out "therapeutic cloning". This was only the second official cloning project in the world. Last month (November 2004), however, a legal challenge was raised to the granting of the licence. But a number of business people want the challenge to fail as the project is hailed as "the key building block for the future of the regional economy". Others are offering hopes of miracle cures. But these are not yet in sight. Critics say these offers of hope are being used as "emotional manipulation". The beginning of life The heart of the ethical debate over embryo research and cloning relates to whether conception is the beginning of life or not. This debate has led people to reject the Geneva Declaration of 1948. This is due, I suggest, to regression from a Christian world view (in Europe in particular) and liberal churchmen in high places who seem to prefer the world's ethic to a biblical ethic. It was noticeable that the chairman of the House of Lords Select Committee on Stem Cell research was the Bishop of Oxford, Richard Harries known for his liberalism on human sexuality. He argued in the debate in the Lords in 2000 that he did not believe human life needed to be protected from the moment of conception. His arguments prevailed. The "fourteen day" rule has again been adopted. But what are the facts? Embryologists seem to agree that "Human development begins at fertilization" and "Although life is a continuous process, fertilization is a critical landmark because, under ordinary circumstances, a new genetically distinct human organism is thereby formed" - to quote two textbooks. Following normal sexual intercourse a new individual gets half his/her chromosomes from the nucleus of the sperm cell and half from the nucleus of the egg cell. The new organism that is produced is then genetically distinct from all other human beings and has started its own distinctive development. However, modern techniques have supplemented this natural process. One is where a sperm and egg unite in a laboratory dish and not in a woman's body. This is "in vitro fertilization" (IVF). But another is where no sperm is needed. Rather an egg has its nucleus removed which is then replaced by a nucleus from another type of cell - a body or "somatic" cell. The egg is then stimulated by an electrical charge and a living human being (or zygote) is created. This is cloning, with the body cell supplying the necessary chromosomes. Both IVF and cloning currently involve the creation of spare or redundant embryos. But the new organisms produced both by fertilization and cloning are quite distinct entities. One bioethicist, William Saunders writes: "From its first moment, supplied with its complete set of chromosomes, each new zygote directs its own integral functioning and development. It proceeds, unless death intervenes, through every stage of human development until one day it reaches the adult stage ... but it will never undergo a change in its basic nature. It will never grow up to be a cow or a fish. It is a human being from the first moment of its existence. As Paul Ramsey has noted, 'The embryo's subsequent development may be described as a process of becoming what he already is from the moment of conception.'" Moral Slippage* So how have we allowed the creation of spare embryos to be discarded and treated like commodities in IVF treatments? How are we allowing some to be used for scientific experiments? One answer is that word games have been played. People now speak of a "pre-embryo" for an embryo prior to implantation in the womb. You can then argue it is not human until fourteen days of life and so it need not be protected. "Certainly," writes Saunders, "the embryo at this point is 'pre-implantation,' and certainly implantation is a highly significant event. If the embryo does not implant, it will die; if it implants, it will receive nutrition and a suitable environment in which to live, grow and develop (every human being at every stage of life similarly requires nutrition and a suitable environment). But the critical question is: Does implantation effect a change in the nature of the thing that implants? It is clear from the basic facts of embryology that it does not." The term pre-embryo was introduced in 1986 largely for public policy reasons as Lee Silver, a Princeton biology Professor and advocate of all the new biotechnologies, tells us in his Remaking Eden (1997): "The term pre-embryo has been embraced wholeheartedly by IVF practitioners for reasons that are political, not scientific. The new term is used to provide the illusion that there is something profoundly different between a six-day-old embryo and a sixteen-day-old embryo. The term is useful in the political arena - where decisions are made about whether to allow early embryo experimentation - as well as in the confines of a doctor's [surgery] where it can be used to allay moral concerns that might be expressed by IVF patients." Similarly, another word game has been played with cloning. After opinion polls found that people did not want any kind of "cloning", some decided to rename the procedure and call it "somatic [from the Greek word for body] cell nuclear transfer". This is mischievous. [See Saunders' arguments in The Human Embryo Debate in Human Dignity in the Biotech Century (2004)] July 2004 In the US there is activity to halt the slide. Some are saying that in IVF treatments no more embryos are to be formed than the number of children patients are willing to parent. And last July, 2,165 US Christian medical professionals opposed to embryonic stem cell research wrote to President Bush. They pointed out that the earliest possible hope for any clinical applications from the research was 10-15 years away if ever. On the other hand, non-embryonic adult stem cells are ethically obtainable from multiple sources in human beings. In the last three years this work has shown significant progress and is already providing hope and therapy for patients suffering from heart muscle injury, diabetes and brain damage from stroke. It has realistic promise for treating other diseases on the horizon. Yet the media is giving little attention to this work. And sadly Europe has frustrated the US attempt at the end of November to check cloning world-wide through the UN. Surely we need to pray for God's mercy.
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