Monday, February 14, 2011
Re-Thinking the Ethics of Stem Cell Research
by Tauriq Moosa
There is always the danger of dogmatism lurking within any collection of ideas. A collection of ideas tied together by a singular focus tends to be called an argument. However, it is often refreshing to have such bundles of ideas untethered and scattered after being cut by a sharper focus. It is, I would like to think, the mark of good critical analysis that one is self-critical, too; that you find an argument that you hold destroyed in order to clear the way for a more robust one.
I recently had such an experience regarding the ethics of human embryonic stem cell (HESC) research. Often we secularists, under some weird broad canvas, regard opponents to things like abortion, HESC research and euthanasia as one large pile of dogmatic reactionaries. And no wonder, considering their spokespeople are often dogmatic religious reactionaries who get given airtime on popular news-sources.
But so often forgotten are careful arguments against the typical liberal secularist view that euthanasia and HESC research is not immoral. Consider the insightful abortion debate between two non-believers, Richard Carrier and Jennifer Roth; there we have good arguments instead of speaking from the knee as many people, on both sides, are prone to do in these discussions. It should be immediately apparent that we ought not to perceive ‘our’ side as the sober, good and right, whilst anyone who disagrees as merely fanatical.
To understand the usual arguments for stem-cell research, this quick clip by Sam Harris at Beyond Belief ’06 is an excellent quick overview. But even if you don’t watch it, the arguments will come up during the post.
My experience of this sudden realisation of (possibly) holding fallacious views was through an article by Don Marquis. Professor Marquis is renowned for an article defending a secular argument for why abortion is immoral (see references). However, I encountered him after reading his, again, secular argument against HESC research.
Marquis opposes those who defend HERC research on the grounds that all religious arguments are by nature bad; that the embryos are not persons, are not morally worth more than, to use one of Sam Harris’ emotive but true examples, a girl with spinal-cord injury. Considering the enormous – possible – benefits of further research into this promising field, possibly curing people suffering all manner of ailments, we should legalise HESC research; otherwise we are simply pandering to silly metaphysical-theological arguments. Marquis proceeds to critique all such arguments.
Marquis notes: “the arguments [in HERC research] that are offered are typically presented in a cursory way. Indeed, often they are more suggested than presented. Arguments that deserve critical scrutiny are quickly set out as if any rational reader would regard them as obviously sound.”
To be fair, he also rightfully dismisses religious arguments for banning HERC research: “in the absence of a great deal of convincing argument that has not yet seen the light of day, particular religious considerations cannot establish the wrongness of HESC research.” He considers religious claims merely “comforting opinions” – an excellent term – like preferences of food or furniture. Comforting preferences, however, are not binding on anyone (including the person herself), which means we have no reason to take such arguments seriously. But, Marquis notes, because religious moral arguments are so weak, it has given the illusion that HERC research defenders need only “wave at some nonreligious arguments” to defend their view.
Contrasting “comforting opinions”, which masquerade as moral argument, is the idea of complete freedom in scientific research. Yet, Professor Marquis thinks this is also a myopic endorsement. Marquis notes that “untrammelled freedom in scientific research” is dangerous. The term is not Marquis' but is presented and supported by some, like Paul Kurtz. All manner of immoral actions could be justified in the name of “untrammelled freedom”, however. Marquis notes, for example, the Tuskagee Study or the Willowbrook experiments. Obviously, the wonderful Professor Kurtz would not support such incidents – but his freedom is not licence. “Untrammelled” is also unhelpful. The opposite of censorship is not complete lack of boundaries but rationally considered ones.
Marquis then delves into the meat of the argument. Those who watched the short Harris clip will recall these arguments.
1. The Beneficence Argument
The major argument to support HESC research is the enormous benefits it might have for those suffering from spinal cord injuries, muscular dystrophy, Alzheimer’s disease, and so on. The University of Michigan has a helpful FAQ on this; it also says:
Research with embryonic stem cells may lead to new, more effective treatments for serious human ailments and alleviate the suffering of thousands of people. Diseases such as juvenile diabetes, Parkinson’s disease, heart failure and spinal cord injuries are examples.
But why do we need HESC for this? What makes them so ‘special’, to use a pejorative term. To quote again from the UM website:
- They can develop into any cell type in the body.
- They can form unlimited quantities of any cell type in the body.
- They will help us understand inherited diseases by allowing us to study human cells bearing the exact genetic defects that cause disease in patients.
- They will allow us to discover safer and more effective drugs by making it easier to screen drug candidates.
If it will save so many lives and aid in the future, what opposition could Marquis possibly have which is not religious?
Marquis reiterates the problems of the Tusgakee and Willowbrook experiments by showing that no matter the benefits, there is a consensus amongst bioethicists and, indeed, the public, that there is a need to respect human subjects for any experiment. Informed consent is sometimes referred to as the essential focus of most bioethics.
Basically, we can counter the beneficence argument by asking how much: If you could save every liver cancer patient in the world by experimenting ‘unethically’ with children – that is without their or their parents consent – would you do so? Informing them would counter the research – say you need them for monitoring or some such affair that requires no awareness of the experiments you are doing. There are excellent reasons why even this stripped utilitarian argument does not work; but that is Marquis’ point.
The beneficence argument also assumes that embryos are not persons with moral concerns in the first instance. That is, the ethics of HESC research is not answered by simply saying “the benefits will be great.” You must still say why possibly violating the essential cornerstone of bioethics, informed consent, is allowed in this instance. The beneficence argument can only help after establishing the embryos are not moral persons.
2. The Case for Qualified Respect for Human Subjects
Of course, for many, the answer appears obvious: We cannot obtain consent from embryos because they are not moral agents. There is nothing about them – a CNS, consciousness, etc. – which is worth a moral concern. We might as well care about the moral agency of rocks.
Marquis major counter to this, which I think is flawed, is to contrast this with infants. Marquis notes: “Plainly this [argument] will not work, since it is agreed by all decent people that scientific research that involves the destruction of two-year-olds is immoral, even though two-year-olds are not moral agents.” He notes that the mentally-retarded children in the Willowbrook experiments where just such cases.
The appeal to “all decent people” is a dubious move. This rhetorical device means that if you disagree, you are not a decent person. It immediately prevents someone from even formulating a case for thinking “the destruction of two-year-olds” is not immoral.
Never considering myself a decent person, anyway, I feel no need to automatically group myself with “decent people” who think babies should not be killed. I fully support infanticide, in those circumstances where it is agreed upon by parents, doctors and if it is for the benefit of the baby. If it makes me "indecent" to think that the unnecessary suffering of any being, regardless of age or species, should be shortened if possible, if warranted, when there is no chance of recovery, and so on, then so be it.
I don’t agree with Marquis here. Marquis says that the reasons for disqualifying embryos from moral agency is because they are not beings that can respond or be part of a rational framework of morality. They have no characteristics that mark them off as entities that can benefit, aside from potentiality (rightfully dismissed by Marquis and most ethicists as bad arguments. We’ll examine it shortly). Yet, infants do have some characteristics that embryos do not: most importantly their ability to suffer or their sentience. Now this is not the space to argue for suffering being the central concern of ethical thinking, but to me, I have yet to see a better case for what ethical thinking should be about (I am not a promoter of utility, but probably a negative utilitarian. For those interested in comprehensive thought-experiments to undermine negative utilitarianism, start with The Pinprick Argument).
Marquis does not respond to such claims. Indeed, the fact is I am willing to say infants should be killed (in specific circumstances, obviously), as I do for people in persistent-vegetative-states or irreversible comas. Thus, my consistency has me defend HESC research and the destruction of embryos.
3. The Capacity for Sentience/Consciousness: Corpses and Robots
Some readers might say it is the capacity for consciousness not sentience that matters. Marquis of course easily dismisses such arguments by pointing to people who are temporarily unconscious or asleep. But I think this is not looked at thoroughly.
Critics respond to such claims by saying if subjects had the capacity in the past to be conscious, a move made by, for example, Michael Tooley, then we ought to treat them as limited moral agents. They are therefore not like embryos because they had consciousness in the past. But Marquis notes: Why can’t we say it is future consciousness that matters? What’s so special about past consciousness? Indeed, if consciousness is what matters, then surely the fact that something will be conscious in the future matters more than people who were conscious in the past, but perhaps have minimal chance of recovery?
I’m uncertain about this argument, however. If we were concerned about future consciousness, or even sentience, then it means we ought all to be breeding to bring that future moral agency into existence. But that would leave little time for anything else and would of course lead to severe overpopulation and a greater reduction in resources, and so on. It is simply absurd to think we ought to promote future consciousness. Indeed I think most potentiality arguments are bad, since all sorts of potential situations could arise but proponents merely and arbitrarily focus on one specific future event that might arise (for example, the arrival of consciousness, sentience, etc.). We also have the potential to die, to become corpses, we have the potential to have our organs replaced by unbreakable robot parts - but should we treat each other as corpses or robots? Of course not. (Think of ages differences: If they consented or acted autonomously, why do we prevent children from buying alcohol, smoking, etc., even though they have the potential to be 18 years old? We treat them according to their ages, not their potential ages.)
4. The “Individual” Argument
Another problem, which applies equally to those who assert the soul or moral agency begins at the moment of conception, is the idea of the individual. That is, the embryo is not yet an individual to whom moral agency can apply. By individual, Carol Tauer, Ronald Green and others means that it lacks “developmental individuation”. Yet, for Marquis this won’t do since you can “count” the embryos. This is of course quickly countered by talking about “twinning”, but even this won’t do for Marquis because the two, or more, further individuals had to come from one! Therefore, just because there is a possibility of twinning doesn’t mean there isn’t an individual to begin with. There has to be.
Marquis is right to say appeals to individuals will not work here. I also think it is a novel response to the idea of twinning countering the claims of moral agency. I’m not completely satisfied with it, but I do like it as a refreshing take on the appeal that moral agency applies only to the individual. To reiterate: He agrees with the appeal but doesn’t think it succeeds because “an individual” does exist before twinning.
5. The Right Environment for Development of Persons
Marquis scrutinises the respect for human subjects (RHS) principle, in research ethics, throughout his article. RHS is about the ethical standards or principles or duties used when dealing with human persons as subjects for scientific experimentation. For example, the most important might be informed consent.
He agrees that we do have duties to respect the subjects. But he is taking on the idea that the RHS principle does not apply to embryos. For example, he cites one claim for embryo destruction.
If an embryo is maintained outside a woman’s body and those who provided the gametes for it have not decided to permit its development in a womb, it is not effectively a state in the early development of a person. (Meyer and Nelson, as cited in Marquis, 2007)
Therefore, it is not morally wrong because the environment is such that an embryo cannot develop into a person. Yet Marquis brings the babies back: If we put infants into such environments, would we allow experimentation? If an abandoned infant was dumped, it is not in a place where it is possible to develop into a person (it will eventually die without aid) – does that mean we are allowed to experiment with it?
But this again conflates the idea of sentience. If we care about unnecessary suffering, and if we are able to avoid it by not experimenting with the infants, we ought not to do so. Also, researchers cannot be in an environment where the infant can’t develop into a person, since the researchers by definition are catalysts to bringing the infant out of such a state. For example, if a researcher found a baby in a dumpster, the researcher’s presence has automatically negated that environment as a space in which the infant can’t develop into a person because the researcher is now an added causal agent who can remove the infant. That is, by simply being aware of the infant’s condition, the environment is no longer one where the infant cannot develop into a person.
Embryos however cannot, when put into certain states, develop into a person. Even with researchers there the embryos are beyond personhood acquisition.
There are further arguments but I don’t have the space to continue. This seems an interesting and novel way to engage with the debate for HESC research. Yet, as I’ve highlighted, there are numerous problems with it. Perhaps operating under the assumption, as I have been, that reduction of suffering of sentient beings is most important (cf. Singer’s equal consideration of interests), is a mistake – but Marquis has not answered these claims. Given, also, that I am consistently in favour of killing being regardless of age or species, when done in specific circumstances, especially for that being’s benefit (even better if that being has autonomously asked for it), I also can’t see how my view is inconsistent with the destruction of embryos.
Furthermore, Marquis must note that given any number of factors, any cell of our body with, say, a nucleus could be a potential person. Every time we touch another person, put on a clothes, scratch our skin, we are committing, in Sam Harris’ words: genocide. This is nonsense of course.
Marquis has written a clear survey but I do not think it accomplished what he wished it to. If he’s goal was for us to radically rethink the ethics of HESC research, he has not done so. If, however, it was to sharpen our arguments on better counter-claims, then he has more than succeeded in taking arguments, or at least mine, further. And that is always a benefit.
References for Marquis' work:
‘Why Abortion is Immoral’ The Journal of Philosophy, Vol. 86, No. 4. (Apr., 1989), pp. 183-202
'Stem Cell Research: The Failure of Bioethics', in Science and Ethics: Can Science Help Us Make Wise Moral Judgments?, ed. by Paul Kurtz and David Koepsell (Amherst, NY: Prometheus Books, 2007).
Posted by Tauriq Moosa at 12:30 AM | Permalink