A reader writes:
I came across an article by Michael Rosen in which he, inter alia, attempts to justify Embryonic Stem Cell research on the basis of the principle of Double Effect. He writes that,
In my understanding, ESC research satisfies the four prongs of this principle: (1) creating stem-cell lines for research is not wrong in itself; (2) the intention of the scientist extracting the lines is right, namely saving lives through research; (3) the bad effect (i.e. killing the embryo) is not a means to the good effect (i.e. saving lives) because although the embryo dies after the stem-cells are extracted, its death is not a "means" to that extraction but rather a result thereof; and (4) the gravity of the reason for creating the ESC lines is commensurate with the foreseen (but unintended) bad effect, namely the death of the embryo.
I would be very interested in hearing what you think about this argument. My own take is that it is his fourth point that fails the test, as medical research is not equal in gravity to the destruction of human life.
The author of the piece writes from a Jewish perspective but draws upon Catholic moral thought in the process of doing so. I commend him for doing that. People of other religions can have valid moral insights, and we should use the best available ones in trying to crack moral problems. I wouldn’t hesitate to draw upon Jewish theologians in trying to crack a moral problem if they had the best insights on the subject at hand, and so I’m glad to see folks from other religions making use of Catholic ones. The truth of a moral insight–not whose community is best known for articulating it–is what is important.
The article contains a number of points that I may end up having to discuss in future posts, such as the interpretation of the verses in Exodus as they apply to abortion and the morality of nuclear deterrence, but for this post let’s stick to the application that the author makes of the principle of double-effect to the embryonic stem cell controversy.
In responding, I will be speaking from a Catholic perspective. Mr. Rosen may make different assumptions at various points (e.g., about whether the unborn are human beings from the moment of conception, though this is a matter of science rather than religion; scientifically a human being or living human organism comes into existence as soon as the germ cells unite), but I hope the exercise will be informative.
Let’s start with an articulation of the elements in the principle of double-effect:
One may perform an action which has two effects, one of which is evil and the other of which is good, if and only if:
1) The action is not itself intrinsically immoral.
2) The evil effect is not an end in itself.
3) The evil effect is not a means to the good effect.
4) The good effect is proportionate to the evil effect (meaning, at least as much good is expected to result as evil).
5) There is not a better way of achieving the good effect.
Now let’s apply this to artificially creating embryos and harvesting their stem cells in order to create a stem cell line for medical research.
While the author is correct in saying that "creating stem-cell lines for research is not wrong in itself," he has misframed the issue. The issue is not "Can you create a stem cell line?" The issue is "Can you artificially create and then destroy embryos for purposes of creating a stem cell line?"
When the correct issue is identified, it is clear that the first condition of the principle of double-effect is not satisfied (at least from the Catholic perspective). The artificial creation of human beings is intrinsically immoral. God designed human reproduction to take place in a certain fashion, and man is not free to circumvent his design. While medical technology can assist human reproduction, it cannot replace it, such as combining human germ cells in vitro.
That said, once a human being has been created–whether in vitro or in utero or by a transporter device or anything else–that human has a right to life and cannot be killed unless he becomes an aggressor who poses a grave danger to other humans so that the principle of legitimate defense becomes involved.
To kill him without the principle of legitimate defense being triggered is to kill an innocent human being and this is (from the Catholic perspective) intrinsically immoral. As John Paul II wrote in his encyclical Evangelium Vitae:
[B]y the authority which Christ conferred
upon Peter and his Successors, and in communion with the Bishops of the
Catholic Church, I confirm that the direct and voluntary killing of an innocent
human being is always gravely immoral. This doctrine, based upon that unwritten
law which man, in the light of reason, finds in his own heart (cf. Rom
2:14-15), is reaffirmed by Sacred Scripture, transmitted by the Tradition of
the Church and taught by the ordinary and universal Magisterium.The deliberate decision to deprive an innocent human
being of his life is always morally evil and can never be licit either as an
end in itself or as a means to a good end. It is in fact a grave act of
disobedience to the moral law, and indeed to God himself, the author and
guarantor of that law; it contradicts the fundamental virtues of justice and
charity [Evangelium Vitae 57].
When we discuss the third condition of the principle of double-effect we will look at whether embryo harvesting constitutes direct killing, but it is already clear that the enterprise of embryonic stem cell research (ESCR)–as it is currently envisioned–will not pass muster under the principle of double-effect because it does not fulfill the principle’s first condition since it involves the creation of human beings in an immoral manner.
It does, however, fulfill the second condition. Advocates of embryonic stem cell research are not proposing to create and destroy embryos for the fun of it. Those things are not the goal they are pursuing, and so the evil involved in their proposed course of action is not the end that they are pursuing. The second condition is thus fulfilled.
What about the third condition–the fact that the bad effect cannot be a means to the good effect?
Here Mr. Rosen makes an interesting statement. He writes:
[T]he bad effect (i.e. killing the embryo) is not a means to the good
effect (i.e. saving lives) because although the embryo dies after the
stem-cells are extracted, its death is not a "means" to that extraction
but rather a result thereof.
The first thing to note is that this is oddly phrased. In particular, note that "the bad effect" is identified with "killing the embryo." But killing the embryo is not an effect. It is an action. The death of the embryo is an effect, though, and Mr. Rosen later in the sentence refers to the embryo’s death ("although the embryo dies") so why don’t we assume that this is what he meant to say and see how the argument works.
The second thing to note is that Mr. Rosen is assuming that the deaths of embryos are brought about in a particular way: They aren’t directly killed, they only die as a result of having their stem cells removed.
I am not certain what technical means of extracting the stem cells Mr. Rosen has in mind here, and I have not had the opportunity to check on the precise methods that are being used to extract stem cells from embryos, but suppose that he is correct: The reason that embryos die in ESCR is that they cannot live without their stem cells (as opposed to, for example, being torn apart in order to get at their stem cells).
In this case the stem cells that are taken from the embryo are playing the same function as vital organs: They are biological components of the embryo that he cannot live without, and to take them out of him causes him to die.
What would we make of the same claim regarding an individual who has already had his stem cells differentiate into full-grown vital organs?
Suppose that I am a medical researcher who has hopes of developing a "heart line" that will allow me to grow new hearts for people and save their lives, but in order to do so I must have a living heart to start with.
Could I take a random person off the street and rip out his heart and then argue that
the bad effect (i.e. the death the person off the street) is not a means to the good
effect (i.e. saving lives) because although the passerby dies after his heart is extracted, his death is not a "means" to that extraction
but rather a result thereof.
It would seem true, on a close analysis, that the person’s death was not the means to the end of developing the heart line. I didn’t need him to die; I just needed his heart. Suppose that when I took it from him, I happened to have an artificial heart in my back pocket, and as soon as I’d extracted his biological one, I shoved the artificial one into his chest and thus kept him alive. That would seem to illustrate the point that his death itself is not a means to an end the way that, for example, bumping off your rich relative in order to get an inheritance would be.
But we still would not (morally) tolerate researchers grabbing people off the streets and ripping out their hearts in order to make advances in cardiology that will save lives.
Why?
Because (among other reasons), in the real world we don’t have good artificial hearts and they’d never be used by organlegging researchers anyway and so the actions of such researchers would cause the deaths of innocent people.
Removing part of a person’s body that that person needs in order to live is directly killing the person. I can’t rip out a person’s heart or liver or lungs or stem cells or anything else that the person needs to stay alive and claim that I’m not killing him.
We thus loop back to the first condition needed for the law of double-effect: The action cannot be immoral in itself, and directly and voluntarily killing a person–by removing his heart or his stem cells–is intrinsically immoral.
The fourth condition–that the good effect is proportionate to the evil effect, is one that is arguable. While we have not yet had life-saving breakthroughs from embryonic stem cell lines, it is quite possible that we will in the future. If so, it is possible that the number of lives that will be saved through these means will be greater than the number of embryos that had to be killed in order to achieve them.
But the fourth condition alone–much less the mere possibility that it will be fulfilled–is not sufficient.
The fifth condition is also relevant: There has to be no better way of achieving the good. This is a subject to which Mr. Rosen devotes some attention in his article, though not in his enumeration of the double-effect conditions. He acknowledges the possibility of doing stem cell research without killing embryos and the moral preferability of such means.
At this point it is uncertain whether some of proposed alternative means are themselves moral, though others (e.g., using adult stem cells or bith matter stem cells) certainly are.
It is also uncertain whether these alternate means can allow us to do everything that ESCR would do, but that’s the nature of things: We know neither the full potential of ESCR or the full potential of the alternative means, so we cannot directly compare the results of the two.
But what we can say is that there are alternatives which at least give the appearance of the fifth condition being unfulfilled. It looks like there may be a better way of achieving the same good without killing embryos.
Whether or not that is the case, the double-effect argument fails because the very first condition is not satisfied: It is intrinsically immoral both to artificially create human beings for purposes of medical experimentation and it is intrinsically immoral to kill innocent humans for purposes of medical experimentation.
