Maieutikos: <font color=#630000>PERSONHOOD x STEM CELL THERAPY</font>

mardi, juin 14, 2005

PERSONHOOD x STEM CELL THERAPY

The false dilemma

Denial of personhood and of humanity always works against Human Rights and minimal principles of Ethics, Democracy and Dignity; and never the other way round. It in itself is a wrong method of argumentation and serves only to justify wrong theses. Still, it is even odder and illogical to use this argument in favour of saving life forms.

The following reflection is in part an answer to post by Jonathan Ichikawa who, in talking about the therapeutic use of stem cells, addresses the question:

(Q) Why should we think embryos are persons?

The arguments he uses are grosso modo the same arguments some advocates of the decriminalisation of abortion had tried in the past. This is something odd, for the reasons I shall go into below. Let me put together my reactions to Jonathan's thoughts:

Denial of Personhood

There are many possible answers to question (Q) above. In all cases the burden of proof rests on those who deny the personhood of embryos. In judicial framework the first and indisputable answer to the question is:

Universal Declaration of Human Rights
Article 6.
Everyone has the right to recognition everywhere as a person before the law.

In the context above, everyone means every human. Other articles reinforce this injunction:

Article 2.

Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. (...)

Article 25.

(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

The Universal Declaration of Human Rights, which comes from the rational tradition of the Philosophers that inspired the French Revolution, is the most important landmark of all times in legal thought, including both Law and Philosophy of Law. It is also the most authoritative document encoding basic principles of Democracy. Thus, it also defines what is ethical and what is not in a democratic society. A Philosophical or other system that disregards Human Rights cannot be considered an ethical system within a democratic frame, even if such system is well constructed from the formal point of view.

The question about denial of personhood, which made the sixth article necessary, is historically the crucial issue for societies that ideally base their rule of law on justice and freedom. Briefly, throughout History denial of personhood has been used as an argument in favour of such inhuman practices and oppressive institutions as systematic genocide, slavery, cannibalism and mass robbery, among others. In Philosophy and Social Sciences, the debate on the personhood of a certain class of humans goes back to the famous Controversy of Valladolid, the official inquiry held in 1550 to determine whether the Indians of the Americas were human persons or not (I have written about the issue here). But in the context of stem cell therapy personhood is not the real ethical issue, it is not actually relevant.

Moreover, in Europe and Latin-America nowadays the arguments in favour of the decriminalisation of abortion do not revolve around whether unborn children have rights or not. The question is that NOT all things that are unethical, i.e., mala in se are illegal and not everything that is illegal is necessarily a crime. And the sanction derived from the practice of a crime must vary according to the actual situation. Sanctions cannot cause more harm than the crimes they punish.

Thus, no modern advocate of the decriminalisation of abortion says it is ethical to kill unborn children. They say that bringing a woman to Court because she had to abort her child is painful and so humiliating and so degrading that, from the perspective of public interest, it is not worthy to do it. Furthermore, the circumstances in which a woman appeals to so a drastic a measure are often such that no proper and fair sanction can be inflicted. Indeed, it is known there are other cases in which the act of killing does not and cannot import sanction, so that abortion, especially during the first weeks, would in their view be among them. The appeal to the denial of personhood and humanity is by now too archaic and obviously useless, since they are absolutely wrong. The current arguments appeal to well known social facts and point to the necessity of arbitration to balance rights and needs.

Where the ethical issues start?

The ethical status of the issues pertinent to stem cell therapy is equivalent and indeed closely related to organ donation. There is nothing wrong with organ donation per se, when the voluntary donor is someone who has already died. After his death, the donor will not need the organs to be transplanted anyway, and, if these organs can help someone else, it is in principle a good deed that a person decides to donate them in case of his death. It is an individual choice: inasmuch as the potential donor has previously authorised it, doctors will not make anything wrong either, if they remove tissues from a dead patient.

The ethical problem begins when the procedure of organ transplantation becomes an industry. Which is to say, when doctors commence to kill patients to get their organs and transplant them, the procedure is no longer ethically acceptable, even if the killed patient had previously decided in good faith to donate them. Or when doctors or others offer money to poor individuals to buy their tissues.

If one transposes these considerations to the more specific case of Stem Cell therapy, there is no ethical dilemma: the only visible complication in such picture is to determine who can make such decision for the embryo, since the embryo cannot decide to donate himself. But, setting aside the issue of who makes the aforementioned decision, the procedure per se is not unethical.

The first potential ethical problem behind stem cell therapy has nothing to do with what is the social or legal status of the embryo. An ethical problem will exist, if doctors start fertilising eggs that will on purpose not develop, because in such case the fertilisation is not intended to assist individuals who want to reproduce. The ethical problem begins when gametes are taken and merged for the sole and direct purpose of creating a reserve of step human tissues. In such a case a criminal industry and a black market are established under the cover of humane and altruistic medicine.

Stem Cell Therapy is not Abortion

Fertilised eggs cannot survive forever in vitro, within the current stage of scientific development. If there is no uterus to host an embryo, he will certainly die before he can develop into a baby. In assisted reproduction procedures, what commonly happens is that the number of fertilised eggs in vitro is greater than the number of eggs that are actually introduced into female patients, whereby a number of embryos will die anyway. In such case, if a doctor uses the cells of one of these embryos to regenerate an organ of another person, he is just using tissue from one human body to heal another human body, just like in the case of organ transplantation.

Furthermore, when an embryo, who will not develop, is entirely absorbed into another body via the therapy, he somehow continues to be alive as part of the receiver. In this sense, the therapy saves the life of an embryo, who would otherwise be discarded, i.e., sentenced to premature death.

Methinks this where is the crucial error behind the discussion: the assumption that stem cell therapy should be accepted on the same premises that in the old days pro-choice militants defended the decriminalization of abortion. But why would the therapeutic use of stem cells be justified on such arguments? When an abortion is made, or when embryos in vitro are discarded, organisms are killed. When the cells in vitro are transferred to the body of an adult human, those cells continue to live, i.e., two organisms are saved. Why does one need to deny the personhood of an embryo if what one does saves him?

So, the whole discussion cannot make sense even if we by any means could accept denial of personhood.