A life to be or not to be
If a Scientist told you that he was "arresting the development of a blastocyst before implantation" or "transferring a nucleus from a human tissue cell to a enucleated human oocyte", would you understand or question the ethical issues arising from the procedures he has described? However, if you were told that what he had described is the production and destruction of a human life for curing diseases or for experimental purposes, what would you feel about the same procedures?Human cloning, stem cell research, abortion and the sale or commercialization of human reproductive materials are some of the hotly debated issues of our time. They evoke different reactions from people ranging from extremes of animosity and outrage to lack of interest and apathy. In this article I would like to present an Orthodox Christian perspective on two of these issues, human cloning and stem cell research.
BACKGROUND TO CLONING AND STEM CELLS
What is a clone? A "clone" is a group of identical individuals of plants or animals, which has originated from one individual by vegetative propagation or asexual reproduction. The members in the clone look alike, as they are genetically similar.
New methods have been developed to produce individual animals such as sheep, dog and humans by asexual methods; in other words, individuals of these species are developed without fertilizing their eggs with their sperms. Thus, cloning is an experimental technique by which identical individuals are produced from a single animal by manipulating a tissue cell of that animal.
The term "cloning" has taken on different meanings within the conceptual and experimental contexts. Cloning in itself refers to the production of a biological entity which is genetically identical or very similar to the one from which it originated. Cloning can occur naturally in the uterus prior to implantation of the fertilized egg in the wall of the uterus. It occurs when one fertilized egg splits into two giving rise to two identical twins. However, this article deals with cloning when defined as the artificial manipulation of mammalian embryonic material at the early stages of development to produce two or more similar (identical) babies.
Human cloning is the scientific technique by which a human being is generated. There are currently three purposes for which human cloning may be attempted; "Reproductive cloning" is the reproduction (producing a copy) of a human being, "Therapeutic cloning" is used to generate embryonic stem cells for tissue engineering and transplantations or for use in cell therapy, and "Nucleus reprogramming" is for experimentation to increase scientific knowledge and understanding of the developmental processes and dynamics.
STEM CELLS
Now let us consider "stem cells". Human beings are placental mammals. The fertilized egg or (zygote) develops inside the mother. The zygote grows by cell division, passing through two, four, eight, sixteen- celled stages. A blas-tu-la is formed at the stage in embryonic development of animals at the end or immediately following the stage of cleavage of the ovum. It consists of a ball made up of a single layer of cells enclosing a fluid-filled cavity. The blastula develops a blas-to-disk, which is the embryo-forming part of a fertilized egg. The remainder of the blastula develops into the placenta which is discarded at birth. It is from the cells of the blastodisk that the stem cells are harvested. Scientists have isolated these embryonic cells that are capable of becoming different organs. It is now known that the stemcells can turn into any type of cell /tissue in the body. That means, stem cells might one day be used to generate replacement tissue for damaged organs and treat numerous diseases.
HISTORY OF STEM CELL RESEARCH
As reported in the New York Times of November 8, 1988, two groups of medical doctors succeeded in growing human stem cells in the laboratory. It was hoped that these could be used to grow organs for transplantation. The two groups used different methods to isolate stem cells.
One group took cells from a 15-20 cell "pre-embryo" the blastocyst, about three days after fertilization. Each cell at this stage of development is "pluripotent" meaning that these cells have the capacity (potential) to become many different organs of the body. The stem cells may even be "totipotent", meaning that they can become all organs in the body. At the blastocyst stage, all cells are the same (homologous).There is no way of knowing whether a particular cell of the blastocyst will become embryo or placenta. Once the embryo becomes differentiated from the placenta, the stem cells start to become specialized into those that become organs and lose their potentiality to become anything else.
The second group isolated stem cells from the 'germ cells' of aborted fetuses. Germ cells give rise to eggs and sperms. These cells, unlike other cells in the developing fetus, are not directed to developing into particular organs. They remain "pluripotent" in order to carry their genetic information forward in the next generation. Stem cells taken from the germ cells of a fetus may be equivalent to the stem cells taken from the blastocyst.
Stem cells are found to grow indefinitely and are thus immortal. Cells only become mortal (losing their ability to divide and grow indefinitely) after they become specialized after organogenesis, the organ forming stage of development.
Scientists are now beginning to develop stem cells into organs for transplantation. This technique is in its infancy. Experiments have been carried out on mice; for example, if a stem cell from a mouse is injected into the heart of another mouse, the injected stem cells will grow into cells of the heart of the recipient mouse. This has great therapeutic value in that a diabetic person may be treated with stem cells injected into his pancreatic tissue. Cells capable of producing insulin may develop and the diabetic condition may be cured. The same technique may be carried out in persons suffering from other debilitating diseases like Parkinson's Disease or Alzheimer's. Therefore, stem cell research has immense potential as a therapeutic technique in curing diseases which adversely affect the health and well being of millions of human beings.
CHRISTIAN UNDERSTANDING OF MAN / ANTHROPOS
Science considers humans as part of the natural world belonging to the Animal Kingdom. Philosophy categorizes humans as rational beings capable of thinking and making rational choices and decisions. The Judeo-Christian understanding of "anthropos" (human being) as created by God is quite different in that, in addition to these qualities, humans "are created a little lower than God (angels) and bestowed with dignity and honor"(Ps.8:4).
This concept of anthropos (man or woman) is derived from the Holy Scriptures, as clearly stated in Genesis chapters 1-3. It is emphasized that God created 'man' in His "image and likeness"(Gen.1:26,27). In Genesis 2:7 it is written "Then the Lord God formed man from the dust of the ground and breathed into his nostrils the breath of life and man became a living being? (Oxford Bible), "a living soul"(King James Bible). This divine "inspiration" has been identified by Church Fathers as 'Soul' or 'Spirit of God' which animates the human life from the beginning, that is, from the time of fertilization or conception. The Book of Job says "Thy hands have made me and fashioned me together", "You clothed me with skin and flesh and knit me together with bones and sinews? (Job 10:8,11). In Psalm 139 it is written "For it was You who formed my inward parts; You knit me together in my mothers womb" (v.13). Psalm 139 continues "I praise You, for I am fearfully and wonderfully made, Wonderful are your works: that I know very well, My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth. Your eyes beheld my unformed substance, in your books were written all the days that were formed for me, when none of them as yet existed." (14-16). God formed the embryo in the womb (poetically called the depths of the earth) and knew the psalmist's character from the moment of conception (Oxford Bible). In Exodus 21:22, accidental miscarriage of an embryo is discussed; the embryo is referred to as FORMED, thus making a distinction between a fetus and embryo as 'unformed' and 'formed'.
The real question is "when does a human fetus receive the soul and therefore be considered a person with dignity and deserving respect?" The Biblical idea is that the body and the soul are formed at the same time, at the very time of fertilization or conception. This means that from the time of fertilization of the egg, the beginning of a human being, a human person "created in the image and likeness of God" is in the making hence this human being (soul) should be considered a person deserving respect and dignity.
The New Testament authors further develop this idea. For example, Luke 1:44 describes John the Baptist as a baby in the womb of his mother Elizabeth recognizing baby Jesus in Mother Mary's womb and dancing with joy. These two babies have been considered as human beings, persons relating to one another and not as fetuses in the processes of development without faculties of perception or without emotions. Therefore the idea is that God creates the "soul" with the body from the very beginning so the human person can participate from the very beginning in the life of God and in the life of other human beings. There is no real distinction between embryo, fetus and child as is made by those who advocate cloning and stem cell research. These are developmental stages of a human being very similar to human stages, baby, child, youth, adult etc. and the person has to be respected as he has legal rights which have to be protected.
The act of conception creates an ?ensouled? person who bears the image and likeness of God, whose destiny is to behold the Lord from the beginning of his/her existence to the very end of life and even beyond life. So from an Orthodox Christian perspective; destruction of a fertilized egg, or a blastocyst, or an embryo, or a fetus, is destruction of an invaluable human life and is unacceptable. This is the stand taken, as I understand, of the Roman Catholic Church, the Eastern Orthodox Church, the United Nations charter and other human rights organizations.
ETHICAL AND THEOLOGICAL ISSUES
From the outset, it has to be emphasized that the Orthodox Christian view point is NOT against scientific research or against developing techniques to help cure debilitating diseases or against minimizing human suffering. In fact the Orthodox Christian understanding is that God has bestowed humans with gifts to experiment and discover techniques and cures for the benefit not only of humans but also of all His creation. Humans have been placed in authority over His creation as priests and kings to exercise caution and to carefully manage human affairs as representatives of God. All life is precious, especially human life. And it is His will that necessary conditions and environmental factors be maintained and preserved for the sustenance and continuation of life. No one has any right to destroy life or to create conditions that may endanger or cause destruction of life, especially human life.
The United Kingdom and Holland have legalized research in which widespread cloning of human beings will be carried out. A question has been raised as to whether cloned babies have souls. This question is from a false premise. No matter whether a baby is produced naturally or by cloning, the Christian view affirms that the baby is a human being or a living soul who should not be deliberately killed or destroyed. It is infanticide and is abhorrent to God and to all believing Christians, irrespective of denominational differences and to others who value human life, dignity and worth. 'Soul' is the transcendent aspect of our being. It is distinct from the 'flesh' that is 'dust' which returns to dust at the time of physical death.
REPRODUCTIVE CLONING
Considering the three purposes for which human cloning are currently being attempted; the "reproductive cloning" (producing a human being by artificial vegetative method) may be acceptable if the child thus produced is not destroyed, but is generated for a mother or a couple who have no other way to have a baby of their own. This too may be debatable and there may be restrictions. Some may advocate adoption as a safer way to have and to own a baby. It is the responsibility of the Church or the community to assist people to arrive at a right decision by counseling or by guidance when they have to make difficult choices.
THERAPEUTIC CLONING
"Therapeutic cloning" to generate embryonic stem cells may be acceptable if the stem cells are from other sources which did not cause the deliberate death of a human being.
NUCLEUS REPROGRAMMING
"Nucleus reprogramming" may be useful, but it may have other complications such as changes in genetic composition and configuration. As these experimental procedures are all in their infancy, no one, not even the scientists engaged in them, can safely or with any certainty predict what the results will be and how they would affect the human race in the future. So extreme caution should be exercised when tampering with the human genome.
The imagination can run wild when considering the future scenarios resulting from human cloning. Human cloning may eventually give rise to a race, or many races, of individuals who have no family ties, and who may look alike and may act alike or may take orders instinctively like a colony of bees or termites or of super humans. Scientists have produced rats with a brain that is partly human. The possibility exists that human beings may be produced with an animal brain or with other body parts. Chimeras may eventually be created. Scientific fiction may become reality in human life. The world may be different in ways that no one can imagine or predict. Adam and Eve wanted to be like God, in His capacity as creator. Their children are now taking up their cause and we do not know what destiny awaits them.
Any treatment of the human embryo or fetus evokes emotional and ethical concerns as it affects the dignity and potential of the human person. The three-day old blastocyst is a "pre embryo" and any particular cell of the blastocyst is as likely to become part of the embryo as it is to become part of the placenta that may be discarded at birth. However, it is taken for granted by some that the "pre embryo" is not even an embryo. The United States of America, the United Kingdom, Austria, and Denmark have approved experimentation with human "pre-embryos" i.e. they have all approved research on the human embryo up to the 14th day of development at which time the primitive streak will develop into the brain and the spinal column and the embryo will be differentiated from the placenta. As there is no possibility of the embryo sensing pain and there is no sentience (have no other faculty for perception), the assumption of these countries, seems to be that they may be subjected to experimentation and destruction.
This is not acceptable from a Christian point of view, because, by whatever name we call the developing human embryo, it is a human person in the process of development, who deserves respect and who has certain inalienable rights as a human being.
Pre-embryos not used in IVF are sometimes donated for research with informed consent from donors. These pre-embryos will never be implanted in a woman's uterus and never be allowed to develop into individual human beings but will be discarded after two or three years. This was banned in 1995. However, from 1999, the ban on research has been lifted and research on embryonic stem cells was allowed. The National Institute of Health (NIH) in the U.S. has approved creation of "pre embryos" specifically for research if there were not enough 'surplus' pre-embryos donated after in-vitro fertilization (IVF).
The proposed research does not depend upon continued use of pre-embryos, as once the stem cells are isolated from the blastocyst, they can grow indefinitely in the laboratory, so new blastocysts from new embryos are not necessary. Therefore, the defenders of stem cell research assert, research on embryos and fetuses that would otherwise be thrown away, does not cause indignity to human life. This appears to be harmless but is questionable since; to start with, embryos have to be destroyed to harvest stem cells to grow more stem cells.
The human embryo, at the time of conception is an 'ensouled' human being, no matter whether it is a 'pre-embryo of 14 days or a 15-day-old fetus or a baby developing and growing up to the time of birth. There is no real meaning in categorization by different names to mislead the general public into thinking that these embryos are not human babies in the making. Therefore, destroying any fetus after conception is dishonoring a human being who would other wise have developed into a person, with dignity and legal identity. So, for an Orthodox Christian, destruction of the embryo at any stage of growth for experimental purposes is tantamount to committing murder and is never acceptable from a biological, moral, ethical or spiritual point of view and should in no way be accepted or tolerated. All Christians should openly oppose such inhuman practices and exert their influence through the legal and moral means at their disposal.
From this perspective, extracting stem cells from a blastocyst (a living developing human embryo) for experimental purposes or medical purposes is unacceptable, because the innocent, defenseless potential human being is thus harmed and the fetus is at the mercy of another human being. Unless this person is working for the good of that particular baby, he is denying dignity and legal status of that child who, by International Law and the Charter of the United Nations, need to be protected and allowed to grow to its full potential as a member of the community at large. No scientist or politician has the right to deprive any baby of its "right to life, dignity and pursuit of happiness".
Stem cells from older humans or from the placenta or discarded cell mass, may be used for scientific research, organ development for transplantation or for curing diseases which have debilitating effect or which may be fatal to human beings.
The Orthodox Christian anthropology with its understanding of the eternal value of the human person, though it considers him a sinner, acknowledges that the chief purpose of human existence is to glorify God and to enter into eternal and blissful communion with God. This implies that there could be no manipulation of the human person on a personal level or on a cellular level, unless that manipulation is for strict therapeutic purposes that will serve the best interests of the person concerned. This necessarily excludes experimentation using viable human embryos which are full persons and not a mere mass of tissue.
We need to oppose the manipulation and destruction of human embryos, particularly since stem cells obtained from the placenta and the umbilical cord have been shown to have as great a therapeutic potential as their embryonic counterparts. The human person created in the image of God and called to progress toward the divine likeness is unique and of infinite value. Any attempt to dismantle that person into its component parts or to reproduce that person through cloning is an offense not only against human rights and human dignity, it is also an offense against God who creates and loves each person, and calls each one without exception to share forever in His divine love.
An interesting article appeared in the New York Times on October 11, 2005 entitled "Embryonic cells, No Embryo needed, Hunting for ways out of an impasse" by medical scientists from California and from M.I.T in Boston. They have advocated, on the basis of their research, that embryonic stem cells may be developed without destroying live human embryos. This theme was commented on by the same paper on Tuesday October 18th, 2005 in an editorial entitled "Stem Cells side shows".
I quote the editorial below: "Scientists experimenting with mice have devised two new ways to derive embryonic stem cells without destroying viable embryos. The work is being hailed for its potential to sidestep some of the ethical controversies that have slowed stem cell research in this country. But each of the new techniques raises ethical issues of its own, and neither is apt to be ready for use in humans for many years.
These and other approaches to deriving stem cells without destroying embryos clearly deserve further research, but they must not be allowed to halt or slow the most proven method of obtaining embryonic stem cells - extracting them from human embryos that are inevitably destroyed in the process.
One technique, developed by scientists at Advanced Cell Technology in Worcester, Mass, is comparable to a procedure already performed at in vitro fertilization clinics to diagnose genetic defects. An embryo is allowed to grow to eight cells, then one cell is plucked out and the remaining seven allowed to go on and develop. In the clinic, the eighth cell would be tested for genetic defects. The new work shows that it could instead be used to derive stem cells.
Unfortunately, the approach has drawbacks. Although some 2,000 babies have been born after a cell was extracted for genetic diagnosis, there is little data on the safety of the procedure or the long-term health of the children. Some ethicists deem it unethical to impose even a small risk on the embryo by extracting a cell just to create stem cells. Moreover the technique has limited scientific value because it cannot produce a stem cell with the exact genetic make up of a particular individual.
The other technique, developed at the Massachusetts Institute of Technology, is a variant of the method known as 'therapeutic cloning', which can produce exact genetic matches but is anathema to religious conservatives because it involves first creating and then destroying a human embryo. The M.I.T. research demonstrates the feasibility of an approach recommended by William Hurlbut, a Stanford professor and member of the President's Council on Bioethics, to avoid ethical objections. Insteadof creating a full-fledged embryo, the scientists manipulated genes to create embryo-like entities that were incapable of implanting in the uterus.
Some critics consider it morally objectionable to genetically engineer a defective embryo that can't implant. But advocates of this approach believe it can be refined to produce disorganized clumps of tissue that will be deemed biological artifacts, not nascent life. It would be great if some way could be found to produce embryonic stem cells of high scientific value without raising ethical objections. But until that day comes, it would be foolish to abandon proven techniques just to meet the ethical objections of a minority." (N.Y. Times Editorial comments of October18, 2005)
This position is somewhat balanced. However, this view seems to imply that genetic engineering of a baby can lead to many complications. When so many people object to and refuse to eat a tomato or any other plant product because they are genetically altered, how would they accept a human baby who is genetically altered without really understanding or finding out the consequences that may affect the future life of the resultant baby?
Also the idea that it is the objection of a "minority" is questionable. Has the majority of the populace been made aware or educated in this field to find out their considered opinion on this very important matter? Or has a careful study been undertaken by a competent and objective organization other than big pharmaceutical companies and commercial interests?
The relevant questions are: "is a human embryo of the same value as an embryo of a dog or a sheep? Should they be treated and experimented with in the same fashion? What is the meaning of human dignity and worth? Has any human being the right or ownership to give a baby in the making or an unborn baby for experimental purposes and for eventual destruction? Has an unborn baby the same and equal rights as a newborn baby? Why are mothers jailed for abandoning or killing their unwanted newly born infants? Do we have double standards in this matter?
Infant sacrifice practiced in some ancient or primitive cultures has been widely and loudly condemned as uncivilized barbarity. Such practices are now dressed in a ?modern civilized? attire in order to fool the general public by disguising the truth that human beings are being experimented with and destroyed in the process. Supporters are emphasizing the benefits that may be reaped by sacrificing the human embryo that has been created to offer at the altar of scientific research.
Do we defend the defenseless human infants who, if they had the ability, would say "our lives, to be or not to be"? Unfortunately it seems that very few of the general public have listened to their silent cry for help and redemption.
Please Note: These are controversial subjects. I have tried to state the facts as objectively as I can. Our Church had not yet expressed an official opinion on these matters. It is hoped that this first article may stimulate some thinking: and as a result comments may be forthcoming. The article is mine and I accept full responsibility for any mistakes. In preparing this paper, I have relied on information from the Internet and from scholars and ethicists especially some articles of Fr. John Breck, eminent theologian and ethicist of the Orthodox Church of America. I would highly recommend his recent book "God with us", published by the St. Vladimir's Seminary Press, for further reading.