Submission by the Catholic Doctors Association of Victoria to the Lockhart Review Committee concerning the Research Involving Human Embryos Act 2002 and Prohibition of Human Cloning Act 2002

 

In summary, this submission has the following recommendations:

 

• The Research Involving Human Embryos Act 2002 should be altered to prohibit the harmful and destructive experimentation on ‘excess ART embryos’ for the purposes of any form of research including Embryonic Stem Cell Research.

 

• The Prohibition of Human Cloning Act 2002 legislation should remain intact and unchanged. The prohibition of all forms of human cloning should continue.

 

These recommendations are based on the following points in summary:

 

 

1.           ‘The human embryo is a human being’. This is a statement of fact and is based on    incontrovertible scientific evidence [1] [2] . Therefore, all research involving human embryos should conform to the standards outlined in the National Health and Medical Research Committee’s (NHMRC) National Statement on Ethical Conduct in Research Involving Humans.

 

            2.         The proponents of human embryo research do not provide evidence to justify the non-human status of the human embryo nor give sound reasons for excluding human embryo experimentation from the ethical conduct expected of ‘research involving humans’ on any other grounds.

 

3.         The arguments put forward to justify a distinction between worthy and unworthy human beings based on various ‘significant marker’ events during the continuum     of human development are erroneous, based ultimately on arbitrary distinctions [3]   and do not hold up to thorough scientific or philosophical scrutiny.

 

4.         On the basis of current scientific knowledge the moment of fertilisation is the only logical and evidence-based marker for when human life begins [4] and      therefore from when it should be respected and protected. This is so regardless of    how the embryo has been produced (ie Artificial Reproductive Technologies or Human Cloning) and regardless of its likely future development and survival.

 

5.              Societies that condone the division of the human family into worthy and unworthy subjects based on certain characteristics such as the various milestones of development, risk undermining the principles by which civilised societies are formed and exist [5] which include the care, respect and protection that is owed the weak, vulnerable and underprivileged.

 

6.              Adult Stem Cell Research is a more promising and successful form of research that is without the ethical concerns of Embryonic Stem Cell Research. Its considerable practical advantages [6] and superior track record in terms of cures, therapies and likely developments [7] , alone negates any pressing need for Embryonic Stem Cell Research.

 

                       

Whilst acknowledging that it is only for very serious reasons that the advancement of medical knowledge should be slowed or halted  we believe that in the case of human embryo experimentation and human cloning such reasons are met.

 

 Although it remains a possibility, merely speculative at this stage [8] [9] [10] that medical benefits and cures may result from embryonic stem cell research, this is still an insufficient reason for permitting  its practice when considered in the light of the nature and significance of the human embryo and the unavoidably harmful and destructive processes that are involved in such research.

 

The NHMRC’s National Statement on Ethical Conduct in Research Involving Humans states in its preamble that “the primary purpose of a statement of ethical principles and associated guidelines for research involving humans is the protection of the welfare and the rights of participants in research”. In the section headed The Principles of Ethical Conduct it states that  “…the guiding ethical principle for researchers is respect for persons”(Section1.2) and “In research involving humans the ethical principle of beneficence is expressed in researchers’ responsibility to minimise risks of harm or discomfort to participants in research projects”(Section1.3) and  “respect for the dignity and well being of the participants takes precedence over expected benefits to knowledge”(Section1.4) [11]

 

It seems clear from this that the destruction of human embryos in the harvesting of embryonic stem cells is either in breach of the guidelines of research involving humans or human embryos are not considered to be human.

 

Although the NHMRC fails to define what it considers to be human, surely this remains of the utmost importance when considering legislation that pertains to research and experimentation  involving human embryos. In view of the recommendations of ethical conduct made by the NHMRC in regard to research involving humans the issue of whether a human embryo is human is of profound and unavoidable significance.

 

The Issues Paper provided by the Lockhart Review Committee states that it is not the Committee’s purpose to “revisit the underpinning debate and rationale for the legislation” but merely to review the legislation in “light of the changes in scientific or community understanding or standards since 2002”.

 

However, this narrow focus of the Review Committee risks avoiding the central issue pertaining to human embryo experimentation, upon which all considerations of changes in techniques and practicalities as well as attitudes and understandings depend, and that is the nature and status of the human embryo.

 

Any consideration of the value, benefit and validity of embryo experimentation must take into consideration the nature, significance and value of human embryos. Without such consideration, the credibility of any conclusions or recommendations regarding this legislation will be called into question.

 

The ethics of all medical research is grounded in a respect for the dignity of the human person. The attainment of a benefit, cure or advancement of knowledge, no matter how great, can never justify disregarding the dignity, worth and respect that is due all human beings. This principle, now universally accepted by all civilised nations [12] , was transgressed with dire consequences in the recent history of the Nazi era. It should serve as a perpetual reminder of the consequences, in principle, that may follow when a society condones the expendability of some for the benefit of others or the advancement of knowledge.

 

 

Therefore, it is incumbent upon the proponents of human embryo experimentation to provide sound reasons for it being an exception to the universally accepted principles and ethics that  govern all other human medical research. Evidence or sound reasons should be given to demonstrate that either the embryo is not human or that there exists some special reason for excluding the human embryo from the strict ethical guidelines of human medical research.

 

 

The implications of allowing nascent human life to be reduced to experimental biological material, are profound and far reaching. When properly reflected upon, in the light of scientific knowledge about the nature and development of the human embryo and by extension its moral and ethical status, our response should be one of respect, care and protection rather than exploitation and abuse.

 

 

The harmful and destructive practices inherent in human embryo research injure not only the dignity and humanity of the embryos themselves but of all those who are involved and benefit from such practices. Of its nature the wilful destruction of human embryos diminishes the value of human life and undermines the principles upon which a civilised society are built. A society that is complicit in such discrimination and disregard of the most vulnerable members of the human family is diminished rather than enhanced by such complicity. Such a society risks being coarsened and dehumanised by its devaluing and careless regard for nascent human life.

 

So is the human embryo a human being?

 

 

From a simply scientific perspective based on current embryological knowledge, the human embryo is nothing less than a new and individual member of the human species. This biological fact is incontestable and is acknowledged in all standard embryological textbooks. [13] The human embryo, whether it be the result of human cloning or the excessive production through ARTs, remains nonetheless a human being at the very beginning of its existence.

 

The human embryo, even as a single celled zygote, is an identifiably unique human individual, separate and distinct from its parents and containing within itself the radical capacity to develop into an adult human being if it is given the proper nutrition and environment, as well as protection and time, necessary for its natural development. [14] These essential requirements are no different from the necessities of all human beings at any stage of their development.

 

The only reasonable conclusion that can be drawn from these realities and the radical capacity for an embryo to develop into an adult human being is that the embryo at its beginning is human already [15] [16] .

 

The assertion that the human embryo is merely a collection of human cells is simply mistaken. [17]

 

 

If the embryo is in fact human does it follow that it is deserving of the same ethical and moral considerations as more developed human beings?

 

The delineation points on the continuum of human development that are suggested as ‘significant markers’ for respect and protection as well as the arguments that are given as justification for this, vary among commentators who are in favour of embryo experimentation. This alone points to an underlying arbitrariness of distinction and indicates the dangerous vulnerability of these ‘distinction points’ for future change, manipulation and abuse.

 

In a civilised society the ethical and legal status of members of the human family should not be decided by the arbitrary opinions of the few, still less the opinions of the powerful and self-inclusive few. If any distinctions of worthiness between human beings is to be proffered then such distinctions must be based on sound and valid universal principles and reasons. A great burden of proof must be met in order to justify the exclusion of certain human beings from the protection and respect that is ordinarily derived from simply being human.

 

 

Unless this is so, such distinctions risk the arbitrary exercise of power by the strong who tyrannise the weak. History is replete with examples of this. When the norm of

 social practice involves defining a subclass of human beings as less than human, slavery is

 revived. There will of course be novel justifications for this but it will be history repeating

itself only in a different context.

 

In what remains I wish to point out the weakness of the arguments given for the various ‘significant markers’ that have been suggested.

 

 

What are the stages of development that are suggested as markers for respect for the developing human and are they valid?

 

 

Syngamy: the time soon after fertilization when the chromosomal pairs are aligned and juxtaposed. This event is simply an identifiable moment during the process of self-organisation  which  the newly formed organism has already begun, following the union of sperm and oocyte. No new and distinct chemical process, genetic material or information directing the zygote’s self-organization is evident or occurs at this point. Syngamy itself is in fact testimony that this newly formed and unique one-celled organism, with the full complement of human genetic information, possesses all the components necessary for the subsequent stages of human development, and is already organising itself.

 

Implantation: Although it is a very important event for the continued development and survival of the embryo, it is misleading to consider it the beginning of a new individual human life.  Implantation does not effect a change in the nature of the ‘thing’ that implants. It simply provides the nutrition and environment necessary for the embryo’s ongoing survival which is no different to any other human being at any stage of development. Prior to implantation the embryo is simply a ‘pre-implanted embryo’ and not a ‘pre-embryo’, which is an erroneous and unscientific term used by some for the purposes of deception.

 

The ‘14 day’ stage:

 

            a. The Pre-Twinning and Mosaicism Argument.

 

It is inferred from this argument that the embryo prior to this stage cannot be regarded as an ‘individual human being’ but merely as the precursor material for one or more individuals because prior to this stage the embryo is capable of ‘twinning’. If this argument  was valid we would no longer be able to speak seriously about an individual and distinct amoeba or rose bush. Now that the cloning of human beings has become a potential reality, can it then remain valid to speak of any human being as possessing a distinct individuality when it now is possible (theoretically at this stage) to clone (or ‘twin’) any human being at any stage of his development?

 

           

 

 

b. The Primitive Neural Streak Argument

 

The appearance of the Primitive Neural Streak is considered a significant event as it represents an identifiable precursor for the developing brain whose function is considered distinctive of our human status. Prior to this it is suggested that the embryo lacks the characteristic requirement for genuine human potentiality. However, why is this precursor event so distinct when there exists precursor events for the development of the Primitive Neural Streak? The Primitive Neural Streak is just as incapable of actualising the desired and characteristic human function as its own precursor would be.

 

In conclusion the name of this stage, ‘the 14 day stage’, itself suggests the weakness of its argument as Sir Bernard Briane pointed out in the House of Commons Hansard debates, 2 April 1990, when he stated “My First question is, 14 days after what?” [18]

 

Viability: (Intra-uterine)

 

This is largely a function of the availability of technology and skilled personnel. It seems somewhat arbitrary to base a distinction as important and otherwise universal as the value and dignity of human life on access to the limited, and ever changing capabilities, of life saving resources. Put simply, can the value, respect and protection that is due a given human individual change depending on the technological capabilities and resourcefulness of the society into which they are born?

 

Survivability: (extra-uterine)

 

This argument seems to hold much sway in the minds of those who advocate the experimental use of ‘excess ART embryos’. It is reasoned that because an embryo will never be transferred from a Petri dish to a woman’s womb, then there is therefore no possibility of survival beyond this arrested stage. The argument then follows that because the embryo is ‘going to die anyway’ it should be permitted to make use of them in some way, for purported benefit to others, thereby reducing them to merely expendable biological material. However, the fact that a human being is dying, regardless of their stage of development, cannot be a justification for the denial of respect to which they are entitled as a human being. If this principle were transgressed what would be the reason for proscribing harmful or even lethal experimentation on the terminally ill and the persitently unconscious when it may be of benefit to others.

 

 

 

 

 

 

 

 

Personhood:

 

This position accepts the human status of the developing human but argues that certain functions or requirements need to be met in order for a human being to claim or be granted the status of personhood and its concomitant dignity, respect, value and protection.

 

1. as conferred

Personhood is something that can be conferred on a human being through a decision made by existing human persons. The status of personhood by consensus, custom, preference or whim undermines the very foundation of a civil society which presumes the innate human equality and dignity of all human beings. Therefore, the status of personhood cannot simply be the domain of decision-making by the majority or by the powerful.

 

2.  as attained.

Personhood requires the realising or attainment of a given set of characteristics and functions.

The lists of ‘attainment definitions’ of personhood are ultimately arbitrary and differ amongst different authors. What they do have in common is that the lists and descriptions are made by human beings who automatically qualify as persons on the basis of their own lists. Functional definitions of personhood ignore the concepts of radical capacity and active potentiality and always exclude the weak and the vulnerable from personhood.

However, it is in the nature of being human and the possession of unique and radical capacities that the inherent dignity of personhood is located and not merely by the realising of these capacities as a result of circumstance, opportunity and good fortune.

 

 

Research Developments since 2002

 

Quite apart from the central issue of the ethical status of the human embryo, the developments in stem cell research in the 3 years since the legislation was enacted confirm the likelihood of a greater potential for adult stem cells to develop therapeutic successes and cures than embryonic stem cells.

 

There are currently over 80 therapies available as a result of adult stem cell research and over 300 clinical trials underway. [19] However, there have been no therapeutic successes with embryonic stem cells nor are there any current human clinical trials underway. Nor do they seem likely at least in the foreseeable future because of the many practical difficulties that beset such research such as teratoma formation, the exhibition of chromosomal abnormalities and the problems of immune rejection. [20] [21]

 

The result is that after 3 years and 9 licence provisions for the use of  ‘excess ART embryos’ there has been little or no contribution or significant advance to the knowledge of stem cell therapies especially as it pertains to the benefit of the sick and injured.

 

Conclusion

 

In a civilised society the State should place its power at the service of all its members, in particular the more vulnerable members of the human family. By excluding categories of human beings from protection by the law the State risks undermining the principles and constitutive elements of civil society on which it is founded.

 

The intervention of the public authority should be inspired by rational principles based on the best available scientific knowledge. In the case of human embryo experimentation, whether involving human cloning or excess ART embryos, the weight of scientific evidence confirms the human status of the developing embryo. Without sound reasons and principles to justify the exclusion of categories of human beings, the State risks the erosion of the fundamental principles of “the inherent dignity and of the equal and inalienable rights of all members of the human family” [22] which form the basis of freedom, justice and peace.

 

 

In view of this, the Review Committee should resist all attempts to condone and legislate for the exploitation of human embryos as disposable biological material and uphold the prohibitions on all forms of human cloning and embryo experimentation. It should also strongly consider repealing the parts of the legislation that allow for the use and exploitation of ‘excess ART embryos’ in order to be consistent with the otherwise reasonable respect and protection that is shown for nascent human life in the current legislation.

 

 

Yours Respectfully,

 

Dr Eamonn Mathieson

 

 

On behalf of the Executive Committee representing the Catholic Doctors Association of Victoria:

                                    Dr Eamonn Mathieson

                                    Dr Nicholas Bare

                                    Dr Michael Plunkett

                                    Dr Dominica Ho

 

We would be happy to answer any further questions pertaining to this most important legislation.

We can be contacted through our website: www.catholicdoctors.asn.au or by emailing committee@catholicdoctors.asn.au