Saletan on the Ethics of Stem Cells

William Saletan takes the position that progressives have no real bioethical position on stem cells in his most recent column in Slate. I’m a bit disappointed with Saletan over this one, because in his never ending quest to be thoughtful about everything, he’s usually much more fair to people – even those he disagrees with. But listen to his characterization of “progressive bioethics”.

I have problems with liberals. A lot of them talk about religion as though it’s a communicable disease. Some are amazingly obtuse to other people’s qualms. They show no more interest in an embryo than in a skin cell. It’s like I’m picking up a radio signal and they’re not. I’d think I was crazy, except that a few billion other people seem to be picking up the same signal. At most liberal bioethics conferences, the main question in dispute, in one form or another, is whether to be more afraid of capitalism or religion.

Lately, “progressives” have taken to issuing talking points. Every time a peer-reviewed science journal reports some new way of deriving embryonic stem cells without having to kill embryos, I can count on receiving a “progressive bioethics” e-mail that warns me not to be distracted by such fantasies. Bioethics has become politics by another name.

To fend off the bullies, the nerds have seized on stem cells. Some of them think embryonic stem-cell cures are just around the corner. Others know better but believe in the research anyway. What unites them is awareness that stem cells score very well in polls, much better than anything else on their agenda. Of 32 commentaries posted on the Web page of the “Progressive Bioethics Initiative,” 26 focus on stem cells. Some don’t even address ethics; they just lay out the polls. Stem cells are a chance for liberal bioethicists to beat the living daylights out of their opponents.

So I went to talk to them last night. I bitched about the atheism, the talking points, and the word progressive. I made a pitch for my version of liberalism. The freedom to strip-mine embryos, have a baby at 60, or kill yourself can’t be the end of the story. Not everything that’s legal is moral. The most interesting moral questions aren’t the ones you can settle with simple rules. They’re the subtle ones you find in literature and real life.

Conservative bioethicists think that when we recoil at something in this gray area, our repugnance signals a moral problem. Liberal bioethicists dismiss this argument as “fuzzy intuitionism” based on an illogical “yuck factor.” The liberals are making a big mistake. Fuzz and yuck are very real. They’re a lot more real to most people than bioethics is. You can’t just ignore them or wish them away. You have to help people sort them out and honor their concerns in a way that doesn’t require prohibition. An embryo may be less than a person, but it’s more than a tissue source. The government can’t stop you from having a baby at 60, but don’t be so reckless.

Is this a fair characterization of the ethics of using stem cells for research and maybe one day, tissue-engineering and cures? It may be what he took from the meeting, but I hope that isn’t the extent of progressive or liberal bioethics on stem cells, a desire to use a hot-button issue to beat conservatives at the polls. As someone who thinks this research important, I’ll try and do Saletan a favor and create a positive argument for embryonic stem cell research.

Much of the “Fuzz and yuck” that Saletan complains of stems from the idea that life begins at conception – an idea that is pervasive well beyond the Catholics who have incorporated it into their dogma. I think the start of an ethical argument on using stem cells from embryos is addressing this fundamental issue of where life begins, and if this gut idea of life is appropriate one to base policy on.

For one, any time someone suggests life “begins” you know that you’re no longer talking about a biological problem but a moral or theological one. It is not a biological problem as life does not “begin” with each round of human reproduction. Life is continuous. Sperm are alive, and eggs are alive, and life has been a continuous stream of living organisms begetting more living organisms since it began in some form some 1 billion years ago. The appropriate question isn’t whether life “begins” but rather when should we care? Should we care about eggs and sperm? Clearly not, they are wasted by humans anytime between once a month for women and 5-times daily for some men. So, most would agree we shouldn’t care about the basic germ cells being spilled upon the dusty ground as Monty Python so eloquently put it. Every sperm is not sacred.

But one could then argue, the fusion of the egg and a sperm is a “new” life. This isn’t a great distinction either for a few reasons. For one, that would also make each egg and sperm that went through recombination and meiosis new life since they don’t have a gene complement identical to their parent cells. So would cancer be “new” life. Just because something is new, doesn’t create a valid argument, in my opinion, for its value or personhood.

The best argument they have is that the embryo is a “potential” life – but is it really? Some 50% of fertilized eggs fail to implant, of those 50% that implant, the spontaneous miscarriage rate is about 10%. So 45% of the time fertilization might lead to a viable fetus. It is potential life, but there’s already a great deal of waste of this kind of life that no one sheds a tear over – probably because they realize that it’s not really a person being lost. Sperm and eggs then have potential of leading to a viable fetus too, what then makes the fertilized embryo more special? The higher probability of viability? What probability of forming a life then confers the value of personhood? Where is the threshold? Is wearing a condom then robbing sperm of their vital probability of making a new life equivalent to abortion? (some would say so – most would not)

Either way, an embryo that hasn’t been implanted doesn’t really represent a new person, as it only has about a 45% potential of becoming life. I realize not everyone will buy that leap, but what does it say of personhood if basic biology leads to the death of some 55% of persons before they’re even born? And shouldn’t we recognize the true origin of the idea that life begins at conception as an equally arbitrary and fundamentally religious one? It used to be that the Catholics believed ensoulment occurred with the “quickening“. Not the quickening from Highlander, it’s when the baby starts moving in the womb – another arbitrary marker. Ahy should conception be any more wise and wonderful than the quickening which served for so many centuries? And is it appropriate to base the ethical policy of a science like stem cells on the dogma of a religion? Since life does not “begin”, nor does life being new justify personhood (tumor rights anyone?), what else is left?

I would argue that fertilized unimplanted embryos do not deserve personhood status, or any other rights, simply because they are “new” life or potential life, or because the dogma of one religion changed from quickening to conception a couple hundred years ago. I believe that the opponents of embryonic stem cell research have failed to make a legitimate, non-dogmatic argument for the personhood or rights of a pre-implantation embryo, that justify its rights beyond that of an egg, or a sperm or a tumor. Personhood should mean more than “potential”. It’s more than just a beating heart. It’s a brain, thinking, feelings, all those things that make us human and not just instinct-driven machines. It’s why brain death is considered an end of life, even though the heart is still beating – remember all organs come from “living” cadavers.

There is more to life than just the presence of living tissue, or a beating heart and I believe a ball of cells isn’t a person. If you ask me it’s a lot more “yucky” for some theologian, or priest, or conservative bioethicist to say that a ball of cells has even a fraction of the value of a life like mine. Does it strike anyone else as being morally repugnant to make such a comparison? Doesn’t it seem even more disrespectful of the value of human life to reduce humanness to something as base as merely having living cells? Or potential? Or newness?

Saletan may not have been able to find progressives at this conference that were willing to debate this without discussing the political advantage or the utility of the science, but that doesn’t mean they don’t exist.