Frame Game

The Ethicist’s New Clothes

As the debate over stem cells and cloning grows, participants on all sides are rushing to show they’ve got ethics. Biotechnology companies have signed up ethicists to serve on advisory boards. President Bush says he’ll appoint a Presidential Council on Bioethics. Critics of the biotech industry have enlisted independent ethicists to accuse the industry’s ethicists of bias. All sides agree on one thing: The key to ethics is following guidelines drafted by qualified and unbiased ethicists.

Wrong. Credentials and committees don’t make you ethical. Principles do. Those principles have to make sense. You have to apply them consistently or rethink them if you can’t stomach their implications. And the easier you make them, the less they matter. The slickest way to make yourself look ethical is to narrow the definition of ethics so that it won’t interfere with what you want to do. But that won’t make you ethical. It’ll just make you an ethicist.

To understand how ethicists create the illusion of ethics without the real thing, let’s examine two case studies. Last month, researchers at the Jones Institute for Reproductive Medicine disclosed that they had created embryos in order to harvest stem cells, thereby killing the embryos. In the journal of the American Society for Reproductive Medicine, they reported that they had subjected the experiment to ethical reviews by four committees. Their diligence was applauded. “I am impressed with the thoughtful approach taken with the ethical issues involved,” said the co-chairman of the ASRM’s ethics panel.

What exactly was this thoughtful approach? In a long-winded discussion studded with meaningless references to clergy, duty, humankind, and various ethics boards, the researchers essentially argued that if they had used embryos left over from in vitro fertilizations, they’d be changing the purpose for which the donors of those embryos had created them. It’s more honest, they reasoned, to tell donors up front that you’re going to use their eggs and sperm to create embryos and destroy them.

Within its parameters, this rationale makes sense. The problem is those parameters. The only question addressed is whether the donors properly consented. The propriety of what they consented to is ignored. Hence the Jones team’s bizarre pride in reporting that it had told donors that their embryos wouldn’t be used to help anybody directly. “It was repeatedly stressed in all information, verbal and written, provided to gamete donors … that the embryos would not be used for the initiation of a pregnancy,” the researchers wrote. “They were also informed that if any ESC [embryonic stem cell] lines were created, they would not be used for therapy in anyone.”

The logical result of this preoccupation with the donors’ will is that the embryo has no intrinsic value. If the donors intended to grow it into a baby, it should be grown into a baby. If they intended to kill it, it should be killed. That’s one reason why the Jones team didn’t use embryos from couples. “Soliciting eggs and sperm from donors who do not know each other and have no reproductive intent can ensure that there is no regret about using the embryo for research,” explained University of Wisconsin ethicist Alta Charo. The Jones embryos were perfectly sterile, uncontaminated by erotic or parental love. If we don’t want them, don’t care about them, and don’t think they’re human, they aren’t.

A day after the Jones study was disclosed, scientists at Advanced Cell Technology said they had launched a project to clone human embryos for research. The chairman of ACT’s ethics board, Dartmouth religion professor Ronald Green, described to reporters the elaborate guidelines the board had imposed on the research. ”We’ve thought long and hard about this,” ACT President Michael West assured the New York Times. The message got through. “Before starting, the company created an independent ethics board with nationally recognized scientists and ethicists to develop a plan with clear moral standards,” the Washington Post reported.

And what was that plan? Green refused to release the company’s ethical guidelines. But according to a summary he provided to the Associated Press, eggs assigned to the project “are taken to a secure location and kept in this location at all times. Access to this location requires permission of two ACT technicians. The incubator where eggs are cultured is locked at all times. … Eggs are repeatedly counted, photographed and videotaped. … By day 13, following any research activities, activated oocyte [the egg] is properly disposed of and the experiment ended.” The Post and Times noted the “extreme precautions” and “elaborate security measures” outlined by Green and West.

There’s only one problem with these ethical rules. They’re not ethical. They’re mechanical. What’s their purpose? To prevent embryos from being smuggled out and implanted in a womb, says Green. Why is that important? And why require disposal after 13 days? To answer those questions, you have to go back to the Dec. 27, 2000, Journal of the American Medical Association, in which West, Green, and other ACT ethicists outlined their thinking. Personhood, they argued, can’t begin until two weeks into human development when embryonic cells, in a process called gastrulation, align to form layers that will eventually become organs.

[B]ecause twinning and chimerism [the merging of two embryos into one] are still possible during the early stages of development, it is doubtful that one can speak of human individuality at this time. Developmental individuality, which is central to personhood, is not attained until the primitive body axis has begun to form. … The line established by gastrulation and the appearance of the primitive streak is a clear one, as is the line between therapeutic and reproductive cloning. It is unlikely that researchers working in properly monitored environments will blur these distinctions.

The breadth of ACT’s “ethical guidelines” conceals the thin logic of this lonely premise on which they stand. Essentially, the argument is that since the early embryo could become one body or two bodies, maybe it’s nobody.

Unless you buy that argument, there’s no apparent reason to draw the line at gastrulation rather than at conception (or its counterpart in the cloning process, nuclear transfer), the onset of the heartbeat, the onset of brain waves, or fetal viability. If the choice among these lines comes down to which one is most clearly drawn by nature, conception wins hands down. So ACT overrides nature. It erects a barrier of surveillance cameras, bodyguards, and disposal deadlines—a “properly monitored environment”—to make gastrulation a clearer line in industry than it is in nature. The company prevents pre-gastrulation embryos from becoming post-gastrulation embryos the same way it prevents therapeutic clones from becoming reproductive clones: by segregating and killing them.

In this way, ACT, like Jones, defines the embryo’s value by its custodian’s intent. Inside the lab, the company locks up, grows, experiments on, and destroys human entities it calls “activated eggs,” “ovasomes,” or “nuclear transfer-derived blastocysts.” According to Green, “These are not embryos” since “they are not the result of fertilization and there is no intent to implant these in women and grow them.” Outside the lab, the company scrupulously avoids soliciting eggs from women who might otherwise donate them to fertility clinics. The inside rules, like the outside rules, are designed to protect the world in which embryos matter from being contaminated by the world in which they don’t.

Is this ethic of segregation itself ethical? ACT’s advisory board didn’t even debate that question. “We didn’t spend an enormous amount of time” discussing the morality of embryonic cloning, Green told the Wall Street Journal. “We wouldn’t have been [on the board] unless we thought that the research had important benefits.” The board confined itself to procedural questions such as how eggs should be obtained and how the doomed embryos should be quarantined. Nor has the board scrutinized other ACT projects. In 1996, the company briefly grew a hybrid embryo by implanting a human cell nucleus in a cow egg. ACT filed patents in 1999 and 2000 on a proposal to grow human tissues inside mice, but West didn’t mention this to the ethics board until last month, and then only vaguely. When one ethicist quit after learning that ACT had cloned an endangered species without informing the board, Green defended the company. The board’s job, he asserted, was to evaluate the human cloning project, not ACT’s other experiments.

Ethicists outside the industry complain that those who advise ACT and other biotechnology companies are unlicensed, unrepresentative, anonymous, and possibly corrupted by the fees they receive. They miss the point. Or rather, they illustrate it. The ethical rules these outsiders would impose on private ethics boards—licensing, diversity, accountability, financial independence—are just as procedural and hollow as the stem-cell ethics those boards have devised. The problem isn’t corruption. It’s timidity. Corporate ethicists, like corporate lawyers, have reduced their purview to technique. Tell them what you want to do, and they’ll tell you how to do it. What they won’t do is question the essential propriety of your enterprise.

Fine. They don’t have to. But somebody should. The rest of us have to stop relying on ethicists to define ethics. We have to ask whether their questions are broad enough and whether their answers make sense. In his speech to the nation last week, President Bush said it was moral for the government to fund research on stem cells derived from embryos that had been destroyed for that purpose. Rather than explain why, the president said he had consulted ethicists and would appoint a panel of them to study the issue further. Bush didn’t even hint at his logic until three days later. “The only licensed live chickenpox vaccine used in the United States was developed, in part, from cells derived from research involving human embryos,” he observed in a Times op-ed. “Many ethical and religious leaders agree that even if the history of this vaccine raises ethical questions, its current use does not.”

That’s it. That’s all the president felt obliged to say: Ethicists and clerics had assured him that in a similar case, making good use of destroyed embryos didn’t even “raise ethical questions.” What principles justified that conclusion? Would those principles extend to stem cells, and if so, where would they stop? What other considerations might be relevant? Bush didn’t answer. Trust the ethicists, he said. Which ethicists? Bush has his; ACT and Jones have theirs. President Clinton’s bioethics council says one thing; Bush’s will say another. Résumés, commissions, and regulations can’t settle these disputes. Nor can ethicists. It’s not their job. It’s yours.