Category Archives: Bioethics

Creating the Missing Link

Bioethics

No stranger to the problem of radical Darwinism that presents man as nothing more than a “trousered ape,” GK Chesterton once quipped that “dogmatism of Darwinians has been too strong for the agnosticism of Darwin; and men have insensibly fallen into turning this entirely negative term into a positive image. They talk of searching for the habits and habitat of the Missing Link; as if one were to talk of being on friendly terms with the gap in a narrative or the hole in an argument, of taking a walk with a non-sequitur or dining with an undistributed middle.”  He condemned the Darwinian habit of looking at the history of prehistoric man (i.e. man before there was history) for the existence of a Missing Link.  What he probably could not have anticipated was that in some time in the future we might cease to look for the Missing Link in the past and begin to create it.

The NIH recently announced that it was in the process of making funding decisions for two areas of research in which:

  1. human pluripotent cells are introduced into non-human vertebrate embryos, up through the end of gastrulation stage, with the exception of non-human primates, which would only be considered after the blastocyst stage, or
  2. human cells are introduced into post-gastrulation non-human mammals (excluding rodents), where there could be either a substantial contribution or a substantial functional modification to the animal brain by the human cells.

Named for the Greek mythological fire-breathing female monster with a lion’s head and a serpent’s tail called a Chimera, the research is focused on creating an organism that is composed of cells derived from human and non-human species.   The name alone ought to give us pause as to whether this is an avenue we ought to be pursuing.

To be fair, it is not the mingling of the cells that is problematic—technically all humans are chimeras in that they have many bacterial cells mixed in their bodies, but it is the type of cells that are problematic.  It helps to see the problem by cutting through some of the scientific jargon.

What exactly is a pluripotent cell?  It is a cell that has the capacity to develop into every cell type in the human body.  There are two main sources for these types of cells—embryonic stem cells and adult stem cells.

Gastrulation is an early developmental stage of an animal embryo in which three germ layers are formed—the ectoderm (by which the skin, nerves and brain are formed), the mesoderm (bone, connective tissue and muscle), and the endoderm (out of which the lungs, liver and digestive system form).

Blatocyst represents the stage in which a ball of cells forms just before implantation.

With these definitions in place we can clarify what is being proposed.

  1. Introducing human cells that have the potential to turn into any types of cells to an animal embryo at an early stage of development.

What researchers have discovered is that if they remove the nonhuman animal gene for the development of a specific body part in that animal and introduce pluripotent cells of another animal, then the animal will develop that body part.  A 2010 study in Japan showed that when researchers injected rat stem cells into embryos of mice that had been modified to not produce their own pancreas, the mice developed a healthy pancreas that was almost completely composed of rat cells.  The proposal is to do something similar with human stem cells that could develop body parts that would be composed of human cells.

2. At a later stage of development, human brain cells would be introduced into the                      animal brain.

This area of research would lead to “a substantial contribution or a substantial functional modification to the animal brain by the human cells.”

Even if we assume that the intention of the research is good, that is, therapeutic in nature, the creating of Chimeras is still morally problematic in ways that might not seem apparent at first.

Obviously the use of embryonic stem cells for research, because it is the result of the destruction of a child, creates a grave problem.  But even if adult stem cells are used, this still represents grossly unethical behavior.

First, the potential for the pluripotent cells to develop into any types of cells is a huge problem.  There is no way to know a priori which types of cells they might turn into.  Knocking out a particular gene may allow some control, but how do they keep them from developing into other types of cells?  In other words, the earlier the human stem cells are introduced during animal development the greater the chance for widespread integration. What would happen if some human cells made their way into the testes or ovaries and human sperm and eggs were grown?  Supposing two chimeric animals were to mate then it is possible that a human embryo could develop.

chimera-greek-mythology

Likewise with the brain.  One experiment took brain cells of developing quail and put them into developing brains of chickens.  The result was that the chickens exhibited vocal trills and head bobs like quails.  Should we expect anything different with the mingling of human and non-human brains?  The animals would begin to exhibit human behaviors.

This sheds light on the bigger issue and one that our society especially is in no position to navigate.  What exactly makes a person a person?  Where do we draw the line between a human and non-human?  The most obvious place to draw the line would be when the offspring has two human parents (we even have trouble doing this!).  When would the animals that have been integrated with human cells cease to be mere animals and instead become human?

This is not a question merely for philosophers but has legal implications.  When do we decide that the creature is worthy of the respect given to all human beings?  Does a humanzee have the same rights as other humans?  What are our obligations towards the Chimera?  When the research is done, can we simply destroy the chimeras or are we obligated to allow them to live?

It is this blurring between human and nonhuman ultimately that makes this type of research so dangerous.  While the researchers may have the best of intentions, there are dangerous consequences.  Fr. Tad Pacholczyk from the National Catholic Bioethics Center proposed the following guidelines when determining the licitness of particular Chimeric research:

  • The procedures must not involve the creation or destruction of human embryos.
  • They must not involve the replication of major pillars of human identity in animals, such as the brain system.
  • They must not involve the production of human gametes, meaning the basic building blocks of human reproduction.

One can easily see that what the NIH is proposing violates all three of these principles and therefore we have an obligation to oppose this.

We have been assuming good will on the part of those who are conducting the experiments, but the fact of the matter is that not all who embark on this work are looking for therapeutic applications.  In the 1920s, Josef Stalin tasked Russia’s top animal breeding scientist Ilya Ivanov to find a way to cross human beings with apes to create a super soldier.  Stalin may have died, but his dream did not die with him.  As CS Lewis said in his book Abolition of Man, “each new power won by man is a power over man as well.”  The power that man has to make himself what he pleases is really the power of some men to make other men what they please.

In conclusion, science offers great hope for the future of medicine.  However this requires a commitment to growth in our moral understanding as well in order to avoid the pitfall of confusing the technically possible with the morally permissible.  We would all be well advised to heed the warning of John Paul II when he said that once “the human body, considered apart from spirit and thought, comes to be used as raw material in the same way that the bodies of animals are used…we will inevitably arrive at a dreadful ethical defeat” (Letter to Families, 19).  We must stop the creation of the Missing Link.

Pulling the Plug

Bioethics, End of Life

After giving them the entire synopsis of the Gospel for the first eleven chapters of his letter to the Romans, St. Paul tells the Christians to be “transformed by the renewal of your mind” (Romans 12:2).  In essence he is telling them that the Gospel ought to penetrate into every single dimension of their lives.  This is the role of the Church as Teacher—to show us just how deeply the Gospel penetrates all areas of our lives and how we can act as “heirs of God and joint heirs with Christ” (Romans 8:17) in all things.  For converts coming into the Church, it is often the Catholic intellectual tradition that makes the Church herself attractive because it reveals truth as an integrative whole—incorporating not just divine Revelation, but philosophy, science and even psychology all leading us to the One Who is Truth itself.  There may be no single area where this integration is more obvious than in the Church’s teaching on end of life.

Modern medicine is plagued by the problem that there is no strictly scientific way in which to determine when someone has died.  St. John Paul II in an Address to the Eighteenth Meeting of the Transplantation Society in 2000 acknowledged this difficulty when he said:

“…the death of the person is a single event, consisting in the total disintegration of that unitary and integrated whole that is the personal self. It results from the separation of the life-principle (or soul) from the corporal reality of the person. The death of the person, understood in this primary sense, is an event which no scientific technique or empirical method can identify directly.”

In defining death as the separation of the soul from the body, it is obvious that it cannot be determined empirically since the soul is non-material in nature.  Furthermore, as the Holy Father pointed out death is not a process but the definite termination of the life of the person.  What this means is that not all parts of the body die at the same time (fingernails and hair continue to grow for example).  Further complicating this is the fact that through ventilators and heart pumps the person can appear to be alive almost indefinitely.  In summary, it seems at best that medicine can only develop a set of criteria that makes the fact that death has occurred very likely.

Despite the fact that no empirical method can identify when death actually occurs, it is possible to apply Thomistic principles in order to create a criterion for death and leave it to modern medicine to determine what clinical signs may be used to obtain moral certainty that death has occurred.

LifeSupportSlider

To understand these principles, we must first look at the Catholic understanding of the human soul.  Technically speaking the soul is simply the animating principle of each living thing.  In other words, there is no such thing as a living being that does not have a soul.  There are three different types of souls that exist in a nested hierarchy of sorts.  First there is a vegetative soul that has the capacity for growth, assimilate nutrition and reproduction.  A sensitive soul has all the capacities of the vegetative soul plus has the capacity for locomotion and perception.  Finally the intellectual soul has all the capacities of the other two plus the capacity for rational thought.

It is also necessary to examine what we mean when say that “the soul is in the body.”  When a spiritual principle is “in” a material principle it really means that the spiritual principle is operating upon it.  But the human soul does not operate upon each part of the body directly.  When I will to raise my hand, it is not my will that operates directly on my arm, but instead it operates on a “primary organ” through which the soul “moves” or “operates” the body’s other parts.    Although St. Thomas thought this organ was the heart, modern biology tells us that this organ is the brain.  His philosophy was solid, he just lacked the necessary biological knowledge to be more precise.

With this understanding of the human soul and its action upon the human body serving as a foundation, we can now apply this to the practical question of when death occurs.  To say that the soul “has left” the body is to say that the soul is no longer acting upon the body.  Because the union of body and soul is a substantial one, this can only occur when it is no longer able to operate on the body because of a permanent defect in the primary organ (the brain).  This is the basis for the Church’s support of the “neurological criteria” for ascertaining death.

The problem of course is that medically speaking, “neurological criteria” for determining death means different things to different people, but the Church has a very specific understanding of this criteria.  Returning to St. John Paul II’s 200 address, he says, “…in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem).”  This is the so-called “whole brain death.”

To see why this must be so, we can return to St. Thomas’ teachings on the human soul.  The human soul operates in three different capacities—rational, sensitive, and vegetative.  Although we have a single soul, not all these capacities need to be exercised for the soul to be present (think of when we are asleep for example).  Even if the higher capacities can no longer be exercised because of brain damage, the soul is still present and operating in its vegetative capacity.  In other words, when the vegetative capacity can no longer be exercised, we can be morally certain that the soul has left the body and the person may be declared dead.

The person who still has vegetative powers is still in fact alive and loses none of their dignity as a person.  They may be in what is defined medically as a (Permanent) Vegetative State (PVS), but they are still a person and entitled to the care that we afford all people who are incapacitated in some way.  This care includes things such as bathing, warmth, turning them to avoid bedsores, pain relief and most importantly providing food and water.

These basic elements of care are distinct from medical treatments (which are interventions made to return someone to health or cure disease) and are never optional.  There is a tendency within some medical communities to treat those in PVS as if they are already dead and only the body is left.  This leads to the practice of removing nutrition and hydration from them; a practice that was rejected by the CDF in their 2007 document Responses to Certain Questions of the USCCB Concerning Artificial Nutrition and Hydration.  In a very clear manner it was taught that

“The administration of food and water even by artificial means is, in principle, an ordinary and proportionate means of preserving life. It is therefore obligatory to the extent to which, and for as long as, it is shown to accomplish its proper finality, which is the hydration and nourishment of the patient. In this way suffering and death by starvation and dehydration are prevented. A patient in a ‘permanent vegetative state’ is a person with fundamental human dignity and must, therefore, receive ordinary and proportionate care which includes, in principle, the administration of water and food even by artificial means.”

This is why the Church so vociferously opposed the ruling in the Terry Schiavo case.  While she was in a PVS and very unlikely to ever regain use of her higher faculties, she was not dying.  Instead her cause of death was dehydration and starvation.  Unfortunately there are cases every single day that do not garner the same national attention, that still require our attention.  All too often when confronted with what appears only to be a medical decision, families defer to unethical doctors.  “Pulling the plug” is always a moral decision and one that we can make well when we value and attempt to see the truth of the Church’s teachings.