I would be lying if I said that this week's topic was easy for me. The first five chapters/sections/blog posts I didn't really struggle with what to write about or have to debate too seriously where I stood on the issue. But the reading today pushed me to question some things. Which isn't entirely a bad thing! That's what the point of this class is anyway, to challenge our positions and ethics and start thinking about ethical and moral questions in different ways and develop as scientists and people. But yikes, this one is a doozy.
Chapter 6 of Medical Ethics is on embryos, stem cells, and reproductive cloning. It's an interesting topic to say the least. It continues the discussion of the rights of embryos and potential personhood, which is one that we've been carrying for a couple of weeks now. It also introduces the science of stem cell research and cloning, which I don't have trouble with for the most part. It's when the questions about the ethics of allowing people to use cloning for reproductive purposes came up that I started to question where I stood. We'll get to those questions a little later, but I do want to talk first about some of the other topics that were discussed in this chapter.
Let's jump first into the rights (or supposed rights) of embryos. The chapter starts off by talking about a couple of cases where couples opted to freeze embryos instead of implanting right away for various reasons and about court cases that followed. In these cases, the courts decided that a parent could not be forced to have a child that they did not want or were not ready to have. This goes back to reproductive rights and parents' right to choose whether or not they want to have a child, and I agree with the courts' decisions. The author (Pence) also went on to discuss the fact that millions of frozen embryos exist around the world, losing viability the longer they stay frozen. And that's if the parents assume responsibility for them and respond when the clinics ask them what they want done with these embryos; which was the case when some clinics in the US had problems with power and their freezers, and wasn't the case when a clinic in England attempted to contact couples without success and ended up getting rid of 2/3 of the embryos frozen at their clinic (Pence 152, 155). The argument stands that human embryos do not have human form and cannot experience pain before 14 days (Pence 153). So is it really a human that is being casually disposed of? Or is it just genetic information and the potential for personhood that is being tossed? Or do we care? If we let the embryos gradually degrade in a freezer, is that more or less ethical than getting rid of the spare embryos? Or is there even such a thing as spare embryos? Should we allow research on these embryos? Should we allow embryos to be created specifically for research? Where do we draw the line?
The book includes several arguments for and against all of these questions, and it definitely makes for some interesting thoughts and/or discussion. For example, some think that treating an embryo as valuable because of its potential can be refuted by a reductio ad absurdum, which shows that implications of an idea are absurd and cast doubt on the idea itself (Pence 154). Also, if embryos are persons, then creating embryos for IVF in general and freezing them for later use, pre-implantation genetic diagnoses, medical research, IUDs, and Plan B would all kill persons (Pence 154). At the same time, when no particular woman (or person) has a legal responsibility to gestate or carry frozen embryos to term, it's hard to argue for the rights to life of a frozen embryo. There is a significant amount of potential contradiction here, and some cognitive dissonance -- which Pence dubs "a philosophical difficulty" (Pence 154).
As far as research goes, blocking funding for embryonic stem cell research and making it illegal was, according to Pence, "a major tragedy" (Pence 156). And that I agree with. The United States has the scientists and resources to dedicate toward research that could be critical in relieving suffering for people afflicted by serious genetic, chronic, and fatal disorders/diseases. Research involving human cadavers has gone on for decades, and as long as respect is maintained for the subject, most people do not have an issue with this kind of research. Research on immortalized stem cell lines from human embryos has the potential to do the same amount of good that cadaver research has done, and as long as a similar level of respect is maintained, there shouldn't be a battle or legislation blocking it.
Now to the conflict of the week, reproductive cloning. There are a lot of ethical issues and questions surrounding the cloning of animals (starting with Dolly the sheep in 1997), let alone humans. Questions surrounding cloning being against the will of God, denying a person the right to a unique genetic identity, cloning being unnatural and perverse, the right of an open future and the choices they would get to make on their own vs being pushed in a certain direction. This reminds me of a book that I read back in middle school, The House of the Scorpion. In this fictional, futuristic story, the main character is a clone of a drug lord who has been around for much longer than should be physiologically possible because he continues to have clones birthed and then he takes their organs for himself. Which is obviously unethical and highly problematic, but is also a good demonstration of what media have done with the idea of cloning humans. In general, I don't have any issues with the potential future possibility of an additional way for people to have children (via cloning). For me the question is more of if cloning would then be considered "elitist" and would lead to increased inequality, and if that were true then doesn't IVF also fall under that question? I think that people should have the right to choose to reproduce, and that those who are unable to conceive a child "naturally" should have other options. I just don't trust people to always have the best of intentions, and don't personally love the idea of a wider gap between the rich and the poor and the creation of dynasties of "superior" humans.
So, again, I don't have all of the answers. But for some reason this week that caused more conflict for me. I know it's probably not to the level of a "Category 55 Doomsday Crisis", but it's cause for me to stop and think more about reproduction and inequality and what the future of the world may look like.
Textbook reference:
Pence, Gregory. Medical Ethics: Accounts of Ground-Breaking Cases. 9th ed., McGraw Hill, 2021.
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