Stumbling on Status: Abortion, Stem Cells, and Faulty Reasoning

By Karen Lebacqz

When the field of bioethics was still in its infancy, abortion was a prominent topic. In the last ten years, human embryonic stem cell (hESC) research has been a prominent topic. Common arguments on both sides of the abortion debate set the stage for the stem cell debate. Unfortunately, those arguments demonstrate flawed reasoning and result in failure to attend to important morally relevant differences between abortion and hESC.

 

Jumping to Conclusions
In the delightful children’s story The Phantom Tollbooth, a little boy named Milo and his two non-human companions are driving along a mythical road when all of a sudden they find themselves on a small island surrounded by a large sea. “Where are we?” asks Milo. “This is the island of Conclusions.” “How did we get here?” “You jumped, of course….every time you decide something without having a good reason, you jump to Conclusions whether you like it or not.” Thus does Norton Juster caution us against an all too common practice: jumping to conclusions.
Jumping to conclusions is so common in the abortion debate that we hardly notice it. The stage is set by the Roman Catholic argument:
Human persons should not be killed.
The embryo is a human person from the moment of conception.
Therefore, the embryo should not be killed.
This reasoning is then applied to abortion and stem cells:
Embryos should not be killed.
Both abortion and stem cell research involve killing embryos.
Therefore, both abortion and stem cell research are wrong.
This argument makes the moral status of the embryo central: if the embryo is a person from the moment of conception, then abortion and stem cell research are both wrong. So unassailable does this logic appear that questions of moral status still plague the stem cell debate. Thinkers on both sides assume that the key question is the moral status of the embryo.
Religious and secular supporters of hESC then argue that the embryo is not a “person” (i.e. protectable) from the moment of conception. In Jewish tradition, the embryo is “like water” until 40 days after conception; while abortion is still discouraged, abortions prior to that time can be justified and some may even be morally required. Some Roman Catholics also declare the early embryo to be part of the human species but not yet a protectable human individual; it lacks full moral status. Philosopher Jeff McMahon creates perhaps the most extreme argument: until there is consciousness, around the 20th week of gestation, there is only “organismic life” and not “personal life.” Hence, for McMahon, the embryo prior to development of the capacity for consciousness is not a person and abortion simply destroys an uninhabited organism.
While these sources differ on the timeline for assigning “protectability” to the developing organism, they nonetheless concur that embryos prior to a certain time are “not fully human” and therefore can be destroyed in some circumstances. In short, several traditions, both secular and religious, take the approach of assuming that if the embryo is not ‘fully human,’ abortion or stem cell research is acceptable.
These various approaches are usually labeled “developmental.” They depend on an unspoken syllogism that looks something like this:
Human persons should not be killed.
The (early) embryo is not yet (fully) a human person.
Therefore, the (early) embryo may be killed.
And therefore, abortion and/or stem cell research are permissible.
But this is flawed reasoning. If red apples are good to eat, but this apple is green (not red), does it follow that this apple is not good to eat? Of course not! Green Granny Smith apples are among the most popular apples for eating. It is a mistake to conclude that this apple is not good to eat just because it is green rather than red. The conclusion does not follow from the premises as stated.
This rather obvious mistake in logic is precisely what is happening in the “developmental” view above. Even if an embryo (or, in the case of stem cell research, a blastocyst) is not yet a “person” in the moral sense, asserting that it is not a person does not make destroying it acceptable. If it is true that non-persons may be killed and it is true that the (early) embryo is not a person, then it would follow that the (early) embryo could be killed. But is it in fact the case that non-persons may be killed? In a day when people fight to keep dolphins and redwood trees alive, and argue over the rights of great apes, it is not obvious that non-persons may be killed. It is not sufficient to assume that non-persons may be killed. What is needed is an argument about when killing is justified.
However, the same applies to those who oppose abortion or stem cell research. Is it true that human beings should not be killed? There may be “no moral belief that is more universal, stable, and unquestioned… than the belief that killing people is normally wrong,” but there have almost always been exceptions-- killing in self-defense, capital punishment, and killing in wartime, for instance. The premise that humans should not be killed must be modified and examined. Good reasons need to be offered for this assertion. As McMahon points out, most commentators fail to give sufficient reasons for the wrongness of killing or to address the full range of intuitions about this wrongness. Qualifications are needed: “human persons should not be killed, unless circumstances X or Y obtain.” Then a debate is needed over the possible circumstances that might justify killing. This step is often neglected, or it is oversimplified by suggesting that “innocent” human life should not be killed and assuming that an early embryo is by definition “innocent.” Those who argue against abortion or stem cell research often simply assume the wrongness of killing human life, and fail to address why killing is wrong and whether the reasons for the wrongness would apply to abortion or stem cells as well as to other instances.
In short, both sides of both debates have been guilty of “jumping to conclusions” and ignoring the need to examine premises carefully. What may look like unassailable logic is in fact not unassailable logic.

 

Clarity about terms
Sondra Wheeler pleads for care in the language used in the stem cell debate. Such care, she argues, is “both an intellectual and a moral obligation in ethical discourse.” Wheeler applies this plea to argue that we should not equate a five day old embryo with a “fully formed and functioning human being.” I will apply it instead to argue that we should not equate destroying something with “killing” it. The term “killing” is a loaded term.
Both sides in both debates tend to assume that abortion and stem cell research involve the “killing” of an embryo. But is this true? Judith Jarvis Thompson argued many years ago that abortion is, technically, the emptying of the womb. It is the separating of the woman from the embryo or fetus. Thompson argued that a woman has the right to separate herself from another, and need not sacrifice her body to support another’s life or growth, even for nine months. We would be appalled, she suggested, if we were required to be hooked up to a famous violinist for nine months in order to keep the violinist alive. As sad as that person’s death might be, we have the right to walk away. Just so does a woman have the right to walk away from an embryo, even though it needs her body in order to survive.
Thompson’s argument has been subject to many criticisms. What is significant about it, however, is simply this: it raises the question of whether abortion should be equated with “killing.” At present, it may not be possible to “empty” the womb without destroying the embryo, but as technology progresses and artificial wombs become available, abortion may not involve the destruction of an embryo. Abortion and “killing” are not synonymous. Are there instances where we allow separation of persons even when we know that one will die? I have argued that there is at least one such instance: the case of conjoined twins. So even if the fetus is fully a “person” and its death will be the consequence of separating it from another person, such separation can be morally defended if the separating of conjoined twins is defensible.
In the case of abortion at present, of course, the embryo dies. But in the case of stem cell research, it may be questioned whether “death” (and hence, killing) is involved at all. Some commentators in the stem cell debate are careful not to use the language of “killing.” Gene Outka speaks of the “disaggregation” of embryos in stem cell research. Does this “disaggregation” constitute “killing”? Has the disaggregated blastocyst been “killed” in the morally relevant sense?
The blastocyst that is disaggregated in stem cell research does not cease to exist; it gains a different kind of existence. Consider, for example, a child whose life is threatened by gangrene. We would have no qualms about amputating both legs if necessary in order to preserve the child’s life, even though we recognize that the life ahead will be quite utterly different than the original life we might have anticipated for this child. If the child would die without the operation, we would do it, even though his/her future life will be very different from a “normal” child’s life. When a blastocyst is disaggregated to create stem cells, it has a future life very different from the life of a child, but nonetheless an ongoing form of life. Glenn McGee and Arthur Caplan argue that, at this early stage, the only personally identifying feature of the embryo is its DNA. Since it is precisely the DNA that is preserved in the line of stem cells that is developed, its personally identifying feature has been retained in the process of creating a stem cell line. Thus, the embryo has not been killed, they suggest, but rather has been given an ongoing life, albeit a life different from the one it would have if it were implanted in a womb. It is not clear that stem cell research can be equated with “killing” at all. Care in our language would help the ethical debate.

 

Morally Relevant Differences
All philosophers agree that moral judgments must be universalized: if something is right for me to do, it must also be right for anyone else in circumstances similar to mine. To argue for a different outcome, one must find “morally relevant differences” in the circumstances.
Because of the constant focus on the status of the embryo and whether it may be “killed,” crucial differences between abortion and stem cells are sometimes overlooked. In fact, there are several morally relevant differences between the two contexts. In my view, at least one of those differences would make embryonic stem cell research less morally acceptable than abortion, while another makes stem cell research more morally acceptable than abortion.
In the case of abortion, the embryo has implanted in the womb. It is considerably later in embryonic development than the five day old blastocyst. The embryo therefore has developed more capacity. Even those who make distinctions based on development or capacity must therefore acknowledge that this embryo is closer to “full” human status. Left alone, it will likely develop into a child. The embryo has more “standing” in the view of many, and I concur.
At the same time, in the case of abortion, the life of the embryo is pitted against the woman’s needs, desires, and circumstances. There is not one human being to consider, but two. Even the most stringent Roman Catholic commentators have always recognized some circumstances in which the woman’s interests might be overriding. In his famous essay, “An Almost Absolute Value in History,” John T. Noonan reviews centuries of Roman Catholic teaching on abortion. Noonan acknowledges that life, “even of the innocent,” was never taken as an absolute. Interests other than fetal life could be overriding and abortion could be permitted in some circumstances. Precisely because there are two human lives at stake, the interests of the woman can sometimes override those of the embryo.
Noonan restricts those circumstances to the case where the woman’s life is at stake and hence calls fetal life an “almost absolute value.” Whether one draws as restrictive a conclusion as Noonan does, or whether one permits other interests of the woman also to override the interests of the developing embryo, it is clear that abortion pits two sets of interests against each other. Precisely because this woman and only this woman can keep the developing fetus alive, Outka argues that abortion is somewhat “sui generis” – there are no entirely satisfactory analogies to the abortion situation.
In stem cell research, there is no pregnancy. The cells are being kept alive in a petri dish. There are no interests of a living woman to pit against the interests of the developing embryo. Hence, the interests of the embryo in its developing life would appear to be more overriding than any other interests, and this would (at least, initially) incline one to think that there is less justification for stem cell research than for abortion.
However, this may not be the case. In Jewish tradition, the mandate to heal may mean that scientific research must go forward: interests in the possibility of healing might override any interests of the blastocyst. This, too, is argued by Glenn McGee and Arthur Caplan, who suggest that the central moral issue in stem cell research should have “less to do with abortion than with the criteria for moral sacrifices of human life.” All humans, including the embryo, may be sacrificed occasionally for the good of the community. While it might seem that only the interests of another specific person, such as the pregnant woman, could override the interests of a developing embryo, even this claim may be contended.
But there is another morally relevant difference as well between abortion and stem cell research that is often overlooked but is significant. In the circumstance of abortion, an embryo has implanted in the womb; barring spontaneous abortion, it will develop to become an infant. In the case of stem cell research, however, the blastocyst involved is not in a womb, there is no intention to implant it, and its normal course is not toward birth but toward death. The blastocyst is destined for death.
Perhaps the question should then be: when, if ever, is it morally permissible to do research on dying subjects? Certainly, when the dying subject is an adult, we think it unethical to do such research without the subject’s permission. Indeed, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research went to great lengths to try to protect the rights of condemned subjects such as prisoners. Should similar protections apply to blastocysts? I think not, for one very simple reason: the blastocyst has not yet developed either the capacity to experience pain or the capacity to give or refuse consent. Lacking these capacities, it does not make sense to speak of honoring the blastocyst’s “self-determination” or even of protecting it from pain. Constraints against research on dying subjects do not apply.
The fact of impending death is morally relevant for several commentators. One of the staunchest protectors of innocent human life was the great theologian Paul Ramsey. Yet Ramsey made exception in cases where innocent life would die anyway and other innocent life could be saved. In fact, Ramsey permitted direct killing in those cases. While I have argued above that it is not clear that the blastocyst is “killed,” Ramsey’s argument would apply even if it is killed: it will die in any event, and using it to develop stem cell lines holds the promise of saving other innocent life. Outka calls this the “nothing is lost” principle, and uses it to make a very cautious justification of some stem cell research. Similarly, in an early essay on abortion, Roman Catholic theologian Bernard Haring suggests that “the malice of abortion is an attack on the right of the fetus to live.” But where the fetus will die in any event (e.g. in an ectopic pregnancy where both mother and fetus will die if the fallopian tube is not removed), removing it does not “truly deprive the fetus of its right to live, since it would not survive in any event….” Further, Haring argues that “the fact that the biological death occurs some days earlier than if the physician allowed both to die does no harm to the right of the fetus….” The implication is clear: fetuses that are “slated for death” can be “killed” and there is no “malice” involved. The same argument would apply to hESC research. The fact that the blastocyst will not live in any event is morally relevant, and makes stem cell research fundamentally different from abortion.
Conclusions
John Noonan’s appellation of the embryo as having “almost absolute value” in Christian history has lead to the entrenchment of a way of thinking that has roots in Roman Catholic tradition but is clearly not the “only” way to think as a Roman Catholic. Alas, once it took root, it skewed the abortion debate so that the status of the embryo has dominated discussion ever since. In spite of the cautions of philosophers such as R. M. Hare, who considers “asking whether the fetus is a person” to be an “unhelpful” even if universally popular approach, so strong is this way of thinking that the subsequent history of stem cells has also been plagued by the question of moral status. Flaws in logic abound, value laden language is used, and morally relevant differences between abortion and stem cells are overlooked as a consequence. Stem cell research differs from abortion in morally relevant ways and should be freed from the abortion debate and its failures of moral reasoning on both sides.
 
 
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Norton Juster, The Phantom Tollbooth (NY: Random House, 1964), 168.
This is true not only in the United States, but also in Europe. See Lars Ostnor, ed., Stem Cells, Human Embryos, and Ethics: Interdisciplinary Perspectives (Springer, 2008).
See Laurie Zoloth, “The Ethics of the Eighth Day,” in The Human Embryonic Stem Cell Debate: Science, Ethics, and Public Policy, eds. Suzanne Holland, Karen Lebacqz, and Laurie Zoloth (MIT press, 2001), 98; also Elliot N. Dorff, Matters of Life and Death: A Jewish Approach to Modern Medical Ethics (Philadelphia: The Jewish Publication Society, 2003), 128.
Thomas A. Shannon and Allan B. Wolter, “Reflections on the Moral Status of the Pre-Embryo,” in Bioethics (4th edition), ed. Thomas A. Shannon (Mahwah, N.J.: Paulist Press, 1993), 45.
Jeff McMahon, The Ethics of Killing: Problems at the Margins of Life (NY: Oxford U. press, 2002), 267.
“To say that the foetus is (or is not) a person gives by itself no moral reason for or against killing it…,” says R.M. Hare in Essays on Bioethics (Oxford: Clarendon press, 1993), 152.
Hare calls the question of the moral status of the embryo an ‘unhelpful’ approach and declares that disputes about this “allegedly crucial question” will be “a waste of time.” Hare, 169.
This is in fact precisely the point that McMahon makes in The Ethics of Killing. Jeff McMahon, The Ethics of Killing: Problems at the Margins of Life (NY: Oxford U. press, 2002), 189.
Sondra Wheeler, “Talking Like Believers: Christians and Jews in the Embryonic Stem Cell Debate,” in God and the Embryo:…, eds. Brent Waters and Ron Cole-Turner (Georgetown U. press, 2003), 154. Wheeler, 155.
For example, Michael Novak objected to President Bush’s support for using stem cell lines that had already been developed because “it is not enough to say…that the embryos have already been killed.” Michael Novak, “The Stem Cell Slide: Be Alert to the Beginnings of Evil,” in The Stem Cell Controversy: Debating the Issues, ed. Michael Ruse and Christopher A. Pynes (Amherst, NY: Prometheus Books, 2003) 101-105 at 103.
John A. Robertson uses slightly different language: “because the embryo is alive at the time that ES cells are removed…, [this research] raises questions about the permissibility of destroying embryos….” John A. Robertson, “Ethics and Policy in Embryonic Stem Cell Research,” in ibid. 121-150 at 129.
For example, she ignores a woman’s possible responsibility for the consequences of voluntarily engaging in sexual intercourse. Karen Lebacqz, “Stem Cell Ethics: Lessons from the Context,” in Stem Cell Research: New Frontiers in Science and Ethics, ed. Nancy E. Snow (U. Notre Dame, 2003), 93f.
Gene Outka, “The Ethics of Stem Cell Research,” in God and the Embryo, 40.
Certainly, in Jewish tradition, the destruction of an embryo prior to 40 days is not equated with “murder.” Dorff, 128.
Glenn McGee and Arthur Caplan, “The Ethics and Politics of Small Sacrifices in Stem Cell Research,” in The Stem Cell Controversy: Debating the Issues, ed. Michael Ruse and Christopher A. Pynes (Amherst: Prometheus books, 2003), 151-158 at 155.
See R.M. Hare, 72 and 176.
John T. Noonan, Jr., “An Almost Absolute Value in History,” in The Morality of abortion: Legal and Historical Perspectives, ed. John T. Noonan (Cambridge, MA.: Harvard U. Press, 1970) Noonan’s reading of history has been challenged by Beverly Harrison. See Beverly Wildung Harrison, Our Right to Choose: Toward a New Ethic of Abortion (Boston: Beacon press, 1985), chapter 5. In the same volume as Noonan’s essay, James Gustafson pointed out that the Roman Catholic position outlined by Noonan suffered from a lack of attention to the real life circumstances and decisions that had to be made by women facing unwanted pregnancy. The juridical model, Gustafson proposed, sees acts as right or wrong based on rules; it leaves little room for moral ambiguity. Individual struggles are reduced to abstract cases; any compassion for suffering is dissolved. Using a case of a woman who was gang-raped, Gustafson suggests that compassion for her suffering and appreciation for the full circumstances in which she finds herself might permit an abortion. Beginning with a perspective that human life is sinful and limited, he suggests, we might focus less on God’s will to preserve creation and more on God’s will to redeem it. James M. Gustafson, “A Protestant Ethical Approach,” in the Morality of Abortion: Legal and Historical Perspectives, ed. John T. Noonan, (Cambridge, MA.: Harvard U. Press, 1970)106.
Outka, 41.
McGee and Caplan, 152.
See the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, Research Involving Prisoners, DHEW Publication No. (OS)76-131, 1976.
See Gene Outka, “the Ethics of Human Stem Cell Research,” in God and the Embryo: Religious Voices on Stem Cells and Cloning, eds. Brent Waters and Ronald Cole-Turner (Washington, D.C.: Georgetown U, 2003), 29-64 at 46.
Bernard Haring, “A Theological Evaluation,” in The Morality of Abortion, ed. John T. Noonan, (Cambridge, MA: Harvard u. Press, 1970), 123-145 at 137ff.
See also Ted Peters, Gaymon Bennett, and Karen Lebacqz, Sacred Cells: Why Christians Should Support Stem Cell Research (NY: Roman and Littlefield, 2008), 146.
R.M. Hare, Essays on Bioethics, (Oxford: Clarendon Press, 1993), 149.
Choosing the time at which a fetus becomes a protectable person is itself a moral decision, he points out. We must have moral reasons for the time chosen. It is not sufficient to depend on intuitions, as they are based on our upbringing.