The Impact of International Bioethics on the ‘Sanctity of Life Ethics’,
and the Ability of OB Gyn’s to Practice According to Conscience

Dianne N. Irving, M.A., Ph.D.
International Conference: The Future of Obstetrics and Gynaecology…
International Federation of Catholic Medical Associations (FIAMC)
and MaterCare International
Rome, Italy, June 18, 2001.
Edited August 28, 2001
Reproduced by permission

“A small error in the beginning leads to a multitude of errors in the end.”
Thomas Aquinas, De Ente Et Essentia Aristotle, De Coelo
 

I. Introduction

It is a great honor and privilege to be able to participate in this much–needed conference on the future of Obstetrics and Gynaecology, and on the fundamental human right to be trained and to practice according to conscience.Tremendous discrimination and pressures now exist world–wide, with dire consequences on the Church’s health care ministry and entire societies of people globally — to which the participants at this conference have come to testify.

One of the most urgent yet least discussed medical dilemmas today is access to the correct basic scientific information regarding the human embryo — scientific information which demonstrates empirically that normally every human being begins to exist at fertilization in the woman’s fallopian tube as a single-cell embryo, the zygote.Indeed, fertilization is the beginning of the existence of the human being, the human embryo, the human organism, the human individual, and the “embryonic period.” Without this correct scientific information we are all precluded from forming our consciences correctly or making morally correct medical decisions about abortion or other related current medical and scientific issues. The use of the correct science is the starting point for thinking about all of this.

To know that the human embryo is a personal human being is central to forming our consciences correctly, and therefore to knowing what actions are right or wrong in a specific medical or research situation. While conscience is the subjective norm in philosophical natural law theory, it must be a correctly formed conscience — one in accord with objective reality and objective truth — starting with and including this objective scientific truth. Any scientific error or scientific mis–information in this regard precludes us from forming our consciences correctly or making morally correct medical decisions.

Although we are here this week to discuss and examine the more obvious causes of the pressures and discriminations against ObGyn’s to practice medicine according to their consciences, my purpose is rather with identifying the “larger picture”, i.e., the more subtle but pervasive pressures and discriminations that stem from the structures and politics informed by international bioethics. These structures are preventing acquisition to and dissemination of the accurate scientific information regarding the full humanity and personhood of the early human embryo.

More specifically, I want to focus: (1) on the profound global impact of the recently formalized and inherently anti–life philosophy of “international secular bioethics” on political and governmental structures; (2) on the long–articulated attack by international bioethics on the “sanctity of life ethics”, especially as formulated in bioethics as “preference” utilitarianism; and (3) on the incorrect science propagated historically and currently in international bioethics debates on human cloning, human embryonic, and human fetal stem cell research.

II. THE ANTI–LIFE PHILOSOPHY OF INTERNATIONAL BIOETHICS:

A. Different Ethics, Different Conclusions:

First, I would like to historically identify the anti–life philosophy inherent to international bioethics by sketching quite briefly the recent formal “birth” of bioethics in the USA. Just what IS “bioethics”?Most people would say that it is just the application of traditional philosophical and theological principles to current technological issues in medicine and medical research — e.g., cloning or experimenting with new AIDS drugs, right?

Not really. The philosophical underpinnings of bioethics are completely different — even contradictory to — the philosophical underpinnings of traditional secular medical ethics or Roman Catholic medical ethics. Traditional medical ethics focuses on the physician’s duty to the individual patient, whose life and welfare are always sacrosanct. The focus of bioethics is fundamentally utilitarian, centered on “maximizing total human happiness”, or, as we shall see, maximizing total “preferences” and “interests.”

To put my endeavor into sharp focus, consider for a moment the strikingly different conclusions reached by secular bioethics and Roman Catholic medical ethics on an array of issues. Secular bioethics generally considers the following as ethical: abortion, contraception, the use of abortifacients, prenatal diagnosis with the intent to abort defective babies; surrogate motherhood; human embryo and human fetal research; human cloning; the formation of human chimeras (cross–breeding with other species); human embryonic and fetal stem cell research; “brain birth”; purely experimental high risk research with the mentally ill; euthanasia; physician–assisted suicide; and living wills documenting consent to just about anything.In contrast, Roman Catholic medical ethics considers all of these unethical.

How is it that these two different ethical systems lead to such opposite and contradictory ethical conclusions? The answer is rather predictable. Every academic ethical theory has its own idiosyncratic ethical principles. Deducing from different ethical principles necessarily leads to different ethical conclusions. For example, Roman Catholic medical ethics is grounded in the ethical principles embedded in the Moral Law (a combination of natural law philosophical ethics, Divine Revelation, and the teachings of the Magisterium).Secular bioethics, as predominantly understood and applied, is grounded in the National Commission’s three ethical principles as articulated in their Belmont Report.Deducing from these two very different sets of ethical principles leads inexorably to these different ethical — and therefore medical ethical — conclusions. Nor is there any such thing as a “neutral” ethics, including bioethics. All ethical theories are normative — i.e., they take a stand on what is right or wrong.Therefore no “ethical theory”, it would seem, should be forced on any members of a pluralistic, multicultural, democratic society!

In short, there is really no such thing as just “ethics per se”, as just “medical ethics per se”, or as a “neutral ethics”. There are different kinds of ethics, and therefore there are different kinds of medical ethics — each with its own unique normative ethical principles, subject matter, method, ethical “conclusions”, and squadrons of “experts”. bioethics is just one idiosyncratic ethical theory among many — albeit relatively new.

B. The Formal “Birth of Bioethics”:

As detailed in his extensively referenced new book, The Birth of Bioethics, Albert Jonsen traces the history of traditional medical ethics from the ancient Hippocratic period to post–World War II traditions. He then describes a couple of decades of famous international conferences on the future of medical ethics/research, and the gradual formation of the three major “think tanks” which were comprised of the leading scholars who would play critical roles in the final formal “birth” of bioethics. These “centers” included: The Hastings Center in New York (founded in 1969 by Willard Gaylin and Daniel Callahan as Co–Directors), The Kennedy Institute of Ethics at Georgetown University (founded in 1971 by Andre Hellegers as Director), and the Society of Health and Human Values (founded in 1970 by the Committee on Medical Ethics and Theology of the United Ministries in Education, with its first Chairman of the Board of Directors, Dr. Edmund Pellegrino).

Bioethics as understood and practiced today was actually “created” out of thin air by a Congressional mandate, with the passage of the National Research Act in 1974.The Act mandated that the Secretary of the Department of Health, Education and Welfare appoint a National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research to: "[1] identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and [2] to develop guidelines that should be followed in such research."As Albert Jonsen, a member of that National Commission, later perceptively noted, “No legislation had ever before charged a government body to identify basic ethical principles as did Public Law 93–348.”

Thus, in 1974, the Secretary appointed an eleven–member National Commissionthat in 1978 issued a document called The Belmont Report,which identified and defined three “ethical principles”: respect for “persons” (immediately deconstructed to mean pure “autonomy”), “justice”, and “beneficence.” To this day, those principles are called “the Belmont principles”, the “Georgetown mantra”, “principlism”, “federal ethics”, or simply “bioethics.” Obviously, as we have seen, deducing from these different normative ethical principles will lead to quite different conclusions about what is right or wrong in health care, as compared to deducing from other ethical principles such as the Moral Law.

Also, as Congressionally mandated, in 1981 the Belmont principles immediately became the explicit foundation for the guidelines that the U.S. federal government’s Office for Protection from Research Risks (OPRR)was to use when assessing the ethics of using human subjects in research. These bioethics principles, as originally defined, also underlie a host of other federal regulations and guidelines for medical research, and have worked their way into the private and international sectors as well.

C. Short Analysis of Bioethics “Theory”:

What is perhaps helpful for ObGyn’s to understand is that bioethics was fatally flawed from the beginning, and therefore it can be easily challenged. The three Belmont Principles — respect for “persons” (autonomy), justice, and beneficence — were supposedly derived from the normative ethical systems of various secular moral philosophers, especially Emanuel Kant, J. S. Mill, and John Rawls (a contemporary influential Harvard University philosopher whose 1971 book, A Theory of Justice,was a blueprint for certain liberal legal and social theories of the 1970’s).

The fact that each of these theories fundamentally and systematically contradicted each other seemed to be irrelevant to the early “ethics–makers”. In effect, they quite selectively took bits and pieces from different and theoretically irreducible ethical systems and rolled them up into one ball. Furthermore, each of these principles were defined as prima facie,i.e., no one principle could overrule any of the others. The way we come to know these bioethics principles is by taking courses, attending seminars, and listening to bioethicists lecture at conferences.

But theoretically and practically it was soon discovered that these bioethics principles simply could not, and would not, work. Because bioethics was derived from bits and pieces of fundamentally different and contradictory theoretical philosophical systems, the result was theoretical chaos, rendering it academically indefensible.

More problematic, when people practically tried to apply the theory, it didn’t work because there was no way to resolve the inherent conflicts among these three prima facie principles. Caution concerning this inherent conflict among the three bioethics principles had been voiced at the beginning of the field, e.g., by Paul Ramsey, who noted, “Within the amplitude … of general ethics, our authors fail to address clearly and rigorously the issue: which of these moral principles has priority (e.g., in the case of conflict)?”For example, how could a patient appeal to “autonomy” to have any and every medical treatment regardless of its efficacy or cost without contradicting an appeal to “justice” and the “fair” allocation of scarce medical resources? It couldn’t.

Furthermore, while the Belmont Report gave a little nod to the traditional Hippocratic understanding of beneficence as doing “good” for the individual patient, it also included a second lengthy definition of beneficence that was essentially utilitarian: doing “good” for society, or, “the greatest good for the greatest number”. The report even declared that citizens have a “strong moral obligation” to take part in experimental research for the greater good of society.This obviously contradicts the Hippocratic interpretation of beneficence, and it also violates time–honored international guidelines, such as the Nuremberg Code and the Declaration of Helsinki, in which the “good” of society may never outweigh the “good” of the individual patient.

The second Belmont principle, justice, was also defined along utilitarian lines, i.e., in terms of “fairness” — “fairness”, that is, in allocating the benefits and burdens of research fairly across the social spectrum. This Rawls–influenced definition of justice is surely quite different from the classic Aristotelian definition of “justice” as treating people fairly as individuals. Rawl’s “theory” of justice also profoundly influenced the theory–makers of bioethics from several other different academic disciplines. For example, it would later be adapted by his student Norman Daniels and applied to health care;it began to “creep into law”, e.g., through lawyer⁄bioethicist John Robertson, who quoted from Rawls in influencing the justices’ decision in the Saikewicz case — resulting in the still controversial legal concept of “substituted judgement”;it has also been applied by Arthur Dyck in international population policy issues.

Even the third Belmont Principle, respect for persons, ended up serving utilitarian goals. Respect for persons is supposed to be a Kantian notion, in which respect for the individual is absolute. But the Belmont Report blurred that idea with Mill’s utilitarian views of personal autonomy. In Mills’ view, only “persons” — that is, fully conscious, rational adults capable of acting autonomously — are defined as moral agents with moral responsibilities. Unfortunately, this issue of mere “moral agency and responsibility” was reinterpreted by bioethics to “read” that those incapable of acting “autonomously” — infants, the comatose, those with Alzheimer’s or Parkinson’s, drug addicts, alcoholics, the mentally ill and mentally retarded, etc. — were “non–moral agents”, and thus “non–persons” with no rights. It is only a short step from this blurred reasoning to that of Princeton’s Peter Singer — a “preference” utilitarian who argues that some animals have more moral value than young human children or ill, disabled human adults.

Eventually discontent began to smolder within the brave new discipline. Even the founders of bioethics have admitted that the Belmont principles of “bioethics” present grave problems as guidelines for physicians and researchers. The Hastings Center Dan Callahan has conceded that after 25 years, bioethics simply has not worked.Gilbert Meilaender has noted “how easily the [reality and worth of the individual human] soul can be lost in bioethics.”National Commissioner Jonsen recently wrote that bioethics should now be regarded as “a sick patient in need of a thorough diagnosis and prognosis.”In a scathing article against bioethics, “Leaving the Field”, Renee Fox and Judith Swazey responded in depth and detail to the horrendous ethical dilemmas they considered posed by bioethics public policy making concerning organ transplantation, especially on an international scale.Other controversies and battles over the validity of the bioethics principles on many levels are documented and collected in an already classic 1195–page tome edited by Rannan Gillon, in which 99 scholars from around the world jump into the fray over bioethics — by far the majority of them arguing against bioethics “principlism”.Bioethics simply cannot be defended, and it does not work.

Another reason for the theoretical and practical chaos surrounding bioethics these days is that almost anyone can be a bioethicist. Few “professional bioethics experts”, the doctors, researchers, and lawyers who sit on hospital and government bioethics committees, have academic degrees in the discipline, and even for those very few who do there is no uniform or standardized curriculum. Most professors of bioethics don’t know the historical and philosophical roots of the subject they teach; the courses vary from institution to institution; there are no local, state, or national boards of examination; and there are no real professional standards. There is not even a professional code of ethics for bioethicists!

Because of these and other stinging criticisms (especially from within the academy and their own ranks), many bioethicists now prefer to say that their field is more a form of “public discourse” than an academic discipline, a kind of “consensus ethics” arrived at by democratic discussions rather than by formal principles.The problem with this line of reasoning is that the ethical principles used in the “discourse” are still defined precisely as defined in The Belmont Report and the early bioethicists, and those who typically reach the “consensus” are the bioethicists themselves (not the patients, their families, or society at large). So the process is not exactly “neutral” or “democratic.” And if bioethics is just a “discourse,” then why are its practitioners regarded as “ethics experts”? Most curiously, if bioethics is a normative ethical theory — i.e., it takes a stand on what is right and wrong — it is thereby not a “neutral” ethical theory — so why should it be allowed to be forced on the citizens of any multi–cultural, pluralistic, democratic society?

D. International Reign and Penetration of Bioethics:

Regardless of such massive and admittedly fatal defects, the three principles of bioethics — autonomy, justice, and beneficence (as originally defined) — still pop up everywhere in the literature of a myriad of public policy making bodies with jurisdiction over political, social, medical and research decisions. For example, The President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, created by the U.S. Congress in 1978, has cited the three bioethics principles in presumably definitive reports on an extensive list of wide-ranging medical ethics issues. The National Institutes of Health’s 1988 Human Fetal Tissue Transplant Conference, its 1994 Human Embryo Research Panel, and the National Bioethics Advisory Commission set up by President Bill Clinton in 1995 also cite the Belmont principles as norms in their determinations of what is “ethical”. This same bioethics is now routinely used in government regulations, e.g., the federal Office for the Protection from Research Risks (OPRR) regulations on the use of human subjects in medical research, The Common Rule, Institutional Review Board Guidebooks, and governmental Hospital Ethics Committee Guidebooks. The list of bioethics-based government regulations and policies is endless — hence the reference to bioethics as “federal ethics”.

In the private sector these same bioethics principles are used to explicitly ground private Hospital Ethics Committee Guidebooks, and most policies for hospitals and other health care facilities — including some Roman Catholic hospitals and health care facilities.

Within academia, the principles of bioethics now also pervade the “ethics” of most other academic disciplines, such as public policy, engineering, journalism and business — even military “ethics”. Many colleges, universities, and medical and nursing schools require a course in secular bioethics in order to graduate. Bioethics has also heavily influenced the media, and legal ethics, even created new legal fields of study — e.g., "health care law", and "animal rights law". Bioethics is actually taught now in high schools, thanks especially to a well-funded program at the Kennedy Institute of Ethics at Georgetown University.

Bioethics is now international. As of 1997, there has been an International Association of Bioethics, whose founders were Australian bioethicists — their first president being Peter Singer. The Council for International Organizations of Medical Sciences (CIOMS), associated with the World Health Organization and UNESCO, has demonstrated interest in bioethics for decades now, and has issued international guidelines on many topics. Since 1985, the Council of Europe has had a Committee of Experts on Bioethical Issues, which with wide international consultation, composed a Convention for Bioethics containing guidelines on major bioethics issues. UNESCO formed an International Bioethics Committee in 1993. The European Community and its legislative arm, the European Parliament, have formulated bioethics policy and sponsored bioethics studies. Centers and institutes of bioethics exist worldwide, “from Bonn to Beijing, and from Bangkok to Buenos Aries,” as Jonsen quips. The 1994 UNESCO Directory list 498 such bioethics centers outside of the United States. These all define “autonomy”, “justice”, and “beneficence” as originally defined in The Belmont Report and by the early bioethicists.

There has always been an undercurrent of concern about the makeup of appointed groups such as the National Commission and the later bioethics commissions. This concern was articulated sometimes by referring to such efforts as “commissioning ethics,” or “consensus ethics,” and was best summed up earlier by one of the original scholars of the Hastings Center, Robert Morison, who very early on sketched his views on this new emerging field called “bioethics”: “What one fears is that the Commission may become the mechanism whereby the speculations of the ethicists become the law of the land. It is already far too easy for abstract notions of right and wrong to emerge as deontological rules which begin their public life as ‘guidelines’ but culminate in the force of law.” As Jonsen opined, “Morison’s letter was a sobering reminder of the anomalous role of an ‘ethics commission’ in a pluralistic, secular society.”

As bioethics supplants traditional ethics before our very eyes, few seem to even question its underlying premises. But we should know it for what it is: a form of extreme utilitarianism in both its theoretical and practical forms. It bears no relation to the patient-centered Hippocratic ethics that for nearly 2500 years required physicians to treat every human being in their care as worthy of respect, no matter now sick or small, weak or disabled. It certainly bears no relation to Roman Catholic medical ethics, which bases its ethics on the principles of the Moral Law.

E. Erroneous Science Used by Early Bioethics:

As mentioned earlier, the use of false science actually precludes ObGyn’s, health care workers, and women from correctly forming their consciences about abortion, the use of abortifacients, and a host of other related issues. Yet right from the start bioethics has propagated its own "science" in order to advance its own agenda.

Of note, the National Commission used several “odd” scientific definitions in its individual reports, e.g., in its Report on Fetal Research(1975). Even the Commission acknowledged this: “For the purposes of this report, the Commission has used the following definitions which, in some instances, differ from medical, legal or common usage. These definitions have been adopted in the interest of clarity and to conform to the language used in the legislative mandate” [referring to the National Research Act of 1974]. Among such “unique” scientific definitions used by the Commission was that of the “fetus” as beginning at implantation (i.e., 5–7 days post–fertilization). Before that there was only a "“pre–embryo”. The terms “human being” and “embryo” were never defined. Similarly, the OPRR federal regulations, based on the Commission’s Belmont principles, contain two “unique” scientific definitions. “fetus” and “pregnancy” are both defined as beginning at implantation! Again, no definition of “human being” or of “embryo”.

Of course, such “definitions” are rather bizarre, as the single dissenting report by National Commissioner Louisell pointed out. Science has known since the 1880’s, with the publication of Wilhelm His’ three–volume tome, Anatomie menschlicher Embryonen, that fertilization was the beginning of the existence of the human being, the human embryo. Normal pregnancy also begins at fertilization in the woman’s fallopian tube. And the “fetal period” doesn’t even begin until the 9th week post–fertilization.

Clearly, such “odd” scientific definitions — or re–definitions — in the National Commission’s Report and in the OPRR federal research regulations would simply serve the purpose of removing “flushed” human embryos, and artificially produced human embryos, from any sort of governmental protection or oversight in the future — especially given the growing interests in viable human embryos as biological materials for use in IVF “therapy” and research. They would be especially prized for used in human cloning and human chimera research.

From the National Commission onward, these early human embryos have never been acknowledged by the federal government as “human research subjects” to be protected from research abuse; instead, they are simply “human research objects”. None of the federal regulations to follow would apply to them — right up to the present. Nor has the correct Biology 101 been used yet with reference to the definition of “early human embryos” or “human fetuses” — especially in the “scientific” language used in federal, state and international legislation, regulations and guidelines on these related issues. No wonder so many people are so confused.

F. Erroneous "Personhood" Theories used by Bioethics:

ObGyn’s might keep in mind that the key to understanding any philosophical or theological ethical theory is to identify its philosophical or theological “anthropology”— or definition of “a human being” or “person”. Different anthropologies lead to different ethical theories. Some anthropologies match reality; others don’t.

Bioethics tries to claim that its theory really has no “anthropology”, i.e., the “personhood” issue. Bioethics is “just” about “ethics”. However, almost all bioethics arguments do incorporate a "delayed personhood" claim, whether or not they know or admit it — especially within the context of debates over abortion, the use of abortifacients, human and fetal research, cloning, stem cell research, euthanasia, etc. That is, most deny the accurate human embryology, or make up their own, to argue that at fertilization there is no human being — or at least no human “person” — there yet. “Whatever” is there has only a “reduced moral status” at best (the language used from the National Commission onward). Only some time period after fertilization, e.g., implantation (5–7 days post–fertilization), 14–days (with the formation of the primitive streak), or “brain birth” (with the formation of the cortex or neocortex), etc. (depending on the theory), is there a real "person" with rights present. Before that biological marker there are only “stem cells”, or “pre–embryos” present.

Virtually all of the arguments for "delayed personhood" use erroneous science on which to ground their philosophical "personhood" claims, hence rendering those claims automatically invalid per se. Regardless, these false claims have had enormous influence in public policy making worldwide — especially the “brain–birth” myths (addressed with “preference” utilitarianism, below), and the “pre–embryo” myth of McCormick and Grobstein. It is worth reviewing even briefly this influence, as it helps to explain at least to some extent the sources of such immense pressures against Catholic ObGyn’s in their daily practice. While many may be aware of McCormick’s influence in moral theology, few seem to be aware of his penetrating work in a totally different field — “secular bioethics”.

Early in the 1970’s, Richard McCormick, S. J., had argued that defective newborns could be allowed to die. Applying the “Catholic” moral theology distinction of the Principle of Double Effect, McCormick concluded that the term “extraordinary” was large enough to justify the omission of life–sustaining treatments on the basis of expected diminished quality of life, defined in terms of the potential for human relationship. McCormick had also agreed with the May 1979 DHEW Ethics Advisory Board recommended approval of federal funding of research on the safety and efficacy of IVF research and embryo transfer in the treatment of infertility — departing from the Vatican’s position against any technologically assisted pregnancies, even in lawfully married couples. Now, following similar work by Andre Hellegers (founder of The Kennedy Institute of Ethics at Georgetown University), McCormick seriously questioned the “moral status” of early human embryos (or, “pre–embryos” as he referred to them), as did several others within the Catholic Health Association. Furthermore, McCormick reluctantly agreed that since some abortions are acceptable, then some fetal research would also be acceptable. He had reasoned that children have a moral obligation to participate in non-therapeutic experimentation where there is no discernible risk or undue discomfort, and therefore their parents may give proxy consent for their children’s participation in such research that would not benefit them personally. He grounded this moral obligation in social justice — i.e., “to contribute to the benefit of the human community.” The same moral obligation, argued McCormick, can now be extended to the fetus. Paul Ramsey also had qualms about the “moral status” of the early embryo, accepting the McCormick⁄Grobstein “pre–embryo”, and therefore also reluctantly sanctioned fetal research.Thus these writers, as many others, claimed that morally relevant characteristics were not present in the early developing embryo until “segmentation”, or the attainment of “individuality” about 14–days or even later during human development.

Regardless of the biological marker used, what these arguments have in common is a claim for some sort of a “delay” — in “personhood”, or even “humanhood” — after fertilization.

Philosophically, such a claim is per se a claim about “anthropology”, and historically a very weak and indefensible one at that. It requires that the soul and the body are two separate and independently existing substances. But think about it. If there is a real split or gap between the “mind” (or “soul”) entity, and the “body” (or “matter”) entity — which is required if there is any “delay” in “personhood” — then one simply cannot successfully explain any causal interaction whatsoever between these two separate entities, either before or even after “uniting”. Nor is there any scientific data to verify such a “split”, nor such a “delay”.

A lengthy response is not practical here, but solid arguments to refute such “delays” have been advanced for many years. Briefly, e.g., if, the “rational soul” contains virtually the other powers of the soul; if there is no split among the several powers of the soul; if there is no split between the soul and the body; if the body and soul must exist together as one single substance (as both Aristotle and St. Thomas have insisted!); and if there is scientific evidence that the “vegetative” power of the human rational soul is present immediately at fertilization (which there is) — i.e., the immediate production of explicitly human proteins and enzymes, the development of specifically human tissues and organs — then the whole rational soul must be immediately present at fertilization. Personhood must begin when the human being begins. There is no carrot or frog produced — and we know that empirically!

It is long past time for us to recognize, acknowledge, and deal with the concrete reality that the earliest human embryo is indeed deserving of exactly the same respect, dignity and legal protections as all human persons — simply even by virtue of his or her inherent humanity which we all share in common (the basis of natural law philosophical ethics), and as stated explicitly in many Church documents. This information is critical for the correct formation of conscience.

To choose not to acknowledge or deal with this information has already led to the acceptance, now almost habitual, of a two–tiered caste of human beings — some of whom are “persons” and some of whom are not — as exemplified in these bioethics “delayed personhood” debates. This “delayed personhood” mental construct has also long since been transferred to bioethics issues involving adult human beings, e.g., in issues concerning the mentally ill, euthanasia, etc. If nothing else the Nazi “science”, rationalizations, propaganda, and experiments, and the on–going scourge of slavery, should have taught us about the inevitable real life consequences of such a “caste”.

The unheralded words of the single dissenting National Commissioner Louisell ring ominously clear: “American society is itself at risk – the risk of losing its dedication to the proposition that ‘all men are created equal.’ We may have to learn once again that when the bell tolls for the lost rights of any human being, even the politically weakest, it tolls for all.”

III. International Bioethics’ Attack on the “Sanctity of Life Ethic”:

Although bioethics is unquestionably predominantly a “utilitarian” ethical theory, there are in fact many different kinds of “utilitarianism”. Probably the most common in bioethics today is “preference” utilitarianism, a deconstruction of the classical utilitarianism of Bentham and Mill. While it would be a mistake to paint all “preference” utilitarians the same, as each proponent differs somewhat in their “theory”, a small sampling of some of the most articulate in the field could serve to indicate, in general, some of the main dogmas they hold in common — which dogmas the Catholic ObGyn meets daily face to face.

In “preference” utilitarianism an action is ethically correct if it satisfies the “preferences” (or, another variety, “best interests”) of those affected and has the best consequences for the greatest number of “people”. Modern utilitarianism, Bernard Williams explains, is supposed to be a system neutral [!] between the preferences that “people” actually have — a “preference” being a reflection of the state of mind of the agent, and not to be judged by some standard of reasonableness other than whether it accords with the best moral theory. Therefore, all preferences go into the melting pot, with no preference to count for more than any other; there must be “equal consideration of interests”, as Singer puts it. But of course ultimately, these individual “interests” will be weighed unequally against the total “good” or consequences for society as a whole — a point about any utilitarian theory that is often overlooked or underestimated.

Of interest is the definition of “people” or “person” used in preference utilitarianism. “Persons” are those who have preferences, interests, desires, etc. For these utilitarians, not all human beings are “persons”, while some animals are “persons”. Preference utilitarians especially need to attack those who hold the “sanctity of life ethic” (which states that only human beings are “persons”), as simply prejudiced and racists tenets of “speciecism”. As Oderberg explains the origins of this attack: “The charge was made famous by Peter Singer and is leveled by virtually all the followers of Singerian bioethics”. They prefer instead a “quality of life” ethic. One way that “preference utilitarianism" attacks the "sanctity of life ethic” is by literally deconstructing or redefining it — usually by means of “soft”, meandering, but very clever “thought experiments” and “logical dialogues” that “evaluate” the “pros” and “cons” of the “sanctity of life ethic” — to support a “quality of life” position.

A. Jonathan Glover:

One of the major theoreticians of “preference utilitarianism” for many decades has been Oxford philosopher⁄bioethicist⁄eugenicist Jonathan Glover. In his 1977 book, Glover literally redefines the “sanctity of life ethic” by means of redefining its major premise. Once that major premise is corrupted, of course, then all conclusions which flow from it will be corrupted as well.

The “sanctity of life ethic” is generally correctly stated as: “It is always a morally evil act to intentionally and directly kill an innocent human being.” From that major premise it follows, e.g., that since human embryos and fetuses are innocent human beings, and since human disabled and terminally ill adults are also innocent human beings, to intentionally and directly kill them would be morally evil actions per se — regardless of any “personhood” status, circumstances or intentions.

But Glover doesn’t hold those actions to be “morally evil per se”; besides, that would impede the advancement of global “positive eugenics” and genetic engineering which he, and most preference utilitarians, strongly advocate. So he redefines the major premise of the “sanctity of life ethic” as follows: “It is always intrinsically wrong to destroy a life that is worth living.” Such a life would not be “mere biological life”, but rather, as Glover vaguely describes it, the quality of life of one who consciously possesses preferences, plans, projects, desires, feelings, memories, a sense of identity, etc. — what later came to be grouped together in bioethics and labeled “rational attributes” and⁄or “sentience”. Only a “person” possesses a life that is worth living. Since unborn, born, and human children, as well as many ill or disabled adult human beings do not have this “quality of life”, they do not have a “life that is worth living”. Therefore, they are “non-persons” — and therefore the direct and intentional killing of these human non–persons would not necessarily be a morally evil act. Voila! The “sanctity of life ethic” now is the “quality of life ethic”!

B. R.M. Hare:

Glover, in turn, was the academic mentor of Oxford philosopher⁄eugenicist R. M. Hare. For Hare, the early human embryo, fetus and even young child are also not “persons”. They are not “real people”; they are just “possible people” — and therefore have no serious “interests” or “preferences” to be respected. We do, however, have “some duties” toward “them”. Thus, applying a sort of mathematical trigonometry to the problem, his international public population policy proposals go like this: “The maximum duty that is imposed is to do the best impartially for all the ‘possible people’ there might be by having an optimal family planning or population policy, which means necessarily excluding some possible people.” Indeed. Hare asserts that “the best policy will be the one which produces that set of people, of all "possible sets" of people, which will have in sum the best life, i.e., the best possible set of future possible people.” Hare’s bioethics interests lie largely in translating the Gloverian theory of “preference” utilitarianism into national (i.e., British) and global population public policies. One of Hare’s most prominent students at Oxford was Peter Singer.

C. Peter Singer:

Most bioethicists today — to one degree or another — agree that a “person” is to be defined in terms of such “rational attributes” or “sentience”. What are really “morally relevant” are “quality of life” characteristics, “preferences”, or “interests”. So too argues Peter Singer, currently the Ira W. DeCamp Professor of Bioethics at Princeton University’s Center for Human Values. Like Glover and Hare before him, Singer — the founder and first President of the International Bioethics Institute at the U. N., and the founder of “animal rights” — argues that the higher primates, e.g., dogs, pigs, apes, monkeys — even prawns — are persons, because they exercise “rational attributes” and⁄or “sentience”. However, some human beings, even normal human infants, as well as disabled and ill human adults, are not persons.

American philosopher⁄bioethicist Richard Frey, pushing Singer’s logic, actually published an article in a major international bioethics textbook that, since many adult human beings are not persons (e.g., Parkinson’s patients, the mentally ill and retarded, the frail elderly, etc.), and since many of the higher primates are persons, then these adult human non–persons should be substituted in purely experimental research in place of the higher primates who are persons.

Recently, Singer applied his form of “preference utilitarianism” to bestiality. He concluded that bestiality can be an “ethically correct” action, as long as it is not cruel, if it satisfies the preferences (e.g., sexual pleasure) of those affected (i.e., the human person and the animal), and if it has the best consequences for the greatest number of people involved (i.e., the total amount of “pleasure” experienced in the world would be increased). And, of course, since Singer defines many animals as “people”, then “the greatest number of people” for Singer would include some human beings and some animals. Therefore, bestiality can indeed be “ethical”. This is surely “theory” run amok!

D. Others:

American bioethicst and “preference” utilitarian philosopher Peter Suber also attacks the “sanctity of life ethic”, which always entails a different definition of “person”: “The ‘life’ that has sanctity for SL [“sanctity of life ethic”] is biological vitality, perhaps with a spiritual glow, but not the complex of powers and interests that we collectively call the person.” This dogma then allows Suber to argue for the range of other bioethics positions already noted — including abortion, euthanasia, and eugenics. He too is impatient with those who would fail to consider “the degree or kind of suffering, deterioration, dependency, or development they manifest, and regardless of the imminence of death, the burden on others, and the wishes of the subject to live or die.” Suber prefers a “combined quality of life” ethics.

United Nations consultant⁄bioethicist⁄biologist Darryl Macer (Japan) also defines a “person” similar to Glover, Hare, and Singer: “A person is generally referred to as someone who is rational, capable of free choices, and is a coherent, continuing and autonomous centre of sensations, experiences, emotions, volitions and actions; these are what may be called the characters of a person.”

Macer, like so many others in the field, conveniently continues to ground his “embryology” and “personhood” concepts at least in part on the amazingly flawed but influential bioethics book by Australian theologian Fr. Norman Ford, When Did I Begin?. Ford himself, unabashedly and without cross-verification, used and applied the same erroneous “human embryology” — as well as the same “moral” conclusions that follow from it — that McCormick and Grobstein used to fashion their scientifically erroneous concept of a “pre–embryo”. Macer argues that the life of a 1–cell embryo is not sacrosanct, and has never been, even in theological circles. “It is clear that the biological qualities of personhood are not present at conception; what is present is something we call the embryo, … but it does not manifest the activities of a human person. It is a potential human person, at the biological level at least, rather than a human person with potential.” Ultimately, Macer leans toward the socially acceptable concept of the “gradual” attainment of “personhood” and “brain birth”, and is a strong proponent of global birth control.

However, although a living human embryo or fetus does not qualify as a “person” for Macer, their manipulation (or destruction) can be useful for purposes of “positive eugenics” — for a “healthy society”. Macer clearly articulates the international bioethics case for “positive eugenics.” But as with all utilitarian theories, there is virtually no “ethical” consideration given to the “means used” to achieve this eugenics agenda. Nor would they need to. The reality of the person of the individual human being at fertilization has been disposed of — “scientifically”, conceptually, and linguistically. It simply remains to be concretized in all international law.

Or ponder the contemporary thoughts of one of bioethics’ founders, “Christian bioethicist” Tristram Engelhardt: “Persons in the strict sense are moral agents who are self–conscious, rational, and capable of free choice and of having interests. This includes not only normal adult humans, but possibly extraterrestrials with similar powers.”

Obviously, “personhood” has been and still is used as a linguistic device for various unethical purposes. It has been used in the medical arena as a justification for abortion, the use of abortifacients, international population policies, euthanasia, and a multitude of related bioethics issues — and often for eugenic purposes. Indeed, many of the leading “savants” who pioneered the early formation of the field of bioethics were quite outspoken eugenicists. This has not changed; it is merely getting more vocal and more universal.

For example, sounding much like Hare (above), bioethicist Dan Wikler, as representative of the World Health Organization, recently declared that: “The state of a nation’s gene pool should be subject to government policies rather than left to the whim of individuals. … The completion of the human genome project would also make it possible to promote some genetic qualities such as intelligence and lower the incidence of others. … It may be conceivably required by justice itself” [“justice”, as in Rawls!]

Of course, the “gene pool” must also be determined by means of abortion, the use of abortifacients, infanticide, IVF, pre–natal selection, surrogate mothers, human embryo and fetal research, human cloning, human chimera research, human embryonic and human fetal “stem cell” research, euthanasia, physician-assisted suicide, etc. These are the usual “bioethics” issues, accomplished via “absolute autonomy” (at least for now) and the other bioethics principles as originally defined. These are not just “issues”, but also the “tools” required to advance a global eugenics agenda — just read their works, and listen to their lectures. And it is the Catholic ObGyn who is standing in the way!

IV. Erroneous Science in Human Stem Cell and Human Cloning Research:

Finally, one of the most hotly debated issues right now is human embryonic and fetal stem cell research, which, researchers claim, can cure many diseases, as well as advance scientific knowledge in early human embryonic development. Here too it is difficult to correctly form one’s conscience because these debates, as with the earlier debates on abortion, the use of abortifacients, etc., are replete with similar false and confusing human embryology and genetics. And although some ObGyn’s are not particularly concerned about these “medical research” issues, you should consider that sooner or later you will be expected to apply “fruits” of such research in your own practice of medicine and on your own patients.

A. “Human Embryonic Stem Cell” Research:

1. The new “pre–embryo”: “just ‘pluripotent’ ’stem cells’”:

Once bioethicists were forced to discard the scientifically erroneous term “pre–embryo”, there was a need to find some term to take its place — some term that could still “scientifically” justify the use of the early human embryo in research and in “therapy”.

Among the more “creative” attempts that have emerged, perhaps the most influential has been to redefine the early human embryo as “just stem cells”. For example, in his 1999 testimony before the U.S. Senate subcommittee hearings on stem cell research, then–Director of the National Institutes of Health, Harold Varmus, actually defined the early human embryo from fertilization to the end of the blastocyst stage as “just stem cells”! The concrete reality of the early human embryo, a whole human organism, simply “vanished”! The NIH Guidelines on stem cell research then proceeded to define all of the “stem cells” derived from frozen IVF–produced human embryos as “just pluripotent”, rather than acknowledging that many of these stem cells are “totipotent”.

2. Separated “stem cells” could become embryos:

It has also not been explained in these debates that most of IVF–produced human embryos are used immediately or frozen down at a very early stages, usually between the 4–8–cell stage (long before any differentiation into an inner and outer cell layer takes place), rather than at the 5–7 day blastocyst stage (when the embryo consists of at least 30–150 cells, and has differentiated into an inner and outer cell layer). Thus most of the “stem cells” retrieved from these early–stage frozen IVF–produced human embryos would actually be totipotent, not pluripotent. Oddly, most of the debate centers on the older blastocyst–stage frozen embryos, all of whose “stem cells” (derived from the inner cell mass) are referred to as “pluripotent”. But most IVF transfers do not use blastocyst–stage embryos; and most frozen embryos do not have inner cell masses!

Nor has it been explained that the term “human embryonic stem cells” can properly refer to those cells only while they are still a part of and intact within the whole embryo. Once these “stem cells” — or even groups of “stem cells” — are separated from the whole embryo, they can be “totipotent”, and therefore quite capable of “healing” themselves (called “regulation”) and becoming new whole living human embryos themselves — per se. That is, they would no longer be “stem cells”; they would be living human beings. Substantial change would have taken place, much as like happens in human cloning, resulting in the formation of a new living human embryo⁄being. So to use such so–called “stem cells” would constitute human embryo research per se.

We know this biological fact about regulation even from natural monozygotic twinning — a form of asexual reproduction called “fission”, “blastomere separation”, or “blastocyst splitting”. In fact, “twinning”, sometimes called “embryo multiplication”, is a form of cloning, in which copies or replicas of human genetic organisms are produced. The method is even being seriously considered by IVF researchers and clinicians themselves for “multiplying” human embryos from single embryos produced by older infertile women who have difficulty maturing viable oocytes during IVF “therapy”. And surely, neither the IVF clinician nor the woman think that what is being implanted in the woman’s uterus is just a “stem cell”!

B. “Fetal Stem Cell” Research:

Another misleading scientific term used in these debates is “fetal stem cells”. These cells are generally retrieved from aborted embryos aged 5–9 weeks. Since the embryonic period extends from fertilization to the end of 8 weeks, the majority of these cells are “embryonic”, not “fetal”. These cells are also not “somatic cells”, but rather the primitive sex cells, the immature human germ line cells. They are still diploid, and therefore can be cloned using any cloning technique (including somatic cell nuclear transfer). They can be matured in vitro to produce the sex gametes (sperms and oocytes) and then used in artificial fertilization. Since they are germ line (sex) cells, they can be manipulated using DNA–recombinant gene transfer, and thereby transmit “foreign” genes down through the generations (eugenics).

V. Conclusion:

As Catholic ObGyn’s continue to insist on your right to be trained and practice in medicine according to your consciences, I hope you will consider how critical it is to develop a well–formed conscience — one that is grounded in reality. Part of that reality is the accurate objective scientific information that the immediate product of fertilization and of cloning is a new, living innocent human being. These are the objective empirical facts of human embryology and human genetics which lead to the conclusions of the Moral Law that they should be treated as persons even at their earliest stages of development. This is the “sanctity of life ethic”, and is the starting point for all further considerations in medicine and research.

I hope you will also consider that another part of reality is the existence of malignant global structures of bioethics which purposefully use erroneous science and an idiosyncratic and very problematic normative “ethics” to redefine the “human being” and “human person” in order to achieve their own medical and research agendas, often eugenic in purpose. Theirs is the “quality of life ethic”, which necessarily comes to far different ethical conclusions in medicine and research.

Until and unless we all come to deal effectively with these concrete realities, the pressures on and discriminations against Catholic ObGyn’s and related health care workers to be trained and practice according to conscience will continue to escalate.

" … [T]here has emerged a phenomenon unknown to antiquity that permeates our modern society so completely that its ubiquity scarcely leaves us any room to see it at all: the prohibition of questioning … We are confronted here with persons who know that, and why, their opinions cannot stand up under critical analysis and who therefore make the prohibition of the examination of their premises part of their dogma … The questions of the "individual man" are cut off by the ukase of the speculator who will not permit his construct to be disturbed." [Emphases added.]

Eric Voegelin
Science, Politics and Gnosticism (1968)

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