An article from www.saltlight.org/mag | © 2004 Salt and Light Ministries | http://europe.saltlight.org/mag/ukraine0311

 

Of Genes and Screens and Clones and Things

A discussion paper by Dr Rick Thomas, Worcester, UK - written for EAT, May 2002

 

Introduction

Key Issue - The status of the embryo

Traditional Christian view:  The embryo is fully human and deserving of respect and protection from the time of conception.

• Human life is sacred and unique - created by God, in His image.
• God is intimately involved in the hidden mysteries of foetal development (Psalm 139), in continuity with the rest of life.  The grace of God to us, from our earliest moments, revealed in covenant love and faithfulness, confers intrinsic value and personhood.
• Jesus was like us in every respect (except for sin), human from the time of his own miraculous conception.  The unborn John leaps in the presence of the unborn Jesus only a few days or weeks later (Luke 1:42-44).
• Doctor Luke uses the same Greek word "brephos" to describe unborn John, newborn Jesus (Luke 2:12) and little children brought to Jesus for a blessing (Luke 18:15), i.e. continuity of existence between foetus, newborn and child.

It is a view that also makes sense biologically:

• "… there is no time between the union of sperm and egg and the birth of the baby at which point we can say that this is not a human being."

and intuitively:

• The maternal instinct, the pain of miscarriage, the guilt of abortion.

Current legal position

The embryo is not a person, in the sense of deserving minimal protection, until 14 days.  Strength for this view is drawn from:

• "Natural" wastage - perhaps 50% of all normal conceptions fail to implant.  If "God" is so wasteful, why worry about a few more.
• Most of the early embryonic tissue will develop into the placenta.  Differentiation occurs only after 12 - 14 days.
• The early embryo can have no consciousness of self.  It is a pre-person, even if it is human.
• The commercial interests of powerful biotechnology and pharmaceutical industries.

The loss of the "sanctity of life" consensus, combined with the revolution in biotechnology, is facing our culture with the greatest long-term challenge to human dignity.  Alongside the profound ethical and philosophical questions are issues of human suffering, heartbreak, disappointment and pain.  "As Christians, we should talk about these issues with tears in our eyes rather than judgement in our voices." (J.W.)

Let's look at the implications of this moral and technological revolution in the areas of contraception, IVF and the new genetics, including cloning.

Contraception

Conception normally takes place in the woman's fallopian tube.  Her now-fertilised egg continues its journey to the womb, multiplying into 2, 4, 8 etc. cells as it goes.  It enters the cavity of the womb 4 or 5 days after fertilisation, as a ball of about 16 cells, and implants in the wall of the womb 2 days later.  At this stage it is not clear what part of the embryo will go on to form the foetus - most of the cells will develop into the placenta - this differentiation occurs only after 12 - 14 days.

Conception can be prevented by inhibiting the release of the egg from the ovary (using the oral contraceptive pill), by barrier methods (condom, cervical cap etc.) or by sterilisation (tying the tubes, his or hers!)

Implantation can be prevented by making the womb "hostile", either with hormones (the "morning after" pill) or by the presence of a foreign body (intrauterine device).  These methods may not prevent conception, but make it impossible for the pregnancy to advance by preventing implantation of the fertilised egg in the wall of the womb. 

There is a growing body of evidence to suggest that occasionally the oral contraceptive pill prevents pregnancy by acting in this way, rather than by inhibiting ovulation.  (This should not surprise us - the "morning after" pill is, after all, only the same as taking four oral contraceptive pills as a single dose.)  In the light of this evidence, we may want to re-examine the contraceptive advice we give to couples preparing for marriage.  At the very least, they need to be aware of the facts, to be able to make an informed decision.

In 1990, a law was passed allowing "spare" embryos from IVF to be destroyed, frozen or experimented upon up to 14 days.  It was not a great leap subsequently to allow over-the-counter purchasing of the morning-after pill.  We now see the early embryo referred to as a pre-embryo, planting the suggestion in our minds that it is somehow less than human and thus "disposable".

In the recent Irish Referendum on Abortion, the proposed law changes included an amendment defining pregnancy as commencing with implantation, not fertilisation.  So the I.U.D. and morning-after pill would no longer be seen as terminating pregnancy, but preventing it.

I.V.F. (In-vitro fertilisation)

What is it?

Louise Brown, the world's first test-tube baby, will be 25 this year, born as a result of IVF, (after 250 attempts!)
IVF was developed to get round the problem of blocked tubes.  The woman is given drugs inducing her to super-ovulate, producing a whole clutch of eggs at the same time.  The eggs are harvested, via a telescope inserted through the abdominal wall, and then fertilised by sperm in a laboratory dish.  About 48 hours later, 2 or 3 of the strongest looking embryos are inserted into the womb.  It's big business, though success rates are still low (about 16%).

Pastoral/Ethical issues

1. Third parties.  The child could have up to 5 parents!
2. "Spare" embryos.  May be destroyed, donated, frozen or used for research up to 14 days.
3. Selective abortion.
4. Legal minefield.  E.g. Rios Case.
5. Emotional and financial cost.  Pain and pressure.  ? Doubled risk of birth defects.

Questions

1. Can infertility be a gift?
2. Is it morally acceptable to make babies this way?
3. Would it be redemptive to extend adoption towards unwanted embryos?
4. Who should be eligible for IVF?

The new genetics

"I think ethics is what the public is comfortable with."  (Brinsden)

Cut loose from any fixed ethical moorings, today's public is being swept along on a tide of relativism and naïve optimism.  Impressed by the hyperbole surrounding every technological "breakthrough", it is persuaded that the ends justify the means.  What was unthinkable yesterday is acceptable today and assumed tomorrow.

"When the potential medical and human benefits are so enormous, what possible grounds can be found to resist?  If we are prepared to accept the generation, manipulation and destruction of human embryos, we may have access to an unparalleled range of new treatments for degenerative, inherited and cancerous diseases." (J.W.)

A.  Embryo selection

Procedure: Produce a clutch of embryos, as in IVF.  Analyse the genetic make-up of each and select the best one(s) for implantation.

Currently restricted, in U.K., to detection of childhood diseases having a severe impact on life expectancy or quality.  Embryos carrying the relevant gene are selected out, e.g. cystic fibrosis.  Certain sex-linked diseases can be avoided by selecting the embryo by its gender.

It is now possible to identify certain genes which predispose to disease later in life, e.g. the BRCA 1 gene carries a 20-fold increased risk of developing breast cancer.

This is a rapidly expanding field of knowledge, and it will soon be possible to detect genetic variants having a less severe impact on life, such as a predisposition to obesity, asthma, diabetes etc.  Likewise, genetic variations that increase resistance to infection will be identified.  We can speculate, not too wildly, that genes predisposing to certain "socially desirable characteristics" will eventually be identified.

Where are the ethical boundaries here?  Should parents be allowed to choose the sex of their child?  Leaving it to chance makes no sense at all in a secular universe.  It makes sense only in a theistic worldview, where children are seen as wonderful and mysterious gifts from God, and not the result of human planning and ingenuity.  Presently, it still feels wrong, intuitively, to be able to choose the sex of our babies (except to avoid sex-linked diseases), but for how much longer?  Legislation appears to follow what the public feels is acceptable.

In other cultures, there are different pressures.  A report in 1994 estimated that in India, 50,000 female foetuses were being aborted every year, since girls are seen as an economic burden because they need a dowry for marriage.  The effect has been to change the population balance so that there are only 927 women for every 1000 men.  Would embryo selection be acceptable here, as the "lesser of two evils".

In 1994 a black woman in Italy received an embryo created from white sperm and egg donors, to avoid the prejudice she felt that a black child would face.

In a world that places such emphasis on autonomy and choice, the pressure to extend the law restricting embryo selection will be irresistible.

"Environment and genes stand side by side.  Both contribute to a child's chances for achievement and success in life, although neither guarantees it.  If we allow money to buy an advantage in one, the claim for stopping the other is hard to make, especially in a society that gives women the right to abort for any reason at all".  "Whether we like it or not, the global market-place will reign supreme."  (Silver)

B.  Cloning

23rd February 1997: Hello Dolly - the process of nuclear transfer

26th February 1997: "…absolutely no possibility whatsoever that human beings could be cloned in the near future."  (Winston)

November 2001: A first for Worcester (Mass.) - cloned human embryos

Definitions:

• Reproductive cloning - inserting the cloned embryo into the womb to produce a child - currently illegal in U.K.
• Therapeutic cloning - producing cloned embryos, up to 14 days, for stem cells.

The "holy grail" of therapeutic cloning is the harvesting of genetically "matched" stem cells from the embryo.  Stem cells are capable of developing into a range of tissue types, and can be "persuaded" to grow into muscle, brain, bone or liver etc for transplantation, but without the problems of rejection.  No embryonic development beyond the 14 - day stage will occur.

Reproductive cloning could also carry medical benefit.  Treatment of leukaemia sometimes depends on finding a suitably matched donor for bone-marrow transplant.  The cloning of a child from genetic material taken from the leukaemia sufferer would provide a source of supply of perfectly matched bone marrow.  Would it be wrong for a couple to use this technology to have a second child who will not only be loved for him/herself, but also have the capability of saving their first child's life?  Or would such a child necessarily be, and feel, less loved, little more than medicine for its older sibling?  Would it be better to have no children to love, than two?  "Is it better to have a baby to give your first kid a playmate than to have one to save your first kid's life?" (Specter)

Other scenarios:

• Mother receives chemotherapy, after giving birth to a baby, and is permanently sterile as a result.  The baby then dies in a tragic accident.  Cloning from the baby's cells would enable her to have another child, genetically her own.
• A couple that become sterile after having one healthy child, and wants a second by cloning the first - a later-born identical twin.  What about non-sterile parents who, for some reason, want the same?
• A lesbian couple could share biological parentage of a child (daughter): one provides the donor cell, the other the "empty" egg and her womb.
• Infertile heterosexual couples, in the same way: father provides donor cell and mother provides her womb
• Single woman could clone herself, and give birth to her identical twin
• Single man could clone himself, with the services of a surrogate mother
• You could buy a Michael Owen gene pack!

Where are the ethical lines to be drawn, and by whom?  The cloning protocol does not tamper with embryos, but only with unfertilised eggs and adult cells.  The resulting embryos could theoretically be treated with the utmost respect.  Are we crossing a moral boundary by creating an identical twin, given that they are born naturally every day of the week?

C.  Gene Therapy

• Rhys Evans - bubble baby syndrome (SCID)
• Direct engineering of genes within a single human embryo is technically very difficult, with an unacceptable failure rate.  But cloning could change everything!  Multiple cells from a single embryo (A) could be grown and subjected to genetic engineering.  One of those few cells successfully engineered as desired could then be used to produce an "improved" embryo (B) by nuclear transfer.  Embryo B, when implanted, would eventually become a "new" human being, with a special genetic gift.
• This is still the stuff of science fiction, but with time such techniques will improve and genetic engineering of human embryos will become feasible, safe and efficient.  The power to change the nature of humankind will be with us.  Would this be to cross the final frontier, trespassing in God's domain?  If we could "add" a gene giving resistance to HIV infection, should we?  If we can identify the gene responsible for ageing, should we replace it?  If it is He who "knits us together in our mother's womb", should we seek to "improve" on his work?  Or can we use technology, as it advances, redemptively to defeat diseases, even at the genetic level, which result from the fall?

The dangers of the new genetics

• Vast numbers of "wasted" or frozen embryos.
• Erosion of marriage and family; confused heritage.
• Children as commodities, not gifts - we already choose "when", and we may choose "what" - if I don't like it I can get rid of it.  Such children, far from being loved unconditionally, are more likely to be abused.
• Pregnancy is tentative and fearful - the "search and destroy" philosophy behind some antenatal tests.  Is screening helpful if abortion is the only "treatment"?  E.g. the practice of amniocentesis, as a test for Down's syndrome, provokes the miscarriage of 4 normal pregnancies for every case of Down's discovered, which is then itself almost always aborted.
• Stigmatisation of genetically abnormal and disabled - discriminated against in employment, insurance, mortgage, even marriage i.e. "chromosomalism".
• Increased social divisions - only the rich can afford to buy genetic advantage or reproductive technology.
• Possible exploitation by dictators - "Man's power over nature turns out to be power exercised by some men over other men."  (C.S. Lewis)

Responding the genetic technology

1.  Genetic determinism is a fallacy.  ("nothing buttery…")

The belief that an "accident" of conception, our genetic inheritance, determines for us a future we cannot control.  Life is a lottery: whether you can successfully hold a tune, a racket, your temper or your hair is all down to blind chance!

• Born of the drive to control our futures and conquer our fears - "If we could just turn the tables on our genes and master them."
• Genes may create a tendency, they don't create a tyranny; they may predispose, they don't predetermine - we have choices! "It was me genes, me lud; I couldn't stop meself," will not stand up in court!
• We are much more than the sum of our genes. - Relationships and environment also shape us; identical twins often grow up to be very different from each other.

2.  Dualism is also a fallacy

The belief that the body doesn't matter, is "rotten", and that only the soul/spirit is important; we can therefore do what we will with the body.  In truth, body, mind and spirit are all important and intertwined.

3.  Life is a gift - we are stewards, not owners

4.  Life is special - even at its most feeble or disabled - and deserving of respect and protection.

5.  Life is a relationship - grace confers value

6.  We are "flawed masterpieces" -  Ethical medicine aims to restore the "artist's" original design.  Technologies should respect the inviolability of embryonic life from conception.  Their applications should honour the integrity of marriage.

Conclusion: the challenge

• To empathise with the pain of childlessness and genetic disease
• To resist the "lego-kit" mentality towards human life
• To encourage our bravest and best to get involved in these arenas
• To demonstrate our belief in the value of every human life through practical compassion and care
• To present an alternative worldview to our society, which encompasses wonder, respect and protection for the weak, vulnerable and unborn; taking our physical bodies seriously while pointing to a greater reality, a deeper healing and a hope which transcends the grave!