What is "Bioethics"? pg.10

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Endnotes: (con't)

72  See, e.g., Richard McCormick, S.J., "Who or What is the Preembryo?", Kennedy Institute of Ethics Journal 1:1 (1991). In this paper McCormick draws heavily on the work of frog embryologist Clifford Grobstein, as well as from "an unpublished study of a research group of the Catholic Health Association entitled 'The Status and Use of the Human Preembryo', (p. 14).

The influence of the McCormick/Grobstein term "pre-embryo" was (and still is) widespread even among Catholic scholars. In addition to the works of McCormick and Grobstein, see acceptance of the term "pre-embryo" also in: Andre E. Hellegers, "Fetal Development," in Thomas A. Mappes and Jane S. Zembatty (eds.), Biomedical Ethics, (New York: Macmillan, 1981); Hellegers, "Fetal Development", Theological Studies (1970), 31:3-9; Charles E. Curran, "Abortion: Contemporary Debate in Philosophical and Religious Ethics", in W. T. Reich (ed.), Encyclopedia of Bioethics 1 (London: The Free Press, 1978), pp. 17-26; Kevin Wildes, "Book Review: Human Life: Its Beginning and Development" (L'Harmattan, Paris: International Federation of Catholic Universities, 1988); Carlos Bedate and Robert Cefalo, "The Zygote: To Be or Not Be a Person", Journal of Medicine and Philosophy (1989), 14:6:641; Robert C. Cefalo, "Book Review: Embryo Experimentation, Peter Singer et al (eds.); 'Eggs, Embryos and Ethics'", Hastings Center Report (1991), 21:5:41; Mario Moussa and Thomas A. Shannon, "The Search for the New Pineal Gland: Brain Life and Personhood", The Hastings Center Report (1992), 22:3:30-37; Carol Tauer, The Moral Status of the Prenatal Human (Doctoral Dissertation in Philosophy; Kennedy Institute of Ethics, Georgetown University, Washington, D.C.: Georgetown University, 1981) (Sister Tauer's dissertation mentor was Richard McCormick; she later went on to become the ethics co-chair of the NIH Human Embryo Research Panel 1994); C. Tauer, "The Tradition of Probabilism and the Moral Status of the Early Embryo", in Patricia B. Jung and Thomas A. Shannon, Abortion and Catholicism (New York: Crossroad, 1988), pp. 54-84; Lisa S. Cahill, "Abortion, Autonomy, and Community", in Jung and Shannon, Abortion and Catholicism (1988), pp. 85-98; Joseph F. Donceel, "A Liberal Catholic's View", in Jung and Shannon, Abortion and Catholicism (1988), pp. 48-53; H. Tristram Engelhardt, The Foundations of Bioethics (New York: Oxford University Press, 1985), p. 111; William A. Wallace, "Nature and Human Nature as the Norm in Medical Ethics", in Edmund D. Pellegrino, John P. Langan and John Collins Harvey (eds.), Catholic Perspectives on Medical Morals (Dordrecht: Kluwer Academic Publishing, 1989), pp. 23-53; Norman Ford, When Did I Begin? (New York: Cambridge University Press, 1988), p. 298; Antoine Suarez, "Hydatidiform Moles and Teratomas Confirm the Human Identity of the Preimplantation Embryo", Journal of Medicine and Philosophy (1990), 15:627-635; Thomas J. Bole, III, "Metaphysical Accounts of the Zygote as a Person and the Veto Power of Facts", Journal of Medicine and Philosophy (1989), 14:647-653; Bole, "Zygotes, Souls, Substances, and Persons", Journal of Medicine and Philosophy (1990), 15:637-652.

The term "pre-embryo" even somehow made its way into the encyclical, Donum Vitae (Congregation for the Doctrine of the Faith) (St. Paul Books & Media, 1987), footnote p. 4. However, the term was rejected by The Third Plenary Assembly of the Pontifical Academy for Life held in Vatican City, 14-16 February, 1997: "At this Assembly papers were presented on the work carried out in the last two years on the subject Identity and Status of the Human Embryo by a study group (Task Force): From a biological standpoint, the formation and the development of the human embryo appears as a continuous, coordinated and gradual process from the time of fertilization, at which time a new human organism is constituted, endowed with the intrinsic capacity to develop by himself into a human adult. The most recent contributions of the biomedical sciences offer further valuable empirical evidence for substantiating the individuality and developmental continuity of the embryo. To speak of a pre-embryo thus is an incorrect interpretation of the biological data. Judgement - as an act of the human mind - on the personal nature of the human embryo springs necessarily from the evidence of the biological datum which implies the recognition of the presence of a human being with an intrinsic active capacity for development, and not a mere possibility of life." [Emphases mine]. [http://www.vatican.va/roman_curia/pontifical_academies/acdlife/documents/rc_pa_acdlife_doc_16021997_final-doc_en.html].[Back]

73  See Richard McCormick's testimony in The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975, pp. 34-35; McCormick, How Brave a New World? (Washington, D.C.: Georgetown University Press), p. 76; McCormick, "Proxy Consent in the Experimentation Situation", Perspectives in Biology and Medicine (1974), 18:2-20.[Back]

74  See Paul Ramsey's testimony in The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975, pp. 35-36.[Back]

75  For further analysis of the use of the erroneous term "pre-embryo" in the work of both McCormick and Grobstein (and others) see: Dianne N. Irving, A Philosophical and Scientific Analysis of the Nature of the Early Human Embryo (Doctoral Dissertation; Department of Philosophy, Georgetown University, Washington, D.C.; University Microfilms, 1991), esp. Chapter 3 (the Dissertation includes an analysis of the works of 28 other bioethicists who also argue for "delayed personhood" based on different biological marker events throughout prenatal development -- and beyond. Most of these bioethicists were referenced in the NIH Human Embryo Research Panel meetings and report). See also: Irving, "Science, Philosophy and Expertise: An Evaluation of the Arguments on 'Personhood'", Linacre Quarterly (Feb. 1993), 60(1):18-46; Irving, "When Does a Human Being Begin? 'Scientific' Myths and Scientific Facts", International Journal of Sociology and Social Policy (1999), 19:3/4:22-47; Ward C. Kischer and Dianne N. Irving, The Human Development Hoax: Time To Tell The Truth! (1997, distributed by American Life League); and note 68, supra.

The use of the term "pre-embryo" has been quite widespread for decades -- nationally and internationally. In addition to the Catholic scholars who accepted the use of the term "pre-embryo" as noted above, a partial list of secular bioethics writers who also accepted the use of the term in these debates includes: Paul Ramsey, "Reference Points in Deciding About Abortion" in J.T. Noonan (ed.), The Morality of Abortion (Cambridge, MA: Harvard University Press, 1970), pp. 60-100, esp. p. 75; John Robertson, "Extracorporeal Embryos and the Abortion Debate", Journal of Contemporary Health Law and Policy (1986), 2;53;53-70; Robertson, "Symbolic Issues in Embryo Research", The Hastings Center Report (1995, Jan./Feb.), 37-38; Robertson, "The Case of the Switched Embryos", The Hastings Center Report (1995), 25:6:13-24; Howard W. Jones, "And Just What is a Preembryo?", Fertility and Sterility 52:189-91; Jones and C. Schroder, "The Process of Human Fertilization: Implications for Moral Status", Fertility and Sterility (August 1987), 48:2:192; Clifford Grobstein, "The Early Development of Human Embryos", Journal of Medicine and Philosophy (1985), 10:213-236; also, Science and the Unborn (New York: Basic Books, 1988), p. 61; Michael Tooley, "Abortion and Infanticide", in The Rights and Wrongs of Abortion, M. Cohen et al (ed.) (New Jersey: Princeton University Press, 1974), pp. 59 and 64; Peter Singer and Helga Kuhse, "The Ethics of Embryo Research", Law, Medicine and Health Care (1987),14:13-14; Kuhse and Singer, "For Sometimes Letting - and Helping - Die", Law, Medicine and Health Care (1986), 3:40:149-153; Kuhse and Singer, Should The Baby Live? The Problem of Handicapped Infants (Oxford University Press, 1985), p.138; Singer, "Taking Life: Abortion", in Practical Ethics (London: Cambridge University Press, 1981), pp. 122-123; Peter Singer, Helga Kuhse, Stephen Buckle, Karen Dawson, Pascal Kasimba (eds.), Embryo Experimentation (New York: Cambridge University Press, 1990); R.M. Hare, "When Does Potentiality Count? A Comment on Lockwood," Bioethics (1988), 2:3:214; Michael Lockwood, "When Does Life Begin?", in Michael Lockwood, (ed.), Moral Dilemma's in Modern Medicine (New York: Oxford University Press, 1985), p. 10; Hans-Martin Sass, "Brain Life and Brain Death: A Proposal for Normative Agreement," Journal of Medicine and Philosophy (1989), 14:45-59; Michael Lockwood, "Warnock Versus Powell (and Harradine): When Does Potentiality Count?" Bioethics (1988), 2:3:187-213.

See also the use of the term "pre-embryo" in many national and international documents (a small sample): Ethics Advisory Board (1979) Report and Conclusions: HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer, Washington, D.C.: United States Department of Health, Education and Welfare, p. 101; National Institutes of Health Human Embryo Research Panel Meetings (Washington, D.C.: NIH, 1994), Feb. 2 meeting, pp. 27, 31, 50-80, 85-87, 104-106; in the Feb. 3, 1994 meeting, pp. 6-55; April 11 meeting, pp. 23-41, 9-22. See also, Dame Mary Warnock, Report of the Committee of Inquiry into Human Fertilization and Embryology, (London: Her Majesty's Stationary Office, 1984), pp. 27and 63; Commonwealth of Australia, Select Senate Committee on the Human Embryo Experimentation Bill, (Canberra, Australia: Official Hansard Report, Commonwealth Government Printer, 1986); Parliamentary Assembly of the Council of Europe, On the Use of Human Embryos and Foetuses for Diagnostic, Therapeutic, Scientific, Industrial and Commercial Purposes, Recommendation 1046, 1986; and On the Use of Human Embryos and Foetuses in Scientific Research, Recommendation 1000, 1989; Ethics Committee of the American Fertility Society (AFS), "Ethical Considerations of the New Reproductive Technologies", Fertility and Sterility (1986), 46:27S. See also Jonsen, esp. Chapters 4 and 12.[Back]

76  E.g., Tom Beauchamp and James Childress, Principles of Biomedical Ethics (1st ed.) (New York: Oxford University Press, 1979), pp. 45-47; Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (2nd ed.) (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), p.26; Tom Beauchamp, Philosophical Ethics (New York: McGraw-Hill Book Company, 1982, pp. 124-128, 141, 188-190; Tom Beauchamp; and Laurence B. McCullough, Medical Ethics: The Moral Responsibilities of Physicians (New Jersey: Prentice-Hall, Inc., 1984), pp. 13-16, 21-22, 39-40, 46, 48, 133-35, 162-64.[Back]

77  Jonsen, p. 328.[Back]

78  The Belmont Report, note 60 supra, pp. 6-7.[Back]

79  Tom Beauchamp and James Childress, Principles of Biomedical Ethics (1st ed.) (New York: Oxford University Press, 1979), pp. 135-167; Tom Beauchamp and LeRoy Walters, Contemporary Issues in Bioethics (eds.) (2nd ed.) (Belmont, California: Wadsworth Publishing Company, 1982), pp. 28-43.[Back]

80  [National Bioethics Advisory Commission] Federal Register: October 5, 1995 (Volume 60, Number 193), pp. 52063-52065; Presidential Documents, Executive Order 12975 of October 3, 1995: Protection of Human Research Subjects and Creation of National Bioethics Advisory Commission. [http://www.bioethics.gov/nbac.html]. See, e.g., the commissioned paper by John C. Fletcher, "Deliberating Incrementally on Human Pluripotential Stem Cell Research", especially pp. E-25-E33, and note 75, p. E-40. [http://bioethics.gov/stemcell2.pdf]. [Back]

81  Declaration of Helsinki 1993 (revised 1964, 1975, 1983, 1989), as published in United States Department of Health and Human Services (1993), Office for the Protection from Research Risks: Protecting Human Research Subjects: Institutional Review Board Guidebook (1993), pp. A6-4 to A6-6. See also: The Nuremberg Code, ibid., pp. A6-1 to A6-2; United Nations (1947) Universal Declaration of Human Rights; United Nations (1991) Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care; and International Covenant on Civil and Political Rights (ratified, Sen. Comm. on Foreign Affairs 1992). For a review, see Leonard S. Rubenstein, "Standards of Accountability for Consent in Research", in Adil E. Shamoo (ed.), Ethics in Neurobiological Research With Human Subjects: The Baltimore Conference on Ethics (Amsterdam: Gordon and Breach Science Publishers,1997), pp. 129-138.[Back]

82  The Belmont Report, p. 8.[Back]

83  The literature on this is legion, but see several excellent recent books by: David S. Oderberg and Jacqueline A. Laing (eds.), Human Lives: Critical Essays on Consequentialist Bioethics (New York: St. Martin's Press, 1997); David S. Oderberg, Moral Theory: A Non-Consequentialist Approach (Malden, MA: Blackwell Publishers Inc., 2000); Oderberg, Applied Ethics: A Non-Consequentialist Approach (Malden, MA: Blackwell Publishers, Inc., 2000). See also Charles Harris, Michael Pritchard and Michael Rabins, Engineering Ethics: Concepts and Cases (New York: Wadsworth Publishing Company, 1995), esp. pp. 156-165; J.J.C. Smart and Bernard Williams, Utilitarianism: For and Against (New York: Cambridge University Press, 1973); Samuel Scheffler, The Rejection of Consequentialism: A Philosophical Investigation of the Considerations Underlying Rival Moral Conceptions (New York: Oxford University Press, 1982); Scheffler (ed.), Consequentialism and Its Critics (New York: Oxford University Press, 1988).[Back]

84  The Belmont Report, p.8.[Back]

85  Jonsen, p. 56.[Back]

864  John Rawls, A Theory of Justice (Cambridge: Belknap Press of Harvard University Press, 1971); Rawls, "Justice as Fairness", in Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (2nd ed.) (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), pp. 44-46, and p. 23-24.[Back]

87  Norman Daniels, Just Health Care (New York: Cambridge University Press, 1985); Jonsen, p. 222.[Back]

88  See, e.g.: , Mass Supreme Court, 1977. 373 Mass. 728, 736 (p. 7); Jonsen, p. 267. The legal concept of "substituted judgment" has been specifically rejected by many writers and courts, e.g.,: Mathy Mezey et al., "Life-Sustaining Treatment Decisions by Spouses of Patients with Alzheimer's Disease," Journal of the American Geriatrics Society (Feb. 1996), pp. 144-150; David C. Thomasma, "A Communal Model for Presumed Consent for Research on the Neurologically Vulnerable," Accountability in Research (1996), 4:227-239; Ralph Baergen, "Revisiting the Substituted Judgment Standard," Journal of Clinical Ethics (Spring 1995), pp. 30-38; Rosalind E. Ladd and Edwin N. Forman, "Adolescent Decision-Making: Giving Weight to Age-Specific Values," Theoretical Medicine (Dec. 1995), pp. 333-345; Jeremiah Suhl et al., "Myth of Substituted Judgment: Surrogate Decision-Making Regarding Life Support is Unreliable," Archives of Internal Medicine (1994), 154:90-96; John Hardwig, "The Problem of Proxies With Interests of Their Own: Toward a Better Theory of Proxy Decisions," Journal of Clinical Ethics (Spring 1993), pp. 20-27; James Coyne King, "The Search for Objectivity in Applying the Substituted Judgment Rule in Medical Care Cases," Boston Bar Journal (1993), 37:10-12, 14; Robert A. Perlman et al., "Contributions of Empirical Research to Medical Ethics," Theoretical Medicine (Sept. 1993), pp. 197-210; Lynne E. Lebit, "Compelled Medical Procedures Involving Minors and Incompetents and Misapplication of the Substituted Judgment Doctrine," Journal of Law and Health (1992-1993), pp. 107-130; Alexander M. Capron, "Substituting Our Judgment," Hastings Center Report (March-April 1992), pp. 58-59; Ezekiel J. Emanuel and Linda L. E. Emanuel, "Proxy Decision-Making for Incompetent Patients: An Ethical and Empirical Analysis," Journal of the American Medical Association (1992), 267:2067-2071; Jan Hare et al, "Agreement Between Patients and Their Self-Selected Surrogates on Difficult Medical Decisions," Archives of Internal Medicine (1992), 152:1049-1054; Thomas G. Gulkeil and Paul S. Appelbaum, "Substituted Judgment: Best Interests in Disguise," Hastings Center Report (June 1983), pp. 8-11; George J. Annas, "Precatory and Mindless Mimicry: The Case of Mary O'Connor," Hastings Center Report (Dec. 1988), pp. 31-33. For recent court decisions, see Illinois. Appellate Court, First District, Fourth Division. In re C.A. North Eastern Reporter, 2nd series. 1992 Oct 15 (date of decision). 603:1171-1194; Illinois. Supreme Court. Curran v. Bosze. North Eastern Reporter, 2nd series. 1990 Dec. 20 (date of decision). 566:1319-1345; Florida. District Court of Appeal, Second District. In re Guardianship of Browning. Southern Reporter, 2nd series. 1989 Apr. 10 (date of decision). 543:258-276; Missouri. Supreme Court, en banc. Cruzan by Cruzan v. Harmon. South Western Reporter, 2nd Series. 1988 Nov 16 (date of decision). 760:408-445.[Back]

89  Arthur Dyck, "Assessing the Population Debate," The Monist 61 (Jan. 1977); Jonsen, p. 302.[Back]

90  Jonsen, p. 114.[Back]

91  Jonsen, p. 335.[Back]

92  Daniel Callahan, "Bioethics: Private Choice and Common Good", Hastings Center Report (May-June 1994), 24:3:31.[Back]

93  Edwin DuBose, Ronald Hamel and Laurence O'Connell (eds.), A Matter of Principles?: Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994), p.1.[Back]

94  Gilbert C. Meilaender, Body Soul, and Bioethics (Notre Dame, IN: University of Notre Dame Press, 1995), p. x.[Back]

95  Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994).[Back]

96  Renee Fox, "The Evolution of American Bioethics: A Sociological Perspective," in George Weisz (ed.), Social Sciences Perspective on Medical Ethics (Philadelphia: University of Pennsylvania Press, 1990), pp. 201-220. Renee Fox and Judith Swazey, "Medical Morality is Not Bioethics -- Medical Ethics in China and the United States," Perspectives in Biology and Medicine 27 (1984):336-360, in Jonsen p. 358.[Back]

97  [Back]

Jonsen, p. 344.

98  Renee C. Fox and Judith P. Swazey, "Leaving the Field", Hastings Center Report (September-October 1992), 22:5:9-15.[Back]

99  See Dianne N. Irving, "Scientific and Philosophical Expertise: An Evaluation of the Arguments on 'Personhood'", Linacre Quarterly (1993), 60:1:18-47.[Back]

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