The Impact of International Bioethics on the 'Sanctity of Life Ethics', and the Ability of OB Gyn's to Practice According to Conscience. pg.2

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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.31 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”.32

In the private sector these same bioethics principles are used to explicitly ground private Hospital Ethics Committee Guidebooks,33 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,34 engineering,35 journalism and business36 — 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".37 Bioethics is actually taught now in high schools, thanks especially to a well-funded program at the Kennedy Institute of Ethics at Georgetown University.38

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.39 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.”40 As Jonsen opined, “Morison's letter was a sobering reminder of the anomalous role of an 'ethics commission' in a pluralistic, secular society.”41

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”42 [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!43 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.44 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,45 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”46 (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”47 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.48 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.49 Now, following similar work by Andre Hellegers50 (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.51 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.52 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.53Thus 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.54

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”.55

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.56 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.57 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.”58

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