The very problematic issue of the cloning of human chimeras should be more clearly addressed in these Regulations. Chimera research would be an indirect form of human cloning. It would also be a form of human embryo research because: (a) theoretically, a human/animal chimera could be "back-bred"15 to produce a new whole human embryo (human being); and, (b) the source of the human DNA used in such chimera research could be living human embryos or fetuses. Therefore, these Recommendations would not ban human cloning by means of the formation of human chimeras; additionally, these Recommendations would also sanction a form of human embryo research.
In sum: The University Faculty For Life would support only ethical medical research that is based on and that uses current and accurate science, and which does not involve the killing of innocent living human beings -- at any stage of development.
The first ethical requirement of any scientific research is that it be based on current, sound and accurate science -- as firmly and succinctly stated in international research guidelines using human subjects such as the Nuremberg Code16, and the Declaration of Helsinki:
Basic Principles: 1. Biomedical research involving human subjects must conform to generally accepted scientific principles and should be based on adequately performed laboratory and animal experimentation and on a thorough knowledge of the scientific literature."17
We would strongly encourage the CIHR Working Group to likewise consider this as the first ethical requirement of their Recommendations.
The means used to achieve the "therapeutic" and "scientific" goals of these Recommendations, even granted that these goals are important and worthy, must also be seriously considered as part of the equation. If the means used in such research are highly objectionable and unethical, then the research itself should be prohibited, regardless of how acceptable the goals may seem. To intentionally kill innocent living human beings as a means to cure diseases in others or to advance scientific knowledge per se is an inherently and highly objectionable unethical means to a goal, and therefore this research should not be permitted. To do otherwise would also violate international codes of research ethics, and clearly an unambiguously articulated in the 1998 Declaration of Helsinki:
Of course, the issue is often raised within bioethics as to whether or not a human being is always simultaneously a human "person" -- and therefore a human subject to be ethically and legally respected and protected to the fullest extent. This issue is closely related to the use of the term "pre-embryo", the 14-day limit on research using living human embryos, and the "reduced moral status" terminology implied in these Recommendations to justify research using early human embryos -- a concept which can be traced back historically to the early bioethics writings of Richard McCormick, S.J. and Clifford Grobstein, e.g., their testimonies before the National Commission (1975), and their work on the DHEW Ethics Advisory Board (1978).19
Any competent and complete response to this divisive issue would be far too lengthy to include in this response; however, the issue should still be raised here. The massive bioethics literature in which "delayed personhood", on which, e.g., the CIHR 14-day limit on the use of living human embryos in research is based, has been extensively identified and analyzed by many critics around the world. It is sufficient to point out, however, just a few essential facts here.
The question of when a human being begins to exist is strictly a scientific question, and should be answered only by human embryologists -- i.e., those scientists who have the academically required training, advanced degrees, and professional experience to be considered "experts" in this field. Physicians, nurses, molecular biologists, geneticists, biochemists, engineers, X-ray technicians, politicians, public policy makers, theologians, philosophers, bioethicists, etc., do not have the necessary academic credentials to answer this strictly scientific question as "experts". Human embryologists internationally all agree, as referenced in Part II (above), that a new unique human being begins to exist immediately at fertilization or at cloning.20
The question of when a human "person" begins to exist is not a scientific question at all, but rather strictly a philosophical question -- and more recently, a "bioethics" question [see (d), below)]. It should be stressed that a "delay" in "personhood" is the major criteria for any conclusion of a "reduced moral status" for the early developing human being, and is the major basis for "biological markers" such as the 14-day marker incorporated by the CIHR Recommendations and other related Canadian (and some international guidelines). However, worldwide, extensive and highly critical analyses of these bioethics debates and conclusions on "delayed personhood" must not be ignored, and any efforts to utilize any of these "delayed personhood" claims as the basis for making public policy should be required to be defended in open public debates and before the full academy. Clearly, if the "science" used to ground any "delayed personhood" argument is false and erroneous "science", the ethical conclusion of "delayed personhood" is automatically likewise invalid.
Virtually all of these "delayed personhood" arguments are grounded in very specific scientific and philosophical claims, and all of these arguments are severely compromised. For example, this writer has written a 400-page doctoral dissertation on human embryo research (as well written as other extensive peer reviewed publications) in which these bioethics arguments for "delayed personhood" were analyzed in depth -- scientifically, philosophically, and logically.21 The conclusions were frankly astounding. Of the 28 representative bioethics arguments analyzed, virtually all of them used extensive erroneous "science", and historically inaccurate or theoretically indefensible philosophical claims (e.g., a "mind/body split") to ground their conclusions on "delayed personhood". Further, virtually none of these conclusions followed logically from their major and minor premises. Such ridiculously erroneous "delayed personhood" arguments are precisely those which ground the Canadian, as well as several of the international documents as noted in the Recommendations -- of particular influence, the arguments incorporating the "pre-embryo" myth, and the "biogenetics" myth (as discussed in Part II above).
The point should be clear. To date there has been absolutely no claim for "delayed personhood" which can withstand any significant scientific or philosophical academic challenge. On the other hand there are significant realist philosophical arguments, using accurate, sound and current science as their starting points, which can and have argued for "immediate personhood", and this is the general position taken by the University Faculty for Life. Human beings are always simultaneously human persons -- and therefore human subjects -- regardless of their particular stage of growth, development, maturity, or state of dependency. The early human embryo and fetus are unquestionably living human beings, therefore human persons, therefore human subjects. Therefore the ethical and legal rights and protections of these young human subjects should be fully and equally respected as those of more mature human subjects.
Regardless of the bioethics or philosophy involved, public policy, we think, should not be based on such highly questionable and extensively refuted "theories" and claims for "delayed personhood" or "reduced moral status". Rather, it is more reasonable to based them on sound, current, and accurate science. We know objectively and empirically that new, unique, living human beings begin to exist immediately at fertilization or at cloning. This is not a "belief" or an "opinion" -- and efforts to attempt to falsely caste this debate in those terms should be ignored. We strongly urge that public policy should be based on the objective scientific facts, and that the life and personhood of these developing human beings be truly respected as equally as those of more mature human beings. The legacies of slavery and numerous holocausts -- currently and historically -- are there to remind us that any two-tiered classification of human beings eventually leads to disaster.
Although the CIHR Working Group encouragingly registers serious concern for an "ethical" foundation for its Recommendations, the following questions should be immediately and directly addressed by the Working Group so that Canadian citizens can better understand the issues involved: (1) Which "ethics" should the Canadian government use on which to base its CIHR Recommendations?; (2) Who should determine which ethics the Canadian government should use?; (3) What does the CIHR consider constitutes "ethical expertise"?; (4) Can the Canadian government, which represents a democratic, pluralistic, multicultural society, legitimately base its public policies on any normative ethical theory -- i.e., a specific ethical theory that takes a stand on what is right and wrong, ethical and unethical?
"Bioethics", "utilitarianism", "consensus ethics", "deontology", "situation ethics", "ethical relativism", "cultural relativism", etc. -- in all their forms -- are all normative ethical theories. They all take a stand on what is right and wrong, ethical and unethical.
Therefore, especially in these scientific and medical public policies, which directly effect the very health and well-being of all members of society, how does the CIHR justify to the Canadian people the answers to these questions? Such major, fundamental and significant issues and questions appear to be ignored, or the answers simply posited and assumed, apparently without sufficient discussion, debate, or justifications in these Recommendations. It would appear, in fact, that these Recommendations, and related Canadian bills, ground "what is ethical" on a specific normative and defunct theory of "bioethics".
Contrary to popular opinion, bioethics, as predominantly practiced today -- is not the same thing as "ethics per se". Academically it is actually a sub-field of ethics, and stands alongside many other theories of ethics, e.g., Kantian deontology, Millsean utilitarianism, casuistry, natural law, egoism, situation ethics, relativism, and various forms of theological ethics, etc. And like all ethical theories, bioethics is by no means "neutral" -- there is no such thing as a "neutral ethics".22 In fact, bioethics defines itself as a normative ethical theory -- i.e., it takes a stand on what is right or wrong.23
Nor is bioethics to be equated with "medical ethics", as that term is still generally understood.24 Bioethics understood as "principlism" is an academic theory of ethics which was formally articulated for the first time in 1978 by the U. S. Congressionally-mandated 11-member National Commission in their Belmont Report.25 That Report, as Congressionally mandated, identified three bioethics principles for the U.S. government to use in issues concerning the use of human subjects in research: respect for persons, justice and beneficence (defining these three bioethics principles in less-than-traditional terms). These ethical principles are now referred to as "principlism", the Belmont principles, or "bioethics". This Congressional mandate, indeed, ushered in what has been referred to as the formal "birth of bioethics".26
The Belmont principles were supposedly ultimately derived from the normative ethical systems of various moral philosophers -- e.g., Kant, John Stuart Mill, and John Rawls. In effect, they quite selectively took bits and pieces from different and contradictory ethical theories and rolled them up into one ball. Furthermore, each of these principles were referred to as prima facie27 -- i.e., no one principle could over-rule any of the others. And the way we come to know these bioethics principles is by taking courses, attending conferences, and listening to bioethicists lecture at conferences.
However eventually, and inevitably, theoretical cracks began to form in the very foundation of this new "bioethics" theory -- eventually rendering the theory defunct. For example, because bioethics was derived from bits and pieces of fundamentally different and even often contradictory theoretical philosophical systems, the result was theoretical chaos, rendering it academically indefensible. More problematic, when people tried to apply the theory, it didn't work because practically speaking there was no way to resolve the inherent conflicts among these three prima facie principles. Paul Ramsey had complained about this specific problem early on, when such a suggestion was submitted at an early conference: "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)?"28 The inherent contradictions and conflicts between and among these prima facie bioethics principles would slowly erode the confidence of even those stalwarts within the field itself.
Even each of the bioethics principles individually is riddled with similar inherently contradictory conflicts and theoretical problems. For example, while the Commissioners of The Belmont Report gave a nod to the traditional Hippocratic understanding of "beneficence" in one definition as "doing good for the patient" (or at least, doing no "harm"), their "second" definition of "beneficence" is essentially utilitarian -- in terms of the good for society at large (or roughly, "the greatest good for the greatest number of people"). Obviously these two different and opposite definitions of "beneficence" could easily contradict each other. How can the "bene" refer to the good of an individual patient in the standard medical or the research settings, and at the same time in the same case refer to the good of society -- calculated in the crude terms of utilitarian "risks and benefits"? What physician, who has sworn the Hippocratic Oath, would even recognize the following definition of "doing good" that is found in the Belmont Report:
Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being. Such treatment falls under the principle of beneficence. The term "beneficence" is often understood to cover acts of kindness or charity that go beyond strict obligation. In this document beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do not harm and (2) maximize possible benefits and minimize possible harms. The Hippocratic maxim "do not harm" has long been a fundamental principle of medical ethics. Claude Bernard extended it to the realm of research, saying that one should not injure one person regardless of the benefits that might come to others. However, even avoiding harm requires learning what is harmful; and, in the process of obtaining this information, persons may be exposed to risk of harm. ... In the case of scientific research in general, members of the larger society are obliged to recognize the longer term benefits and risks that may result from the improvement of knowledge and from the development of novel medical, psychotherapeutic, and social procedures.29 [Emphases mine.]
It was The Belmont Report's utilitarian definition of "beneficence" which was to be quickly perpetuated throughout the emerging bioethics literature, e.g., as defended in the first bioethics textbooks by Beauchamp, Childress and Walters,30 incorporated in the OPRR federal regulations, and assumed by bioethics conferences, committees, panels and commissions to come -- up to and including the current National Bioethics Advisory Commission appointed by President Clinton.31 This "strong obligation" of the utilitarian-defined Belmont principle of "beneficence" blatantly contradicts the long-held international codes of research ethics, e.g., the Nuremberg Code and the Declarations of Helsinki, in which the protection of the individual patient always outweighs the needs or "good" of science or society (as already noted). Even The Belmont Report itself admits this inherent contradiction in its own definition of "beneficence": "Here, again, as with all hard cases, the different claims covered by the principle of beneficence may come into conflict and force difficult choices."32
Utilitarianism has always had serious problems with defining in practice what "good" is,33 but it is generally very roughly reduced to some sort of physical or mental pain or pleasure. One thing is clear, however. All utilitarian formulas, by definition, leave minorities and the vulnerable out in the cold. There are no moral absolutes here - only "rules" or mathematical risk/benefit ratios, which are by definition relative to "the greater good". As utilitarian, the general norm or standard against which one determines if an individual action is right or wrong is "utility"; i.e., if that action is useful to achieving good consequences, those also being defined in terms of "the greatest good for the greatest number". Even more problematical is the deconstruction of these classical forms of utilitarianism into what would be termed "preference" utilitarianism (as evidenced in these CIHR Recommendations), where what would be weighed and balanced would be "best interests" -- as developed in the works of British eugenicists such as Jonathan Glover and R.M. Hare, and Australian eugenicists Peter Singer, Helga Kuhse, etc.
The bioethics principle of "justice" in The Belmont Report is also ultimately defined along utilitarian lines, in terms of "fairness" -- i.e., fairness in the distribution of the benefits and burdens of research.34 This is not your classic definition of "justice", e.g., in the Aristotelean sense of communitive or distributive justice, but rather in terms strongly influenced by Harvard Graduate School philosophy professor John Rawls, as articulated in his then-new book, A Theory of Justice.35 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;36 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";37 it has also been applied by Arthur Dyck in international population policy issues.38 Recently international bioethicist Dan Wikler, as representative of the World Health Organization, appealed to this Rawlsian definition of "justice", declaring 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,"39 (i.e., "justice" as defined by Rawls.).
Even the bioethics principle of "respect for persons" eventually ends up serving "the greatest good". As noted above, it is The Belmont Report that explains that "respect for persons" includes the duty to participate in non-therapeutic research for the greater good of society. And the question arises: How could the principle that was supposed to ground an inviolable respect for each individual human being be defined in terms of a utilitarian respect for "society"? One explanation comes from Jonsen: "When Beauchamp and Childress formulated the principle of autonomy, they fused the Kantian deontological concept of respect for persons with John Stuart Mill's quite different notion of liberty ... Folding together the distinct views of Kant and Mill blurred the edges of both the Kantian and the Millsean notions."40 It also, of course, blurred the edges of the metaphysical, epistemological, and anthropological presuppositions inherent in those diverse and contrary theories of ethics. Hence, Kant's "respect for persons" evolved rapidly into the Millsean utilitarian version of "respect for autonomy" (pace Tom Beauchamp) -- where "autonomy" referred only to "persons", and "persons" were defined only as "moral agents". Most unfortunately, what it also did therefore was turn non-autonomous human beings into non-persons (since they are not "autonomous moral agents"). We now have bioethicist Richard Fry, pushing Peter Singer's "logic", and publishing his own "theory": Since many adult human beings are not perfectly "autonomous" and therefore not "persons", and many of the higher primates are "persons", these adult human "non-persons" should be substituted in purely experimental research for these higher animal "persons".41 This is surely "theory" run amok.
At any rate, after all is said and done, bioethics is ultimately reduced more or less to some form of utilitarianism or relativism -- both normative ethical theories -- where "the good of society" is the morally relevant principle, and the "good of the individual person" is clearly not top priority.
Eventually, practical cracks too began to form in the foundations of this brave new bioethics, cracks which seemed to widen deeper the more the "theory" was applied -- as admitted in publications by even many of the Founders themselves. For example, The Hastings Center's Daniel Callahan conceded in the 25th anniversary issue of The Hastings Center Report celebrating the "birth of bioethics", that the principles of bioethics simply had not worked. But not to worry, he said, we might try communitarianism now: "The range of questions that a communitarian bioethics would pose could keep the field of bioethics well and richly occupied for at least another 25 years".42 Jonsen himself devotes considerable space to the critics of bioethics in his book, The Birth of Bioethics, and even courageously admitted years earlier, in his "Preface" to the first serious book confronting the myriad inadequacies of "bioethics principlism", that there were only two real ethicists on the National Commission, and that they had essentially made the principles up. Jonsen also agrees with the premise of that book that bioethics should now be regarded somewhat as "a sick patient in need of a thorough diagnosis and prognosis":
A fairly widespread perception exists, both within and without the bioethics community, that the prevailing U.S. approach to the ethical problems raised by modern medicine is ailing. Principlism is the patient. The diagnosis is complex, but many believe that the patient is seriously, if not terminally, ill. The prognosis is uncertain. Some observers have proposed a variety of therapies to restore it to health. Others expect its demise and propose ways to go on without it.43
Gilbert Meilaender's early and incisive suspicions about the consequences of the several philosophical "mind/body splits" inherent in bioethics theory emerged in yet another important book, Body, Soul and Bioethics, in which he explained "how easily the 'soul' - attention to the meaning of being human, a meaning often illuminated by religious and metaphysical insight - can be lost in bioethics."44 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,45 in which 99 scholars from around the world jump into the fray -- by far the majority of them arguing against bioethics "principlism".
One of the strongest critiques of "bioethics" came from another one of the early Founders, Renee Fox, a sociologist. Referring to "American bioethics" as isolated from the relationships, communities, and values of real life in sickness and health, she argued that the isolation produced an uneasy relationship between the social sciences and bioethics. Bioethics, she wrote, confined in its individualism and American chauvinism, rendered an "impoverished and skewed expression of our society's cultural tradition (which), in a highly intellectualized but essentially fundamentalistic way, thins out the fullness of that tradition and bends it away from some of the deepest sources of its meaning and vitality."46 As Jonsen puts it, Fox perceived a genuine gap in the theory and method of bioethics. There is no easy and consistent flow of empirical data into ethics. Methods for gathering that sort of data, for interpreting it and fitting it into normative analysis are seldom familiar to ethicists. And the methods of ethicists are seldom known to behavioral scientists. Additionally, Fox argues that the data of the behavioral sciences often reveal situations as more complex than ethicists perceive them to be, rendering a straightforward ethical analysis more difficult.47 In a scathing article against bioethics, "Leaving the Field", Fox and Swazey responded in depth and detail to the horrendous ethical dilemmas they considered posed by organ transplantation, especially on an international scale.48
Equally problematic is the fact that only a very tiny percentage of "professional bioethics experts" have any academic degrees in bioethics at all, and even for those few that do there is no uniform or standardized curriculum, most teachers don't really know the subject matter themselves, the courses vary from institution to institution, there are no local, state or national boards of examinations, and no standardized professional responsibilities are required. There is not even a code of ethics for bioethicists. Most "bioethicists" by far have never taken even one formal academic course in bioethics.49 The question necessarily arises, then: What are bioethicists "experts" in? To whom are they accountable for their "expertise"?
Such pervasive concerns about "bioethics" were articulated even at the beginnings of the field, as in the following quote from founder Robert Morison (reiterated by Jonsen):