In the previous parts of this series we have spoken about the possibilities of various kinds of stem cells. We saw that the most important principal difference is between embryonic stem cells that are obtained from human embryos and body stem cells and embryonic resembling stem cells that are acquired from common cells, the so-called iPS cells. In this last article I will address explicit some central ethical questions that play a role in research and the use of human stem cells. I will start this discussion with some general remarks about ethics from a Christian point of view.

In the first place, ethics has to do with all of life. It concerns not so much a sector of life alongside other sectors, but a certain aspect, a certain way of judging all human actions. Ethics does not limit itself to the consideration of various interests or the looking for solutions of moral dilemmas. Ethics reflects on responsible living and acting of people and communities from the point of view of care for people and things. In this sense it is in ethics not only about limits but also what our responsibility is, what we ought to do – and of course also not to do.

Three Ethical Approaches⤒🔗

In ethics there are three approaches to the question of responsible acting, namely, the duty ethics, the goal ethics, and the virtue ethics. I will give a brief overview and Christian interpretation of these three perspectives. From these three ethical perspectives I will then discuss the use of human embryos, therapeutic cloning and very briefly the using of adult stem cells.

Duty Ethics←⤒🔗

The duty ethics focuses on the act itself in light of ethical principles or commands that for the acting person constitute a duty. In Christian ethics this perspective often has often been in the center. After all, for life in this world, from a Christian perspective, God’s commandments are applicable. With that we especially need to keep in mind the Ten Words and the elaboration of these through Jesus and the apostles.

For our subject of stem cell research and therapeutic cloning, two matters are important in this regard namely, the moral status of the starting material, embryos or (adult) stem cells, and the obtaining of egg cells. We will discuss this successively.

(1) The status of the human embryo←↰⤒🔗

In the first place the question about the moral status of the human embryo. We have seen earlier that we are working with different sources of stem cells: on the one hand embryos, and on the other hand cells and tissues of people after birth. A crucial question in duty ethics then is how to think about human embryos.

The dominant approach in scientific and political circles is that the embryo merits a relative protection. The protection of an embryo increases as the embryo further develops. Thus, good scientific stem cell research that uses embryos in aiming at good pursuits (goal ethics) can outweigh the protection of these embryos. I reject this approach.

In my opinion the human embryo deserves complete protection. Viewed biologically, the human embryo has to be considered as a human being, and then it is obvious to also treat it as such.

Psalm 139←↰⤒🔗

This general consideration is supported in the Bible and perhaps the most in Psalm 139. From Psalm 139 John Stott (a well-known British evangelical theologian) derives three characteristics of early embryonic human life:

First of all, it is God’s creation: “You have created me.” In rich language, with words like “woven” and “formed,” God is unmistakably shown as the Creator.

The second element is the continuity between the psalmist now and the fruit in the womb. The psalmist is talking about himself in that early phase. There is a continuity, for it is about the same person.

The third element is the lasting personal relation: the I-you relation permeates the whole psalm in a radical, very existential way.

The conclusion that Stott is drawing – and that I share with him – is: In the early human embryo we are dealing with an embodied person, created in the image of God. That “embodied” recognizes that we are talking about a process. That means, among others things, that the experiencing of the relation with the embodied person in the course of his or her development can change. (A pregnant woman experiences a very early miscarriage different than delivering a stillborn baby.) But this experience is not the norm for what this is all about: a developing human being. This means that at the very least to deliberately let embryos die, in order obtain embryonic stem cells, is ethically irresponsible.

(2) Egg Cells←↰⤒🔗

The second important issue that plays a role from a duty ethics perspective is the securing of egg cells. The most important question here is where one gets the egg cells that would be required to bring about embryos for research, either via natural fertilization or cloning. Especially (therapeutic) cloning would require many egg cells. Meanwhile, the pressure on women to “sell” egg cells increases. Already now in the United States thousands of dollars are offered to young, preferably beautiful and intelligent women, to donate as many egg cells as possible after ovulation stimulation for the benefit of reproductive medicine. Cloning on a larger scale would enormously increase the demand for egg cells, and with that the pressure on women to sell these. Would this not lead to exploitation of poor women? The same considerations are of course true with the payment for egg cells for research or reproduction, as is now also happening in England.

Goal ethics←⤒🔗

The second approach relates to the goal that is aimed for. If a good or useful goal is achieved or is aimed for, then following up is good. It needs no argument that doing good, promoting life, alleviating suffering etc. is also from a Christian point of view an important ethical motive (see, for instance, Rom. 12:9-21). But in Christian ethics a duty ethic and a goal ethic approach fit together. The believer trusts that the commandments of God fits this world and the way God has created the world.  Complying with that promotes indeed the good life and society. That does not mean that there are no dilemmas – and even sometimes very painful ones. That has to do with the brokenness of life as result of evil and sin that have entered the world. But this does not nullify the validity of the commandments and the responsibility to observe them as well as possible. Also good goals do not justify all means.

Applied to embryonic stem cell research and therapeutic cloning: embryos are made in order to be destroyed for the benefit of possible treatments of others - whereby the risk of serious side effects is considerable. Moreover, there is for medical treatments more perspective in the use of adult stem cells. Research on adult stem cells are ethically certainly recommended.

Virtue ethics←⤒🔗

In the virtue ethics, the correct deed is the deed as the upright person will do it. It is here not so much about visible acts that one does or does not do. In the first place it is not about the consequences either, for you are not always able to assess these well. It is about the question whether in your behavior the merits are visible. How do you keep others in mind? And applied to the practice of medical care: what is the moral character of the care providers, and how are we upholding that? One could see virtues as an internalization of duties to good habits. These are, biblically speaking, the commandments, written by the Holy Spirit in the heart of the believer (Jer. 31; Heb. 8).

An important virtue in this setting is in my opinion prudence, also to be seen as carefulness (not fear), practical wisdom, sensitivity. In prudence an attitude is displayed wherein modesty and respect meet. Respect for man created in God’s image. At the same time a humility in the sense of acknowledging the limitedness of our knowledge and of creation, which as the work of God always carries a mystery that we never are able to get a grip on. When we are trying the latter anyway, we violate creation.

Applied to medical cloning one could say that the consequences thereof in medical terms are incalculable, and that it is very conceivable that the consequences in ethical terms will be negative. Continuing with this is therefore not prudent. And does such a treatment of the beginning of human life show the required respect? Are there no utopian characteristics emerging in this development that redefine the promised kingdom of God (coming from above!) as a technical paradise to be realized by us?

In my opinion, the virtue of prudence requires a reserved attitude towards embryonic stem cells and even more so against “therapeutic cloning.”

Conclusion←⤒🔗

In short, stem cell research absolutely promises new therapies. But these promises are most valid with adult stem cells, against which there are no specific ethical objections. On the other hand, against embryonic stem cell research and specific research with human clone embryos, there are serious ethical objections that in my opinion are much greater than the (potential) advantages of that research.

This article was translated by Karel le Grand