Embryo Harvesting & Double Effect

A reader writes:

I came across an article by Michael Rosen in which he, inter alia, attempts to justify Embryonic Stem Cell research on the basis of the principle of Double Effect.  He writes that,

In my understanding, ESC research satisfies the four prongs of this principle: (1) creating stem-cell lines for research is not wrong in itself; (2) the intention of the scientist extracting the lines is right, namely saving lives through research; (3) the bad effect (i.e. killing the embryo) is not a means to the good effect (i.e. saving lives) because although the embryo dies after the stem-cells are extracted, its death is not a "means" to that extraction but rather a result thereof; and (4) the gravity of the reason for creating the ESC lines is commensurate with the foreseen (but unintended) bad effect, namely the death of the embryo.

I would be very interested in hearing what you think about this argument.  My own take is that it is his fourth point that fails the test, as medical research is not equal in gravity to the destruction of human life.

FIRST, GET THE STORY.

The author of the piece writes from a Jewish perspective but draws upon Catholic moral thought in the process of doing so. I commend him for doing that. People of other religions can have valid moral insights, and we should use the best available ones in trying to crack moral problems. I wouldn’t hesitate to draw upon Jewish theologians in trying to crack a moral problem if they had the best insights on the subject at hand, and so I’m glad to see folks from other religions making use of Catholic ones. The truth of a moral insight–not whose community is best known for articulating it–is what is important.

The article contains a number of points that I may end up having to discuss in future posts, such as the interpretation of the verses in Exodus as they apply to abortion and the morality of nuclear deterrence, but for this post let’s stick to the application that the author makes of the principle of double-effect to the embryonic stem cell controversy.

In responding, I will be speaking from a Catholic perspective. Mr. Rosen may make different assumptions at various points (e.g., about whether the unborn are human beings from the moment of conception, though this is a matter of science rather than religion; scientifically a human being or living human organism comes into existence as soon as the germ cells unite), but I hope the exercise will be informative.

Let’s start with an articulation of the elements in the principle of double-effect:

One may perform an action which has two effects, one of which is evil and the other of which is good, if and only if:

1) The action is not itself intrinsically immoral.
2) The evil effect is not an end in itself.
3) The evil effect is not a means to the good effect.
4) The good effect is proportionate to the evil effect (meaning, at least as much good is expected to result as evil).
5) There is not a better way of achieving the good effect.

Now let’s apply this to artificially creating embryos and harvesting their stem cells in order to create a stem cell line for medical research.

While the author is correct in saying that "creating stem-cell lines for research is not wrong in itself," he has misframed the issue. The issue is not "Can you create a stem cell line?" The issue is "Can you artificially create and then destroy embryos for purposes of creating a stem cell line?"

When the correct issue is identified, it is clear that the first condition of the principle of double-effect is not satisfied (at least from the Catholic perspective). The artificial creation of human beings is intrinsically immoral. God designed human reproduction to take place in a certain fashion, and man is not free to circumvent his design. While medical technology can assist human reproduction, it cannot replace it, such as combining human germ cells in vitro.

That said, once a human being has been created–whether in vitro or in utero or by a transporter device or anything else–that human has a right to life and cannot be killed unless he becomes an aggressor who poses a grave danger to other humans so that the principle of legitimate defense becomes involved.

To kill him without the principle of legitimate defense being triggered is to kill an innocent human being and this is (from the Catholic perspective) intrinsically immoral. As John Paul II wrote in his encyclical Evangelium Vitae:

[B]y the authority which Christ conferred
upon Peter and his Successors, and in communion with the Bishops of the
Catholic Church, I confirm that the direct and voluntary killing of an innocent
human being is always gravely immoral.
This doctrine, based upon that unwritten
law which man, in the light of reason, finds in his own heart (cf. Rom
2:14-15), is reaffirmed by Sacred Scripture, transmitted by the Tradition of
the Church and taught by the ordinary and universal Magisterium.

The deliberate decision to deprive an innocent human
being of his life is always morally evil and can never be licit either as an
end in itself or as a means to a good end. It is in fact a grave act of
disobedience to the moral law, and indeed to God himself, the author and
guarantor of that law; it contradicts the fundamental virtues of justice and
charity [Evangelium Vitae 57].

When we discuss the third condition of the principle of double-effect we will look at whether embryo harvesting constitutes direct killing, but it is already clear that the enterprise of embryonic stem cell research (ESCR)–as it is currently envisioned–will not pass muster under the principle of double-effect because it does not fulfill the principle’s first condition since it involves the creation of human beings in an immoral manner.

It does, however, fulfill the second condition. Advocates of embryonic stem cell research are not proposing to create and destroy embryos for the fun of it. Those things are not the goal they are pursuing, and so the evil involved in their proposed course of action is not the end that they are pursuing. The second condition is thus fulfilled.

What about the third condition–the fact that the bad effect cannot be a means to the good effect?

Here Mr. Rosen makes an interesting statement. He writes:

[T]he bad effect (i.e. killing the embryo) is not a means to the good
effect (i.e. saving lives) because although the embryo dies after the
stem-cells are extracted, its death is not a "means" to that extraction
but rather a result thereof.

The first thing to note is that this is oddly phrased. In particular, note that "the bad effect" is identified with "killing the embryo." But killing the embryo is not an effect. It is an action. The death of the embryo is an effect, though, and Mr. Rosen later in the sentence refers to the embryo’s death ("although the embryo dies") so why don’t we assume that this is what he meant to say and see how the argument works.

The second thing to note is that Mr. Rosen is assuming that the deaths of embryos are brought about in a particular way: They aren’t directly killed, they only die as a result of having their stem cells removed.

I am not certain what technical means of extracting the stem cells Mr. Rosen has in mind here, and I have not had the opportunity to check on the precise methods that are being used to extract stem cells from embryos, but suppose that he is correct: The reason that embryos die in ESCR is that they cannot live without their stem cells (as opposed to, for example, being torn apart in order to get at their stem cells).

In this case the stem cells that are taken from the embryo are playing the same function as vital organs: They are biological components of the embryo that he cannot live without, and to take them out of him causes him to die.

What would we make of the same claim regarding an individual who has already had his stem cells differentiate into full-grown vital organs?

Suppose that I am a medical researcher who has hopes of developing a "heart line" that will allow me to grow new hearts for people and save their lives, but in order to do so I must have a living heart to start with.

Could I take a random person off the street and rip out his heart and then argue that

the bad effect (i.e. the death the person off the street) is not a means to the good
effect (i.e. saving lives) because although the passerby dies after his heart is extracted, his death is not a "means" to that extraction
but rather a result thereof.

It would seem true, on a close analysis, that the person’s death was not the means to the end of developing the heart line. I didn’t need him to die; I just needed his heart. Suppose that when I took it from him, I happened to have an artificial heart in my back pocket, and as soon as I’d extracted his biological one, I shoved the artificial one into his chest and thus kept him alive. That would seem to illustrate the point that his death itself is not a means to an end the way that, for example, bumping off your rich relative in order to get an inheritance would be.

But we still would not (morally) tolerate researchers grabbing people off the streets and ripping out their hearts in order to make advances in cardiology that will save lives.

Why?

Because (among other reasons), in the real world we don’t have good artificial hearts and they’d never be used by organlegging researchers anyway and so the actions of such researchers would cause the deaths of innocent people.

Removing part of a person’s body that that person needs in order to live is directly killing the person. I can’t rip out a person’s heart or liver or lungs or stem cells or anything else that the person needs to stay alive and claim that I’m not killing him.

We thus loop back to the first condition needed for the law of double-effect: The action cannot be immoral in itself, and directly and voluntarily killing a person–by removing his heart or his stem cells–is intrinsically immoral.

The fourth condition–that the good effect is proportionate to the evil effect, is one that is arguable. While we have not yet had life-saving breakthroughs from embryonic stem cell lines, it is quite possible that we will in the future. If so, it is possible that the number of lives that will be saved through these means will be greater than the number of embryos that had to be killed in order to achieve them.

But the fourth condition alone–much less the mere possibility that it will be fulfilled–is not sufficient.

The fifth condition is also relevant: There has to be no better way of achieving the good. This is a subject to which Mr. Rosen devotes some attention in his article, though not in his enumeration of the double-effect conditions. He acknowledges the possibility of doing stem cell research without killing embryos and the moral preferability of such means.

At this point it is uncertain whether some of proposed alternative means are themselves moral, though others (e.g., using adult stem cells or bith matter stem cells) certainly are.

It is also uncertain whether these alternate means can allow us to do everything that ESCR would do, but that’s the nature of things: We know neither the full potential of ESCR or the full potential of the alternative means, so we cannot directly compare the results of the two.

But what we can say is that there are alternatives which at least give the appearance of the fifth condition being unfulfilled. It looks like there may be a better way of achieving the same good without killing embryos.

Whether or not that is the case, the double-effect argument fails because the very first condition is not satisfied: It is intrinsically immoral both to artificially create human beings for purposes of medical experimentation and it is intrinsically immoral to kill innocent humans for purposes of medical experimentation.

Author: Jimmy Akin

Jimmy was born in Texas, grew up nominally Protestant, but at age 20 experienced a profound conversion to Christ. Planning on becoming a Protestant seminary professor, he started an intensive study of the Bible. But the more he immersed himself in Scripture the more he found to support the Catholic faith, and in 1992 he entered the Catholic Church. His conversion story, "A Triumph and a Tragedy," is published in Surprised by Truth. Besides being an author, Jimmy is the Senior Apologist at Catholic Answers, a contributing editor to Catholic Answers Magazine, and a weekly guest on "Catholic Answers Live."

16 thoughts on “Embryo Harvesting & Double Effect”

  1. Removing part of a person’s body that that person needs in order to live is directly killing the person. I can’t rip out a person’s heart or liver or lungs or stem cells or anything else that the person needs to stay alive and claim that I’m not killing him.
    Isn’t removing the fallopian tube in an ectopic pregnancy, the environment that the embryo needs to survive, the same as directly killing it? It would be the same as removing all the oxygen from a room. What’s the difference?

  2. Isn’t removing the fallopian tube in an ectopic pregnancy, the environment that the embryo needs to survive, the same as directly killing it? It would be the same as removing all the oxygen from a room. What’s the difference?

    Depends. Pumping all the oxygen out of a room isn’t necessary wrong, even if it results in people dying, if you have a proportionate reason for doing it — provided “doing it” = “pumping the oxygen” and not “killing the people.”
    For example, if by pumping the oxgyen out of the room you could pump it into another room where there were more people suffocating who needed the air more, then that would be morally valid. But you can’t pump all the oxygen out of the room in order to kill the people in the room and thus appease a psychotic mad scientist who has threatened to kill the larger crowd in the other room unless you kill the first group of people.
    Silly example, of course.

  3. Also, removing a damanged organ (fallopian tube) which has caused a pathological condition is a good thing, not an evil thing. It just so happens that removing it treats the pathology and has a secondary & unintended (double) effect of bringing about the death of the child.

  4. I should have been more clear above – and prefixed my statement with “if it is the only means to save ones life, then removing a damaged organ is a good thing.

  5. If you have an oxygen bottle you’d pump it into the room with the most people, but I’m not sure you could take the oxygen away from one group of people to save the other…
    In any event, the fallopian tube is licit because there is no need for the baby to die in order to save the mother, there is only a need to remove the diseased fallopian tube. Removing or destroying a vital organ is the same act as killing someone, in fact that’s how it’s done in most circumstances.
    Sadly, the only clearly licit treatment of an IVF embryo is to simply allow him or her to die. Freezing would not be a moral means to preserve life, and ET itself may be immoral.

  6. After reading the article I had a couple more observations:
    1. Rosen not only fails on his application of the principle of double effect, he dishonestly ignores the fact that the Church hierarchy has correctly applied the teaching and authoritatively done so.
    2. He uses self-defence killing, which is permitted in both Jewish and Christian theology, to justify any killing for the greater good. This is a gross missappropriation of that principle in both Christian, and presumably Jewish traditions.
    3. He mistakenly suggests that disease is a moral evil, which it is not, at least in Christian theology. One can use the term “evil” to apply to a grave disease, but we all know that is not the same application as a moral evil.

  7. Suppose some scientists were hired by the Nazis to run experiments on the Jews in order to find cures for life-threatening diseases. Would those experiments be justified? What if the experiments didn’t kill them, but it was known that it would significantly shorten their lives?
    The moral question is a lot clearer when the subject in question is truly recognized as a person.

  8. If you have an oxygen bottle you’d pump it into the room with the most people, but I’m not sure you could take the oxygen away from one group of people to save the other…

    Yes, you can. You aren’t killing the first group of people. Their deaths aren’t a means or an end, only a consequence (a direct consequence, but still a consequence) of your moving the air needed to save the other people, which is good in itself.

  9. A more real world analogy would be in the case of ship-board damage control.
    A repair party is fixing a hole in the ship. Suddenly the situation goes from bad to worse and the choice is to lose the party of x number of people or lose the ship.

  10. “Yes, you can. You aren’t killing the first group of people. Their deaths aren’t a means or an end, only a consequence (a direct consequence, but still a consequence) of your moving the air needed to save the other people, which is good in itself.”
    I think this would need further analysis. Regardless of intent, the act of removing air from the room is a direct cause of their death. What if they tried to defend themselves and prevent their air supply from being removed, could you take action against them?

  11. The damage control party situation is different. The people die because the air escapes from their portion of the ship, not because you took the air away… you didn’t put the hole in the ship. You sealed off the damaged section to prevent the remainder of the crew being killed.

  12. I think this would need further analysis. Regardless of intent, the act of removing air from the room is a direct cause of their death.

    The law of double effect allows for acts that directly cause evil effects, including people dying. What it stipulates is that the evil effect must be neither an end in itself, nor a means to another end, only a consequence. Those conditions apply here.

    What if they tried to defend themselves and prevent their air supply from being removed, could you take action against them?

    Let me put to you a counter-example, no less artificial than the one we are considering.
    You are standing outside a building with thousands of occupants who are about to be killed by a car bomb in the ground level parking garage. The only way to save them is to rush in and drive the car out of the building, though this will result in the deaths of a number of people on the street.
    As you rush toward the building, the people on the street try to prevent you from doing so — let us say in all innocence, not even to save their own lives, but to save yours.
    Is it not lawful to take action against them in order to prevent them from stopping you from getting the bomb out of the building?

  13. “Isn’t removing the fallopian tube in an ectopic pregnancy, the environment that the embryo needs to survive, the same as directly killing it? It would be the same as removing all the oxygen from a room. What’s the difference?”
    The baby isn’t going to survive in that enviroment, when it grows, the tube is going to burst and cause the death of the child and the Mother. Since the tube is obviously defective, it needs to be removed, perhaps in the future we will have the technology to implant the baby in the mother’s womb but I don’t think we do right now. Which is maybe what some scientist ought to be working on right now, instead of some of the things that some of them are working on. Perhaps someone is, that would be awesome.
    Let’s say you have a man in a room that is wounded so badly that it is apparent that he is going to die, next door is a man that has a broken leg, just a simple fracture, there is only enough oxygen for one of them to live off of until help arrives to get them out of there. What would YOU do?

  14. “As you rush toward the building, the people on the street try to prevent you from doing so — let us say in all innocence, not even to save their own lives, but to save yours.
    Is it not lawful to take action against them in order to prevent them from stopping you from getting the bomb out of the building?”
    I don’t know, it’s certainly a conundrum. While you may voluntarily martyr yourself, you may not force someone else to be a martyr. In fact if defenders of Pius XII said this in response to critics who said he should have taken stronger action against Germany, in effect forcing German Catholics to be martyred by reprisals by the Nazi’s.
    There are times when no action may be taken even to reduce the loss of life. An ectopic pregnancy where the baby is embedded in a vital organ. Removing the organ kills both, but direct action against the baby is immoral. Another example is an overloaded lifeboat, you could volunteer to swim even if it would result in your death, but you can’t compel anyone else to do so.

  15. There are times when no action may be taken even to reduce the loss of life.

    I agree, and I gave an example of this in my first post above with the mad scientist. To give a more real-world example, you may not kill life in the laboratory no matter how many lives you will then save with the fruits of your work. It doesn’t matter if a hundred thousand people will die because you aren’t allowed to kill one embryonic life in the laboratory — you can’t do it.

    While you may voluntarily martyr yourself, you may not force someone else to be a martyr.

    Prescinding from issues around the word “martyr,” isn’t the acceptance of collateral damage in just warfare a recognition that sometimes you will directly bring about the deaths of innocents and non-combatants whom you have no right to kill as a means or an end, but whose deaths may be foreseen as a consequence of a morally justified act?
    If there were innocent people on the Death Star, would it have been immoral for Luke to blow it up, directly causing their deaths?

    An ectopic pregnancy where the baby is embedded in a vital organ. Removing the organ kills both, but direct action against the baby is immoral. Another example is an overloaded lifeboat, you could volunteer to swim even if it would result in your death, but you can’t compel anyone else to do so.

    I suspect these cases may be more debatable than you think.

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