What's New in Life Science Research

I trust that the people unwilling to look at the balance of harms and benefits in this context -- who want to draw a bright line that forbids research with human embryos under any circumstances -- aren't going to let themselves lapse into utilitarian calculations in any other part of their ethical decision making, and furthermore, that they will be opting out of all the medical advances (both treatments and knowledge) that results from crossing this line. You have to have your own ethical house in order before you start imposing your ethical judgments on others, right?

There is, of course, the stickier question about the what kind of say you should have when your tax dollars are being spent in ways that run counter to your ethical commitments. We'll get to that in just a moment.

As noted above, there are efforts afoot to develop methods of extracting the stem cells without harming the embryo. The hope is (I'm guessing) that this would allow researchers to sidestep the ethical objections of those who accord special moral status to human embryos. I have my doubts that it would.

For one thing, any scientific procedure under the sun can (and will, from time to time) fail. In other words, a technique that (usually, when performed competently) extracts stem cells without harming the embryo always involves a nonzero probability of harm to the embryo.

Indeed, even if a technique for extracting stem cells with minimal risk of harm to the embryo were developed, it would bring new ethical questions to the table. For instance, what would a researcher's obligations be as far as taking steps to prevent harm to the embryo? What would a researcher's obligations be as far as repairing damage done to the embryo by the procedure? Is this going to involve special oversight, or will the local IRB do the job?

You can argue that, should this kind of extraction technique be perfected, the very small chance of harm is clearly outweighed by the much larger probability of benefit without harm. But this kind of argument will be more successful with the people who were already willing to weigh risks and benefits than with those who prioritized protecting the human embryos at all costs. In other words, it might turn out to be a lot of scientific effort to allay the worries of a relatively small proportion of the public (while still leaving some portion of the public completely unconvinced).

Here, it's tempting to ask how committed vocal opponents of embryonic stem cell research really are about protecting human embryos at all costs. Can we ask why this harm matters? Is this an embryo that is to be carried to term? One that will be destroyed? One that will be cryogenically stored indefinitely? Unless the embryo has a future as a baby, why should damage to the embryo that is the source of the stem cells matter to us? And if such damage really does matter to the most vocal opponents of embryonic stem cell research, why are they not devoting their efforts to rescuing the frozen "excess" embryos at IVF clinics?

Asking these questions might help some of these folks see that they don't really believe the welfare of the embryo should trump that of other human beings. On the other hand, asking these questions might energize some opponents of embryonic stem cell research to become politically active opponents of IVF.

More knowledge, after all, can change our assessment of the morality of activities that are widely accepted, but it's not guaranteed that this assessment will change in just one direction. Sometimes people will decide that what they thought to be objectionable is acceptable, other times they decide that what they thought to be acceptable is objectionable.

But what if the hardcore objections come from a minority of the population? The U.S. government does not put every piece of regulation to a direct vote by the people, but if it did, the conventional wisdom says that research with embryonic stem cells would meet with wide public approval and our regulations would reflect this.

Reducing what is ethical -- or even what is permitted -- to what the majority approves may seem like a good idea at first, but can end up being problematic. (What did the majority approve during the civil rights movement? Given what the majority of voters in California approved on election day, should those Californians who want to marry someone who happens to be of the same sex just accept that they cannot?) In a pluralistic society, taking account of the rights of those with minority views is generally a good thing.

How far do those rights extend, though? Far enough to prevent research (and eventually, medical knowledge and treatments) that the majority favors? Or maybe not far enough to outlaw such research, but to restrict the amount of public funding (from taxes) allocated to such research? Just as the U.S. does not have direct popular votes on every piece of regulation, so our tax forms do not let us pick and choose which pieces of government spending we will support with our taxes and which we will opt out of. Unless you're willing to take a stand by not paying your taxes (and accepting whatever punishment that might earn you), you're bound to end up directing some of your money to purposes you do not support.

That those purposes are officially sanctioned and paid for does not necessarily make them good or ethical. However, discerning what is good or ethical can be pretty tricky, and people of good will can arrive at different conclusions. Navigating these differences -- including trying to understand the reasoning of those who arrived at a conclusion different from your own -- and finding a way to move forward together is seriously hard work. Hard though it may be, though, to navigate successfully between the poles of Whatever-the-majority-wants-is-fine and My-way-or-no-way, to work together effectively as members of a shared society rather than reducing the problem of being ethical to policing our own individual actions and expenditures, serious discussions about ethical concerns -- even those not held by a majority of scientists or members of the public -- need to be part of the public discourse about stem cell research.

Thinking along similar lines in a post from a couple years ago, I wrote:

[W]e're living in a pluralistic society, where people have different views. Deciding whose views set the boundaries of acceptable research is a very hard problem.

This is not a problem most scientists feel they have the training to solve; they are neither moral philosophers nor politicians. And, they have a hard time believing that all the folks on the "restrict it all" side are bargaining in good faith -- this could be more of the Wedge. So, what comes off as bafflement that other people might have ethical worries about stem cell research, or that ethical considerations might impose some limits on scientific research, is really, I think, bafflement that a relatively small portion of the public -- a portion that doesn't seem to understand how science works or how its work could be of value -- seems to have the power to rob everyone else of the benefits of scientific research. They see that vocal portion of the public as being paternalistic -- something the scientists are accused of being. And it blows their minds.

Navigating the waters of pluralism is hard. But, unless scientists can get their own country somewhere, it has to be done. (Even then, it's not like scientists are all of one mind -- but at least most of them aren't anti-science. Scientists need to get the public to see them as people who take moral decision-making seriously, and this will require not being dismissive of moral concerns raised by non-scientists. This is not the same, of course, as agreeing with all these moral concerns, or being bound by them. But, they ought to be acknowledged and dealt with reasonably. The recent consensus statement on stem cell research coming out of the Hinxton Group looks like a good start, but there is surely a great deal more work to do on this.

One of the things scientists can get out of a public discourse about stem cell research, on top of a better understanding of what ethical concerns the public might have, is a sense of who can help them. There are moral philosophers and politicians, science popularizers and science communicators, who can bring their skills to the table and help the scientists communicate clearly and effectively -- what their research involves, what outcomes it might deliver, how these might be of benefit (and to whom), and what costs they might incur (and who will shoulder these costs). If stem cell research is intended, ultimately, to benefit the public, then the public ought to be a partner, at least in discussions of the science and its implications, from the very start.