Bioethics and Public Policy
Fullam, Lisa, O'Neill, William R., Theological Studies
TWO RECENT MAGISTERIAL TEXTS set the stage for our reflections: the instruction, "Dignitas personae on Certain Bioethical Questions" issued by the Congregation for the Doctrine of the Faith (CDF) on June 20, 2008; and Pope Benedict XVI's encyclical, Caritas in veritate, promulgated on June 29, 2009. (1) Pope Benedict insists that bioethical issues fall under the purview of the Church's social teaching on human rights. However, as Maura Ryan has recently argued, we have only "begun to see the implications of a human rights focus for bioethics." (2) In Part I, we consider two bioethical issues notable for generating debate on public policy: stem cell research and questions concerning HIV/AIDS. In Part II, we explore what Benedict calls the "strong links between life and ethics and social ethics" for public policy in religiously pluralist polities. (3)
Stem Cell Research
Dignitas personae is an update of the 1987 instruction Donum vitae. (4) The Instruction takes up beginning-of-life questions including fertility treatments, embryo adoption, stem cell research, preimplantation genetic diagnosis, gene therapy, and cloning; it concludes by considering the use of cells derived by destruction of human embryos.
The key to the particular applications offered in the second half of the instruction is found in the first half--in the section entitled "Anthropological, Theological, and Ethical Aspects of Human Life and Procreation": "The body of a human being, from the very first stages of its existence, can never be reduced merely to a clump of cells. The embryonic human body develops progressively according to a well-defined program with its proper finality, as is apparent in the birth of every baby." (5)
While Donum vitae stopped short of declaring the embryo to be a human person, Dignitas personae stops only a hairsbreadth from doing so. It reiterates that Donum vitae "did not define the embryo as a person," (6) and concurs with Donum vitae that science gives "a valuable indication for discerning by the use of reason a personal presence at the moment of the first appearance of a human life." (7) Moreover, "the reality of the human being for the entire span of life ... does not allow us to posit either a change in nature or a gradation in moral value, since it [the embryo] possesses full anthropological and ethical status. The human embryo has, therefore, from the very beginning, the dignity proper to a person." (8) Accordingly, Dignitas personae rejects arguments that offer individuation (the point in development after which neither twinning nor combination of two embryos into one is possible) or later stages as possible points at which full personal dignity may be imputed to the embryo: "The introduction of discrimination with regard to human dignity based on biological, psychological, or educational development, or based on health-related criteria, must be excluded." (9)
To meet Dignitas personae's moral standards, then, stem cells must be derived using technologies that: (1) do not harm extant embryos, and (2) do not inadvertently create embryos en route to producing stem cells. In laboratory language, the latter goal is to avoid totipotency while achieving pluripotency. A totipotent cell is capable of producing all the tissues of an adult, as well as the extraembryonic tissues produced by embryos--amnion, placenta, etc. A pluripotent cell can become any of the cell types of the adult organism. The instruction does not define the traits of what it calls a "true" embryo. In recent years, several technologies have been offered to derive stem cells without destroying embryos. Since the moral question hinges in part on the specifics of the technical intervention, some notes on such technologies are apropos.
In 2007, Somatic Cell Nuclear Transfer (SCNT) was achieved in primates. (10) In this process, the nucleus of an adult cell is inserted into an oocyte and induced to differentiate into various tissue types, all genetically identical to the donor cell. …