A New Right To Life Issue

A New Right to Life Issue

When the rules for human relationships became too complicated, Jesus cut through the casuistry with a startlingly simple way of expressing what God wants from us. In the words of his second commandment (of only two), we are to love our neighbors as we love ourselves. Later, the philosopher Immanuel Kant would put it this way: treat every human being as an end in himself or herself, and not as a means to our own ends.

Jody Picoult's widely read novel, My Sister's Keeper, got Jesus and Kant right up in our faces with her soul-searing portrait of Anna, conceived for the purpose of helping reverse her older sister's leukemia. In telling us about Anna, and the impact that her artful creation eventually had on all of her family members, Ms. Poucault clearly hopes to leave us mired in moral uncertainty about a decision that recent technology is making available for an increasingly wide variety of purposes. Her strategy seems to be one of enveloping us in an emotional force field that threatens to de-magnetize our moral compass altogether.

What made the conception of Anna worth entertaining at all by her parents was a new medical procedure, "pre-implantation genetic diagnosis" (PGD), a procedure that screens embryos produced by in vitro fertilization for genetic defects. Technologically, the procedure has a lot going for it. It can detect genes that make for inevitably fatal childhood diseases, such as Tay-Sachs, and help parents come to a responsible decision about not implanting an embryo carrying those genes, in favor of implanting one that is free of them. Morally, however, there is something scary about PGD: it aids and abets parental selection of only the very healthiest of their petri-dish embryos for implantation. The troublesome question here is: "healthiest" on what and whose terms?

Currently, PGD is expanding to screen for genes that contribute only to adult diseases, not to childhood ones. And according to medical experts, some of these adult diseases are not certain to develop and are highly treatable even if they do. Further, most couples who seek PGD are doing so for the primary purpose of sex selection, not of screening for sex-related disorders. So just how moral is it to discard embryos not selected for implantation because some of their genes happen not to measure up fully to the sometimes disproportionately self-centered standards of their owners?

Most problematic is the use of PGD described wrenchingly in the novel, to facilitate the creation of babies whose umbilical cord stem cells can be harvested to treat siblings with disorders of which the newborns' originally implanted embryos were found to be free. However advantageous one child's stem cells, or bone marrow, or transplantable organs could be to the health and well-being of an older sibling, conceiving that child primarily for the purpose of rendering its body useful to the other is a morally questionable act from the moment its very possibility is entertained, and not only on the basis of the kinds of consequences Jody Picoult surveys powerfully.

From a medical perspective, of course, there are no ethical objections relevant to the use of pre-implantation genetic diagnoses, just as there are none with respect to practicing contraception in the first place, or by preventing implantation in the second (e.g., by use of the so-called "morning-after" pill). Why? Because medical science holds that a conceptus becomes a human embryo only after implantation. From a moral perspective, however, PGD performed on the cells of fertilized ova can only be described in life and death terms, because the results of these procedures influence and even determine decisions to create a certain kind of human being and to prevent the creation of other kinds (viz.: disease-free and diseased, or worse still, male and female respectively).

One by-product of PGD makes this perspective even more germane to parental decisions about employing the procedure. In specific, a cell that PGD requires from an embryo for testing can be allowed to divide. Then, that original cell can be used for the tests, and the others for establishing a new stem cell line, with which to carry on further research. In vitro fertilization for the purpose of conceiving offspring is one thing. When this sacred purpose is contaminated by preoccupation with creating stem cell lines, the ethics of desirable consequences (e.g., of treating otherwise intractible diseases by injecting umbilical cord stem cells) come into conflict with the ethics of intentionality (e.g., of assessing the moral validity of an act in terms of the purpose(s) for which it was performed.)

Kate, in Jodi Picoult's story, is the victim of a disease that she did not deserve and that seemed to justify almost any kind of aggressive response of the part of her stricken family members. That she survived and that her donor sister eventually did not is as inexplicable metaphysically as the disease was in the first place. Picoult absolves Kate from any blame for the claims she made on her donor sister, and we should too. Faced with a similar situation, many if not most of us might have embarked on the same course that Kate's parents did. But we would have no more moral justification for doing so than they had.