Ask the bioethicist

Cell respect

Illustration: Noah Woods

By DAVID MAGNUS

Question: I am generally in favor of stem cell research because of its promise for medicine -- yet the use of embryos in the research makes me uncomfortable. It's not that I consider embryos to be human beings, but I do think they merit more respect than just any old clump of cells. Can you reconcile my conflict?

Your question get gets raised at just about every talk I give on stem cell research. It is a very good question.

Those of us who work in medical settings tend to support stem cell research because we see the people who might benefit from it. We look to stem cell research with hope for our patients.

At the same time, opponents of stem cell research are concerned about the destruction of embryos it requires. As a result, we debate about "what's in the dish?" Are these embryos that are created outside of the body, people? Or are they just a clump of cells, no more deserving of respect than cultured skin cells? Most of the debate has led to polarized positions -- either these embryos have the same status as infants or virtually no status at all.

Biology offers some help answering "what's in the dish?" Some people claim that the moment of fertilization marks when the fundamental line between personhood is crossed. Others point to the time, about 14 days later, when twinning (the creation of two people out of one embryo) and fusion (the combination of two embryos to produce one person) can no longer take place -- as it is only at this point that discrete individuals exist. And some move the line back yet further, until features that are more recognizably human begin to emerge.

What the biology shows us is that there is no "moment" when we can say that a major change has taken place. It's a developmental process. This suggests that the amount of respect we owe at different stages of development should be seen as a matter of degree that increases over time, rather than all or nothing.

We often show respect for aspects of humanity that clearly lack personhood. Just because someone is declared brain dead does not mean that we do not respect the body or the wishes of family members. We sometimes wait to withdraw life support keeping the body of a brain-dead individual functioning until family members have a chance to say goodbye. So it is plausible to say that we should treat embryos with respect, even if they do not have the same moral status that you and I do.

Practically, what does that mean? It seems excessive and misguided to believe that the respect owed to an early stage embryo in a petri dish is sufficient to prevent us from engaging in research that may one day lead to treatments for literally millions of people. However, respect for these embryos should make us careful in how and when we use them.

One question that we are charged to consider in research with human subjects is whether it is worth it: Is the value of the research reasonable in relation to the risks? If we are going to sacrifice embryos, it is important that the goals of the research, its scientific merit and its prospects for success, outweigh the sacrifice of something that, while not a person, nonetheless merits respect.

David Magnus, PhD, co-directs the Stanford Center for Biomedical Ethics. Send your questions to or Ask the Bioethicist, Stanford Center for Biomedical Ethics, 701 Welch Road, Suite 1105, Palo Alto, CA 94304

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