ObGyn's might keep in mind that the key to understanding any philosophical or theological ethical theory is to identify its philosophical or theological "anthropology"-- or definition of "a human being" or "person". Different anthropologies lead to different ethical theories. Some anthropologies match reality; others don't. Bioethics tries to claim that its theory really has no "anthropology", i.e., the "personhood" issue. Bioethics is "just" about "ethics". However, almost all bioethics arguments do incorporate a "delayed personhood" claim, whether or not they know or admit it -- especially within the context of debates over abortion, the use of abortifacients, human and fetal research, cloning, stem cell research, euthanasia, etc. That is, most deny the accurate human embryology, or make up their own, to argue that at fertilization there is no human being -- or at least no human "person" -- there yet. "Whatever" is there has only a "reduced moral status" at best (the language used from the National Commission onward). Only some time period after fertilization, e.g., implantation (5-7 days post-fertilization), 14-days (with the formation of the primitive streak), or "brain birth" (with the formation of the cortex or neocortex), etc. (depending on the theory), is there a real "person" with rights present. Before that biological marker there are only "stem cells", or "pre-embryos" present.

Virtually all of the arguments for "delayed personhood" use erroneous science on which to ground their philosophical "personhood" claims, hence rendering those claims automatically invalid per se. Regardless, these false claims have had enormous influence in public policy making worldwide -- especially the "brain-birth" myths (addressed with "preference" utilitarianism, below), and the "pre-embryo" myth of McCormick and Grobstein. It is worth reviewing even briefly this influence, as it helps to explain at least to some extent the sources of such immense pressures against Catholic ObGyn's in their daily practice. While many may be aware of McCormick's influence in moral theology, few seem to be aware of his penetrating work in a totally different field -- "secular bioethics". Early in the 1970's, Richard McCormick, S. J., had argued that defective newborns could be allowed to die. Applying the "Catholic" moral theology distinction of the Principle of Double Effect, McCormick concluded that the term "extraordinary" was large enough to justify the omission of life-sustaining treatments on the basis of expected diminished quality of life, defined in terms of the potential for human relationship. McCormick had also agreed with the May 1979 DHEW Ethics Advisory Board recommended approval of federal funding of research on the safety and efficacy of IVF research and embryo transfer in the treatment of infertility -- departing from the Vatican's position against any technologically assisted pregnancies, even in lawfully married couples. Now, following similar work by Andre Hellegers (founder of The Kennedy Institute of Ethics at Georgetown University), McCormick seriously questioned the "moral status" of early human embryos (or, "pre-embryos" as he referred to them), as did several others within the Catholic Health Association. Furthermore, McCormick reluctantly agreed that since some abortions are acceptable, then some fetal research would also be acceptable. He had reasoned that children have a moral obligation to participate in non-therapeutic experimentation where there is no discernible risk or undue discomfort, and therefore their parents may give proxy consent for their children's participation in such research that would not benefit them personally. He grounded this moral obligation in social justice -- i.e., "to contribute to the benefit of the human community." The same moral obligation, argued McCormick, can now be extended to the fetus. Paul Ramsey also had qualms about the "moral status" of the early embryo, accepting the McCormick/Grobstein "pre-embryo", and therefore also reluctantly sanctioned fetal research. Thus these writers, as many others, claimed that morally relevant characteristics were not present in the early developing embryo until "segmentation", or the attainment of "individuality" about 14-days or even later during human development.

Regardless of the biological marker used, what these arguments have in common is a claim for some sort of a "delay" -- in "personhood", or even "humanhood" -- after fertilization.

Philosophically, such a claim is per se a claim about "anthropology", and historically a very weak and indefensible one at that. It requires that the soul and the body are two separate and independently existing substances. But think about it. If there is a real split or gap between the "mind" (or "soul") entity, and the "body" (or "matter") entity -- which is required if there is any "delay" in "personhood" -- then one simply cannot successfully explain any causal interaction whatsoever between these two separate entities, either before or even after "uniting". Nor is there any scientific data to verify such a "split", nor such a "delay".

A lengthy response is not practical here, but solid arguments to refute such "delays" have been advanced for many years. Briefly, e.g., if, the "rational soul" contains virtually the other powers of the soul; if there is no split among the several powers of the soul; if there is no split between the soul and the body; if the body and soul must exist together as one single substance (as both Aristotle and St. Thomas have insisted!); and if there is scientific evidence that the "vegetative" power of the human rational soul is present immediately at fertilization (which there is) -- i.e., the immediate production of explicitly human proteins and enzymes, the development of specifically human tissues and organs -- then the whole rational soul must be immediately present at fertilization. Personhood must begin when the human being begins. There is no carrot or frog produced -- and we know that empirically!

It is long past time for us to recognize, acknowledge, and deal with the concrete reality that the earliest human embryo is indeed deserving of exactly the same respect, dignity and legal protections as all human persons -- simply even by virtue of his or her inherent humanity which we all share in common (the basis of natural law philosophical ethics), and as stated explicitly in many Church documents. This information is critical for the correct formation of conscience.

To choose not to acknowledge or deal with this information has already led to the acceptance, now almost habitual, of a two-tiered caste of human beings -- some of whom are "persons" and some of whom are not -- as exemplified in these bioethics "delayed personhood" debates. This "delayed personhood" mental construct has also long since been transferred to bioethics issues involving adult human beings, e.g., in issues concerning the mentally ill, euthanasia, etc. If nothing else the Nazi "science", rationalizations, propaganda, and experiments, and the on-going scourge of slavery, should have taught us about the inevitable real life consequences of such a "caste".

The unheralded words of the single dissenting National Commissioner Louisell ring ominously clear: "American society is itself at risk -- the risk of losing its dedication to the proposition that 'all men are created equal.' We may have to learn once again that when the bell tolls for the lost rights of any human being, even the politically weakest, it tolls for all."

III. INTERNATIONAL BIOETHICS' ATTACK ON THE "SANCTITY OF LIFE ETHIC":

Although bioethics is unquestionably predominantly a "utilitarian" ethical theory, there are in fact many different kinds of "utilitarianism". Probably the most common in bioethics today is "preference" utilitarianism, a deconstruction of the classical utilitarianism of Bentham and Mill. While it would be a mistake to paint all "preference" utilitarians the same, as each proponent differs somewhat in their "theory", a small sampling of some of the most articulate in the field could serve to indicate, in general, some of the main dogmas they hold in common -- which dogmas the Catholic ObGyn meets daily face to face. In "preference" utilitarianism an action is ethically correct if it satisfies the "preferences" (or, another variety, "best interests") of those affected and has the best consequences for the greatest number of "people". Modern utilitarianism, Bernard Williams explains, is supposed to be a system neutral [!] between the preferences that "people" actually have -- a "preference" being a reflection of the state of mind of the agent, and not to be judged by some standard of reasonableness other than whether it accords with the best moral theory. Therefore, all preferences go into the melting pot, with no preference to count for more than any other; there must be "equal consideration of interests", as Singer puts it. But of course ultimately, these individual "interests" will be weighed unequally against the total "good" or consequences for society as a whole -- a point about any utilitarian theory that is often overlooked or underestimated.

Of interest is the definition of "people" or "person" used in preference utilitarianism. "Persons" are those who have preferences, interests, desires, etc. For these utilitarians, not all human beings are "persons", while some animals are "persons". Preference utilitarians especially need to attack those who hold the "sanctity of life ethic" (which states that only human beings are "persons"), as simply prejudiced and racists tenets of "speciecism". As Oderberg explains the origins of this attack: "The charge was made famous by Peter Singer and is leveled by virtually all the followers of Singerian bioethics". They prefer instead a "quality of life" ethic. One way that "preference utilitarianism" attacks the "sanctity of life ethic" is by literally deconstructing or redefining it -- usually by means of "soft", meandering, but very clever "thought experiments" and "logical dialogues" that "evaluate" the "pros" and "cons" of the "sanctity of life ethic" -- to support a "quality of life" position.

A. Jonathan Glover:

One of the major theoreticians of "preference utilitarianism" for many decades has been Oxford philosopher/bioethicist/eugenicist Jonathan Glover. In his 1977 book, Glover literally redefines the "sanctity of life ethic" by means of redefining its major premise. Once that major premise is corrupted, of course, then all conclusions which flow from it will be corrupted as well.

The "sanctity of life ethic" is generally correctly stated as: "It is always a morally evil act to intentionally and directly kill an innocent human being." From that major premise it follows, e.g., that since human embryos and fetuses are innocent human beings, and since human disabled and terminally ill adults are also innocent human beings, to intentionally and directly kill them would be morally evil actions per se -- regardless of any "personhood" status, circumstances or intentions.

But Glover doesn't hold those actions to be "morally evil per se"; besides, that would impede the advancement of global "positive eugenics" and genetic engineering which he, and most preference utilitarians, strongly advocate. So he redefines the major premise of the "sanctity of life ethic" as follows: "It is always intrinsically wrong to destroy a life that is worth living." Such a life would not be "mere biological life", but rather, as Glover vaguely describes it, the quality of life of one who consciously possesses preferences, plans, projects, desires, feelings, memories, a sense of identity, etc. -- what later came to be grouped together in bioethics and labeled "rational attributes" and/or "sentience". Only a "person" possesses a life that is worth living. Since unborn, born, and human children, as well as many ill or disabled adult human beings do not have this "quality of life", they do not have a "life that is worth living". Therefore, they are "non-persons" -- and therefore the direct and intentional killing of these human non-persons would not necessarily be a morally evil act. Voila! The "sanctity of life ethic" now is the "quality of life ethic"!

B. R. M. Hare:

Glover, in turn, was the academic mentor of Oxford philosopher/eugenicist R. M. Hare. For Hare, the early human embryo, fetus and even young child are also not "persons". They are not "real people"; they are just "possible people" -- and therefore have no serious "interests" or "preferences" to be respected. We do, however, have "some" duties" toward "them". Thus, applying a sort of mathematical trigonometry to the problem, his international public population policy proposals go like this: "The maximum duty that is imposed is to do the best impartially for all the 'possible people' there might be by having an optimal family planning or population policy, which means necessarily excluding some possible people." Indeed. Hare asserts that the best policy will be the one which produces that set of people, of all "possible sets" of people, which will have in sum the best life, i.e., the best possible set of future possible people." Hare's bioethics interests lie largely in translating the Gloverian theory of "preference" utilitarianism into national (i.e., British) and global population public policies. One of Hare's most prominent students at Oxford was Peter Singer.

C. Peter Singer:

Most bioethicists today -- to one degree or another -- agree that a "person" is to be defined in terms of such "rational attributes" or "sentience". What are really "morally relevant" are "quality of life" characteristics, "preferences", or "interests". So too argues Peter Singer, currently the Ira W. DeCamp Professor of Bioethics at Princeton University's Center for Human Values. Like Glover and Hare before him, Singer -- the founder and first President of the International Bioethics Institute at the U. N., and the founder of "animal rights" -- argues that the higher primates, e.g., dogs, pigs, apes, monkeys -- even prawns -- are persons, because they exercise "rational attributes" and/or "sentience". However, some human beings, even normal human infants, as well as disabled and ill human adults, are not persons.

American philosopher/bioethicist Richard Frey, pushing Singer's logic, actually published an article in a major international bioethics textbook that, since many adult human beings are not persons (e.g., Parkinson's patients, the mentally ill and retarded, the frail elderly, etc.), and since many of the higher primates are persons, then these adult human non-persons should be substituted in purely experimental research in place of the higher primates who are persons.

Recently, Singer applied his form of "preference utilitarianism" to bestiality. He concluded that bestiality can be an "ethically correct" action, as long as it is not cruel, if it satisfies the preferences (e.g., sexual pleasure) of those affected (i.e., the human person and the animal), and if it has the best consequences for the greatest number of people involved (i.e., the total amount of "pleasure" experienced in the world would be increased). And, of course, since Singer defines many animals as "people", then "the greatest number of people" for Singer would include some human beings and some animals. Therefore, bestiality can indeed be "ethical". This is surely "theory" run amok!

D. Others:

American bioethicst and "preference" utilitarian philosopher Peter Suber also attacks the "sanctity of life ethic", which always entails a different definition of "person": "The 'life' that has sanctity for SL ["sanctity of life ethic"] is biological vitality, perhaps with a spiritual glow, but not the complex of powers and interests that we collectively call the person." This dogma then allows Suber to argue for the range of other bioethics positions already noted -- including abortion, euthanasia, and eugenics. He too is impatient with those who would fail to consider "the degree or kind of suffering, deterioration, dependency, or development they manifest, and regardless of the imminence of death, the burden on others, and the wishes of the subject to live or die." Suber prefers a "combined" quality of life" ethics.

United Nations consultant/bioethicist/biologist Darryl Macer (Japan) also defines a "person" similar to Glover, Hare, and Singer: "A person is generally referred to as someone who is rational, capable of free choices, and is a coherent, continuing and autonomous centre of sensations, experiences, emotions, volitions and actions; these are what may be called the characters of a person." Macer, like so many others in the field, conveniently continues to ground his "embryology" and "personhood" concepts at least in part on the amazingly flawed but influential bioethics book by Australian theologian Fr. Norman Ford, When Did I Begin?. Ford himself, unabashedly and without cross-verification, used and applied the same erroneous "human embryology" -- as well as the same "moral" conclusions that follow from it -- that McCormick and Grobstein used to fashion their scientifically erroneous concept of a "pre-embryo". Macer argues that the life of a 1-cell embryo is not sacrosanct, and has never been, even in theological circles. "It is clear that the biological qualities of personhood are not present at conception; what is present is something we call the embryo, ... but it does not manifest the activities of a human person. It is a potential human person, at the biological level at least, rather than a human person with potential." Ultimately, Macer leans toward the socially acceptable concept of the "gradual" attainment of "personhood" and "brain birth", and is a strong proponent of global birth control.

However, although a living human embryo or fetus does not qualify as a "person" for Macer, their manipulation (or destruction) can be useful for purposes of "positive eugenics" -- for a "healthy "society". Macer clearly articulates the international bioethics case for "positive eugenics." But as with all utilitarian theories, there is virtually no "ethical" consideration given to the "means used" to achieve this eugenics agenda. Nor would they need to. The reality of the person of the individual human being at fertilization has been disposed of -- "scientifically", conceptually, and linguistically. It simply remains to be concretized in all international law.

Or ponder the contemporary thoughts of one of bioethics' founders, "Christian bioethicist" Tristram Engelhardt: "Persons in the strict sense are moral agents who are self-conscious, rational, and capable of free choice and of having interests. This includes not only normal adult humans, but possibly extraterrestrials with similar powers."

Obviously, "personhood" has been and still is used as a linguistic device for various unethical purposes. It has been used in the medical arena as a justification for abortion, the use of abortifacients, international population policies, euthanasia, and a multitude of related bioethics issues -- and often for eugenic purposes. Indeed, many of the leading "savants" who pioneered the early formation of the field of bioethics were quite outspoken eugenicists. This has not changed; it is merely getting more vocal and more universal.

For example, sounding much like Hare (above), bioethicist Dan Wikler, as representative of the World Health Organization, recently declared that: "The state of a nation's gene pool should be subject to government policies rather than left to the whim of individuals. ... The completion of the human genome project would also make it possible to promote some genetic qualities such as intelligence and lower the incidence of others. ... It may be conceivably required by justice itself" ["justice", as in Rawls!]

Of course, the "gene pool" must also be determined by means of abortion, the use of abortifacients, infanticide, IVF, pre-natal selection, surrogate mothers, human embryo and fetal research, human cloning, human chimera research, human embryonic and human fetal "stem cell" research, euthanasia, physician-assisted suicide, etc. These are the usual "bioethics" issues, accomplished via "absolute autonomy" (at least for now) and the other bioethics principles as originally defined. These are not just "issues", but also the "tools" required to advance a global eugenics agenda -- just read their works, and listen to their lectures. And it is the Catholic ObGyn who is standing in the way!

IV. ERRONEOUS SCIENCE IN HUMAN STEM CELL AND HUMAN CLONING RESEARCH:

Finally, one of the most hotly debated issues right now is human embryonic and fetal stem cell research, which, researchers claim, can cure many diseases, as well as advance scientific knowledge in early human embryonic development. Here too it is difficult to correctly form one's conscience because these debates, as with the earlier debates on abortion, the use of abortifacients, etc., are replete with similar false and confusing human embryology and genetics. And although some ObGyn's are not particularly concerned about these "medical research" issues, you should consider that sooner or later you will be expected to apply "fruits" of such research in your own practice of medicine and on your own patients.

A. "Human Embryonic Stem Cell" Research:

1. The new "pre-embryo": "just 'pluripotent' 'stem cells'": Once bioethicists were forced to discard the scientifically erroneous term "pre-embryo", there was a need to find some term to take its place -- some term that could still "scientifically" justify the use of the early human embryo in research and in "therapy".

Among the more "creative" attempts that have emerged, perhaps the most influential has been to redefine the early human embryo as "just stem cells". For example, in his 1999 testimony before the U.S. Senate subcommittee hearings on stem cell research, then-Director of the National Institutes of Health, Harold Varmus, actually defined the early human embryo from fertilization to the end of the blastocyst stage as "just stem cells"! The concrete reality of the early human embryo, a whole human organism, simply "vanished"! The NIH Guidelines on stem cell research then proceeded to define all of the "stem cells" derived from frozen IVF-produced human embryos as "just pluripotent", rather than acknowledging that many of these stem cells are "totipotent".

2. Separated "stem cells" could become embryos:
It has also not been explained in these debates that most of IVF-produced human embryos are used immediately or frozen down at very early stages, usually between the 4-8-cell stage (long before any differentiation into an inner and outer cell layer takes place), rather than at the 5-7 day blastocyst stage (when the embryo consists of at least 30-150 cells, and has differentiated into an inner and outer cell layer). Thus most of the "stem cells" retrieved from these early-stage frozen IVF-produced human embryos would actually be totipotent, not pluripotent. Oddly, most of the debate centers on the older blastocyst-stage frozen embryos, all of whose "stem cells" (derived from the inner cell mass) are referred to as "pluripotent". But most IVF transfers do not use blastocyst-stage embryos; and most frozen embryos do not have inner cell masses!

Nor has it been explained that the term "human embryonic stem cells" can properly refer to those cells only while they are still a part of and intact within the whole embryo. Once these "stem cells" -- or even groups of "stem cells" -- are separated from the whole embryo, they can be "totipotent", and therefore quite capable of "healing" themselves (called "regulation) and becoming new whole living human embryos themselves -- per se. That is, they would no longer be "stem cells"; they would be living human beings. Substantial change would have taken place, much as like happens in human cloning, resulting in the formation of a new living human embryo/being. So to use such so-called "stem cells" would constitute human embryo research per se.

We know this biological fact about regulation even from natural monozygotic twinning -- a form of asexual reproduction called "fission", "blastomere separation", or "blastocyst splitting". In fact, "twinning", sometimes called "embryo multiplication", is a form of cloning, in which copies or replicas of human genetic organisms are produced. The method is even being seriously considered by IVF researchers and clinicians themselves for "multiplying" human embryos from single embryos produced by older infertile women who have difficulty maturing viable oocytes during IVF "therapy". And surely, neither the IVF clinician nor the woman think that what is being implanted in the woman's uterus is just a "stem cell"!

B. "Fetal Stem Cell" Research:

Another misleading scientific term used in these debates is "fetal stem cells". These cells are generally retrieved from aborted embryos aged 5-9 weeks. Since the embryonic period extends from fertilization to the end of 8 weeks, the majority of these cells are "embryonic", not "fetal". These cells are also not "somatic cells", but rather the primitive sex cells, the immature human germ line cells. They are still diploid, and therefore can be cloned using any cloning technique (including somatic cell nuclear transfer). They can be matured in vitro to produce the sex gametes (sperms and oocytes) and then used in artificial fertilization. Since they are germ line (sex) cells, they can be manipulated using DNA-recombinant gene transfer, and thereby transmit "foreign" genes down through the generations (eugenics).

V. CONCLUSIONS:

As Catholic ObGyn's continue to insist on your right to be trained and practice in medicine according to your consciences, I hope you will consider how critical it is to develop a well-formed conscience -- one that is grounded in reality. Part of that reality is the accurate objective scientific information that the immediate product of fertilization and of cloning is a new, living innocent human being. These are the objective empirical facts of human embryology and human genetics which lead to the conclusions of the Moral Law that they should be treated as persons even at their earliest stages of development. This is the "sanctity of life ethic", and is the starting point for all further considerations in medicine and research.

I hope you will also consider that another part of reality is the existence of malignant global structures of bioethics which purposefully use erroneous science and an idiosyncratic and very problematic normative "ethics" to redefine the "human being" and "human person" in order to achieve their own medical and research agendas, often eugenic in purpose. Theirs is the "quality of life ethic", which necessarily comes to far different ethical conclusions in medicine and research.

Until and unless we all come to deal effectively with these concrete realities, the pressures on and discriminations against Catholic ObGyn's and related health care workers to be trained and practice according to conscience will continue to escalate.

" ... [T]here has emerged a phenomenon unknown to antiquity that permeates our modern society so completely that its ubiquity scarcely leaves us any room to see it at all: the prohibition of questioning ... We are confronted here with persons who know that, and why, their opinions cannot stand up under critical analysis and who therefore make the prohibition of the examination of their premises part of their dogma ... The questions of the "individual man" are cut off by the ukase of the speculator who will not permit his construct to be disturbed."  [Eric Voegelin Science, Politics and Gnosticism (1968) ]