Abstract
In addition to the common ethical concerns raised by any new biomedical research application, particular ethical concerns have been raised about the sources of human stem cells, especially those stems cells derived from human embryos and aborted fetuses. Catholic health care organizations share these concerns. Their affiliation with the Catholic Church prohibits them from creating or destroying human embryos or from using aborted fetal tissue for research or therapeutic purposes, and thus they cannot licitly participate in activities that involve the derivation of human embryonic or fetal stem cells. Still under consideration in Catholic health care circles, however, is the question of whether these organizations can licitly use the human embryonic and fetal stem cell lines derived by others. To date, the Catholic Church has not definitively answered this question. However, it is a question that is being vigorously debated and will soon need to be resolved. Here, I summarize the debate thus far and then try to clarify and extend it by considering the recent work of two legal scholars, M. Cathleen Kaveny and Christopher Kutz. I conclude that, should they use the embryonic and fetal stem cell lines derived by others, Catholic health care organizations cannot avoid being morally complicit in the processes by which the stem cells were derived. But I also suggest some conditions that, if addressed, might nevertheless permit Catholic agents licitly, if reluctantly, to use embryonic and fetal stem cell lines.
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Notes and References
Human stem cells derived from other sources are not problematic in the same ways, of course, and are not considered here.
Catholic health care organizations are prohibited from using IVF technologies to create human embryos artificially, from destroying human embryos created either naturally or artificially, and from using the tissue of aborted fetuses. See United States Conference of Catholic Bishops. (2001) Ethical and Religious Directives for Catholic Health Care Services, Fourth Edition, Directives 38–41, 45, and 66. United States Conference of Catholic Bishops, Inc., Washington, DC.
For a summary of the processes of derivation, see the National Institutes of Health, Department of Health and Human Services, Stern Cells: Scientific Progress and Future Research Directions, June 2001.
This is not merely a self-interested concern, although it could be viewed as such. Catholic sponsors believe their organizations are continuing the healing mission of Jesus, and the loss of the health care ministry or some significant portion of it would be viewed as the loss of a significant moral and religious good.
Whether it is morally acceptable to use human stem cells from a cultured stem cell line, as defined and permitted for federal funding by President Bush, is hotly debated among Catholic ethicists.... The Church’s magisterium has not as yet specifically addressed this question.“ Albert S. Moraczewski, ”Human Cloning and Stem Cell Research,“ supplement to Cataldo, P. J. and Moraczewski, A. S. eds. (2001) Catholic Health Care Ethics: A Manual for Ethics Committees. The National Catholic Bioethics Center, Boston, p. 7/4.
It is possible to craft an alternative argument regarding the derivation of human embryonic stem cells by trying to persuade Catholic bishops that the church’s position on the status of human embryos is not defensible, but it is highly unlikely that this argument could succeed.
Rourke, K. D. (2001) Genetics and ethics, Health Progress March-April, 28–32.
The proportionate consideration above introduces a consequentialistlike calculation into the principles, but the conclusion to the calculation tells the agent only that cooperation can be considered; it does not justify the cooperation as such.
Readers might wish to explore these interesting and complex principles further in an article referenced in the discussion below: Kaveny, M. C. (2000) Appropriation of evil: cooperation’s mirror image, Theological Studies 61, 280–313. In developing her position of the appropriation of evil, Professor Kaveny helpfully summarizes and contrasts it to cooperation with evil.
Branick, V. and Therese Lysaught, M. (1999) Stem cell research: Licit or complicit?“ Health Progress 37–42. (This article was printed improperly, with some text missing and some repeated. It can be found intact at http://www.chausa.org/PUBS/PUBSART.ASP?ISSUE=HP9909&ARTICLE=B.)
See Stem-Cell Plan Termed `Complicity in Evil,“’ Catholic Health World (September 4, 2001). This article can also be found at http://www.chausa.org/PUB/PUBSART.ASP?ISSUE=W010901&ARTICLE=F.
See “CHA Disappointed by Stem Cell Compromise,” Catholic Health World (September 4, 2001). This article can also be found at http://www.chausa.org/PUB/PUBSART.ASP?ISSUE=W010901&ARTICLE=E.
Burtchaell discusses complicity in relation to the use of aborted fetal tissue. See Burtchaell, J. T. (1989) The use of aborted fetal tissue in research and therapy, in The Giving and Taking of Life: Essays Ethical. University of Notre Dame Press, Nortre Dame, pp. 155–187.
This criterion is not entirely clear. They give an example of a janitor who cleans hospitals where abortions are performed and claim the janitor would not be complicit in abortions that take place there.
See Kenny, J. (1999) Accepting vaccination OK, according to ethicist. St. Louis Review December 24, 1999.
Here, I ask this question from a Catholic perspective. Other options are available to non-Catholics and, interestingly, to Catholics not working in Catholic health care organizations.
“Kaveny, ”Appropriation of Evil.“
“One could appropriate the fruits of future actions, of course, but these actions would still be in the past at the time the fruits were appropriated.
O’Rourke, “Genetics and Ethics,” p. 31.
Kaveny explores some of these effects in an interesting discussion of how a secondary agent’s character is morally “contaminated” by “seepage” and “self-deception,” Kaveny, “Appropriation of Evil,” pp. 305–306.
Professor Kaveny related this to me in conversation.
Kutz is more concerned with grounding individual complicity for collective harms or wrongs than he is in assessing that complicity in moral terms. He also interested in the legal application of complicity, but this topic, though interesting, is beyond the scope of this discussion. See Kutz, C. (2000) Complicity: Ethics and Law for a Collective Age. Cambridge University Press, Cambridge.
Kutz, Complicity, p. 166.
Kutz, Complicity, p. 71.
Kutz, Complicity, p. 74.
Kutz, Complicity, p. 103.
Kutz, Complicity, p. 18.
Kutz, Complicity, p. 139.
Kutz, Complicity, pp. 117–120.
Kutz is also concerned with his claim that any agent-centered morality, especially one that understands moral accountability merely in terms of those intentional wrongs or harms caused by agents, will not be adequate to account for our common moral intuitions about individual complicity in collective wrongs or harms. The multiple perspectives are part of his response to this concern. Kaveny’s notion of appropriation is also concerned about moral accountability for actions not caused by the agents in question, though she remains committed to an agent-centered morality.
Kutz, Complicity, pp. 156–157.
Kutz, Complicity, p. 122.
Kutz, Complicity, pp. 166–167.
I credit this condition to Professor LeRoy Walters, who made this point at a meeting we attended together in Washington, DC.
“United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services, note 45, p. 43.
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Heller, J.C. (2004). Complicity in Embryonic and Fetal Stem Cell Research and Applications. In: Humber, J.M., Almeder, R.F. (eds) Stem Cell Research. Biomedical Ethics Reviews. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-674-4_6
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DOI: https://doi.org/10.1007/978-1-59259-674-4_6
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