Dignitas Personae: instruction on certain bioethical questions

Dignitas Personae, an instruction on certain bioethical questions, was released from the Vatican’s Congregation for the Doctrine of the Faith on Friday to offer a new doctrinal Instruction which addresses some recent questions in the light of the criteria expressed in the Instruction Donum vitae from 1987. After an initial reading of the text Michelle (doctoral student in cell biology) and I (master of theological studies) found a number of a) summary points worth highlighting, b) questions or challenges, and c) areas for Christians in biological sciences to carefully evaluate.

By taking the interrelationship of…the human and the divine as the starting point Dignitas Personae uses both natural law and divine revelation as the basis for the central moral claim that human life has unassailable value…that belongs to all without distinction. By virtue of the simple fact of existing, every human being must be fully respected (8). Although not fully expounded, it must be remembered that this is always a moral claim, one that cannot be proven or disproven in an experimental manner. Though scientific inquiry is properly praised in Dignitas Personae, we must remember that science neither claims nor provides meaning or valuation. We value life–all life–as a moral stance, whether explicitly religious or otherwise. Because all persons possess this full anthropological and ethical status, regardless of their developmental status, discrimination against any such persons is excluded. Moreover, certain criteria emerge by which the Church, within her mission of contributing to the formation of conscience calls everyone to ethical and social responsibility reminding us that the ethical value of biomedical science is gauged in reference to both the unconditional respect owed to every human being at every moment of his or her existence and the defense of the specific character of the personal act which transmits life (10, emphasis original).

In response to current infertility remediation procedures the Church reminds everyone that all techniques of heterologous artificial fertilization, as well as those techniques of homologous artificial fertilization which substitute for the conjugal act, are to be excluded. On the other hand, techniques which act as an aid to the conjugal act and its fertility are permitted (12). We see that the moral concerns with such techniques are not arbitrary but rather that such techniques of in vitro fertilization are accepted based on the [morally fallacious] presupposition that the individual embryo is not deserving of full respect in the presence of the competing desire for offspring (15). Moreover, in addressing concerns regarding the banks of embryos that have arisen as result of such illicit treatment of infertility, we see that proposals to use these embryos for research or for the treatment of disease are obviously unacceptable because they treat embryos as mere biological material and result in their destruction (19).

In the third and final part the Church notes that procedures of gene therapy used on somatic cells for strictly therapeutic purposes are in principle morally licit (26) while in the present state of research, it is not morally permissible to act in way that ma cause possible harm to the resulting progeny…therefore…germ line cell therapy in all its forms is morally illicit (26). Human cloning, both for reproductive and therapeutic purposes, is underscored as contrary to the moral law as the former seeks to give rise to a new human being without a connection to the act of reciprocal self-giving between spouses and, more radically, without any link to sexuality (28) while the latter because it is gravely immoral to sacrifice a human life for therapeutic ends (30). In examining stem cell research the Church urges us to consider the methods of obtaining stem cells as well as the risks connected with their clinical and experimental use (32). Thus, since there are no moral objection to the clinical use of stem cells that have been obtained licitly, research initiatives involving the use of adult stem cells…should be encouraged and supported (32). Calling upon all people of good will to formulate general principles on the basis of which people of good conscience can evaluate and resolve situation in which they may possibly be involved on account of their professional activity, the Church specifically notes that the criterion of independence is not sufficient to avoid a contradiction in the attitude of the person who says that he does not approve of the injustice perpetrated by others, but at the same time accepts for his own work the biological material which the others have obtained by means of that injustice. When the illicit action is endorsed by the laws which regulate healthcare and scientific research, it is necessary to distance oneself from the evil aspects of that system in order not to give the impression of a certain toleration or tacit acceptance of actions which are gravely unjust (35). In conclusion:

There are those who say that the moral teaching of the Church contains too many prohibitions. In reality, however, her teaching is based on the recognition and promotion of all the gifts which the Creator has bestowed on man: such as life, knowledge, freedom and love. Particular appreciation is due not only to man’s intellectual activities, but also to those which are practical, like work and technological activities. By these, in fact, he participates in the creative power of God and is called to transform creation by ordering its many resources toward the dignity and wellbeing of all human beings and of the human person in his entirety. In this way, man acts as the steward of the value and intrinsic beauty of creation.

Human history shows, however, how man has abused and can continue to abuse the power and capabilities which God has entrusted to him, giving rise to various forms of unjust discrimination and oppression of the weakest and most defenseless: the daily attacks on human life; the existence of large regions of poverty where people are dying from hunger and disease, excluded from the intellectual and practical resources available in abundance in many countries; technological and industrial development which is creating the real risk of a collapse of the ecosystem; the use of scientific research in the areas of physics, chemistry and biology for purposes of waging war; the many conflicts which still divide peoples and cultures; these sadly are only some of the most obvious signs of how man can make bad use of his abilities and become his own worst enemy by losing the awareness of his lofty and specific vocation to collaborate in the creative work of God.

At the same time, human history has also shown real progress in the understanding and recognition of the value and dignity of every person as the foundation of the rights and ethical imperatives by which human society has been, and continues to be structured. Precisely in the name of promoting human dignity, therefore, practices and forms of behaviour harmful to that dignity have been prohibited. Thus, for example, there are legal and political – and not just ethical – prohibitions of racism, slavery, unjust discrimination and marginalization of women, children, and ill and disabled people. Such prohibitions bear witness to the inalienable value and intrinsic dignity of every human being and are a sign of genuine progress in human history. In other words, the legitimacy of every prohibition is based on the need to protect an authentic moral good (36).

When Michelle looked at Dignitas Personae initially, it seems to her to reaffirm the Church’s support of scientific discoveries, contrary to what one so often heard voiced in the popular discourse that surrounded to California’s stem cell research proposition (2005) wherein religion was hyperbolically portrayed as trying to prevent access to scientific truths. By acknowledging that scientific inquiry does lead to many good things, it becomes impossible to have such a simplistic read of science versus religion that is so often voiced (see Father Robert Baron’s YouTube video response to scientism). Michelle further commented that the conversation regarding what can licitly be done with embryos already frozen (19), which was the topic of her Science and Society debate at Duke last month, is the most troubling statement in Dignitas Personae. The particularly strong statement that the very existence of such frozen embryos represents a situation of injustice which in fact cannot be resolved was troubling to Michelle given that it is known that a high percentage of embryos do not survive thawing and gives rise to questions such as, ‘Would just allowing them to thaw be similar to end of life situations of declining treatments that would be known to keep life going?’ Michelle also noted some inconsistency in argumentation by juxtaposing the above evaluation that such banks of embryos are an intractable problem with the statement that the proposal that these embryos could be put at the disposal of infertile couples as a treatment for infertility is not ethically acceptable for the same reasons which make artificial heterologous procreation illicit as well as any form of surrogate motherhood; this practice would also lead to other problems of a medical, psychological and legal nature (19). From the perspective of a medical research this seems to be the only morally acceptable thing to do with such embryos, that is to implant them all, and thus to give a chance for life to survive. To allow infertile couples to have access should be the same as adoption of a child who would otherwise be neglected! Of course there are problems–economically, people could profit from letting others buy their unused embryos–but at least they would be given an opportunity for viability rather than being reduced to biological commodities bought and sold for stem cell research. Commenting on somatic cell gene therapy (25-27), Michelle noted her surprise to see that procedures used on somatic cells for strictly therapeutic purposes are in principle morally licit, as this is actually quite a hot topic for scientist ethicists. Michelle further noted that the divide between therapeutic correction to normalcy and improvement is not as clear as one might assume. And, while specifically addressing the proposed manufacturing of super brains or bionic muscles (assuming the genes that controlled as much were discovered, 27), she found the evaluation here more lenient than she might have otherwise expected and certainly different than what the popular discourse would have one believe about Catholic teaching. Finally, with regard to the condemnation of the recent use of animal oocytes…for reprogramming the nuclei of human somatic cells (33), Michelle remarked that in her estimation not enough is known about this approach to let it be totally condemned. If adult stem cells are acceptable for ongoing therapeutic research, she thinks this could be as well.

It seems to me that several challenges and questions that Dignitas Personae poses for those people of faith engaged in scientific research remain unanswered. For example, while Dignitas Personae offers a compelling although simplified statement of reasonable conclusions given the acceptance of the primary premise that life–defined morally, socially, and scientifically–begins at conception, it leaves unresolved the grounding for scientists to engage in policy and ethical decision making, with which they are certainly concerned. In other words, without a common foundation like that which is given in the first part of Dignitas Personae how will scientists engage in ethical conversation? Without a common framework, it is hard to see how Dignitas Personae or any other document will have an impact on policy. That said, the willingness of scientists, Christians, and the general population–not that those are mutually exclusive categories–to engage in dialogue about these matters of serious import is very hopeful. The challenge to Catholics, however, is to know that their tradition encourages such dialogue, seeing faith and reason as complimentary ways in which the truth comes to be known, and to do so in informed and faithful manner.

Toward that end, Saint Thomas More will be hosting a conversation on Dignitas Personae in order to listen to those professionals engaged in such research, the faithful who continue to grapple with such issues, and to reflect together on the moral guidance offered by the Church. Together with Paul Griffiths (Warren Professor of Catholic theology at Duke Divinity) and Jim Hynes (Director of Faith Formation and trained in chemistry), I will be facilitating a discussion on Sunday, January 18 following the 9:15 Mass until noon at Saint Thomas More. It is my hope that my many will read Dignitas Personae, join in this conversation, and continue the work of bringing science and our Catholic faith together.

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