The thought that Catholic leaders could approve the use of a vaccine developed from an aborted fetus cell line appears, at first glance, shocking. Yet this is exactly what the St. Louis Archdiocese and the editor of Ethics & Medics at the National Catholic Bioethics Center did recently. The question that their approval raises is whether they have placed themselves on the same path that connects a tragic past with a dangerous future. So whose side are we on?
Science of Life
The moral ramifications of the issue are, indeed, highly complex. What may initially seem shocking may turn out to be, if not permissible, then at least less shocking.
My personal sense is that the private and medically indicated uses of vaccines derived from aborted fetuses, such as WI-38, which was developed from a 3-month aborted female in 1961, can be viewed as “remote material cooperation” and morally permissible. Where no alternative is available, cooperation in immoral acts admits to a variety of important moral distinctions. Not every kind of such cooperation is morally equal.
At their general meeting in November 1994, the Catholic bishops of the United States approved a revised and expanded text of their Ethical and Religious Directives, a document summarizing much of the Church's teaching regarding health care. At the end of the Directives, in an appendix, the bishops provide a statement intended to clarify the terms pertaining to different degrees of cooperation in immoral acts.
The first important distinction they make is between the “action of the wrongdoer” (whom we might call the “operator”) and the “action of the cooperator.” It may prove helpful here to note that the notion of “cooperation” can be so limited and tenuous, in certain circumstances, that it may be more accurately represented by the word “involvement.” “Cooperation” suggests willful complicity, whereas “involvement” leaves room for a person being “drawn into” a situation in which his degree of consent is significantly weaker.
According to the bishops, if the cooperator intends the object of the wrongdoer's activity, he exemplifies formal cooperation (which is always morally wrong), whereas if he does not, he exemplifies material cooperation (which may or may not be morally wrong). With regard to the medically indicated, private use of the vaccine in question, it is clearly not a case of formal cooperation (explicit or implicit) where the agents neither intend, approve, nor condone either the act of abortion or the acts by which fetal tissue was used to generate the vaccine.
The second important distinction that the bishops make is between immediate and mediate material cooperation. One is guilty of the former when his object is the same as the object of the wrongdoer (the collusion of the pharmacists and the abortionists, for example). Here, immediate material cooperation is tantamount to implicit formal cooperation. In the case of mediate material cooperation, the object of the cooperation is not the object of the wrongdoer. Concerning the vaccine, the object of the user is health and not the abortion of the fetus or the cultivation of a cell line. The bishops state: “When the object of the cooperator's action remains distinguishable from that of the wrongdoer's, material cooperation is mediate and can be morally licit.”
Over the years, Catholic moral-ists have employed a further refinement, dividing mediate material cooperation into the proximate and the remote. While it is difficult to draw a clear line that would separate the two, the distinction can be useful.
Here is an example. A secretary is aware that some of the statements that she types for her boss are lies. She may be disturbed by this and may feel that, if she protests, she risks losing her job. At the same time, she has no prospects for another job and has a child who is dependent on her. She cooperates materially, but not formally (she does not assist in crafting more convincing lies). She does not intend the object of her boss's deception. Her cooperation is proximate. But the cooperation of people in the mailroom (who also know about the lies) is remote. And that of the mail carriers who deliver the mail is so remote as to be clearly morally inculpable. As material cooperation becomes increasingly remote, it passes from cooperation to increasingly diluted forms of involvement, through loose association to complete dissociation.
Many churches have been built and maintained thanks to Mafia contributions. But it would seem that church attendance would exemplify an extremely remote (and therefore morally inculpable) material involvement, especially where the participant does not affirm in any way how the donors acquired their money or even the fact that they made their contributions. Nor would a store clerk be morally cooperating in wrongdoing by selling merchandise to a member of the Mafia whom he has good reason to believe derives his income from illicit activities.
Wrongdoing leaves its fingerprints virtually everywhere. Can a person stay at a hotel that provides “adult” entertainment for its patrons without cooperating illicitly with an evil? It would seem that such cooperation is sufficiently remote as to be innocent of any moral censure.
The bishops also advise that the “object of material cooperation should be as distant as possible from the wrongdoer's act,” and that any act of material cooperation requires “a proportionately grave reason.”
The grave reason for using the vaccine may very well be the health and continued life of one's children, surely a grave reason. But is such a reason “proportionate,” that is, does the good of the vaccine outweigh whatever evils might be unleashed as a result of its use?
One must take into consideration the possibility of scandal, the charge of hypocrisy, further institutionalizing the abortion-vaccine industry, and so on. These potential evils, however, can, at least theoretically, be effectively opposed. One can publicly denounce abortion and the cultivation of vaccines from aborted fetuses, lobby to encourage scientists to cultivate vaccines from non-human sources, and still use the vaccine. On the other hand, not to use the vaccine could be interpreted as an abdication of parental responsibility and could bring considerable stress into a marriage relationship. In short, the use of such a vaccine may be understood as a form of morally acceptable cooperation that is material and remote.
Can it really be morally permissible to benefit from something whose genesis is morally impermissible? Surely a child conceived by rape can enjoy the benefits of human existence without endorsing the nature of the act that brought him into being.
It can be permissible to enjoy such a benefit if there is a proportionate reason to use the benefit and the degree of material cooperation is so remote from the wrong-doing that the cooperator does not incur any moral culpability for the wrongdoings that were initially committed. In particular cases, however, where one is able to defend his actions, one may even be obliged to do so. One is not morally bound to refrain from performing a good action because others, who are ignorant, may voice censure or disapproval. The obligation to educate may be very strong. A moral choice with an explanation is better than inaction combined with a fear of the opinions of others.
Part of the meaning of the “global village” in which we live is that the contamination from various acts of wrongdoing has seeped into almost every corner of our existence. Given what is shown on television these days, can anyone justify owning one? Many food items one purchases at the grocery store have a genesis that involves worker-exploitation or even slave labor. Is one even allowed to watch an NBA game, given the stories that exist concerning the making and selling of certain sneakers? We pay taxes to governments that subsidize abortion and other crimes. Too scrupulous a moral attitude can lead to paralysis and, as a consequence, leave a great deal of good undone.
The notion of excusable, remote material cooperation allows us to be involved in a morally contaminated world without contributing to that contamination. The medically indicated use of vaccines cultivated from aborted fetuses can be morally licit. And it can be done without giving approval to the way they were developed, and without necessarily contributing to any of the associate evils that we rightly denounce. There are distinctions that must be made so that we can live with a clear conscience and cooperate with others in our problematic world — so that that we can be effectively in the world without being of it.
Don DeMarco, a philosophy professor at St. Jerome's University in Waterloo, Ontario, is a member of the American Bioethics Advisory Commission.