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Bioethics: Rome Speaks

Vatican Breaks New Ground in Answering Questions

BY Edward Pentin

REGISTER CORRESPONDENT

January 4-10, 2009 Issue | Posted 12/19/08 at 1:44 PM

 

VATICAN CITY — A new instruction from Rome clarifies the Church’s position in a number of areas of bioethics, including stem cells and Plan B “emergency contraception.”

The new Vatican instruction clarifies the enormous danger humanity faces in new biotechnologies, according to a leading Church expert in bioethics. “Frankenstein was nothing compared to what we are about to encounter,” said Father Robert Gahl, associate professor of ethics at the Pontifical University of the Holy Cross in Rome.

Dignitas Personae (The Dignity of the Person) outlines dangers to the dignity of man and tries to equip the Church to fight dangerous new biomedical developments.

But it offers “encouragement and guidance” and acts as a reminder that science must always serve humanity and respect the human being, Father Gahl told the Register Dec. 16. It encourages biomedical investigation that respects the dignity of all human beings and of procreation and does not find all biomedical technology illicit.

The instruction was released by the Congregation for the Doctrine of the Faith Dec. 12. That is the same congregation that published a similar document, Donum Vitae (The Gift of Life) in 1987 under its then-prefect, Cardinal Joseph Ratzinger. Dignitas Personae bears the signature of Cardinal William Levada, the former archbishop of San Francisco who succeeded Cardinal Ratzinger as prefect. It was seven years in the making and drew upon a large number of experts, coordinated by the Congregation for the Doctrine of the Faith. Pope Benedict XVI personally approved the text and ordered its publication.

While Donum Vitae rejected in vitro fertilization, human cloning, surrogate motherhood and non-therapeutic experiments with human embryos, Dignitas Personae takes up subjects such as human-animal hybrid embryos, embryonic stem-cell research, gene therapy and embryonic experimentation.

The instruction also contains significant development of doctrine in several areas, according to Father Gahl. “The Church now more forcefully defends the embryo as the bearer of the rights proper to a person,” he said. And the development of a category of early abortion clarifies the distinction between preventing a fertilized egg (an early embryo) from implanting and causing its elimination after it is implanted. This, he said, provides a better reason to administer ovulation tests to victims of rape to ensure that “emergency contraception” will not cause an early abortion.

Dignitas Personae condemns the so-called “morning-after pill” and other drugs and techniques that prevent implantation of a newly developed embryo as morally illicit because they intend to cause an abortion — even if they don’t actually do so every time they are used.

The document distinguishes between contraception and two types of intervention that cause a very early abortion: “Alongside methods of preventing pregnancy which are, properly speaking, contraceptive, that is, which prevent conception following from a sexual act, there are other technical means which act after fertilization, when the embryo is already constituted, either before or after implantation in the uterine wall,” it says. “Such methods are interceptive if they interfere with the embryo before implantation and contragestative if they cause the elimination of the embryo once implanted.”

The use of anti-implantation methods “falls within the sin of abortion” and is gravely immoral, the document said.

But do these proscriptions apply to “Plan B,” the rape treatment drug now used in hospitals, including Catholic ones, intended to prevent pregnancy? Father Gahl believes the document does indeed describe drugs like Plan B. And the makers of Plan B, Duramed, a division of Barr Pharmaceuticals, Inc., describe the drug as an “emergency contraceptive that can prevent a pregnancy after unprotected sex, contraceptive failure, or sexual assault.”

Duramed’s website, Go2PlanB.com, says that Plan B “is believed to work by preventing ovulation, possibly preventing fertilization by altering tubal transport of sperm and/or egg, [or] altering the endometrium, which may inhibit implantation.”

The last scenario — where a fertilized egg (which is a human embryo) is prevented from implanting so that it may develop normally — makes Plan B what Dignitas Personae calls “interceptive,” an intervention that interferes with an embryo before it is implanted.

“While I am fully aware of the current practices in Catholic hospitals and of the debates regarding the Peoria Protocol and a modified version of the Peoria Protocol, I don’t see how one can read Dignitas Personae in such a way that administrating Plan B (or other morning-after pill or emergency contraception) can be justified,” Father Gahl said. He referred to an Oct. 31, 2000 statement on the morning-after pill by the Pontifical Academy for Life, which said, “The same absolute unlawfulness of abortifacient procedures also applies to distributing, prescribing and taking the morning-after pill.”

But Bishop William Lori of Bridgeport, Conn., chairman of the U.S. bishops’ Committee on Doctrine and Pastoral Practices, does not believe the document addresses Plan B. “If it had wanted to, it could have and would have,” Bishop Lori told the National Catholic Reporter’s John Allen. “It doesn’t settle that question.”

The bishops of Connecticut chose not to challenge a state law in 2007 that requires all hospitals to offer emergency contraception to rape victims. Previously, Catholic hospitals required an ovulation test before administering the drug. If a woman had ovulated already, there was a strong possibility that Plan B would terminate any pregnancy resulting from the rape.

Richard Doerflinger, associate director of the U.S. bishops’ Pro-Life Secretariat, also does not believe Dignitas Personae declares that the practice of administering Plan B in Catholic hospitals is illicit. “It clarifies that this is a very important moral issue, but it doesn’t say that what Catholic hospitals are doing to prevent pregnancy in rape victims has been established as an abortifacient and therefore can’t be used,” he told the Reporter. “That has to be settled by more definitive science, not in a Church document.”

Calls to Bishop Lori and Doerflinger were not returned by the Register’s press deadline. Marie Hilliard, director of Bioethics and Public Policy of the National Catholic Bioethics Center, told the Register that, because of the doubt in the scientific data on whether Plan B does actually adversely affect the endometrium in each victim and the doubt as to whether an embryo has been engendered, some bishops have determined that a pregnancy test ascertaining that the victim was not already pregnant prior to the assault is sufficient before administering Plan B. However, her position is that testing to determine that the emergency contraception can have its proper effect of preventing ovulation necessitates testing to determine that ovulation has not already been initiated.

On stem-cell research, the document states that it is morally acceptable to take stem cells when they do no serious harm to the subject, such as using adult stem cells. However, it is always “gravely illicit” to take stem cells from a living human embryo, because it invariably causes the death of the embryo.

The instruction also made a distinction between two kinds of gene therapy, techniques of genetic engineering applied to human beings for therapeutic purposes. Therapy that aims to correct genetic defects by intervening on non-reproductive cells — somatic cell gene therapy — is in principle morally acceptable. But it is not permissible to make genetic modifications that seek to transmit the effects to the subject’s offspring — germ-line cell therapy — because of potential harm to the progeny.

The document repeated earlier condemnations of in vitro fertilization, first because it separates procreation from the conjugal act in marriage, and second, because, in practice, unused embryos are often discarded, thus violating the principle that “the human being is to be respected and treated as a person from the moment of conception.”

Freezing such embryos is itself a violation of ethics, because it exposes them to a serious risk of death or harm, the document said.

For several years, some advocates and groups have called for what appears to be a pro-life solution to the problem of the existence of thousands of unused embryos: embryo adoption. Dignitas Personae addresses the question in this way: “This proposal, praiseworthy with regard to the intention of respecting and defending human life, presents, however, various problems not dissimilar to those mentioned above.”

Those problems seem to be what is mentioned in the previous paragraph: “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.” The word heterologous refers to the fact that sperm or egg comes from a donor outside the marriage.

Where the instruction was clearer was on clarifying the definition of an embryo. Until now, the Church has consistently avoided formally issuing a definition in order to avoid taking sides in certain philosophical and juridical debates. Nonetheless, this instruction constitutes a significant advance insofar as it comes closer to stating that an embryo is a human person and affirming that it is, in any case, subject to the dignity of every human life.

On the issue of cloning, the document rejected as immoral recent efforts to use animal eggs to reprogram human cells in order to extract embryonic stem cells from the resulting embryos. These efforts represent a grave offense against human dignity, as they will disrupt “the specific identity of man.”

Dignitas Personae is by no means just a list of prohibitions. It often speaks of a number of scientific advances that are ethically permissible, such as certain fertility treatments. It reiterated the teaching outlined in Donum Vitae: Any medical intervention that assists the conjugal act achieve its purpose — procreation — is to be allowed, while any intervention that substitutes for it, such as artificial insemination, is not.

“There are those who say that the moral teaching of the Church contains too many prohibitions,” states Dignitas Personae, but “behind every No in the difficult task of discerning between good and evil, there shines a great ‘Yes’ to the recognition of the dignity and inalienable value of every single and unique human being called into existence.”

Dominican Father Augustine Di Noia, undersecretary at the Congregation for the Doctrine of the Faith, called the instruction a “litany of Yeses.” Speaking to Vatican Radio Dec. 12, he said the principle direction of the document is “a positive account, a vision of what it means to be human, and why human life is sacred.”

The Vatican hopes the document will offer scientists a coherence in both morality and science. “In the document, there is a very particular statement about science: that one can only receive the science when science is able to also receive ethical principles,” Archbishop Rino Fisichella, president of the Pontifical Academy for Life, told the Register Dec. 12. “Scientific research cannot be pressured by the economy or financial powers,” he added. “It must be coherent with the common good and coherent with the dignity of the human person.”

Edward Pentin is based in Rome.

CNS contributed to this article.