The Catholic Church says no, and so do many evangelical Christians, according to an ABC News/Beliefnet poll. The same poll shows that the majority of Americans support such research, and recently, prominent pro-life advocates, such as Senator Orrin Hatch of Utah, have urged President George W. Bush, who is said to be wavering, to allow federal funds to pay for research using discarded embryos. Some oppose stem cell research owing to the spiritual belief that embryonic material is sacred. Others counter that if stem cell breakthroughs save those with incurable diseases, then stem cell research is pro-life. It's a conundrum no matter how you slice it.
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But are we focusing on the right conundrum? So far, the stem cell debate has centered entirely on whether federally funded researchers should be allowed to derive stem cells from discarded embryos. But the key ethical question doesn't originate with the stem cell research--it originates with fertility clinics, where the discarded embryos are made.
No matter what we decide about stem cells, fertility clinics will continue to manufacture and discard the embryos the researchers want permission to use. Public funds do not create the embryos, nor do stem cell researchers need anything close to the very large number of excess embryos fertility clinics generate and inevitably destroy (or freeze indefinitely, which is the same in the sense that it precludes life). If there's something immoral about embryos being destroyed or discarded, the questionable practices start at the fertility clinics.
What's more, while federally funded scientists are subject to strict rules of protocol and disclosure, most fertility clinics are private institutions essentially subject to no laws other than the free market's and are allowed to do mostly what they please to human eggs, sperm, and unions of the two. But because fertility clinics exist to bring human life into the world, their work is largely supported by the pro-life movement. The clinics are the good guys. This support by Protestant evangelicals and others who make up the nation's pro-life movement has focused the policy debate on stem cells and not the clinics that make them. But ground zero for the debate is actually in the clinics themselves.
Physicians at Loma Linda will only provide artificial-reproduction assistance to married couples, create as few excess embryos as possible, and freeze for storage only embryos couples plan to use. Nevertheless, the Loma Linda clinic is artificially making embryos that never become babies.
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The United States today has 390 fertility clinics, according to the federal Centers for Disease Control. In 1998, the most recent year for which statistics are available, these clinics conducted about 81,000 "cycles," or attempts at artificially aided reproduction. (Usually, this means joining a couple's sperm and egg "in vitro," or in a lab dish; sometimes it means either a donor's egg or donor's sperm or both.) The 81,000 attempts made in 1998 resulted in about 20,000 live births. Rates of lab-assisted births are skyrocketing. Altogether, some 45,000 "test tube" babies have been born in the United States in the last two decades, with most of the births in the last few years. Fertility clinics, in short, are a booming business.
There are no central statistics on discarded or unwanted embryos, but the numbers are thought to be high. It's estimated that for each "cycle," somewhere around five embryos end up either discarded immediately or frozen and discarded later. That would suggest some 400,000 embryos went unused in 1998 alone. Total embryos created and destroyed or discarded by the U.S. fertility clinic industry so far might exceed one million.
Of these discarded embryos, federally funded researchers have asked for permission to destroy perhaps a few dozen. These would be used to create "lines" of self-reproducing cells for further stem cell research. Once self-reproducing stem cell "lines" exist in major university laboratories, no further use of embryos is expected. But if destroying or discarding embryos is what is ethically repugnant, fertility clinics will continue committing this transgression--and vastly more often than the researchers propose.
(At present, the Vatican is the lone prominent opponent of lab-aided conception, though it supports other scientific help for infertile couples.) The first American test-tube baby, Elizabeth Carr, starts her sophomore year at Simmons College in Boston this fall. She is bright, happy, and hopes to become a journalist. Most important, she is priceless.
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But if the advent of test-tube birth should be praised, the discarded-embryo issue has been swept under the rug. Maybe embryos are just cell clusters, in which case discarding them is fine--and in which case there's no reason to oppose stem cell research based on cells derived from embryos. But if embryos have an inviolate ethical status, then it is the fertility clinics--the good guys--who are causing the taboo to be broken.
Advocates of lab-assisted reproduction believe that the destruction or discarding of created embryos is justifiable because in wholly natural reproduction, the majority of fertilized eggs never become babies. But even if they are right, these embryos still float in an ethical and regulatory no-person's-land. Congress has never enacted a law governing biotechnology. Federal rules apply only to institutions that accept federal grant money. Private fertility clinics are essentially unrestricted in what they do to human cells in test tubes and generally not required to disclose what they do.
In the absence of governmental oversight, the courts have in some cases stepped in with confusing, overlapping decisions about destruction or preservation. But not even the Supreme Court has made the responsibilities of fertility clinics clear. Not even medical professional societies regulate this question. The American Society of Reproductive Medicine says, "As an ethical matter, a [clinic] should be free to dispose of embryos after a passage of time that reasonably suggests that the couple has abandoned the embryos." Thus operators of fertility clinics believe it is ethically fine to destroy embryos. Maybe they're right. But before we skip to the next question, we ought to at least ask ourselves if we agree.
