Stem Cell Research Annotated Bibliography
The following sources do not necessarily reflect the Center's position and, likewise, may or may not be consistent with a biblical worldview. These sources, however, are excellent resources for familiarizing oneself with the all sides of the issue.
Cameron, Nigel M. de S., ed. Embryos and Ethics: The Warnock Report in Debate. Edinburgh: Rutherford House, 1987.
In this book, writers who ascribe to the Judeo-Christian philosophical and moral foundations of traditional western medical practice critically assess the way key issues were or were not addressed in Dame Mary Warnock's Report of the Committee of Inquiry into Human Fertilisation and Embryology, published by the government (London, H.M.S.O.) in 1984. Their analyses in this early report prefigure current critical lines of inquiry.
In "The Christian Stake in the Warnock Debate," Nigel M. de S. Cameron attributes the furor raised by the report (which came with three appended dissents) to its failure to face the central issue of using human embryos for research purposes, as well as to its "compromise" permitting experimental use of embryos up to 14 days after fertilization. The underlying question of the nature of the human embryo was never asked, making it impossible to offer principled considerations of how such embryos should be treated.
Several essays challenge Peter Singer and colleagues' concept of speciesism and their focus on the embryo's capacity to display "morally relevant characteristics" over against any ascription of inherent human dignity. In pointing out how the view of Singer and his colleagues contradicts the Christian doctrine of the creation of human beings, Cameron considers questions of potentiality, the image of God, and the incarnation. In two essays, Teresa Iglesias looks at notions of potentiality/development and challenges the reliance on utilitarian thinking, which she notes is not the only way to evaluate moral and social problems. Iglesias asks theologians to consider what doctrinal development may be necessary to correct the suggestion, often based on Greek philosophy, that the soul gets "added on" at a later point in development. She notes that, for Christians, "truths of faith are not human achievements as philosophical doctrines are."
Richard Higginson examines the ethics of nontherapeutic experimentation in light of international conventions and explores possible applications to human fetuses, with a look at the work of Paul Ramsey, Richard McCormick, and other theologians on the issue of experimentation on children. While upholding Christian considerations, which he points out bolster his belief that the embryo is a human person, he emphasizes other arguments based on natural justice that he believes will be persuasive to a broad group of people. In a second essay, Higginson warns of risks to both "childless couples and rootless children" in rushing into artificial reproduction too quickly. David Atkinson presents a theological account of the human embryo's status by invoking biblical themes such as the story of the Flood, the prohibition of destroying innocent human life, the meaning of the imago Dei, generalizations from Psalm 139, the virginal conception of Jesus, parenthood, and souls. Ian Donald sharply critiques the Warnock report's main assertions, warning against beguiling language that veils what the prophet Jeremiah described as "broken cisterns that can hold no water," hewed out by those who have rejected God. He catalogs practical problems likely to result from efforts to implement the report's recommendations. Isobel Grigor examines what the responses of various denominations, particularly those based in Scotland, indicate about how churches have performed as witnesses and advocates of the Christian faith. Observing that the Anglican and Methodist churches differ from the Scottish churches in accepting the 14-day cut-off, she urges all churches to work on discussing and clarifying the issues within their denominations. In "After the Embryo the Fetus?" John Peel chastises the profession for its erosion of discipline and questions whether the 14-day cut-off point will hold, noting that it has no real scientific, moral, or practical basis. In "A View from the Other End," George L. Chalmers comments on the nebulous concepts, undefined terms, and weak arguments that have replaced simple and direct principles of morality. He likens the Warnock Report to the Tower of Babel, which failed because it was contrary to the law and purposes of God, as well as to the eternal law of love.
Green, Ronald M. The Human Embryo Research Debates: Bioethics in the Vortex of Controversy. New York: Oxford University Press, 2001.
The author, a professor of ethics in a university department of religion, draws on his experience as a member of the 1994 NIH (National Institutes of Health) Human Embryo Research Panel to make the case for federally funded human embryo research and to counter the arguments of religious groups opposed to such research. (The NIH panel's recommendations were undercut by politics and ultimately superseded by the work of the National Bioethics Advisory Commission (NBAC), established by President Clinton in February 1997.) Detailed chronological accounts of the social forces and opposition groups following specific scientific breakthroughs, as well as philosophical reflections on the subject matter, are provided. Extensive endnotes, a bibliography, two appendices, and a three-level index make the work a valuable reference tool, despite strident objections to religious groups and individuals who are opposed to human embryo research. In an "Afterword" added as the book was about to go to press, the author notes his acceptance of an invitation to chair an ethics advisory board for Advanced Cell Technology (ACT), a biotechnology company that has announced its intention to clone human beings.
Green sharply criticizes the search for "objective markers" in debate over moral status, personhood, and related concepts, arguing that "biology involves continuous processes rather than events" and that determinations of defining points are made solely through value-based decisions. Faced with the NIH panel's charge to identify criteria for when to allow federally funded research on the human embryo, Green called for a "pluralistic and pragmatic" approach using multiple criteria (such as "developmental potential," "semblance of human bodily form," "some degree of developed cognitive ability," and "independent existence") together to assign relative moral weight. Language chosen to finesse the controversial matter of creating embryos solely for research purposes appeared in the panel's report as "fertilization of oocytes expressly for research purposes" and "developing research embryos" (rather than "using spare embryos").
The interplay of Congressional and federal health agency politics, new administrations with new personnel, and the cloning of Dolly the sheep through somatic cell nuclear transfer (SCNT) shaped the development and outcome of NBAC's reports. Comparing this group with the NIH panel (while acknowledging his partiality), the author judges NBAC's handling of the cloning issue in its first report (1997) to be "a case study in poorly conducted public bioethics," both in process and substance, and finds that the deficiencies carried over to the Commission's final report on stem cell research (1999). He argues that NBAC should have rejected the assignment to rush out a report on such complex scientific and technological developments and, furthermore, that it should not have given such a high profile to religious views in invited testimony and written reports. Green predicts that evangelical Christian groups, who apparently were not invited to speak, will not long tolerate exclusion, and he foresees future hearings growing into "larger cultural wars." Also harmful, asserts the author, were NBAC's recommendation to prohibit both public and private attempts at human cloning (which "introduced a dangerous new precedent to federal efforts to control life sciences research") and its decision not to make any recommendations about human embryo research as related to cloning. Green suggests that in trying to sidestep political controversy over embryo research, the NBAC failed to follow through on its professed concern about the risk of harming children. Such concern requires new thinking and a deliberate choice of "points at which moral protection begins and ends." In conclusion, Green holds that federally funded health-related research should not be classified "as discretionary and unrelated to the fundamental rights of citizens" and that no research should be obstructed on the basis of "majority whim or minority pressure." Religious and moral objections "must be set aside" unless they can be "grounded in concerns appropriate to a pluralistic democracy" and "reasonably clear issues of public health and safety."
Holland, Suzanne, Karen Lebacqz, and Laurie Zoloth, eds. The Human Embryonic Stem Cell Debate: Science, Ethics, and Public Policy . Cambridge, MA: MIT Press, 2001.
This compilation of original essays and excerpted or adapted reports and testimonies illustrates the issues raised by stem cell research and the way they are argued, mainly from the perspectives of individuals already engaged in the research as scientists or ethics consultants. The introduction identifies key players in the debate as well as the major regulatory and funding hurdles that have been encountered. Twenty chapters are organized under four major sections--"The Science and Background of Human Embryonic Stem Cells," "Raising the Ethical Issues," "Angles of Vision" (which includes various religious perspectives), and "Public Discourse, Oversight, and the Role of Research in Society." A brief glossary and a detailed index are also included.
The religious views included in this book tend to support embryonic stem cell research, thereby emphasizing alternative rather than formal or official rationales (as is the case with all three essays describing "Catholic" perspectives). The positions of many religious groups known to avidly oppose stem cell research are not represented. Nevertheless, those opposed to this research on religious grounds will likely find the book to be valuable because of its authoritative insider accounts of how various individuals and groups have addressed issues such as the status of the human embryo and whether it should be protected against destruction, the limits of scientific inquiry, the meaning of "respect" (as upheld by the National Bioethics Advisory Commission (NBAC)), the concept of "dignity" (as upheld by organizations such as Do No Harm: Coalition of Americans for Research Ethics), and the consent process for women and couples donating "excess" embryos for research. Critiques of NBAC's analysis, as well as of the evidence offered in support of this research, are also included. In the concluding chapter, editor Laurie Zoloth calls upon bioethics consultants to ask moral questions first before engaging in research as a means of warding off the reactive legal maneuvering and justification that often ensues.
Kass, Leon R. Life, Liberty, and the Defense of Dignity: The Challenge for Bioethics. San Francisco: Encounter, 2002.
Leon Kass introduces his completed book at the end of 2001 upon having been appointed to chair the new President's Council on Bioethics to monitor stem cell research and consider the medical and ethical ramifications of biomedical innovation. "Human nature itself lies on the operating table, ready for alteration, for eugenic and neuropsychic 'enhancement,' for wholesale redesign," and "for anyone who cares about preserving our humanity, the time has come to pay attention," he warns.
Calling for a "richer bioethics," Kass offers a series of meditations to show what we as humans stand to lose--and what we must defend--from the reductive scientific-technological transformation of the meaning of humanity. The major principles of professional bioethics are faulted for their narrow focus on avoiding bodily harm, on patient autonomy and informed consent, and on equal access, as such principles miss the possibility of "willing dehumanization." Kass urges that our notion of human dignity move beyond the concept of "personal dignity" to embrace a full and proper anthropology "that richly understands what it means to be a human animal, in our bodily, psychic, social, cultural, political, and spiritual dimensions."
The book's ten chapters are divided into three sections: "Nature and Purposes of Technology and Ethics," "Ethical Challenges from Biotechnology," and "Nature and Purposes of Biology." Specific topics include in vitro fertilization, genetic screening and engineering, the Human Genome Project, stem cell research and cloning, organ transplantation, and "immortality research." Issues addressed include commerce and biotechnology, commodification, health care costs, federal funding and regulation, assisted suicide, euthanasia, abortion and the sanctity of life, family and lineage, identity and individuality, care of the dying, and legal principles and constitutional law.
Kass relates the grounding of human dignity to biblical, philosophical, and natural law concepts and principles, arguing that the legitimacy of the Bible's assertions about respect for innocent life and its prohibition of murder does not rest on biblical authority alone but rather is inherent in humanity and is proved whenever societies are set up under such laws. The concluding chapter, "The Permanent Limitations of Biology," proposes that the root of biology's failure to "do justice to human life" as it is actually lived lies not in biotechnologies spawned by the "brave new biology" but in the underlying scientific thought. Biology's chief defects include foolishly pursuing limitless goals, proceeding by methods and concepts that impose artificial boundaries that are not true to life, and falling unavoidably under the limits posed by the deficiencies of human reason and by "the mysteries of its subject, life itself." Specific philosophical tendencies examined include reductionism, mechanistic models, Cartesian mind-body dualism, and objectification. New currents of thinking that may serve to redress biology's problems are also noted. "Biology may do some of its finest work," concludes Kass, "when it is brought to acknowledge and affirm the mysteries of the soul and the mysterious source of life, truth and goodness."
National Bioethics Advisory Commission. Religious Perspectives. Vol. 3 of Ethical Issues in Human Stem Cell Research. Rockville, MD: NBAC, 2000. http://bioethics.georgetown.edu/nbac/stemcell3.pdf (Accessed April 21, 2009).
The National Bioethics Advisory Commission (NBAC) was chartered by President Clinton in 1995 to address ethical issues arising from biomedical and behavioral research and to make recommendations to the President, the National Science and Technology Council, and others. Its first report, Cloning Human Beings, was quickly released in 1997 to address the new cloning technique known as somatic cell nuclear transfer (SCNT). The Ethical Issues in Human Stem Cell Research report was requested late in 1998 upon the announcement that scientists had successfully derived and cultured in the laboratory human pluripotent stem cells from embryos remaining after infertility treatments and from aborted fetuses.
The report presents 13 recommendations advising that the existing statutes and regulations be changed to allow federal funding of research involving the derivation and use of human stem cells from aborted fetuses and from embryos that would otherwise be discarded. The NBAC recommended that research involving the derivation or use of stem cells from human embryos created through SCNT not be eligible for federal funding at that time but that the therapeutic potential, scientific progress, and medical utility of such research be monitored closely.
Recommendation 8 called for creating a broad, multidisciplinary National Stem Cell Oversight and Review Panel (to be chartered for not longer than five years) to ensure conformance with the report's stated ethical principles and recommendations. The NBAC's charter expired October 3, 2001, but its recommendations and approach to reaching a consensus on stem cell research continue to fuel debate and to shape federal and state legislative proposals.
The report summarizes ethical and policy considerations arising out of diverse positions on how (and for some, whether) to afford human embryos "respect as a form of human life," what such respect should entail, and what level of protection is required at different stages of embryonic development. Ten commissioned papers are drawn upon in this summary. Religious perspectives are also presented through individual testimonies on Catholicism (Kevin W. Wildes, Georgetown University; Edmund D. Pellegrino, Georgetown University; Margaret Farley, Yale University); Judaism (Rabbi Elliot N. Dorff, University of Judaism; Rabbi Moshe Tendler, Yeshiva University; Laurie Zoloth, San Francisco State University); Eastern Orthodoxy (Father Demetrios Demopulos, Holy Trinity Greek Orthodox Church); Islam (Abdulaziz Sachedina, University of Virginia); and Protestantism (Gilbert C., Jr., Valparaiso University; Nancy J. Duff, Princeton University Theological Seminary; Ronald Cole-Turner, Pittsburgh Theological Seminary).
Prentice, David A. Stem Cells and Cloning . San Francisco: Benjamin Cummings, 2003.
This pamphlet explains the processes of stem cell research and cloning in simple, layperson's language. It presents key terms in boldface type, illustrates the various developmental stages with simple diagrams, and notes relevant principles of and standards for scientific research. Clinical studies are briefly reported upon, and a resources section lists the reports of several national organizations, as well as bioethics centers and their web sites. A section on bioethics asserts that the moral status of the human embryo lies at the heart of the stem cell research debate and includes a brief consideration of "what it means to be human." A section on politics covers the current status of this research internationally as well as with respect to U.S. federal and state legislation. The appearance of new coalitions defying left-right stereotypes is also noted, demonstrating that "the debate regarding the early embryo is not the abortion debate."
The President's Council on Bioethics. Human Cloning and Human Dignity: The Report of the President's Council on Bioethics. New York: PublicAffairs, 2002. http://www.bioethics.gov/ reports/cloningreport/pcbe_cloning_report.pdf (accessed April 21, 2009).
This is the first report of the President's Council on Bioethics (PCBE), formally established by President Bush on November 28, 2001 (and originally announced in August 2001), to advise the President on bioethical issues related to advances in biomedical science and technology. In his Letter of Transmittal to the President (July 10, 2002), Council Chair Leon R. Kass, M.D., Ph.D., stresses an intention to illuminate, not suppress, differences. Describing the report's disciplinary scope, Kass explains that "we have eschewed a thin utilitarian calculus of costs and benefits, or a narrow analysis based only on individual 'rights'" and instead "have grounded our reflections on the broader plane of human procreation and human healing, with their deeper meanings." Cloning is portrayed as "a turning point in human history--the crossing of an important line separating sexual from asexual procreation and the first step toward genetic control over the next generation."
While Council members remained divided on ethical conclusions and recommendations, they unanimously concluded that the entire report presented a fair and accurate reflection of their individual views and the reasons for them. The report offers three chief findings:
- First (unanimous): Cloning-to-produce-children (so-called reproductive cloning) is unethical, ought not to be attempted, and should be indefinitely banned by federal law, regardless of who performs the act or whether federal funds are involved.
- Second: On the ethics of cloning-for-biomedical-research (so-called therapeutic cloning), the council is of several minds and is divided in its policy preferences. Seven members (a minority) are eager to see the research proceed and recommend that it go forward, but only under strict federal regulation. Ten members (a majority) are convinced that no human cloning should be permitted (at least for the time being) and recommend instituting by law a four-year ban on cloning-for-biomedical-research, applicable to all researchers regardless of whether federal funds are involved.
- Third: The same ten-member majority recommends a federal review of current and projected practices of human embryo research, preimplantation genetic diagnosis, genetic modification of human embryos and gametes, and related matters, with a view to recommending and shaping ethically sound policies for the entire field.
The report's revised and standardized terminology, based on a clear rationale, will be useful for all interested science and policy parties as well as for the general public. To ensure fairness and accuracy, definitions should be anchored in the act itself, not in its purpose or the technique used to carry it out. In the case of embryonic stem cell research, for instance, the terms "somatic cell nuclear transfer [SCNT] for stem cell research," "nuclear transplantation for regenerative medicine" (or "to produce stem cells"), and "therapeutic cloning" all miss the mark. Similarly, distinguishing between the product of SCNT cloning ("blastocyst," "preimplantation clump of cells," "totipotent cell") and the product of cloning-to-produce-children, in vitro fertilization, and natural reproduction ("human embryo") is dishonest. All of these processes, asserts the report, produce a human embryo, and the ethical and moral issues should not be masked by choice of language.
Religious positions are not addressed directly, but are touched on under broader moral categories and are reflected in some individual statements. Different concepts of "respect" and "dignity" are illuminated. The moral case against cloning-for-biomedical-research, for instance, is based on the "moral status of the cloned embryo," "exploitation of developing human life," "moral harm to society," and "what we owe the suffering." Proponents of this position conclude: "As much as we wish to alleviate suffering now and to leave our children a world where suffering can be more effectively relieved, we also want to leave them a world in which we and they want to live--a world that honors moral limits, that respects all life whether strong or weak, and that refuses to secure the good of some human beings by sacrificing the lives of others."
This report includes chapters on the meaning of human cloning, historical aspects, terminology, scientific background, ethics, public policy options, and policy recommendations. Also included are reviews of conclusions of earlier federal and professional association reports, as well as a bibliography, a glossary, and personal statements from 14 of the 17 council members.
Ruse, Michael, and Christopher A. Pynes, eds. The Stem Cell Controversy: Debating the Issues. Amherst, NY: Prometheus, 2003.
The editors of this book have brought together contributions from scientists, clinicians, philosophers, theologians, historians, and policy analysts to offer both the layperson and the professional a spectrum of different perspectives and to suggest tools for engaging the issues. Included are a 12-page glossary and President George W. Bush's August 9, 2001 news release announcing the formation of the President's Council on Bioethics. Eight of the 25 contributions come from the stem cell report of the National Bioethics Advisory Commission (NBAC) established by President Clinton (the charter for which expired October 3, 2001).
The editors' general introduction reviews common religious and philosophical schools of thought and how they are likely to shape the stem cell debate. Each of the book's five sections--"The Science of Stem Cells," "Medical Cures and Promises," "Moral Issues," "Religious Issues," and "Policy Issues"--leads off with an identification of the key concepts.
The first section begins with a National Institutes of Health "Primer," which casts doubt about the potential of adult stem cell research. The primer is balanced with considerations from Jane Maienschein, who underscores the importance of clarifying definitions, and Sidney Houff, who offers a positive perspective on adult stem cell potential.
The four contributions on moral issues are 3 to 1 in favor of embryonic stem cell research. Seven contributions on diverse religious perspectives, all taken from testimony to the NBAC, do not claim to offer authoritative statements representing official positions, although affiliation is identified for five of them. Two contributions in this section present patients' perspectives: a 16-year-old cancer patient whose life was saved by cord blood research and who opposes embryonic stem cell research (as stated in testimony to the NBAC), and the founding chairman of the Patients' Coalition for Urgent Research (Patients' CURe).
Included in the five contributions on policy issues is the NBAC report's conclusions and recommendations, which favored federal support for research on stem cells derived from surplus embryos resulting from reproductive technologies or obtained from aborted fetuses but which objected to the use of embryonic stem cells from embryos made for research purposes. The other four contributions in this section are split 2 to 2 on immediately proceeding with research versus exercising caution or forgoing it at this time.
Shostak, Stanley. Becoming Immortal: Combining Cloning and Stem-cell Therapy. Albany: State University of New York Press, 2002.
The author, a professor of biological sciences, wrote this book "to give the possibility of immortalizing human beings a realistic face so that it would be looked at seriously." Totally excluded from this book are any considerations of the consequences of immortality for society, culture, or bioethics. The author promotes a course of research leading to the achievement of immortality as a feasible alternative to aging and death. Separate chapters are devoted to explaining why human beings did not evolve immortality and why at present we cannot develop it.
The possibility of biological immortality rests on two premises: (1) anyone able to perpetually regenerate, reinvigorate, and replace aged or diseased parts of their body could live in the same body from birth through eternity with their persona intact; and (2) a clone of one's own cells could serve as a source of embryonic stem cells able to support cellular renewal. Grafting a clone to an embryo would create a permanent "generator" of embryonic stem cells and thereby immortalize the host organism. Human beings could be made immortal through the simple device of replacing germ cells with stem cells. Such persons would be sterile and their bodies would remain permanently prepubescent, but the stem cells would keep them perfectly balanced between development and aging, between growth and decay.
As for the future, the author speculates that "human-machine synthesis" and "cyborgian replacement therapy" will advance rapidly and that a "human-machine lobby" will try to "dampen enthusiasm for immortality" but that "the growth of an immortality lobby will ultimately overwhelm resistance." An international scenario is envisioned with specific organizations mobilizing to reduce population growth and prevent "domination of immortality" by rich nations. Shostak advocates leaving the decision to become immortal up to parents and concludes by considering the different possible perspectives of non-immortals and immortals and the potential conflicts between them.
Waters, Brent, and Ronald Cole-Turner, eds. God and the Embryo: Religious Voices on Stem Cells and Cloning. Washington, DC: Georgetown University Press, 2003.
The editors of this book have put together a collection of essays and documents illustrating the sharp religious conflicts in the debate over human embryonic stem cell research and cloning, with the intention of improving understanding so that better ethics and policy may ensue. Readers can learn of and compare particulars in the two-level index and eight appendices of documents from specific religious organizations and groups, which reflect official positions or formal statements of groups within the organization. A ninth appendix contains the Executive Summary from the President's Council on Bioethics report, Human Cloning and Human Dignity: An Ethical Inquiry.
In three essays in the first section, "Frameworks," the editors and Gene Outka examine the impact of religious disagreement on science and research and explore the appropriate contributions of religious communities to the public debate. Specific concepts and arguments pertaining to the status of the human embryo are critiqued in four essays in the second section, "Embryos." Confessing his ambivalence on the prospect of embryonic research, Brent Waters suggests asking a relational question, "Is the embryo my neighbor?," to replace the abstract consideration, "Does the embryo have moral status?" In a review of traditional Christian and Jewish thinking, James C. Peterson observes an active "developmental tradition" among Catholics that departs from the official teaching that the embryo is a human being from the point of conception on. Ronald Cole-Turner compares the principles and politics of the pro- and anti-research groups, concluding that those who are opposed have stronger arguments but that their all-or-nothing position on a ban (as opposed to limited regulation) could actually be judged to show less respect for the embryo. Robert Song critically assesses "burden of proof" issues in the face of doubt regarding the embryo's moral status, pointing out that "to be willing to kill what for all one knows is a person is to be willing to kill a person." Four essays in the final section, "Research," assess the principles that determine research policy. Ted Peters and Gaymon Bennett argue that the principle of beneficence trumps other religious values, thereby concluding that research to benefit those afflicted with disease should proceed. Weighing the goods and harms in light of the complexity and uncertainty in embryonic research, Kevin T. Fitzgerald, S.J., comes down on the other side. He suggests that research using animal models and non-embryonic human stem cells should instead be encouraged. In the face of intractable discord over the status of the human blastocyst, Laurie Zoloth calls for shifting the focus away from the embryo's moral status to a consideration of the duties and limits that should govern bioethics. She elaborates on six moral duties: justice, moral discernment, healing and caring, tending and transforming, learning and studying, and solidarity and community. Sondra Wheeler asks first that we "get our information straight" and shows how clear language will facilitate discernment in both Jewish and Christian thinking. She also points out the importance of a shared theological anthropology in determining the meaning and purpose of life.
Updated April 2009