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The Mind of a Catholic Moralist? March 06, 2002

Every living being has organs. Even the simplest kind of organism, plants, have "organs, though very elementary," Aristotle taught. For example, the philosopher mentions: roots "are like mouths, for both draw in nourishment."

So when the Minnesota Center for Health Care Ethics boasts on its web page that its "tap root" is the Sisters of St. Joseph of Carondelet, it is stating metaphorically that the Center draws its deepest nourishment from a Catholic source.

The Center’s senior scholar is Carol Tauer, a former Sister of St. Joseph who taught mathematics at the College of St. Catherine in St. Paul, Minnesota, for 17 years before her life took a different direction. Late in the 1970s she shifted her academic focus to philosophy, left her religious order "on good terms," earned a doctorate from Georgetown University, and returned to the College of St Catherine to teach her new specialty, biomedical ethics.

Founded in 1905 by the Sisters of St. Joseph, the College of St. Catherine is another sponsor of the Minnesota Center for Health Care Ethics. The remaining two sponsors of the Center are secular corporations. But both of them--Fairview Health Services and the HealthEast System--incorporate hospitals which were originally founded by the Sisters of St. Joseph in the 1800s.

Such are the roots of the Minnesota Center for Health Care Ethics. But what were the fruits, when the senior scholar from the center joined the ethics advisory board for Advanced Cell Technology? Did that biotech firm, based in Worcester, Massachusetts, receive the benefit of authentically Catholic moral instruction?

Before giving readers an opportunity to answer that question for themselves, we should say something about the activities of Advanced Cell Technology (ACT). In an article that appeared in the January 2001 issue of, Scientific American, ACT scientists reported:

They were such tiny dots, yet they held such immense promise. After months of trying, on October 13, 2001, we came into our laboratory at Advanced Cell Technology to see under the microscope what we’d been striving for--little balls of dividing cells... Insignificant as they appeared, the specks were precious because they were, to our knowledge, the first human embryos produced using the technique of nuclear transplantation, otherwise known as cloning.

With a little luck, we hoped to coax the early embryos to divide into hollow spheres of 100 or so cells called blastocysts. We intended to isolate human stem cells from the blastocysts to serve as the starter stock for growing replacement nerve, muscle, and other tissues that might one day be used to treat patients with a variety of diseases. Unfortunately, only one of the embryos progressed to the six-cell stage, at which point it stopped dividing ...

In the eyes of many reporters, since the cloned embryos did not survive, the story was not a particularly important one--certainly not nearly so important as it might have been if the clones had flourished. So many major media reports reduced Advanced Cell’s salvo from a bang to a whimper. "Just Cloning Around" was Time magazine’s headline. The goal was to produce stem cells, the Time article pointed out, and the fact is ACT had not produced stem cells. Still, Time allowed, "just getting a human embryo started without the union of sperm and egg was a feat never before achieved."

Before the company went forward to produce the first cloned human embryo, ACT considered five related ethical questions. In a sidebar accompanying the Scientific American article, Ronald Green, the chairman of the company's ethical advisory board, suggested that the most important issue was the last question on his list: Would this "therapeutic cloning" undertaken by ACT facilitate reproductive cloning--that is, the birth of a cloned human child?

Green (who is director of the Ethics Institute at Dartmouth College) and other scientists and executives connected with the firm repeatedly assured the media that ACT was not interested in producing cloned babies; the company was only interested in growing "activated cells"--their term for the cloned embryos--until they became 100-cell blastocysts from which human stem cells could be harvested. In fact, Green distanced ACT from the "renegade scientists" who, he reported, "have announced their intent to clone a human being and will presumably do so regardless of whether therapeutic cloning is banned."

Carol Tauer was a member of the ACT advisory board during the time when these discussions were taking place. Yet she does not recall any particularly intense discussion of whether or not a cloned child should be brought into the world. Nor does she remember any debate on more speculative questions about the moral status of the clone created, and whether it was permissible to create a human being with the full intention of destroying it.

Tauer does remember discussion of some other ethical issues. The advisory board discussed whether the cells to be cloned could be taken from children, and decided that--although the process of donating cells is a harmless, risk-free procedure: a swipe from inside the mouth--children should not be involved. Tauer recalls one issue that was thoroughly hashed out: whether it is right to seek human eggs for scientific research. But since there was apparently universal agreement that it was right, that question evolved into a more practical concern about how the firm treated the women who donated the eggs.

In her career as a bioethicist, Carol Tauer has worked closely with such influential (if not completely orthodox) Catholic scholars as Father Richard McCormick of Georgetown and Father Richard McBrien of Notre Dame. In June 2001--during the very period when the ACT board was considering the cloning issue--she addressed the nationwide Catholic Health Assembly in Atlanta, Georgia.

So again, did Carol Tauer advise ACT to accept the moral guidance of the Catholic Church? Or did the company take its cue from Macbeth:

…. For mine own good, All causes shall give way: I am in blood Stepp'd in so far that, should I wade no more, Returning were as tedious as go o'er: Strange things I have in head, that will to hand; Which must be acted ere they may be scann'd.

[TEXT]

How did you become a member of ACT's ethics advisory board?

Carol Tauer: I have a PhD.in philosophy from Georgetown University, with a specialization in bioethics, and my dissertation topic was "The Moral Status of the Pre-Natal Human Subject of Research." And I wrote that between 1978 and 1982, so it was just at the time that the first in-vitro fertilized child was being born. I have published some articles related to that.

Since your publication is a Catholic one, I had an article in 1984 in Theological Studies journal, with the title "The Tradition of Probabilism and the Moral Status of the Early Embryo." That article is probably the one that’s the best known in Catholic circles. It all relates to the status of the early embryo within the first few weeks after fertilization--or after whatever process is used to bring it into existence. And at that time it was simply fertilization; we weren’t thinking at all of cloning, of course.

What was your thesis?

Tauer: My main thesis was to look at why, in all official Church documents, there is an acknowledgment of a continuing debate about the moral status of the early embryo. Some philosophers and theologians would hold that it is a human being from conception, and other philosophers and theologians would hold that it is not. Both opinions have been very well defended by very reputable theologians: for example, Bernard Haring and Karl Rahner are two of the theologians who hold the view that it is not a human being from the time of fertilization on.

So what I looked at is, given that this is a continuing debate philosophically--and it is a philosophical matter; it’s not something you can resolve simply by looking at biology--and since the official Church documents do acknowledge this, and do acknowledge that there are legitimate opinions on both sides here, I have always been puzzled about why then the Church takes the absolute position that we must treat it from the moment of conception as if it were a full human person--even though that’s very debatable.

In your mind, is there a distinction between "human being" and "human person?"

Tauer: For this purpose I would not make a distinction. For other purposes I might. But in terms of Church teaching I would not because I think Church teaching would say it doesn’t really matter if it’s a human being or a human person: it has to be respected in the same way. I think Church teaching would say that, If it’s a human being, then it absolutely cannot be violated or killed, or whatever.

And when you say "Church teaching," what kind of sources or sacred texts do you have in mind?

Tauer: Oh, the Sacred Congregation for the Doctrine of the Faith’s Declaration on Abortion. That would be my main source.

In that 1974 document, the Congregation quotes the Church father Tertullian: "To prevent birth is anticipated murder; it makes little difference whether one destroys a life already born or does away with it in its nascent stage. The one who will be a man is already one."

Tauer: Well, then you’re looking at the potential of it.

The Declaration On Procured Abortion reaches the same conclusion: "From the time that the ovum is fertilized, a life is begun... It would never be made human if it were not human already."

Tauer: I think if you really want to see what my views are, you’d need to look at that article from Theological Studies….

What do you say in that article?

Tauer: I go over the history. I go over the fact that Augustine and various other teachers of the 3rd, 4th, and 5th centuries did say that it’s not fully a human being until it is formed as a body. Before that it would be seriously wrong to destroy it: but that was because it would be a contraceptive act, not because it would be killing a human being. And other people take a different view of course. But all through history there has been this debate. In that article I’m not expressing an opinion; I’m simply looking at the history, and all the different points of view that have been expressed.

What’s your own personal opinion on abortion?

Tauer: My view is the one I expressed in this 1984 article: that is, that there is very good evidence that, during the first couple of weeks after fertilization, it is not yet a human being; and that therefore--although we should be very respectful of it and would need to have a very good reason to violate it or to harm it--that there could be overriding reasons--for instance a woman who was raped. Because at that point, within the first week after fertilization, it does not have the status of a human being yet. And therefore for a very serious reason--such as that this woman has been raped and feels that she can’t go through with the pregnancy--at that point it would be all right to have a D and C [dilatation and curettage--that is, an abortion] and to use a morning-after pill.

Why two weeks instead of four weeks or six weeks or six months?

Tauer: Yeah, well, that’s been discussed really widely.

Within the first two weeks the cells have not differentiated yet, and all the cells are basically alike; so that any one of them could go on to become a human being. So you don’t know: Do you have one? Do you have four? If you had three [cells], you could put them together to make one again. If you have any concept of a human being as having a soul, or being a substantive unity, that isn’t really established until approximately two weeks, when the primitive streak [of the spinal column] appears. And it’s at that point it starts differentiating and gets some organization.

So it’s not an organism?

Tauer: There aren’t different parts: it isn’t an integrated organism.

And also there's the idea that twinning is possible up to that point;. How can one entity which has a soul become two? Does the soul split, or does another soul suddenly appear? If another soul suddenly appears, then the one embryo "gave birth" to the other one--which seems a little peculiar.

It is peculiar. Perhaps that’s why in that Declaration on Procured Abortion in 1974, the Congregation for the Doctrine of the Faith added a footnote which says:

… this declaration expressly leaves aside the question of the moment when the spiritual soul is infused. There is not unanimous tradition on this point and the authors are as yet in disagreement. From some it dates from the first instant; for others it could not precede at least nidation [nestling in the mother’s womb]. It is not within the competence of science to decide between these views, because the existence of an immortal soul is not a question in its field. It is a philosophical problem from which our moral affirmation remains independent for two reasons: 1) supposing a belated animation, there is still nothing less than a human life, preparing for and calling for a soul in which the nature received from the parents is completed; 2) on the other hand, it suffices that this presence of the soul be probable (and one can never prove the contrary) in order that the taking of life involve accepting the risk of killing a man...

The Declaration also says: "Created immediately by God, man’s soul is spiritual and therefore immortal." My understanding is that that is what the Church teaches.

Tauer: Well, I think what you’re saying is correct.

In the first centuries there were some competing views. The one view was that the soul was passed from the father-progenitor to the child. The other view, which we no longer hold, is the view of Plato that the souls are all existing out there somewhere and that at some point they’re joined to bodies.

In any case, getting back to your involvement with ACT--Is it fair to say that your article in Theological Studies came to the attention of Ronald Green, so that when he put together ACT’s ethics advisory board he called on you?

Tauer: You’re jumping too far ahead. In 1994 the National Institute of Health {NIH] had got permission from Congress to begin to fund research on in vitro fertilization. Now for some reason some members of Congress didn’t understand that, if you fund research on in vitro fertilization, you’re going to be working on human embryos.

Anyway, before they realized this, they [Congress] had approved NIH’s funding of research involving in vitro fertilization as infertility research--which it is. And so NIH could have just gone ahead and started funding it, without much of a fuss. But instead of that, they set up a panel which they called the Human Embryo Research Panel. I was a member of that panel, and Ronald Green was on it… We developed what we thought were the guidelines which NIH should use in their funding of in vitro fertilization research and research involving early human embryos. That’s how I became involved with Ron Green, writing some of the parts of that report.

But then after the report came out, these members of Congress who didn’t know what they were doing woke up and said, "Oh, we didn’t really mean that." So… they put in a stipulation that this research could not involve research on human embryos that might harm them or destroy them. So as a result of that, NIH was not able to do any funding.

So when did you join the board for ACT?

Tauer: February of 2001. Advanced Cell Technology had already started their work… So I knew what they were doing when I got on [the ethics advisory board]. And I basically thought, as long as they remained adamantly opposed to cloning a human child, that I could participate in developing ethical guidelines for cloning research that would be ordered to developing tissues and organs and so on--that would be therapeutic.

I knew that the goal of the company was to develop tissues and organs for use in therapy.

Why then did they need an ethics advisory board? It sounds as if they already made up their minds. What advice could you have given?

Tauer: That’s an excellent question, and most people have overlooked a lot of the things we did.

Like one really big question--and I think it’s still a controversial one--is, in order to do the work, they needed donated eggs. Now this is very controversial: Where do you get eggs for research? And you know that women are donating eggs… I don’t know if "donating" is the right word…

Selling?

Tauer: …because they’re getting paid.

Women are providing eggs for infertile couples; and they’re getting paid anywhere from $3,000 to $8,000 dollars for providing eggs. Now whether women should be allowed to do that same thing purely for research purposes: that's very controversial because the women who do this do have to undergo quite an arduous set of medical procedures: injections of hormones and so on. And it’s not a totally risk-free enterprise.

So I’d say this was one of the issues we were really concerned about: how should we get women to provide their eggs for this purpose? What kind of women would they be? How would we minimize the risks? How would we make sure they were fully informed? How would we make sure these were medically and psychologically healthy women, so that they would be able to do this without harm?

You know that when women do this for infertility purposes, they are sometimes given huge injections of hormones so that they produce 20 to 25 eggs. The more hormone stimulation they get, the more risk there is that they could what they call "hyperstimulate," and there could be very serious medical problems. So we had to set a limit so that the amount of hormone stimulation they would get would be not high enough to put them at risk--that they would be monitored constantly to ensure that they would not be at risk, because all women react differently to these hormones.

So those are the kinds of issues we really spent a lot of time on.

For instance we decided that the woman had to have had at least one child, so that in case they were not able to bear children later they would not wonder whether it was because of this procedure they had gone through. It wouldn’t be, but, you know, they might still think maybe it was. So they would have to had at least one child; they would have to be of a certain age; they would have to undergo psychological screening, medical testing; they would have be interviewed to make sure they really understood what their eggs were being used for.

In the Scientific American article, the men who did the cloning wrote: "Interestingly, our proposal appealed to a different subset of women than those who might otherwise contribute eggs to infertile couples for in vitro fertilization. The women who responded to our ads were motivated to give their eggs for research, but many would not have been interested in having their eggs used to generate a child they would never see." Did the women who provided their eggs do it for the noble purpose of helping humanity?

Tauer: I wouldn’t want to make it sound as if providing an egg for an infertile couple was not a noble purpose. I don’t know that I would use that wording. I think that what is most interesting was this: Our board was afraid that we were going to be recruiting women away from donations for fertility purposes--in other words, that we would kind of co-opt these women. But what we found was that the women who were interested in donating for this purpose almost universally (I can’t say universally; I don’t know for sure) said: "I would not have wanted to donate eggs to an infertile couple." Some said this was because "I would not have wanted my own genetic children out there in the world without my knowing about them." That’s what I think is interesting; I don’t want to make one purpose sound better than the other. But don’t you think that’s kind of interesting: that they seem to be differently motivated?

The Scientific American report notes that the donors were recruited by a team based in Somerville, Massachusetts. Since that is an area thick with universities, and the age range of the donors was 24-32, I wondered whether any of the women were graduate students.

Tauer: My impression is that these are not students. For one thing, they’ve already had a child. Secondly, [the recruiters] found that they got most responses from media like these free community papers--things you pick up free, you know?--not some professional type, or not even your standard daily newspaper. So I got the impression that the people were not mainly students.

Would you explain a bit about the process of donating eggs? How does that process of hormone-stimulated ovulation differ from normal ovulation, and what are the risks?

Tauer: Well, I’m not a scientist; so I don’t think I’m the person who should do that, but I do know something about the process. Normally a person ovulates one egg per month, and that’s the normal thing. ... If you have sex at the right time, that’s the one that gets fertilized. What they want to do here is, rather than just taking the one that is mature at that month, they would like more than just that one to work with. So what the drugs do is stimulate the ovaries to mature more than one egg. So there could be 4 or 5 or 8 or 10 or 12 that would then become mature. Then the scientists--or the medical people--apparently can look through a laproscope, and they can see which follicles contain a mature egg, and then they can aspirate those out.

Now my understanding is that the risk comes if you produce too many eggs; but I can’t really tell you exactly, you know, what the risk is.

"In the end," write the ACT cloners, "it took a total of seventy eggs from seven volunteers before we could generate our first cloned early embryo." Does that mean that each woman provided about 10 eggs?

Tauer: Well, the numbers were quite varied. Again, I don’t have the material with me so I can’t tell you what the range is, but some produced less and some produced more... For instance, one may have just produced 5 and one may have produced 14. My recollection is that there was quite a bit of variety.

And each donor went through the process once?

Tauer: Right; each did it once. We did discuss whether a woman be allowed to do it again, and that, we felt, should be restricted. It's not that we’d never let her do it again, but that women should be aware that the more often you’re doing this, the more you’re putting yourself at risk.

Other than issues of risk to the women, what else did the ethics advisory board discuss?

Tauer: We also discussed the compensation: should they be compensated?

And yes we felt that we should give them compensation. We wanted to set the level of compensation at the same level as if they were providing the eggs for someone in infertility. So we didn’t want to either undercut or overcut that market. So I think what was decided was, since it’s about the going rate in New England, was I think about $4,000. We discussed that.

Did you discuss whether the providers should be ethnically diverse?

Tauer: You know, that’s a real interesting subject; and we talked about it. But we felt we could not--you know, we wanted to encourage it--but we felt we could not set quotas or anything like that.

I think it’s certainly an important thing to think of down the line, because a lot of people have said that the stem-cells lines that exist are mostly from upper-class Caucasian women; so that you’re getting a certain type of genetic constitution. I think maybe we felt it was--well, a little too early to start specifying that at this point.

Also, you want to be very careful not to be recruiting really destitute people. You know what I mean? Because that seems kind of exploitative, if they’re really desperate.

Why not avoid even the appearance of financial exploitation by accepting only volunteers who would provide eggs for free?

Tauer: Well, I don’t know that we even raised the issue. I think we just decided that since women are getting paid for going through this--it takes a lot of time, effort, risk, inconvenience and so on--and since women were receiving this level of compensation to do it for infertility, we tried to do it approximately the same way. Now I’m not saying that no woman would have done it; there may have been some who would have done it for free.

Was there a minimum income a woman had to have?

Tauer: No, we didn’t, we didn’t do that. But I think my point is that once you start saying: "We've got to look for different social classes or different ethnic groups," or so on, then you kind of get into: "Well, we've got to be looking for poor people as well as affluent." You know what I mean? We didn’t have any specifications that way: in terms of income level, ethnicity--just health: psychological health and physical health.

And how did you measure health?

Tauer: There were a lot of interviews and screens. They went through every conceivable sort of screening for infectious diseases. That's very important: so that they’re not providing eggs that have some kind of disease to them.

How often does the ethics advisory board meet?

Tauer: We meet quarterly. So we met three times during 2001. There were probably a couple of meetings before I was involved; I’m not sure about that, but I think there were.

Now that the cloning has been done, will the board continue to meet?

Tauer: Oh yes, Ron [Green] says that they’re looking for another meeting date. So we will be continuing to meet, definitely. Definitely. For there are always questions that come up. I haven’t even told you all of them; and I can’t even remember all the different things that have come up.

Now that a human clone has been developed, have new ethical questions…

Tauer: (interrupts) You know, I think you need to--how would I put it?--you need to be very tentative how you express this, because, as you know from the article [in Scientific American], they were really developed only to a very early stage. So I wouldn’t --

But I mean, they’re not cow clones --

Tauer: It’s just at the very beginning stages.

[AUTHOR ID] James McCoy lives in Still River, Mass.