This ethics seminar was hosted by the Wellcome-funded Human Developmental Biology Initiative (HDBI) and consisted of two talks, followed by a confidential discussion.
The first talk was delivered by Professor Misao Fujita from the Centre for iPS Cell Research and Application at Kyoto University, Japan, who shared challenges unique to Japan when establishing guidelines for fetal tissue research.
The second talk promised an insider view on a question of research ethics; Dr Hafez M'hamdi, vice chair of the Dutch Centre for Ethics and Health, shed light on the Dutch Health Council's recommendation to extend the 14-day limit on embryo research to 28 days.
I was drawn to the seminar's promise to delve into questions about how society should weigh the moral status of the embryo or fetus against opportunities for scientific research. I wasn't disappointed as both talks were rich with fascinating insights; but I occasionally found that they raised more questions than they answered.
Professor Fujita started her talk by sharing a picture of her own umbilical cord, contained in a small box carved with characters celebrating long life. She explained that, according to ancient Japanese tradition, umbilical cords hold a special power, meaning they have been treated with reverence in Japan for over a millennium.
If you're wondering why an ancient tradition celebrating the power of umbilical cords is relevant to modern-day fetal tissue research, you're not alone. Professor Fujita skilfully used the umbilical cord to illustrate how Japanese culture and history can cause complications for those conducting fetal tissue research in Japan today. She explained that, after these ancient burial practices began to be regarded as unhygienic, a series of regulations sprang up to control the disposal of umbilical cords. Confusingly for Japanese researchers, it's unclear whether these regulations apply to the scientific use of fetuses under 12 weeks old; whereas fetuses older than this are legally regarded as dead people in Japan, the status of fetuses under 12 weeks old is ambiguous.
In addition to the legal status of the fetus under 12 weeks old, Professor Fujita further explored the lack of rules directly regulating fetal tissue research; the fact that Japan, astonishingly, requires spousal consent for any woman seeking an abortion; and the high emotional and financial burden on these women. These last two issues are pertinent because abortion is the only permitted source of fetal tissue for scientific research in Japan.
Professor Fujita's research group set out to tackle these four issues after realising they couldn't use the guidelines developed by the International Society for Stem Cell Research on how to obtain informed consent for the use of aborted fetal tissue, because they were in conflict with Japanese regulations. I would have been eager to know more about the details of this conflict, including which specific regulations were at issue. I would have also liked to hear more about whether the guidelines they developed were working in practice: were they successful at shielding researchers from the legal issues she had raised? Did they receive any objections, and if so, how did they deal with these? Though light on solutions, the short talk was packed with interesting information about problems unique to Japanese researchers, and I appreciated hearing these first hand.
Next to speak was Dr M'hamdi, a member of the committee of scientists, ethicists and legal scholars who drafted the Dutch Health Council's recommendation to double the 14-day limit on embryo research. Although I had heard Dr M'hamdi speak at the PET 2023 Annual Conference (see BioNews 1220), I still found the talk fascinating on second viewing.
It is well known that a litany of voices in the scientific community are calling for the 14-day rule to be extended to 28 days, in order to tackle the 'black box' in our understanding of early human development. Dr M'hamdi briefly sketched the scientific benefits of doing so; but the bulk of the talk, as well as the bulk of my interest, lay in the ethical considerations of experimenting on human embryos up to 28 days old.
Dr M'hamdi divided these into two camps: intrinsic considerations, for the embryo's own sake, and extrinsic considerations, for the sake of others. So far as intrinsic considerations, Dr M'hamdi shared the committee's reasoning that only the embryo's potentiality should be weighted, ruling out the other possible considerations of sentience, awareness, self-awareness, personhood, and species membership. It is somewhat trendy among philosophers to regard that last consideration as 'speciesism', a form of unwarranted discrimination analogous to racism or sexism, and Dr M'hamdi referenced this school of thought approvingly. I would have liked to hear more about whether the committee considered the full implications of endorsing speciesism, particularly regarding the equal treatment of non-human animals.
Moving on to the extrinsic considerations, Dr M'hamdi considered ways in which an embryo has value for reasons external to itself. One such value he defined is the 'relational value' of embryos, by saying that even if the embryo has no value in itself, 'there is something about the relation between human beings and their embryos which itself is worthy of moral concern'. Another value recognised by the committee was the embryo's symbolic value. Dr M'hamdi used the example of a flag to illustrate this point – the cloth and colours of a flag have no inherent value, but the flag has symbolic value for what it represents. The same is true of an embryo, which could have symbolic value in representing, for example, the sanctity of human life.
Although the Health Committee concluded that these values were in tension with the extension of the 14-day rule, they ultimately decided to recommend that the rule be extended to 28 days, because of the strong scientific considerations weighing in the other direction. These included the possibility of shedding light on the early causes of miscarriage, developmental disorders, disease prevention strategies, and the effectiveness of fertility treatments.
Dr M'hamdi acknowledged that the choice of 28 days was an arbitrary one: there is nothing about 28 days, rather than 27 or 29, that makes the limit ethically acceptable. In fact, he said, it was impossible to pinpoint a moment in time beyond which research on embryos would become ethically unacceptable. Earlier in the talk, he had stressed the importance of society accepting whichever limit was imposed; the public would likely not accept the limit jumping from 14 days to, say, 100 days. However, Dr M'hamdi's acknowledgement of the ethical slippery slope left me wondering how far we could push the limit in future.
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