Jack Kevorkian shocked consciences and turned stomachs a few years ago when he advocated using assisted-suicide victims as subjects of medical experimentation, a process he planned to call “obitiatry.” Even though Kevorkian is now in prison in Michigan, it appears that his idea of medically experimenting on the bodies of dying people is gaining adherents in the bioethics and medical research communities. Indeed, if a story in the January 19 Pittsburgh Gazette is true, it appears that such research is already being conducted.
Gazette science editor Byron Spice’s story primarily concerned the recent use by medical researchers of the bodies of persons who had been declared “brain dead.” Many may be shocked at the idea, but assuming a proper diagnosis, a “brain dead” person is as dead as someone whose heart and lungs have permanently ceased functioning. However, unlike other cadavers, the body of a person declared dead by neurological criteria — meaning the whole brain and each of its constituent parts have permanently ceased all brain function — is kept functioning temporarily, usually to permit time to procure organs for transplantation. Since these are the bodies of the dead and not the living, assuming proper regulation, it would seem this research would be as appropriate as that using other corpses.
The real bombshell in Spice’s story concerned the potential that catastrophically ill or injured people are also being used in research, the “very sick people whose life support or drug therapy is about to be withdrawn.” Indeed, according to Spice, the bodies of “nearly dead patients” have already been used in researching a new cancer drug. But nearly dead isn’t dead. Someone who is very sick, whose life support is about to be withdrawn, isn’t dead — he’s living.
To understand the full import of this story we need to connect some important dots by considering the context in which it arises. Unbeknownst to many, the sanctity-of-human-life ethic is under sustained attack. Indeed, the predominant view of contemporary bioethics rejects the view that life is sacrosanct simply and merely because it is human. Rather, what matters morally is whether a life — be it animal, human, space alien, or machine — is a “person,” a status that must be earned by possessing relevant cognitive capacities.
This subjective view of life — as opposed to the objective approach contained in the sanctity-of-life ethic — strips some humans of their moral equality and threatens to transform them into the moral equivalent of a lab animal or a natural resource. This was the very point made by Georgetown University bioethicist Tom L. Beauchamp in the December 1999 Kennedy Institute of Ethics Journal, one of the most influential bioethics publications in the world. Since “many humans lack properties of personhood or are less than full persons,” Beauchamp wrote, they are “equal or inferior in moral standing” to some animals. As a consequence, such “unlucky humans” might be available for use in the same ways as are “relevantly similar nonhumans. For example, they might be aggressively used as human research subjects and sources of organs.”
In a similar vein, philosopher and bioethicist R. G. Frey, of Bowling Green University, has explicitly asserted that, for humans as well as animals, the “value of life is a function of its quality.” This the so-called quality-of-life ethic leads to very dark conclusions. “Because some human lives fare drastically below the quality of life of normal (adult) human life,” Frey writes, “we must face the prospect that the lives of some perfectly healthy animals have a higher quality and greater value than the lives of some humans. And we must face this prospect, with all the implications it may have for the use of these unfortunate humans by others” including “the use of defective humans in [medical] research.”
This kind of thinking is even more common in the organ-transplant community. In order to increase the number of vital organs available for transplantation, some bioethicists and transplant professionals want to redefine death to include a diagnosis of permanent coma or unconsciousness. If that were done, the thousands of people in comas at any given time could have their organs procured. Pending such a redefinition, some have suggested that non-vital tissues and organs be procured, such as corneas and single kidneys.
Meanwhile, Norman Fost, director of the Program in Medical Ethics at the University of Wisconsin at Madison, has opined that we should be able to take vital organs from the living, even if doing so would kill them: “My contention is that that there is ample precedent in the law and good moral justification for removing [vital] organs from persons who are not legally dead,” Fost wrote. Such procurement would not be limited to the unconscious — it could also include conscious people who are terminally ill, whose organ harvesting before dying would be considered “part of their terminal care.”
These same attitudes drive much of the thinking of bioethicists and medical researchers in the embryonic-stem-cell and human-cloning debates. Since embryos are not sentient, the thinking goes, the fact that they are human is not morally relevant. Indeed, it is their very membership in the human species that makes them so attractive for use in medical research and as a source of what could be a very profitable commodity: human embryonic stem cells.
The desire to harvest embryonic stem cells has led bioethicists, patient groups, ill and disabled movie stars, and politicians to seek the legalization of human cloning for biomedical research. At present, most of these cloning advocates would require all human clones to be destroyed while still in the embryonic stage of development. But this seems primarily a political expedient rather than a never-to-be-violated moral boundary. Indeed, to the applause of the biomedical research community and cloning advocates, the New Jersey state senate recently passed S. 1909, a radical human-cloning-for-biomedical-research legalization bill.
Tellingly, S. 1909 would not prohibit the implantation of cloned embryos into women’s wombs. It would not outlaw their gestation into fetuses. In fact, it only requires human clones to be killed before they reach the “newborn” stage of life, meaning that New Jersey is, quite literally, on the verge of permitting the creation of — and experimentation upon — cloned human babies through the ninth month of pregnancy.
Throughout life’s spectrum — from the beginning to the end — the value of human life is increasingly being measured through a distorting, utilitarian prism. This is happening a little bit here, and a little bit there, by small steps. But just as a roaring river is created by the coming together of many streams, our current piecemeal deconstruction of the sanctity-of-life ethic is leading toward an explicit hierarchy of human life that would permit some to be exploited and destroyed for the benefit of others deemed to have superior moral worth. Seen in this light, research on the near-dead as if they were already corpses is but one short chapter in a much longer book.