Monday, March 7
Last week I watched the President's Council on Bioethics discuss an idea to solve the stem cell debate. The idea was to tweak a gene in the cloning process so that the resulting "biological artifact" would grow human stem cells without developing the structure of an embryo. Charles Krauthammer called the idea troubling. Robert George said if the product wasn't an embryo, it was OK. Michael Sandel said it was creepy. Peter Lawler said the key was to avoid destroying embryos. Leon Kass, the council's chairman, said it might seem acceptable to some people but dubious to others. Afterward, I asked some council aides what they thought. At their previous meeting, council members Mary Ann Glendon and Alfonso Gomez-Lobo had all but endorsed the proposal. With a couple of exceptions, the reactions fell into two camps. Catholics leaned one way, Jews the other.
Don't get me wrong. The Catholics had caveats, and the Jews had ambiguities. But caveats and ambiguities are different things. The Catholics were clear about what was moral and what wasn't. The Jews were fuzzy. The best part of the show was George's cross-examination of Krauthammer on the definitions of "creature" and "human." It was like Socrates trying to carve up a bowl of chicken soup. Periodically, Kass waded into the fray to say on the one hand this, on the other hand that. The original ban on funding of destructive embryo research "wasn't written at Sinai," he joked. "And even the things that were written at Sinai are"—he groped for a rabbinical exit—"under review."
I thought about that conversation as I flew to this week's bioethics conference at the Regina Apostolorum Pontifical University in Rome. That's pontifical, as in pope. I was invited to speak by Eric Cohen of the Ethics and Public Policy Center; the deal was that EPPC would cover my expenses but wouldn't pay me. I learned later that the conference sponsors include the Culture of Life Foundation, the Federalist Society, and the Catholic Family and Human Rights Institute. The conference has a secular title, but let's be real. One of every three people here is a priest. The Washington representative of the U.S. Conference of Catholic Bishops is here. So is President Bush's coordinator for Catholic issues. We're here to talk about the Catholic position on human biotechnology.
To give the event an ecumenical feel, Cohen kicks off the day with an overview. Cohen is a Kass protégé. He's young, lanky, and solemn with glasses and a square-jawed black beard. He sometimes fills in for Kass as a speaker—"the backup Leon," he jokes—but in this case, he's filling in for Yuval Levin, the executive director of the president's council. Cohen's speech touches all the Jewish bases: Abraham, Sarah, Isaac, Moses, modesty, shame, fear of death, understanding our past, perpetuating our lineage, and the inexplicability of bad things happening to good people. The equality of human beings can't be proved by reason, he says. It's more like a commandment.
The first presenters, a couple of scientists, summarize the state of stem cell research. When they're done, a soft-spoken young priest in the front row raises his hand. "In a case of aneuploidy, it may be possible to laser ablate one or two of the blastomeres," he says. A priest in the back row asks about "aberrant silencing of the IGF and IGF2 receptor." I can hardly believe what I'm hearing. Afterward, I ask the first priest, Father Tad Pacholczyk, where he learned this stuff. Turns out he's got a Ph.D. in neuroscience from Yale, plus a research stint at Harvard Medical School and undergraduate degrees in biochemistry and molecular biology. Around the room, half the guys in collars are scientists. A couple of weeks ago, there was a conference here on the concept of brain death, which the Vatican is reconsidering in light of new findings.
This is the gauntlet that awaits the conference's two main presenters. One is a team of medical experts from Columbia University, Drs. Don Landry and Howard Zucker. Their plan is to define embryonic death as "the irreversible arrest of cell division," so that cells can be harvested at that point—without destroying a living embryo—to make stem cell lines. The other plan, by Bill Hurlbut, a member of the president's council, is the one that would create "artifacts." Landry, Zucker, and Hurlbut have come here to sell their proposals to the church in the hope that the church, in turn, will help sell these proposals to politicians and the public. Hurlbut has been running his ideas by Pacholczyk and other priests all along. The science and the religion are interwoven. Landry has the lingo down: intrinsic, person, human dignity. When a priest compares embryonic cell harvesting to fetal tissue harvesting, Landry replies, "In abortion, the objective is death." Hurlbut says legalized abortion has become a "travesty" and is "not altogether unfairly called the silent holocaust."
Hurlbut gets an A for effort, but the priests conclude that his science needs work. His plan is to test his idea on mice before trying it on humans. Father Nicanor Austriaco, a white-robed Dominican brother with a doctorate in biology from MIT, uses PowerPoint to demonstrate that the gene Hurlbut wants to delete in mice * doesn't affect the embryo until at least the eight-cell stage. This means Hurlbut's "artifact" would develop just like an embryo until then, which in humans would raise theological problems. Austriaco cites lab data indicating that the embryonic axis begins to form at the two-cell stage. Therefore, the only moral approach is to delete a gene that enables differentiation at the first cell division.
Cohen follows with a more nuanced critique. He worries about "the meaning of limited development," "creating beings that are deliberately less than human," and whether this might "deform our understanding" of our relationship to others. He questions the instrumental laboratory use of eggs and sperm, which "have a kind of meaning" as seeds of the next generation, even if they aren't embryos. He finds Hurlbut's artifacts creepy because cloned entities "want to develop," even if they can't. The priests scratch their heads. What does wanting have to do with it? Either the thing can grow into a baby, or it can't. If it can, it's sacred. If it can't, all this fuzzy stuff about limited development and deformed understanding and kinds of meaning doesn't add up to a basis for withholding stem cells that might save people's lives.
The guy who seems most impressed by Cohen's talk is Zucker. On the bus back to our hotel, I ask what he thinks of the afternoon's presentations. He picks up on Cohen's point about a human-derived entity that wants to develop but can't because of scientific manipulation. Zucker says there are lots of troubling ways we could start doing this in utero. Of the three people pitching alternative stem-cell proposals to the priests, Zucker is the only one who hasn't taken a whack at abortion. He's also the only Jew.
Monday night at dinner, I ask Austriaco if he sees a Catholic-Jewish difference on these questions. He does, particularly among theologians. Jews follow diffuse commentary, he says; Catholics follow streamlined authority. Jews trust intuition; Catholics trust reason. "You don't have as clear a definition of boundaries as we have," he observes. This is why Catholics have an easier time getting over the yuck factor. "We say, 'Yeah, it looks yucky.' But I'm a molecular biologist. We make tumors in the lab all the time. For a Catholic, if I can articulate what I'm doing, it's not yucky."
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Tuesday, March 8
It turns out that Catholic faith in reason cuts both ways. It can dispel the yuck factor but can just as easily override our sense of goodness. That's the inadvertent lesson of Pacholczyk's morning presentation on women who "adopt"—i.e., implant and carry to term—IVF embryos. He asserts that such adoptions are intrinsically evil. I stare at him in disbelief, but he makes a case. Procreation is unitary; therefore, just as it's wrong to have sex without openness to pregnancy, it's wrong to get pregnant without sex. What if a woman has hired a clinic to cultivate IVF embryos and is on the table ready to have them implanted? Pacholczyk says she should "stop the train of evil"—get up and leave the clinic. The embryos must be left in limbo because they can't be "licitly" implanted.
Father Thomas Williams, the dean of university's theology school, makes the opposite case. Pacholczyk's theory collapses, he says, because it implies that IVF embryos are "partially procreated children." "All beings are either persons or non-persons," Williams argues. "From a Catholic perspective, there's no such thing as partial persons, part something and part someone." It's an incisive critique, but I'm struck by its tone. I look at Williams' written speech, then at Cohen's. Each is 13 pages. I count the question marks. Williams has seven. Cohen has 21. Pacholczyk actually quoted one of Cohen's essays in his talk. He misattributed the quote to Levin, maybe because Cohen and Levin write in the same language. The quote ended with two questions.
It isn't that the Catholics are incurious; they're insatiable. Over evening cocktails, Austriaco says he's been online today looking at hydatidiform moles—eggs that have been fertilized by two sperm, or by one sperm after losing the egg nucleus. He's discovered cases of fraternal twins in which one becomes a fetus and the other a mole. He recalls the Dec. 3 meeting of the president's council, at which Hurlbut outlined the artifact idea. That's where I learned about cdx2, the gene Hurlbut wants to tweak. Austriaco was there, too—he wanted to see whether Hurlbut would be questioned about cdx2. Why? "I knew the Catholic theologians had problems with cdx2," he says. They had already hashed out the genetics.
At dinner, Austin Ruse, the guy who runs the two Catholic lay organizations sponsoring the conference, quizzes me on my politics. We disagree on nearly everything, but I can't help liking him. He admits with a devilish grin that his real ambition is to bring people into the church. He's been working on the guy next to me for years. Ruse's friend, Father John McCloskey, has reeled in some big ones: Robert Bork, Larry Kudlow, Bernard Nathanson, Bob Novak, and Mark Belnick, the super-lawyer who got nailed in the Tyco scandal. Hadley Arkes has all but joined the club. I do the math: five Jews and an agnostic. What did they do it for? Maybe for what Judaism can't promise: answers.
Back at the hotel, I run into Cohen. We make a breakfast plan. He suggests 7:30. I mull it over. He offers 7:00. I agonize. He shrugs. "7:15," he says, and we're done. In the morning, we head for the buffet. I cover half my plate with prosciutto before realizing he keeps kosher. I atone by covering the other half with lox. I ask him how he got interested in bioethics. "In another age, I probably would have been a rabbi," he sighs. He used to work for Kass at the president's council. Now he's a consultant there. That's where he met Levin, who knows the Bible inside out. The three of them share a basic outlook. They've worked together on the council's reports.
As Cohen tells it, Kass has been misunderstood. Kass is agnostic on the moral status of the embryo. His greater concern is what kind of society we'll become if we treat humanity as something to manipulate. He worries about what we create, not just what we destroy. Above all, he worries about new threats to the family. Kass has written a whole volume on the book of Genesis. It's about Sarah, Abraham, Isaac, and the challenge of passing on a moral way of living. Family, not individual life extension, is our true immortality. Cohen says Levin has written a wonderful essay on this point.
I'd mentioned the Catholic-Jewish question to Cohen the previous evening. He's been mulling it over. "Christians have a lot more theological confidence than Jews," he says. "The Jews will raise 36 questions about something. The Catholics will raise the deepest questions and then presume to offer a rational account of things." He laughs. "It's not a confidence I share." He admires Catholics for their faith in reason—"the faith required to live with the consequences of their conclusions," even when intuition screams the other way. "You have to have a ridiculous faith in reason to let your child die rather than use an embryo to save them," he says, staring at the table.
That night, Ruse invites me to dinner with a monsignor from the Congregation for the Doctrine of the Faith. This is the same body, according to the Vatican's web site, that "was originally called the Sacred Congregation of the Universal Inquisition" and still stands guard against "new and unacceptable doctrines." You might remember its encounter with Galileo. But times have changed. "Meet Charlie Brown," Ruse tells me as the boyish monsignor shakes my hand. Over dinner, Msgr. Brown explains how the church has worked through the question of transgendered applicants for the priesthood. The church defines gender chromosomally—not by your feelings, but by your genes. If you're chromosomally male, you can't be a nun. The church will deal with Hurlbut's artifacts the same way: Either they have the requisite genes to be embryos, or they don't. Science rules.
The dessert arrives, and Ruse asks me mischievously, "Do you know how many angels can dance on the head of a pin?" I stare at him blankly. "This is the great thing about the Catholic church," he says with a smile. "There is an answer." And then he reveals it: All of them.
Correction, March 15: The article initially implied that cdx2 was the gene Hurlbut would delete in humans. Cdx2 is the gene he proposes to delete in preliminary mouse experiments. If those experiments work, he would then try to identify and delete an equivalent gene in humans. (Return to the corrected sentence.)