A Prayer

In honor of Easter Week, I decided to do something different for my post this week and share a prayer from the book of Common Prayer:

O God, who for our redemption didst give thine only-begotten Son to the death of the cross, and by his glorious resurrection hast delivered us from the power of our enemy: Grant us so to die daily to sin, that we may evermore live with in him in the joy of his resurrection; through the same thy Son Christ our Lord, who liveth and reigneth with thee and the Holy Spirit, one God, now and for ever. Amen.

As I read and contemplated this prayer, I was reminded of our work as Christian bioethicists and the redemption that God offers to each of us daily. As we encounter individuals going through trials, tragedies, and challenging decisions, may we always remember the redemption that Christ offers and choose to respond to all situations we face in light of the joy of his resurrection.

Reframing Abortion

This morning I read an article in the Washington Post titled “Yes, they do abortions.” The article featured a clinic in the Washington D.C. area that is part of the movement to de-stigmatize abortions. Featuring a “spa-like” setting and blunt advertising (using ads in Metro stations with phrases such as, “Abortion. Yeah, we do that.”) this abortion clinic is trying to reframe the position many have that abortion is a “necessary evil” to make it seem like it is not a big deal, or that it is even a positive experience. The article went on to discuss other people/groups who are part of this movement to de-stigmatize abortion and make it to be a “normal,” or even “moral decision” in a woman’s reproductive life rather than have abortion be considered a “necessary evil.”

As I was reading this article, and learning more about the spread of this movement, I became both deeply concerned and upset. I am concerned about the women who this movement is targeting. Early pro-life feminist Mattie H. Brinkerhoff wrote, “When a man steals to satisfy hunger, we may safely conclude that there is something wrong with society – so when a woman destroys the life of her unborn child, it is an evidence that either by education or circumstances she has been greatly wronged.” I am upset about the callousness and deception taking place. Abortion is not a “normal” part of a woman’s reproductive life and reframing it to be considered a moral choice comparable with bringing a new life into the world is a distortion of truth and morality that is both harmful to women and to society.

An abortion is never a first choice decision. It is a reaction to a situation a woman finds herself in that she didn’t intend. Whether it be an unplanned pregnancy, or a change in a financial or relational situation, the abortion procedure was not part of the original plan (at least not that I’ve ever encountered – I have yet to hear of a situation where a woman became pregnant with the purpose to abort; if these situations do exist that opens up a pandora’s box of additional ethical concerns). Trying to reframe abortion as a first choice scenario, like a day trip to the spa would be, is denying women the opportunity to address the harm that brought them to this point.

I am not writing to condemn women who find themselves in situations where they think an abortion is their best option, but to challenge those of us who believe in the value of life – both mother’s and child’s – to take a stand where we acknowledge that abortion is a failure to women. By acknowledging this, we can act to eliminate situations where abortion is thought to be “needed” or, even worse, considered comparable to a day at the spa.

To read the article that inspired this post click here

A Right to Know?

As humans, we have a desire to know who we are and from where we come. Perhaps our reason for this desire is to learn our history, or to help determine our future. Perhaps we desire this knowledge to understand our current condition – be it a medical condition or simply curiosity. Whether this stems from a desire to better understand one’s own identity or medical conditions, many individuals are denied access to information regarding their parentage and family medical histories due to the circumstances of their birth.

In the United States, there is not a federal standard or law granting individuals a right to access this information, and very few states have laws regarding this either, especially in the context of individuals conceived from assisted reproductive technology (ART). Last week Utah became one of the few states to pass a law allowing individuals conceived through ART to have some access to this information. In the law passed in Utah, individuals were granted the right to access to the medical records of their biological fathers if they (the children) were conceived through sperm donation. Although this law does not open access to information for all situations, it does have important implications for individuals seeking health information, or wanting to have a full background of their family medical history.

This issue of ART is controversial and it often overlaps with issues of marriage, abortion, and embryo creation/destruction, making it treacherous ground for legislators. However, even though it is controversial, thousands of children are born each year from ART (see 2012 CDC report for more information regarding the numbers). Because we don’t have laws in place granting these individuals a “right to know,” in most states, this information on parentage and family medical history is almost entirely unattainable. I hope to see more states follow Utah’s lead and begin to discuss and legislate on the issue of ART, even if it starts with small steps, such as access to medical information.

Please note: I realize that ART includes many different procedures that each have unique ethical considerations. For this post I decided not to delve into the ethical consideration of each of these issues or the specific regulations that would be ideal in each situation.

When Bioethics and Politics Intersect

This morning the Senate voted on an anti-human trafficking bill, The Justice for Victims in Trafficking Act, that would bolster legal protections for children who are victims of human trafficking. Up until this week, the bill had received bi-partisan support and was expected to pass with little opposition. However, this week discussion arose regarding a provision in the bill that referenced the Consolidated Appropriation Act of 2014 (Division H, Section 506, 507) which states that federal funding cannot be used for abortions (with some exceptions listed). What this essentially did was make the Hyde amendment – an act prohibiting federal funding of abortion – applicable to the funds of the anti-trafficking bill which are collected through fines. Upon the recognition that provisions were incorporated into the bill that applied the laws preventing federal funding from being used for abortion, debate emerged and partisan politics and accusations ran rampant.

The purpose of this bill was to offer legal protection to children being horrifically abused. Some things the bill provided for included: increasing funding for law enforcement action against traffickers and solicitors of child victims, providing grants to non-profit organizations, and expanding the definition of trafficking to include child pornography. The bill was defeated with a vote of 55-43 (60 votes were needed to pass) because the bioethical issue of abortion was referenced in this bill. Senators decided that rather than accept a bill that prevented the funding provided for in this bill to be used for abortion, they would reject an entire piece of legislation that would have protected children who are trafficking victims.

I find this situation to be especially heartbreaking – human trafficking is crime that is horrible beyond description. This bill set out to offer protection for the victims of this crime while also trying to prevent the government from funding the injustice of abortion. The purpose of this bill was to protect innocent children from being trafficked and abused; unfortunately the purpose was overshadowed by politics in this situation.  Although not all intersections between politics and bioethics result like this, in the instance at hand the intersection of bioethics and politics resulted in a mess where something good was sacrificed for a political play.

Text of the bill is available here

The Consolidated Appropriations Act of 2014 is available here

Why Bioethics Matter

I recently had a conversation with a mentor and friend, that encouraged me to contemplate on what it means as professional to be engaged in the issues of bioethics. So rather than address a particular issue or news item this week, I decided to share a few of my thoughts on why bioethics matter and why we should engage in these issues.

First, bioethics matter because we are people created in the image of God. Living in a way that recognizes the inherent dignity that results from this truth requires treating everyone with respect, compassion, and as beings of the utmost value.

Second, issues of bioethics affect everyone. We are all born, will need healthcare, and will eventually die. I don’t intend to be morbid, but with each of these major stages, bioethical issues arise. Whether we struggle with infertility, need treatment for disease, or are struggling with losing a loved one, bioethics will touch our lives very personally at some point. Having an understanding of these issues can help when put in a position where you must make a decision that will have an ethical impact in your life, or the lives of those you love.

Third, as an attorney, I am often asked “What does the law say about ____” (you can fill in the blank). With issues of bioethics, there may or not may not be a law addressing a particular bioethical issue, and even where there is, using this as the sole measuring point of whether or not an action should be taken can be problematic. Though the law provides parameters in which we must operate, it does not always equate to what is ethical. It often sets up situations where “just because you can doesn’t mean you should.” Having an understanding of bioethical issues, as a professional, helps answer the question of “What should I do?” instead of just focusing on “What am I allowed I do?”

Finally, bioethics allows us to speak guidance into people’s lives at various life stages, often presented in trying circumstances. It provides us the opportunity to be a point of grace in the life of someone who has reached a point of vulnerability or suffering.

Printing Resources & Prosthetic Hands

When discussing issues of technological development, specifically for use in the field of medicine, one aspect of bioethical consideration includes the determining the allocation of this new resource. In many (not all) situations, the allocation can be driven by cost: those who can afford the resource get it, while those who cannot afford it do not. While this does not completely seem out of line with the market principles many embrace in the United States, it does not always align with the bioethical concern for promoting justice. Often, even in situations where all other bioethical concerns are fully addressed, there is the unresolved issue of cost. So as these medical breakthrough technologies emerge, often we find ourselves in dilemma: do we limit the use of medical innovation to those who can afford it, or, as the principle of justice may lead, do we offer up the new resource to all in need without consideration of the cost (this assuming that the only limitation on the resources availability is prohibitive costs – not a lack of ability to produce more).

In the case of a recent innovation, however, affordability and innovative medical technology are not mutually exclusive. Thanks the technologies of 3D printing, prosthetic hands are now available for children for costs as low and $20-$50 USD. This makes the use of this innovation attainable to many families who would not be able to afford many of the prosthetics currently available, especially for growing children who need to replace the prosthetic more frequently. Although these printed prosthesis may not work for everyone, they have made an expensive medical technology affordable for many people, effectively addressing the bioethical concern for justice in the distribution of medical resources.

For more about 3D printed prosthetic hands, check out this article.

Non-Embryonic Stem Cells and Malaria Treatment

A recent study from MIT (available here) has found that stem cells developed from blood and skin samples can be manufactured into liver like cells. The implications of this are exciting on two different levels: 1) this is another success for ethically derived stem cells; 2) this study is being used to develop treatment for malaria – a disease that has a lifelong impact on those it affects.

The use of stem cells for the development of treatments for various diseases is something frequently researched in the scientific community, and often debated in the bioethics community. Stem cells are valued because of their potential to grow into different types of cells. The debate stems (no pun intended) from the source of the stem cells. Some proponents of stem cell research argue that research should focus on embryonic stem cells – which necessitates the destruction of a human being at the embryonic stage to harvest the stem cells. This is not a method that is consistent with recognizing the dignity of every individual human being, as it requires the destruction of a human in its earliest stages to potentially benefit people in later developmental stages. However, other proponents of stem cell research believe that the research should only use non-embryonic stem cells. These stem cells can be manufactured from donated skin or blood cells, or even obtained from the umbilical cord after a baby is born. Proponents of non-embryonic stem cell use focus on its ethical origins – no embryos are destroyed – as well as the potential of personalized application in medicine (your body is less likely to reject treatment developed from your own cells).

In the study referenced above, the liver like stem cells are created using non-embryonic, adult blood and skin cells. Once the cells have grown, they are infected with malaria for the purpose of testing new treatment options for the disease. This research exemplifies a discovery respectful of human dignity in its development, as well as it purpose.  Malaria is  a disease that plagues approximately 198 million people (as of 2013 – see here), and seeking treatment for this disease is another way to respect the dignity of those suffering from it.  As we fund, support, develop, or conduct research, it is important that human dignity be respected and valued in both the methods and purpose of the research.  How encouraging it is to be reminded of the successful stories in scientific advancement that are not at the expense of human dignity!

For more on stem cells go here

For an article discussing the MIT study read this

Three-Parent IVF

The ways to make a baby have been expanded once again. While the ways to bring a baby into this world can be the source of much bioethical debate, it was generally accepted that two people would be part of the process. After a recent decision in the British House of Commons, this given has changed – three parent in vitro fertilization (IVF) has been approved.

The way three-parent IVF works (in a very simplified explanation) is the nucleus from an egg with defective mitochondria would replace the nucleus of an egg with healthy mitochondria (see here).  This means that embryos developed from this process would have two mothers and a father. This process, referred to as “mitochondrial transfer” by supporters, has been banned in every country except the United Kingdom at this point based on the germline alteration that occurs during the process (see here). However, this process has been proposed for research approval in the United States, as well (see here).

This procedure of three-parent IVF raises a myriad of bioethical concerns. Rather than address all of the potential ethical concerns created by this technique in one blog post, today I’m going to focus on ethical concerns for the child created through this process.

First, although we live in a time when family seems to have a fluid definition, we do not have children with three biological parents. This raises the need for ethical consideration of the social situation we are creating for children through this process. How will parental rights be determined? Would this be treated as a contractual agreement or a family law determination? How would custody be determined should something go awry and the relationship (be it contractual or familial) between the three parents changes? Although we could look to situations where a child was conceived through egg donation to get an idea of the answers, this is truly a field without any precedent. Second, three-parent IVF raises ethical concerns regarding potential health risks that could be manufactured through this process. Because this is new process, the children created through it are potentially at risk for health consequences that cannot be known or predicted. I cannot help but think of the situation with Dolly the sheep being cloned and suffering from many health consequences that were unforeseeable at her creation using the (then) new process of cloning. We cannot predict the future, and it is the children without a say in the matter whose future we are gambling with. Finally, there is concern about the application of the three-parent technique. At this point, the three-parent IVF technique is only being promoted to help treat infertility in older women and for treating mitochondrial disease. There is a strong concern, however, that once it is approved for these processes it will subsequently be approved for manipulation of genetic material for other reasons that may not be therapeutic in nature.


The Power of a Commercial

I don’t know about all of you, but one of my primary reasons for watching the Super Bowl each year is for the commercials. They often are silly and extravagant, but also can be creative, entertaining, and even impactful. This week I was extremely encouraged to hear of a positive impact that a super bowl commercial made a few years back. Five years ago Focus on the Family aired a commercial featuring Pam Tebow, Tim Tebow’s mother (the 2007 Heisman winning quarterback) sharing the life affirming story of her “miracle baby,” Tim. Watching the commercial was Susan, a young woman who had just found out she was pregnant and was planning on having an abortion. The commercial impacted Susan so profoundly that after watching it and contemplating it afterwards, she decided to continue the pregnancy and keep her daughter. Now her daughter is four years old and one of the greatest sources of joy in her mother’s life. This little girl was given a chance at life that began with a Super Bowl commercial. How incredible and beautiful is this example of the impact something as small as a commercial can have?!

This year many of the commercials had a heavy tone, but powerful messages were shared, as well. For example, the Proctor and Gamble commercial calling for the reclaiming of the phrase “like a girl” sends the message that being a girl or woman is something powerful and good. This commercial demonstrated “like a girl” should not be used as an insult, but should mean giving it your all, recognizing the inherent value of girls and women that should not be forgotten. Dove also put out a commercial emphasizing how important it is for fathers to be in their kids’ lives. This demonstrated the importance of fatherhood and how being there for your children matters. I hope that, like the commercial featuring Pam Tebow, these commercials inspire positive changes, and even lead to future decisions that have a powerful bioethical impact.
For more on Susan’s story check out this link