Imagine you are the owner of a real estate firm. You rent out all kinds of buildings for different purposes, and you don’t have any personal ties to the buildings. It’s just business. Then one day a private company rents out one of your larger buildings and decides to use it as an orphanage. They receive some support from donors, and some support from the government. None of that matters to you, because your job is to make sure the pipes work and the roof is repaired, and you contract out for property management anyway, so you personally never have to go out to the buildings.
One day, the director of the orphanage approaches you with a proposal. The director has a team of scientists who are proposing to use some of the orphans for the Greater Good of humanity. Their reasoning is that these children are orphans, and some of them will never be adopted. Even if they were to be adopted, the orphanage has had some issues with bad placements, and some of their kids have wound up in abusive families. So the scientists and the director have decided they want to use some of these kids for medical and scientific advancements. First, they would take some samples from the kids, maybe a little blood, maybe some skin cells. If that goes well, they hope one day to be able to grow organs and help cure all kinds of diseases based on this research, and all of this at a very minimal cost to the orphans.
You think about it for a while—it is your building, after all—and then you decide it’s fine. It might be a little unfair to the orphans, since they don’t have anyone to represent their own rights, but they’ll probably be fine, and they’d be contributing to life-saving research and to the Greater Good.
A little while later, the director approaches you again. Things have been going well, and the kids are mostly cooperating. No one in the community has noticed, because none of the procedures has been anywhere close to dangerous. But there’s a problem: it turns out they haven’t figured out how to turn a skin cell into a kidney in the lab yet. And people are still getting sick in the real world. So the director wants to know whether you’re okay with them expanding their facilities and streamlining a process for small surgeries and procedures. Maybe they could start taking a kidney here or there, maybe some bone marrow. These would certainly save other people’s lives. Any small amount would help. And in the meantime, the director assures you that the scientists will keep trying to use the minimal means necessary and to try to maximize lives saved.
You’re somewhat troubled, but the director assures you they would only take non-essential organs, and they would be very careful to minimize procedures and to use as few orphans as possible. And think of how many lives could be saved this way! Besides, they would focus on orphans with no chance of being adopted. These kids would otherwise be headed for trouble, but instead will be used for the Greater Good. Somewhat apprehensively, you agree. You tell yourself it’s for the Greater Good, and anyway you’re just a real estate agent, so you’re not really involved.
Some time passes by, and you start to receive thank-you notes from families whose children have been saved because of organ transplants. The media pick up the story, and public opinion is split—some people are grateful and think this is a wonderful idea, other people are horrified and think this is unethical. In the meantime, in your own life, you’ve just gotten married and are expecting your first kid. You find out that your kid has a heart disease and will soon need a transplant.
The director of the orphanage comes back to you at this point, having heard the news about your baby. The scientists have an offer for you: why not take the heart of one of the orphans? Your baby is wanted. Your relationship is stable. Your finances are stable. You have a strong support network. The orphan, by contrast, has no chance of adoption, and is also the child of a criminal who is now behind bars. No one knows this orphan, and in fact the orphan’s mother never told anyone she was pregnant, so very few people even know this orphan exists.
You’re now torn. You love your baby, and you want your child to be disease-free. You’ve never met this orphan, or any orphans for that matter, and the director assures you that you would never have to see the inside of the orphanage or see any faces of orphans.
On the other hand, you’re starting to wonder if you should’ve just said no to the orphan experiments from the beginning. It seemed okay to use non-essential parts, and it was really tempting in light of how many potential lives could be saved. But as time has gone on, there haven’t proven to be as many benefits as were initially advertised. Moreover, based on how eager the director was to offer you a replacement heart, you’re starting to get suspicious that the orphanage has already tried this type of procedure before.
The other question that’s troubling you is whether this is the best solution to ongoing problems. What is the long-term plan? If you take an orphan’s heart to save your own baby, the orphan dies, but your baby lives. At some point, inevitably, other parents will find out about this transplant option. If you’re willing to do it for your kids, chances are other parents will be equally desperate to save their children too. And then what happens? Do you expand the orphanage and start collecting orphans for this type of purpose? Is that a sustainable solution? What happened to trying to find a scientific breakthrough at the minimal cost to other human beings? Where is the Greater Good?
You debate these questions for a few days and ultimately decide you cannot take another child’s heart, even to save your own firstborn. In fact, you tell the orphanage director that you’ve changed your mind about the whole situation. You realized that all of the orphans are in fact human children, and no one is protecting their best interests. You’ve started digging into the orphanage records and you realize that countless children have been dismembered and used in all kinds of ways, and you don’t want to be facilitating that any more. You ask the orphanage director to find a different building to rent, or even better, to stop violating orphan rights altogether.
At this point, the director is incensed. What about all of the people who have benefitted? What about the new insights we have gained from being able to study the different parts of these orphans? What about all the potential to understand the complete development of the human being? These are unique opportunities, and no one wants these orphans anyway. They’re nameless, faceless, untraceable. Most of the time, you can make yourself forget they were ever human persons, because you can take them apart limb by limb, cell by cell. The orphans are completely powerless and completely under the control of the orphanage. The campaign for the Greater Good has convinced a lot of people that the orphans aren’t yet persons; they’re just resources that would otherwise be going to waste.
You decide to evict the orphanage from your property. You realize this will not solve the orphanage problem entirely, because the director can just relocate to another site. You hope that other real estate agents will refuse to rent out space to the orphanage, and maybe that will be enough to slow down the system. You even reach out to some of the other realtors you know, imploring them to refuse to facilitate this operation. Some of them agree with you, others don’t. By now, the orphanage director has gone public with all of the benefits of orphan research. People are confused. It all sounds so promising for the people who stand to benefit.
But what about the orphans?
The Reality of Embryo-Destructive Research
As you may have guessed, the allegory above is meant to illustrate the reality of embryo-destructive research (EDR). In the contentious debate surrounding this issue, some people, like the directors of the orphanage, are active proponents of EDR. They often call upon noble-sounding ideas. They promise to reduce suffering, cure and prevent diseases, and provide large-scale benefits at minimal costs.
Another group of people, like the scientists and orphanage employees, are motivated to pursue EDR not so much by these noble slogans as by intellectual curiosity. They are often able to avoid debates because they are largely shielded from direct public interaction. Moreover, the majority of these people are not the ones actively retrieving embryos. A few may be involved in acquisition of embryos and fetal tissue from either IVF embryo banks or abortion facilities because of their technical expertise, but more likely they simply purchase embryos or embryonic stem cell lines via the internet or third parties.
Others, exemplified by the real estate agent, may not have any strong feelings about EDR. Their work generally does not intersect with any of these contentious issues, and often they can be motivated to accept EDR because of the advertised benefits of this line of research, particularly if they themselves do not need to participate directly in any way. They may not realize their indirect participation in EDR, although occasionally they may be confronted with the reality that their passive acceptance paves the way to broader social endorsement.
Though they are missing in the allegory above, in reality parents play a more active role in consigning their children to scientific research by donating or selling their embryos. They may be motivated by a desire to justify an IVF or abortion procedure by contributing to scientific advancements, or they may view embryos as “products of conception” rather than as living human beings. Like the orphans, these vulnerable embryos contain all the same root capacities for mature human life. Yet because they are not able to consent or protest, they are often disregarded or assigned a status lower than that of an extrauterine person.
Most of the people responsible for allowing EDR to continue are those who consider themselves one or more steps removed from the actual issue. Although they are not the ones physically destroying embryos, it is precisely through the bystander mentality exemplified by the real estate agent, government, private donors, and others described above that these embryos continue to be exploited and destroyed. And as long as the bystanders refrain from voicing dissent, this destruction will continue to masquerade as a practical, commonplace business, rather than the social cancer it truly is.
Ana Maria Dumitru is a sixth-year MD-PhD candidate at Dartmouth’s Geisel School of Medicine.