The Ethics of Medical Research
"Paul looked intently at the Sanhedrin and said, "My brothers, I have conducted myself with a perfectly clear conscience before God to this day."" Acts 23:1
In recent decades the medical field has made great strides. As Catholics, we advocate for medical research to find treatments for all the diseases and injuries that afflict humans. However, the end (saving lives) does not justify any means. The possibility of curing a disease or healing an injury does not justify any means to medical research.
All medical research must respect the dignity of life. This necessity of respect begins at conception and continues until death and even after death. Let's begin at the end. The Church recognizes the value of medical research on the body after a person has died for the diagnosis and treatment of diseases and injuries in the future. The Church is firm that the body, even though deceased, still deserves to be treated with respect. As the researchers handle the body it must be treated with respect. When the research is completed, the remaining body parts should receive a proper burial.
A related topic is the issue of organ donation. The Church firmly believes in organ donation. The Ethical and Religious Directives for Catholic Health Care, Fifth Edition (USCCB, 2009) states in paragraph 63
"Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death."
The Church simply asks that it be done in a value to respect the body of the deceased. When death is known to be imminent, preparations may be made but the moment of death must not be hastened to obtain the organs and the organs should not be taken before the moment of death.
Returning to the question of medical research we turn to the question of experimentation vs. medical research. No matter the condition of the ill person, their body and life must always be treated with respect and dignity. They should never be treated as "guinea pigs." Even when there is no hope of recovering, one cannot just take a "trial and error" approach. The medical researcher needs to ask the question of how it will affect the ill person. It should not be seen as an opportunity to try a new and unknown treatment just to see what effect it has.
In 1987, The Congregation for Doctrine of the Faith wrote on the questions of medical research in "Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day", which has become known as Donum Vitae (The Gift of Life). In question 4 they write
"* Since the terms "research" and "experimentation" are often used equivalently and ambiguously, it is deemed necessary to specify the exact meaning given them in this document.
1) By research is meant any inductive-deductive process which aims at promoting the systematic observation of a given phenomenon in the human field or at verifying a hypothesis arising from previous observations.
2) By experimentation is meant any research in which the human being (in the various stages of his existence: embryo, foetus, child or adult) represents the object through which or upon which one intends to verify the effect, at present unknown or not sufficiently known, of a given treatment (e.g. pharmacological, teratogenic, surgical, etc.). "
In the movie, Star Trek IV: The Voyage Home it is said "Just because we can do a thing does not mean we should do a thing." The human body is not just a machine. It is part of a person to be treated with dignity and respect. Medical research needs to understand this.
The question of the ethics of medical research also surfaces at the beginning of life. Perhaps the most well-known area of discussion here is stem-cell research. Researchers argue that many people will one day be cured from research on embryos. The problem is that the embryos are destroyed in the course of the research. When an embryo is destroyed a life is destroyed. Life is precious. Life is a gift that must be respected. That embryo is a unique individual with all the genetic material of a unique individual that will never be conceived again.
Often the researchers respond with the statement (first refuting the embryo is life) that even recognizing that embryos are destroyed that one day many more lives will be saved if the cures they are searching for are found. First, note the "if." There is no guarantee of a cure. More importantly, their response attempts to play a numbers game. Their position would seem to be if we just save more lives than we kill it is ok.
In question two of Donum Vitae, the Congregation for the Doctrine of the Faith writes
"Science and technology are valuable resources for man when placed at his service and when they promote his integral development for the benefit of all; but they cannot of themselves show the meaning of existence and of human progress. Being ordered to man, who initiates and develops them, they draw from the person and his moral values the indication of their purpose and the awareness of their limits.
It would on the one hand be illusory to claim that scientific research and its applications are morally neutral; on the other hand one cannot derive criteria for guidance from mere technical efficiency, from research's possible usefulness to some at the expense of others, or, worse still, from prevailing ideologies. Thus science and technology require, for their own intrinsic meaning, an unconditional respect for the fundamental criteria of the moral law: that is to say, they must be at the service of the human person."
All life is precious, whether it be one life or thousands. Life must be respected. Saving many lives does not justify ending one. Otherwise, one could argue that some people should "donate their lives" for research so that one day many more people might be saved.
There is also the question of genetic research on embryos such as that to cure genetic diseases is morally permissible as long as life is not destroyed. The goal is to cure. However, there is a caution to be heard here. The goal is always to cure. Genetic engineering to obtain the perfect baby is not. Again, life is a gift. To seek a genetically engineering baby that might have a specific IQ, hair color, eye color, or any other physical qualities (except good health) completely misses the point of recognizing life as a gift. Genetic engineering says life is good only with very specific qualities.
These are just a few of the issues of faith and ethics in medical research. If you are involved in medical research I encourage you to read the documents listed below.
Bibliography
Congregation for Doctrine of the Faith, Donum Vitae Instruction on Respect for Human Life in Its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day, 1987. Available online at http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19870222_respect-for-human-life_en.html. Access date March 29, 2009.
Congregation for the Doctrine of the Faith, Instruction Dignitas Personae, On Certain Medical Questions. 2008. Available online at http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html. Access date March 29, 2009.
United States Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care, Fifth Edition. 2009. Available online at http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf. Access date August 28, 2011.
"Paul looked intently at the Sanhedrin and said, "My brothers, I have conducted myself with a perfectly clear conscience before God to this day."" Acts 23:1