Arguing by analogy in the fetal tissue debate

Bioethics

Volumn 11, Issue 5, 1997, Pages 397-412

  Gillam, Lynn ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ANALYTICAL APPROACH; ARTICLE; ATTITUDE; CADAVER; COMPLICITY; DONOR; ETHICAL THEORY; ETHICS; FETAL TISSUE TRANSPLANTATION; FETUS; FETUS DEATH; GENETICS AND REPRODUCTION; GOVERNMENT REGULATION; HEALTH CARE AND PUBLIC HEALTH; HOMICIDE; HUMAN; INDUCED ABORTION; MORALITY; MOTIVATION; PHYSICIAN; POLICY; PREGNANCY; PREGNANT WOMAN; PRISONER; SOCIAL CHANGE; SOCIAL CONTROL; TISSUE TRANSPLANTATION; TRANSPLANTATION;

ANALYTICAL APPROACH; GENETICS AND REPRODUCTION; HEALTH CARE AND PUBLIC HEALTH;

ABORTED FETUS; ABORTION, INDUCED; ADULT; ATTITUDE; CADAVER; COMPLICITY; ETHICAL ANALYSIS; ETHICAL THEORY; ETHICS; FETAL TISSUE TRANSPLANTATION; FETUS; GOVERNMENT REGULATION; HOMICIDE; HUMANS; MORALS; MOTIVATION; PHYSICIANS; PREGNANCY; PREGNANT WOMEN; PRISONERS; PUBLIC POLICY; SOCIAL CHANGE; SOCIAL CONTROL, FORMAL; TISSUE AND ORGAN PROCUREMENT; TISSUE DONORS; TISSUE TRANSPLANTATION;

EID: 0347173656     PISSN: 02699702     EISSN: None     Source Type: Journal    
DOI: 10.1111/1467-8519.00080     Document Type: Article

References (21)

1. Examples include Robert C. Cefalo and H. Tristram Engelhardt, 'The Use of Fetal and Anencephalic Tissue for Transplantation', Journal of Medicine and Philosophy 1989; 14: 25-43; D. Gareth Jones, 'Fetal Neural Transplantation: Placing the Ethical Debate within the Context of Society's Use of Human Material', Bioethics 1991; 5(1):23-43; and Carson Strong, 'Fetal Tissue Transplantation: Can it be Morally Insulated from Abortion?', Journal of Medical Ethics 1991; 17:70-76.
2. Examples include Robert C. Cefalo and H. Tristram Engelhardt, 'The Use of Fetal and Anencephalic Tissue for Transplantation', Journal of Medicine and Philosophy 1989; 14: 25-43; D. Gareth Jones, 'Fetal Neural Transplantation: Placing the Ethical Debate within the Context of Society's Use of Human Material', Bioethics 1991; 5(1):23-43; and Carson Strong, 'Fetal Tissue Transplantation: Can it be Morally Insulated from Abortion?', Journal of Medical Ethics 1991; 17:70-76.
3. Examples include Robert C. Cefalo and H. Tristram Engelhardt, 'The Use of Fetal and Anencephalic Tissue for Transplantation', Journal of Medicine and Philosophy 1989; 14: 25-43; D. Gareth Jones, 'Fetal Neural Transplantation: Placing the Ethical Debate within the Context of Society's Use of Human Material', Bioethics 1991; 5(1):23-43; and Carson Strong, 'Fetal Tissue Transplantation: Can it be Morally Insulated from Abortion?', Journal of Medical Ethics 1991; 17:70-76.
4. James T. Burtchaell, 'University Policy on Experimental Use of Aborted Fetal Tissue', IRB: A Review of Human Subjects Research 1988; 10(4): 7-11.
5. John A. Robertson, 'Fetal Tissue Transplant Research is Ethical', IRB: A Review of Human Subjects Research 1988; 10(6), p. 7.
6. Jones, op. cit., p. 26.
7. Richard B. Miller, 'On Transplanting Human Fetal Tissue: Presumptive Duties and the Task of Casuistry', Journal of Medicine and Philosophy 1989; 14, p. 630.
8. All of these are raised by Jones, op. cit. The first four are also mentioned by other writers: for example, Robertson, op. cit., p. 7, refers to Nazi data and data from the Warsaw ghettos, and James F. Childress, 'Ethics, Public Policy and Human Fetal Tissue Transplantation Research', Kennedy Institute of Ethics Journal 1991; 1(2):93-121 mentions accident victims (p. 101). The latter two are found only in Jones, op. cit., pp. 32-37.
9. All of these are raised by Jones, op. cit. The first four are also mentioned by other writers: for example, Robertson, op. cit., p. 7, refers to Nazi data and data from the Warsaw ghettos, and James F. Childress, 'Ethics, Public Policy and Human Fetal Tissue Transplantation Research', Kennedy Institute of Ethics Journal 1991; 1(2):93- 121 mentions accident victims (p. 101). The latter two are found only in Jones, op. cit., pp. 32-37.
10. Some road accidents are of course caused by culpable negligence, such as driving at excessive speed or driving while drunk. While there is an increasing willingness in the general community to regard such actions as morally wrong, it is not a firm universally shared view, nor is the wrongness usually held to be as equivalent to murder (partly because the killing was not intended, whereas in murder it is).
11. Op. cit., 30-32.
12. See, for example, B.M. Ashley and K.D. O'Rourke, Healthcare Ethics: A Theological Analysis. 3rd ed. St. Louis: The Catholic Health Association of the United States, 1989, pp. 188-90. This is one of many similar discussions of co-operation.
13. In the standard Catholic analysis of complicity, the fundamental issue is whether or not Person A, when performing his morally good or neutral action, directly intends the associated wrong-doing of Person B, or merely foresees it. Where direct intention is involved, the co-operation is labelled formal co-operation and is definitely illegitimate, because it involves directly intending evil. However, if Person A does not share the intention of Person B, or in fact disapproves of B's action, then this is only material co-operation, and is frequently acceptable, because B's wrong-doing is not intended by A, but only foreseen or permitted (Ashley and O'Rourke, loc. cit.). The problem lies in the type of situation envisaged by this account. Intention and foresight really only make sense in a situation where A's morally good or neutral action come before B's action. If B robs a bank, it seems that A can only have acted with the intention that B do so by providing the weapon before the robbery. If A hands the weapon to B after the robbery, it does not seem sensible to say that A did this with the intention that B rob the bank. Intention cannot work backwards. The same applies for foresight.
14. Douglas K. Martin, 'Abortion and Fetal Tissue Transplantation', IRB: A Review of Human Subjects Research 1993; 15(3), p. 2.
15. Douglas K. Martin et al., 'Fetal Tissue Transplantation and Abortion Decisions: A Survey or Urban Women', Canadian Medical Association Journal 1995; 153(5): 545-552.
16. Dorothy E. Vawter and Karen G. Gervais, 'Commentary on 'Abortion and Fetal Tissue Transplantation''. IRB: A Review of Human Subjects Research 1993; 15(3), p. 5.
17. Note that I am not in any way suggesting here that the abortion rate needs to be increased in order to provide enough tissue for fetal tissue transplant to become routine clinical practice. The number of abortions already performed obviously provides an ample supply. My point is rather that an increased abortion rate could be an (unintended) effect of the routine practice of fetal tissue transplant. That these extra abortions are in no way needed would not prevent them from occurring.
18. The clues to this in Jones and Robertson are not explicit, but are still telling. Robertson notes than an 'alternative strategy' in the fetal tissue debate would be to question the wrongness of abortion (op. cit., p. 8.) This implies that he thinks the moral status of abortion is open to question, in a way that he presumably does not with regard to murder. (It would seem very odd to suggest an alternative strategy of questioning the wrongness of murder.) Jones says that the complicity argument about fetal tissue transplantation only has force if abortion is always wrong - and that he will accept this 'for the sake of argument' (op. cit., p. 26). Again, this implies at least ambivalence about abortion, and is not the sort of thing one would say if one believed abortion to be the obvious moral equivalent of murder.
19. Burtchaell posits another version of this sort of analogy, involving an abundant supply of cadavers of healthy, young black people coming from South Africa and being offered to US medical schools for use in dissections (op. cit., p. 11). His purpose in mentioning this analogy is not explicitly stated, but is presumably similar to mine.
20. British Medical Association Medicine Betrayed: The Participation of Doctors in Human Rights Abuses, London: Zed Books, 1992, pp. 100-101.
21. Ibid., p. 100.