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Published by Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK, and
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METAPHILOSOPHY
Vol. 38, Nos. 2–3, April 2007
0026-1068

THE AMBIGUITY OF THE EMBRYO:


ETHICAL INCONSISTENCY IN THE HUMAN EMBRYONIC
STEM CELL DEBATE

KATRIEN DEVOLDER AND JOHN HARRIS

Abstract: We argue in this essay that (1) the embryo is an irredeemably


ambiguous entity and its ambiguity casts serious doubt on the arguments claiming
its full protection or, at least, protection against its use as a means for stem cell
research, (2) those who claim the embryo should be protected as ‘‘one of us’’ are
committed to a position even they do not uphold in their practices, (3) views that
defend the protection of the embryo in virtue of its potentiality to become a
person fail, and (4) the embryo does not have any rights or interests to be
protected. Given that many are willing to treat the embryo as a means in other
practices, and that human embryonic stem cell (hESC) research holds great
potential to benefit many people, one cannot but conclude that hESC research is
permissible and, because of its immense promise for alleviating human suffering,
even obligatory.

Keywords: embryo, embryonic stem cells, ethical inconsistency, moral status,


potentiality.

The Ambiguity of the Embryo


The embryo is a deeply, perhaps irretrievably ambiguous entity, one that
defies classification and slips seamlessly between moral and biological
categories. While many features of this ambiguity have been evident for
millennia, discussed by Aristotle (Barnes 1984) and in many religious
traditions, it is only really with the advent of modern embryology,
genome analysis, and stem cell science that the truly radical features of
the power of cells, to differentiate and specialise, have challenged many of
the myths concerning the embryo, and its moral status.1 If we start by
examining some of the ways in which the ambiguity of the embryo is at its
most dramatic, the problems created by this dubious status will become
clearer.
1
For more on the ambiguity of the embryo see Harris 1980, 1983, 1997, 1999 and Burley
and Harris 1999. See also Devolder 2006a and Devolder and Ward, McMahan, Marquis,
Sagan and Singer, and Gruen in this collection.

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154 DEVOLDER AND HARRIS

Embryo Splitting
When identical twins occur in nature they result from the splitting of the
early embryo in utero, and the resulting twins, true clones, have identical
genomes. This process can be mimicked in the laboratory, and in vitro
embryos can be deliberately split, creating matching siblings, which can
be used for reproduction, genetic testing, or scientific research. This
process itself has a number of ethically puzzling if not problematic
features (Harris 1998, 2004; see also Marquis, McMahon, and Sagan
and Singer in this collection).
Embryo splitting can be done at various stages of embryonic
development. When performed in an embryo consisting of 32 to 150
cells, the technique is referred to as ‘‘blastocyst division.’’ The blastocyst
is split in half, and the two halves, when implanted into a uterus, can
develop as identical ‘‘twins.’’ Embryo splitting at a very early stage of
embryonic development (o32 cells) is called ‘‘blastomere separation.’’ In
an embryo consisting of four cells, all cells (blastomeres) are still
‘‘totipotent’’ (that is, where all cells could become any part of the
resulting individual or, indeed, could develop into a whole new
individual). Consequently, if you take a four-cell-stage embryo and split
it into four cells, each one of these cells constitutes a new embryo, which
could be implanted with the potential for successful development into
adulthood (as we discuss below, there is a dramatic wastage rate of
embryos in all human reproduction). Each cell is the clone or identical
‘‘twin’’ of any of the others and comes into being not through conception
but because of the division of the early cell mass. Moreover, these four
cells can be recombined into one embryo again. This creates a situation
where, without the destruction of a single human cell, one human life, if
that is what it is, can be split into four and can be recombined again into
one.
Did ‘‘life’’ in such a case begin as an individual, become four
individuals, and then turn into a single embryo again? We should note
that whatever our answer to this question, all this occurs without the
creation of extra matter and without the destruction of a single cell. Those
who think that ensoulment takes place at conception have an interesting
problem in having to account for the splitting of one soul into four, and
for the destruction of three souls when the four embryos are recombined
into one, and to account for (and resolve the ethics of) the killing of three
individuals, without a single human cell being removed or destroyed.
These possibilities should perhaps give us pause in attributing the
beginning of morally important life to a point like ‘‘conception,’’ which,
moreover, is not a point but a process.2

2
For more on the problematic nature of attributing moral significance to early embryos
see Harris 1980, 2003.

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THE AMBIGUITY OF THE EMBRYO 155

Embryo splitting allows the use of genetic and other screening by


embryo biopsy. In embryo biopsy usually one or two cells are detached
from an early embryo for genetic testing. If the biopsied cell is totipotent,
it is effectively an embryo (or would be considered so by many). Embryo
biopsy would then involve the testing of one embryo to ascertain the
health and genetic status of the remaining clone or clones (since the rest of
the embryo may be further split to multiply cloned siblings).
Embryo splitting may also be used to create human embryonic stem
cell (hESC) lines. Recently, a research team from the biotechnology firm
Advanced Cell Technology in Massachusetts succeeded in producing an
hESC line from a biopsied blastomere obtained from an embryo in the
eight-cell stage (Klimanskaya et al. 2006). If the biopsied cell and the
seven remaining cells could still develop into an adult human being
without being aggregated or combined with other embryos, they are
totipotent. It is not certain whether or not a blastomere from an eight-
cell-stage embryo has become sufficiently differentiated to lose its
totipotency. If the biopsied blastomere does have the capacity to develop
into a full-grown human being, then it would be an embryo, and those
who care about embryos as ‘‘one of us’’ would find the destruction of
blastomeres for stem cell production immoral.
Splitting one embryo into two or more embryos could also be of great
benefit for infertile couples by increasing the number of embryos available
for transfer in a single in vitro fertilisation (IVF) cycle (Wood 2001). Not
only would this reduce the number of egg retrieval cycles, thus relieving
the physical burdens and costs of IVF treatment for infertility, it could
also increase the pregnancy rate. If a couple can only produce one or two
embryos, their chance of having a baby would be increased by splitting
each of the embryos into two or four. This implies that a child could be
produced that may otherwise not exist. An obvious question is whether it
would be morally defensible, by outlawing the creation of such ‘‘clones’’
by twinning, to deny a woman the chance to have the child she
desperately seeks. If this procedure would enable a woman to create a
sufficient number of embryos to give her a reasonable chance of a
successful pregnancy, then the objections would have to be weighty and
would have to distinguish this sort of embryo loss from that which
naturally and inevitably occurs in sexual reproduction (see below).
We should note a tension between how we think of the ethics of the
destruction of an individual embryo involving cell loss, on the one hand,
and destruction of an individual embryo without cell loss, on the other.
As we have seen, the process of embryo splitting also allows for
recombination. If the embryos are recombined following embryo split-
ting, a number of individual twins will have been ‘‘destroyed’’ or ‘‘killed’’
without the destruction of a single cell. Is such a process more ethically
problematic or less ethically problematic than destroying a biopsied
totipotent cell or a clump of cells that has the capacity to implant and

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156 DEVOLDER AND HARRIS

grow to term? If, as seems likely, the reason why it is thought objection-
able to recombine such clones is the loss of potential human beings, then
perhaps it would be considered unethical not to split any embryo into as
many twins as possible. By so doing we would after all maximise just that
potential, the loss of which, supposedly, inhibits recombination. If all this
has a dizzying effect, it is perhaps because the language that we use
misleads us.
We are often misled by terminology. To call these early cells or clumps
of cells ‘‘twins’’ tempts us to think of them as ‘‘persons.’’ But, as we have
pointed out, if an in vitro embryo in which all cells are at the totipotent
stage were to be split into four cells, you will have created four (new?)
embryos, quadruplets. Take three away and destroy them or recombine
all four into one and you are in a sense back where you started, having
done exactly the same, namely, created a single potentially viable embryo
with a particular genome. You have wasted potential experimental
material or potentially viable embryos or even killed three human
individuals. Yet this waste arguably also occurs whenever a cell mass
that could viably be divided is left undivided. If the recombined embryo,
or the surviving quadruplet, is implanted, comes to birth, and grows to
maturity, it will have the same genome it would have had if the division
and recombination had never taken place or if its siblings had never been
created and disappeared. Will it be the same person it would have been?
Does it have the same identity it had in its former incarnation? Certainly
its life story is different.
It is difficult to analyse the ethics of the possibilities we have just
described. In the recombination scenario not a single human cell has been
destroyed. In the case of embryo splitting no new cells or matter have
been created, and yet three individuals come and go. Have the interests of
any individuals been harmed? If these embryos may be said to have an
interest in actualising their potential, then perhaps there may be a sense in
which they have been wronged if not harmed.3 We must look at
potentiality more closely.

Potentiality
The idea of potentiality is central in discussing the ethics of using embryos
for research and therapy. One feature of human embryos that members of
other species do not share is their particular potential, not simply to be
born and to be human but to become the sort of complex, intelligent, self-
conscious, multifaceted creatures typical of the human species. There
seem to be at least two problems with potentiality interpreted as the idea
that human embryos or fetuses are morally important beings in virtue of
3
For a discussion on the distinction between harming and wronging see Harris 1992,
79–98. See also Harman in this collection.

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THE AMBIGUITY OF THE EMBRYO 157

their potential or their having a protectable interest in actualising that


potential.4
The first objection to protecting individuals because of their potential
is logical: acorns are not oak trees, nor are eggs omelettes. It does not
follow from the fact that something has potential to become something
different that we must treat it always as if it had achieved that potential.
Unless and until we achieve the possibility of immortality, all of us share
one important and inexorable potentialityFwe are all potentially dead,
but it does not follow that we must be treated as if we were dead now.
The second difficulty with the potentiality argument involves the scope
of the potential for personhood. If the human zygote has the potential to
become an adult human being and is supposedly morally important in
virtue of that potential, then what of the potential to become a zygote?
Something has the potential to become a zygote, and whatever has the
potential to become the zygote has whatever potential the zygote has. It
follows that the unfertilized egg and the sperm also have the potential to
become fully functioning adult humans. In addition, it is possible to
stimulate eggs, including human eggs, to divide and develop without
fertilization (parthenogenesis). As yet it has not been possible to continue
the development process artificially beyond the blastocyst stage, but if it
ever does become possible, then the single unfertilized egg, without need
of sperm or cloning, would itself have the potential of the zygote. Cloning
by nuclear transfer, which involves deleting the nucleus of an unfertilized
egg, inserting the nucleus taken from any body cell, and electrically
stimulating the resulting newly created egg to develop, can in theory
produce a new human. This was the method used to produce the first
mammal cloned from an adult body cell, Dolly the sheep, in 1997. This
means that any cell from a human body has the potential to become a new
‘‘twin’’ of that individual. All that is needed is an appropriate environ-
ment and appropriate stimulation. The techniques of parthenogenesis and
cloning by nuclear transfer mean that conception or ‘‘fertilization’’ is not
a necessary precursor process for the creation of human beings. (See also
Sagan and Singer in this collection.)
The account of potentiality given here may be thought to have
misrepresented the argument from potential. John Finnis, for example,
has argued that ‘‘[a]n organic capacity for developing eye-sight is not ‘the
bare fact that something will become’ sighted; it is an existing reality, a
thoroughly unitary ensemble of dynamically inter-related primordia of,
bases and structures for, development’’ (Finnis 1995, 50). He concludes
that ‘‘there is no sense whatever in which the unfertilized ovum and the
sperm constitute one organism, a dynamic unity, identity, whole’’ (50).
This sort of potentiality is often referred to as ‘‘active’’ or ‘‘inherent’’

4
Adapted from Harris and Holm 2003. Thanks to Sren Holm for permission to adapt
these jointly written ideas and present them here.

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158 DEVOLDER AND HARRIS

potentiality: an internal state that gives an entity, say A, the capacity to


change itself, under appropriate conditions, and that determines that A as
a potential Z will become Z rather than something else (Persson 2003). A
has an ‘‘inherent dynamic’’ causing A to realise its potential if it is not
hindered in its natural development.
However, it is surely the case that A has the potential for Z if, when a
certain number of things do and do not happen to A (or to A plus N),
then A (or A plus N) will become Z. For even a ‘‘unitary ensemble of
dynamically inter-related primordia of, bases and structures for, devel-
opment’’ must have a certain number of things happen to it and a certain
number of things that do not happen to it if its potential is to be
actualized. If A is a zygote, it must implant, be nourished, and not be
exposed to dangerous substances in the womb, and it must have a genetic
constitution compatible with survival to term and beyond. Defining
potentiality as an all-or-nothing matter solely dependent on an entity’s
inherent dynamic to become a human person ignores the immense
importance of diverse external factors that play a role in the actualisation
of this potential as well as the substantial differences in potential at
various stages of development (Devolder 2005). Moreover, insistence on a
‘‘unitary ensemble,’’ on ‘‘one organism,’’ seems also to apply to cloning
by nuclear substitution, surely an embarrassing fact. In any body cell
there is a complete single human genome; if treated appropriately, that
genome present in the cell nucleus might be cloned. Thus this method of
cloning allows for the ‘‘existing reality’’ of a complete genome which
exhibits the ‘‘dynamic unity, identity, whole[ness]’’ that the Finnis
analysis requires, and we can therefore now ascribe potentiality in the
Finnis sense to the nucleus of every cell in every body.
Some, however, would object that only the entity resulting from
nuclear transfer (after the somatic cell has been fused with the enucleated
egg) has the same potential as an embryo and, therefore, should be
equally protected. Only then would a new cell exist that would have the
inherent dynamic necessary to become a human person. But even if there
would indeed be a difference in potential between a somatic cell before
and after nuclear transfer, we still need a strong argument why a
particular ‘‘sort’’ or ‘‘amount’’ of potential would give us a reason to
protect an entity as an adult human being. A particular ‘‘inherent
dynamic’’ or ‘‘inherent potential’’ may be a necessary condition to
become a human person and thus to accord value to an entity, but it is
far from obvious why this should also be a sufficient condition.
The moral importance of drawing attention to the potentiality of
something suggests that it is actualising a particular potential that
matters. Our moral concern with what it is that has the potential to
become an adult human being would be inexplicable if persons or adult
humans did not matter. We are interested in the potentiality argument
because we are interested in the potential to become a particular, and

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THE AMBIGUITY OF THE EMBRYO 159

particularly valuable, sort of thing. If the zygote is important because it


has the potential for personhood, and if that is what makes it a matter of
importance to protect and actualize its potential, then whatever has the
potential to become that zygote must also be morally significant for the
same reason. Those who value potentiality for personhood surely do so
not because the potential is contained within ‘‘one organism’’ but because
it is the potential to become something the actualisation of which has
moral importance.
Moreover, it is not required that potentiality be contained within one
organism in order to be preserved or actualised, as has been demonstrated by
recent developments in stem cell research (see Devolder and Ward in this
collection). ESCs are obtained from embryos at the blastocyst stage. A
blastocyst consists of two distinct cell types: inner cell mass (ICM) cells,
which will become the ‘‘embryo proper,’’ the fetus, and later the adult human
being, and trophoblast cells, which will contribute to the placental support
system necessary for the development of the fetus in the uterus. ESCs are
derived from the isolated ICM. So far, it has been generally accepted that
hESCs have no significant moral status because, just like ICM cells, they are
‘‘merely’’ pluripotent, which means they can form all embryonic but only
some extra-embryonic tissues. A totipotent cell (i.e., an embryo) can produce
the extra-embryonic tissues as well and can thus result in a whole new
individual. This moral division between pluripotent and totipotent cells,
however, may not be as sound a criterion as it seems to be.
Scientific evidence suggests that human ICM cells as well as hESCs can
develop into a whole new person. In the mouse it has been proved that the
isolated ICM as well as mESCs derived from it maintain their capacity to
form an adult mammal. When they are aggregated with tetraploid
embryosFtwo-cell-stage zygotes that have been fused and have twice
the normal number of chromosomesFthey develop into normal mice (Li
et al. 2005a, 2005b; Nagy et al. 1990, 1993). These mice consist only of the
ICM cells or the ESCs and not of the tetraploid embryos, which only
provide a surrogate trophectoderm. (The cells of the trophectoderm give
rise to extra-embryonic tissues and do not incorporate into what is
referred to as the ‘‘embryo proper,’’ which will eventually form the fetus
and adult organism.) Moral issues prevent these aggregation experiments
from being carried out in humans, but there is no reason why such
procedures would not work with human ICM cells or hESCs. Because the
use of tetraploid human embryos as surrogate trophectoderm could raise
moral issues, as it involves the instrumental use of embryos, tetraploid
embryos could be replaced by trophectodermal cells derived from hESCs
(Gerami-Naini et al. 2004).
The aggregation process has not been done yet, but it is theo-
retically possible.5 This highlights a further ambiguity with the embryo
5
Personal communication from Christopher M. Ward to Katrien Devolder, 2006.

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160 DEVOLDER AND HARRIS

(see Devolder and Ward in this collection). If these possibilities are


proved, then there will be elasticity between pluripotent and totipotent
cells, and it will not be possible to claim that pluripotent cells have
permanently lost the capacity to form an embryo and a fetus because they
cannot make the required extra-embryonic tissue and membrane. If
hESCs can do everything a totipotent cell or an embryo can, then those
who accord full moral status to the embryo should treat hESCs, and also
ICM cells (which have the same potential), as moral equals of the embryo
and thus of the adult human being.
The conclusions we can derive from the fact that something has the
potential to become a human person are few. It may be a necessary
condition to accord moral status to an entity, but saying that it is also a
sufficient condition, and that therefore we need to protect an embryo as a
full human being, lacks every rational basis. If there is a protectable
‘‘interest’’ in actualising potential or even a powerful moral interest in
doing so, then the consequence is a very demanding ethic and one that
would surely require us to actualise all human potential whenever we have
an opportunity to do so. Particularly given the present state of technol-
ogy, this would be a very demanding ethic indeed for women. That is not,
of course, a decisive argument against acceptance of the ethic of always
attempting to actualise valuable potential. However, those who use this
argument as a reason for protecting embryos must, in order to be
consistent, protect whatever has the potential to become a human being
in the same way and to the same extent. This, among many other things,
would entail an ethic of maximal procreation, or never knowingly missing
an opportunity to create and protect embryos.

Rights
Failing to protect embryos does not involve any violation of the rights, at
least of the embryos, although the progenitors or others in lawful
possession of embryos may have rights at stake. Perhaps a word or two
of explanation for this claim is appropriate. There are two main theories
of rights: choice theory and interest theory (Cohen 1995, 68; Dworkin
1977 and 1994, 210–16; Steiner 1994; Waldron 1988). Choice theory sees
rights as securing ‘‘the protection and promotion of autonomy or
liberty,’’ and interest theory sees rights as serving to further individual
well-being or welfare. Clearly, on choice theory embryos cannot possess
rights because embryos are not autonomous and so their rights cannot be
analysed in terms of choices. Even according to interest theory embryo
rights are problematic, not least because, arguably, embryos cannot
experience welfare and therefore have no welfare interests that can be
served. Joseph Raz, for example, suggests that an individual is capable
of possessing rights ‘‘if and only if . . . his well-being is of ultimate
importance’’ (1986, 166). Embryos, however, have no well-being, for

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THE AMBIGUITY OF THE EMBRYO 161

well-being is a state of being experienced as good by the subject of the


relevant experiences. Certainly all early embryos, such as those in the pre-
implantation stage that we have been discussing, lacking as they do both a
central nervous system and indeed a brain, are incapable of experiences of
any sort (Sumner 1987, 47).
Most legal systems and international human-rights law find no room
for attributing rights, particularly the right to life, to embryos or fetuses.
Two recent cases decided by the European Court of Human Rights have
added to a formidable set of precedents confirming this status as far as the
law of most jurisdictions is concerned.6

Humans Are Reckless of Embryonic Human Life


A further feature of current attitudes to the embryo which reveal not only
the ambiguous status of the embryo but also the ambivalence of most
humans towards the precursor forms of themselves concerns the extre-
mely high rate of embryo loss and abnormality in human reproduction. It
is doubtful that sexual reproduction, with its risk of sexually transmitted
disease, its high abnormality rate in the resulting children, and its gross
inefficiency in terms of the death and destruction of embryos, would ever
have been approved by regulatory bodies if it had been invented as a
reproductive technology rather than simply been ‘‘found’’ as part of our
evolved biology.
Given the moral importance attached to embryos and the fact that
embryos are regarded by many as sharing the same moral status with the
rest of humankind, it is the tolerated rate of embryo loss that is
particularly interesting. Embryo loss in normal sexual reproduction,
including unprotected intercourse not directly intended to result in
conception, is certainly very high. Robert Winston gave the figure of
five embryos lost for every live birth some years ago in a personal
communication (to John Harris). Anecdotal evidence from a number of
sources confirms this high figure, but the literature is rather more
conservative, making more probable a figure of three embryos lost for
every live birth (Boklage 1990; Leridon 1977). Again, in a personal
communication (to John Harris) Henri Leridon confirmed that a figure of
three lost embryos for every live birth is a reasonable conservative figure.
Ron Green (2001, note 185) has suggested (to John Harris) that between
two-thirds and three-quarters of all embryos do not implant.7 Additional
6
The European Court of Human Rights, case of Vo v. France (application no. 53924/00),
Judgment, Strasbourg, 8 July 2004. And most recently in Evans v. The United Kingdom
(application no. 6339/05), Judgment, Strasbourg, 7 March 2006.
7 A figure of 70 percent total embryo loss is confirmed by Macklon et al. 2002. Edmonds

et al. 1982 gives a figure of 61.9 percent loss before twelve weeks, but since this figure does
not include embryo loss before implantation or from miscarriage after twelve weeks, the
figure of 80 percent estimated by Winston may not be an unreasonable estimate. See also
Hertig and Rock 1973 and Adams et al. 1956. See also Roberts and Lowe 1975.

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162 DEVOLDER AND HARRIS

embryo loss occurs as a result of various means of contraception that are


widely accepted. The combined oral contraceptive pill has a number of
modes of operation, one of which prevents implantation of the embryo at
between five and eight days’ development. The so-called morning-after
contraceptive pill also prevents implantation, as does the intra-uterine
device, or coil. Even those who use so-called natural means of contra-
ception, such as the rhythm method, intentionally decrease the chances of
the embryo to implant and thus to actualise its potential (Bovens 2006).
The combined effects of these various contraceptive methods increase the
tally of embryo loss as a ‘‘side effect’’ of human sexuality, but it is
impossible to arrive at reliable estimates as to the total numbers of
embryos involved. Interestingly, most of this embryo loss involves the
death of embryos at precisely the stage of development at which stem cells
are usually harvested for hESC research, namely, between five and eight
days’ development. Those who attempt to have children in the light of
these facts and indeed those who have unprotected intercourse and those
who use contraceptive methods that risk embryo loss are all accepting
that what they are doing or trying to do justifies the creation and sacrifice
of embryos.
In the case of attempts to procreate using sexual reproduction, one
obvious and inescapable conclusion is that God or nature has ordained
that ‘‘spare’’ embryos be produced for almost every pregnancy, and that
most of these will have to die in order that a sibling embryo can come to
birth. Thus the wilful creation and sacrifice of embryos is an inescapable
and inevitable (and presumably acceptable, or at least tolerable?) part of
the process of procreation, and is not unique to assisted reproduction
technologies (ART). Both natural procreation and ART involve a process
in which embryos, additional to those that will actually become children,
are created only to die. If either of these processes is justified it is because
the objective of producing a live healthy child is judged worth this
particular cost. It follows that no one who regards it as acceptable to
try to have children has any principled objection to the creation and
destruction of embryos in a good cause. The only question is how good
the cause must be to justify such deliberate embryo destruction. Those
who accept such destruction as part of a procreative project accept that
the creation of new life is a cause good enough to justify such a course of
action. Since most people believe that the saving of existing life takes
priority over the creation of new life, research directed towards life-saving
therapies or the production of those therapies must justify embryo loss if
reproduction does (Harris 2002, 2003a).

Embryo-Sparing Assisted Reproduction Technologies


It might be said that there is a difference between justifying the embryo
loss entailed in reproduction and justifying the embryo loss entailed in life-

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THE AMBIGUITY OF THE EMBRYO 163

saving therapies. Researchers who engage in assisted reproduction create


and destroy an unnecessarily high number of embryos and do not do
everything they can to actualise the potential of each embryo created,
whereas in sexual reproduction the sacrifice is not intentional, and it
happens despite us doing everything we can to realise the potential of the
embryo. Embryo loss may indeed not be intentional sacrifice, and it may
not attend every pregnancy. However, the loss of many embryos, includ-
ing ‘‘healthy’’ ones that would have grown to term in other circumstances
(e.g., another womb or other conditions in the womb), is the inevitable
consequence of the vast majority of (perhaps all) pregnancies. If creating a
single embryo by IVF became a reliable technique for procreation, it
would be interesting to know whether those from a rather inappropriately
termed ‘‘pro-life’’ position would feel obliged to use this method rather
than sexual reproduction because of its embryo-sparing advantages
(Harris 2003a). We say inappropriately termed ‘‘pro-life’’ because those
who regard themselves as ‘‘pro-life’’ so often support positions that can
only be thought of as anti-life and that moreover are profligate of human
life and safety (Harris 2003b). IVF could also be combined with the
possibility to grow embryos to term in artificial wombs, which, when
perfected, will offer a safer environment for the embryo than a woman’s
womb. Furthermore, the use of artificial wombs could save the lives of
embryos left over from IVF treatments (Kaczor 2005) or from totipotent
cells obtained through embryo splitting in order to maximise human
procreation. Would ‘‘pro-lifers’’ support these technologies? It looks as
though there would indeed be a strong moral obligation to abandon sexual
procreation and use only embryo-sparing ART. If such an improvement in
ART occurred, this development would seem to make using it mandatory
for those who believe that the embryo is one of us. It is interesting that so-
called pro-lifers are not investing heavily in technologies to this end in the
hope that sexual reproduction could eventually be entirely replaced by an
embryo-sparing method of reproduction.
What follows from all this? It is difficult to see how most people could
live lives that are today accepted as normal while maintaining a strict
‘‘pro-life’’ position or by acting consistently to protect embryos. The
alternatives seem clear. We, humankind, must accept that human
embryos are deeply ambiguous and problematic entities of a kind whose
lives or ‘‘dignity’’ simply cannot be protected in ways consistent with
other values that we hold. Does this mean we should accord a moral
status to early embryos that is compatible with their use for purposes
considered morally at least as important as creating new life, such as
saving lives through stem cell research?
Ethical Inconsistency in the Embryonic Stem Cell Debate
The hESC debate has been characterized by a search for compromise
positions that seek to find a middle ground between the position that

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164 DEVOLDER AND HARRIS

embryos can be used for morally important purposes and the position
that embryos should be protected as one of us and, consequently, their
use for stem cells should be opposed (see Tännsjö in this collection). Most
countries do not want to forego the potential benefits of hESC research
and have adopted regulations based on one of the main compromise
positions. Some countries allow the use of hESCs but not the derivation
process, as the latter involves killing embryos. There are several variations
of this compromise, such as restricting the use of hESCs to those derived
before a set date, with private money, or abroad.8 Other countries are a
bit more liberal, allowing the use of embryos left over from infertility
treatments and no longer used in a parental project but rejecting the
creation of embryos solely for the purpose of stem cell research.9
We have seen, however, that the view that embryos have a moral status
incompatible with their instrumental use as stem cell source is not
supported by strong argumentation and cannot be maintained consis-
tently with other values or with how most people live their lives. Why,
then, should we look for compromises that try to satisfy this view and, by
doing so, slow down or block hESC research?
Many people may have some respect and care for some kind of
protection of the embryo, but these feelings can change and often depend
on people’s intentions, in particular on whether the embryo is included in
a parental project. Moreover, there are forms of respect and deference
that are less absolute and that admit of gradations. The respect one has
for an entity does not exclude it, provided that a meaningful argument is
presented, from being used as a resource for a goal that is believed to be
important (which is comparable with research on cadavers). A way to
show respect to early embryos is by ensuring that they are used with care
in research that incorporates substantive values, such as the alleviation of
human suffering, which is in accordance with the widely accepted
principles of beneficence, non-maleficence, and proportionality (see
Manninen in this collection). Well-regulated hESC research can be
consistent with these widely accepted principles. Of course, disagreement
can still exist on the scope of the principles. However, arguments for
establishing scope, such as stating that the protection of the embryos falls
within the scope of the principle of non-maleficence, like the principles
themselves, have to meet the standards of adequacy and validity required
for arguments to hold true (Harris 2005a).
We have shown that no strong argumentation that meets these
standards has been provided. First, the embryo is an ambiguous entity,
which casts serious doubt on the arguments claiming its full protection.
Secondly, those who claim the embryo should be protected as if it was a
person are committed to a position even they do not uphold in their

8
For a critical analysis of this compromise position see Devolder and Harris 2005.
9
For a critical analysis of this compromise position see Devolder 2005b.

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THE AMBIGUITY OF THE EMBRYO 165

practices. No society treats the embryo as one of us or has ever done so.
Third, views that defend the protection of the embryo in virtue of its
potentiality to become a person fail, and, finally, the embryo does not
have any rights or interests to be protected. Moreover, the validity of not
considering the embryo as one of us is corroborated by scientific evidence
and analysis of the (changing) and ambiguous characteristics of an early
human embryo. New technical possibilities to manipulate embryos and
assemble and reassemble them will continue to challenge our views about
the embryo and what constitutes its value. Even if these views cannot
conclusively be shown to be fallacious, they can at least be shown to be
inconsistent, erroneous, or suspect.
Compromising on the moral status of embryos is impossible. Once one
accepts certain uses of embryos it will always be hard, if not impossible, to
justify prohibiting other uses for morally equivalent purposes. This is the
main reason why the compromise positions in the hESC debate cannot be
sustained (Devolder 2006b). Given that many are willing to treat the
embryo as a means in other practices, and that hESC research holds great
potential to benefit many people, one cannot but conclude that hESC
research is permissible and, given its immense promise for alleviating
human suffering, even obligatory (Devolder and Savulescu 2006).
Moral diversity on deeply held beliefs about the embryo must be
respected. But powerful moral reasons to pursue research should not be
drowned by the powerful reasons we have to respect people’s funda-
mental views (Harris 2005b). Respect for morally diverse views does not
require that we as a society prohibit or severely restrict hESC research.
Pursuing and supporting hESC research is in the interests of all people,
now and in the future. The compromise positions that restrict hESC
research cannot be sustained and therefore cannot offer a legitimate
moral basis for stem cell policy.
The way we respond to practical dilemmas can differ from our
professed beliefs about abstract problems. These revealed beliefs should
influence our ideas about what is good or bad. They say something about
the morality we accept. (Many practices that are now routine and
uncontroversial, such as blood transfusion and organ transplantation,
were once considered unethical by many). This morality should be
projected onto the principles we profess. If our reactions in real-life
situations are inconsistent with the beliefs we profess, then these princi-
ples and/or their scope may have to be reviewed and modified in the light
of the morality we accept or wish to retain. It is important to realise that
there is a two-way interaction between the principles we accept and our
practices. There is nothing fundamentally wrong with temporal incon-
sistency, as it is part of moral development. There is something seriously
wrong, however, with knowingly being inconsistent. Just as we cannot
force people to act morally, we cannot force them to apply their principles
consistently. What we can do, however, is point out inconsistencies

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166 DEVOLDER AND HARRIS

through critical analysis of the arguments and by properly informing


people through an honest and open debate. Justifying a prohibitive or
restrictive stem cell policy by citing a moral position that is not based on
solid arguments and by employing principles that are not applied
consistently in practice is hypocritical and also, in a sense, ‘‘instrumenta-
lises’’ ethics in order to find a purely political compromise.10

Katrien Devolder
Bioethics Institute Ghent
Department of Philosophy and Moral Sciences
Ghent University
Blandijnberg 2
9000 Ghent
Belgium
Katrien.Devolder@UGent.be

John Harris
Institute of Medicine Law and Bioethics
School of Law
University of Manchester
Oxford Road
Manchester M13 9PL
United Kingdom
john.harris@manchester.ac.uk

Acknowledgments
Katrien Devolder gratefully acknowledges support from the Fund for
Scientific ResearchFFlanders.

References
Aristotle. 1984. De anima (bk. II, no. 1) and Metaphysics (bk. VII, no. 10).
In The Complete Works of Aristotle, edited by Jonathan Barnes.
Princeton: Princeton University Press.
Boklage, Charles E. 1990. ‘‘Survival Probability of Human Conceptions
from Fertilization to Term.’’ International Journal of Fertility 35, no.
2:75–94.
Bovens, Luc. 2006. ‘‘The Rhythm Method and Embryonic Death.’’
Journal of Medical Ethics 32, no. 6:355–57.
10
Some of the argument of this essay is also developed in John Harris, Has Humankind a
Future? Ethics and Policy of Human Enhancement (Princeton: Princeton University Press,
forthcoming).

r 2007 The Authors


Journal compilation r 2007 Metaphilosophy LLC and Blackwell Publishing Ltd
14679973, 2007, 2-3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/j.1467-9973.2007.00480.x by Marmara University, Wiley Online Library on [20/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
THE AMBIGUITY OF THE EMBRYO 167

Brown, Grattan. 2005. ‘‘Philosophy and Theology.’’ National Catholic


Bioethics Quarterly 5, no. 3:599–606.
Burley, Justine, and John Harris. 1999. ‘‘Human Cloning and Child
Welfare.’’ Journal of Medical Ethics 25, no. 2:121–26.
Cohen, G. A. 1995. Self-Ownership, Freedom, and Equality. Cambridge:
Cambridge University Press.
Devolder, Katrien. 2005a. ‘‘Human Embryonic Stem Cell Research: Why
the Discarded-Created Distinction Cannot Be Based on the Potenti-
ality Argument.’’ Bioethics 19, no. 2:167–86.
FFF. 2005b. ‘‘Creating and Sacrificing Embryos for Stem Cells.’’
Journal of Medical Ethics 31, no. 6:366–70.
FFF. 2006a. ‘‘What’s in a Name? Embryos, Entities, and ANTities
in the Stem Cell Debate.’’ Journal of Medical Ethics 32, no. 1:
43–48.
FFF. 2006b. ‘‘The Ethics and Regulation of Human Embryonic Stem
Cell Research: A Critical Analysis of the Debate.’’ Ph.D. dissertation,
Ghent University.
Devolder, Katrien, and John Harris. 2005. ‘‘Compromise and Moral
Complicity in the Embryonic Stem Cell Debate.’’ In Philosophical
Reflections on Medical Ethics, edited by Nafsika Athanassoulis,
88–108. Basingstoke: Palgrave Macmillan.
Devolder, Katrien, and Julian Savulescu. 2006. ‘‘The Moral Imperative to
Conduct Cloning and Stem Cell Research.’’ Cambridge Quarterly of
Healthcare Ethics 15, no. 1:7–21.
Dworkin, Ronald. 1977. Taking Rights Seriously. London: Duckworth.
FFF. 1994. Life’s Dominion. London: HarperCollins.
Edmonds, D. Keith, K. S. Lindsay, J. F. Miller, E. Williamson, and P. J.
Wood. 1982. ‘‘Early Embryonic Mortality in Women.’’ Fertility and
Sterility 38:447–53.
Finnis, John. 1995. ‘‘A Philosophical Case against Euthanasia.’’ In
Euthanasia Examined: Ethical Clinical and Legal Perspectives, edited
by John Keown, 23–35. Cambridge: Cambridge University Press.
Gerami-Naini, B., O. V. Dovzhenko, M. Durning, F. H. Wegner, J. A.
Thomson, and T. G. Golos. 2004. ‘‘Trophoblast Differentiation in
Embryoid Bodies Derived from Human Embryonic Stem Cells.’’
Endocrinology 145:1517–24.
Green, Ronald M. 2001. The Human Embryo Research Debates. New
York: Oxford University Press.
Harris, John. 1980. The Value of Life. London: Routledge.
FFF. 1983. ‘‘In Vitro Fertilisation: The Ethical Issues.’’ Philosophical
Quarterly 33, no. 132:217–38.
FFF. 1992. Wonderwoman and Superman. Oxford: Oxford University
Press.
FFF. 1997. ‘‘Goodbye Dolly: The Ethics of Human Cloning.’’ Journal
of Medical Ethics 23, no. 6:353–60.

r 2007 The Authors


Journal compilation r 2007 Metaphilosophy LLC and Blackwell Publishing Ltd
14679973, 2007, 2-3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/j.1467-9973.2007.00480.x by Marmara University, Wiley Online Library on [20/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
168 DEVOLDER AND HARRIS

FFF. 1998. ‘‘Rights and Reproductive Choice.’’ In The Future of


Human Reproduction: Choice and Regulation, edited by John Harris
and Sren Holm, 5–37. Oxford: Oxford University Press.
FFF. 1999. ‘‘The Concept of the Person and the Value of Life.’’
Kennedy Institute of Ethics Journal 9, no. 4:293–308.
FFF. 2002. ‘‘The Use of Human Embryonic Stem Cells in Research
and Therapy.’’ In A Companion to Genetics: Philosophy and the Genetic
Revolution, edited by Justine C. Burley and John Harris, 158–75.
Oxford: Blackwell.
FFF. 2003a. ‘‘Stem Cells, Sex and Procreation.’’ Cambridge Quarterly
of Healthcare Ethics 12, no. 4:353–72.
FFF. 2003b. ‘‘Pro-Life Is Anti-Life: The Problematic Claims of Pro-
Life Positions in Ethics.’’ In Scratching the Surface of Bioethics, edited
by Matti Hayry and Tuija Takala, 99–109. Amsterdam: Rodopi.
FFF. 2004. On Cloning. London: Routledge.
FFF. 2005a. ‘‘Global Norms, Informed Consensus and Objectivity in
Bioethics.’’ Paper presented at the Symposium on Global Bioethics,
Dartmouth College (16–18 October).
FFF. 2005b. ‘‘Scientific Research Is a Moral Duty.’’ Journal of Medical
Ethics 31, no. 4:242–48.
Harris, John, and Sren Holm. 2003. ‘‘Abortion.’’ In The Oxford Hand-
book of Practical Ethics, edited by Lafollette Hugh, 112–36. Oxford:
Oxford University Press.
Hertig, Arthur T., and John Rock. 1973. ‘‘Searching for Early Fertilised
Human Ova.’’ Gynecaelogical Investigation 4:121–39.
Adams, Eleanor C., Arthur T. Hertig, and John Rock. 1956. ‘‘A
Description of 34 Human Ova within the First 17 Days of Develop-
ment.’’ American Journal of Anatomy 98:435–93.
Kaczor, Christopher. 2005. ‘‘Could Artificial Wombs End the Abortion
Debate?’’ National Catholic Bioethics Quarterly 5, no. 2 (Summer):
283–301.
Klimanskaya, Irina Y., S. Chung, S. Becker, J. Lu, and R. Lanza. 2006.
‘‘Human Embryonic Stem Cell Lines Derived from Single Blasto-
meres.’’ Nature 444, no. 7118:481–85.
Leridon, Henri. 1977. Human Fertility: The Basic Components. Chicago:
University of Chicago Press.
Li, X., W. Wei, J. Yong, Q. Jia, Y. Yu, and K. Di. 2005a. ‘‘The Genetic
Heterozygosity and Fitness of Tetraploid Embryos and Embryonic
Stem Cells Are Crucial Parameters Influencing Survival of Mice
Derived from Embryonic Stem Cells by Tetraploid Embryo Aggrega-
tion.’’ Reproduction 130:53–59.
Li, X., Y. Yu, W. Wei, J. Yong, J. Yang, J. You, X. Xiong, T. Qing, and
H. Deng. 2005b. ‘‘Simple and Efficient Production of Mice Derived
from Embryonic Stem Cells Aggregated with Tetraploid Embryos.’’
Molecular Reproduction and Development 71:154–58.

r 2007 The Authors


Journal compilation r 2007 Metaphilosophy LLC and Blackwell Publishing Ltd
14679973, 2007, 2-3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/j.1467-9973.2007.00480.x by Marmara University, Wiley Online Library on [20/02/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
THE AMBIGUITY OF THE EMBRYO 169

Macklon, N. S., J. P. Geraedts, and B. C. Fauser. 2002. ‘‘Conception to


Ongoing Pregnancy: The ‘Black Box’ of Early Pregnancy Loss.’’
Human Reproduction Update 8, no. 4:333–43.
Nagy, A., E. Gocza, E. M. Diaz, V. R. Prideaux, E. Ivanyi, M. Markkula,
and J. Rossant. 1990. ‘‘Embryonic Stem Cells Alone Are Able to
Support Fetal Development in the Mouse.’’ Development 110:815–21.
Nagy, A., J. Rossant, R. Nagy, W. Abramow-Newerly, and J. C. Roder.
1993. ‘‘Derivation of Completely Cell Culture–Derived Mice from
Early-Passage Embryonic Stem Cells.’’ Proceedings of the National
Academy of Sciences of the United States of America 90:8424–28.
Persson, Ingmar. 2003. ‘‘Two Claims about Potential Human Beings.’’
Bioethics 17, nos. 5–6:503–16.
Raz, Joseph. 1986. The Morality of Freedom. Oxford: Clarendon Press.
Roberts, C. J., and C. R. Lowe. 1975. ‘‘Where Have All the Conceptions
Gone?’’ Lancet 305, no. 7905:498–99.
Steiner, Hillel. 1994. An Essay on Rights. Oxford: Blackwell.
Sumner, L. W. 1987. The Moral Foundation of Rights. Oxford: Clarendon
Press.
Wood, Carl. 2001. ‘‘Embryo Splitting: A Role in Infertility?’’ Reproduc-
tion, Fertilility and Development 13, no. 1:91–93.

r 2007 The Authors


Journal compilation r 2007 Metaphilosophy LLC and Blackwell Publishing Ltd

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