Stem Cell Research and Double Effect

My TCS column:

In his recent TCS column, For Stem Cell Research: A Lesser Malevolence, Michael Rosen offered a thoughtful and balanced analysis of the morality of embryonic stem cell research. There is much in Rosen's analysis that people of good will on both sides of this contentious debate should embrace; most notably, his "to calm the heated rhetoric on both sides of the issue."

I would not presume to critique Rosen's analysis of Jewish theology as applied to the problem of stem cell research, but I must take issue with his venture into Christian theology. Rosen writes:

"In my understanding, ESC research satisfies the four prongs of ["double-effect" principle in traditional Catholic doctrine]: (1) creating stem-cell lines for research is not wrong in itself; (2) the intention of the scientist extracting the lines is right, namely saving lives through research; (3) the bad effect (i.e. killing the embryo) is not a means to the good effect (i.e. saving lives) because although the embryo dies after the stem-cells are extracted, its death is not a "means" to that extraction but rather a result thereof; and (4) the gravity of the reason for creating the ESC lines is commensurate with the foreseen (but unintended) bad effect, namely the death of the embryo."

Unfortunately, in my understanding, Rosen has misapplied the doctrine of double effect.

The principle of double effect is an old doctrine, traceable back at least to St. Thomas Aquinas, which seeks to sort out the moral problems inherent when a proposed action has both good and bad consequences (a so-called "double effect"). Specifically, the principle distinguishes between an act that deliberately causes harm in order to achieve some desirable outcome and an act that achieves a desirable outcome in a manner by which some harm foreseeably results as a side-effect. The former is never morally permissible, while the latter may be if the act satisfies the principle of double effect.

The New Catholic Encyclopedia identifies four conditions for the principle of double effect to be satisfied:

1. The act itself must be morally good or at least indifferent.
2. The agent may not positively will the bad effect but may permit it. If he could attain the good effect without the bad effect he should do so. The bad effect is sometimes said to be indirectly voluntary.
3. The good effect must flow from the action at least as immediately (in the order of causality, though not necessarily in the order of time) as the bad effect. In other words the good effect must be produced directly by the action, not by the bad effect. Otherwise the agent would be using a bad means to a good end, which is never allowed.
4. The good effect must be sufficiently desirable to compensate for the allowing of the bad effect.

In applying the doctrine, the initial question thus is: What is the "act" to be evaluated. Rosen uses the clinical and neutral phrase "creating stem-cell lines for research" to identify the morally relevant act. Yet, given the current state of technology, there is a clinically necessary prior to creating such lines; namely, the destruction of an embryo so that stem cells may be harvested.

My claim that Catholic theology would view the destruction of an embryo as the morally relevant act to be evaluated under the tenets of double effect is supported by the highly authoritative Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells by the Pontifical Academy for Life: "the ablation of the inner cell mass (ICM) of the blastocyst, which critically and irremediably damages the human embryo, curtailing its development, is a gravely immoral act and consequently is gravely illicit." (Emphasis in the original.)

With the morally relevant act correctly identified, it is clear that embryonic stem cell research violates at least the first and third conditions of the principle of double effect. As to the first condition, the act itself is neither "morally good" nor even "indifferent," but rather a grave evil.

As to the third condition, the actor is "using a bad means to a good end." The Declaration states: "No end believed to be good, such as the use of stem cells for the preparation of other differentiated cells to be used in what look to be promising therapeutic procedures, can justify an intervention of this kind. A good end does not make right an action which in itself is wrong." (Emphasis in the original.)

The Declaration therefore concludes that it is not morally licit to (1) "produce and/or use living human embryos for the preparation of ES cells," (2) "engage in so-called therapeutic cloning," or (3) "use ES cells, and the differentiated cells obtained from them, which are supplied by other researchers or are commercially obtainable."

We owe Rosen thanks for bringing faith-based moral principles into the public square. Faithful Catholics looking for a moral justification for embryonic stem cell research, however, cannot take comfort from Rosen's analysis. The principle of double effect simply does not justify the acts necessary for such research to occur.