Those Divisive Stem Cells: Dealing with Our Most Contentious Issues

One can distinguish two types of perspectives from which it is possible to approach the debate on the ethics of stem cell research. One type involves arguing from a substantive moral position. Here one puts forward and defends views on substantive issues, such as the moral standing of pre-embryos, or whether stem cell research is ethically permissible and, if so, under what circumstances. In taking this type of perspective, one is in the fray, so to speak, slugging it out with those who hold opposing views. With the other type of perspective, one attempts to stand above the fray, to get an overview of the conflict. From this perspective, one attempts to characterize the conflict and to address questions such as "What would be a reasonable process for establishing public policy concerning stem cell research?" Here one attempts to put aside one's own substantive views concerning pre-embryos, although of course no one can fully do so, in order to address the meta-level questions concerning what the process should be.

Most of the debate so far about the ethics of stem cell research has involved the first type of perspective, the putting forward of substantive views. This is true of debate both in scholarly journals and political forums. But as we observe the continuing attention the media is giving to this issue, the polarization of viewpoints in the political arena, and the entrenchment of those views, it becomes more and more apparent that bioethics should also direct its attention toward the second type of perspective.

At the center of the debate over stem cell research is the most contentious substantive issue in bioethics--the question of the moral status of pre-embryos, embryos, and fetuses. The presence of such disputatious issues is unavoidable in a nation that tolerates, even encourages, diversity and that values freedom of thought and expression. We should not regard the existence of these highly contentious bioethics issues as a terrible thing, but rather see them as part of the "package," part of what comes with the flourishing of pluralistic democracy. But if these polarized debates are unavoidable, then bioethics should step up to the plate and address this question: By what process should we establish public policy concerning our most contentious ethical issues?

All three target articles identify shortcomings in the current debate over the ethics of stem cell research. Zoloth (2002) states that we need a "new language," that we need to think in a way that is "Exodic." This sounds similar to, although not exactly the same as, a plea that I have made. I have argued (1997a) that we need a new ethical framework for addressing issues in reproductive medicine and research on pre-embryos. I do not see the fulfillment of this need as involving some kind of radical shift in our way of thinking, as Zoloth sometimes seems to imply, but rather as focusing our attention on some important questions that we have largely overlooked. And both types of perspectives referred to above need our attention. We need to articulate frameworks that describe and further develop our substantive views concerning the ethics of reproductive medicine and research on pre-embryos, which is something I have tried to do (1997a; and 1997b), and we need to develop frameworks for a reasonable process of policy making in face of entrenched polarized viewpoints.

Maienschein (2002) points out another problem with the current process--the lack of a common understanding of what the basic terms such as embryo mean. And Green (2002) identifies additional problems with the debate. One is a failure of many to understand the science, in particular that embryonic development is better understood as a process rather than a series of discrete events. According to Green, this contributes to another problem: a failure of some to understand that the moral standing of embryos is conferred rather than intrinsic (Strong 1997a). A main theme that emerges from the three articles is that we need to improve the quality of our thinking and understanding in regard to the stem cell research ethics debate. Although Zoloth...