STANFORD, Calif. – Human dignity rises above all other considerations in biomedical research and health care and must govern ethical decisions in the lab and at the bedside, Dr. Edmund Dr. Pellegrino, the chairman of the President’s Council on Bioethics, told Stanford University law students April 9.
Dr. Pellegrino spoke about the council’s newly published anthology, “Human Dignity and Bioethics.” The book is a response to critics who have complained that dignity is both too vague a standard and too theologically oriented to have a place in bioethics.
Addressing students in a classroom at Stanford Law School, Dr. Pellegrino made a forceful claim for the inescapability of dignity – the lived experience of being human – for anyone making ethical choices in research, in the clinic and in general biology.
“Wherever you start, wherever you go, you’ll have to come back to either accepting the notion or denying it utterly, and then we can weigh out for you the implications of denying that to a human being,” he said.
“There are too many examples in the world’s history of the denigration of the special nature of being human,” he said. “I can only mention the Holocaust. It’s a reality then – a value you must deal with.”
Dr. Pellegrino did not address embryonic stem-cell research directly, but his appearance came just four days after an advisory group to the state-funded California Institute for Regenerative Medicine recommended issuing $262 million in Proposition 71 funds for stem-cell research facilities.
Stanford is in line to receive $47.5 million, which would be the largest of the 12 grants the panel is proposing.
The Catholic Church condemns embryonic stem-cell research because the work involves the destruction of days-old human embryos to obtain the cells. Surplus embryos from in-vitro fertilization clinics are one source of the embryos used in research. The church supports other avenues of stem-cell research that do not destroy life, such as research using adult stem cells.
Henry T. Greeley, a Stanford law professor who chairs the California Advisory Committee on Human Embryonic Stem-Cell Research, addressed the Stanford class after Dr. Pellegrino. He said he has some sympathy for an ethical theory that goes beyond individual autonomy but argued that proponents of dignity have not made a suitably rigorous case.
“I don’t see why the human species as a whole is inherently entitled to dignity,” he said. “If it turns out we encounter nonhuman persons, either biological, mechanical or computational, earthly or alien, I think dignity should apply to them as well. Furthermore, the idea that the species as a whole has some essence that shouldn’t be violated strikes me as way too abstract.”
A third panelist, David Magnus, an associate professor of pediatrics at the Stanford School of Medicine, said the council’s new book constitutes a rejection of academic bioethics in favor of more attention to religion and efforts to probe the deeper questions of human dignity and human nature. He said the book brings out a fundamental tension between those who are theologically inclined and those who are less so.
Magnus said that perhaps two types of dignity could be articulated, one arising from human nature and another governing threats to dignity in the lived experience.
He cited what he said was the factual example of a gravely ill infant who was being maintained on life support at the request of the family but whose plight was deeply troubling to the caregivers. Nurses and social workers felt the treatment was unethical.
“It was hard to see what they were saying except in the sense that the human dignity of the child was being violated, the sense that even though the patient doesn’t feel pain, the patient’s dignity is being violated,” he said. “Its spirit is being injured.”