A to Z of Bioethical Issues

At the risk of trivialising important issues, here is a bioethical alphabet. We may not make it through the whole 26 letters, but at least ‘z’ will be no problem with either zona pellucida, or zygote.

[This little series of articles was first published in the FIEC’s Christian Citizenship Bulletins between 1999 and 2000. Since then, some of the figures may have changed slightly, but the core issues remain].

A is for ABORTION. The official abortion figures for 1997 have recently been released by the Office for National Statistics. The number of abortions performed in England and Wales in 1997 rose by 2,365 (1.3%), compared with the 1996 data, to a total of 179,590.

Divide that ignominious total by the number of weeks in a year and then by 6 and what do you get? The number of abortions performed each working day, and the answer is, 575. Can you believe that? Consider it as equivalent to about 10 busloads, or 20 classrooms of children.

But these facts and figures are not just statistics - they are the record of human misery and a society that has taken the wrong path. Can there be any activity more uncivilised than killing your own defenceless offspring?

It is now 30 years since abortion was legalised in the UK. During that period almost 5 million unborn children have lost their lives. And everyday more women are added to the vast numbers already suffering from post-abortion syndrome and the literature, both scientific and anecdotal, on the physical and psychological effects of abortion, is growing and growing. There is now irresistible evidence that abortion is bad for women. So how can any doctor ‘act in good faith’ and authorise an abortion on the ground that ‘continuance of the pregnancy poses a greater risk of injury to the physical and mental health of the woman’ - this is ground C, the so-called ‘social ground’ - on which 90%+ of all abortions are done. Should a doctor who performs an abortion under this ground still be protected by the Abortion Act?

B is for BLOOD. To be precise, Mrs Diane Blood. The issues surrounding her overwhelming desire to be inseminated with sperm extracted from her dead husband were discussed in Bulletin No. 39. Now, 16 months after winning her case in the Court of Appeal, comes the news that she is pregnant after treatment in Belgium; ‘it is a great, great feeling’, she said. It seems as though Mrs Blood has won the support and admiration of almost everyone.

Should this be the case? The deathbed is a solemn, and even mysterious, place. Was it not inappropriate for doctors to be there collecting sperm from Mr Blood? Would a husband asking for ova to be collected from his wife’s cadaver generate such public sympathy? Is it proper to separate procreation from the act of sexual intercourse with its profound, and again, even mysterious, aspects of shared human relationships? Is not this whole episode another example of that post-Christian mentality that refuses to recognise the existence of any ethical boundaries – ‘if we can do it, let’s go for it’. After all, we don’t want to upset anyone, do we?

We wish Mrs Blood a trouble-free pregnancy and a happy and fulfilling life with her child. But we also wish that this will be the first and last case of deliberate posthumous fatherhood.

C is for CLONING. The practice of cloning is hotting up. Eighteen months ago there was Dolly the sheep, the world’s first mammal cloned from an adult cell. Then there was Polly, the first cloned transgenic sheep. And now in Japan a group of scientists from the Livestock Research Centre at Ishikawa claims to have produced the first twin calves cloned from the cells of an adult cow - though the poor cow that gave birth was reported to have died two days later.

Recently PPL Therapeutics was granted a worldwide licence for the use of the cloning technology that they pioneered with researchers at the Roslin Institute at Edinburgh where Dolly was made. There is a fear, not only among the tabloid press, that one day cloning technology will be applied, not to silly sheep, but to human beings. Some think that this is most likely to occur in Britain. After all, countries such as Denmark, Germany, Norway, Spain, Sweden and Switzerland already prohibit the cloning of human embryos. So why is Britain so unregulated and so keen to be the first in the field?

When we think of these issues we need to be reminded of the created order - men are not sheep, or even rats. Animals are to be used, of course, wisely and without cruelty, for the benefit of ‘those made in His image’. Conversely, men are not to be treated like animals.

So what does someone from the heart of the cloning culture think about doing it with human beings? Alan Colman, the research director of PPL Therapeutics, has stated that: ‘I just do not believe that man-made clones would be granted the same freedom [as Louise Brown, the first test-tube baby, was allowed] to develop and therefore, I say that human cloning using adult cells in unethical. I believe cloning is unsafe.’

‘So human cloning is, and will, I hope, continue to be unethical. A child so ‘manufactured’ - and that I believe is the appropriate term, could be a 21st-century circus act. Even if the child’s uniqueness is not compromised, the technique is unsafe and inefficient and the risks greatly outweigh any marginal benefit.’

This is a fascinating statement from a leading authority in the area. We should note at least three points. First, there is a strong repudiation of human cloning with the use of words like ‘unethical’ and ‘unsafe’. These may sound reassuring to some, but recent history teaches us that what was deemed ‘unethical’ twenty, or even ten years ago is now deemed ‘ethical’ by most. Anyway, which ethical code are we talking about - that of the Christian or that of the pagan? Furthermore, procedures that are ‘unsafe’ are the very stuff of medical advances and we should not be duped by such wordsmithy. Second, there is religious talk here - but is the repeated use of phrases like ‘I believe’ and ‘I hope’ anything but sentimental humbug, added in an effort to sound concerned and sincere? Third, we have been here before. Remember how abortion laws were changed to benefit just a few, poor, suffering women? Yet look at the free supply of abortion today, thirty years on. Or look at reproductive technology that was, and still is, ‘unsafe and inefficient’, but that has not diminished the public’s appetite for it. Even Dr Colman is apparently not persuaded by his own rhetoric because he concedes that: ‘Perhaps the only reasonable case for human cloning is when the prospective mother suffers from a genetic disease ...’ Go on, open that door wide and put both your feet on that slippery slope!

D is for DECEIT. Why are we still trying to deceive women? Why is the male-dominated abortion industry currently trying to market new forms of an old product? The ‘lunch-time’ abortion has arrived. But women do not need ‘lunch-time’ or ‘quickie’ abortions, which pretend that aborting a child is no big deal. Nor do they need the ‘morning-after pill’ (MAP) over the counter, without prescription, as recommended recently by a group of MPs and abortion agencies. It is not a form of emergency contraception, rather it causes an early abortion and ends a human life already begun. Such deregulation of the MAP will encourage exactly that form of sexual irresponsibility that the government had said it is so eager to curb. And the hormonal action of the MAP can seriously damage women’s health, especially for young girls, the main target for MAP usage, who could have their fertility and general health spoilt forever.

Surely the time has come to abandon these deceitful policies of increased liberalisation and replace them with policies of genuine care and protection, including enforcing the law on the age of consent.

E is for EUTHANASIA. Who could doubt that euthanasia is now the biggest topic in medical ethics? We have seen it coming, little by little, a court decision here, a heart-rending case there. And although Lord Irvine, the Lord Chancellor, has stated that plans to clarify the law surrounding ‘living wills’ will ‘not mark a step along the road to euthanasia’ we are not persuaded. Just look at some of the steps that have already been taken down that road this year.

Dr David Moor, a family doctor from Tyneside, has been accused of murdering George Liddell, an elderly cancer patient, in a so-called ‘mercy-killing’. This doctor is well known for previously supporting a fellow GP, Dr Michael Irwin, who has himself admitted assisting at least 50 patients to end their lives.

A High Court judge has granted yet another request for treatment to be withdrawn from a 24-year-old man who has been in a persistent vegetative state for the past six years. Again ‘treatment’ has been defined as nutrition and hydration, or as we used to know it ‘food and drink’, which was never regarded as ‘treatment’, but as absolutely essential for life.

Gillian Jennison, a college lecturer, who helped her ailing mother to kill herself, has been put on probation for just one year. Her mother took an overdose of sleeping pills and her daughter then smothered her with a pillow.

The parents of Catherine Roberts, a 26-year-old psychology student at Bath University were told by doctors that their daughter would never regain consciousness after suffering a severe brain haemorrhage. The doctors then did not feed Catherine for two months, but the day before the life support equipment was due to be switched off Catherine responded to her mother when she told her daughter that she loved her. Is this another case of a coma victim hearing and understanding everything, but being physically unable to respond normally for several months? Catherine is now pursuing an Open University degree.

F is for FEAR. ‘Fear God and keep his commandments, for this is the whole duty of man. For God will bring every deed into judgment, including every hidden thing, whether it is good or evil.’ [Ecclesiastes 12:13-14].

G is for GENETICS. Genetics used to be just about the most boring, moribund subject ever taught in schools and universities. Today, it is just about the hottest. Of course, we all remember Gregor Mendel, that Augustinian monk, who played with his peas and found that some produced smooth and some produced wrinkly offspring and thus he uncovered something of the mechanisms of genetic inheritance. That was way back in about 1860. Then it all went quiet until 1953 when James Watson and Francis Crick reported the structure of DNA (deoxyribonucleic acid) and suggested, in a one-page article in Nature, that DNA carried the ‘message of the genetic code’ - for that they won a Nobel prize.

Then came the greatest genetic venture of all, the cracking of the genetic code of human beings in the so-called Human Genome Project. The unravelling of each of the 46 human chromosomes and then the sequencing or ordering of the three billion constituent nucleotide bases, which are known in shorthand as A, C, G or T. This international project has been heralded as one of the greatest feats of modern science and it should produce a ‘rough draft’ early next year, ahead of schedule, with the final version in 2003.

A decade ago some scientists were convinced that amazing benefits of medical genetics were just around the corner - their enthusiasms now look over-blown and even silly. Genetics has yet to change the face of human medicine, but there can be little doubt that eventually it will. Someone has said that instead of the A,C,G,T code, medical genetics has so far been only H,Y,P,E.

So how will a knowledge of the genetic code revolutionise human medicine? Currently doctors treat the effects rather than the causes of a disease. Genetic medicine will allow doctors, for the first time, to begin to understand the pathogenesis of diseases and then pharmaceutical and biotechnology industries will use the information to design better-targetted drugs. Perhaps within the next ten years most of the genetic factors involved in common human diseases will be defined and this information will be used to redefine disease, clarify the biological mechanisms involved and hasten new treatments. Genetics will enable us to identify unambiguously the biochemical pathways involved in pathogenesis and diseases will be better classified in terms of different physiologies, clinical course and patients’ responses to treatment.

Few, if any, of us need have ethical concerns about such developments. Many of us are alive today because of such medical advances in the past; we owe our health to discoveries, like antibiotics and vaccinations, and we should thank God for such medicines.

However, some fear this genetic-based medicine because it is ‘unnatural’. But we have an elusive concept of ‘natural’. Past objections to blood donations or kidney transplants are rarely heard today, and what could be less natural than a stainless steel replacement hip! Others consider that this type of genetic engineering is a threat to our humanness. This presupposes that our genes determine, in an important and predictable way, who we are and how we will behave. So that this, like all deterministic theories, means that we would no longer be responsible for our actions – ‘my genes made me do it’. Or there is a fear that others will manipulate our genes and will thus control our behaviour.

These fears are largely ungrounded. We already know that our environment (‘nurture’) in addition to our genes (‘nature’) plays a considerable part in our identity. Furthermore, embryonic development is different for each individual and brain cell arrangements are as unpredictable as each person’s environment. Therefore we are all different, each is unique, just as identical twins are, or even human clones would be. But we could never predict the outcome of a child’s life even if we could fully describe a child’s genes plus his environment. To describe a person completely we must add what Dame Mary Warnock would call the human imagination, or, in more Biblical terms, the soul or the spirit. Genetic medicine will never make a child more brave. Nor will it make him more generous. Only God can bring about such permanent good in us. Why? Because He does not change our genes or our environment, but rather our hearts, our souls, our spirits.

H is for the HFEA. This is the Human Fertilisation and Embryology Authority. What an unprincipled lot they are, yet they have the huge responsibility of licensing and regulating IVF and human embryo research throughout the UK.

They can trace their ancestry back to the Warnock Committee Report of 1984 and the Human Fertilisation and Embryology Act of 1990. We have tracked their sub-standard decision-making since they were established in August 1991. Readers will remember the HFEA’s fudges and U-turns over, for example, extending the storage time of frozen human embryos, the debacle over Diane Blood, the payments for surrogacy and egg and sperm donors and so on.

Looking at these so-called guardians of UK embryo ethics they do appear to be a bunch of ‘poachers turned gamekeepers’ - the majority have a professional interest in maintaining destructive human embryo research and the rest probably simply follow suit. The Warnock Report originally recommended that any such statutory committee should have a considerable lay representation - but where are they? There is no-one with pro-life convictions among them. Their debates must be pretty one-sided.

Yet their greatest failure, and the cause of their dithering, is that they operate without any sound ethical base. A problem arises - what do they do? They look around for the easy, cost-effective, quick solution. It’s like putting a sticky plaster on a tumour. Small wonder they are confused and confusing.

I is for IVF. This is in vitro fertilisation, the most common of all the ARTs, or assisted reproductive techniques. Louise Brown, the first IVF baby, is now a 21-year-old university student. And in the UK over 30,000 babies, like her, have now been conceived in little glass dishes, or in vitro.

We have rehearsed the arguments against IVF before, but they are worth repeating - the inevitable destruction of hundreds of thousands of tiny human embryos, the cost, both financial (about £2000 per treatment cycle) and psychological (characterised by stress and relationship failure), the poor success rate per treatment cycle (about 15%, or, in other words, an 85% failure rate), the dubious ethics of the hi-tech ‘making’ of babies, the abnormally high incidence of multiple pregnancies in IVF and their attendant risks, the indignity of freezing, storing and thawing human embryos for up to 5 years to be typically followed by their destruction, the problems of pregnancy in post-menopausal women, the bizarreness of posthumous fatherhood, and so on. You might think it’s enough to make anyone flee from IVF, but you would be wrong, quite wrong.

J is for JACK. Dr Jack Kevorkian has always been keen to tell the world that he has assisted about 100 patients to commit suicide. For years this awful man has baited the US authorities to prosecute him. And recently he has been given what he asked for - a 10-year prison sentence for the second degree murder of Mr Thomas Youk, who suffered from Lou Gehrig’s disease. Kevorkian has previously been acquitted three times on charges of physician-assisted suicides or, as we say more plainly in the UK, euthanasia. But this time, instead of merely assisting, he went the whole hog and delivered the lethal injection himself. This self-proclaimed Dr Death had even prepared a video of the whole event, including the moment of death, and the CBS network in the US has since shown it on prime time TV.

Jack Kevorkian, the TV star, displayed his bedside manner. ‘I am going to inject in your right arm,’ he said as he reached for the potassium chloride watched by 22 million Americans. ‘OK? Okey-doke.’ And with those, the last words he heard in this world, the 52-year-old Thomas Youk went to meet His Maker, just in time for a TV commercial break.

True, ‘death with dignity’ proponents find this maverick doctor somewhat of an embarrassment to their cause. After all, as a retired pathologist, throughout his whole career, he never had a patient whom he cured. On the other hand, such a cranky enthusiast for such a deadly cause should make us ask; are we sensible enthusiasts for a better cause?

K is for KNOWLEDGE. Without this we are sunk. Yet some evangelicals are still happy to live their lives entirely reliant on feelings rather than fact. But if the Bible is anything it is a book of prepositional truths, and it is the knowledge of these truths that sets us free. But Biblical truth is not exhaustive - there is also other knowledge out there, like 2 + 2 = 4. Like abortion takes the life of a real human being. In common with all knowledge, bioethical knowledge does not come easy, we cannot catch it like measles, we have to work at it. And there is a fascinating pattern of knowledge acquisition. It starts with us - we read, listen, see and think. Once we have grasped it then it flows through our family, then into our church fellowship, then out into the world. Where is your knowledge?

L is for the LIFE HEALTH CENTRE. This was opened in 1995 on the outskirts of Liverpool. Its aim has been to provide the highest standards of pro-life, woman-centred gynaecological counselling, fertility treatment and training in primary healthcare. In addition, Zoe’s Place, the UK’s first baby hospice, is also located there providing 24-hour care and support for babies from birth to three years and respite care for the whole family. It is a remarkable place - you should visit it sometime.

Recently a new procedure has been started there. NaPro (Natural Procreative), established in the USA some 20 years ago, provides a pro-life treatment for female infertility caused by disease rather than anatomical abnormalities, such as tubal blockage. It has two key features. Firstly, there is the careful diagnosis of the underlying diseases. Monitoring menstrual cycles, hormone profiles and so on allows a woman to understand and manage her own fertility. Secondly, there is treatment by an appropriate programme of hormone and vitamin support for each couple. Obviously it circumvents the blunderbuss approach of IVF - NaPro is cheaper, less intrusive and apparently has a higher success (‘baby take home’) rate than IVF clinics. Since the LIFE Health Centre has started offering this fertility programme some couples have already achieved pregnancies, some of which have already gone to term, despite previous miscarriages and IVF failures.

Now there is the prospect of establishing the second LIFE Health Centre, this time in the Midlands, between Coventry and Nuneaton. Plans have already been drawn up for this custom-built venture for opening in late 2000.

What these ventures offer is an alternative to the hi-tech, expensive, embryo-destructive, impersonal, IVF-type procedures. Evangelicals are not all fertile and many pastors and church leaders are confused about advising such infertile couples. Now they can contact the LIFE Health Centre, Yew Tree Lane, West Derby, Liverpool L12 9HH or call 0151-228-0353.

M is for MERCY. This is the deep, heartfelt compassion, which results from not only seeing the needs of others, but which then proceeds to meet those needs. Mercy should be the bedrock of bioethics. Sadly, such issues are prone to armchair casuistry rather than bedside compassion. Mercy without action is not mercy. And all Christians are under orders to ‘Be merciful, just as your Father is merciful.’ [Luke 6:36].

N is for NUMBERS. You don’t have to be a statistician to be fascinated by numbers. And numbers have an interesting place in bioethics. We need to grasp some of them, even though they tell unhappy stories.

For example, the abortion statistics are always depressing. The latest figures from the Office for National Statistics show that there was a grand total of 187,393 abortions in England and Wales during 1998. That’s the highest ever and is about the population size of Swansea or Luton. But you get a far better grasp of this total if you divide it by 52 and then again by 6. This gives you the average number of abortions carried out each and every working day in England and Wales. And the answer is, 600. Shocking, isn’t it?

Or here is another collection of numbers, this time from the Human Fertilisation and Embryology Authority. By the end of March 1998 the number of human embryos created in the IVF units of UK hospitals and clinics was a staggering 763,499. Yet only 36,317 of these embryos have resulted in a born baby. That is a mere 4.75 per cent.

At least 90 per cent of the 763,499 are already dead. They will have been thrown away. Some were discarded because they were ‘sub-standard’, or ‘surplus to requirements’. Others were wasted because they were experimented on up to the 14-day legal limit, and others will be the result of failed IVF treatments. The remainder will now be frozen in liquid nitrogen and thousands will be killed by either this process or the subsequent thawing process. Others will have been destroyed because they have reached the end of their 5- or 10-year statutory storage period. By the time you read this, the total number of human embryos produced in the UK will have passed the 1 million mark.

If there were just say, 5 abortions performed and 11 human embryos frozen each year both practices would still be wrong. The numbers make no ethical difference. The numbers simply highlight the horrors.

O is for OATHS. These are not of the expletive variety, but rather of the deliberate sort, which express a person’s solemn intention. Medicine has always had oaths. Medical ethics and practice were initially governed by the Hippocratic Oath, which not only explicitly forbade euthanasia and abortion, but also insisted that doctors ‘Do no patient any harm’.

Over the intervening 2000 years other medical oaths have echoed the Hippocratic oath. For example, the Declaration of Geneva (adopted by the General Assembly of World Medical Organisation in 1949) stated: ‘I will maintain the utmost respect for human life from the time of conception, even under threat I will not use my medical knowledge contrary to the laws of humanity.’ That was written just two generations ago.

But more recent revisions have been much weaker affairs. They have reflected the great shift in our society as a whole from its Christian ethos (with all human life regarded as precious and inviolable) to one of secular humanism (with human life regarded as cheap and expendable). For example, in 1997 the British Medical Association produced a draft revision of the Hippocratic oath. It stated: ‘... I recognise the special value of human life but I also know that prolongation of human life is not the only aim of health care. Where abortion is permitted, I agree that it should take place only within an ethical and legal framework.’

Can you see the downgrade? Can you see how medicine has become corrupted?

P is for PREIMPLANTATION GENETIC DIAGNOSIS (PGD). PGD is the latest technique in the eugenic armoury. We are already familiar with PND, or prenatal diagnosis. PND is the searching for genetic diseases in the unborn either by chorion villus sampling (CVS) at 9-12 weeks of a pregnancy, or by amniocentesis at 16 weeks. In reality these are 'search and destroy' tactics, looking for Down's syndrome or spina bifida and so on, and then offering abortion as the so-called 'cure' or 'prevention'. In 1994, the science magazine Nature rightly called this ‘eugenics of a milder sort’.

Now the latest push is for PGD, which must be linked to IVF. The general idea is that a couple submit to IVF, and when the embryos have developed to the 8- or 16-cell stage, 1 or 2 cells are removed from each and subjected to chromosomal analysis to detect genetic disorders. Meanwhile, the remainder of the embryos are frozen until either 'passed' or 'failed'. If the former, then the embryos will be transferred to the woman’s womb, if the latter, then the embryos will be destroyed and therefore the disease will be ‘prevented’. It is, of course, nothing more than quality control for humans.

Earlier this year the FIEC submitted a response to a Discussion Document on PGD, issued jointly by the Human Fertilisation and Embryology Authority and the Advisory Committee on Genetic Testing. Copies can be obtained from the FIEC Office.

Q is for QUALITY OF LIFE. This is a tricky concept. We all know that moving immobile granny out of a high-rise flat and housing her in a bungalow will improve her quality of life. Similarly, corrective surgery for a severely-disabled child. But what happens when economics clashes with the so-called quality of life? How do we decide who has a life worth living? What about assessments that deny the old man heart surgery because he is considered to be too old to benefit? What about the newborn child with Down’s syndrome who is ‘allowed to die’ on the hospital sluice because it is thought he will never enjoy life?

Quality of life assessments are generally too subjective and too hedonistic. One such mathematical system is the QALY, or quality-adjusted life years. This measures a person’s ability in terms of personal and manipulative skills. Then a line is drawn - above it you pass, below it you fail. And with impending euthanasia legislation this is a frightening prospect.

Life is more than the sum of physical and mental abilities. There is also a spiritual dimension - not mentioned much in medical circles - but foundational to understanding a person’s worth. ‘I have come that they may have life, and have it to the full.’ [John 10:10].

R is for REPRODUCTIVE CLONING. The general public is fascinated by cloning. It began in earnest on 5 July 1996, in a shed just outside Edinburgh, when a mother gave birth to a 6.6 kg snow-white Finn-Dorset lamb, called 6LL3, or more commonly Dolly, the clone. A couple of years ago the Daily Mirror ran the headline, Plans to Clone Elvis Presley from His Toenails. A group called ACE (Americans for Cloning Elvis) had gathered a 3000+ petition urging the use of Elvis’ DNA to produce his double. In a recent poll, Mother Theresa was the most popular choice for cloning, closely followed by Michelle Pfeiffer.

There are two cloning techniques. There is embryo splitting, which can occur either naturally, such as when identical human twins are produced in the womb, or it can be induced artificially, in the laboratory. And there is cell nuclear replacement (CNR), where the nucleus (which contains the genetic material) from a cell of one animal is transferred into an ovum (with the nucleus already removed) of another animal and the resultant cell is induced to implant in the womb. This was how Dolly was created.

Cloning comes in two types. First, there is therapeutic cloning. The cells from an early embryo have a remarkable property, they are totipotent. That means they can be induced to become different types of cell, perhaps brain, skin, spleen, or fingernail. These could be used to regenerate human spare parts and tissues. This is on the brink of being approved by the UK government. The future idea is that two embryos could be produced by IVF - one becomes YOU and the other is frozen and used for spare parts later in your life. The big plusses are seen as overcoming donor organ shortages and circumventing transplantation rejection, because the cloned tissue will identically match yours.

Second, there is reproductive cloning. Human reproductive cloning is currently illegal in the UK. But what is used with farm animals (sheep, pigs, calves) today, will probably be used with humans tomorrow. Someone, somewhere, soon will clone humans - indeed, there are already reports of this from Korea.

Cloning ethics tend to be totally utilitarian and utterly self-serving. They are part of the scientific imperative: ‘we have the technology, so why not?’ But we must be clear that both reproductive and therapeutic cloning result in the exploitation and deliberate destruction of human embryos. But there is more. There is some exciting research from the US that indicates that these totipotent cells, called stem cells, can be obtained from adults rather than embryos. The destruction of human embryos may be totally unnecessary.

Whatever the outcome, we must protect the dignity and value of all those made in His image, from earliest times to natural death. We must oppose all medical procedures and experiments that treat human beings as mere expendable, laboratory materials. Reproductive cloning, like much of human genetic experimentation is a prescription for a clinical, dehumanised world, where there is not much awe, little reverence, and virtually no dignity.

And as exciting as genetic medicine is, it is limited. It will never make a child more brave. Nor will it make a man more generous. Only God can bring about such permanent good in us. Why? Because He does not change our genes, or even our environment, but rather our hearts, our souls and our spirits.

S is for SINGER. Peter Singer has been described as a Nazi, an enemy of civilisation and the most dangerous man in the world. Until recently he was professor of bioethics at the University of Monash, Australia. Now he is working at Princeton University in the USA. There his office has a police guard and an x-ray machine to screen visitors, as well as a constant protest outside by pro-life activists and disability support groups.

Why the fuss? Because Professor Singer advocates that parents of severely disabled babies should be allowed to kill their newborn infants. In other words, he is a supporter of infanticide. But there is more to him than that. He has also proposed his theory of ‘speciesism’, the idea that it is wrong to treat humans better than other animals because basically we are all of the same stuff.

Yet like most men, his life is complex and inconsistent. He does not believe in God. His grandfather died, along with other family members, during the Nazi Holocaust. He is passionate about social justice. He gives 20% of his income to third-world charities. He is currently looking after his mother, who is suffering from Alzheimer’s disease.

Even bad men have some ethical standards. But ethics are now arbitrary, rather than absolute. Practice is now utilitarian, rather than principled. Singer is a thoroughly modern man, confused and confusing. On the other hand, the Christian is to strive to be consistent in ethics and holy in practice. The Christian must aim to be mature, with the mind of Christ, informed by the Word of God, and guided by the Holy Spirit.

T is for THERAPEUTIC CLONING. On 16 August 2000, the long-awaited report from the Donaldson Committee recommended to Parliament that reproductive cloning of humans becomes illegal, but that research into therapeutic cloning, using human embryos, be allowed. Therapeutic cloning relies on the technique of cell nuclear replacement (see above, under ‘R’), whereby cells, say skin cells, from a human patient, are cloned to produce human embryos from which the all-important stem cells can be obtained.

These stem cells have a most remarkable property because they are totipotent. This means that they can be induced, either naturally in the body, or artificially in the laboratory, to become any of the different types of body cell, perhaps brain, skin, spleen, fingernail, and so on.

The much-heralded motive behind therapeutic cloning is that the cells produced could be used to replace a patient’s diseased or damaged cells and thus conquer diseases like Alzheimer’s, Parkinson’s, leukaemia, and diabetes. One advantage of this procedure is that the cells produced would have no problems of tissue rejection because they would be genetically identical to the patient’s originals.

But our primary objection to therapeutic cloning must be that it results in the exploitation and the deliberate destruction of human embryos. It is always wrong to use any human life as a means to an end - it is utilitarian, certainly not Christian.

However, it seems that the benefits of therapeutic cloning can be achieved without this wholesale destruction of human embryos. Recent research from the USA, Sweden, and elsewhere has shown that adult tissues, and even umbilical cords, retain some stem cells, and surprisingly, and contrary to accepted biological dogma, these too can be reprogrammed to generate a broad range of different cells and tissues. In other words, stem cells from adults, rather than from human embryos, can be used for therapeutic purposes. So stem cell therapies that require the destruction of human embryos already appear to be redundant. A better way forward had been found.

Yet the Donaldson Committee Report discussed therapeutic cloning almost exclusively in terms of stem cells derived from human embryos produced by nuclear transfer, or from the ‘spare’ embryos generated by IVF procedures. The possibility of using stem cells from adults was largely ignored. Why? Because scientists want to perfect the nuclear transfer technique so that they can use it when reproductive cloning inevitably becomes legal? Because they are fascinated only by experimenting with human embryos? Because the scientific imperative makes them thirst for the big breakthrough with its attendant publicity, kudos, and power?

Such a blinkered approach to progress in science and medicine is reprehensible. But it is not only the Donaldson Committee that has virtually dismissed adult stem cell work. The world-famous National Institutes of Health in the USA has too. It has argued that, ‘Adult stem cells are often present in only minute quantities, are difficult to isolate and purify, and their numbers may decrease with age.’ Yet on the very day the Donaldson Report was released, The Times carried news from a research group in New Jersey which had used stem cells, isolated from adult bone marrow, and transformed them into nerve cells. The group’s spokesman, Dr Ira Black, said, ‘These cells grow like wildfire in culture, so we have a virtually unlimited supply.’ These two statements are quite incompatible. Stem cell science is moving so fast - there was just a three-month gap between these two reports.

We do not want, or need, human therapeutic cloning. Instead, we should welcome adult stem cell research; it is a new and revolutionary approach to medicine, yet it is also bioethically uncontroversial. The prospects of stem cell therapies are exciting, but if they are going to be monopolised by those from the culture of death then they will never be a praiseworthy venture. We are not anti-science, or anti-research, or anti-progress. But we do insist that science and medicine are practised within a wholesome bioethical framework, firmly rooted within a culture of life.

U is for U-TURN. U-turns in bioethics are one-way. I have still not met anyone who was once pro-life, but who has now shifted to the pro-choice, pro-death camp; yet I know of many who have made the reverse journey.

There can hardly be a more notable case of a U-turn than that of Aleck Bourne. He was the obstetrical surgeon who became the defendant in Rex v. Bourne, a pivotal legal case, which, in 1938, changed the law under which abortions were performed in England and Wales for the next thirty years.

On 27 April 1938, a 14-year-old girl, known as Miss H., was walking with friends outside Wellington Barracks in London. Some soldiers invited her in to see a horse with a green tail. Sadly, she was raped. She was so physically traumatised by this, that she was admitted to hospital. She was now pregnant. Aleck Bourne kept her in St Mary’s Hospital and on the eighth day, he performed an abortion.

He was arrested and charged under the Offences Against the Person Act 1861 and what followed was an historic trial at the Old Bailey before Mr Justice Macnaghten. After two days, Bourne was acquitted. But it was a most dubious decision, not least because of the judge’s celebrated summing-up, which was both confused and confusing. The law already allowed a pregnancy to be terminated ‘for the purpose only of preserving the life of the mother’. Rex v. Bourne established that an abortion could also be legal if it was performed ‘in good faith for the purpose of preserving the physical and mental health of the mother.’ This was the beginning of the so-called ‘therapeutic’ abortion. As a result the door to legal abortion was pushed open much, much wider.

However, here is the U-turn. Aleck Bourne was for many years a key member of the Abortion Law Reform Association’s (ALRA) medico-legal committee. ALRA was that little band of campaigners who beyond doubt did more than anyone else to bring about the introduction of the hideous Abortion Act 1967. Bourne was a maverick doctor and he had for many years wanted to challenge the UK’s abortion law - the case of Miss H had given him that opportunity. But in 1943 he resigned from ALRA, switched sides, and eventually even became a member of the executive committee of the pro-life group, the Society for the Protection of the Unborn Child (SPUC). He believed that his acquittal in 1938 had had an undesirable effect and he later stated that he was, ‘strongly opposed to abortion for purely social or trivial indications.’

V is for VICTORY. The culture of death has taken root firmly in our society - the notion that some human beings are substandard, subhuman, and worthless is now believed by many. Will there ever be victory on the bioethical front? Of course, I do not know. Yet there is that comforting doublet, Christian hope. A society’s thinking and practice can be renewed. An individual’s and a church’s mindset can be reformed. Remember the global influence for good caused by the New Testament church, the Reformation, the eighteenth-century revivals, and so on? We are still feeling the positive ripples of these movements today. Who, in the eighteenth century, would have thought that the well-ingrained practice of slavery would have ended in the following century? Or who, twenty years ago, would have thought that evangelicals today would be interested in responding to bioethical issues?

We can rightly expect, and pray, that truth will eventually triumph. We can hope that principled compassion will win the day. Another generation will be grateful that we were sure-footed. I hope there will be a better bioethical day. And it will come even sooner if we all learn to respond to the culture of death, in a Christlike manner. Yes, there is victory for every Christian, every overcomer, every worldbeater [1 John 5:4-5].

W is for WORLD-WIDE WEB. As many of you already know, this is the computer-based source of millions and millions of articles and comments. But it must be said that the vast majority are pretty poor and unsuitable. However, there are some good websites that cover bioethical issues, such as:
British Medical Journal (BMJ), www.bmj.com - excellent, fully-searchable site from this authoritative journal.
Centre for Bioethics and Human Dignity (CBHD), www.cbhd.org - a daily up-dated US site with good essays on key issues.
Christian Action, Research and Education (CARE), www.care.org.uk - Christian perspective on bioethical issues and much, much more.
Christian Institute, www.christian.org.uk - bioethical campaigning and educating information, plus many useful links.
International Anti-Euthanasia Task Force,www.iaetf.org - updates on euthanasia, assisted suicide, advance directives, etc. -
Human Fertilisation and Embryology Authority (HFEA), www.hfea.gov.uk - information from the official watchdog on reproductive issues and more.
Human Genetics Commission (HGC), www.hgc.gov.uk - the latest official news and views on matters of human genetics.
LIFE, www.lifeuk.org - press releases, facts and figures, some especially designed for students.
LIFE Fertility Programme, www.lifefertility.co.uk - everything you need to know about this pro-woman, pro-child approach.

X is for X-CHROMOSOME. We all have 23 chromosomes in every gamete cell of our body, that is, in either our sperm cells, or our egg cells. By contrast, in every other cell of our body there are 46 chromosomes (arranged as 23 pairs). One of these pairs is called a sex chromosome. If we are men then that sex chromosome is designated XY, and if you are a woman then it is XX. How did that come about? Half of your father’s sperm carried an X-chromosome and the other half a Y-chromosome. All your mother’s ova carried an X-chromosome. So at fertilisation if a Y-bearing sperm fertilised an ovum, then the combination was XY and the result was a boy. The union of an X-bearing sperm with an ovum produced XX, a girl. Remarkable, or what?

So it is the father’s gametes, his sperm, rather than the mother’s, that determine the sex of the unborn child. This is reminiscent of a Biblical motif. As any schoolboy, who, as part of his religious education, had to read the Authorised Version of the Bible, will tell you, ‘The Bible is full of begetting.’ This somewhat archaic word describes the key role of the father in procreation - it is by ‘fathering’ that he passes on his genetic material to the next generation, how he achieves posterity, how he puts another branch into his genealogical tree. In one sense, he does nothing else during the next nine months, because the mother is the one involved in implantation, nutrition, gestation, labour, and birth. This begetting (as found, for example, in Genesis 5 and Matthew 1) is not only synonymous with fertilisation, it is also when the sex of the child is determined. The Bible declares and records this as a most notable event - indeed, those little sex chromosomes, X or Y, alter history.

Y is for YEARS. Here is a fascinating little collection of data published by the Office for National Statistics. If you look up your current age, it tells you how many more years you have to live. So, for example, if you are now a 60-year-old man, then you have 18.4 more years left. Of course, these are only averages, so 50% of you will live longer, but 50% will live shorter!

And the take-home lesson is: ‘Teach us to number our days aright, that we may gain a heart of wisdom’ [Psalm 90:12].

Z is for ZYGOTE. And finally, a grammar lesson: ‘I was a zygote, You were a zygote, He/she was a zygote, We were zygotes, You were zygotes, They were zygotes.’ Yes, every human being, in every age, and in every place was once a zygote. It is that tiny, single cell formed when one of your father’s sperms fertilised one of your mother’s ova. That was you - it was when you were conceived, it was your beginning. Genetically you were complete even then.

But you don’t remember being a zygote, do you? Nor did your parents know. But God knew. In His foreknowledge He knew all about you (Genesis 25: 23; Jeremiah 1: 5 and Psalm 139: 13-16).

You were then no bigger than the fullstop at the end of this sentence. Within about a day you had become two cells, then four, eight ... You then became a morula. After six days you were beginning to implant in the lining of your mother’s womb and you were now a blastocyst. By day 21 you were an embryo and your little heart was beating. Isn’t all this development amazing? We can join with David in his paean of praise to God: ‘I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well.’ [Psalm 139:14].