Stem cells - Who cares?: Jeff W. Dahms Metanexus:Views 2002.05.10 2234 words "The issue about stem cells," writes physician Jeff Dahms, "matters presumably because a chance at life (however we want to talk about it) matters - because children matter - because children having a chance at life matters. The very special issue of stem cells is a subtle instance of the larger issue of children and a chance at life. Perhaps if we addressed the question in this broader context we could see a little more clearly." And that is part and parcel of what Jeff Dahms, an Australian independent scholar living in New York, is addressing in today's column about stem cells--what it is that we fear and what it is we hope where that issue is concerned. Today's columnist, Jeff Dahms, is a physician-surgeon and research scientist associated with Sydney University's teaching hospitals and who works intermittently in primary care in the developing countries of Asia and the Americas. For the last two years he has worked on the design of what will become the first international health information utility, an internet service that will provide doctors and patients in the developed world, as well as field workers in the developing world, with the up to the minute, complete, and accurate decision making information about all major health issues. His scientific interests are in mind/brain evolution and the philosophy of science, particularly in the fundamental areas of physics and biology, and in relational areas such as the science religion discussion. --Stacey E. Ake =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Subject: Stem cells - Who cares? From: Jeff W. Dahms Email: The Editorial lead in the New York times on April 11 was 'President Bush and 40 Nobel Prize winners went head to head yesterday on the controversial issue of human cloning.' What are we to make of such an imbroglio? Well, quite a lot unfortunately. First up it tells us about the currency of the discussion. Nobel Prize winning is once confirmed again as the only serious measure on the popular scale of scientific understanding - the Oscars of Science. There is an implicit calculus. The weight of a moral judgement here is the degree of scientific expertise times the level of moral authority on the part of the person making the call. 40 Nobel prizes is, well.....40 times the best scientific mind. But this is coupled with somewhat limited moral authority because science has limited moral authority. Science has the keys to the kingdom, but deep down we don't really trust it much less understand it. On the other hand President Bush presumably by virtue of the electoral process carries high moral authority coupled in his case with a somewhat lesser knowledge of cell biology. The NY times gave the decision to the 40 Laureates. But if we are not to conduct the discussion in this gladiatorial Hollywood language how then are we going to consider the issue? To begin, what are the issues? On the surface they are stem cells and the start of life or individuality and 'what we ought to do.' Perhaps we can gradually unpack these and see where we are getting into trouble. The question of the stem cells although up for debate is relatively easy in comparison. There are various arguments - how many labs have what kind of stem cells, how useful adult stem cells versus embryonic stem cells are really going to be and so on. With a little effort we can at least imagine that we could get a crude consensus. The start of life question seems like it should be easy in principle also. Unfortunately asking when life begins is an arbitrary issue of language not biology. We can draw the linguistic line anywhere we like as we do for example at the terminal end. Death is when the heart stops for 30 seconds or 30mins or when the majority of the brain cells cease to function or when the last cell in the body dies. Perfectly reasonably we adopt legal definitions for death - very necessary when you are going to make hard, fast decisions like organ salvage for transplants and so on. But the line, nonetheless is completely arbitrary. We often draw the line at the point of irreversible cessation of higher brain function. Contained in that definition are references to the current state of technology, guesses about the state of end stage neural cellular biology, sharp distinctions between higher and lower brain functions and so on. In five years we may draw a different dividing line. It is a culturally determined, necessary but completely arbitrary point. In exactly the same vein, life starts whenever we say it does though for quite different reasons. There is smooth molecular continuity from the time of the gametes being separated by a short distance on the dance floor to a shorter distance in the womb to an even shorter distance when their separate body building specifications are temporarily housed in the one cell. A few days later, multiple independent cellular structures have made hundreds of copies of the still separate plans from passing molecules. For those who are tempted, one can add some metaphysics at this point by trying to determine the nature of identity. We can arbitrarily define a single cell containing two matching sets of blueprints as 'alive' - as an 'individual' - as having an identity. A skin cell from this viewpoint is not an individual. Biologically the main difference is that some of its switches on the blueprints are set differently. That this is a reversible situation has been manifestly evident since 'Dolly.' It's like one of those old fashioned cards in your computer that you can adjust for function by pushing switches backwards or forwards. Still we might get agreement to define this point in a cells short individual life as the start of individuality even if we understand it is only determined by these switch settings. But what do decide a day or so later when this cell has divided into a loosely aggregated clump of 8 perfectly identical cells? Any one of these 8 or 16 or 32 cells can make a complete body. And sometimes they do so either with a scientist's help or just at the whim of mother nature. Genetic (identical) twins are an example. Is each of these divisions doubling of identities of the number of human beings there? If so what are we to make of this individual person status when, after a little further self-cloning these individual human beings suicide by the most extraordinary mechanism? They each throw different switches on their identical blueprints and sign on for a destiny as the separate founders of dynasties of liver or kidney or brain cells. Did those individuals die then? Was their individuality traded in for a new status for the group? Is the group now the individual? The point of this is not to advance any particular argument about how we as a culture might choose to label this sequence of events or even whether we should label it at all. Even more than the definition at the terminal end there is an extended range of choices about how we might label everything if we feel we must. Whether we think we can construct a cellular ontology with any sense or consistency, the biology is clear-cut. Only the genetic code (the informational abstraction not even the molecular instantiation of it) persists to some significant degree. A multi-cellular structure continuously creates itself by destroying and replacing all its componentry even assembling the ongoing code for the new cells from breakfast molecules captured from the external world as they flow past. Continuity and individuality in the world of biology are the smile on the face of Cheshire cat', even less ephemeral than Schroedinger's cat. Additionally some will wish to nicely swaddle the above with further additions like soul or spirit. Again this is not an argument for or against any piece of labeling. It is just that we cannot reach into biology to help us do it, to buttress any position we might want to take. Early biology is so confounding to metaphysical definition that even philosophers are too sensible to touch it. Most people choose to simply imagine the biology, to conjure fictions of staple singular entities. These are more amenable to labeling than the flickering morphing realities the embryo collection really is. The 'what we ought to do', the moral vision, is the really messy bit as it is very hard even to arbitrarily define our way through. There are professionals in this arena who actually could be a little helpful. Philosophers wait in the wings for years for some one to come and ask them these questions. And they can give us answers - not very satisfying ones like 'what we actually ought to do' - but how we ought to understand 'what we actually ought to do.' Condensing a few thousand years of thought into a few lines, what we know about moral language comes down to this. Moral language is an arbitrary device in spite of the individual surety with which we use it. The 'good' might mean many very subtle things but basically one of the following: * An independent objective property of actions and events that we can directly discern. * An arbitrary subjective property conferred on events by approval of a god or a social group or a legal system. * Not a property of the action or event at all (subjective or objective) but simply a shorthand for our individual emotional response at the time. But the reason philosophers are willing sell their souls for the smell of tenure, and the reason they don't get the big bucks, is they can't tell us which one. We still have to choose. Unfortunately we take little notice of philosophers at all perhaps because we are disappointed that they can't answer the really, really big ones. As a result we tend to do moral thinking in a philosophic vacuum putting together some personal mix of the above completely unaware of the position(s) we are taking. So what have we got to work with here? Biologists can probably sort out some of the 'relatively' minor questions about stem cells for us but that doesn't get us very far. Biology is completely useless for any embryo metaphysics we might want to attempt. We are on our own when it comes to life and death and ironically so it seems also when it comes to labeling them. So to come to a considered decision we need to untangle completely different and even incompatible notions of moral sensibility, hack our way through the thicket of cellular embryology and then surmount an arbitrary set of metaphysical notions. Given all this maybe George Bush arm wresting 40 Laureates for a decision can hardly be worse. So is all lost? Have the scoundrel solipsists and wretched relativists won the day? We have no hope of consensus because we have no way to agree on how to set up the parameters. When things get tough, scientists usually reach for the magic at the bottom of the bag - an intuition, a subtle gestalt shift, even a hunch that they paper over later with lots of equations. Maybe there is another way into this question. The one thing we can all agree on is that we don't have a confident consensus about what to do. Clearly we need much better community intuition, a real feeling for the issues. The professionals, the biologists and the philosophers, have looked over the problem, spoken in tongues and left. We clearly don't have the requisite feel for the issues. Well, maybe we could acquire it. The issue about stem cells matters presumably because a chance at life (however we want to talk about it) matters - because children matter - because children having a chance at life matters. The very special issue of stem cells is a subtle instance of the larger issue of children and a chance at life. Perhaps if we addressed the question in this broader context we could see a little more clearly. If we acquired a concrete feel for this broad concern the subtler issue might be less opaque. Do we as a culture already care so much for the right of a child to a chance at life that we bend all our endeavors to making sure they are all fed, kept healthy, educated and so on? Do we actually care for children or just for conjured abstractions, for political posturing, for righteous blame, for own fantasies and power in fact? In ways too awful to list we starve, callously neglect, oppress and exploit a big fraction of our children. Those that survive learn the lesson well - and pass it on. There, we have a touchstone - a concrete measure of our moral capacity. This concrete measure might be considered our pass - the right to a hearing of our best intuitions on what to do about work with stem cells. If we learned to care so much that we personally took to reconstructing a society wherein all children thrived we might then believably turn our attentions to weightier discussions of the subtle metaphysics of the blastocyst. Then again if we were living lives like that, the apparently intractable problem of the stem cells might be transparent to such caring minds. =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= This publication is hosted by Metanexus: The Online Forum on Religion and Science . The views expressed here do not necessarily reflect those of Metanexus or its sponsors. To comment on this message, go to the browser-based forum at the bottom of all postings in the magazine section of our web site. Metanexus welcomes submissions between 1000 to 3000 words of essays and book reviews that seek to explore and interpret science and religion in original and insightful ways for a general educated audience. Previous columns give a good indication of the topical range and tone for acceptable essays. Please send all inquiries and submissions to Dr. Stacey Ake, Associate Editor of Metanexus at . Copyright notice: Columns may be forwarded, quoted, or republished in full with attribution to the author of the column and "Metanexus: The Online Forum on Religion and Science ". Republication for commercial purposes in print or electronic format requires the permission of the author. Copyright 1998, 1999, 2000, 2001, 2002 by William Grassie.