Prof. Dr. Dianne Nutwell Irving, M.A., Ph.D. Journal: Canadian Chapter, Fellowship of
Catholic Medical Association (USA) Catholic Scholars (Autumn 2002), pp. 7-32;
copyright June 18, 2001 also see International Federation of Catholic Medical Associations (FIAMC) website: <http://perso.club-internet.fr/frblin/fiamc/last/ gyneco/gyntexts/irving.html>
"THE IMPACT OF INTERNATIONAL BIOETHICS ON
THE "SANCTITY OF LIFE ETHICS", AND THE ABILITY OF
OB GYN'S TO PRACTICE ACCORDING TO CONSCIENCE" **
"A small error in the beginning leads to a multitude of errors in the end."
Thomas Aquinas, De Ente Et Essentia
Aristotle, De Coelo
It is a great honor and privilege to be able to participate in this much-needed conference on the future of Obstetrics and Gynaecology, and on the fundamental human right to be trained and to practice according to conscience. Tremendous discrimination and pressures now exist world-wide, with dire consequences on the Church's health care ministry and entire societies of people globally -- to which the participants at this conference have come to testify.
One of the most urgent yet least discussed medical dilemmas today is access to the correct basic scientific information regarding the human embryo -- scientific information which demonstrates empirically that normally every human being begins to exist at fertilization in the woman's fallopian tube as a single-cell embryo, the zygote. Indeed, fertilization is the beginning of the existence of the human being, the human embryo, the human organism, the human individual, and the "embryonic period." Without this correct scientific information we are all precluded from forming our consciences correctly or making morally correct medical decisions about abortion or other related current medical and scientific issues. The use of the correct science is the starting point for thinking about all of this.
To know that the human embryo is a personal human being is central to forming our consciences correctly, and therefore to knowing what actions are right or wrong in a specific medical or research situation. While conscience is the subjective norm in philosophical natural law theory, it must be a correctly formed conscience -- one in accord with objective reality and objective truth -- starting with and including this objective scientific truth. Any scientific error or scientific mis-information in this regard precludes us from forming our consciences correctly or making morally correct medical decisions.
Although we are here this week to discuss and examine the more obvious causes of the pressures and discriminations against ObGyn's to practice medicine according to their consciences, my purpose is rather with identifying the "larger picture", i.e., the more subtle but pervasive pressures and discriminations that stem from the structures and politics informed by international bioethics. These structures are preventing acquisition to and dissemination of the accurate scientific information regarding the full humanity and personhood of the early human embryo.
More specifically, I want to focus: (1) on the profound global impact of the recently formalized and inherently anti-life philosophy of "international secular bioethics" on political and governmental structures; (2) on the long-articulated attack by international bioethics on the "sanctity of life ethics", especially as formulated in bioethics as "preference" utilitarianism; and (3) on the incorrect science propagated historically and currently in international bioethics debates on human cloning, human embryonic, and human fetal stem cell research.
II. THE ANTI-LIFE PHILSOPHY OF INTERNATIONAL BIOETHICS:
A. Different Ethics, Different Conclusions:
First, I would like to historically identify the anti-life philosophy inherent to international bioethics by sketching quite briefly the recent formal "birth" of bioethics in the USA. Just what IS "bioethics"? Most people would say that it is just the application of traditional philosophical and theological principles to current technological issues in medicine and medical research -- e.g., cloning or experimenting with new AIDS drugs, right?
Not really. The philosophical underpinnings of bioethics are completely different -- even contradictory to -- the philosophical underpinnings of traditional secular medical ethics or Roman Catholic medical ethics. Traditional medical ethics focuses on the physician's duty to the individual patient, whose life and welfare are always sacrosanct. The focus of bioethics is fundamentally utilitarian, centered on "maximizing total human happiness", or, as we shall see, maximizing total "preferences" and "interests."
To put my endeavor into sharp focus, consider for a moment the strikingly different conclusions reached by secular bioethics and Roman Catholic medical ethics on an array of issues. Secular bioethics generally considers the following as ethical: abortion, contraception, the use of abortifacients, prenatal diagnosis with the intent to abort defective babies; surrogate motherhood; human embryo and human fetal research; human cloning; the formation of human chimeras (cross-breeding with other species); human embryonic and fetal stem cell research; "brain birth"; purely experimental high risk research with the mentally ill; euthanasia; physician-assisted suicide; and living wills documenting consent to just about anything. In contrast, Roman Catholic medical ethics considers all of these unethical.
How is it that these two different ethical systems lead to such opposite and contradictory ethical conclusions? The answer is rather predictable. Every academic ethical theory has its own idiosyncratic ethical principles. Deducing from different ethical principles necessarily leads to different ethical conclusions. For example, Roman Catholic medical ethics is grounded in the ethical principles embedded in the Moral Law (a combination of natural law philosophical ethics, Divine Revelation, and the teachings of the Magisterium). Secular bioethics, as predominantly understood and applied, is grounded in the National Commission's three ethical principles as articulated in their Belmont Report. Deducing from these two very different sets of ethical principles leads inexorably to these different ethical -- and therefore medical ethical -- conclusions. Nor is there any such thing as a "neutral" ethics, including bioethics. All ethical theories are normative -- i.e., they take a stand on what is right or wrong. Therefore no "ethical theory", it would seem, should be forced on any members of a pluralistic, multicultural, democratic society!
In short, there is really no such thing as just "ethics per se", as just "medical ethics per se", or as a "neutral ethics". There are different kinds of ethics, and therefore there are different kinds of medical ethics -- each with its own unique normative ethical principles, subject matter, method, ethical "conclusions", and squadrons of "experts". Bioethics is just one idiosyncratic ethical theory among many -- albeit relatively new.
B. The Formal "Birth of Bioethics":
As detailed in his extensively referenced new book, The Birth of Bioethics, Albert Jonsen traces the history of traditional medical ethics from the ancient Hippocratic period to post-World War II traditions. He then describes a couple of decades of famous international conferences on the future of medical ethics/research, and the gradual formation of the three major "think tanks" which were comprised of the leading scholars who would play critical roles in the final formal "birth" of bioethics. These "centers" included: The Hastings Center in New York (founded in 1969 by Willard Gaylin and Daniel Callahan as Co-Directors), The Kennedy Institute of Ethics at Georgetown University (founded in 1971 by Andre Hellegers as Director), and the Society of Health and Human Values (founded in 1970 by the Committee on Medical Ethics and Theology of the United Ministries in Education, with its first Chairman of the Board of Directors, Dr. Edmund Pellegrino).
Bioethics as understood and practiced today was actually "created" out of thin air by a Congressional mandate, with the passage of the National Research Act in 1974. The Act mandated that the Secretary of the Department of Health, Education and Welfare appoint a National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research to: " identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and  to develop guidelines that should be followed in such research." As Albert Jonsen, a member of that National Commission, later perceptively noted, "No legislation had ever before charged a government body to identify basic ethical principles as did Public Law 93-348."
Thus, in 1974, the Secretary appointed an eleven-member National Commission that in 1978 issued a document called The Belmont Report, which identified and defined three "ethical principles": respect for "persons" (immediately deconstructed to mean pure "autonomy"), "justice", and "beneficence." To this day, those principles are called "the Belmont principles", the "Georgetown mantra", "principlism", "federal ethics", or simply "bioethics." Obviously, as we have seen, deducing from these different normative ethical principles will lead to quite different conclusions about what is right or wrong in health care, as compared to deducing from other ethical principles such as the Moral Law.
Also, as Congressionally mandated, in 1981 the Belmont principles immediately became the explicit foundation for the guidelines that the U.S. federal government's Office for Protection from Research Risks (OPRR) was to use when assessing the ethics of using human subjects in research. These bioethics principles, as originally defined, also underlie a host of other federal regulations and guidelines for medical research, and have worked their way into the private and international sectors as well.
C. Short Analysis of Bioethics "Theory":
What is perhaps helpful for ObGyn's to understand is that bioethics was fatally flawed from the beginning, and therefore it can be easily challenged. The three Belmont Principles -- respect for "persons" (autonomy), justice, and beneficence -- were supposedly derived from the normative ethical systems of various secular moral philosophers, especially Emanuel Kant, J. S. Mill, and John Rawls (a contemporary influential Harvard University philosopher whose 1971 book, A Theory of Justice, was a blueprint for certain liberal legal and social theories of the 1970's).
The fact that each of these theories fundamentally and systematically contradicted each other seemed to be irrelevant to the early "ethics-makers". In effect, they quite selectively took bits and pieces from different and theoretically irreducible ethical systems and rolled them up into one ball. Furthermore, each of these principles were defined as prima facie, i.e., no one principle could overrule any of the others. The way we come to know these bioethics principles is by taking courses, attending seminars, and listening to bioethicists lecture at conferences.
But theoretically and practically it was soon discovered that these bioethics principles simply could not, and would not, work. Because bioethics was derived from bits and pieces of fundamentally different and contradictory theoretical philosophical systems, the result was theoretical chaos, rendering it academically indefensible.
More problematic, when people practically tried to apply the theory, it didn't work because there was no way to resolve the inherent conflicts among these three prima facie principles. Caution concerning this inherent conflict among the three bioethics principles had been voiced at the beginning of the field, e.g., by Paul Ramsey, who noted, "Within the amplitude ... of general ethics, our authors fail to address clearly and rigorously the issue: which of these moral principles has priority (e.g., in the case of conflict)?" For example, how could a patient appeal to "autonomy" to have any and every medical treatment regardless of its efficacy or cost without contradicting an appeal to "justice" and the "fair" allocation of scarce medical resources? It couldn't.
Furthermore, while the Belmont Report gave a little nod to the traditional Hippocratic understanding of beneficence as doing "good" for the individual patient, it also included a second lengthy definition of beneficence that was essentially utilitarian: doing "good" for society, or, "the greatest good for the greatest number". The report even declared that citizens have a "strong moral obligation" to take part in experimental research for the greater good of society. This obviously contradicts the Hippocratic interpretation of beneficence, and it also violates time-honored international guidelines, such as the Nuremberg Code and the Declaration of Helsinki, in which the "good" of society may never outweigh the "good" of the individual patient.
The second Belmont principle, justice, was also defined along utilitarian lines, i.e., in terms of "fairness" -- "fairness", that is, in allocating the benefits and burdens of research fairly across the social spectrum. This Rawls-influenced definition of justice is surely quite different from the classic Aristotelian definition of "justice" as treating people fairly as individuals. Rawl's "theory" of justice also profoundly influenced the theory-makers of bioethics from several other different academic disciplines. For example, it would later be adapted by his student Norman Daniels and applied to health care; it began to "creep into law", e.g., through lawyer/bioethicist John Robertson, who quoted from Rawls in influencing the justices' decision in the Saikewicz case -- resulting in the still controversial legal concept of "substituted judgement"; it has also been applied by Arthur Dyck in international population policy issues.
Even the third Belmont Principle, respect for persons, ended up serving utilitarian goals. Respect for persons is supposed to be a Kantian notion, in which respect for the individual is absolute. But the Belmont Report blurred that idea with Mill's utilitarian views of personal autonomy. In Mills' view, only "persons" -- that is, fully conscious, rational adults capable of acting autonomously -- are defined as moral agents with moral responsibilities. Unfortunately, this issue of mere "moral agency and responsibility" was reinterpreted by bioethics to "read" that those incapable of acting "autonomously" -- infants, the comatose, those with Alzheimer's or Parkinson's, drug addicts, alcoholics, the mentally ill and mentally retarded, etc. -- were "non--moral agents", and thus "non-persons" with no rights. It is only a short step from this blurred reasoning to that of Princeton's Peter Singer -- a "preference" utilitarian who argues that some animals have more moral value than young human children or ill, disabled human adults.
Eventually discontent began to smolder within the brave new discipline. Even the founders of bioethics have admitted that the Belmont principles of "bioethics" present grave problems as guidelines for physicians and researchers. The Hastings Center Dan Callahan has conceded that after 25 years, bioethics simply has not worked. Gilbert Meilaender has noted "how easily the [reality and worth of the individual human] soul can be lost in bioethics." National Commissioner Jonsen recently wrote that bioethics should now be regarded as "a sick patient in need of a thorough diagnosis and prognosis." In a scathing article against bioethics, "Leaving the Field", Renee Fox and Judith Swazey responded in depth and detail to the horrendous ethical dilemmas they considered posed by bioethics public policy making concerning organ transplantation, especially on an international scale. Other controversies and battles over the validity of the bioethics principles on many levels are documented and collected in an already classic 1195-page tome edited by Rannan Gillon, in which 99 scholars from around the world jump into the fray over bioethics -- by far the majority of them arguing against bioethics "principlism". Bioethics simply cannot be defended, and it does not work.
Another reason for the theoretical and practical chaos surrounding bioethics these days is that almost anyone can be a bioethicist. Few "professional bioethics experts", the doctors, researchers, and lawyers who sit on hospital and government bioethics committees, have academic degrees in the discipline, and even for those very few who do there is no uniform or standardized curriculum. Most professors of bioethics don't know the historical and philosophical roots of the subject they teach; the courses vary from institution to institution; there are no local, state, or national boards of examination; and there are no real professional standards. There is not even a professional code of ethics for bioethicists!
Because of these and other stinging criticisms (especially from within the academy and their own ranks), many bioethicists now prefer to say that their field is more a form of "public discourse" than an academic discipline, a kind of "consensus ethics" arrived at by democratic discussions rather than by formal principles. The problem with this line of reasoning is that the ethical principles used in the "discourse" are still defined precisely as defined in The Belmont Report and the early bioethicists, and those who typically reach the "consensus" are the bioethicists themselves (not the patients, their families, or society at large). So the process is not exactly "neutral" or "democratic." And if bioethics is just a "discourse," then why are its practitioners regarded as "ethics experts"? Most curiously, if bioethics is a normative ethical theory -- i.e., it takes a stand on what is right and wrong -- it is thereby not a "neutral" ethical theory -- so why should it be allowed to be forced on the citizens of any multi-cultural, pluralistic, democratic society?
D. International Reign and Penetration of Bioethics:
Regardless of such massive and admittedly fatal defects, the three principles of bioethics -- autonomy, justice, and beneficence (as originally defined) -- still pop up everywhere in the literature of a myriad of public policy making bodies with jurisdiction over political, social, medical and research decisions. For example, The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, created by the U.S. Congress in 1978, has cited the three bioethics principles in presumably definitive reports on an extensive list of wide-ranging medical ethics issues. The National Institutes of Health's 1988 Human Fetal Tissue Transplant Conference, its 1994 Human Embryo Research Panel, and the National Bioethics Advisory Commission set up by President Bill Clinton in 1995 also cite the Belmont principles as norms in their determinations of what is "ethical". This same bioethics is now routinely used in government regulations, e.g., the federal Office for the Protection from Research Risks (OPRR) regulations on the use of human subjects in medical research, The Common Rule, Institutional Review Board Guidebooks, and governmental Hospital Ethics Committee Guidebooks. The list of bioethics-based government regulations and policies is endless -- hence the reference to bioethics as "federal ethics".
In the private sector these same bioethics principles are used to explicitly ground private Hospital Ethics Committee Guidebooks, and most policies for hospitals and other health care facilities -- including some Roman Catholic hospitals and health care facilities.
Within academia, the principles of bioethics now also pervade the "ethics" of most other academic disciplines, such as public policy, engineering, journalism and business -- even military "ethics". Many colleges, universities, and medical and nursing schools require a course in secular bioethics in order to graduate. Bioethics has also heavily influenced the media, and legal ethics, even created new legal fields of study -- e.g., "health care law", and "animal rights law". Bioethics is actually taught now in high schools, thanks especially to a well-funded program at the Kennedy Institute of Ethics at Georgetown University.
Bioethics is now international. As of 1997, there has been an International Association of Bioethics, whose founders were Australian bioethicists -- their first president being Peter Singer. The Council for International Organizations of Medical Sciences (CIOMS), associated with the World Health Organization and UNESCO, has demonstrated interest in bioethics for decades now, and has issued international guidelines on many topics. Since 1985, the Council of Europe has had a Committee of Experts on Bioethical Issues, which with wide international consultation, composed a Convention for Bioethics containing guidelines on major bioethics issues. UNESCO formed an International Bioethics Committee in 1993. The European Community and its legislative arm, the European Parliament, have formulated bioethics policy and sponsored bioethics studies. Centers and institutes of bioethics exist worldwide, "from Bonn to Beijing, and from Bangkok to Buenos Aries," as Jonsen quips. The 1994 UNESCO Directory list 498 such bioethics centers outside of the United States. These all define "autonomy", "justice", and "beneficence" as originally defined in The Belmont Report and by the early bioethicists.
There has always been an undercurrent of concern about the makeup of appointed groups such as the National Commission and the later bioethics commissions. This concern was articulated sometimes by referring to such efforts as "commissioning ethics," or "consensus ethics," and was best summed up earlier by one of the original scholars of the Hastings Center, Robert Morison, who very early on sketched his views on this new emerging field called "bioethics": "What one fears is that the Commission may become the mechanism whereby the speculations of the ethicists become the law of the land. It is already far too easy for abstract notions of right and wrong to emerge as deontological rules which begin their public life as 'guidelines' but culminate in the force of law." As Jonsen opined, "Morison's letter was a sobering reminder of the anomalous role of an 'ethics commission' in a pluralistic, secular society."
As bioethics supplants traditional ethics before our very eyes, few seem to even question its underlying premises. But we should know it for what it is: a form of extreme utilitarianism in both its theoretical and practical forms. It bears no relation to the patient-centered Hippocratic ethics that for nearly 2500 years required physicians to treat every human being in their care as worthy of respect, no matter now sick or small, weak or disabled. It certainly bears no relation to Roman Catholic medical ethics, which bases its ethics on the principles of the Moral Law.
E. Erroneous Science Used by Early Bioethics:
As mentioned earlier, the use of false science actually precludes ObGyn's, health care workers, and women from correctly forming their consciences about abortion, the use of abortifacients, and a host of other related issues. Yet right from the start bioethics has propagated its own "science" in order to advance its own agenda.
Of note, the National Commission used several "odd" scientific definitions in its individual reports, e.g., in its Report on Fetal Research(1975) Even the Commission acknowledged this: "For the purposes of this report, the Commission has used the following definitions which, in some instances, differ from medical, legal or common usage. These definitions have been adopted in the interest of clarity and to conform to the language used in the legislative mandate" [referring to the National Research Act of 1974]. Among such "unique" scientific definitions used by the Commission was that of the "fetus" as beginning at implantation (i.e., 5-7 days post-fertilization). Before that there was only a "pre-embryo". The terms "human being" and "embryo" were never defined. Similarly, the OPRR federal regulations, based on the Commission's Belmont principles, contain two "unique" scientific definitions. "fetus" and "pregnancy" are both defined as beginning at implantation! Again, no definition of "human being" or of "embryo".
Of course, such "definitions" are rather bizarre, as the single dissenting report by National Commissioner Louisell pointed out. Science has known since the 1880's, with the publication of Wilhelm His' three-volume tome, Anatomie menschlicher Embryonen, that fertilization was the beginning of the existence of the human being, the human embryo. Normal pregnancy also begins at fertilization in the woman's fallopian tube. And the "fetal period" doesn't even begin until the 9th week post-fertilization.
Clearly, such "odd" scientific definitions -- or re-definitions -- in the National Commission's Report and in the OPRR federal research regulations would simply serve the purpose of removing "flushed" human embryos, and artificially produced human embryos, from any sort of governmental protection or oversight in the future -- especially given the growing interests in viable human embryos as biological materials for use in IVF "therapy" and research. They would be especially prized for used in human cloning and human chimera research.
From the National Commission onward, these early human embryos have never been acknowledged by the federal government as "human research subjects" to be protected from research abuse; instead, they are simply "human research objects". None of the federal regulations to follow would apply to them -- right up to the present. Nor has the correct Biology 101 been used yet with reference to the definition of "early human embryos" or "human fetuses" -- especially in the "scientific" language used in federal, state and international legislation, regulations and guidelines on these related issues. No wonder so many people are so confused.
F. Erroneous "Personhood" Theories used by Bioethics:
ObGyn's might keep in mind that the key to understanding any philosophical or theological ethical theory is to identify its philosophical or theological "anthropology"-- or definition of "a human being" or "person". Different anthropologies lead to different ethical theories. Some anthropologies match reality; others don't.
Bioethics tries to claim that its theory really has no "anthropology", i.e., the "personhood" issue. Bioethics is "just" about "ethics". However, almost all bioethics arguments do incorporate a "delayed personhood" claim, whether or not they know or admit it -- especially within the context of debates over abortion, the use of abortifacients, human and fetal research, cloning, stem cell research, euthanasia, etc. That is, most deny the accurate human embryology, or make up their own, to argue that at fertilization there is no human being -- or at least no human "person" -- there yet. "Whatever" is there has only a "reduced moral status" at best (the language used from the National Commission onward). Only some time period after fertilization, e.g., implantation (5-7 days post-fertilization), 14-days (with the formation of the primitive streak), or "brain birth" (with the formation of the cortex or neocortex), etc. (depending on the theory), is there a real "person" with rights present. Before that biological marker there are only "stem cells", or "pre-embryos" present.
Virtually all of the arguments for "delayed personhood" use erroneous science on which to ground their philosophical "personhood" claims, hence rendering those claims automatically invalid per se. Regardless, these false claims have had enormous influence in public policy making worldwide -- especially the "brain-birth" myths (addressed with "preference" utilitarianism, below), and the "pre-embryo" myth of McCormick and Grobstein. It is worth reviewing even briefly this influence, as it helps to explain at least to some extent the sources of such immense pressures against Catholic ObGyn's in their daily practice. While many may be aware of McCormick's influence in moral theology, few seem to be aware of his penetrating work in a totally different field -- "secular bioethics".
Early in the 1970's, Richard McCormick, S. J., had argued that defective newborns could be allowed to die. Applying the "Catholic" moral theology distinction of the Principle of Double Effect, McCormick concluded that the term "extraordinary" was large enough to justify the omission of life-sustaining treatments on the basis of expected diminished quality of life, defined in terms of the potential for human relationship. McCormick had also agreed with the May 1979 DHEW Ethics Advisory Board recommended approval of federal funding of research on the safety and efficacy of IVF research and embryo transfer in the treatment of infertility -- departing from the Vatican's position against any technologically assisted pregnancies, even in lawfully married couples. Now, following similar work by Andre Hellegers (founder of The Kennedy Institute of Ethics at Georgetown University), McCormick seriously questioned the "moral status" of early human embryos (or, "pre-embryos" as he referred to them), as did several others within the Catholic Health Association. Furthermore, McCormick reluctantly agreed that since some abortions are acceptable, then some fetal research would also be acceptable. He had reasoned that children have a moral obligation to participate in non-therapeutic experimentation where there is no discernible risk or undue discomfort, and therefore their parents may give proxy consent for their children's participation in such research that would not benefit them personally. He grounded this moral obligation in social justice -- i.e., "to contribute to the benefit of the human community." The same moral obligation, argued McCormick, can now be extended to the fetus. Paul Ramsey also had qualms about the "moral status" of the early embryo, accepting the McCormick/Grobstein "pre-embryo", and therefore also reluctantly sanctioned fetal research. Thus these writers, as many others, claimed that morally relevant characteristics were not present in the early developing embryo until "segmentation", or the attainment of "individuality" about 14-days or even later during human development.
Regardless of the biological marker used, what these arguments have in common is a claim for some sort of a "delay" -- in "personhood", or even "humanhood" -- after fertilization.
Philosophically, such a claim is per se a claim about "anthropology", and historically a very weak and indefensible one at that. It requires that the soul and the body are two separate and independently existing substances. But think about it. If there is a real split or gap between the "mind" (or "soul") entity, and the "body" (or "matter") entity -- which is required if there is any "delay" in "personhood" -- then one simply cannot successfully explain any causal interaction whatsoever between these two separate entities, either before or even after "uniting". Nor is there any scientific data to verify such a "split", nor such a "delay".
A lengthy response is not practical here, but solid arguments to refute such "delays" have been advanced for many years. Briefly, e.g., if, the "rational soul" contains virtually the other powers of the soul; if there is no split among the several powers of the soul; if there is no split between the soul and the body; if the body and soul must exist together as one single substance (as both Aristotle and St. Thomas have insisted!); and if there is scientific evidence that the "vegetative" power of the human rational soul is present immediately at fertilization (which there is) -- i.e., the immediate production of explicitly human proteins and enzymes, the development of specifically human tissues and organs -- then the whole rational soul must be immediately present at fertilization. Personhood must begin when the human being begins. There is no carrot or frog produced -- and we know that empirically!
It is long past time for us to recognize, acknowledge, and deal with the concrete reality that the earliest human embryo is indeed deserving of exactly the same respect, dignity and legal protections as all human persons -- simply even by virtue of his or her inherent humanity which we all share in common (the basis of natural law philosophical ethics), and as stated explicitly in many Church documents. This information is critical for the correct formation of conscience.
To choose not to acknowledge or deal with this information has already led to the acceptance, now almost habitual, of a two-tiered caste of human beings -- some of whom are "persons" and some of whom are not -- as exemplified in these bioethics "delayed personhood" debates. This "delayed personhood" mental construct has also long since been transferred to bioethics issues involving adult human beings, e.g., in issues concerning the mentally ill, euthanasia, etc. If nothing else the Nazi "science", rationalizations, propaganda, and experiments, and the on-going scourge of slavery, should have taught us about the inevitable real life consequences of such a "caste".
The unheralded words of the single dissenting National Commissioner Louisell ring ominously clear: "American society is itself at risk -- the risk of losing its dedication to the proposition that 'all men are created equal.' We may have to learn once again that when the bell tolls for the lost rights of any human being, even the politically weakest, it tolls for all."
III. INTERNATIONAL BIOETHICS' ATTACK ON THE "SANCTITY OF LIFE ETHIC":
Although bioethics is unquestionably predominantly a "utilitarian" ethical theory, there are in fact many different kinds of "utilitarianism". Probably the most common in bioethics today is "preference" utilitarianism, a deconstruction of the classical utilitarianism of Bentham and Mill. While it would be a mistake to paint all "preference" utilitarians the same, as each proponent differs somewhat in their "theory", a small sampling of some of the most articulate in the field could serve to indicate, in general, some of the main dogmas they hold in common -- which dogmas the Catholic ObGyn meets daily face to face.
In "preference" utilitarianism an action is ethically correct if it satisfies the "preferences" (or, another variety, "best interests") of those affected and has the best consequences for the greatest number of "people". Modern utilitarianism, Bernard Williams explains, is supposed to be a system neutral [!] between the preferences that "people" actually have -- a "preference" being a reflection of the state of mind of the agent, and not to be judged by some standard of reasonableness other than whether it accords with the best moral theory. Therefore, all preferences go into the melting pot, with no preference to count for more than any other; there must be "equal consideration of interests", as Singer puts it. But of course ultimately, these individual "interests" will be weighed unequally against the total "good" or consequences for society as a whole -- a point about any utilitarian theory that is often overlooked or underestimated.
Of interest is the definition of "people" or "person" used in preference utilitarianism. "Persons" are those who have preferences, interests, desires, etc. For these utilitarians, not all human beings are "persons", while some animals are "persons". Preference utilitarians especially need to attack those who hold the "sanctity of life ethic" (which states that only human beings are "persons"), as simply prejudiced and racists tenets of "speciecism". As Oderberg explains the origins of this attack: "The charge was made famous by Peter Singer and is leveled by virtually all the followers of Singerian bioethics". They prefer instead a "quality of life" ethic. One way that "preference utilitarianism" attacks the "sanctity of life ethic" is by literally deconstructing or redefining it -- usually by means of "soft", meandering, but very clever "thought experiments" and "logical dialogues" that "evaluate" the "pros" and "cons" of the "sanctity of life ethic" -- to support a "quality of life" position.
A. Jonathan Glover:
One of the major theoreticians of "preference utilitarianism" for many decades has been Oxford philosopher/bioethicist/eugenicist Jonathan Glover. In his 1977 book, Glover literally redefines the "sanctity of life ethic" by means of redefining its major premise. Once that major premise is corrupted, of course, then all conclusions which flow from it will be corrupted as well.
The "sanctity of life ethic" is generally correctly stated as: "It is always a morally evil act to intentionally and directly kill an innocent human being." From that major premise it follows, e.g., that since human embryos and fetuses are innocent human beings, and since human disabled and terminally ill adults are also innocent human beings, to intentionally and directly kill them would be morally evil actions per se -- regardless of any "personhood" status, circumstances or intentions.
But Glover doesn't hold those actions to be "morally evil per se"; besides, that would impede the advancement of global "positive eugenics" and genetic engineering which he, and most preference utilitarians, strongly advocate. So he redefines the major premise of the "sanctity of life ethic" as follows: "It is always intrinsically wrong to destroy a life that is worth living." Such a life would not be "mere biological life", but rather, as Glover vaguely describes it, the quality of life of one who consciously possesses preferences, plans, projects, desires, feelings, memories, a sense of identity, etc. -- what later came to be grouped together in bioethics and labeled "rational attributes" and/or "sentience". Only a "person" possesses a life that is worth living. Since unborn, born, and human children, as well as many ill or disabled adult human beings do not have this "quality of life", they do not have a "life that is worth living". Therefore, they are "non-persons" -- and therefore the direct and intentional killing of these human non-persons would not necessarily be a morally evil act. Voila! The "sanctity of life ethic" now is the "quality of life ethic"!
B. R. M. Hare:
Glover, in turn, was the academic mentor of Oxford philosopher/eugenicist R. M. Hare. For Hare, the early human embryo, fetus and even young child are also not "persons". They are not "real people"; they are just "possible people" -- and therefore have no serious "interests" or "preferences" to be respected. We do, however, have "some" duties" toward "them". Thus, applying a sort of mathematical trigonometry to the problem, his international public population policy proposals go like this: "The maximum duty that is imposed is to do the best impartially for all the 'possible people' there might be by having an optimal family planning or population policy, which means necessarily excluding some possible people." Indeed. Hare asserts that the best policy will be the one which produces that set of people, of all "possible sets" of people, which will have in sum the best life, i.e., the best possible set of future possible people." Hare's bioethics interests lie largely in translating the Gloverian theory of "preference" utilitarianism into national (i.e., British) and global population public policies. One of Hare's most prominent students at Oxford was Peter Singer.
C. Peter Singer:
Most bioethicists today -- to one degree or another -- agree that a "person" is to be defined in terms of such "rational attributes" or "sentience". What are really "morally relevant" are "quality of life" characteristics, "preferences", or "interests". So too argues Peter Singer, currently the Ira W. DeCamp Professor of Bioethics at Princeton University's Center for Human Values. Like Glover and Hare before him, Singer -- the founder and first President of the International Bioethics Institute at the U. N., and the founder of "animal rights" -- argues that the higher primates, e.g., dogs, pigs, apes, monkeys -- even prawns -- are persons, because they exercise "rational attributes" and/or "sentience". However, some human beings, even normal human infants, as well as disabled and ill human adults, are not persons.
American philosopher/bioethicist Richard Frey, pushing Singer's logic, actually published an article in a major international bioethics textbook that, since many adult human beings are not persons (e.g., Parkinson's patients, the mentally ill and retarded, the frail elderly, etc.), and since many of the higher primates are persons, then these adult human non-persons should be substituted in purely experimental research in place of the higher primates who are persons.
Recently, Singer applied his form of "preference utilitarianism" to bestiality. He concluded that bestiality can be an "ethically correct" action, as long as it is not cruel, if it satisfies the preferences (e.g., sexual pleasure) of those affected (i.e., the human person and the animal), and if it has the best consequences for the greatest number of people involved (i.e., the total amount of "pleasure" experienced in the world would be increased). And, of course, since Singer defines many animals as "people", then "the greatest number of people" for Singer would include some human beings and some animals. Therefore, bestiality can indeed be "ethical". This is surely "theory" run amok!
American bioethicst and "preference" utilitarian philosopher Peter Suber also attacks the "sanctity of life ethic", which always entails a different definition of "person": "The 'life' that has sanctity for SL ["sanctity of life ethic"] is biological vitality, perhaps with a spiritual glow, but not the complex of powers and interests that we collectively call the person." This dogma then allows Suber to argue for the range of other bioethics positions already noted -- including abortion, euthanasia, and eugenics. He too is impatient with those who would fail to consider "the degree or kind of suffering, deterioration, dependency, or development they manifest, and regardless of the imminence of death, the burden on others, and the wishes of the subject to live or die." Suber prefers a "combined" quality of life" ethics.
United Nations consultant/bioethicist/biologist Darryl Macer (Japan) also defines a "person" similar to Glover, Hare, and Singer: "A person is generally referred to as someone who is rational, capable of free choices, and is a coherent, continuing and autonomous centre of sensations, experiences, emotions, volitions and actions; these are what may be called the characters of a person."
Macer, like so many others in the field, conveniently continues to ground his "embryology" and "personhood" concepts at least in part on the amazingly flawed but influential bioethics book by Australian theologian Fr. Norman Ford, When Did I Begin?. Ford himself, unabashedly and without cross-verification, used and applied the same erroneous "human embryology" -- as well as the same "moral" conclusions that follow from it -- that McCormick and Grobstein used to fashion their scientifically erroneous concept of a "pre-embryo". Macer argues that the life of a 1-cell embryo is not sacrosanct, and has never been, even in theological circles. "It is clear that the biological qualities of personhood are not present at conception; what is present is something we call the embryo, ... but it does not manifest the activities of a human person. It is a potential human person, at the biological level at least, rather than a human person with potential." Ultimately, Macer leans toward the socially acceptable concept of the "gradual" attainment of "personhood" and "brain birth", and is a strong proponent of global birth control.
However, although a living human embryo or fetus does not qualify as a "person" for Macer, their manipulation (or destruction) can be useful for purposes of "positive eugenics" -- for a "healthy "society". Macer clearly articulates the international bioethics case for "positive eugenics." But as with all utilitarian theories, there is virtually no "ethical" consideration given to the "means used" to achieve this eugenics agenda. Nor would they need to. The reality of the person of the individual human being at fertilization has been disposed of -- "scientifically", conceptually, and linguistically. It simply remains to be concretized in all international law.
Or ponder the contemporary thoughts of one of bioethics' founders, "Christian bioethicist" Tristram Engelhardt: "Persons in the strict sense are moral agents who are self-conscious, rational, and capable of free choice and of having interests. This includes not only normal adult humans, but possibly extraterrestrials with similar powers."
Obviously, "personhood" has been and still is used as a linguistic device for various unethical purposes. It has been used in the medical arena as a justification for abortion, the use of abortifacients, international population policies, euthanasia, and a multitude of related bioethics issues -- and often for eugenic purposes. Indeed, many of the leading "savants" who pioneered the early formation of the field of bioethics were quite outspoken eugenicists. This has not changed; it is merely getting more vocal and more universal.
For example, sounding much like Hare (above), bioethicist Dan Wikler, as representative of the World Health Organization, recently declared that: "The state of a nation's gene pool should be subject to government policies rather than left to the whim of individuals. ... The completion of the human genome project would also make it possible to promote some genetic qualities such as intelligence and lower the incidence of others. ... It may be conceivably required by justice itself" ["justice", as in Rawls!]
Of course, the "gene pool" must also be determined by means of abortion, the use of abortifacients, infanticide, IVF, pre-natal selection, surrogate mothers, human embryo and fetal research, human cloning, human chimera research, human embryonic and human fetal "stem cell" research, euthanasia, physician-assisted suicide, etc. These are the usual "bioethics" issues, accomplished via "absolute autonomy" (at least for now) and the other bioethics principles as originally defined. These are not just "issues", but also the "tools" required to advance a global eugenics agenda -- just read their works, and listen to their lectures. And it is the Catholic ObGyn who is standing in the way!
IV. ERRONEOUS SCIENCE IN HUMAN STEM CELL AND HUMAN CLONING RESEARCH:
Finally, one of the most hotly debated issues right now is human embryonic and fetal stem cell research, which, researchers claim, can cure many diseases, as well as advance scientific knowledge in early human embryonic development. Here too it is difficult to correctly form one's conscience because these debates, as with the earlier debates on abortion, the use of abortifacients, etc., are replete with similar false and confusing human embryology and genetics. And although some ObGyn's are not particularly concerned about these "medical research" issues, you should consider that sooner or later you will be expected to apply "fruits" of such research in your own practice of medicine and on your own patients.
A. "Human Embryonic Stem Cell" Research:
1. The new "pre-embryo": "just 'pluripotent' 'stem cells'":
Once bioethicists were forced to discard the scientifically erroneous term "pre-embryo", there was a need to find some term to take its place -- some term that could still "scientifically" justify the use of the early human embryo in research and in "therapy".
Among the more "creative" attempts that have emerged, perhaps the most influential has been to redefine the early human embryo as "just stem cells". For example, in his 1999 testimony before the U.S. Senate subcommittee hearings on stem cell research, then-Director of the National Institutes of Health, Harold Varmus, actually defined the early human embryo from fertilization to the end of the blastocyst stage as "just stem cells"! The concrete reality of the early human embryo, a whole human organism, simply "vanished"! The NIH Guidelines on stem cell research then proceeded to define all of the "stem cells" derived from frozen IVF-produced human embryos as "just pluripotent", rather than acknowledging that many of these stem cells are "totipotent".
2. Separated "stem cells" could become embryos:
It has also not been explained in these debates that most of IVF-produced human embryos are used immediately or frozen down at very early stages, usually between the 4-8-cell stage (long before any differentiation into an inner and outer cell layer takes place), rather than at the 5-7 day blastocyst stage (when the embryo consists of at least 30-150 cells, and has differentiated into an inner and outer cell layer). Thus most of the "stem cells" retrieved from these early-stage frozen IVF-produced human embryos would actually be totipotent, not pluripotent. Oddly, most of the debate centers on the older blastocyst-stage frozen embryos, all of whose "stem cells" (derived from the inner cell mass) are referred to as "pluripotent". But most IVF transfers do not use blastocyst-stage embryos; and most frozen embryos do not have inner cell masses!
Nor has it been explained that the term "human embryonic stem cells" can properly refer to those cells only while they are still a part of and intact within the whole embryo. Once these "stem cells" -- or even groups of "stem cells" -- are separated from the whole embryo, they can be "totipotent", and therefore quite capable of "healing" themselves (called "regulation) and becoming new whole living human embryos themselves -- per se. That is, they would no longer be "stem cells"; they would be living human beings. Substantial change would have taken place, much as like happens in human cloning, resulting in the formation of a new living human embryo/being. So to use such so-called "stem cells" would constitute human embryo research per se.
We know this biological fact about regulation even from natural monozygotic twinning -- a form of asexual reproduction called "fission", "blastomere separation", or "blastocyst splitting". In fact, "twinning", sometimes called "embryo multiplication", is a form of cloning, in which copies or replicas of human genetic organisms are produced. The method is even being seriously considered by IVF researchers and clinicians themselves for "multiplying" human embryos from single embryos produced by older infertile women who have difficulty maturing viable oocytes during IVF "therapy". And surely, neither the IVF clinician nor the woman think that what is being implanted in the woman's uterus is just a "stem cell"!
B. "Fetal Stem Cell" Research:
Another misleading scientific term used in these debates is "fetal stem cells". These cells are generally retrieved from aborted embryos aged 5-9 weeks. Since the embryonic period extends from fertilization to the end of 8 weeks, the majority of these cells are "embryonic", not "fetal". These cells are also not "somatic cells", but rather the primitive sex cells, the immature human germ line cells. They are still diploid, and therefore can be cloned using any cloning technique (including somatic cell nuclear transfer). They can be matured in vitro to produce the sex gametes (sperms and oocytes) and then used in artificial fertilization.  Since they are germ line (sex) cells, they can be manipulated using DNA-recombinant gene transfer, and thereby transmit "foreign" genes down through the generations (eugenics).
As Catholic ObGyn's continue to insist on your right to be trained and practice in medicine according to your consciences, I hope you will consider how critical it is to develop a well-formed conscience -- one that is grounded in reality. Part of that reality is the accurate objective scientific information that the immediate product of fertilization and of cloning is a new, living innocent human being. These are the objective empirical facts of human embryology and human genetics which lead to the conclusions of the Moral Law that they should be treated as persons even at their earliest stages of development. This is the "sanctity of life ethic", and is the starting point for all further considerations in medicine and research.
I hope you will also consider that another part of reality is the existence of malignant global structures of bioethics which purposefully use erroneous science and an idiosyncratic and very problematic normative "ethics" to redefine the "human being" and "human person" in order to achieve their own medical and research agendas, often eugenic in purpose. Theirs is the "quality of life ethic", which necessarily comes to far different ethical conclusions in medicine and research.
Until and unless we all come to deal effectively with these concrete realities, the pressures on and discriminations against Catholic ObGyn's and related health care workers to be trained and practice according to conscience will continue to escalate.
" ... [T]here has emerged a phenomenon unknown to antiquity that permeates our modern society so completely that its ubiquity scarcely leaves us any room to see it at all: the prohibition of questioning ... We are confronted here with persons who know that, and why, their opinions cannot stand up under critical analysis and who therefore make the prohibition of the examination of their premises part of their dogma ... The questions of the "individual man" are cut off by the ukase of the speculator who will not permit his construct to be disturbed." [Emphases added.]
Science, Politics and Gnosticism (1968)
** This paper was presented at the international conference, "The Future of Obstetrics and Gynaecology: The Fundamental Human Right to Practice and Be Trained According to Conscience"; sponsored by the International Federation of Catholic Medical Associations (FIAMC), and MaterCare International, Rome, Italy, June 18, 2001. Edited August 28, 2001.
 For extensive philosophical the theological references pertaining to the correct formation of conscience and its relation to the medical moral decision making process, see my recent article on the use of abortifacients: "The Woman and the Physician Facing Abortion: The Role of Correct Science in the Formation of Conscience and the Moral Decision Making Process", presented at "The Scientific Congress, The Guadalupan Appeal: The Dignity and Status of the Human Embryo", Mexico City, October 28-29, 1999; published in Un Appello Per La Vita: The Guadalupan Appeal: Dignita E Statuto Dell'embryione Umano (Libreria Editrice Vaticana (2000), pp. 203-223; also in, Linacre Quarterly Nov./Dec. 2000.
 See, e.g.: Keith Moore and T. V. N. Persaud, The Developing Human: Clinically Oriented Embryology (6th ed. only) (Philadelphia: W. B. Saunders Company, 1998): "Human development is a continuous process that begins when an oocyte (ovum) from a female is fertilized by a sperm (or spermatozoon) from a male. (p. 2); ibid.: ... but the embryo begins to develop as soon as the oocyte is fertilized. (p. 2); ibid.: Zygote: this cell results from the union of an oocyte and a sperm. A zygote is the beginning of a new human being (i.e., an embryo). (p. 2); ibid.: Human development begins at fertilization, the process during which a male gamete or sperm ... unites with a female gamete or oocyte ... to form a single cell called a zygote. This highly specialized, totipotent cell marks the beginning of each of us as a unique individual." (p. 18).
William Larsen, Human Embryology (New York: Churchill Livingstone, 1997): "In this text, we begin our description of the developing human with the formation and differentiation of the male and female sex cells or gametes, which will unite at fertilization to initiate the embryonic development of a new individual. ... Fertilization takes place in the oviduct ... resulting in the formation of a zygote containing a single diploid nucleus. Embryonic development is considered to begin at this point. (p. 1); ibid.: This moment of zygote formation may be taken as the beginning or zero time point of embryonic development." (p. 17).
Ronan O'Rahilly and Fabiola Muller, Human Embryology & Teratology (New York: Wiley-Liss, 1994): "Fertilization is an important landmark because, under ordinary circumstances, a new, genetically distinct human organism is thereby formed. (p. 5); ibid.: Fertilization is the procession of events that begins when a spermatozoon makes contact with a secondary oocyte or its investments ... (p. 19); ibid.: The zygote ... is a unicellular embryo." (p. 19); ibid.: "The ill-defined and inaccurate term pre-embryo, which includes the embryonic disc, is said either to end with the appearance of the primitive streak or ... to include neurulation. The term is not used in this book." (p. 55).
Bruce Carlson, Human Embryology and Developmental Biology (St. Louis, MO: Mosby, 1994): "Human pregnancy begins with the fusion of an egg and a sperm." (p. 3); " ... finally, the fertilized egg, now properly called an embryo, must make its way into the uterus ...." (p. 3).
Carlson (1994), p. 407: "After the eighth week of pregnancy the period of organogenesis (embryonic period) is largely completed and the fetal period begins." O'Rahilly and Muller (1994), p. 55: "The embryonic period proper ... occupies the first 8 postovulatory weeks ... The fetal period extends from 8 weeks to birth ... ."; Moore and Persaud (1998), p. 6: "The embryonic period extends to the end of the eighth week ... After the embryonic period, the developing human is called a fetus. During the fetal period (ninth week to birth) ... ."
See especially, e.g., Albert Jonsen, The Birth of Bioethics (New
York: Oxford University Press, 1998); David J. Rothman, Strangers at
the Bedside: A History of How Law and Bioethics Transformed Medical
Decision Making (New York: BasicBooks/Perseus Books, L.L.C., 1991).
Dr. Irving holds a doctoral degree level concentration in "secular
bioethics" from the Kennedy Institute of Ethics, Georgetown University; her
400-page doctoral dissertation on bioethics and human embryo research was,
Philosophical and Scientific Analysis of the Nature of the Human Embryo
(Washington, D. C.: Georgetown University, 1991). For extensive
historical, governmental, and scientific references on the "birth" of
bioethics, and an analysis of its principles, see Dianne N. Irving, "What
is 'bioethics'? (Quid Est 'Bioethics'?"), in Joseph Koterski (ed.),
Life and Learning X: University
Faculty for Life: Proceedings of the Conference 2000
(in press). For earlier discussions about "bioethics", see also, D. N.
Irving, "The Bioethics Mess", Crisis Magazine, Vol. 19, No. 5, May
2001; "The Stem Cell Decision in the Labs: Beware of Flawed Ethics and
False Science", Newsday.com, July 15, 2001, B5; "Quality Assurance
Auditors: Between a Rock and a Hard Place", Quality Assurance: Good
Practice, Regulation, and Law March 1994, 3(1):33-52; "Which
Ethics for Science and Public Policy?", Accountability in Research
1993, 3(2-3):77-99; "Science, Philosophy and Expertise: An Evaluation of
the Arguments on 'Personhood'", Linacre Quarterly Feb. 1993,
60(1):18-46. See also, Wesley J. Smith, Culture of Death: The
Assault on Medical Ethics in America (San Francisco, CA: Encounter
Books, 2000); "Is Bioethics Ethical?" Weekly Standard (April 3,
2000), pp. 26-30; "The Deadly Ethics of Futile Care Theory," Weekly
Standard (November 30/December 7, 1998), pp. 32-35. See also, Ruth
Shalit, "When We Were Philosopher Kings", The New Republic (April 28,
1997); Eugene Russo, "'Bioethicists' Proliferate Despite Undefined Career
Track", The Scientist (Apr. 12, 1999), 13:8:16
[http://www.the-scientist.com/yr1999/apr/prof_990412.html]; Neil Boyce,
"And Now, Ethics For Sale?", U.S. News, July 30, 2001
Gay Stolberg, "Bioethicists Fall Under Familiar Scrutiny", New York Times,
Aug. 1, 2001
William Saletan, " The Ethicist's New Clothes", Slate Magazine
 These bioethics positions have been addressed at great length by bioethicists for over 30 years now, using predominantly the bioethics principles as so defined in The Belmont Report, since the formal beginning of the field -- especially in such typical secular bioethics journals as The Hastings Center Report; The Journal of Medicine and Philosophy; The Journal of Clinical Ethics; Bioethics News; The Journal of Law and Medicine; Law, Medicine and Health Care; American Journal of Law and Medicine; The Kennedy Institute of Ethics Journal; Bioethics; Medical Humanities Review; Cambridge Quarterly of Healthcare Ethics; Christian Bioethics; Journal of Religious Ethics; Philosophy and Public Affairs; etc. (See also, Jonsen, p. 414). There now exists an entire library containing, almost exclusively, bioethics articles, books and archives -- i.e., The Kennedy Institute of Ethics (the National Reference Center for Bioethics Literature) at Georgetown University which is also contained in the software BioethicsLine (which is plugged into the NIH National Library of Medicine and to bioethics centers around the world). The arguments from these secular bioethics journals, books, etc., also have been continuously applied for over 30 years to "ethics" issues in other fields, e.g., medical research, law, business, engineering, religion, politics, education, military ethics, etc. -- and then extended to international issues and governing bodies. (See note 31, infra).
 See, e.g., National Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services (Washington, D.C.: United States Catholic Conference, Inc., 1995); these directives are supposed to be made known by Catholic health care institutions and followed by "the sponsors, trustees, administrators, chaplains, physicians, health care personnel, and patients or residents of these institutions and services.", p. 2. See also, The Pontifical Council for Pastoral Assistance, Charter For Health Care Workers (Boston: St. Paul Books and Media, 1995); Humanae Vitae (1968); Declaration on Procured Abortion (1974); Declaration on Euthanasia (1980); Donum Vitae (1987); Veritatis Splendor (1993); Evangelium Vitae (1995).
 See, Humanae Vitae (Boston: Pauline Books & Media, 1968): "It is, in fact, indisputable, as our predecessors have many times declared, that Jesus Christ, when communicating to Peter and to the apostles His divine authority and sending them to teach all nations His commandments, constituted them as guardians and authentic interpreters of all the moral law, not only, that is, of the law of the Gospel, but also of the natural law, which is also an expression of the will of God, the faithful fulfillment of which is equally necessary for salvation." (p. 2; emphases added); the National Conference of Catholic Bishop's, Ethical and Religious Directives for Catholic Health Care Services: "The moral teachings that we profess here flow principally from the natural law, understood in the light of the revelation Christ has entrusted to his Church." (p. 2; emphases added). See generally, Thomas Aquinas, Summa Theologica, Ia IIae, q. 94, Fathers of the English Dominican Province (trans.) (Westminster, MD: Christian Classics, 1981); Austin Fagothey, Right and Reason (3rd ed. only)(St. Louis, MO: The C.V. Mosby Company, 1963); Vernon Bourke, Ethics (New York: The Macmillan Company, 1953); Ralph McInerny, Ethica Thomistica (Washington, D.C.: The Catholic University of America Press, 1982).
 The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research; U.S. Department of Health, Education and Welfare (Washington, D.C.: Government Printing Office, 1978).
 See, e.g., Tom Beauchamp and James Childress, Principles of Biomedical Ethics (New York: Oxford University Press, 1979), pp. 7-9; also, Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), pp. 1-3.
 Jonsen (1998), pp. 20 - 26.
 The National Research Act, Public Law 93-348, 93rd Congress, 2nd session (July 12, 1974); 88 STAT 342.
 Jonsen (1998), pp. 94-98, 333.
 Ibid., Jonsen (1998), p. 98.
 The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, established by Title II of The National Research Act (Public Law 93-348).
 The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research ; U.S. Department of Health, Education and Welfare (Washington, D.C.: Government Printing Office, 1978).
 Title 45; Code of Federal Regulations; Part 46 [45 CFR 46]; Office for the Protection from Research Risks [OPRR]; U.S. Department of Health and Human Services, 1981 [revised 1983, 1991, 1993, and incorporated into the Federal Policy (or, Common Rule), 1991.]
 John Rawls, A Theory of Justice (Cambridge: Belknap Press of Harvard University Press, 1971); Rawls, "Justice as Fairness", in Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (2nd ed.) (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), pp. 44-46, and pp. 23-24.
 E.g., Tom Beauchamp and James Childress, Principles of Biomedical Ethics (1st ed.) (New York: Oxford University Press, 1979), pp. 45-47; Tom Beauchamp and LeRoy Walters (eds.), Contemporary Issues in Bioethics (2nd ed.) (Belmont, CA: Wadsworth Publishing Company, Inc., 1982), p.26; Tom Beauchamp, Philosophical Ethics (New York: McGraw-Hill Book Company, 1982, pp. 124-128, 141, 188-190; Tom Beauchamp; and Laurence B. McCullough, Medical Ethics: The Moral Responsibilities of Physicians (New Jersey: Prentice-Hall, Inc., 1984), pp. 13-16, 21-22, 39-40, 46, 48, 133-35, 162-64. The Belmont Report, pp. 6-7.
 In Jonsen (1998), p. 328.
 The Belmont Report, pp. 6-7: "Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being. Such treatment falls under the principle of beneficence. The term "beneficence" is often understood to cover acts of kindness or charity that go beyond strict obligation. In this document beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do not harm and (2) maximize possible benefits and minimize possible harms. The Hippocratic maxim "do not harm" has long been a fundamental principle of medical ethics. Claude Bernard extended it to the realm of research, saying that one should not injure one person regardless of the benefits that might come to others. However, even avoiding harm requires learning what is harmful; and, in the process of obtaining this information, persons may be exposed to risk of harm. ... In the case of scientific research in general, members of the larger society are obliged to recognize the longer term benefits and risks that may result from the improvement of knowledge and from the development of novel medical, psychotherapeutic, and social procedures," (emphases added). See also, Tom Beauchamp and James Childress, Principles of Biomedical Ethics (1st ed.) (New York: Oxford University Press, 1979), pp. 135-167; Tom Beauchamp and LeRoy Walters, Contemporary Issues in Bioethics (eds.) (2nd ed.) (Belmont, California: Wadsworth Publishing Company, 1982), pp. 28-43.
 "Concern for the interests of the subject must always prevail over the interests of science and society [Basic principles]... The physician can combine medical research with professional care, the objective being the acquisition of new medical knowledge, only to the extent that medical research is justified by its potential diagnostic or therapeutic value for the patient [Medical research combined with clinical care - clinical research]... In research on man, the interests of science and society should never take precedence over considerations related to the wellbeing of the subject [non-therapeutic biomedical research involving human subjects - non-clinical biomedical research], Declaration of Helsinki 1993 (revised 1964, 1975, 1983, 1989), as published in United States Department of Health and Human Services (1993), Office for the Protection from Research Risks: Protecting Human Research Subjects: Institutional Review Board Guidebook (1993), pp. A6-4 to A6-6 (emphases added). See also: The Nuremberg Code, ibid., pp. A6-1 to A6-2; United Nations (1947) Universal Declaration of Human Rights; United Nations (1991) Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care; and International Covenant on Civil and Political Rights (ratified, Sen. Comm. on Foreign Affairs 1992).
 Norman Daniels, Just Health Care (New York: Cambridge University Press, 1985); Jonsen (1998), p. 222.
 See, e.g.: Superintendent of Belchertown State School v. Saikewicz, Mass Supreme Court, 1977. 373 Mass. 728, 736 (p. 7); Jonsen (1998), p. 267. The legal concept of "substituted judgment" has been specifically rejected by many writers and courts, e.g.: Mathy Mezey et al., "Life-Sustaining Treatment Decisions by Spouses of Patients with Alzheimer's Disease," Journal of the American Geriatrics Society (Feb. 1996), pp. 144-150; David C. Thomasma, "A Communal Model for Presumed Consent for Research on the Neurologically Vulnerable," Accountability in Research (1996), 4:227-239; Ralph Baergen, "Revisiting the Substituted Judgment Standard," Journal of Clinical Ethics (Spring 1995), pp. 30-38; Rosalind E. Ladd and Edwin N. Forman, "Adolescent Decision-Making: Giving Weight to Age-Specific Values," Theoretical Medicine (Dec. 1995), pp. 333-345; Jeremiah Suhl et al., "Myth of Substituted Judgment: Surrogate Decision-Making Regarding Life Support is Unreliable," Archives of Internal Medicine (1994), 154:90-96; John Hardwig, "The Problem of Proxies With Interests of Their Own: Toward a Better Theory of Proxy Decisions," Journal of Clinical Ethics (Spring 1993), pp. 20-27; James Coyne King, "The Search for Objectivity in Applying the Substituted Judgment Rule in Medical Care Cases," Boston Bar Journal (1993), 37:10-12, 14; Robert A. Perlman et al., "Contributions of Empirical Research to Medical Ethics," Theoretical Medicine (Sept. 1993), pp. 197-210; Lynne E. Lebit, "Compelled Medical Procedures Involving Minors and Incompetents and Misapplication of the Substituted Judgment Doctrine," Journal of Law and Health (1992-1993), pp. 107-130; Alexander M. Capron, "Substituting Our Judgment," Hastings Center Report (March-April 1992), pp. 58-59; Ezekiel J. Emanuel and Linda L. E. Emanuel, "Proxy Decision-Making for Incompetent Patients: An Ethical and Empirical Analysis," Journal of the American Medical Association (1992), 267:2067-2071; Jan Hare et al, "Agreement Between Patients and Their Self-Selected Surrogates on Difficult Medical Decisions," Archives of Internal Medicine (1992), 152:1049-1054; Thomas G. Gulkeil and Paul S. Appelbaum, "Substituted Judgment: Best Interests in Disguise," Hastings Center Report (June 1983), pp. 8-11; George J. Annas, "Precatory and Mindless Mimicry: The Case of Mary O'Connor," Hastings Center Report (Dec. 1988), pp. 31-33. For recent court decisions, see Illinois. Appellate Court, First District, Fourth Division. In re C.A. North Eastern Reporter, 2nd series. 1992 Oct 15 (date of decision). 603:1171-1194; Illinois. Supreme Court. Curran v. Bosze. North Eastern Reporter, 2nd series. 1990 Dec. 20 (date of decision). 566:1319-1345; Florida. District Court of Appeal, Second District. In re Guardianship of Browning. Southern Reporter, 2nd series. 1989 Apr. 10 (date of decision). 543:258-276; Missouri. Supreme Court, en banc. Cruzan by Cruzan v. Harmon. South Western Reporter, 2nd Series. 1988 Nov 16 (date of decision). 760:408-445.
 Arthur Dyck, "Assessing the Population Debate," The Monist 61 (Jan. 1977); Jonsen (1998), p. 302.
 Daniel Callahan, "Bioethics: Private Choice and Common Good", Hastings Center Report (May-June 1994), 24:3:31.
 Gilbert C. Meilaender, Body Soul, and Bioethics (Notre Dame, IN: University of Notre Dame Press, 1995), p. x.
 Jonsen, in Edwin DuBose, Ronald Hamel and Laurence O'Connell (eds.), A Matter of Principles?: Ferment in U.S. Bioethics (Valley Forge, PA: Trinity Press International, 1994), p.1.
 Renee C. Fox and Judith P. Swazey, "Leaving the Field", Hastings Center Report (September-October 1992), 22:5:9-15.
 Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994).
 See D. N. Irving, "Science, philosophy and expertise: An evaluation of the arguments on 'personhood'", Linacre Quarterly Feb. 1993, 60(1):18-46. Also, note 3, supra.
 E.g., see Jonsen (1998), p. 345.
 For extensive discussions and references for the following, see D. Irving, "What Is 'Bioethics'? "Quid Est Bioethics?", in Joseph Koterski (ed.), Life and Learning X: University Faculty For Life: Proceedings of the Conference (in press). See, e.g.: The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, The Belmont Report (Washington, D. C: U.S. Department of Health, Education, and Welfare, 1978) is the explicit (sometimes implicit) "ethical" basis for all of the following documents (a very small sample): United States Code of Federal Regulations: Protection of Human Subjects [OPRR] 45 CFR 46 (revised Jan. 12, 1981, Mar. 8, 1983; reprinted July 1989, revised 1991 -- now in the Common Rule for all departments of the federal government which volunteer to comply), (Washington, D.C.: DHHS); The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, 10 individual Reports including Summing Up (Washington, D.C., U.S. Government Printing Office, 1983); National Institutes of Health: Report of the Human Fetal Tissue Transplant Research Panel (Washington, D.C.: NIH, December 1988); NIH Guide for Grants and Contracts (Washington, D.C.: NIH, 1990); Office for the Protection from Research Risks (OPRR -- now the OHRP), Protecting Human Research Subjects: Institutional Review Board Guidebook (Washington, D.C. NIH, 1993); National Institutes of Health: Report of the Human Embryo Research Panel (Washington, D.C.: NIH, Sept. 27, 1994); NIH Guidelines on the Inclusion of Women and Minorities as Subjects in Clinical Research, Federal Reg. 59 FR 14508 (Washington, D.C.: NIH, March 28, 1994); NIH Outreach Notebook On the Inclusion of Women and Minorities in Biomedical and Behavioral Research (Washington, D.C.: NIH, 1994); the CIOMS/WHO International Ethical Guidelines for Biomedical Research Involving Human Subjects (Geneva: CIOMS/WHO, 1993); the proposed legislation in the State of Maryland for the use of incompetent mentally ill patients in experimental research; the current NIH Human Pluripotent Stem Cell Research Guidelines, (Washington, D.C.: NIH, 2000). See also Jonsen (1998), esp. Chapter 12.
 See Jonsen (1998), p. 342: "'Federal ethics' became a significant source of opinion in bioethics as public moral discourse took place not only on federal premises but also in state agencies, professional societies, institutional committees, and public forums."
 See Jonsen (1998), pp. 362-365.
 See, e.g., Tom Beauchamp and Terry Pinkard, Ethics and Public Policy (New Jersey: Prentice-Hall, Inc., 1983).
 Charles Harris, Michael Pritchard, and Michael Rabins, (eds.), Engineering Ethics: Concepts and Cases (Belmont, CA: Wadsworth Publishing Company, 1995), esp. pp. 97-102; p. 186 note 4; p. 224 notes 2 and 3.
 See, e.g., Tom Beauchamp, Case Studies in Business, Society and Ethics (New Jersey: Prentice-Hall, Inc., 1983).
 See Jonsen (1998), pp. 342-344, 371-372.
 See, "High School Bioethics Project", Kennedy Institute of Ethics, Georgetown University: http://www.georgetown.edu/research/kie/
 See, Jonsen (1998), p. 377.
 Ibid., Jonsen (1998), pp. 109-110.
 Ibid., Jonsen (1998), pp. 109-110.
 The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975, p. 5.
 Title 45; Code of Federal Regulations; Part 46 [45 CFR 46]; Office for the Protection from Research Risks [OPRR]; U.S. Department of Health and Human Services, 1983, p. 12.
 Wilhelm His (the "Father of Human Embryology"), Anatomie menschlicher Embryonen (Leipzig: Vogel, 1880-1885). For an extensive discussion of the erroneous science used in bioethics on these issues, see D. N. Irving, "When does a human being begin? 'Scientific' myths and scientific facts", International Journal of Sociology and Social Policy, 1999, 19:3/4:22-47. Also, for detailed scientific references, see note 2, supra.
 For a long and detailed philosophical and scientific analysis of the "delayed personhood" arguments of 28 current bioethicists see my 400-page Doctoral Dissertation, A Philosophical and Scientific Analysis of the Nature of the Early Human Embryo (Department of Philosophy, Georgetown University, Washington, D. C: University Microfilms, 1991). A very short summary of the dissertation can be found in Dianne N. Irving, "Science, Philosophy and Expertise: An Evaluation of the Arguments on 'Personhood'", Linacre Quarterly (Feb. 1993), 60(1):18-46.
 A short list of bioethicists who argue for "personhood" at "brain birth" (or beyond) includes: Jonathan Glover, What Sort of People Should There Be? (New York: Pelican Books, 1984); Glover, Causing Death and Saving Lives (New York: Pelican Books, 1977); Clifford Grobstein, "The Early Development of Human Embryos", Journal of Medicine and Philosophy (1985),10:213-236; Grobstein, Science and the Unborn (New York: Basic Books, 1988), p. 61; Joseph Fletcher, Humanhood: Essays in Biomedical Ethics (New York: Prometheus Books, 1979), and in Jonsen (1998), pp. 46-47; Tris Engelhardt, The Foundations of Bioethics (New York: Oxford University Press, 1985), p. 111; John Robertson, "Extracorporeal Embryos and the Abortion Debate", Journal of Contemporary Health Law and Policy (1986), 2;53;53-70; Robertson, "Symbolic Issues in Embryo Research", The Hastings Center Report (1995, Jan./Feb.), 37-38; Robertson, "The Case of the Switched Embryos", The Hastings Center Report (1995), 25:6:13-24; Michael Tooley, "Abortion and Infanticide", in The Rights and Wrongs of Abortion, M. Cohen et al (eds.) (New Jersey: Princeton University Press, 1974), pp. 59 and 64; Peter Singer and Helga Kuhse, "The Ethics of Embryo Research", Law, Medicine and Health Care (1987), 14:13-14; Kuhse and Singer, "For Sometimes Letting - and Helping - Die", Law, Medicine and Health Care (1986), 3:40:149-153; Kuhse and Singer, Should The Baby Live? The Problem of Handicapped Infants (Oxford University Press, 1985), p. 138; Singer, "Taking Life: Abortion", in Practical Ethics (London: Cambridge University Press, 1981), pp. 122-123; Singer and Kuhse, Stephen Buckle, Karen Dawson, Pascal Kasimba (eds.), Embryo Experimentation (New York: Cambridge University Press, 1990); R. M. Hare, "When Does Potentiality Count? A Comment on Lockwood," Bioethics (1988), 2:3:214; Michael Lockwood, "When Does Life Begin?", in Michael Lockwood (ed.), Moral Dilemmas in Modern Medicine (New York: Oxford University Press, 1985), p.10; Hans-Martin Sass, "Brain Life and Brain Death: A Proposal for Normative Agreement," Journal of Medicine and Philosophy (1989), 14:45-59; Michael Lockwood, "Warnock versus Powell (and Harradine): When Does Potentiality Count?" Bioethics (1988), 2:3:187‑213; see Robert Edwards, Donald MacKay, Bernard B. Haring, D. Wells, in D. Gareth Jones, "Brain Birth and Personal Identity", Journal of Medical Ethics (1989), 15:4; Goldenring, "Development of the Fetal Brain," New England Journal of Medicine (1982), 307:564; Thomasine Kushner, "Having a Life Versus Being Alive," Journal of Medical Ethics (1984), 10:5-8; M. C. Shea, "Embryonic Life and Human Life," Journal of Medical Ethics (1985), 11:205-209; Richard G. Frey, The Ethics of the Search for Benefits: Animal Experimentation in Medicine", in Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994), pp. 1067-1075.
 The term "pre-embryo" has been explicitly rejected by the International Nomina Embryologica, as noted earlier by one of its committee members in his text: "The ill-defined and inaccurate term pre-embryo, which includes the embryonic disc, is said either to end with the appearance of the primitive streak or ... to include neurulation. The term is not used in this book." [O'Rahilly and Muller (1994), p. 55] Unlike some other scientific fields, the field of human embryology is professionally required to follow the standard "Carnegie Stages", terminology and definitions as determined by this international committee composed of expert human embryologists from around the world. The "arbitrary" use of terms and definitions are not professionally accepted.
 Richard A. McCormick, S. J., "To Save or Let Die," Journal of the American Medical Association (1974), 229:172-176. See also, John C. Fletcher, "Abortion, Euthanasia and Care of the Defective Newborn", New England Journal of Medicine (1975); 292:75-79; H. Tristram Engelhardt, Jr., "Ethical Issues in Aiding the Death of Young Children," in Martin Kohl (ed.), Beneficent Euthanasia (Buffalo, N.Y.: Prometheus Books, 1975), pp. 180-192; John Robertson and Norman Fost, "Passive Euthanasia of Defective Newborn Infants," Journal of Pediatrics 88 (1976), 88:883-192; John Robertson, "Involuntary Euthanasia of Defective Newborns: A Legal Analysis," Stanford Law Review (1975), 27:213-269; Albert R. Jonsen and Michael J. Garland (eds.), Ethics of Newborn Intensive Care (Berkeley: Institute for Government Studies, 1976), pp. 33 and 190; Albert Jonsen, William Tooley, Roderick Phibbs, and Michael Garland, "Critical Issues in Newborn Intensive Care: A Conference Report and Policy Proposal," Pediatrics (1975), 55:756-768; Barbara Culliton, "Intensive Care for Newborns: Are There Times to Pull the Plug?", Science (1975), 188:133-134; Paul Ramsey, "An Ingathering of Other Reasons for Neonatal Infanticide," in Ethics at the Edges of Life: Medical and Legal Intersections (New Haven: Yale University Press, 1978), pp., 228-267, 250; Darrel W. Amundsen, "Medicine and the Birth of Defective Children: Approaches of the Ancient World," in Richard M. McMillan, H. Tristram Engelhardt, Jr., and Stuart F. Spicker (eds.), Euthanasia and the Newborn: Conflicts Regarding Saving Lives (Dordrecht/Boston: D. Reidel Publishing Company, 1987), pp. 3-22; Maria W. Piers, Infanticide (New York: Norton, 1978); Clement A. Smith, "Neonatal Medicine and Quality of Life: An Historical Perspective", in Jonsen and Garland (eds.), Ethics of Newborn Intensive Care, p. 33; Alexander Schaffere, Diseases of the Newborn (Philadelphia: Saunders, 1960); William Silverman, "The Lesson of Retrolental Fibroplasia," Scientific American (1977), 236:100-107; Paul A. Freund, "Mongoloids and 'Mercy Killing'" in Reiser et al, Ethics in Medicine, pp. 536-538; James M. Gustafson, "Mongolism, Parental Desires and the Right to Live," Perspectives in Biology and Medicine (1973), 16:4:529-557; Raymond S. Duff and A. G. M. Campbell "Moral and Ethical Dilemmas in the Special-Care Nursery," New England Journal of Medicine (1973), 289:890-984; President's Commission on Ethical Problems in Medicine and Biomedical and Behavioral Research, Deciding to "Forego Life-Sustaining Treatment: A Report on the Ethical and Legal Issues in Treatment Decisions (Washington, D.C.: U.S. Government Printing Office, 1982), Chapter 6; Cindy Bouillon-Jensen, "Infanticide," in Warren T. Reich (ed.), Encyclopedia of Bioethics (2nd ed.) (New York: Simon and Schuster Macmillan, 1995), pp. 1200-1205; Martin S. Pernick, The Black Stork: Eugenics and the Death of "Defective" Babies in American Medicine and Motion Pictures (New York: Oxford University Press, 1996)
 See discussions on the impact of the work of Richard McCormick on the development of bioethics in the current NBAC commissioned paper by John C. Fletcher, "Deliberating Incrementally on Human Pluripotential Stem Cell Research", [http://bioethics.gov/stemcell2.pdf], Sept. 1999, p. E-11 and several others; also in Jonsen, pp. 52-56, 100, 106, 154-155, 247, 259, 291, 293, 310-311.
 Andre E. Hellegers, "Fetal Development", Theological Studies (1970), 31:3-9; Hellegers,
"Fetal Development", in Thomas A. Mappes and Jane S. Zembatty (eds.), Biomedical Ethics (New York: Macmillan, 1981).
 See, e.g., Richard McCormick, S. J., "Who or What is the Preembryo?", Kennedy Institute of Ethics Journal 1:1 (1991). In this paper McCormick draws heavily on the work of frog embryologist Clifford Grobstein, as well as from "an unpublished study of a research group of the Catholic Health Association entitled 'The Status and Use of the Human Preembryo' ...". (p. 14).
The influence of the McCormick/Grobstein term "pre-embryo" was (and still is) widespread even among Catholic scholars. In addition to the works of McCormick and Grobstein, see acceptance of the term "pre-embryo" also in the work of other Catholic writers: Andre E. Hellegers, “Fetal Development,” in Thomas A. Mappes and Jane S. Zembatty (eds.), Biomedical Ethics, (New York: Macmillan, 1981); Hellegers, "Fetal Development", Theological Studies (1970), 31:3-9; Charles E. Curran, "Abortion: Contemporary Debate in Philosophical and Religious Ethics", in W. T. Reich (ed.), Encyclopedia of Bioethics 1 (London: The Free Press, 1978), pp. 17-26; Kevin Wildes, "Book Review: Human Life: Its Beginning and Development" (L'Harmattan, Paris: International Federation of Catholic Universities, 1988); Carlos Bedate and Robert Cefalo, "The Zygote: To Be or Not Be a Person", Journal of Medicine and Philosophy (1989), 14:6:641; Robert C. Cefalo, "Book Review: Embryo Experimentation, Peter Singer et al (eds.); 'Eggs, Embryos and Ethics'", Hastings Center Report (1991), 21:5:41; Mario Moussa and Thomas A. Shannon, "The Search for the New Pineal Gland: Brain Life and Personhood", The Hastings Center Report (1992), 22:3:30-37; Carol Tauer, The Moral Status of the Prenatal Human (Doctoral Dissertation in Philosophy; Kennedy Institute of Ethics, Georgetown University, Washington, D.C.: Georgetown University, 1981) (Sister Tauer's dissertation mentor was Richard McCormick; she later went on to become the ethics co-chair of the NIH Human Embryo Research Panel 1994); C. Tauer, "The Tradition of Probabilism and the Moral Status of the Early Embryo", in Patricia B. Jung and Thomas A. Shannon, Abortion and Catholicism (New York: Crossroad, 1988), pp. 54-84; Lisa S. Cahill, "Abortion, Autonomy, and Community", in Jung and Shannon, Abortion and Catholicism (1988), pp. 85-98; Joseph F. Donceel, "A Liberal Catholic's View", in Jung and Shannon, Abortion and Catholicism (1988), pp. 48-53; H. Tristram Engelhardt, The Foundations of Bioethics (New York: Oxford University Press, 1985), p. 111; William A. Wallace, "Nature and Human Nature as the Norm in Medical Ethics", in Edmund D. Pellegrino, John P. Langan and John Collins Harvey (eds.), Catholic Perspectives on Medical Morals (Dordrecht: Kluwer Academic Publishing, 1989), pp. 23-53; Norman Ford, When Did I Begin? (New York: Cambridge University Press, 1988), p. 298; Antoine Suarez, "Hydatidiform Moles and Teratomas Confirm the Human Identity of the Preimplantation Embryo", Journal of Medicine and Philosophy (1990), 15:627-635; Thomas J. Bole, III, "Metaphysical Accounts of the Zygote as a Person and the Veto Power of Facts", Journal of Medicine and Philosophy (1989), 14:647-653; Bole, "Zygotes, Souls, Substances, and Persons", Journal of Medicine and Philosophy (1990), 15:637-652.
 See Richard McCormick's testimony in The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975, pp. 34-35; McCormick, How Brave a New World? (Washington, D.C.: Georgetown University Press), p. 76; McCormick, "Proxy Consent in the Experimentation Situation", Perspectives in Biology and Medicine (1974), 18:2-20.
 See Paul Ramsey's testimony in The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975, pp. 35-36.
 For further analysis of the use of the erroneous term "pre-embryo" in the work of both McCormick and Grobstein (and others) see: Dianne N. Irving, A Philosophical and Scientific Analysis of the Nature of the Early Human Embryo (Doctoral Dissertation; Department of Philosophy, Georgetown University, Washington, D.C.; University Microfilms, 1991), esp. Chapter 3 (the Dissertation includes an analysis of the works of 28 other bioethicists who also argue for "delayed personhood" based on different "biological marker events" throughout prenatal development -- and beyond. Most of these bioethicists were referenced in the NIH Human Embryo Research Panel meetings and report). See also: Irving, "Science, Philosophy and Expertise: An Evaluation of the Arguments on 'Personhood'", Linacre Quarterly (Feb. 1993), 60(1):18-46; Irving, "When Does a Human Being Begin? 'Scientific' Myths and Scientific Facts", International Journal of Sociology and Social Policy (1999), 19:3/4:22-47; Ward C. Kischer and Dianne N. Irving, The Human Development Hoax: Time To Tell The Truth! (1997, distributed by American Life League).
The use of the term "pre-embryo" has been quite widespread for decades -- nationally and internationally. In addition to the Catholic scholars who accepted the use of the term "pre-embryo" as noted above, a partial list of secular bioethics writers who also accepted the use of the term in these debates includes: Paul Ramsey, "Reference Points in Deciding About Abortion" in J. T. Noonan (ed.), The Morality of Abortion (Cambridge, MA: Harvard University Press, 1970), pp. 60-100, esp. p. 75; John Robertson, "Extracorporeal Embryos and the Abortion Debate", Journal of Contemporary Health Law and Policy (1986), 2;53;53-70; Robertson, "Symbolic Issues in Embryo Research", The Hastings Center Report (1995, Jan./Feb.), 37-38; Robertson, "The Case of the Switched Embryos", The Hastings Center Report (1995), 25:6:13-24; Howard W. Jones, "And Just What is a Preembryo?", Fertility and Sterility 52:189-91; Jones and C. Schroder, "The Process of Human Fertilization: Implications for Moral Status", Fertility and Sterility (August 1987), 48:2:192; Clifford Grobstein, "The Early Development of Human Embryos", Journal of Medicine and Philosophy (1985), 10:213-236; also, Science and the Unborn (New York: Basic Books, 1988), p. 61; Michael Tooley, "Abortion and Infanticide", in The Rights and Wrongs of Abortion, M. Cohen et al (eds.) (New Jersey: Princeton University Press, 1974), pp. 59 and 64; Peter Singer and Helga Kuhse, "The Ethics of Embryo Research", Law, Medicine and Health Care (1987),14:13-14; Kuhse and Singer, "For Sometimes Letting - and Helping - Die", Law, Medicine and Health Care (1986), 3:40:149-153; Kuhse and Singer, Should The Baby Live? The Problem of Handicapped Infants (Oxford University Press, 1985), p.138; Singer, "Taking Life: Abortion", in Practical Ethics (London: Cambridge University Press, 1981), pp. 122-123; Peter Singer, Helga Kuhse, Stephen Buckle, Karen Dawson, Pascal Kasimba (eds.), Embryo Experimentation (New York: Cambridge University Press, 1990); R. M. Hare, "When Does Potentiality Count? A Comment on Lockwood," Bioethics (1988), 2:3:214; Michael Lockwood, "When Does Life Begin?", in Michael Lockwood (ed.), Moral Dilemma's in Modern Medicine (New York: Oxford University Press, 1985), p. 10; Hans-Martin Sass, "Brain Life and Brain Death: A Proposal for Normative Agreement," Journal of Medicine and Philosophy (1989), 14:45-59; Michael Lockwood, "Warnock Versus Powell (and Harradine): When Does Potentiality Count?" Bioethics (1988), 2:3:187‑213.
See also the use of the term "pre-embryo" in many national and international documents (a small sample): Ethics Advisory Board (1979) Report and Conclusions: HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer, Washington, D.C.: United States Department of Health, Education and Welfare, p. 101; National Institutes of Health Human Embryo Research Panel Meetings (Washington, D.C.: NIH, 1994), Feb. 2 meeting, pp. 27, 31, 50-80, 85-87, 104-106; in the Feb. 3, 1994 meeting, pp. 6-55; April 11 meeting, pp. 23-41, 9-22. See also, Dame Mary Warnock, Report of the Committee of Inquiry into Human Fertilization and Embryology, (London: Her Majesty's Stationary Office, 1984), pp. 27 and 63; Commonwealth of Australia, Select Senate Committee on the Human Embryo Experimentation Bill, (Canberra, Australia: Official Hansard Report, Commonwealth Government Printer, 1986); Parliamentary Assembly of the Council of Europe, On the Use of Human Embryos and Foetuses for Diagnostic, Therapeutic, Scientific, Industrial and Commercial Purposes, Recommendation 1046, 1986; and On the Use of Human Embryos and Foetuses in Scientific Research, Recommendation 1000, 1989; Ethics Committee of the American Fertility Society (AFS), "Ethical Considerations of the New Reproductive Technologies", Fertility and Sterility (1986), 46:27S. See also Jonsen (1998), esp. Chapters 4 and 12.
 In historical terms, this is referred to as the "chorismos" (or, "separation") problem in philosophy, originated by Plato in his famous "Theory of Forms". For discussions of Plato's quite extensive chorismos problems, see: Etienne Gilson, Being and Some Philosophers (Toronto: Pontifical Institute of Mediaeval Studies, 1949); Frederick Copleston, A History of Philosophy (New York: Image Books, 1993), Vol. 1, pp. 167 ff; Leonard J. Eslick, "The Material Substrate in Plato", in Ernan McMullin (ed.), The Concept of Matter in Greek and Medieval Philosophy (Indiana: University of Notre Dame Press, 1963); Frederick Wilhelmsen, Man's Knowledge of Reality (New Jersey: Prentice-Hall, Inc., 1956), esp. Chaps. 2 and 3. Descartes tried to give an explanation of interaction, but miserably failed and was literally laughed out of the academy. See Descartes' efforts in his Meditations (especially his Sixth Meditation), in J. Cottingham, R. Stoothoff, D. Murdoch (trans.), The Philosophical Writings of Descartes (Cambridge: Cambridge University Press, 1989). See also, Frederick Copleston, A History of Philosophy (New York: Image Books/Doubleday, 1994), Vol. 4, pp. 120 ff; Paul Edwards, The Encyclopedia of Philosophy (New York: Macmillan Publishing Co., Inc. and The Free Press, 1972), Vols. 1 and 2, pp. 353-354.
 For extensive philosophical and scientific analyses of these positions, see references in note 54, supra.
 The Church has consistently taught that to intentionally and directly kill an innocent human being at any stage of development is inherently evil -- regardless of the "personhood" status. E.g., Declaration on Procured Abortion: "In the course of history, the Fathers of the Church, her Pastors and her Doctors have taught the same doctrine -- the various opinions on the infusion of the spiritual soul did not introduce any doubt about the illicitness of abortion ... This condemnation was in fact unanimous [II.6]. ... The tradition of the Church has always held that human life must be protected and favored from the beginning, just as at the various stages of its development [II.6]. E.g., Donum Vitae: "From the moment of conception, the life of every human being is to be respected in an absolute way ... [Intro. 5]. ... At the second Vatican Council, the Church for her part presented once again to modern man her constant and certain doctrine according to which: 'Life, once conceived, must be protected with the utmost care; abortion and infanticide are abominable crimes.' More recently, the Charter of the Rights of the Family, published by the Holy See, confirmed that 'human life must be absolutely respected and protected from the moment of conception.' ... The Congregation recalls the teachings found in the Declaration on Procured Abortion: 'From the time that the ovum is fertilized, a new life is begun which is neither that of the father nor of the mother; it is rather the life of a new human being with his own growth. It would never be made human if it were not human already. To this perpetual evidence ... modern genetic science brings valuable confirmation.' ... This teaching remains valid and is further confirmed ... by recent findings of human biological science which recognize that in the zygote resulting from fertilization the biological identity of a new human individual is already constituted. ... Certainly no experimental datum can be in itself sufficient to bring us to the recognition of a spiritual soul; nevertheless, the conclusions of science regarding the human embryo provide a valuable indication for discerning by the use of reason a personal presence at the moment of this first appearance of a human life; how could a human individual not be a human person? ... [S]ince the embryo must be treated as a person, it must also be defended in its integrity, tended and cared for, to the extent possible, in the same way as any other human being as far as medical assistance is concerned." [I.1]
 The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research; Report and Recommendations; Research on the Fetus; U.S. Department of Health, Education and Welfare, 1975; "Dissenting Statement of Commissioner David W. Louisell" (p. 77-82).
 See David S. Oderberg, Moral Theory: A Non-Consequentialist Approach (Oxford: Blackwell Publishers Inc., 2000), pp. 167-168. See also definition of "preference utilitarianism" at: <http://www.utilitarianism.com/prefutil.htm>.
 Ibid., Oderberg (2000), p. 174.
 Jonathan Glover, Causing Death and Saving Lives: The Moral Problems of Abortion, Infanticide, Suicide, Euthanasia, Capital Punishment, War, and Other Life-or-Death Choices (New York: Penguin Books, 1977).
 See, e.g., Jonathan Glover, What Sort of People Should there Be? (New York: Penguin Books, 1984): "[T]he central issue is about changing human nature. I want to argue for greater willingness to consider policies that would do this, so it seems important to meet conservatism about human nature on its strongest ground (p. 16). ... [O]n the way we will be forced to do some fresh thinking about what autonomy is, and why we value it. ... Changes in society and in human nature can be expected to involve changes in values (p. 19). ... There is a widespread view that any project for the genetic improvement of the human race ought to be ruled out: that there are fundamental objections of principle. The aim of this discussion is to sort out some of the main objections. It will be argued that [such] resistance is based on a complex of different values and reasons, none of which is, when examined, adequate to rule out in principle this use of genetic engineering." (p. 25). Glover also considers human cloning, and human/animal cross-breeding as well.
 Op. cit., Glover, Causing Death and Saving Lives (1977), pp. 50-59.
 R. M. Hare, "When Does Potentiality Count? A Comment on Lockwood", Bioethics (1988), 2:3:214.
 Peter Singer, Practical Ethics (London: Cambridge University Press, 1985), pp. 118, 123; see also, Helga Kuhse and Peter Singer, "For Sometimes Letting - and Helping - Die," Law, Medicine and Health Care (1986), 3:4:149-153; Kuhse and Singer, Should the Baby Live? The Problem of Handicapped Infants (Oxford: Oxford University Press, 1985), p. 138.
 R. G. Frey, "The Ethics of the Search For Benefits: Animal Experimentation in Medicine", in Raanan Gillon (ed.), Principles of Health Care Ethics (New York: John Wiley & Sons, 1994), pp. 1067-1075. Frey is now a Senior Scholar at The Hastings Center.
 Peter Singer, "Heavy Petting", Nerve.com [http://www.nerve.com/Opinions/Singer/heavyPetting].
 Peter Suber, "Against the Sanctity of Life" [Philosophy Dept., Earlham College, Indiana -- Quaker] (http://www.earlham.edu/~peters/writing/sanctity.htm).
 Ibid., Suber: "But in general the QL ["quality of life"] view is easy to state. It is the view that the value of a life varies with its quality. That value might be absolute, infinite, or maximum, but only if circumstances permitted it; other circumstances can reduce that value. The value of a life is contingent. It follows directly that not all lives have equal value. Hence, QL denies both the equality condition and the unqualified ultimity condition of SL ["sanctity of life" view]. ... The positive approach requires that a life possess some positive features or set of features to be worth living, such as dignity, autonomy, and rationality, while the negative approach requires that a life simply lack certain negative features to be worth living, such as extreme pain, hopeless deterioration, and irreversible incapacity to give or withhold consent. The positions can be combined to hold that a life is worth living only if certain positive features are present and certain negative features absent."
 Darryl R. J. Macer, Shaping Genes: Ethics, Law and Science of Using New Genetic Technology in Medicine and Agriculture, (Eubios Ethics Institute, Japan, 1990), Chapter on "Status of the Embryo", on-line at: <http://www.biol.tsukuba.ac.jp/~macer/sg/SG5.html>.
 Norman Ford, When Did I Begin? (New York: Cambridge University Press, 1988).
 Ibid., Macer (1990): "The current attitude of society is that there is a steady and gradual unfolding of life and a gradual assumption of rights by the embryo. ... From the reasoned argument based on biological knowledge, and ethical principles it is possible to draw different lines in the status of the embryo at fertilisation, implantation, formation of the cerebral cortex, and viability. An early embryo is a body in preparation at least, and the likelihood of homicide increases with the age of the individual. ... There are sufficient doubts over the commencement of human personhood until the cerebral cortex begins to function, not to consider the embryo a person until at least 8 weeks and possibly up to 24 weeks."
 Ibid., Macer (1990): "When the earth is crowded, and so many resources used, we should not overfill it. There is a limit to the land. We need to control the desire to have many children, and what is more important allow choice to those who want birth control, and use reason and common sense, and the techniques that we have been given in our technology to practise sensible birth control." (In Chapter on "Human Reproduction"; http://www.biol.tsukuba.ac.jp/~macer/sg/SG11.html).
 Ibid., Macer (1990): "One of the aims of eugenics today is the "application of societal measures at improving physical and mental attributes of future generations" (Eugenics Society 1988). This is not in itself dissimilar from most peoples' attitude. It is held by many that it is in the interests of the state to reduce the incidence of genetic disease (Mason & McCall-Smith 1983)." (Chapter on "Selective Breeding"; http://www.biol.tsukuba.ac.jp/~macer/sg/SG12.html) ... In favour of genetic engineering is utilitarian thinking. Although there will be risks for individuals the goal of the application of these techniques will be to aid human beings, in reducing genetic disease and its affects, and possibly improving the human race (Brody 1981). We are rational beings and we should take advantage of the chances used to apply our rationality to the control of something so important as the generation of children, and to agriculture and environmental modification. We have allowed many people that have genetic disease to live, and so have exposed the human race to genetic decay, for example diseases like diabetes are increasing. This is seen as a bad affect on the human gene pool, and something to counter." (Chapter on "Genetic Engineering"; http://www.biol.tsukuba.ac.jp/~macer/sg/SG15.html)
 H. Tristram Engelhardt, "Viability and the Use of the Fetus", in Tom L. Beauchamp and Terry P. Pinkard (eds.), Ethics and Public Policy: An Introduction to Ethics (Englewood Cliffs, NJ: Prentice-Hall, Inc., 1983, pp. 299-230; reprinted from W. B. Bondeson, H. Tristram Engelhardt, Jr., S. F. Spicker, and Daniel Winship (eds.), Abortion and the Status of the Fetus (Dordrecht, Holland: Reidel Publishing Company, 1982).
See also Engelhardt's further reflections on the "personhood" of human pre-born and young children: "... It is for these reasons that the value of zygotes, embryos, and fetuses is to be primarily understood in terms of the values they have for actual persons. Zygotes, fetuses, and embryos do not have the rich inward life of adult mammals. ... However, one must remember that the sentience of a zygote, embryo, or fetus is much less than that of an adult mammal. One might even develop a suggestion of the natural theologian Charles Hartshorne so as to argue that from the perspective of the Deity the intrinsic value of a human fetus will be less than that of an adult normal member of some other mammalian species. (pp. 112-113). ... One also owns what one produces. One might think here of both animals and young children. Insofar as they are the products of the ingenuity or energies of persons, they can be possessions. There are, however, special obligations to animals by virtue of the morality of beneficence that do not exist with regard to things. Such considerations, as well as the fact that young children will become persons, limit the extent to which parents have ownership rights over their young children. However these limits will be very weak with regard to ownership rights in human zygotes, embryos, and fetuses that will not be allowed to develop into persons, or with regard to lower vertebrates, where there is very little sentience. For example, it would appear very plausible that plants, microbes, and human zygotes can be fashioned as products, and be bought and sold as if they were simply things. In contrast, strong claims of ownership would cease, as children become persons and sui juris, self-possessing. This latter moral issue also arises with regard to normal adult non-human higher primates. It is much more plausible to suspect that higher non-human primates are in possession of themselves than to suspect that such is the case with even one-year-old human infants. At the point that an entity becomes self-conscious, the morality of mutual respect would alienate the property rights of the parents over the children or other animals (129-130). ... These reflections can be encapsulated in what one may term the principle of ownership. This principle will be central to understanding the roles of public and private funding in health care, as well as the rights of physicians to exempt themselves from the constraints of national health services. Owning private property, insofar as such private ownership exists, will always permit patients merely to buy around the established system. So, too, having the right to own one's talents will permit physicians to sell around the constraints of the system. This can be tendentiously summarized as the basic right of persons to the black market." (emphases added) Engelhardt, The Foundations of Bioethics (New York: Oxford University Press, 1986), pp. 133-134.
 See, Victoria Button, "Control Gene Pool, Says Ethicist", The Age [theage.com.au], October 13, 2000.
 Quoting from Dr. Harold Varmus' Senate testimony: "Totipotent stem cells -- such as the product of fertilization of an ovum and its progeny -- are stem cells that have total potency, which means that they have the ability to form an entire mature organism, e.g., a human being, although only if placed in a woman's uterus. In contrast, human pluripotent stem cells, which are under discussion today, do not have total potency, and hence cannot form an entire organism under any known condition. But pluripotent stem cells can give rise to all of the different types of specialized cells in the body." (emphases added) [http://www.nih.gov/news/stemcell/statement.htm]
 "For purposes of these Guidelines, 'human pluripotent stem cells' are cells that are self-replicating, are derived from human embryos or human fetal tissue, and are known to develop into cells and tissues of the three primary germ layers. ... NIH research funded under these Guidelines will involve human pluripotent stem cells derived 1) from human fetal tissue; or 2) from human embryos that are the result of in vitro fertilization, are in excess of clinical need, and have not reached the state at which the mesoderm is formed." (p. 7) (emphases added) [http://www.nih.gov/news/stemcell/stemcellguidelines.htm]
 "Successful transfer of four- to eight-cell embryos ... to the uterus after thawing is now a common practice (Fugger et al., 1991) ..." (Moore and Persaud, p. 39); "After thawing four-cell embryos, some cells may not survive, leaving one-, two-, or three-cell embryos [in Prof. Dr. Mithhat Erenus, "Embryo Multiplication" (<http://www.hekim.net/~erenus/20002001/asistedreproduction/
micromanipulation/embryo_multiplication.htm>)]; "The oocytes are allowed to mature to the second meiotic metaphase and then fertilized with previously capacitated sperm, allowed to develop, and then inserted into the uterus at the 2- to 4-cell stage (or later)." (Larsen 1998, p. 18); "The embryos are usually allowed to develop to the two-to-eight-cell stage before they are considered ready to implant into the uterus. ... Embryos other than those used during the initial procedure are stored for future use if the first embryo transfer proves unsuccessful." (Carlson 1999, p. 35).
 " ... (2) the fertilized egg, which has not yet divided, is now known as a zygote; (3) the egg begins to divide and is now known as an embryo; at this point each blastomere, or cell, within the embryo, is capable of developing into an identical embryo." [Geoffrey Sher, Virginia Davis, and Jean Stoess, In Vitro Fertilization: The A.R.T. of Making Babies (copyright 1998 by authors; information by contacting Facts On File, Inc., 11 Penn Plaza, New York, NY 10001), pp. 20]
"The embryo enters the uterine cavity after half a week, ... . Each cell (blastomere) is considered to be still totipotent (capable, on isolation, of forming a complete embryo), and separations of these early cells is believed to account for one-third of cases of monozygotic twinning." [ O'Rahilly and Muller (1994), p. 23]
Even NIH, in its recent stem cell research report, acknowledges that some of these "stem cells" are totipotent and can revert to whole embryos: "If these cells separate, genetically identical embryos result, the basis of identical twinning." ([National Institutes of Health, "Stem Cells: Scientific Progress and Future Research Directions; (Ruth Kirschstein and Lana R. Skirboll), Appendix A: Early Development, p. A-3) [http://www.nih.gov/news/stemcell/appendixa.pdf]
 For more details, please see my recent report, Analysis: Parts I and II: Stem Cells That Become Embryos: Implications for the NIH Guidelines on Stem cell Research, the NIH Stem cell Report, Informed Consent, and Patient Safety in Clinical Trials (July 22, 2001), written as a Fellow of the Linacre Institute, a Consultant for the Catholic Medical Association (USA), and a Consultant for the International Federation of Catholic Medical Associations (FIAMC), on issues relating to human embryology and human embryo research. See also my analyses for The University Faculty for Life: "University Faculty for Life: Submission of Concern to the Canadian CIHR Re the 'Human Stem Cell Research Recommendations 2001'"; written as UFL Board Member on behalf of UFL; submitted to Dr. Alan Bernstein, President, Canadian Institutes of Health Research Working Group on Stem Cell Research, Ottawa, Ontario, Canada, on June 3, 2001; "University Faculty for Life: Submission of Concern to the British House of Lords Re the 'Human Fertilisation and Embryology (Research Purposes) Regulations 2001'"; and, "University Faculty for Life: Letter of Concern to Sen. Brownback and Congressman Weldon Re the 'Human Cloning Bill 2001'".
See also: "Early mammalian embryogenesis is considered to be a highly regulative process. Regulation is the ability of an embryo or an organ primordium to produce a normal structure if parts have been removed or added. At the cellular level, it means that the fates of cells in a regulative system are not irretrievably fixed and that the cells can still respond to environmental cues. ... Of the experimental techniques used to demonstrate regulative properties of early embryos, the simplest is to separate the blastomeres of early cleavage-stage embryos and determine whether each one can give rise to an entire embryo. This method has been used to demonstrate that single blastomeres, from two- and sometimes four-cell embryos can form normal embryos, ... . ... Another means of demonstrating the regulative properties of early mammalian embryos is to dissociate mouse embryos into separate blastomeres and then to combine the blastomeres of two or three embryos. The combined blastomeres soon aggregate and reorganize to become a single large embryo, which then goes on to become a normal-appearing tetraparental or hexaparental mouse.... Blastomere removal and addition experiments have convincingly demonstrated the regulative nature (i.e., the strong tendency for the system to be restored to wholeness) of early mammalian embryos. Such knowledge is important in understanding the reason exposure of early human embryos to unfavorable environmental influences typically results in either death or a normal embryo." [Carlson (1999), pp. 44-49.]
 "... Some types of twinning represent a natural experiment that demonstrates the highly regulative nature of early human embryos, ... Monozygotic twinning: If the splitting occurred during cleavage -- for example, if the two blastomeres produced by the first cleavage division become separated -- the monozygotic twin blastomeres will implant separately, like dizygotic twin blastomeres, and will not share fetal membranes. Alternatively, if the twins are formed by splitting of the inner cell mass within the blastocyst, they will occupy the same chorion but will be enclosed by separate amnions and will use separate placentae, each placenta developing around the connecting stalk of its respective embryo. Finally, if the twins are formed by splitting of a bilaminar germ disc, they will occupy the same amnion." [Larsen (1998), p. 325].
"Monozygotic twins and some triplets, on the other hand, are the product of one fertilized egg. They arise by the subdivision and splitting of a single embryo. Although monozygotic twins could ... arise by the splitting of a two-cell embryo, it is commonly accepted that most arise by the subdivision of the inner cell mass in a blastocyst. Because the majority of monozygotic twins are perfectly normal, the early human embryo can obviously be subdivided and each component regulated to form a normal embryo." [Carlson (1999), pp. 44-49].
 "The term 'clones' indicates genetic identity and so can describe genetically identical molecules (DNA clones), genetically identical cells or genetically identical organisms. Animal clones occur naturally as a result of sexual reproduction. For example, genetically identical twins are clones who happened to have received exactly the same set of genetic instructions from two donor individuals, a mother and a father. A form of animal cloning can also occur as a result of artificial manipulation to bring about a type of asexual reproduction. The genetic manipulation in this case uses nuclear transfer technology: a nucleus is removed from a donor cell then transplanted into an oocyte whose own nucleus has previously been removed. The resulting 'renucleated' oocyte can give rise to an individual who will carry the nuclear genome of only one donor individual, unlike genetically identical twins. The individual providing the donor nucleus and the individual that develops from the 'renucleated' oocyte are usually described as "clones", but it should be noted that they share only the same nuclear DNA; they do not share the same mitochondrial DNA, unlike genetically identical twins." [Tom Strachan and Andrew P. Read, Human Molecular Genetics 2 (New York: John Wiley & Sons, Inc, 1999), pp. 508-509]
"Clone describes a large number of cells or molecules identical with a single ancestral cell or molecule." [Benjamin Lewin, Genes VII (New York: Oxford University Press, 2000), p. 955)]
 " Some couples, however, may have only one or two embryos available for replacement. In such cases, patients may benefit from embryo multiplication, as discussed in the study by Massey and co-workers. ... In humans, removal of less than half of the cells from an embryo have been documented. No adverse effects were reported when an eighth to a quarter of the blastomeres were removed from an embryo on day 3 after insemination. ... Further evidence supporting the viability and growth of partial human embryos is provided by cryopreservation. After thawing four-cell embryos, some cells may not survive, leaving one-, two-, or three-cell embryos. These partial embryos survive and go to term, but at a lower rate than whole embryos." [in Prof. Dr. Mithhat Erenus, "Embryo Multiplication" (<http://www.hekim.net/~erenus/20002001/asistedreproduction/
"Now, a new method of actually producing identical twins looms near. Called "blastomere separation" (the separation of a two- to eight-cell blastomere into two identical demi-embryos), it is potentially one method of helping infertile couples have children through in vitro fertilization (IVF)." [in The Twins Foundation, "New Ways to Produce Identical Twins -- A Continuing Controversy" (http://twinsfoundation.com/ru-v9n1-1994.htm)]
"Because early embryonic cells are totipotent, the possibility of splitting or separating the blastomeres of early preimplantation embryos to increase the number of embryos that are available for IVF treatment of infertility is being discussed. Because embryo splitting could lead to two or more embryos with the same genome, the term "cloning" has been used to describe this practice. ... Splitting one embryo into two or more embryos could serve the needs of infertile couples in several ways. For couples who can produce only one or two embryos, splitting embryos could increase the number of embryos available for transfer in a single IVF cycle. Because the IVF pregnancy rate increases with the number of embryos transferred, it is thought that embryo splitting when only one or two embryos are produced may result in a pregnancy that would not otherwise have occurred. For couples who produce more than enough embryos for one cycle of transfer, splitting one or more embryos may provide sufficient embryos for subsequent transfers without having to go through another retrieval cycle, thus lessening the physical burdens and costs of IVF treatment for infertility. In addition, this technique may have application in preimplantation genetic diagnosis." [in American Society of Reproductive Medicine, "Embryo Splitting for Infertility Treatment" (http://www.asrm.com/Media/Ethics/embsplit.html)].
 “Prenatal life is conveniently divided into two phases: the embryonic and the fetal. The embryonic period proper during which the vast majority of the named structures of the body appear, occupies the first 8 postovulatory weeks.” [O’Rahilly and Müller (1994), p. 55]; "After the eighth week of pregnancy the period of organogenesis (embryonic period) is largely completed, and the fetal period begins." [Carlson (1999), p. 447]; "The first 8 weeks constitute the embryonic period. The remainder of gestation constitutes the fetal period." [Larsen (1998), p. 317].
 "Like all normal somatic (non-germ- cells), the primordial germ cells contain 23 pairs of chromosomes, or a total of 46." [Carlson (1999), p. 2]; "In a mitotic division, each germ cell produces two diploid progeny that are genetically equal." [Larsen (1998), p. 4].
"A subset of the diploid body cells constitute the germ line. These give rise to specialized diploid cells in the ovary and testis that can divide by meiosis to produce haploid gametes (sperm and egg). ... The other cells of the body, apart form the germline, are known as somatic cells ... most somatic cells are diploid ...". [Tom Strachan and Andrew Read, Human Molecular Genetics: Second Edition (New York: Wiley-Liss, 1999), p. 28].
"Gametogenesis is the production of germ cells (gametes), i.e., spermatozoa and oocytes. These cells are produced in the gonads, i.e., the testes and ovaries respectively. The gametes are believed to arise by successive divisions from a distinct line of cells (the germ plasm), and the cells that are not directly concerned with gametogenesis are termed somatic. ... The reduction of chromosomal number from 46 (the diploid number) to 23 (the haploid number) is accomplished by a cellular division termed meiosis. ... Primordial germ cells ... are difficult to recognize in very young human embryos. Claims for them have been made as early as in the blastocyst, and they are believed to be segregated at latest by 2 weeks and possibly much earlier." [O'Rahilly and Muller (1994), pp. 13-14].
"Meiosis is a special type of cell division that involves two meiotic cell divisions; it takes place in germ cells only. Diploid germ cells give rise to haploid gametes (sperms and oocytes) [after puberty and beyond, that is]. [Moore and Persaud (1998), p. 18].
 "From the ethical point of view, an important consideration is to what extent technologies developed in an attempt to engineer the human germline could subsequently be used not to treat disease but in genetic enhancement. There are powerful arguments as to why germline gene therapy is pointless. There are serious concerns, therefore, that a hidden motive for germline gene therapy is to enable research to be done on germline manipulation with the ultimate aim of germline-based genetic enhancement. The latter could result in positive eugenics programs, whereby planned genetic modification of the germline could involve artificial selection for genes that are thought to confer advantageous traits." [Strachan and Read (1999), pp. 539-541].
The use of germ-line gene "therapy" by U.S. scientists has recently been published, producing genetically altered human infants. See, Dr. David Whitehouse, "Genetically altered babies born: Mitochondria contain genes outside the cell's nucleus", BBC News Online, (<http://news.bbc.co.uk/hi/english/sci/tech/newsid_1312000/1312708.stm>).