BMJ  2008;336:1132 (17 May), doi:10.1136/bmj.39581.436875.94

Views & Reviews

Can a cell have a soul?

The current UK parliamentary debate on amendments to the 1990 Human Fertilisation and Embryology Act (BMJ 2008:336;1089 doi: 10.1136/bmj.39581.373403.DB) has brought to the fore once again the challenging debate between those who argue that all research involving embryonic stem cells is immoral and those who see immense medical potential in this area of research. As a clinical geneticist raised in the Christian tradition and interested in gene hunting and cancer chemoprevention I can claim to offer a dispassionate opinion. As head of the research institute where some of the most controversial work is under way, and having been a signatory to Liam Donaldson’s report that recommended that this research should proceed,¹ I must declare an interest.

Three aspects of stem cell research in which my Newcastle colleagues have special interest are mitochondrial transplantation, in vitro gamete development, and human admixed embryos. In all cases, legitimate clinical targets may be presented as a powerful argument in favour of avoiding blanket legal barriers. Counter-arguments combine anxiety about misuse of funds, threats to the structure of the family, and the dangers of cross species transfer of pathogens and unexpected malformation. None of these threats, real or imagined, require an act of parliament to ensure that they are properly dealt with.

Anyone who thinks that research funds can be misappropriated on the basis of hype has clearly never seen a Medical Research Council committee at work. Existing statutory bodies, including the Human Fertilisation and Embryology Authority (HFEA), have shown their capacity to judge the balance of benefit and risk; an excellent example is pronuclear transfer to allow a woman who carries a mitochondrial disorder to have her and her partner’s chromosomes transferred to a donor egg. This work promises effective interventions for families affected by mitochondrial diseases. The HFEA has access to all the necessary expertise and can reach reasoned conclusions even in the glare of catchy headlines.

But there is one criticism that such committees cannot now be left to answer, one that lay at the heart of recent Easter sermons: that stem cell research is an assault on the sanctity of human life. The essence of this whole issue returns to the thorny question of when life begins. The Catholic church has made its position absolutely clear. Life begins at conception, and any deliberate generation of embryonic stem cells—or, to some, generation of embryos without the intention of implanting them into a woman—is tantamount to murder. Catholics support adult stem cell research that shows more promise without the "ethical problems."

For readers unfamiliar with recent Catholic history, Pius IX issued the papal bull "Aeterni Patris," convoking the first Vatican council, on 29 June 1869. Two of its decisions influence the current debate: papal infallibility was made church dogma and, as a precautionary principle, life should be considered to commence at conception. Given the contemporary advances in microscopy, the second decision was defensible, as the previous limit of 40 days—still used in Jewish and Islamic teaching—extended to a point where an embryo is a few millimetres long and has a primitive nervous system. The 40 day ruling dates back to Aristotle, who concluded that man receives his soul after 40 days and woman hers after 80 days. Setting aside the intriguing sex difference, and voices of dissent ever since, the fact remains that this limit was accepted by the Catholic church. Benedict XVI is the 265th pope since Peter and one of only 10 who declared that ensoulment might occur at conception, which strictly speaking occurs at around five days, when the blastocyst is "taken in" (Latin "concipere") to the wall of the uterus.

At that point the zygote, about the size of a sugar grain, contains a small group of cells called the inner cell mass, which will give rise to the embryo proper—or two. Indeed these cells may rarely initiate up to five identical embryos. Only at around 14 days, when the primitive streak forms, can a single embryo be said to exist. If souls are delivered it is difficult to see how this can occur before the end of the second week of gestation. If an individual blastomere is deserving of personhood (even if cultivated outside the body) because it might become a human, then removal of a cell for preimplantation diagnosis becomes murder.

Adult stem cell research offers a limited haven for opponents; recent work indicates that introduction of four genes and selection for expression of a particular transcription factor can identify fibroblasts that have regained their embryonic potential.² But if this proves really so, do they not also then achieve instant ensoulment? And why all the fury about admixed embryos, the cow-human hybrids of the tabloids? The stem cells being developed, using enucleated cows eggs as mini-incubators, are grown by fusion with a skin cell. They are adult stem cells. If used solely for research they present fewer ethical problems than the practice over many decades of testing human sperm by letting them fertilise Chinese hamster eggs³ (this reference having been selected because the paper was from a Catholic university). Admixed embryos use tissue from the abattoir to preserve precious human eggs and advance laboratory research that offers real hope.

Just as protests about cadaver organ donation were addressed rationally and led to the widespread acceptance that the definition of death could no longer depend on biblical interpretation, so medical need dictates that the origin of human individuality must be defined with similar pragmatic precision. A cell cannot have a soul.

References

1. Department of Health. Stem cell research: medical progress with responsibility (the Donaldson report). London, Department of Health, 2000. www.doh.gov.uk/cegc/stemcellreport.htm.
2. Park IH, Zhao R, West JA, Yabuuchi A, Huo H, Ince TA, et al. Reprogramming of human somatic cells to pluripotency with defined factors. Nature 2008;451:141-6.[CrossRef][Medline]
3. Morales P, Llanos M, Yovich JL, Cummins JM, Vigil P. Pentoxifylline increases sperm penetration into zona-free hamster oocytes without increasing the acrosome reaction. Andrologia 1993;25:359-62.[ISI][Medline]

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