Fight Over Fetuses

When the U.S. Supreme Court legalized abortion in 1973, it settled some issues but stirred up others. One of the most emotion-laden is the morality of medical research on the vastly increased number of fetuses that might be considered available for experimentation because they are going to be aborted. Last year Congress joined the debate and temporarily banned H.E.W. from funding experiments that are not intended to be of benefit to the living fetus before or after abortion. Congress also asked the newly established National Commission for the Protection of Human Subjects to set rules for research.

In order to do so, the commission asked for testimony from anti-abortion activists, lawyers, experts in medical morality and medical researchers. The Battelle Memorial Institute of Columbus, Ohio, a science research center, reported to the commission that tens of thousands of lives have been saved and countless future birth defects prevented by fetal research that would have been impossible under the present ban. By using live fetuses, important medical advances were made in developing German measles and Rh vaccines and in studying infant breathing problems and amniotic fluids.* At base the commission faces a classic conflict. On one hand, scientists argue that experiments that benefit countless future children must not be prohibited. On the other, many ethicists insist that benefits or no, living fetuses must be protected.

It is "indisputable" that the fetus, though dependent on the mother, is a separate organism, argued Leon Kass, a physician and professor of "bioethics" at Georgetown University. The fetus is also "human," at least in being "of human origin and in the process of becoming a human being --if nothing interferes." Paul Ramsey, professor of religion at Princeton University, says in his new book, The Ethics of Fetal Research (Yale University Press; $2.95), that the fetus is "live enough not to be dead, not yet mature enough to be an infant, yet a human being enough to deserve protection."

Because of such reasoning, six of the testifying ethicists would rule out virtually all experiments that might harm a fetus, even if it is to be aborted. Ramsey drew an analogy with medical tradition that forbids risk to children and to persons who are condemned to death, irreversibly dying or unconscious.

Bizarre Scenario. Sissela Bok, a lecturer on medical ethics at Harvard and M.I.T. and wife of Harvard President Derek Bok, is concerned about the "brutalization" of scientists and of society unless most research is banned on fetuses that might be viable (that is, able to live outside the womb). At what point fetuses become viable is, of course, a subject under hot dispute. Federal guidelines proposed in 1971 limited experiments to fetuses less than 500 grams in weight (one fetus that weighed only 395 grams has survived outside the womb).

Of the ethicists, only Episcopal Clergyman Joseph Fletcher of Situation Ethics fame justified unlimited experimentation on fetuses that face abortion, if the mother gives her consent. The traditional requirement of "informed consent" for experiments is a thorny one when the subject is a fetus. Ramsey, as well as Georgetown's Father Richard McCormick and Rabbi Seymour Siegel of Jewish Theological Seminary, pointed out that parents have been allowed to give consent for treatment of a child because they have the child's interests at heart. The consent of mothers who plan to have abortions is morally questionable.

Kass sketched a bizarre scenario that would have mothers trafficking in fetuses for research use. He believes women might one day be able to perform abortions on themselves, thus creating a shortage of fetuses, and some might "become pregnant purely and simply for research purposes."

Taking all this into consideration, the commission must decide by May 1 what federal controls on fetal experiments are needed and how to apply them. Arthur Dyck of the Harvard Divinity School offered the commission a practical solution: the committee that reviews experiments in each hospital should include those who consider the fetus a "person" worthy of protection as well as those who do not.

*Amniotic fluid studies, which were used in development of the two vaccines and involved the largest number of fetuses, were experiments aimed at helping particular fetuses and are therefore not now at issue.

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