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Human embryo research – the need for a more democratic approach

19 December 2016
By Giulia Cavaliere
Department of Global Health and Social Medicine, King's College London
Appeared in BioNews 882

Should the 14-day limit for embryo research be extended? This question is the subject of countless articles in the media, and it was the focus of both the Progress Educational Trust (PET)'s Annual Conference, 'Rethinking the Ethics of Embryo Research: Genome Editing, 14 Days and Beyond' earlier this month and a recent Harvard Law School debate.

The subject was broached at last year's PET conference, and attracted major interest in May 2016 when two research groups based between the UK and the US published the results of their experiments on in vitro human embryos in a letter in Nature (1) and in an article in Nature Cell Biology (2). They showed that for the first time, they were able to sustain these embryos in absence of maternal tissue (i.e. in vitro) for 12–13 days. Prior to this, scientists were only able to sustain an embryo in vitro for about seven days (3).

Members of the scientific and bioethics communities reacted enthusiastically to these advances (4) because they represent the potential of uncovering previously unknown stages of embryo development, as well as allowing an increased understanding of the causes of early miscarriages, problems related to infertility and birth defects. Calls for extending the statutory limit for embryo research, currently set at the 14th day after fertilisation, were put forward. These calls were echoed at the PET conference by scientists such as Professor Magdalena Zernicka-Goetz, Professor Robin Lovell-Badge and Professor Simon Fishel. They gave two main reasons for extending the limit: the potential benefits of research on human embryos for a longer time, and the technical feasibility of doing such research beyond 14 days.

Arguments of technical feasibility and the benefits of research, as a means of challenging currently set legal boundaries, are common in bioethics, and are used both implicitly and explicitly in debates on the ethics of newly discovered biotechnologies and practices. They are also presented as the rational choice and the most obvious path towards noble ends, such as relieving human suffering. Despite the power of such arguments, there is more to them than meets the eye.

The idea that research ought to go forward because it is technically feasible is problematic because it relies on what philosopher David Hume considered an 'inconceivable deduction' of what ought to be done from a set of is-premises (5). Hume believed that it was logically fallacious to infer a normative judgment (ought-conclusion) from a set of factual claims (is-premises). Following Hume, the normative conclusion 'there are good reasons to change the 14-day rule' cannot be rightly inferred from the factual premise 'embryos can now survive in vitro for longer than before' (i.e. technical feasibility of extending the timespan for embryo research).

The argument of the beneficence of research is also more problematic than those in favour of extending the limit suggest. According to this argument, the 14-day limit should be extended because of the potential benefits of such research, and because these benefits outweigh the costs of embryo research. Despite it seemingly being fairly obvious that if something is beneficial it should be allowed, this approach relies on an optimistic view of scientific progress, research and technologies (6). It echoes the post-Enlightenment positivistic ideas of science and technology, often overemphasising the potential benefits of scientific research and its progressive and linear endeavour (7,8).

The results of the aforementioned experiments on in vitro human embryos reopened the Pandora's Box of the moral status of the embryo. Those who argue in favour of extending the limit for embryo research usually grant a low or nonexistent moral status to human embryos, and thus conclude that the costs to those embryos are negligible (or outweighed by the benefits). However, since the benefits will be societal benefits, potential societal costs should be taken into account, rather than solely considering costs to the embryos. Disagreements on the moral status of embryos, and on the moral acceptability of using them for research, show that embryo research remains a controversial issue.

When the 14-day limit was enshrined in UK law, philosopher Baroness Mary Warnock attempted to find a solution of compromise that would allow research to go forward while respecting the view of those who attributed high moral status to the embryo.

Today, we should remember the work of the inquiry chaired by Warnock, and learn from its approach to fundamental moral disagreement. The moral status of embryos, and the question of how we ought to treat them, are issues that divide society and that reflect conflicting moral views and beliefs. It is important to respect such conflicting moral views, just as it is important to defend democracy as a political system and as a valuable form of governance. People or groups holding these different views are respected by granting them equal say on matters of common concern. This is the basic principle of equality that is central to our democracy. In a democratic society, even those who do not accord intrinsic value to the human embryo should at least respect, if not the embryos themselves, those who hold opposing views on their worth.

For this reason, any proposal to change the 14-day rule needs careful evaluation of the scientific feasibility and effective benefits of embryo research; it needs an extensive inquiry into public attitudes concerning such research; and it needs a deliberative process that considers all these elements. Baroness Warnock and the other members of her inquiry, albeit possibly guided by utilitarian-inspired views, opted for valuing compromise over other strategies. The inquiry deliberated behind closed doors, and was a group composed largely of experts. In this sense, the recent experiments published in Nature and Nature Cell Biology, and the newly sparked debate on embryo research, represent a valuable opportunity to begin a truly deliberative and democratic debate on this issue – a debate that should consider public attitudes to embryo research.

A balanced ethical assessment of extending the 14-day rule must balance potential benefits are balanced against potential costs. In addition, it should entail an evaluation of viable alternatives that do not rely exclusively on medical/scientific solutions (see BioNews 868). Embryo research may have the societal cost of offending certain moral feelings on the value of early human life, and of not respecting certain strongly held convictions on how we ought to treat human embryos. Thus, individuals who hold such views may find themselves feeling alienated from or devalued by society.

I have focused on the arguments of those in favour of extending the limit for embryo research. The reason for this is that it is often believed by proponents of technological advances that the burden of justifying one's claims rests solely on those who take a precautionary approach to technological progress, or who hold more conservative views. While I do not personally share the values and beliefs of those who consider embryos as persons and research on them highly problematic, I think that the burden of justifying one's claim should rest both on those defending this view, and on those advocating for the extension of the 14-day limit. New technical possibilities allow us greater potential, but they should also translate into greater responsibilities and need for deliberation.

1) Self-organization of the in vitro attached human embryo
Nature |  12 May 2016
2) Self-organization of the human embryo in the absence of maternal tissues
Nature Cell Biology |  4 May 2016
3) Embryology policy: Revisit the 14-day rule
Nature (comment) |  4 May 2016
4) Inside the 'black box' of human development
The Guardian |  5 June 2016
5) A treatise of human nature
Oxford University Press |  2006
6) Bioethics and the reinforcement of socio-technical expectations
Social Studies of Science |  2009
7) Adventure! comedy! tragedy! robots! How bioethicists learned to stop worrying and embrace their inner cyborgs
Journal of bioethical inquiry 2(1) 18-23 |  2005
8) Compressed foresight and narrative bias: pitfalls in assessing high technology futures
Science as Culture, 15(4) 327-348 |  2006
24 June 2019 - by Susan Tranfield-Thomas 
Dr Simon Fishel, founder of the CARE Fertility Group, has a long and distinguished career behind him. As a young biochemist he began his research career at the University of Cambridge with IVF pioneer Professor Robert Edwards, who together with Dr Patrick Steptoe was responsible for the birth of the first IVF baby, Louise Brown, in 1978...
30 January 2017 - by Sarah Gregory 
Matthew Hill covers the 30-year history of the 14-day rule on human embryo research, bringing the topic right up to the present day and the current debate on extending the rule...
23 January 2017 - by Annabel Slater 
The fourth session of the Progress Educational Trust's annual conference 'Rethinking the Ethics of Embryo Research: Genome Editing, 14 Days and Beyond' delved into the new genome-editing technique CRISPR/Cas9 and what it means for embryo research...
9 January 2017 - by Baroness Mary Warnock 
As the Progress Educational Trust's Patron, Baroness Mary Warnock, is made a Companion of Honour in the New Year Honours List 2017, she offers her thoughts on whether the 14-day limit on human embryo research (which she originally proposed in 1984) should be extended...
9 January 2017 - by Dr Valerie Shaikly 
The second session of the Progress Educational Trust's annual conference 'Rethinking the Ethics of Embryo Research: Genome Editing, 14 Days and Beyond', looked at new embryo images that have potential to challenge the 14-day rule and discussed the potential benefits of extending the rule beyond the existing time limit...
5 December 2016 - by Annabel Slater 
An extension to the 14-day human embryo research rule will be proposed at the annual Progress Educational Trust conference on 7 December...
10 October 2016 - by Giulia Cavaliere 
The announcement of the first baby born using mitochondrial spindle transfer, one of the two techniques that allow the replacement of faulty mitochondrial DNA, caught the UK scientific and bioethics community by surprise...
12 September 2016 - by Dr Silvia Camporesi and Giulia Cavaliere 
By focusing all our attention on the ethics of human–animal hybrids, we may be overlooking non-technical solutions to the short supply of human organs for transplantation...
9 May 2016 - by Julianna Photopoulos 
Scientists from the UK and US have grown human embryos in the lab for 13 days after fertilisation – the longest ever recorded. This is beyond the stage when embryos would normally implant in the womb, but just before the 14-day legal limit in the UK...
9 May 2016 - by Julian Hitchcock 
The advances of Magdalena Zernicka-Goetz, the opportunities to undertake valuable medical research and our changed sense of values all demand that we reappraise the 14-day limit...
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