The Use of Gametes and Embryos in Human Reproductive Research: Determining Policy for New Zealand
Submission from The New Zealand Catholic Bishops' Conference and The Nathaniel Centre
Issue 21, April 2007
Life and physical health are precious gifts that have been entrusted to us. We have a responsibility to take care of them while taking into account the needs of others and the common good. Concern for the health of its citizens requires that society work assiduously to support all persons to live fulfilled lives. To this end the Catholic Church recognises the importance of, and is committed to, ongoing research into human health and well-being.
All research on human beings must be subject to respect for the dignity of human life. Science and technology must be ordered to the well-being of human kind from which they take their origin and development. The purpose of human research and an awareness of the ethical limits of research are grounded in, and remain at the service of, the integral good of human beings. Actions that are of themselves contrary to the dignity of persons cannot be legitimated in the name of research or experimentation. "The Church respects and supports scientific research when it has a genuinely human orientation avoiding any form of instrumentalization or destruction of the human being." (Pope John Paul II, Address to the Pontifical Academy for Life, February 24, 2003)
The question is whether our technical progress will be guided by an equally advanced sense of the dignity of each and every human life. Human society only benefits from research that reflects good science and good ethics. The debate over the use of embryos for research highlights a paradox: Whether or not we should destroy human life in its earliest and most vulnerable form in the cause of following our deeply humanitarian impulses to reduce suffering and find cures to human diseases.
This introduction outlines the context in which we offer the following comments on the proposed guidelines for the use of gametes and embryos in reproductive research within New Zealand.
The question that stands at the heart of the debate about embryo-destructive research is whether or not it is ethical to achieve a good outcome using bad means – in this case the destruction of pre-nascent human life. Catholic teaching provides clear guidance on this question and the stance taken by the Catholic Bishops of New Zealand in their submission is summarised below. The position is essentially a positive one that argues an alternative way forward based on sound principles that reflect a rich understanding of the human person, a desire to protect and promote human dignity and a deep commitment to research and healing.
Only interventions which respect the life and integrity of the embryo and are directed towards its well-being are morally licit. All other research or interventions on embryos should be prohibited. We oppose the deliberate creation of embryos for embryo-destructive research. We also oppose the use of so-called "surplus" IVF embryos for embryo-destructive research.
In the case of embryo-destructive research carried out in the name of finding cures, the means actually contradicts and undermines the end or outcome being sought – human life is destroyed in the name of preserving human life.
Other alternatives to embryo-destructive research exist. Real progress that is genuinely "therapeutic" has been, and continues to be, made with 'adult' stem cells. Progress is also being made in sourcing pluripotent cells that exhibit the same behaviours as ESC's but which can be obtained without the need to destroy human embryos.
We consider that the inviolable dignity of the human embryo is sufficient reason for us as a society to step back from embryo-destructive research. However, even leaving aside the controversial question of the moral status of the embryo, it is our considered view that taking proper account of all other relevant moral factors, it is not possible to create a sufficiently persuasive - let alone substantially persuasive - moral account necessary to justify allowing the practice of embryo-destructive research in New Zealand.
The divide in the debate surrounding the use of embryos in research is sometimes falsely presented in terms of those in favour of progress and those against. This is a misrepresentation. Our stance against embryo-destructive research reflects a positive commitment to uphold the inviolable dignity of human life. Research that does not uphold human dignity will not ultimately advance human well-being.
A recommendation by ACART in favour of embryo-destructive research would be a recommendation for New Zealanders to cross a fundamental moral line never before crossed: permitting the direct killing of human life in its earliest and most vulnerable stages in the name of medical 'progress'.
New Zealand is currently in a unique position of being able to exercise moral leadership by rejecting embryo-destructive research and supporting stem cell research.
Research using gametes should be regulated through guidelines and then allowed to proceed on a case-by-case basis with appropriate ethical scrutiny. Particular regard needs to paid to informing women of the risks associated with egg donation and to protecting them from exploitation. The commodification of human life is also of concern.
1. What are your views on research, or aspects of research, using gametes?
Research using gametes should be regulated through the development of guidelines and then allowed to proceed on a case-by-case basis having undergone appropriate ethical scrutiny and having received appropriate ethical approval. We would expect that such research would be governed by the same or very similar ethical provisions as applies to research on other types of human tissue.
We uphold the principle enshrined in New Zealand legislation that transactions involving body tissue not be commercialised. We are concerned about the very real potential for the exploitation of women that would result from an increased demand for human eggs for purposes unrelated to fertility treatment. The potential for exploitation is there whether or not women are remunerated for their tissue. Egg donation carries very high risks and there needs to be very specific protocols developed to protect women donors. In particular, consent must be sought in a non suggestive and non coercive way that ensures women are fully informed of all the consequences and risks. Even benign appeals to a woman's altruistic nature can be coercive, especially when the health of other family members is involved and egg donation is presented as a necessary step towards therapies.
We are also concerned that an increased demand for human gametes, and eggs in particular, might contribute – even unintentionally – to furthering the commodification of human life.
We are opposed to any research with gametes that results in the creation of an embryo that would then be destroyed for the reasons we outline in answer to question 2 (see below).
We are also opposed to all research involving the fusion of human gametes with gametes of other species so as to create human-animal hybrid embryos. Such research raises profound questions regarding the identity and moral status of the new life forms.
2. What are your views on research, or aspects of research, using embryos?
It is our strongly held view that all research, or aspects of research, using embryos should be prohibited. The reasons for our view are as follows:
i. Human embryos are a part of the human family and deserve the same level of respect that is due to all human beings.
The desire to carry out research on human stem cells originates from a concern to better understand the human body, alleviate disease and improve people's quality of life. Without doubt, this desire is grounded in the integral good and well-being of human beings. The debate about the use of embryos in human reproductive research is not a debate about the merits of stem cell research. There are ethical and unethical ways to conduct stem cell research and the question is to which category a particular technique – the destruction of living embryos for their cells – belongs.
Neither is the debate about when human life begins. It is an accepted biological fact that a human life begins when a human embryo is created, irrespective of the means by which it was created. We were all once embryos! Proponents and opponents of embryo-destructive research agree that the dilemma associated with research on human embryos is the destruction of developing human life. The ethical questions centre on the sort of respect we should accord human life; in particular whether it is ethically consistent to accord a different level of respect to humans in the earliest stages of life, as well as whether there are ever factors that mitigate the respect due to human life at any stage of development.
The belief held by some that the life of a human embryo matters less than other human life at a more developed stage may reflect the fact that it is largely invisible – it isn't missed as other human beings can be missed. Yet even at the four cell stage, an embryo is not simply a collection of cells that happen to be contiguous. These cells are a human embryo, a new human individual and part of the human family. Embryos become children in the same sense in which children become adults, not by some addition to what they are, but simply by developing further as the kind of beings they already are.
To claim that a four-celled embryo is a human being clearly takes us beyond the level of empirical observation. However, to judge something solely at the 'material' level ("it is only a clump of cells") is to ignore the fact of what something is – in this case it omits an important truth about embryos in the same way that the statement 'I am sitting on a collection of timber and steel' omits the crucial truth that I am sitting on a chair. In other words, that a particular statement is strictly speaking accurate may not reflect its adequacy in describing the full reality of the situation.
The common understanding of person in our culture has been shaped by modern philosophies' emphasis on self-consciousness as the mark of personhood. A much older understanding of person, however, locates personhood in the dignity of a being's rational nature, irrespective of whether that being is conscious at a particular phase in his or her life. According to this traditional view there is nothing problematic about saying that an unborn child or a persistently unconscious patient is a person, for they are truly our fellow human beings. The key to understanding what a human embryo is lies in the connection that exists between a human embryo and an adult member of the human species.
The Catholic position accords unconditional respect for human life at all stages of its development. In calling for unconditional respect Catholic teaching is being absolutely consistent. It holds that without exception the living embryo has, from the moment of fertilisation, an absolute right to life. A life is begun which is neither that of the father nor the mother. It is already the human being it will always be and will only grow in size and complexity. On that basis all embryos are entitled to be granted a place in the human family and treated with the same respect as persons.
ii. Support for embryo-destructive research is based on a flawed understanding of human dignity as externally conferred rather than being an intrinsic characteristic of human life.
Arguments in favour of embryo-destructive research are premised on the belief that embryos possess varying degrees of moral status depending on the circumstances. The highest status is reserved for the 'wanted embryo in the womb'. Equally a very high value is attached to the 'wanted unfrozen embryo outside of the womb' because the parents have done so much in order to have it. The 'wanted frozen embryo' enjoys a mixed status – it is wanted but not wanted just yet.
The 'unwanted frozen embryo' has a certain status as a potential object for donation or research, and if the parents agree then its status can change from being unwanted (by them) to being wanted by others. In fact its status is reduced to that of 'experimental laboratory material'. If not wanted by others for research then it appears to have even less status or no status at all.
However, there is something inherently illogical about this rationale - the varying degrees of status belie the scientific fact that all embryos are biologically and ontologically the same kind of being, all members of the human species. Our common biological origins and shared ontological nature highlight the moral inconsistency of according embryos varying degrees of status and rights based on human subjective preference.
We can only justify such a range of 'status' if we are prepared to accept that human dignity and moral principles can be reduced to matters of preference, subjective opinion and even convenience. To take such a stance is to countenance an approach to bioethics that elevates personal choice and personal preference over a principled and objective approach to decision making.
From a Catholic perspective it is not so much a question of a different calculation of the amount of respect due to embryos as it is a question of the type of respect that is due. Catholic teaching believes that human dignity must be based on an 'intrinsic' respect; that is a respect which is independent of all factors or conditions that are extrinsic or external to the embryo including what ever subjective value might be attached to it by the couple whose gametes have contributed to the creation of the embryo.
Ultimately, to abandon an intrinsic understanding of human dignity and make it contingent on subjective preference is to destroy the foundation upon which universal human rights are based.
iii. There is no precedent for the introduction of embryo-destructive research in New Zealand, despite claims that the availability of abortion provides a precedent.
It has been argued that if we do not allow destructive embryonic research then, logically, we also have to repeal the abortion laws. In other words, the availability of abortion is seen as setting a moral precedent for embryo-destructive research; as an indication that our society already accepts that pre-nascent human life may be terminated for good reason.
At first glance we might be inclined to agree with the sentiments of the argument on the basis that there is a direct link between the two issues – the direct killing of unborn human life. That said, the question invites a deeper consideration.
The way in which the abortion laws in New Zealand work is to recognise certain situations in which the mother's rights have precedence over the rights of the embryo/fetus. In other words, current laws governing abortion in New Zealand do not extinguish the rights of the embryo / fetus. Rather, they confirm the existence of embryonic / fetal rights. That is, when considering legislation and/or regulations involving embryo-destructive research, the current legal situation reinforces the existence of such rights as the starting point for any debate. What is at stake is the moral significance of those rights in the face of society's desire to develop new cures – a very different moral dilemma from the typical abortion scenario.
A critical difference is the status of the 'second party'. Abortion is a procedure which is reluctantly allowed to proceed in very limited circumstances on examination of the particular situation by a competent authority. In a paradoxical way the application of abortion law in New Zealand actually confirms that the norm is for human life, once conceived, to be born, not destroyed. Abortion is an exception to the norm in cases where it is deemed that there is a proven disadvantage to the mother and it is tolerated as a way of preventing specific harm to a specific person in a specific situation – essentially the mother. It is quite another thing to allow the destruction of pre-nascent human life for a cause that is only potentially related to the generic good of society sometime in the future.
Consequently, it does not immediately and automatically follow that we should equate the rights of a woman wanting an abortion with the needs of society to carry out stem cell research. That conclusion remains to be debated. Embryo-destructive research is not a logical consequence of the current abortion laws in New Zealand.
iv. Embryo-destructive research is unethical because the means employed is in conflict with the end that is sought.
The dilemma posed by embryo-destructive research comes about because of an apparent conflict between two key values; the desire - indeed responsibility - we have of curing terrible illnesses and diseases versus the need to show respect to human life in all its stages.
Moral theories offer various ways of resolving such conflicts. One approach that is favoured in our society today is to evaluate the competing values in terms of 'cost' and 'benefit'. For many people, the payoff of developing cures that could benefit millions is seen as being worth the cost – in this case the lives of a few (perhaps unwanted) human embryos. The ethical dilemma is presented in fundamentally numerical terms. This cost-benefit analysis reflects a desire to produce the best outcome and to maximise benefits – commonly referred to as the utilitarian principle. In simple terms 'the end justifies the means'.
It is over-simplistic to say that we are concerned about saving human lives and that this is sufficient justification for destroying human embryos. This is not an adequate ethical description of what is actually happening. It is inadequate because it ignores the deeper meaning of the action. Actions chosen as the means to an end have a meaning and moral quality of their own, independent of the circumstances or outcome, and not reducible to the outcome. The deeper meaning of what is happening is revealed by a closer analysis of the 'intent' and 'content' of the actions of those involved in embryo-destructive research.
In embryo-destructive research there is a lack of congruence between the means employed and the outcome or end that is sought? The 'intent' of the action and the 'content' of the action are at odds with one another. In fact there is a contradiction – human life is destroyed in the name of saving human life.
For any action to be ethically acceptable there has to be consistency between what is done – the means – and the reason it is done - the end.
v. To the extent that we are prepared to look at early human life in a more utilitarian and commodified way we are more likely to view and treat other human life in such a way.
"But they are going to be destroyed anyway!" This line of reasoning is used to justify research on embryos that are 'left over' from fertility treatments. Those who argue this way sometimes draw a parallel with the practice of organ donation; in giving its life for the sake of others an embryo's existence is given meaning and value. Its proponents argue that such an outcome appeals as a moral choice because it confers a reason for existence on the embryo, casting its death as an altruistic and salvific act and giving some value to its (otherwise meaningless) life.
This argument ignores any difference between what philosophers refer to as 'evil done' vs. 'evil suffered'; a distinction that rests on the moral importance of intention. If a person is run over and accidentally killed by a vehicle and another person is deliberately killed by another vehicle, it is not untrue to say that the outcome is exactly the same – in each case a dead person. However, at the moral and legal level we do not regard the two incidents in the same way because intention matters. It is always bad when a human being is killed, but it is worse when their death results from the deliberate and evil will of another. In other words, the moral evil of murdering someone is a greater threat to human dignity and society than is the physical 'evil' of death alone. In the same way, just as it is ethically inadequate to judge these two incidents simply from the perspective of what is lost, so too it is inadequate to count and compare the lives of embryos lost while assuming that how they are lost somehow does not matter.
While embryos created for IVF and held in storage are eventually going to perish this is not the same as intentionally destroying them. (The same logic applies to those who argue that the high natural attrition rate of embryos in utero somehow makes it acceptable to intentionally kill embryos.) To consider that there is no ethical distinction between allowing embryos to die and intentionally destroying them is to fail to take proper account of the moral harm associated with the deliberate destruction of human life; in particular its wider repercussions and consequences for the way we look at all human life.
What might be the wider repercussions? Firstly, it is a fundamental axiom of morality that all our actions are self-reflexive; that is to say, what we do reflects back on ourselves; we become what we do. Our actions have either a positive or a negative effect on our moral sensibilities, both individually and collectively. Once we recognise that all our actions shape our characters - either positively or negatively - we can also recognise that there are some things we should never do simply because they will damage our moral character and the moral underpinnings of our society.
To the extent that we are prepared to adopt a utilitarian approach to the status of human life in embryonic form, we are more at risk of perceiving and treating other human life in a utilitarian manner.
vi. Because the proposed benefits of embryonic stem cell research are at best hypothetical and indeterminate, there is no basis for even a utilitarian rationale in favour of embryo-destructive research.
Even a cursory analysis of the New Zealand discussion about the use of human embryos as a source of stem cells shows that the promise of beneficial treatments remains uppermost in people's minds. A recent Sunday Star Times article is typical of the way the debate has been carried out in New Zealand: "Embryonic stem cells have the potential to turn into any other cell in the human body ... and hold the promise of astonishing new disease therapies" (Sunday 18 Feb 2007). In that same article the chair of ACART suggests that the dilemmas posed by the use of human embryos can be resolved by a process of weighing up and comparing the benefits versus the harms.
Our own position (as already noted) is that utilitarianism cannot offer an adequate framework for resolving the ethical dilemmas associated with the deliberate destruction of human life. We recognise that not everyone is prepared to accept that this is the case. Nevertheless, without yielding our own moral ground, we fail to see that any real or meaningful comparison of "benefits" and "risks" is able to be made at this point in time given that there is no tangible evidence of outcomes, and given the general consensus that the clinical benefits could be a decade or more away.
To this end, we were somewhat surprised (and concerned) that the ACART discussion document continues to refer to SCNT as "therapeutic cloning". In overseas literature there has been a deliberate move to re-label such cloning, many preferring to use the term SCNT. Using the term "therapeutic" provides an inaccurate description of what is actually happening and reinforces the mistaken impression that such experiments are therapeutic in nature. In short the term conceals rather than reveals what is really happening.
If alternatives exist that will enable stem cell research to continue without the need for further destruction of embryos – and they do – then, from a purely utilitarian perspective, it would seem imperative that there be specific evidence of additional benefits to justify the immense additional "harm" associated with the destruction of human life. Lack of such evidence renders the utilitarian calculation impotent. From a strictly rational point of view it is irresponsible, and therefore unethical, to follow a path that results in extra harm in the absence of any tangible evidence of additional benefits.
We make this point not to imply that evidence of such benefits would legitimise embryo-destructive research, but simply to emphasise that, for those who subscribe to utilitarianism, an honest utilitarian calculation cannot currently be made in support of such research.
Recent comments made by eminent stem cell researchers not averse to embryo-destructive research highlight the uncertainty surrounding the prospects of therapies. Alan Trounson, an eminent Australian scientist involved in stem cell research, has been quoted in a Nature Medicine article as saying: "The so-called therapeutic cloning to my mind is a non event." In terms of developing therapies or cures he has said that "it's just not realistic." ("Scientists seek simple remedies to cloning conundrums". Nature Medicine. May 2005, p. 459.) In the same article a prominent US cloning researcher, Jose Cibelli, professor of animal biotechnology at Michigan State University concurs: "I can predict that therapeutic cloning is going to be obsolete." In a similar vein Lord Winston, a pioneer of fertility research in the UK who has pushed for embryo-destructive research, has admitted that in the 2001 debate in the UK the immediate potential of embryonic stem cells was exaggerated. He has described the debate surrounding embryo stem cells as a case study in scientific arrogance and the dangers of 'spinning' a good story and has commented: "I view the current wave of optimism about embryonic stem cells with growing suspicion" (The Guardian, September 5, 2005).
The disconnect that exists between the picture of individualised cures painted by those pushing for embryo-destructive research, and the lack of evidence that sick people will ever benefit from stem-cell research, remains of very real concern to us, as does the lack of awareness of that disconnection in the general media and public perception. The net effect of this is to exploit the emotions of many patients and their families. The existence of the disconnect threatens to undermine the integrity and value of the public consultation process currently being undertaken in New Zealand. While the ACART discussion document warns that "[an] appropriate degree of caution is therefore necessary in discussing the potential benefits of this research" (n. 88) it appears that it is the prospect of therapies that continues to be used to drive public opinion about the merits of embryo-destructive research.
If contemplating relaxing a legislative ban on SCNT, or the creation of embryos specifically for embryo-destructive research, it would at this point in time be grossly misleading – if not unethical – if ACART's advice to the Minister was argued on the basis of unproven potential for therapeutic outcomes.
vii. Other ethical alternatives to embryo-destructive research exist and New Zealand has a unique opportunity to exercise leadership by taking a principled stand in favour of stem cell research AND the dignity of human life.
In recent years there has there has emerged a growing body of research that is focused on developing cells with the abilities of those derived from embryos, but without the need to harm human embryos. The new avenues include the reprogramming of adult cells to function like embryonic stem cells, deriving pluripotent cells from testes and the discovery of cells with seemingly pluripotent abilities in the placenta, human cord blood and amniotic fluid. On top of that, progress continues in the field of adult stem cell research, including promising studies that are challenging the long held paradigm that adult stem cells have undergone an irreversible process of terminal differentiation. In other promising research carried out in 2006 Japanese scientists Kazutoshi Takahashi and Shinya Yamanaka have produced pluripotent stem cells by introducing four key factors into mouse cells under specific culture conditions; a process that totally bypasses the use of eggs and the creation of embryos.
When other alternatives exist we have an ethical obligation to follow those alternatives.
New Zealand has, over the years, consistently shown moral courage and leadership by taking principled stands on a host of issues related to upholding human dignity and advancing human well-being. Research that does not uphold human dignity will not ultimately advance human well-being. We need to foster and support stem cell research in New Zealand that is ethical and that promotes human dignity even while it seeks to serve the greater common good. Ample opportunity exists for us to do. We have the opportunity to make a significant contribution to advancing the causes of human health and well-being without resorting to the deliberate and intentional destruction of human life in embryonic form.
3 . The discussion paper outlines a number of possible sources of gametes and embryos for use in research. What are your views on the use of these sources?
All sources of embryos should be prohibited. We oppose all forms of embryo-destructive research as noted above.
The donation of gametes would need to be governed by strict procedures that uphold the key principles that form the basis of all health research ethics review in New Zealand. As noted in our response to Question 1 we are particularly concerned about the potential exploitation of women as a source of eggs, as well as the risks to women inherent in obtaining the eggs.
The HART Act requires ACART to give advice specifically on the genetic modification of gametes and embryos and the import and export of gametes and embryos.
4. What are your views on genetic modification of gametes?
We believe that the genetic modification of gametes should be subject to a lengthy moratorium.
We believe that this question has huge implications for society. It is too important and too complex to be dealt with in such a cursory fashion in a document that is arguably focussed on a range of other ethical dilemmas. The ethical issues associated with this question warrant a discussion document and full and substantial public consultation in their own right.
It is questionable whether at this time we possess the wisdom and maturity to handle such technology wisely and safely.
5. What are your views on genetic modification of embryos?
Genetic modification of embryos should likewise be subject to a lengthy moratorium.
The only basis on which we would ever consider that it might acceptable to genetically modify a human embryo would be in circumstances where it was done as a therapeutic intervention that was aimed at the prevention of serious hereditary diseases and specifically carried out in the interests of the embryo in question and prior to it being implanted. In other words such interventions would need to uphold the inviolable dignity of all human life as expressed in our response to Question 2 above.
6. What are your views on the import and export of gametes?
We think it is acceptable that the import and export of gametes should be regulated through the development of guidelines and then assessed on a case-by-case basis.
That said, New Zealand must not compromise its stance against the commercialisation of body tissue including gametes. A fundamental premise of research in New Zealand is that the tissue is donated by people who were fully informed, and who gave their full consent as part of a process that was free from any sort of coercion. This should remain a condition of using gametes in research, whether that research is based in New Zealand or overseas and whether the gametes were sourced in New Zealand or overseas. Our commitment to the non-commercialisation of tissue should mean we reject the importation of all tissue obtained in a commercialised manner.
One of the challenges facing researchers who import gametes is the difficulty in verifying the manner in which tissue was obtained overseas. Given the potential for exploitation of women in order to gain eggs, we are particularly concerned about the importation of eggs from other countries where ethical oversight may be less robust than it is in New Zealand.
Similarly the export of gametes raises ethical as well as cultural and spiritual issues. It is questionable whether the provisions upon which tissue is donated will always be upheld by researchers in other countries.
7. What are your views on the import and export of embryos?
The import and export of embryos should be prohibited. We are opposed to all embryo-destructive research and therefore oppose the import and export of embryos for research purposes.
8. Principle (g) of the HART Act states that the different ethical, spiritual, and cultural perspectives in society should be considered and treated with respect.
We are interested in your views on how this principle could be incorporated into New Zealand's policy position on gamete and embryo research.
What are your views on how this principle could inform ACART's advice to the Minister, and, if research does proceed in some form, how it could be reflected in guidelines?
New Zealanders hold various ethical, spiritual and cultural beliefs which influence their views regarding the use of human embryos in research. Nevertheless, we believe that there is a clearly identifiable common core of values that form part of most people's world view. We identify the values relevant to this discussion as: a concern to find cures and advance medical research; a commitment to uphold human dignity and promote respect towards human life; a commitment to show appropriate respect to human life in its earliest forms; and a strong sense of stewardship of, and respect for, all life forms and the environment.
These core values which characterise the various ethical, spiritual and cultural perspectives of New Zealanders can best be respected by a policy position that promotes only stem cell research using pluripotent cells obtained by means that do not require the destruction of human life in its most basic form.
It is possible to foster and support stem cell research in New Zealand that is ethical and that promotes human dignity even while it seeks to serve the greater common good. As noted above, research that does not uphold human dignity will not ultimately advance human well-being. New Zealand researchers are already renowned for their groundbreaking work with adult stem cells.
New Zealand has the opportunity to continue making a significant contribution to advancing the causes of human health and well-being in the field of stem cell research without resorting to the intentional destruction of human life in embryonic form.
The Nathaniel Report - Issue Twenty-One - April 2007