Science and the Unborn, by Clifford Grobstein
After Roe V. Wade
Science and Unborn: Choosing Human Futures.
by Clifford Grobstein.
Basic Books. 207 pp. $18.95.
It is widely assumed that, one way or another, Roe v. Wade, the 1973 Supreme Court decision legalizing abortion, will be superseded in the near future. That assumption is shared by both “pro-life” and “pro-choice” parties, and by observers comfortable with neither of those defined positions. In the several cases scheduled to come before the Court, Roe could be reversed quite directly, although that may be improbable in view of the felt need to demonstrate respect for precedent (stare decisis). More probably, the Court will challenge key legal premises of the Roe decision, such as the much-debated discovery of a constitutional right to privacy. The result will be to create legal space for a stronger assertion of state interest in, and responsibility for, the unborn, with the consequent regulation of access to abortion. What that might mean more specifically will be the subject of vigorous, and no doubt impassioned, debate in fifty state legislatures.
In the journals of opinion and op-ed pages, the debate has already started. Pro-choice proponents are deeply disappointed that Roe, which was supposed to have settled the abortion question by judicial fiat, turns out to have settled little or nothing. Their aim, understandably, is to devise a legal and political strategy for rescuing what they can from the anticipated wreckage of what now seems to have been a temporary victory. The pro-life proponents, on the other hand, whom the prestige media have for sixteen years tended to treat as marginal troublemakers, are buoyed by what they view as the stunning achievement of having defied and prevailed against the American establishment. So they will clearly be moving into the state legislative arenas with a psychological edge over their opponents. But momentum is not everything. At least as critical are the ways in which arguments, including moral arguments, will be recast in the period ahead.
As a foretaste of things to come, we are fortunate to have Clifford Grobstein’s Science and the Unborn: Choosing Human Futures. This intriguing study comes warmly recommended by prominent figures in biomedical ethics and reproductive sciences. Daniel Callahan of the Hastings Center, which is always to be found on the leading edge of discussions of the relative merits of life and death, takes note of the author’s “superb scientific knowledge and his ethical sensitivities,” and hails the book as “a significant contribution to a rapidly escalating debate.” Richard McCormick, a Jesuit at Notre Dame University, declares Grobstein’s analysis to be “scientifically informed, ethically sensitive, politically realistic,” and says the book “is must reading for anyone concerned about our common future.” That, presumably, includes most of us.
According to Grobstein, who is professor of biological science and public policy at the University of California, San Diego, our treatment of the unborn cannot be securely determined by “abstract moral principle or bloodless constitutional dogma.” What is required, he urges, is an understanding of “consensual objectives,” goals that we as a society want to advance, including respect for life. These objectives and the rules that follow from them are subject to public debate and political negotiation aimed at producing policies that, among other things, “must not offend the overall public ethos.” If this “demanding requirement” is forgotten, the result will be “public policy without moral foundations”—and such a public policy will not be sustainable in our kind of society.
In order to arrive at “consensual objectives,” Grobstein notes, we must be aware of the scientific facts. But we need to know more than facts. Objectives are shaped by value judgments, and we must therefore first of all determine what values we are going to employ in deciding what can and cannot be done with human life at its various stages. That is why the first chapter of Science and the Unborn addresses “The Significance of Status,” for, as we shall see, the author’s conclusions follow logically from his own assumption that the main question before us is one of assigning status to human life. The second chapter, “Becoming an Individual,” then treats what we know scientifically about the very beginnings of human life, while in the following chapters Grobstein extends the moral methodology of “status assignment” to the later stages of pregnancy and beyond. He then draws conclusions, of varying degrees of tentativeness, about what public policy ought to be with respect to assigning “protective status” both to the unborn and to those who are born but whose qualifications for status assignment might be in question. The book includes a useful appendix of simplified medical charts and commentaries on the stages of human development, and ends with an intriguing epilogue on biotechnology and space exploration.
Grobstein assuredly gives the reader much to think about, and his moral reasoning requires careful attention. Before we look more closely at that reasoning, however, it might be useful to return briefly to his notion of “consensual objectives.” As a biologist, Grobstein is aware of the frequently inflated claims made for science as a value-neutral source. On the question of who is a human being to be protected by society, he writes, it should be “especially clear that scientific fact is value-laden” just as, at the same time, “morality must be science-aware.” And he recognizes the solemnity of the issues being engaged: we are of necessity making decisions about who is and who is not a human being entitled to the community’s protection. But despite this, or maybe because so much is at stake, Grobstein would exclude from the discussion moral considerations that are religiously grounded. The exclusion applies to all religion, but he is especially adamant about Roman Catholic moral teaching, which he lumps together with what he judges to be sundry fundamentalist obscurantisms and characterizes as tradition-bound, rigid, simplistic, irrational, ignorant of scientific progress, and part of a “frozen past” that must make way for the needs of the present and future. What Grobstein so vehemently opposes is exemplified in the 1987 Vatican Instruction on Respect for Human Life in its Origins and the Dignity of Procreation. This, he writes, “reasserts a rigid doctrine in the face of advancing reproductive knowledge and its derivative technology, even though the technology is designed to yield a clear human benefit.”
There are several problems with Grobstein’s dismissal of religion-based teaching. For one thing, he seems to assume that statements from religious sources are expressive of private and nonrational (or even irrational) convictions, whereas they are typically intended to be public articulations of rational argument. It would have been more helpful if Grobstein had argued why his way of thinking is rational while other ways are not, rather than merely asserting this to be the case. Then, too, his claim that religious statements ignore scientific realities is curious in view of the fact that there is nothing of a scientific nature in Science and the Unborn that is not taken into consideration by, for example, the Vatican Instruction, and on a number of developments in reproductive science the Instruction is considerably more detailed than Grobstein’s book. But of course what he calls “value-laden” science is very differently laden in the Vatican statement.
Finally, Grobstein’s dismissal of religiously-informed considerations wreaks havoc with his emphasis on the need for communal consensus and for sensitivity to the ethos of society. He writes: “To assign status [to the unborn] rigidly on the basis of morality subscribed to by only a fraction of the population will seem arbitrary to all others and will only invite continued dissension.” If one includes all those in America who claim to subscribe to a biblical basis of morality, it is true that one has a “fraction of the population,” but the fraction is considerably above 80 percent.
Where then is the consensus to come from? Against “absolute criteria based on traditional concepts,” Grobstein wants “relative criteria appropriate to the current state of knowledge and specific currently formulated purposes” (emphasis in original). But how are we to formulate those purposes, and who is the “we” who will do the formulating? As soon becomes evident in Science and the unborn, scientific experts and medical professionals are the controlling participants in the “societal consensus” that Grobstein envisions.
In this respect Grobstein is by no means unique. On the contrary, he is typical of those who wish to construct “values” apart from tradition, and most particularly apart from the religious dimensions of tradition. All the more reason, then, to follow his arguments about human life and its protection with some care.
The more reflective proponents of the pro-choice position have learned one thing for certain from their failure to obtain the democratic ratification of Roe v. Wade. This is that the overwhelming majority of the American people do intuit, however confusedly, that there is something “there” in the womb that is disturbingly like one of us. Whatever we call what is in the womb, it is not a wart, and it is not a potential goldfish. The fact is that, barring natural misfortune or direct attack, it will become what is indisputably a human being. In short, human life is a continuum from conception to death.
As a scientist, Clifford Grobstein readily agrees. Of the zygote, the single human cell produced at conception, he writes: “Scientifically there is no question; the zygote is certainly human to its core.” The embryo, too, “is clearly a member of the human family, and . . . its biological humanness, therefore, should be affirmed in the status assigned to it.” But here is the catch: none of this need get in the way of the possibility of abortion, or of experiments with embryos, or of using fetuses for “spare parts.” What Grobstein does in this book is to recast the pro-choice argument in terms newly respectful of the unborn, but only to lead us through a course of reasoning by which it becomes evident, at least to him, that killing the unborn can in fact be an affirmation of their humanity.
That may seem an implausible task, but it begins to make sense if we allow that what is under consideration is not the recognition of any rights that the unborn might possess, and certainly not anything so “simplistic” as the right to life. It is true, Grobstein writes, that in our society, “whatever the intrinsic state of the offspring, its perceived human quality may induce empathy—in turn, leading observers to wish to assign a protective status.” But the critical thing to keep in mind is that we (society) are doing the valuing. Or, as Grobstein repeatedly puts it, we “assign status” to the unborn.
In other words, the status (as opposed to the humanness) of the unborn is not something that is “there,” which we are then obliged to respect and protect. Rather, the moral status of the unborn—and, it turns out, of others already born—is both created and maintained by our assignment. This is why it is so inappropriate to think in language such as that in the Declaration of Independence about “unalienable rights” bestowed by “Nature and Nature’s God.” Such language, says Grobstein, may be suited to political entities struggling to be free, but hardly applies to “cells and tissues” in the womb. Here, the only question that can be admitted is the question of the rational criteria by which we will or will not assign status to a human life.
What are those criteria? Grobstein is a champion of the liberal individualist theory of society. “Human society,” he writes, “is taken to consist of individuals with rights and responsibilities that are assigned through the mechanism of societal status.” Not everyone, however, counts as an individual. A human life must “possess certain properties,” and we decide which properties are pertinent. Most people, Grobstein believes, will agree that status should be contingent upon sentience and a sense of selfhood. A human life that is not conscious of itself as an “I” has no claim on the rest of us.
Grobstein employs the term “egogenesis” as shorthand for what might also be described as a neurocentric doctrine of individualism. He leaves no doubt that there are gradations in both the development and decline of the ego, and these gradations have a strong bearing on status assignment. He is more straightforward than some who write about these matters in acknowledging that the approach he favors can justify both infanticide and adult euthanasia. After all, status assignment always implies the possibility of status reassignment. But as a scientist, Grobstein is actually less interested in infanticide and euthanasia than in the experimental uses of the unborn, especially of those in the embryonic stage. His explanation of how such activity is compatible with the acknowledgment that the unborn are “members of the human family” achieves a subtlety that is almost exquisite.
It is the case, he says, that even the “pre-embryo” has “biological membership in the human community,” and must be respected for its “profound potential” to become “an individual in the fullest sense, an undeniable person.” And such respect is appropriate “so long as [the unborn] has a reasonable probability of continuing development to become an infant and then an adult.” But now comes the subtlety: “The situation is transformed if, for whatever reason, a particular pre-embryo has no reasonable prospect of developing further.”
And why should it have no reasonable prospect of developing further? The answer is simple: because we have decided to terminate it. It all comes back to status assignment. Human beings are what we assign them to be. The decision to terminate a life is premised upon its assignment as a life to be terminated. That, then, is what that life is.
Some may be more impressed by the circularity of this argument than by its subtlety. Such people would not likely be any more impressed by Grobstein’s further argument that, in those cases where use is made of the unborn for experimental and other purposes, not only has no injury been done the terminated life in question, it has actually received a great benefit. The unborn who have had their lives offered to science are blazing “a possible path to a cellular ‘fountain of youth’ for therapeutic purposes.” They have become “a symbol—and indeed truly a currency—for this profoundly human mutuality would seem to elevate rather than to denigrate their moral value.”
Of course Grobstein is chiefly discussing the use of early embryos, but he indicates that he is well aware of the possible implications of his argument for the aged, the severely handicapped, and others who are not capable of giving compelling reasons for status assignment as human beings to be protected. He knows that some people are fearful of the human hatcheries of the Brave New World, and others fret about euthanasia centers of the kind devastatingly described in Walker Percy’s novel Love in the Ruins. But he assures us that such fears are exaggerated, at least in the “short term.” At present, there are “few, if any, serious current research purposes” requiring the lethal use of human life beyond the early embryo stage, although such proposals “may not be fanciful in the longer term.”
The elderly in our society are, for whatever reason, made particularly nervous by such language. Grobstein tries to alleviate their anxiety. While there is a connection between the unborn and the declining elderly—“each represents a transitional state to, or from, typical personhood”—nevertheless “the two situations are not, of course, identical.” True, elderly people “with severe cognitive defect might not be admitted to personhood if their status were to be reconsidered on strictly definitional grounds,” but “by general consensus and for complicated reasons, their status is continued as an entitlement.” Again, at least for the present. As Grobstein emphasizes throughout, the urgent need is to reexamine and renegotiate existing assumptions, and to sort through the complicated and frequently irrational factors that stand in the way of arriving at a new and more coherent approach to status assignment in our society.
Clifford Grobstein is a distinguished biologist and policy analyst. Science and the Unborn has been hailed as a conceptual breakthrough. The argument he makes is certainly an advance over earlier pro-choice advocacy, in that it recognizes the inescapability of the question of the moral status of the unborn. The author is also to be credited for his candid admission that the question of the unborn is not just about the unborn, but entails of necessity our understanding of persons and our obligations to them at every stage of life. Further, he is surely right in saying that we must work toward a better consensus on questions of life and death.
It seems highly improbable, however, that Grobstein’s argument will help to build a consensus that, as he says, “must not offend the overall public ethos of a moral society.” A moral society we may not be, but ours is certainly a moralistic society. Its moralism is incorrigibly entangled with religion, and that, in turn, is reinforced by national traditions by which, as in the Declaration of Independence, we hold some truths to be self-evident.
Americans are not always very articulate about those truths, some of which are more like deeply entrenched intuitions. But none is more deeply entrenched than the intuition that the moral status of human beings is something given, maybe something endowed by God, but certainly not something assigned by us. Americans may not be certain what that means for public policy when it comes to the protection of vulnerable human life, both before and after birth, but they are not likely to take kindly to arguments that rule out of order their deepest intuitions. Proposals such as those in Science and the Unborn clarify for the debate ahead the crucial difference between those who believe that moral status is for us to assign and those who believe it is there for us to respect.