Julius Tudela
Bioethics Observatory
Life Sciences Institute
Catholic University of Valencia
The miracle of life. The wonder of human life
Two small cells, the male and female gametes, which will not live for more than 120 or 24 hours respectively, are the protagonists of an impressive biological event: their complementary fusion gives rise to a surprising form of life: they can live for more than 100 years.
Recent scientific findings related to the early evolutionary stages of embryonic human life are astounding.
The penetration of the sperm through the membrane of the oocyte, in a well-organized biological ritual, triggers a biochemical storm in the oocyte accompanied by profound metabolic and structural changes that signal the beginning of the journey of a new biological unit: an individual of the human species.
Despite its immaturity – it has only one cell at the beginning of its existence – it shows amazing potential. The development program contained in its genetic endowment opens like a complex instruction manual that begins to forge the miracle.
“Human genetics can be summed up in this basic credo: In the beginning is the message, and the message is in life, and the message is life. And if the message is a human message, then the life is a human life.” (Jerome Lejeune)
The initial cell, the zygote, will begin to divide, and each resulting cell will begin to learn the evolutionary path to follow. The embryonic cells divide and specialize progressively, gradually completing their own instruction manual, perfecting it, to provide this embryo with an organized, programmed, evolutionary and continuous structure, on the way to birth, adulthood and death.
These early stages of the journey, still in his mother’s fallopian tube, are exciting. The embryo must progress, helped by her, until it reaches the uterine endometrium, which, if everything has gone well, will have developed to receive it. Here your difficulties may begin.
This endometrium may not be in a position to perform this function for many reasons, some natural and others caused. Many contraceptives work by turning this endometrium into an inhospitable place to harbor life. The fragile and complex human embryo will then be forced to «pass by», rushing to certain death.
But if it is allowed to grow, it continues to amaze scientists, who observe how a simple cell contains all the information to develop a sophisticated program of differentiation, perfectly ordered, progressive, of increasing complexity and without interruption.
A surprising fact also happens: on his first trip through his mother’s fallopian tubes, and advancing with the help of her, he establishes his first mother-child dialogue. Today a multitude of chemical substances secreted by the embryo are known that act as «signals» for his mother, who answers, in turn, with new molecules that the embryo receives. This dialogue is a wonderful courtship between the mother and her child that prepares the subsequent implantation, selectively inhibiting the possible immune response of the mother towards her child, who is genetically different from her, has proteins that she recognizes as foreign and could reject. But it’s not like that. The mother, surprisingly, triggers an exceptional response: her son, although genetically different, is not her enemy, as are bacteria, viruses, fungi, tumors, etc. or transplanted donor tissues. And, therefore, it respects it, modulating her immune response so that it continues to protect her and, at the same time, respecting something valuable, different from her: her own son.[1]
The embryonic cells, at first very similar to each other, are specializing and forming tissues, organs, structures, regulatory chemical substances… that not only appear surprisingly, but also know where they should position themselves within the small embryonic structure, which is acquiring very soon a recognizable physiognomy in his head, his limbs, the heartbeat, his eyes… that can already be distinguished in just four weeks from conception.
And the cells of your retina know perfectly where they should travel and how to form it, just like the cells of your liver or your heart, your neurons, your red blood cells or your bones. And they do it in an orderly way: they all follow the program to the letter and the embryonic and fetal structures take shape as if it were a work of art, gradually revealing the face of an original, unique and unrepeatable person.
He will soon develop his sense of smell which will help him identify his mother later on. Her growth propels her toward birth, where she will continue to mature into adulthood.
Attempts to define a change of nature in the evolution of the embryo, which would exclude it from its human identity -the pre-embryo- in its initial stages of development, have failed in the face of the accumulation of scientific evidence that recognizes a continuum, without change of nature, that defines an individual from the first moment of its existence: fertilization.
Even those who proposed the term pre-embryo in the eighties, after the appearance of in vitro fertilization, have abandoned this claim.[2]
To speak today of a cellular aggregate, as something other than an individual, when referring to the early embryo, shows ignorance of the scientific evidence that accumulates about the nature of human beings in their initial stages of development.[3]
Difficult times in defense of life
But this amazement at the nascent human life, its complexity, its originality and the perfection of its development program, goes unnoticed by many.
The human embryo is weak, dependent, fragile, it cannot assert its rights, and its mother is its protection, its food, its custody. Although many of them do not even have this: generated in the laboratory, exposed to a foreign medium, they are left at the mercy of those who manipulate them.
They are selected for their quality or discarded for their imperfection. Or because of their characteristics, which may be more or less useful to those who manipulate them. Or they are directly destroyed to extract their cells, still immature, undifferentiated, pluripotent, longed for by scientists who want to produce tissues, organs or use them in other research.
But, although still very immature, they are people. That is what Shinya Yamanaka, Nobel Prize winner in Physiology and Medicine in 2012 thought, when one day in his laboratory, working with human embryos from which he extracted these pluripotent cells, after destroying them, he realized that the embryos he was observing through the eyepieces of his microscope they were similar to those that were his daughters in their early stages of development. Someone who had done what he did with those embryos would have ended their lives.
This reflection moved him to the need to stop destroying embryos in his research, and look for pluripotent cells -or stem cells- elsewhere. Thus, he designed a gene editing process for adult cells that would give them a status similar to that of embryonic cells, without the need to continue destroying embryos.
But not all scientists have had that sensitivity, which allows them to better observe the reality of human life.
More than 600,000 human embryos are waiting frozen at 196 degrees below zero in liquid nitrogen in Spain alone. More than 1,500,000 in the US It can be many more.
Only a small number of them will be implanted in the uterus of their mothers or donated to other women for gestation. The rest is doomed to destruction.
These embryos, left over from assisted reproduction techniques, continue to be produced in large quantities, because these techniques thus improve their chances of success, being able to use them in new attempts if their attempts fail.
From time to time, an incident is reported in one of these freezers that causes the death of the hundreds of embryos cryopreserved there.[4]
Right to abortion ?
In June 2021, the same day that the euthanasia law was approved in Spain, the Matic Report was approved at the European Parliament, which demanded that abortion be recognized as a right for women, with all that this recognition implies: it must be procured as long as you request it and in no case should the abortion process be obstructed, including conscientious objection as another obstacle.[5]
Later, a few weeks ago, French President Emmanuel Macron urged that the defense of abortion should be included in the Charter of Fundamental Rights of the European Union.
Other movements in this direction, such as the law of the Spanish Government that sanctions with prison «those who inform or pray for life» in the vicinity of abortion clinics, are also described by our archbishop as «an outrage with very serious consequences”.
Eugenics
The possibility of manipulating the embryo in the laboratory opens the door to eugenic practices that seek to select human beings based on their characteristics or health status.
This type of experiment is not new, and we remember with bitterness the attempts to obtain «pure» races by selecting or exterminating individuals based on certain interests. One would expect humanity and civilization to learn better from their own mistakes, which does not seem to happen in many cases.
Thus, the number of babies born with Down syndrome in Denmark continues to decline, with the lowest number recorded since the country started a Down syndrome registry in 1970: The Copenhagen Post noted that only 18 babies were born with Down syndrome in the year 2019.
Iceland made international headlines several years ago when it was revealed that the country has a nearly 100% abortion rate for babies with Down syndrome.
In Poland, of just under 1,100 abortions in 2016, almost all were due to disability. In the Netherlands, women are told they have a «moral duty» to abort if their child has Down syndrome, and Australian media enthusiastically praised a new prenatal screening test that could, in their words, «end effectively with Down syndrome. Obviously, he was not referring to ending the syndrome, but to the people who suffer from it.[6]
“To avoid exacerbating the debate, I’ll go back many years, to the Spartans, the ones who killed newborns when they thought they wouldn’t be able to bear arms or father future soldiers. Sparta was the only Greek city that practiced this kind of eugenics, this systematic elimination. And nothing remains of her: Not a single poet, not a single musician, not even a ruin has left us! Sparta is the only Greek city that did not contribute anything to humanity. Is it a coincidence or is there a direct relationship? Geneticists ask the question: Did they become stupid because they killed their future thinkers and artists when they killed their less beautiful children? (Jerome Lejeune)
The aftermath of abortion
Women who have aborted suffer. Many do not decide freely, because they are not duly informed. They do not know alternatives, they are not offered help, the nature of their children is hidden from them, and they are forced to decide in circumstances of anguish in many cases, of desperation. That is, without freedom. Induced abortions increase the risk in women who abort of suffering future psychological disorders. More if the abortion is repeated.[7]
In women who have suffered an induced abortion (TOP) the risk of mortality is 170% higher compared to those who have given birth to a live child, and double compared to those who have suffered a spontaneous abortion.[8]
Adolescents who abort reduce their life expectancy compared to those who continue with their pregnancy, according to a recent study. Continuing pregnancy in adolescents is a protective factor that reduces the risk of suicide by 50% and death from other causes by 40%.[9]
Not only the embryo that dies is a victim of abortion. So is the woman, or those who cooperate with it. But so is society, which sees the population ageing, causing a huge demographic problem, to which abortion contributes significantly.
Embryo handling
But there is more. Embryos can be manipulated, genetically edited to reproduce certain characteristics, or directly, to improve them, as proposed by transhumanist theses, which seek to alter the human, creating the «posthuman».[10]
Advances in gene editing, hand in hand with CRISPR techniques, open up dangerous opportunities for many researchers, who can modify the human genetic code, with consequences as unpredictable as they are catastrophic.
Human cloning experiments, hybridization with animals producing chimeras, the possible obtaining of gametes or even embryos artificially from any cell of the organism or artificial gestation paint a bleak picture for human progress.
Limitation to conscientious objection
Extinguish consciences seems an unavoidable step to guarantee the right to kill. Pointing out and prosecuting objectors who refuse to abort or perform euthanasia seems possible if killing is recognized as a right.[11]
Legal euthanasia
Analogously to the above, the final phase of human life offers a fragility similar to that of its beginning. An incurable, dependent, suffering, incapable patient is very much like an embryo. It is not autonomous, it does not produce, it cannot assert its rights in many cases, it will not resist being exterminated.
Recently, as we have published in our Observatory, a doctor who practices euthanasia tries to justify himself by stating that he does not end with the patient, but with his pain. I think he strikes the comment.[12]
That is the mission of the health system as a whole when it cannot heal: alleviate the suffering of the weak, the sick, the elderly or the dying. Dignifying life and not death is the measure of true civilization. Taking care of the living, accompanying him, calming him down, encouraging him, crying with him, suffering with him, but minimizing his suffering is to dignify life. Ending him is undignified.
“We must be clear: The quality of a civilization can be measured by the respect it has for its weakest members. There is no other criteria.” (Jerome Lejeune)
Freedom and truth: the limits of personal autonomy
“It’s my body, let me do what I want with it”: Freedom of choice is something more complex than the simple possibility of choosing.
There is no freedom without the one who chooses knowing the truth of what he evaluates, takes, or leaves. Choosing without knowing what I am doing, what I am giving up, what alternatives exist and what consequences my decisions have, means choosing without freedom.
Furthermore, certain circumstances may render us incapable of choosing freely. These circumstances must be identified to prevent erroneous choices from being harmful. They usually occur in situations of vulnerability, which can drag the weak person to his destruction.
[1]Tudela J, Estellés R, Aznar J. Maternal-foetal immunity: an admirable design in favor of life. Medicine and Morals 2014;5:833-45
[2]Ferrer Colomer M, Pastor Garcia LM. The brief life of the pre-embryo. Story of a word. Bioethics Notebooks, 2012;23(79):677-94.
[3]Tudela J, Aznar, J. The Biological Status of the Early Human Embryo. When Does the Human Being Begin. Conception: An Icon of the Beginning. Chapter 5, Part II, p. 1 – 26. (United States of America): In Route Books & Media, 07/26/2019. ISBN 978-1950108244
[4]Bioethics Observatory. The tragedy of frozen embryos sentenced to death.https://www.observatoriobioetica.org/2022/05/la-tragedy-of-the-frozen-embryos-condemned-to-death/38681. Accessed May 06, 2022.
[5]Tudela J. Right to kill, right to kill oneself: a moral pandemic threatens Europe. ABC Journal. June 26, 2021. https://www.abc.es/espana/comunidad-valenciana/abci-julio-tudela- Derecho-matar- Derecho-matarse-pandemia-moral-amenaza-europa-202106261354_noticia.html
[6]One of Us. The number of babies born with Down syndrome in Denmark continues to decline.https://oneofus.eu/en/the-number-of-babies-born-with-down-syndrome-in-denmark-continues-to-decrease/. Accessed April 30, 2022.
[7]Coleman, PK, Boswell, K., Etzkorn, K., & Turnwald, R. Women Who Suffered Emotionally from Abortion: A Qualitative Synthesis of Their Experiences. Journal of American Physicians and Surgeons. 2017;22(4):113-8.)
[8]Reardon DC, Thorp, JM. Pregnancy associated death in record linkage studies relative to delivery, termination of pregnancy, and natural losses: a systematic review with a narrative synthesis and meta-analysis. SAGE open medicine. 2017; 5: 2050312117740490.
[9]Jalanko, E., Leppälahti, S., Heikinheimo, O., & Gissler, M. Increased risk of premature death following teenage abortion and childbirth–a longitudinal cohort study. European journal of public health. 2017;27(5): 845-9.
[10]de Melo-Martin I, Rosenwaks Z. Searching for the perfect child. Fertility and Sterility. 2015; 103(2), 342-3.
[11]Bioethics Observatory. Conscientious objection or good practice?https://www.observatoriobioetica.org/2021/10/objecion-de-conciencia-o-buena-praxis/36972. Accessed October 30, 2021.
[12]Bioethics Observatory. Does performing euthanasia affect the psyche of doctors?
https://www.observatoriobioetica.org/2022/05/afecta-a-la-psique-de-los-medicos-realizar-euthanasias/38752. Accessed May 10, 2022.
