The question whether it is morally licit
- to produce cell lines from embryonic and fetal cells,
- to use these cell lines for the research on or the production of vaccines, and
- to be vaccinated with a vaccine of such pedigree
has received new urgency because of the current worldwide COVID-19 health crisis. Prior to this emergency, the issue has been dealt with by three ecclesial pronouncements: a 2005 note by the Pontifical Academy for Life (PAV 2005),1 the 2009 Instruction Dignitas Personae by the Congregation for the Doctrine of the Faith (CDF 2009),2 and another note by the Pontifical Academy for Life in 2017 (PAV 2017).3 In December 2020 the Congregation for the Doctrine of the Faith has issued another statement on the matter with specific application to the question of the preparation and use of vaccines against the SARS-CoV-2 virus (CDF 2020).4
From the outset it must be made clear that the research on and production of vaccines making use of human cell lines does not necessitate the continued utilization of ever new human embryos or fetuses. Once these cell lines have been produced by the manipulation of the original cells, they enjoy a quasi-immortality and can be multiplied almost indefinitely. In the preparation of anti-COVID-19 vaccines, two cell lines have been of particular relevance: the HEK-293 and the PER.C6 cell lines. In the preparation of the majority of the vaccines available, these cell lines have been used as a sort of miniature factory to produce high quantities of adenoviruses which are used as vectors to introduce certain genes of the SARS-CoV-2 coronavirus into the vaccine, which will then stimulate the immune response in those vaccinated. Alternatively, they serve to reproduce the spike protein of the SARS-CoV-2 coronavirus, which, once injected under the skin will cause the desired immune reaction.5
Fetal cells are not used in the production of the vaccines, nor does the research on or preparation of the vaccines increase the demand for newly aborted fetuses. The fact of the matter is, however, that the HEK-293 cell line did derive from the human embryonic kidney cells (hence “HEK”) of a female fetus aborted around the year 1972, while the cell lines themselves were generated in 1973.6 The precise circumstances of the abortion can no longer be established with certainty. Given that the fetus was healthy, it is it is highly improbable that the abortion was spontaneous. The PER.C6 line was obtained from an 18-week-old fetus, aborted in 1985.7 It is the fact of these abortions that makes the question of the anti-COVID-19 vaccines an issue. All people of good will agree that it is never morally licit to use human beings as mere tools, as happens, for instance, in slavery or organ trafficking. What is increasingly being lost today, however, is the awareness of the fact that human embryos and human fetuses, too, are human beings, who must be treated with the same respect as is due to human beings already born. The use of fetal cells to produce cell lines would in most scenarios seem to constitutes an instrumentalizing use of these fetuses, particularly if they have been victims of an induced abortion. For the following reflections it will nonetheless be important to keep in mind that
- it is at least thinkable that a fetus providing the original cells died on account of a spontaneous abortion and that his or her case could be understood in terms analogous to an adult organ donator who has died from a natural death (the mother expressing consent on his or her behalf).
- even if the fetus died on account of an induced abortion, it is at least thinkable that the researcher using the fetal cells to produce a cell line did not formally cooperate with that abortion, benefiting from someone else’s evil action without previously having encouraged it in any way. Helen Watts makes a strong point when she argues that such scenario generally speaking extremely unlikely.8 At least in the case of HEK-293, however, this would seem to be the more likely scenario, as significant time had passed between the original abortion in about 1972 and the production of the cell line in 1973.9In addition, Frank Graham, the original researcher establishing HEK-293, declares to have no knowledge of what had happened to the fetus and of where the cell had come from.10 He did not therefore assist in any way in the 1972 abortion of the female fetus whose embryonic kidney cells he turned into the HEK-293 cell line in 1973. One might be able to conceive of her case as one analogous to an adult organ donator who had died from a violent crime and who donates an organ to someone who had nothing to do with his or her death. These considerations go to say that the connection between producing human cell lines and recurring to induced abortion is accidental. In some, most, or possibly even all actual cases, there might in fact have been this connection, but this connection is not substantial, inasmuch as it is at least thinkable to produce a human cell line without formal cooperation with abortion.Producing cell lines from cells deriving from an aborted fetus is a case where one can will the end (the cell lines) without necessarily willing the means (induced abortion), as long as one has not assisted in the abortion or encouraged it. One of my main arguments in this piece is in fact that not every time we are benefiting from someone else’s evil action, our benefiting signals formal cooperation with that evil. There are many cases in which one can will one’s own (good) end without willing the other’s (evil) means, from the results of which one nonetheless draws benefit for proportionate reasons. This is not to say that there are no moral difficulties with making use of the results of someone else’s evil action – it is just to say that such benefiting from someone else’s evil act is not necessarily formal cooperation in evil.
If it is morally problematic to use a fetus deriving from an induced abortion for the production of cell lines, why not solve the problem by simply establishing cell lines deriving from a fetus who died from natural causes or use other alternative sources of cell lines entirely unconnected to abortion? Of course, this is exactly the solution for which to strive and for which to make a public appeal. There are, however, difficulties connected with it, which need to be acknowledged, even if the goal should not be abandoned. It would seem that particularly in the case of HEK-293, its original creation has been a major feat11; it has since become extremely common, to the point of having become somewhat of the “gold standard” in research, and according to some, replacing it would mean having to go back 30 years and having to “reinvent the wheel.”12
For the time being, in any case, the only cell lines available for research seem to be those of compromised or at least doubtful origin. They were established by researchers who benefitted from or perhaps even directly and formally cooperated with the deliberate suppression of an unborn human being, from whose cells these cell lines were created.
The question arises how to deal with these cell lines, now that they have become a “thing” in the world. Can scientists in good conscience use them in the process of producing vaccines? Can the public, in good conscience, agree to being vaccinated? What exactly is at stake here? I will take for granted that induced abortion is always morally illicit and must never be done. But this affirmation alone does not yet answer the question whether, and if yes, under which conditions, one may licitly benefit from the results of such evil action perpetrated by others.
I will argue that one formulates the matter inadequately if one puts it in terms of material or even formal cooperation with evil and that one gets much closer to the root of the problem if one applies the categories of what moral theologians in the late 20th century have christened “appropriation of evil.”14 Put in general terms, the issue at stake in the vaccine controversy would seem to be this one: Is it ever morally licit to make use of the convenient results of other people’s evil actions, and if yes, under which conditions?Not availing themselves of the conceptual framework of appropriation, all four ecclesial documents mentioned above make use of the category of the cooperation with evil, which was first conceptually elaborated by Alphonsus Liguori in the 18th century15 and is thus more time-honored than the category of appropriation, but is still relatively recent from the perspective of the Church’s bi-millennial history.
Benefiting is not the same as cooperating. Answering a question about benefiting with conceptual categories proper to cooperation may make one’s argument appear incoherent and unconvincing, even if one’s conclusions should turn out to be sounder than one’s arguments in their favor. In any case, formulating a question in the wrong way and using inadequate categories to confront an issue is bound to have some undesirable consequences.In what follows, I will first point out the difficulties connected to these four documents in their content (they don’t agree), and in their reception (some high ecclesiastics feel duty-bound to reject their teaching and some Catholic intellectuals, while accepting what the documents say, would appear to misinterpret their argumentative principles). I will then argue that these problems result from the use of a conceptual category (cooperation with evil) which is inadequate to deal with a question that is really about benefiting (“appropriation”). Applying the category of appropriation, one may still arrive at very much the same conclusions as Dignitas Personae, while at the same time presenting an argument that is more convincing, more coherent, and clearer.
The Disagreement between PAV 2005, CDF 2009, CDF 2020 on the One Hand and PAV 2017 on the Other
If one approaches PAV 2005, CDF 2009, PAV 2017, and CDF 2020 with the question of whether, under certain circumstances, one may vaccinate one’s children or be oneself vaccinated with vaccines of illicit origin, all four answer in the affirmative and all four frame their argument by making use of the category of cooperation. There are, however, fundamental divergences about the reasons adduced and the conditions indicated between PAV 2005, CDF 2009, and CDF 2020 on the one hand, and PAV 2017 on the other. We will turn to these differences right away. However, a quick word should first be said about the degrees of authority proper to these different documents. The Congregation for the Doctrine of the Faith shares in the papal magisterium: both its 2009 Dignitas Personae and its 2020 note on anti-COVID-19 vaccines were examined by the respective reigning pontiff who himself ordered their publication. Of the two, Dignitas Personae is more authoritative, inasmuch as it is an instruction and as such “trumps” a note. The Pontifical Academy for Life, in contrast, is an advisory body. Its pronouncements are not part of the magisterium, nor is its task strictly speaking that of teaching. Nonetheless, the fact is that the ordinary Catholic is usually unaware of this difference, and the media typically do not discriminate: the PAV is presented as “the Vatican” no more and no less than the CDF. It is therefore important not to leave to one side the PAV documents but to examine them as well.
Let us begin with a discussion of the three documents that are in essential concord not only about the argumentative framework (cooperation) and the general answer (affirmative), but also on the reasons and conditions. Dignitas Personae speaks of a duty to refuse the use of biological material of illicit origin, but it also states that this duty is not exceptionless: “Grave reasons may be morally proportionate to justify the use of such ‘biological material’. Thus, for example, danger to the health of children could permit parents to use a vaccine which was developed using cell lines of illicit origin” (n. 35). Apart from the proportionate gravity of the reasons apt to justify such use, the Congregation adds another condition, which at first sight may seem curious, but which, upon closer inspection will prove to be fundamental: for the CDF, while one makes use of said vaccine, one must keep in mind “that everyone has the duty to make known their disagreement and to ask that their healthcare system make other types of vaccines available” (n. 35).
Someone might object that it is incoherent first to speak of a duty and then to list the conditions under which one may be exempt, or to tell people that they can licitly benefit from the use of an item and then urge them publicly to object to the way this item has been produced. But there is really nothing inconsistent about these conditions. Though there are some duties that are exceptionless – the duty never to commit acts that are intrinsically evil, such as directly killing the innocent or committing adultery – the concept of duty as such is compatible with the concept of exceptions. The Congregation does not contradict itself when it states that there is a duty (on principle) not to use biological material of illicit origin while also affirming that at times this duty can licitly be overturned for grave reasons. Many, even most duties have exceptions for proportionate reasons. The CDF implicitly affirms that there is a difference between the use of biological material of illicit origin and the illicit act at its origin: receiving a vaccine is not the same as procuring an abortion. There exist, in fact, “differing degrees of responsibility” (n. 35). One must never, under any thinkable circumstance, procure an abortion, but one may, under certain conditions and for grave reasons, receive a vaccine that has a procured abortion in its pedigree (that is of “illicit origin”). Further, the evident tension between benefiting from someone else’s immoral action while at the same time declaring one’s disapproval of that action does not need to be a contradiction, especially if one has few options in the matter, so that one’s freedom is limited.
In its conclusions on the question at hand, Dignitas Personae essentially reaffirms what was said by PAV 2005. The 2020 note by the Congregation for the Doctrine of the Faith bases itself, in turn, on Dignitas Personae, so that all three documents agree on the following points:
1. There is a moral problem with the use of vaccines of illicit origin. However, under certain conditions and for grave reasons, it is morally licit to have oneself or those in one’s care vaccinated, even if the vaccine has an ethically reproachable origin. Implicitly the point is made that benefiting from an intrinsically evil act is not the same as committing an intrinsically evil act. Explicitly it is stated that there are grades of moral responsibility.
2. In making this ethically licit use of such vaccines, there is the danger of giving the impression of endorsing the use of cell lines deriving from aborted fetuses. This danger must be avoided. One must therefore find appropriate ways of making one’s disapproval known and encourage those responsible to produce ethically acceptable vaccines.
3. Dignitas Personae frequently refers to biological material of “illicit origin.” While an origin is not a concrete thing as is a vaccine, it is nonetheless a thing, albeit an abstract one. If in their literal use, terms of moral disapprobation such as “tainted,” “reproachable,” or “illicit” refer to actions, their use to describe things is metaphorical. All three documents share the conviction that the metaphorical use of adjectives of moral disapprobation to describe certain types of vaccines or their origin is semantically intelligible and morally warranted.
In contrast, on all three points the 2017 note by the Pontifical Academy for Life significantly departs from the teaching proposed by the other three documents. Here, the PAV argues that “the cell lines currently used are very distant from the original abortions and no longer imply that bond of moral cooperation indispensable for an ethically negative evaluation of their use.” Therefore, in conclusion, “all clinically recommended vaccinations can be used with a clear conscience.”16 There is therefore no need for particular circumstances and particularly grave reasons to justify an exception from a prima facie duty. The question is not one that poses any difficulty to conscience (as opposed to the above point 1). In addition, the duty incumbent on everyone – taken quite individually – to express one’s disagreement and to encourage alternative ways of production is transformed into “a common commitment to ensure that each vaccine has no reference for its preparation to any material of abortive origin.”17 Now a “common commitment” is really the commitment of no one. And it is a commitment that the common Catholic faithful can do little about – how can I ensure that there is no longer such reference if I’m not working in the laboratory? Well, I could make known my disapproval, in conversation, by making phone calls or writing emails. But there is none of this here. Rather, the emphasis is clearly on the “moral responsibility to vaccinate … in order to avoid serious health risks for children and the general population” (together, this is opposed to the above point 2). Finally, for PAV 2017, there are no morally tainted vaccines of illicit origin: “As for the question of the vaccines that used or may have used cells coming from voluntarily aborted fetuses in their preparation, it must be specified that the ‘wrong’ in the moral sense lies in the actions, not in the vaccines or the material itself” (as opposed to the above point 3). In sum, the immoral action of committing abortion has long receded into the past, so that the degree of cooperation is insufficient to warrant moral reprobation. The solution to the problem is to understand that there is no problem.
The objection that there are no “illicit” vaccines is rather superficial. It is of course true that, strictly speaking, acts are immoral and not things. Ordinary language, however, allows us to speak of “dirty money,” for instance, and no one objects to this expression as being imprecise or implying a magic notion of reality where evil haunts things. We all understand that “dirty money” refers to funds that have derived from morally and legally illegitimate activities such as drug trafficking, extortion, or prostitution. If the generally accepted rules for the use of metaphors allow us to speak of “dirty” money in such cases, then we should, by the same rules, be allowed to speak of “tainted” or “morally reproachable” vaccines.
The weightier point of PAV 2017’s objection is its reference to the temporal distance from the original abortions. What bond of cooperation does one establish with those past immoral actions if one has oneself vaccinated today – or, we may add, even if one does research on those cell lines established 40 years ago? The most plausible answer is indeed the one given by the document: a cooperation not sufficient to warrant a negative moral qualification – or, to be more precise: none. This holds doubtlessly true if one speaks of material cooperation, as do PAV 2005, CDF 2009, and CDF 2020. In the context of the argumentative framework of cooperation with evil, the position proposed by PAV 2017 seems to be more coherent than that of the other three documents. If it were a question of cooperation, the reasons and conclusions proposed by PAV 2017 would be incontrovertible, unless we wanted to turn the question into one of formal cooperation, which is always illicit and which would require all people of good conscience to refuse vaccination (and, then even more so, refuse to engage in research conducted with such cell lines). However, as we will argue, this framework is inadequate to answer the question. The moment one applies the categories of appropriation of evil, the conclusions proposed by the other three ecclesial documents appear much more convincing than those presented by PAV 2017.
The Difficulties in the Reception of the Teaching
The magisterial teaching encounters difficulties in its reception: there are some Catholic bishops who publicly claim that it is always immoral to be vaccinated with vaccines of illicit origin, thereby claiming that the CDF’s and PAV’s teaching is inacceptable for Catholics.18 There are some Catholic academics who until December 2020 would have eschewed proportionalist thinking, but now, having read CDF 2020, begin measuring what is incommensurable, weighing lives against each other on a scale. In a doubtful application of the principle of double effect (a principle of which the CDF 2020 document is silent), they claim that under conditions of necessity one is morally obliged to choose the action whose results are more beneficent than damaging – in the case in point, the action that saves more lives than the alternative one: getting vaccinated saves more lives than are killed by the practice of fetal research which it might encourage.19 Taken literally, such reasoning can be and has in fact been used to justify any kind of action or practice, from the legalization of abortion to the nuclear bombing of cities. On any calm day, this maxim probably does not represent the authors’ mind, and it certainly does not represent the CDF’s position. My point here is only this: while no writing is immune from being misunderstood, at times it shares some of the responsibility for being misunderstood. To my mind, the greatest misunderstanding is that of treating a question of appropriation – of benefiting from someone else’s evil action – as if it were a question of cooperating with that action.
In what follows, then, I will argue that it is possible to explain the incongruities among the four ecclesial documents and the difficulties in their reception by their use of the conceptual framework of cooperation, which is not entirely appropriate for the original question. I will try to show how most, if not all, of the difficulties we have thus far encountered can be resolved by applying the category of appropriation instead.
The question of cooperation was first treated (though not conceptually elaborated) by a Church document in a note by Pope Innocent XI of 1679, in which he condemns the proposition that
“A male servant who knowingly by offering his shoulders assists his master to ascend through windows to ravage a virgin, and many times serves the same by carrying a ladder, by opening a door, or by cooperating in something similar, does not commit a mortal sin if he does this through fear of considerable damage, for example, lest he be treated wickedly by his master, lest he be looked upon with savage eyes, or lest he be expelled from the house.”20
It is not licit for a servant to cooperate in his master’s act of rape by holding or carrying a ladder or lending the use of his shoulders so the master can enter through the maiden’s window. Ever since then, elaborate principles of moral cooperation have been developed, in particular with the work of Saint Alphonsus Liguori, who introduces the distinction between formal and material cooperation.21 In formal cooperation, the cooperator in the evil act shares the evil intent of the principal agent. Such sharing is always immoral. When it comes to material cooperation, by which the cooperator provides some enabling conditions for the principal agent to execute his evil action, moral theologians today usually distinguish between immediate, proximate, or remote cooperation, between necessary and non-necessary cooperation, and between one that is active or passive, as when someone cooperates with evil by not resisting it. All cooperation with evil should generally be avoided.
Nonetheless some types of material cooperation can be morally justified for proportionate reasons, while others are always immoral. Thus, immediate, necessary material cooperation is always immoral, as when a nurse passes the scalpel to a doctor who is performing an abortion. Working as a cook in an abortion clinic, in contrast, would qualify as remote material cooperation and could therefore be justified for proportionate reasons, as when someone cannot easily find a different employment and really needs the income to provide for his or her family. All four ecclesial documents which we have discussed claim that receiving vaccines that in their research or production stage have made use of fetal cell lines, which in turn have been prepared by making use of cells belonging to aborted fetuses is an act of remote material cooperation with the evil of abortion. The PAV 2017 document considers this material cooperation remote enough to have essentially disappeared from sight, so that the use of these vaccines no longer presents any difficulty for conscience and does not need to be further justified. Here PAV 2017 correctly points to the fact that the research on or the production of said vaccines does not keep using up ever new fetuses. What is at stake is using fetal cell lines, which once produced, can be reproduced and maintained for decades on end. As I explained in the beginning, essentially all fetal cell lines currently utilized in the research on or the production of vaccines derive from a limited number of concretely identifiable incidents of induced abortion, performed in the 1970s and 1980s. PAV 2005, CDF 2009, and CDF 2020 operate on the same scientific premises and come to the conclusion that a moral problem does exist. The solution is first to look for alternatives to the use of such vaccines. Then, if alternatives do not exist and there is grave necessity, one may licitly use these vaccines, though one should make known one’s opposition to abortion and urge that alternatives be provided.
There is however, a grave conceptual difficulty. It is simply not evident how someone’s getting vaccinated today with a vaccine of illicit origin assists or provides the material conditions for the abortions performed in the 1970s and 1980s, or, to put it more generally, how there can be material cooperation with evil acts performed in the past. In order to be able to rape the maiden, the master needs the ladder carried and held by his servant. The servant might not share his master’s intentions, but still provides necessary conditions for him to carry these out. To perform an abortion, an abortion doctor needs the scalpel provided by the nurse and, in a much more remote way, he also needs food, provided by the cook. The abortion doctor who in 1972 aborted the fetus whose kidney cells were then used to produce the HEK-293 cell line does not need me to get vaccinated. My getting vaccinated does not provide any facilitating conditions for his or her action, which becomes neither easier nor harder. The past cannot be changed. No one today can assist in the performance of someone else’s past action any more than he or she can prevent it. One may of course object and say that one cooperates by encouraging a present or future evil practice or by seeming to approve of it. But these are precisely the problems with benefiting from someone else’s evil action. If it is strictly speaking a matter of material cooperation, i.e., of lending assistance to someone else’s evil action, and if we look at the relation between the original abortions that happened some 40 years ago and persons getting vaccinated today, then no material cooperation is detectable and PAV 2017’s argument is completely coherent.
There is of course a way in which one can cooperate even with past evil, and that is formal cooperation. Since the past cannot be changed, today it is metaphysically impossible for anyone to give material assistance to the Nazi-crimes of the 1930s and 1940s. Formal cooperation, instead, remains a metaphysical possibility, even if it regards past actions: it is enough to approve of them. Assistance given by providing material enabling conditions tinkers out over time the more the assisting act is removed from the evil act, and it only goes in one direction: from the present into the future. Intentions, on the other hand, seem to be more indifferent to the passing of time and the direction of its flow. By approving a past crime, to the point of affirming that one would have committed it oneself had one had the chance, one has made this crime one’s own, even if it is past. Temporal and spatial distance is essentially insignificant here. One can condone a moral atrocity committed by the ancient Romans no less than a crime committed by contemporary agents. Somebody can condone a present wrongdoing no less than an anticipated future one. If we want to use the categories of cooperation with evil in order to answer the question whether it is ever morally licit to be vaccinated with a vaccine of illicit origin, then the most plausible view would be to frame the matter in terms of formal cooperation. But it is always sinful to cooperate with evil formally. Hence the decisive “no” recently given to the question by some high prelates of the Church.
To sum up, the PAV’s 2017 rather unqualified “yes” to the question of whether it is morally licit to get vaccinated with vaccines of illicit origin is based on an understanding of the issue in terms of material cooperation. The Academy finds that, for all intents and purposes, there is no material cooperation, which is why it is morally licit, nay, obligatory, to get vaccinated. Cardinal Janis Pujats’ and his colleagues’ unqualified “no” to the same question is likewise based on an understanding of the issue in terms of cooperation, though this time, in the final analysis, in terms of formal cooperation, which is more plausible if we want to frame the matter in terms of cooperation in the first place. The qualified “yes, but” given by PAV 2005, CDF 2009, and CDF 2020 seems to me the best answer, but it is truly coherent only if the issue is formulated in terms of appropriation of evil and not in terms of cooperation with evil, since for metaphysical reasons, one cannot say that the cooperation is material and for moral reasons, one does not want to say that the cooperation is formal.
How can one benefit from someone else’s evil act and why could it ever be a moral problem? One benefits for one’s own ends. Someone else’s evil act assists one in pursuing one’s interests and in bringing about one’s intentions. The “evil” agent here is the cooperator, the one benefiting is the principal agent, and the question is not whether the cooperating agent acts in a morally licit way – this question is decided: he or she does not – but rather whether the principal agent is morally justified in availing him- or herself of the results of the evil acts. The question of the appropriation of evil, of benefiting from someone else’s evil, is therefore the exact mirror of the question of cooperation with evil, as M. Cathleen Kaveny has felicitously formulated it in her landmark paper on the matter.22
There would seem to be four distinct ways in which one can benefit from the results of someone else’s evil act, depending on how one’s own intentions in acting are related to the intentions of the maleficent auxiliary agent.23
1. With one’s own action one pursues a goal that is in accordance with the intentions of the one who committed the evil act from whose results one now benefits. The useful result of the other’s evil act cannot be reached by means other than the evil act. By making use of this result for one’s (good) ends, one also wills the (evil) means by which the result has been produced. Here appropriation necessarily implies sharing the other’s evil intention; here appropriation indeed amounts to formal cooperation. Example: Let us suppose a maleficent auxiliary agent produces a movie with murder scenes in which it is not just the characters who are killed, but literally the actors. Let us further suppose that the goal of the primary agent in watching this movie is not to conduct a murder investigation but to get excitement and a new kind of thrill, which is precisely what the producer intended it for. In this case, the primary agent would seem to be formally cooperating with murder. It is analytically true that there is no other way of producing such movie. The result of which one avails oneself is defined by the evil act by which it has been produced. Using such movie for the ends for which it has been intended is also to want the means by which it has been produced.
2. With one’s own action one pursues a goal that is at least partially in accordance with the intentions of the one who committed the evil act from whose results one now benefits. The useful result of the other’s evil act could also be reached by means other than the evil act. Example: A medical doctor encounters difficulties during a surgical operation. She needs to free a pinched nerve in her patient’s knee but is unable to find the nerve. Prior to the operation, her patient had declared that she no longer wanted to live with the excruciating pain caused by the nerve and desired her leg to be amputated in case there was no other remedy for the situation. The doctor is in possession of a book with the most accurate and most detailed anatomical drawings available to date, the so-called Pernkopf illustrations. Standing at the operation table, she calls a colleague and asks him to go to her office, find the book, take pictures of the relevant pages and send them to her on her smartphone. On receiving the anatomical drawings, she is able to locate the nerve, set it free and save her patients’ leg. The moral difficulty consists in the fact that these drawing have been produced in Austria in the late 1930s by doctors who, to arrive at this anatomical detail, used the bodies of those unjustly executed by the Nazis.24 While in her use of the plates, our present-day doctor had no intention to murder people, her use of the drawings was precisely for the purposes intended by the Nazi-doctors. In theory, however, one can produce illustrations of this quality by using other means. Therefore, her using the picture for the same end as intended by the Nazis does not commit her to willing the same means applied by the Nazis to produce the picture. Willing the use of these illustration is not the same as willing the execution of innocent victims. Here the result of which one avails oneself is not defined by the evil act by which it has been produced. There is no necessary formal cooperation with evil here. There is no material cooperation either. And yet, a moral problem would seem to persist.
3. With one’s own action one pursues a goal that is parallel to the intentions of the one from whose evil act one now benefits. Example: A patient with a kidney deficiency receives a donor kidney from a murder victim who had previously declared his willingness to serve as an organ donor in the event of his death. The murder was not commissioned by the organ recipient and not perpetrated for the sake of organ-trafficking.
4. With one’s own action one pursues a goal that is contrary to the intentions of the one from whose evil act one now benefits. Example: A police officer’s professional activity depends on the activity of criminals. If there were no one who breaks the law, there would be no need of the action of law enforcement agents. In what they are doing, police officers benefit from the activities of criminals, inasmuch as criminals give them something to do in the first place, preventing them from becoming unemployed.
No moral issue seems to arise in cases 3 and 4. Case 1 is clearly one in which appropriation is formal cooperation and therefore morally illicit, not to say atrocious. A true moral difficulty is raised by case 2. It would appear that we instinctively feel uncomfortable at the thought of benefiting from Nazi-drawings, even if it is for a good purpose. At the same time, we would probably not blame the doctor for what she has done and may even recommend her for it. And yet, if we, as she herself did, feel a certain unease, one must wonder where it comes from. What is involved with benefiting from the results of others’ evil acts and thereby in some ways even bringing to fruition their original intention, though we are not committed to willing their evil means because the useful result could also be produced in other ways? There would seem to be at least the following four issues at stake here:
1. Accepting to benefit from the results of someone else’s evil action, even if it is past, may encourage present or future evil practices.25 By using the Nazi-drawings, our doctor does nothing to assist the Nazi-doctors in the 1930s. But present or future agents might be encouraged to engage in instrumentalizing research on human subjects when learning that good may come from it. Accepting the benefit may suggest to some that there is a demand for the results of such evil actions and encourage them to provide the supply (though, as we have seen, in this case the supply could also be met by morally licit means).
2. Accepting to benefit from the results of someone else’s evil action weakens the credibility of one’s objection to that action. There is no strict logical contradiction between benefiting from an action and at the same time objecting to it, but it would need particular circumstances not to appear or literally be hypocritical. It weakens one’s witness.
3. Accepting to benefit from the results of someone else’s action may give the impression of approving it. There is no strict logical connection between benefiting from an action and approving of that action, but it would need particular circumstances not to appear to be or literally be approving of that evil action. There is a risk of scandal.
4. Accepting to benefit from the results of someone else’s evil action may feed into our complacency and darken our mind.26 It may weaken our intellect when it comes to understanding the evil at stake and weaken our will when it comes to resisting it. There is a risk that the appropriation of evil undermines our moral character and leads us to condone evil. While the appropriation of evil is not the same as formal cooperation with evil, the former may lead to the latter.
However, to benefit from evil is not the same as to commit evil. Therefore, despite these undesirable potential consequences, the appropriation of evil, unlike the perpetration of evil, is not always morally wrong but can be justified for proportionate reasons and under certain circumstances. What could these reasons and circumstances look like? How can one counteract the four dangers involved in the appropriation of evil just mentioned? There would seem to be three conditions that could justify and at the same time counteract the moral risks of appropriation:
1. There would have to be a grave necessity and no viable alternative. Our doctor’s use of the Nazi-drawings was not for trivial reasons, like winning an anatomy contest in medical school. She used them to save her patient’s leg. There was no alternative available, not at the given place and time and not absolutely speaking.
2. One would have to look for adequate ways of expressing one’s disapproval of the evil action from whose results one now benefits. And this disapproval is credible only if condition 1 is fulfilled, that is, if there is in fact a grave necessity and no alternative.
3. One would have to look for ways to influence the decision makers to develop alternatives. Any cellphone user of good conscience will feel uncomfortable when learning that the battery of his or her device most likely contains cobalt, a “dirty” material, 60% of the world’s supply coming from mines in Congo that are notorious for exploiting children.27 Does using a phone, or any other item using lithium-ion batteries, mean condoning child labor and slavery? No. It is practically impossible today to renounce all items making use of lithium-ion batteries. And alternatives to the use of cobalt in batteries or to the abuse of children in the mining of this mineral are conceivable. Over and above stating these facts, however, it would also seem just and right to voice our disapproval and to use our leverage as customers, write an email to customer service and encourage our phone maker to renounce the use of “dirty” materials, such as cobalt, making it clear that we will move our allegiance to the first phone maker who provides an alternative to the use of components of “illicit origin.”
Using Nazi drawings in an operation room is not torturing and killing people. Using a smartphone with a lithium-ion battery containing traces of cobalt is not enslaving people. The appropriation of evil is not the same as the perpetration of evil. And yet, the motives for why we nonetheless feel uncomfortable with appropriating evil are rationally compelling. It seems that appropriation needs a justification, especially if by appropriating evil we bring at least part of the evil intention of the maleficent agent to fruition: the Nazi-drawings were made for use in the operation room; cobalt is being mined for use in cellphone batteries. Benefiting does not automatically imply condoning – it does not necessarily involve formal cooperation, so long as the result from which we benefit is not intrinsically connected to the evil action from which it has derived but could also be achieved in other ways. Benefiting is not material cooperation in evil, which would be impossible in the case of using the Nazi-illustrations, and which would be extremely remote in the case of the use of lithium-ion batteries containing cobalt. However, benefiting may encourage present and future evil practices, weaken our witness against this evil, lead to scandal and undermine our character. For all these reasons we should refuse to appropriate evil unless there are compellingly grave reasons, we voice our objection to the very evil from whose use we’re benefiting, and we appeal to the appropriate places to provide alternatives. Presumably most people could agree to these conditions when it is a question of benefiting from Nazi-drawings or cobalt mining. And these turn out to be precisely the conditions for the licit use of vaccines deriving from biological material of illicit origin, as presented by Dignitas Personae and taken up by CDF 2020. It is a “yes but.” And the “but” is important.
The practical conclusions to be drawn from the above considerations are thus none other than those taught by CDF 2009 and taken up again by CDF 2020. And, inasmuch as the Congregation for the Doctrine of the Faith participates in the papal magisterium and thus teaches authoritatively, its authority regards specifically and directly these conclusions and not directly the argumentative process leading up to them. My proposal is that the Congregation’s authoritative conclusions will appear more plausible and will be less likely to be misunderstood if one arrives at them using the category of appropriation of evil rather than that of cooperation with evil.
(Editor’s note: A substantial revision was made to this essay on January 28, 2021. The original version had been written without properly distinguishing between stem cell research and cell line research. Therefore, several erroneous references to “stem cells” have been removed and corrected. We apologize for the error.)
1 https://www.ewtn.com/catholicism/library/moral-reflections-on-vaccines-14480 (I will use the acronym “PAV” on account of the Academy’s Latin name: Pontificia Academia pro Vita.)
5 For all this, see Roberto Colombo, “Vaccini anti-Covid19 da aborti? La Chiesa: leciti a certe condizioni,” Avvenire, 26 agosto 2020. https://www.avvenire.it/mondo/pagine/coronavirus-vaccini-da-aborti-cosa-dice-la-chiesa
6 For the history of the HEK-293 cell line, see: Alvin Wong, “The Ethics of HEK 293,” National Catholic Bioethics Quarterly 6 (2006) 473-496.
7 Cf. Colombo, “Vaccini anti-Covid19.”
8 Helen Watts, The Anscombe Bioethics Centre. COVID-19 briefing paper, http://www.bioethics.org.uk/images/user/covidbriefing2.pdf
9 Cf. Wong, “Ethics of HEK 293,” 474.
10 Pier Giorgio Austriaco Nicanor, “Moral Guidance on Using COVID-19 Vaccines Developed with Human Fetal Cell Lines,” Public Discourse, May 26, 2020, https://www.thepublicdiscourse.com/2020/05/63752/. Nicanor’s article is very helpful. His is one of the still all too few contributions that coherently make use of the category of appropriation in discussing the problem at hand.
12 Cf. the comment made to Agence France Press by Andrea Gambotto, professor at the University of Pittsburgh: https://www.france24.com/en/live-news/20201020-how-fetal-cells-from-the-1970s-power-medical-innovation-today
14 The pioneering work on this issue has been composed by M. Cathleen Kaveny, “Appropriation of Evil: Cooperation’s Mirror,” Theological Studies 61 (2000) 280-313.
15 For a history of the principle, cf. Kevin Flannery, Cooperation with Evil: Thomistic Tools of Analysis, Catholic University Press, Washington DC 2019.
17 Only the original Italian version of the note speaks of a “common commitment.” http://www.academyforlife.va/content/pav/it/the-academy/activity-academy/note-vaccini.html One needs to read the Italian text to understand what went wrong with the English translation, which seems to be missing a verb in the subordinate clause: “While the commitment to ensuring that every vaccine has no connection in its preparation to any material of originating from an abortion, the moral responsibility to vaccinate is reiterated in order to avoid serious health risks for children and the general population.”
18 Card. Janis Pujats, Tomash Peta, Jan Pawel Lenga, Joseph E. Strickland, Athanasius Schneider, https://www.crisismagazine.com/2020/covid-vaccines-the-ends-cannot-justify-the-means: “In the case of vaccines made from the cell lines of aborted human fetuses, we see a clear contradiction between the Catholic doctrine to categorically, and beyond the shadow of any doubt, reject abortion in all cases as a grave moral evil that cries out to heaven for vengeance (see Catechism of the Catholic Church n. 2268, n. 2270), and the practice of regarding vaccines derived from aborted fetal cell lines as morally acceptable in exceptional cases of ‘urgent need’ – on the grounds of remote, passive, material cooperation. To argue that such vaccines can be morally licit if there is no alternative is in itself contradictory and cannot be acceptable for Catholics.”
19 I have come across this interpretation on several occasions, and the attribution is not decisive here. My point is to say that the CDF 2020 document, though certainly not proposing such teaching, unfortunately lends itself to such a reading, lacking the precision with which the Congregation usually formulates its texts.
20 Innocent XI, “Sixty-Five Condemned Propositions by the Laxists,” proposition 51, Heinrich Denzinger – Peter Hünermann, Compendium of Creeds, Definitions, and Declarations on Matters of Faith and Morals, 43rd ed., Ignatius Press, San Francisco 2012, n. 2151. For a detailed discussion of this proposition – in the context of an attempt to find a new perspective on the problem of cooperation, see: Andrew McLean Cummings, The Servant and the Ladder: Cooperation with Evil in the Twenty-First Century, Gracewing, Herefordshire, UK 2014.
21 Alphonsus Liguori, Theologia moralis, book 2, n. 63; reference owed to Flannery, Cooperation with Evil, 5.
22 Cf. again: Kaveny, “Appropriation of Evil.”
23 Cf. Alexander R. Pruss, “Cooperating With Past Evil and Use of Cell-Lines Derived From Aborted Fetuses,” The Linacre Quarterly, 71 (2004) 335-350. The author’s considerations and examples are very insightful and have proven extremely helpful for the present argument, even if he formulates the question in terms of cooperation and despite the fact that he argues that there can be material cooperation with past evil, a claim of which I continue to be unconvinced. I owe to him the essence of the following distinctions, though point 1 is my own addition.
24 For this real-life example see: https://www.statnews.com/2019/05/30/surgical-dilemma-only-nazi-medical-text-could-resolve/
25 Cf. Ronald M. Green, “Benefitting from ‘Evil’: An Incipient Moral Problem in Human cell Research,” Bioethics 6 (2002) 544-556.
26 Cf. again Kaveny, “Appropriation of Evil,” for whom the question of what appropriation does to our virtuous character is one of the greatest problems with it.
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