The use of human “bodyoids”: An alarming proposal

Many of us know someone—and perhaps that “someone” is you—whose life depended on an organ transplant. Many also know how challenging it can be to procure a needed organ and receive it in time for a transplant to be completed successfully (the heart, for instance, only remains viable for transplantation four to six hours after death).

Further, many are aware—especially those working in the realm of the biological sciences—that most of the research relied upon today for advancing our ability to understand, diagnose, assess, and treat disease, is conducted on animals. For obvious reasons, the results obtained through research on non-human animals (usually rodents like rats or mice) often do not correspond sufficiently with the particularities of human biology, limiting their predictive power. We all yearn for greater progress in the biomedical sciences, but the ethical constraints that limit studies on living humans prevent rapid advancement.

At the heart of these practical complications, observe a trio of Stanford University academics, is “a severe shortage of ethically sourced human bodies.”

Genetic engineer Carsten Charlesworth, professor of law Henry Greely, and professor of genetics Hiromitsu Nakauchi, offer a potential solution that, they contend, could revolutionize medicine:

There might be a way to get out of this moral and scientific deadlock. Recent advances in biotechnology now provide a pathway to producing living human bodies without the neural components that allow us to think, be aware, or feel pain. Many will find this possibility disturbing, but if researchers and policymakers can find a way to pull these technologies together, we may one day be able to create “spare” bodies, both human and nonhuman.

What if, in other words, we could engineer unconscious living human bodies specifically purposed for scientific use?

Problematic moral assumptions

For one thing, this would resolve the organ shortage problem and make organ donations more readily accessible in every locality. For another thing, this would open the doors wide to the possibility of more studies conducted on living human bodies, making positive developments in pharmaceutical research and other therapeutic advancements far more rapid. Thirdly, the emergence of such “spare” bodies—or what Charlesworth, Greely, and Nakauchi also term bodyoids—would reduce if not eliminate the violence done to animal research subjects.

Though they admit their excitement about the possibilities of such a proposal, Charlesworth, Greely, and Nakauchi are careful to avoid advocating outright for the production of bodyoids. “Even if it looks possible,” they write, “determining whether we should make bodyoids, nonhuman or human, will require considerable thought, discussion, and debate.”

We should commend the authors for their careful analysis of the ethical conundrums that arise from such a proposition. In their article, they echo a principle found throughout Pope Benedict XVI’s writings on science and technology: if we can do something, we should always first consider whether we ought to do it. “As we proceed,” write Charlesworth, Greely, and Nakauchi, “the ethical and social issues are at least as important as the scientific ones. Just because something can be done does not mean it should be done.”

Though they admit that many questions remain unanswered concerning the ethical implications of such a project, their proposal still implies some striking moral assumptions: if we could, 1) manufacture living human bodies outside of the maternal body, and 2) if we can engineer such bodies to be void of the neural components that permit consciousness even at full developmental maturity, then we will have finally achieved a morally licit solution to the “severe shortage of ethically sourced human bodies.” They state,

Until recently, the idea of making something like a bodyoid would have been relegated to the realms of science fiction and philosophical speculation. But now it is at least plausible—and possibly revolutionary. It is time for it to be explored.

The debate Charlesworth, Greely, and Nakauchi want to initiate is far from trivial, no matter how ludicrous or malevolent we judge their proposal to be. Embedded in this debate are questions concerning the nature of the human being, the meaning of embodiment, the essence of consciousness, the ethics of in vitro fertilization, and the moral boundaries of biomedical exploration, among others. We should have the conversation, which is only to say (repeating Pope Benedict’s aforementioned principle) that in considering that we could do x, we should engage in a robust debate of whether we should do x.

Three evils

But I want to argue emphatically that we should not do it. We should not pursue the development of bodyoids because a “bodyoid” is a living human body, and every living human body is a person. Further, every human person—conscious or unconscious, whether reproduced in vitro or procreated in vivo—is endowed with the same, God-given dignity and thus the same right to life and freedom. And every living human person, being made in God’s image from the moment of conception unto natural death, can never be treated ultimately as an object of use—no matter how much others may be benefitted.

Thus, I want to highlight three evils implicit in this bodyoid proposal. First, it treats neural function as an indicator of personhood. Second, it promotes an exponential increase in in vitro fertilization (IVF). Third, it assumes that living human beings may be treated strictly as—indeed, even engineered for—the usage of others.

What makes a human being a person? Given that personhood is not in itself quantifiable nor observable, we are faced here with a metaphysical question. The early medieval philosopher Boethius defined a person as an individual substance of a rational nature. This became the standard definition throughout the Middle Ages, until Descartes and other Enlightenment thinkers began to muddy the anthropological waters with more mechanistic accounts of man and world.

According to the Boethian definition—which is also congruent with the Catholic view of personhood—a person can be divine, angelic, or human. The human person is by nature a rational body—a body made rational through union with a spiritual soul, thus endowing him with the spiritual powers of intellect and will. (For a more in-depth philosophical discussion of man as an embodied soul, see my recent essay “What it Means to be a Body: A Philosophical Primer”).

It is neither the brain, nor more broadly the nervous system, nor any other part of the human being that makes a human being to be a person. Personhood, again, is a metaphysical determination. Man is made personal by his innate capacity—his potential—for knowledge and love. Spirit (i.e., the rational soul) is the principle of man’s rational life, and as such, it follows that every living human is a living person. No man can be alive except if he is ensouled. To be alive is just to be ensouled. And to be ensouled as a human being is to be endowed with a rational, personal nature—even if that nature has not yet “blossomed” into its full expression; even if its full expression has been “blocked” by engineering, disease, or some other inhibitory means.

Even a living human body rendered—whether naturally or by technological means—genetically incapable of conscious experience is equally as much a human person as an Albert Einstein or Saint Francis of Assisi, for it is not the rational function of a person that makes him what he is, but his nature.

The brain and its functions constitute part of a whole person. The alteration of brain function, even if by “design” (say, by gene modification) or by pathology (say, by dementia), does nothing to alter one’s human nature. The human nature, or essence, is ontologically stable in the sense that body parts can be removed, inhibited, disfigured, or enhanced without changing what the living human body is. Provided that a human body is living—whatever the state of its parts—it is necessarily ensouled and thereby wholly and necessarily a person.

Further, to attribute personhood to the organs or functions of the nervous system is to commit what Peter Hacker calls the mereological fallacy, namely, to ascribe to a part what only makes sense to ascribe to a whole. As Hacker has demonstrated to great length in his noted Philosophical Foundations of Neuroscience (co-written with neuroscientist Max Bennett), the mereological fallacy lies at the heart of widespread conceptual error concerning the relationship of brain and person, especially in the fields of neuroscience, philosophy, and medicine. Hacker is also one of the world’s leading experts on the philosophy of Ludwig Wittgenstein, who was keenly aware of the important nuances between the person, his brain, and the functions of the body.

Among one of Wittgenstein’s more famous observations is this: “Only of a living human being and what resembles (behaves like) a living human being can one say: it has sensations; it sees; is blind; hears; is deaf; is conscious or unconscious.” To attribute thought, sensation, perception, or consciousness to anything less than the whole person is, thus, to speak nonsense. Personhood, too—and all the more—can be attributed to no less than the whole living human being.

Further moral concerns

The concern of Charlesworth, Greely, and Nakauchi, is that in most cases conscious living human bodies cannot be ethically sourced for organ transplantation (an exception would be electively donating one’s kidney) or invasive scientific procedures for the sake of research (an exception would be some experimental intervention, pharmaceutical or surgical, consented to by a person suffering from late stage cancer).

But they seem to suggest that if the prerequisite neurological components for consciousness were intentionally eliminated congenitally, the present ethical constraints would dissolve. However, as I have said, the structure or function of any part of a living human body does not change the nature of what, or who, that body is.

Charlesworth, Greely, and Nakauchi also seem to suggest that if potential bodyoids have their origin outside of the womb, this would “make it possible” for their proposal to be deemed acceptable. They write,

At the same time, artificial uterus technology is rapidly advancing, and other pathways may be opening to allow for the development of fetuses outside of the body. Such technologies, together with established genetic techniques to inhibit brain development, make it possible to envision the creation of “bodyoids.”

One might take this to imply that human beings conceived through IVF have, by virtue of where they were conceived, a diminished moral status. The authors don’t explicitly say this, and I should not assume this to be their position. It is certainly not the stance of the Catholic Church. As the Congregation for the Doctrine of the Faith affirmed in its 1987 document Donum Vitae, “Human embryos obtained in vitro are human beings and subjects with rights: their dignity and right to life must be respected from the first moment of their existence.” A human life conceived—period—is a life of a human person worthy of care and protection.

On the other hand, the Church also takes a firm stance against any form of IVF. Why? First, it has nothing to do with intentions. A husband and wife may have honorable motives for pursuing IVF, most often because they want to fulfill their natural, God-given desire to conceive a child together. But there are ignoble ways to fulfill noble desires.

What makes IVF ignoble? The essential problem is that through IVF a new human life is conceived, not by a loving union of husband and wife but via a sterile, impersonal laboratory procedure. One might wonder whether it really matters if a baby is “made” via intercourse or outside the womb, provided a baby is made. But as bioethicist John Haas puts it, “Husbands and wives ‘make love,’ they do not ‘make babies.’” Or as moral theologian William May has emphasized, human parents do not reproduce their babies through their marital union; they beget them. As May puts it, through so-called new reproductive technologies, “Babies are not ‘begotten’ in the act of conjugal love ‘proper and exclusive to spouses,’ but are rather the ‘products’ of reproductive technologies.”

The practical implications of IVF (at least in its current state) are also extremely problematic, since it tends to lead to more death than life as more embryos are destroyed than fertilized in the processes involved. There are several reasons that most embryos conceived in vitro will be discarded: some stop growing; some have chromosomal abnormalities; and some are just left behind. Our culture is conditioned to hear the terms “embryo” and “child” and understand them as two separate ontological categories. But an “embryo,” being simply a living human body at a very early stage of development is just a term we use to describe a certain category of persons. The same would apply to the term “bodyoid.” In both cases, in considering our treatment of embryos and bodyoids, we are ultimately considering how we ought to treat our children in their earliest stages of development and in later stages of their biological maturity.

Pope John Paul II also warned of the pitfalls of artificial reproduction:

The number of embryos produced is often greater than that needed for implantation in the woman’s womb, and these so-called “spare embryos” are then destroyed or used for research which, under the pretext of scientific or medical progress, in fact reduces human life to the level of simple “biological material” to be freely disposed of.

This leads to a third reason that the proposal put forth by Charlesworth, Greely, and Nakauchi must ultimately be rejected, namely, that it instrumentalizes human beings. “It may be disturbing to characterize human bodies in such commodifying terms,” they acknowledge, “but the unavoidable reality is that human biological materials are an essential commodity in medicine, and persistent shortages of these materials create a major bottleneck to progress.”

The notion here seems to be that although we can intuitively sense that there is something wrong with “commodifying” living human beings, what we have to gain materially is so monumental that we are just in ignoring our moral sensibilities. There is no more nefarious ethical principle than this. It is a perversion of the principle of the “common good,” or “the sum of those conditions of social life which allow social groups and their individual members relatively thorough and ready access to their own fulfillment.” But the common good and the good of the individual are intrinsically and irrevocably linked. It mandates that the good of society—no matter how great and praiseworthy that good is—can never be obtained licitly at the intentional expense of the good of any person.

Love and ends

A living human being is, and must always be, treated essentially as an end rather than a means. The human person is, above all, created as an object of love, and no act toward man that is contrary to this definitive end can be right and just. Put in negative terms, the human person can never be justly used without at the same time being an object of love.

To love is, using Saint Thomas Aquinas’s succinct definition, to will the good of the other. I can “use” my son to help me do chores on the farm, but this is ultimately grounded in his good as a developing young man for whom it is good to learn the virtues of hard work, perseverance, self-control, and even further, to get fresh air, exercise, and sunshine for the sake of his physical health. On the other hand, if I were to impose farm chores on him when he is sick or disabled in some other way for my own sake and contrary to his own good, then I am using him as a pure means beneath his dignity.

The “bodyoid” is ultimately a living human person willed solely for the good of others, but not for his own good. He would, thus, be merely an instrument of use and an object of violence. The Catholic views every living body, whatever his origin and whatever his level of function, as a creature made definitively in the image and likeness of God and destined for bodily resurrection at the end of time. For this reason, no Catholic could ever morally endorse the project of engineering living human beings for scientific use, no matter how righteous the intended practical outcomes may be.