By Valerie Schmalz

Pontiff affirms inherent dignity of all humans

His United Nations address comes at critical moment in U.S. debate

The chair of President Bush's bioethics advisory council got some indirect support when Pope Benedict XVI spoke to the United Nations during his visit to the United States.

This is no surprise given the Church's condemnation of abortion, assisted suicide and human embryonic stem cell research and Dr. Edmund Pellegrino's formidable reputation as a Catholic medical ethicist.

Nevertheless, when Pope Benedict cited the 1948 U.N. Declaration on Human Rights to criticize scientific advances that use or destroy people, he gave a central, practical argument against human cloning -- namely, a world that abandons its support for human dignity is walking away from a central tenet of the United Nations.

Rooted in natural law

The President's Council on Bioethics recently released "Human Dignity and Bioethics," a book of more than 20 essays containing diverse views on the meaning and usefulness of the concept of human dignity in making ethical decisions.

"Ultimately, the fundamental questions in law and ethics will be decided by what we think it means to be human and what we understand to be the ethical obligations owed to the human person," wrote Pellegrino, the council's chairman, in a letter to President George W. Bush presenting the volume last month.

In his address to the United Nations, Pope Benedict reminded the world community that the United Nations was founded in the aftermath of the Holocaust and in fear of nuclear war after the bombing of Hiroshima.

"The founding of the United Nations, we all know, coincided with earthshaking upheavals that humanity suffered when the reference to the meaning of transcendence and natural reason was abandoned, and in consequence, freedom and human dignity were grossly violated," the pope said.

The intrinsic worth of each person must be at the base of nations' and the world's legal frameworks, Pope Benedict said.

Human rights "are based on the natural law inscribed on human hearts," he said in his April 18 address. "When presented purely in terms of legality, rights risk becoming weak propositions divorced from the ethical and rational dimension which is their foundation and their goal."

Scientific skepticism

The council's book is in part a response to criticisms by some academic ethicists, particularly Albert Einstein College of Medicine's Ruth Macklin. In a frequently cited 2003 British Medical Journal essay, Macklin argued that "dignity is a useless concept in medical ethics and can be eliminated without any loss of content." Macklin singled out the President's Council references to "human dignity" in some of its works as "a mere slogan." Macklin, instead, advocated the overarching principle "respect for autonomy."

"Respect for autonomy" is commonly understood by bioethicists to mean noninterference in an individual's right to self-determination, and can be used to justify abortion, assisted suicide and human cloning.

The pope's U.N. address came just days after an April 9 panel discussion at Stanford Law School highlighted how far the Church has to go to persuade many scientists to protect human life from conception to natural death. Pellegrino presented Human Dignity and Bioethics and was debated by two influential Stanford bioethicists who support human embryonic stem cell research.

"I don't know what we mean by the human species as a whole, or why the human species as a whole is inherently entitled to some dignity that is denied everyone else," said Henry Greely, law professor and director of the Stanford Center for Law and the Biosciences.

Do the book's essays "cash out the concept of human dignity in a way that will work?" asked David Magnus, Ph.D., who serves on the Stanford Hospital ethics committee and is director of the Stanford Center for Biomedical Ethics. Magnus answered his own question: "Without an appeal to any religious beliefs. I think it is a struggle."

The academic assumption that faith is a disqualifier for intellectual or political participation must be discarded, Pope Benedict said. "It should never be necessary to deny God in order to enjoy one's rights."

Sacredness of life

The pope did not specifically address any one topic, and his U.N. speech was directed to all nations.

However, in one of many statements, in 2002 the Holy See specifically urged the United Nations to adopt a worldwide and comprehensive ban on human embryonic cloning for both reproductive and scientific purposes. The United States is one of a small number of nations that effectively allows unrestricted experimentation until birth. In addition, since the first "test-tube baby" was born in 1978, an estimated 3 million children have been born worldwide using in-vitro fertilization. So-called discarded embryos from in-vitro fertilization as well as specifically created embryos are used for human stem cell research.

"Our thoughts turn to the way the results of scientific research and technology have sometimes been applied," Pope Benedict XVI said. "Notwithstanding the enormous benefits that humanity can gain, some instances of this represent a clear violation of the order of creation, to the point where not only is the sacred character of life contradicted, but the human person and the family are robbed of their natural identity."

The world's outrage over the Holocaust fueled the U.N. decision to place human dignity at its heart despite nations' different cultures and belief systems, said Pellegrino, professor emeritus of Medicine and Medical Ethics at Georgetown University and former director of the Georgetown Center for Clinical Bioethics.

Speaking at the United Nations, the pope said the world community and individual nations must not reject the inherent respect for each person articulated in the U.N. Universal Declaration of Human Rights.

"The merit of the Universal Declaration is that it has enabled different cultures, juridical expressions and institutional models to converge around a fundamental nucleus of values, and hence of rights," he said.

At Stanford, Pellegrino made a similar point. "What is the characteristic that makes you say that this person should or should not have his or her decision overruled?" he asked. "The right to be treated as a human being is not limited to autonomy."

Role of the council

On Aug. 9, 2001, President George W. Bush created the President's Council on Bioethics at the same time as he announced his executive order to limit federal funding for embryonic stem-cell research to research using existing stem-cell lines. That federal funding decision earned him the enmity of a large portion of the scientific community and sparked state initiatives to provide government funding for research into human cloning and embryonic stem cells.

In 2004, California voters approved Proposition 71, which created the California Institute for Regenerative Medicine and authorized $3 billion in bonds over 10 years primarily for human embryonic stem-cell and cloning research. Most of the funds are expected to be awarded to build research facilities at California campuses. A working group this month recommended distribution of $262 million, with $47.5 million for Stanford facilities. Final decisions will be made at a meeting of the Institute's governing board.

While the U.S. presidential and congressional campaigns this summer and fall will determine who will control Congress and the White House, the Council continues to examine key bioethical issues. During the summer, the Council will publish a major report on organ transplantation and a companion publication on "controversies over the determination of death," which will look at issues related to brain death.

Valerie Schmalz writes from California. For information on "Human Dignity and Bioethics," visit www.bioethics.gov/ reports/human_dignity/index.html.