Copyright (c) 1999 First Things 96 (October 1999): 13-15.
Remember the story of the guy who died in the flood? A Red Cross boat had come by earlier when the water was above the window sills, but the fellow refused rescue saying, "The Lord will save me." A second boat came when the water was to the eaves and the man was hanging from the gutters. But again he refused rescue. "The Lord will save me," he declared. Scrambling onto his roof ahead of the ever–rising waters the man spied a helicopter heading his way. A rope was lowered from the copter, but the obstinate guy batted it away and shouted over the din of the rotors, "The Lord will save me." Of course he drowned. He arrived at Heaven’s throne perplexed, hurt, angry, and dripping wet. "Why," he shouted at God, "didn’t you save me?" "Give me a break," sighed the Lord God Almighty. "I sent two boats and a helicopter."
I am a diabetic, Type II. I flunked a health insurance examination in March 1995. That’s how I found out. Six months before, an annual health exam said I was as fit as I could be, for a man my age. (Doctors always add that part.) But somewhere on the inclined plane to forty–eight, my pancreas decided to malfunction and it stopped producing enough insulin to keep my blood sugar count within normal range. All of a sudden, my blood count was hitting the 400 mark. That’s somewhere just short of the point where you either go blind or tank out in a coma. A blood count of 80 to 120 an hour after eating is considered normal. I guess I was lucky. Of the nation’s diabetics, so estimates go, only about half have been diagnosed.
Since becoming a diabetic I’m more aware of other diabetics. It seems, in fact, I can’t get away from them. For most of my whole life I knew only one diabetic, a fellow up in Nebraska, but now I know literally dozens. I’m sure I knew others before, but now that my awareness has been sensitized, suddenly they’re all over the place, and it seems they are losing body parts. There’s Frank, age seventy. Doctors took off his lower left leg earlier this year. His trouble began with bypass surgery a year before. Any kind of surgery can be serious trouble for a diabetic. We have trouble healing. The blood doesn’t travel quite as fast or as far as it should to help mend flesh. His slow recovery led to complications. At first he was to lose only the tips of his toes. His physician took those off, but after ten days in the hospital with no appreciable sign of healing, Frank lost his leg at the knee. About six weeks ago he lost the tips of his other toes. He’s a game fellow, though, traveling with a walker and a prosthesis, but traveling.
Then there’s Alma, eighty–three. She has lost both legs, the last of a series of amputations that began three years ago with the loss of two toes on the left leg. She never healed and her surgeon kept cutting—toes, mid–calf, mid–thigh—until he found a place where the blood did reach and would heal the wound. Then little blisters popped up on her other leg, and the tiresome ordeal began all over again. She resisted, mightily. That last leg was her last shred of mobility and she kept it as long as possible, hopping to and fro in her room at the nursing home until the pain overwhelmed her and the blood poisoning almost killed her. Indeed, as she told me, she was hoping the blood poisoning would kill her, and then she could be done with this misery. It was the pain that compelled her consent. Alma has been a Type II diabetic since she was in her thirties. At an age now when she ought to be puttering around her farm house, she’s propped up in a nursing home wheelchair.
Being a diabetic at first wasn’t a hard thing, except for the daily finger pricks for blood samples. My blood count was controlled by a diet of 1,400 to 1,800 calories a day, and that took care of it. I could eat a whole pie, the doctor said, just so long as I ate nothing else the entire day. I wasn’t exactly overweight, but trimming down a bit seemed like a good idea. At least it did until I reached my college weight of, lo! some twenty–five years before, and then kept on losing, finally dropping down to my high school weight. I was turning back into that lanky, skinny geek all the girls loved so much. That’s when the doctor said, eat more. Some of the pounds came back on and I went on oral medication, one pill a day. Now I’ve graduated to two medications, five pills a day, and one finger prick every morning to sample my blood count. One finger prick is progress, of a sort. Early on it had been three a day. That was the bad news, the doctor said. The good news was, I could alternate fingers. She’s something of a bedside humorist, the doctor is.
A chronic illness, I am learning, is a real burden. It’s the chronic part that gives it such an oppressive weight, knowing I’ll never be rid of it. I have discovered a new empathy with those of my parishioners who suffer similar or worse disorders, a shared experience none of us likes. But for whatever good my illness may produce—endurance, patience, character, that stuff St. Paul wrote that sounds so nice in the abstract but requires the spirituality of a saint to comprehend—I’d just as soon have let this particular cup pass, had God given me the choice. But He didn’t. So I filled out the papers for free diabetic supplies and I scan the literature touting new medications, insulin pumps, magic bullets, anything that holds some promise that I won’t end up clomping around like Frank or getting myself carried to the toilet like Alma. I watch my diet, stick with the medication, and, don’t doubt it, I inspect my feet every morning.
There’s my dilemma. There is something supposedly just over the horizon that sounds for all the world like two boats and a helicopter, and if I don’t grab it, maybe I’m the fool? The promise is fetal stem cell therapy.
Stem cells are cell tissue extracted from human embryos. These are marvelous little things, so researchers are saying. They can be teased into providing an endless supply of healthy cells for unhealthy organs. The cells have been "convinced" by researchers to grow into nerve cells, skin cells, heart cells—in fact, potentially all of the 210 kinds of human cells can be grown from fetal stem cells. There is even a possibility of stem cells being used to treat Down Syndrome babies in the womb. Fetal cells that have become healthy pancreatic cells might be injected into a diseased pancreas and provide a lifelong cure for diabetes. Or they might be used to treat any number of other disorders like Parkinson’s and Alzheimer’s. There is a whole list of things at which we might squirt stem cells if researchers have their way. Stem cells are described as the Rosetta Stone for all cell research, including cloning. Quite a claim, and it may be true. It may also be quite terrible.
Fetal stem cells presently come from two sources, abandoned embryos from fertility clinics and five–to–nine–week–old aborted fetuses. So, when this research is perfected and receives FDA approval, all I have to do to benefit from it is give up my opposition to abortion and most forms of embryonic research. Swallow a little pride, take a shot or two, whatever’s called for, and pretty soon I’ll be eating like a regular guy, all my body parts intact. Why, after all, should we let a perfectly good embryo, one that is not a candidate for implantation in a vacant womb, go to waste? Otherwise abandoned and unwanted, should it languish frozen on a shelf somewhere, especially when there is so much good it can do for others? Aborted fetuses are already just so much waste material. Let’s be green, if that’s the phrase, and recycle those little suckers for all they’re worth.
There may be a way to avoid abortions and embryos as a stem cell source by regressing adult cells. Take some skin cells, tease them back to their primal state, and then grow them forward to make hearts, brain matter, and a cure for diabetes. The research is only in its beginnings and far, far from complete. It may be years before anything like that approaches reality. So why wait, when, according to some researchers, fetal stem cells already have proven their potential? From a utilitarian view, the argument is unassailable.
There is for the moment, but only for the moment, a federal ban on this kind of research. There is a great deal of pressure for repeal. Naturally, the ban affects only researchers who receive federal money. There is no ban against privately funded research. Drug companies and biotech firms are getting into this big. The financial gain that would accrue from a successful and proven stem cell therapy is unimaginable, and there are financial interests with some very big imaginations at play. This is one of the arguments for lifting the federal ban on fetal cell research. Someone is going to do it, is already doing it, and all of it outside the glare of public accountability. This research had better be tucked inside a government package, sanitized by a ton of federal regulations, organized by the National Institutes of Health, all to get this thing under public control. Quick. Otherwise in some few short years we will be dealing with questions of patented life, private cloning, vats of transplantable organs, and maybe the "decanted babies" and "Bokanovskian twins" (clones in today’s phrase) from Brave New World.
But that is exactly what we are dealing with already. Science has once again sped beyond the ken of ethical insight. The cat is out of the bag and research is roaring ahead. Federalizing fetal stem cell research will solve nothing morally because, whether federal or commercial, it requires the destruction of human embryos and it feeds on abortion. Find another source of stem cells and the moral problem goes away. But, as mentioned, finding that source will be a much slower process. Meanwhile, present research goes on with the moral status of the embryo up for grabs—is the embryo human life or a mere bit of research material?—and it walks hand in hand with that negation of life known as a woman’s right to choose.
Aldous Huxley, who wrote Brave New World in 1933, worried that science was being twisted all around. Where once, as with the sabbath, science was made for man, he foresaw and chillingly created in his novel a world where man is made for science. In Huxley’s fictionalized world the process that turned science around was methodical and deliberate, and without moral regard. In our own world, the process going on is less tidy but no less deliberate, and with equally little moral restraint.
My answer to the moral status of the embryo or the use of aborted fetuses tends to be as simple as it is adamant. It is not right for big, strong human beings to benefit themselves by preying upon weak, little human beings. And if someone wants to suggest that stem cell therapy really is God’s way of coming to rescue me from an insulin drought, well, just call me gimpy.
Russell E. Saltzman is the pastor of Christ Lutheran Church in Stover, Missouri, and editor of Forum Letter, an independent Lutheran publication where an earlier version of this article appeared.