Friday, April 27, 2007

Human Technology Manufacturing Platforms Part V: What Happens Now?

At the beginning of this series I stated that the question of the correct moral response to vaccines manufactured from cell lines derived from aborted babies was no longer confined to simply the parents of small children. We have seen that this is true; using just the pandemic flu and seasonal flu vaccines as examples, the question will quite soon apply to virtually everyone. Likewise, we have seen that the "vaccination question" really isn't a question about just vaccinations. The moral problems presented by the use of human cell lines from aborted babies are going to be attached to an ever growing number of diverse therapeutic regimens: I believe that the day is not too far away where it will be easier to define what in medicine is not tainted by this evil, rather than what is, for this sort of corruption is going to invest itself in every aspect of the medical enterprise if we allow it to. Nevertheless, the issue was raised in the context of pediatric vaccinations, and it is to pediatric vaccinations that we shall now return.

The Vatican paper does a good job at clarifying some issues regarding parental involvement with the evil of the original abortions, but it is, perhaps, a little too nuanced, and this has led to extensive, and occasionally acrimonious, disagreement within the Catholic press. The study appears to set a threshold for parental refusal of the vaccine at "no significant risk," a threshold which not easily defined. Regarding varicella, refusing the WI-38-based vaccine may indeed involve "no significant risk." It is arguable that there should not even be a mass varicella vaccination campaign: the introduction in the U.S. of required mass immunization against varicella was controversial in when VARIVAX was introduced in 1995, and remains so now. Indeed, outside of the United States, only one nation - Germany - requires universal varicella vaccination as of 2005.[1] Analysis by the Public Health Service for England and Wales concluded in 2003 that, "routine infant varicella vaccination is unlikely to be cost effective and may produce an increase in overall morbidity."[2] Nevertheless, the U.S. Advisory Committee on Immunization Practices recommended universal pediatric immunization with VARIVAX in 1996, the year after the vaccine was introduced. These recommendations were expanded in 1999 to include vaccination requirement prior to daycare or school.[3] Currently the requirement for a second VARIVAX vaccination is under consideration, essentially a “booster shot”, due to the problem of waning immunity as the child who was immunized matures to adulthood. Varicella, while innocuous in children, is a serious and potentially life-threatening illness in adults, and it is possible that we have traded relatively mild childhood morbidity for more serious future problems as the artificially immunized population ages. The point is this: one can easily argue that abstaining from the varicella vaccine as an "objection of conscience" is the right thing to do, since physicians and governmental public health departments don't even agree on whether it should be used universally or not. Regarding rubella, the situation is more complicated. It could be the case that the vaccine is currently unnecessary in the United States, but this is only because of the low level of endemic rubella currently, which in turn is due to the high level of immunity, much of which is supplied by the vaccine (or it's non-tainted predecessors). Were immunization levels to drop the disease might reappear. In addition, even though rubella is at a low level in the United States, it's still pretty widespread in the world, and given the high level of international travel it's not unreasonable to posit that an un-immunized American child could, on an overseas trip, catch rubella, and then transmit it to an unimmunized mother and from there to the unborn child.[4] So, rubella's a little less clearcut regarding "significant risk." Finally, when - not if - the MRC-5 derived polio vaccine replaces the current polio vaccine, the parent will have the choice of cooperating with the evil (the document does not say the parent is not cooperating with evil, only that the level of cooperation is remote, and excusable) or exposing their child to a very real and very devastating illness.

The document does enable us to evaluate the actions of those involved in the production and distribution of these products. We noted above that the document considers three categories of people: makers, marketers/distributors, and users. Parents and physicians were in the last category, and we discussed them earlier. It is those in the first two categories we now look at. The document says that the activity of those involved in "the preparation, distribution and marketing of vaccines produced as a result of the use of biological material whose origin is connected with cells coming from foetuses voluntarily aborted" is "as a matter of principal, morally illicit."[5] If the activity of the original Merck, Karolinska Institute and Wistar researchers back in the early 1960's was illicit - and I do not see how it could not have been - it is even more true of the activities of the researchers at University of Leiden who developed PER.C6, Crucell N.V., the company developing and marketing this human technology manufacturing platform, and those fifty or more companies licensing this "platform." It would also be especially true of the U.S. Department of Health and Human Services, which is pouring hundreds of millions of dollars of U.S. taxpayer money into, specifically, the PER.C6 based influenza vaccine program being developed by Crucell and Sanofi, even though licit alternatives are available - conventional egg based vaccines, and/or animal cell culture vaccines.

The main drawback of the Vatican paper is that it doesn't address the larger reality that exists. As noted above, the document uses phrases such as "temporary basis" and "vaccines for which there are not yet acceptable alternatives," suggesting that the authors believe this issue to be temporary, confined to a relatively small group of parents who worry about such things, and likely to resolve itself. Though not explicitly stated, one gets the impression that the authors of the Vatican study believe that, perhaps, the pharmaceutical companies didn't know the source of their cell cultures, or were unwitting accomplices in the development of these lines. Further, this line of reasoning might go, now that the manufacturers know the true source of these lines, they will distance themselves from the evil, and pursue righteous alternatives. The reality is that pharmaceutical manufacturers and biotechnology companies are driving full speed ahead on the development and implementation of human technology manufacturing platforms, aided and abetted by taxpayer dollars, because such technologies are laden with profit, both current and future. These people know what they are doing, and they are not going to stop. We are not at the sunset of a dead end aberration which involves only a handful of parents agonizing over whether it is right to vaccinate their children with immoral vaccines; we are at the dawn of a whole new world utilizing human technology, a world where this technology will intertwine itself with every aspect of medicine.

In developing a coherent response to this looming moral disaster, two points are worth considering. First, when considering the problem, substitute "vaccines and therapies made from cell lines derived from Jewish concentration camp victims killed decades ago" for "vaccines and therapies made from cell lines derived from fetuses aborted decades ago." This is not hyperbole. If the Church considers these two acts, murder of concentration camp prisoners and murder of unborn babies, morally equivalent - and I believe the Church does - then it does not matter who was killed, or when they were killed, or why they were killed. Deliberate killing of innocents - murder - is proscribed by the Church. If it is morally admissible under some circumstances (e.g., remote passive material cooperation under moral coercion) to utilize the products whose origins lie in the murder of unborn children, then likewise it should be morally admissible to use the same product under the same circumstances if their origins lay in the murder of concentration camp victims, or any other group of murdered innocents one might imagine. Perhaps the Church might teach that would be admissible to use these vaccines even if derived from murdered concentration camp victims, and perhaps the Church might teach that it would not be. But whatever the Church would teach, I should think it should be the same for any group of murdered innocents.

The second factor to consider is this: the use of cell lines developed from aborted babies in manufacturing vaccines (or anything else) strikes me as no different, conceptually, from using embryonic stem cells for all the various things they might be used for. The only difference, really, is that the fetal cell lines are already in use, while the stem cell applications are still pretty much hypothetical. But in both cases you have an unborn child being killed and disassembled for useful parts, nothing more. The Pontifical Academy for Life document entitled "Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells" states that use of stem cells, or cells differentiated from them, is illicit.[6] Since the hypothetical "product" of the embryonic stem cell is the differentiated cell, it does not seem to be too much of a stretch to conclude that the Church is heading in the direction of stating that using the "products" derived from embryonic stem cells is immoral, because their origin is immoral. I am unable to discern a significant conceptual distinction between products from embryonic stem cells and products from fetal cell lines.

As the Ghost of Christmas Yet to Come said to Ebenezer, "These are scenes of things which might yet be." As a nation, we chose the evil fork in the road when we legalized contraception in 1965; and took the next evil fork with abortion in 1973. Initially, though, abortion "rights" were somewhat limited; we came to the fork labeled "unlimited abortions" in 1993. Today, the US has the most liberal abortion laws on the planet (with the possible exception of China), and since we live in a county where we can abort a baby for no reason whatsoever and up until the moment her entire head is out of the birth canal, why fuss about babies whose abortions produce something good and useful? We chose the evil road then, and now, like an ever branching tree, the choices before us are multiplying faster and faster, and are more and more bewildering: embryonic stem cell research, cloning, euthanasia, doctor assisted suicide, vaccines and cancer therapies whose origins are in dead babies; the list grows with a dull, constant pounding. This paper has been about yet another fork, just one of many: do we allow ourselves to embark on the use of human technology manufacturing platforms, or do we not? They are not necessary, we can develop these things - vaccines, monoclonal therapies, what have you, without them. We can still choose the moral path, even at this late date. We can start to climb down from this tree. What, then, will we decide?

[1] "Varicella zoster virus vaccination policies and surveillance strategies in Europe." Eurosurveillance, Euro surveill 2005;10(1):43-5; published online Jan 2005.
[2] Brisson, M. "Varicella vaccination in England and Wales: cost-utility analysis." Arch Dis Child 2003; 88:862-869. My emphasis. The reason for increased morbidity is due to zoster in later years as the vaccine acquired immunity wanes.
[3] “Prevention of Varicella: Update Recommendations of the Advisory Committee on Immunization Practices (ACIP).” Morbidity and Mortality Weekly Report Reports and Recommendations Vol. 48, No. RR-6, 28 May 1999. It's worth noting here that ACIP, and even the 1998 WHO position paper on varicella (online at, go to "vaccine position papers") notes that the primary reasons for universal varicella vaccination in the "developed world" are economic - "lost workdays.". In other words, in the US, most parents work. If the children get chickenpox, somebody has to stay home to take care of them.
[4] This situation was outlined in the "Moral reflections" document in footnote 15. The footnote put the moral responsibility for any damage to the hypothetical unborn child on the parents who didn't have their own child immunized. The footnote didn't indicate whether the unimmunized pregnant mother had any responsibility, such as to ensure she was protected against rubella by, for example, gamma globulin injections, which would protect her during the susceptible period of her pregnancy and do not have any moral problems associated with them..
[5] "Moral reflections," ibid. My emphasis.
[6] Pontifical Academy for Life, "Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells" 25 August 2005. See in particular page 5 where the full text reads, "The third ethical problem can be formulated thus: Is it morally licit to use ES cells, and the differentiated cells obtained from them, which are supplied by other reasearchers or are commercially obtainable? The answer is negative..." The text does not make any distinction as to who is doing the 'using,' researcher or clinician. Further, the title of the document makes it clear that the authors intend the conclusions to cover both research and therapeutic uses of stem cells. Available at numerous websites including

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