Arthur Caplan's Reckless Charge of "Dangerous" [Jay Watts]

John Rawls once wrote that he always took for granted that the people that he was reading were smarter than him. If not, then why on earth was he reading them in the first place.

I mention that because I read Arthur Caplan, the head of medical ethics at NYU, precisely because he is a smart man. I often learn something when I read his work though I disagree with him on important issues. His newest offering in Forbes criticizing Senator Marco Rubio’s arguments about when human life begins during a television interview with CNN TV personality Chris Cuomo is a disappointing exception to that rule.

The editorial is entitled "Marco Rubio and The GOP's Dangerous Misconception On When Life Begins." There appears to be so much to immediately challenge in this article that it is difficult to know where to start. Owing to that, please forgive the length of this post.

He starts out with this:

“Amazingly despite indifference to science regarding other matters like evolution and climate change, they invoke science on behalf of their advocacy of what might best be called ‘conceptionalism.”

Who is “they?” This is an article addressing the specific arguments made by Senator Rubio. When you begin by shifting gears into an act of poisoning the well while dragging in the always easy to disparage “they” you are setting the bar low from the outset.

We will have to wait another two paragraphs to actually address the arguments made by Senator Rubio because Caplan has a little more pre-argument work to do. Before we discuss when the life of an individual human organism begins it is important for you to know that Senator Rubio and the rest of THEM want to force mentally ill 12 year old women raped by their predatory fathers to have babies. He also has a list of other consequences that arise should any reader accept that Senator Rubio’s argument is scientifically correct that run the gamut of fear mongering (the end of fertility treatments!) to ongoing issues of debate (the end of embryonic stem cell research) to quite honestly puzzling as to why it is problematic (if you murder a pregnant woman you will be culpable for two murders). In spite of the fact that all of these issues have been openly argued and discussed for years, Dr. Caplan hints that political defenders of an inclusive view of human value either have not thought about this or are purposely not mentioning it. 

Now we finally get to his position. "Science supports no such view that life begins at conception." His arguments in support of this position are (1) that conception is a fuzzy concept and hard to nail down as a distinct event, (2) the majority of conception events do not produce a viable pregnancy, (3) twinning and recombination raise troubling questions about the nature of early life, (4) and a number of post implantation pregnancies spontaneously miscarry.

His first real argument is that conception is unwise to use as a point of demarcation for the beginning of human life because the boundaries of the event are fuzzy according to Dr. Caplan.  He asks:

"Is conception when a sperm reaches an egg, when it penetrates the shell of an egg, when genetic recombination begins, when a new genome is formed, or, when a functioning new genome is formed?"

This is an interesting question and one that Francis Beckwith addressed in Defending Life. In responding to what he considers an important objection on this grounds offered by David Boonin he says:

"It seems to me that Boonin commits the fallacy of the beard: just because I cannot tell you when stubble ends and a beard begins does not mean that I cannot distinguish bearded faces from clean-shaven ones. After all, abortion-choice supporters typically pick out what they consider value-making properties - for example, rationality, having a self-concept, sentience, or organized cortical brain activity (as in the case of Boonin) - that they justify concluding that a being lacking one or all of them does not have a right to life. But it is nearly impossible to pick out at what precise point in a being’s existence it acquires the correct trait, for example, when it becomes rational enough or has a sufficient amount of organized cortical brain activity to warrant a right to life. But it’s doubtful whether the abortion-choice advocate would abandon her position on those grounds."

These two things can simultaneously be true; that Caplan is correct in the difficult nature of breaking down exactly when conception begins and that once the fertilization process is finished we have a whole, living, and distinct new human organism. This first argument does nothing to defeat the position that nascent human life, even as a zygote, is a full member of the human family.

Second, he argues that the majority of conception events do not end in a human organism. His evidence of this is a study published in the journal Science that seems to show that 75% of conceptions result in chromosomal abnormalities of such an extreme nature that fewer than 30% of conception events lead to viable human organisms and pregnancy. This is interesting information, but it puzzles me as to why Dr. Caplan sees it as a defeater for an inclusive view of human value.

I acknowledge that this raises interesting questions about what we know about human reproduction. Is this new life form a human organism that is suffering from such profound genetic abnormalities that his life ends very early or is it so profoundly chromosomally disordered that it is not properly understood as an organism at all? Does it have more in common with a hydatidiform mole?

If the latter, then this is an interesting objection that has been addressed by Dr. Maureen Condic. (See here for more) As she points out, though these molar pregnancies have human DNA they are never whole, living, and distinct human organisms. They are not healthy human lives that degrade but begin as something entirely different and grow in accordance with what it is.  We have an issue in discerning what they are prior to particular levels of development, but our lack of ability to distinguish what they are doesn’t change the nature of the life. If Dr. Caplan’s more than 70% of conception events that fail to produce whole human life fall into this category, then it is an interesting fact that in no way impacts the nature of those whole, living, and distinct human organisms that are present after the minority of conception events.

His third argument relies on the objection from twinning and recombination. Dr Caplan writes:

“Just to reinforce the point that conception is a bad place to begin when it comes to legislating personhood sometimes, conception creates more than one life, twins or triplets, but then one of those lives is absorbed into the body of another–fetal resorption.

Not only is it unlikely that a life begins at conception, even if life begins it really is not clear how many lives start at the moment of conception until later in pregnancy.”

Robert George and Christopher Tollefsen address this objection in their book Embryo. They write:

"This conceptual question of whether an entity of that is genuinely one could be spilt so as to become two has a ready answer. Consider the parallel case of the division of the flatworm. Parts of a flatworm have the potential to become a whole flatworm when isolated from the present whole of which they are a part. Yet no one would suggest that prior to the division of a flatworm to promote two whole flatworms, the original flatworm was not a unitary individual.

Likewise, at the early stages of human embryonic development, before specialization by the cells has progressed very far, the cells or groups of cells can become whole oranisms if they are divided and have an appropriate environment after the division. But that fact does not in the least indicate that prior to such an extrinsic division the embryo is other than a unitary, self-integrating, actively developing human organism."

If Dr. Caplan’s argument undermines the humanity of early human life then it scientifically undermines our ability to categorize any individual planarian as an independent organism. That would be a weird leap to make without having to do so. This capacity is certainly odd, but it doesn’t do the work necessary to support Dr. Caplan’s conclusion.

His final argument is that since 10% to 25% of implanted embryos ultimately miscarry then… well he doesn’t really flesh this one out. He drops it as an afterthought. He is using post implantation events to undermine the humanity of the unborn at the conception event. Why stop there? Why not drag in infant mortality rates? The mortality rate of humanity is 100% on a long enough timeline. Why not mention that? How any of these facts about the death of human life impact the question of when a distinct human organism begins to exist is beyond me, but we will just have to imagine that since we aren’t actually offered any argument.

Dr. Caplan fails to make a persuasive case for his position. That isn’t so bad in and of itself, but he fails to do so while dismissing those who disagree with him as perpetuating a canard into the silence left by reputable scientist too intellectually cautious to declare when human life begins. This is uncharitable. It is also indefensible to claim such silence exists. I will include a handful of quotes to counter his claim in a postscript below on that point, but given the readily available substantive responses offered to his arguments from respected scholars his cavalier attitude on this matter is unearned.   

Postscript

1. "[The zygote], formed by the union of an oocyte and a sperm, is the beginning of a new human being."

Keith L. Moore, Before We Are Born: Essentials of Embryology, 7th edition. Philadelphia, PA: Saunders, 2008. p. 2.

2. "Although life is a continuous process, fertilization (which, incidentally, is not a 'moment') is a critical landmark because, under ordinary circumstances, a new genetically distinct human organism is formed when the chromosomes of the male and female pronuclei blend in the oocyte."

Ronan O'Rahilly and Fabiola Müller, Human Embryology and Teratology, 3rd edition. New York: Wiley-Liss, 2001. p. 8.

3. "Development begins with fertilization, the process by which the male gamete, the sperm, and the femal gamete, the oocyte, unite to give rise to a zygote."

T.W. Sadler, Langman's Medical Embryology, 10th edition. Philadelphia, PA: Lippincott Williams & Wilkins, 2006. p. 11.

(Items 3 & 4 are admittedly older that 1-3, but I offer them to counter evidence of scientific consensus argued by Dr. Caplan from the same year in quoting the NAS)

4.“So, therefore, it is scientifically correct to say that an individual human life begins at conception, when egg and sperm join to form the zygote, and this developing human always is a member of our species in all stages of its life.”

Dr. Micheline Matthews-Roth, Associate Professor of Medicine, Harvard Medical School, The Human Life Bill S. 158 (US Senate Judiciary committee 1981)

5. “I think we can now say that the question of the beginning of life – when life begins – is no longer a question for the theological or philosophical dispute. It is an established scientific fact. Theologians and philosophers may go on to debate the meaning of life, but it is an established fact that all life, including human life, begins at the moment of conception... I have never ever seen in my scientific reading, long before I became concerned with issues of life of this nature, that anyone has ever argued that life did not begin at the moment of conception and that it was a human conception if it resulted from the fertilization of the human egg by a human sperm. As far as I know, these have never been argued against.”

 The late Dr. Hymie Gordon of the Mayo Clinic in the same Judiciary Committee