The pre-embryo: an illusory category of convenience.

Abstract

1. Edmund D. Pellegrino, MD* 1. 2. *Director, Center for Clinical Bioethics and The John Carroll Professor of Medicine and Medical Ethics, Georgetown University Medical Center, Washington, D.C. 1. Is there such a thing as pre-embryo in the real world? 2. Are personhood and individuality the same thing? 3. Can the embryo really be harmed without being wronged? 4. Can benefit to others be used to justify the death of an embryo? 5. Is a purely negative morality sufficient to describe the moral life of humans? Goldworth has examined the ethical implications of IVF in terms of possible harms to the “pre-embryo,” the participating couple, the offspring produced thereby, and the community. Using the principle of “primum non nocere” as his moral guide, he concludes that although harms may occur by the use of IVF, there are no moral wrongs. In each case, he detects sufficient good for others to override the prima facie obligation not to inflict “gratuitous” harm. I take issue with this conclusion, the line of reason leading to it, the presuppositions with which it begins, and the subsidiary arguments it employs to buttress its justifications of IVF. I argue, to the contrary, that IVF does cause both harm and moral wrong to embryos and that even within the restricted moral constraints adopted by Goldworth, it is morally unjustifiable. Although I will confine myself to the embryo, my criticisms apply, mutatis mutandis, to the author’s other conclusions concerning harm and wrong to the couple, the offspring, and the community. Goldworth’s line of argument starts from a single moral presupposition, namely, “… any decision is ethically permitted if it is voluntary and does not cause gratuitous harm to others.…” He distinguishes“ harm” (ie, death or damage to others) from wrongs, which are morally condemnable because they are“ gratuitous” (ie, inflicted without adequate justifying reason). Therefore, he takes the proscription against harming as a prima facie obligation that can be trumped for a good reason, such as benefiting others. In the case …