When does a foetus become human?

All of us who believe in the advance of science should be afraid of ending up as inflexible as our opponents

Sometimes, Britain's championship of stem cell research can appear like an exercise in jingoism. Advocates of this controversial area of medical research will boast that we are international pioneers in the field - even opening the planet's first ever stem cell bank - and rub their hands as they speculate whether, if President George Bush gets his way, a brain drain of US scientists to Britain will be triggered.

Sometimes, Britain's championship of stem cell research can appear like an exercise in jingoism. Advocates of this controversial area of medical research will boast that we are international pioneers in the field - even opening the planet's first ever stem cell bank - and rub their hands as they speculate whether, if President George Bush gets his way, a brain drain of US scientists to Britain will be triggered.

At other times, it can seem like emotional blackmail. Christopher Reeve was only one of millions of people suffering from disabilities that may or may not at some time in the future be cured by techniques developed as a result of stem cell research. Already, quite a number of those millions have been quoted in the press, offering testament to the misery of their conditions, and pleading for the research that may transform their lives to be done.

Actually though, neither the desire to be first, nor the personalised offer of almost certainly unrealistic hope to unfortunate individuals, are particularly good reasons for going ahead with controversial and possibly fruitless research. In fact, they're the very same reasons cited by those rogue scientists who persist in outraging humanity with their efforts to clone a human baby.

Britain, as stem-cell enthusiasts are wont to elate, was the first nation in the world to ban such reproductive cloning, in 2001, while at the same time it endorsed therapeutic cloning. George Bush is now lobbying the United Nations to draft an international convention banning all forms of human cloning, while Britain, along with many other countries, wants a convention which draws the same distinctions between reproductive and therapeutic cloning as the Human Fertilisation and Embryology Authority does here.

Passions run so high on this subject that Mr Bush hasn't actually managed to ban reproductive cloning within his own borders, only acting to damage its prospects by ensuring no federal funding will be available to researchers. In fact the most outrageous of all the scientists working on human cloning, Panayiotis Zavos, works out of Kentucky. It is to get round this little local difficulty that Mr Bush is suddenly so engaged by the UN, even though many fear that an unacceptably rigorous convention will be one that not many countries will sign up to.

Yet since our abhorrence of the idea of a cloned human - shared by the scientist and the layman - is so powerful and so visceral, surely it is worthwhile pinning down just what it is that makes it okay to create embryos to extract cells from, but not okay to create embryos and allow them to develop into people. This is the central issue, after all, that dominates all debate around reproduction and reproductive rights. I remain convinced that it is sufficient for pro-choice voices to contend that life begins at the point when independent life is possible, not at the moment of fertilisation.

There has been much talk recently of a renewed assault on Britain's abortion law in the wake of the survival of "miracle babies" of tiny size or unfeasibly short gestation. Yet this sensible definition, in the wake of such cases as that of Charlotte Wyatt, has been bolstered rather than undermined. Charlotte Wyatt was the prematurely born baby whose doctors applied to the courts for permission not to resuscitate her when she next fell victim to an opportunistic infection. The baby, they said, experienced nothing but pain which increased every time she was saved.

Lord Justice Healy concurred with their view, adding fuel to growing beliefs that sometimes attempts to save very premature babies were misguided. The fact is that only one per cent of babies born before 26 weeks survive without disability, even with all the medical technology that is available to them today. The embryos created for stem cell research are by law destroyed at 14 days old. At the time the stem cells are harvested, the potential life they supposedly represent is a ball of about 200 undifferentiated cells. Yet the fate of poor Charlotte reminds one of another aspect of science that we too often forget. That is that sometimes the expectations it raises are far greater than it can meet. It is unfair that in order to justify the entirely valid and honourable desire to increase the sum of human knowledge, participants in the debate feel they must somehow balance the human suffering that will be alleviated against the imaginary human suffering it will putatively cause.

All those people rolled out by the media to talk of their hope of a cure for motor neurone disease, or blindness, or Parkinson's or Alzheimer's, are being asked to beg for a longed-for cure to combat the arguments of a group of people who want to stop human suffering in the abstract, but demand that it be borne or even fetishised in reality. This they do by arguing that dabbling in even the most rudimentary cells of human flesh is at least demeaning to human dignity, and possibly even a process that desensitises humans to cruelty or encourages lack of empathy.

It's the "any man's death diminishes me" argument, and it is seductive because it's so lofty. (Interestingly, some of abortion's most ardent supporters use the same argument when demanding the banning of fox hunting.) Much of it is high-blown hokum. But at the same time, there is a degree of truth in it. Sometimes, pro-choicers can be guilty of being too strident and knee-jerk and not sensitive enough to the real issues of flesh and blood.

The rather overblown discovery that the British Pregnancy Advisory Service had been giving information about the availability of late abortion in other countries to women past the 24-week limit for "social" abortion in Britain, for example, was stalwartly defended. Yet, knowing what we do about the viability of healthy foetuses after 24-weeks, isn't it worth considering whether there might be another choice for women seeking late abortions?

Maybe, for example, women might be able to widen their choices in these circumstances. Instead of travelling abroad for an abortion in which a possibly viable baby is killed, they may sometimes prefer a caesarean delivery and adoption. This is a choice that some women might welcome, and surely the extension of choice and the preservation of life ought to be considered a humane and positive possibility. For some, the suggestion may seem outlandish. But the testament of surrogate mothers who carry babies for others suggests that this might be a rewarding experience. It might also be an option for women who have decided they do not want their pregnancies to continue after the 24-week limit has passed.

It may be that stem-cell research is going to deliver on its hype, and cure millions of terrible diseases. It may be however, that instead it alters human understanding of illness in many more subtle but no less valuable ways. And the latter, in its more modest wonder, is what we should all be striving for.

All those who wish for religious reasons to defend the sanctity of a group of cells on a slide, are enemies, not friends of human endeavour. But in opposing such views, it is important not to become fundamentalists too. All of us who believe that the advance of science should be supported, and doctors and scientists should do what they can to alleviate human suffering, should be afraid of ending up as inflexible and hard line as those we oppose.

d.orr@independent.co.uk