When does the right to life end?

The recent debacle with the Susan G Komen foundation and the (now resigned) vice president, Karen Handel, highlighted some of the major dilemmas that go on in the political versus scientific arena.  The split between SGK and Planned Parenthood has probably had some unforeseen benefits, and thankfully a rallying cry from Americans who have been disenfranchised left and right through the last decade of chipping away individual liberty. 

What remains, however, is the stark reality that there is an incoherent message that is being sent by political parties, scientific parties, charities, religious groups and the citizenry.   

On the right, we have prolife groups that are against abortion, eugenics, euthanasia, IVF and embryonic stem cell research.  One the left, we have prochoice groups that want more access to birth control to prevent unintended pregnancies, safer access to abortion when unwanted or unhealthy pregnancies ensue, the right to die with dignity and on our own terms, and the right to prolong our lives through the use of tissue transplantation, or medicines derived from embryos and fetuses.  Most of us lie along the spectrum of life, choice and embryos.  Most of us don't like the reality of abortion and most of us don't like the reality of death.   

Without abortions, we have more births, and with more births, we have more lives. More citizens make more demands on the environment, and have greater and greater expectations to live a long life.   Every measure of life prolonging intervention is expected for all pregnancies, even those that are naturally not very viable, and yet women whose lives are threatened by those pregnancies are expected to risk death than be allowed to make the choice between their own and the fetus (or embryo).  Their lives are the equivalent of an embryo, or a fetus.  Either way, an unborn human life or a born human life may end from the pregnancy.  Nature selects about 1 in 4 conceptions to make it to implantation.  Whether you believe life begins at conception or not, pregnancy does not result from every conception.  

We are in an era of unprecedented scientific advance into the realms of life prolonging medicine.  SGK had dedicated their mission to finding a cure for breast cancer, and probably found along the way that the lofty goal is unlikely to be reasonable or possible without a foundation of ethics and principles.  Scientists of all stripes fall on both sides of the ethical divide on embryonic stem cell research.  Destroying a human embryo, a conception, a life, must occur for it to happen.  Whether conception is achieved naturally, or artificially, every cell of the blastocyst has some programming that will eventually turn on and and form a neural tube, a heart, the digestive and urinary tract, arms and legs, reproductive organs.  The structure of a human life.  Or they will turn on and result in death, as genetic diseases kick in and cause miscarriage or fetal death.  Sometimes children are born with their diseases, and die soon after.  Some linger for years in agony and disability. 

The question of merit in research is always at hand.  But the merit must lie in the framework of ethics and goals- which must continually be reviewed.  There is no point in endlessly prolonging human life.  The natural cycle of life includes death, for every living thing, there comes an end.  For humans, we have reached a time when we can prolong life for far more people than ever possible.  Death comes from many things, but somehow we believe we should all die at an ever increasing old age, hale and healthy right until the end moment.  To cure all illness would mean that we all live 80-120 years, until our worn out parts and worn out hearts give up.  As we come to regenerate new tissue from stem cells (adult and embyronic), those parts get replaced and we live a little longer.  Someone else dies in an accident, we maybe get a new liver or a new heart or a new kidney.  Watching a loved one die is horrible, and most of us would take any measure to keep them alive if we could.  

And still, that measure may have come by the death of another human.  

Scientists will never resolve this debate, as scientists are humans who vary in their beliefs about ethics, as anyone else.  They are not a uniform, cohesive group of individuals who have the same approach or belief to all things.  Politics has no reason to choose science over religion any more than it has reason to choose religion over science.  It must balance what is in the best interest of humans, in the time they live in.  Many amazing discoveries about the plasticity of DNA, the role of environment on shaping its expression (epigenetics) and the continuum of life can be made under the most ethical or gruesome of circumstances.  Many studies can not be done, because they would require destroying the boundaries of human decency to get there.  Killing animals seems like the next best step, until we realize we are still purposefully creating and destroying life in order to find out how to prolong the life of a select few people.  Who deserves to live forever?  Who deserves the right to reproduce past their natural capacity?  When is a life a life, and when is it just some tissue?

The irony in many ways, as the story continues to unfold in the meltdown between Planned Parenthood, Susan G Komen, and the stem cell research groups, is that control over reproduction is part of the big picture on human life and longevity.  For many years, the stem cell population was derived from discarded IVF embyros, which were made so couples could ensures a healthy pregnancy and birth of their own progeny.  Surely, we don't want to see a society of extremely ill people having many babies that are physically and mentally unfit, and surely we don't want to see a society of only healthy children that are preselected in vitro.  

Part of improving the lives and health of people is to make sure they have the best possible start from before conception:  the mother is healthy and nourished, the genes are healthy, the environment is supportive and nurturing, and the early years are free from stress, abuse, starvation and toxicity.  Changing that, which is in our reach now, will do more to change the lives of future generations on all measures of health than anything else.  We have been going in the opposite direction on that for years now, as more and more children are plunged into poverty, more and more mothers are given toxic "food" to support themselves, their pregnancy, their infant, their children, as they live in toxic jungles of poverty and pollution, and enduring physical and emotional abuse- or creating it themselves.   We have been going in the wrong direction for years, chipping away reproductive rights for women, meaning more and more at risk children are being born- more and more children that will develop heart disease, cancer, diabetes- because of the environment in which they were conceived and born into.  

If SGK wants to see the "cure" of cancer, they should put their money where their mouth is:  stronger enforcement of the EPA, bans on bisphenol A, synthetic hormones, much stronger controls on the chemicals we put into our air, water, food supply, housing, environment.  They should be lobbying against tobacco, jet fuel, industrial solvents, preservatives, alcohol, sugar.  

Of course, we insist on our freedoms to "choose" and most of us end up choosing the very things that are part of the diseases we develop.  We may not have control over our conception and birth, or early environment, but as adults we all choose again and again for the very things that will lead to our eventual death.  Genetics has a role, but only one part.  If you think the cure for cancer involves the slurry of human tissue, you may be right.  If you think the cause is unknowable,  you are buying the the lobbying message.  

Some of the best news in the past decade about cancer and prevention has come in the identification of HPV (a virus) as the primary cause of cervical, anal, head and neck cancer.  The vaccine developed has not only significantly halted the spread of the disease, but will likely reduce deaths by those kinds of cancers by far more numbers than we realize today.  But, most cancer is not caused by a virus, and surviving one kind does not protect you from another.  

The Big C is part of the drama of life- as is infection and inflammation.  Treating them all as one disease is like treating all skin conditions the same.  The risks for some kinds of breast cancer are similar to some kinds of lung cancer and colon cancer:  toxic fumes in your environment like smoke, char, and car fumes.  Add up a number of risk factors (we all have a bunch of genetic risks and environmental risks and personal habits) and eventually, one of them "wins".   Everyone one of us has a relative risk for all diseases, some more likely than others.  The guessing game really could be why we wait so long to start screening people and prodding them along the path to their individual prevention.  Freedom to have a long and healthy life may mean loss of freedom to live life as we want.

And then there is the real politics behind it all.  Money.  Who gets to decide where it gets spent, and who gets to reap the rewards of its findings.  It is impossible for physicians and scientists to bear the burden, without the support of society and corporations on the other side.   Money doesn't trickle down as quickly as despair, and it is never evenly distributed when it gets there.  If you want to see the end of disease... well, it's not coming.  However, if you want to see the improvement of the lives and healths of most human beings, it starts not with fighting for the life of the unborn- but the respecting the lives of those already born.   This doesn't take a miracle, after all.  It is in the hands and reach of humans, not heaven.