By / Dec 15

Several COVID-19 treatments and vaccines have come under scrutiny because their development included testing possibly using abortive fetal cells. Here is what you should know about the fetal tissue cells and the ethical concern about using them to develop therapeutics and vaccines. 

What are fetal tissue cells, and how are they used?

A human fetus (Latin for “offspring”) is the stage of human development from the embryo stage (the end of the eighth week after conception, when the major structures have formed) until birth. When the fetus dies, either naturally or by an elective abortion, the tissue (including intact organs) can be legally donated for research purposes.

As Christians committed to the cause of human dignity, we affirm that a human life begins at the moment of conception. Further, we recognize that every human life, even in the earliest or most advanced stages, bears all the rights and dignity of a person. Therefore, the use of fetal tissue in medical research and treatments is a matter of deep concern for believers.

Fetal tissue can be used in biomedical research for transplantation material and other purposes, but is more often connected to the creation of “immortalized” cell lines. Immortalized cell lines are established by culturing fetal cells in such a way that they continue growing and multiplying in laboratory dishes indefinitely. These cells can then be used for such activities as testing a drug’s ability to damage genetic material or to test the effects of specific viral infection.  

While immortalized cell lines began with fetal cells, they no longer contain fetal body parts, and no fetal tissue remains. No cells remain from the original fetal tissue. 

Fetal tissue—obtained both ethically and unethically—has been used to develop life-saving vaccines and therapeutic treatments for diseases such as cancer. For example, the 1954 Nobel Prize for Medicine, for instance, was awarded for a polio vaccine that was developed from fetal kidney cells. Fetal cells were also used in the production of a widely used vaccine for measles. In both cases, the tissue was obtained from spontaneous abortions and ectopic pregnancies. Cells from aborted fetuses, however, have been used in a number of more recent vaccines for chickenpox, hepatitis, measles, mumps, poliomyelitis, rabies, rubella, and smallpox. Fetal tissue from aborted fetuses has also been used in cosmetics and anti-aging creams.

As Nicholas Evans, a bioethicist at the University of Massachusetts Lowell, says, “Chances are if you have had a medical intervention in this country or pretty much any other country, you have benefited from the use of these cell lines in some way.”

Were fetal cells used in the experimental treatment for COVID?

Regeneron Pharmaceuticals manufactured an experimental antibody cocktail known as REGN-COV2. Regeneron has clarified that the company tested the effectiveness of REGN-COV2 by creating a “pseudovirus” mimicking the actual one. One element of the pretend virus is a cell line known as HEK293T. 

HEK293T is a widely used immortalized cell line that was made from fetal tissue acquired in the Netherlands in the 1970s. The records pertaining to the origins of HEK293T were lost, so it is not know whether the tissue came from a spontaneous miscarriage or an elective abortion.

In either case, it’s important to distinguish between “fetal tissue cells” and “cells derived from a long chain that arose from cells in fetal tissue.” The HEK293T cells are no longer fetal tissue cells. 

Were cells derived from fetal cells used in the creation of COVID-19 vaccines?

In addition to the use on REGN-COV2, at least five of the candidate COVID-19 vaccines being developed in America use cells from HEK293T cells or PER.C6, a cell line developed from retinal cells from an 18-week-old fetus aborted in 1985. 

The vaccines by Pfizera and Moderna recently approved by the FDA used HEK293T cells in the testing process, but not in the production of the vaccines themselves.

Is it immoral to use treatments and vaccines developed using aborted fetal cells?

Christians should always prefer medical treatments that have no connection to elective abortions. But in light of the COVID-19 pandemic and the approval of at least one vaccine for use in the United States, it is important to understand whether taking a vaccine that utilized (or potentially utilized) aborted fetal cells is morally permissible.

A common way of addressing this question is to determine what type of cooperation is undertaken in the evil act of abortion. To cooperate in evil, the cooperator contributes in some way to the wrongful action of the principal agent, either by formal cooperation or material cooperation.

Formal cooperation happens when a person cooperates with the immoral action of another person, sharing in the latter’s evil intention, while material cooperation occurs when the person cooperates with the immoral action of another person, without sharing the evil intention. While formal cooperation is always evil, making a determination on material cooperation depends on other additional factors. 

For example, if the abortion was conducted in order to harvest tissues that were to be used for the purpose of creating a cell line, then it would clearly be immoral. But in the case of  HEK293T, even if an abortion occured it was not carried out for that reason, and the tissue was acquired for the purpose of medical research only after the death of the child occurred for other reasons. This has significant consequences for determining whether such research is either licit or immoral.

To determine the morality of using the cells, it is helpful to compare it to another situation: the use of organs from a person who has been murdered. If a doctor were to offer to transplant a kidney or heart from the murder victim into a Christian, we would likely not have any objection. The primary concern would be whether the victim consented to organ donation prior to their death. 

Most Christian ethicists agree that fetal tissue donation is not inherently unethical if the tissue was obtained from a spontaneous abortion (miscarriage) or an ectopic pregnancy (a pregnancy in which the fetus implants in the fallopian tube instead of the uterus) and was willingly donated by the parent. Such donations would be similar to a parent agreeing to donate the organs of an infant or a child that had died by natural causes.

The donation of fetal tissue may be morally tainted, though, when the tissue is derived from a fetus that has been killed in the womb. Allowing and condoning such donations of tissue derived from abortion to continue would make us indirectly morally complicit in the act of abortion, conveying a sense of approval for an ongoing regime that sanctions the killing of the unborn. 

That raises the question of whether the use of cells from HEK293T would promote abortion in just such a way. While pro-life Christians may disagree on how to answer that question, it is unlikely that the use of the HEK293T cell line will lead to additional children being murdered in the womb in order to expand the number of fetal tissue cell lines. The reason is that it is completely unnecessary, and medically inexpedient, to create new cell lines from aborted children. As Rev. Nicanor Pier Giorgio Austriaco, a Catholic biomedical researcher, explains

. . . HEK293 is an established cell line. What this means is that these cells have been used and studied by biologists for nearly half a century. They are well characterized, and they have been validated for their safety. I point this out because it helps explain why it is unheard of for a vaccine manufacturer to seek out new human fetal cells from a recent abortion. Such novel fetal cells would be uncharacterized, unvalidated, and unapproved by regulatory agencies like the U.S. Food and Drug Administration (FDA) for human vaccine production. Why waste time, effort, and money to obtain, characterize, and validate new human fetal cells when the classic fetal cell lines obtained decades ago like HEK293 are readily and cheaply available? 

Currently, the use of the HEK293T cells in biomedical research is not increasing the number of abortions that are being carried out every year. If we were to see evidence of that happening, however, it would change the moral calculation.

The remaining question is whether accepting the use of HEK293T cells would potentially be cooperating with the killing of the child in the 1970s. For a number of reasons, many if not most Christian bioethicists would argue that it is not (assuming an abortion even occured). The primary reason being that this situation is morally analogical to the case of the murder victim/organ donor. No one would say the Christian who received the organ was morally responsible in any way for the murder. 

For this reason, Christians are not morally culpable if they use treatments and vaccines that were developed using such cells, even if the cells originated in aborted fetal tissue. As David Prentice, vice president and research director of the pro-life Charlotte Lozier Institute, says, “We would prefer they not use the controversial cell line even in the testing, because there are other alternatives. But that testing on the side doesn’t affect me in terms of the recipient of the drug.” Ethicist Christopher O. Tollefsen also adds, “Because researchers may ethically use the HEK cell lines to develop vaccines, people can of course ethically use a vaccine should it be developed from the HEK cell lines.”

For more on the ethics of the COVID-19 vaccines:

By / Aug 25

Recently, the Human Fetal Tissue Ethics Advisory Board released its recommendations for funding based on proposals submitted to the National Institute of Health. This board, tasked with the oversight of projects that would require the use of fetal tissue, recommended that the Health and Human Services Secretary Alex Azar withhold funding from all but one project. This has led to charges that the board is bringing ideology to bear on an objective process. However, the board is made up of experts across the ideological spectrum who weighed the proposals and made recommendations based on the merits or deficiencies of the proposals. 

Background: Defining fetal tissue research and a history of the oversight board

Fetal tissue research is the use of cells “that are harvested for the purpose of establishing cell lines or for use as transplantation material and other purposes.” This process of harvesting cells can be done through induced abortions or from miscarriages, but the mother must consent for the cells to be used in NIH proposals and research. 

The Human Fetal Tissue Research Ethics Advisory Board was announced in June of 2019 when the Trump administration banned the current use of fetal tissue in federally funded projects. Previously, the process had been for grants to go from the National Institutes of Health to the Secretary for final approval. However, with the creation of the new board, previous projects were halted, and all new proposals had to go through an additional layer of ethical review. This board, made up of 15 individuals who meet specific qualifications, and which must be made up of a broad range of experts, considered the ethical ramifications of the research and the necessity of the fetal tissue research. Their recent meeting recommended withholding funds from 13 proposals previously approved by the NIH and the funding of one proposal. It will now be up to Secretary Azar to make the final decision under HHS rules.

The members of the board include scientists, theologians, ethicists, and medical professionals. There are a range of perspectives on the board raging from those opposed to fetal research and those who are advocates of the procedure. One member in particular, Ben Mitchell, should be noted because of his expertise in this area. He is a Southern Baptist bioethicist, a member of the ERLC’s Research Institute, and the former Graves Professor of Moral Philosophy at Union University.

What recommendations were made?

Reviewing the recommendations of the board, there are several things to note about the proposals that were rejected and the one that was approved. Though there is no identifying information about the proposals, it is clear that, despite the ideological diversity of the board, there was not much disagreement on board about most proposals. When comparing the votes, only two of the proposals received relatively close votes. The other 12 ranged from 10-5 to 15-0 voting to withhold funds. So it is clear that on a board containing members across the ideological spectrum, a clear supermajority was reached as to the viability of these studies in almost every case. 

When looking at the reasons that the proposals were rejected, the participants noted a number of problems that caused them to vote as they did. These ranged from procedural and privacy concerns about the research to larger scale questions such as the manner in which the tissue would be obtained, whether another type of tissue could be used, and even the concern that one institution could be profiting from the procurement of the tissue. Also, it should be noted that several members of the board made clear that they would be willing to support the proposal if the problematic uses of tissue were removed or corrected. 

The board voted 9-6 for the proposal they recommended funding. The proposal is for a study of alternatives to fetal tissue and substitutes. In a study of this type, some fetal tissue is necessary as a control group so as to judge the experimental group. However, the recommendation clarifies that this study would be using existing fetal tissue which had been stored rather than acquiring new sources. Thus, it would not run afoul of causing the researchers to participate in abortion or other procedures to procure the samples. and if successful, it would eliminate the need for future research with fetal tissue by providing an alternative. 

How should Christians think about fetal tissue research?

There are several ethical considerations when it comes to fetal tissue research for the Christian. The first is the manner in which the tissue was originally collected. As noted above, fetal tissue can be taken from miscarriages or induced abortions. Christians ought to reject any willful taking of the life of a child for medical research purposes because of the child’s right to life. However, in the cases of miscarriages, there is room for disagreement among Christians about how to use the cells, just as in the case of individuals who donate their organs after death or bodies for medical research.

The other concern is what is to be done with cell lines that are already in existence from previously harvested tissue. Some of these were taken from aborted children, and thus were collected through unethical and immoral means. But does this mean that all research from the stem cell line must be rejected? While there is room for debate in this area, the salient ethical concern is whether an individual is participating in the evil of abortion by benefiting from the research of tissue collected by immoral means. As with vaccines developed with stem cell lines from aborted children, the individual who chooses to receive the vaccine is not morally culpable for the methods used to create the vaccine, but they should pursue ethical vaccine creation with alternatives to fetal tissue. 

In general, Christians should oppose the use of fetal tissue in research because of the way it incentivizes the marketing of aborted human fetal tissue. Though there are ways to obtain the tissue ethically, as with the consent of parents after a miscarriage, it is impossible to avoid the way this practice incentivizes the treatment of children as tools for scientific experimentation. One abortion provider, after intense public backlash following horrific videos detail practices for obtaining the tissue, said that it would no longer attempt to recoup the $45-60 that it receives as reimbursement for the tissue collection. When they made that statement in 2015, that $45 (taking the lower estimate) would have netted the abortion provider, if half of their 140,000 abortions resulted in fetal tissue to be sold, an additional $3 million. Christians should oppose this commodification of children and a Darwinistic worldview struggle that defines individuals by their utility rather than their intrinsic worth.

Ethics, science, and pro-life policies

For these reasons, the ERLC is grateful for the careful consideration the advisory board clearly carried out with respect to the proposals before it. The ERLC applauds the work of the board in ensuring an ethical approach to such a sensitive subject. 

Some detractors of the board have castigated it as a group which has brought ideology to bear on the rational and objective sciences. However, it should be noted that these ethical review boards arise out of a history of scientists objectifying individuals and populations and treating them as subjects for research rather than individuals possessing unique dignity and worth, most notably the notorious Tuskegee Study in the early 20th century. There is a need for ethical oversight when it comes to human research, especially when vulnerable populations are involved. 

Though there are cases where fetal tissue can be obtained ethically, as in the case of miscarriages, there is also the danger of incentivizing the death and sale of children through fetal tissue research. Thus, it is imperative that a board such as this review proposals and ensure that a culture of death is not expanded under the banner of improving life for the rest of humanity. We cannot sacrifice the weakest for our own benefit—that is a Darwinistic outlook that sees power and might as the standard of morality and defines a child in terms of his or her usefulness, not their intrinsic worth. The work that the advisory board is doing helps to promote an ethical approach to research that defends the rights of the most vulnerable.

By / Jan 27

Steven Harris, Paige Cunningham, Tim Goeglein, and Dr. Freda Bush combine their expertise to discuss the undercover Planned Parenthood videos and what implications we can expect.