Stem Cell Research – Is There a Lutheran Ethical Position?
 One of the fields continuously raising ethical questions is the fast development within biotechnology. Constantly new possibilities arise and lead to ethical questions. For a Lutheran ethic the challenge is twofold - it is both a challenge to determine the key ethical questions in general and a question whether or not there is a specific Lutheran answer to these questions. This twofold challenge is also present when we deal with one of the more recent questions related to biotechnological research, namely the question what ethical stance we should take concerning stem cell research.
 In recent years the question on the status of and subsequent possible research on stem cells has attracted considerable attention. This is due to both moral and political reasons. Politically the question has split the US and the European Council. In September 2006 President George Bush vetoed a bill on embryonic stem cell research which would have loosened the restrictions on federal funding. The arguments against the bill were primarily ethical, as he argued that this bill would cross a moral boundary. The acceptance of research on embryonic stem cell research would not sufficiently take into account the moral status of the human embryo. The decision of the American president went against the Senate which would have passed the bill. A similar division could be seen in the European Council. An intense discussion along the same lines as in the US was led among the member states of the European Union. As in the US the discussion was focused on whether this research should receive funding. And again the crucial question was the ethical issue. Countries such as Germany, Austria, Poland, Lithuania, Luxembourg, Slovakia, and Malta - with Germany in a leading opposition - opposed that EU should fund research which could further the killing of human embryos. However, in contrast to the US it was decided in the EU that research on stem cells should receive funding - but with the significant adjustment that no funding will be given to research which destroys human embryos.
 The ethical discussion has focused on the status of the human embryo. This is due to the methods of obtaining stem cells, where one of the methods has implied the destruction of the human embryo. Therefore, the central issue in the debate has been the status of the human embryo. In the present article, this question will be discussed from a Lutheran perspective. However, before we turn to that a few facts on stem cell research need to be outlined.
4] Stem cells are cells with a unique ability to develop into most of the different types of cells found in the human body. They are unspecialized and renew themselves for long periods through cell division. Further, "… under certain physiologic or experimental conditions, they can be induced to become cells with special functions such as the beating cells of the heart muscle or the insulin-producing cells of the pancreas". Stem cells are obtained primarily from either human embryos or adults. When obtained from human embryos they are taken from embryos that were created for infertility purposes through in vitro fertilization. When no longer needed for that purpose these embryos have been donated for research with the informed consent of the donor. Extracting stem cells from embryos implies the deliberate killing of the embryo. Only recently, a new method seems to have appeared where one can take stem cells from human embryos without harming them. The other source of stem cells is from adults where stem cells are extracted from various organs and tissues, such as brain, bone marrow, peripheral blood, blood vessels, skeletal muscle, skin and liver. The problem with this source is that there is a small number of stem cells in each tissue and that they may not produce as many different cells as the embryonic stem cells.
 The prospects of stem cell research is that these cells in the future could be used in various cell-based therapies and thereby further the treatment of diseases such as Parkinson's and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis. 
The Debate on Lutheran Bioethics
 When we turn to the question, if there is a Lutheran ethical position, we are immediately confronted with the twofold challenge outlined in the beginning of this paper. Let us first turn to the first question - what are the key ethical questions?
 In the ethical debate on stem cells the focus is on the source of the desired stem cells. There does not seem to be any significant discussion on the potential benefits of stem cells in the cure of the mentioned diseases. The ethical concern lies with the two mentioned methods of getting stem cells. The method of getting stem cells from adults is less controversial. But the second method, where stem cells are taken human embryos, is much more controversial. The ethical problem with this method is that it implies the destruction of human embryos. Therefore, the crucial ethical question is, what moral status one ascribes to the human embryo. If one regards the human embryo as having a dignity which raises a moral demand of care and respect, this method of getting stem cells implies so fundamental moral problems that it probably must be rejected on ethical grounds. However, if one sees the human embryo as something which could develop into a human being worthy of care and respect, the door seems to be at least slightly opened for getting stem cells from human embryos.
 Having seen the key ethical question, we can now turn to the second challenge - i.e. the question on the specific Lutheran position. The question on the specific nature of a Lutheran bioethics has been dealt with in various articles during the last few years. It has been argued that there are Lutheran approaches to bioethics, but not one specific approach which can claim to be the Lutheran bioethic.  Further, the argument has been made that Lutheran bioethics rests on a practicing of neighbour love in a secular context where it to some extent corresponds with natural law ethics. This also entails that there is no Lutheran doctrine on the status of the human embryo. Lastly, it has been argued that a Lutheran bioethic implies an honouring of the bios, i.e. the body, which entails a renewed understanding of the distorted relation between generations in new reproductive technologies. I will not enter into a discussion on each of these approaches to Lutheran bioethics, but only point to the simple fact that it is evidently true that there is not one approach which can be called Lutheran. Rather, various approaches all seem to qualify to this label. Obviously, there are approaches which would not be Lutheran. But in the present context it suffices to answer affirmatively - yes, there is such a thing as a Lutheran bioethic.
Dietrich Bonhoeffer's Contribution to Bioethics
 The affirmative answer is, however, not confining. Rather, it opens up for a variety of approaches which could all claim to be Lutheran. My own approach in this debate leads me back to the Lutheran theologian and pastor, Dietrich Bonhoeffer. Bonhoeffer is not well known for his contributions to bioethics. But this does not mean that we look in vain when reading his ethics. In his posthumously published work Ethics Bonhoeffer actually deals quite extensively with issues which we today would call bioethical. In the section on "Natural Life" Bonhoeffer discusses notions such as the right to bodily life, self-murder, reproduction and developing life, and the freedom of bodily life. Bonhoeffer's views on these issues provide a helpful source when taking a stance on e.g. stem cell research.
 Bonhoeffer appreciates that the notion of the natural has fallen into disrepute in Protestant ethics. This has also lead to a confusion and lack of guidance in many crucial questions, not to say a static proclamation of divine grace. Therefore, it is important for Bonhoeffer that the notion of the natural is retrieved. In Bonhoeffer the natural is defined christologically. This means that the natural is that which is directed toward the coming of Christ, in contrast to the unnatural which closes itself off from the coming of Christ. Therefore, the natural is confirmed in Christ and only through Christ's becoming human do we have the right to call people to natural life.
 "Natural life may not be understood simply as a preliminary stage toward the life with Christ; instead, it receives its confirmation only through Christ. Christ has entered into natural life. Only by Christs's becoming human does natural life become the penultimate that is directed toward the ultimate. Only through Christ's becoming human do we have the right to call people to natural life and to live it ourselves." 
 This notion also leads to a protective understanding of natural life. The unnatural is that which distorts life and is contrary to life.  This also implies for Bonhoeffer that he argues for a right to bodily life. Bodily life bears intrinsically the right to its preservation, just as the bodily life is understood as an end in itself. This right to natural life also implies the protection of bodily life from arbitrary killing. Arbitrary killing is here understood as every conscious killing of innocent life. With regard to the human embryo Bonhoeffer makes a close link between his understanding of marriage and the subsequent development of human life. For Bonhoeffer marriage is given with the creation of the first human beings and is, as such, rooted in the very beginnings of humanity. Closely related to marriage is the acknowledgement of the right of life that will come into being within this marriage. This developing life has a right to life as it is an expression of God's will to create a human being and a deliberate ending of this life is simply murder, according to Bonhoeffer.
To kill the fruit in the mother's womb is to injure the right to life that God has bestowed on the developing life. Discussion of the question whether a human being is already present confuses the simple fact that, in any case, God wills to create a human being and that the life of this developing human being has been deliberately taken. And this is nothing but murder.
Bonhoeffer is very explicit in his views on abortion. He may be more explicit than most of us feel comfortable with. I would be hesitant about using a word like murder, as it is deeply laden with emotional connotations. But the main idea is quite reasonable, as I see it. I see no reason why one should not maintain that the human embryo holds a dignity as a developing human life from the very fertilization. I agree with the positions that would argue that there is no other equally decisive break in the process of development of the human embryo.
Stem Cell Research - Is There a Lutheran Ethical Standpoint?
 Returning to the issue of stem cell research and the question, if there is a Lutheran ethical standpoint, I will answer with three points: 1. Yes, there is such a thing as a Lutheran ethical standpoint. There is a widespread consensus among Lutheran ethicists that it does make sense to speak of a Lutheran ethical position. 2. Yes, it is possible to point to traits within the Lutheran tradition that could serve as a source of guidance when dealing with specific questions such as e.g. stem cell research. The challenge is, however, that a variety of approaches all qualify as Lutheran and seem to point in different directions. There is not one specific position which can claim to be Lutheran at the expense of other positions, even if there are positions that also would qualify as not being Lutheran. 3. The variety of Lutheran approaches to bioethics provides a fruitful basis for a lively dialogue on difficult issues. My own approach is inspired by Bonhoeffer and his notion of the natural life. Based on this source of inspiration I would not defend getting stem cells from human embryos. This would be the case both for the "old" method, where the human embryo is destroyed, and the "new" method where the uncertainty concerning the impact on the development of the human embryo is unclear. I do think, however, there are good reasons for and no significant ethical reasons against doing further research on stem cells taken from adults using the existing methods.
 One of the significant challenges for Lutheran ethics in the years to come is to continue this discussion on the distinctive contribution to bioethics from a Lutheran perspective. This debate will not only be fruitful from a Lutheran perspective, it will also continue to hold importance for a wider audience, as the fruitful disagreement among Lutherans continuously furthers the dialogue and ethical insights.
© October 2006
Journal of Lutheran Ethics