How best for a Christian to explore the ethics of a Covid-19 vaccine that might use farmed cell-lines from aborted foetuses?

Question

I looked through the CMF website at their Briefing paper When demand outstrips supply: A Christian view of the ethics of healthcare resource allocation during the COVID-19 pandemic:

“The British Medical Association (BMA) has recently produced guidance around the ethical issues presented by the COVID-19pandemic.8 NICE has also produced a rapid guideline for adult critical care during the pandemic, which includes guidance for decision-making around escalation. 9 In addition, the Royal College of Physicians (RCP) has issued guidance, in conjunction with other stakeholders such as the General Medical Council, the Faculty of Intensive Care Medicine, the Intensive Care Society, royal colleges and faculties.10 As Christian doctors, we must consider how we can respond to the ethical challenges posed. Here we will attempt to consider some of the issues involved, and how to think about them biblically, using Beauchamp and Childress’ widely recognised four pillars of medical ethics11 as a framework.”

However, it must be too soon for a briefing paper on whether any of the current seven Covid-19 vaccinations produced have utilised cell-lines from aborted foetuses. The matter of demand for vaccines was not included. Then I looked at a tagged blog, posted 20 November 2020, which sounded promising, COVID-19 vaccines: the wider ethical questions for Christians. Alas, no mention was made of the ethical issue I wish to explore.

Some success came via a contact working professionally in the realms of Christian ethics. He sent a pdf of an article written by a colleague of his in a Catholic journal, Anscombe Bioethics Centre – Friends’ Newsletter, Summer 2020, Issue 47. (His link to the pdf will not open when I copy it.) Dr Helen Watt, Senior Research Fellow of the Anscombe Bioethics Centre, wrote the article, pp 9-12.

“… Vaccines are normally, though not always,4 produced in living cells. While they can be generated (as with some COVID-19 vaccines in the making) in cells derived from ethically uncontentious sources such as insects,5 tobacco plants,6 and hamster ovaries,7 they can also be produced in cell-lines made from tissue derived from an aborted unborn child. One such cell-line used in COVID-19 vaccine research (including a project of the University of Oxford8 ) is the HEK 293 cell-line modified from tissue taken from the kidney of an unborn child aborted probably in 1972, while another is the PER C6 cell-line from the retinal tissue of an 18-week baby aborted in 1985.”

I wish to know both ethical considerations involved and how to identify which Covid-19 vaccinations might have such ethically questionable ‘ingredients’. I will not go to popular media outlets for this as a huge amount of disinformation is being bandied around. This question is addressed to Christians who have ethical compunctions against any use of aborted foetuses, which transcends denomination. I note this related question indicates deep concern but I seek to know how to find out if that's being used with some vaccines.

Answer 1

This is a matter of conscience, quite clearly.

I well know how these matters may be viewed by the ungodly as I was disciplined in a certain company many years ago (final written warning on the first instance of its occurrence) because of this very issue arising, suddenly, without my being prepared to meet it and I reacted in a way which was unacceptable to the management.

However in this case I wonder if the words of Paul are not relevant :

... asking no question for conscience sake: [1 Corinthians 10:25 KJV]

In the situation the apostle speaks of, one wishes food and wishes to buy it in a market but its origin is unknown. It could have been previously offered to an idol and one would not want to partake of that, but that is only one of a variety of possibilities.

Paul advises not to delve into origins for the sake of conscience. He advises to accept what is being traded at face value and not to make the enquiry.

In our current situation, what is being offered to us is not - principally, in a way of being an absolute necessity of its development and function - fundamentally dependent on the issue that has been here raised.

Certain cell lines have been incorporated into general medical research. A prime example is that of Henrietta Lacks' (1920-1951) cancer cells which became the HeLa line of cells and have been enormously productive, medically speaking, and her memory is now being properly recognised.

It may be that other cells, which in the past have been taken from a source that I would prefer they had not been, have been incorporated into the various research lines which are part of an established data base of genetics.

But as far as I know, the origin of those cell lines is not a fundamental necessity to the development of the product. The cells could have been from anywhere.

The efficacy of the product is not dependent on that issue for its success, is what I am emphasising.

To me, in this particular case, I feel it not necessary for me to make elaborate enquiries in order to free my conscience from any burden. I am content with the words of the apostle, in this instance.

When I was offered treatment by a dentist to strengthen the bone in my jaw, it was he who mentioned that 'donor' tissue (from a cadaver) could be used and I declined and he said he could use proprietary collagen instead.

Once I was injected and no longer aware of my surroundings, he could, for the sake of his own convenience, have used cadaver tissue in my jaw. But I do not feel the necessity to further interrogate him and to demand that he prove to me what he did or did not do. I stated my conscience and I have left it at that.

Looking back with hindsight, I could probably have avoided a final written warning over the matter of a supposed 'abortion' being the source of a sample I was testing, and looking back, it now becomes clear that someone knew my sensitivity and was merely trying to provoke me over it. But I later took voluntary redundancy and got a very generous termination package (thank you to all concerned) and I now reap the reward of a useful pension from the company.

I hope that this helps in the present situation.

---

I am a Licentiate of the Royal Society of Chemistry (1978) and was given further private training in Molecular Biochemistry when I worked in the Pharmaceutical Industry making products which incorporated radioactive isotopes (for medical research purposes and for cancer treatment).

Answer 2

I do not have own insights to this topic, but I want to point to some statements of representants of the Catholic Church. In the last month many dealt with this topic, e.g the Bishops Conferences of the UK, the US, Ireland and Slowakia (source, German).

The United States Conference of Catholic Bishops (Chairmen of the Committee on Doctrine and the Committee on Pro-Life Activities, 11 December 2020) writes:

[... ] Neither Pfizer nor Moderna used morally compromised cell lines in the design, development, or production of the vaccine. A confirmatory test, however, employing the commonly used, but morally compromised HEK293 cell line was performed on both vaccines. Thus, while neither vaccine is completely free from any connection to morally compromised cell lines, in this case the connection is very remote from the initial evil of the abortion.

In view of the gravity of the current pandemic and the lack of availability of alternative vaccines, the reasons to accept the new COVID-19 vaccines from Pfizer and Modernaare sufficiently serious to justify their use, despite their remote connection to morally compromised cell lines. In addition, receiving the COVID-19 vaccine ought to be understood asan act of charity toward the other members of our community. In this way, being vaccinated safely against COVID-19 should be considered an act of love of our neighbor and part of our moral responsibility for the common good.

The AstraZeneca vaccine is more morally compromised. The HEK293 cell line was used in the design, development, and production stages of that vaccine, as well as for confirmatory testing. [...] The AstraZeneca vaccine should be avoided if there are alternatives available. [...]

It may turn out, however, that one does not really have a choice of vaccine, at least, not without a lengthy delay in immunization that may have serious consequences for one’s health and the health of others. In such a case [...] it would be permissible to accept the AstraZeneca vaccine. [...] [pp. 5f.]

After many and sometimes conflicting statements by Catholic officials the Congeragation for the Doctrine of Faith published a "Note on the morality of using some anti-Covid-19 vaccines" (21 December 2020) with approval of Pope Francis. It refers to the abstract statements on such vaccines of the Pontifical Academy of Life (2005, 2017) and the Congregation (2008) and explains for the current situation [emphasis in source]:

[...] (2) In this sense, when ethically irreproachable Covid-19 vaccines are not available (e.g. in countries where vaccines without ethical problems are not made available to physicians and patients, or where their distribution is more difficult due to special storage and transport conditions, or when various types of vaccines are distributed in the same country but health authorities do not allow citizens to choose the vaccine with which to be inoculated) it is morally acceptable to receive Covid-19 vaccines that have used cell lines from aborted fetuses in their research and production process.

(3) The fundamental reason for considering the use of these vaccines morally licit is that the kind of cooperation in evil (passive material cooperation) in the procured abortion from which these cell lines originate is, on the part of those making use of the resulting vaccines, remote. The moral duty to avoid such passive material cooperation is not obligatory if there is a grave danger, such as the otherwise uncontainable spread of a serious pathological agent -- in this case, the pandemic spread of the SARS-CoV-2 virus that causes Covid-19. It must therefore be considered that, in such a case, all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive. It should be emphasized, however, that the morally licit use of these types of vaccines, in the particular conditions that make it so, does not in itself constitute a legitimation, even indirect, of the practice of abortion, and necessarily assumes the opposition to this practice by those who make use of these vaccines.

(4) In fact, the licit use of such vaccines does not and should not in any way imply that there is a moral endorsement of the use of cell lines proceeding from aborted fetuses. Both pharmaceutical companies and governmental health agencies are therefore encouraged to produce, approve, distribute and offer ethically acceptable vaccines that do not create problems of conscience for either health care providers or the people to be vaccinated.

(5) At the same time, practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary. In any case, from the ethical point of view, the morality of vaccination depends not only on the duty to protect one's own health, but also on the duty to pursue the common good. In the absence of other means to stop or even prevent the epidemic, the common good may recommend vaccination, especially to protect the weakest and most exposed. Those who, however, for reasons of conscience, refuse vaccines produced with cell lines from aborted fetuses, must do their utmost to avoid, by other prophylactic means and appropriate behavior, becoming vehicles for the transmission of the infectious agent. In particular, they must avoid any risk to the health of those who cannot be vaccinated for medical or other reasons, and who are the most vulnerable.

(6) Finally, there is also a moral imperative for the pharmaceutical industry, governments and international organizations to ensure that vaccines, which are effective and safe from a medical point of view, as well as ethically acceptable, are also accessible to the poorest countries in a manner that is not costly for them. The lack of access to vaccines, otherwise, would become another sign of discrimination and injustice that condemns poor countries to continue living in health, economic and social poverty. [...]

Answer 3

I wish to know both ethical considerations involved and how to identify which Covid-19 vaccinations might have such ethically questionable ‘ingredients'.

How to identify

The Pro-Life Charlotte Lozier Institute maintains an up to date, complete with references, but easy to read table of coronavirus vaccines (pdf version here). Each vaccine has 3 ethical status (one for each stage: Design & Development, Production, and Confirmatory Test). The status is clearly marked with one of the following flags:

• DOES NOT USE abortion-derived cell line
• DOES USE abortion-derived cell line
• SOME tests DO NOT use abortion-derived cells, SOME DO.
• Currently undetermined

The Institute also provides a quick reference chart for the top candidates (pdf version here).

How Coronavirus Vaccine works

The institute also provides an excellent visual aid (pdf version here) to how viral infection works as well as how 5 vaccine strategies work in the human cell:

1. Live-Attenuated/Inactivated Vaccines
2. Viral Vector-based Vaccines
3. Protein-based Vaccine
4. DNA Vaccine
5. RNA Vaccine

Another visual aid shows how fetal cell lines are used in some vaccines.

Deliberation Process

When the only practical option (i.e. the availability in one's particular region) is ethically tainted in one or more stages, one has to deliberate prior to making the decision. Some helpful factors to consider:

1. Which of the main vaccines on offer today use ethically compromised cells and in what stage (i.e. design & development, production, confirmatory lab tests), see the table referenced above.

2. Timely (11 Dec 2020) statement from the United States Conference of Catholic Bishops. (see quotes in K-HB's answer)

3. How to balance various degrees of cooperation with evil (formal vs. material, immediate vs. mediate, proximate vs. remote, active vs. passive, etc.) with the moral duties (of protecting oneself, and of the common good). For a guide, see another timely (21 Dec 2020) Papal note from Congregation for the Doctrine of the Faith.

4. A sample primer on what cell lines are and why HEK-293 and HeLa are prevalent in the research & development, and even production of biological products: ScienceNews 7 July 2020 article How making a COVID-19 vaccine confronts thorny ethical issues.

5. More technical details on Thomistic moral reasoning mentioned in the Papal note referred above: a section of the document "Moral Reflections on Vaccines Prepared From Cells Derived from Aborted Human Foetuses" attached to the 9 June 2005 letter response by Pontifical Academy of Life.

   The principle of licit cooperation in evil

   The first fundamental distinction to be made is that between formal and material cooperation. Formal cooperation is carried out when the moral agent cooperates with the immoral action of another person, sharing in the latter's evil intention. On the other hand, when a moral agent cooperates with the immoral action of another person, without sharing his/her evil intention, it is a case of material cooperation.

   Material cooperation can be further divided into categories of immediate (direct) and mediate (indirect), depending on whether the cooperation is in the execution of the sinful action per se, or whether the agent acts by fulfilling the conditions - either by providing instruments or products - which make it possible to commit the immoral act. Furthermore, forms of proximate cooperation and remote cooperation can be distinguished, in relation to the "distance" (be it in terms of temporal space or material connection) between the act of cooperation and the sinful act committed by someone else. Immediate material cooperation is always proximate, while mediate material cooperation can be either proximate or remote.

   Formal cooperation is always morally illicit because it represents a form of direct and intentional participation in the sinful action of another person.¹⁰ Material cooperation can sometimes be illicit (depending on the conditions of the "double effect" or "indirect voluntary" action), but when immediate material cooperation concerns grave attacks on human life, it is always to be considered illicit, given the precious nature of the value in question¹¹.

   A further distinction made in classical morality is that between active (or positive) cooperation in evil and passive (or negative) cooperation in evil, the former referring to the performance of an act of cooperation in a sinful action that is carried out by another person, while the latter refers to the omission of an act of denunciation or impediment of a sinful action carried out by another person, insomuch as there was a moral duty to do that which was omitted¹².

   Passive cooperation can also be formal or material, immediate or mediate, proximate or remote. Obviously, every type of formal passive cooperation is to be considered illicit, but even passive material cooperation should generally be avoided, although it is admitted (by many authors) that there is not a rigorous obligation to avoid it in a case in which it would be greatly difficult to do so.

Answer 4

Similarly, the surgeon’s best book on human anatomy, and probably vital for the most excellent surgery, especially in difficult cases, is “Pernkopf Topographic Anatomy of Man” by Eduard Pernkopf. But the dilemma for the surgeon is “Should I be using it?” https://www.bbc.co.uk/news/health-49294861

But Joseph said to them, “Do not fear, for am I in the place of God? As for you, you meant evil against me, but God meant it for good, to bring it about that many people should be kept alive, as they are today. So do not fear; I will provide for you and your little ones.” Thus he comforted them and spoke kindly to them. (Genesis 50:19-21, ESV)

But it seems it was almost impossible for Joseph's brothers to believe Joseph. Perhaps it was simply too strange a thing for them to believe that their own wickedness was in God's plan and that their evil had played a major part in bringing them to that place where God could bless them and save their lives from death by famine.

It is hard to appreciate when God intends to bring good out of man's wickedness or even to think it is right. How can a good God bring good out of evil? How can evil be a part of his plan? While man intends evil and does evil, in the same moment and by the very same act God ultimately intends good. The motive is evil on man's part (and man will be held entirely responsible for his evil) and the motive is entirely good on God's part.

On the very Day of Pentecost the Apostle Peter gives his first (and greatest?) sermon in which he expresses precisely the same strange feature of God's dealings with humanity:

Him, being delivered by the determinate counsel and foreknowledge of God, ye have taken, and by wicked hands have crucified and slain: (Acts 2:23 KJV)

The sermon ends with

Therefore let all the house of Israel know assuredly, that God hath made that same Jesus, whom ye have crucified, both Lord and Christ. (Acts 2:36 KJV)

Again, God brings good out of man's evil. Of course, no Christian here has decided to say "I simply refuse to get any benefit from that extremely wicked act, from what those extremely wicked men did to the Lord Jesus Christ!" Was the murder of the Lord Jesus Christ not more wicked than abortion?

But we see that God was in it; and while the men intended evil (and will One Day be held fully responsible for it unless they repented of it) God was ultimately intending good, the saving of much people alive for eternity.

The selling of Joseph into slavery was in the plan of God. The murder of our Lord Jesus Christ was in God's plan. And abortion is also in God's plan. And he can, does, and will, bring much good out of abortion, just as he always does bring good out of evil, because that is what our God specialises in doing.

In truth if God was not able to bring good out of man's evil then no good would be possible at all, because ultimately "all our righteousnesses are as filthy rags", so all the things that man does is evil; tainted and marred by evil, some more, some less (Isaiah 64:6).

I guess if we were to refuse to get any benefit from evil sources then we would have to go out of this world altogether.

I think on the issue of taking a vaccine which has used aborted foetal tissue these are the kinds of questions that we need to work through:

Would my agreeing to take the vaccine:

1. make me complicit in the whole abortion industry?
2. trivialise (the whole horror of) abortion?
3. compromise my position against abortion?
4. (perhaps unwittingly to me) lessen my opposition to abortion?
5. make me a hypocrite - a hypocritical benefactor of abortion?
6. encourage more abortion?
7. encourage an industry of making use of foetal tissue, leading to yet more abortions in order to get the right kinds of foetal tissue?

Or does my unwillingness to use the good arising from this evil come partly or mainly from the guilt arising from a feeling that I have failed to sufficiently oppose the evil itself? (Who can avoid this guilt? But there is forgiveness in Jesus).

Personally, I think it is the evil source we should speak out against. But an evil source does not always make the outcome unusable, eg the murder of Christ at the hands of wicked men.

Finally, what is the possible good that God can bring from abortion?

Through it, God can bring sinners to a conviction of their sins. Could God bring a Christian revival through conviction of this evil? (Let us pray for it.)

God is blameless on the Day of Judgement for the punishment of the wicked.

It shows the wickedness of mankind in a way that few other things do. It shows how great is the darkness of the paths they walk in of those who do not have the Light of the World. When young Irish adults fly half way across the world back to Ireland to vote in favour of abortion in a referendum it confirms to us the lost are dead in trespasses and sins, and not just at enmity against God but strongly so (Romans 8:7). They want to show their enmity. The same is shown when an English woman gets really angry with a doctor and threatens him with legal action because he refuses to refer her for a late abortion because the continued pregnancy would prevent her enjoying her planned winter skiing holiday.

Rather than be always full of righteous anger, those sheep without a shepherd that our Lord had compassion on were just the same. He died for sinners. Have we forgotten we too are sinners?

It shows the godly that we are not as godly as we should be. We are too indifferent to evil. We often cannot say Rivers of water run down my eyes because they keep not thy law (Psalm 119:136).

Nevertheless our attitude to abortion does put a distinction between the righteous and the unrighteous: And the LORD said to him, go through the midst of the city and set a mark upon the foreheads of the men who sigh and cry for all the abominations that be done in the midst thereof (Ezekiel 9:4).

The unborn child that is murdered goes straight to heaven forever. Though not all calvinist baptist evangelicals share this view, many do. This is the greatest encouragement of all to those who have the battle against abortion in their heart. I don’t see how anyone can maintain a fight against abortion without this belief to sustain them. https://www.spurgeon.org/resource-library/sermons/infant-salvation/#flipbook/