Opinion ID: 2431350
Heading Depth: 2
Heading Rank: 3

Heading: The Scientific Testimony

Text: In the record, and especially in the trial court's opinion, there is a great deal of discussion about the proper descriptive terminology to be used in this case. Although this discussion appears at first glance to be a matter simply of semantics, semantical distinctions are significant in this context, because language defines legal status and can limit legal rights. [11] Obviously, an adult has a different legal status than does a child. Likewise, child means something other than fetus. [12] A fetus differs from an embryo. There was much dispute at trial about whether the four- to eight-cell entities in this case should properly be referred to as embryos or as preembryos, with resulting differences in legal analysis. One expert, a French geneticist named Dr. Jerome Lejeune, insisted that there was no recognized scientific distinction between the two terms. He referred to the four- to eight-cell entities at issue here as early human beings, as tiny persons, and as his kin. Although he is an internationally recognized geneticist, Dr. Lejeune's background fails to reflect any degree of expertise in obstetrics or gynecology (specifically in the field of infertility) or in medical ethics. His testimony revealed a profound confusion between science and religion. For example, he was deeply moved that Madame [Mary Sue], the mother, wants to rescue babies from this concentration can, and he concluded that Junior Davis has a moral duty to try to bring these tiny human beings to term. [13] Dr. LeJeune's opinion was disputed by Dr. Irving Ray King, the gynecologist who performed the IVF procedures in this case. Dr. King is a medical doctor who had practiced as a sub-speciality in the areas of infertility and reproductive endocrinology for 12 years. He established the Fertility Center of East Tennessee in Knoxville in 1984 and had worked extensively with IVF and cryopreservation. He testified that the currently accepted term for the zygote immediately after division is preembryo and that this term applies up until 14 days after fertilization. He testified that this 14-day period defines the accepted period for preembryo research. At about 14 days, he testified, the group of cells begins to differentiate in a process that permits the eventual development of the different body parts which will become an individual. Dr. King's testimony was corroborated by the other experts who testified at trial, with the exception of Dr. Lejeune. It is further supported by the American Fertility Society, an organization of 10,000 physicians and scientists who specialize in problems of human infertility. The Society's June 1990 report on Ethical Considerations of the New Reproductive Technologies [14] indicates that from the point of fertilization, the resulting one-cell zygote contains a new hereditary constitution (genome) contributed to by both parents through the union of sperm and egg. Id. at 31S. Continuing, the report notes: The stage subsequent to the zygote is cleavage, during which the single initial cell undergoes successive equal divisions with little or no intervening growth. As a result, the product cells (blastomeres) become successively smaller, while the size of the total aggregate of cells remains the same. After three such divisions, the aggregate contains eight cells in relatively loose association... [E]ach blastomere, if separated from the others, has the potential to develop into a complete adult... . Stated another way, at the 8-cell stage, the developmental singleness of one person has not been established. Beyond the 8-cell stage, individual blastomeres begin to lose their zygote-like properties. Two divisions after the 8-cell stage, the 32 blastomeres are increasingly adherent, closely packed, and no longer of equal developmental potential. The impression now conveyed is of a multicellular entity, rather than of a loose packet of identical cells. As the number of cells continues to increase, some are formed into a surface layer, surrounding others within. The outer layers have changed in properties toward trophoblast ..., which is destined [to become part of the placenta]. The less-altered inner cells will be the source of the later embryo. The developing entity is now referred to as a blastocyst, characterized by a continuous peripheral layer of cells and a small cellular population within a central cavity ... It is at about this stage that the [normally] developing entity usually completes its transit through the oviduct to enter the uterus. Cell division continues and the blastocyst enlarges through increase of both cell number and [volume]. The populations of inner and outer cells become increasingly different, not only in position and shape but in synthetic activities as well. The change is primarily in the outer population, which is altering rapidly as the blastocyst interacts with and implants into the uterine wall ... Thus, the first cellular differentiation of the new generation relates to physiologic interaction with the mother, rather than to the establishment of the embryo itself. It is for this reason that it is appropriate to refer to the developing entity up to this point as a preembryo, rather than an embryo. Id. at 31S-32S (emphasis added). For a similar description of the biologic difference between a preembryo and an embryo, see Robertson, In the Beginning: The Legal Status of Early Embryos, 76 Va. L.Rev. 437 (1990), in which the author summarizes the findings of Clifford Grobstein in The Early Development of Human Embryos, 10 J.Med. & Phil. 213 (1984). Admittedly, this distinction is not dispositive in the case before us. [15] It deserves emphasis only because inaccuracy can lead to misanalysis such as occurred at the trial level in this case. The trial court reasoned that if there is no distinction between embryos and preembryos, as Dr. Lejeune theorized, then Dr. Lejeune must also have been correct when he asserted that human life begins at the moment of conception. From this proposition, the trial judge concluded that the eight-cell entities at issue were not preembryos but were children in vitro. He then invoked the doctrine of parens patriae and held that it was in the best interest of the children to be born rather than destroyed. Finding that Mary Sue Davis was willing to provide such an opportunity, but that Junior Davis was not, the trial judge awarded her custody of the children in vitro. The Court of Appeals explicitly rejected the trial judge's reasoning, as well as the result. Indeed, the argument that human life begins at the moment of conception and that these four- to eight-cell entities therefore have a legal right to be born has apparently been abandoned by the appellant, despite her success with it in the trial court. [16] We have nevertheless been asked by the American Fertility Society, joined by 19 other national organizations allied in this case as amici curiae, to respond to this issue because of its far-reaching implications in other cases of this kind. We find the request meritorious.