interview with norman ford

Monash Bioethics Review Vol. 27 No.3

INTERVIEW

25 July 2008

Interview with Norman FordGEORGINA HALLMemERN Project OfficerMCR! Ethics Unit

ABSTRACTAfter twelve years as the inaugural Director ofthe Caroline ChisholmCentre for Health Ethics, leading Melbourne bioethicist Dr Norman MFord has resigned his position. Instead of contemplating retirementhowever, the tireless septuagenarian, who is also a philosopher,author, Honorary Research Fellow in the School of Philosophy andBioethics at Monash University and Catholic Salesian priest, has hissights set on tackling even more controversial biomedical issues asan independent research scholar and author. Georgina Hall gets aninsight into his life's work.

IntroductionNorman Ford would have made a marvellous detective. In the

relatively new philosophical field of bioethics, he is something of amodern-day Sherlock Holmes, intricately dissecting the challengingmoral propositions posed by IVF technology, stem cell research andcloning - to name but a few. On meeting Dr Ford you can almostpicture him wearing the famous detective's tweed cap, cape andperhaps an ornate pipe puffing impatient bursts of smoke as he castshis eye critically over a crime scene. A detective is exactly what NormanFord wanted to be as a boy. Then destiny, in the shape of a religiousvocational calling, led him to the Salesian College Sonada, nearDarjeeling and three years in the foothills of the Indian Himalayas,then to the hallowed halls of academia in Rome and Turfn andeventually back to Melbourne. It is here that his razor-sharp mind andseemingly unquenchable thirst for empirical truth have positioned himas a pre-eminent modern philosopher and bioethicist, genuinelyrespected in religious and secular domains alike.

Dr Ford is an avid consumer of cutting edge global scientificresearch in the ever-evolving biomedical arena, in constant touch withworking scientists particularly in America and England. He devours thelatest complex developments in areas like brain activity in patients withpost-coma unresponsiveness (PCU) or vegetative states. Developmentsin altered nuclear transfer (ANT) in relation to somatic cell nucleartransfer (SCNT), is another current area of interest in his tireless bid tounearth what he considers to be ethical alternatives to biomedicaltechnologies. He runs all this information through a sort of 'ethical filter',informed by his Catholic stance but rooted strictly in empirical fact .

Monash Bioethics Review Vol. 27 No.3 26 July 2008

Dr Ford is also known to, or in contact with, a veritable who'swho of the international bioethics community, not limited to the likes oflocal home-grown talents Professor Peter Singer and Professor AlanTrounson. He is in regular contact with long-time friend and colleagueDr William Hurlbut, consulting professor in human biology at StanfordUniversity and a member of the United States President's Council onBioethics. They are both closely monitoring research coming out ofGermany that may provide a scientific foundation for the idea thatindividual human life begins at the single cell stage. Emails betweenthe two show the strength of their bond, starting with 'Norm' andsigned off 'Bill' .

Dr Ford knows many key players in academic, scientific andmedical fraternities in Italy and England and frequently tours on theinternational academic speaking circuit. Earlier this year he spent sixweeks in the United Kingdom and Europe, where he was keynotespeakerat two bioethics conferences in Italy. Few others could boast ofone of his travel tales from that recent trip: when in England, Dr Fordwas collected from the Cambridge train station by none other than thesurviving father of IVF technology, reproductive scientist ProfessorRobert Edwards. Professor Edwards, who is in his early eighties butapparently 'in good nick for his age', drove Dr Ford back to hissprawling home for lunch and 'a bit ofa chat about bioethics'. He wastreated to a leisurely walk through Edwards' pet project - hisimpressive horticultural gardens, as Edwards mapped out his currentthinking on the future direction of stem cell research.

This extraordinary encounter occur Professor red because DrFord had just submitted a 9500-word summary of the CatholicChurch's position on reproductive technologies that was commissionedas one of four such religious essays in Edwards' prestigious bioethicsjournal, REM Online (Reproductive BioMedicine Online); of the threeother articles commissioned for the supplements one represented theviewpoint of Judaism and the others, the Islamic and secular positionson such technologies.

Dr Ford is a man with his finger seriously on the pulse. Yet hecould just as easily be mistaken for the kindly headmaster of theCatholic boys school Salesian College in Chadstone, where he resides.As he walks around the beautiful elevated school grounds, wearing anaffable smile and comfy knitted cardigan, it is difficult to believe this isthe same man who is a shining light in the sphere of bioethics not onlyin Australia, but on the world stage.

It would appear Dr Ford has always been a keen and disciplinedphilosophical thinker. During his time in India as a young Salesian, thescholar within was already evident. He was taught local Indian historyat the Salesian College he attended, which is affiliated with CalcuttaUniversity, and easily kept up with his fellow Indian students. 'Welearnt it all in Latin, and I guess I had a photographic memory for allthe pages I studied repeatedly. I would close my eyes at night beforeexams and see all the 200 pages of philosophy in Latin in my mind,paragraph by paragraph .. . It wasn't so much my ability to rote learn,


but the ability to actually see the pages in my mind's eye,' he recalls. Itis undoubtedly this ability to visualise so vividly that proved invaluableto Dr Ford in the years to follow. For amidst all the abstract scientificand philosophical concepts that present themselves to bioethicists, DrFord has an imaginative mind that can handle all the abstraction.

In short, Dr Ford has worked tirelessly and relentlessly in thefield of bioethics for more than twenty-five years: studying, researching,carefully combing through and analysing the latest local andinternational scientific advancements in the field, writing, teaching andeking out philosophical truth. This is no easy task in a field shroudedby science-talk and polarised by two extreme ethical standpoints - thereligious and the secular.

To hear Dr Ford speak on issues ranging from euthanasia andordinary or extraordinary care for the sick or elderly, to surrogacy, IVF,stem cells and cloning is to witness a sharp mind conditioned tocarefully and ruthlessly dissect published, accredited scientificresearch and filter it through a scrupulously constructed philosophicalsieve. He is knowledgeable and unerring in his pursuit of empiricaltruth (something not always readily attributed to Catholic leaders) yethe is also the ultimate realist, pragmatic in a world where unswervingadherence to the dictates of moral absolutes can just as readily alienateas it seeks to include.

The emerging scholar completed his doctorate in philosophy inRome, after researching in Oxford, in just two years and has taughtphilosophy, in various forms, for over four decades. After completinghis doctorate he taught philosophy at Auxiliam College, a smallCatholic teacher's college in Lysterfield, from 1967 and thenincreasingly focused on bioethics from the early 1980s. The 1980s wasan exciting and pioneering time in bioethics with the emergence of IVFand associated reproductive technologies and Melbourne was certainlyan international epicentre for this latest scientific wonder - twelve ofthe world's first sixteen IVF children were born in Melbourne.

Dr Ford climbed aboard the newly established St Vincent'sBioethics Committee at the urging of the then-Archbishop ofMelbourne, Frank Little. Dr Joseph Santamaria was president of thecommittee and other members included the renowned Dr John Billings,Dr Eric Seal and Dr Bernard Clarke. Dr Ford recalls, 'I was alreadyinterested in ethics but that was really when my interest in bioethicsemerged. I was primarily interested in the research angle of it all; thatis ... go to the things that are happening, study them up then see ifthere's a new angle or new approach. We picked up the ethical issuesin the community at large; it wasn't just a hospital ethics committee assuch. It served the hospital's needs but also the broader communityand there wasn't a lot of that sort of work going on at that time.'

During some spirited debate at the St Vincent's committee aboutwhen life begins, Dr Ford's enquiring mind becomes apparent, 'Wecame to the issue of frozen embryos and some right-to-life people calledit murder to dispose of them. I thought to myself, "We've got to be verycareful using this word, are we certain of it?" It's one thing to say that


we 've got to respect life from conception and I do and always havesubscribed to that. It's another thing to say its murder, that's a legalterm. I didn't like that. I said to the committee members, "Let 's reallylook at this a bit more," and they looked at me and said "What do youmean, everyone knows life begins at conception?" I said I'd beenreading and looking at the evidence and it wasn't quite that clear tome.' It was this lack of clarity that started Dr Ford on the path ofwriting a book on the subject, When Did I Begin? Conception of thehuman individual in history, philosophy and science,' published in1988. After its publication in English and Italian and a subsequentstudy period at Clare Hall in Cambridge (where the seeds of his secondbook, The Prenatal Person: ethics from conception to birth,2 were sown)Dr Ford was invited in 1995 by the leading Catholic hospital to head itsnew research ethics and education unit that became known as theCaroline Chisholm Centre for Health Ethics.

Based in East Melbourne, the Caroline Chisholm Centre wasprimarily established to provide ethical guidance and clinicalframeworks to doctors and nurses working in Victoria's Catholic' healthcare institutions, including Bethlehem Health Care, St Vincent's publicand private hospitals, Cabrini Hospital and the Mercy Women's publicand private hospitals. A glimpse at the topics covered in the Centre'squarterly newsletter offers insight into the range of issues examined:abortion, aged care and treatment issues, clinical trials, conflict ofinterest in health care, confidentiality, death and dying, euthanasia,genetics, human embryo and stem cell research. Dr Ford, anaccomplished public speaker and prolific writer with two books alreadypublished, constantly and tirelessly contributed articles as editor of thenewsletter. He insisted all articles were written in language that waseasy to read and were not much longer than 2000 words so they wereeasily digestible for clinical hospital staff, university students,politicians and any Catholics wishing to sharpen and hone their dinnerparty arguments on abortion, cloning and other contentious issues.

In a practical sense, Dr Ford's work at the Caroline ChisholmCentre was very straightforward, 'I worked and I still work for ethicalsolutions to biomedical issues. One example I can give you is this: ifpluripotent stem cells ever do become available, I want Catholic doctorsand Catholic hospitals to be able to use them, but it has to be from anethical source. Catholic hospitals would not be able to use stem cellsthat have come from the destruction of embryos. We risk losingexcellent doctors who might want to go and work at other hospitalsthat use E8 cells so they .can use their skills at the highest level. Ifthey're not allowed to do that work at our hospitals because the cellsare coming from destroyed embryos it's a limitation for them and us inthe services we can offer. I'm looking for the ethical alternative soCatholic hospitals can offer the same treatments to patients as allhospitals, but using ethical methods. That's what keeps me going.'

But what motivates Dr Ford? Is he a Catholic looking for ethicallyacceptable therapeutic alternatives to the growing glut of scientificadvances? Or is he primarily an academic, a scholar who happens to


be Catholic? When put to him, Dr Ford answers this question quickly.'I'm both and they go together. I'm an academic Catholic and I want toput my brain to good use, an ethical use of finding therapies that don'thave ethical problems like destroying embryos. That's my focus. Oncethat's done, I'll go and look for another problem. Working at theCaroline Chisholm Centre I had to look at the whole gamut ofbiomedical issues,' he says. Does his role as an ethicist mean he ispositioned as an interpreter of scientific information through an ethicalfilter? 'I try to use my talents and academic acumen and curiosity tofind an ethical way to promote therapies for humans. Particularly asthe easy way is often the unethical one, I believe you've got to find anethical way if there is one.' By ethical, most people would assume DrFord is referring to a framework that remains true to the dictates of theCatholic Church, yet he insists his credibility as a bioethicist hingesnot only on his religion and moral principles but also on his respect forand reliance on empirical data. 'We can never deny the empirical truth;it's up to us to interpret it. For example, everyone knows (in relation tohuman fertilisation) the first cell is a single cell. If I denied this andsaid the first cell was four cells I'd be ridiculous because the evidence isit's only one cell,' Dr Ford says. 'But when it divides, it is two cells,that's empirical truth. The big question now is, is it only one livingbeing or is it two entities on the way to becoming a living being?' This iswhere, as well as biology, philosophy comes in.

At the outset it may appear that the words 'Catholic priest' and'bioethicist' make uneasy bedfellows. After all, many could postulatethat the moral conclusions drawn by a Catholic bioethicist wouldsurely be foregone. The obvious predicament for a Catholic bioethicist,which would lead many people to dismiss the opinions of a religiousscholar in the realm of bioethics, is the intractability of the rulesCatholic doctrine imposes upon its followers . While some may assumethat 2000 years of Catholic dogma is enough to warn any priest off thestandard bioethics fodder of abortion, euthanasia, end-of-life care, IVF,stem cell research and cloning, Dr Ford deals deftly with doubts abouthis ability to engage in rigorous, objective, logical and intellectualdebate on these issues.

'I am committed to the truth, including moral truth, which hasgot to be in conformity with empirical truth, not just an imagined orimposed truth. The world is scientific, so you've got to make sure whatyou're saying is not bad science, because then you lose credibility.You've got to show you know your science before you move into areaslike bioethics and I believe I've done that. I've got credibility among thenonbelievers. I don't manipulate the scientific facts for good purposes.In other words, I'm not advancing the pro-life exercise by neglectingcertain facts and disseminating others to serve ethical purposes. I don 'tthink that's sound because we defeat ourselves if we do that,' he says.

Dr Ford does not even consider the root of his arguments to benecessarily religious. He maintains it is in the objective interpretationof each new piece of empirical scientific data that one finds thejustification of, not Catholic, but Aristotelian metaphysical philosophy,


whose insight leads to moral solutions. Anybody who knows theirhistorical timelines knows Aristotle preceded Christianity and thereforeDr Ford asserts the basis of his ethical platform is rooted in a broaderphilosophical base that was brought to us by the ancient Greeks. 'It'snot the Christian faith I use in my arguments, as many people assume,it's sound metaphysical philosophy which is pre-Christian in origin, thesource is Aristotle! This is the dilemma, people say to me, "Of course,you're a Catholic so you have to think or interpret in a certain way.""No!" I say. What is particular to Christians is the truth of the Bible,God and our sacramental life. When it comes to ethics the mainprinciples are contained in the Ten Commandments, in particular,"Thou shalt not kill", as well as the directive "Love God and yourneighbour as yourself'.'

Dr Ford does not see the Church's role in the scientific realm asdirectly interventionist. 'It's not the business of the Catholic Church toget into this scientific work. The Catholic Church teaches virtue and itcondemns things that are wrong. You don't have to wait for the Churchto tell you how to get out of bed and tie your shoelaces ... Scientists cando their research provided they're not creating or destroying embryos. Ifscience and scientific breakthroughs can be medically useful and cancure or ease pain and suffering then that's great and should bepursued, provided there are no ethical objections: for example, if you'recreating and destroying embryos.' When pressed about the maindifferences between secular and religious philosophers, Dr Fordbelieves it is the secular view that is restricted in its scope. 'I mean,who's locked into a situation where you can't have an open dialogue?Not me. What concerns me is that public discussion in philosophy,particularly in universities which are funded by the public, areconducted only within a narrow circle of those who don't believebeyond matter. That is, confined to material reality. If we are after fairand balanced, active debates, then those types of universities are notserving the public. Statistics show that well over half, more like sixtypercent of the Australian public do believe in the Supreme Being. Someuniversities are locked into a little cosy world where they avoid theword "religious" - what they really mean to say is "We don't handle thattype of metaphysics." Aristotelian metaphysics can transcend matter,and that enables God to fit in. The early Christians used Greekphilosophy to explain the mystery of God and Christ. St ThomasAquinas and the Middle Ages Christian philosophers got a hold ofAristotle and his works, and they provided the philosophies andmetaphysics for all our positions on the human person, the rationalnature. There are philosophical avenues that are not explored by manysecular philosophers doing bioethics.'

Dr Ford maintains that using the pro-life stance associated with'Thou shalt not kill' makes it important to interpret when killing isunethical and when it is not. 'For example, if a pregnant woman has alethal cancer of the uterus and they can't wait to save her life until thebaby is born, I would say that even in removing the uterus we know thefetus will die, this is not offending against the law of "Thou shalt not


kill" because the death of the fetus is a side effect of a life saving act.It's the principle of double effect: one action, two outcomes. And this iswhere the interpretation comes in, and this is the work of the scholarsand not necessarily of the Church. The Church teaching authorityneeds philosophical research and bioethical researchers because thepope and the cardinals who ultimately determine the doctrine rely onresearchers who come forward with advice on the next step. It's all aboutresearch and interpretation. I've got to be attuned to the basic [Christian]principles which are already determined and which I agree with. But Icannot deny science or empirical evidence in the process,' he says.

The staunch pro-life stance of the Catholic Church isunequivocally the cornerstone of Dr Ford's Catholic viewpoint. 'Thebasis of the interpretation is always the same, the basics never change.Intentional killing of human life is immoral and has been regarded asimmoral from the beginning of Christianity,' he says. The assertion thathuman life exists from the point of conception is also his firmly heldposition. 'It has always been held that human life begins at conceptionand as such is morally inviolable and should be protected from harm,'he says. 'This was always accepted by the Catholic Church,' Dr Fordcontinues, 'even during past centuries when it was commonly taken forgranted among Catholics that a human spirit, or soul, was not createduntil some forty days after conception - it was as late as 1854 when theVatican announced in the Dogma of Mary's Immaculate Conception thatfocused scholars on thinking the spirit may be created at conception.'

It is at about this point that things get a little fuzzy, things thatappear black and white start to blur into grey, a point even Dr Fordagrees with. The tension is this : as a Catholic he respects and seeks topreserve and protect life from conception in keeping with the Church'steaching. Yet as a credible bioethicist he relies on empirical data toinform his search for the ethical truth, and thus he argued in 1988that available scientific evidence supported the view that an individualhuman life was present at fourteen days post-conception. So thebioethicist in him led him to argue it is possible the formation of ahuman individual begins about fourteen days after fertilisation, but theCatholic in him also believed that the formative process for a humanindividual begins at conception, thereby demanding moral respect for itcould also reasonably be construed to mean the individual begins thenalso, but at this point in time empirical proof was lacking.Furthermore, at that stage there could not be empirical proof for thecreation of the spiritual soul. While few could deny the power,conviction and accuracy of his published academic arguments, it iswhen respect for human life is made conditional on the presence of aperson from fertilisation that the waters. definitely start to look a littlemurky. Dr Ford comments, 'For well over a thousand years, inviolablerespect was demanded for human life from conception, even when itwas commonly assumed the soul was not created before forty days.'

Dr Ford clarifies this apparent confusion by asserting that heagrees with the Catholic Church, that human life is present fromconception, whilst in his 1988 book he wrote that he found no evidence

Monash Bioethics Review Vol. 27 No, 3 32 July 2008

of the assertion that a human individual was present from day one. 'Inmy first book in 1988 I argued in favour of the fourteen-day position, but Inever said my position was certain and I always supported protecting lifefrom the beginning, ie. day one. In those days the evidence was not asclear as it is today. Back then the implication of my position was that itcould not be murder to destroy an embryo, but it was immoral todestroy early human life. I knew I was on safe ground and was flushingout the arguments from the evidence as it emerged,' he says.

'Empirical evidence is important regarding facts. But sometimesthere is scope for interpretation relating to moral implications. Now in2008 the scientific evidence is strong enough for me to hold that it isscientifically and philosophically credible to hold the human individual,understood as a human person with a spiritual soul is present fromfertilisation onwards.'

In some limited American academic circles it is known that thescientific evidence he is referring to may soon be completed andpublished by a German research team. It is hoped that futuredevelopments could be very enlightening for all who are interested instem cell research, including the Catholic Church. Until the empiricalevidence is at hand in detail and confirmed, it would be foolish tospeculate. As Dr Ford says, 'We all have to wait and see the evidencebefore we start to interpret it or guess outcomes.'

'The point is, after normal fertilisation you've got both cells, andthat makes a far more credible argument that you've got the individualfrom day one. It's all organised from day one, the first cell organises thedivision. So it's all in the first cell and it's organised enough to separateout the two cell types that are required for further ongoingdevelopment. This is a significant scientific development if this can beseen. The evidence to date is that the differentiation or the division ofthe two cell types is clear at the eight cell stage and possibly at the fourcell stage. They lack the scientific means to be able to see or read thedifference in the cells before the four cell stage.'

Dr Ford is also hopeful that through ANT, by knocking out theCDX2 gene in a somatic cell nucleus and in an enucleated egg prior toSCNT, pluripotent stem cells could be created that are not in factembryos at all in the first place. Once there is agreement there is noembryo involved at all, this could pave the way for the Catholic Churchto have no opposition to such research from a pro-life perspective.

It seems Dr Ford is not the only person searching for lessethically controversial applications of biomedical advances. From hisdiscussions with Robert Edwards in Cambridge earlier this year, DrFord recounts the IVF pioneer's plans for the future. 'Even he says hewouldn't be interested in' embryonic stem cell research now. Notinterested. Because he's got another idea. He says why not use thestem cells that are already in the body and enable them to do whatthey're supposed to be doing? An example I mentioned was when youconduct fetal surgery in utero, the baby comes out with no scars, thefetus repairs itself. When you're born that capacity is gone. Why can'twe turn the genes on again that did that repairing? Robert Edwards is


hell-bent on discovering how you can get stem cells in the body toswitch on again so they produce the cells that are useful for therapies.He is working on an article and in it he'll refer to animal models forthis. He wants to see how we can reactivate the capacity of our ownstem cells without creating embryos and put to better use what's in ourbodies. We might need a little nudge to get it going. He's all for doingthings in a way that could provide effective therapies but doesn't havethe controversies of destroying embryos.'

'Edwards is still directly involved in what's going on, and he talksabout starting or founding new journals. One could be dedicated to thefunctions of chromosomes, their development and ethics. He's got avery fertile mind and he's not slowing down at present.'

And neither, it would seem, is Dr Norman M Ford.

ENDNOTES

2

Ford NM, When Did I Begin? Qmception of the human individual in history, philosophyand science, Cambridge and Melbourne: Cambridge University Press, 1988.Ford NM, The Prenatal Person: ethics from conception to birth, Oxford and Malden,MA: Blackwell Publishing, 2002.

interview with norman ford

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