Last week, I criticized religious opposition to the vaccine mandate regarding Christian liberty, faith vs fear, and more, and I found these issues do not provide a good reason to oppose the vaccine mandate. In this four-part series, I am evaluating religious, ethical, medical, and legal opposition to the vaccine mandate from a Christian perspective and show that the opposition is either not legitimate, not Christian (i.e. implied from Christian teachings), or both. In this second article, I will examine ethical opposition to the vaccine mandate surrounding the use of fetal cells. Like last week (and every post ever), I welcome feedback, missing arguments, holes in my discussion, or other considerations.

Ethical Opposition: Use of Fetal Cells
a. Scientific Background
b. Cooperation in Evil
c. Appropriation of Evil
d. Consistency Check
Summary and Outlook

Ethical Opposition: Use of Fetal Cells

It is no secret that substantial, if not the most, opposition to abortion comes from conservative Christians, though there are non-Christian pro-life organizations, such as Secular Pro-Life. It is natural for Christians to be concerned when hearing that cells derived from an aborted fetus were used in either the research & development or production of the vaccines. However, the moral wrongness of abortion, along with the extreme value of the human fetus and embryo, do not imply that the use of fetal cells in vaccine research is also wrong. (Note on nomenclature: I will be using the term “fetus” as that seems to be the most neutral term to use and is what is used in ethics for talking about vaccine research, although it would be just as correct to say, “unborn baby,” “child,” or “human being.”)

It is true that the main COVID vaccines have used cells (more details on this later) derived from aborted fetuses at some point in their lifecycle. Johnson and Johnson use cells from a cell line from an aborted fetus in the research & development (R&D) and production stage, whereas Pfizer and Moderna only used them in the R&D stage for m-RNA vaccine research generally. Since Pfizer and Moderna are both readily available and further disconnected from aborted fetal cells, thus representing the likely more-ethical options, I will focus on the ethics of Pfizer and Moderna in their connection to fetal cell usage. Ultimately, I will argue that use of these vaccines is ethical and, given the great results from appropriating a single evil act in the distant past without any cooperation in the act, results in net good for society.

How would such an argument go if we are to get from a) Christian teaching and the wrongness of abortion or the value of human life and therefore fetuses to b) the wrongness of using cells derived from aborted fetuses in the research and development? Such an argument may go like this:

1. Christianity is true.
2. If Christianity is true, then human fetuses have great value.
3. If human fetuses have great value, then benefiting from cells derived from an aborted fetus is wrong.
4. Therefore, benefiting from cells derived from an aborted fetus is wrong.
5. Getting the vaccine is benefiting from cells derived from an aborted fetus.
6. Therefore, getting the vaccine is wrong.

Let’s grant 1 and 2. How can 3 be supported? I do not think it can be, and this section will explore that. We can also investigate a slightly modified argument with 2’ implying that abortion is wrong, but then 3’ would still be the contentious premise without support.

a.      Scientific Background

In vaccine and pharmaceutical research, immortalized cell lines are used for testing, which is where cells were isolated from its original source and, because of mutation, have the ability to divide indefinitely (not to be confused with stem cells, which form naturally in organismal development without a special mutation). These cells are advantageous for research because once a cell line is developed, no new samples need to be obtained. This single batch of cells can be well-characterized and established, serving as a scientific standard for comparison. The cells can then be used for testing on many different things, and indeed they are. One cell line can be (and is) used for maybe hundreds or more of different research projects at the same time.

Both Pfizer and Moderna employed cells from the same cell line, HEK-293, or human embryonic kidney 293, in their research & development stage. HEK-293 is a specific immortalized cell line that is ubiquitous in biological research and has been used for decades. Indeed, “A student or fellow involved in life sciences research would almost inevitably encounter this cell line [HEK-293] in the course of his work.”[1] The cell line of HEK-293 was started in 1973 based on kidney cells obtained from an aborted fetus. Whether the abortion was a spontaneous abortion (the medical term for miscarriage) or an elective abortion is uncertain, but the preponderance of evidence seems to favor it being from an elective abortion with unknown reason[2] (though was NOT obtained for the purpose of using its cells for research). While there is some uncertainty, we will assume a worst-case scenario of being an elective abortion moving forward.

Let us recap the situation. A fetus, a human with great value, was intentionally killed for unknown reason. This is morally bad. However, using his or her cells for a good purpose is not obviously wrong by mere implication. The cells used in research for the COVID vaccines are generations away from the original fetal cells. None of the original fetal cells remain, by many generations. No fetal cells are contained in the vaccine, either. The cells, generations removed from the original fetus down the cell line, are only used for testing purposes, and not in production and are certainly not in the vaccine.

b.     Cooperation in Evil

One line of thought that might show how this is problematic is that using these cells is cooperation in evil, where the cooperator contributes in some way to an evil action. Cooperation can be formal (sharing in evil intent) or material (cooperator has a different intent). Since the elective abortion was not carried out in intention for cell extraction and research purposes, then the cooperation could not have been formal. Furthermore, material cooperation can be either immediate or mediate. Immediate cooperation, from an external perspective, looks like the cooperator and evil actor are doing the same thing. Mediate cooperation, however, means there is some distance (whether temporal or spatial) between the two actions. There is clear differentiation in time and space between elective abortion and kidney cell extraction, so the cooperation was not immediate. Finally, since the cooperator was not necessary for the evil action to be carried out, the cooperation was contingent.

Therefore, a worst-case scenario thus far investigated is a contingent, remote, mediate, material cooperation. Of all the types of cooperation in evil considered, this is by far the most justifiable. Since the research from this one cell line has, by now, saved countless lives, it is quite possibly justified. However, is using the cells “cooperation” at all? Does cell extraction contribute in any way to the elective abortion? Does it factor into the causal explanation of the elective abortion (death of the human fetus)? No, it does not. Cell extraction does not aid elective abortion in any way, as they can be performed completely independently of the other and removing kidney cells does not make the abortion process any easier. Rather, deriving a cell line from an aborted fetus is likely more accurately termed as an appropriation of evil.

c.      Appropriation of Evil

The appropriation of evil is where agents “take advantage of the fruits or byproducts of some else’s wrongful acts in order to facilitate their own morally worthwhile activity.”[3] The appropriation of evil “is not about contributing to, but about benefiting from evil.”[4] The evil action is going to happen anyway. Is appropriation of evil also evil? I think the answer is definitely not. Now, Paul did say that we should not do evil so that good may come (Romans 3:8), but we are not doing evil and not even in a position to prevent the evil. Appropriation of evil is where you take an evil act that someone else did and turn it into something good. If that wording sounds familiar, it is because the concept is biblical, central to Christianity.

After Joseph’s brothers sold him into slavery in Egypt (an evil act), a huge famine swept the land, but Joseph had risen to prominence in Egypt and was entrusted to save grain for the famine. Joseph’s family returned to Egypt to receive assistance, and Joseph confronted his brothers, giving a demonstration of the appropriation of evil: “You intended evil against me, but God intended it for good to accomplish what is now being done, the saving of many lives” (Genesis 50:20). The fetus that was aborted around 1972 to support the HEK-293 cell line could reasonably say the same thing to his killer (assuming an afterlife interaction): “What you intended for evil, God intended for good to save many lives.” Appropriation of evil does not excuse the evil or allow it in the future (because that may turn into cooperation with evil), but it does allow for making the most of the current situation. If appropriation is wrong, then it seems Joseph (or anyone else who has ever been harmed) is wrong to take advantage of the harm done to them to do good.

The appropriation of evil is also the cornerstone of Christianity: the crucifixion of Jesus was an evil act that was used for the single greatest event in the history of mankind: the resurrection of Jesus Christ and offering salvation to the entire world. The entire Christian faith is built on the appropriation of evil. So in reality, I am not sure a better response to evil than its appropriation (among other things, such as righteous indignation).

d.     Consistency Check

Since I am running out of space and time, I will briefly mention two final things on this topic. First, if you support organ donation generally, then you should support the use of fetal cells to develop vaccines. Some organs are donated as a result of homicide or other crimes,[5] which are evil acts, and would thus be relevantly similar. Both actions are taking cells from dead humans to put it for a good medical cause that saves lives.[6]

Secondly, rejecting a vaccine because it is associated with a fetal cell line means you should also reject some ubiquitous over-the-counter and prescription medicines. For example, the following drugs were tested on HEK-293: Tylenol (acetaminophen), Advil (ibuprofen), Aspirin, Benadryl, Robitussin, Mucinex, Tums, Colace, Ex-Lax, Pepto-Bismol, and two of the vaccine treatment alternatives: hydroxychloroquine and ivermectin.[7] For this reason, Conway Regional Health System’s religious exemption form (see figure below) requires a signature agreeing that you “do not use or will not use any of the medications listed,” subject to disciplinary action for failure to adhere. This point does not show that such research is justified, but it does mean that avoiding these medications is required to maintain consistency.

Finally, the Catholic Church and Southern Baptist Ethics & Religious Liberty Commission have both said that “receiving a COVID-19 vaccine that required fetal cell lines for production or manufacture is morally acceptable.”[8] Beyond this, many Christian groups are starting to speak out against religious exemptions, stating that they will not offer nor approve them because there is no Christian basis for them.[9]

Summary and Outlook

In conclusion, the use of cells derived from aborted fetuses in the development of the vaccine is ethical, so these considerations do not offer any compelling reason to not get vaccinated, and it is not legitimate opposition to the vaccine mandate.

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[1] Wong, Alvin. “The Ethics of HEK 293.” The National Catholic Bioethics Quarterly 6.3 (2006): 473-495, p. 473-474.

[2] Ibid, p. 474-476.

[3] Ibid, p. 479.

[4] Ibid, p. 480.

[5] https://www.wrtv.com/longform/homicide-victims-are-rarely-candidates-for-organ-donation-scott-morin-was-one-of-the-few. Accessed 9.21.2021. This discusses one particular example in depth and also has some relevant statistics.

[6] There are some sticky issues I don’t have space to explore, such as the issue of consent. Some of the issues are parallel to organ donation and some are not. In the end, I do not think it changes the result. 

[7] https://www.somerset-kentucky.com/opinion/letters_to_the_editor/there-are-no-aborted-fetal-cells-in-vaccines/article_14809887-84f7-58a4-bb4c-76bc29724d8a.html. Accessed 9.21.21. There is substantial overlap between this list and the one on Conway Regional Health System’s religious exemption form, so the lists seem partially verified. I have not done further verification at this time (all the news articles on this claim do not help). At least some of these medicines had passed the initial R&D phase and had been manufactured for decades by the time HEK-293 was a thing. However, even these medicines were still tested using HEK-293.

[8] http://publichealth.lacounty.gov/media/coronavirus/docs/vaccine/VaccineDevelopment_FetalCellLines.pdf. Accessed 9.21.21.

[9] https://dnews.com/local/many-faith-leaders-in-america-say-no-to-endorsing-vaccine-exemptions/article_5bb15b7c-acd7-5dd5-b4cf-ef016eb2175a.html. Accessed 9.21.21.