Preparing for public discussions about the ethics of extending the 14-Day Rule: challenges and questions

Recently, the possibility of extending the so-called 14-Day Rule on human embryonic research has received increased attention, but many ethical, legal, scientific and logistical questions about doing so remain. When the 14-Day Rule was developed in 1979, human embryos could only be cultured for 3-5 days. Recently, embryos have been cultured for up to 13 or 14 days, which has the potential to provide important health benefits. Statements advocating extending the Rule have all stipulated that public engagement is essential. But crucial challenges arise, which have received relatively little attention, regarding specifically what and how to communicate about these controversial topics to policymakers, journalists and the public-what precisely to convey, how exactly such public discussions should occur, what content such communication should include, what obstacles may emerge and how best to respond to these barriers. Particular ethical, attitudinal, psychological, political, historical, educational and logistical obstacles emerge. Terms other than embryo 'destruction', for instance, may help. Empirical survey research is urgently needed to comprehend how policymakers and the public view and understand these issues and what educational approaches will be most effective. This paper examines challenges that emerge, suggests ways of addressing these and highlights needs for enhancing education, communication and literacy concerning relevant scientific and ethical issues. The enactment of ethically informed policy requires attention to not only what policies to pursue but how to communicate about these to stakeholders. Advocates for extensions of the Rule should recognise and begin to address these challenges as soon as possible.