Week 13: Stem Cells 101 Dennis M. Sullivan, MD, MA (Ethics) Cedarville University

Human stem cells are the “starter” cells that act as precursors of mature bodily tissues. Such cells have not yet differentiated (become specialized) into their mature forms. All human beings possess such cells. For example, precursors of mature blood cells are the pluripotent stem cells of the bone marrow. These cells are called “pluripotent” (L. “many” + “powers”) because one of these undifferentiated cells can become any of a variety of different blood cells. These include the various white blood cells that protect against bodily infection, platelets that help the blood to clot, and the red blood cells that carry oxygen throughout the body.

All adult cells once developed from stem cells by the process of cell division, with daughter cells successively becoming more complex than their precursors. However, adult cells that constitute bodily organs have mostly lost the ability to divide. Unlike bone marrow cells, mature cells in the brain, spinal cord, skeletal muscle, heart muscle, and many other organs no longer have any corresponding pluripotent stem cells to repopulate them when they are damaged. Therefore, brain cells (for example) are limited to the number that arose from their original stem cells. Despite some limited exceptions, these are incapable of repair or replacement.

In a stroke, a sudden blockage of the blood supply to a region of the brain destroys brain cells, never to be replaced. Rehabilitation from a stroke involves training other brain centers to take over the function of the damaged region, but there is no natural process that can replace the dead cells. The same problem occurs in the heart, where repeated heart attacks weaken the heart wall. Since heart cells cannot be replaced, there is a limit to how much damage the heart may sustain before permanent disability or death occurs.1-3

What if there were stem cells that could replace damaged brain cells or heart muscle? This could conceivably improve one’s lifespan, or at least the quality of life. The biological possibilities are intriguing. An equally compelling case can be made for the use of stem cells to repair spinal cord injuries, to provide new pancreatic cells in diabetes mellitus, or to cure Parkinson’s disease.

Where would such stem cells come from? One source is from human embryos, composed exclusively of unprogrammed early stem cells, any one of which may become the precursor of adult tissues and organs. Two possible sources for embryonic stem cells are the excess embryos from in-vitro fertilization procedures (often called “frozen embryos” because of the cryogenic process used to preserve them) or embryos derived from human cloning. The ethical dilemma arises from the fact that the harvesting of embryonic stem cells destroys human embryos.

Another source for stem cells is adult tissues such as bone marrow, fat, and even tooth pulp. Numerous studies demonstrate that some adult stem cells are as flexible as embryonic stem cells. Indeed, these ethically non-controversial adult stem cells are currently being used to benefit human patients.4

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References:

1. Tortora GJ, Derrickson B. Principles of Anatomy and Physiology. Eleventh ed. New York: John Wiley & Sons; 2006.

2. Martini F. Anatomy & physiology. San Francisco: Benjamin Cummings; 2005. xx, 845 p., [77] p.

3. Medina J. The Outer Limits of Life. Nashville: Thomas Nelson; 1991. 287 p.

4. For more on adult stem cells, see http://www.stemcellresearch.org/

Week 12: A Critique of The Five Principles

I think the authors 5 basic principles are a valuable guide, but I do not think they solve the problem of synthesizing all ethical systems together.  The problem remains and goes back to what I have stated earlier in this class about world-views, for example:

The principle of Life:

1. There is no empirical evidence that suggest life has value ?

• The author states: “This principle of life is empirically prior to any other because without human life there can be no goodness or badness, justice or injustice, honesty or lack of it.  The problem with the authors argument is that he claims the principle of life is valid because without life there would be no values, but the author is assuming that values have meaning because of life (without proof) and then life has value because of values (without proof); well which is it?  One does not prove the other it only assumes the other. The argument is invalid.  The question remains: what gives human life its value?  There is no synthesizing a worldview that sees life as a cosmic accident and a worldview that thinks an intelligent and purposeful creator made life because they are contradictory propositions and lead to completely opposing views of reality.

The Principle of Goodness over Badness

• The author states that,”Ethicist may differ over what they actually consider to be good and bad or right and wrong, but they all demand that human beings strive for the good and the right”.  The author is correct except for possibly the relativist ethical system, but since this principle is already found in most ethical systems what makes this principle valuable since it cannot tell us what is good or bad?  It has not resolved the conflict.

The Principle of Justice and Fairness

• Since most ethical systems have a concern for justice, again why do we need this as a principle, and if all ethical systems hold to some form of these five principles, what is the point of synthesizing what everyone already agrees on?  I would say that the problem isn’t a synthesizing of terms but the meaning we have behind the terms. Two groups may use the same word but have entirely different conceptions of  its meaning and/or application.  It is in the defining and practice where the ethical differences are exasperated.

The Principle of Truth Telling and Honesty

• I would have to agree with the author because even if we believe in relativism, ethical egoism, or we are completely selfish, we must communicate, and for communication to have any reasonable advantage there must be truthfulness.

The principle of Freedom

1. What if am into psychological, sociological, biological, or theological determinism?  How can a determinist synthesize with an ethical system that supports freedom when they believe there is no such truth to the concept of freedom?  

Thiroux said “First, it is important to clearly delineate several basic assumptions concerning what constitutes a workable set of standards for morality.”  Assumption are not scientific facts by definition, so if the author rejects an ethical system based on a belief in God because he believes there is no evidence to support the belief, why is it acceptable for everyone to “accept” assumptions that cannot be scientifically or in any other way proved true?

How do you synthesize religious moral conviction with Thiroux's secular humanistic view.  By definition, God is an ultimate power and authority, so if a religious person believes that God has told them something is not morally permissible, how can she negotiate with Thiroux's secular humanistic view?  If I concede to Thiroux's secular humanistic view then God is no longer the person's ultimate moral authority and God ceases to be God, unless God has given a person the freedom to "work out their ethical salvation" within the society he has placed them in.  

Module 11: The Right to Die

This is a difficult topic to lecture on.  The title is a bit misleading because we are not addressing the right of people to end their lives for any and all reasons.  I am referring to the terminally ill or mortally wounded who will not recover from disease or injury. What we have is a somewhat difficult set of ideals; one is the person has intrinsic value and two their humanity must be maintained regardless of disease or injury.  We have difficulty because we value human life and the disagreement is not in the value of human life but in how we honor the value of each human life in terminal illness and injury.  Some say to allow someone to die without attempting to save them is devaluing their humanity because of their condition, the other believes we are devaluing their humanity by prolonging the suffering.

In my opinion, each side has a point to be made and depending on the circumstance I might agree with each of them.  Example: Joni has been told she has 6 months to live and only 10 percent chance of survival if she agrees to chemotherapy.  Joni’s mother and father want her to go through chemotherapy because a 10 percent chance of survival is better than none.  Joni’ and her husband do not want her last remaining months to be spent suffering in chemotherapy. Everyone agrees that life is worth fighting for but not everyone agrees when there is no longer a reason to continue the fight.

I do not have a problem with allowing someone to die of natural causes when there is nothing further that can be done to save them. Life is more than breathing and a beating heart, the whole life must be considered when allowing someone to die.  To extend suffering for the sake of breathing and a pumping heart is not to consider the individual but only their temporary bodily function.  To be human is more than how our individual parts function. A person who no longer has the use of their  legs, eyes, or mental sharpness is not less human than anyone else, dignity is not in our functioning but in our being human.

Mercy death is the act of killing another person with their permission to do so,  This is problematic because we are no longer addressing only a persons right to die, but a persons right to allow another human being to kill them. The problem with mercy death is no one has a natural right to ask another person to kill them.  To make that request of another is to potentially harm them psychologically for the rest of their life.  The other issue is that it provides an opportunity for the psychologically disturbed to take advantage of someone who is dying and in pain.  In each circumstance someone is potentially being grossly violated or allowing another person to participate in killing another human being without legal consequences for their actions.  Allowing nurses or doctors the right to kill their patients could attract individuals in the medical field we would not feel comfortable with treating our loved ones.

Mercy killing is the act of taking a terminally ill persons life without their consent.  This is problematic for obvious reasons.  First and foremost it has nothing to do with the right of a patient to die since the individual has not been given a choice over the action.   Second, even if the act was done with good intentions there is plausible doubt as to if the person wanted to have their life ended since no consent was given only assumed; this puts the individual with the good intentions in the moral, social, and legal hot seat.

The heart of the issue with the right to die is to protect individual humanity and to not prolong unnecessary suffering.  We do not want others or ourselves to suffer a slow agonizing death, but at the same time we must think and act carefully about how we handle these emotionally and ethically difficult circumstances.  The truth is that it can be just as unethical to prolong life as it can be to end it.  Because we can keep someone physically alive does not  imply that we should, and because we can end the life of a suffering loved one does not mean that we should.

If Aristotle was correct that excellence of virtue is our end he may have approved of the term ‘Euthanasia” which means “ a good death”, but what a good death is must be well defined.  I would like to define a good death as the following: a good death is where neither the one dying or those near the dying have their humanity , dignity, or moral conscience violated or compromised by another.

Week 9: Determinism

How would you feel going through your whole life, the ups the downs, the good the bad and everything else in between, if you were confronted with the hard cold fact that every choice in thought, word, or deed, you believed you made, was not a choice you made but was the result of some psychological, sociological, psychological, or theological pre-determined cause?  How would it feel to know from here on out, neither you, me or anyone else really existed; that the “I” was an illusion created by organic and chemical reactions to chaotic natural causes or simply robotic creatures programmed by some power that reeks disaster or pleasure for reasons we can never know?

This is what is at stake in the debate over freedom and determinism.  If hard determinism is true nothing matters. If hard determinism is true it does not matter what or who is the cause because we have no control over the cause or the effect and we have no way of knowing if our perception of reality is determined.  Determinism jeopardizes the following:

• Self-Knowledge
• Knowledge of others
• Moral Knowledge
• Scientific knowledge
• Justice
• truth

Determinism destroys our ability to have a coherent theory of knowledge (epistemology) because we can never know if what we are experiencing is true because it has been determined.  The leads to gross relativism.  I can never know the real me because there is no real me, just a biological or even spiritually programmed robot who thinks and acts as he/she has been programmed.  

I can never know others because my perceptions have been determined and since the other person has been determined there is no other person to know.

Moral knowledge is lost because we can only do what we have been determined to do and know what we have been determined to know regardless of the truth.  Without choice moral accountability is impossible, of course, unless we have been programmed to be ridiculous. There would be no moral difference between Jesus and Hitler because neither had any say in who they were.

Science is obsolete.  This is ironic since some have used science to promote determinism.  How can scientists know anything if everything they think they know was caused by some force outside of themselves.  If everything is determined, including scientific reasoning, perceptions, theories, and experiments how do we know they are valid since we have no choice but to come to those conclusions?

The law courts become invalid because people can't be judged for choices they did not make.  If I steal it is because that is what I was programmed to do; if I cheat on my taxes or steal from my boss it is because I am programmed to take from others.  There are no just wars or causes only pre-determined acts of violence.  There is no love only programmed desire.  There is no forgiveness because there is no wrong or immoral choices made because there are no choices only cause and effect.

Determinism negates truth because we can never really know anything.  If determinism is true we can never know if determinism is or isn't a reality because we can only perceive what has been caused to be perceived and we can only discover what has been caused to be discovered.

There are aspects of life that are determined. If we do not eat we will die. We cannot choose our biological parents.  Humans cannot be any other species, such as, a dog or a goat.  However this determinism is related to our nature.  We are limited by our nature and to some degree determined by it.  This is not a hard deterministic position. Example: fire will burn your hand if you put it over the flame of the stove, but that does not mean your hand was determined to be burned.  It is the nature of fire to consume or to burn.

Week 8: Absolutely Relative?

The title of this lecture is a contradiction.  If an individual states there are absolutely no absolutes they have fatally contradicted their own statement because they are making an absolute proposition affirming a universal non-absolutism.  Therefore it is impossible that relativism is true.  So where do we go from here?  The next question is, if there are absolute propositions with exceptions are there moral absolutes?  The problem may be in the way we are defining our terms.  Example: the author of the textbook uses the term kill and shows that there are exceptions to the absolute not to kill; the proposition we should never kill is then defined by the textbook as a “near” absolute.  The problem is the author never defines the term kill.

The problem I have with the term kill is that it is too general.  Does kill refer only to humans or does it include all life, such as, insects, cattle, birds, and fish? There is no doubt that moral absolutes are a reality which I have demonstrated by proving relativism is absolutely false, There are exception to moral “absolutes” because we have been to general when defining our ethical terms.  The first order of business when defining moral absolutes is to be specific about our proposition and terms.  What do we mean by kill? Does kill mean to take any life, a specific type of life?  What is the difference between a convicted mass murderer and a war hero? Each has killed yet one is condemned and the other praised.  This would indicate the term kill is not specific enough to get at the heart of societies desire to punish those who “kill”.

So the problem is that kill may not be the word we are looking for, or we can simply define it in a more specific manner. So we can ask: is it absolutely unethical to extinguish human life for pleasure? The answer is yes. Is it morally acceptable to force another human being to work without pay until they collapse and die because of the color of their skin, religion, nationality, or gender? The answer is no.  It is at this point that if we were to say these acts are acceptable, and these acts have no real meaning within themselves, that the fabric of human relationships and existence dissolve.  There are some things we are not capable of explaining but the reality is fundamental for human life to flourish..

Lying:  Is it ever ok to lie or sometimes necessary to lie?  Yes it is.  Example: Robbers break into your home and demand to know where the rest of your family is, you lie and say they are out of town on a trip when they are hiding under the bed. So what do we mean by lying? The concern over lying is more than just stating something that is false, it is deceiving someone in order to take unfair advantage or avoid a just punishment.  Example: a man lies to his wife about working late so he can go out partying with his new female friend. The intention of the lie is to take advantage of his wife's trust in order to violate it.

Moral propositions require us to avoid being too general concerning the terms we use in our statements. If I ask my wife where my keys are and she tells me “over there”, she has answered my question but has told me nothing helpful about where my keys are. If she tells me the keys are on the counter next to the coffee pot, I will find me keys.  If you want to find moral truth you are going to have to define your terms and if you are engaged in a conversation over moral questions make sure the individual(s) you are speaking with are all defining the terms in the same way. Example: A vegan might use the term killing to include cows, chickens, and fish, but you are thinking of the word kill as in taking only human life.

Absolutes are unavoidable but not always obvious.  We have to think through what it means to be human, why being human matters or if it truly does matter.  If being human has significance then so does our words and actions.  If human existence is pointless and without meaning then so are our words and actions.  Remember the laws of logic and the law of excluded middle?  The law of excluded middle says there is no middle ground and when it comes to the value of human life, our words and action, they ultimately have meaning and value or they ultimately do not.  There is no middle ground.

Module 14: Virtue Ethics

“Virtue Ethics”.  Unlike consequentialist and nonconsequentialist act and rule theories of ethics, virtue ethics focuses on the quality of being human.  Virtue ethics seeks to unite the entire individual both emotion, mind and body into a habitually formed creature of excellence.  The whole person is brought into subjection to the idea of what it means to be truly human.

For Aristotle, being human was defined by our ability to reason, therefore we should strive to reason with excellence.  According to Aristotle, “ the end of human life is happiness, and the basic activity of human beings is to reason—a virtuous activity"; therefore, the aim of human beings, according to Aristotle, is to reason well for a whole or complete life.

The problem I see with Aristotle is his assumption that we will all reason to the same conclusions because everyone has different ideas of happiness.  Reason itself does not lead one to truth although without it truth will be a hard find.  Happiness is a vague term in our society, so Aristotle may be misunderstood when he speaks of happiness.  By happiness Aristotle was not referring to material wealth, a great sex life, or power, but contentment through wise living; by acting in accordance with what is virtuous.

The question remains: what is virtue or virtuous?  How do we define or know what is truly good or true?  I would agree with Aristotle that virtue involves the entire person and flows from a persons character but we have no real way of defining or detailing what makes for virtuous character.  If we use rules to define virtuous character, then we are back at rule based ethics or non consequentialism; if we say “we just know” then we are act consequentialism or intuition.

Once again we are at worldviews.  The terrorist see courage in blowing themselves up in a crowded mall although they are killing innocent citizens because their spiritual leader has convinced them that their holy book affirms the act.  Is this the same act as a soldier who is blown up throwing himself on a grenade to save his fellow soldiers.  Which one was truly courageous?  How do we define the virtue of courage? Before we can judge by our intuition, rules, or habitually begin to form our character towards virtue, we need to know what is truly virtuous.

Aristotle is correct that reason can be a guide but reason must help us to begin to answer important questions:  Where do we derive our ethical reason and desire from and how do we account for and resolve the broad range of ethical opinions being advocated.  For all of the ethical diversity there are still fundamental agreements about what is good and evil, but the difficulty comes in the decision making process during ethical crises or conflicts.  Also, there are cultural customs and norms that people must adhere and incorporate into good and bad choices. Within cultures, the values, customs, and norms change and reevaluations of what is right and wrong.

The United States is a good example of how quickly values and morals can change in a short span of time.  Example, 30 years ago society largely rejected homosexuality as immoral and yet today the general population no longer believes gay relationships to be unethical.  Living together before marriage was considered at one time a scandal, and now many accepts such arrangements as normal.  This does not mean that in the past our culture was mistaken and today we are wiser, but it does reveal how our values in relationships, marriage and child rearing have changed.  Change is inevitable but the impact of fundamental ethical changes in society can take decades to reveal if the direction was wise or foolish.

Thoughts on Divine Command Theory

Thoughts on Divine Command Theory

In our Ethics for Life textbook author Judith A. Boss states the following:

"Divine command theory claims that morality is dependent on or relative to God’s commands and, therefore, can change from time to time and person to person. Civil religion, which blends religion and cultural relativism, is a variant of divine command theory. It claims that God’s commands are relative to a particular nation or culture. Natural law theory, in contrast, maintains that morality is based on universal, unchanging principles and that God commands or approves something because it is right prior to the command.

Natural Law and divine command

The problem I have with this statement is it provides no description of what divine command theorist believe about the nature of God. Natural Law claims "universal, unchanging principles" and according to natural law theorist, God approves a universal or principle before a command.  Natural Law seems to be a separate ideal from God that God approves.

 The Jewish and Christian views accept that the divine and perfect nature proceeds God's commands and gives moral perpetuity and authority to the divine commands.  In other words from a divine command perspective, God's nature is eternal, pure, good, and unchanging therefore like the natural law theory, God's commands are "universal and unchanging".  However, unlike natural law, the universal, unchanging principles are inherent in God's nature not separate from God. Since God's nature is unchanging the divine commands do not change. God's commands flow from a perfect, just, holy, and righteous character that cannot change and will not change.  Therefore divine command is not a relativist ethical theory.

Who is God's judge?

The textbook states," There are no independent, universal moral standards by which to judge God’s commands."

This statement seems to ignore the very definition of God or who God is perceived to be.  God by definition is eternal and the creative source of all beings, objects, knowledge and wisdom. God is, to use Aristotle’s concept, the unmoved mover of all things. To clarify, God is the uncaused cause of all things.  Look at it this way: you want to borrow a lawn mower to mow your yard, so you ask your neighbor if you may borrow her lawn mower, your neighbor states it is not hers to lend and that you will have to ask the other neighbor. You proceed to ask all other neighbors only to be told the same, It is not ours to lend, you will have to ask another neighbor.  In order for you to finally get permission to borrow the mower there will have to be an "Owner" of the lawn mower that can give you the authority or permssion to borrow the lawn mower to mow your yard.  God is the final authority or "independent standard" by which we get the lawn mower. Without an owner there is no lawnmower to lend.

If there was a principle or standard outside of God, that God acquiesced to then he would not be God by definition, the standard or principle itself would be God.  Also the author does not see that even if we say there is another universal standard, lets say natural law, then by what independent or universal moral standard do we judge natural law?

The problem for natural law is increased because human reason is not eternal, transcendent, inherently moral, or uncaused, so how can finite natural law or human reason trump its eternal maker as the final authority of what is good or evil? It cannot. This also begs the question, who endowed humans with reason in which we find this moral law?  If natural reason has an inherent law, we know that laws and ideas are not physical properties but properties of mind, so if reason has an originator this creator must have mind or intelligence which proceed creation, therefore this mind has precedent and authority over human reason or natural law.

Was Abraham's God a relativist?

The textbook seems to be comparing the 2001 Muslim terrorist who murdered 2000 US citizens and Andrea Yates who murdered her children with Abraham in the book of Genesis.  Is this a fair comparison or a hasty generalization of divine command theory? Let’s look at each of the situations:

Muslim terrorist:

1.       Terrorist claim the Koran gave them moral authority to kill unbelievers.

2.       Qur’an states that “. . . anyone who murders any person who had not committed murder or horrendous crimes it shall be as if he murdered all the people” (5:32)

3.       Terrorist did not claim to hear voices or a voice commanding them to kill.

4.       They believed they had a moral duty to murder infidels according to the Koran, but violated the divine command in the Koran. 

5.       Muslims do not believe that God speaks directly to people because the Koran is the exact words of God therefore God does not need to speak any further because Mohammed was his final prophet.

6.       There was no known mal-psychological history or issues with the terrorist.

7.       Only 10% of Muslims believe such murder is sanctioned by the Koran.

8.       They were successful in committing murder

Andrea Yates:

1.       Known to have previous psychological issues with depression, postpartum depression and postpartum psychosis. 

2.       Attempted suicide on several occasion and was prescribed strong anti-psychotic medications, including Haldol.

3.       Believed she was possessed by the devil and by killing her children was saving children from hell because she was a "bad mother". 

4.       Andrea did not hear voices from God but did hear voices from devil telling her to kill her children. 

5.       Was told by minister and minister's wife that she was evil and going to hell if she did not change (preacher was self-proclaimed prophet).

6.       Andrea successfully murdered her children

Abraham:

1.       No documented mental disorders.

2.       Polytheistic background (belief in many gods).

3.       Was held in high esteem among the surrounding people and Kings and considered a prophet among some;

4.       Possessed no known authoritative scriptures that determined his latter view of one God.

5.       At 75 years of age Abraham was told by God:

 “I will make you into a great nation,

    and I will bless you;

I will make your name great,

    and you will be a blessing.[a]

3 I will bless those who bless you,

    and whoever curses you I will curse;

and all peoples on earth

    will be blessed through you.

6.       We do not know how Abraham received this command only that he believed this is what God wanted him to do. 

7.       There is no dispute that Abraham's inclination that he would become a great nation was correct. 

At a later age Abraham believed God said the following:

"Then God said, “Take your son, your only son, whom you love—Isaac—and go to the region of Moriah.

Sacrifice him there as a burnt offering on a mountain I will show you.”

1.       Abraham believes God is asking him to sacrifice his son, but since God, according to Abraham cannot lie, he knows that somehow God will either stop him or raise Isaac from the dead.

2.       Child sacrifice was not uncommon among the polytheistic religions surrounding Abraham.  It is believed that God is demonstrating or teaching Abraham that he is not that kind of God. 

3.       This God had already promised that Isaac would be Abrahams Heir.

4.       This God had protected him in previous dangerous circumstances and affirmed his divine will to not punish the good with the evil

5.       Later in the Jewish Decalogue, human sacrifice is strictly forbidden with a promise of severe judgment if children are sacrificed.

6.       Abraham is stopped by God and does not kill Isaac. 

I have demonstrated the obvious differences between the examples given in the textbook and I think the textbook is incorrect to make a moral equivalency among the 3 separate events by possibly distorting or failing to accurately report Andrea Yates condition.

As stated previously, Abraham had no previous authoritative knowledge concerning God’s commands other than that he was to go to another country, also Abraham did not kill Isaac, and Jewish law forbids sacrificing children to any god.

Andrea Yates mental illness was well documented, she was on numerous medications, and she did not believe God wanted her to kill her children, but that the devil was demanding her to kill her children. Andrea Yates believed she was a horrible parent and she killed her children so they would go to heaven because she was such a poor mother they would end up in hell.  She received no divine command to murder her children.

The Islamic terrorist interpreted the Koran in a way that justified their murderous crimes. A large majority of Muslims believe the terrorist acted contrary to the Koran.  The terrorist did not hear voices from God or the devil but were influenced by certain Islamic Imam's (teachers)

Each of these examples are so different in circumstance and outcome that they cannot be used to make a singular point about the relativistic nature of divine command theory. Some either outright violated their religious teaching or were stopped by their God from following through with the moral violation.

Do we need God to justify ethics?

The textbook states, "God cannot be used as a fundamental criterion for moral goodness, nor is God necessary for morality. Instead, the claim that what God wills is good is dependent on a previous belief that there exists a being worthy of worship. Thus, rather than God being the foundation of morality, a belief in God is dependent on our already having a concept of moral goodness."

The author’s reasoning fails to explain how humans obtained the knowledge of moral goodness. If God created the world (how it was done is irrelevant), then it is rational to conclude that a rational, moral creator instilled in creation the knowledge of moral goodness. If, as the textbook claims we would have to obtain this knowledge from elsewhere, it would appear they are simply trading one god for another.  Moral knowledge must be true or false, if true it must be grounded in a source outside of nature since nature is finite and had a beginning. The source must therefore be transcendent (outside of creation), eternal, and unchangeable.  Since we have concluded previously that these are characteristic of the definition of God, then God must be necessary for "universal, unchanging principles".  This does not imply that we must believe or accept this God, only that the existence of this God is logically necessary in order for ethics to be "universal and unchanging principles".