International Catholic University
In general, technology outpaces ethics, that is, technology figures out how to do things before it asks the question "ought this be done" and medicine suspects that a sick person might benefit from some intervention and proceeds without asking the question "ought this therapeutic modality be undertaken." Science is propelled by the energy of the research imperative and medicine is driven by the compassion to the therapeutic imperative. The moral questions such as: is this a contribution to real human flourishing; are the means to accomplish the desired end good; is the end itself a real human good, do not enter consciousness at the same time and with the same exigency as the research imperative and the cure imperative. Human cloning would be no exception to this observation, except for scientific failure to this point. The roadblock to the scientific and medical juggernaut to the industrialization of cloning is that the technique of cloning in human beings has heretofore baffled researchers. This is most likely a temporary delay caused by lack of understanding of the necessary elements required for epigenesis and subsequent epigenetic reprogramming failures or abnormalities. It is likely that these obstacles will be overcome. There will no doubt be an insight into the art of human cloning, just as the insight into the spiraling double helix was the clue to the unraveling of the structure of the human gene.
This pause in technological facility provides the opportunity for careful considerations of the moral concerns surrounding human cloning before it becomes a practice. The next lectures will address the issue of human cloning in the following manner: (1) a brief history of cloning; (2) an introduction to two significant reports on cloning; (3) clarification of terms and a description of the process; (4) an examination of the ethical issues and the opposing views surrounding human cloning-to-produce-children; (5) an examination of the issues and the opposing views surrounding human cloning-for-biomedical-research, that is the use of human embryonic stem cells; and, finally (6) some conclusions will be drawn and some lingering questions will be raised.
Cloning of animals is a relatively new procedure in the biological sciences and its few successes have been accompanied with much failure and wastage. In 1938, Hans Speman was the first to envision cloning. Most of the early attempts at cloning were limited to frogs and, in 1952, King and Briggs successfully cloned frogs. The first results, however, were dismal; no healthy frogs reached adulthood. As scientists began to discover the reasons for their failure, they became more successful. In 1997, the first cloned mammal, Dolly the sheep, was born. Success with the production of Dolly was achieved only after the production and death of two hundred and seventy-seven sheep embryos. Dolly was euthanized at age six because of illnesses usually associated with elderly sheep. Sheep of her breed usually live for sixteen years. In 1998, the University of Hawaii cloned healthy mice which have produced offspring. In 2002, researchers at Texas A&M University cloned the first cat who was appropriately named CC or Calico Cat. In 2003, Banteng calves were cloned from frozen somatic cells of a calf that had died twenty years earlier. And in the Spring of 2003, a mule of particularly valuable traits was successfully cloned.
The most significant reports on the issues of cloning, both cloning-to-produce-children and cloning-for-biomedical-research, have been presented by The Report of the National Academy of Science: Scientific and Medical Aspects of Human Cloning, which was published in January of 2002, and The Report of the President's Council on Bioethics: Human Cloning and Human Dignity, which was published in July of 2002. The National Academy of Science, in its report, made the following recommendation in regard to human reproductive cloning: "Human cloning should not now be practiced. It is dangerous and likely to fail. The panel therefore unanimously supports the proposal that there should be a legally enforceable ban on the practice of reproductive cloning." The National Academy of Science from the outset limited its work to the scientific and medical issues surrounding human cloning. The report of the Academy focuses on the safety issues for the clone and the mother, calls attention to the need to follow already established rules of scientific research including success in animals, and suggests that the Academy revisit the issue in five years. Dr. Irving L. Weissman, chair of the NAS panel, summarized the position of the panel in the following:
Data on the reproductive cloning of animals demonstrate that only a small percentage of attempts are successful, many of the clones die during all stages of gestation, newborn clones often are abnormal or die, and the procedures may carry serious risks for the mother. The proposed ban on human cloning should be reviewed within five years, but it should be reconsidered only if a new scientific review indicates that the procedures are likely to be safe and effective, and if a broad national dialogue on the social, religious, and ethical issues suggests that a reconsideration of the ban is warranted.
The NAS committee, however, approved cloning-for-biomedical-research. The Report had this to say:
Finally, the scientific and medical considerations that justify a ban on human reproductive cloning at this time are not applicable to nuclear transplantation to produce stem cells. Because of its considerable potential for developing new medical therapies for life-threatening diseases and advancing fundamental knowledge, the panel supports the conclusion of a recent National Academies report that recommended that biomedical research using nuclear transplantation to produce stem cells be permitted. A broad national dialogue on the societal, religious, and ethical issues is encouraged in this matter (NAS, p 2).
Note that in both sets of recommendation, the NAS panel calls for broad national dialogue on both issues.
The President's Council on Bioethics, whose membership was broader in its expertise than is the membership of the National Academy of Science, included, in addition to scientists, philosophers, theologians, as well as those with expertise in law and public policy. The President's Council held unanimously that cloning-to-produce-children is unethical and recommended that this type of cloning ought not to be attempted, and, finally, that cloning-to-produce-children should be indefinitely banned by federal law no matter whether the project was supported by the use of private funds or the use of public funds. The potential for physical harms to children in the process by cloning are so grave that all of the reputable scientific-ethical bodies to have studied the issue are at this time of one mind on the issue, namely, the possible risks to the new human being are greater that the benefits that might accrue from its existence. The Report of the President's Council did not enjoy the same unanimity on the issue of cloning-for-biomedical-research. Seven members of the Council voted to ban cloning-for-biomedical research; three voted to place a moratorium for four years on cloning-for-biomedical-research and seven voted to go forward with cloning-for-biomedical-research. The compromise position reached by the majority vote (10-7) of the Council was to recommend a four-year moratorium on cloning-for-biomedical-research. In voting for this compromise recommendation, the Council, as did the NAS panel, called for broad dialogue on the issues and, in addition, the Council called for a comprehensive national review of all "current and projected practices of human embryo research, preimplantation genetic diagnosis, genetic modification of human embryos and gametes, and related matters, with a view to recommending and shaping ethically sound policies for the entire field" (PCR, 231).
Before taking up the ethical issues inherent in human cloning, a significant language issue needs to be addressed. Because there is considerable confusion about different kinds of cloning, it is important to use terminology that is precise and fair. To use a term such as "therapeutic" cloning in regard to the use of stem cells derived from human embryos, which were destroyed to harvest the stem cells, is to focus on the intention of the cloning without considering the source of the stem cells. It obscures the process in the end. To continue the use of the term "therapeutic" by itself tends to make compassion the sole value in decision-making. Recall that the integral goodness of an act requires more than a good intention. The object, the circumstances and the intention must be good also. The terms that will be used in this lecture are those adopted by the President's Council on Bioethics. That report used the following descriptive terms: "cloning-to produce-children" and "cloning-for-biomedical-research." These descriptive terms embody a clear definition of the process and the goals of the process. The summary of the Council's report contains the terms and their descriptions. They are:
Cloning-to-produce-children: Production of a cloned human embryo, formed for the (proximate) purpose of initiating a pregnancy, with the (ultimate) goal of producing a child who will be genetically virtually identical to a currently existing or previously existing individual.
Cloning-for-biomedical-research: Production of a cloned human embryo, formed for the (proximate) purpose of using it in research or for extracting its stem cells, with the (ultimate) goals of gaining scientific knowledge of normal and abnormal development and of developing cures for human diseases (PCR, XLIII).
Note that each process requires the production of a human embryo -- a living developing human being.
The scientific description of the process of cloning and the chosen ends of the process attest to the accuracy of the terms. Cloning is a kind of asexual reproduction. It is distinguished from sexual reproduction in which the new human being arises from the union of the germ cells from two biological parents, the egg of the female and the sperm of the male. Cloning is a procedure in which a somatic cell -- a body cell which contains the full complement or the diploid number of chromosomes rather than a germ cell which contains the haploid or half complement -- from an adult is reduced to a primitive stage and fused, either by electronic or chemical stimulation into an enucleated oocyte (an egg cell from which the nuclear DNA has been removed) of the same species kind as the somatic cell. Once placed within the egg cell the reconstituted egg is activated -- usually electronically -- and cell division commences and organism growth begins. The technical name for this procedure is somatic cell nuclear transfer and it is often referred to in the literature as SCNT. The embryo that was established in the SCNT process is sustained in vitro, in a laboratory dish, until its development is appropriate for its use. If pregnancy be the desired end, the resulting cloned embryo would be transferred to a female host that has been suitably prepared for it. And if all went well, a clone that is virtually identical (except for mitochondrial DNA of the oocyte) to the human who donated the somatic cell nucleus would be born. If, on the other hand, research into the process of early human development is the goal or if the gathering and use of the pluripotent stem cells for regenerative medicine is the goal, then the established embryo becomes the matter for those purposes.
With the understanding of the scientific process of cloning in place, the next step is the complex set of moral issues. The first set of moral issues centers on the question of cloning-to-produce-children. The second set of moral issues centers on the question of cloning-for-biomedical-research. However, there is a fundamental issue underlying the process of cloning despite the ultimate goal of the process, that is the status of the embryo. Until there is a careful and satisfying resolution -- one that comports with scientific data -- of the ontological status of the embryo there will be no consensus on its proper use.
The question of cloning-to-produce-children will of necessity be set within the very human framework of human desires and human compassion. There is a natural human desire to have children and there is a natural human emotion to love children and family members. If one cannot have a child sexually, that is, by union of the sperm of the father and egg of the mother or if having children sexually is undesirable because of the possibility of the transmission of inherited disease from either the mother or the father, cloning might appear as an acceptable alternative inasmuch as the biological tie to at least one parent might be maintained. In addition, if a child or another family member is dying, the desire to duplicate that family member by the process of cloning might appear as an acceptable and merciful possibility. Further, cloning might make it possible to produce organs for transplantation that would not be susceptible to rejection. And finally, cloning offers the possibility of duplicating the talent or the beauty or the intelligence or the athletic prowess of especially gifted human beings. Cloning to produce a child under most of these circumstances present a powerful case for compassion. Cloning human beings of superior genetic endowment carries with it the worry of past eugenics programs gone awry. There are limits even to the alleviation of this suffering and there are limits to the attempts to fashion human beings with superior or culturally desirable traits. Recall that for an act to be morally good the intention, object, and circumstances must also be good. The intention of compassion is both good and strong in itself, however if the object -- cloning-to-produce-children -- is wrong, then the act is wrong and must be resisted despite the strength or power of the passion. Reason must inform the heart. Similarly cloning to produce human beings with desirable characteristics for the human good as a whole is an intention that has a tainted past and an intention whose worth must be measured along with the object and the circumstances of the act. Cloning to produce a child with characteristics desired by the parent or the parents, the right to have a particular kind of child, may be an attempt to exercise inappropriate control over progeny. Children have destinies of their own. Parents need to give their children the power -- roots and wings -- to discern their paths.
In addition to the possibility that cloning might satisfy particular human desires or might be a compassionate human response to particular human needs, there are other more general goods that have been set forth to defend the right to clone. Among these goods are the goods of freedom, of autonomy, of existence, and of human well-being. There is no denying these goods. However, the absolutization of any one of these goods as an individual right is dangerous for both the individual who makes the claim and and for the society which permits such a claim. Human beings have a limited right to exercise freedom and the right to free exercise is accompanied by the obligation to exercise freedom rightly. The claimed autonomous right of one human being to exercise a procreative right to clone must be viewed within a context which includes the rights of possible new human being generated in the process (the current legal status of abortion and the current public ambiguity in regard to abortion tend to conceal the third party interests), the rights of the family within which the cloned individual will be nurtured, and the rights of society to good order.
One of the most ardent defenders of human cloning-for-producing-children presents his position in the following:
A society that bans acts of human creation that reflect unconventional sex roles or parenting models (surrogate motherhood, in vitro fertilization, artificial insemination, and the like) for no better reason than that such acts dare to defy "nature" and tradition (and to risk adding to life's complexity) is a society that risks cutting itself off from vital experimentation and risks sterilizing a significant part of its capacity to grow (Tribe, 321).
Here is a very clear statement grounded in the prevailing philosophy of the contemporary culture. It promises human progress if human freedom is unhampered by claims of tradition and nature. To make this categorical claim is to forget the dismal history of human performance and to buy into the myth of inevitable human progress. Human decline is just as real a possibility as human advancement. "To ignore the fact of decline was the error of the old liberal views of automatic progress" (Lonergan, I, 260).
Existence is a basic human good and well-being is good for both individuals and for society. However, to choose to bring a human being into existence without regard for the significant probability of causing grave danger to that human being is to act irresponsibly regardless of whether the human life is brought forth by sexual or asexual reproduction. Human reproduction requires careful attendance to duties to the newly generated human being. Hence, well-being as well as existence is a legitimate concern. Concern for well-being of individual human beings ought not to be equated with the elitist notion that only the planned, perfect, and privileged have a rightful place in the human community. Those who are born with disabilities and those who become disabled later on in life do not lose human significance and worth on account of their limitations. Nonetheless, responsible human beings ought not to knowingly and willfully behave in such a way as to risk grave danger for other human beings. Concern for well-being as a societal good, that is, that the members of society be healthy and have effective treatment for illness and injury, is a limited good that should be sought within a context that accepts human finitude and that understands the limitation of the principle of totality as it applies to a physical organism and as it applies to a moral organism. This topic of the application of the principle of totality to a moral organism will be of considerable concern in the issue of cloning-for-biomedical-research.
In regard to ethics of cloning-to-produce-children, the myriad questions are the following: (1) the safety of the procedure, (2) the concordance of the procedure with norms governing experimentation on human subjects, (3) potential harms and injustices to prospective human offspring, (4) potential harms and injustices to women, (5) potential harms and injustices to families, (6) potential harms and injustices to society, and (7) violation of religious principles. In this lecture the safety issue, based on animal experimentation, will be addressed.
The National Academy of Science Report and the Report of the President's Council on Bioethics both concur that, at present, there is not sufficient technological expertise to successfully clone a human being. The Report of the National Academy of Science contains a rather complete collection of data on live births from the cloning of animals (Table 1, page 114). The Report of the President's Council contains a summary report of live births from the cloning of animals (Table 1, page 72). The extensive data in the NAS Report summarize the cloning results for a wide variety of animals -- sheep, cattle, mice, pig, goats, monkeys -- and from a wide variety of cell types. The data in both reports show such low level of success and such high level of mortality and morbidity that, if these were transferred to human experimentation, would be unacceptable. The high rate of failure as fetal loss in the cloning of animals and the high rate of damaged and impaired offspring in animals preclude reputable scientists from moving beyond animal experiments to human experimentation. Furthermore, those scientists, who before the issue of the ethics of human cloning became a central ethical concern, experimented with the cloning procedure were unable to move beyond the six cell stage before the organism began to deteriorate. The scientific suspicion is that the lack of success results from failure in the epigenetic programming and/or in imprinting mechanisms that have not been successfully activated or only incompletely activated in the cloning process. Epigenetic programming coordinates the processes required for the proper and orderly early development. Imprinting mechanisms direct the timely expression of appropriate genes. Misexpression or perturbations in expression result in developmental failure.