My thesis is that we need an international moratorium on human
cloning, that is, on any production of human embryos through
somatic cell nuclear transfer (SCNT) at this time, because this
is the only way to achieve a prohibition of reproductive cloning,
for several reasons. Practically, if any laboratory is free
to create human embryos through SCNT, the result will be cloned
babies or, at the very least, serious attempts to create them.
Politically, in order to enact a ban on reproductive cloning
at the federal level, it appears very likely that a moratorium
on research cloning will also be needed. By the end of the moratorium
period, means can be developed-which do not now exist in state
or federal law-both to rein in some of the wilder, entrepreneurial
aspects of the "fertility business" in the United
States and to exercise appropriate control over the manner and
circumstances under which cloned human embryos would be produced
for therapeutic purposes.
Not only is a moratorium on the laboratory production of cloned
human embryos needed for prudential reasons, but it can be achieved
without adverse effects on other important interests. Placing
a moratorium for three to seven years on human embryo cloning
will not thwart developing the potential therapies that are
commonly cited as the reason for allowing research cloning.
(Indeed, I think it amounts to a gross misrepresentation for
those who favor research cloning to try to sell it to the public
as "therapeutic cloning" and to suggest that a ban
will prevent thousands-or millions-of patients with serious
and even lethal diseases from obtaining rejection-proof transplants.)
Furthermore, adopting a moratorium on the creation of human
embryos through somatic cell nuclear transfer will position
the United States to take a leadership role in international
cooperative efforts that are now underway to restrict the misuse
of this new technology. Finally, allowing the uncontrolled creation
of cloned human embryos risks undermining public support for
human embryonic stem cell (hESC) research-support which I believe
has been grounded on the argument that these cell lines have
been and can be created from frozen embryos left over from infertility
treatment and donated by couples who would otherwise discard
them. The question is therefore not whether to destroy the embryos
(that decision has already been made) but merely how they will
be destroyed: by being washed away or by being used as a source
of stem cells for important biomedical research. The notion
of creating embryos solely for research which will necessarily
entail their destruction is much more controversial, and substantial
risk therefore attaches to any program-such as embryo cloning-
that involves the creation of research embryos.
I. A Few Introductory Remarks on Reproductive Cloning
I do not intend thoroughly to analyze the merits of reproductive
cloning, that is, the creation of children through SCNT. Yet
I cannot totally ignore the topic, as it undergirds the whole
notion of restricting cloning for research purposes, that is,
the creation of human embryos through SCNT as a source of stem
cells or for other laboratory studies restricted to the first
two weeks of embryonic development and without implantation
into a uterus. It is widely agreed that reproductive cloning
should be prohibited. That was the position recommended to President
Clinton by the National Bioethics Advisory Commission in June
1997, in the first major report on the possibility that the
SCNT transfer technique demonstrated in mammals by the cloning
of the sheep Dolly might be applied to human beings.1 This conclusion
rests principally on the ethical unacceptability of using such
a highly experimental technique with many known and hypothesized
(but unresolved) physical risks with unconsenting human subjects;
it also recognizes that many substantial psychological, social,
legal, and ethical objections to using SCNT for reproduction
have yet to be settled. The conclusion that reproductive cloning
should not be permitted has been reached by virtually every
group to examine the subject since 1997, most recently by a
panel of the National Research Council (NRC) in mid-January
2002.2 The week before that, the California Advisory Commission
on Human Cloning recommended legislating against reproductive
cloning on even broader grounds, including the psychological
and social harms.3
The reasons for banning reproductive cloning are many, beginning
with the results of cloning research in animals. As of September
2001, Ian Wilmot (the cloning pioneer who created Dolly at the
Roslin Institute in Scotland) reported that worldwide, there
have been 31,007 sheep, cow, goat, pig and mouse eggs used in
cloning research. These have produced 9,391 embryos for implantation,
but out of that process have come only 267 live-born offspring,
many of whom have had crippling and even lethal abnormalities.
With results like these in mammals, I cannot imagine that any
reasonable researcher-or any reasonable person of any sort-would
even be talking about attempting to use any other novel technology
on human beings. Yet, as you know, there are physicians and
scientists who have very publicly proclaimed that they intend,
or are now attempting, to use SCNT to create human babies.
What is particularly worrisome about the physical risks to the
products of cloning-to say nothing of the additional risks to
the women who would have to be manipulated to produce the eggs
needed or who would act as "surrogate mothers," especially
since a number of the animals carrying clones have themselves
died in the process, apparently due to abnormal development
of the fetus they were carrying-is that these risks apparently
cannot be fully predicted or avoided. The epigenetic changes
that have been found to occur as a result of SCNT seem to relate
to the fashion in which the DNA in the nucleus has to be re-programmed
back to the embryonic state,4 which differs from what occurs
in normal embryogenesis in ways that are not yet fully understood.
For this reason, it would not even be possible to "screen"
embryos for genetic abnormalities, as some of the malfunctioning
genes would not express themselves in the embryo and there is
as yet no way to know which defects in "genetic imprinting"
physicians should be looking for. Moreover, the usual reason
for engaging in a risky medical experiment-that it offers the
only hope of saving a life that is otherwise beyond medical
rescue-is absent here, for without the cloning procedure there
would be no "patient" and no one placed in harm's
way.
Despite these substantial reasons why reproductive cloning would
be a reckless and indefensible act, simply on physical grounds
to say nothing of the other sorts of harms it might cause, there
are those who have not only announced that they are attempting
reproductive cloning but who proclaim that prohibiting the use
of SCNT for the creation of children would violate their "reproductive
rights." The United States Supreme Court has never decided
whether our protected liberty interests in making decisions
about family life and in using medical means to prevent the
birth of children encompasses unrestricted access to any and
all forms of artificial reproductive technologies; moreover,
even if the constitution protects "reproductive liberty,"
it is far from obvious that it would cover the use of techniques
to allow asexual replication rather than sexual reproduction.
It is my own judgment that even were SCNT techniques proven
through animal research to pose no greater risk of physical
harm than artificial reproductive technologies and even were
these techniques the only means for some people (a very small
number under any credible scenario) to produce genetically related
children, a prohibition on reproductive cloning would still
pass constitutional muster.5 (Moreover, I do not see how any
"last hope" right to use cloning, were it recognized,
could be cabined; rather it would establish a right of any person
who wanted to use SCNT to do so and to use any other available
means of controlling the genetic makeup of his or her children.)
For the purposes of this article, suffice it to say that the
constitutional objections to banning reproductive cloning are
dubious and unproven, whereas support for such a prohibition
has been demonstrated repeatedly in public opinion polls, in
legislative debates in this country and by enactments around
the world; most remarkably, leaders in medicine and science-who
rarely if ever favor outlawing any technology-have supported
the enactment of legal prohibitions that carry severe criminal
penalties.
II. Holding Back Research Cloning to Prevent Reproductive
Use
The question is thus whether a ban on reproductive cloning
ought-or must, at least for the time being-also extend to research
cloning. I am not arguing here in favor of any particular piece
of legislation. In particular, I think Sen. Brownback's bill,
S. 1899 (the Senate version of H.R. 2505, passed by the House
last July), which prohibits cloning for any purpose, has several
flaws, not the least of which is that its ban on research cloning
does not take the form of a time-limited moratorium. Rather,
I hope to demonstrate that a moratorium on research cloning
is needed both to make the ban on reproductive cloning effective
and simply to achieve the passage of such a ban at all.
a) The Connections Between Cloning for Research and for
Reproduction
To begin, we need to be clear that cloning does not differ depending
on its purpose. The NRC report labels research cloning "a
very different procedure"6 from human reproductive cloning,
but this is clearly a matter of political advocacy rather than
science. For those who object to restricting research cloning,
it would be handy if the procedure the NRC would have us call
"nuclear transplantation to produce stem cells" were
different, but as the NRC's own illustrations make clear (compare
Figure 1 and Figure 2 in the report), the cloning procedure
is identical up to the point where a blastocyst created through
human SCNT is either implanted into a woman's uterus (reproductive
cloning) or used as a source of stem cells (research cloning).
Since the procedure is the same, creating cloned embryos for
research would greatly increase the risk of reproductive cloning,
just the way the availability of guns greatly increases the
risk of homicide. That homicide is itself the object of criminal
prohibitions does not obviate the need for gun controls; likewise,
a prohibition on reproductive cloning would not end the need
to place a ban on research cloning until greater assurances
can reasonably be made that embryos cloned "for research
purposes" will not be stolen or misappropriated for reproductive
uses. This concern is not merely rhetorical, as the highly entrepreneurial
and largely unregulated IVF business in the United States has
already been marked by instances of misappropriation of embryos.
The connection between research and reproductive cloning is
especially important if it turns out to be difficult to produce
viable human blastocysts through SCNT. The scientific sophistication
to create such blastocysts may well be beyond the ability of
the self-proclaimed cloners. In that case, not only might the
results of studies carried out to create "research embryos"
ease the way for those who have announced their intention to
engage in reproductive cloning, but they could actually provide
reproductive cloners with a source of embryos. Such "leaked"
embryos could make it possible for such would-be cloners to
overcome their own technical inabilities to generate the necessary
embryos, leaving them with the less technically demanding task
of achieving pregnancies, using standard measures developed
by IVF clinics.
Finally, in addition to the risk of surreptitious misappropriation,
the existence of cloned embryos in laboratory increases the
risk that reproductive cloning will occur for another reason,
namely the constitutional uncertainties surrounding this field
that I mentioned before. While I am not persuaded by the "reproductive
liberty" arguments against a ban on reproductive cloning,
there is no question that the claim to override such a prohibition
would be stronger on behalf of a woman who has had a clone of
herself created than on behalf of a woman who wants to enjoin
the enforcement of the statute so that a lab will be willing
to attempt to create such a cloned embryo. In the former case,
the woman could say, "I have a constitutional right to
have my embryo implanted rather than destroyed. When the cloning
procedure was started, I agreed to allow it to be created for
research purposes, but the rule in all research is that the
subject can change her mind at any time and I have changed mine
now and want to attempt to allow this embryo to be born."
Most judges, I would hope, would reject this argument, but there
is nothing in the existing case law that says it might not persuade
some courts. In disputes between a man and a woman over possession
and use of frozen embryos created with their gametes (as, for
example, when a divorced woman wants to attempt pregnancy with
some or all of the IVF embryos created with her ex-husband,
who objects to such use), courts have responded no differently
because the embryos exist than they would if one person were
insisting on using gametes from another (unwilling) person for
reproductive purposes.7 But these rulings clearly rest on the
notion that no one should be forced into parenthood. In the
hypothetical cloning case, the position of the woman asserting
a right to use her cloned embryo is not opposed by another person
(since this is asexual reproduction, there is no other person!).
Rather, her position is closer to that of a couple seeking to
obtain their frozen IVF embryos from a fertility clinic that
does not want to release them; in the only litigated case of
this sort I'm aware of, the couple prevailed. Thus, the disposition
of a challenge to a ban on reproductive cloning brought by a
woman with an existing cloned embryo, legally created in the
absence of a ban on research cloning (with or without the cooperation
of the lab where the cloning occurred) would seem to be in doubt
and not resolved by existing cases. The constitutional claim
might be sufficient to persuade some judges to allow the woman
to use her embryo to attempt a pregnancy. Moreover, once a cloned
embryo has been implanted, no court would order an abortion
as a means of implementing a statutory prohibition on reproductive
cloning.
b) A Broad Moratorium is Needed to Get Any Restrictions
Adopted
Besides the practical reasons for not allowing research cloning,
the political reality is that the only way to get a ban on reproductive
cloning out of the United States Congress is to put a moratorium
on research. On one side stand the right-to-life forces who
insist on a total ban on all cloning, lest the government say,
in effect, "It's okay to make cloned embryos so long as
you kill them rather than implant them." That, of course,
is an anathema to them. On the other side are those who are
not only inclined to favor unfettered research but who do not
want to vote for S. 1899 (or any bill with comparable sponsorship)
because they do not want to hand their political opponents an
apparent victory. This stalemate has prevented the Congress
from acting on reproductive cloning for the past five years.
We really do need federal legislation in this field, as national
uniformity is the only effective way to control human cloning
efforts; furthermore, only federal legislation will permit U.S.
representatives to play an effective leadership role in the
international efforts to prevent reproductive cloning.8
Looking at the wide margin (265-162) by which the House passed
H.R. 2505 (which, like S. 1899, was originally sponsored by
anti-abortion Members), one might be tempted to think that this
time deadlock will be avoided because the Senate will also pass
a broad ban. There are several reasons for thinking otherwise.
The most basic is that the Senate is under Democratic control,
which means that a measure restricted to reproductive cloning
and sponsored by right-to-choice Senators (such as S. 1758,
introduced by Sen. Feinstein) is not only more likely to be
favored by a majority for party-line reasons but also enjoys
the parliamentary advantages of being favored by the Senate
leadership. Second, the research community, having been surprised
by the extent of support for H.R. 2505, has mounted a vigorous
lobbying campaign in favor of "therapeutic cloning."
Last summer, researchers were much more concerned with ensuring
that federal support would be available for hESC research. HHS
Secretary Tommy Thompson had suspended the rules adopted by
the National Institutes of Health in 2000 under President Clinton,
under which federal research support could be provided to scientists
to use (albeit not to derive) stem cells from discarded IVF
embryos. Scientist and disease-related advocacy groups that
see hESC research as a promising avenue to cures for conditions
such as Alzheimers, Parkinsons, and diabetes were recruiting
conservative politicians to lobby President Bush to allow funding
of hESC research, even if it meant backing away from his pledge
to right-to-life groups not to allow federal funds to be spent
to destroy embryos.9 For Representatives who wanted to show
their support for stem cell research while not unduly offending
their right-to-life constituents, a vote in favor of H.R. 2505
was particularly attractive: it allowed them to say "I
oppose any creation of embryos for research, especially when
it involves a technique as unnatural as cloning," while
simultaneously joining researchers in urging the President to
not to overturn the Clinton policy on hESC research support.
The same political circumstances do not now exist in the Senate
as on July 31, 2001, when House members cast their lopsided
vote for H.R. 2505, because nine days later the President announced
his compromise (funding for hESC, but only using stem cells
from embryos destroyed before 9 p.m. EDT on August 9, 2001,
when he announced his decision). Today, with the hESC decision
behind them, disease-advocacy and research lobbyists can focus
on protecting freedom to create cloned human embryos for scientific
purposes, and Senators have little need to seek political cover
on the hESC issue through taking a restrictive stance on embryo
cloning.
The net result is that one cannot predict that the Senate will
favor S. 1899 simply because the margin of victory for H.R.
2505 was very great and included many pro-choice Members and
moderate Democrats. Rather, inaction on banning reproductive
cloning remains a real possibility, either because the Senate
deadlocks and is unable to pass any bill or because it passes
S. 1758 and the House-Senate conferees are unable to reconcile
the differences between their measures. Therefore, a second
advantage to a moratorium on research cloning is that it is
a middle ground on which both sides ought to be able to agree:
it gives pro-life advocates a ban on all human embryo cloning,
albeit one that it time limited, while reassuring pro-research
advocates that the ban is only temporary and subject to review
in a few years, at which time the need to create cloned embryos
to provide therapeutic benefits to individuals will either have
been substantiated or not. Furthermore, in the meantime, state
and federal officials can take steps-which are needed any way-to
implement effective regulatory measures for the fertility business,
and the public can be engaged in a broadly based debate over
the pro's and con's of human cloning and genetic modification
of children as part of this general examination of state regulation
of reproductive technologies.
While research advocates might fear that a moratorium on all
forms of cloning would become permanent, that does not seem
a real risk to me, for several reasons. First, a moratorium
could include an automatic review every five or so years, perhaps
even one with a "sunset provision," meaning that the
ban would lapse unless re-enacted after a specified term. Second,
our experience with governmental decisions about hESC research
demonstrates that when the prospect of real therapeutic benefit
is sufficiently great, politicians find ways to support research
even while proclaiming their adherence to principles that would
seem to lead in the opposite direction. Notwithstanding the
label "therapeutic," human embryo cloning is not yet
at this point. Hence, the willingness of legislators to ban
the creation of human cloned embryos for research today is not
a good basis for predicting how they would vote five years from
now if research on animal cloning and with stem cells derived
from non-cloned embryos demonstrated the need for, and potential
value in, creating cloned embryos for non-reproductive purposes.
Furthermore, the intervening period would not only allow serious
efforts to control the fertility business but also the working
out of appropriate structures for "therapeutic cloning."
Should specially licensed, secure laboratories be established
where cloning would be conducted without risking "leakage"
of cloned embryos to reproductive facilities? How-and with what
safeguards against exploitation and physical and psychological
harm-will eggs (potentially millions, were each patient with
a relevant disease to be treated with custom-made stem cells
from his or her own cloned embryos) be obtained from women?
What additional authority does the Food and Drug Administration
need in order to play a useful regulatory role? Are Institutional
Review Boards the appropriate mechanism for overseeing therapeutic
cloning research and what standards ought they to apply?10 These
are only a few of the issues that could receive serious examination
during a moratorium and which are not addressed in present bills.
c) A Moratorium Will Not Cripple Research
Thus far I have argued that for practical and political reasons,
legislation to ban reproductive cloning should also include
a time-limited moratorium on the creation of human embryos through
SCNT. Opponents of such a limitation-most of whom, such as the
members of the NRC panel, apparently favor criminal penalties
on any attempt at producing babies through cloning-suggest that
it would cripple essential research. Their principal argument,
and the one relied upon by disease-advocacy groups, is that
it will be essential to clone human embryos for therapeutic
purposes because the stem cells derived from a cloned embryo
would match the patient-somatic cell donor and hence would avoid
the rejection phenomenon that now limits organ and tissue transplantation.
If this claim were persuasive, it would certainly weigh against
enacting a moratorium on the creation of cloned embryos for
non-reproductive uses, but it simply isn't.
As I have already mentioned, it's very misleading to call this
"therapeutic cloning." If the term "therapeutic"
were applicable here, we might as well simply drop the term
"research" generally and call all processes of developing
new biomedical technologies "therapies" from the outset.
There is nothing therapeutic about the possible creation of
cloned human embryos as a source of stem cells, and there won't
be for many years. Indeed, the underlying field of hESC research
is itself in its infancy. The term "therapeutic cloning"
represents an attempt to recruit patient advocates to the cause,
and it seems to me it has been a really unseemly exploitation
of their desperation. Michael West, the head of Advanced Cell
Technology, the principal company that is now pursuing this
technology, told a Senate committee last year that a ban on
therapeutic cloning would cost 3,000 lives a day, so that even
if a ban only created a six-month delay Congress would in effect
be responsible for taking half a million lives. In fact, both
the need for and the eventual utility of so-called therapeutic
cloning are unproven.
A moratorium on research cloning will not prevent progress
towards therapy. First, much research must be carried out using
hESCs (which can be derived from IVF embryos that are being
discarded and are donated for research instead) before there
is any reason to use cloned embryos as a source for stem cells.
Scientists need to learn how to induce hESCs to differentiate
reliably into particular cell types before it will be possible
safely to produce cells and tissues for treatment. They will
also have to demonstrate that these transplanted cells have
the ability to produce therapeutic benefits. Will they function
normally? Will they avoid the fate of the originals? Some recent
studies suggest, for example, that where diabetes results from
an autoimmune mechanism, the implantation of new pancreatic
cells is not the solution, which may lie instead in overcoming
the autoimmune response, which will otherwise produce the same
fate for the implanted cells.
Furthermore, it is not clear that cloned embryos would represent
a better source than banks of hESCs for most patients. First,
the very premise that cloned embryos offer a rejection-proof
alternative to hESC lines is itself in doubt because in most
cases (except where a woman is the source of both the egg and
the somatic cell used to create a cloned embryo) the cloned
embryo and the patient would have different mitochondrial DNA
(that is, the genes in the cytoplasm of the cell, outside the
nucleus), and this difference has been reported to cause immune
responses in laboratory animals. Second, research is underway
to determine whether hESC lines can become "universal donors"
or can at least be made less antigenic, so that transplanted
cells would be less likely to provoke immune rejection by the
patient. Third, hESC lines offer a much quicker and more cost-effective
prospect for transplantation than would stem cells from cloned
embryos. Not only would the latter task face logistical difficulties
(will the SCNT technique become reliable enough to produce embryos
quickly and easily? where will all the eggs necessary to treat
patients come from?), but the expense of such "custom-made"
therapy is likely to be prohibitive for most patients. Fourth,
the use of adult stem cells (that is, regenerative cells present
in various tissues of an organism after the embryonic stage)
could offer a means of avoiding immune rejection without having
to create cloned embryos and attempting to derive stem cells
from them. Research on the properties of adult stem cells is
a very active field today. If such cells can be manipulated
in a fashion comparable to what is being sought with ESCs, it
might be possible to create cells, tissues, or organs for transplantation
by harvesting readily available stem cells from a patient's
fat or bone marrow and then transforming them into the desired
type (perhaps to replace damaged heart muscle or deteriorated
neurological cells). Likewise, with further understanding of
the underlying mechanisms, physicians might be able to coax
the stem cells already available in the patient to perform needed
repairs without even being removed from a patient's body.
Alongside research on human embryonic and adult stem cells,
much research is required with cloned cells from mammals before
the need arises to clone human embryos for research. For example,
are the epigenetic errors that occur in cloned animals such
that it would be foolish to use cells from cloned human embryos
for therapeutic purposes? If a gene that is disrupted because
of the SCNT procedure were important to the healthy functioning
of a particular type of cell, then using a cloned embryo as
a source of such cells for transplantation could be very risky.
Having a moratorium on human cloning would push researchers
to carry their research as far as they could in mammals, including
primates, before turning to human studies. The upshot of all
this is that a moratorium encompassing all human cloning, rather
than just implantation of cloned embryos, will not prevent any
therapies from being used because none are in prospect any time
soon nor is it likely to delay the development of such therapies.11
III. Conclusion
Plainly, the practical and political problems that I foresee
if Congress do not include a moratorium on research cloning
in its efforts to prohibit reproductive cloning, as well as
the lack of deleterious effects that I believe such a moratorium
would have on research, are matters of prediction not of proof.
There is some risk-principally, a risk of delay-if the predictions
are wrong, especially about the effects on research. That risk
might not be worth taking if the production of children through
cloning is not something to be concerned about, indeed, not
something to be avoided if possible. So, in the end, we come
back to reproductive cloning and to the merits of efforts to
prevent it occurring.
In the early post-Dolly debates about human cloning, some fairly
specious (or at least to me, unpersuasive) arguments were raised
against it based on clones being genetically identical.12 Were
objections of this sort the only ones, I would be inclined to
agree with my colleague Michael Shapiro who wrote last fall,
"The main reason why human cloning is such a horror is
that much of the world would watch them, poke them, tell them
how repulsive their origins are, and generally treat them as
an 'it'." If he is right, the problem-which would not be
an objection to cloning, but rather to our reaction to it-is
plainly avoidable. But I don't think that is all there is, even
when (if ever) the physical risks involved are eliminated.
Nonetheless, the other concerns are neither self-evidently
disqualifying of reproductive cloning nor are they supported
by directly relevant experiential or experimental data; rather,
they are matters to be analyzed, investigated, and debated,
and about which in the end disagreements are so likely that
the decisive question will be where the burden of proof rests,
with those who would prevent use of SCNT for the creation of
human children or with those who would employ this radical new
means of creating children. Usually the response in this country
is to place the burden on those who would regulate, but I think
in this case, given what a fundamental and radical shift asexual
reproduction represents, one could-as the Europeans now do routinely
in environmental matters-employ the precautionary principle.
This holds that once a certain prima facie case of significant
and irreversible risks has been made out, those who would go
forward bear the burden of negating the risks and the absence
of definitive evidence cuts against the innovation rather than
against its regulation.
So what are some of the concerns about reproductive cloning?
One issue about asexual reproduction is whether children would
be harmed by having only one parent in a genetic sense of the
term. Obviously there are many families in which a stepparent
raises a child, or a father raises a child born within the marriage
who is known not to be his own biological offspring, without
such circumstances always raising substantial problems. But
the relevance of such experience is not entirely clear, because
even then there actually are two biological parents, whether
or not they are both currently involved with the child.
A second issue is whether the relationship between a person
who is the source of a somatic cell nucleus and the one or more
persons who are that person's clones can even be described in
ways that make sense legally, socially, morally, or what have
you. Obviously, such relationships don't fit existing categories
and raise questions about who is a "sibling" (as the
phrase "later-born twin" suggests) or who is a "parent"
(the donor of the somatic cell nucleus or his or her own parents,
whose sexual act gave rise to the unique genome represented
in the clones?) Consider the question of whether there ought
to be restriction on who, a clone could wed. My wife and I have
nothing but sons. If we wanted to have a daughter, probably
our best method would be to clone my wife. Now, suppose we did
that and then tragically my wife died. Would her clone, who
has no biological relationship to me, be a suitable replacement
for my now dead spouse (assuming the clone were by then old
enough to marry)? She would be the embodiment of the woman I
had married, which is exactly the kind of "replacement"
that people who want to use cloning to replace a dead child
are talking about. Should the rules against incest apply? What
if the clone had been raised by someone other than me and my
late wife?
Many of the most contentious issues about reproductive cloning
concern the impetus it gives to the already existing phenomenon
of "designer babies." The notion that children should
be "wanted" is an attractive one, especially compared
with the alternative,. One of the arguments for reproductive
liberty is to allow people to be better parents in all sorts
of ways, especially by not having children they don't want.
When there is freedom to choose, those who are born are that
much more precious. Some evidence now seems to suggest that,
while artificial reproductive technologies are associated with
slightly elevated physical risks, the children tend to be wanted
(and loved) at least as much as children born through traditional
reproduction. Yet the line between a wanted child and a made-for-order
child is a small one. The available means for designing children
are too new and too modest to have produced much evidence about
what the harm of being wanted may be-not in a general sense
"a wanted child," but being wanted for specific characteristics
and capabilities, be it male or female, with a known genetic
makeup and specifically, with my own genetic makeup (and, if
Dr. Segal's extrapolation is correct, a cloned child might be
more like me than two twins are like one another).
Raising these issues does not mean that one buys into genetic
determinism-quite the contrary! There are good reasons, however,
to think that people who are drawn to cloning are in many instances
trying to get a predetermined result. Indeed, the whole reason
for using cloning rather than a method of sexual reproduction
("assisted" or otherwise) is to control the child's
genome. So, while it is plainly the case that a genome is of
importance only as it functions in a cellular, organismic, and
social environment, people can be excused for thinking otherwise,
given the prominent attention that science and the media pay
to mapping the genome and to discovering "the gene for"
this and that. Given the uniqueness of each individual's environmental
experience, from the earliest embryonic moment onwards, it's
true that if Mozart were cloned, you wouldn't get another Mozart.
But so long as the impulse to act otherwise exists, the failure
of the Mozart clones to measure up to expectations is likely
to be a source of harm rather than benefit for them, as their
makers' expectations-and elaborate plans or fantasies-are disappointed.
Of course, it is not uncommon for parents to have hopes and
expectation for their children. But when these fly in the face
of the reality of the child, there are also social forces that
rein in-indeed, that at some point ridicule-parents who try
too hard to mold their children's lives. Were medicine to sanction
cloning as a legitimate way of getting the child you want, it
would exacerbate rather than reduce the drive to regard children
as objects to fulfill parental wants rather than as individuals
who are entitled to their own, self-directed lives. Nor is this
a matter of determining the outer limits of some "right"
of paternal manipulation. As Peggy Radin pointed out years ago,
any process that commodifies children has effects on people
who don't even use the technology, and I think that is something
which will prove true here as well. To the extent that procreation
becomes manufacture, the choice to go on with unmediated "sexual
roulette"-free of whatever benefits genetic tinkering or
outright cloning might provide-is likely to seem increasingly
irresponsible and perhaps even impermissible.
There are a wealth of other issues that deserve to be examined,
and remarkably little data to use in the process. It is frequently
suggested-as it was by Professor Segal in this symposium- that
we can rely on studies of twins, which are read to be largely
reassuring about the results of cloning. This seems largely
specious because we have no studies of twins who are separated
in time, especially where one is an adult at the time the other
is born. This difference is crucial regarding concerns over
the domination of a clone by the other, the extent to which
the younger one (when aware of the life of the older progenitor,
even if not raised by that person) would lack the sense of an
"open future" and would instead feel bound to a path
laid out in the life of the other. To the extent the twin studies
teach us anything, they sound a cautionary note. Professor Segal
reported that twins who are more physically alike appear behaviorally
to be more different because their parents place a bigger emphasis
on treating on them differently, and because they try harder
to differentiate themselves. With twins, we have two people
who (in principle) begin on a footing of equality; one will
have been born shortly before the other (which I gather is frequently
an issue in the relationship), but they are basically equal.
That is not true in cloning of temporally separated clones,
and the issue that arises is obviously why would someone be
using cloning except to be getting a particular result, so that
rather than wanting to differentiate from the identical twin,
people in this circumstance would be using cloning precisely
because they wanted to get a particular result and would exert
pressure toward that result.
There are many other concerns about the potential effects of
cloning that a moratorium would give us an opportunity to evaluate,
at least to some extent even if in the end we may have to base
decisions on very incomplete data. Above all, I hope that society
as a whole will be mindful of the enormous power of cloning
and genetic modification of reproduction and of the dangers
that inhere in our inevitable temptation by such power. Often,
great hopes have attached to technological developments, but
the experience of recent years should have taught us that we
need caution too. Thinking of the great power represented by
the prospect of human cloning, I am reminded of C.S. Lewis's
remark three decades ago in The Abolition of Man, that
"Each new power won by man is a power over man as well."13
Cloning provides the ultimate example of his warning, the power
of one generation to determine the makeup of the next.
NOTES
Alexander Morgan Capron is a University Professor, Henry W. Bruce Professor of Equity,
Professor of Medicine, and Co-Director, Pacific Center for Health
Policy and Ethics, University of Southern California.
1. National Bioethics Advisory Commission, CLONING HUMAN BEINGS,
Rockville, MD: National Bioethics Advisory Commission (June
1997).
2. Committee on Science, Engineering, and Public Policy, Board
on Life Science, Division on Earth and Life Studies, National
Research Council, SCIENTIFIC AND MEDICAL ASPECTS OF HUMAN REPRODUCTIVE
CLONING, Washington, DC: National Academy Press (2002) [hereinafter
SCIENTIFIC AND MEDICAL ASPECTS].
3. California Advisory Committee on Human Cloning, CLONING
CALIFORNIANS?, Sacramento, CA: California Department of Health
Services (2002).
4. D Humphreys, K. Eggan, H. Akutsu, K. Hochedlinger, W.M.
Rideout III, D. Biniszkiewicz, R. Yanagimachi & R. Jaenisch,
Epigenetic Instability in ES Cells and Cloned Mice, 293 SCIENCE
95 (2001).
5. A central reason why we generally respect the rights of
couples to make their own choices about reproductive and rearing
their children is that the kinds of interventions that would
be required if the state tried to decide who was or was not
likely to produce good children or to be a good parent would
be enormously intrusive Indeed, Griswold invoked "privacy"
as the right that protected individual choice about reproduction
because the statute in question intruded not only on the physician's
office where a contraceptive might be prescribed but also upon
the marital bedroom where it might be used. In controlling a
high tech procedure like cloning, the state need not invade
the sanctity of the home or set off down a slippery slope of
judging the appropriateness of all reproductive choices.
6. SCIENTIFIC AND MEDICAL ASPECTS, note 2 supra, at ES-5.
7. Nor have the courts regarded the embryos to possess a "right
to be born" such that the party wishing to attempt pregnancy
ought necessarily to prevail.
8. Already more than 30 countries have prohibited cloning,
though some only restrict reproductive cloning. The United King,
which is the best example of such a policy, is in a very different
situation than the US because their Human Fertilisation and
Embryology Authority exercises real control over the fertility
business in their country. They know how many embryos have been
created in their labs and the uses made of them, whereas we
have no idea about that. Under a motion made by the delegates
of France and Germany, the United Nations' Sixth Committee is
beginning in March 2002 a year-long process of developing treaty
structures for international control of human cloning.
9. See A.M. Capron, Stem Cells: Ethics, Law and Politics, 20
BIOTECHNOLOGY L. RPT. 678 (2001).
10. Section 4(b) of S. 1758 amends the Public Health Service
Act (42 U.S.C. 289 et seq.) by adding § 498C entitled "Ethical
Requirements for Nuclear Transplantation Research," under
which human SCNT research "shall be conducted in accordance
with the applicable provisions" of 46 CFR 45 (2001), the
so-called "Common Rule" governing research with human
subjects. This provision raises a number of questions, not the
least of which is whether this structure-developed for research
that is federally funded, or at least is conducted at institutions
that do a lot of federally funded research and that have agreed
to apply the same procedures to their non-federally funded research-will
work if applied to research all of which is privately funded
(because other, existing appropriations provisions prevent any
federal funding of research in which a human embryo would be
created or destroyed). Furthermore, the Common Rule generally
requires that research subjects consent to participate (clearly
not possible for embryos) and not be exposed to undue risks
of harm (cloned embryos would be destroyed in the process of
creating stem cell lines); thus, the only possibility for such
research to be approved at all is for cloned embryos not to
be regarded as research subjects. But in that case, the Institutional
Review Boards charged under the Common Rule with reviewing research
protocols would have little basis for deciding whether or not
to approve one or another proposal for research cloning.
11. The moratorium would prevent other research, such as the
creation of cloned embryos from somatic cells in which genetic
mutations are expressed, as a possible means of developing stem
cells that express the mutation, to aid in studying "how
inherited and acquired alterations of genetic components might
contribute to disease processes." SCIENTIFIC AND MEDICAL
ASPECTS, note 2 supra, at ES-12. The NRC panel also opined that
cloning embryos would be useful to ensure that stem cell research
"covers a more genetically diverse human population than
that represented in the blastocysts stored in IVF clinics"
but did not explain why it would be necessary to create cloned
embryos to achieve this diversity, and concluded, without explanation
or support, that "studies of genetic reprogramming and
genetic imprinting will be substantially enhanced" through
SCNT-derived stem cells compared with other hESCs. Id.
12. One respected person at the University of Chicago suggested
that clones would be used as living sources for replacement
parts and organs because they would not be fully human since
their lack of genetic uniqueness would keep them from being
individuals or moral agents. Another notion in the early coverage
of cloning in the popular media was that somehow it would immediately
produce "xerox copies." For example, in the film Multiplicity,
the character(s) played by Michael Keaton emerged from the duplication
process as ever-more aberrant copies of a full-grown man (with
most of his memory-if not his judgment-intact). As Professor
Mclain suggests in her article, this public misunderstanding
was exacerbated by the fact that when we first met Dolly she
was already a sheep and not a lamb, leaving the sense that cloning
was capable of producing fully adult organisms, rather than
baby replicants.
13. C.S. Lewis, THE ABOLITION OF MAN (1965). |