This staff working paper was
discussed at the Council's January
2002 meeting. It was prepared by staff solely to aid discussion,
and does not represent the official views of the Council or of the
United States Government.
This working paper, prepared for the
third of our three sessions on human cloning, is devoted to public
policy questions, and, in particular, the legislative alternatives
now under active consideration. The working paper, like the
discussion it seeks to prepare, is divided into two parts. The first
part addresses the following matters: What are the major legislative
or public policy alternatives with regard to human cloning? What are
the arguments for each and the advantages and disadvantages of each?
The second part explores in greater detail one of the critical
issues in the public policy debate, the alleged promise of
"research" (or "therapeutic") cloning and its significance for
finding and choosing the wisest public policy.
I. Human Cloning and Public Policy: The Major
Legislative Alternatives
At the end of its deliberations on human
cloning, the Council may well be expected to provide specific
recommendations regarding national public policy. It is therefore
vital for the Council to begin to consider the major policy
alternatives, even as it considers the meaning of cloning human
beings and the moral and ethical arguments for and against doing it.
While there may certainly be many possible combinations and
arrangements of policies and regulations regarding human cloning,
the public debate and discussion has focused on a legislative ban.
Here there are three options: no legislative ban; a ban on
"reproductive" cloning only, which would prohibit implanting cloned
embryos into a woman's uterus to begin a pregnancy; or a ban on all
human cloning, beginning with the first step, the creation of cloned
human embryos. These seem to be the most likely options, and policy
makers will probably be faced with a choice among them.
A. No Legislative Ban
The first option would be
to enact no new federal legal restraints or prohibitions on human
cloning. This option would continue the legal status quo: a
continued moratorium on federal funding of any sort of human cloning
("research" or "reproductive") but no legal barrier to such work
carried out with private funds (except in those six states that have
enacted state statutes forbidding human cloning).1
Advocates
of this approach make the following arguments, among others:
1. A ban on human cloning is unnecessary. The technical
ability to clone humans successfully is far off in the future.
Banning activities in the absence of clear and present danger sets a
bad precedent and is, in general, bad public policy. There is, at
least for now, no need for the government to act.
2. A ban
on human cloning violates private rights. Cloning is a matter of
private choice and reproductive freedom, and therefore not properly
a matter for governmental action. (A temporary -- and perhaps only
voluntary -- moratorium on human cloning may be acceptable until the
technology is sufficiently safe for use, but thereafter the law
should be silent.)
3. A ban on human cloning interferes with
important public goods -- not only as a means for medical research
and scientific progress, but also as a new mode of human
reproduction with potentially good outcomes for society.
4.
A ban on human cloning is unconstitutional. Congress lacks the
constitutional authority to prohibit a scientific, medical, or
technological activity, especially on moral grounds.
5. A
ban on human cloning, while constitutional, is undesirable.
Criminalization of scientific research would set a dangerous
precedent and would tend to stifle scientific progress in the United
States. Leading scientists would leave the country to work in more
permissive places. The American economy would suffer in competition
with other less restrictive nations.
6. A ban on human
cloning will not succeed. The ban will be violated, if not here,
then in other countries. It will also be unenforceable: It is
impossible to police laboratories or clinics to prevent it; and
there can be no acceptable and enforceable remedy should cloning
occur, especially once a pregnancy has begun.
For one or more
of these reasons, some have argued that the government should
refrain from banning human cloning in any form. This option,
however, seems to lack public and congressional support, as
evidenced in the recent vote on human cloning in the House of
Representatives, where nearly every member voted for at least some
sort of federal ban on human cloning. Most Americans and most
legislators seem to believe that some legislative action is required
with regard to human cloning (for some of the reasons laid out in
the previous working papers), but they are divided on which of the
next two alternatives is the better legislative course.
B. Ban on Clonal Reproduction Only: Prohibit
Attempts to Initiate Pregnancy with Embryonic Clones
One proposed legislative
option seeks to ban only "reproductive" cloning. It would ban
attempts to start a pregnancy by banning the transfer to a woman's
uterus of a cloned human embryo. This option would allow, and even
sanction or encourage, the creation of cloned human embryos for
research purposes, provided that none of these embryos were used in
efforts to produce a baby.
Advocates of this approach make
the following arguments, among others:
1. This is an
effective way to ban the cloning of human beings. If the goal is
(only) to stop "reproductive" cloning (the cloning of live-born
human babies), banning the implantation of cloned embryos will be
just as effective as banning the creation of cloned embryos.
2. A more restrictive ban is too costly. Proscribing the
creation of cloned embryos, usable for research purposes, would shut
down unique and promising new avenues of stem-cell research (such as
"therapeutic" cloning), which seek to derive embryonic stem cells
that are genetically virtually identical to (and therefore
presumably immunologically compatible with) the person in need of
stem cell therapy. Even if the promise of this research is
uncertain, its value cannot be judged in any definitive way without
allowing it to go forward. [This issue of "therapeutic" cloning
figures prominently in the public and legislative debates. We shall
return to it in the second part of this working paper.]
3. A
more restrictive ban is unjustified and arbitrary. A ban on the
creation of cloned embryos for research is inconsistent with present
law and policy regarding embryo research. Research on cloned embryos
is no different from other forms of embryo research that we allow in
the private sector -- specifically, research on IVF embryos left
over in assisted reproduction clinics and on IVF embryos created
solely for research and destruction -- despite the fact that many
people believe this research is unethical. A ban only on
implantation would thus maintain the precedent set by President Bush
with his decision on federal funding of embryonic stem cell
research: Not every morally debated form of research justifies a
criminal ban, but not every medically desirable form of research
deserves public funding and endorsement.
4. A more
restrictive ban will hurt science. The criminalization of research
on cloned embryos would create a "chilling effect" in the scientific
community that would hurt other avenues of scientific research, and
set a dangerous precedent that scientific inquiry is no longer free.
Scientists may take their work out of the United States, and thus
harm America's standing as a world leader in scientific and medical
research.
5. A more restrictive ban will hurt reproductive
and genetic medicine. The criminalization of research on cloned
embryos will create a "spill-over" effect, threatening the legality
of other medical procedures and research -- such as IVF, gene
therapy, and research with embryonic stem cells. For one or more
of these reasons, some of those involved in the public debate about
cloning argue that a total ban on all human cloning (including
research on cloned embryos) is not advisable and not necessary for
the prevention of clonal baby-making. They suggest that banning the
implantation of cloned embryos would be enough to stop
"reproductive" cloning while allowing scientific research to
continue.
C. Ban on All Human
Cloning (Including the Creation of Embryonic Human
Clones) This option seeks to ban all human
cloning from its very start, beginning with the creation of cloned
human embryos. The proponents of this option hold that a ban on the
transfer to the uterus of a woman is insufficient, and that cloning
must be comprehensively stopped before it starts.
Advocates
of this approach make the following arguments, among others:
1. Only a total ban will work. The only effective way to
stop reproductive cloning is to stop the creation of cloned embryos.
The reasons for this include the following:
a. The
commercial production of embryos for research is protected by
industrial secrecy. This means that those charged with monitoring
and enforcing the ban on reproductive cloning will not know who is
doing what with cloned embryos.
b. The transfer of cloned
embryos to begin a pregnancy would be virtually undetectable and
protected by doctor-patient confidentiality.
c. The IVF and
assisted-reproduction industry is largely unregulated: The federal
government has no track record in regulating or keeping track of the
number and fate of embryos produced in IVF clinics. There is little
or no reason to be confident that the necessary institutions exist
or could exist to monitor the use of cloned embryos.
d. A
ban only on implantation would be unenforceable: Once pregnancy has
begun, there is no real remedy except forced abortion, something
neither reproductive rights advocates nor pro-life advocates would
accept.
2. The promise and especially the necessity of
"research" cloning are exaggerated. "Therapeutic" cloning is a
highly speculative form of research with no imminent medical
benefits. It may not be needed to solve the "rejection problem"; it
may not succeed in doing so; even if it succeeds, it will not be
practicable on a large scale. [We will offer an expanded discussion
of these matters in the second part of this working paper.]
3. The total ban would not have "spill-over" effects. A ban
on the creation of cloned embryos would not affect other accepted
forms of assisted reproduction -- including IVF, artificial
insemination, etc. The proposed legislative total ban on human
cloning has been carefully and narrowly drawn.
4. A ban only
on the implantation of cloned embryos is morally and politically
highly problematic. The less-total ban (option B, above), which
explicitly allows the creation of cloned embryos for research and
destruction, would permit and even endorse the creation of a new
class of human embryos that cannot be brought to term but must be
destroyed (or else left frozen indefinitely). Failure to destroy (or
leave frozen) these embryos would be a federal crime. A ban on only
the implantation of cloned embryos would put the federal government
in the morally dubious position of sanctioning the creation of a
class of embryos solely for research purposes and then mandating
their eventual destruction.
5. The total ban on all human
cloning, including cloning embryos for stem-cell research, is not,
as some have alleged, arbitrary or inconsistent. Exploiting unused
IVF embryos may have its own moral difficulties, but the deliberate
creation of embryos exclusively for the purpose of their use and
destruction is, in moral and social terms, a different and far more
serious matter entirely. Besides, the point of this comprehensive
ban is to stop all human cloning before it starts: It is a cloning
ban, not an embryo research ban.
6. A ban on all human
cloning, including the creation of embryonic human clones, would not
affect other forms of scientific research -- such as embryonic stem
cells, gene therapy, cell or molecular cloning, animal cloning, etc.
Federally funded research on existing embryonic stem cell lines and
private-sector research on new embryonic stem cells derived from IVF
embryos will proceed. The feasibility of stem cell therapies will
become clearer, without the need for research on cloned embryos.
Moreover, if scientists can one day clearly demonstrate the "need"
for cloned embryos for research, the ban can be revisited.
7. A total ban on cloning will not hurt the United States in
the international arena. A comprehensive ban in the United States
would be an important step in moving toward a worldwide ban of human
cloning, now being explored at the United Nations. By enacting a
total ban on human cloning, the United States would clearly stake
out a position of leadership in this global effort.
For one
or more of these reasons, many opponents of clonal baby-making
believe that the only way to effectively and ethically prevent human
"reproductive" cloning is to prohibit human cloning entirely,
beginning with the creation of cloned human embryos. They argue that
the potential scientific promise is not sufficient to offset the
very serious moral, ethical and prudential arguments against human
cloning. They argue, in addition, that scientists must, in rare
cases, accept moral limits on what they may do. Scientists want
complete freedom to experiment without restrictions -- believing
both that science itself is a self-justifying enterprise, and that
scientists have professional institutions in place to govern
themselves. For the most part, society gladly grants them this
freedom; we support, celebrate, and benefit from their work.
Occasionally, however, scientists must accept the need for limits,
when their research and the technologies it creates threaten core
human, moral, and social goods. While conceding that some future
benefits may be delayed or lost by banning the creation and use of
cloned human embryos, proponents of a total ban argue that the
increased risk of opening the door to cloned children and the moral
problem of creating human embryos solely for research, exploitation,
and federally required destruction justify a total restriction in
this case.
II. "Research" (or
"Therapeutic") Cloning -- Some Scientific, Moral, and Policy
Questions
Central to the current debate over
whether or how to ban human cloning are questions about the promise
and morality of "research" (or "therapeutic") cloning. As indicated
above, opponents of a total ban on human cloning believe that the
potential medical benefits of "research" cloning are sufficient to
justify allowing the creation of cloned human embryos to continue.
In recent months, some scientists and biotechnology advocates have
been strongly making the case for the prospects and benefits of this
research. In November 2001, Advanced Cell Technology (ACT) published
the first results of its program in "research" (or "therapeutic")
cloning, the creation of a zygote by somatic cell nuclear transfer
and its subsequent cleavage to form a six-celled embryo (see Working
Paper: Scientific Aspects of Human and Animal Cloning).
In testimony before Congress and in various media
appearances, the ACT scientists touted the therapeutic promise of
"rejection-proof" stem cells that their research on cloned human
embryos would, they claimed, soon make possible. Because of the
importance of this matter to the current policy debates, and also
because of the importance of this issue both in itself and as a test
case for thinking about how to judge competing claims about
scientific promise and moral hazard, we shall look into the subject
of "research" cloning. We will focus in particular on the issue of
"therapeutic" cloning, which is the most widely discussed and
defended (at least in public debate and discussion) form of research
on cloned human embryos. We shall first present an account of what
"therapeutic" cloning is and what it hopes to accomplish. We shall
then pose a series of questions about the necessity, efficacy,
feasibility, practicality, and morality of this research. Our
purpose here is to indicate and open up some of the questions that
are relevant to evaluating the significance of "therapeutic" cloning
for the public policy options now before us.
A. "Therapeutic" Cloning: What It Is and What It
Hopes to Achieve Q: What is the idea behind
"therapeutic" cloning? How do advocates for this research claim that
it will work?
In several significant human diseases (for
example, Parkinson's disease), cells that produce a needed substance
die selectively, and disease results from the lack of that
substance. In theory, such diseases could be treated by isolating
cells that produce the needed substance (dopamine in the case of
Parkinson's) in appropriate amounts, and then transplanting such
cells into the patient. This is the hypothesis and goal of embryonic
stem cell research: the capacity to regenerate, repair, or replace
the diseased or damaged cells that cause many human diseases or
disabilities, including Parkinson's disease, juvenile-onset
diabetes, leukemia, stroke, burns, and spinal cord injury, among
others.
However, if stem cell therapies are to work, the
transplanted cells must not be recognized as "foreign" by the immune
system of the patient. If this happens, the transplanted cells will
be attacked and the transplantation therapy may not produce a
lasting improvement. Researchers disagree about how best to try to
solve this problem, and about which avenues of research or possible
research are currently the most promising.
One proposed
method for solving the rejection problem is to produce
"individualized" stem cells that are genetically virtually identical
to the patient who needs them. It is this avenue of research that is
now commonly referred to as "therapeutic" cloning. These presumably
immunocompatible stem cells would be obtained by taking cells from
the living patient, inserting the DNA from those cells into an
enucleated human egg using "somatic cell nuclear transfer,"
developing the resulting (genetically virtually identical) zygote to
the blastocyst stage in the laboratory, and then deriving stem cells
from the embryo clone (which is destroyed in the process). The
hypothesis is that by deriving these stem cells from an embryonic
clone of the patient, the cells would not be rejected, since the
patient's body would treat them as if they were his or her own
cells.
As an example, in the case of a patient with
Parkinson's, the following steps could be envisioned:
1.
Obtain human egg cells from informed and consenting donors.
2. Remove the nucleus from these eggs and insert a nucleus
from an informed and consenting donor-patient with Parkinson's. The
zygote and the resulting embryo would be a clone of the patient.
3. Grow the reconstructed egg in vitro until the embryo
reaches the stage where an inner cell mass containing stem cells has
been formed.
4. Take the embryo apart and isolate
"individualized" stem cells that are genetically virtually identical
to the patient.
5. Induce the "individualized" stem cells to
differentiate in vitro into dopamine-producing, neuron-like cells.
6. Transplant these dopamine-producing cells into the
appropriate brain location of the donor-patient.
As only
experiments resembling steps 1 and 2 have been reported to date, and
no "individualized" stem cells have been isolated, it may take years
or decades to develop such therapies. It should also be noted that a
legislative ban on all human cloning (Option C, in Part I above)
would make continuing such research a criminal offense. Evaluating
the promise of such therapies is therefore an essential factor in
weighing the alternative cloning policy options (though certainly
not by itself determinative of which option should be chosen).
B. Scientific and Practical
Questions about "Therapeutic" Cloning The idea
and rationale of "therapeutic" cloning are clear enough. But the
idea is not yet a reality. Even before reaching possible moral and
political difficulties, there are a series of scientific and
practical questions that need to be considered, including its
likelihood of success and the availability of alternative approaches
to the same goal. Among these questions are the following:
1. Will "therapeutic" cloning work? Will it solve the
rejection problem? In addition to the many unanswered
questions surrounding embryonic stem cell research in general, many
scientists dispute whether "therapeutic" cloning would actually
solve the problem of immune rejection of transplanted stem cells.
Some questions include: Is there evidence from animal studies that
"individualized" stem cells can be developed through cloning? If
such "individualized" stem cells are transplanted into the donor
animal, are they rejected by the immune system of the recipient? In
animal systems, when stem cells that have been differentiated in
vitro to produce neuron-like cells are transplanted into the brain
of the donor animal, are they attacked and killed (for example, by
microglial cells)? Do the mitochondrial proteins derived from the
egg (and which render the clone not 100 percent identical to the
donor-patient of the somatic cell nucleus) cause the
"individualized" stem cells to be recognized as foreign by the
recipient and attacked by the immune system? Do the animal cell
proteins in the media used to grow the reconstructed egg and
"individualized" stem cells cause the cells to be recognized as
foreign by the recipient?
Scientific opinion is not clear on
these questions, even if many leading scientists believe ACT's
claims for "therapeutic" cloning are premature and overly
optimistic. But defenders of continuing research on cloned human
embryos, whatever their judgment of ACT's work in particular, argue
that it is different to say that something will not imminently work
versus something will never work, which is different in turn from
saying that nothing useful will be learned by doing such research.
What works and what doesn't is often unpredictable, and often the
pursuit of a hypothesis that turns out to be wrong opens up avenues
of inquiry that might not otherwise have been possible or likely.
2. Is "therapeutic" cloning necessary? Or are
there other, simpler, more promising, and less controversial ways of
solving the rejection problem? Is "therapeutic" cloning
necessary for solving the problem of immune rejection in proposed
stem-cell therapies? Critics of the research argue that the
development of stem-cell based cures is going to take a long time,
and therefore that immunogenics may very well solve the stem-cell
rejection problem well before the treatments are ready; or that
adult stem cells taken from the patient's own body (and which would
be in principle immunocompatible) could be used to treat the
disease; or that standardized embryonic stem cell lines can be used
rather than having to create customized cell lines for each patient;
or that recent studies with cross-species stem-cell transfer may
offer more promise; or that stem cells, once available, could be
turned into bone marrow cells, injected into the patient's bone
marrow where the cells of the immune system are generated, and thus
could create a mixed immune system that would not treat transplanted
cells as "foreign."
Defenders of "therapeutic" cloning
counter that we cannot know for sure which avenue of research will
eventually work; and that it would be a shame if major advances in
stem cell therapy were held back by rejection problems that could
have been fruitfully explored by studying cloned embryos.
3.
Is "therapeutic" cloning an accurate term? The term
"therapeutic" cloning is a heavily disputed one. It was created to
describe the above hypothesized procedure, named both for the
intention of the researchers and for what it might make possible in
the future. It was also created in an effort to separate the
creation of embryonic clones for research from the identical
procedure of creating embryonic clones for reproduction.
However, both many advocates and many opponents of this
research believe the term is misguided. Some research advocates
believe that the use of the term "cloning" is inaccurate because the
researchers have no intention of creating a cloned live-born human
being. They say that what they are really doing is one (or all) of
the following: "somatic cell nuclear transfer" (the procedure used
to create embryonic clones); "nuclear transplantation" (which
presumably describes both the transplantation of DNA used to create
embryonic clones and the hoped-for transplantation of stem cells to
future patients); or "cell replacement by nuclear transfer" (again,
putting the emphasis on the procedure that creates embryonic clones
and the future hoped-for medical benefits).
At the same
time, some opponents of this research believe that the term is
inaccurate for very different reasons. They argue that "therapeutic"
cloning is cloning, because the nature of the act does not turn on
the intention: The product of the procedure (namely, cloned embryos)
does not differ from the cloned embryos created for the purpose of
initiating a pregnancy. The intended uses may be different, but the
cloned embryos are not. The opponents have difficulty especially
with the label "therapeutic." They argue that to refer to the
procedure as "therapeutic" cloning suggests that the procedure
itself is therapeutic -- that is, that the act of "therapeutic"
cloning serves or heals an existing patient. But there is no patient
as yet, only future and hoped-for patients. In reality, they argue,
"therapeutic" cloning is simply a euphemistic way of describing
experimental research on cloned human embryos, thereby obscuring the
fact that the embryos would be destroyed in the process of deriving
stem cells from them. A more accurate term, they argue, would be
"experimental" cloning or "research" cloning.
4. Are
there additional reasons, besides "therapeutic" cloning, that might
make research on cloned human embryos useful or desirable?
In addition to "therapeutic" cloning, there may be other
potentially beneficial scientific or medical reasons to conduct
research on cloned human embryos. Some scientists would like to use
cloned embryos to study the mechanism by which somatic cell nuclei
undergo reprogramming, hoping thereby to learn ways to convert any
adult somatic cell into a pluripotent stem cell, available for
regenerative medicine without the need for embryonic cells at all.
In addition, there may be benefits of having genetically virtually
identical embryos to study how the introduction of specific genes
affects early human development.
C.
Moral, Social, and Prudential Considerations In
addition to these scientific and practical questions, the issue of
"therapeutic" cloning raises a series of moral, social, and
prudential questions. These questions include the following: Would
the creation of cloned embryos for research increase the risk or
likelihood of reproductive cloning, and if so, to what extent? Does
the risk of future dangers (live human clones) outweigh the hope of
future benefits (new medical therapies and cures for diseases)? Even
if "therapeutic" cloning became possible, would it be practicable
for large-scale use? Would its benefits be equitably or widely
available or only available to select groups (such as the very
wealthy and those able to secure a large supply of human eggs)? Does
the possibility of saving future lives justify the present
exploitation and destruction of embryos, especially embryos created
solely for research use? Does the need to treat certain diseases or
forms of suffering justify using what may be morally hazardous forms
of research?
Here we try to consider some of these questions
in greater detail:
1. Would "therapeutic" cloning be
practicable for large-scale use?
Given the low success
rate of attempts to bring a cloned zygote to the blastocyst stage,
it appears that a very large number of eggs would be required to
make "therapeutic" cloning a reality. Will this large supply of eggs
be available? Who will provide them? What will be required to obtain
them? How much will it cost? Will entrepreneurs be willing to invest
in such a high-risk venture, especially if there are cheaper and
simpler avenues to pursue to solve the "rejection problem"? Will
regulators be able to verify the safety of each cell line? Is the
creation of "individualized" stem cells practicable on a large
scale?
2. Would its medical benefits be equitably
available? Given the above concerns, would access to
"therapeutic" cloning be equitably distributed and widely available,
or would it be available only to those who could bear high financial
costs or those who have access to large supplies of human eggs? How
should these considerations bear on the public policy debate
regarding what to do about human cloning?
3. Is
"research" (or "therapeutic") cloning morally acceptable? It
is at this point that the subject of the ethics of human cloning
intersects with the otherwise separate subject of the ethics of
human embryo research, crucial to the debate about embryonic stem
cell research. Our current study of human cloning cannot take up the
ethics of embryo research in general (this is a topic for another
occasion, as when the Council examines the federally funded work now
being done with stem cells). Nevertheless, we must acknowledge that
the moral acceptability of "therapeutic" cloning research is tied to
the moral acceptability of all embryo research, especially where the
embryos are specially created for research purposes. And we must
also acknowledge that for some who favor a total ban on all human
cloning, it is their objections to the use and abuse of human
embryos that centers their opposition. Accordingly, we indicate here
a few of the relevant moral questions regarding the ethics of embryo
research in general, before looking at moral questions peculiar to
research with cloned human embryos.
a. When, if ever, is it ethical to use nascent human life
for research purposes? In answering this question, what if any is
the moral significance of the following distinctions?
i.
Between different stages of nascent human life: fertilized egg or
zygote, embryo (including the blastocyst stage), fetus.
ii.
Between the manner in which and for which nascent human life is
created: IVF embryos created for reproductive purposes and left over
in clinics; IVF embryos created solely for research purposes and
eventual destruction; cloned embryos created solely for research
purposes and eventual destruction.
iii. Between different
experimental uses of nascent human life: stem cell research,
fertility research, embryological or genetic research.
iv.
Between forms of research that should be publicly funded and
endorsed, allowed in the private sector but not publicly funded or
endorsed, or regulated or banned.
b. Does the use of embryo
clones for research or experimental purposes create new moral
problems or questions distinct from the moral problems and questions
raised by research on IVF embryos? Conversely, how significant are
the unique scientific or medical benefits of conducting research on
cloned embryos? Three considerations seem most important:
i.
Would the use of embryo clones increase the risk of human
"reproductive" cloning?
ii. What is the moral significance of
the fact that legislation may create a new class of human embryos
that must be destroyed? Of the fact that it would be illegal not to
destroy them?
iii. How do we balance these moral concerns
with the potentially unique scientific or medical benefits of
research on cloned embryos?
c. Besides the moral questions
regarding the use and fate of human embryos, there are questions
about the moral implications for the human researchers and the
society that encourages and supports them: What happens to the
attitudes, sensitivities, and outlooks of people who are willing to
regard nacsent human life as a resource to be exploited?
4. How do we judge among present versus speculative
hazards and benefits? What does prudence require? What are the
different human goods that are at stake? The ethical and
prudential considerations regarding "therapeutic" cloning raise more
general questions about how we judge present versus future hazards
and benefits -- especially when the hazards are mostly moral and the
benefits are mostly medical. In the matter of human cloning, we must
judge among (and perhaps between) the following:
a. The
possible future medical benefits of research on cloned human
embryos, and whether those benefits can or cannot be achieved in
other, less morally problematic ways.
b. The likelihood that
the creation of embryo clones for research will increase the
probability that cloned children will be produced and that a ban
only on reproductive cloning will be violated.
c. The ethics
of creating cloned human embryos for research, exploitation, and
destruction.
d. The use or non-use of government power to
stop certain scientific research from proceeding, and whether this
will have other unintended and undesirable effects.
e. The
precedent that judgment on these matters establishes for future
public decisions about advances in the science of human cloning,
assisted reproduction, and genetic engineering.
D. Conclusion: The Need for
Prudence We have tried to outline some of the
major questions about "therapeutic" cloning, and in particular how
these questions (scientific, moral, prudential) bear on the
legislative options regarding human cloning. In this policy context,
it is not enough to set forth a vision of possible future benefits.
Much work remains to be done evaluating the science of "therapeutic"
cloning and the scientific alternatives, but more importantly seeing
the science in the clearest possible ethical, social, and prudential
terms. In making judgments about "therapeutic" cloning (as with any
other future scientific prospect), we need to take into account the
best scientific opinion about where the research will lead and how
successful it might be in achieving the human benefits it promises.
But, at least in matters such as the present one of cloning human
beings, the judgment about policy cannot and should not be made on
the basis of the scientific judgment alone (or by scientists acting
alone). It must be made on the basis of prudent (and moral) judgment
about what the community believes is the wisest course.
In
the end, a practical decision will have to be made about how and
whether the public should act, and about which policy option, if
any, it should pursue. When that judgment is finally made, it should
be made soberly -- with the knowledge that some human goods may be
foregone for the sake of protecting or preserving others. (Or
conversely, that some human goods may be risked in the pursuit of
other, more important ones.) But it is also true that any such
judgment, when finally made, is not necessarily final. Even a
permanent ban, in a democracy like ours, can be revoked if
scientific, ethical, and prudential considerations justify doing so.
As we seek to clarify what prudence demands in the matter of
human cloning, a final point deserves emphasis. A ban on human
cloning would shift the burden of proof to those who seek to revoke
it (those who seek to clone), and away from those who seek to stop
cloning. This would represent a significant departure from previous
practice in the area of scientific research and technology. Some
people believe strongly that, given the high human stakes involved,
such a shift in the burden of proof is necessary, if only with
regard to those few areas of science and technology that may pose
significant threats to the meaning of our humanity. Others regard
such a shift as perilous, a threat to scientific and technological
progress and to individual freedom. The decision about human cloning
should have this issue clearly in mind. The prudent choice of who
bears the burden of proof must be informed by the kind of analysis
the Council is undertaking: an investigation of the state of science
and scientific opinion on the potential benefits of research on
cloned human embryos; a deeper consideration of the human meaning of
cloning human beings and an assessment of the ethical implications
involved; and an ethical and prudent deliberation about the policy
options available, keeping in view the competing human goods at
stake.
Appendix A: Typology of the Moral Status of the
Embryo
The following staff-prepared typology of views
about the moral status of the human embryo is for members'
discussion purposes only and does not purport to be definitive or
exhaustive.
a. Embryos are cells, no different from other
cells in the body. All types of embryos should be available for use
in biomedical research.
b. Embryos are not nothing, but they
are certainly not the moral equivalent of the later stage fetus or
of post-birth human beings: Therefore, possible medical benefits for
the living do justify the use of all types of embryos for research
-- both those created via IVF and those created via cloning.
c. Embryos are not nothing, but they are not the moral
equivalent of the later stage fetus or of post-birth human beings:
Given this, possible medical benefits for the living do justify the
use of embryos for reproductive purposes through IVF but left
unused, but do not justify the creation of cloned or IVF embryos
solely for research and destruction or the added danger of opening
the door to human reproductive cloning.
d. Embryos are not
nothing, but they are not the moral equivalent of the later stage
fetus or of post-birth human beings: Nevertheless, possible medical
benefits for the living do not justify the use of any embryos for
research and destruction or the added danger of opening the door to
human reproductive cloning. Embryos created through IVF that are
left over in clinics should be left to "die naturally" or be
adopted.
e. Embryos are the moral equivalent of both the
later stage fetus and all living human beings. They are what human
beings should look like -- what human beings are -- at that stage of
development. They should not be used for research in any way, and
couples that use IVF should not create embryos that they do not
intend to implant with the goal of pregnancy.
1. The states
that have enacted legislation banning human cloning are California,
Louisiana, Michigan, Missouri, Rhode Island, and Virginia.
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