"This transcript has not been edited or
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FOURTH MEETINGThursday, June 20,
2002
Session 3: Human
Cloning 12: Public Policy
Options
CHAIRMAN KASS: I
think we're all here. We're expecting Charles Krauthammer who is
traveling and I hope he hasn't been unduly delayed, but he said he'd
try to be here for this afternoon's session.
We're in the
middle and I don't think I'll even hazard a summary and just allow
us to continue where we were. And people who I had on the list
previously included Robby George, Bill Hurlbut, Mike and Paul --
Bill Hurlbut, Mike Gazzaniga and Paul. Have I omitted somebody who
-- okay.
Robby, would you like to start?
DR.
GEORGE: I want to respect Frank's desire not to get into
the big debate, at least not here, but I did want to at least offer
a clarification from my point of view about what the debate is about
because I think that the examples that Frank raised when he was
talking about the political and civil rights of children and the
question of the status of human corpses, I do want to clarify what I
think the debate is about that we've been carrying on, at least to
some extent in submissions that many of us have made to the
Council.
I think it's about the question of what confers upon
the human being at whatever stage of development, a status that is
sometimes referred to as inviolability and whether one and the same
substantial entity can be morally inviolable at some stages of
development, but not morally inviolable at other stages of
development.
So as I see it, we've got a dialectic going on,
at least between those of us who think that the embryo deserves full
moral respect than those of us who think that the embryo deserves
intermediate status or I think what we've been referring to as
special moral respect.
And the argument has been going back
and forth and I do hope that it will continue to go back and forth
because I think it's kind of hanging in mid air. Those who have
argued for the special respect view have presented some arguments
including the question of an argument based on the possibility of
monozygotic twinning prior to 13 or 14 days of embryonic
development. The question of the high rate of natural pregnancy
loss, our emotional responses to miscarriages as distinguished from
the loss of children at later stages of development and so forth and
I think that those of us on the other side have proposed responses
and counter arguments to those various points and I hope that this
debate will continue because I think that it's an important
one.
Of course, there's also the point that Michael Gazzaniga
has pressed about the importance of brain development and there's
been a response from me and from others to that as well and I think
Michael has now responded to our response, so perhaps on that one
the ball is in my court and others who have my point of view. I
actually have something drafted to submit on that. Perhaps others do
as well. But I do think that this debate should continue and that we
shouldn't simply say well, look, we're not ever going to convince
each other on something like this. Perhaps we won't convince each
other, but I think we can better inform each other and who knows,
but that minds yet could be changed one way or the
other.
That was my first point. The second point I would like
to frame as a question to the scientists on the Council, I have
heard that there's at least speculation that it might be possible to
avoid the basic question that vexes us, at least some of us on
research cloning of the moral status of the embryo. By the
deliberate create of entities possessing a human genome, but lacking
other features such that people who believe that the -- as I do --
that the human embryo, strictly speaking, is morally inviolable,
would not consider the entity to be -- that has been produced to be
a human being or an embryo strictly speaking, but that nevertheless,
the entity could develop in such a way as to make the extraction of
stem cells possible. And I wonder if scientists on the Council just
happen to know the factual answer to the question whether that is
within the realm of possibility.
The third point is
completely unrelated to the other two. And that is the question with
respect to what we've been calling reproductive cloning and
anticipating as a moratorium or ban on reproductive cloning. What is
it that we would be proposing to ban when we propose to ban
reproductive cloning? Would the crime or offense be the creation by
somatic cell nuclear transfer of an embryo with the purpose of
implanting the embryo? Or would the crime or offense be the
implantation of an embryo that was created by or brought into being
by somatic cell nuclear transfer? It seems to me that quite a lot
from an ethical viewpoint might depend on which of those is what, in
fact, is being proposed. So it's something that I hope will at least
clarify and if we have different views on what it is that ought to
be banned, perhaps those could be gotten out onto the
table.
PROF. SANDEL: I'd just ask, Robby, a
quick question. Which of those do you think would be ethically less
objectionable?
DR. GEORGE: The ban or
moratorium on creating, on synthesizing or creating, bringing into
being an embryo by somatic cell nuclear transfer with the purpose of
implanting.
CHAIRMAN KASS: I have to tell
you, just as a legislative matter, I shouldn't be telling you, you
should be telling me, that if one wants to prescribe a certain
activity one wants to prescribe it precisely so people will know
what it is that is wrong and approving intent is difficult and to
make the crime to create the embryo with the purpose of implanting
it would lead to the following situation. Person 1 produces the
embryo with the purpose of using it for research, gives it to Person
B who then implants it and neither of them does anything wrong.
Anybody who wanted to prevent this activity would never write the
statute the way you would find it morally -- easy to support. That's
the difficulty.
DR. GEORGE: Well, I do think
it would be difficult to draft a statute and any statute that you
drafted would have loopholes and there would be cases where people
would actually get around the law. I do think you could probably
draft it in such a way as to impede the development of a commercial
human reproductive cloning industry.
CHAIRMAN
KASS: Point taken.
DR. GEORGE: I
wonder if anybody knows the answer to the
question?
CHAIRMAN KASS: Did someone respond
to the first question about, if I understand the question, is it
possible to produce -- precisely because they're not embryos, they
might be -- they would not be inviolate and therefore, but they
might be perfectly good for all the research that one would like to
do.
DR. GEORGE: The closest thing I can
think of to it in nature would be a hydatidiform mole, but a
hydatidiform mole that or like entity that would be sufficiently
differentiated to make possible the extraction of stem
cells.
Does anybody know anything about
that?
DR. BLACKBURN: I think there might be
an issue in which the DNA would be the same, but what's called the
imprinting of the DNA which can lead to these abnormal outcomes like
the hydatidiform mole, that would be different, so that would have
some commonalities with the normal embryo that had been normally
imprinted, but it wouldn't be the same.
I honestly don't
know what you're referring to, but perhaps that's what you're
meaning.
DR. GEORGE: That is it. If I
understood you correctly, I think that is what I'm
asking.
DR. BLACKBURN: So the imprinting
that is happening is probably, as we've seen in various written
documents, much of the source of the problem with getting cloning,
for reproductive purposes to work in animals, that it doesn't happen
very well, even with somatic cell nuclear transfer of a diploid cell
into say a human egg, well, this hasn't been done, but into a mouse
egg.
So I'm not sure whether you had that in mind or Bill
had proposed something. I didn't know whether that was what you had
in mind as well.
DR. GEORGE: Well, maybe
Bill could say.
DR. HURLBUT: Well, on the
end of my comments for my moral position, I added what I call a
speculative proposal. I apologize for the length of it and maybe
some of you didn't get that far. But it was what it took for me to
think about the issues.
And I formulated that with some
conversations with scientists, Paul Berg sparked some of my ideas
and Irv Weissman, and others, and talking with developmental
biologists, and then thinking about the theological issues,
theological objections and some of the traditional medical and legal
objections, it struck me that if the objection hinges on the
potential of the embryo, that actually what we're going on about
here in our disputes about the status of the embryo is pretty much
the meaning of potential, whether potential is in a sense actual or
sort of theoretical.
Well, if you could render the potential
not there in a certain sense, then you couldn't say that there was
in any sense personhood present or human inviolability, even if you
don't say personhood. So it struck me that if you could do some
simple gene transformation, alteration of the cytoplasm or maybe
even alteration of the culture medium, that maybe there would be a
way to say we've created what Paul's been on to, an artifact.
And I have to say I sympathize with it to a degree to what
Paul says because it feels like a lab procedure to me. But what
troubles me with Paul's point of view is that you could implant that
entity and it would become, I'm convinced, a person. Paul, whether
you think fully human or not, I don't know, but I'm inclined to give
it that.
So what if we could render it sort of disarm -- I
hate to even use the word embryo, but disarm it and take it to the
most extreme. If you could do a nuclear transfer that was missing a
chromosome or something like that that wasn't necessary for the
production of anything -- or put it another way, it was essential
for the production of an embryo, but wasn't essential for the
production of say a kidney, well then you could do this lab
procedure without having the moral problem present. You think,
Robby?
DR. GEORGE: This is precisely what
I'm asking. And what I'm interested in right now is not the ethical
issue, but simply the factual -- the question of whether such an
entity could be brought into being. And by that, I mean is there
some lab that could do it tomorrow? Is this the kind of thing that
if people put their minds to it, could be accomplished in the
foreseeable future.
DR. HURLBUT: Well, I've
had numerous conversations with scientists about this and it sounds
to me like this could be done. Not only that, but scientists told me
yesterday that you could first render the gene inoperable and then
reverse it when you had the stem cell isolated. I know it sounds
like a technicality, but so what? There are important principles
here.
And I see this as a way to go forward with the science
even better than what's proposed in a sense because we know from --
I don't think so much hydatidiform moles. We know from teratomas
that you can get whole portions of a body like teeth, fingernails,
hair wrapped into an ovarian tumor. So we know that you don't have
to have the whole embryo present to generate partial parts.
So what I'm interested in is parts apart from wholes and
partial generative potential. And Janet and I were talking about
this over lunch and based on a preliminary conversation seemed like
Janet -- I think there were some possibilities. What do you think,
Janet?
DR. ROWLEY: I haven't had any time
really to think about how one would do this practically. It's
certainly in the laboratory, there are ways of putting genes under
the control of say tetracycline and in the presence of tetracycline,
the gene is operative and when you withdraw it, the gene becomes
inoperative or vice versa. There are a number of different
strategies called that lead to conditional expression, but how you
could get such a system to work reliable such that you could put
such a genetically altered nucleus into a somatic cell nuclear
transplant into an oocyte and expect the oocyte to grow under those
circumstances to give you a multicellular embryo, I'm totally
ignorant of whether such a strategy could work or alternatively when
you do just removing genes through homologous recombination and just
alter a single gene which can be done in the laboratory and
obviously mice are developed and live with such altered genes. But
how applicable that is to the human situation, I'm totally ignorant
of.
DR. HURLBUT: Well, let me give you a
suggestion. Suppose you rendered a gene essential for angiogenesis.
This is the production of blood vessels. Suppose you rendered that
gene inoperable. Clearly, you'd never get an embryo, but you don't
need that gene because for stem cell, simple stem cell transplants,
they don't need to generate their own blood supply, so you could
theoretically deactivate a gene essential for embryological
formation that was not essential for the uses you wanted to make of
the cells or tissues, and claim a good moral position and also good
science at the same time.
What do you think, Elizabeth? Is
this maybe a break to the impasse?
DR.
GAZZANIGA:: I think this is nutty.
(Laughter.)
DR.
GAZZANIGA:: That's a technical
word.
CHAIRMAN KASS: Next
argument.
DR. GAZZANIGA::
The notion of doing a gene knockout that will selectively hit --
let's go for your pet topic, the soul, so therefore this thing that
-- this blastocyst doesn't have it and the notion of doing away with
the embryo by not giving it the genes for the blood supply -- well,
it's just another form of doing the deed. So I just think this whole
-- this does sound Frankensteinian to me and it gets into all kinds
of convoluted reasoning that doesn't make much
sense.
DR. HURLBUT: It's not at all
--
DR. GAZZANIGA:: On the
positive note though, on the positive note and going back to Mary
and the dilemma this morning or suggestion, I guess it was. A lawyer
never has a dilemma, they just have suggestions. I looked up what
moratorium means because I thought we were sliding around with the
definition and the definition is a legally authorized period of
delay on the performance of a legal obligation. So I assume that's
correct. That would mean that if one signed on to a moratorium, it
would men that they would be open, I assume, once certain issues
were cleared up to go ahead with the intent of the act for which
there is a moratorium, for which a moratorium has been placed on it.
Is that going too far?
PROF. GLENDON: That's
one definition.
DR.
GAZZANIGA:: Definition 2 is a suspension of
activity. Is that what you mean by it? So it's another -- you mean
there's truly an equivalence between ban and
moratorium.
PROF. GLENDON: A temporary
ban.
DR. GAZZANIGA:: But
temporary then means you're ready to go to action once all the
issues have been cleared up.
CHAIRMAN KASS:
Let me clarify. Since the term comes from headquarters. It wasn't
taken from the dictionary. It was meant to indicate a ban for a
limited period of time which unless the ban were reinstituted would
automatically lapse, whereas a ban which doesn't have a fixed limit
on it requires someone to make an argument to lift the ban. That's
the difference.
DR. KRAUTHAMMER: And the
word already has a historical use. It isn't as if it came out of a
dictionary yesterday. We have had a moratorium on nuclear testing.
Everybody understands what that means, the temporary ban which if
and when it expires, is reversed.
CHAIRMAN
KASS: Let me say this is not the place, I think, to argue
out the possibility or impossibility of these modified beings that
may or may not be whatever they are and that it would make them
suitable or not suitable for experimentation. The possibility has
been noted. It is at this point speculative.
DR.
GEORGE: I think, Leon, that it is relevant. I'll tell you
why I think it's relevant.
CHAIRMAN KASS:
How would it be relevant to deciding in the next week, month, three
months, six months, one way or the other on what is before
us?
DR. GEORGE: I think it could affect
someone's judgment as to whether they think a moratorium is
appropriate.
CHAIRMAN KASS: I see. In other
words, if he told you scientists are working on this and they will
find you something --
DR. GEORGE: That
within two years you could, it's realistic, that there could be an
unobjectionable entity from which we could extract stem cells and
even the people like myself who believe in the inviolability of the
human being at the embryonic stage as well as all other stages
wouldn't have a problem with this. That might lead some people who
might otherwise be for going forward right now with it to the
thought that well, gee, our fellow citizens do have some grounds for
their moral objection. I don't happen to share it, but if there's a
way to avoid putting them in the position of -- that they would be
in.
CHAIRMAN KASS: I understand. Thank
you.
DR. FOSTER: The one thing that I would
say and I agree, we need to move on is that within the realm absent
some miracle from the deity to speculate that within two years that
you would get something like this working, all these chromosomes act
in all different ways. I mean one of the problems of the genome is
that you can't take some isolated thing out and expect to get the
VEGF which is the key angiogenic early has many other effects in the
embryo than it does in forming blood vessels. Everybody knows that.
And as a consequence, to say well, I'm going to knock out -- that's
vascular endothelial growth factor, you know. VEGF is just one of
the angiogenic. It does many other things. It controls other genes
and so forth so the idea to me, I'm not a developmental biologist,
but I certainly would be skeptical that many scientists think this
is -- I mean I'll check this out myself, I don't know, because we
have very good, but I think to put an early time limit on that would
be very unrealistic. It would -- and then even if it's a good idea,
I'm not sure that it's going to apply in the short run, Robby. I
just don't know, but I'd be very interested to know what Paul -- I'd
be interested to know what Paul Berg said about this or others. I
just don't think that's possible.
DR.
HURLBUT: Let me clarify it. I didn't mean to say that Paul
Berg is endorsing this, but I've talked with him about it. I've
talked with Irv Weissman. I've talked with other developmental
biologists. I agree with what you say, largely the genes operate in
important ways that are much more complicated than one gene, one
trait. I'm not arguing that. But we do know from teratomas that it's
possible to produce parts apart from the integrated whole.
I
think what I'm trying to do here in suggesting this is I don't think
inappropriate or nutty. Frankly --
DR.
FOSTER: By the way, I did not say nutty. That was Mike. So
turn --
(Laughter.)
DR. HURLBUT:
Well, let me just say this. Frankly, I wouldn't be very satisfied,
personally, if after the effort we've all put into this and the
importance of the issue are taken account of, that this Council
comes out with just a more articulate restatement of what the public
already knows are the central issues. I personally think if we could
define the boundaries of the moral problem more clearly and at least
make some, clear some territory for if you could do this, you would
have the consensus, I think that would be a real contribution and I
don't think what I'm suggesting is unrealistic and neither did
certain developmental biologists I talked with. And I think it's
important that we work for moral consensus in our society as we go
forward. This is a much more hotly debated and deeply felt issue
than is sometimes acknowledged within the scientific community. And
I think it's our moral responsibility to see and listen rather than
just spend 30 seconds on a subject. If somebody comes up with a
proposal, I think we need to explore whether it's a reasonable way
to proceed and not just label it nutty.
DR.
BLACKBURN: Could I add something? I see a parallel which
may be a constructive one. In the debate on recombinant DNA, I think
-- Bill, correct me if this is correct analogy, but the proposal
that was made and was enacted earlier was to have strains of
bacteria which were unable to survive outside the laboratory. So I
think that is an analogous situation to what Bill is
saying.
Now the difficulty that we've been alluding to,
Robby, is this internet work sort of behavior of genes. I'm just
thinking of a gene that one of my colleagues found to do with the
immune system. It was key. He thought it was absolutely only
involved in the immune system, but it turned out to be involved in
the development of the nose and all sorts of other things as
well.
So I see the idea, I think, and am I understanding that
you're saying that you think that something that would allow a
certain portion of the development of the embryo, that you'd know it
could never become a full person, would be an acceptable proposal?
Am I correct?
DR. GEORGE: I would put it in
different language, I think, Elizabeth. But I think you understand
where I'm going. In other words --
DR.
BLACKBURN: If it could never live to be a
baby.
DR. GEORGE: No, not that it could live
to be -- in other words, it would not be -- it would lack the
epigenetic primordia for self-directed growth to the next more
mature stage on the continuum of life. That would -- in the way, for
example, that a teratoma would, despite possessing a human genome.
Right?
DR. BLACKBURN: I think the concern
would be to sort of make that a condition because as Dan says that
mightn't be easy to put into practice.
DR.
GEORGE: This is really my question.
DR.
BLACKBURN: At least if it were one of the proposals out
there to -- I think it's something to consider, but I think at this
stage it wouldn't be realistic to say oh, we could do this now, so
therefore let's make this the way to do it.
DR.
GEORGE: Oh no, I understand that. I'm not asking whether it
can be done now. Although I think -- if we knew the answer to the
question, is it reasonable to suspect or to hope that this could be
done in the next few years. I think that if the answer to that
question were yes, it could factor significantly into the thinking
of some people about what policy they think we ought to adopt now
even if they don't share my view about the inviolability of the
embryo.
DR. BLACKBURN: I think people could
try, attempt to do it, but I think there would be absolutely no
guarantee that it would --
DR. GEORGE: No
guarantee. I understand that.
DR. BLACKBURN:
Right.
DR. GEORGE: How would be obtain
better information about that, about that possibility? I mean is it
out there and we just don't happen -- the people here just don't
happen to do that kind of work or is this just something nobody has
ever thought of?
DR. BLACKBURN: I think it
would a type of the work that I had alluded to in the morning
session where one would be doing somatic cell nuclear transfer type
of development of stem cells. And then using the kind of approaches
you are talking about and saying ah, can we now modify that process.
I think it would be very hard not to do the kind of research that
would involve somatic cell nuclear transfer and getting to say stem
cells out of it, to get the answers out. But once one had the answer
out, then one could say, okay, well, there is a way that now would
be doable perhaps. But I don't know -- I can't think of how you
could find that out, actually without being in control of the
beginning material for the experiment. Could you do it with excess
IVF embryos, for example? I can see that might be tougher.
I
haven't thought about it enough either to be
honest.
PROF. SANDEL: Could I just ask Robby
a quick question. On the first part of his comments, not on this
issue.
DR. GEORGE: I want to say -- go ahead
that's fine. Go ahead, Michael.
PROF.
SANDEL: Going back to the moral status
--
DR. GEORGE: The moral status,
yes.
PROF. SANDEL: Would you say given your
view of the moral status of the embryo that cloning for stem cell
research is morally worse than reproductive cloning, where after
all, no person is killed?
DR. GEORGE: Oh
yeah, I thought I had made that clear. If I hadn't -- yeah, I'm
sorry.
Just a final note on that since Michael raised this
question of the soul, I hope jocularly. It has circulated, I mean
sometimes it seems to be an assumption that those of us who are --
who believe in the moral inviolability of the embryo believe that on
the basis of putatively revealed propositions, religious
propositions or theological propositions about the presence of a
soul, I don't think that that's the case, as a matter of fact. And
as far as I can tell, I think Daniel alone has raised the question
of the soul or presence of the soul as relevant to a determination
of the moral status of the embryo. I certainly have not in any of my
-- we've now had four meetings. Any of my interventions, I don't
think any of the submissions that have been made have raised that
issue, so I don't think that we've got here a debate about revealed
truth.
CHAIRMAN KASS: Could I intervene
here? We've got about another hour to go on this topic. There are
people in the queue. I don't want to demonstrate disrespect to the
suggestion that's been offered. I understand both why it matters to
Bill, Bill Hurlbut, that if there is, in fact, a way to use our
science to get around what is for many people a profound moral
objection to doing this, that would be very nice to think about and
to do, right? That's a creative thought which hasn't generally
appeared. I also see its relevance for someone like Robby who by and
large wouldn't be in favor of anything other than calling for a ban.
I'm simply assuming. He might go along with something more
temporary. One of the things that might lead him at least to think
about it is if he thought the intervening time might actually
provide him with an alternative, might provide us all with an
alternative, now not available.
I think if I could say that
that's -- and if there's great uncertainty with varying degrees of
skepticism around the table, but without a lot of evidence at the
moment, and if people would like to gather further evidence on this
matter and maybe Bill would like to provide it, I think we should
have it, but there's no way in the world I think that we here can do
much more on this than we've done and I think we should, if it's all
right, I would like to move back to the options themselves that are
here and not the various possible reasons that might ultimately be
one way or the other.
Bill, you're next in the queue, so you
can just rebut the Chair's admonition that we try, I think to come
back. There's still people who want to have their first say on what
they think we should do. But the floor is yours and if I've done you
an injustice, please correct it.
DR.
HURLBUT: A fortuitous sequence.
CHAIRMAN
KASS: It's just there.
DR. HURLBUT:
Actually, I'd like to first ask Janet a question and maybe Elizabeth
too. How important is it that we come up with a solution that opens
up the possibilities for federally-funded research? Obviously, we
could do nothing and the private research would continue, but how
important is it for federally-funded research to be
opened?
DR. ROWLEY: Well, I think it's
extremely important for federal funding to be available to
scientists on some of the issues we have said are important to get
answers on which we cannot at the present time obtain answers
because of the lack of funding and I point out that this has been a
ban for a number of years. I know Clinton reaffirmed that there
could be no research using embryos and embryonic stem cells.
There is now, of course, with President Bush's allowing the
use of cell lines, I understand that the first serious of grants has
actually been reviewed and funded, I believe from NIH in that
particular, using that particular source of cells, but I think that
many of the questions that we would like to know the answers to, to
come to a much more informed judgment ourself are presently
prohibited, so we just have to wait for scientists in other
countries where they do have the opportunity to do this research to
provide us with the information.
DR.
HURLBUT: Can I ask Elizabeth the same question? How
important is it that we able to do things like nuclear
transplantation at the university level, not at just the currently
accepted private level?
DR. BLACKBURN: Well,
some of my points this morning were addressed to why I think that
kind of research is very important. As to the setting of it, I think
that if one grants that the research is important to be done, then
the university setting which is an open setting, where there is
review, where there is critical input, much better information made
the quality of the sciences generally going to be much better, will
use the resources that the country has in terms of its brain power
to do it right.
So my view, that's the way research really
does get done right in that kind of environment because I think
while there are talented people in industry, they're not guided by
the same sets of imperatives, necessarily, and one also doesn't have
access to it and the information about what the quality control has
been in the same way as the more open sort of scientific community
which is exemplified by universities. In my view, it's very
important.
DR. HURLBUT: So I want to make
the point that this is what I've heard from all the scientists I've
spoken with that we need to open up the broadest possible, morally
acceptable science at the level of basic research because without
that, first of all, as William May said earlier, that it's hostage
to proprietary interests and secrecy if it's in the private sphere
only. Is that what you were implying, right?
That's
unfortunate, plus there's kinds of research that can be done at the
university level that won't be done in the private level. And the
science can go forward more rapidly if it's broadly published, so
this is why I think it's very important that we not -- that we
define our moral boundaries carefully, that we see if we can find a
way scientifically to work within those moral boundaries. I'm not
very political and I don't want to pretend I know what's going to
happen, but I think I'm awake enough to know that even if our
counsel were to unanimously vote in favor of all kinds of cloning,
that that's not going to happen because our President has plainly
said that he will not favor that. So it would take, at least I guess
two-thirds of the Congress to override that. And that doesn't seem
imminent.
So it seems to me very worthwhile for us to try to
define what the moral boundaries are and seek, at least to tell
scientists what they might work toward. I just feel like that's the
direction to go and if it takes a little bit of speculative
proposal, so be it. At least it clarifies to us what our moral
positions really are.
CHAIRMAN KASS: Mike
Gazzaniga. You were on the list before lunch, maybe you ate too
well. Okay. Paul McHugh.
DR. MCHUGH: Yes.
When I came after having read the draft of Chapter 7, the moratorium
idea seemed perhaps right. There are a number of reasons I thought
that. One of them was Mary Ann's point. It would continue the
conversation and perhaps win people over even to my idea that this
is a better way of looking at these clonotes and that the clonote
and the zygote were distinction with a big difference. But even more
so, a period of time we've already talked ourselves and we're still
making progress in the conversation and so more time perhaps would
do as well.
I also felt that a moratorium might also show
some respect from each of our points of view to the other points of
view about not only of our members here, but of the feelings of
people in the country, feelings that derive from their points of
view, some of the feelings that derive from their religious points
of view, that that might be able to be done during a moratorium. And
it would be a clear gesture of ours to the sense that we are
pluralistic society and that there are voices that we want to
respect and that thirdly, that there would be more opportunity for
research that would go, particularly in animal research that would
do a number of things for us. Particularly, I thought it would
reduce the hype around this and get us knowing more about what we
had and what we could accomplish and it would, for example, also
bring up more issues in relationship to the adult stem
cells.
But in the conversation today and this morning, I
began to wonder whether a moratorium was really the right thing
because a moratorium, I think has to have a particular meaning. You
have to -- really, it's not just the inchoate feelings that I have
about what might happen during this time, and what I might wish, but
it has to have some meaning and for a reason not only to have it,
but to give it a particular time. And it was when I thought about
the time that was going to be given to what has sounded now more and
more like a ban, I begin to worry about time because time is of the
essence in this, if like me, you have to talk to patient populations
about the possibility or the probability or the may be possibility
of their treatment.
Remember, if this work goes forward and
the science goes forward with it in any time, there's still going to
be lots of other times that are required because we're talking about
therapeutics and you're going to have to get into the FDA business
and the Phase I, Phase II, Phase III and we know that there are
years and years that are going to come. Even if we have a terrific
discovery tomorrow, there's going to be years and years of trials
before it will be available and for the patients that we're talking
about time is of the essence.
And so as I thought then about
the moratorium and I listened to Rebecca and to Frank and to others,
it seemed to me that perhaps we were talking against what I feel and
hope for patients and for this possibility and that maybe the idea
of working, considering a de facto moratorium as we work out the
regulations would, in fact, accomplish all the things that I had
wanted for a moratorium. It would, by giving a further arena of
debate as we were talking about licensing and things of that sort,
allow people, well, allow people to listen to me more about what we
were feeling; think about what Bill has proposed. By the way, I
think this idea is a very good idea. The coincidence of it, showing
that this idea is just around the corner was that the day before I
received Bill's e-mail and old friend had raised exactly the same
question to me, but I didn't have Paul Berg to go to, but when I got
your kind of reinforcement, I thought yeah, well, that's what our
talking is supposed to do. It's supposed to bring these things up
for us to consider. And since we heard this morning that it takes
four, five, six years from even the beginning of some gesture in
this to get a regulatory body up and running, that would accomplish
pretty much what the moratorium would be trying to do, it seemed to
me.
So that given the fact that time is of the essence, that
there are very important things both at stake in the moral issues,
but also at stake in the clinical issues, I'm moving towards issue 3
and feel that it would accomplish all the things that I had wanted
to accomplish when I came.
CHAIRMAN KASS:
Alfonso and then someone else.
DR.
KRAUTHAMMER: Excuse me, could I ask a question just on the
meaning of 3 of Paul? You then would say ban present regulation with
the understanding that there would be a moratorium imposed until the
regulations are issued or would you be permissive in the interim?
Prohibitive in the interim, rather than
permissive?
DR. MCHUGH: Yes. Because it
would be licensing that would be at issue in the regulations, I
would be prohibitive during that time.
DR.
KRAUTHAMMER: Is that how we are to understand Option 3?
Because as I read it, I would have assumed the ban plus regulation
means that research cloning would be permitted and then regulated at
a later date. I just want to understand what you mean by
that.
CHAIRMAN KASS: Certainly, I think that
since no one in the current debate has been proposing that we set up
a body like the Human Fertilization and Embryology Authority, the
more liberal of the bans being proposed in the Senate on
reproductive only, at least to this point have barely gestured in
the direction of regulation. The original bill, even the modified
bill talks about certain rules at the NIH that govern
experimentation on human subjects and that means everybody but the
embryo. I gather that there's some proposal now that there might be
an amendment saying nothing past 14 days, but no one over there is
thinking about setting up a regulatory agency that would then have
to take these things under consideration prior to the existence of
which nothing would happen.
So I read Proposal 3 as not being
-- the people who tried to collapse Proposal 3 and Proposal 6, I
think did so erroneously. Proposal 3 would be some new legislation
now that's set forth a few conditions, but that didn't really
establish the kind of regulatory system that the British have. It's
perfectly possible for that to be modified by saying look, I don't
want to join a moratorium for any reason other than my interest in
regulation and therefore we beef up Proposal 3 to include precisely
that this research is prohibited, unless and until a regulatory body
was in place and that addressed the questions of commercialization
that addressed the question of duration, of licensing, of all of
those things that one saw that seemed to be common practices in the
British and Canadian system. That's a possible recommendation that
we could make, but as it appears here, we could dress it up that way
if that is the way people would certainly like to
go.
Janet?
DR. ROWLEY: Yes, I'm
surprised at your statement because certainly the National Academy
report recommended that there be a regulatory body that would be
established and I guess I had assumed that in the Feinstein bill,
there was something about regulation, but I don't remember the
details.
CHAIRMAN KASS: I don't think that's
accurate. There's some reference to guidelines that are operative.
Rebecca, do you know, do you recall
off-hand?
PROF. DRESSER: I think
you're right, although I would like to see it again, but that's my
recollection.
I didn't interpret 3 the way you were
interpreting. I interpreted it in the more restrictive way, so I
don't know if Frank had that same
interpretation.
CHAIRMAN KASS: Well
--
PROF. SANDEL: I also want to address this
because it seems to me that this Council can define Option 3
--
CHAIRMAN KASS:
Absolutely.
PROF. SANDEL: However it wants
to. Moreover, we already can easily imagine language that would
provide exactly the understanding about licensing and
noncommodification that Rebecca and Frank and Paul and Charles have
raised just now. The language wouldn't be hard to draft. We could
say that it would have -- a regulation would have to include (1)
establish a number of days, whether it's 14 days or other; (2)
license and conduct prior review of all research involving cloned
embryos or for that matter all human embryos; (3) register and track
each individual cloned human embryo; (4) establish a list of what
may and may not be done with cloned human embryos once they're
created and so on; (5) oversee corporate, academic and industrial
cloning for biomedical research; (6) monitor and regulate or for
that matter the buying and selling of cloned embryos and human
oocytes; (7) establish guidelines -- we would have to work very hard
to develop language of that kind.
CHAIRMAN
KASS: To be sure. In fact --
PROF.
SANDEL: Mr. Chairman, I didn't want to refer to any
documents because I know we don't do that
--
(Laughter)
-- so I simply offered seven
descriptions of the regulatory regime that this Council could
perfectly well adopt.
CHAIRMAN KASS:
Correct.
PROF. SANDEL: And the licensing
one, in particular, is the one that triggers what Rebecca called and
Frank the de facto moratorium because if we say that it should be
permitted only under conditions of regulation where one of the
regulations, perhaps the second item in the list we would devise,
says license and conduct and according to that position, the Council
would be saying there shall be no research done on cloned or human
embryos for that matter, except in such time they're duly licensed
by a proper authority.
DR. MCHUGH: The time
-- excuse me, please. I just meant the time would be being spent in
an appropriate, discussive way with a goal in mind and in a fashion
that just a flat out moratorium would not. There would be work.
There would be debate. There would be change, but there would be
progress.
CHAIRMAN KASS: Let me make a small
comment. I'm on the list for my own comment in a moment, but I would
just simply remark on the oddity of developing this massive proposal
for regulation on cloned embryos alone and --
PROF.
SANDEL: Why would be restricted to that? Why couldn't we
say for all embryos?
CHAIRMAN KASS: But here
is how we started on a project that was really primarily interested
in the question of cloning to produce children. It turned out that
we ran into the embryo problem as a complication of trying to figure
out what to do about that. In my view, the proper context for the
discussion of the ethics and the policy about cloned embryos belongs
in the embryo research question, not somehow as a little tiny piece
of the cloning question, although there are people here who disagree
with me because cloning is cloning. But now it would turn out that
one in a way envies these other countries where they have at least,
in the case of the Brits, they put everything around the embryo so
it's the fertilization and embryological authority. The Canadians
talk about reproduction and have put the context somewhat
differently, but they at least have larger contexts in which they
can plug this question. We would be trying to invent the whole
thing, attached to a question of public policy connected to cloning.
I'm not saying it's wrong. I'm not saying we shouldn't, but it would
seem that this is part of a piece for a longer term matter, rather
than something that -- well, certainly as I speak I can hear the
counter arguments.
PROF. SANDEL: In that
case, you can offer it, Mr. Chairman.
CHAIRMAN
KASS: Let me see. There are people who want to jump in the
queue, but Alfonso is waiting and then I am after him. Are there
small things to what's just been said because we should have
it?
Gil, on the list; Rebecca; Frank.
Alfonso.
PROF. GÓMEZ-LOBO: Okay, just a
minor reminder here that we're already talking about regulation, but
we're talking about experimentation on human beings without consent
and with destruction. Now I know that immediately raises the
problem, but I want to raise the problem of the moral status of the
embryo. I don't think, and Frank you'll forgive me, that it's enough
to say we will not come to an agreement. I don't know. You may
produce arguments that are so clear that I may be convinced. I'm
open to that. But I think that moral skepticism is a very serious
matter. Let me just give you an example. There was a woman in Spain
in the 16th Century where there was skepticism, I mean it wasn't
clear of the status of Native Americans, whether they were human
beings or not. And that cost thousands of lives until you had
someone who decided not to be skeptical, Bartoleme Las Casas and
that's very important in this case. I just cannot sit back and say
look, we don't know or we can't agree. I think if anybody in this
republic has to make the effort to hash it out it has to be this
one.
Now I want to make an objection of that with what Bill
Hurlbut was saying because I think -- I see something very admirable
in that and I'm not going to go back to your adjective, Mike,
because it's really a bona fide effort to do this, to say look, for
us the science is tremendously important. We have a tremendous trust
in what is being done and although some people say it's a hype, it's
an exaggeration, I'm personally willing to bet that it's very, very
important and that a lot of good is going to come from it. But there
is this matter of making it compatible with a very deep-rooted
principle of our civilization is that you just don't kill innocent
human beings for the benefit of the rest of us.
Now how can
we make that compatible? Well, any exploration of that along the
lines of saying well, if there's an organism that we have reason to
think is not human, then that would be a solution. Then we would not
have a problem. Then that would be wonderful. Whether it's feasible,
whether it's an allusion, I don't know, but in a way it's a goal.
It's an end. It's a way of preserving a very basic right and of
course, I could go back and discuss with Frank the question of
evolving rights and why I think it's an incoherent notion. I think
much of it and I'm just suggesting it now, has to do with the kinds
of rights and the kinds of goods we consider. Sure, your voting
rights come with age, but there are other more basic rights such as
the right to physical integrity that we have to respect even in a
small child. So I think that there's an allusion there that because
certain perhaps secondary rights have to do with our age, that that
would entail at some basic rights or rights of noninterference with
basic goods would be affected.
Now that's exactly the kind of
discussion I would love to have.
PROF.
SANDEL: Could I just ask Alfonso if that leads him, that
those considerations lead you to favor a ban or a
moratorium?
PROF. GÓMEZ-LOBO: I'm really
flexible because the -- as Mary Ann Glendon said, a ban is just a
moratorium of a different sort. If a moratorium means that this is
not going to be done, either destruction of early human embryos and
there's going to be a chance in the country to rethink it and to
have discussions, for instance, like the one I would like to have,
surely that would be a favorable situation.
PROF.
SANDEL: Just a quick follow-up, Alfonso. If you regard
embryonic stem cell research as morally tantamount to infanticide,
yanking organs out of an infant for good ends, would you also favor
a moratorium rather than a ban on infanticide for that
purpose?
PROF. GÓMEZ-LOBO: Well, I don't
think anyone thinks -- is proposing, infanticide at the moment, but
there are people proposing stem cell research with destruction of
the blastocysts.
CHAIRMAN KASS: Why don't
you go first and I'll go next?
PROF.
MEILAENDER: Yes, because what I had to say really does
follow up on this in some ways. A lot of the discussion has really
centered on the question of whether 3 and 6 are distinct policy
options or whether in a sense, they roughly collapse and I would
like to keep them separate and it seems to me that there's a good
reason for that. Unless I just misunderstand what's been going on.
As I understand 3, even on the restrictive McHugh, Sandel,
Fukuyama interpretation, what it means is is that the moratorium,
the moratorium means that we intend to go forward with research
cloning, but we need time to figure out the circumstances under
which and the limits on which, on the basis of which we will go
forward.
If that's what it means then that's saying that some
of us really don't need to enter into that conversation any longer.
The crucial question has been answered and it's over. We're not
thinking about extending the conversation or trying to prolong it in
order to reach better understanding or more consensus.
If
what the moratorium means is we don't know whether at the end of
this time we'll say yes or no to this, and during the time of the
moratorium some of us will come up with model legislation for what
regulation could look like and thereby stimulate discussion. Some of
us will keep working on animal studies. Some of us will try to
persuade people that it's a bad idea to do it, but everybody is in
the conversation, so that the two different understandings of what a
moratorium means are quite different in that respect. To collapse 6
into 3 is to say that really we've made what at least some people
regard as a fundamental decision and they don't have anything to
contribute to the conversation any longer. To leave 6 as an
independent option means that everybody continues to be a
contributor to the argument, or so it seems to me
anyway.
CHAIRMAN KASS: That certainly and
I'm glad you went first, because that certainly is part of why I
think that Option 6 is the preferable option for us at this
time.
My own thinking goes something like this, it's partly
informed by principle. It's partly informed by the fact that there
is this deep disagreement, and it is modestly informed by my concern
that once again we will not be able to do anything at all on the
thing I care most about, namely a ban on cloning for reproduction
because of the continued division over this other matter which
divides us.
Let me see if I can put together certain things
which I would stipulate as, if I say they're facts, I'm only going
to raise the flag and someone will shoot them down, but let me call
them assumptions, close enough to the facts. First of all, Council
is unanimous in opposing cloning to produce children as far as I
know. I don't have any dissenters from that. Maybe some are for it
only temporarily, maybe they wouldn't want a moratorium on it. Maybe
some would want a ban, but that's number one.
Number two, the
Council has been of many minds on the question of cloning for
biomedical research and don't simply divide neatly into those who
approve it and those who disapprove it, not only because of whether
we approve with enthusiasm or approve with concern, but there are
even some people who might approve the research, but who might not
be willing to approve it just yet either because of the absence of a
regulatory scheme or because they think there might be at the moment
lack of sufficient evidence to sustain the claims for the unique
value of cloning for biomedical research or because they are
concerned to ride roughshod over the powerfully held opinions of
colleagues in the absence of sufficient evidence. So there are a
variety of positions out there. And of the people who declare
themselves in opposition, some will do so because they will always
be in opposition unless Bill Hurlbut's proposal or something like it
could be met and others are opposed to -- would be in favor of a ban
or oppose it because even if they don't hold the embryo to be
inviolate, they worry about, and this I think is Charles' position,
they worry about us starting down the course of treating nascent
human life as a natural resource for the benefit of others with what
some people call the "slippery slope" but what Bill Hurlbut has
called establishing a principle that our subsequent practice will
merely catch up with once it turns out that going further is even
better for Paul McHugh's patients.
And then there are finally
some people and I include myself among them, who are worried about
permitting cloning for biomedical research because they're concerned
also that once the embryos are available there, it will be much more
difficult to in the absence of regulation to certainly police what's
done with them and there's a slightly greater risk how much is an
empirical question, but I don't want to find out that this will lead
to cloning to produce children.
That, I think, is an accurate
assessment of where the Council has been. I would note another thing
that figures into my consideration is the great uncertainty about
the research, not just with cloned embryos and clones, but even with
stem cells all together, embryonic adult, we just don't know.
Everybody has said that and it's agreed.
And there's no
question, I think all of us have seen the promising benefits of this
research though it's still too early to tell.
These
uncertainties cut sort of in two directions. I mean on the one hand,
Paul McHugh has said several times they ought to temper something of
the immodest claims that the miracles are just around the corner and
they place a very high -- they should place a certain kind of higher
demand on the cautious accumulation of evidence and yet they should
also temper people with their equally immodest assertions that we
can know in advance that there will be a morally nonproblematic way
of doing what needs to be done. I mean the uncertainty question, it
seems to me, goes in both directions and doesn't settle anything but
it should make us very, very modest, I think, about what it is we
do.
Next point I think which is very important and doesn't
show up in the question of federal funding. Legal proposals to ban
cloning for producing children which then tacitly and then in some
cases even explicitly would allow cloning for biomedical research
would be different from simply allowing it without legislation at
all for this reason. You would have the official legislative
endorsement of crossing this boundary, of creating embryos solely
for research. To this point, we don't have this. It's not illegal,
the private sector can do it. We have federal funding of the stem
lines, but we do not have -- we have no official government policy
which says it is all right to cross this boundary and we would do so
explicitly and officially, approve crossing this boundary, a
boundary that the previous federal advisory body, including the
NBAC, said should not be crossed at least not with official
government sanction. See, that's an important political step.
Whatever you think about -- wherever you come out, that's a
statement of our whole community.
Last point, I think that's
also a fact. You may not value the fact very much, but it is a fact.
And the other fact that's important to me is having watched now in
1998 and again in the present time, seeing the Congress struggle to
try to enact a ban on cloning to produce children and with what
looks like very likely a failure once again, a failure that nearly
everybody supports and we might be overtaken by events, a failure
that is the result of the fact that we have a standoff between and I
say this without meaning to disparage, the zealous proponents of
biomedical research and the zealous opponents of any research that
destroys cloned or any other kind of human embryos. And zeal, I mean
to be a praiseworthy term. There are moral goods here that are being
passionately defended. That, I take it, is our situation.
How
to solve the situation, assuming you want to get passed this impasse
at the very end which is very important to me. Let's get an
agreement on what it is there is an agreement on which is a ban on
cloning that would produce children. Let us recognize, let us get us
a little extra insurance in the absence of regulation by not
allowing the cloned embryos to be produced period. And let's have
time for the following important public reasons. Several of them
have been said. One is the question to get a little extra research
so that the scientific case could be made more compelling so that it
isn't just the promise, but we've got models with cloned embryos in
animals where you've actually produced some kind of therapeutic
value. Or let's show that -- we can spell it out. I don't want to
spin out the scientific possibilities.
There would be time
and there would be an incentive to develop the regulatory mechanisms
if one of the reasons for the moratorium was explicitly to say to
those people, you want to do it? Go out there and devise the -- go
out and devise those regulations that would be able to persuade
people that you could lift this moratorium without really running
grave risks of any of the harms that people want.
We haven't
had really, there's been an interesting debate. We don't normally
have these things and unless you think it's just deplorable that the
country should try to decide about these things -- I don't mean we
here, I think we've done pretty well, but it's been interesting to
see the nation struggle over this little tiny question, but to
wrestle with things that really are about terribly important things,
but it hasn't been conducted all together on the highest level. You
don't somehow really try to win the moral argument, either by having
the Bishop threaten the candidate in Missouri or rolling out
Christopher Reeve and Michael J. Fox in the Senate and have that
serve in place really of a deliberation about where the boundaries
should be. It seems to me that with -- that the argument can
continue and if you got the reproductive cloning issue off the
table, that ban stays in place. Then the argument would have to be
thought out where it really is. You couldn't somehow use people's
disgust over cloning to produce children to try to try to smuggle
through the back door a ban on some embryo research. And you
couldn't -- and you would have to take up the embryo research
question two part, and then try to figure out what's the right way
in this country to regulate embryo research across the board and not
sort of fight it all out over this little tiny matter.
It
also seems to me and here I make this appeal to the scientists. You
might think I'm wrong, there are cowboys out there and there are
disasters that are in the making and it seems to me that a
moratorium that was undertaken not just as a stop gap measure, but
as an invitation to the scientific and technological community come
forward, join the process, help the community design those kinds of
boundaries and standards that we all would be willing to live by, it
seems to me the scientific community could only gain an increased
trust and support of the nation as a whole.
If I really
thought, I mean, if I really thought that we really were turning
down the manna from heaven tomorrow or the next couple of years in
cloned stem cell, cloned embryo research, I might have more
hesitancy, Paul, but I really have the feeling that at the moment, I
mean it's uncomfortable to say that any kind of scientific research
would be banned and it makes me uncomfortable notwithstanding what
you might suspect of me. It makes me uncomfortable and I don't like
the jail time. I mean I would never -- but it seems to me to ride
roughshod over this moral boundary on a mere promise of the absence
of the evidence when so many of our fellow citizens would be
offended by this, I think it calls for a delay affirmatively, not as
some kind of fall back measure. We simply -- we don't have a
consensus on this and the question is how can we move toward getting
-- we may never get a consensus, but we can at least have this
argument prolonged on a higher level, perhaps even stimulated by
something of the way in which we would contribute to that
discussion.
I don't think that's a mere compromise. I think
that's to somehow dignify what this debate is about and to try to
let it go forward without undue sacrifice and in fact, really
inviting the scientific community to come forward and say look,
you're right, you've raised certain kinds of moral hazards for us.
We respect that. We'll help design ways in which those things can be
respected without crippling our research.
Now -- sorry for
-- I think it was semi-coherent. I've been worrying this for months.
There was a line -- was I last? I guess I'm last, so Michael Sandel
and Michael Gazzaniga.
Excuse me, oh, there was Rebecca. I'm
sorry. So eager was I to speak I didn't write her name down. I'm
sorry. Please.
PROF. DRESSER: Well, I'm not
sure I want to follow that, but it was very rich. Just a couple, a
few comments. I agree with you, certainly on the uncertainty, I
agree with you. And I agree with you that this is really a broader
issue in terms of embryo research in general and it would be
certainly intellectually more appropriate to tackle the whole
question. So I know I've heard some discussion. I don't know whether
this Council is going to take on that topic in the near future, but
it sounds as though we might. So one way to address that would be to
say something, if we were -- if the people who wanted to endorse
some version of 3 were to say the regulatory principles and
procedures appropriate to such a regulatory system applicable to
biomedical research cloning would also be relevant to the general
question of the use in embryo research and so -- of embryos in
research, generally, and so really in order to move forward with 3,
we have to think through what the process and procedures, in
general, ought to be and then we could start working on our thoughts
about that.
Another point, I guess another reason why I have
more difficulty seeing differences between 3 and 6 is because for
me, at least, a regulatory system does not have to be very
permissive, that is, I could imagine a regulatory system that would
have a process and principles in place that were extremely demanding
and would demand an exceptionally compelling showing of necessity
before something would be allowed to go forward and a showing that
would have to be accepted by people not only from the scientific
community, but from a broader group of people. So I could see -- and
this, I guess, leads me to my last point which is in some ways I
think you're talking about the work that could go on during a
moratorium is very similar to what some of us would think about the
work that could go on during a process of thinking about what a
regulatory system would look like which would involve scientists
talking with other people in the community to figure out what kinds
of principles would work, what kinds of a showing would be
acceptable, a lot of these details that we've been struggling with a
little bit today. So in some ways it just sounds as though your
thoughts about a moratorium would also include some of this process
going on informally that some of us are thinking about well, if we
took 3, then there would be some process of proposal, notice and
comment, public discussion, probably revised proposal, you know,
on-going in a more official way. So whether it would be informal or
formal, might be more the difference.
CHAIRMAN
KASS: Good. Thank you. I have the two Michaels and Mary
Ann. Charles, we haven't heard from at all. Let's just go in order.
Mike Gazzaniga and then Michael Sandel and then
--
DR. GAZZANIGA: We're all sort of just
weighing in here. The rationale that I would follow would be pretty
much what Liz said this morning and maybe to add a little flavor to
it to go to your Option 2 and not that I would do that, but that by
during the establishment of the regulations not to have any police
around which would be a way of social engineering to get the
regulators to work fast and get their job done, in other words, I
don't know -- I just wouldn't know how one would recommend, with
regulation, and then put various specific moratoriums out on
activity.
But I do want to just say one last thing. And
remind the Council why I think the scientists here are so clear
about this and the reason is that we know and everyone knows if they
think about it, the most and I've said this before, the most
conservative group of people in this room are scientists -- maybe
not the scientists, but science. It moves slowly. It checks. It
double checks. It's out in the open. It will be the thing that moves
this question along and you have to start because it's slow in its
activities and in how it actually establishes truth. So I think you
can have policy discussions, philosophical discussions, ethical
discussions for 10 years on this, why not? They're tough questions,
but if you don't let the science go forward it will be in a factual
vacuum.
CHAIRMAN KASS: Michael Sandel, Mary
Ann and Charles, and Frank.
PROF. SANDEL:
Well, Leon, you asked whether your statement was coherent. I would
say more than coherent, it was an eloquent statement of the case for
the moratorium/ban which however one wants to describe it, it's been
articulated here today. Some of the defenders of the moratorium
define it as more or less interchangeable with the ban that Mary Ann
and Gil and Alfonso and Leon, you made a strong case for at least
some version of a moratorium which in this discussion today has
essentially become merged with the ban and I think it's a powerful
statement and set of considerations.
I would just like to
address two of them. One is that you feel it would have the
moratorium/ban would take the reproductive cloning issue on which
there's wide agreement off the table and so it wouldn't muddle the
other discussion. But that seems to me true of all of the proposals
we're considering. All of the proposals, policy proposals would ban
the reproductive cloning and therefore take it off the table. And so
that's not uniquely true of the moratorium/ban.
The second
thing I'd like to address is a point that you raised, Leon, and that
Mary Ann and Gil and Alfonso raised, the idea that a moratorium
would allow the moral argument to continue. I think it's very
important that the moral argument continue and that the moral/policy
argument continue. I think it's a mistake to assume that any of
these proposals would prevent that argument from continuing. I think
the reason we are tempted to think that a policy decision of one
kind or another would somehow prevent public discourse in wrestling
with these moral questions including the moral status of the embryo
which I think should be preserved as a live argument and debate in
public discourse, regardless of what policies are recommended or
enacted. The reason I think that we -- people fear rightly the
danger of kind of shoving off the public agenda that question or
related questions is what happened with the abortion debate, but
there's a big difference. The abortion debate -- the Supreme Court
decision did contribute, it seems to me, to taking off, out of
public deliberation the question about abortion and the moral status
of the embryo, precisely because it took that decision out of the
legislative arena, out of the democratic arena, but nothing -- we
are not a Supreme Court and if there is a decision taken, a
recommendation by this Council, enacted into law by the Congress or
by some state legislature, the debate is still open in a democratic
society as all such debates are open and should be open. So we're
not facing a question here of a Supreme Court ruling that's going to
say no, there can be no more democratic deliberation about this
question, forget about it except for journal articles and philosophy
journals. This will still be and should be the subject of continuing
discussion including on the most fundamental of the moral questions
that we've discussed here.
I think the question we should ask
ourselves is not are we by one policy recommendation or another
going to suddenly prevent public debate on this question. I think we
should ask ourselves how can we frame the alternatives that have
developed over this 6-month period in a way that not only will
permit, but will give focus and structure and maybe inspiration to
continued public debate about these ethical issues.
I think
that we sell ourselves short, if we think that offering two major
policy options, some favoring one, others the second, whether it's
called the moratorium or a ban, developing the reasons as we've
developed the ethical arguments and the various sides, that in
itself, would be not only a contribution, but it would be a way of
giving focus and inspiration and animation to a continued public
debate on this question. We're not the Supreme Court.. We're not
foreclosing. Whatever of these we choose or whatever pair of them,
we recommend, we're not going to be foreclosing public debate on
these moral questions and shouldn't. The question is how can we give
it structure and focus and I think listening to the comments this
morning and today, we're basically there. We basically, I think,
have thrashed it out to their two clear positions and people have
developed -- have defended the two positions broadly speaking,
whether you want to call the second a moratorium or a ban, that can
be up to the final drafting, but I think that we've really
identified the major alternatives, both ethically and in terms of
policy and I don't think we should underestimate the public service
that that constitutes.
CHAIRMAN KASS: I have
Mary Ann, Charles and Frank, in that order.
Please.
PROF. GLENDON: As I recall, the
reason that we took up cloning was not because
--
CHAIRMAN KASS: I wish somebody could
remember.
PROF. GLENDON: Not because there
was any logic to it, but rather that because there was pending
legislation and we were asked or thought it was a good idea to
address ourselves to that problem because it was so
current.
But especially listening to the discussions this
morning of how other commissions and other countries have approached
these issues, and listening to the discussion this afternoon, it
seems to me that maybe where we are is that we're ready to make a
policy recommendation on cloning for reproductive purposes, but the
second matter, cloning for research purposes really, logically
belongs within the general question of embryonic research which
other countries and other commissions have taken up systematically.
So I guess what -- thinking out loud and maybe this is zany, but it
seems to me that maybe what this Commission ought to do is unlink
the policy recommendation about reproductive cloning from the more
complex issue of embryonic research of which cloning for medical
research purposes is a sub-issue and take that up
systematically.
CHAIRMAN KASS: Can I just --
boy, would I love to do that, but I don't think one can make -- I
don't think -- well, I mean you could say look, we make a
recommendation that we would like to see cloning for producing
children banned and the world will not because even the National
Academy of Sciences thinks that. So -- but then you sit down and try
to give effect to that and you can't do it without trampling on this
other tirade. If we could do it, fine. Part of the reason I think --
part of the reason for wanting to have some time where you don't
explicitly give permission for that to go ahead, not just that it
doesn't go ahead, but that you've sort of explicitly sanctioned it
by law, that's one of the advantages, it seems to me, for the
moratorium, so that the next time the question comes up, the no baby
making part is there and this could then be dealt with in the
context where I think it properly -- I absolutely am sympathetic,
but if we're asked to make a recommendation that actually could have
-- could be implemented, we're in the soup. That's the real --
Robby, George and I, 18 months ago because we started in different
places, had an agreement that we would sit down and try to draft
legislation that was like Item 2, absolutely silent on the other
question. Write a legislation that would just ban cloning for baby
making and didn't say a peep, one way or the other, didn't imply
anything about the other. I mean better people -- in fact, I even
asked Michael Sandel if he had had a shot at it, because I thought
he thought it was a preferable -- I don't know if you tried. It's
very hard.
I'm sorry, I've abused the privilege of the chair.
I wish we could do that. I don't think we can make a responsible
policy recommendation and simply say this other thing isn't here.
It's attached to this like a barnacle.
PROF.
GLENDON: Can I?
CHAIRMAN KASS:
Please.
PROF. GLENDON: I wasn't suggesting
that we say the other thing isn't there, but that this Committee
should take the time to systematically --
CHAIRMAN
KASS: I see. Forgive me.
PROF.
GLENDON: -- View the second issue within its proper context
of embryonic research.
CHAIRMAN KASS: I see
and therefore not have a full policy
recommendation.
PROF. GLENDON: And make a
policy recommendation later.
DR.
KRAUTHAMMER: But Mary Ann --
CHAIRMAN
KASS: You have the floor, actually,
Charles.
DR. KRAUTHAMMER: Yes. If we were
designing a seminar on the question of embryo research we may not
have chosen in advance that cloning be the entry point, but in fact,
it has been the entry point just by historical accident, if you like
and I think that, in fact, if you look at all of the documents that
have been produced in all of our discussion, we have done a pretty
thorough investigation of the issue of embryo research, even though
it focused on the cloning aspect.
I think it would be a pity
to throw away everything that we've done which is quite extensive, I
think, quite remarkable. I've looked at the documents that were
produced. I think there are major contributions to the national
debate and I think we ought to -- given that we have spent all this
time and gone deep into the issue, both the science and the ethics
of it, I think it would be a mistake not to go to the next logical
step which is to issue a recommendation on the basis of what we've
said. I'm sorry, I missed the discussion this morning, I was out of
town and I -- perhaps I'm stepping back here, but I just want to
step what my position is on the question and that is, as you know, I
oppose research cloning really on two bases: (a) I think it crosses
a new moral frontier which is the creation of a nascent human life
for its exploitation and use by others; and secondly, because I
distrust and this is just based on experience and observation of
what happens in Washington when with the regulation I distrust our
ability to establish a new line, a line that will hold.
But
these are both credentialed judgments and they are subject to
review, given new facts and new history that we will be creating in
the future. So I would come out at position 5 where I would prefer a
ban on both, but I could live with 6 which would be a ban, plus a
moratorium. I see the difference. You probably have had this
discussion. I'm sorry that I'm late. I'm probably repeating it, but
in a democratic society obviously all bans are temporarily. They can
all be reconsidered, so that the difference between a ban and a
moratorium is simply that when we do inevitably reconsider this
issue, a ban means the burden of proof is on those who want to undo
it and a moratorium means that the burden of proof will be on those
who want to institute a ban. And as a proponent of the ban, I'd be
quite willing, happy, to restate, refight the fight in the future,
if necessary. So I would be for 6.
CHAIRMAN
KASS: Frank.
PROF. FUKUYAMA: Well,
just one last comment on why I prefer 3. Gil was saying that 3 made
the decision in principle in favor of embryo cloning and therefore
in a way it foreclosed that discussion. I understand that point, but
I think that you need to consider the question of whether 6 may not
actually lead to the same result faster because it's one thing if
you assume -- okay, we have a two to three-year moratorium. Either
people are convinced by Alfonso and Robby about the moral status
questions which I think there's close to zero probability of, or
adult stem cells or some other approach seems very promising and the
embryonic stem cells seem less promising which may also happen, but
there's also the possibility that after that period of time the
embryonic stem cell research from animal studies or from other
countries will seem so promising that in fact, once the moratorium
expires you will go right into unregulated embryonic cloning. I mean
that that pressure -- the moratorium period will be used to build
pressure for that. And at that point, you're going to have the
cloning and you won't have a regulatory structure in place. And so
that seems to me a risk that you have to consider if you go for
number 6.
Now on Leon's point that it seems a little strange
to want to create this huge new regulatory structure just to deal
with the cloning issue, I actually regard that as an opportunity
because I actually think that there are many issues out there much
more important than cloning that will need a regulatory structure:
pre-implantation, genetic diagnosis, you know, germ line, when we
get to it, creation of hybrids, I mean, all the things, issues that
these other agencies deal with that we ought to be as a Council
thinking about where we don't have rules, where we don't have an
institution capable of dealing with that and so I welcome the fact
that this gives us a good excuse to actually set this kind of
institution up or think seriously about what such an institution
would look like.
Charles, a couple of years ago wrote this
article where he said about stem cells that people ought to be more
worried about where the stem cells are going, rather than where they
came from and I think that's absolutely right. I mean it's where
they're going that creates, for me, all of the really frightening
possibilities. And for that, you are going to need a broad-based
regulatory institution that will not hold back therapeutic
technologies, but will put some kind of long-term societal control
on ethically questionable things that go way beyond this particular
embryo cloning thing. So I would say the issue is not just embryo
research, it's embryo in general and new biotechnologies, in
general. Because I think, for example, if you looked under this rock
of the American IVF industry, you'll find exactly the same sort of
things that Patricia Baird found when the Canadians looked under
their IVF industry, that there's a lot of stuff that is going on
that doesn't get a lot of attention, but really probably needs
further regulation. So all of those are issues that are tangential
to cloning, but I think we need to address, so that's why I think
that number 6 is actually a good excuse to get us into
this.
CHAIRMAN KASS: You meant 3,
right?
PROF. FUKUYAMA: I'm sorry, 3 is a
good excuse to get us into this.
CHAIRMAN
KASS: The only thing I would say and -- yes, please. Are
you going to respond? The only thing I would say is that the general
sort of political economic climate in this country is not Canada and
that is to say, the ease of doing something like what they've done
there given our absence of bureaucracy and the laissez-faire
attitude in the industry is -- means that one shouldn't be too
sanguine about how easy it -- we can sit here and recommend whatever
regulatory agency you'd like, but if you think that -- if you saw
how unhappy the industry that had basically not much interest in
cloning for biomedical research was about this, wait until you see
what happens when you sort of threaten the whole activity in which
they're engaged because to do this thing right, you're not just
interested in dealing with the area of federal funding. I mean if
you really want regulation, you want it across the board, and let's
not be naive about how -- it's very easy to kill legislation in this
town. It's very hard to pass it and especially something which goes
against the grain of the leading zealots for doing these
things.
PROF. SANDEL: Was that also zealot
in the complimentary sense?
CHAIRMAN KASS:
Yes, yes. Dan, I'm sorry.
DR. FOSTER: I
think I would just like to say that I will support position 3 and
having heard your very eloquent presentation including at lunch when
we talked privately, the key issue for me has to do with the
inviolability of the embryo. If you believe that, then you have to
say no cloning at all. You simply have to say that. This is the same
thing as destroying or sacrificing a human. You have to say that. I
don't hold that view. I don't even know what the evidence is for
that view. I mean this is in that broad space between -- that
Russell talked about, this no man's land. People can say what they
think it is, and one follows the logic of the reasoning and see
whether it's valid or not. So that's out.
I think that -- I
once gave a speech where there was an argument and I ended with a
confession of faith, not a religious faith, but you might claim that
I'm making a religious faith. I said I thought it was an argument
about whether science should exist in medical education and so forth
that I thought that in the end science would win and that is because
you cannot squelch truth ultimately.
I have a high
confidence in what has already been said in the practicality of the
scientific communities, sometimes even in the biotechnology
community. And that is I do think that they're cautious and things
that don't work quickly get dropped. In the first place, they can't
get published and secondly, they don't work. Even with such a
hopeful thing in the treatment of cancer as the angiostatin, you
know, the stuff as Bill was talking about to stop the growth of
blood vessels to stop -- stuff to cure cancer, I think it was $35
million to the rights of that that a biotech company paid. They
dropped it like a hot cake because it didn't work. Even a biotech
company dropped it like a hot cake.
I don't think that the
new evidence that we need to make a decision after a moratorium of
three years or six years or 10 years can be forthcoming without the
kind of comparative investigation that several of us spoke about
this morning. Scientists do not wish to look at things in isolation.
They look to the whole truth. They would like to look to the whole
truth, whether stem cells, adult stem cells are better or cloned
stem cells and so forth. And to put a moratorium on this simply begs
the question of the information that one wishes to make. We have all
the information we need to make a moral decision. I mean because the
arguments have been made ad nauseam. If I've heard one time that we
were once an embryo, I must have heard it even in the course of this
conversation multiple times. The argument is almost always the same.
The same people, different people speak, but it's the same message.
So I think that we ought to just have -- we ought to just vote for
what we think.
I said in a very short public statement in an
e-mail that if I was convinced that this was an inviolable thing, I
would be with Gil or whoever. I wouldn't do it, no matter what the
promise was. But I happen not to think that's true and therefore for
not only individual patients, but for humanity itself and so forth,
I think we ought to let the facts that science gives us tell us what
to do.
Now do I think this ought to be regulated? Yes, I do.
And how long it takes to do that, I don't know. And maybe we'll just
say that the American scientists will wait for the English
scientists to do this, but in one sense, I don't want this to sound
wrong, but in one sense I have confidence in the -- maybe because
the society in which we live more confidence in the caution of the
scientific investigation with American scientists who are influenced
by all the moral issues that we've talked about here, about making
these judgments as well. That was almost never talked -- but I did
want to say the reasons why I think we ought to go ahead and we
ought to do it in terms of what we think the embryo is and what we
think the risks, is this a line? Leon thinks this is a bright line
that we're making life and then killing life. Do we believe that?
Then I don't even know why you want to do a moratorium. If you
believe that, then you ought to just have a permanent ban and try to
defend yourself.
But it is my confession of faith that
finally you cannot stop what biological or other truth is and we
have to simply see if these things work and I would like it much
better if we could work on it and get the answers and if it doesn't
work, let's get on to Bill's view or something else along those
lines.
DR. KRAUTHAMMER: Dan, if I could just
make one point. For some of us, the reason that we oppose this is
not because we see a bright line between life and nonlife and
creation and believe it's the destruction of a person. And our
concerns are rather different. They're about the possibilities of
what this research could lead to. So I just want to clarify that
it's not -- this is not a debate, if you like, a recapitulation of
the abortion debate. For some of us, it's a debate about what might
eventuate, rather than say origins of the cell.
DR.
FOSTER: Well, thanks for that clarification. I know that
you feel that way. You've told me that previously.
I think
that the issue that we worry about would be the one that it would
make it much easier to make human beings for rogue scientists or
other scientists to do that and that's a -- there are evil people
around and there are things like that will happen. I somehow think
at least in the developed countries, maybe that doesn't -- that that
would be -- I mean there's such a universal -- some people have used
the term here revulsion against that, a revulsion which I hold, I
might add, that it would not -- that that would be easier to police
and to prevent than -- you know, than maybe what you think it would
be. I don't know.
DR. KRAUTHAMMER: What I
worry about is not what the rogue scientists will do, it's what the
good scientists, the good society will allow itself to
do.
CHAIRMAN KASS: Robby George, we're going
to wind up very soon. If there are any people who want to add
something before a break, Robby, a comment?
DR.
GEORGE: Yes. Dan, I appreciate the frustration of hearing
the same argument from the same people, time and time again, and
particularly, the point that the being that is now you or me was at
the earliest stage of his existence an embryo. And we have heard it
time and time again. But I don't think I've heard the counter
argument to that. The point of the assertion is the claim that we
have our inviolability and our dignity by virtue of the kind of
entity we are, rather than by virtue of some acquired characteristic
that may or may not come with fuller development and which different
people have in different degree. I think it's therefore incumbent on
people who take the position that the embryo is not inviolable, is
not fully one of us to say what it is then or to say in virtue of
what it is that those human beings who have inviolability and
dignity, who have achieved whatever it is you need to achieve to
have inviolability and dignity have. That -- Michael Gazzaniga, I
think, has put something on the table with brain development and
there has been an exchange about that and if that's the general
position, then at least we know what the argument is, but I don't
think it's enough simply to say I don't accept the claim that the
embryo is inviolable. I think if you're going to reject that claim,
given that reasons have been advanced for the claim, it is incumbent
to say in virtue of what then, if it's not the kind of entity we are
that gives us our inviolability, in virtue of what it is that we
have our inviolability. Because if people on my side of this debate
knew that, what it was, then either we'd be persuaded by it or we
could give our reasons for why that -- as far as we can see, doesn't
work.
DR. FOSTER: Sure and I know we have to
quit and I respect the argument. I would say that I would put myself
in a position that I'm agnostic because I don't know how to answer
that question and you tease me a little bit about bringing in the
issue of the soul. I was just repeating an old story from the Bible
and saying at least the person who wrote it, that the soul came in
later. That's all I meant. I didn't mean that I -- I wasn't trying
to introduce a revelation in here. I carefully said that I didn't
know who wrote this and that it was old, but it was very interesting
that it was into the intact human that God breathed life and that
the human became a living soul and it's just a story from Genesis.
That's all I meant by that.
So the reason that I don't -- it
doesn't make sense to me and I really followed at some point I wrote
a little short paragraph about that that along the lines that this
was a potential human being incapable of doing, becoming life itself
because it wasn't implanted or anything else. It had no organ, no
brain neuron, it had no sentience at all and as a consequence,
common sense, just mere common sense said to me that biologically at
least, this was pre-human and not human and as a consequence I did
not think that it had the same inviolability that I might make at
the time 40 days later. I don't know what the time is, but let's say
40 days or whatever, which I would move away.
But I speak of
this in an agnostic position and one of the things that concerns me
so much is the absolute certainty that some people have that they
can do that. I'm not speaking about -- I'm sure you're probably
worried about this as much as I am, but some people are absolutely
certain that the moment -- we've heard this expressed here, that the
moment that the sperm hits the egg, that that is
inviolable.
Now I heard Bill quoted this -- when Gil and I
were talking a little bit later about the estimate that every year,
if you just look at a one to one loss -- if for every child born,
there's one that's not born. It's not implanted, and I was telling
him that the World Health Organization says that there are -- they
estimate that there are 363,000 babies born every day, 100,000
deaths, so that means that nature in one year, I know these figures
may be soft, eliminate 130,495,000 human things. And so Gil said
well, Bill thought that they were not complete. I hadn't seen this
argument. They were not completely fertilized or something like
that, but my point is here that one has to be agnostic about this
and that's all I'm trying to say.
DR.
GEORGE: But I don't think you have to be agnostic about
what it is in virtue of which human beings have inviolability.
That's what I'd really like to know. If it's not by virtue of the
kind of entity they are, that is, an entity with a rational nature,
then what is it? Is it sentience? Is it brain wave function? Is it
the realized capacity for self-consciousness or self-awareness as my
colleague Peter Singer says. I'd just like to know what argument it
is I'm supposed to answer.
DR. FOSTER: Well,
I say I can't answer it because I don't know and I don't -- I'm
further trying to say that I'm not sure that any human knows the
answer to the question that you wanted to -- I can decide -- I mean
I might decide at the time there's the first -- because you can't --
the highest organ system, as far as I understand it as a physician
scientist is the central nervous system, the body will try to
protect that against all odds and secondarily, it supports the
circulatory system in order to protect the central nervous system.
So if you've pushed me, I would say it's at the point where one had
the capacity to sustain life with an organized or the beginning
organization of a central nervous system because without that, there
will be no progression under any circumstance of this organism to a
full human and these are simple arguments.
DR.
GEORGE: I know, but I think we're actually getting
somewhere. So if the reason we don't look at just an individual
innocent person on the street, and say gee, that's one person, it's
a good thing that there's one person, but we've got 26 or 27 people
in hospitals waiting for organs, so with that one person's organs,
counting two kidneys, one heart, one pancreas, one liver, etcetera,
we could save 26 or 27 people. The reason we don't do that is
because that innocent individual like all other innocent individuals
has inviolability and he has this inviolability by virtue of having
a central nervous system?
DR. FOSTER: No,
his inviolability is much more than that. You're asking, I think, at
the embryonic level where I would make this
decision.
DR. GEORGE: No. I'm just asking
for any human being you think who's there, the human being has got
there, by virtue of what does he have --
DR.
FOSTER: Mr. Chairman, rescue me here. I do not wish to be a
-- I need to be rescued. All I was trying to say is I was voting for
Proposition 3. That's all.
CHAIRMAN KASS:
I'm going to rescue --
DR. KRAUTHAMMER: We
need to discuss this.
DR. FOSTER: Not here
and not now.
CHAIRMAN KASS: Look, if I could
ever overcome my new phobia of all conversations about embryos which
is the result of all of this discussion, I would at some point down
the road after all of this is behind us, it's occurred to me, it's
occurred to me that we could make a useful contribution, separate
from any public policy question at all. In other words, get it out
of the argument to actually have -- get some embryologists in here,
get some philosophical biologists, people whose field is the
philosophy of biology and maybe have a conversation about this with
some presented papers, rather than continue to -- the conversation
has to go on and it's obvious it's not the only thing here. I don't
agree with that that it's the only issue. I think Charles has and
Dan has conceded that.
This isn't, I think, the place to do
that. I would recommend that the two of you have dinner together and
report the --
DR. FOSTER: I already
acknowledge defeat, Charles.
CHAIRMAN KASS:
But it seems to me if I may on Dan's behalf say to you, Robby, since
Jim Wilson has, in a way, spoken for many of the people on the -- I
shouldn't take his name in vain because he's absent. I think he's
still out of the country. He tried to make a kind of moral intuition
argument which doesn't settle anything as people who talk about the
wisdom of repugnance know all too well, but that argument can
embarrass intuition or say maybe your intuitions are senseless or
wrong, that's a nice ploy, but when you finish arguing with him, you
tell me why your moral intuition that cannibalism and incest are
abominations? You give me an argument that's adequate to that. Not
now.
(Laughter.)
DR. GEORGE: Can I
just cite an article I've written?
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