Human Cloning and Human Dignity:
An Ethical Inquiry

Table of Contents

The President's Council on Bioethics
Washington, D.C.
July 2002
www.bioethics.gov

Appendix

Personal Statements

Elizabeth H. Blackburn, Ph.D., D.Sc.
Rebecca S. Dresser, J.D., M.S.
Daniel W. Foster, M.D.
Michael S. Gazzaniga, Ph.D.
Robert P. George, D.Phil., J.D. (joined by Alfonso Gómez-Lobo, Ph.D.).
William B. Hurlbut, M.D.
Charles Krauthammer, M.D.
Paul McHugh, M.D.
William F. May, Ph.D.
Gilbert C. Meilaender, Ph.D.
Janet D. Rowley, M.D., D.Sc.
Michael J. Sandel, D.Phil.
James Q. Wilson, Ph.D.

Statement of Professor Blackburn

There are several reasons why a moratorium on cloning-for-biomedical-research (SCNT) is not a logical or productive direction in which to proceed.

The goal of a moratorium is to wait until something happens, then make a decision. For a moratorium on SCNT (cloning-for-biomedical-research), waiting would have several consequences that I do not believe reflect the spirit of much of the Council's opinion.

First, during any such proposed moratorium, patients will continue to have currently incurable diseases – for which there is now no hope of alleviation – and many will continue to die of them. Second, a moratorium is used to gain more information. It may sound tempting to impose a moratorium to get more information, since, despite very promising results, it is true, at this early stage of the research, that we still know only a little. But that information can only be gained by performing the same research that the moratorium proposes to halt.

It has been proposed that other kinds of research will provide such answers. One cannot find out the answers about oranges by doing all the research on apples. Some kinds of research on apples will be useful, because it will provide information about generalities that apply to fruit in general. But diseases are very specific, and humans are very specific. They share overarching features with other animals, but the very nature of disease is to be particular. Thus, diabetes research does not apply to Parkinson's research.

Furthermore, it has been proposed that the needed information can be gained from research in animal models. However, it is of crucial importance to be aware that human diseases are different, in certain specific ways, from their counterpart models in animals. This is the case just as the course of development in a mouse has overarching similarities to, yet at the same time startling and highly specific differences from, the course of development of a human. Hence, animal models, while invaluable up to a point, cannot provide the needed information for understanding and treating a human disease.

Currently, there are excess in vitro fertilization embryos, and it has been proposed that biomedical research on these, if allowed by their parents and those responsible for them, would be adequate for obtaining the types of information that could be gained from research that involves SCNT. But first, these excess embryos represent only a limited set of genetic backgrounds. They do not represent the wide diversity of genetic and ethnic groups that will be needed if the fruits of this research are to be available to all. Second, the limited set of available excess IVF embryos would not, of course, represent the very genotypes of perhaps greatest interest: those representing the diseases that are the rightful subject of research involving SCNT. A final point concerns why these embryos are in excess. It is not only to attempt to ensure success of IVF, but also, in current IVF practice, these excess embryos are more often the ones that were judged by the IVF clinic professionals as appearing less likely to develop well – which is why they were not chosen for implantation in the first place. If they have a higher chance of abnormality, this is not the group of embryos that is ideal for obtaining the best, most relevant information about development and disease.

SCNT-derived stem cells could provide other crucial information, in a way impossible for excess in-vitro-fertilized-embryo-derived stem cells. Researchers could address, in a clear and experimentally controlled way, a key unknown issue about the therapeutic value of stem cell use for regenerative medicine: the immune rejection issue. There are excellent in vitro investigations that could cast a lot of much needed light on this area, and could be done only with cells derived from the same genetic background – i.e., using stem cells from SCNT. Again, this cannot be done with animal models alone, which have been the only source of information on this topic to date, because we know that animal models are not complete models for many particular biological questions in humans.

In sum, reliance on excess IVF embryos would severely hobble efforts to gain the information that is needed to be able to judge the promise of cloning-for-biomedical-research. Further, the use of IVF embryos in no way facilitates the most immediately promising areas of SCNT research, which involve not tissue transplantation but rather the development of laboratory tissue that has been grown from somatic cells with known genetic mutations that are needed for study and for testing of new pharmaceutical interventions.

Hence, a moratorium, imposed in order to wait for more information that will give us a better informed set of facts from which to proceed, is logically flawed.

The President's Council on Bioethics currently is proposing two possible policy recommendations. Both would ban cloning-to-produce-children. One proposal is to proceed with cloning-for-biomedical-research (SCNT) with appropriate regulations; the other is to put it under a four-year moratorium. I support the former proposal.

Some have called for a moratorium pending development of elaborate regulatory innovations, such as the creation of a new government body to oversee all this research. Unfortunately, such regulations might well never emerge, allowing opponents of research to accomplish by administrative delay what they have been unable to accomplish through legislation, that is, a de facto ban on SCNT research. Furthermore, these proposals ignore the extensive regulation already in place.

Based on the Council's public deliberations, over half of the Council do not have ethical problems with cloning-for-biomedical-research based simply on the status of the embryo. The proposal of a moratorium on SCNT, and not its outright ban, by the President's Council on Bioethics certainly implies that the Council deems this research to be important for medical science. A moratorium can only be counterproductive to the good that can come out of this research. Rather, the thoughtful application of current regulations to all SCNT research and consideration of independent efforts to regulate the market in human gametes will allow this research to proceed with its risks minimized and its benefits maximized for all.

Statement of Professor Dresser

I. Cloning to Have a Child

The ethical question presented today is not, "if cloning to have a child were safe, should it then be permitted?" Instead, the question is whether societies should allow scientists and physicians to conduct research aimed at producing babies through cloning. Posing the question this way highlights the research ethics issues raised by this form of cloning.

A central ethical issue is whether studies of cloning to have a child would present a balance of risks (to women, fetuses, children, and society) and expected benefits (to the child, prospective parents, and society) that justifies proceeding with human trials. The National Academy of Sciences (NAS) report Scientific and Medical Aspects of Human Reproductive Cloning observes that high numbers of human eggs would be required for this research. Women serving as research subjects would be exposed to the risks presented by fertility drugs and egg retrieval procedures. Women would also be exposed to risks associated with gestating a cloned fetus. As the NAS report notes, animals pregnant with cloned fetuses have had miscarriages and other health complications. If prenatal tests revealed problems in the fetus, women would face decisions about pregnancy termination. At least initially, human studies would expose children to the risk of disability and premature death. Parents and society could face burdens associated with caring for disabled children. Even if further cloning work in other species leads to better outcomes, good outcomes would not be assured in humans.

Added to these risks are the broader ethical concerns raised by cloning to have a child, such as psychological harm and objectification of children. Admittedly, many children today are born into environments that expose them to serious physical, social, and psychic harms. Prenatal and preimplantation screening allow parents to exercise deliberate control over children=s genetic makeup. Confused and difficult family relations can arise in "natural" family settings and as a result of currently practiced assisted reproduction methods. Certain social practices may allow and encourage parents to regard children as projects or products.

What is different about cloning is the array of risks and worries it presents, together with the relatively little that would be gained by developing the procedure. Although there are a few cases in which cloning to have a child might be morally acceptable, there are not enough of those cases to justify exposing research subjects and others to the harms that could accompany human testing.

Research on cloning to have children would also consume resources that might otherwise be devoted to more worthwhile projects. The limited resources available to support biomedical research should go to studies relevant to serious human health problems. Responsible companies and scientists ought to devote their efforts to research on important health problems, rather than on cloning to have children.

Several U.S. court opinions and advisory panel reports assign an intermediate moral status to the human embryo. According to these statements, embryos should be treated with special respect – not the respect we give to fully developed humans, but more respect than we give to items of property. One difficulty with the intermediate status position is that there is little clarity or agreement on what it means to treat human embryos with special respect.

Special respect might mean that embryos ought not be created purely for use as a research tool or a therapy to help others. Creating embryos for these purposes would represent a significant step beyond allowing the research use of donated IVF embryos that would otherwise be destroyed. Creating embryos for research would require women to provide eggs for research use. It is possible that payment would be necessary to attract a sufficient number of egg – providers (this would depend on the number of eggs needed and the number of women willing to donate for altruistic reasons). In this context, women would be helping to produce a research tool, rather than helping infertile people to have children.

Some people believe that creation of cloned and other embryos for research would be consistent with the special respect view. In 1994, a majority of the National Institutes of Health Human Embryo Research Panel said that creating embryos for research "for the most serious and compelling reasons" would be permissible. Former President Clinton disagreed with this judgment, however. And because panel Members themselves were concerned about the risks associated with egg donation, they recommended that eggs for research embryos be obtained solely from women already undergoing IVF for infertility treatment, women undergoing gynecological surgery for other reasons, and deceased women based on their previous consent or the consent of their next-of-kin. The deliberations in 1994 concerned acceptable conditions for government funding of human embryo research, but I do not think the participants meant to suggest that privately funded research should be evaluated according to wholly different moral considerations.

Because there are legitimate moral concerns raised by the practice of creating human embryos for research, I believe it would be premature to endorse cloning-for-biomedical-research. To approve cloning is to approve the creation of embryos as research tools. Past advisory groups and others have expressed sufficient reservations about this step to warrant more extensive national deliberation about whether it is justified at all and, if so, under what conditions.

I find it hard to reconcile the special respect view with a policy that allows embryos to be created purely as a research tool. I also recognize that some individuals assign a higher moral status to the early embryo. I do not want to endorse a practice that many people believe is wrong in the absence of compelling reasons to do so. At the same time, I can imagine studies that would offer sufficient benefit to patients to justify the creation of embryos for research through cloning or other methods.

For me, an important consideration is whether there are or will be in the near future alternative methods of investigating the relevant scientific questions. With regard to potential stem cell therapies, the question is whether cloning will be necessary to avoid the immune rejection problem. The NAS report Stem Cells and the Future of Regenerative Medicine repeatedly states that additional research in many areas is needed to determine whether embryonic stem cells can provide effective therapies to patients. A period of research focused on stem cells from donated embryos remaining after infertility treatment and on the immune rejection problem in animals could help to clarify whether it is necessary to move to research on stem cells from cloned human embryos. As for other types of research that might be conducted with stem cells from cloned human embryos, I believe scientists need to explain in more detail the significance of the research questions and the reasons why they cannot be investigated using alternative methods.

The appropriate oversight system is another matter meriting further analysis. In my view, proposals to create research embryos should be evaluated by a group that includes scientific experts, members of other professions, and ordinary citizens. The review group should include individuals with different positions on the moral status of early embryos. Approval should occur only after a rigorous and thorough analysis of individual proposals. The review group should require strong evidence that a proposal will generate information both relevant to a serious human health problem and not available through alternative research approaches.

I also believe that the temptation will be strong to extend the time limits for permissible human embryo and fetal research. Events in the past demonstrate that the desire to advance knowledge can lead to immoral research practices. Because there is likely to be pressure to allow destructive research on developing humans past the point at which stem cells can be retrieved, our nation should establish a strong moral and policy basis for drawing the line at a particular point in development.

In sum, I believe that a four-year moratorium on cloning-for-biomedical-research is justified for a variety of reasons. A moratorium gives scientists time to gather data and develop a stronger account of why it is necessary to obtain stem cells from cloned embryos. A moratorium allows Members of this Council and others to consider embryo cloning in its broader ethical and policy context and to deliberate about appropriate oversight structures for cloning and related practices. I hope that the moratorium also gives members of the public an opportunity to learn more about the actual state of stem cell research. This is truly a promising area, but it is far from certain that all or even some of its projected therapeutic benefits will materialize.

Finally, I hope that future public and policy discussions will confront the challenge of providing patients with access to any stem cell therapies that may be developed. Millions of patients in the United States lack access to established health care that could improve and extend their lives. People in developing countries lack access to the most basic medical assistance. Because helping patients is the ethical justification for conducting stem cell and other forms of biomedical research, improved access to existing and future therapies must be part of the national discussion.

Statement of Dr. Foster

I begin by saying that the deliberations of the Council have been from the beginning serious, open and collegial. Although strong differences exist amongst some members, these have been expressed in scholarly and dignified fashion, without anger or personal attacks.

I support Proposal 2. The core issues in the discussion have been two. The first is "the nature of the embryo" argument. Some supporting Proposal 1 feel strongly that from the moment of conception, or the moment of cloning, the germ of potential life is so powerful as to render the nascent embryo deserving of protection equal to that of a full human. Others believe that respect for the embryo, though it is not yet fully human, requires a moratorium to see if alternatives might render cloning unnecessary. There is no doubt that a five or six day embryo is potentially human, but it cannot become a human by itself as would occur in normal human conception. The one or two hundred cell organism, the blastocyst, is neither viable nor feeling; there are no organs and there is no brain. There is nothing it can do without external help and implantation. From the standpoint of science it is potentially human but biologically pre-human. The evidence for this conclusion seems unarguable to me.

Proponents of Proposal 1, although they may agree with the biological facts, focus on "what might be" for the embryo. If implanted, some of the blastocysts from any source might become fully human, a child. However, in natural conception many embryos, perhaps half or more, are deleted in the first trimester. I calculated, using the World Health Organization 2001 estimate of about 360,000 births in the world each day, and assuming 50 percent implantation possibility, that more than 130 million embryos are lost naturally each year. Thus what any embryo might become is far from certain. Obviously the philosophical/moral argument of absolute or near absolute sanctity of any embryo cannot be answered by the scientific/biological argument. But I hold to the latter.

The "slippery slope" argument has been extensively discussed and fundamentally devolves to the fear or belief that lessons learned in cloning for research and therapy would make cloning-to-produce-children easier or more likely to occur. That is a legitimate fear, hence the desire by all of us for a ban on cloning-to-produce-children and the demand for regulation of all cloning.

I believe that biomedical science is a powerful good in the universe. The achievements in the prevention and cure of human disease and suffering over the past half century have been remarkable. What we know about nature grows daily. Stem cell research has great potential to take us further. Is it certain that dramatic health benefits will follow? Of course not. Science is a discipline of uncertainty. That is why in my view we should begin the research. I believe we have to compare the stem cells side by side: adult stem cells versus IVF stem cells versus cloned stem cells. Then we will know whether the potential is real and what the advantages or disadvantages of each cell type might be. Supporters of Proposal 1 also believe that research is necessary and argue that the moratorium will allow research on adult and IVF stem cells. But it eliminates a critical element, the direct comparison by controlled experiments for all three types of potentially therapeutic cells.

I said above that science is a discipline of uncertainty that requires experiments to answer questions of truth. It is also a discipline of hope. I believe that Proposal 2 is a very good thing for all those who suffer from disease. It is a decision for hope. It is for this reason that I support it.

Statement of Dr. Gazzaniga

Oscar Wilde's lament, "A man who moralizes is usually a hypocrite," is a fairly rough statement. While I don't fully subscribe to it, I do believe that it cuts to the heart of much of the problematic nature of moralization: the divide that can exist between reasoning as reflected in actions in the face of a collection of facts and reasoning grounded on little more than a cultural belief system.

Of course, we are all free to have our views on everything from baseball to embryos. This is a large part of what makes this country great. But moralizers often go much further. Frequently, they want you to conform to their views, an agenda that I find entirely disturbing, and particularly troubling, when cast in the large, as a basis for social and even scientific policy.

My personal view on these matters is driven by forty years of scientific study on how the brain enables mind, which gives me a particular professional perspective on how our species forms and maintains its belief systems. This, for better or worse, is the lens through which I see these deliberations.

I disagree with most of the moral reasoning argued in this report. For me it is full of unsubstantiated psychological speculations on the nature of sexual life and theories of moral agency. In what follows, I state my position on the issue of both cloning-to-produce-children and cloning-for-biomedical-research in the form of a short essay. I try to capture my own passion for what is at stake.

It was a bright and wintry January day when President Bush convened his advisory panel on bioethics in the Roosevelt Room of the White House. I was excited to be there and our charge was, and is, to see, explicate, and finally advise him how to respond to the flood of ethical complexities unearthed by the torrent of new biomedical technology. The President implored us to engage in that age-old technique of intellectual dueling that is debate. I was confident that a sensible and sensitive policy might evolve from what was sure to be a cacophony of voices of scientists and philosophers, representing a spectrum of opinions, beliefs, and intellectual backgrounds.

It was thus a surprise to me to hear the President's April speech on cloning. His opinions appeared fully formed, even though our panel had yet to finalize a report and still awaited a vote on the singularly crucial point of so-called cloning-for-biomedical-research. While it is true that the President's position is one held by some of the Members of the panel, it is not unanimous, and the panel's charge, the public nature of our panel's debate, and our national political process leave me wanting to make public my own personal view at this time.

Most people are aware that we no longer see cloning in a simple one-process-fits-all framework. At the very least there are two flavors. Cloning-to-produce-children is that process by which a new human being might be grown from the genetic material of a single individual. At this point in our history, no one supports cloning-to-produce-children. It is, by consensus, dangerous, probably not even attainable for years, and simply an odd concept. Even if cloning-to-produce-children did succeed in the future, the idea of informing one's spouse, "Let's go with my genes, not yours," is bizarre and socially a nonstarter.

In juxtaposition to cloning-to-produce-children is cloning-for-biomedical-research. This is another matter entirely. Cloning-for-biomedical-research is carried out with a completely different set of intentions from cloning-to-produce children. Cloning-for-biomedical-research is a bit of a misnomer, but it is the term the panel wants to use instead of "therapeutic cloning," for it is meant to cover not only cloning for therapeutics (for such diseases as diabetes, Parkinson's disease, and so on) but also that cloning now deemed necessary for understanding all genetic disorders. This is cloning for the sole purpose of enabling various types of lifesaving biomedical research. Perhaps the Council should have called it "lifesaving cloning."

Intentions aside, it is worth recalling the mechanics of cloning-for-biomedical-research. Scientists prefer to call this somatic cell nuclear transfer for a simple reason. That is all it is. Any cell from an adult can be placed in an egg whose own nucleus has been removed and given a jolt of electricity. This all takes place in a lab dish, and the hope is that this transfer will allow the adult cell to be reprogrammed so that it will form a clump of approximately 150 cells called a blastocyst. That clump of cells will then be harvested for the stem cells the clump contains, and medical science will move forward.

The general public gets confused around this point in a discussion. The confusions come from a conflation of ideas, beliefs, and facts. At the core seems to be the idea, asserted by some religious groups and some ethicists, that this moment of transfer of cellular material is an initiation of life, and so is the moment when a moral equivalency is established between a developing group of cells and a human being. They believe this is true for a normally sexually produced embryo and now so too for this new activated cell. This is the point of view that led to the President's view that both cloning-to-produce-children and cloning-for-biomedical-research should be outlawed. But in light of modern biological knowledge, is the view that life and moral agency start at the same time reasonable and true? Some think not.

First, consider embryos. We now know that as many as 50 to 80 percent of all fertilized eggs spontaneously abort. Those fertilized eggs are simply expelled from the body. It is hard to believe that under any religious belief system people would grieve and/or hold funerals for these natural events. Yet, if these unfortunate zygotes are considered human beings, then logically they should. Second, the process of a single zygote splitting to make identical twins can occur at least until fourteen days after fertilization. Thus, how could we possibly identify a person with a single fertilized egg? Additionally, even divided embryos can recombine back into one. The happy result would be a person who has emerged from two distinct fertilized eggs but is otherwise just like you and me. The "person = zygote" theory would have to say that he is two people! Finally, with respect to activated cells, there is no real claim when it all starts because it is not known in any detail.

Because the fertilization process is now understood, it serves as the modern scientific basis for the British position, which does not grant moral status to an embryo until after fourteen days, the time when all the twinning issues cease and the point where it must be implanted into the uterus if development is to continue. Thus, in Britain, embryo research goes on up to the blastocyst stage only and now, most recently, attempts at cloning to the blastocyst stage will be permitted.

The laboratory-devised blastocyst to be used for cloning-for-biomedical-research, the biological clump of cells at issue here, is the size of the dot on this "i." It has no nervous system and is therefore not sentient in any way and has no trajectory to becoming a human unless it is re-implanted into a women's uterus. And yet it likely carries the gold for the cure of millions of people. My brother is a general surgeon. He has saved hundreds of lives because he was able to transplant hearts and livers and kidneys and lungs to others from clinically brain-dead patients. The next of kin gave their loved one's tissue to help others, a practice which is condoned by all of society, including Catholics. It seems only right that those adults not needing leftover IVF embryos or eggs, neither of which have a brain at all, should have the same right to will them for use in biomedical research. The no-brained blastocyst that can develop from these tissue gifts, from both IVF and biomedical cloning technologies, is ready to help the suffering of brain – alive children and adults.

The President asked us to debate on our opening day. He said, "That's what I want. You haven't heard a debate until you have heard Colin Powell and Don Rumsfeld go at it." He lets these two trusted aides have it out, and I think he made a courageous and wise decision to send in the troops to have at the terrorists who would destroy innocent women and children. Disease does the same. I only hope he hears the debate, and then I hope he decides to send in the stem cells to root out disease. In the spirit of these times, I too say, "Let's roll."

Statement of Professor George
(Joined by Dr. Gómez-Lobo)

The subject matter of the present report is human cloning, the production of a human embryo by means of somatic cell nuclear transfer (SCNT) or similar technologies. Just as fertilization, if successful, generates a human embryo, cloning produces the same result by combining what is normally combined and activated in fertilization, that is, the full genetic code plus the ovular cytoplasm. Fertilization produces a new and complete, though immature, human organism. The same is true of successful cloning. Cloned embryos therefore ought to be treated as having the same moral status as other human embryos.

A human embryo is a whole living member of the species homo sapiens in the earliest stage of his or her natural development. Unless denied a suitable environment, an embryonic human being will by directing its own integral organic functioning develop himself or herself to the next more mature developmental stage, i.e., the fetal stage. The embryonic, fetal, infant, child, and adolescent stages are stages in the development of a determinate and enduring entity – a human being – who comes into existence as a single cell organism and develops, if all goes well, into adulthood many years later.ⁱ

Human embryos possess the epigenetic primordia for self-directed growth into adulthood, with their determinateness and identity fully intact. The adult human being that is now you or me is the same human being who, at an earlier stage of his or her life, was an adolescent, and before that a child, an infant, a fetus, and an embryo. Even in the embryonic stage, you and I were undeniably whole, living members of the species homo sapiens. We were then, as we are now, distinct and complete (though in the beginning we were, of course, immature) human organisms; we were not mere parts of other organisms.

Consider the case of ordinary sexual reproduction. Plainly, the gametes whose union brings into existence the embryo are not whole or distinct organisms. They are functionally (and not merely genetically) identifiable as parts of the male or female (potential) parents. Each has only half the genetic material needed to guide the development of an immature human being toward full maturity. They are destined either to combine with an oocyte or spermatozoon to generate a new and distinct organism, or simply die. Even when fertilization occurs, they do not survive; rather, their genetic material enters into the composition of a new organism.

But none of this is true of the human embryo, from the zygote and blastula stages onward. The combining of the chromosomes of the spermatozoon and of the oocyte generates what every authority in human embryology identifies as a new and distinct organism. Whether produced by fertilization or by SCNT or some other cloning technique, the human embryo possesses all of the genetic material needed to inform and organize its growth. Unless deprived of a suitable environment or prevented by accident or disease, the embryo is actively developing itself to full maturity. The direction of its growth is not extrinsically determined, but is in accord with the genetic information within it.ⁱⁱ The human embryo is, then, a whole (though immature) and distinct human organism – a human being.

If the embryo were not a complete organism, then what could it be? Unlike the spermatozoa and the oocytes, it is not a part of the mother or of the father. Nor is it a disordered growth such as a hydatidiform mole or teratoma. (Such entities lack the internal resources to actively develop themselves to the next more mature stage of the life of a human being.) Perhaps someone will say that the early embryo is an intermediate form, something that regularly emerges into a whole (though immature) human organism but is not one yet. But what could cause the emergence of the whole human organism, and cause it with regularity? It is clear that from the zygote stage forward, the major development of this organism is controlled and directed from within, that is, by the organism itself. So, after the embryo comes into being, no event or series of events occur that could be construed as the production of a new organism; that is, nothing extrinsic to the developing organism itself acts on it to produce a new character or new direction in development.

But does this mean that the human embryo is a human being deserving of full moral respect such that it may not legitimately be used as a mere means to benefit others?

To deny that embryonic human beings deserve full respect, one must suppose that not every whole living human being is deserving of full respect. To do that, one must hold that those human beings who deserve full respect deserve it not in virtue of the kind of entity they are, but, rather, in virtue of some acquired characteristic that some human beings (or human beings at some stages) have and others do not, and which some human beings have in greater degree than others.ⁱⁱⁱ

We submit that this position is untenable. It is clear that one need not be actually conscious, reasoning, deliberating, making choices, etc., in order to be a human being who deserves full moral respect, for it is clear that people who are asleep or in reversible comas deserve such respect. So, if one denied that human beings are intrinsically valuable in virtue of what they are, but required an additional attribute, the additional attribute would have to be a capacity of some sort, and, obviously a capacity for certain mental functions. Of course, human beings in the embryonic, fetal, and early infant stages lack immediately exercisable capacities for mental functions characteristically carried out (though intermittently) by most (not all – consider cases of severely retarded children and adults and comatose persons) human beings at later stages of maturity. Still, they possess in radical (= root) form these very capacities. Precisely by virtue of the kind of entity they are, they are from the beginning actively developing themselves to the stages at which these capacities will (if all goes well) be immediately exercisable. In this critical respect, they are quite unlike cats and dogs – even adult members of those species. As humans, they are members of a natural kind – the human species – whose embryonic, fetal, and infant members, if not prevented by some extrinsic cause, develop in due course and by intrinsic self-direction the immediately exercisable capacity for characteristically human mental functions. Each new human being comes into existence possessing the internal resources to develop immediately exercisable characteristically human mental capacities – and only the adverse effects on them of other causes will prevent their full development. In this sense, even human beings in the embryonic, fetal, and infant stages have the basic natural capacity for characteristically human mental functions.

We can, therefore, distinguish two senses of the "capacity" (or what is sometimes referred to as the "potentiality") for mental functions: an immediately exercisable one, and a basic natural capacity, which develops over time. On what basis can one require for the recognition of full moral respect the first sort of capacity, which is an attribute that human beings acquire (if at all) only in the course of development (and may lose before dying), and that some will have in greater degree than others, and not the second, which is possessed by human beings as such? We can think of no good reason or nonarbitrary justification.

By contrast, there are good reasons to hold that the second type of capacity is the ground for full moral respect.

First, someone entertaining the view that one deserves full moral respect only if one has immediately exercisable capacities for mental functions should realize that the developing human being does not reach a level of maturity at which he or she performs a type of mental act that other animals do not perform – even animals such as dogs and cats – until at least several months after birth. A six-week-old baby lacks the immediately exercisable capacity to perform characteristically human mental functions. So, if full moral respect were due only to those who possess immediately exercisable capacities for characteristically human mental functions, it would follow that six-week-old infants do not deserve full moral respect. If one further takes the position that beings (including human beings) deserving less than full moral respect may legitimately be dismembered for the sake of research to benefit those who are thought to deserve full moral respect, then one is logically committed to the view that, subject to parental approval, the body parts of human infants, as well as those of human embryos and fetuses, should be fair game for scientific experimentation.

Second, the difference between these two types of capacity is merely a difference between stages along a continuum. The proximate, or immediately exercisable, capacity for mental functions is only the development of an underlying potentiality that the human being possesses simply by virtue of the kind of entity it is. The capacities for reasoning, deliberating, and making choices are gradually developed, or brought toward maturation, through gestation, childhood, adolescence, and so on. But the difference between a being that deserves full moral respect and a being that does not (and can therefore legitimately be dismembered as a means of benefiting others) cannot consist only in the fact that, while both have some feature, one has more of it than the other. A mere quantitative difference (having more or less of the same feature, such as the development of a basic natural capacity) cannot by itself be a justificatory basis for treating different entities in radically different ways. Between the ovum and the approaching thousands of sperm, on the one hand, and the embryonic human being, on the other hand, there is a clear difference in kind. But between the embryonic human being and that same human being at any later stage of its maturation, there is only a difference in degree.

Third, being a whole human organism (whether immature or not) is an either/or matter – a thing either is or is not a whole human being. But the acquired qualities that could be proposed as criteria for personhood come in varying and continuous degrees: there is an infinite number of degrees of the relevant developed abilities or dispositions, such as for self-consciousness, intelligence, or rationality. So, if human beings were worthy of full moral respect only because of such qualities, and not in virtue of the kind of being they are, then, since such qualities come in varying degrees, no account could be given of why basic rights are not possessed by human beings in varying degrees. The proposition that all human beings are created equal would be relegated to the status of a superstition. For example, if developed self-consciousness bestowed rights, then, since some people are more self-conscious than others (that is, have developed that capacity to a greater extent than others), some people would be greater in dignity than others, and the rights of the superiors would trump those of the inferiors where the interests of the superiors could be advanced at the cost of the inferiors. This conclusion would follow no matter which of the acquired qualities generally proposed as qualifying some human beings (or human beings at some stages) for full respect were selected. Clearly, developed self-consciousness, or desires, or so on, are arbitrarily selected degrees of development of capacities that all human beings possess in (at least) radical form from the coming into being of the organism until his or her death. So, it cannot be the case that some human beings and not others are intrinsically valuable, by virtue of a certain degree of development. Rather, human beings are intrinsically valuable in virtue of what (i.e., the kind of being) they are; and all human beings – not just some, and certainly not just those who have advanced sufficiently along the developmental path as to be able to exercise their capacities for characteristically human mental functions – are intrinsically valuable.

Since human beings are intrinsically valuable and deserving of full moral respect in virtue of what they are, it follows that they are intrinsically valuable from the point at which they come into being. Even in the embryonic stage of our lives, each of us was a human being and, as such, worthy of concern and protection. Embryonic human beings, whether brought into existence by union of gametes, SCNT, or other cloning technologies, should be accorded the status of inviolability recognized for human beings in other developmental stages.

Three arguments have been repeatedly advanced in the course of our Council's deliberations in an effort to cast doubt on the proposition that human embryos deserve to be accorded such status.

(1) Some have claimed that the phenomenon of monozygotic twinning shows that the embryo in the first several days of its gestation is not a human individual. The suggestion is that as long as twinning can occur, what exists is not yet a unitary human being but only a mass of cells – each cell is totipotent and allegedly independent of the others.

It is true that if a cell or group of cells is detached from the whole at an early stage of embryonic development, then what is detached can sometimes become a distinct organism and has the potential to develop to maturity as distinct from the embryo from which it was detached (this is the meaning of "totipotent"). But this does nothing to show that before detachment the cells within the human embryo constituted only an incidental mass. Consider the parallel case of division of a flatworm. Parts of a flatworm have the potential to become a whole flatworm when isolated from the present whole of which they are part. Yet no one would suggest that prior to the division of a flatworm to produce two whole flatworms the original flatworm was not a unitary individual. Likewise, at the early stages of human embryonic development, before specialization by the cells has progressed very far, the cells or groups of cells can become whole organisms if they are divided and have an appropriate environment after the division. But that fact does not in the least indicate that prior to such an extrinsic division the embryo is other than a unitary, self-integrating, actively developing human organism. It certainly does not show that the embryo is a mere clump of cells.

In the first two weeks, the cells of the developing embryonic human being already manifest a degree of specialization or differentiation. From the very beginning, even at the two-cell stage, the cells differ in the cytoplasm received from the original ovum. Also they are differentiated by their position within the embryo. In mammals, even in the unfertilized ovum, there is already an "animal" pole (from which the nervous system and eyes develop)^iv and a "vegetal" pole (from which the future "lower" organs and the gut develop). After the initial cleavage, the cell coming from the "animal" pole is probably the primordium of the nervous system and the other senses, and the cell coming from the "vegetal" pole is probably the primordium of the digestive system. Moreover, the relative position of a cell from the very beginning (that is, from the first cleavage) has an impact on its functioning. Monozygotic twinning usually occurs at the blastocyst stage, in which there clearly is a differentiation of the inner cell mass and the trophoblast that surrounds it (from which the placenta develops).^v

The orientation and timing of the cleavages are species specific, and are therefore genetically determined, that is, determined from within. Even at the two-cell stage, the embryo begins synthesizing a glycoprotein called "E-cadherin" or "uvomorulin," which will be instrumental in the compaction process at the eight-cell stage, the process in which the blastomeres (individual cells of the embryo at the blastocyst stage) join tightly together, flattening and developing an inside-outside polarity.^vi And there is still more evidence, but the point is that from the zygote stage forward, the embryo, as well as maintaining homeostasis, is internally integrating various processes to direct them in an overall growth pattern toward maturity.^vii

But the clearest evidence that the embryo in the first two weeks is not a mere mass of cells but is a unitary organism is this: if the individual cells within the embryo before twinning were each independent of the others, there would be no reason why each would not regularly develop on its own. Instead, these allegedly independent, noncommunicating cells regularly function together to develop into a single, more mature member of the human species. This fact shows that interaction is taking place between the cells from the very beginning (even within the zona pellucida, before implantation), restraining them from individually developing as whole organisms and directing each of them to function as a relevant part of a single, whole organism continuous with the zygote. Thus, prior to an extrinsic division of the cells of the embryo, these cells together do constitute a single organism. So, the fact of twinning does not show that the embryo is a mere incidental mass of cells. Rather, the evidence clearly indicates that the human embryo, from the zygote stage forward, is a unitary, human organism.

(2) The second argument we wish to address suggests that since people frequently do not grieve, or do not grieve intensely, for the loss of an embryo early in pregnancy, as they do for the loss of a fetus late in pregnancy or of a newborn, we are warranted in concluding that the early embryo is not a human being worthy of full moral respect.

The absence of grieving is sometimes a result of ignorance about the facts of embryogenesis and intrauterine human development. If people are told (as they still are in some places) that there simply is no human being until "quickening" – a view which is preposterous in light of the embryological facts – then they are likely not to grieve (or not to grieve intensely) at an early miscarriage. But people who are better informed, and women in particular, very often do grieve even when a miscarriage occurs early in pregnancy.

Granted, some people informed about many of the embryological facts are nevertheless indifferent to early miscarriages; but this is often due to a reductionist view according to which embryonic human beings are misdescribed as mere "clumps of cells," "masses of tissue," etc. The emotional attitude one has toward early miscarriages is typically and for the most part an effect of what one thinks – rightly or wrongly – about the humanity of the embryo. Hence it is circular reasoning to use the indifference of people who deny (wrongly, in our view) that human beings in the embryonic stage deserve full moral respect as an argument for not according such respect.

Moreover, the fact that people typically grieve less in the case of a miscarriage than they do in the case of an infant's death is partly explained by the simple facts that they do not actually see the baby, hold her in their arms, talk to her, and so on. The process of emotional bonding is typically completed after the child is born – sometimes, and in some cultures, months after the child is born. However, a child's right not to be killed plainly does not depend on whether her parents or anyone else has formed an emotional bond with her. Every year – perhaps every day – people die for whom others do not grieve. This does not mean that they lacked the status of human beings who were worthy of full moral respect.

It is simply a mistake to conclude from the fact that people do not grieve, or grieve less, at early miscarriage that the embryo has in herself less dignity or worth than older human beings.

(3) We now turn to the third argument. Some people, apparently, are moved to believe that embryonic human beings are not worthy of full moral respect because a high percentage of embryos formed in natural pregnancies fail to implant or spontaneously abort. Again, we submit that the inference is fallacious.

It is worth noting first, as the standard embryology texts point out, that many of these unsuccessful pregnancies are really due to incomplete fertilizations. So, in many cases, what is lost is not actually a human embryo. To be a complete human organism (a human being), the entity must have the epigenetic primordia for a functioning brain and nervous system, though a chromosomal defect might only prevent development to maximum functioning (in which case it would be a human being, though handicapped). If fertilization is not complete, then what is developing is not an organism with the active capacity to develop itself to the mature (even if handicapped) state of a human.

Second, the argument here rests upon a variant of the naturalistic fallacy. It supposes that what happens in "nature," i.e., with predictable frequency without the intervention of human agency, must be morally acceptable when deliberately caused. Since embryonic death in early miscarriages happens with predictable frequency without the intervention of human agency, the argument goes, we are warranted in concluding that the deliberate destruction of human beings in the embryonic stage is morally acceptable.

The unsoundness of such reasoning can easily be brought into focus by considering the fact that historically, and in some places even today, the infant mortality rate has been very high. If the reasoning under review here were sound, it would show that human infants in such circumstances could not be full human beings possessing a basic right not to be killed for the benefit of others. But that of course is surely wrong. The argument is a non sequitur.

In conclusion, we submit that law and public policy should proceed on the basis of full moral respect for human beings irrespective of age, size, stage of development, or condition of dependency. Justice requires no less. In the context of the debate over cloning, it requires, in our opinion, a ban on the production of embryos, whether by SCNT or other processes, for research that harms them or results in their destruction. Embryonic human beings, no less than human beings at other developmental stages, should be treated as subjects of moral respect and human rights, not as objects that may be damaged or destroyed for the benefit of others. We also hold that cloning-to-produce-children ought to be legally prohibited. In our view, such cloning, even if it could be done without the risk of defects or deformities, treats the child-to-be as a product of manufacture, and is therefore inconsistent with a due respect for the dignity of human beings. Still, it is our considered judgment that cloning-for-biomedical-research, inasmuch as it involves the deliberate destruction of embryos, is morally worse than cloning-to-produce-children. Thus we urge that any ban on cloning-to-produce-children be a prohibition on the practice of cloning itself, and not on the implantation of embryos. Public policy should protect embryonic human beings and certainly not mandate or encourage their destruction. An effective ban on cloning-to-produce-children would be a ban on all cloning.^viii

Although an optimal policy would permanently ban all cloning, we join in this Council's call for a permanent ban on cloning-to-produce-children combined with a four-year ban (or "moratorium") on cloning-for-biomedical-research for the reasons set forth by Gilbert Meilaender in his personal statement. It is our particular hope that a four-year period will provide time for a careful and thorough public debate about the moral status of the human embryo. This is a debate we welcome.

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1. A human embryo (like a human being in the fetal, infant, child, or adolescent stage) is not properly classified as a "prehuman" organism with the mere potential to become a human being. No human embryologist or textbook in human embryology known to us presents, accepts, or remotely contemplates such a view. The testimony of all leading embryology textbooks is that a human embryo is – already and not merely potentially – a human being. His or her potential, assuming a sufficient measure of good health and a suitable environment, is to develop by an internally directed process of growth through the further stages of maturity on the continuum that is his or her life.Back to Text
   

2. The timing of the first two cleavages seems to be controlled by the maternal RNA within the embryo rather than by its new DNA (see Ronan O'Rahilly and Fabiola Mueller, Human Embryology and Teratology (New York: John Wiley & Sons, 1992), 23). Still, these cleavages do not occur if the embryo's nucleus is not present, and so the nuclear genes also control these early changes. Back to Text

3. A possible alternative, though one finding little support in current discussions, would be to argue that what I am, or you are, is not a human organism at all, but rather a nonbodily consciousness or spirit merely inhabiting or somehow "associated with" a body. The problem with this argument is that it is clear that we are bodily entities-organisms, albeit of a particular type, namely, organisms of a rational nature. A living thing that performs bodily actions is an organism, a bodily entity. But it is immediately obvious in the case of the human individual that it is the same subject that perceives, walks, and talks (which are bodily actions), and that understands, deliberates, and makes choices – what everyone, including anyone who denies he is an organism, refers to as "I." It must be the same entity that perceives these words on a page, for example, and understands them. Thus, what each of us refers to as "I" is identically the physical organism that is the subject both of bodily actions, such as perceiving and walking, and of mental activities, such as understanding and choosing. Therefore, you and I are physical organisms, rather than consciousnesses that merely inhabit or are "associated with" physical organisms. And so, plainly, we came to be when the physical organism we are came to be; we once were embryos, then fetuses, then infants, and so on. Back to Text

4. Werner A. Muller, Developmental Biology (New York: Springer Verlag, 1997), 12 f. Scott Gilbert, Developmental Biology 5th edition (Sunderland, Mass.: Sinnauer Associates, 1997); O'Rahilly and Mueller, Human Embryology and Teratology, 23-24. Back to Text

5. O'Rahilly and Fabiola Mueller, Human Embryology and Teratology, 30-31. Back to Text

6. Ibid. 23-24; Keith Moore, and T.V.N. Persaud, Before We Are Born: Essentials of Embryology and Birth Defects (Philadelphia: W.B. Saunders, 1998), 41; William J. Larson, Human Embryology 3rd edition (New York: Churchill Livingstone, 2001), 18-21. Back to Text

7. Gilbert, Developmental Biology, 12 f; 167 f. Also see O'Rahilly and Mueller, Human Embryology and Teratology 23-24. Back to Text

8. A ban on implantation of an existing embryo or class of embryos would be subject to constitutional as well as moral objections. Such a ban would certainly be challenged, and the challenge would likely come from a powerful coalition of "pro-life" and "pro-choice" forces. A prohibition of the production of embryos by cloning would have a far better likelihood of withstanding constitutional challenge than would a ban on implantation. Back to Text

   
   
   

Statement of Dr.Hurlbut

In joining with fellow Members of the Council in support of a moratorium on cloning for biomedical research, I consider this recommendation not an admission of ambivalence on matters of policy, but a recognition of the difficulty of the moral issues involved and an affirmation of the need for further discussion and deliberation. Throughout our proceedings it has become increasingly apparent that without clear and distinct moral principles, grounded in scientific evidence and reasoned moral argument, no policy can be effectively formulated or enforced. Most specifically, the proposed limitation of fourteen days for research on human embryos and the prohibition against implantation appear to be arbitrarily set and therefore vulnerable to transgression through the persuasive promise of further scientific benefit. Clearly, a more thorough and thoughtful consideration of the moral status of the human embryo is warranted. It is in the spirit of this continuing discussion that I offer the personal perspectives that follow.

In pondering the ethics of cloning-for-biomedical-research it is apparent that as our science is changing, so is the nature of our moral dilemmas. Each advance forces us to think more deeply about what it means to be human. As the scientific focus on genomics moves on to proteomics and now to the early stages of the study of developmental biology, we are confronted with the challenge of understanding the moral meaning of human life in its dynamics of change, as both potential and process.

A reasonable anticipation of the likely course of science suggests that concerns about cloning are just the beginning of a series of difficult ethical issues relating to embryo experimentation and medical intervention in developing life. In addition, advances in developmental biology will open more deeply the dilemmas related to human-animal hybridization, extra-corporeal gestation, and genetic and cellular enhancement. Driven by the vast range of research applications and opportunities for clinical interventions in disease and disability (especially the open ended possibilities promised by regenerative medicine) this technology will be powerfully propelled into the forefront of medical science.

Given the complex course of science and the drive to its development, any moral assessment of cloning-for-biomedical-research (CBR) must describe the central human goods it seeks to preserve, the range and boundaries of these values, and the broad implications for science and society implied by them. Such an assessment should serve the dual purpose of helping to define the moral dangers while clearing the course for the fullest and most open future for scientific investigation and application.

Although there are already numerous promising approaches for research on human development even without cloning-for-biomedical-research (CBR), I believe this technology could provide valuable tools for scientific inquiry and medical advance. In my judgment, the moral imperative to foster an increase of knowledge and new modes of therapeutic intervention weighs heavily in the equation of consideration. Nonetheless, I believe that, as they stand, current proposals for CBR will breach fundamental moral goods, erode social cohesion and ultimately constrain the promise of advances in developmental biology and their medical applications. However, there may be morally acceptable ways of employing CBR that could both preserve our commitment to fundamental moral principles and strengthen our appreciation of the significance of developing life, while also opening avenues of advance less limiting and more promising than the current scientific proposals.

The principle of human life as the fundamental good serves as the cornerstone of law for our civilization. In no circumstance is the intentional destruction of the life of an innocent individual deemed morally acceptable. Even where a right to abortion is given, for example, it is based on a woman's right not to be encumbered, a right of privacy, not a right to directly kill the fetus.ⁱ This valuing of human life is indeed the moral starting point for both advocates and opponents of CBR. This principle of the inviolability of human life is the reciprocal respect that we naturally grant as we recognize in the other a being of moral equivalence to ourselves. Although different cultures and different eras have affirmed this recognition in varied ways, I will argue that it is reasonable in light of our current scientific knowledge that we extend this principle to human life in its earliest developmental stages.

When looked at through the lens of science, it is evident that human existence cannot be defined atemporally, but must be recognized in the full procession of continuity and change that is essential for its development. From conception, our unique genetic endowment organizes and guides the expression of our particular nature in its species and individual character. Fertilization initiates the most complex chemical reaction in the known universe: a self-directing, purposeful integration of organismal development. In both character and conduct the zygote and subsequent embryonic stages differ from any other cells or tissues of the body; they contain within themselves the organizing principle of the full human organism.

This is not an abstract or hypothetical potential in the sense of mere possibility, but rather a potency, an engaged and effective potential-in-process, an activated dynamic of development in the direction of human fullness of being. For this reason a zygote (or a clonote) differs fundamentally from an unfertilized egg, a sperm cell, or later somatic cells; it possesses an inherent organismal unity and potency that such other cells lack. Unlike an assembly of parts in which a manufactured product is in no sense "present" until there is a completed construction, a living being has a continuous unfolding existence that is inseparable from its emerging form. The form is itself a dynamic process rather than a static structure. In biology, the whole (as the unified organismal principle of growth) precedes and produces the parts. It is this implicit whole, with its inherent potency, that endows the embryo with its human character and therefore its inviolable moral status. To interfere in its development is to transgress upon a life in process. ⁱⁱ

The major alternative to the view that an embryo has an inherent moral status is the assertion that moral status is an accrued or accumulated quality related to some dimension of form or function. Several arguments have been put forward for this position.

One such accrual argument is based on the idea that before gastrulation (designated as the fourteenth day) the embryo is an inchoate clump of cells with no actuated drive in the direction of distinct development.^v It is argued that the undifferentiated quality of the blastocyst justifies its disaggregation for the procurement of stem cells, while the evident organization at gastrulation reveals an organismal integrity that endows inviolable moral status to all subsequent stages of embryological development. Scientific evidence, however, supports the argument that from conception there is an unbroken continuity in the differentiation and organization of the emerging individual life. The anterior-posterior axis appears to be already established within the zygote, early cell divisions (at least after the eight-cell stage) exhibit differential gene expression^vi and unequal cytoplasmic concentrations of cell constituents suggest distinct cellular fates. This implies that the changes at gastrulation do not represent a discontinuity of ontological significance, but merely the visibly evident culmination of more subtle developmental processes (at the cellular level) driving in the direction of organismal maturity.

Another argument for accrued moral status is that as long as an embryo is capable of giving rise to a twin it cannot be considered to have the moral standing of an individual. There is the obvious objection that as one locus of moral status becomes two it does not diminish but increases the moral moment. But perhaps more substantially, this argument actually supports the notion that crucial dimensions of individuation (and their disruption that results in twinning) are already at work in the blastocyst, the stage at which most twinning occurs. Monozygotic twinning (a mere 0.4 percent of births) does not appear to be either an intrinsic drive or a random process within embryogenesis. Rather, it is a disruption of normal development by a mechanical or biochemical disturbance of fragile cell relationships that provokes a compensatory repair, but with the restitution of integrity within two distinct trajectories of embryological development.^vii In considering the implications of twinning for individuation, one might ask the question from the opposite perspective. What keeps each of these totipotent cells from becoming a full embryo? Clearly, crucial relational dynamics of position and intercellular communication are already at work establishing the unified pattern of the emerging individual. From this perspective twinning is not evidence of the absence of an individual, but of an extraordinary power of compensatory repair that reflects more fully the potency of the individual drive to fullness of form.

Some have argued that the implantation of the embryo within the uterine lining of the mother constitutes a moment of altered moral status. Implantation, however, is actually a process that extends from around the sixth or seventh day to about the eleventh or twelfth day when the uteroplacental circulation is established. This complex circulatory exchange extends the earlier relationship between mother and embryo in which physiological conditions, including the diffusion of essential nutrients, sustained the life and nourished the growth of the developing embryo. Although these early conditions can be artificially simulated as in IVF, the delicate balance of essential factors and their effect on development (as seen in Large Offspring Syndrome)^viii is evidence of the crucial contribution of the mother even in the first week of embryogenesis. Changes in the intricate interrelations between mother and infant cannot be viewed as an alteration of moral status, but as part of the ongoing epigenetic process all along the continuum of natural development that begins with conception and continues into infancy. This continuity implies no meaningful moral marker at implantation.^ix

Arguments for a change in moral status based on function are at once the most difficult to refute and to defend. The first and most obvious problem is that the essential functions (even their minimal criteria and age of onset) are diverse and arbitrarily assigned. Generally they relate to the onset of sentience, awareness of pain, or some apparently unique human cognitive capability such as consciousness.^x But if human moral worth is based on actual manifest functions, then does more of a particular function give an individual life a higher moral value? And what are we to make of the parallel capacities in animals that we routinely sacrifice for food and medical research? Furthermore, what becomes of human moral status with the degeneration or disappearance of such a function? While we might argue that our relational obligations change along with changes in function, such as occur with senile dementia, we would not sanction a utilitarian calculus and the purely instrumental use of such persons no matter how promising the medical benefits might be. The diagnostic requirements of "brain death" for removing organs for transplantation, far from being a justification for interrupting a developing life before "brain birth", actually point to the moral significance of potential and the stringency of the criteria for irreversible disintegration and death.

From a scientific perspective, there is no meaningful moment when one can definitively designate the biological origins of a human characteristic such as consciousness. Even designations such as 'the nervous system' are conceptual tools, reifications of an indivisible organismal unity. Zygote, morula, embryo, fetus, child and adult: these are conceptual constructions for convenience of description, not distinct ontological categories. With respect to fundamental moral status therefore, as distinguished from developing relational obligations, the human being is an embodied being whose intrinsic dignity is inseparable from its full procession of life and always present in its varied stages of emergence.

If the embryo has an inherent moral status that is not an accrued or accumulated quality related to some dimension of form or function, then that moral status must begin with the zygote (or clonote). Anything short of affirming the inviolability of life across all of its stages from zygote to natural death leads to an instrumental view of human life. Such a revocation of our most fundamental moral principle would reverse a long and overarching trend of progress in moral awareness and practice in our civilization. From human sacrifice,^xi to slavery, child labor, women's rights and civil rights, we have progressively discerned and prohibited practices that subject the individual to the injustice of exploitation by others. The reversal of such a basic moral valuation will extend itself in a logic of justification that has ominous implications for our attitude and approach to human existence. This is not a mere "slippery slope," where we are slowly led downward by the ever more desirable extension of exceptions to moral principle. It is, rather, a "crumbly cliff" where the very utility of abrogating a basic moral prohibition carries such convenience of consequence that the subsequent descent is simply practice catching up with principle.

The inviolability of human life is the essential foundation on which all other principles of justice are built, and any erosion of this foundation destabilizes the social cooperation that makes possible the benefits of organized society. Medicine is especially vulnerable to such effects since it operates at the intrinsically moral interface between scientific technique and the most tender and sensitive dimensions of personal reality in the vulnerable patient. As we descend into an instrumental use of human life we destroy the very reason for which we were undertaking our new therapies; we destroy the humanity we were trying to heal.

The promise of stem cells lies beyond simple cell cultures and cell replacement therapies. The fourteen-day marker will not hold up to logical argument.^xii The technological goal is to produce the more advanced cell types of tissues, organs, and possibly even limb primordia. Producing such complex tissues and organs may require the cell interactions and microenvironments now available only through natural gestation.^xiii The benefits of implanting cloned embryos (either into the natural womb or possibly an artificial endometrium) so as to employ the developmental dynamics of natural embryogenesis seem self-evident. The implantation of cloned embryos for the production of patient-specific tissue types to bypass problems of immune rejection would further extend the logic of the instrumental use of developing life. The public pressure that has already been brought to bear on the politics of stem cells and cloning by patient advocacy groups has provoked such a sense of promise that it may propel the argument for allowing implantation of cloned embryos. Different people may have different limits to the duration of gestation they find morally acceptable, but in light of the current sanction of abortion up to and beyond the end of the second trimester, it is difficult to argue that creation, gestation and sacrifice of a clone to save an existing life is a large leap in the logic of justification.

While maintaining a bright line at conception safeguards our most fundamental moral principle, the challenge remains to find an acceptable method of drawing on the great medical promise of CBR while precluding its use in ways that degrade the dignity of human existence. Some proponents of CBR maintain that the laboratory creation of the cloned embryo makes it a "pseudo-embryo" or "artifact," a product of human technological production.^xiv The problem with this assertion is that, once created, the cloned embryo appears to be no different than the product of natural fertilization. But what if we could use the cloning techniques of nuclear transfer to create an entity that lacks the qualities and capabilities essential to be designated a human life in process? By intentional alteration of the somatic cell nuclear components or the cytoplasm of the oocyte into which they are transferred, could we truly create an artifact (a human creation for human ends) that is biologically and morally more akin to tissue or cell culture?^xv

The intention in creating such an intrinsically limited "clonal artifact" would not be one of reproduction, but simply the desire to draw on natural organic potential through technological manipulation of biological materials. This intention is in keeping with the purposes of scientific research and medical therapy in which many "unnatural" manipulations are used for human benefit. In order to employ such an entity for research, it must be capable of yielding stem cells while lacking the capacity for the self-directed, integrated organic functioning that is essential for embryogenesis. The intervention that precludes the possibility of human development would be undertaken at a stage before the development was initiated, and thus, no active potentiality, no human life in process, would be violated. If the created artifact were accorded a certain cautionary respect (as with all human tissues), even though not the full protection of human life, the consequences of such a program would not compromise any moral principle.

The project of creating these altered "clonal artifacts" for the procurement of human stem cells could have many loci of scientific intervention. Techniques might range from removing genes for extra-embryonic structures, to the alteration of genes for angiogenesis (such that the stem cells procured could produce differentiated cell types with therapeutic potential, but would have to rely on the host into whom they were placed for their vascular connections). If the created stem cells could only form specific germ layers or limited lineages of cell types, they still might be useful for the generation of valuable research models as well as many cell lines, tissues and organs. Furthermore, in bypassing the moral concerns associated with full embryonic potential, the created cells might legitimately be developed within artificial microenvironments beyond fourteen days. This would allow the production of more advanced cell types, the study of tissue interactions and the formation of primordial organismal parts. Just as we have learned that neither genes, nor cells, nor even whole organs define the locus of human moral standing, in this era of developmental biology we will come to recognize that tissues with "partial generative potential" may be used for medical benefit without a violation of human dignity.^xvi The fact that one does not need full embryonic integrity for these partial generative capacities is evident in the well-formed body parts such as teeth, fingernails and hair seen in teratomas.^xvii

Clearly, there will be some point where partial generative potential is so close to full human development that our basic moral principals would be violated. We will need to carefully define the circumstances under which it is acceptable for serious medical purposes to manipulate human parts apart from their natural context in human development. Here the fundamental principle of protection of human life must be affirmed, while the more subtle moral issues concerning respect and natural integrity are carefully explored.

At this early stage in our technological control of developing life, we have an opportunity to break the impasse over stem cell research and provide moral guidance for the biotechnology of the future. This may require a constructive reformulation of some aspects of moral philosophy, together with creative exploration of scientific possibilities, but any postponement of this process will only deepen the dilemma as we proceed into realms of technological advance unguided by forethought. A moratorium will allow the cooperative dialogue that is essential to frame the moral principles that can at once defend human dignity and promote the fullest prospects for scientific progress and its medical applications.

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1. If the fetus is delivered alive during an abortion, there is a legal obligation to resuscitate and sustain its life. Back to Text

2. To recognize a potential as in some sense "actual" and worthy of protection, we need only consider how we would react to the intentional sterilization of a prepubescent girl when her fertility was only potential yet precious to her larger dignity and developmental integrity as a human person. Back to Text

3. Such an argument might hold some weight if one could argue that a given stage of development represents an emergent state in which a relational property is in ontological discontinuity with the material from which it emerged. At first consideration, this seems true of all biological systems where the whole reveals properties unpredicted within the parts. The problem in this line of reasoning, however, is that these properties are exactly that to which the whole is ordered and so are inherent powers, "actual" within the whole when seen across time. To know what a biological being is, we must observe it over time, understand it across its life span. It is the essence of life that it is ordered to employ these leaps to emergent states as an agency in development. New realities will emerge; this is established in the potency of the developing organism. Back to Text

4. A similar problem arises in clinical medicine. It is crucial that we not equate the statistical probability of a specific outcome with the actual prognosis of the individual patient involved. Back to Text

5. The differentiation of the trophoblast, which will form the extra-embryonic membranes, is generally considered as distinct from the embryo itself. More true to the nature of life, it might be recognized as an organ of embryogenesis used and discarded within the dynamic process of development. Throughout the continuum of human life, from the embryo to the adult, cells, tissues and organs are reabsorbed, transcended and transformed. Examples include the umbilical vein and arteries (which become supporting ligaments), neurologic cells (more than half of which are culled by apoptosis and reabsorption), systems of reflexes (such as the moro reflex which is manifest only in infants), immune organs and functions such as the thymus (which shrivels in an adult), and allergies (which change throughout life and generally wane in mid-life). We do not just develop and then age, but undergo a continuous transformation and fuller manifestation of our organismal nature present within the earliest embryo. Back to Text

6. In fact, the first several cell divisions after natural fertilization do not require a nucleus to be present and therefore may not involve gene expression from the newly united bi-parental genetic material. The mRNA essential for protein synthesis at these early stages appears to be generated during the maturation of the egg and then remains dormant until after fertilization. This may very well preclude the possibilities of the optimistic but simplistic proposal that merely by adding a recipe of cytoplasmic factors essential for reprogramming we could transform any cell into a functional zygote. Nonetheless, even without differential gene expression, cytoplasmic studies reveal unequal cytoplasmic distributions, and implicit differential cell fates, even at these early stages. Back to Text

7. The fact that these early cells retain the ability to form a second embryo is testimony to the resiliency of self-regulation and compensation within early life, not the lack of individuation of the first embryo from which the second can be considered to have "budded" off. Evidence for this may be seen in the increased incidence of monozygotic twinning associated with IVF by Blastocyst Transfer. When IVF embryos are transferred to the uterus for implantation at the blastocyst stage, there is a two to ten-fold increase in the rate of monozygotic twinning, apparently due to disruption of normal organismal integrity. It is also interesting to note that with Blastocyst Transfer there is a slightly higher rate of male births. Back to Text

8. In some animal studies, it has been noted that particular components in the culture medium in which the embryo is nourished increase the size of the offspring during later stages of gestation. Back to Text

9. It should be noted that this argument could be used as a counter-argument against the disaggregation of the preimplantation embryo, or as a justification for the production of more advanced cells, tissues, and organs either through implantation into an artificial endometrium or through natural gestation. Back to Text

10. In fact, from a scientific perspective, we should have a measure of humility when drawing conclusions about moral status from evidence concerning consciousness or capacities involving subjective experience. The fact that consciousness and subjective awareness appear to be mediated by matter does not exhaust their mystery. Back to Text

11. The sacrifice of infants for the supposed larger flourishing of life bespeaks the potency ascribed to purity and generative potential. Back to Text

12. The designation of fourteen days as the moral boundary for embryo experimentation is in the category of a "received tradition," almost a superstition in the sense that it is a belief in a change of state without a discernible cause. The validity of this designated moral marker has not been reexamined in the light of recent advances in our understanding of developmental biology. As a moral marker of ontological change fourteen days makes no sense. Even if one disagrees with the discussion above, the date should be set earlier: implantation is complete by the twelfth day, the onset of gastrulation occurs between the twelfth and fourteenth day and twinning is rare after the ninth day. Furthermore, it is worth noting that fourteen days is not of current scientific relevance since stem cells can be procured at the four-five day stage and, with present technology, human embryos can sustain viability in culture for only eight-nine days. Back to Text

13. Natural development proceeds within the context of a highly refined spatial and temporal niche of organized complexity of positional cues, signal diffusion and cell-cell contact between cellular lineages of diverse types. See for example the recent article, "Dominant role of the niche in melanocyte stem-cell fate determination" (Nature 25 April 2002). Back to Text

14. In fact, there will be several (and perhaps numerous) ways to produce cloned blastocysts from which stem cells can be harvested. These include: the current common method of cloning designated somatic cell nuclear transfer (SCNT) or nuclear transplantation, embryo splitting, use of animal oocytes as receptacles of nuclear transfer, fusion of embryonic stem cells and possibly fetal or adult stem cells into existing blastocysts and possibly the production of artificial gametes for the transfer of adult nuclear material, (and probably others more difficult to anticipate or legally regulate). Back to Text

15. Such a procedure could be designated "Altered Nuclear Transfer" (ANT). Back to Text

16. Consider blood transfusions, organ transplantation, and the recombination of human genes into bacteria for the production of human hormones such as growth hormone and insulin. All of these raised initial moral controversy until it was recognized that the locus of human dignity lies not it human parts but in the full organismal integrity of a human life. Back to Text

17. These benign ovarian tumors, derived by spontaneous and disorganized development of activated ova, typically have a full array of primary tissue types and some well-developed body parts. The possibility that embryonic stem cells could be derived from entities lacking integrated developmental potential is given further support from recent studies in which cells from abnormal early embryos were fused with normal embryos and went on to produce normal tissues in the developed organism. (See "Dependable Cells From Defective Embryos." Science 3 May 2002, p. 841, and Byrne, Simons and Gurdon: Proceedings of the National Academy of Sciences (PNAS) online, April 23, 2002.) Back to Text
    
    
    

Statement of Dr. Krauthammer

I oppose all cloning, reproductive and research. I would like to see them banned. But I live in the real world. As I have explained, both in the Council and in my writings, I oppose research cloning for prudential reasons. Prudence dictates taking into account the real world, meaning the realities of American democracy, and at present there is no consensus for banning research cloning. I therefore strongly support a moratorium. At this point in the history of this debate, a moratorium is more than a compromise. It is an important achievement.

Let's remember. In a democracy, there is no such thing as a permanent ban in any case. Any ban can be revisited at any time. Thus the difference between a ban and a moratorium is simply this: Under a ban, when the issue is reconsidered, the burden of proof is on those who wish to lift the ban. With a moratorium, when the issue is reconsidered, the burden of proof is on those who wish to maintain the ban. I have no trepidation about remaking the case for a ban when the moratorium expires.

In the interim, I vote strongly in favor of the moratorium over the alternative proposal of regulation. First, because I am keenly aware of the power of the scientific imperative to breach frontiers of ethics, and deeply distrustful of the ability of society to resist those scientific imperatives. I am highly skeptical about the ultimate efficacy of regulation in preventing the breaching of further moral barriers.

And second, because regulation is really just a nicely confectured way of saying that we are prepared as a society today to utterly abolish a crucial moral barrier, namely, the prohibition of the creation of human embryos solely for the purpose of experimentation.

That is a serious moral barrier. The argument that we already crossed that barrier when we permitted the use of discarded embryos from IVF clinics for stem-cell research is simple sophistry.¹ Creating human embryos solely for their exploitation in research and therapy is new. It is dangerous. It is something that we will live to regret. A moratorium will prevent that for now, and allow a restatement of the case for its unwisdom and its danger when the issue is later reconsidered.

I support the moratorium on research cloning for several additional reasons. First, because the impasse on research cloning has led to congressional failure to enact any anti-cloning legislation. That is absurd. There is a unanimous national feeling that reproductive cloning should be banned. Our proposal provides a compromise that both sides can embrace so that cloning legislation can be passed.

Second, for those who support regulation, the moratorium is the only effective way to move toward serious regulation. The vague call for regulation, made by proponents of Position Two, has no political traction. None of the relevant players has any incentive to prepare the regulations. The scientific community is largely opposed to any interference in this research. And while people are dithering, the cloning research in the private biotech industries will put facts on the ground that will be difficult to challenge. Only a moratorium can test the good faith of those who say they want regulation. Moreover, Position Two does not explicitly say that the existence of the strict regulations it calls for is a precondition for allowing the research to go forward. There is no talk here, as there was in the public Council sessions, that this proposal amounts to a de facto moratorium.

Third, this proposal does not abandon the strong anti-cloning position. It stops cloning at the very beginning, namely at the point of creating a cloned embryo. It is thus much stronger than the pseudo-ban on cloning proposed by those who want regulation, which would block only implantation.

A ban on reproductive cloning and a moratorium on research cloning allows the country to clearly express itself: definitively make law regarding reproductive cloning and at least temporarily prevent the launching of an industry whose business is the manufacture of (cloned) human embryos purely for experimentation. And it allows the country to engage now in a serious and extended debate on the virtues and pitfalls of such an enterprise, on the promise and problems of regulation, and, ultimately, on the question of not only where these cells come from, but where these cells are taking us.

I include here a memo that I circulated to Council Members during our deliberationsⁱⁱ :

The conquest of rejection is one of the principal rationales for research cloning. But there is reason to doubt this claim on scientific grounds. There is some empirical evidence in mice that cloned tissue may be rejected anyway (possibly because a clone contains a small amount of foreign-mitochondrial-DNA derived from the egg into which it was originally injected). Moreover, enormous advances are being made elsewhere in combating tissue rejection. The science of immune rejection is much more mature than the science of cloning. By the time we figure out how to do safe and reliable research cloning, the rejection problem may well be solved. And finally, there are less problematic alternatives – such as adult stem cells – that offer a promising alternative to cloning because they present no problem of tissue rejection and raise none of cloning's moral conundrums. These scientific considerations raise serious questions about the efficacy of, and thus the need for, research cloning. But there is a stronger case to be made. Even if the scientific objections are swept aside, even if research cloning is as doable and promising as its advocates contend, there are other reasons to pause.

The most obvious is this: Research cloning is an open door to reproductive cloning. Banning the production of cloned babies while permitting the production of cloned embryos makes no sense. If you have factories all around the country producing embryos for research and commerce, it is inevitable that someone will implant one in a woman (or perhaps in some artificial medium in the farther future) and produce a human clone. What then? A law banning reproductive cloning but permitting research cloning would then make it a crime not to destroy that fetus – an obvious moral absurdity.

This is an irrefutable point and the reason alone to vote for the total ban on cloning. Philosophically, however, it is a showstopper. It lets us off too early and too easy. It keeps us from facing the deeper question: Is there anything about research cloning that in and of itself makes it morally problematic?

Objection I: Intrinsic Worth

For some people, life begins at conception. And not just life – if life is understood to mean a biologically functioning organism, even a single cell is obviously alive – but personhood. If the first zygotic cell is owed all the legal and moral respect due a person, then there is nothing to talk about. Ensoulment starts with Day One and Cell One, and the idea of taking that cell or its successor cells apart to serve someone else's needs is abhorrent.

This is an argument of great moral force but little intellectual interest. Not because it may not be right. But because it is unprovable. It rests on metaphysics. Either you believe it or you don't. The discussion ends there. I happen not to share this view. I do not believe personhood begins at conception. I do not believe a single cell has the moral or legal standing of a child. This is not to say that I do not stand in awe of the developing embryo, a creation of majestic beauty and mystery. But I stand in equal awe of the Grand Canyon, the spider's web, and quantum mechanics. Awe commands wonder, humility, appreciation. It does not command inviolability. I am quite prepared to shatter an atom, take down a spider's web, or dam a canyon for electricity. (Though we'd have to be very short on electricity before I'd dam the Grand.)

I do not believe the embryo is entitled to inviolability. But is it entitled to nothing? There is a great distance between inviolability, on the one hand, and mere "thingness," on the other. Many advocates of research cloning see nothing but thingness. That view justifies the most ruthless exploitation of the embryo. That view is dangerous. Why? Three possible reasons. First, the Brave New World Factor: Research cloning gives man too much power for evil. Second, the Slippery Slope: The habit of embryonic violation is in and of itself dangerous. Violate the blastocyst today and every day, and the practice will inure you to violating the fetus or even the infant tomorrow. Third, Manufacture: The very act of creating embryos for the sole purpose of exploiting and then destroying them will ultimately predispose us to a ruthless utilitarianism about human life itself.

Objection II: The Brave New World Factor

The physicists at Los Alamos did not hesitate to penetrate, manipulate, and split uranium atoms on the grounds that uranium atoms possess intrinsic worth that entitled them to inviolability. Yet after the war, many fought to curtail atomic power. They feared the consequences of delivering such unfathomable power – and potential evil – into the hands of fallible human beings. Analogously, one could believe that the cloned blastocyst has little more intrinsic worth than the uranium atom and still be deeply troubled by the manipulation of the blastocyst because of the fearsome power it confers upon humankind.

The issue is leverage. Our knowledge of how to manipulate human genetics (or atomic nuclei) is still primitive. We could never construct ex nihilo a human embryo. It is an unfolding organism of unimaginable complexity that took nature three billion years to produce. It might take us less time to build it from scratch, but not much less. By that time, we as a species might have acquired enough wisdom to use it wisely. Instead, the human race in its infancy has stumbled upon a genie infinitely too complicated to create or even fully understand, but understandable enough to command and perhaps even control. And given our demonstrated unwisdom with our other great discovery – atomic power: As we speak, the very worst of humanity is on the threshold of acquiring the most powerful weapons in history – this is a fear and a consideration to be taken very seriously.

For example. Female human eggs seriously limit the mass production of cloned embryos. Extracting eggs from women is difficult, expensive, and potentially dangerous. The search is on, therefore, for a good alternative. Scientists have begun injecting human nuclei into the egg cells of animals. In 1996 Massachusetts scientists injected a human nucleus with a cow egg. Chinese scientists have fused a human fibroblast with a rabbit egg and have grown the resulting embryo to the blastocyst stage. We have no idea what grotesque results might come from such interspecies clonal experiments.

In October 2000 the first primate containing genes from another species was born (a monkey with a jellyfish gene). In 1995 researchers in Texas produced headless mice. In 1997 researchers in Britain produced headless tadpoles. In theory, headlessness might be useful for organ transplantation. One can envision, in a world in which embryos are routinely manufactured, the production of headless clones – subhuman creatures with usable human organs but no head, no brain, no consciousness to identify them with the human family.

The heart of the problem is this: Nature, through endless evolution, has produced cells with totipotent power. We are about to harness that power for crude human purposes. That should give us pause. Just around the corner lies the logical by-product of such power: human-animal hybrids, partly developed human bodies for use as parts, and other horrors imagined – Huxley's Deltas and Epsilons – and as yet un imagined. This is the Brave New World Factor. Its grounds for objecting to this research are not about the beginnings of life, but about the ends; not the origin of these cells, but their destiny; not where we took these magnificent cells from, but where they are taking us.

Objection III: The Slippery Slope

The other prudential argument is that once you start tearing apart blastocysts, you get used to tearing apart blastocysts. And whereas now you'd only be doing that at the seven-day stage, when most people would look at this tiny clump of cells on the head of a pin and say it is not inviolable, it is inevitable that some scientist will soon say: Give me just a few more weeks to work with it and I could do wonders.

That will require quite a technological leap because the blastocyst will not develop as a human organism unless implanted in the uterus. That means that to go beyond that seven-day stage you'd have to implant this human embryo either in an animal uterus or in some fully artificial womb.

Both possibilities may be remote, but they are real. And then we'll have a scientist saying: Give me just a few more months with this embryo, and I'll have actual kidney cells, brain cells, pancreatic cells that I can transplant back into the donor of the clone and cure him. Scientists at Advanced Cell Technology in Massachusetts have already gone past that stage in animals. They have taken cloned cow embryos past the blastocyst stage, taken tissue from the more developed cow fetus, and reimplanted it back into the donor animal.

The scientists' plea to do the same in humans will be hard to ignore. Why grow the clone just to the blastocyst stage, destroy it, pull out the inner cell mass, grow stem cells out of that, propagate them in the laboratory, and then try chemically or otherwise to tweak them into becoming kidney cells or brain cells or islet cells? This is Rube Goldberg. Why not just allow that beautiful embryonic machine, created by nature and far more sophisticated than our crude techniques, to develop unmolested? Why not let the blastocyst grow into a fetus that possesses the kinds of differentiated tissue that we could then use for curing the donor?

Scientifically, this would make sense. Morally, we will have crossed the line between tearing apart a mere clump of cells and tearing apart a recognizable human fetus. And at that point, it would be an even smaller step to begin carving up seven – and eight-month-old fetuses with more perfectly formed organs to alleviate even more pain and suffering among the living. We will, slowly and by increments, have gone from stem cells to embryo farms to factories with fetuses in various stages of development and humanness, hanging (metaphorically) on meat hooks waiting to be cut open to be used by the already born.

We would all be revolted if a living infant or developed fetus were carved up for parts. Should we build a fence around that possibility by prohibiting any research on even the very earliest embryonic clump of cells? Is the only way to avoid the slide never to mount the slippery slope at all? On this question, I am personally agnostic. If I were utterly convinced that we would never cross the seven-day line, then I would have no objection on these grounds to such research on the inner cell mass of a blastocyst. The question is: Can we be sure? This is not a question of principle; it is a question of prudence. It is almost a question of psychological probability. No one yet knows the answer.

Objection IV: Manufacture

Note that while, up to now, I have been considering arguments against research cloning, they are all equally applicable to embryonic research done on a normal – i.e., noncloned – embryo. If the question is tearing up the blastocyst, there is no intrinsic moral difference between a two-parented embryo derived from a sperm and an egg and a single-parented embryo derived from a cloned cell. Thus the various arguments against this research – the intrinsic worth of the embryo, the prudential consideration that we might create monsters, or the prudential consideration that we might become monsters in exploiting post-embryonic forms of human life (fetuses or even children) – are identical to the arguments for and against stem-cell research.

These arguments are serious – serious enough to banish the insouciance of the scientists who consider anyone questioning their work to be a Luddite – yet, in my view, insufficient to justify a legal ban on stem-cell research (as with stem cells from discarded embryos in fertility clinics). I happen not to believe that either personhood or ensoulment occurs at conception. I think we need to be apprehensive about what evil might arise from the power of stem-cell research, but that apprehension alone, while justifying vigilance and regulation, does not justify a ban on the practice. And I believe that given the good that might flow from stem-cell research, we should first test the power of law and custom to enforce the seven-day blastocyst line for embryonic exploitation before assuming that such a line could never hold.

This is why I support stem-cell research (using leftover embryos from fertility clinics) and might support research cloning were it not for one other aspect that is unique to it. In research cloning, the embryo is created with the explicit intention of its eventual destruction. That is a given because not to destroy the embryo would be to produce a cloned child. If you are not permitted to grow the embryo into a child, you are obliged at some point to destroy it.

Deliberately creating embryos for eventual and certain destruction means the launching of an entire industry of embryo manufacture. It means the routinization, the commercialization, the commodification of the human embryo. The bill that would legalize research cloning essentially sanctions, licenses, and protects the establishment of a most ghoulish enterprise: the creation of nascent human life for the sole purpose of its exploitation and destruction.

How is this morally different from simply using discarded embryos from in vitro fertilization (IVF) clinics? Some have suggested that it is not, that to oppose research cloning is to oppose IVF and any stem-cell research that comes out of IVF. The claim is made that because in IVF there is a high probability of destruction of the embryo, it is morally equivalent to research cloning. But this is plainly not so. In research cloning there is not a high probability of destruction; there is 100 percent probability. Because every cloned embryo must be destroyed, it is nothing more than a means to someone else's end.

In IVF, the probability of destruction may be high, but it need not necessarily be. You could have a clinic that produces only a small number of embryos, and we know of many cases of multiple births resulting from multiple embryo implantation. In principle, one could have IVF using only a single embryo and thus involving no deliberate embryo destruction at all. In principle, that is impossible in research cloning.

Furthermore, a cloned embryo is created to be destroyed and used by others. An IVF embryo is created to develop into a child. One cannot disregard intent in determining morality. Embryos are created in IVF to serve reproduction. Embryos are created in research cloning to serve, well, research. If certain IVF embryos were designated as "helper embryos" that would simply aid an anointed embryo in turning into a child, then we would have an analogy to cloning. But, in fact, we don't know which embryo is anointed in IVF. They are all created to have a chance of survival. And they are all equally considered an end.

Critics counter that this ends-and-means argument is really obfuscation, that both procedures make an instrument of the embryo. In cloning, the creation and destruction of the embryo is a means to understanding or curing disease. In IVF, the creation of the embryo is a means of satisfying a couple's need for a child. They are both just means to ends.

But it makes no sense to call an embryo a means to the creation of a child. The creation of a child is the destiny of an embryo. To speak of an embryo as a means to creating a child empties the word "means" of content. The embryo in IVF is a stage in the development of a child; it is no more a means than a teenager is a means to the adult he or she later becomes. In contrast, an embryo in research cloning is pure means. Laboratory pure.

And that is where we must draw the line. During the great debate on stem-cell research, a rather broad consensus was reached (among those not committed to "intrinsic worth" rendering all embryos inviolable) that stem-cell research could be morally justified because the embryos destroyed for their possibly curative stem cells were derived from fertility clinics and thus were going to be discarded anyway. It was understood that human embryos should not be created solely for the purpose of being dismembered and then destroyed for the benefit of others. Indeed, when Senator Bill Frist made his impassioned presentation on the floor of the Senate supporting stem-cell research, he included among his conditions a total ban on creating human embryos just to be stem-cell farms.

Where cloning for research takes us decisively beyond stem-cell research is in sanctioning the manufacture of the human embryo. You can try to regulate embryonic research to prohibit the creation of Brave New World monsters; you can build fences on the slippery slope, regulating how many days you may grow an embryo for research; but once you countenance the very creation of human embryos for no other purpose than for their parts, you have crossed a moral frontier.

Research cloning is the ultimate in conferring thingness up on the human embryo. It is the ultimate in desensitization. And as such, it threatens whatever other fences and safeguards we might erect around embryonic research. The problem, one could almost say, is not what cloning does to the embryo, but what it does to us. Except that, once cloning has changed us, it will inevitably enable further assaults on human dignity. Creating a human embryo just so it can be used and then destroyed undermines the very foundation of the moral prudence that informs the entire enterprise of genetic research: the idea that, while a human embryo may not be a person, it is not nothing. Because if it is nothing, then everything is permitted. And if everything is permitted, then there are no fences, no safeguards, no bottom.

1. i As I elaborate in my memo to Council Members, reprinted below. Back to Text
   
   
2. ii
3. A longer version of this argument appears in my article, "Crossing Lines," The New Republic, April 29, 2002, pp. 20-23. Back to Text
   
   
   CHARLES KRAUTHAMMER
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   Statement of Dr. McHugh

   I am concerned that section (g) of Part I of Chapter Eight does not adequately describe my views about somatic cell nuclear transfer (SCNT), expressed at several meetings of the Council. That section says, "[P]roposals to engage in cloning-for-biomedical-research necessarily endorse the creation of human (cloned) embryos solely for the purpose of such research. Public policy that specifically promoted this research would thus explicitly and officially approve crossing a moral boundary." (Italics in the text.) I believe (1) those words imply that the prime effect of SCNT is the creation of a new individual human being and (2) that implication prejudges the problem before us and does not comport to my opinion of this matter.

   I hold that SCNT rests on a major discovery in cellular biology, the implications of which need much more discussion and debate than it receives in Chapter Eight (and especially in section (g)). With this discovery we now know that every one of our somatic cells not only has a full complement of our genes but as well that every one of our somatic cells, if manipulated in a particular fashion, has the power to recapitulate in growth its own beginnings.

   When a technician takes a donor's somatic cell and proceeds with it to follow the method of somatic cell nuclear transplantation, he or she evokes an intrinsic program present within that nucleus that brings about cellular multiplication and differentiation. One need not hold that a new and unique human individual starts up immediately as these cells are made and multiply. One could see this process as an engineered culturing of cells from the somatic nucleus that recapitulates embryonic development but rests upon a potential for growth and replication resident in and intrinsic to all somatic cells. The cellular products are direct extensions of the donor as with other forms of tissue culture and as such have some licit potentials for further use.

   I agree with those who say that my argument – that the products of SCNT and the products of impregnation are crucially different – places a strong emphasis on origins of these products and less emphasis on potentials that we deplore. But I would hold that the section (g) from Part I of Chapter Eight places all the emphasis on potential and no emphasis on origins. It thus ignores the fact that an overemphasis on potential would lead us to the unreasonable position that since every one of our somatic cells has "potential" for producing a human, it should receive some reverence. I believe that in our presentation to the American people we must acknowledge that some of the arguments in favor of the use of SCNT rest upon the view that what is emerging here are cells and not human beings. This very fundamental disagreement should be thoroughly aired, as it carries with it quite different policy implications.

   PAUL McHUGH    
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   Statement of Dr. May

   Substantial moral debate on cloning-for-biomedical-research focuses on the question as to whether the preimplanted embryo is "one of us" or not. The group in favor of unregulated research would define "one of us" narrowly in order to exclude the microscopic material in the petri dish from "one of us." Therefore we can do with it what we will. Proponents of a ban define "one of us" broadly to include the preimplanted embryo. Therefore they would refuse to clone/kill a preimplanted embryo used in research, even at the expense of the relief that successful research might offer some patients who are seriously impaired or face premature death. Both parties seek to escape the stigma (and perhaps the regulatory burdens) that might accompany therapy that owed something to "one of us."

   However, there is a way of thinking about the preimplanted embryo that does not rely on the inclusionary/exclusionary language of "one of us." The somewhat awkward language of the intermediate status of the embryo (neither a mere thing nor a full human being) both permits research but also requires regulation. The status of the preimplanted embryo permits research because it does not hold such a claim on us as to ban a line of inquiry that might thwart grave human suffering and premature death. However, the source of this research in the human argues for the necessity of regulations. The preimplanted embryo is more than a yard lot of building materials; it is a cluster of cells moving toward, if implanted, nourished, and protected, a human life. In removing it, through research, from the circle of life, we cannot remove it from the circle of human indebtedness.

   This position has powerful implications for the content as well as the necessity of regulations. Most discussion has centered on regulations as they might bear on the generation of knowledge and therapies (for example, the protection of women as the source of eggs, the time limit on research to a fourteen-day period before the onset of the neural streak, the development of licensing and monitoring procedures, and extending the scope of regulations to private as well as publicly funded projects). However, the acceptance of a human source for the conduct of this research has equally powerful consequences for the distribution of knowledge and therapies. Gratefully accepting a human source that makes possible the conduct of this research requires the most inclusive destination of its fruits in the common good. The element of gift in origin requires common human access to benefits. It does not permit the capture of knowledge and benefits in such a way as to thwart their eventual arrival to all in need.

   William F. May    
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   Statement of Professor Meilaender

   Like some of my colleagues on the Council, I believe that a ban on all forms of human cloning (including a ban on what in this report is called cloning-for-biomedical-research) would be the optimal policy for this Council to recommend and for our society to adopt. Nevertheless, because other Council Members who have serious moral reservations about human cloning are not at this time prepared to recommend a permanent ban on all human cloning, we have joined with them to support a policy that would ban cloning-to-produce-children and would place a four-year moratorium on cloning-for-biomedical-research. Even if the policy I regard as optimal is for now impossible, we need not settle for no policy at all. Nor should we think of the majority recommendation as simply a compromise position. On the contrary, we have found genuine – though only partial – agreement with some of our colleagues on the Council, and I prefer to try to use and build on that partial agreement than to act as if it were unimportant or insignificant. Were the majority recommendation enacted into law, it would prohibit all human cloning (whether publicly or privately funded) for four years. That would be a considerable achievement. It would give us a period in which the optimal policy was in place, during which time we would hope that further moral debate and advances in alternative forms of research (that would not involve human cloning or destruction of embryos) would persuade others to continue that optimal policy indefinitely.

   In the Council's deliberations, those who oppose all human cloning have worked very hard to respect and acknowledge the views of Council Members with whom we disagree or do not fully agree. In particular, the following points are worth noting:

   (a) For the sake of continued conversation, we have acquiesced in terminology that some of us do not fully accept and that to some extent distorts our position. That is, any human cloning is morally objectionable, and there is for some of us no crucial moral divide between cloning-for-biomedical-research and cloning-to-produce-children. Put differently, research cloning is also reproductive cloning, since it brings into existence a new human being (in the very earliest stages of developing human life). Agreeing to converse in terms that do not fully acknowledge this has inevitably been problematic; nevertheless, we have accepted this burden so that the Council's work could proceed. I believe that the definitions of cloning-for-biomedical-research and cloning-to-produce-children given at the end of Chapter Three of the Council's report make clear that, however the proximate or ultimate purposes of those engaged in cloning may differ, the nature of the act remains the same.

   (

   b) In supporting a proposed four-year moratorium on cloning-for-biomedical-research (even though some of us are quite prepared to support a permanent ban) we have sought to make common cause with those Council Members who worry more about cloning-to-produce-children than about cloning-for-biomedical-research and for whom control of the latter is chiefly a means to control of the former. I myself incline to think, on the contrary, that an industry of routinized embryo cloning (which would be the inevitable result of approval of cloning-for-biomedical-research) would be an even greater moral evil than the gestation and birth of a cloned human being. Nevertheless, recognizing that some colleagues on the Council who support a moratorium do not yet share this view, others of us have chosen to endorse the partial agreement that we do now share.

   (c) We have accepted in good faith the assertion – and it has seldom been more than an assertion – that advocates of cloning-for-biomedical-research have a principled commitment to drawing a line at a very early point in embryonic development and permitting no research beyond that point. We have accepted this in good faith even though we have been offered no coherent argument to support the "developmental" view of human status put forward by cloning proponents. Other Members of the Council have offered a variety of arguments against that view. We have offered evidence that embryologists do not make the sort of distinction on which cloning proponents rely. We have noted that the embryo's "potential" is something actual, something present in the developing human being, and that it is a misuse of the idea of potential to describe the embryo as merely a potential human being. We have argued that, while it is true that we would be unlikely to feel the same grief at the death of an embryo as we do at the death of a child, this hardly means that the embryo's life should not be protected. We have noted that criteria for "protectability" offered by at least one Council member (namely, the presence of brain activity) would clearly permit research to a point well beyond the development of the early embryo. Indeed, I do not think that the Council has been fully willing to take up the question of the moral status of the embryo. Nevertheless, despite the belief of some of us that the morality of human cloning probably cannot be addressed satisfactorily without doing so, we have agreed that the Council must examine the morality of cloning in ways alert to the many other important moral issues it also raises.

   (d) Most of all, we have been willing to join in this report's majority recommendation of a policy that would prohibit cloning-to-produce-children and prohibit for four years all cloning-for-biomedical-research, even though such a policy is not, in our view, the optimal one. We have concurred in this recommendation in order to join with some Council Members who, because of their moral concerns about human cloning, endorse a moratorium for reasons somewhat different from ours. I, for instance, specifically decline to think of a moratorium as simply providing time to put in place regulations – after which cloning-for-biomedical-research could proceed. For me a moratorium is good because it prohibits all human cloning for four years and provides opportunity to continue the argument and the research that may, one hopes, make the case against cloning still more persuasive four years hence. Although some of us would favor a ban on all cloning, including cloning-for-biomedical-research, we have recognized that such a policy proposal would, in effect, have said to fellow Council Members who, for their own different reasons, support a moratorium: "We're not prepared to continue this discussion." Rather than adopt such a position, we have been willing to support a position we regard as good even if less than optimal. As I noted above, however, this is not simply a compromise position. On the contrary, it is a partial agreement which may, I hope, give rise to still greater agreement in the future.

   Finally, I note the following about the moral (and not simply the policy) aspects of the human cloning debate:

   (a) A number of Council Members, of whom I am one, hold that the human embryo is fully deserving of our moral respect and that such respect is incompatible with its deliberate destruction in research. That judgment about the status of the human embryo (whether cloned or resulting from union of egg and sperm) is not, so far as I can see, based on our religious beliefs. We have taken seriously what the science of embryology teaches us. We have taken seriously what careful philosophical reasoning about the meaning of "potentiality" teaches us. We have taken seriously the lessons of human history in which the limits of our sympathy for fellow human beings who seem "different" from us have more than once had to be overcome in order to learn a more inclusive and egalitarian respect for human life. This does not mean, for me at least, that religious belief should play no role here. On the contrary, Jews worship a Lord who favors the widow and the orphan, who teaches us to speak on behalf of those no one else defends. And Christians worship a crucified God who has himself accepted vulnerability. Instructed by our religious traditions, we may see in the weakest and most vulnerable of human beings – those unable to speak in their own behalf – special objects of our care. Such care for the vulnerable seems to me incompatible with an industry of routine manufacture, use, and destruction of cloned embryos – even if the goal is to help others who are also vulnerable.

   (b) The position of those who support cloning-for-biomedical-research (while opposing cloning-to-produce-children) amounts, in effect, to criminalizing the implantation of cloned embryos. Nothing could be more revealing of the moral underpinnings of their position. In their view, moral status is conferred not by belonging to the human species but by the will and choice of some human beings (those like us who are stronger and in control). We cannot pretend that being unimplanted is somehow a natural fact about an embryo; on the contrary, it is what we choose. First we produce the cloned human embryo, then we decide to use it for our purposes in research rather than to implant it, and then we argue that until implanted it lacks the capacity for continued development. This reasoning is specious, it should be rejected, and it can find no support in the definitions given at the close of Chapter Three of this report.

   (c) Because the defense of cloning-for-biomedical-research rests ultimately upon a view that the will and choice of some confers moral status on others, and because no coherent defense of the "developmental" approach to human dignity and worth has been offered by proponents of research cloning, I think it very unlikely that research – if allowed to proceed – can really be confined to the early blastocyst. With no principled reasons to place limits on our will, and with the likelihood that more developed embryos or fetuses will actually be much more useful for researchers, I doubt whether the momentum of cloning research can be stopped in any way other than by stopping all human cloning. Indeed, I suspect that, if cloning-for-biomedical-research proceeds, the distinction between cloning-for-biomedical-research and cloning-to-produce-children will come to seem artificial. Having accustomed ourselves to use cloning techniques to shape and mold the next generation, we will be hard-pressed to explain why we should not, in fact, exercise an even fuller control by cloning-to-produce-children. Our earlier opposition to it will seem to have been merely sentimental.

   I am happy, therefore, to join with other colleagues on the Council in recommending a policy that would prohibit for at least four years all human cloning, whether for the purpose only of research or for the additional purpose of producing children, but it is imperative to emphasize that this good policy is less than optimal. We should hope that four years from now our society will be able to do still better.

   GILBERT C. MEILAENDER    
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   Statement of Dr. Rowley

   Support for Position Two

   During the deliberations of the President's Council on Bioethics, we asked many questions about the comparative usefulness of embryonic compared with adult human stem cells to treat a host of fatal and non-fatal but debilitating diseases. We never received a clear answer; thus the role of stem cell treatment is largely based on promise, rather than on persuasive evidence of efficacy. Given the intense interest of scientists in this research problem for at least a decade, the public can reasonably ask why we do not have convincing data on the use of embryonic stem cells to treat diabetes, Parkinson's disease and other medical problems?

   The answer is shockingly clear! American scientists have been prevented from working on these very critical problems because of a ban on any federally funded research using cells from human embryos. Progress in our understanding of human diseases and the development of effective treatment for these diseases has come largely from federally funded research, primarily supported through NIH. Thus, a consequence of the present Congressional ban (instituted in 1994 after an NIH panel established guidelines and oversight to allow such research) has been that the only research on the development of embryonic stem cell lines and on the use of embryonic cells has been limited to private and for-profit ventures. Not only are these efforts relatively small as compared with those funded by NIH, the results are largely hidden from the general scientific community and the benefits are likely to be available to the public on a very restricted basis, usually based on the ability to pay whatever price is asked. The effect of extending and expanding this moratorium will be to maintain our ignorance by preventing any research for four more years; this proposal will force American scientists who have private funding to stop their research. It will also accelerate the scientific "brain-drain" to more enlightened countries.

   The recent publication of reports on the plasticity of human stem cells from adult bone marrow has raised the possibility that the problem is solved, that we do not need stem cells derived from embryos. However, even Dr. Catherine Verfaillie (author of one such report) emphasizes the need for research on embryonic stem cells to complement work on adult stem cells. Will adult stem cells have the same unlimited capacity for renewal as is present in embryonic cells? Will embryonic and adult stem cells both be suitable for somatic cell nuclear transfer? Will embryonic or adult stem cells be more amenable to manipulation to reduce the problem of immune rejection? These are just a few of the critical questions that are urgently in need of answers – answers that NIH is prohibited from allowing American scientists to answer.

   As summarized here, it is clear that there is an urgent need immediately to fund research on the actual potential of human embryonic stem cells to treat human disease. However, it is equally clear that research using cells from human embryos requires great sensitivity and careful thought. It is thus appropriate to accompany the lifting of the NIH ban with the simultaneous implementation of an appropriate regulatory mechanism. It is important to emphasize that every US academic institution has an Institutional Review Board in place, whose function is to review all research related to human subjects before a grant can be submitted to any agency for funding; this ensures that the research proposal protects the health, safety and privacy of the individuals involved in the project. In 1998, the NIH Director established a task force to review the policy regarding stem cell research. This task force developed Guidelines for Pluripotent Stem Cell Research which were approved after extensive public comment (more than 50,000 responses) and which were published in the Federal Registry, August 2000. The task force proposed the establishment of The Human Embryonic Research Board. This Board would represent a broad constituency including consumers, ethicists, lawyers, as well as scientists knowledgeable in all aspects of human and animal embryonic stem cell research appointed by the Secretary of HHS. Thus there is no need to delay research until a Board is in place because the design of the Board is already in place.

   Our ignorance is profound; the potential for important medical advances is very great. We must remove the current impediments to this critical research. Congress should lift the ban and establish a broadly constituted regulatory board, NOW.

   JANET D. ROWLEY
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   Statement of Professor Sandel

   After six months of searching ethical and scientific inquiry, a majority of this Council has rejected a ban on cloning-for-biomedical-research of the kind passed by the House of Representatives last year. Among those of us who reject a ban, some prefer a moratorium, while others would permit such research to proceed subject to regulation. (See table in Chapter Eight.)

   I will first give my reasons for concluding that cloning-for-biomedical-research should not be banned, and then explain why I believe such research should be permitted subject to regulation.

   Any ethical analysis of cloning-for-biomedical-research must address the moral status of the human embryo. Before turning to that question, however, it is important to place cloning-for-biomedical-research in the broader context of embryonic stem cell research. Some who find cloning-for-biomedical-research morally objectionable support stem cell research that uses spare embryos left over from fertility clinics. They argue that it is wrong to create embryos for research (whether cloned or non-cloned) but morally acceptable to use excess embryos created for reproduction, since these "spare" embryos would otherwise be discarded. But this distinction is not persuasive. If it is wrong to carry out stem cell research on embryos created for research, it is wrong to carry out any embryonic stem cell research.

   Those who oppose the creation of embryos for stem cell research but support research on embryos left over from in vitro fertilization (IVF) clinics beg the question whether those IVF "spares" should have been created in the first place: if it is immoral to create and sacrifice embryos for the sake of curing or treating devastating diseases, why isn't it also objectionable to create and discard spare IVF embryos for the sake of treating infertility? After all, both practices serve worthy ends, and curing diseases such as Parkinson's, Alzheimer's, and diabetes is at least as important as enabling infertile couples to have genetically related children.

   Those who would distinguish the sacrifice of embryos in IVF from the sacrifice of embryos in stem cell research might reply as follows: the fertility doctor who creates excess embryos does not know which embryos will ultimately be sacrificed, and does not intend the death of any; but the scientist who deliberately creates an embryo for stem cell research knows the embryo will die, for to carry out the research is necessarily to destroy the embryo.

   But it is hard to see the moral difference between a practice that typically sacrifices embryos (by the tens of thousands, in the case of the IVF industry) and one that inevitably does so. If IVF as currently practiced in the United States is morally permissible, its justification does not rest on the idea that the sacrifice it entails is only typical, not inevitable. It rests instead on the idea that the good achieved outweighs the loss, and that the loss is not of a kind that violates the respect embryos are due. This is the same moral test that must be met to justify the creation of embryos for stem cell research and regenerative medicine.

   Comparing the range of practices that sacrifice embryos clarifies the stakes: if cloning-for-biomedical-research is morally wrong, then so is all embryonic stem cell research, and so is any version of IVF that creates and discards excess embryos. If, morally speaking, these practices stand or fall together, it remains to ask whether they stand or fall. The answer to that question depends on the moral status of the embryo.

   There are three possible ways of conceiving the moral status of the embryo – as a thing, as a person, or as something in between. To regard an embryo as a mere thing, open to any use we may desire or devise, misses its significance as nascent human life. One need not regard an embryo as a full human person in order to believe that it is due a certain respect. Personhood is not the only warrant for respect; we consider it a failure of respect when a thoughtless hiker carves his initials in an ancient sequoia – not because we regard the sequoia as a person, but because we consider it a natural wonder worthy of appreciation and awe-modes of regard inconsistent with treating it as a billboard or defacing it for the sake of petty vanity. To respect the old growth forest does not mean that no tree may ever be felled or harvested for human purposes. Respecting the forest may be consistent with using it. But the purposes should be weighty and appropriate to the wondrous nature of the thing.

   One way to oppose a degrading, objectifying stance toward nascent human life is to attribute full personhood to the embryo. Because this view is associated with the religious doctrine that personhood begins at conception, it is sometimes said to be a matter of faith that lies beyond rational argument. But it is a mistake to assume that religiously informed beliefs are mere dogmas, beyond the reach of critical reflection. One way of respecting a religious conviction is to take it seriously – to probe and explore its moral implications.

   The notion that the embryo is a person carries far-reaching consequences, some of which emerged in the course of this Council's deliberations. One is that harvesting stem cells from a seven-day-old blastocyst is as morally abhorrent as harvesting organs from a baby. This is a bold and principled claim, even if deeply at odds with most people's moral intuitions. But the implications do not stop there. If the equal moral status view is correct, then the penalty provided in recent anti-cloning legislation – a million dollar fine and ten years in prison – is woefully inadequate. If embryonic stem cell research is morally equivalent to yanking organs from babies, it should be treated as a grisly form of murder, and the scientist who performs it should face life imprisonment or the death penalty.

   A further source of difficulty for the equal moral status view lies in the fact that, in natural pregnancies, at least half of all embryos either fail to implant or are otherwise lost. If natural procreation entails the loss of some number of embryos for every successful birth, then perhaps we should worry less about the loss of embryos that occurs in IVF and in stem cell research. It might be replied that a high rate of infant mortality does not justify infanticide. But the way we respond to the natural loss of embryos suggests that we do not regard these events as the moral or religious equivalent of infant mortality. Otherwise, wouldn't we carry out the same burial rituals and the same rites of mourning for the loss of an embryo that we observe for the death of a child?

   The conviction that the embryo is a person derives support not only from certain religious doctrines but also from the Kantian assumption that the moral universe is divided in binary terms: everything is either a person, worthy of respect, or a thing, open to use. But as the sequoia example suggests, this dualism is overdrawn.

   The way to combat the instrumentalizing impulse of modern technology and commerce is not to insist on an all-or-nothing ethic of respect for persons that consigns the rest of life to a utilitarian calculus. Such an ethic risks turning every moral question into a battle over the bounds of personhood. We would do better to cultivate a more expansive appreciation of life as a gift that commands our reverence and restricts our use. Human cloning to create designer babies is the ultimate expression of the hubris that marks the loss of reverence for life as a gift. But stem cell research to cure debilitating diseases, using seven-day-old blastocysts, cloned or uncloned, is a noble exercise of our human ingenuity to promote healing and to play our part in repairing the given world.

   Those who warn of slippery slopes, embryo farms, and the commodification of ova and zygotes are right to worry but wrong to assume that cloning-for-biomedical-research necessarily opens us to these dangers. Rather than ban stem cell cloning and other forms of embryo research, we should allow them to proceed subject to regulations that embody the moral restraint appropriate to the mystery of the first stirrings of human life. Such regulations should include licensing requirements for embryo research projects and fertility clinics, restrictions on the commodification of eggs and sperm, and measures to prevent proprietary interests from monopolizing access to stem cell lines. This approach, it seems to me, offers the best hope of avoiding the wanton use of nascent human life and making these biomedical advances a blessing for health rather than an episode in the erosion of our human sensibilities.

   MICHAEL J. SANDEL    
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   Statement of Professor Wilson

   Regulated Cloning-for-Biomedical-Research

   I would allow regulated biomedical research on cloned embryos provided the blastocyst is no more than fourteen days old and would not allow implantation in a uterus, human or animal.

   I take this position because I believe that research on human blastocysts may have substantial medical value in finding ways of improving human life. As our report indicates, such research may help doctors deal with Parkinson's disease, Alzheimer's disease, juvenile diabetes, and spinal cord injury. Members of the Council disagree as to how best to do that research.

   The group that favors a moratorium on the use of cloned embryos for such research may think that the study of adult stem cells or in vitro fertilized eggs that are not used to impregnate a woman will produce all the knowledge we need to discover whether stem cells have therapeutic value. The other group, of which I am a part, favors regulated research on cloned embryos because it believes that all sources of stem cells, including those produced from cloned blastocysts, must be studied if we are to discover whether great medical advances are possible. That is because the use of cloned blastocysts may be the only important way of overcoming the problems of immune rejection and learning more about genetic diseases. If substantial medical benefit can be had from research, then it is unlikely that those benefits will derive from studying only stem cells derived from adult tissue or from leftover IVF eggs. To follow the policy recommended by the majority of this Council would be to do research with one hand tied behind our backs.

   Moreover, I do not think there is any moral difference between a fertilized egg created in an in vitro fertilization clinic and one created by cloning an embryo. Both eggs are deliberately produced by scientific intervention and both (except for the IVF egg used to impregnate a woman) are destroyed.

   Having said that there is no moral difference between these two sources of eggs does not mean, I believe, that using either kind of egg does not raise important and difficult moral questions. Every human begins as a fertilized egg, even though not every fertilized egg becomes a human. But the issue before us is not whether any human life should be destroyed but whether every fertilized egg should be preserved. To oppose the willful destruction of any fertilized egg is to oppose in vitro fertilization (since all fertilized eggs beyond that needed for successful implantation will be destroyed). Yet, in vitro procedures have produced (as of 1999) about thirty thousand babies for otherwise infertile couples. Initially, in vitro fertilizations were opposed by many who have since changed their minds, because the great benefits (many healthy new infants) so greatly outweighed the trivial costs (some tiny cells frozen or destroyed).

   A fertilized cell has some moral worth, but much less than that of an implanted cell, and that has less than that of a fetus, and that less than that of a viable fetus, and that the same as of a newborn infant. My view is that people endow a thing with humanity when it appears, or even begins to appear, human; that is, when it resembles a human creature. The more an embryo resembles a person, the more claims it exerts on our moral feelings. Now this last argument has no religious or metaphysical meaning, but it accords closely, in my view, with how people view one another. It helps us understand why aborting a fetus in the twentieth week is more frightening than doing so in the first, and why so-called partial birth abortions are so widely opposed. And this view helps us understand why an elderly, comatose person lacking the ability to speak or act has more support from people than a seven-week-old fetus that also lacks the ability to speak or act.

   Human worth grows as humanity becomes more apparent. In general, we are profoundly grieved by the death of a newborn, deeply distressed by the loss of a nearly born infant or a late-month miscarriage, and (for most but not all people) worried but not grieved by the abortion of a seven-week-old fetus. Our humanity, and thus the moral worth we assign to people, never leaves us even if many elements of it are later stripped away by age or disease.

   This fact becomes evident when we ask a simple question: Do we assign the same moral blame to harvesting organs from a newborn infant and from a seven-day-old blastocyst? The great majority of people would be more outraged by doing the former than by doing the latter. A seven-day-old blastocyst that is no more than one millimeter in diameter and contains only a hundred or so largely undifferentiated cells does not make the same moral claims on us as does a live infant. Unless everyone who makes this distinction is wrong, then the moral status of a blastocyst is vastly less compelling than that of a neonate.

   Some people believe that human life begins at conception and ought to be free from any human attack from that moment on. The difficulty with this rejoinder is that a large fraction (perhaps one-third or one-half) of fertilized cells fail to implant in the uterus or, if implanted, fail to develop into an embryo. Knowing this, one who offers this rejoinder would have to say that there is at best only a reasonable chance that the event of conception begins a human life.

   But even blastocysts and leftover IVF eggs deserve some protection, because if society authorizes their destruction it has taken a dramatic and morally significant step. It has intervened in a profoundly important human process in ways that may lead future generations to take what may then appear to be the easy next steps, such as implanting a cloned embryo in a uterus or killing a fetus to extract some supposedly beneficial substance.

   To avoid this, I favor federal regulations that would ban implanting a cloned embryo in any uterus, animal as well as human, and would insist that every cloned embryo raised in a glass dish exist for no more than fourteen days.

   There is always some risk that allowing even strongly regulated research will create conditions that lead some scientists to ask for access to fertilized eggs beyond the blastocyst stage. But I do not believe we can object to this by making a generalized slippery slope argument, since virtually every medical procedure that involves entering or affecting the human body would also be liable to such an argument, a conclusion that would leave us (for example) without surgery. The slippery slope argument, stated baldly, would lead us to oppose allowing doctors to remove an inflamed appendix because they might later decide to remove a kidney, and after that a heart, and to oppose as well doctors prescribing a drug that will harm 0.5 percent of its recipients because we suspect that, once they do this, they will later insist on prescribing drugs that harm 1 percent, and then 10 percent, and possibly 50 percent of their patients. There may be good slippery slope arguments, but they cannot rest simply on the phrase "slippery slope"; they must also point clearly to a serious moral hazard and contain some reason for thinking that this hazard will become much more likely if we take the first step.

   James Q. Wilson