"This transcript has not been edited or corrected, but rather appears as received from the commercial transcribing service. Accordingly, the President's Council on Bioethics makes no representation as to its accuracy."
THIRD MEETING
Thursday, April 25, 2002
Session 7: Public Comments
CHAIRMAN KASS:
Let me ask the Council's consent to -- if I'm not mistaken, we have three
public comments on the list. Is that correct? Three?
Would Council -- rather than take the scheduled break, and then reconvene,
since we have I think public testimony from three people, could we take
this now and then adjourn afterwards, since we're already together and
we don't want to make lots of people sit extra time? If all these people
are here. We did say it was going to be at 12:00.
So is Mo Woltering from the American Life League here? And is Richard
Doerflinger here? And is Susan Poland here? Is that the right pronunciation.
MS. POLAND: Poland.
CHAIRMAN KASS: Poland? Would you mind going
-- if we began now? Then, let's go in that order. Mo Woltering of the
American Life League, please step to the microphone. It's on.
MR. WOLTERING: I'd like to thank Dr. Kass and
all the members of the Council for the opportunity to present these remarks.
I'm the Director of Public Policy for American Life League.
My remarks today center around a very simple fact that's been scarcely
mentioned in the discussions of this Council and even the larger national
and international debate surrounding embryonic stem cell research and
human cloning. However, I believe this fact has a profound significance
for the discussion that is currently taking place.
The controversy surrounding embryonic stem cell research and human cloning
eventually returns to the debate over the moral status and value of the
human embryo.
And with this in mind, I would like to ask the Council to reflect for
a moment on one simple fact: that human embryos are either boys or girls.
This is an indisputable fact that's very seldom mentioned. The human embryo,
from the very first moment of life as a single-celled embryo, is either
a boy or a girl. That is, either a male or female.
Every high school student, in fact, learns this in biology class. One's
sex is determined by chromosomes which are present at the very beginning
of one's life as a single-celled creature. So I would ask you to keep
in mind that when you are talking about human embryos you are talking
about male and female human embryos. Knowing that every human embryo is
either a boy or a girl adds an important perspective to the moral status
and value of the human embryo.
One's sex is probably the most fundamental component of one's personal
identity. And we know this when we reflect upon ourselves. We also know
this when we reflect upon our everyday encounters. The sex of a person
is the first thing we notice when we meet people on the street, and it's
a major determinant of how we interact with people.
We will never be able to empirically confirm the presence of the soul,
but we know that in order for a person to exist a living, human body must
exist. And we know that human bodies essentially come in only two forms
-- male and female.
At the single-cell stage, we can identify a living male or female human
body. At the most -- one of the most fundamental components of personal
identity is present at this very beginning stage of life. I believe that
this alone is enough reason to recognize the personal rights of the human
embryo.
So I think here we must be honest. Many are apprehensive about recognizing
the rights of male and female human embryos.
As we all know, many widely accepted practices subject human embryos to
death. Here I'm referring to the practices of IVF, embryonic stem cell
research, even contraceptive practices which prevent the implantation
of the embryo.
Clearly, if we were to boldly recognize the personal rights and the dignity
of the human embryo, we must then reject all these practices that I have
just mentioned.
The President's Council on Bioethics has a critical teaching opportunity
here. History is filled with examples of societies that accepted a mistaken
understanding of human dignity, and they allowed horrible crimes to take
place against innocent people, yet people came together to correct those
mistakes and to defend the dignity of the person.
You have a chance to lead Americans to a renewed understanding of human
dignity, and I ask that you overcome all the apprehension. Human embryos
are either boys or girls.
Thank you.
CHAIRMAN KASS: Thank you very much.
Richard Doerflinger, United States Conference of Catholic Bishops.
MR. DOERFLINGER: Thank you. I wasn't going to
address the Council again, but when I saw such a short list I decided
to help the members earn their per diems.
I want to begin by saying how honored I was to be given respectful attention
by Dr. Outka in the session yesterday. I want to offer two clarifications
on his description of my views there, however. He seems to attribute to
me the view that there is no moral difference between destroying so-called
spare embryos and specially creating embryos for research that will destroy
them.
And he also says that John Robertson accepts my point on that in order
to point to the opposite moral conclusion about both.
First, it was really Dr. Robertson's point to which I was responding.
My paper was written as a response to Robertson's. But, more importantly,
I don't think I've ever argued there's no moral difference between the
two practices.
Obviously, I think the practice of specially creating embryos simply to
destroy them for research is more morally abhorrent in more ways, just
as it would be more horrific to conceive a child solely in order to abort
her for organs than to abort in some other circumstances. My point is
just that that does not mean the other abortions are morally right.
The point I was trying to make is this: there is often some measure of
selfishness in our reasons for conceiving children, just as in our reasons
for doing many other things. As a Catholic, I tend to attribute that to
original sin.
For example, in having a child, I may have in the back of my mind that
I would like this child to go to college and achieve things that I never
did, to give myself some vicarious satisfaction. And in that sense, I
am treating that child partly as a means.
But this becomes much more problematic if we are treating our offspring
as mere means in ways that do them great harm for the benefit of others.
And if we explore our reasons why so many of us, quite rightly, strongly
object to creating embryos in order to do them harm for research, we will
find in our feelings the roots of an argument that it is wrong to harm
embryos generally. But I didn't equate the two practices.
Secondly, I wanted to comment briefly on the slippery slope. I wanted
to confirm what Dr. Krauthammer said yesterday. During the debate on use
of spare embryos in Congress, every member of Congress, every Senator,
claimed to oppose specially creating embryos for research, by cloning
or other means.
Outside research groups and patient advocacy groups declared the same
ethical position, arguing, for example, that the Clinton guidelines on
stem cell research kept this research within ethical limits precisely
by excluding any involvement in special creation of embryos for research.
But when the debate switched to cloning for research, many of these Senators
and outside groups immediately switched their position and endorsed what
they had previously condemned.
I am tempted to agree with what Dr. Rowley said yesterday that this was
not a slippery slope, that these people always knew where they wanted
to go in the end. But that seems to suggest that they were simply being
deceptive in their first position and raises the question why we should
believe some of their claims now.
The rule "fool me once, shame on you; fool me twice, shame on me"
seems to hold here. I do think there was a great deal of insincerity in
the earlier claims to share moral concerns of the rest of us about specially
creating.
My point is simply that I have no reason to believe that the slope does
not extend further down. I want to raise two things about -- does this
stop with the embryo?
The latest bill, alternative bill to be introduced -- and it has been
called a compromise by its sponsors, S.2076 -- does not, like some previous
bills, ban the implantation of cloned embryos in the womb. It allows the
implantation of cloned embryos in the womb, as long as that is not done
for the purpose of "creating a cloned human being" by which
I assume we mean a born human being or the bill would be incoherent.
In other words, this latest bill already endorsed by some Senators would
allow implanting cloned embryos in the womb, to grow them to a certain
stage of gestation at any time before birth, and then kill them for their
organs.
The other reality is that when asked to proffer examples in animal models
of what therapeutic claims can be made for therapeutic cloning, supporters
have noted two studies. The first involves trying to make new kidney tissue
for cows, but it required growing the cow embryos, the cloned cow embryos
to fetal stage and then harvest their kidneys.
The second was an attempt to cure an immune deficiency in mice, and that
did not work until they actually brought the embryo to live birth and
then harvested its adult stem cells for treatment in the original mouse.
In fact, there are no models at this point of therapeutic cloning that
stays at the embryonic stage.
And I would like to offer for any Council members who are interested a
document that offers a little snapshot of the advances that are being
made now against some of these diseases without using any embryonic stem
cells or cloning.
Thank you.
CHAIRMAN KASS: Thank you very much. If you'd
give the documents to the staff table, we'll see that everybody receives
these.
The last comment is from Susan Poland speaking as a private citizen. Ms.
Poland, welcome.
MS. POLAND: Thank you. Mr. Chairman, members
of the Council, my name is Susan Poland, and I work as a library researcher
for the Bioethics Library at Georgetown University.
However, I am speaking only on myself and on behalf of no other entity.
I'm also speaking from my experience as one of the first 10 women police
officers in New Hampshire, and also as one of the first four lab techs
in basic reproductive research at the Jones Institute in Norfolk, Virginia.
Recently, I co-authored a bibliography on cloning. Others I had done were
on gene patenting and bioethics commissions. So I'm also speaking from
what I learned from those.
And I have two basic insights, one comment on terminology, and then I'd
like to really spend most of the comment time on illustrating what it
was like to be, in 1985, a first-hand account of doing unregulated in
vitro fertilization basic research.
First, a clone is a group of genetically identical offspring or progeny.
It implies birth, and, therefore, I think that reproductive cloning is
redundant, and therapeutic cloning is a misnomer and misleading, like
gene therapy is. I would like to see you use the term "IVD"
for in vitro division or duplication.
If you're going to have implantation into the uterus in hopes of a pregnancy,
IVD/ET, just like IVF means in vitro fertilization, not necessarily followed
by implantation, or IVF/ET.
My first comment or insight in working on the cloning bibliography is
that the U.S. patent system is the most powerful and most unique law enforcement
regulation that this particular government has for controlling research
done abroad and in the U.S. You cannot really regulate the scientific
research, but you can regulate and control access to the patent system.
And I was expecting or hoping that like you have IRBs or a super IRB for
FDA, you would have something like RAC, because the patent system right
now is overextended. It does over 10,000 patents applications in one year.
It took over 40 years to reach the first 10,000 applications. Those people
are not qualified, I believe, for adequately evaluating whether or not
research is done correctly under bioethical principles.
Second insight -- that was a short-term insight. A long-term insight is
that the legacy, I believe, of this group will be its impact on human,
and the definition of human to further councils and lawyers in the future,
maybe not in my daughter's generation but the generation following that.
If you take a look at what's happening with cooperative robotics, autonomous
robots that are making decisions, I wonder if we're going to define "human"
as one cell, whether it's an embryo or what, and go back to the racist
policies or miscegenation and one drop of blood.
And now I'd like to go into explaining what it was like to be a person
that walks into a bioethic -- excuse me, into a basic reproductive research
laboratory with a background in law enforcement when you had a .38 Smith
& Wesson on your hip, but you also had some experience with bioethics
and the issues.
The first time I was there they looked at me like, well, are you going
to stop the conversation talking about law, or are you going to just tell
us what to do as a bioethicist? And I told them, "No, bioethics is
not a badge."
Lawyers have -- lawyers and policemen have judges. They give you a final
decision. Bioethicists and theologians have no judge. And so the discussion
continued, and they would talk, and it was a very small group. It was
very similar to what I believe 19th century Britain was for discussing
science.
We had close communications. I worked with Gary Hodgen, who you may know
left NIH in 1984 because he could no longer do embryo research as a bureau
chief. And the Joneses -- Howard and George-Anna Jones had left Johns
Hopkins sometime before because they were no longer allowed to teach because
they had reached the age of 70.
So we were working with our small group. And, like I said, I was one of
the first four. There were close ties to Patrick Steptoe and John Edwards
in England. Everyone knew everything. This was in the age when there were
no faxes. Well, they were relatively new. No cell phones, no internet.
You were lucky to get things.
And at the time, in the U.S., what had happened with us doing basic research
was a scarcity of materials. We were working basically with animals, and,
when we could get them, human materials. But because of the fall of the
Marcos regime, we were not allowed to get very many primates. They are
very hard to get. And when you could find a monkey to work on, if you
were using human material, just like with vaccines, three times of exposure
to human hormonal material would immunize the monkey and you would no
longer get valid results.
So, consequently, a good deal of research in IVF was done using the litter-bearing
models of mice, which their ovaries do not react the same as, say, a singleton
birth.
At the same time when we were sitting there, I remember one of the business
meeting discussions like, well, what do you think? Do you think we should
screen for AIDS? That seems to be a new disease. And you know what has
happened since then.
I also sat in a meeting with Etienne Balieu, who was running Roussel-Uclef.
We were doing work on RU-486 with one other woman. It was a small group
of men and us two women. We were the only two people that thought we still
agree with diaphragms, because we like control of our own bodies. Forget
about giving us drugs that we can't shut out or whatever.
At the same time we were working with RU-486 on monkeys who were giving
still birth, or the newborns would die relatively soon, Roussel-Uclef
had signed an agreement with the Chinese government to test on people.
When you have a policy of one birth or less, it's very easy to allow your
people to go sterile.
Also, at the same time, in the summer of 1985, a professor named Akira
Iritani, who is still in practice and still working today, came over.
And it was sort of like the beginning of 2001 when you see the bone going
up in the air from the cave man, and you see the space ship.
We had just gotten our first micromanipulator, a Japanese machine that
Professor Iritani had used quite a bit. He had a graduate student, much
like Briggs & King -- King being the expertise for Briggs with all
the insight. He had a graduate student when he showed us at the end of
his term staying with us that could do two to three hundred embryos in
an afternoon, splicing them, which we would call now embryo-splitting
or blastomere separation.
And one of the slides at the very end was a picture of five identical
goats born by an eight-cell embryo. And I thought my God, there you have
the perfect drug testing system for a pharmaceutical company. I have as
yet, as a professional researcher, to see anything in print. If you have
any sway with people at the NIH, both at NLM and with research to get
more Japanese work put out into the U.S. mainstream for people to know,
that would be very nice.
China obviously takes one view based on a Confucian and socialist system,
or a Communist system, rather, of human life. Japan takes a different
view. Professor Iritani shocked even me when I discovered that in January
this year he announced that his group and a different university is viewing
genetic engineering -- had actually inserted a spinach gene into a pig,
and then produced two successive birth generations. From my Western mind,
I don't mix plant and animal kingdoms.
And then, lastly, back in 1985, we were there watching what was happening
in 1984 with the Medical Infertility Procedures Act when it was passed
in Australia in Victoria. And the "hot dogs and cowboys" were
going to be put in their place by the legislators.
Well, they certainly did. They emigrated to the U.S. as IVF Australia,
became IVF America, and today they are now IntegreMed, Incorporated, responsible
for one-sixth of all IVF births in the U.S., and our local outlet is Shady
Grove Adventist Hospital.
So I feel that when Australia came into the U.S., what basically we lost
was that very close-knit tie of research and clinical care, because it
suddenly overwhelmed the system and it became just clinical care and consumers.
When I was working there in Norfolk doing basic research, we got human
materials. There was a pecking order. Any human material was first used
for patient care, and those people there would decide which ones were
the best ones with the best opportunity of going on to help these people
that wanted to have babies.
Anyone else would come second for research, mind you that not the best-looking
embryos always were the best ones that went and implanting. So we had
to rely on their judgment.
We did use cadaver eggs. I'm grateful for the one woman that did donate
her ovarian tissue. But the eggs, of course, were dead, as I believe many
of the 100,000 embryos are that are sitting around in the nitrogen tanks
throughout the country.
But both groups, the clinical practice and basic research, were in service
together on improving care. I've never seen such a group of remarkable
people with high esprit de corps.
And there wasn't a feeling that this is a researcher-subject relationship
or a doctor-patient relationship. We were more or less fiduciaries, trying
to do best for individual people and yet also trying to do best for society
by improving the science.
My own feelings about the moral evaluation of this, having been given
the power to use my own judgment when I was 23 to use deadly force to
kill a person if I had to, was that this wasn't destruction of embryos.
This was actually loss. There was a real grief every time we had to kill
an animal or lost an embryo that we just didn't work.
I'm sorry. Am I over my limit? Is that just some --
CHAIRMAN KASS: No, that's just some -- that's
just some --
MS. POLAND: Okay. And today I know that talk
about the Human Embryology Authority and CCNE in France, while they have
asked and joined Germany to put a ban through, or look at regulating human
embryo research and, in particular, cloning, they also -- the CCNE has
asked the President to look at establishing its own authority like the
HEFA.
They also use, by the way, the British term, which is cellular nuclear
-- cell nuclear -- CNR. I'm sorry. Cell nuclear replacement I believe
is what it is.
I was going to ask you, and then respectfully request, and actually I
think the term I want is beg -- beg you to regulate this. It was very
scary to do IVF, which is fertilized or sexual reproduction, and now you're
looking at in vitro asexual reproduction. To do it in an unregulated atmosphere
because you didn't know what you were going to do, if you were going to
hurt someone, and where the government would draw the line suddenly.
And that's about all I can do is ask -- there's a balancing mechanism.
My own -- as I started to say, my own moral feelings about this, having
been given deadly force, I have discovered have changed. And they evolve
the more and more information I take in.
Thank you.
CHAIRMAN KASS: Thank you very much.
Did you want to say something, Janet?
DR. ROWLEY: I just wanted to correct Ms. Poland
in terms of the definition of cloning, because cloning has been used in
the biological community for many, many years. And its first use is --
that I am aware of was really when you had a cell line, you knew that
it was heterogeneous, and you wanted to take the cells in that cell line
and begin new cell lines derived from a single cell, and that was called
cloning.
So that, then, you had a homogeneous cell line derived from this heterogeneous
cell line. So it in no way implies live birth.
CHAIRMAN KASS: Thank you.
Any comments? Could I ask -- is Ms. Poland still here? Could I just ask,
as a point of information, are you aware of -- this is a question, too,
as librarian. Are you aware of any overarching study on the practice of
IVF along these lines? I mean, has there been any review studies that
we -- that --
MS. POLAND: On the safety of IVF?
CHAIRMAN KASS: No, not on the safety. Just on,
in fact, the practice. I mean, you were talking really something about
the unregulated character or the practice, the profession -- the society
has its own guidelines, which it has -- which it has promulgated, and
most of the members of that society abide by it. But there are also other
groups that do this practice that are not members of the society. Is there
any -- are there any studies?
MS. POLAND: For clinical care, I'm not aware
of any. And by the way, I did give Ms. Zwanziger one cite, which is the
Hayflick 1965 cite, which relates to -- it's a seminal article about the
number of times you can actually reproduce a cell. It's supposed to be
50 generations, and I explained to her about checking to see if additional
-- but I can look into that if you'd like, if you can tell me later more
--
CHAIRMAN KASS: We'll make the request more precise,
and we might be in touch with you. Thank you very much.
MS. POLAND: Okay.
CHAIRMAN KASS: Robby George, and then --
DR. GEORGE: Yes. Can I ask Richard Doerflinger
a question?
CHAIRMAN KASS: Is Richard still here? Yes, please,
Richard.
DR. GEORGE: Richard, since you're here, I
thought I could get an answer to a question that frequently comes up,
and it's this. Does the position of the Catholic Bishops Conference, or
the Catholic Church generally, on the issue of the moral status of the
embryo and what public policy ought to be on that depend on a view about
the infusion of a spiritual soul in the early embryo?
MR. DOERFLINGER: No. There have been a lot of
speculations during the course of Catholic history about ensoulment. Even
during times when people thought they were pretty sure based on the biology
of Aristotle and the philosophy of Thomas Aquinas that the early embryo
was not ensouled, it still rejected abortion as an act that shows disrespect
for this developing life that has a human destiny, that God is at the
very least forming to prepare for a soul.
The current teaching is that abortion and destruction of embryos is wrong,
first of all, because it destroys a living member of the human species,
and that that's enough to deserve our respect.
And, secondly, that since we cannot be sure that the early embryo is not
-- does not have an immortal soul that when you are destroying that embryo
you in addition risk the full gravity of killing a human person in the
full sense. But ensoulment is not the factor that means the difference
between moral right or wrong or even the difference between something
that would be seen as an abortion as versus contraception. Is that --
DR. GEORGE: Yes, that answers it. Thank you.
CHAIRMAN KASS: Thank you very much.
Thank you all for your wonderful work, your endurance. The meeting is
adjourned.
(Whereupon, at 12:18 p.m., the proceedings in the foregoing matter were
adjourned.)
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