Therapeutic cloning and its ethical implications

Gonzalo Herranz.
department de Humanities Biomedical, University of Navarra.
Intervention in Interdisciplinary Meetings, IESE.
Madrid, 22 February 2001.

After what Dr Montuenga has said, one thing is clear: stem cells obtained from adult organisms look as promising as those that could be obtained from embryos and cloned embryos. And, moreover, they are free from the serious ethical problems incurred by producing cloned embryos and having to destroy them in order to harvest stem cells from them.

The ethical refutation of therapeutic cloning is straightforward.

It is based on consequentialist-utilitarian arguments (it is technologically more complicated, financially more expensive, and inferior in promise to the non-embryonic stem cell alternative, and is exclusively and hopelessly destined for the individual who donated the nucleus), and

skill It is also based on deontological arguments (therapeutic cloning is to be rejected because it does not respect human beings: it requires the creation of human embryos destined to be sacrificed for the benefit of others, turning human beings into means that serve the ends of others; it degrades weakness, abusing it; it is possessive, not respectful; it breaks the rules of biomedical experimentation, as it does not seek alternatives that are more respectful of the dignity of the research subjects).

Finally, it relies on ontological arguments. A cloned embryo is not transmuted in its essence, it is not one thing or another, by being directed to reproduction or stem cell production.

Out of common sense and respect for human embryos, therapeutic cloning should be abandoned.

That said, there are two things to do: One is to immediately open a discussion on the above statements. The other is to confess that what is really important has already been said and to fill the time to justify the journey by telling a story that seems to me to be of interest to people who are in business and who care about business ethics.

This is the story of the legislative process in the UK that led to approve the testing of cloned embryos for stem cell procurement: in December 2000 in the House of Commons; in January 2001 in the House of Lords. It is a story that has not been told in depth in the media and which holds some interesting lessons about the way ethics is sacrificed for the sake of efficiency.

When Dolly was born, four years ago now, the British government joined the chorus of voices clamouring that cloning techniques would never be applied to human beings. A chorus of unprecedented polyphony: the Pope and Clinton, the WHO and the WMA, the US Senate, the European Parliament and Japan's per diem expenses , Europe's committee , the French National Committee and the Pontifical Academy for Life. All of them. Surprising that in our time of ethical pluralism something should be condemned so universally and so forcefully.

Although dissenting voices had already begun to be heard a few months later, in June 1997, the British Health Minister declared: "the deliberate cloning of human beings is ethically unacceptable".

But, curiously, three and a half years later, in August 2000, the British government took the initiative to amend the 1990 Act (the Human Fertility and Embryology Act) to allow the cloning of embryos and experimentation on them in their early stages at development. But curiously it did not ask Parliament, in clear and unequivocal words, to allow human cloning for therapeutic purposes: it urged Parliament to simply expand the list of areas in which experimentation on embryos can be authorised, adding to the five existing ones two new ones: "research on embryos created by nuclear transfer to increase our knowledge of human diseases and how to cure them by stem cell treatment" and "research to develop treatments for mitochondrial diseases".

The two chambers, as we know, approved by B majority the amendments recommended by the government.

What happened to cause the British government's attitude to change so strongly? One thing I was not unaware of was that a strong and notorious rejection of cloning had been detected among the British public. The Wellcome Trust had done a very original and well-designed survey in 1998: Public Views on Human Cloning. It concluded: "1. There is virtually no support in the UK for human reproductive cloning. 2. Many people are also very concerned about the therapeutic uses of cloning and have no confidence in the ability of scientists to make rules for themselves. 3. People would like scientists to produce very useful cells and organs or tissues to cure diseases, but are unhappy about how embryos are to be used for that purpose.

When the people were against it, why did the government go against the people's opinion?

(In parentheses: people in the United States are also against all forms of cloning, including so-called therapeutic cloning. A Time/CNN survey , the results of which were reported by Reuters on 12 February 2001, indicates that 72 per cent of respondents "think cloning is not justified to produce organs to save the lives of others"; 80 per cent opposed reproductive cloning. Many respondents cited their religious beliefs as a decisive factor in their opposition).

It is a very interesting and somewhat complicated story.

As always when there is a problem, the government commissioned a committee to prepare a document for discussion public. It set up the group Working Group on Cloning in 1998, a group of four people with a keen interest in cloning and its potential benefits, drawn from the HFEA and HGAC [Anne McLaren (Wellcome/CRC), George Poste (SK Beecham), Rev Polkinghorne (of fame for his views on the use of foetal tissue and a member of HGAC) and Christine Gosden (of the HFEA)]. By the end of the year, the group had produced the report "Cloning: issues in reproduction, science and medicine".

Its conclusion was to be expected given the ideological and professional orientation of the members of group: it recommended to the government that embryo research be authorised to design procedures to reconstitute damaged organs and tissues and to treat mitochondrial diseases.

Interestingly, the document commissioned by the government with the purpose of "stimulating a broad and informed social discussion " was not presented to the general public, but only to scientific, legal and clinical organisations and specialists with ethical interests.

The people were excluded: there were no representatives of the different ethical traditions on the group de Trabajo. The report was left in the hands of experts. The elitist character of the group was shown in the recommendation it made to the government: "We wish to collaborate in the necessary task of dispelling the mistrust that may exist among the public and to engage in a task of education to help overcome irrational fears and to build confidence in the applications of science".

The most curious thing about this report is that it was commissioned to group not by the Minister of Health, but by the Minister of Trade and Industry. This means that even then the commercial and industrial interests of cloning prevailed over scientific, legal, clinical or social considerations. It should not be forgotten that by then Geron Co. had taken control of PPL and the Roslin Institute in Edinburgh, the centre where Dolly had been cloned.

As was later justified, the document was quietly put to bed and not given the circulation it was intended for, because at the time the GM food crisis was raging in the UK. By January 1999, distrust of biotechnology was running high. It was not an easy time. And it was realistic to think that the rejection of GM soya and the marketing of unbranded GM foods could spread to the biotech industry. Industrialists urged the government to be cautious and cloning was hardly mentioned again until very late in 1999.

While waiting for the weather to improve, the government set up a new committee, chaired by Chief Medical Officer Dr Liam Donaldson, the man who had solved the GM food crisis. Again, the group was a group of experts: it was made up of 12 medical and genetic professionals, a lawyer and a professor of medical ethics.

With the year 2000 came the turn of the millennium and a time of predictions and promises, of scientistic intoxication and optimistic millenarianism. It was a time of tireless talk of sensational discoveries: of genomes and stem cells and the wave of health and healing they would bring. People were worked up to believe that soon, thanks to project Genome and embryonic stem cells, the scourges of advanced society, the terrible degenerative diseases of the nervous system (Alzheimer's disease, Parkinson's disease, multiple sclerosis), cancer, stroke, cirrhosis, diabetes, would be conquered.

That was report Donaldson's topic of choice. Interestingly the report was sent to the department of Health, which published it under the title "Stem cell research: medical progress with responsibility", A report of the group of CMO Experts examining the possibilities of development stem cell research and nuclear transfer for the benefit of human health.

There is no more talk of cloning: only of the new technicality of nuclear transfer. The main conclusion of report was very precise and ended in utilitarian core topic : the potential advantages of creating embryos and culturing them to obtain cells for clinical use far outweigh any moral or ethical scruples that some people might express.

The document was made public in August 2000 and with many people on holiday. And, despite this being a period not very conducive to political activity, the government immediately accepted the recommendations and conclusions of report Donaldson and sent draft of the Bill to Parliament on 16 August for discussion as soon as possible. It made it clear that Members of Parliament were given the fullest possible freedom to vote.

Everything happened very quickly and at a time that was not conducive to a thorough discussion . Members of Parliament, although they had a free vote, had little time and little opportunity to study and contrast the project bill.

Firstly, to see if it was necessary. The report Donaldson clearly stated that "Research to create embryos by nuclear transfer is not prohibited by the 1990 Act. All that is required for cloning to be legal in the UK is for the HFEA to grant authorisation to the applicant". And, interestingly, the HFEA had said in 1998 that it had no objection to granting such authorisation. The new Act did not require it. And the 1990 Act had made reproductive cloning a criminal offence. But all therapeutic cloning was unpopular: approving it under that name would have been a political blunder. It had to be made politically correct by changing the name.

Wellcome's survey had said that the language you choose when talking about scientific research has a big influence on how people answer questions. So, for example, it is much more appropriate to talk about gene therapy than genetic engineering or genetic research. Gene therapy sounds more "friendly".

The first government document spoke of cloning (reproductive and therapeutic). Clearly the difference, as the words say, is not in cloning, but in the fate of the cloned embryos. But the action of cloning is the same: some uses of it are declared abhorrent and others beneficial: the adjectives are loaded with ethical overtones, because who could object to treating terrible diseases, to providing benefits? But one conclusion was drawn from Wellcome's survey : better not to talk about cloning. The important thing is for the media to persuade people that obtaining precious stem cells is worth destroying special clumps of cells we call embryos. And that overcoming the possibility of rejection of transplanted stem cells is worth using nuclear transfer technology. It will be another year or two before therapeutic cloning disappears from circulation as an unmentionable archaism. Because, as the 1998 report of the group Cloning Task Force said, "It is clear that the term 'cloning' is a stigmatised word for many because of the inevitable association of ideas with the story in Brave New World".

In this context, talk of cloning has been increasingly avoided. Scientists interested in objectivity speak of somatic nuclear transfer. Those who are more interested in efficiency prefer to speak of directed cell cultures, of specialised cell cultures. This is what had happened with the now disused term pre-embryo, or with cell complexes no bigger than a pinhead. And it is what has happened with abortion and abortion, microaspiration or menstrual regulation, or what is happening with euthanasia and dignified death, compassionate release, benign withdrawal , euthanasia therapy, legally prescribed overdose, and others. This is what Chesterton denounced: the rich man who steals is compassionately diagnosed as a kleptomaniac; the poor man is simply called a chauvinist.

Finally, why the rush? Many Members of Parliament complained that they were not allowed time, that a parliamentary committee was not set up. In the speeches in both Houses - too much information on the Hansard Internet - there was a lot of rhetoric: we cannot prolong for one more day the suffering of thousands of patients, the suffering of those who care for the sick. We cannot collaborate with the obscurantists. etc.

But the UK's discussion had an insistent tone: the Act was necessary to put the UK at the forefront of stem cell technology. The United States is overtaking us. If parliament passes the bill, the UK will be back at the head of the race. It was with Wilmut and Dolly. The race is not just against disease: it is against competitors. Patents here will be worth years of abundance. The UK must take the lead in regenerative medicine research. "We are not debating whether or not embryonic stem cell research is acceptable. Whether we like it or not, the research is already being done in the US. The medical industry is international. The question is not so much whether or not we want to fight some diseases, but whether we are willing to make the decisions, to make the ethical and moral sacrifices that will encourage this research here. We do not have to balance the ethical arguments in favour of embryo research against the moral risks of exploiting and destroying embryos. We have to decide whether exploiting and destroying embryos is more or less worth our biotech industry leaving home, more or less worth retaining with us. We have to do some things we don't like very much, but we can't let it go. The question final is whether or not we want to approve that subject of research in order to be able to compete without disadvantage in the biotechnology field".

At the end of discussion, parliamentarians' attention was not focused on cloned embryos, nor even on the ethics of nuclear transfer. The discussion responded to the imperatives of industrial competitiveness. Curiously, the proposal was entrusted, again and for the second time, to the Ministry of Trade and Industry, not to the Ministry of Health.

All this raises very profound questions, revealing the perennial Christian message of what are the limits of man's lordship over the world. The essential meaning of man's dominion over the visible world, assigned to him as a task by the Creator himself, consists in the priority of ethics over technology, in the primacy of the person over things, in the superiority of the spirit over technology subject.

And, finally, I would like to add that this is not just an issue for the British. It is coming our way. I have news that the new Ministry of Technology and Research wants to take over the leadership of Biotechnology and that it wants to take over the CNRHA, to decide what is done with supernumerary embryos. And if we are to compete, whether we will change the law to clone, or as the creator of the law says to produce egg cells, the neologism Made in Spain for cloned embryo.