Cloning Embryos from Adult Human Beings: The Relative Merits of Reproductive, Research and Therapeutic Uses
For as children tremble and fear everything in the blind darkness, so we in the light sometimes fear what is no more to be feared than the things children in the dark hold in terror and imagine will come true.
At present, “excess” embryos2 from in vitro fertilization (IVF) procedures can be used by scientists to extract stem cell lines3 for research. Federal funding for such research, however, is prohibited.4 The clear weight of current evidence suggests that embryonic stem cell lines are superior to adult stem cell lines.5 However, if the research conducted on these stem cell lines is to prove optimally useful for gene therapy, cloned embryos (embryos created by scientists from Somatic Cell Nuclear Transfer (SCNT)6 or similar methods) should be used. Such embryos are optimal because if the “sick” patient is cloned and an embryo produced, the patient’s immune system is less likely to reject the therapy made possible by its own cloned embryo’s stem cells.7
While there is considerable agreement among scientists that embryos left over from fertility treatments should be used to extract new stem cell lines beyond those allowed by President Bush,8 creating a cloned embryo in order to destroy it for its stem cells, as the South Koreans have just done,9 is not as widely accepted. However, if the medical research involving stem cells from excess embryos proves as fruitful as many suspect and leads to successful drug or gene therapy, the utilitarian argument10 for cloning such embryos can be expected to overwhelm the deontological argument11 for not creating them.
While the utilitarian arguments for reproductive use of cloned embryos may not be as strong as those for the therapeutic uses, they do exist. Couples who cannot conceive by any other means,12 lesbian couples,13 and individuals who want to reproduce without a partner14 would all be benefited by reproductive cloning.15
Once the cloning of embryos for research and therapy becomes widely accepted, it is probably true that nothing can stop the use of such clones for reproduction.16 At the same time, the deontological argument for reproductive use may even be stronger than the argument for therapeutic and research uses because we do not destroy the embryo in reproductive cloning; we use it as an end in itself to create sustainable life. It is my purpose in this paper to argue that the deontological reasons for reproductive cloning, coupled with the significant utilitarian reasons for such cloning, make the argument for reproductive use of such clones at least as strong as those for research or therapeutic uses. Furthermore, the argument for the relative merits of reproductive cloning versus research or therapeutic cloning may be strengthened if embryonic stem cell research proves less fruitful then expected.
Ultimately, I will argue that legislation and regulation should permit the cloning of embryos via SCNT and that there is no real need for lawmakers to try to prohibit the use of such embryos for reproductive purposes while allowing it for research and therapy. Once the clone is created, it can, and should, be used in any of these ways; prohibition of any of the uses will not work.17 Thus, lawmakers should allow cloning by SCNT and related procedures and not worry about trying to ban one use of the clones (reproduction) while allowing others (research and therapy). There are sufficient reasons to allow any of the mentioned uses.
I. Cloning For Research and Therapy
It is not a purpose of this paper to enter the dispute over whether stem cells from adults can supplant embryonic stem cells. Rather, for purposes of this argument, I will assume that embryonic stem cells are clearly superior.18 Once the need for embryonic stem cells is accepted, preference for cloned embryos over IVF embryos requires explanation.
Initially, I believe it is necessary to separate research uses of embryos from therapeutic uses. Research uses have created present demand for such embryos, while the therapeutic uses are largely speculative, though their projected benefits are spectacular.
The general idea behind the therapeutic uses of cloned embryos is as follows: Take a patient’s healthy somatic cell and create a clone; then retrieve the stem cells from this cloned embryo that can be used to repair a patient’s failing organ without fear of rejection by the patient’s immune system.19 Excess IVF embryos would not have this feature. According to Rick Weiss of the Washington Post:
[T]his potential to regenerate ailing organs [through a cloned embryo’s stem cells] has been a powerful—though so far unsuccessful—selling point as scientists and advocates have tried to persuade Congress and the Bush administration to loosen restrictions that preclude the use of federal funds for work involving cloned embryos.20
An important reason for this lack of success is that therapeutic cloning, even if perfected, faces “technical and regulatory hurdles so high that it could be a decade before the first proposal is ready for consideration by a Food and Drug Administration.”21 The FDA has already said it will want answers to questions such as the following: “Will the stem cells go where they’re supposed to go in the body? Could they turn into the wrong kinds of cells once they’re in the body? Will they start multiplying uncontrollably and form cancers?”22
Because of the futuristic nature of therapeutic cloning, and Congress’s recent unresponsiveness to its potential, scientists are beginning to talk about the more immediate research uses of cloned embryos:
Instead of making cloned embryos a source of healthy stem cells for transplantation into patients, scientists are proposing to make cloned embryos that explicitly bear the genetic glitch or glitches at the root of a patient’s disease…. [For example] they would start with … a degenerating nerve cell … from a person with Lou Gehrig’s disease, a neurological disorder that robs people of control over their muscles. Using cloning techniques, scientists would transform that cell into an embryo, which … would produce stem cells … [bearing] the genetic roots of the disease….23
Since “[r]esearchers already know how to force stem cells to become nerve cells[,] … they would do so with stem cells taken from a cloned Lou Gehrig’s embryo and watch those cultured nerves as they degenerate in a laboratory dish.”24 Then, they could watch the disease unfold outside a person and test whether chemicals or drugs might somehow alter the process. Or, they could inject these fresh, but degenerating neurons into the brain of a mouse or rat and watch how they develop, die and/or respond to various drugs.25
So the fact is that there is considerable utility in cloning embryos whether or not the therapeutic uses trumpeted in the media come to pass soon or at all. The ethical problem remains, however, that even though early embryos are not generally considered “human life” (except by the religious right), there is some consensus, as the court said in Davis v. Davis, that embryos fall into an interim category, between persons and property, and are thus entitled to a measure of “respect,” which is not well-defined.26 Thus, when we create embryos by cloning we are creating an entity in this interim category solely to destroy it for its stem cells, so that experimentation and, later perhaps, therapy can take place. It might be argued that these embryos are being cloned as a means to an end, not as ends in and of themselves (as would occur if cloned for reproductive, rather than experimental, purposes).27
II. Cloning For Reproduction
The utility of cloning for reproduction receives very little attention in the media. Perhaps this is partly because controversial groups, like lesbians and single parents wishing to reproduce, would derive much of this utility. Another group that might want to use the technology for reproduction would be those unable to produce children by conventional means or other forms of reproduction; however, this group seems rather limited.28 There also appears to be a concern that cloned embryos, left to develop into children, would produce children with physiological and perhaps psychological defects. Society would not be burdened by such potentially damaged children if cloned embryos were destroyed early to extract their stem cells.
Some opponents of reproductive cloning argue that creating a cloned child is creating a child destined to be burdened with psychological problems. One such problem is that the child may suffer from a loss of identity and individuality since he is technically a delayed twin and not a unique child.29 Others have posited that the cloned child may endure biological and familial problems due to the fact that the cloned child is a virtual twin of his parents—is the clone a child or a sibling?30 Finally, some speculate that the child may suffer from an “expectations problem.” Since the child will grow up with the same DNA as one of his parents, will the parent saddle the cloned child with expectations and forced desires that the parent had (or wished they had) when they were younger?31
The psychological problems a cloned child might encounter seem overblown.32 A child produced by SCNT would actually be less genetically similar to its “parent” than an ordinary “identical” twin would be to its sibling because the clone can carry the different mitochondrial DNA of the host egg.33 The mitochondrial DNA would be from a different source than would the donor nucleus unless, of course, a female did the cloning all by herself and carried the resultant child.34 Also, the “expectations” problem would seem less severe than with identical twins.35 A clone would typically be a generation or two younger than its “parent.”36 Unlike the identical twin, the clone would hardly be expected to look like the entity with its same DNA. In fact, it might develop into a substantially different adult than its parent due to various environmental influences.37 As far as the clone becoming “enslaved” to the expectations of its parent, there seems little reason to distinguish any parental expectations for the clone from those a parent might have for a conventionally conceived child.38
On the other hand, there are serious risks that the cloned child may have physiological damage, at least initially. Animal studies show that cloned individuals tend to be “defective” in some way.39 For example, Dolly the sheep, the first cloned animal, did not live to the age of a “normal” sheep.40 While Robertson, among others, has argued that an individual with such physical problems is “better off” than if it had not been born at all, this might depend on how serious the physical anomalies are.41
Thus, the “safety” issues for clones that are allowed to develop into children appear to be real ones at present—or at least, so the preliminary evidence suggests. It does, however, seem somewhat “circular” for us to deny funding to, or even to block research about, human reproductive cloning due to fear for the clone’s health. This stymies research and clinical trials that might ensure healthier outcomes for cloned children. One problem is surely that developing embryos and maybe even resulting children would be lost in experiments to improve “safety.”42 It is likely that such embryos would be significantly further along developmentally than the minute ones destroyed for their stem cells. This reality engenders greater ethical concerns. If the embryos are implanted, the mother’s safety also becomes a factor.
If the United States continues to stymie research into reproductive cloning, it is to be expected that researchers in other countries will “pick up the slack.” Eventually, we may find that cloning for reproduction is nearly as safe as normal reproduction, or at least as safe as other means of assisted reproduction.43 If the safety issues are resolved, those who would ban reproductive cloning must squarely face the reasons for their unease.44 If there is utility for some from the procedure, why ban it?
Opponents of the procedure might then be forced into weak arguments such as the “yuck” factor, psychological speculations and disgust with “asexual” as opposed to sexual reproductions.45 These can be countered on an ethical basis by noting that embryos cloned for such a purpose are being used to produce life, not to destroy, at least a preliminary form of life. The opposite is true when embryos are cloned for research or therapeutic purposes. Since this reality may make the deontological argument for reproductive cloning stronger than that for research or therapeutic cloning, the considerable utility from such a procedure, at least to some groups, would seem to tip the balance in favor of reproductive use.
III. Comparing Reproductive Cloning with Research and/or Therapeutic Cloning
If a strong argument can be made for allowing human reproductive cloning once the physical safety issue is removed, where does that leave cloning for research and/or therapeutic uses? Obviously, once human cloning through SCNT is allowed and perfected for any purpose, it will be practically impossible to prevent its use for another.46 The biology is the same: all that is involved is a change in human will.47 The current excitement over possible therapeutic cloning has made commentators like Professor Makdisi confident that cloning for such a purpose is likely to be allowed due to its supposedly great utility.48 I have argued that the deontological argument for such cloning may actually be weaker than that for reproductive cloning—at least once the safety concerns about the latter are resolved. But perhaps the battle over which uses of cloned embryos to permit will be fought on the grounds of utility, with the optimistic biotech companies initially prevailing over lesbian couples or others wanting or needing to reproduce by cloning.
Currently, those advocating cloning for research or therapy tend to argue that the two-day-old embryo has little or no moral status and can be destroyed for its stem cells without serious ethical difficulty.49 Many of them would attach moral status to the embryo only when it reaches the fourteen-day mark at which the “primitive streak” (neural tube) first appears.50 The reasoning is that the embryo could not be until it has at least the most primitive means of experiencing sensations. Since the embryos used for research are destroyed well before they develop the “primitive streak”,51 many advocates see no ethical problem in this destruction. If pressed, they may respond that the “cluster of cells” being destroyed has no more potential for life than a single human cell since such a cell itself can divide and eventually become a human being.52
However, it is possible to differentiate a single human cell that must be made to divide from the tiny cluster of cells that has already begun to divide and will continue to do so, and if attached to the female uterus may become a human being. While many scientists believe that after the appearance of the primitive streak, the embryo may experience pain,53 we really have no way of assessing whether the embryo experiences any sensations. Thus, picking fourteen days as the point at which protectible life begins is as much a political choice as choosing the time of fertilization or conception to begin such protection.54 There is no biological necessity for the choice to protect life at fourteen days as opposed to some other point such as fertilization, or, in the case of the clone, its creation. The choices society has made about when to protect “life” also vary with the issue under discussion.55
Drawing the line at or before the appearance of the primitive streak is critical to those who would argue that research and therapeutic cloning are ethically permissible.56 If we are not creating (either by IVF or cloning) a human life form, but just a cluster of cells, then these may be destroyed for their stem cells without pause.57 Thus, the “primitive streak” dividing line between a cluster of cells (entitled to no protection) and an embryo (entitled to some, undefined protection) is a very convenient one for those who wish to destroy these “pre primitive streak” entities for their stem cells. The choice of an earlier developmental point as the demarcation line would, of course, open cloning for research or therapy to ethical questions.58 If it is really society’s choice whether to protect the cloned embryo at creation, then such cloning is at least morally questionable.59
In cloning an embryo for strictly reproductive purposes, other ethical issues are presented. Once the embryo attaches to the uterine wall, it is clearly on its way to becoming a human being. At first blush, this might seem to make the implanted embryo more entitled to protection than the unattached, pre implantation embryo. However true this would be if we viewed the implanted embryo in isolation, we now must consider the rights of a full juridical person—the mother—as well. In the event that the mother wants an abortion, her rights trump those of the fetus before the fetus is judged viable60 and gradually give way to those of the fetus as it develops further.61
Because of the competing rights of the mother, it may fairly be argued that the two-day-old cloned embryo (pre primitive streak) is in a stronger position ethically than the implanted embryo, at least pre viability. If we choose creation of the cloned embryo as the point at which we would protect it, then the tiny bundle of cells, viewed in isolation has at least some rights62—and arguably is entitled to greater protection—than the pre viable implanted embryo (whose mother’s rights may be in competition with its own). This may be true even though the implanted embryo is clearly “further along” in becoming a human being than, say, a two-day-old non-implanted embryo.
If the intention behind the cloning is reproduction, it must be admitted that the embryo is being used as an end in itself, rather than being sacrificed for the good of others (as in research or therapeutic cloning). On the other hand, one may argue that cloned embryos, as opposed to “excess” IVF embryos, may not have been created for reproductive purposes in the first place—they may have been created simply to extract their stem cells. When seen in this way, they could be viewed as being used for their intended purposes of research or therapy and not as a means to an end.63
The strength of this seemingly plausible argument ultimately depends on whether we view the embryo as having as its inherent purpose (regardless of human intentions for it) development into a human being. If the moral status of the embryo is neutral—if this tiny cluster of cells has no inherent purpose—it is only human intention that directs its use.64 However, if this cluster is inherently human (exhibiting the potential for life), destroying it in hopes of benefiting others is an action in opposition to the intended purpose of these cells. In this case, the creation of these cells can be viewed as simply a means to an end, whereas using it for reproduction would be utilizing it for its intended purpose. By contrast, if the cluster of cells has no purpose until human will acts on it, cloning for either research or therapy (just as for reproduction) would represent use of this entity for its end purpose, not merely as a means to that end.
IV. Summary of the Argument
In attempting to prevent or to regulate human cloning by SCNT or similar processes, lawmakers have had difficulty deciding whether to differentiate cloning for reproductive purposes on one hand, from cloning for research and therapeutic purposes on the other.65 While a number of lawmakers would like to ban reproductive cloning outright, some of these would like to permit other uses. In either case, the clone produced is exactly the same; it is only the purpose for which the clone is used that varies.66 It may thus be practically impossible to stop one use of cloning and permit another.67
There has been much public pressure for therapeutic cloning generated because of the notion that afflictions such as those suffered by Ronald Reagan68 and Christopher Reeve69 might be cured by gene therapy and replacement using the stem cells from cloned embryos. As we have noted, any real success along these lines may be a decade away.70 However, scientists have delineated various ways that such embryos can be used immediately for research into diseases and other afflictions.71 If, on one hand, both research and therapeutic cloning appear to have strong utility, their appeal seems grounded in the popular belief that it may be acceptable to sacrifice a tiny two-day-old embryo for the perceived greater good of many afflicted persons.
While one might question the utility of largely futuristic uses of cloning for therapy, there is little reason to question its strength when the cloning is for basic research into diseases. While the public appeal of therapeutic cloning is clear, the public case is just beginning to be made for research cloning.72 When weighed against the lingering question of the morality of cloning for either research or therapy, the case for the strong utility of research cloning will have to be convincingly made.
The ethical problem for research cloning is essentially the same as that for therapeutic cloning: What moral or legal status will be given to the two-day-old embryo before we decide whether to destroy it for its stem cells?73 On one hand, the rights of this tiny embryo can be considered without regard to the rights of an adult human; the latter consideration would be necessary if the embryo were implanted for reproductive purposes. On the other hand, many do not believe this tiny cluster of cells has any moral or legal status at all until the primitive streak (or neural tube) first appears in the embryo at about fourteen days.74
I have argued that the choices of when to begin protecting the embryo are essentially political and are not biologically determined.75 A starting point for making these choices is whether one believes the tiny embryo has an inherent purpose: Is it meant to be a human being? If we decide yes on this question, then this entity, if destroyed for its stem cells, is not being used for its intended purpose and is therefore but a means to an end. On the other hand, if we believe this tiny cluster of cells has no inherent purpose—is morally neutral—then creating it by SCNT in order to extract its stem cells is precisely to use it for its intended purpose, and not as a means to an end.