Stem cell research cloning human beings: an assessment of the ethical issues pro and con



Download 122.67 Kb.
Date03.05.2016
Size122.67 Kb.

HUMAN CLONING AND

STEM CELL RESEARCH

CLONING HUMAN BEINGS: AN ASSESSMENT OF THE ETHICAL ISSUES PRO AND CON

Dan W. Brock

INTRODUCTION

The world of science and the public at large were both shocked and fascinated by the announcement in the journal Nature by Ian Wilmut and his col­leagues that they had successfully cloned a sheep from a single cell of an adult sheep. Scientists were in part surprised because many had believed that after the very early stage of embryo development at which differentiation of cell function begins to take place it would not be possible to achieve cloning of an adult mammal by nuclear transfer. In this process the nucleus from the cell of an adult mam­

Reprinted with permission from Cloning Human Beings: Report and Recommendations of the National Bioethics Ad­visory Commission, Rockville, MD, 1997.

Editors' note: This article has been edited and most of the notes omitted. Readers who wish to follow up on sources should consult the original.

mal is inserted into an enucleated ovum, and the resulting embryo develops following the complete genetic code of the mammal from which the in­serted nucleus was obtained. But some scientists and much of the public were troubled or apparently even horrified at the prospect that if adult mam­mals such as sheep could be cloned, then cloning of adult humans by the same process would likely be possible as well. Of course, the process is far from perfected even with sheep-it took 276 failures by Wilmut and his colleagues to produce Dolly, their one success, and whether the process can be suc­cessfully replicated in other mammals, much less in humans, is not now known. But those who were horrified at the prospect of human cloning were not assuaged by the fact that the science with humans is not yet there, for it looked to them now perilously close.

The response of most scientific and political leaders to the prospect of human cloning, indeed of



~

631

632


Part Four / Reprogenetics

,

j


Dr. Wilmut as well, was of immediate and strong condemnation. In the United States President Clinton immediately banned federal financing of human cloning research and asked privately funded scientists to halt such work until the newly formed National Bioethics Advisory Commission could review the "troubling" ethical and legal implications. The Director-General of the World Health Organization characterized human cloning as "ethically unacceptable as it would violate some of the basic principles which govern medically as­sisted reproduction. These include respect for the dignity of the human being and the protection of the security of human genetic materiaL" Around the world similar immediate condemnation was heard as human cloning was called a violation of human rights and human dignity. Even before Wilmut's announcement, human cloning had been made illegal in nearly all countries in Eu­rope and had been condemned by the Council of Europe.

A few more cautious voices were heard both suggesting some possible benefits from the use of human cloning in limited circumstances and ques­tioning its too quick prohibition, but they were a clear minority. In the popular media, nightmare sce­narios of laboratory mistakes resulting in monsters, the cloning of armies of Hitlers, the exploitative use of cloning for totalitarian ends as in Huxley's Brave New World, and the murderous replicas of the film Blade Runner, all fed the public controversy and un­easiness. A striking feature of these early responses was that their strength and intensity seemed far to outrun the arguments and reasons offered in sup­port of them-they seemed often to be "gut level" emotional reactions rather than considered reflec­tions on the issues. Such reactions should not be simply dismissed, both because they may point us to important considerations otherwise missed and not easily articulated, and because they often have a major impact on public policy. But the formation of public policy should not ignore the moral reasons and arguments that bear on the practice of human cloning-these must be articulated in order to un­derstand and inform people's more immediate emotional responses. This paper is an effort to artic­ulate, and to evaluate critically, the main moral con­siderations and arguments for and against human



cloning. Though many people's religious beliefs in­form their views on human cloning, and it is often difficult to separate religious from secular positions, I shall restrict myself to arguments and reasons that can be given a clear secular formulation and will ig­nore explicitly religious positions and arguments pro or con. I shall also be concerned principally with cloning by nuclear transfer, which permits cloning of an adult, not cloning by embryo splitting, although some of the issues apply to both.

I begin by noting that on each side of the issue there are two distinct kinds of moral arguments brought forward. On the one hand, some opponents claim that human cloning would violate fundamen­tal moral or human rights; while some proponents argue that its prohibition would violate such rights. On the other hand, both opponents and proponents also cite the likely harms and benefits, both to indi­viduals and to society, of the practice. While moral and even human rights need not be understood as absolute, that is, as morally requiring people to re­spect them no matter how great the costs or bad consequences of doing so, they do place moral re­strictions on permissible actions that an appeal to a

mere balance of benefits over harms cannot justify

overriding. For example, the rights of human sub­jects in research must be respected even if the result is that some potentially beneficial research is more difficult or cannot be done, and the right of free ex­pression prohibits the silencing of unpopular or even abhorrent views; in Ronald Dworkin's striking formulation, rights trump utility (Dworkin 1978). I shall take up both the moral rights implicated in human cloning, as well as its more likely significant benefits and harms, because none of the rights as applied to human cloning is sufficiently uncontro­versial and strong to settle decisively the morality of the practice one way or the other. But because of their strong moral force, the assessment of the moral rights putatively at stake is especially im­portant. A further complexity here is that it is sometimes controversial whether a particular con­

sideration is merely a matter of benefits and

harms, or is instead a matter of moral or human rights. I shall begin with the arguments in sup­port of permitting human cloning, although with no implication that it is the stronger or weaker position.




Section 5 / Human Cloning and Stem Cell Research

633

MORAL ARGUMENTS IN SUPPORT OF HUMAN CLONING

A.

Is There a Moral Right to Use Human Cloning?

What moral right might protect at least some access to the use of human cloning? Some commentators have argued that a commitment to individual lib­erty, as defended by J.S. Mill, requires that individ­uals be left free to use human cloning if they so choose and if their doing so does not cause signifi­cant harms to others, but liberty is too broad in scope to be an uncontroversial moral right. Human cloning is a means of reproduction (in the most lit­eral sense) and so the most plausible moral right at stake in its use is a right to reproductive freedom or procreative liberty. Reproductive freedom includes not only the familiar right to choose not to repro­duce, for example, by means of contraception or abortion, but also the right to reproduce. The right to reproductive freedom is properly understood to include as well the use of various artificial repro­ductive technologies, such as in vitro fertilization (IVF), oocyte donation, and so forth. The reproduc­tive right relevant to human cloning is a negative right, that is, a right to use assisted reproductive technologies without interference by the govern­ment or others when made available by a willing provider. The choice of an assisted means of repro­duction, such as surrogacy, can be defended as in­cluded within reproductive freedom even when it is not the only means for individuals to reproduce, just as the choice among different means of pre­venting conception is protected by reproductive freedom. However, the case for permitting the use of a particular means of reproduction is strongest when that means is necessary for particular in­dividuals to be able to procreate at all. Sometimes human cloning could be the only means for indi­viduals to procreate while retaining a biological tie to the child created, but in other cases different means of procreating would also be possible.

It could be argued that human cloning is not covered by the right to reproductive freedom be­cause whereas current assisted reproductive tech­nologies and practices covered by that right are remedies for inabilities to reproduce sexually, hu­



man cloning is an entirely new means of reproduc­tion; indeed, its critics see it as more a means of manufacturing humans than of reproduction. Hu­man cloning is a different means of reproduction than sexual reproduction, but it is a means that can serve individuals' interest in reproducing. If it is not covered by the moral right to reproductive freedom, I believe that must be not because it is a new means of reproducing, but instead because it has other ob­jectionable moral features, such as eroding human dignity or uniqueness; we shall evaluate these other ethical objections to it below.

When individuals have alternative means of pro­creating, human cloning typically would be chosen because it replicates a particular individual's genome. The reproductive interest in question then is not simply reproduction itself, but a more specific interest in choosing what kind of children to have. The right to reproductive freedom is usually under­stood to cover at least some choice about the kind of children one will have; for example, genetic testing of an embryo or fetus for genetic disease or ab­normality, together with abortion of an affected em­bryo or fetus, ~ now used to avoid having a child with that disease or abnormality. Genetic testing of prospective parents before conception to determine the risk of transmitting a genetic disease is also intended to avoid having children with particular diseases. Prospective parents' moral interest in self ­determination, which is one of the grounds of a moral right to reproductive freedom, includes the choice about whether to have a child with a condi­tion that is likely to place severe burdens on them, and to cause severe burdens to the child itself.

The more a reproductive choice is not simply the determination of oneself and one's own life but the determination of the nature of another, as in the case of human cloning, the more moral weight the interests of that other person, that is, the cloned child, should have in decisions that determine its nature. But even then parents are typically taken properly to have substantial, but not unlimited, dis­cretion in shaping the persons their children will be­come, for example, through education and other child rearing decisions. Even if not part of reproduc­tive freedom, the right to raise one's children as one sees fit, within limits mostly determined by the in­terests of the children, is also a right to determine

634


Part Four I Reprogenetics

within limits what kinds of persons one's children will become. This right includes not just preventing certain diseases or harms to children, but selecting and shaping desirable features and traits in one's children. The use of human cloning is one way to exercise that right.

It is worth pointing out that current public and legal policy permits prospective parents to con­ceive, or to carry a conception to term, when there is a significant risk, or even certainty that the child will suffer from a serious genetic disease. Even when others think the risk or presence of genetic disease makes it morally wrong to conceive, or to carry a fetus to term, the parents' right to reproduc­tive freedom permits them to do so. Most possible harms to a cloned child that I shall consider below are less serious than the genetic harms with which parents can now permit their offspring to be con­ceived or born.

I conclude that there is good reason to accept that a right to reproductive freedom presumptively includes both a right to select the means of repro­duction, as well as a right to determine what kind of children to have, by use of human cloning. How­ever, the particular reproductive interest of de­termining what kind of children to have is less weighty than other reproductive interests and choices whose impact falls more directly and exclu­sively on the parents rather than the child. Accept­ing a moral right to reproductive freedom that includes the use of human cloning does not settle the moral issue about human cloning, however, since there may be other moral rights in conflict with this right, or serious enough harms from human cloning to override the right to use it; this right can be thought of as establishing a serious moral presumption supporting access to human cloning. . . .

B. What Individual or Social Benefits

Might Human Cloning Produce?

Largely Individual Benefits The literature on hu­man cloning by nuclear transfer, as well as the liter­ature on embryo splitting where it is relevant to the nuclear transfer case, contain a few examples of cir­cumstances in which individuals might have good reasons to want to use human cloning. However,

a survey of that literature strongly suggests that human cloning is not the unique answer to any great or pressing human need and that its benefits would at most be limited. What are the principal benefits of human cloning that might give persons good reasons to want to use it?

1. Human cloning would be a new means to re­lieve the infertility some persons now experience. Human cloning would allow women who have no ova or men who have no sperm to produce an off­spring that is biologically related to them. Embryos might also be cloned, either by nuclear transfer or embryo splitting, in order to increase the number of embryos for implantation and improve the chances of successful conception. While the moral right to reproductive freedom creates a presumption that individuals should be free to choose the means of reproduction that best serves their interests and de­sires,

the benefits from human cloning to relieve in­

fertility are greater the more persons there are who cannot overcome their infertility by any other means acceptable to them. I do not know of data on this point, but they should be possible to obtain or gather from national associations concerned with infertility.

It is not enough to point to the large number of children throughout the world possibly available for adoption as a solution to infertility, unless we are prepared to discount as illegitimate the strong desire many persons, fertile and infertile, have for the experience of pregnancy and for having and raising a child biologically related to them. While not important to all infertile (or fertile) individuals, it is important to many and is respected and met through other forms of assisted reproduction that maintain a biological connection when that is possi­ble; there seems no good reason to refuse to respect and respond to it when human cloning would be the best or only means of overcoming individuals' infertility.



2. Human cloning would enable couples in which one party risks transmitting a serious hereditary disease, a serious risk of disease, or an otherwise harmful condition to an offspring, to reproduce without doing so. Of course, by using donor sperm or egg donation, such hereditary risks can generally be avoided now without the use of


Section 5 / Human Cloning and Stem Cell Research

635

human cloning. These procedures may be unaccept­able to some couples, however, or at least consid­ered less desirable than human cloning because they introduce a third party's genes into their re­production, instead of giving their offspring only the genes of one of them. Thus, in some cases hu­man cloning would be a means of preventing ge­netically transmitted harms to offspring. Here too, there are not data on the likely number of persons who would wish to use human cloning for this pur­pose instead of either using other available means of avoiding the risk of genetic transmission of the harmful condition or accepting the risk of transmit­ting the harmful condition.

3. Human cloning a later twin would enable a per­son to obtain needed organs or tissues for trans­plantation. Human cloning would solve the problem of finding a transplant donor who is an ac­ceptable organ or tissue match and would elimi­nate, or drastically reduce, the risk of transplant rejection by the host. The availability of human cloning for this purpose would amount to a form of insurance policy to enable treatment of certain kinds of medical needs. Of course, sometimes the medical need would be too urgent to permit wait­ing for the cloning, gestation and development of the later twin necessary before tissues or organs for transplant could be obtained. In other cases, the need for an organ that the later twin would him- or herself need to maintain life, such as a heart or a liver, would preclude cloning and then taking the organ from the later twin.

Such a practice has been criticized on the ground that it treats the later twin not as a person valued and loved for his or her own sake, as an end in itself in Kantian terms, but simply as a means for benefit­ing another. This criticism assumes, however, that only this one motive would determine the relation of the person to his or her later twin. The well­known case some years ago in California of the Ayalas, who conceived in the hopes of obtaining a source for a bone marrow transplant for their teenage daughter suffering from leukemia illus­trates the mistake in this assumption. They argued that whether or not the child they conceived turned out to be a possible donor for their daughter, they would value and love the child for itself, and treat it as they would treat any other member of their fam­



ily. That one reason it was wanted was as a means to savh1g their daughter's life did not preclude its also being loved and valued for its own sake; in Kantian terms, it was treated as a possible means to saving their daughter, but not solely as a means, which is what the Kantian view proscribes.

Indeed, when people have children, whether by sexual means or with the aid of assisted reproduc­tive technologies, their motives and reasons for do­ing so are typically many and complex, and include reasons less laudable than obtaining lifesaving medical treatment, such as having a companion like a doll to play with, enabling one to live on one's own, qualifying for public or government benefit programs, and so forth. While these other motives for having children sometimes may not bode well for the child's upbringing and future, public policy does not assess prospective parents motives and reasons for procreating as a condition of their do­ing so.

One commentator has proposed human cloning for obtaining even lifesaving organs. After cell differentiation some of the brain cells of the embryo or fetus would be removed so that it could then be grown as a brain dead body for spare parts for

its earlier twin. This body clone would be like an

anencephalic newborn or presentient fetus, neither of whom arguably can be harmed because of their lack of capacity for consciousness. Most people would likely find this practice appalling and im­moral, in part because here the cloned later twin's capacity for conscious life is destroyed solely as a means for the benefit of another. Yet if one pushes what is already science fiction quite a bit further in the direction of science fantasy, and imagines the ability to clone and grow in an artificial environ­ment only the particular lifesaving organ a person needed for transplantation, then it is far from clear that it would be morally impermissible to do so.

4. Human cloning would enable individuals to clone someone who had special meaning to them, such as a child who had died. There is no deny­ing that if human cloning were available, some in­dividuals would want to use it in order to clone someone who had special meaning to them, such as a child who had died, but that desire usually would be based on a deep confusion. Cloning such a child would not replace the child the parents had loved

636


Part Four / Reprogenetics

and lost, but rather would create a new different child with the same genes. The child they loved and lost was a unique individual who had been shaped by his or her environment and choices, not just his or her genes, and more importantly who had expe­rienced a particular relationship with them. Even if the later cloned child could have not only the same genes but also be subjected to the same environ­ment, which of course is in fact impossible, it would remain a different child than the one they had loved and lost because it would share a different history with them. Cloning the lost child might help the parents accept and move on from their loss, but an­other already existing sibling or another new child that was not a clone might do this equally well; in­deed, it might do so better since the appearance of the cloned later twin would be a constant reminder

of the child they had lost. Nevertheless, if human

cloning enabled some individuals to clone a person who had special meaning to them and doing so gave them deep satisfaction, that would be a benefit to them even if their reasons for wanting to do so, and the satisfaction they in turn received, were based on a confusion.

Largely Social Benefits

5. Human cloning would enable the duplication of individuals of great talent, genius, character, or other exemplary qualities. The first four reasons for human cloning considered above all looked to benefits to specific individuals, usually parents, from being able to reproduce by means of human cloning. This reason looks to benefits to the broader society from being able to replicate extraordi­nary individuals-a Mozart, Einstein, Gandhi, or Schweitzer. Much of the appeal of this reason, like much thinking both in support of and in opposition to human cloning, rests on a confused and mistaken assumption of genetic determinism, that is, that one's genes fully determine what one will become, do, and accomplish. What made Mozart, Einstein, Gandhi, and Schweitzer th~ extraordinary individ­uals they were was the confluence of their particu­lar genetic endowments with the environments in which they were raised and lived and the particular historical moments they in different ways seized. Cloning them would produce individuals with the same genetic inheritances (nuclear transfer does not even produce 100% genetic identity, although



for the sake of exploring the moral issues I have fol­lowed the common assumption that it does), but neither by cloning, nor by any other means, would it be possible to replicate their environments or the historical contexts in which they lived and their greatness flourished. We do not know, either in gen­eral or with any particular individual, the degree or specific respects in which their greatness depended on their "nature" or their "nurture," but we do know in all cases that it depended on an interaction of them both. Thus, human cloning could never replicate the extraordinary accomplishments for which we admire individuals like Mozart, Einstein, Gandhi, and Schweitzer.

If we make a rough distinction between the ex­traordinary capabilities of a Mozart or an Einstein and how they used those capabilities in the particu­lar environments and historical settings in which they lived, it would also be a mistake to assume that human cloning could at least replicate their extraor­dinary capabilities, if not the accomplishments they achieved with them. Their capabilities too were the product of their inherited genes and their environ­ments, not of their genes alone, and so it would be a mistake to think that cloning them would produce individuals with the same capabilities, even if they would exercise those capabilities at different times and in different ways. ill the case of Gandhi and Schweitzer, whose extraordinary greatness lies more in their moral character and commitments, we un­derstand even less well t~ extent to which their moral character and greatness were produced by their genes.

None of this is to deny that Mozart's and Ein­stein's extraordinary musical and intellectual capabilities, nor even Gandhi's and Schweitzer's extraordinary moral greatness, were produced in part by their unique genetic inheritances. Cloning them might well produce individuals with excep­tional capacities, but we simply do not know how close their clones would be in capacities or accom­plishments t9 the great individuals from whom they were cloned. Even so, the hope for exceptional, even if less and different, accomplishment from cloning such extraordinary individuals might be a reasonable ground for doing so.

I have used examples above of individuals whose greatness is widely appreciated and largely uncontroversial, but if we move away from such




Section 5 / Human Cloning and Stem Cell Research

637

cases we encounter the problem of whose standards of greatness would be used to select individuals to be cloned for the benefit of society or mankind at large. This problem inevitably connects with the im­portant issue of who would control access to and use of the technology of human cloning, since those who controlled its use would be in a position to im­pose their standards of exceptional individuals to be cloned. This issue is especially worrisome if par­ticular groups or segments of society, or if govern­ment, controlled the technology for we would then risk its use for the benefit of those groups, segments of society, or governments under the cover of bene­fiting society or even mankind at large.

.

6. Human cloning and research on human cloning

might make possible important advances in scien­tific knowledge, for example about human devel­opment. While important potential advances in scientific or medical knowledge from human cloning or human cloning research have frequently been cited in some media responses to Dolly's cloning there are at least three reasons why these possible benefits are highly uncertain. First, there is always considerable uncertainty about the nature and importance of the new scientific or medical knowledge that a dramatic new technology like hu­man cloning will lead to; the road to that new knowledge is never mapped in advance and takes many unexpected turns. Second, we also do not know what new knowledge from human cloning or human cloning research could also be gained by other methods and research that do not have the problematic moral features of human cloning to which its opponents object. Third, what human cloning research would be compatible with ethical and legal requirements for the use of human sub­jects in research is complex, controversial, and largely unexplored. For example, in what contexts and from whom would it be necessary, and how would it be possible, to secure the informed consent of parties involved in human cloning? No human cloning should ever take place without the consent of the person cloned and the woman receiving a cloned embryo, if they are different. But we could never obtain the consent of the cloned later twin to being cloned, so research on human cloning that produces a cloned individual might be barred by ethical and legal regulations for the use of human

subjects in research. Moreover, creating human clones solely for the purpose of research would be to use them solely for the benefit of others without their consent, and so unethical. Of course, once hu­man cloning was established to be safe and ef­fective, then new scientific knowledge might be obtained from its use for legitimate, non-research reasons. How human subjects regulations would apply to research on human cloning needs much more exploration than I can give it here in order to help clarify how significant and likely the potential gains are in scientific and medical knowledge from human cloning research and human cloning.

Although there is considerable uncertainty con­cerning most of the possible individual and social benefits of human cloning that I have discussed above, and although no doubt it may have other benefits or uses that we cannot yet envisage, I believe it is reasonable to conclude that human cloning at this time does not seem to promise great benefits or uniquely to meet great human needs. Nevertheless, a case can be made that scientific freedom supports permitting research on human cloning to go forward and that freedom to use hu­man cloning is protected by the important moral right to reproductive freedom. We must therefore assess what moral rights might be violated, or harms produced, by research on or use of human cloning.



MORAL ARGUMENTS AGAINST HUMAN CLONING

A.

Would the Use of Human Cloning Violate Important Moral Rights?

Many of the immediate condemnations of any pos­sible human cloning following Wilmut's cloning of an adult sheep claimed that it would violate moral or human rights, but it was usually not specified precisely, or often even at all, what the rights were that would be violated. I shall consider two possible candidates for such a right: a right to have a unique identity and a right to ignorance about one's future or to an open future. The former right is cited by many commentators, but I believe even if any such a right exists, it is not violated by human cloning. The latter right has only been explicitly defended to my knowledge by two commentators, and in the

638


Part Four / ReproKenetics

context of human cloning, only by Hans Jonas; it supports a more promising, even if in my view ul­timately unsuccessful, argument that human clon­ing would violate an important moral or human right. . . .

We need not pursue what the basis or argument in support of a moral or human right to a unique identity might be-such a right is not found among typical accounts and enumerations of moral or hu­man rights-because even if we grant that there is such a right, sharing a genome with another in­dividual as a result of human cloning would not violate it. The idea of the uniqueness, or unique identity, of each person historically predates the de­velopment of modern genetics and the knowledge that except in the case of homozygous twins each individual has a unique genome. A unique genome thus could not be the ground of this long-standing belief in the unique human identity of each person.

I turn now to whether human cloning would violate what Hans Jonas called a right to ignorance, or what Joel Feinberg called a right to an open future (Feinberg 1980). Jonas argued that human cloning in which there is a substantial time gap be­tween the beginning of the lives of the earlier and later twin is fundamentally different from the si­multaneous beginning of the lives of homozygous twins that occur in nature. Although contempora­neous twins begin their lives with the same genetic inheritance, they also begin their lives or biogra­phies at the same time, and so in ignorance of what the other who shares the same genome will by his or her choices make of his or her life. To whatever extent one's genome determines one's future, each begins ignorant of what that determination will be and so remains as free to choose a future, to con­struct a particular future from among open alterna­tives, as are individuals who do not have a twin. Ignorance of the effect of one's genome on one's future is necessary for the spontaneous, free, and authentic construction of a life and self.

A later twin created by human cloning, Jonas ar­gues, knows, or at least believes he or she knows, too much about him- or herself. For there is already in the world another person, one's earlier twin, who from the same genetic starting point has made the life choices that are still in the later twin's future. It will seem that one's life has already been lived and played out by another, that one's fate is already



determined, and so the later twin will lose the spon­taneity of authentically creating and becoming his or her own self. One will lose the sense of human possibility in freely creating one's own future. It is tyrannical, Jonas claims, for the earlier twin to try to determine another's fate in this way. And even if it is a mistake to believe the crude genetic determin­ism according to which one's genes determine one's fate, what is important for one's experience of freedom and ability to create a life for oneself is whether one thinks one's future is open and unde­termined, and so still to be determined by one's own choices. . . .

In a different context, and without applying it to human cloning, Joel Feinberg has argued for a child's right to an open future. This requires that others raising a child not so close off the future pos­sibilities that the child would otherwise have as to eliminate a reasonable range of opportunities for the child to choose autonomously and construct his or her own life. One way this right to an open future would be violated is to deny even a basic education to a child, and another way might be to create it as a later twin so that it will believe its future has al­ready b{en set for it by the choices made and the life lived by its earlier twin.

A central difficulty in evaluating the implica­tions for human cloning of a right either to igno­rance or to an open future, is whether the right is violated merely because the later twin may be likely to believe that its future is already determined, even if that belief is clearly false and supported only by the crudest genetic determinism. I believe that if the twin's future in reality remains open and his to freely choose, then someone's acting in a way that unintentionally leads him to believe that his future is closed and determined has not violated his right to ignorance or to an open future. Likewise, sup­pose I drive down the twin's street in my new car that is just like his knowing that when he sees me he is likely to believe that I have stolen his car, and therefore to abandon his driving plans for the day. I have not violated his property right to his car even though he may feel the same loss of opportunity to drive that day as if I had in fact stolen his car. In each case he is mistaken that his open future or car has been taken from him, and so no right of his to them has been violated. If we know that the twin will believe that his open future has been taken


Section 5 / Human Cloning and Stem Cell Research

639

from him as a result of being cloned, even though in reality it has not, then we know that cloning will cause him psychological distress, but not that it will violate his right. Thus, I believe Jonas' right to igno­rance, and our employment of Feinberg's analogous right of a child to an open future, turns out not to be violated by human cloning, though they do point to psychological harms that a later twin may be likely to experience and that I will take up below.

The upshot of our consideration of a moral or human right either to a unique identity or to igno­rance and an open future, is that neither would be violated by human cloning. Perhaps there are other possible rights that would make good the charge that human cloning is a violation of moral or hu­man rights, but I am unsure what they might be. I turn now to consideration of the harms that human cloning might produce.



B.

What Individual or Social Harms Might Human Cloning Produce?

There are many possible individual or social harms that have been posited by one or another commen­tator and I shall only try to cover the more plausible and significant of them.

Largely Individual Harms

1. Human cloning would produce psychological distress and harm in the later twin. This is per­haps the most serious individual harm that oppo­nents of human cloning foresee, and we have just seen that even if human cloning is no violation of rights, it may nevertheless cause psychological dis­tress or harm. No doubt knowing the path in life taken by one's earlier twin may in many cases have several bad psychological effects. The later twin may feel, even if mistakenly, that his or her fate has already been substantially laid out, and so have dif­ficulty freely and spontaneously taking responsibil­ity for and making his or her own fate and life. The later twin's experience or sense of autonomy and freedom may be substantially diminished, even if in actual fact they are diminished much less than it seems to him or her. Together with this might be a diminished sense of one's own uniqueness and in­dividuality, even if once again these are in fact di­minished little or not at all by having an earlier twin with the same genome. If the later twin is the clone



of a particularly exemplary individual, perhaps with some special capabilities and accomplish­ments, he or she may experience excessive pressure to reach the very high standards of ability and ac­complishment of the earlier twin. All of these psy­chological effects may take a heavy toll on the later twin and be serious burdens under which he or she would live. One commentator has also cited special psychological harms to the first, or first few, human clones from the great publicity that would attend their creation. While public interest in the first clones would no doubt be enormous, medical confi­dentiality should protect their identity. Even if their identity became public knowledge, this would be a temporary effect only on the first few clones and the experience of Louise Brown, the first child con­ceived by IVF, suggests this publicity could be man­aged to limit its harmful effects.

While psychological harms of these kinds from human cloning are certainly possible, and perhaps even likely, they do remain at this point only specu­lative since we have no experience with human cloning and the creation of earlier and later twins. With naturally occurring identical twins, while they sometime~ struggle to achieve their own identity, a struggle s~d by many people without a twin, there is typically a very strong emotional bond be­

tween the twins and such twins are, if anything, generally psychologically stronger and better ad­justed than non-twins (Robertson 1994b). Scenarios are even possible in which being a later twin con­fers a psychological benefit on the twin; for ex­ample, having been deliberately cloned with the specific genes the later twin has might make the later twin feel especially wanted for the kind of per­son he or she is. Nevertheless, if experience with human cloning confirmed that serious and un­avoidable psychological harms typically occurred

to the later twin, that would be a serious moral rea­son to avoid the practice.

In the discussion above of potential psychologi­cal harms to a later twin, I have been assuming that one later twin is cloned from an already existing adult individual. Cloning by means of embryo split­ting, as carried out and reported by Hall and col­leagues at George Washington University in 1993, has limits on the number of genetically identical twins that can be cloned. Nuclear transfer, however, has no limits to the number of genetically identical


640

Part Four / Reprogrnetics

individuals who might be cloned. Intuitively, many of the psychological burdens and harms noted above seem more likely and serious for a clone who is only one of many identical later twins from one original source, so that the clone might run into an­other identical twin around every street comer. This prospect could be a good reason to place sharp lim­its on the number of twins that could be cloned from anyone source. . . .

2. Human cloning procedures would carry unac­ceptable risks to the clone. One version of this objection to human cloning concerns the research necessary to perfect the procedure, the other ver­sion concerns the later risks from its use. Wilmut's group had 276 failures before their success with Dolly, indicating that the procedure is far from per­fected even with sheep. Further research on the pro­cedure with animals is clearly necessary before it would be ethical to use the procedure on humans. But even assuming that cloning is safe

3

and effec­tiveness is established with animals, rese rch would need to be done to establish its safety d effective­ness for humans. Could this research be ethically done? There would be little or no risk to the donor of the cell nucleus to be transferred, and his or her informed consent could and must always be ob­tained. There might be greater risks for the woman to whom a cloned embryo is transferred, but these should be comparable to those associated with IVF procedures and the woman's informed consent too could and must be obtained.

What of the risks to the cloned embryo itself? Judging by the experience of Wilmut's group in their work on cloning a sheep, the principal risk to the embryos cloned was their failure successfully to implant, grow, and develop. Comparable risks to cloned human embryos would apparently be their death or destruction long before most people or the law consider it to be a person with moral or legal protections of its life. Moreover, artificial reproduc­tive technologies now in use, such as IVF, have a known risk that some embryos will be destroyed or will not successfully implant and will die. It is pre­mature to make a confident assessment of what the risks to human subjects would be of establishing the safety and effectiveness. of human cloning proce­dures, but there are no unavoidable risks apparent at this time that would make the necessary research clearly ethically impermissible.



Could human cloning procedures meet ethical standards of safety and efficacy? Risks to an ovum donor (if any), a nucleus donor, and a woman who receives the embryo for implantation would likely be ethically acceptable with the informed consent of the involved parties. But what of the risks to the human clone if the procedure in some way goes wrong, or unanticipated harms come to the clone; for example, Harold Varmus, director of the Na­tional Institutes of Health, has raised the concern that a cell many years old from which a person is cloned could have accumulated genetic mutations during its years in another adult that could give the resulting clone a predisposition to cancer or other diseases of aging. Moreover, it is impossible to ob­tain the informed consent of the clone to his or her own creation but, of course no one else is able to give informed consent for their creation either.

I believe it is too soon to say whether unavoid­able risks to the clone would make human clon­ing unethical. At a minimum, further research on cloning animals, as well as research to better define the potential risks to humans, is needed. For the reasons given above, we should not set aside risks to the clone on the grounds that the clone would not be harmed by them since its only alternative is not to exist at all; I have suggested that is a bad argu­ment. But we should not insist on a standard that requires risks to be lower than those we accept in sexual reproduction, or in other forms of assisted reproduction. It is not possible now to know when, if ever, human cloning will satisfy an appropriate standard limiting risks to the ~lone.



Largely Social Harms

3. Human cloning would lessen the worth of in­dividuals and diminish respect for human life. Unelaborated claims to this effect in the media were common after the announcement of the cloning of Dolly. Ruth Macklin has explored and criticized the claim that human cloning would diminish the value we place on, and our respect for, human life because it would lead to persons being viewed as replace­able (Macklin 1994). As I argued above concerning a right to a unique identity, only on a confused and indefensible notion of human identity is a person's identity determined solely by their genes. Instead, an individual's identity is determined by the inter­action of his or her genes over time with his or her environment, including the choices the individual




Section 5 / Human Clonin:;( and Stem Cell Research

641

makes and the important"relations he or she forms with other persons. This means in turn that no indi­vidual could be fully replaced by a later clone pos­sessing the same genes. Ordinary people recognize this clearly. For example, parents of a 12-year-old child dying of a fatal disease would consider it in­sensitive and ludicrous if someone told them they should not grieve for their coming loss because it is possible to replace him by cloning him; it is their child who is dying whom they love and value, and that child and his importance to them could never be replaced' by a cloned later twin. Even if they would also come to love and value a later twin as much as their child who is dying, that would be to love and value that different child who could never replace the child they lost. Ordinary people are typ­ically quite clear about the importance of the re­lations they have to distinct, historically situated individuals with whom over time they have shared

experiences and their lives, and whose loss to

would therefore be irreplaceable.

A different version of this worry is that human cloning would result in persons' worth or value seeming diminished because we would now see hu­mans as able to be manufactured or "handmade." This demystification of the creation of human life would reduce our appreciation and awe of it and of its natural creation. It would be a mistake, however, to conclude that a human being created by human cloning is of less value or is less worthy of respect than one created by sexual reproduction. It is the nature of a being, not how it is created, that is the source of its value and makes it worthy of respect. Moreover, for many people gaining a scientific understanding of the extraordinary complexity of human reproduction and development increases, instead of decreases, their awe of the process and its product.

A more subtle route by which the value we place on each individual human life might be diminished could come from the use of human cloning with the aim of creating a child with a particular genome, either the genome of another individual especially meaningful to those doing the cloning or an indi­vidual with exceptional talents, abilities, and ac­complishments. The child might then be valued only for its genome, or at least for its genome's ex­pected phenotypic expression, and no longer be rec­ognized as having the intrinsic equal moral value of all persons, simply as persons" For the moral value

and respect.due all persons to come to be seen as resting only on the instrumental value of individu­als, or of individuals' particular qualities, to others would be to fundamentally change the moral status accorded to persons. Everyone would lose their moral standing as full and equal members of the moral community, replaced by the different instru­mental value each of us has to others.

Such a change in the equal moral value and

worth accorded to persons should be avoided at all costs, but it is far from clear that such a change would take place from permitting human cloning. Parents, for example, are quite capable of distin­guishing their children's intrinsic value, just as indi­vidual persons, from their instrumental value based on their particular qualities or properties. The equal moral value and respect due all persons just as per­sons is not incompatible with the different in­strumental value of people's particular qualities or properties; Einstein and an untalented physics graduate student have vastly different value as sci­entists, but share and are entitled to equal moral value and respect as persons. It would be a mistake and a confusion to conflate the two kinds of value and respect. Making a large number of clones from one original person might be more likely to foster this mistake and confusion in the public, and if so that would be a further reason to limit the number of clones that could be made from one individual.

4. Human cloning would divert resources from other more important social and medical needs. As we saw in considering the reasons for, and potential benefits from, human cloning, in only a limited number of uses would it uniquely meet im­portant human needs. There is little doubt that in the United States, and certainly elsewhere, there are more pressing unmet human needs, both med­ical or health needs and other social or individual needs. This is a reason for not using public funds to support human cloning, at least if the funds ac­tually are redirected to more important ends and needs. It is not a reason, however, either to prohibit other private individuals or institutions from using their own resources for research on human cloning or for human cloning itself, or to prohibit human cloning or research on human cloning.

The other important point about resource use is that it is not now clear how expensive hu­man cloning would ultimately be, for example, in


642


Part Four I Reprogenetics

comparison with other means of relieving infertility. The procedure itself is not scientifically or techno­logically extremely complex and might prove not to require a significant commitment of resources.

5. Human cloning might be used by commercial interests for financial gain. Both opponents and proponents of human cloning agree that cloned em­bryos should not be able to be bought and sold. In a science fiction frame of mind, one can imagine com­mercial interests offering genetically certified and guaranteed embryos for sale, perhaps offering a catalogue of different embryos cloned from individ­uals with a--variety of talents, capacities, and other desirable properties. This would be a fundamental

violation of the equal moral respect and dignity owed to all persons, treating them instead as objects to be differentially valued, bought, and sold in the marketplace. Even if embryos are not yet persons at the time they would be purchased or sold, they would be being valued, bought, and sold for the persons they will become. The moral consensus against any commercial market in embryos, cloned or otherwise, should be enforced by law whatever public policy ultimately is on human cloning. It has been argued that the law may already forbid mar­kets in embryos on grounds that they would violate the thirteenth amendment prohibiting slavery and involuntary servitude (Turner 1981).



6. Human cloning might be used by governments or other groups for immoral and exploitative pur­poses. In Brave New World, Aldous Huxley imag­ined cloning individuals who have been engineered with limited abilities and conditioned to do, and to be happy doing, the menial work that society needed done. Selection and control in the creation of people was exercised not in the interests of the persons created, but in the interests of the society and at the expense of the persons created. Any use of human cloning for such purposes would exploit the clones solely as means for the benefit of others, and would violate the equal moral respect and dig­nity they are owed as full moral persons. If human cloning is permitted to go forward, it should be with regulations that would clearly prohibit such immoral exploitation.

Fiction contains even more disturbing and bi­zarre uses of human cloning, such as Mengele's cre­



ation of many clones of Hitler in Ira Levin's The Boys from Brazil, Woody Allen's science fiction cine­matic spoof Sleeper in which a dictator's only re­maining part, his nose, must be destroyed to keep it from being cloned, and the contemporary science fiction film Blade Runner. Nightmare scenarios like Huxley's or Levin's may be quite improbable, but their impact should not be underestimated on pub­lic concern with technologies like human cloning. Regulation of human cloning must assure the pub­lic that even such farfetched abuses will not take place.

7. Human cloning used on a very widespread ba­sis would have a disastrous effect on the human gene pool by reducing genetic diversity and our capacity to adapt to new conditions. This is not a realistic concern since human cloning would not be used on a wide enough scale, substantially replac­ing sexual reproduction, to have the feared effect on the gene pool. The vast majority of humans seem quite satisfied with sexual means of reproduction; if anything, from the standpoint of worldwide popu­lation, we could do with a bit less enthusiasm for it. Programs of eugenicists like Herman Mueller ear­lier in the century to impregnate thousands of women with the sperm of exceptional men, as well as the more recent establishment of sperm banks of Nobel laureates, have met with little or no public in­terest or success. People prefer sexual means of re­production and they prefer to keep their own biological ties to their offspring.

CONCLUSION

Human cloning has until now received little serious and careful ethical attention because it was typically dismissed as science fiction, and it stirs deep, but difficult to articulate, uneasiness and even revulsion in many people. Any ethical assessment of human cloning at this point must be tentative and pro­visional. Fortunately, the science and technology of human cloning are not yet in hand, and so a pub­lic and professional debate is possible without the need for a hasty, precipitate policy response.

The ethical pros and cons of human cloning, as I see them at this time, are sufficiently balanced and



Section 5 / Human Cloning and Stem Cell Research

643

uncertain that there is not an ethically decisive case either for or against permitting it or doing it. Access to human cloning can plausibly be brought within a moral right to reproductive freedom, but the cir­cumstances in which its use would have significant benefits appear at this time to be few and infre­quent. It is not a central component of a moral right to reproductive freedom and it serves no major or pressing individual or social needs. On the other hand, contrary to the pronouncements of many of its opponents, human cloning seems not to be a vio­lation of moral or human rights. But it does risk some significant individual or social harms, al­though most are based on common public confu­sions about genetic determinism, human identity, and the effects of human cloning. Because most moral reasons against doing human cloning remain speculative they seem insufficient to warrant at this time a complete legal prohibition of either research

on or later use of human cloning. Legitimate moral concerns about the use and effects of human cloning, however, underline the need for careful public oversight of research on its development, to­gether with a wider public debate and review be­fore cloning is used on human beings.

REFERENCES

Dworkin, R. (1978). Taking Rights Seriously. London:

Duckworth.

Feinberg, J. (1980). "The Child's Right to an Open Future," in Whose Child? Children's Rights, Parental Authority, and State Power, ed. W. Aiken and H. LaFollette. Totowa, NJ: Rowman and Littlefield.

Macklin, R. (1994). "Splitting Embryos on the Slippery Slope: Ethics and Public Policy." Kennedy Institute of Ethics Journal 4: 209-226.





Share with your friends:




The database is protected by copyright ©essaydocs.org 2020
send message

    Main page