Defending Life and Dignity
How, finally, to ban human cloning.
Feb 25, 2008, Vol. 13, No. 23 • By LEON R. KASS
In his State of the Union address President Bush spoke briefly on matters of life and science. He stated his intention to expand funding for new possibilities in medical research, to take full advantage of recent breakthroughs in stem cell research that provide pluripotent stem cells without destroying nascent human life. At the same time, he continued, "we must also ensure that all life is treated with the dignity that it deserves. And so I call on Congress to pass legislation that bans unethical practices such as the buying, selling, patenting, or cloning of human life."
As in his previous State of the Union addresses, the president's call for a ban on human cloning was greeted by considerable applause from both sides of the aisle. But Congress has so far failed to pass any anti-cloning legislation, and unless a new approach is adopted, it will almost certainly fail again.
Fortunately, new developments in stem cell research suggest a route to effective and sensible anti-cloning legislation, exactly at a time when novel success in cloning human embryos makes such legislation urgent. Until now, the cloning debate has been hopelessly entangled with the stem cell debate, where the friends and the enemies of embryonic stem cell research have managed to produce a legislative stalemate on cloning. The new scientific findings make it feasible to disentangle these matters and thus to forge a successful legislative strategy. To see how this can work, we need first to review the past attempts and the reasons they failed.
Three important values, differently weighted by the contending sides, were (and are) at issue in the debates about cloning and embryonic stem cells: scientific and medical progress, the sanctity of human life, and human dignity. We seek to cure disease and relieve suffering through vigorous research, conducted within acceptable moral boundaries. We seek to protect vulnerable human life against destruction and exploitation. We seek to defend human procreation against degrading reproductive practices--such as cloning or embryo fusing--that would deny children their due descent from one father and one mother and their right not to be "manufactured."
Embryonic stem cell research pits the first value against the second. Many upholders of the sanctity of human life regard embryo destruction as unethical even if medical good may come of it; many partisans of medical research, denying to nascent human life the same respect they give to life after birth, regard cures for disease as morally imperative even if moral harm may come of it. But the deepest challenge posed by cloning has to do not with saving life or avoiding death, but with human dignity, and the cloning issue is therefore only accidentally bound up with the battle about stem cell research. Yet both parties to the stem cell debate happily turned the cloning controversy into the life controversy.
The faction favoring embryonic stem cell research wanted to clone embryos for biomedical research, and touted cloning's potential to produce individualized (that is, rejection-proof) stem cells that might eventually be used for therapy. Its proposed anti-cloning legislation (the Kennedy-Feinstein-Hatch bill) would ban only "reproductive cloning" (cloning to produce children) while endorsing the creation of cloned human embryos for research. Such cloning-for-biomedical-research its proponents originally called "therapeutic cloning," hoping that the goal of "therapy" would get people to overcome their repugnance for "cloning." But when that strategy backfired, they disingenuously denied that the cloning of embryos for research is really cloning (they now call it, after the technique used to clone, SCNT, somatic cell nuclear transfer). They also denied that the product is a human embryo. These Orwellian tactics succeeded in confusing many legislators and the larger public.
The faction opposed to embryonic stem cell research wanted to safeguard nascent human life. Its proposed anti-cloning legislation (the Weldon-Stupak bill in the House, the Brownback-Landrieu bill in the Senate) would ban all human cloning--both for reproduction and for biomedical research--by banning the initial step, the creation of cloned human embryos. (This is the approach I have favored, largely because I thought it the most effective way to prevent the production of cloned children.) But most of the bill's pro-life supporters cared much more that embryos not be created and sacrificed than that children not be clones. Accordingly, they sought to exploit the public's known opposition to cloning babies to gain a beachhead against creating embryos for destructive research, which practice, although ineligible for federal funding, has never been illegal in the United States. Initially, this strategy worked: In the summer of 2001, the Weldon-Stupak bill passed the House by a large bipartisan majority. (It has been passed again several times since.) But momentum was lost in the Senate, owing to delays caused by 9/11 and strong lobbying by the pro-stem cell forces, after which time an impasse was reached, neither side being able to gain enough votes to close debate.
Concerned that the United States appeared to be incapable of erecting any moral barriers to the march toward a Brave New World, the President's Council on Bioethics (I was then its chairman) sought to show the president and Congress a way forward. Setting aside our deep divisions (on the moral status of human embryos and federal funding of stem cell research), we successfully sought common ground and recommendations on which we could all agree.
In our 2004 report, Reproduction and Responsibility, we unanimously proposed a series of legislative bans to defend human procreation against certain egregious practices--practices that would blur the boundary between the human and the animal, exploit the bodies of women, deny children the right to normal biological lineage, and commodify nascent human life. We called for legislative moratoria on: the placement of a human embryo in the body of an animal; the fertilization of a human egg by animal sperm (or vice versa); the transfer of a human embryo to a woman's uterus for purposes other than producing a child; the buying, selling, and patenting of human embryos or fetuses; and (on the cloning front) the conception of a child other than by the union of egg and sperm, both taken from adults--a provision that would ban cloning as well as other unwelcome forms of reproduction.
Though these recommendations received a favorable response from the White House and from some members of Congress (in both parties), our recommendations were attacked from both sides. The scientists and the assisted-reproduction professionals, as anticipated, wanted no restrictive federal legislation whatsoever. Surprisingly, we were hit also from the right: Several leading pro-lifers objected to the "children's provision" on the ground that it appeared to be a retreat from the Brownback total ban on cloning--a bill they nevertheless conceded had no chance of passage in the Senate. To my astonishment, some powerful lobbyists privately told me they objected also to the animal-transfer provision, on the grounds that one should not ban any method that might rescue "extra" IVF embryos that would otherwise die. (When pressed on this point, one interlocutor said that she would gladly give a child a pig for a mother if that were the only way to rescue an otherwise doomed embryo!)
Of the Council's sensible recommendations, only one has been enacted: a ban on initiating a pregnancy for any purpose other than to produce a child. (This bill, enacted as an anti-"fetal-farming" rather than a defense of women measure, also amended the existing statute to forbid the use of cells or tissues derived from a human embryo gestated in an animal.)
Fast forward to 2008. We are in the last year of the Bush presidency. Despite the president's numerous calls for action, we remain the only major nation in the high-tech world that cannot summon itself to ban human cloning, thanks to the standoff over the embryo issues. Fortunately, science has given Congress another chance to act. In the last six months, the scientific landscape has changed dramatically. On the one hand, the need for anti-cloning legislation is now greater than ever; on the other hand, there are reasons why a new approach can succeed.
Here is what's new. After the 2005 Korean reports of the cloning of human embryos turned out to be a fraud, many said that human cloning could not be achieved. Yet late in 2007 Oregon scientists succeeded for the first time in cloning primate embryos and growing them to the blastocyst (5-7-day) stage, and then deriving embryonic stem cells from them. More recently, other American scientists, using the Oregon technique, have reported the creation of cloned human embryos. The age of human cloning is here, and the first clones, alas, do not read "made in China."
On the stem cell front, the news is decidedly better. In the last two years, several laboratories have devised methods of obtaining pluripotent human stem cells (the functional equivalent of embryonic stem cells) without the need to destroy embryos. The most remarkable and most promising of these approaches was reported last November by both Japanese and American scientists (including Jamie Thompson, the discoverer of human embryonic stem cells). It is the formation of human (induced) pluripotent stem cells (iPSCs) by means of the reprogramming (also called de-differentiation) of somatic cells. Mature, specialized skin cells have been induced to revert to the pluripotent condition of their originating progenitor.
The therapeutic usefulness of this approach has also been newly demonstrated, by the successful treatment of sickle cell anemia in mice. Some iPSCs were derived from skin cells of an afflicted mouse; the sickle cell genetic defect in these iPSCs was corrected; the treated iPSCs were converted into blood-forming stem cells; and the now-normal blood-forming stem cells were transferred back into the afflicted mouse, curing the disease.
Scientists have hailed these results. All parties to the stem cell debates have noted that the embryonic-stem-cell war may soon be over, inasmuch as science has found a morally unproblematic way to obtain the desired pluri-potent cells. But few people have seen the implications of these developments for the cloning debate: Cloning for the purpose of biomedical research has lost its chief scientific raison d'être. Reprogramming of adult cells provides personalized, rejection-proof stem cells, of known genetic make-up, directly from adults, and more efficiently than would cloning. No need for human eggs, no need to create and destroy cloned embryos, no need for the inefficient process of deriving stem cell colonies from cloned blastocysts. Ian Wilmut himself, the British scientist who cloned Dolly the sheep, has abandoned his research on cloning human embryos to work with reprogrammed adult cells.
Another effect of this breakthrough is that the value for stem cell research of the spare embryos that have accumulated in IVF clinics has diminished considerably, defusing the issue of the ban on federal funding of such research. Why work to derive new stem cell lines from frozen embryos (of unknown quality and unknown genetic composition, and with limited therapeutic potential owing to transplant immunity issues) when one can work with iPSCs to perfect the reprogramming approach and avoid all these difficulties?
That's not the only way the new scientific landscape changes the policy and legislative pictures. We are now able to disentangle and independently advance all three of the goods we care about. First, it now makes great sense to beef up federal support for regenerative medicine, prominently featuring ramped-up work with iPSCs (and other non-embryo-destroying sources of pluripotent human stem cells). The timing is perfect. The promise is great. The potential medical payoff is enormous. And the force of example for future public policy is clear: If we exercise both our scientific wit and our moral judgment, we can make biomedical progress, within moral boundaries, in ways that all citizens can happily support.
Second, we should call for a legislative ban on all attempts to conceive a child save by the union of egg and sperm (both taken from adults). This would ban human cloning to produce children, but also other egregious forms of baby making that would deny children a link to two biological parents, one male and one female, both adults. This approach differs from both the Kennedy-Feinstein-Hatch and the Brownback-Landrieu bills, yet it could--and should--gain support from people previously on both sides. It pointedly neither endorses nor restricts creating cloned embryos for research: Cloning embryos for research is no longer of such interest to scientists; therefore, it is also no longer, as a practical matter, so important to the pro-life cause. Moreover, the prohibited deed, operationally, should be the very act of creating the conceptus (with intent to transfer it to a woman for pregnancy), not, as the Kennedy-Feinstein-Hatch bill would have it, the transfer of the proscribed conceptus to the woman, a ban that would have made it a federal offense not to destroy the newly created cloned human embryos. The ban proposed here thus deserves the support of all, regardless of their position on embryo research.
Third, the time is also ripe for a separate bill to defend nascent life, by setting up a reasonable boundary in the realm of embryo research. We should call for a (four- or five-year) moratorium on all de novo creation--by whatever means--of human embryos for use in research. This would block the creation of embryos for research not only by cloning (or SCNT), the goal of the Brownback-Landrieu anti-cloning bill, but also by IVF. Such a prohibition can now be defended on practical as well as moral grounds. Many human embryonic stem cell lines exist and are being used in research; 21 such lines, still viable, are available for federally funded research, while an even greater number are being studied using private funds. The new iPSC research, however, suggests that our society can medically afford, at least for the time being, to put aside further creation of new human life merely to serve as a natural resource and research tool. We can now prudently shift the burden of proof to those who say such exploitative and destructive practices are absolutely necessary to seek cures for disease, and we can require more than vague promises and strident claims as grounds for overturning the moratorium.
Morally and strategically speaking, this triple-pronged approach has much to recommend it. It is at once more principled, more ambitious, and more likely to succeed than its predecessors. By addressing separately the cloning and embryo-research issues, we can fight each battle exactly on the principle involved: defense of human procreation or defense of human life. By broadening the first ban to include more than cloning, we can erect a barrier against all practices that would deny children born with the aid of reproductive technologies the ties enjoyed by children conceived naturally. By extending the second ban to cover all creation of life solely as an experimental tool, we can protect more than merely embryos created by cloning. We would force everyone to vote on the clear principles involved: Legislators would have to vote yea or nay on both weird forms of baby-making and the creation of human life solely for research, without bamboozling anyone with terminological sleights of hand. And by combining these legislative restrictions with strong funding initiatives for regenerative medicine, we can show the American people and the world that it is possible to vigorously pursue the cures all dearly want without sacrificing the humanity we rightly cherish.
Politically as well, this triple-pronged approach is a winner for all sides. Because the latest science has made creating embryos for research unnecessary and inefficient by comparison with reprogramming, we have the chance to put stem cell science on a footing that all citizens can endorse. Indeed, in return for accepting a moratorium on a scientific approach that is not very useful (creation of new embryos for research), scientists could exact large sums in public support for an exciting area of science. With pro-lifers as their biggest allies, they could obtain the research dollars they need--and their supposed enemies would write the biggest checks. Meanwhile, at the very time the latest science has made affronts to human procreation--cloning, but not only cloning--more likely and even imminent, pro-lifers and scientists can come together to ban these practices in America, as they have already been banned in the rest of the civilized world, without implicating the research debate at all.
In an election year, Congress will be little moved to act quickly on these seemingly low priority items. Moreover, the partisans who have produced the current impasse may still prefer to keep things at stalemate, the better to rally their constituents against the other side. But we can ill afford to be complacent. The science is moving very rapidly. Before the end of the summer, we may well hear of the cloning of primate babies or perhaps even of a human child. Now is the time for action, before it is too late.
Leon R. Kass is Hertog Fellow at the American Enterprise Institute, Harding Professor of Social Thought at the University of Chicago, and former chairman of the President's Council on Bioethics. He speaks here only for himself.