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Society, Religion and Technology Project Church of Scotland Looking at the ethics of technology for a New Millennium

The First Cloned Human Embryos

In February 2004, seven years after Dolly the sheep was cloned at the Roslin Institute outside Edinburgh, I was present at a scientific meeting in Seattle where Korean scientists announced the first successful creation of cloned human embryos for research. Excitement at the meeting was palpable, because after several false claims, the Dolly technique had worked on humans, at least up to the early embryo stage called the blastocyst. In August a Newcastle research group was granted a license by the Human Fertilisation and Embryology Authority to create and use clone embryos in medical research, and the Roslin Institute has also applied. Like Dolly, this is raising much debate.

Back in 1997 Dolly began a biological revolution. The idea that people could now take ordinary body cells of a mammal and turn them backwards into an embryo had been thought impossible. For many, it raised the spectre of whether this could be done in humans to make cloned people. So a rather friendly Finn Dorset sheep became an overnight icon for both the threat and the promise of the biosciences. The Church of Scotland SRT Project knew the Roslin researchers and was immediately in the forefront of the ethical debate and prominent in the media. We appeared on BBC's Newsnight programme next day, and this week in December 2004, we're back on the programme to discuss the latest cloning dilemmas. So what are the issues?

Embryo Stem Cell Research

The Korean scientists said that their purpose was not to create cloned babies. Human reproductive cloning continues to be widely condemned, and would be illegal in Korea, the UK and many other countries. The justification for their research is linked to a wider issue about embryonic stem cells. These are special general cells which are formed in the early embryo after about 4 days, and which then gradually 'differentiate' over a few weeks into all the different types of cell of the human body. In 1998, American scientists isolated these stem cells from a human embryo for the first time, and showed that they could keep them alive in the laboratory for prolonged periods. They were also able to stimulate the stem cells to start the process of differentiation into different cell types.

The research community hopes that stable lines of embryonic stem cells can be created and used to make specific replacement cells to treat a wide range of incurable degenerative diseases, such as nerve cells for Parkinson's, pancreas cells for diabetes, and so on. Although many years away, this is called stem cell therapy, and should not to be confused with cloning. It is also ethically highly ersial because it involves research on embryos.

To date, most embryonic stem cells have come from so-called surplus embryos from IVF treatments. These are frozen in case couples wish to have further attempts to have children. In practice many are no longer required. Since they are now destined to be destroyed, many see an ethical case for using these for useful research. Tens of thousands exist, so why go to all the trouble of making cloned embryos? Using cells from IVF embryos, however, risks the patient's body rejecting the cells as 'foreign' because they are not of the same genetic type. Both the Korean and Newcastle research groups want to get round this by so-called 'therapeutic cloning'. They would take some skin or blood cells from the patient, and use the Dolly procedure to turn these into a cloned embryo. Instead of implanting it, embryo stem cells would be extracted from it. These would used to make replacement cells that are genetically matched to the patient.

Therapeutic cloning looks impractical

Some scientists see this as impracticable, however. For example, Roslin researchers and the Geron

Corporation in California which has funded much of their stem cell research, have said publicly that cloned embryos are very unlikely to be used routinely in therapies. This is because of the cost and the sheer impracticality of obtaining enough donated human eggs to provide genetically matched replacement cell treatments of many hundreds of thousands of individual patients. This would require millions of eggs. The donation of intimate tissues by an invasive and sometimes painful procedure on such a scale is without precedent. It could also raise ethical concerns about financial and other pressures that might be put on women to donate. As things stand, therapeutic cloning does not look set to be the medical breakthrough for humanity which its promoters (including the Government) have often claimed, but only for a few who are fortunate or rich enough to have access to it. Some suggest that human eggs could one day be made from embryo stem cells, based on some very preliminary animal experiments, but one would not justify today's cloned embryo research on such a speculative solution. No one knows if this would be feasible, therapeutically practicable or safe in humans.

Roslin's proposal is somewhat different. It would use cloning technology to make cells which exhibit motor neurone disease in order to study the causes of this disease. It is extremely difficult to obtain such cells from a patient. The idea is to make a cloned embryo from, say, a blood sample from the patient, extract the stem cells from this embryo and, from these, derive a continuous supply of the diseased cells. Other cloned embryo research ideas include attempts to find chemicals within embryo cells that might be used to change one adult cell type into another without in future needing to use embryos.

Ethical and Legal Issues

Cloned embryo research for studying serious diseases was made formally legal by the UK Parliament in 2001 but it remains ethically contentious. Many European countries which would allow research with surplus IVF embryos disallow cloned embryos. The European Parliament has voted against it on several occasions. The European Commission's ethical advisory group consider cloned embryo research premature. In the UK, doubts have been expressed about the ethics, the need and the advisability of this research at this time. We evaluate some of these issues.

For those for whom every embryo is already a human person, such research is ethically abhorrent, for well established reasons. Others object to the idea of creating of embryos solely for the purpose of destroying them to extract stem cells. This is seen as too instrumental a way of using human embryos, treating them as little more than a research tool or a resource for spare parts. It loses any sense that the human embryo retains a special status. Many who might accept using stem cells from more readily available spare IVF embryos see the case for cloned embryo research for therapy as dubious. There are also concerns that it could become used as a route to the germline genetic engineering of humans.

In 2002 a House of Lords select committee was asked to assess the wide ranging terms which the UK Parliament had allowed for stem cell research. In the case of cloned embryos, it gave a stricter interpretation than the law, that they "should not be created for research purposes unless there is a demonstrable and exceptional need which cannot be met by the use of surplus embryos." The EC ethical advisors' logic is similar, namely that while much could be done with IVF embryos and adult cells, we should not resort to creating cloned human embryos. Speculative research for therapeutic cloning would thus not be justified. One would have to ask if it was an exceptional case which would achieve a specific and major medical breakthrough that nothing else could hope to achieve. On the basis of the published information, the rather general Newcastle proposal did not appear to be so. In allowing the licence, the HFEA apparently fell back on the wide powers of the Act instead of the Lords' interpretation, which caused some surprise.

Roslin's motor neuron disease research might be more valid exceptional case, since disease cells from cloned embryos would open up a way of examining the disease which would not be available otherwise. This needs careful evaluation. On the other hand some consider there is a moral obligation to pursue this research, justified by its aims.

Adult Stem Cells

Stem cells are also found, less commonly, in some adult tissues and in placental cord blood. Some have already been used in therapy to treat blood and bone marrow diseases. They have the advantage that they would be of the same genetic type as the patient, but the disadvantage that they are generally fewer in number. For whom the use of any embryos to produce stem cells is wrong these are the only permissible sources of stem cells. Normally stem cells in adult tissues are present to regenerate only cells relevant to that particular part of the body. Recent research suggests that they may sometimes be induced to make a wider range of cells types. Some opponents of embryo research have put great stress on this and have claimed that it is not necessary to do embryo research because of the "facts emerging" about adult stem cells.

With such new science, it is important for Christians not to make exaggerated claims for the potential of any stem cell method, embryonic or adult, or to raise undue expectations. Embryo stem cells also remain to be proven, but it would be equally premature to claim that the full range of desired cell types for all degenerative diseases could be produced from adult or cord blood cells in sufficient numbers and quality. By definition embryonic stem cells must be capable of producing all cell types of the human body, whereas adult stem cells are not designed to do this. If it turned out that some cell types could only be produced using embryo stem cells, restricting research to adult or cord blood would mean that these diseases would presumably remain untreatable. Those opposed to the use of embryos would accept this limitation, maintaining that it is not acceptable to destroy some human lives in order to save other ones.

Conclusions

On present evidence, many in the research community consider that that important data are expected to come from researching adult and IVF embryo stem cells in parallel. Different diseases may require different routes to make replacement cells. Some researchers hope that adult cells may eventually be the preferred way to therapies, but that to achieve this would only be possible from doing research on embryos, possibly using cloned embryos. Within the UK law, this latter use and making disease state cells, as in Roslin's proposal, seem to be the only justifications at present for cloned embryo research, whereas therapeutic cloning looks dubious.

There is, however, a wider context of reproductive human cloning. Claims of cloned babies by the Raelian sect and others are seen as publicity and funding stunts. Meanwhile attempts to have a UN ban on reproductive cloning, for which there is near universal support, have reached stalemate because of a rival US-backed proposal for a wider ban on research cloning as well, which has little chance of enough consensus for the UN to proceed. In the absence of a UN ban on reproductive cloning, which the General Assembly called for in 1997, it seems unwise to allow research which would make it easier for maverick scientists to make and implant cloned embryos to create cloned babies, regardless of major risks and ethical objections, in some other country with little or no regulation. In a globalised research environment, the UK bears some moral responsibility to the wider international community for the outcomes of its internal actions.

This brief article has sought to bring readers up to date on recent developments and lay out some of the possible issues. An expert working group on human embryology and stem cells has recently been set up within the new Church and Society Council to examine these and other issues, and we hope to report progress to the 2005 Assembly.