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This set of comments from January 2000 is part of SRT's archive on cloning and stem cells. See our many subsequent articles ...
The report of the Human Embryology Authority and Human Genetics Advisory Commission Report on Cloning Issues in Reproduction, Science and Medicine is welcomed in its clear conclusion to ban the reproductive cloning of human beings, in line with the Church of Scotland General Assembly in May 1997 and many national and international bodies throughout the world.
What is far more controversial are the non-reproductive applications. There could be many welcome uses of cloning in medical research, but some potential uses of the technology discussed in the report raise serious ethically problems - especially its intention to open the door for the use of cloning to produce embryos to produce human cells as replacements for damaged tissue in certain serious medical conditions. While the Kirk has no formal view as yet, for many inside and outside the churches this would represent an unacceptable dispensing with something that has the potential to become a full human being. Moreover if we agree that it is wrong to create cloned people, how can it be ethical to create a cloned embryo, knowing full well it must be destroyed to avoid ever growing to become a human being? There seems to be a case of ethical double-think.
What the UK report envisages is an entirely new way using the human embryo, as the source material for spare tissues, a use never considered by the existing Human Fertilisation and Embryology Act or the Warnock Report which preceded it. The import of these changes inevitably opens up afresh the status of the human embryo and what we may do with it. The consultation made an error in taking for granted the status quo of the status of the embryo assumed in the HFE Act - when the new developments give a completely different context for the question from what was originally envisaged, and also given how controversial this whole area has remained, not only in the UK, but in attempts to legislate at a European level.
The Government should now therefore begin a much wider public discussion and debate in the UK before it proceeding to make changes in the legislation and regulations along the lines suggested in this report. In January the HFEA/HGAC said to those it invited to comment that the intention of this consultation was that it should be followed by a wider public discussion. It would be ironic if this were now not done, given new initiative begun in March by the then Minister for Science, to find better ways of enabling the public to engage in debate on far reaching developments in the biosciences like cloning. The HFEA/HGAC report reflects a mere 200 responses and a limited list of 1000 people to whom it was sent. While very valuable as far as it goes, this is not enough on its own for such far reaching issues. We now need a wider debate on whether it is acceptable to use create and use cloned embryos for replacement tissues instead of reproductive purposes.
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Research in this area is proceeding at a rapid rate. Even during the consultation period, developments in stem cell and cloning technology greatly changed the picture of the issues under debate. This is brought home further by the claim on December 15 that Korean scienctists have cloned a very early human embryo. At the moment we should be sceptical about this claim. It has not been published in a scientific journal and the Roslin Institute says that since the experiment only went as far as the 4 cell stage, it had not reached a stage where it was possible to say that it was a cloned embryo. Nonetheless, the fact that they have apparently tried raises exactly the ethical questions of whether we should allow the creation cloned embryos which we have posed above.
Update on this point, 18 Febraury 2004. The same Korean group has just announced credible scientific data that they have indeed produced the first genuine cloned human embryos and a stem cell line derived from one of these. See SRT comments ...
The Church of Scotland has called for an international ban on cloing human beings, on which there seems to be a substantial policital mandate. The situation on non-reproductive uses and research is much more complex, but it would be important at the very least to work towards establishing some internationally agreed guidelines what should and should not be allowed in such research. A number of bodies could address this question. The SRT Director was part of the UK delegation at a summit meeting of national bioethics committees in November in Japan. A committee was set up to see what collaborative work could be done. Here is an excellent subject which it could address. Dr Bruce was also recently invited as an observer to the meeting of the International Bioethics Committee of UNESCO. In 1997 this committee produced a Universal Declaration on the Human Genome, together with a statement against cloning human beings, recently endorsed by the UN General Assembly. Again, this should now address the question of cloning research. The Council of Europe's Bioethics Convention also has a Protocol on Human Cloning also could do the same.
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Two pieces of research announced in late 1998 suggest that, after many years of trying, scientists appear to have been able to "redirect" human embryos from their normal course of forming a complete person to becoming only certain types of body cells. Using special cells, known as stem cells, cells of, say bone marrow or different tissues, could be produce more or less indefinitely in the laboratory. In theory, this would open up immense potential for treatments of degenerative diseases where fresh cells could be injected into the patient, in that way that, for example, foetal brain cells have been used on some Parkinson's disease sufferers (currently with uncertain results). One problem with this is rejection by the body, but if the embryo were cloned from cells taken from one's own body, would it be possible to overcome the rejection? No one knows whether any of this can be done successfully and safely.
At the moment it is speclation, but it is seen as important enough to need to know what are the ethical implications of such developments, were they to be possible. During 1998, the UK Human Embryology Authority and Human Genetics Advisory Commission ran a limited public consultation on medical uses of cloning technology, both reproductive and non-reproductive (albeit that these most recent research findings came too late for public comments to be submitted. The joint report "Cloning Issues in Reproduction, Science and Medicine" in December 1998 proposed that the UK regulations should now be amended to allow research into cloning embryos for cell replacement and another non-reproductive application involving mitochondrial disease. Elsewhere on this page, you can see our reaction to this proposal and the ethical dilemmas it poses.
Some have speculated whether it would be possible on the basis of these discoveries could be the ability to grow not an entire human being, but living organs from cells. Experts at the Roslin Institute and a number of other authorities see this as very unlikely to be posible in most cases. There would be many immense practical questions to answer, and it would be naive to assume that just because we think it, science will one day find a way to do it. This would also raise a number of serious problems ethically. It could be almost as controversial as human cloning. This was brought into focus by the announcement in October 1998 of work in which headless frog embryos were produced by reprogramming cloned cells. This was extrapolated, rather over-sensationally, by the researcher to the possibility of creating separate human organs surrounded by sacks of skin, grown as it were in a test tune from reprogrammed, cloned cells. This was also reported briefly during an excellent BBC TV Horizon documentary on cloning. Aside from the technical questions begged by this extrapolation, there is a serious question about whether it would be ethically acceptable to create organs as separate entities from human tissue. This needs careful thought, rather than knee jerk reactions, but at first sight this would probably be unacceptable to many people. And this may be only a thought experiment, albeit a dangerous one, since to be of any use, one would have to have such an organ already existing at the same age and stage of development as the patient requiring one. Would this be possible without having a sustitute organ already growing from the time of one's birth?
Even this could be overcome, it could be argued that this was only justified in extremis and only for the benfit of the individual involved, or, with appropriate informed consent, a close relative. And underneath this partial cloning, lies the ethical problem known as "gradualism". By a progression of small steps you could eventually provide all the conditions needed to clone the entire human being, even though that had never been the stated intention of the research. This raises a much deeper question about how the direction of research is determined and controlled.
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The cloning report from the HFEA/HGAC argued ethically against cloning human beings, but it very surprisingly avoided serious ethical reflection on its main proposal - to allow research into cloning embryos as a source of transplant cells. It reviewed the scientific possibilities and recommended allowing research into them, without really addressing whether the end product of the research would be ethical if it were successful. There's a danger that having said "no" to cloning human beings, we automatically say an uncritical "yes" to all non-reproductive cloning, on the basis that so long as doesn't produce cloned babies, it's OK. Notwithstanding all the medical prospects, I suspect for a lot of people cloning embryos for spare parts would not be OK, and not just a few "fundamentalists" either.
What the research would hope to achieve is an entirely new use of the human embryo - one never considered by the existing Human Fertilisation and Embryology Act or the Warnock Report which preceded it. The new report declared that its purpose was not to "re-open old debates". This seems a bit ostrich-like. It cannot avoid re-opening the debate about the embryo and its status. What is envisaged would be a profound ethical change in what is considered right about the embryo - deliberately to create something which has the capacity to become a human being, knowing full well we will then redirect it to become, in effect, spare parts of human beings. Instead of being an end in itself, to be accorded "special status" in Warnock's phrase, this use would make an embryo just a means to an end. The report merely says that this would be a small change to a law that already allows doing some sorts of research. That is not enough. We must already consider the aim of the research, if it worked, and that would be a very big step. These are implications about embryo use which no one had in view in 1990. We have to go right back and ask whether as a society we are still happy with the status of the embryo, in this new light.
There are other issues. Can we ethically create embryos by cloning - knowing that on ethical grounds we could never allow them to develop to full term? Could we achieve the same result better in other ways - like reprogramming cells without going through a complete embryo? We also seem to have swallowed whole the notion that cloning embryos to make stem cells is infallibly going to provide transplant cells for a whole array of serious diseases. How realistic are the prospects? No one knows if the science would work, how successful cloned cell transplants would be on patients, nor what risk there is of stem cells becoming cancerous, as the New Scientist recently pointed out. How far has speculative medical research become a new ethical absolute which justifies crossing all moral watersheds?
This is why it's important to begin a wider public debate about these developments, before committing ourselves too quickly to regulation. In March the minister for science began a process to improve consultation with the public about bioethical issues such as these. On December 15 he met a group of us to review where this process has got to. Here surely is a classic case for trying different ways of wider consultation. The HFEA/HGAC effort is valuable but only got 200 responses. On such a sensitive issue that is not yet enough to gauge the opinions of 50 million, at a time of increasing public concern about science going too fast. The Act has been in force for eight years. It would be no bad thing to take a few months to ask the public whether, now we can see what happens in practice, we are still happy with allowing embryo research for reproductive purposes or for non-reproductive purposes. Responsible science is not carte blanche for scientists, but science which is accountable to the public, for whose benefit it is supposedly done. Here is a case for checking the status of the account. Beware gradualism.
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This page has been produced by the Society Religion and Technology Project of the Church of Scotland. For more about our work on other issues, see our Other SRT Project pages, our SRT Publications List, or our On-line SRT Newsletter.
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This page was created on 14 January 2000 and revised 19 February 2004
