|
SRT Home Page What is the SRT Project? Site Map & Subject Index What's New? Highlights Current Talking Point SRT Publications SRT Newsletter SRT Information Sheets SRT Topical Papers Press Room Contact SRT Send a comment Guest Book SRT Trust & Associates Links European Christian Environmental Network Eco-Congregation |
|
A Submission to the Chief Medical Officer's Expert Group on Cloning (CEGC), Department of Health
Statement of Context
The following is a joint submission from the Church of Scotland "Society, Religion and Technology Project" and the Board of Social Responsibility. The views expressed in this submission should not, however, necessarily be taken to represent the formal view of the Church of Scotland, as this can only be expressed by its annual General Assembly.
Dr Donald M. Bruce, SRT Project Director
21 October 1999
We welcome the setting up of this new committee and the opportunity it ought to provide for further discussion of these complex issues. It is not clear to us what is the nature and purpose of the committee, however. The impression we have is that the primary focus is to the scientific aspects rather than the ethical issues. It would be of great concern to the Church of Scotland and, we believe, many other churches, if the ethical questions were not a primary focus of this committee. It would also be of concern if its work were done as a closed discussion and did not attempt to engage wider public debate.
There are several important ethical concerns which were not adequately addressed in the HGAC/HFEA report,1 either in the original questions posed to respondents or in their analysis. Indeed, it was of great surprise to see the care with which their report examined the ethics of cloning human beings and the casualness with which the ethics of non-reproductive cloning were considered. In essence, the argument merely pointed to the potential benefits of cell replacement therapy using stem cells derived from cloned embryos, and observed that a large parliamentary majority voted in favour of embryo research leading to the 1990 HFE Act. No ethical assessment was made of the novel aspects of these applications with regard to the status and use of embryos. There was indeed a substantial hint in paragraph 9.1 that the committee had adopted a prior policy decision not to enter into any discussion which might relate to the status of the embryo. The question was merely asked whether there were new issues, and when (as it was claimed) a majority answered negatively, no further account was taken of the matter. Bearing in mind the radical nature of the proposed research and the new developments which had made it scientifically conceivable, and considering the current extreme sensitivity of public concerns about developments in biotechnology in general, the neglect to pursue these questions further was very ill-advised.
One of us drew this to the attention of the Ministers for Public Health and for Science. Lord Sainsbury's reply failed to respond adequately to the concerns, in that the import was to reiterate that a public consultation had been held and that "a majority of respondents thought that using nuclear replacement technology raised no new ethical issues". Firstly, the scope of the consultation was very limited, with only 122 responses (not 194 as stated in the Lord Sainsbury's letter) made to this question. Secondly the conclusion is a dubious interpretation of the statistics of the HGAC/HFEA report. While 44% thought that no new ethical issues were raised and 30% took the opposite view, what Lord Sainsbury's letter declined to add was that a further 16% considered that the 14 day limit for embryo research was wrong in principle. If it may fairly be assumed that these were people who objected on principle to embryo research, we contend that this it casts serious doubts on validity of the both "majority" to which he refers, and, in particular, of the interpretation that nuclear replacement technology was therefore approved of by the majority of the respondents. Moreover, according to the appendix to the HGAC/HFEA consultation it seems that most of the ethicists who gave evidence thought that therapeutic cloning raised new ethical issues, but most of the clinicians did not. This is an interesting reflection of what constitutes an issue for groups of people with very different aims. It is perhaps symptomatic of the orientation of the final report that it sides with the clinicians on an issue of ethics, against the ethicists.
This latter and more important question - whether nuclear replacement technology is ethically acceptable or not - was not asked in the consultation. Yet, in its recommendations to Government, the HGAC/HFEA report interpreted the above results to mean that a majority of people considered that it was ethically acceptable. So clear cut a conclusion is difficult to justify from the data. If the 30% who thought that new ethical issues were raised and the 16% who thought that the 14 day limit was wrong in principle were both assumed to be opposed to nuclear replacement technology, and the 44% who thought no new issues were raised and the 6% who wanted the law explicitly changed to allow nuclear replacement therapy then one obtains 46% opposed and 50% in favour. It is not clear whether the remaining 4% (who were concerned about breaching the 14 day limit) would be opposed or not. The ambiguous picture that emerges hardly justifies the confidence stated in Lord Sainsbury's letter that a majority view of the public consultation was to proceed with research in this area. All that may reasonably said is that the date were on a limited sample on which it was not possible to state a statistically significant answer, but that opinion was deeply divided without a clear majority either way.
We also note that the Wellcome Trust's contemporary survey, referred to by the HGAC/HFEA consultation report, revealed that while members of the public were relatively clear over reproductive cloning, they were very confused in their understanding of non-reproductive cloning, and Wellcome wisely did not draw a strong conclusion on this issue. In our own discussions with lay people in the churches, it appears that very few understand the technology sufficiently to give a view one way or the other. We therefore urge a wider programme of public debate over this issue, similar to that held by HFEA over foetal ovarian tissue, in parallel with the exercise of your committee. This would seek to establish a greater understanding of what the public actually think than the confused picture that presently exists. There is a danger that an inadequate discussion, based on a limited public consultation with only 122 responses will be seen to have settled this issue. It seems only a matter of justice and common sense that this must be subjected to a much wider public debate and then the Government should put it to Parliament.
There are five main ethical issues to consider :
The Church of Scotland General Assembly considered a range of embryological issues in 1995 and cloning of both humans and animals in 1997. Views of church members are divided on the former issue. Some regard embryo research as absolutely impermissible, on the grounds that full human status must be accorded to the embryo. For such the answer to all the above questions is that they would be impermissible. The position taken by the 1995 General Assembly, however, affirmed the sanctity of the human embryo from conception affirmed but granted that there were limited circumstances under which such research might reluctantly be allowed prior to the primitive streak stage, bearing in mind the seriousness of certain medical conditions. These were primarily seen as infertility and genetically transmitted diseases.
Firstly, it seems illogical to create a cloned human embryo knowing full well one would have to destroy it on ethical grounds, because it was unethical to allow it to go to term to produce a cloned baby. Secondly, there is a gradualism argument. Once cloned human embryos were created, there would be strong pressures to go the next step and allow them to be implanted, whether legally or not.
The third argument is one of instrumentality. The intent is to the possibility of treating extremely serious diseases in another human being, but is this sufficient cause to justify the application? Ethically we recoil at the idea of killing a human being in order to provide spare parts for another, so should we allow an early embryo to be destroyed to provide cells for potential transplantation? To the extent that embryo research may be allowed for the above limited purposes a measure of instrumentality towards the embryo has been accepted. The question is whether this constitutes an allowance for all instrumental uses, or only some. In the applications to date, it would seem that the embryo is being treated as an entity in itself, and the research upon it as a means of better understanding of embryo development, fertilisation and genetic disease. The proposed research would seem to reduce the embryo from being an entity in itself to having only the status of a resource from which convenient parts are taken.
The 1984 Warnock Report implied that the embryo should be accorded "a special status", although the notion was left somewhat ill defined. This new proposal would seem to remove any vestiges of special status, and would seem to treat the early embryo in this application only as a means to an end. In striking contrast, the Farm Animal Welfare Council report on animal cloning, which came out a week after the HGAC/HFEA report, made a careful review of the ethics of cloning animals and says we should not see animals merely as means to an end.2 It would seem strange indeed at a time when animal experimentation is increasingly being brought into question, the use of human embryos seems to be much more acceptable.
It might be said that an early embryo is potentially all the cells of the human body, and one is not destroying it, but merely it to become choosing certain cells and not others. The concern, however, is that by the same token the embryo is prevented from developing in its normal complete fashion. It is not "taking a cutting" from the embryo, but completely reprogramming it. This would surely be a profound ethical change in what is considered right about the embryo. De facto this would drive the ambiguity of the status of the embryo down the side of being a ball of cells and much further away from its connection with a delivered baby.
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 HGAC/HFEA report declared that its purpose was not to "re-open old debates". 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.
2
Farm Animal Welfare Council (1998), Report on the Implications of Cloning for the Welfare of Cloned Livestock, PB 4132, Ministry of Agriculture, Fisheries and Food, London. 3
Cohen, P. "Hold the Champagne", New Scientist 14 November 1998, p.6. 4
Cohen, P. (1998) "Organs without Donors", op cit. 5
"Headless frog opens way for human organ factory", Sunday Times, London, 19 October 1997. 6
Ministry of Agriculture, Fisheries and Food (1995) Report of the Committee to consider the Ethical Implications of Emerging Technologies in the Breeding of Farm Animals, (Banner Committee report), HMSO: London 7
FAWC (1998) op cit
Specific Ethical Issues
Instrumental Use of the Embryo
Experimental Uncertainties
In effect, the HFEA/HGAC argument is that to look at the potential medical benefits is answer enough. To justify a course of action with profound ethical difficulties, however, one must be brutally honest about its chances of success. There is a formidable list of experimental hurdles to overcome. No one knows how successful cloned cells would be on patients, nor what risk there is of cultured cells becoming cancerous, as the New Scientist recently pointed out.3 At the time of the Roslin Biomed - Geron merger Ian Wilmut said that their aim is only to use cloned embryos as an intermediate stage of the eventual goal of taking the skin cell and reprogramming it directly to become another sort of tissue. Ethically this would remove much of the above objections, but this is even more remote technically. It needs to be clarified whether this could be achieved without research that involved the intermediate creation of a cloned embryo.
Human - Cow Nuclear Transfer
An alternative means to the same end, but one with perhaps equally problematical ethics, is to produce non-viable human embryos within cow's eggs. This arose out of the failure of Neal First's trans-species nuclear transfer to produce viable embryos from different animal cells, mentioned in the previous section. The idea mooted by Advanced Cell Technologies is to take a human cell and perform a nuclear transfer into a denucleated cow's egg. Passing an electric current would fuse the two and stimulate the human cell to divide as though it were a human embryo, but one which was not viable.4 At the blastocyst stage of division, the stem cells would be removed and cultured as human somatic cells. Aside from the formidable technical problems, one would need to be quite sure that the use of a cow's egg as a host for the human cell had no adverse effect on the eventual human cell lines. This is the opposite way round to the interspecific quandaries of xenotransplantation, but it is also arising in a number of other areas, such as suggestions of growing human sperm in rats. Ethically this would avoid one problem - the creation of a human embryo which could otherwise go to term - but create another, in mixing genetic material across species at such a profound level, which as argued above would seem to raise major intrinsic objections.
Separate Organs
The prospect of creating entirely separate organs for donation is a very remote indeed and is unlikely to be practicable, but it would raises profound problems about the nature of a human being. Again, a reductionist and utilitarian view might see the creation of separate human parts as of no particular significance beyond the medical benefit that might accrue. A more holistic view of the human person might well find the idea repulsive. However, it may never get to that stage, because of the nature of the animal experimentation that would presumably be necessary en route. If it meant examples as the headless frog, 5 this application would be ruled out as unethical on animal welfare grounds, as falling foul of the Banner Committee's first criterion of harms of a degree which are unacceptable under any circumstances. 6
Drawing Distinctions - Humans, Embryos and Animals
The trend of instrumentality is, however, a matter of great concern. It is illustrated by a remarkable statement made, in passing, in the Farm Animal Welfare Council report, that, "It is not clear that a radical distinction between human and non-human is now defensible, either biologically or ethically".7 Functional logic here has led to a profoundly false conclusion, because it has been seen, arbitrarily, as the determining factor in an issue which involves many other factors from a wider evaluative context. To put it in context, not only do we share 98% of our genes with chimpanzees but we share (it is said) 35% with daffodils. To draw any ethical distinction from such physical statistics is bizarre. The best one can say is that we are all creatures of the same God by a process which links all creatures at one level, and yet also is the basis for their distinctiveness. Animals and humans are no less distinct just because a scientist cannot define what the distinction is, as though science was the supreme way of knowing. This is a scientistic conclusion because there are other criteria than science which are just as relevant, or more so. There is also a danger in the underlying logic, in so far as a blurred distinction between humans and animals could be used as an excuse not to elevate animals but to degrade humans. Most people would not like to be treated like a battery hen. It is also ironic that, according to the HGAC/HFEA we can make a clear ethical distinction between human and embryo, in terms of cloning, but according to the FAWC we cannot do so between animal and human.
Public Debate
In the current unfortunate climate of scepticism over biotechnology, it is important that the Government is not seen to be making major changes to the law by small steps made by experts far away from public scrutiny. This sort of "gradualism" is one of the things which emerges again and again in our conversations with the public that most worries them and leads to the scepticism. We welcome very much the new climate of openness that is emerging with regard to some areas of biotechnology, but are anxious that on this particular issue - of all issues - the pressure from the scientific and medical communities is not balanced by a consideration of the wider ethical issues.
References
1
Human Genetics Advisory Commission and Human Embryology Authority (1998), Cloning Issues in Reproduction, Science and Medicine, Human Genetics Advisory Commission, London
Return to Contents
SRT's Cloning and Stem Cells pages
About Copyright
This page has been produced by the Society Religion and Technology Project of the Church of Scotland (SRT for short), 17 December 1998. It is copyright, © SRT Project, 1998. We're usually happy for people to reproduce all or part of our articles, but please write or email us for permission first, at our address below.
Return to the top of the Page
This page was set up on 14 January 2000
