Are Embryonic Stem Cells a Step too Far?
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Dolly the cloned sheep has become an icon for biotechnology, with a characteristically post-modern ambivalence. She represents both the hopes and the fears of what embryology and genetics might led us to. The world's media and many of its leaders set off hares with fears that cloned human beings were just around the corner. In the Church of Scotland, we had already been discussing these issues with the Roslin scientists. We argued that not only would this be ethically unacceptable on principle, it would carry an unacceptably high risk of producing deformed babies. To most people's relief, the fear of human cloning has not materialised. The science has focused on the hopes that Roslin's Dolly technology and other breakthroughs could herald exciting medical benefits. On 19 December 2000, MP's voted to allow research on human embryos as sources of stem cells for treating degenerative diseases. Despite careless use of words, this was not primarily about cloning, but about embryo use.
What are Embryonic Stem Cells?
The present Human Fertilisation and Embryology Act (1990) allows embryo research only for limited purposes mainly to do with infertility. The vote is whether to extend this to allow a potential new use of embryos to make embryonic stem cells. These are special cells in the early embryo before it begins to differentiate. At this point, they can turn into any type of cell in the human body. Two years ago, US scientists found a way to isolate them. Using special chemical treatments, they believe they can direct them into becoming any type of human cell they choose - skin, heart muscle, nerve cells, etc. This opens up a possibility to create replacement cells to inject into patients suffering from a wide range of diseases which cause irreversible cell degeneration, like Parkinson's, some heart conditions and diabetes. This is not cloning, but it raises deep ethical concern whether it changes our view and ethical evaluation of the human embryo.
What is the Status of the Embryo?
There are three positions on this. For two of them, the vote is already quite clear. One extreme sees the early embryo as a ball of cells and nothing more. Because it is undeveloped and would not survive out of the womb, any research is permissible, including the new proposals. The medical benefits, remote as may be, wholly justify the action. At the opposite pole, the Roman Catholic church and many individual Christians of other denominations, believe that from conception onwards the embryo has the full status of humanity. On principle, this allows no research or use not for the benefit of that particular embryo, including both present and the new potential uses. The Church of Scotland has a middle position, which affirms the special status as created by God, but also recognises potential benefits of embryo research under limited circumstances.
Stepping over a New Ethical Barrier?
The question for us, and for many who support the current position of the Act, is whether the new applications step over a second ethical barrier. Present research for infertility still treats the embryo as a reproductive entity, for the long term benefit of other embryos. To use an embryo as a source of body cells is a very different notion both scientifically and ethically. It treats the embryo purely functionally, as a resource and no longer as a whole. The present Act accords the human embryo with a "special status". This was an ethical compromise, but it restricted the conditions under which embryos can be created or used. The small change now proposed by the Government would push this compromise finally down the "ball of cells" side. It is hard to see how the embryo would retain any "special status" if becomes a routine resource for replacement cells. A 1998 Ministry of Agriculture report into animal cloning cautioned against seeing animals "merely as means to an end". Would we now be treating human embryos with less respect than animals?
Are there Viable Alternatives?
Cell replacement therapy is certainly a goal to pursue, but not at any ethical cost. There have been many statements claiming that there is a complete alternative by deriving stem cells from adults or even umbilical cord blood. We have much sympathy for avoiding embryonic stem cells, but the claims are misleading, and we should be careful not to raise expectations in patients. At present, no one knows. Most of the world's experts on stem cells came to a conference at the Royal Society of Edinburgh in October 2000. Research was reported showing that adult cells are much more adaptable than had been thought. But most considered that embryos stem cells would still allow treatments for a wider range of diseases than adult cells. Adult cells may carry greater risks; being older they could have developed defects. There is more radical idea, to adapt Roslin's work to reprogramme ordinary adult non-stem cells directly into the desired type of cell, without intermediate embryos. This is highly speculative, but several methods have been suggested which merit serious research investment. But it would probably mean limited embryo research as a bridge in understanding. For that one purpose personally I might countenance it, on condition that it avoids using embryos routinely.
Where does Cloning come into it?
The main source for embryo stem cells would be so-called "spare" embryos left over after IVF treatments, or occasionally embryos created specially for research. Cloning only comes in play if there was a problem of rejection. By definition these cells would be of a different genetic type from the patient. For some diseases cloning might be used to make replacement cells of the same genetic type as the patient, to minimise rejection. A skin or blood sample would be taken from the patient. The Dolly technique would be used to create a temporary cloned embryo, but instead of implanting it to make a cloned baby, it would be used to create genetically matched cells. No one knows yet if it would work, or how often such a route might be preferred over using IVF embryos.
Why we still need a Specific Vote on Embryo Cloning
The careless use of the word cloning to describe the whole area of embryonic stem cells has generated much confusion. In fact MP's have not had any chance to vote on the cloning of embryos, because it is technically legal through a loophole in the Act. Ten years ago, Roslin's method of cloning wasn't envisaged and so was not excluded. The Commons vote to allow embryo research into stem cells, also automatically allowed the cloning of embryos, without ever voting on it. The influential European Commission ethical advisory panel reported on these issues last month and drew an ethical line at cloning embryos, as did the European Parliament. Surely it is wrong for the UK Parliament to allow this simply by default. We need early primary legislation on therapeutic as well as reproductive uses of cloning. The vote should not be seen as a mandate to allow cloned embryos also. That has not been put to a proper democratic test.
Is this the End of Special Status of the Human Embryo?
The new regulation is worryingly open ended. Any use of the human embryo for "increasing knowledge about serious disease" is allowed. On so sensitive a public issue, such indiscriminacy is unwise. In 1990 the HFE Act adopted a strict "No, unless ..." Approach. Now we have "Yes, for everything". This puts far too much at the discretion of the Human Fertilisation and Embryology Authority. We now need clear ethical guidelines about what is and what is not a legitimate research proposal. How ironic that we have lines for what may never be done to animals, but not for human embryos. It seems we have discarded any remaining notion of Warnock's "special status" of the human embryo, and reduced it to a mere ball of cells which no one respects.
For Further Information
The Society, Religion and Technology Project has done extensive work on the ethics of cloning in humans, animals and for medical applications.
SRT Information Sheets
This is an SRT Information Sheet, one a series aimed at presenting some of the key aspects of current ethical and social issues in technology in simple terms for the non-expert. Other SRT Information Sheets are available on BSE, Car Use and the Environment, Church Energy Conservation Scheme, Land Use in Scotland, SRT Environmental Work, Genetic Engineering in Animals, Genetically Modified Food, Environmental Risks of GM Crops, Patenting, What is Genetic Engineering, Cloning for Therapeutic Purposes, Human Cloning, Animal Cloning.
Contact
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Ref.no. CLONINF7.LWP 22/12/00.
