Cell 
                  division 
                  by George J. Annas, 4/21/2002 | 
               
             
            
            
            Delegates from around the world met at the United Nations recently 
            to begin preparing an international treaty to outlaw the reproductive 
            cloning of humans. Representatives from countries as diverse as Brazil 
            and Sweden, Uganda and China, Japan, Germany, and France all strongly 
            support a treaty to ban reproductive cloning.
 No country wants to allow use of the ''Dolly the sheep'' cloning 
              technique - the one since used to create mice, pigs, cows, and most 
              recently, rabbits and a kitten - to make a human child. Virtually 
              every nation agrees that children should not be commodified like 
              barnyard animals or pets, even like beloved cats or dogs. 
            The powerful global consensus that human reproductive cloning should 
              be outlawed provides an unprecedented opportunity for the world 
              to take united action on a bioethical issue that could profoundly 
              affect the future of our species. It would be a tragedy if this 
              opportunity were lost because the United States refuses to support 
              a ban. 
            The United States has, nonetheless, threatened to take its ball 
              and go home if the world community does not give in to its demands 
              to outlaw not just reproductive cloning but also research cloning. 
              (Sometimes called ''therapeutic cloning'' - though no therapies 
              have been produced - research cloning involves making human embryos 
              by somatic cell nuclear transfer with the goal of deriving stem 
              cells for medical research.) This all-or-nothing, take-it-or-leave-it 
              approach is the same position taken by the House of Representatives 
              last August, and repeated this month by President Bush, who has 
              urged the Senate to join the House in outlawing both reproductive 
              and research cloning. 
            The Senate will debate the ban soon. Observers think the outcome 
              is too close to call, but unless a compromise can be reached so 
              that outlawing reproductive cloning is not held hostage to banning 
              research cloning, the likely outcome is that no law will pass. Without 
              congressional action banning reproductive cloning in the United 
              States, it will likely be attempted by its radical proponents - 
              Panos Zavos, a specialist in turkey sperm, and the Raelians, a Canada-based 
              group that believes humans were created by extraterrestrials - long 
              before any UN treaty comes into force. Zavos's partner, Italian 
              physician Serverino Antinori, announced recently in Abu Dhabi that 
              a patient of his is eight weeks pregnant with a human clone. Even 
              though this is almost certainly untrue, Antinori and Zavos seem 
              determined to try to produce the world's first human clone regardless 
              of world opinion and the overwhelming scientific evidence of likely 
              serious physical harm to the child. Can a compromise be found that 
              can stop the renegades while permitting legitimate medical research? 
            The first step toward a solution is to understand the Bush administration's 
              position. Leon Kass, its intellectual architect and the head of 
              the president's newly formed Bioethics Council, has argued eloquently 
              and passionately that if you oppose creating a child by cloning, 
              you must also oppose creating human embryos for research by cloning. 
              This is because, he says, if research cloning is permitted, it is 
              inevitable that someone will try to implant one of the cloned embryos 
              in a woman, and once this occurs, no government would ever force 
              the woman to abort the clone. Moreover, he argues, research cloning 
              would result in private industry stockpiling human embryos, and 
              mining, exploiting, and selling them. Opponents of research cloning 
              are already running radio ads warning of ''embryo hatcheries'' and 
              ''embryo farms.'' A ban on implanting these embryos, Kass says, 
              would require the government to destroy cloned embryos rather than 
              preserve and protect this form of nascent human life, action that 
              would be repugnant to many. 
            Kass reiterated this position in January when he opened the first 
              meeting of the Bioethics Council with a discussion of Nathaniel 
              Hawthorne's ''The Birthmark.'' In the story, a scientist, Alymer, 
              marries a beautiful young woman, Georgiana, who has a small handlike 
              birthmark on her face. Alymer becomes obsessed with removing it, 
              and the potion he ultimately creates to successfully remove it also 
              kills her. Imperfection, of course, is an inherent characteristic 
              of humans, and attempting to make the perfect human is certainly 
              dangerous, and ultimately impossible. Kass takes the story as a 
              cautionary tale that science's attempt to perfect humans by, among 
              other things, changing our basic sexual nature (as by making sexual 
              reproduction optional) could have deadly consequences. 
            I am sympathetic to Kass's slippery slope argument, and have even 
              gone further than Kass by suggesting that by combining cloning technology 
              with genetic engineering, we would inevitably put ourselves on the 
              eugenics road not just to ''designer babies'' but to attempting 
              to create perfect humans as well. If we fail, the consequences would 
              be felt primarily by the children created in the failed experiments. 
              But if we succeed, the consequences would be even deadlier, since 
              the ''improved'' posthumans would inevitably come to view the ''naturals'' 
              as inferior, as a subspecies of humans suitable for exploitation, 
              slavery, or even extermination. Ultimately, it is this prospect 
              of what can be termed ''genetic genocide'' that makes cloning combined 
              with genetic engineering a potential weapon of mass destruction, 
              and the biologist who would attempt it a potential bioterrorist. 
            So Kass (and Bush, and the United States at the United Nations) 
              is right to caution us about the limits of our technology and the 
              slippery slope. Alymer was wrong to see human perfection through 
              scientific technique as a reasonable human goal, and ''The Birthmark'' 
              rightly warns us about that nightmarish eugenic goal. But is Kass 
              right to oppose research cloning aimed at finding cures for devastating 
              human diseases and alleviating severe human suffering, historically 
              both important and completely legitimate goals of medical research? 
              I don't think so, at least not if we can take effective regulatory 
              steps. And this points the way to a possible political compromise. 
             
            There are two basic ways the Senate could act to stop baby-making 
              cloners without outlawing research on cloned embryos. The first 
              is to put a moratorium on research cloning until the use of adult 
              stem cells is fully explored, and/or until research using stem cells 
              from ''spare'' or leftover embryos created at in vitro fertilization 
              clinics is demonstrated to be of therapeutic value in tissue regeneration. 
            The second, and I think better and more permanent, solution is 
              to create a regulatory framework that would make the administration's 
              dreaded commercial stockpiles (and farms) of cloned embryos and 
              the initiation of a pregnancy with one of them virtually impossible. 
            Regulation would be a challenge. Historically, embryo research 
              has never been regulated, primarily because the US government has 
              never funded it. Nonetheless, Congress has the authority to regulate 
              all such research, not just publicly funded research, if it wants 
              to. In particular, Congress could greatly improve the overall ethics 
              of now wholly unregulated research with cloned human embryos, permitting 
              the science to proceed, and at the same time virtually guarantee 
              that no cloned human embryo lawfully made would be implanted - or 
              even have to be ordered destroyed by the government. 
            Here's how it would work. Ideally, Congress would create a federal 
              oversight authority (similar to England's Human Fertilization and 
              Embryology Authority) that would have exclusive authority to approve 
              any proposed embryo research project, including those in the private 
              sector. Approval would only be granted for those projects soundly 
              designed to address a compelling medical need that could be successfully 
              addressed no other way. 
            To prevent the horrors envisioned by Kass and the administration, 
              specifically the stockpiling and commercial use of cloned research 
              embryos and the implanting of a research embryo to start a pregnancy, 
              at least three prohibitions are required: 
            The freezing and storage of cloned embryos should be outlawed. 
              Cloned embryos would be created solely for use in approved research 
              projects, and there is no reason to ''store'' or ''stockpile'' them 
              since the research embryos are destroyed in the research process. 
              A strict limit of seven days should be placed on the length of time 
              any cloned human embryo can be maintained. 
            The purchase and sale of human eggs and human embryos should be 
              outlawed. This would help to eliminate the increasing commercialization 
              of embryo research and the commodification of both human eggs and 
              embryos. 
            All individuals, including physicians, scientists, and biotech 
              companies who have not been approved to do research cloning must 
              be prohibited from making or possessing cloned embryos. In addition, 
              all in vitro fertilization clinics and physicians and embryologists 
              associated with them would be specifically prohibited from doing 
              research on cloned embryos - making it virtually impossible for 
              a cloned embryo to ever be used to initiate a pregnancy. 
            Alymer's real crime was that he was unable to separate his love 
              for his wife from his love of science, and in joining them, he killed 
              her. Combining bans on both reproductive and research cloning in 
              one bill is likely to kill the anticloning legislation as well. 
              And since reasonable compromise is available, this lethal outcome 
              is unnecessary. 
            We can sketch a parallel from another regulatory realm that helps 
              demonstrate that the law can effectively ban one activity without 
              banning two related activities. There is a reasonable argument that 
              an effective ban on offensive biological weapons research requires 
              a ban on defensive biological weapons research as well. Nonetheless, 
              it would be self-defeating and irrational to refuse to support a 
              ban on offensive weapons research solely because defensive research 
              was not banned simultaneously. Defensive biowarfare research can 
              be used to make an offensive weapon, of course, but this requires 
              both a much greater volume of toxins as well as their introduction 
              into a delivery system. 
            Likewise, cloned embryos could be used to make babies, but we are 
              much more likely to prevent this eventuality with a ban on implanting 
              human cloned embryos, such as that proposed by Senator Edward M. 
              Kennedy, (coupled with regulation of embryo research) than with 
              no regulation of cloning at all. It's time for Congress to pass 
              a ban, and for the United States to support the treaty banning reproductive 
              cloning. We can outlaw cloning to engineer children without outlawing 
              cloning to engineer medicines. 
            This story ran on page E1 of the Boston 
              Globe on 4/21/2002 
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