The President's Council on Bioethics
Washington, D.C.
July 2002
www.bioethics.gov
For the past five years, the prospect of human cloning has been the subject of considerable public attention and sharp moral debate, both in the United States and around the world. Since the announcement in February 1997 of the first successful cloning of a mammal (Dolly the sheep), several other species of mammals have been cloned. Although a cloned human child has yet to be born, and although the animal experiments have had low rates of success, the production of functioning mammalian cloned offspring suggests that the eventual cloning of humans must be considered a serious possibility.
In November 2001, American researchers claimed to have produced the first cloned human embryos, though they reportedly reached only a six-cell stage before they stopped dividing and died. In addition, several fertility specialists, both here and abroad, have announced their intention to clone human beings. The United States Congress has twice taken up the matter, in 1998 and again in 2001-2002, with the House of Representatives in July 2001 passing a strict ban on all human cloning, including the production of cloned human embryos. As of this writing, several cloning-related bills are under consideration in the Senate. Many other nations have banned human cloning, and the United Nations is considering an international convention on the subject. Finally, two major national reports have been issued on human reproductive cloning, one by the National Bioethics Advisory Commission (NBAC) in 1997, the other by the National Academy of Sciences (NAS) in January 2002. Both the NBAC and the NAS reports called for further consideration of the ethical and social questions raised by cloning.
The debate over human cloning became further complicated in 1998 when researchers were able, for the first time, to isolate human embryonic stem cells. Many scientists believe that these versatile cells, capable of becoming any type of cell in the body, hold great promise for understanding and treating many chronic diseases and conditions. Some scientists also believe that stem cells derived from cloned human embryos, produced explicitly for such research, might prove uniquely useful for studying many genetic diseases and devising novel therapies. Public reaction to the prospect of cloning-for-biomedical-research has been mixed: some Americans support it for its medical promise; others oppose it because it requires the exploitation and destruction of nascent human life, which would be created solely for research purposes.
The intense attention given to human cloning in both its potential uses, for reproduction as well as for research, strongly suggests that people do not regard it as just another new technology. Instead, we see it as something quite different, something that touches fundamental aspects of our humanity. The notion of cloning raises issues about identity and individuality, the meaning of having children, the difference between procreation and manufacture, and the relationship between the generations. It also raises new questions about the manipulation of some human beings for the benefit of others, the freedom and value of biomedical inquiry, our obligation to heal the sick (and its limits), and the respect and protection owed to nascent human life.
Finally, the legislative debates over human cloning raise large questions about the relationship between science and society, especially about whether society can or should exercise ethical and prudential control over biomedical technology and the conduct of biomedical research. Rarely has such a seemingly small innovation raised such big questions.
As Members of the President's Council on Bioethics, we have taken up the larger ethical and social inquiry called for in the NBAC and NAS reports, with the aim of advancing public understanding and informing public policy on the matter. We have attempted to consider human cloning (both for producing children and for biomedical research) within its larger human, technological, and ethical contexts, rather than to view it as an isolated technical development. We focus first on the broad human goods that it may serve as well as threaten, rather than on the immediate impact of the technique itself. By our broad approach, our starting on the plane of human goods, and our open spirit of inquiry, we hope to contribute to a richer and deeper understanding of what human cloning means, how we should think about it, and what we should do about it.
On some matters discussed in this report, Members of the Council are not of one mind. Rather than bury these differences in search of a spurious consensus, we have sought to present all views fully and fairly, while recording our agreements as well as our genuine diversity of perspectives, including our differences on the final recommendations to be made. By this means, we hope to help policymakers and the general public appreciate more thoroughly the difficulty of the issues and the competing goods that are at stake.
There is today much confusion about the terms used to discuss human cloning, regarding both the activity involved and the entities that result. The Council stresses the importance of striving not only for accuracy but also for fairness, especially because the choice of terms can decisively affect the way questions are posed, and hence how answers are given. We have sought terminology that most accurately conveys the descriptive reality of the matter, in order that the moral arguments can then proceed on the merits. We have resisted the temptation to solve the moral questions by artful redefinition or by denying to some morally crucial element a name that makes clear that there is a moral question to be faced.
On the basis of (1) a careful analysis of the act of cloning, and its relation to the means by which it is accomplished and the purposes it may serve, and (2) an extensive critical examination of alternative terminologies, the Council has adopted the following definitions for the most important terms in the matter of human cloning:
Cloning research and stem cell research are being actively investigated and the state of the science is changing rapidly; significant new developments could change some of the interpretations in our report. At present, however, a few general points may be highlighted.
Two separate national-level reports on human cloning (NBAC, 1997; NAS, 2002) concluded that attempts to clone a human being would be unethical at this time due to safety concerns and the likelihood of harm to those involved. The Council concurs in this conclusion. But we have extended the work of these distinguished bodies by undertaking a broad ethical examination of the merits of, and difficulties with, cloning-to-produce-children.
Cloning-to-produce-children might serve several purposes. It might allow infertile couples or others to have genetically-related children; permit couples at risk of conceiving a child with a genetic disease to avoid having an afflicted child; allow the bearing of a child who could become an ideal transplant donor for a particular patient in need; enable a parent to keep a living connection with a dead or dying child or spouse; or enable individuals or society to try to "replicate" individuals of great talent or beauty. These purposes have been defended by appeals to the goods of freedom, existence (as opposed to nonexistence), and well-being all vitally important ideals.
A major weakness in these arguments supporting cloning-to-produce-children is that they overemphasize the freedom, desires, and control of parents, and pay insufficient attention to the well-being of the cloned child-to-be. The Council holds that, once the child-to-be is carefully considered, these arguments are not sufficient to overcome the powerful case against engaging in cloning-to-produce-children.
First, cloning-to-produce-children would violate the principles of the ethics of human research. Given the high rates of morbidity and mortality in the cloning of other mammals, we believe that cloning-to-produce-children would be extremely unsafe, and that attempts to produce a cloned child would be highly unethical. Indeed, our moral analysis of this matter leads us to conclude that this is not, as is sometimes implied, a merely temporary objection, easily removed by the improvement of technique. We offer reasons for believing that the safety risks might be enduring, and offer arguments in support of a strong conclusion: that conducting experiments in an effort to make cloning-to-produce-children less dangerous would itself be an unacceptable violation of the norms of research ethics. There seems to be no ethical way to try to discover whether cloning-to-produce-children can become safe, now or in the future.
If carefully considered, the concerns about safety also begin to reveal the ethical principles that should guide a broader assessment of cloning-to-produce-children: the principles of freedom, equality, and human dignity. To appreciate the broader human significance of cloning-to-produce-children, one needs first to reflect on the meaning of having children; the meaning of asexual, as opposed to sexual, reproduction; the importance of origins and genetic endowment for identity and sense of self; the meaning of exercising greater human control over the processes and "products" of human reproduction; and the difference between begetting and making. Reflecting on these topics, the Council has identified five categories of concern regarding cloning-to-produce-children. (Different Council Members give varying moral weight to these different concerns.)
Ethical assessment of cloning-for-biomedical-research is far more vexing. On the one hand, such research could lead to important knowledge about human embryological development and gene action, both normal and abnormal, ultimately resulting in treatments and cures for many dreaded illnesses and disabilities. On the other hand, the research is morally controversial because it involves the deliberate production, use, and ultimate destruction of cloned human embryos, and because the cloned embryos produced for research are no different from those that could be implanted in attempts to produce cloned children. The difficulty is compounded by what are, for now, unanswerable questions as to whether the research will in fact yield the benefits hoped for, and whether other promising and morally nonproblematic approaches might yield comparable benefits. The Council, reflecting the differences of opinion in American society, is divided regarding the ethics of research involving (cloned) embryos. Yet we agree that all parties to the debate have concerns vital to defend, vital not only to themselves but to all of us. No human being and no society can afford to be callous to the needs of suffering humanity, or cavalier about the treatment of nascent human life, or indifferent to the social effects of adopting one course of action rather than another.
To make clear to all what is at stake in the decision, Council Members have presented, as strongly as possible, the competing ethical cases for and against cloning-for-biomedical-research in the form of first-person attempts at moral suasion. Each case has tried to address what is owed to suffering humanity, to the human embryo, and to the broader society. Within each case, supporters of the position in question speak only for themselves, and not for the Council as a whole.
A. The Moral Case for Cloning-for-Biomedical-ResearchThe moral case for cloning-for-biomedical-research rests on our obligation to try to relieve human suffering, an obligation that falls most powerfully on medical practitioners and biomedical researchers. We who support cloning-for-biomedical-research all agree that it may offer uniquely useful ways of investigating and possibly treating many chronic debilitating diseases and disabilities, providing aid and relief to millions. We also believe that the moral objections to this research are outweighed by the great good that may come from it. Up to this point, we who support this research all agree. But we differ among ourselves regarding the weight of the moral objections, owing to differences about the moral status of the cloned embryo. These differences of opinion are sufficient to warrant distinguishing two different moral positions within the moral case for cloning-for-biomedical-research:
Position Number One. Most Council Members who favor cloning-for-biomedical-research do so with serious moral concerns. Speaking only for ourselves, we acknowledge the following difficulties, but think that they can be addressed by setting proper boundaries.
Position Number Two. A few Council Members who favor cloning-for-biomedical-research do not share all the ethical qualms expressed above. Speaking only for ourselves, we hold that this research, at least for the purposes presently contemplated, presents no special moral problems, and therefore should be endorsed with enthusiasm as a potential new means of gaining knowledge to serve humankind. Because we accord no special moral status to the early-stage cloned embryo and believe it should be treated essentially like all other human cells, we believe that the moral issues involved in this research are no different from those that accompany any biomedical research. What is required is the usual commitment to high standards for the quality of research, scientific integrity, and the need to obtain informed consent from donors of the eggs and somatic cells used in nuclear transfer.
B. The Moral Case against Cloning-for-Biomedical-ResearchThe moral case against cloning-for-biomedical-research acknowledges the possibility though purely speculative at the moment that medical benefits might come from this particular avenue of experimentation. But we believe it is morally wrong to exploit and destroy developing human life, even for good reasons, and that it is unwise to open the door to the many undesirable consequences that are likely to result from this research. We find it disquieting, even somewhat ignoble, to treat what are in fact seeds of the next generation as mere raw material for satisfying the needs of our own. Only for very serious reasons should progress toward increased knowledge and medical advances be slowed. But we believe that in this case such reasons are apparent.
The Council recognizes the challenges and risks of moving from moral assessment to public policy. Reflections on the "social contract" between science and society highlight both the importance of scientific freedom and the need for boundaries. We note that other countries often treat human cloning in the context of a broad area of biomedical technology, at the intersection of reproductive technology, embryo research, and genetics, while the public policy debate in the United States has treated cloning largely on its own. We recognize the special difficulty in formulating sound public policy in this area, given that the two ethically distinct matters-cloning-to-produce-children and cloning-for-biomedical-research-will be mutually affected or implicated in any attempts to legislate about either. Nevertheless, our ethical and policy analysis leads us to the conclusion that some deliberate public policy at the federal level is needed in the area of human cloning.
We reviewed the following seven possible policy options and considered their relative strengths and weaknesses: (1) Professional self-regulation but no federal legislative action ("self-regulation"); (2) A ban on cloning-to-produce-children, with neither endorsement nor restriction of cloning-for-biomedical-research ("ban plus silence"); (3) A ban on cloning-to-produce-children, with regulation of the use of cloned embryos for biomedical research ("ban plus regulation"); (4) Governmental regulation, with no legislative prohibitions ("regulation of both"); (5) A ban on all human cloning, whether to produce children or for biomedical research ("ban on both"); (6) A ban on cloning-to-produce-children, with a moratorium or temporary ban on cloning-for-biomedical-research ("ban plus moratorium"); or (7) A moratorium or temporary ban on all human cloning, whether to produce children or for biomedical research ("moratorium on both").
Having considered the benefits and drawbacks of each of these options, and taken into account our discussions and reflections throughout this report, the Council recommends two possible policy alternatives, each supported by a portion of the Members.
Majority Recommendation: Ten Members of the Council recommend a ban on cloning-to-produce-children combined with a four-year moratorium on cloning-for-biomedical-research. We also call for a federal review of current and projected practices of human embryo research, pre-implantation genetic diagnosis, genetic modification of human embryos and gametes, and related matters, with a view to recommending and shaping ethically sound policies for the entire field. Speaking only for ourselves, those of us who support this recommendation do so for some or all of the following reasons:
The decision before us is of great importance. Creating cloned embryos for any purpose requires crossing a major moral boundary, with grave risks and likely harms, and once we cross it there will be no turning back. Our society should take the time to make a judgment that is well-informed and morally sound, respectful of strongly held views, and representative of the priorities and principles of the American people. We believe this ban-plus-moratorium proposal offers the best means of achieving these goals.
This position is supported by Council Members Rebecca S. Dresser, Francis Fukuyama, Robert P. George, Mary Ann Glendon, Alfonso Gómez-Lobo, William B. Hurlbut, Leon R. Kass, Charles Krauthammer, Paul McHugh, and Gilbert C. Meilaender.
Minority Recommendation: Seven Members of the Council recommend a ban on cloning-to-produce-children, with regulation of the use of cloned embryos for biomedical research. Speaking only for ourselves, those of us who support this recommendation do so for some or all of the following reasons:
Permitting cloning-for-biomedical-research now, while governing it through a prudent and sensible regulatory regime, is the most appropriate way to allow important research to proceed while insuring that abuses are prevented. We believe that the legitimate concerns about human cloning expressed throughout this report are sufficiently addressed by this ban-plus-regulation proposal, and that the nation should affirm and support the responsible effort to find treatments and cures that might help many who are suffering.
This position is supported by Council Members Elizabeth H. Blackburn, Daniel W. Foster, Michael S. Gazzaniga, William F. May, Janet D. Rowley, Michael J. Sandel, and James Q. Wilson.