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The Moral Imperative to Conduct
Cloning and Stem Cell Research
Article in Cambridge Quarterly of Healthcare Ethics · February 2006
Impact Factor: 0.68 · DOI: 10.1017/S0963180106060026 · Source: PubMed
Katrien Devolder University of Oxford 26 PUBLICATIONS 221 CITATIONS SEE PROFILE Julian Savulescu University of Oxford 276 PUBLICATIONS 4,375 CITATIONS SEE PROFILE Available from: Julian Savulescu Retrieved on: 23 May 2016 Special Section: Open Forum The Moral Imperative to Conduct Embryonic Stem Cell and Cloning Research
KATRIEN DEVOLDER and JULIAN SAVULESCUThe United Nations Declaration on Human Cloning On March 8, 2005, the General Assembly adopted the United Nations Declaration on Human Cloning 1 in which Member States are called upon to
a) protect adequately human life in the application of life sciences
b) prohibit all forms of human cloning inasmuch as they are incompatible with human dignity and the protection of human life
c) prohibit the application of genetic engineering techniques that may be contrary to human dignity
d) prevent the exploitation of women in the application of life sciences
e) adopt and implement national legislation to bring into effect paragraphs a to d
f) take into account the pressing global issues such as HIV/AIDS, tuberculosis, and malaria, which affect in particular the developing countries.
We will argue that cloning research does not exploit women (as d implies) and does address global health problems (not as f implies). More importantly, we will argue that it is immoral to prohibit all forms of cloning (as b suggests) and that national legislation is required to ban reproductive cloning but not therapeutic cloning (and that e is too broad). This declaration fails to take account of new research into cloning and of the distinction between cloning research for the purposes of regenerative medicine (self-transplantation) and cloning research for the purposes of developing what we call cellular models of human disease. This second application is immune to virtually all objections to cloning research.2 The United Nations should withdraw its unethical Declaration on Human Cloning. The Declaration is as immoral as it is lethal, or so we shall argue.
Breakthroughs in Cloning Research Two months after the adoption of the UN Declaration on Human Cloning, Woo Suk Hwang and colleagues of Seoul National University reported that they had
Katrien Devolder acknowledges the stimulus and support of the European project “CLEMIT:
Developing an operational ethical framework to analyse and monitor the ethics of creating and redesigning human beings,” sponsored by the European Commission, DG-Research as part of the Science and Society research programme — 6 th Framework, in the preparation of this paper. The authors are also grateful to Norman Ford and Carolyn Cameron for their helpful comments on an earlier draft and to Konrad Hochedlinger for advice.
Cambridge Quarterly of Healthcare Ethics (2006), 15, 7–21. Printed in the USA.
Copyright © 2006 Cambridge University Press 0963-1801/06 $16.00 Katrien Devolder and Julian Savulescu successfully cloned 31 human embryos and had produced 11 embryonic stem (ES) cell lines from these.3 The cells were cloned from body cells from patients with diseases potentially amenable to stem cell therapy, including genetic disease, spinal cord injury, and diabetes. This was the most important scientific event in cloning research since Ian Wilmut cloned a sheep, Dolly, in 1997. One year ago, the team in South Korea cloned embryos from a woman’s body cells, using her own eggs. Twenty embryos were of good enough quality to extract stem cells.4 This new research is significant for several reasons. First, it is indisputable evidence of cloning of human embryos. There were some concerns that the embryos in their 2004 research were parthenogenetic in origin. These embryos are clearly clones derived from donor oocytes and nuclear DNA from patientdonors. Second, the research is vastly more efficient. From 185 eggs, 129 fused nuclear transfer constructs were created and 31 blastocysts survived. About 1 in 6 eggs produced a blastocyst. This is high in reproductive terms — only about 1 in 5 embryos become a baby. The process is 10 times more efficient than it was one year ago. The accelerating pace of progress in this area is illustrated in Table 1.
Third, it opens up two radically new avenues for developing treatments for human disease and injury, which we will describe in more detail presently.
First, it is proof in principle of self-transplantation. Second, it opens the possibility of developing human cellular models of disease.
Cloning research is advancing quickly worldwide. In August 2004, the Human Fertilisation and Embryology Authority (HFEA) granted the first license for cloning human embryos in the United Kingdom. On May 19, 2005, Alison Murdoch and her colleagues in Newcastle created the country’s first cloned embryo from human somatic cells.5 Ian Wilmut also received a license to clone human embryos. The goal in all these research projects is not to use cloning as a form of assisted reproduction to create babies (what is sometimes called “reproductive cloning”), but to advance understanding of the causes and treatment of a whole range of currently incurable diseases and conditions, including neurological disease or injury and diabetes (sometimes called “therapeutic cloning” or as we prefer, “cloning for the purposes of research and therapy”).
Many people, however, have expressed their disapproval of cloning research.
Senator Sam Brownback, who takes a leading role in the anticloning movement in the United States, said the research by scientists from Seoul National University “underscores the need for complete national and international bans
Table 1. Milestones in Cloning and Embryonic Stem Cell Research
1997, Wilmut et al., Nature, cloning of a sheep from a somatic cell 1998, Thomson et al., Science, derivation and culture of human embryonic stem cells 2004, Hwang et al., Science, first human embryo cloned and stem cell line developed from it — but from own egg 2005, Hwang et al., Science, first human embryo cloned from donor oocytes and from patients with disease or injury and successful derivation of self-compatible stem cell lines
Embryonic Stem Cell and Cloning Research
on all human cloning,” because “human cloning is wrong.” 6 Monsignor Elio Sgrecia, vice president of the Vatican’s Pontifical Academy for Life, said, “you can’t kill human life in the hopes of finding medicines to save other lives. This is not a victory for humanity but a crime twice over.” 7 Leon Kass, President of the U.S. President’s Council on Bioethics, stated that “allowing cloned embryos to be produced for biomedical research and/or stem cell extraction is morally highly problematic. It crosses several important moral boundaries, accelerating our slide down a slippery slope (or, more accurately, jumping us off an ethical cliff) into a dehumanizing world of genetic control of offspring and the routine use of nascent human life as a mere natural resource.” 8 Embryonic Stem Cell Research Before we discuss the concept of cloning for the purpose of research and therapy, it is necessary to review another recent scientific advance — the ability to culture human ES cells. Stem cells are undifferentiated or immature cells that have the capacity for unlimited or prolonged self-renewal and, under the right conditions, for developing into one or several types of our body cells, such as liver cells or heart cells. These characteristics make them valuable means for research and therapy. Totipotent stem cells are cells with the potential to form a complete human being if placed in a uterus. They are early embryos.
Pluripotent stem cells are undifferentiated stem cells with the potential to develop into any of the approximately 200 different mature cell types in the human body, but cannot by themselves form a complete human being if placed in a uterus. They can be obtained from the inner cell mass of the blastocyst or preimplantation embryo. At this stage, the embryo is a microscopic ball of around 100–200 cells, and is only a few days old and one-tenth the size of a pinhead. Human ES cells were established for the first time in 1998.9 Since then, the interest in ES cell research has increased significantly, and, worldwide, researchers are investigating their potential and how to control their differentiation to specific types of body cells. Mouse ES cell lines have been induced to differentiate in vitro into a variety of cell types, including cardiomyocytes, hematopoietic progenitors, yolk sac, skeletal myocytes, smooth muscle cells, adipocytes, chondrocytes, endothelial cells, melanocytes, neurons, glia, pancreatic islet cells, and primitive endoderm.10 In January 2005, a Japanese team announced that it had successfully treated monkeys with Parkinson’s disease through an ES cell transplant.11 ES cell technology has been described as the most significant development since recombinant DNA.12 Cloning Cloning is the creation of a genetic copy of a sequence of DNA or of the entire genome of an entire organism. Although there are different cloning methods, in the cloning debate, the term cloning typically refers to somatic cell nuclear transfer (SCNT). This involves taking the nucleus with the DNA code of a somatic cell (any body cell other than a germ cell) and transferring it to an enucleated egg to create a totipotent stem cell — or early embryo — capable of producing a clone or genetic copy of the entire genome from which it was derived. On February 24, 1997, Scottish scientists announced that they had cloned Dolly the sheep using the SCNT technique.13 She was the first mammal Katrien Devolder and Julian Savulescu ever to be cloned this way. Using SCNT to produce live offspring is often referred to as “reproductive” cloning.
The subject of this paper is cloning for nonreproductive purposes, that is, for research and therapy.
The Human Significance of Cloning and Embryonic Stem Cell Research The recent research involving cloning of human embryos is of enormous significance for humanity. Indeed, California has devoted US$3 billion to this research. Dr. Hwang took mature cells from patients with genetic disease, spinal cord injury, and diabetes, cloned them, and produced 11 embryonic stem cell lines. These ES cells from patients with diseases have enormous significance for two reasons that are significantly different but currently conflated in debate about human cloning.
1. Self-Transplantation The first reason this research is important is that it is a leap toward selftransplantation. The objective of what is often indicated as “therapeutic cloning” is to produce pluripotent stem cells that carry the nuclear genome of the patient and then induce them to differentiate into replacement cells, such as cardiomyocytes to replace damaged heart tissue or insulin-producing beta-cells for patients with diabetes,14 or virtually any cell type, including sex cells. Dr.
Hwang has shown that one day we may be able to take a skin cell from a patient with diabetes, clone it, derive ES cells, produce insulin-producing cells from these, and transfer the resulting cells back as a transplant. Because the cells would come from the patient, as in Hwang’s experiment, there would be no need for drugs to prevent rejection, which can be lethal. Although cloning research is still in its infancy and much more research needs to be done, it may give us one day the possibility to produce “patient matched” tissue to repair damaged organs like the heart and brain, which have no capacity for regeneration, providing radical new treatments for stroke and heart attack, Parkinson’s disease, and many other diseases. This is regenerative medicine. It is the Holy Grail of medicine.