In their own image

Britain?s go-ahead for the cloning of human embryos for stem-cell research will be a medical money-spinner. Ethics is being made to dance to the scientists? tune

THE decision of the Human Fertilisation and Embryology Authority (HFEA) to grant a licence to British scientists to engineer a cloned human embryo has put Britain into a class of its own, scientifically and ethically. The point of the research, which will be conducted by a combined university and NHS team in Newcastle-upon-Tyne, is not to create a cloned human being but to produce embryos for the purpose of harvesting ?stem cells? for therapeutic purposes. Stem cells are primitive ?mother? cells which theoretically can be turned into any of the 200 cell types found in the human body. Some scientists (but not all) claim that only cells taken from human embryos have ideal properties for stem cell therapy for an array of illnesses, ranging from Parkinson?s to diabetes.

Enthusiasts for such research argue that it will one day be possible to grow a new liver, heart, or spinal cord by this method: what is more, these replacements, because of the cloning technique, will be matched precisely to the patient?s DNA. But the promised benefits go far beyond therapies for the sick. In many parts of the world, but specifically in the Ukraine, Haiti, and Mexico, countries where medical-ethical protocols are less stringent, scientists are planning stem cell treatment for ageing, cosmetic surgery, and rejuvenation.

What precisely is being proposed? And is it ethical? The DNA, or nucleus, is taken from a skin cell of a post-natal human being. That nucleus is then injected into a human egg from which the DNA has been extracted. An electric shock then triggers a division process to initiate development in what is now an ersatz egg or cloned embryo. After six days the embryo will have grown to a 100-cell mass known as a blastocyst (still only the size of a full stop on this page). Cells which have pluripotency (in other words, can in theory be turned into any kind of human cell type, hence ?stem? cells) are then removed from the blastocyst for research purposes. These stem cells can now be diversified by culture techniques in petri dishes. The strategy is to manipulate the cells so as to create replacements for diseased or deficient tissue, blood, and even new organs.

Most European countries, including Germany, France, and Italy, are against the therapeutic exploitation of both cloned and non-cloned embryos. Germany has traditional reasons, relating to its Nazi past, and wishing to distance itself from human experiments in the death camps; France is unhappy about entering the scientific unknown; while Italy tends to take a Catholic view of the embryo as a human individual. The European Parliament, despite intense lobbying by pro-embryo-research scientists, failed to sanction funding for human embryonic research last year. The United States, in a fudge that has pleased neither side of the ethical-scientific divide, has banned government grants for human embryo research, but allows private research on ?spare? IVF embryos dating in age no later than 9 August 2001. In Britain, people of different faiths, and of none, represented by groups such as Comment on Reproductive Ethics (Core), have objected to the decision, stating that it offends the sanctity of human life. But reaction to the HFEA announcement last week was fairly muted and short-lived. The only other country to have created a cloned human embryo is South Korea (after 240 tries), although peer reviewers in the field have cast doubt on their claimed success which was reported last year.

There are objections, both from scientists and ethicists, that cloned embryos could be a ?slippery slope?, prompting wide-ranging experiments with human forms of life. Last year biologists at the Second Medical University in Shanghai announced that they had reprogrammed human cells by fusing them with rabbit eggs emptied of their genetic material. The ?slippery slope? argument includes not only a sense of repugnance at hybrid species, but fear of taking human reproductive engineering into unknown realms. Because cloning involves the exploitation of the cell of a fully grown organism, it involves skipping a segment of development (from sperm to full organism). Some scientists, such as Stephen Rose of the Open University, liken this to skipping a stage in evolution, with consequent dangers. The fate of Dolly the sheep, which began to deteriorate genetically within a year of its birth, is an example of this.

That Britain has emerged as the sole pioneer in this work in the West is both significant and disturbing. Public and scientific opinion has been shaped, it appears, more by zealous medical enthusiasm, if not downright hype, as well as the prospects for commercial advantage, than by ethical considerations. The decision to grant the licence, moreover, was entrusted solely to the HFEA, a body of 16 professionals, which has a reputation for being close to the scientists who urge such research. Established in 1991 as a result of the 1990 HFEA Act, no less than nine of the authority?s members work scientifically and clinically in the ambit of infertility, assisted conception, and gynaecology, and hence would be likely advocates for the creation and wastage of embryos for IVF. The rest are an assortment of individuals, including a dentist, an academic lawyer, the chief ombudsman, and the newspaper columnist and former editor of The Times, Simon Jenkins. Just two members would appear to have credentials in moral philosophy: Professor Tom Baldwin of York University, and the Anglican Bishop of Oxford, Richard Harries.

The history of stem cell discovery provides clues to the hazards, the scientific and medical promise, as well as the potential for massive financial rewards. Scientists first came across stem cells some 40 years ago when they were found to be the cause of monstrous cancers known as teratocarcinomas. Men with lingering groups of embryonic stem cells in their genitals were found to grow teeth, toenails, hair and cartilage in their testicles. Such cancers raise crucial questions about how to guarantee the genetic stability of stem cells; also how to switch their proliferation on and off. Since therapeutic techniques involve ?colonisation? and the encouragement of cell multiplication in parts of the body such as the brain or liver, scientists must be sure that the grafted cells will not run out of control and cause tumours.

There have been cogent arguments from scientists in the field that stem cells can be exploited from the umbilical cord or even the gut, thus precluding the exploitation of embryos, cloned or natural. But there are equally powerful arguments from top researchers who insist that stem cell benefits will always be questionable unless we can understand the entire development process of cells from the embryo to organism. Only by experimenting with embryos will such knowledge be gained, say the advocates. Professor Roger Pedersen of Cambridge University, who did a reverse brain drain by coming to Britain from California four years ago (he was fleeing America?s research restrictions on human embryos), maintains that the ultimate goal will be to ?understand how cells develop throughout their entire life cycle: how they flourish and how they go wrong to cause cancers and other diseases?.

It is clear that the research group that succeeds in patenting techniques of stem cell genetic stability, differentiation, proliferation, and control, will reap financial benefits for years to come. There are thousands of groups around the world striving for that Holy Grail. That Britain has become an ethical haven for such work means that the country will attract investment, funding, and qualified personnel in abundance. Patent-savvy scientists and politicians have learned lessons from the case of mono-clonal antibodies (a crucial diagnostic tool in medicine), developed in Cambridge in the Seventies by Cesar Milstein. Milstein and the Medical Research Council failed, or disdained, to patent the process. It was patented instead in the United States by a young American former member of the team, thus losing in time billions of dollars of patent revenue for Britain and its biotech industry. The cloned embryo decision seems set to reverse that story.

But the central issue remains the ethical one. Patients (and their relatives) struggling with devastating diseases that might one day be cured by stem cell therapy make strong advocates for abandoning scruples on the status of the embryo. Christopher Reeve, the former Superman, paralysed from the neck down by a fall from a horse, travels the world raising funds and urging the benefits of embryonic stem cell work. The argument of the medical advocates is principally consequentialist. If cloning an embryo will save lives and hurt nobody, surely it must be right.

Giving further impetus to this view are the attempts of leading interested scientists to change perceptions and language about the human embryo. An eloquent defender of embryo research is Irving Weissman at Stanford?s Institute for Cancer/Stem-cell Biology and Medicine in California. ?Whenever we asked people, even scientists, to draw an embryo?, he says, ?they?d usually draw a foetus with legs, head and so on.? The reality, he says, is ?is a ball of 150 cells?. Professor Pedersen wants to stop calling embryos ?human beings?, he says, and to use the term ?unique genetic entities?. The fact that the cloned cell can be viewed as virtually ?artificial? and probably unviable (Dolly the sheep was the result of more than 200 failed embryos) would seem to aid this argument. But Pedersen goes on: ?For me there?s a distinction to be made between an embryo and a neonate. A baby is capable of communication, interaction and a degree of reciprocity.? By this definition Pedersen would find no problem with the laboratory exploitation of foetuses, or indeed post-natal human beings, that had failed in communication, interaction and a degree of reciprocity.

The terms ?viability? and ?human being? have long been a focus of contention between biologists and ethicists. Since half of all embryos fail to implant in the course of nature, it is incorrect in the view of many scientists to talk of embryos being ?viable? when nature itself liberally disposes of them. This consideration was raised by the Jesuit theologian Karl Rahner, who once commented on the natural wastage of human reproduction: ?Will theologians be able to accept that 50 per cent of all human beings ? real human beings with immortal souls and an eternal destiny ? will never get beyond this first stage of human existence?? To raise the question, however, is not to settle it.

The firm, and arguably the most influential recent re-statement of objections to human embryonic stem cell research comes from the Pontifical Academy for Life, a body of ethicists composed of moral philosophers, theologians, and scientists brought together by the Holy See. Early last year the academy published a paper entitled ?Ethics of biomedical research ? a Christian vision?.

The paper made plain that a concern for ethics does not preclude scientific advances. The academy enthusiastically welcomed research and acknowledged the ?cascading? effect of stem cell work for therapies. But the document challenged the idea that science should do things just because it is possible to do them. ?What is technically possible,? declared the writers, ?is not for that reason morally admissible.? The academy reiterated the Catholic position that the embryo is a ?human individual? thus deserving ?the full respect that is due to every human person?. The text continued: ?Human embryos are certainly not subjects who can give their personal consent to experimentation that exposes them to grave risks without the benefit of any directly therapeutic effect for themselves.?

The experimental sciences, the document pointed out, are not complete in themselves, but ?instruments in human hands, which must be directed to defined ends and put in dialogue with the world of values?. The academy supported a widely accepted Kantian approach in its rejection of using persons as instruments, as well as encouraging an ontological as opposed to a purely utilitarian understanding of the status of the embryo.

The Catholic view of the status of the embryo, which is shared by a wide constituency of pro-life groups as well as many individual scientists, has hardly gained purchase in official and public circles in Britain today, although that view has strongly affected opinion throughout Europe and North America. The situation suggests that Britain is a country that easily accepts the notion that is okay to do bad things in order to achieve widespread good: which is no different from the ethics of some forms of terrorism. There is, of course, another diagnosis: that Britain is currently a country dominated by scientific pragmatism, commercial advantage, and widespread public indifference.

John Cornwell is director of the Science and Human Dimension Project, Jesus College, Cambridge.