Cloning of cells not involving the creation of embryos

In its report on human cloning, the U.S. National Bioethics Advisory Commission refers to alternative procedures for obtaining cells to be used in transplantation: procedures which it sees as morally preferable to the use of human embryos (Chapter Two). We would agree that such procedures would be morally preferable to the use of unconsenting human subjects, and would strongly urge that research in this area be pursued.

Cloning to produce surviving children

It is worth stressing that the development of cloning and similar techniques to produce surviving children would only take place after a history of non-therapeutic experiments on embryos, and of failures and/or malformations at the stage of clinical trials. Such a cost would not be morally acceptable, whether those affected were embryos or foetuses or surviving babies, children or adults (Question 5). The Consultation paper asks how costs in terms of human experimentation compare with the experiments which led to successful IVF procedures (paragraph 8.6). In our view, the cost of IVF in terms of human experimentation should be seen as grounds for condemnation of the road to IVF, rather than as grounds for accepting a similar cost in regard to human cloning. It is not acceptable to submit human beings to destructive or high-risk experiments, or otherwise to treat them as expendable at any stage of their lives.

Medical risks and financial costs of cloning

Even after extensive research had been performed, the medical risks and financial costs of cloning might be difficult to justify. This might be so even if in cases where the motive for cloning (or nuclear replacement not involving cloning) was to prevent the transmission of a serious genetic disorder. The production of children in ways which carry risks to those children needs to be evaluated differently from high-risk treatments of existing human beings, since commissioning couples will always have the option of avoiding conception altogether.5 It seems likely that many of the couples who might, in the future, have children produced on their behalf via nuclear replacement would not have had children at all had nuclear replacement not been made available. More risks can be justified in the attempt to treat an existing individual with a serious genetic disorder than can be justified in the attempt to produce an individual who is only produced because a certain procedure is on offer.

Cloning and human identity

Leaving aside the medical risks of cloning and other forms of nuclear replacement, are there any further objections to these procedures? We believe there are a number of serious moral objections to cloning to produce surviving children, some of which do and some of which do not apply to other reproductive technologies. We will begin by discussing one objection specific to cloning: the objection which concerns the need to safeguard a person's individual genetic identity (Question 3).

A clone is not the same human being as the individual from whom he or she was cloned. Rather, cloning can be regarded as a form of asexual reproduction. Just as an individual embryo can give rise to a twin or twins distinct from him or herself, so an individual adult could give rise to clones distinct from him or herself. An individual can produce a new individual, with a totally separate identity. The physical similarity of two individuals does not make them one and the same individual.

However, similarity, if carried to extremes, can have harmful effects on the individuals concerned. As the consultation paper notes (paragraph 8.2) identical twins can experience psychological problems, at least if they are brought up in ways which do not adequately recognize their separate identity. Such problems might well be exacerbated in the case of cloning, since whereas twins are not deliberately created as identical clones would often, if not always, be created in order to resemble someone else.

It is true that, unlike naturally occuring twins, clones would (or could) be widely separated in age from the person from whom they were cloned. However, the difference in age, where this existed, could create problems in itself. The clone would see the person from whom he or she was cloned developing certain features, whether positive or negative, and would feel him or herself in tension with this pre-existing life.6 Similarly, the cloned human being would live in the shadow of his or her genetic counterparts, with whom he or she would be liable to compare him or herself, and be compared by others. Even if the clones would never meet each other or the person from whom they were cloned, the mere knowledge that genetic counterparts existed to themselves would be likely to give both the clones and the original a sense of incompleteness, and prevent them, at least to some degree, from concentrating on their separate lives. Cloning is, we would argue, an offense to the dignity both of the clone produced and of the person cloned, even if this person has given his or her consent. While genetic similarity is certainly compatible with full moral status on the part of clones (or on the part of identical twins), genetic difference is nonetheless a powerful symbol of separate identity, which should not be deliberately abandoned. Physical differences, starting with genetic differences, visibly witness to the fact that each person is a separate individual with his or her own life to lead. This is particularly evident when we think of large numbers of clones being produced together - for example, twenty at a time. While each of the clones produced will be a separate human being with his or her own life to lead, clones are likely to be treated as interchangeable by some of those with whom they have to deal. People value less what they see as interchangeable. If, as we will argue, the symbolism of production is itself inappropriate to human generation, that of mass identical production is still more inappropriate.

We will return to genetic difference as a symbol of moral separateness in the section on the good of children below. At this point we will focus on the relationship of cloning to natural identical twinning.

Natural and artificial processes

In referring to natural twinning, the consulation paper asks if there is reason to distinguish, from a moral point of view, between artifical processes for which there are parallels in nature, and those for which there are not (Question 5). For example, is cloning by embryo splitting, which mimics natural twinning, morally preferable to cloning by nuclear transplantation, which is not found in nature (paragraph 8.7)?

It is important to remember here that nature is not a moral agent, whereas human beings are. No natural process may be deliberately brought about, or deliberately copied, simply because it is a natural process. On the contrary, we need to make a judgement both on the kind of process which is in question and on the social context in which this process would take place. For example, procreation, even where totally 'natural' (that is, involving no technology) will be justified or otherwise depending on such factors as the parents' commitment to the child.

Healthy human functioning

The appropriate social conditions for procreation will be looked at in the following section. Here we will focus on the relationship between those occurrences which are part of healthy human functioning and those which are not. It is, we believe, insufficient to establish if a procedure is morally acceptable to ask if it promotes, or closely imitates, healthy human functioning. However, there is certainly more reason to question a procedure which does not promote or imitate such functioning, but instead seriously distorts it. Distortions of function can be deliberately and/or artificially produced, or they can occur naturally. Because a distortion can occur naturally is, however, no reason to cause it deliberately.

Embryo splitting, in which the original embryo is (or risks being) destroyed, reproduces what is arguably a natural accident, not a natural function. There may be some value, at least in some cases, to the imitation of natural functions; there is none to the imitation of natural dysfunctions - at least where these involve the death of the individual concerned. It is, for example, no better to cause death deliberately by causing heart failure - something which can occur naturally - than to cause death deliberately by some means not found in nature.

Clearly, distortions of function which cause death are still more to be avoided than distortions which do not. For this reason, embryo splitting (and nuclear transplantation using the nucleus or pronuclei 7 of a pre-existing embryo) are still more objectionable than nuclear transplantation from somatic cell to ooctye (or from oocyte to ooctye) since the individuals produced would owe their lives to the death of a previous individual. However, even cloning which does not involve the death of a previous individual involves a distortion of function without (we would argue) any compensatory gain in terms of human well-being.

Medical treatment

In addition to the social problems raised by cloning and similar techniques - problems which will be discussed in the following sections - it is worth noting the fact that such techniques would not be medical treatments, even when used to circumvent infertility, or to prevent the transmission of genetic disease. To be a medical treatment, an intervention must help a patient to have or exercise some function which he or she needs to have or exercise in order to be healthy. As functions are more and more distorted by some procedure, it is less and less plausible to argue that the procedure promotes the healthy functioning of the person or people involved.

Consider the case of nuclear tranplantation to prevent the transmission of mitochondrial disease (paragraph 7.3). In one scenario, the woman with mitochondrial disease would provide an oocyte from which the nucleus would be removed. This nucleus would be placed in the enucleated oocyte of a donor, and the resulting 'combination' oocyte would be used in in vitro fertilisation. It is doubtful whether such an intervention can be seen as a genuine medical treatment, since it does not confer on the woman with mitochondrial disease any function she needs to have or exercise in order to be healthy. (It does not, for example, give her - even temporarily - the ability to become a full genetic mother without passing on her disorder.) Certainly, nuclear transplantation is a means of avoiding the transmission of mitochondrial disease; however, it is neither the sole means of doing this, nor a means which promotes or leaves intact normal healthy human functioning.

The good of children

However, our main objection to nuclear transplantation, and to cloning in particular, concerns the welfare of the child. Having children is - as most would agree - an activity of great social importance. It is not just a private, but a public policy issue; we are all affected when children are conceived in ways which do not respect their dignity. Where third parties are involved in procreation, as in the case of reproductive technologies, there is a particular need to protect children's interests, as well as those of parents. There is, in short, a need, when determining which reproductive technologies will be licensed and funded, to think of what children need for a good life. 8

The child's sense of separateness

One of the things children need for a good life is a sense of separateness both from their parents and from others. As we argued in the previous section, genetic individuality, while not a condition of separateness is nonetheless a symbol of separateness. Normal human procreation carries with it a valuable symbolic content, not only (as we would argue) at the level of sex itself, but also at that of fertilisation. The fusion of the genetic contributions of the two parents symbolizes both relatedness and difference. The child is genetically related to both parents, but is still genetically unique, just as his or her life is both a new start and owes a debt to the past.9

The child is not only different from both parents, but (except in the case of identical twins) is also different from his or her siblings. The contingent nature of procreation - the unpredictability of the child's makeup, both mental and physical - also carries with it a valuable message both for the child and for the parents. Genetic novelty and unpredictability is a symbol of the forward-looking and flexible nature of good parenthood and healthy child development: of the way in which parents and child should respond to life's demands as they meet them, rather than seek to reproduce some model taken from the past.

Like marriage, parenthood involves, or should involve, a going beyond oneself to another: an acceptance of difference. The perennial temptation for parents is, however, to seek excessive control over their children's characteristics, and to value their children only according to how well they meet their own requirements. Cloning, it is clear, will do nothing to help parents guard against this particular temptation, as cloning itself involves a very high degree of parental control.

Even in the case of natural procreation, children will often need to struggle hard to establish a separate identity from their parents, particularly if the parents are too dominant in how they treat the child. How much more of a struggle will be needed when the child is genetically identical either to one social parent, or to someone the parent or parents want reproduced?

It is no answer to this objection to assert that there will be significant differences, due to differences in environment, between the clone and the original. The point is not that the clone will be in every way similar to the original. The point is rather that the parents will expect a high degree of similarity between the clone and the original, since this will often be the very reason why the clone has been produced.10

Cloning and human lineage

Children need a sense of separateness from their parents; they also need a clear sense of lineage. The potential of cloning for the disruption of human lineage is, in fact, considerable, as it is quite unclear what relationship the clone would have to the original. Even where two people of different sexes have been used to produce a clone, he or she will have literally no genetic parents in the normal sense of the term.

We mentioned earlier the proposal for nuclear replacement (in this case, not involving cloning) to prevent the transmission of mitochondrial disease. Such a procedure presents the child produced with two candidates for the role of biological mother - or, indeed, with three candidates if, as some have suggested,11 a surrogate mother is used to gestate the child. The child will grow up knowing that he or she has two genetic mothers, or rather, 'part-mothers': the woman who provided the nucleus of the 'combination' oocyte, and the woman who provided the remaining material, including extranuclear genetic material. It is, however, disorienting for children when their genetic makeup results from several people, of whom one at least is a stranger who wants no involvement in their lives. 12

Fatherless children

In the case described above, the child produced would at least have a full genetic father, since the 'combination' oocyte would be fertilised in vitro. In the case of cloning, in contrast, there would be no genetic parents in the normal sense of the term; only providers of nuclei and/or enucleated oocytes - or, in the case of embryo splitting, embryos who die in giving rise to new embryos. Cloning is asexual in a still more radical sense than IVF, in that procreation is distorted to such an extent that two people of different sexes are no longer required. Thus a single woman could have a child using only her own genetic material. A lesbian couple could have a child, using a nucleus from one woman and an enucleated oocyte from the other. Such conceptions would be utterly lacking in the complementarity - the 'union-in-difference' - of procreation involving two sexes, and would deprive the resulting child of both a social and a genetic father. Society would find itself with literally fatherless families, with the male still more radically excluded than he is in the case of (for example) sperm donation. This exclusion of the male from reproduction would only exacerbate the tensions which already exist to some degree between the sexes. It is, in any case, unlikely that a child conceived in this way would not be adversely affected in her relation to the sex which contributed neither to conception nor to postnatal care.

As to the case of the woman who clones herself using her own oocyte, this is a disturbingly solitary, rootless and narcissitic form of reproduction. What kind of social identity will the child have when she is missing one side of a human family?13 Is it right to make one-parent families deliberately? Of course, one-parent families already exist in large numbers; however, the lack of one parent is not normally planned in advance, and is normally regarded - not least by members of such families - as less than ideal. 14

Cloning and other reproductive technologies

It is, however, the case that the objections raised above to human cloning can also be raised, to some extent, to other forms of human reproduction. Existing reproductive technologies, for example, already make it possible for single women and lesbians to conceive and bring up children in the absence of a male. While the child who results from these technologies will have a genetic father, he or she will not know the genetic father, and in that sense will be missing one side of a normal human family. Even where the child is brought up by a heterosexual couple, and thus by a social father, the child will not know his or her genetic father if he or she is the result of donor sperm. In the same way, in the case of ovum donation, while the child will have a full genetic mother, he or she will not know the genetic mother. The donor is excluded from social parenthood, if not from full genetic parenthood.

Certainly, many objections cloning raises are raised by other forms of reproduction. We ourselves reject as irresponsible -however well-intentioned - contributions to procreation by donors who will never see or care for the children who result. Nor is our objection to existing technologies limited to those involving donation. We have, on the contrary, more radical objections to IVF and similar techniques: objections which would also apply -perhaps in stronger form - to the case of human cloning.

The production of children What is the common factor between human cloning and existing reproductive technologies? It is the fact that children are literally manufactured, by means of a procedure which bears a close resemblance to any other manufacturing process. The symbolic content of this process has, we would argue, a harmful effect on the way in which the 'product' is regarded. To produce a child as if he or she were an artefact offends against the dignity of all of those involved, and creates a situation in which the child produced is liable to be treated as an artefact. In contrast, sexual procreation by those who are committed to each other and to the nurture of new lives has its own symbolic content: that of interpersonal giving and receiving. An act with this symbolic content is, we believe, more appropriate to human generation, and will help the parents to respect as a person any child who may result. 15

Our objection is not, we want to stress, to the use of technology in reproductive medicine. Technology which helps a married couple to conceive a child by having intercourse is, on the contrary, welcome, since it leaves intact the symbolism of sexual procreation. What we object to is technology which replaces, rather than assists, normal sexual procreation, and substitutes for the symbolism of giving and receiving the symbolism of production.

The mentality of production

What is the evidence that the symbolism of production is harmful to attitudes to children? In the case of IVF, there is, in fact, no doubt that the 'product' of the process is normally regarded -at least in the early stages - as a product, not a child. In IVF, the 'producer' mentality can be seen in the way in which IVF embryos are, in practice, treated by parents and clinicians. These embryos are mass-produced, screened, discarded, used in experiments and so on; in short, they are treated as products or possessions under adult control. Such de facto expressions of the 'producer' mentality are sometimes confirmed by explicit statements on the part of parents or clinicians. For example, one study found that over 90% of IVF patients regarded the embryo as their property.16

With cloning, too, those prepared to defend the procedure show by their proposed applications a 'producer' mentality towards the envisaged 'products'. It has been observed that supposed justifications of cloning are in fact symptoms of the moral problem it creates. 17 To begin with, there is the proposal mentioned above to use cloned embryos in non-therapeutic research. Far from being, as some maintain, the best suggestion for the use of human cloning, this is the most grotesque example of the production-line mentality. Similarly revealing are proposals to generate embryos to be used in transplantation: such proposals reduce new human lives to disposable genetic material.

Less grossly immoral, but nonetheless disturbing, are proposals to 'replace' the dead by cloning. It is both dishonest and cruel to offer to 'replace' a child who died after birth (or before birth, in the case of abortion) by what would be another child entirely (paragraph 8.3). It is similarly dishonest and cruel to encourage the belief of those who think they can 'cheat death' by making a clone of themselves. Genetic similarity must not be confused with literal sameness of identity. Those who die will not be brought back to life by cloning. Those who are killed, in the case of abortion, are wronged twice over by being deprived of their lives, and by being used as unconsenting sources of genetic material. In this last case, there would be a danger of women who were otherwise reluctant to abort being urged to do so on the grounds that the child could 'come back' when they were ready to be pregnant. Society would once again demonstrate its willingness to terminate existing human lives, as the same time as its willingness to go to extraordinary lengths to generate new lives if desired.

New issues raised by cloning to produce surviving children

Like IVF and similar techniques, cloning invites those who choose it to adopt the 'production-line' mentality to children. In some ways, however, cloning would constitute still more of a production-line process than existing techniques. As we have said, the symbolic content of mass identical production would be still less appropriate to human generation than that of production per se. Moreover, to the 'quality control' of human embryos - which cloning would doubtless reproduce - would be added control over even non-disease features of children. Even more than in the case of IVF, parents would be invited to accept the child conditionally, as he or she would be constructed to meet very detailed requirements on their part. In the case of IVF, the focus of the parents is on a healthy child. After the child is born, the parents may want to 'play down' the way in which the child was conceived. The child will also have some opportunity of forgetting, in the course of daily life, the circumstances of his or her conception. In contrast, in the case of cloning, the focus of the parents is much more on the future: the parents want not just a child but a 10 year old, a 20 year old or a 30 year old with certain characteristics.

Visibility of cloning

Cloning, unlike IVF, will be visible in the child's very facial makeup. The child's appearance will be a daily reminder, both to the child and to the parents, of the circumstances of his or her conception. The tension between the parents' expectations and the child's wish and ability to meet these expectations will thus be felt on an ongoing basis.

If the child is a clone of someone famous - and/or one of many clones - the child will bear the signs of his or her origin plain for everyone to see: the signs of someone produced by artificial means to meet someone else's expectations. Quite generally, genetic privacy - something we normally go to some lengths to protect18 - will be unavailable in the case of clones, as their genotype will already exist.

Cloning and 'geneological bewilderment'

Cloning would, moreover, replace not only sexual procreation but its outcome: fertilisation. IVF impoverishes parenthood - particularly where donors are involved - while cloning would fragment it to the point of unrecognizability. The primary role of the agent in procreation would be handed over even more completely to technicians, since prospective 'parents' would be reduced to providers of parts even smaller than a gamete.

The child's sense of confusion based on his or her all-too evident resemblance to the person cloned will be compounded by confusion with regard to his or her lineage19 (what some have called the 'genealogical bewilderment syndrome'20). Whereas in the case of existing techniques involving donation, the child is deprived of one or both genetic parents, in the case of cloning there is not even a genetic parent, in the familiar sense, of whom he or she can be deprived.

Commercial applications of cloning

Finally, there is the fact that cloning lends itself, perhaps even more than IVF, to commercial exploitation. We will not attempt to deal with this aspect of cloning in any kind of detail. However, it is clear that there is great potential for commercial applications of cloning, given the fact that even healthy couples would be in the market for cloning procedures. Already, positive eugenics, in the form of sperm banking, is aggressively marketed in some countries. How much more attractive a proposition will positive eugenics become when the features of the child to be conceived can be more firmly guaranteed?

Conclusion Cloning does, then, raise some new ethical issues, in addition to those raised by existing procedures. However, we welcome the invitation of the HFEA and HGAC to address not only these new issues but the setting in which cloning would take place. An ethical analysis of any kind of depth must involve a serious attempt to engage with the issues raised by the practice in question, even if these issues are also raised by practices already taking place. Room must be left for a re-evaluation of (in this case) practices in reproductive medicine, without assuming that such pratices are - because familiar - morally acceptable. We note that the HFEA and HGAC have the task of advising Ministers on ways of building public confidence in genetic techniques (Paragraph 9.2). If the techniques in which the public lacks confidence - techniques including human cloning - are such as to raise quite legitimate fears, there should clearly be no question of building public confidence in these techniques. Rather, the concerns of the public must be taken up both by Governmental and by quasi-Governmental bodies, so that techniques which harm human beings and their relationships will not be carried out. What we urge, above all, is that there be no proposal to allay public concern by banning cloning to produce surviving children, while continuing research involving the cloning of human embyros. Not only does such research involve an instrumentalization of those treated as laboratory material, but it paves the way for further instrumentalization of human beings when sufficient research has been performed. Whatever view is taken on embryo research in itself, those who are serious in opposing at least those forms of cloning where the embryo is implanted should also oppose research which seems likely to lead - and is, indeed, intended to lead - to such cloning in the future.

Notes (1) The Submission has been prepared on behalf of the Linacre Centre by Dr Helen Watt, a Research Fellow of the Centre, in consultation with Luke Gormally, its Director. back to text

(2) To speak of the human being or person as the living human organism is not to imply that the living human organism is a purely material entity. Rather, it is to stress the importance of the body - animated, in Christian theology, by a rational human soul or 'life-principle' - as at least an aspect of the human being or person. back to text

(3) For a defence of this position, see L. Gormally, 'Diritti dell'Embrione' in S. Leone and S. Privitera (eds.), Dizionario di Bioetica (Bologna, Editoriale Dehoniano, 1994) pp.257-61; A. Sutton, Prenatal Diagnosis: Confronting the Ethical Issues (London, The Linacre Centre, 1990) pp.104-19; T. Iglesias, IVF and Justice (London, The Linacre Centre, 1990) esp. pp.62-68; H. Watt, 'Potential and the early human', Journal of Medical Ethics 22, 222-226 (1996); H. Watt, 'Personhood and the human embryo' in H.Watt (ed.), The Human Embryo: Science, Law, Ethics and Public Policy (in preparation). back to text

(4) See, for example, G. Grisez, J. Boyle and J. Finnis, 'Practical Principles, Moral Truth and Ultimate Ends', American Journal of Jurisprudence 32, 108 (1987). back to text

(5) Report of the Catholic Bishops' Joint Committee on Bioethical Issues Working Party on Gene Therapy: Genetic Intervention on Human Subjects (London, Catholic Bishops' Joint Committee on Bioethical Issues, 1996) p.34; H. Watt, 'Germ-line therapy for mitochondrial disease: some ethical objections', forthcoming in the Cambridge Quarterly of Healthcare Ethics. back to text

(6) See S. Holm, 'A Life in the Shadow: One Reason Why We Should Not Clone Humans', Cambridge Quarterly of Healthcare Ethics 7, 160-162 (1998). back to text

(7) We would argue that the embryo originates after sperm entry, but before syngamy, so that the human individual is already present at the pronuclear stage. See Watt, 'Germ-line therapy for mitochondrial disease: some ethical objections'; Watt, 'Personhood and the human embryo'. back to text

(8) D. Callahan, 'Cloning: The Work Not Done', Hastings Center Report 27, 19 (1997). back to text

(9) L. Kass, 'The Wisdom of Repugnance', The New Republic, June 2, 1997, reprinted in the Human Life Review 23, 73 (1997). back to text

(10) Holm, 'A Life in the Shadow', p.62. back to text

(11) D. Rubenstein, D. Thomasma, E. Schon and M. Zinaman, 'Germ-line Therapy to Cure Mitochondrial Disease: Protocol and Ethics of In Vitro Ovum Nuclear Transplantation', Cambridge Quarterly of Healthcare Ethics 4, 322. back to text

(12) Watt, 'Germ-line therapy for mitochondrial disease: some ethical objections'; A. Fisher, IVF: The Critical Issues (Melbourne, Collins Dove, 1989) p.73. back to text

(13) Kass, 'The Wisdom of Repugnance', p.79. back to text

(14) In this context, it is worth noting that the Human Fertilisation and Embryology Act requires those providing fertility treatment to take account of the future child's welfare, including his or her need for a father (Section 13.5). back to text

(15) See, for example, the Catholic Bishops' Joint Committee on Bioethical Issues, In Vitro Fertilisation: Morality and Public Policy (Submission to the Warnock Committee) (Abingdon, Catholic Bishops' Joint Committee on Bioethical Issues, 1983) pp.12-18. back to text

(16) Fisher, IVF: The Critical Issues, p.156. back to text

(17) Cardinal William Keeler, Testimony on Cloning to the (US) Subcommittee on Health and Environment Commerce Committee. back to text

(18) L.Andrews, 'Mom, Dad, Clone: Implications for Reproductive Privacy', Cambridge Quarterly of Healthcare Ethics 7, 176-186 (1998). back to text

(19) Kass, 'The Wisdom of Repugnance', p.78. back to text

(20) Fisher, IVF: The Critical Issues, p.73. back to text