Summer Conference 1999: Science, Ethics & Human Destiny

Ethics and a Sense of Meaning: What is it that we must do?

MARGARET SOMERVILLE, McGill Centre for Medicine, Ethics and Law

I want to talk to you this morning about cloning, particularly, human cloning.

I recently saw a cartoon depicting the subject and I puzzled over its meaning for a long time. It showed God designing a person on a canvas and a man copying God doing this. The most obvious response to it was, well, it’s man playing God and we ought not to play God.

But I think the message is probably more complex than that; that cloning is not just going to be a matter of replicating people, but it’s going to open up the possibility of we humans being the creators.

And, so I think we’re playing God here in a special way in which we haven’t played it in other areas where we’ve been accused of doing that. I suggest that we have to think very seriously about whether or not we ought to be doing this.

Another cartoon I saw dealt with two scientists who discovered how to do human cloning. The first thing they decided to do to deal with the moral issues this raised was to clone the ethicist.

What the conference organizers asked me to address was the question, ethics and a sense of meaning what is it we must do?

I would change that question, because I think the single most important question we’re facing at the moment with our new science is not is what is it that we must do, but what is it that we must not do with that new science?

These are questions that no previous group of humans has ever had to face, simply because there wasn’t any option of doing the things that we can do.

And asked another way, putting it more in ethical terms, that question would be: are some of the possibilities opened up by the new science, what we should call inherently wrong?

And if we say that it is inherently wrong to clone humans what that means is that no matter how much good could come out of doing that, we can’t do it. The end, to do good, doesn’t justify the means, which is cloning people.

And so labeling something as inherently wrong is a very difficult decision, because what it means is that we’re turning down some immense benefits with respect to eliminating suffering and prolonging of life that could come from doing this science.

And that situation arises because the means of getting those benefits would be labeled inherently wrong and, therefore, we can’t use those means.

The most recent example where we need to ask, is it inherently wrong? is in relation to what’s called human embryonic stem cell research.

The term doesn’t have the word cloning in it at all but, in actual fact, that’s what it involves.

So, what we’ve got to ask is: how do we go about ethically analyzing whether we ought to do this kind of research?

There’s a saying in ethics that good facts are essential to good ethics. You can add to that good ethics are essential to good law, which is why I was protesting a little bit to the conference organizers about talking about law without talking about the ethics first.

In the past what we used to do was, more or less, use law and assume that it reflected our ethics. In our kind of multicultural, pluralistic, secular, societies, we can’t assume that. So, we have to actually work out the ethics first and then we would have the ethics inform the law.

But before we can work out the ethics, we have to have the facts inform the ethics. Bad facts usually result in bad ethics.

And one of the things that makes doing ethics such a challenge and often so difficult is that the facts change so incredibly rapidly in these areas.

A month ago I was flying to Budapest for the World Science Conference as part of the Canadian delegation. I was going to give a presentation on human reproductive cloning. At that time that was the only kind of cloning that anybody thought could happen with respect to humans.

As I flew from Heathrow to Budapest, the cabin attendant asked if I would like a newspaper. On the front of the newspaper they announced this scientific breakthrough in human therapeutic cloning, which is either the same thing as human embryonic stem cell research, or, if not, raises many of the same issues. Both involve the use of human embryos and this, of course, raises serious ethical issues.

One of the things we need to know is what’s the difference between human therapeutic cloning and human reproductive cloning.

In both, you start off with a donor of tissue who is the person to be cloned and another who donates an ovum, or egg. Then, take the nucleus from the egg and replace it with the DNA from the cells from the [tissue] donor and then activate the hybrid cloned cells and what you get is an egg which has a full chromosomal complement in the nucleus identical to the DNA of the tissue donor.

You now have a human embryo that is genetically identical with respect to its nucleus DNA to the donor. In fact, the egg will have the mitochondrial DNA, that’s the DNA that’s outside the nucleus, from the egg donor.

We don’t know exactly all the roles that plays and it is a slight genetic difference. The other possibility, to get an absolutely genetically identical embryo, would be to take an egg and the cells from the same woman donor. You could only do it with a woman, because men don’t have ova.

Now you’ve got the fertilized egg and this can be used in two ways: first, for reproductive cloning. What you’re meaning to do is to make a child that will be genetically identical to the cell donor. In fact, you’re cloning that person. In fact, we can now split up the various aspects of parenthood.

For example, you can clone a woman using the ovum from another woman and you could have a third woman who would carry that child so the gestational mother doesn’t have to be either the egg or tissue donor. And you could have two different parents who would bring up the child, who we refer to in reproductive technology jargon as the social parents.

There’s a wonderful New Yorker cartoon with this little kid with a nurse holding his hand and there are all these New Yorker-type people standing with a glass of champagne. There are about seven of them and the nurse says to the child:

That’s genetic mommy, genetic daddy, gestational mommy, social mommy, social daddy. That’s your psychiatrist and here’s a lawyer to sort it all out.

That is what is possible with this new technology.

In fact, what we have done is we’ve totally split apart the aspects of parenting that in nature are impossible to divide.

Second, the other possibility is therapeutic cloning. What you do there is that you clone the embryo, which you can do at the early stage of embryo development, and you’ve got no intention of making another human out of those embryos.

What you want to do is to use them for either research, or you want to use them, as what is referred to as living human tissue generators. In other words, you set up -– putting it in blunt terms -– a human embryo-based manufacturing plant.

That’s what I want to talk about, human therapeutic cloning.

Should we do it because it offers huge benefits, or is it inherently wrong to do it? What are the facts about the human embryonic stem cells that are taken from cloned embryos?

What they then do is take the stem cells out of the embryos they’ve created.

One of questions I’ve asked numerous scientists around the world is: are human embryonic stem cells really human embryos? But it’s extremely difficult to get a straight answer from the scientists.

To the best of my knowledge, providing you treat these cells in certain ways, they are what is called totipotential.

Totipotential means that that cell has the possibility of forming another human being with the same genetic makeup. There are also what is called pluripotential.

That means that the cells can be caused to veer off from development to a full human person at a very early stage of embryonic development and be programed, or re-programed, to form certain tissues that you would want.

In other words, they have the capacity to make any tissue organ in the body, because every cell in your body has all of the genes that you have.

But, for instance, your liver cells only express the liver gene and thereby create the liver. Likewise, the skin cells only express the skin gene.

So, what you can do with these cells is make them just express the gene for whatever tissue organ you want.

And this raises the question: is this totipotential cell, this pluripotential cell, really different from a human embryo, or is it, in fact, a human embryo?

That’s one of things we have to decide. And if it is a human embryo, how we should we treat it? Is it ethical for us to use it in this way?

The way that you put that question is, what is the moral status of the human embryo? What’s the moral status of these human embryonic cells?

What’s been our approach to human embryo research so far?

There’s been very discordant views on this. In fact, you see this discord most powerfully acted out in the United States.

Currently in the United States, any institution receiving any federal funds at all – not just for this research, but for any purpose – is banned from undertaking human embryo research.

In Wisconsin, however, in order to try to get around this ban, they set up a privately-funded research facility that isolated human embryo stem cells. I think it was the first facility in the world to have success in doing that.

Now it’s being argued that once you’ve got the cell lines that you can use, that they are not really human embryos, therefore, they don’t fall under the ban on human embryo research. Therefore, it follows you can do this research at the National Institute of Health, or other federally-funded institutions.

That line of reasoning is currently the subject of huge debate. How we characterize what we’re dealing with here is very important.

It’s also very interesting that the English government didn’t know what to do about this, so it set up an expert committee.

The expert committee recommended that human reproductive cloning should be totally banned; you’re not allowed to make a human identical to someone else, but that human therapeutic cloning ought to go ahead.

The article that I picked up on the way to Budapest was a front page headline that said that despite the expert committee’s recommendation, the English government had decided to ban, at least for the present, human therapeutic cloning.

That’s just two examples of the controversy and disagreement the new human cloning possibilities are raising.

Looking now at what we’ve got in Canada, Bill C-247, which is currently before the Parliamentary Standing Committee on Health, and it deals with human cloning in general. It certainly deals with human reproductive cloning and says that will be prohibited. It also has a provision in it that says alteration of the human germ cell line will be prohibited.

We’ll get back to that; whether that’s a good idea.

It’s hard to work out whether the Bill would prohibit human therapeutic cloning.

This raises an interesting insight. . Here’s a Bill that’s very recently in Parliament; not even passed into legislation yet, and we can’t agree on what it says. In fact, it was drafted at a time when the only thing people were thinking about was human reproductive cloning, not human therapeutic cloning.

So the people who oppose any interference with human embryos, including for cloning, say, for instance, as some Constitutions do -– the German and the Swiss Constitutions -– that the earliest form of human life is human life and deserves the same respect as all other human life from the moment of conception. Therefore, an embryo has human moral status and must be treated as such.

This is not necessarily to trespass on abortion, because it can be agreed that there are some other situations where you have to take other claims into account, and that abortion involves a separate set of arguments.

In the past what people would say in support of this approach, is that this embryo you’re going to do research on is a genetically-unique "individual."

And that was true because the way we produced human embryos was from fertilization of an ovum. But, now that genetically-unique argument isn’t true when the way in which you’ve created the embryo is from human cloning.

Another group of people, including many scientists, say well, the human embryo is a special kind of human tissue because it’s got this potential to become a person and it’s got the means of passing on human life. Therefore, it’s got a special moral status, but it’s not the same moral status as everybody else.

And, therefore, it doesn’t deserve yet the same respect as the rest of us. And, therefore, they’ve tried to work out, what does respect for that human embryo require?

For instance, if you look at the report of the Royal Commission on New Reproductive Technologies – and that reflects fairly generally held views around the world – what people say is: First you must not create this embryo just for the purpose of carrying out research on it; that is not acceptable. What you can do, is with the consent of both donors, the man and the woman, use what are called spare embryos; that is embryos left over from in vitro fertilization procedures, which the people whose gametes were used to create the embryo and who give full and informed consent to research being carried out on those embryos.

They would also not only require that it be a spare embryo, but that the research be limited to the first 14 days of active cell division after fertilization, which is not necessarily the first 14 days after fertilization because these embryos can be preserved in liquid nitrogen at minus 273 C and they don’t continue to divide until you take them out and let them go on.

One of the questions raised is, what are we doing when we’re cloning an embryo?

If the first embryo we used was spare, does that make all the other embryos spare? Or, in fact, are we creating embryos for the purpose of research, which would be banned under your normal rules and, therefore, should it be banned under therapeutic cloning rules?

One thing that’s really important in doing ethics is our choice of language. And it is extremely interesting to track the way that we change our language as we change what we want to do, as we change our perceptions of the ethics involved.

And sometimes we think we overcome ethical problems, simply by calling what we’re dealing with something else.

So if you call the living entity you’re dealing with a human embryo a lot of people get very upset about it. If, on the other hand – as happened with embryo research – you say, well, you really haven’t got an embryo until 14 days after fertilization and up to that time let’s call it a pre-embryo.

Then, instead of associating that entity during that time with an embryo that would require certain respect, what you do is say: Well, this is really no different than a mixture of a sperm and an ovum and, if you took the sperm and ovum separately, would you feel okay about doing properly-regulated, ethically-approved, very important, valuable scientific research?

And everyone says, yes, that’s okay. Therefore, let’s get on with it.

So one of the things we have to do is watch the language that we’re using. And this is something that I’ve pointed out to you; we’ve already, indirectly, stopped calling these cloned cells, "embryos," and we’re calling them human embryonic stem cells.

There is a difference between an embryonic stem cell and a full embryo. But the issue is: is that a valid difference for the purpose of moral and ethical distinction governing the way we break those earliest forms of human life?

The other very interesting language issue in this area is that we’re a secular society and we can’t use religion as the basis of our public and social policy, much as religion is important to some people in their forming their personal views about such policy.

But in the kind of society we are, we have to be able to present those views from a secular base and for most of us, if we are religious, we hope that the resulting policy doesn’t in any way contravene our religion.

One of the problems in these areas is that almost all of the language we have available so far to express important values and shared concerns has religious connotations or associations, even though we’re using it secularly.

And the problem is that that freaks out a lot of people who feel that religion shouldn’t be playing any role in determining what the public policy should be on these issues.

We don’t yet have – and I’m not sure whether we ever will have – an alternative vocabulary. And that’s not an accident. The reason for that is because the kind of value issues that we’re dealing with here, up until the last 20 years, were usually determined through religion.

So, it’s not surprising that the terminology and language we use has those religious connotations.

But, there again there’s a confusion in the associations that you can get. And those confusions of associations can be ethically misleading.

So, what does human embryonic stem cell research involve?

You clone a human embryo from either another embryo or an adult cell. You take the stem cell from the embryo and then you can clone embryonic stem cells from that.

The questions raised by this include the following:

First, I’ve already mentioned: is the embryonic stem cell another embryo? I’ve already pointed out that it is totipotential and pluripotential, which is a very important characteristic of embryos.

Is it acceptable to make multiple embryos, as long as you start with a spare embryo? Does that make all the resulting embryos spare embryos?

If a stem cell is not an embryo, or is not regarded as one, do the prohibitions on embryo research apply to its use?

In other words, does the source of the stem cell matter once it has been isolated?

One of the areas of huge contention is where you connect abortion with this research, because one of the sources of stem cells is aborted fetuses. So does that matter? Is it okay to use those?

Is human therapeutic cloning inherently wrong?

To argue that it is, we would start with the fact that it involves the intentional destruction of a human embryo and, for some people, destructive human embryo research contravenes their religious beliefs and they would believe it’s inherently wrong for that reason.

But, as I said to you, we can’t use religion as a direct basis of public policy in a secular society.

So, what we can do is that we can and must use ethics which, in a way, you can regard as a secular religion of a global, pluralistic, multicultural society.

So, the question becomes – and it’s really a tricky question – can you argue that anything is inherently wrong without resort to some absolute, external moral authority, whether it’s God, religion, or an absolute Monarch, none of which we can use today as the basis for saying something is inherently wrong.

And what I would suggest to you is that maybe we can – and that’s one of the areas that I’ve been doing my research on.

What I’m playing around with is that we could possibly use two secular values, important, fundamental secular values, that could indicate that some things are inherently wrong.

The two values I would suggest are: First, we always must act in a way that respects life and I mean life in general and, in particular, human life. So respect for human life is a sub-category of respect for life. And second, we must act to protect and promote the human spirit. There, I do not mean, something religious, or supernatural, or immortal, or eternal.

What I mean by the human spirit is the essential, intangible, invisible, unmeasurable reality that we need to experience to live fully human lives. Put another way, that intangible, essential reality through which we find a sense of meaning in our lives.

And so what I think we have to then do, if we accept those two values, is to ask, how does therapeutic cloning measure up to those two values? Is it contravening those values in ways that we do not think are acceptable, or that we shouldn’t accept and, therefore, we ought not to do it.

I’ll come back to that in a moment.

The alternative to doing that kind of analysis, which is a deontological analysis, is to do what’s called a situational ethics analysis. This is the dominant kind of ethical analysis in our kind of society, partly because we are pluralistic and we are secular.

The secular means that we don’t have an external moral authority that we can easily resort to and the pluralistic means that we don’t have even a facade of consensus on fundamental values.

In situational ethics you work from a base that can be expressed as, nothing is inherently wrong; rather it all depends on the circumstances.

The big difference between this approach to an ethical analysis of therapeutic cloning and the inherently wrong one – and it’s an extraordinarily significant difference – is that under this kind of analysis doing good can be a justification for unavoidable harm.

Under inherently wrong, no matter how much good you do, you can’t justify it, if the means you use are inherently wrong. But under situational ethics, doing good can be a justification.

So, in the case of human therapeutic cloning and human embryonic stem cell research the good would include producing perfectly matched organs and tissues for transplantation.

It could enable us to repair severed nerves, which is being done on mice; treat multiple sclerosis by replacing the myelin sheet that’s damaged in this disease.

And, goes without saying, it’s extraordinarily hard to refuse those kinds of benefits.

We also, however, need to ask whether we could argue that therapeutic cloning is unethical, even under a situational ethics approach.

And here you would have to consider the harms of therapeutic cloning that need to be balanced against those benefits that I’ve just outlined.

One of the problems here is also a post modern problem.

It is that most of us get most of our information through visual media, namely the television. And you cannot put on television, there is no image of, the intangible, unmeasurable realities that are so important to us and that would be damaged by some things we could do with the new science including human cloning of any kind.

It is extremely difficult to present the case based on these harms other than simply through words and images and imagination. But that is often not as strong as powerful physical images , for instance, of very sick people being cured. It’s hard to put the case for protection of these intangible realities against that.

So, what would be some of the harms of therapeutic cloning?

First of all, it makes human reproductive cloning more likely. So it would be certainly more difficult to effectively prohibit reproductive cloning. It opens up a slippery slope.

That would only matter if you thought that human reproductive cloning was inherently wrong. If you don’t think that’s wrong, then you wouldn’t care about opening up that possibility to a greater degree.

Both kinds of cloning, both the reproductive and the therapeutic, open the possibility of alteration of the human germ cell line; that is the genes that we pass on from generation to generation.

In whatever way you alter an embryo’s germ cell line, you alter every descendent of that embryo in the same way unless you change the germ cell again.

It opens up the possibility of what’s called genetic enhancement and the much less talked about possibility, of genetic dis-enhancement.

I was recently in California and the American scientists that I was working with there, who were from some of the leading universities, such as Princeton, said they really thought cloning was a non-issue. As far as they were concerned it would be done and they were going to do it.

But they thought the ethical problems, if there were any, really centered around enhancement and dis-enhancement. They mainly talked about enhancement technologies.

The sort of argument that was being put forward was, look at all the money people spend on sports coaching, music lessons, private schools for their children. And they estimated that within the relatively near future, for between U.S. $5,000 and $10,000, you would be able to redesign your human embryo and have its intelligence enhanced. That, they said, would save you a lot of money in the future for these other things that you had to do.

They thought I was completely unrealistic that I thought that:

A – this wouldn’t happen; and,

B – there were serious moral problems with this.

Lee Silver, was one of the scientists at this meeting who, in his book, Out of Eden, talks about the genetically rich and genetically poor. He said that just as economically-rich people marry other economically-rich people to enhance their fortunes, in the future parents genetically rich, genetically enhanced children will arrange marriages with other genetically-rich partners so they produce further-enhanced embryos.

It is a really serious issue if this proves true.

One tends to think of this as being something very few people could do that is, even if we think it’s wrong, we don’t have to worry about it having a major impact on our gene pool or on the world.

But Professor Silver, spoke of an embryologist he would not name, who had trained 20 housewives with high school educations and they had become expert at manipulating the genes in embryos. They would train for one small part of the procedure and become expert at this. This made genetic enhancement very inexpensive and the process could be set up, more or less, like an assembly line production. And he said it will be within the price range of anybody but the poorest.

That’s one of the other things that’s extremely interesting and, if we are concerned about use of the technology, frightening; that as these technologies become refined they become vastly cheaper.

You can think about computers, how in the beginning only an organization like the CIA could afford a computer. Now everybody has them at home and carts them around.

So, it’s the same sort of thing.

A small analogy to the Internet will I think give you an idea of what will happen with this technology.

If you look at what makes up the Internet, the modems, the telephones, the fax lines, etc. all of that technology was around for from 30 to 40 years before we connected it, and brought into existence the virtual reality of the world-wide web, which is different in kind from any of the component technology.

The only thing that we’re missing with the reproductive technologies at the moment for a similar change of reality, a massive shift to a different reproductive world, is an artificial uterus. That is being researched, so that you’ll be able to have ecto-genesis, which is out of the uterus gestation.

If that becomes available you will have a total possibility of production-line-designed, enhanced, whatever-you-want future generation.

So that’s what we’re dealing with.

The dis-enhancement worry is that there will be so many boring jobs, especially for people who are super-enhanced and intelligent, that we’ll need a crowd of dis-enhanced people who think those jobs are okay.

One of the things that we also have to think about here, even if we don’t regard using human embryos for research as showing disrespect for individual human life, is whether it shows disrespect for human life itself, in general, which is a different failure to show respect. I believe it does that.

In fact, in the past the only way we could show disrespect for human life itself was to show disrespect for individuals. Now, because we can intervene on the essence of human life itself, or other life, we can actually show disrespect for that life in general.

So, we have to ask: would using human embryos in therapeutic cloning, as they have been called as living human tissue-generators as I said to you before, as a manufacturing plant for the benefit of other people, show disrespect for human life in general?

And also I would argue that cloning, certainly reproductive cloning, and probably therapeutic cloning, shows disrespect for the transmission of human life.

You can go to a nature argument, that is, we should start from a presumption of respect tor the natural, which is one aspect of respect for the transmission of human life, but this is not determinative. Just because it’s not natural doesn’t necessarily mean it’s wrong.

On the other hand, I think we should start from a presumption of a respect for the natural way, even if we displace that presumption through other reasoning.

As I was writing this, I read a review in the National Post of the movie, ‘Eyes Wide Shut’ and I had this feeling of resonance with what I was trying to convey about respect for the transmission of human life in what the reviewer said about the sex scene in the movie:

"Because I believed the events were real I savored every moment. One isn’t aroused. One is sexualized; made conscious of sexuality and since sexuality is the transmitter of human life, the feeling was akin to becoming more conscious of life itself.

What would it mean to such insights and experiences to transmit human life asexually through replication." Cloning?

What that quote shows is that what we would lose is highly subtle, but it’s extraordinarily important.

We could lose, depending on how we use these technologies, our sense of ourselves as both individuals and a society and of the meaning of human life, because the sexual transmission of human life is integral.

How would asexual transmission, whether for research or reproductive purposes, affect our perceptions of who and what we are?

What we have not sufficiently recognized is that we have an extraordinary power that no previous generation of humans has ever possessed.

We have the power to intervene on and alter the essence of human life itself. We can’t afford to say this is just science.

We have to ask is: what does this power demand of us in terms of its ethical use and its ethical non-use? And we have to ask this before we do the science, not after we’ve done it. We can’t do the science and worry about the human consequences later.

We have to embed the ethics in the science, which is why I was objecting to the statement that science is neutral.

We have to ask what do the ethics of responsibility require? We’re the first generation that has ever held life itself on trust for future generations. And we have to ask what that requires of us.

And we have to go further and say, are there any answers to the ethical problems of human embryonic stem cell research on which there could be consensus, on which we wouldn’t disagree?

For instance, one way to avoid ethical problems, and on which we could all agree, would be if we didn’t have to use human embryos, but could obtain the necessary stem cells from some other source.

The perception of some scientists is that ethics is going to totally destroy everything they have devoted their lives to doing scientifically.

But something that people don’t always think of is that sometimes further scientific advances solve the ethical problems..

If we could develop the science that would allow us to use stem cells from a person who needs a tissue or organ or stem cells , from another person, to produce organ or tissue we need and we didn’t have to use an embryo and we certainly didn’t have to create one, that would solve the ethical problem.

The difficulty is that developing this science – which is being looked at, this is something that’s under consideration – will take time.

And it’s very interesting if you look at ‘science time’ and ‘medicine time’. The scientists want to have done it yesterday, if possible. The physicians, who have a dying patient in front of them, rightly want to do it now.

But, ‘ethics time’ may be an incompressible time. It might need necessary slowness; it might need natural time. It certainly needs a time for sedimentation of values to take place, and not just the experts’ values, but everybody’s values.

And it takes time to work out the science in order to address the ethical problems. It also takes time to work out the ethics to address the science that is currently possible.

So in conclusion we need deep consideration of the competing interests that are brought into play by therapeutic cloning, namely, on the one hand, that we can’t wait for further scientific advances; that those who are suffering or dying and could be helped by human embryonic stem cell research need treatment now. We must compare with this the reality that we will not be able to repair or reverse the harm that we would do to our sense of respect for human life, and wonder about human life, if we act unethically in relation to human cloning and our treatment of human embryos.

I believe it’s so important that we protect our sense of wonder about human life, and we’ll harm that, if we unethically use human embryos.

If we proceed with human therapeutic cloning, or perhaps even more so human reproductive cloning, we will irreversibly change the moral, or metaphysical reality, with which we surround human life itself.

We will not have the luxury of a trial run. The damage we cause to this moral, or metaphysical reality, is almost certain to be irreversible.

Therefore, what we have to ask ourselves is, are we justified in causing this change if not ever, at least tomorrow, which is when the scientists want to do this?

These are truly momentous decisions.

Couchiching Online History Table of Contents 1999 Summer Conference