Report on Cloning
Church
of Scotland Board of Social Responsibility May01
Church of Scotland contact: AROSS@COFSCOTLAND.ORG.UK
4.4 Human Genetics Group/Society, Religion and Technology Project
Over the last few months, much of the Human Genetics Group's work has concerned the "Donaldson" Report and its Recommendations on Stem Cell research.
Why All the Interest in Stem Cells?
All of us began life as a fertilised egg. This divided into two cells, and each of these divided, and this happened again and again until our bodies now contain millions upon millions of cells. All of our cells have the same genes, but they have specialised in different ways to form the different sorts of tissue in our bodies.
Some common diseases (diabetes and Parkinson's for example) happen when one type of cell fails, and could be cured if we could replenish a sufferer's supply of that type of cell. This means getting them from elsewhere, or - much better - persuading some of the sufferer's own cells to change into the type needed.
At the moment we can't make just any cell from our bodies change into another type of cell. However we can do some things with the less-specialised cells called 'stem cells' which specialise in our bodies as required to replace worn-out cells. But even by the time we're born, each of our stem cells has already specialised too far to turn into just any type of cell, and it can be hard to find stem cells of the type and number we need.
The easiest place to find human stem cells is in a human embryo a few days old. These are made up of no more than a few hundred cells, and half of these are completely unspecialised stem cells which can become any other kind of cell in our body. So researchers have been calling for a change in the law to allow cells to be taken from human embryos, to find out how stem cells develop, and perhaps to use in medical treatment until we can use a patient's own cells. These embryos would be made in vitro and might be spare ones from IVF treatment (which would otherwise be discarded), or made specially for this research from sperm and ova, or, to preclude rejection by a patient's body, made by 'cell nuclear replacement' ('the Dolly method') from a patient's own cell and a donated human egg.
The Donaldson Recommendations
The Donaldson Report made nine Recommendations about the use of human embryos in stem cell research. These are given below.
1. Research using embryos (whether created by in vitro fertilisation or cell nuclear replacement) to increase understanding about human disease and disorders and their cell-based treatments should be permitted, subject to the controls in the Human Fertilisation and Embryology Act 1990.
2. In licensing any research using embryos created by cell nuclear replacement, the Human Fertilisation and Embryology Authority should satisfy itself that there are no other means of meeting the objectives of the research.
3. Individuals whose eggs or sperm are used to create the embryos to be used in research should give specific consent indicating whether the resulting embryos could be used in a research project to derive stem cells.
4. Research to increase understanding of, and develop treatments for, mitochondrial diseases using the cell nuclear replacement technique in human eggs, which are subsequently fertilised by human sperm, should be permitted subject to the controls in the Human Fertilisation and Embryology Act 1990.
5. The progress of research involving stem cells which have been derived from embryonic sources should be monitored by an appropriate body to establish whether the research is delivering the anticipated benefits and to identify any concerns which may arise.
6. The mixing of human adult (somatic) cells with the live eggs of any animal species should not be permitted.
7. The transfer of an embryo created by cell nuclear replacement into the uterus of a woman (so called 'reproductive cloning') should remain a criminal offence.
8. The need for legislation to permit the use of embryo-derived cells in treatments developed from this new research should be kept under review.
9. The Research Councils should be encouraged to establish a programme for stem cell research and to consider the feasibility of establishing collections of stem cells for research use.
The Board wholeheartedly endorses Recommendation 6, which opposes the creation of human/animal hybrids, and Recommendation 7 which opposes human "reproductive cloning". Recommendations 2, 3, 5, 8 and 9 seem appropriate given that stem cell research using human embryos is to be permitted. The Board does have difficulty with Recommendation 4, which would authorise research into the treatment of mitochondrial diseases by replacing the embryo's defective mitochondria, treatment which would technically give an embryo three parents. However the research itself raises no issues not raised in Recommendation 1.
So the Board has been mainly concerned with Recommendation 1, and that for two reasons: (a) to take stem cells from a human embryo destroys the embryo, while in 1996 the Assembly affirmed "the sanctity of the embryo from conception"; and (b) to create embryos by cell nuclear replacement is human cloning, to which the Assembly expressed "the strongest possible opposition" in 1997. It appears, then, that previous Assembly Deliverances implicitly - and strongly - oppose stem cell research upon human embryos.
However the matter is not so clear. The 1996 Deliverance did not condemn the use and destruction of human embryos in research, but rather recognised "that IVF treatment may be right for [some] couples"; and if IVF treatment is right, the past and present research using human embryos upon which the success of IVF treatment depends was and is justified.
And with regard to human cloning, the Donaldson Report makes a strong distinction between "therapeutic cloning" (that is, cloning in order to produce human tissue), and "reproductive cloning" (that is, cloning in order to produce whole, mature organisms). It seemed to the Board that the General Assembly opposed the latter in 1997; the Assembly had "Brave New World" in mind, not the production of replacement cells for those who suffer from heart disease or diabetes.
So while the Board clearly had a duty to respond to the Donaldson Recommendations, it could neither oppose nor endorse stem cell research upon human embryos. All it could do, in a letter sent to all Scots MPs, and then in a second letter sent to all UK MPs (a copy of the latter is given in Appendix 2), was call for delay to permit wider public debate and new legislation.
The letters' main argument was that the use of human embryos in stem-cell research raises different ethical issues from those addressed in the Human Fertilisation and Embryology Act of 1990. This only permitted research upon embryos for purposes which are related to the health, or otherwise, of embryos, and arguably are for embryos' collective benefit. The research now permitted is for patients' benefit, not for embryos' benefit. The former respects embryos' biological agenda; the second treats them as resources to be exploited at will.
MPs were not persuaded by the Board's letter, and by objections from other religious groups, but voted by 366 to 174 to accept the Donaldson Recommendations. The Lords also voted to accept them, by 212 to 92, and the research was authorised in principle as of 31st January. But the Board was heartened by the responses from some MPs, who had clearly thought hard about the ethical issues and had come to a conscientious decision, whether for or against the Recommendations.
Since stem cell research and "therapeutic cloning" may produce standard medical treatments, it seems unsatisfactory for the Assembly to have an ambiguous position upon the former, and never to have addressed the latter. The Board believes that the General Assembly ought to take a position upon these matters since this field is developing so rapidly.
Conclusion
1. The Board aims to help people live the best lives they can. Since the human body repairs injury by generating new cells which are genetically and functionally identical to others which it already possesses, the Board doesn't think it wrong in principle to do this in the laboratory for someone whose body cannot do this for itself. That is, the Board isn't against cloning a person's cells in order to produce "spare parts" or fresh cells of a special type for that human being. Nor does the Board think it wrong in principle for a volunteer to donate cells for use in the medical treatment of another human being. The Board is therefore in favour of stem cell research as such.
2. In 1996 the Assembly affirmed "the sanctity of the embryo from conception", and presumably had serious reservations about the use of embryos in research or treatment. But the Assembly also recognised "that the IVF treatment may be right for [some] couples", treatment which depends upon the use of human embryos in IVF research. So notwithstanding the Assembly's high view of the human embryo, the Assembly stopped short of saying that it is always wrong to use human embryos in research.
3. We can only use human embryos in research if God has not forbidden it. There comes a point in a human embryo's development when we must call it a baby, and we should cherish babies. Christians who accept the use of human embryos in research must, therefore, limit the age up to which embryos may be used. Current legislation forbids researchers to allow embryos to develop in vitro beyond their 14th day. At this age the "primitive streak" begins to develop, which is the earliest stage at which it is possible to tell if the embryo will develop as one person, or twins etc., or develop only as a placenta. If human embryos are to be used in research, we may reasonably argue that up to 14 days of age they are still embryos, not babies.
4. For guidance as to the type of research in which human embryos might properly be used, the Board looks to God's purposes. God created us "to glorify God, and to enjoy him for ever". Our physical development from embryo to adult is part of the process by which God means us to "progress in wisdom and age and favour before God and man". From this it is evident that God intended human embryos, not as an end in themselves, but as a means to the end of human reproduction. The embryos used in IVF research are denied the opportunity to develop, but through their use, other embryos develop which otherwise would not do so, thereby contributing indirectly to human reproduction. So if it is ever permissible to use human embryos in research, it is certainly permissible to use them in IVF research. Conversely, to concede that human embryos may be used in IVF research is not to concede that they may be used in any other type of research.
5. If God intends human embryos as a means of human reproduction, we certainly go beyond God's intention if we use them for other purposes. The Board takes the stronger view that we go against God's intention if we so use them, and hence opposes their use in medical research or medical treatment.
6. The above 5 points refer to human embryos created from human sperm and (whole) human eggs; but since the creation of "Dolly", it has been clear that human embryos might also be created by cell nuclear replacement. Knowing human nature, it has also been clear that human embryos would be created in this way sooner or later, however much we may regret this. Since Parliament has now given the go-ahead for their creation, we must consider how we ought to treat them.
6.1 We could argue that human embryos should be treated alike however they are created. However the traditional arguments against the indiscriminate use of human embryos apply specifically to embryos created from human eggs and sperm, and can't be applied to human embryos created by cell nuclear replacement.
6.2 The Board argued above against the therapeutic use of human embryos created from human eggs and sperm on the grounds of God's intention for such embryos. This clearly doesn't apply to embryos created in other ways.
6.3 Some argue against the use of embryos created from human eggs and sperm on the grounds that they embody a unique genetic pattern. This clearly doesn't apply to a cloned embryo. A cell nuclear replacement embryo is not a perfect clone of its progenitor, since it acquires its mitochondrial DNA from the denucleated egg rather than its progenitor, but the difference is much, much less than that between full siblings.
6.4 Some argue that since we ought to cherish human babies, and a human baby develops continuously from conception, we should cherish a human embryo as we would a human baby. But we can hardly apply this argument to human cell nuclear replacement embryos when we do not know for sure - and think it would be wrong to find out - if human babies can develop from them.
6.5 Even if we grant that the embryos which develop into human babies ought to be cherished from conception, it does not follow that all human embryos ought to be cherished. In particular, it does not follow that we should cherish embryos which we know will not develop into human babies (for example, because we mean not to implant them). Those who argue that we ought to cherish all human embryos tacitly assume that, if implanted, human embryos seldom fail to develop into human babies. In fact, this isn't the case. Only something like 50% of "natural" human embryos go to term, and at present, only something like 1 in 100 cell nuclear replacement embryos go to term. If that were the natural success rate for humans, it would never have occurred to us to wonder if we should cherish all embryos. We would not have valued them until late enough in their development for us to be reasonably sure that they would go to term.
6.6 It might be argued that even if 99 embryos out of 100 failed to develop into a human baby, and notwithstanding how much good we might do by using embryos, we should still not use them for the sake of the hundredth. But in life we have to balance the statistical certainty of harm to a few against certain benefit to the many. For example, there will certainly be some miscarriages of justice if we have a criminal justice system, but we continue to accept such a system for the sake of the benefit it offers to society as a whole. We might wonder if the potential benefit from the use of embryos in research or therapy justifies the certain harm to the embryos used; but to judge how much harm we would do, we would have to know these embryos' viability, that is, we would have to try to grow human babies from them, which we believe that it would be wrong to do.
7. Finding the arguments to the contrary uncompelling, the Board is of the opinion that we are free to use human cell nuclear replacement embryos for a good purpose. The Board accepts that stem cell research and therapy are good as such; and hence that human cell nuclear replacement embryos may be used for them, subject to the 14-day limit.
8. To create human embryos by cell nuclear transfer is to clone the human being who provided the cell nucleus, and in 1997 the General Assembly categorically opposed human cloning. The Board distinguishes between "human therapeutic cloning" (that is, cloning in order to produce human tissue), and "human reproductive cloning" (that is, cloning in order to produce whole human beings). The Board opposes human reproductive cloning but accepts human therapeutic cloning.
9. For the avoidance of doubt: while the Board opposes the transfer of human cell nuclear replacement embryos to a womb, whether human or animal, or artificial (should such exist in the future), the Board believes that should this be done, the embryos concerned, and any babies into which they develop, should be cherished exactly as if they were created from human eggs and human sperm.
10. Some types of stem cell can be derived from human placentas after birth, and stem cells taken from animal embryos are already being used in some of the applications for which human embryonic stem-cells are being proposed. There is clearly medical potential in stem cells from sources other than human embryos, and the Board welcomes research in this area.
CHURCH OF SCOTLAND BOARD OF SOCIAL RESPONSIBILITY HUMAN GENETICS GROUP
COMMENTS ON THE "DONALDSON" REPORT
In general, we heartily approve of medical treatment which helps the human body to fulfil its potential. Since the human body repairs injury by cloning stem cells which specialise to take over the function of damaged cells, we do not think it unethical in principle either to clone a patient's cells or to reprogram them into whatever type of cell the patient requires. Nor can we think it unethical for an adult to donate tissue for use in the medical treatment of someone else. We are not, therefore, against stem cell research as such.
However the use in research of cells derived from embryos raises issues of conscience for those who hold that embryos do or may deserve full human status. There are also those who doubt the morality or wisdom of creating human embryos by cell nuclear replacement (the "Dolly method"). In the light of these strong feelings, and since gene technology is already widely distrusted, this research could easily cause major social division. If this research is to be safely undertaken, it must be with the consent of the vast majority of Britons, and it will take time to achieve this consensus.
Accordingly, we do not favour the Donaldson Report's first and most important Recommendation, "Research using embryos (whether created by in vitro fertilisation or cell nuclear replacement) to increase understanding about human disease and disorders and their cell-based treatments should be permitted, subject to the controls in the Human Fertilisation and Embryology Act 1990".
The Act itself, as its title makes plain, governs the study of embryos as embryos, while the Donaldson Report recommends the study of embryos as medical resources. We agree that research into degenerative conditions such as Alzheimer's and diabetes is no less worthy than the research into contraception which the Act permits. But the Act treats embryos as entities, while the Donaldson Report recommends breaking embryos up for usable parts. At best the Act does not seem to be an appropriate instrument to govern the latter, and some argue that to use the Act for this purpose would be to deny the "special status" of the embryo safeguarded under the Act.
We are also concerned that, contrary to public expectation, in addressing the Donaldson Recommendations, Parliament will not be addressing the issue of cloned embryos. The first Recommendation includes the granting of permission for research using embryos created by cell nuclear replacement, so that a vote to accept this Recommendation would be a vote to permit, in principle, the creation of embryos by this method. However, as the Donaldson Report points out, the Act does not prevent the creation of embryos by this method, provided that this is done for one of the 5 research purposes which the Act presently permits; so that a vote to reject the first Recommendation would not be a vote against the creation of such embryos in principle. And the creation of such embryos is a matter of widespread concern, since it would raise the possibility of reproductive human cloning and of human germline engineering analogous to that already done with animals. It is true that these things may not happen if we allow the creation of such embryos, but it is equally true that at present they cannot happen unless we allow this.
We do not here argue against the research proposed in the Donaldson Report. Although the Church of Scotland "affirms the sanctity of the embryo from conception", it also "recognises the differences of view which exist on the ethical acceptability of embryo research", and has not yet addressed "therapeutic cloning". But we do believe that if Parliament approves of the research envisaged in the Report, the research should be governed by fresh legislation.
|
If you have come to this page from an outside location click here to get back to mindfully.org |
