November 28, 2001
I Fear No Clone
J. C. Adamson
A Massachusetts company called Advanced Cell Technology has announced the successful cloning of human cells. Their process created only a few cells, but demonstrated two techniques that might be useful in future cloning research. The company has made no attempt to create a live birth from its experiments, has not determined that its cloned cells could in fact be nurtured to a human fetal state, and has said it has no intention to pursue that line of research.
Advanced Cell Technology's stated intention is to create stem cells that can be used for research along a variety of medical avenues. Many biologists are pursuing similar research, using already established fetal stem cell lines, in the hopes of conquering a list of diseases, including arthritis and Alzheimer's disease. Some also hold out hope for regenerating nerve tissue, and growing human replacement organs. The possibility of creating replacement organs from cloned cells is particularly attractive because the resulting organs would be exact genetic matches to the patients' body. Such organs would presumably be free of rejection problems because the patient's immune systems would not see them as foreign tissue.
Advanced Cell Technology's announcement was met with much wailing and gnashing of teeth from several members of congress, and from President Bush. I simply don't understand the knee-jerk reaction many display toward the idea of human cloning.
Before discussing the issue further, I'd probably be wise to divide the topic into two parts. What is being discussed today, as a very real possibility, is medical or therapeutic cloning—the limited use of cloned cells to treat disease and to replace human organs. An entirely separate concern is the far more distant possibility that viable human fetuses might someday be created via cloning. Certainly these two parts of the issue involve different moral considerations. I'll discuss them both, but separately.
The use of cloning to replace organs, regenerate nerve tissue, or treat disease seems to me to be without serious complications. Compare the idea of cloning a liver or kidney to performing a skin graft. It is common practice in treating burn victims to remove skin from an uninjured part of the patient's anatomy, and transplant it to a burn-damaged site. Skin can regenerate itself, so new skin grows to replace that which is surgically removed, and the grafted skin grows additional cells, expanding the grafted area, and joining it to surrounding skin. The technique has been used for decades, and has saved untold thousands of lives. Countless other patients have experienced quicker and less painful recoveries as a result of skin grafting than they might have had otherwise.
I see the transplantation of a cloned liver as being similar to a skin graft, albeit much more complicated, and admittedly involving embryonic cells rather than skin cells. The process would simply involve using a patient's own tissues to effect healing.
Consider a patient who is dying of liver disease. If the person is otherwise in reasonably good health, she might be a candidate for an organ transplant. Her condition will be closely monitored, and she will wait. She waits for a suitable organ, and waits to rise to the top of the donor list. As months or years go by, her health deteriorates, her activities become limited, and other organs may be affected. If she is lucky, she will be matched to an organ before she becomes too ill to benefit from a transplant, and she'll undergo surgery. When the surgery is completed, she will begin a long battle to combat rejection of the organ. The drugs that help prevent rejection will also weaken her immune system, making her susceptible to infection. If the liver is rejected, she'll have to go through the entire process again, this time with far greater urgency, and beginning from an even more weakened state.
Still, her prognosis is reasonably good. According to the United Network for Organ Sharing, nearly 5,000 liver transplants were performed in the U. S. in the year 2000. However, more than 26,000 people died of liver disease that year—for a variety of reasons—some because suitable donor organs could not be found, some because of organ-rejection, some because they were too ill to survive transplant, and some because they simply chose not to go through the ordeal of surgery and recovery. And today, nearly 19,000 people are on the waiting list for liver transplants.
How might the situation of our hypothetical liver disease victim be different if cloned organ transplant becomes practical? Well, liver disease is no walk-in-the-park under any circumstance. Our patient would still probably not receive a transplant immediately upon diagnosis of liver disease; drug therapies would be attempted first. But if the drug therapy were to prove unsuccessful, and if her condition were to deteriorate to the point where a transplant was indicated, the rest of the story would probably be much different from today. Instead of waiting and suffering, possibly for years, she would begin the transplant process immediately. A small sample of cells would be taken from some healthy part of her anatomy, in a process no more painful or invasive than a skin biopsy. She would wait, probably for several months, for the cloning to be done, and for a new liver to be cultivated and grown from the clone-produced stem cells. Then her surgery date would be scheduled, long before her health deteriorated significantly. The surgery might well be very much like transplant surgery today. Her recovery from surgery would probably be relatively uncomplicated, and rejection of her new organ would be much less likely than it is with today's transplants. The new organ would, of course be just that—new. It would have no miles on it—no history of battling the daily toxicities of life such as medicines and margaritas. It would have no injury from the surgical removal process, or from the accidental death that might have befallen the organ donor. It would be a pristine organ, ready to provide a lifetime of service.
Another group of maladies that might be significantly impacted by clone-related therapies is nerve-tissue damage and disease. Nerve cells don't regenerate, so injured or diseased cells are permanently lost. But stem cells derived via cloning might well be used to grow new nerve cells that could heal spinal injuries and other nerve damage. People long confined to wheelchairs might walk again—or even run. The deaf might hear; the blind might see.
Medical procedures to accomplish all this could be decades in the future, or they might be only a few years beyond us. But without the basic research that this cloning work has begun to provide, the benefits will never materialize. No one can know if Advanced Cell Technology will be the organization to realize these technologies. Their techniques may only demonstrate that better methods must be found. But they have begun, and I applaud them.
You may recall that as I began this article, I divided its topic into two parts. I have heard many commentators build a tall wall between the concept of cloning tissues or replacement organs, and that of reproductive cloning. Indeed, the two concepts should be treated separately. We can certainly decide to proceed with research into treatment methodologies without embracing the cloning of human fetuses. But many people, even those who would consider therapeutic cloning, seem to view reproductive cloning as completely repugnant. I'm as baffled by that reaction as I am by people's out-of-hand rejection of therapeutic cloning.
Two images seem to pop into discussions of human cloning—those of a mad scientist, ala Frankenstein , and of Aldous Huxley's novel, Brave New World . Neither is applicable without a great stretch of imagination and probability. Genetic researchers aren't mad scientists, even remotely likely to lose control of their experiments. All the human cloning research we've seen has been measured, methodical and cautious. It's actually hard to conceive of it being otherwise. Rigorous, meticulous practice is essential to achieve results at all, and progress is slow at best. Human cloning isn't the stuff of hobbyists. No Dr. Frankensteins will be creating clumsy monsters through cloning accidents.
Discussion of the Brave New World scenario requires both a scientific and a political analysis. Admittedly, it's been years since I last read Huxley's novel, but I recall that it was frightening, not because of the technology of cloning, but because of the totalitarian political universe in which all of its technologies were implemented. The idea of life without civil liberties is frightening and appalling to me; life with human cloning is not. A government that imposes life or death on its subjects is terrifying. But we have countless examples of governments doing that today, using technology no more advanced than daggers and rifles. The idea of a government, or even of a corporate or religious entity, creating baby factories is as improbable as the notion of such an entity enslaving women for breeding purposes. It is remotely possible, but could occur only with the total collapse of the political ideals we hold dear.
Of course, I want to defend myself and my nation against that potential collapse of our democratic system, but I think the battle is to be fought by protecting our constitutional rights, not by stifling scientific research, or corporate and academic freedoms. Government intervention in the medical and reproductive choices of private citizens is exactly the danger Aldous Huxley warned against. And government throttling of genetic research seems very similar to the reaction of the medieval church against renaissance science. The erosion of our First and Fourth Amendment rights is far more frightening to me than some imagined degradation of society that might result from the practice of human cloning. And if we lose those precious constitutional rights, we will indeed live in a Brave New World —with or without cloning.
Suppose we allow cloning research to proceed unchecked, and within a decade the technology is perfected. How might it be employed? What will our new world look like? I don't envision Ford-like factories churning out blonde-haired, blue-eyed populations, or issuing plantations of dark-haired, dark-skinned slaves. I envision a few individuals and couples—not many, really—thoughtfully entering into the cloning process after considering a variety of options. Relatively few people utilize in-vitro fertilization for child bearing today, even though the process has been available and practical for years. I suspect that even fewer people would opt for cloning. After all, much of the magic of child rearing is watching a totally new human appear and mature—a person unlike any who has ever existed. I think that's what people want when they choose to have a child. And a clone is not that. A cloned child would grow, physically at least, into a duplicate of its parent. It wouldn't be a new beginning, but a re-run. It would seem more like a manipulation than like a miracle.
Some people might want to reproduce exact copies of themselves, for legitimate and understandable reasons. Suppose an only child is the last descendant of a family, and is incapable of reproducing, perhaps because of a debilitating injury. If that person could produce and raise a clone, there would be one more chance for the family to leave progeny. I don't find that to be a repellant idea at all. I suspect that similar scenarios would account for most decisions to produce cloned children.
Could cloning be abused on small scales? Of course it could be, and it will be—just as natural childbirth is abused every day. Countless teenaged women have multiple children, as a rite of passage, often without being married. They seem to believe that motherhood is a viable route to adulthood and to personal freedom and fulfillment. Many of their resulting children are condemned by poverty and abuse to difficult and damaging childhoods, and ultimately to repeating the mistakes of their mothers and fathers. This kind of unwitting and irresponsible parenting is far more damaging to our society and culture than cloning would be.
The religious moralists who vehemently oppose cloning are fond of trotting out the idea that we are playing God if we create embryos in the laboratory. But they miss the point. Two geneticists who clone a living cell aren't creating life, anymore than two lovers who conceive a child are creating life. In either case the life already exists; the people are only manipulating it. Humans may someday be able to create primitive life forms through some gimmickry with amino acids, but they haven't done it yet, in decades of trying. It's even conceivable that science may one day know enough about genomes to chemically manufacture DNA. Then we might talk about the possibility of creating human life. We are decades, perhaps centuries from that time. All we can do today is to manipulate the life we have been given.
I don't advocate the development of human cloning specifically as a method of reproduction, but neither do I fear it. I don't think we can stop its development, any more than the medieval church stopped Galileo and Copernicus from investigating the nature of the cosmos. And I don't think the development of reproductive cloning techniques will impact the daily lives of most people much more than awareness that the earth revolves around the sun affects our lives today.
Cloning as a therapeutic practice, however, is another matter. Its benefits will be real and vital. The healing that results from today's research will one day restore the quality of countless lives. My grandchildren may not have to fear living long, lonely years, victimized by Alzheimer's, or watching the creeping debilitation of Parkinson's Disease attack their bodies. If one of them should suffer the horror of a severe spine injury in an automobile accident, she might not have to live a life of paralyzed confinement and deprivation.
Each decade of my life has yielded medical advances that have vastly improved lives. I've seen polio conquered, and am witnessing victory over cancer and heart disease. I've seen smallpox eradicated, and the incidence of infant mortality significantly reduced. I wouldn't want to turn back the calendar and have vaccines or antibiotics go undiscovered because people thought the research too dangerous. I wouldn't want to give up the benefits of open-heart surgery and transplant technology because people might once have thought those endeavors constituted playing God. And I don't want to deny your children and grandchildren the benefits of genetically based medical techniques. I don't fear cloning. I eagerly anticipate the blessings of healing that will bring to us.
© J. C. Adamson, 2001