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The notion that man might sometime
soon be reproduced asexually upsets many people. The main
public effect of the remarkable clonal frog produced some
ten years ago in Oxford by the zoologist John Gurdon has not
been awe of the elegant scientific implication of this frog's
existence, but fear that a similar experiment might someday
be done with human cells. Until recently, however, this foreboding
has seemed more like a science fiction scenario than a real
problem which the human race has to live with.
For the embryological development
of man does not occur free in the placid environment of a
freshwater pond, in which a frog's eggs normally turn into
tadpoles and then into mature frogs. Instead, the crucial
steps in human embryology always occur in the highly inaccessible
womb of a human female. There the growing fetus enlarges unseen,
and effectively out of range of almost any manipulation except
that which is deliberately designed to abort its existence.
As long as all humans develop in this manner, there is no
way to take the various steps necessary to insert an adult
diploid nucleus from a pre-existing human into a human egg
whose maternal genetic material has previously been removed.
Given the continuation of the normal processes of conception
and development, the idea that we might have a world populated
by people whose genetic material was identical to that of
previously existing people can belong only to the domain of
the novelist or moviemaker, not to that of pragmatic scientists
who must think only about things which can happen.
Today, however, we must face
up to the fact that the unexpectedly rapid progress of R.
G. Edwards and P. S. Steptoe in working out the conditions
for routine test-tube conception of human eggs means that
human embryological development need no longer be a process
shrouded in secrecy. It can become instead an event wide-open
to a variety of experimental manipulations. Already the two
scientists have developed many embryos to the eight-cell stage,
and a few more into blastocysts, the stage where successful
implantation into a human uterus should not be too difficult
to achieve. In fact, Edwards and Steptoe hope to accomplish
implantation and subsequent growth into a normal baby within
the coming year.
The question naturally arises,
why should any woman willingly submit to the laparoscopy operation
which yields the eggs to be used in test-tube conceptions?
There is clearly some danger involved every time Steptoe operates.
Nonetheless, he and Edwards believe that the risks are more
than counterbalanced by the fact that their research may develop
methods which could make their patients able to bear children.
All their patients, though having normal menstrual cycles,
are infertile, many because they have blocked oviducts which
prevent passage of eggs into the uterus. If so, in vitro
growth of their eggs up to the blastocyst stage may circumvent
infertility, thereby allowing normal childbirth. Moreover,
since the sex of a blastocyst is easily determined by chromosomal
analysis, such women would have the possibility of deciding
whether to give birth to a boy or a girl.
Clearly, if Edwards and Steptoe
succeed, their success will be followed up in many other places.
The number of such infertile women, while small on a relative
percentage basis, is likely to be large on an absolute basis.
Within the United States there could be 100,000 or so women
who would like a similar chance to have their own babies.
At the same time, we must anticipate strong, if not hysterical,
reactions from many quarters. The certainty that the ready
availability of this medical technique will open up the possibility
of hiring out unrelated women to carry a given baby to term
is bound to outrage many people. For there is absolutely no
reason why the blastocyst need be implanted in the same woman
from whom the pre-ovulatory eggs were obtained. Many women
with anatomical complications which prohibit successful childbearing
might be strongly tempted to find a suitable surrogate. And
it is easy to imagine that other women who just don't want
the discomforts of pregnancy would also seek this very different
form of motherhood. Of even greater concern would be the potentialities
for misuse by an inhumane totalitarian government.
Some very hard decisions may
soon be upon us. It is not obvious, for example, that the
vague potential of abhorrent misuse should weigh more strongly
than the unhappiness which thousands of married couples feel
when they are unable to have their own children. Different
societies are likely to view the matter differently, and it
would be surprising if all should come to the same conclusion.
We must, therefore, assume that techniques for the in vitro
manipulation of human eggs are likely to become general medical
practice, capable of routine performance in many major countries,
within some ten to twenty years.
The situation would then be
ripe for extensive efforts, either legal or illegal, at human
cloning. But for such experiments to be successful, techniques
would have to be developed which allow the insertion of adult
diploid nuclei into human eggs which previously have had their
maternal haploid nucleus removed. At first sight, this task
is a very tall order since human eggs are much smaller than
those of frogs, the only vertebrates which have so far been
cloned. Insertion by micropipettes, the device used in the
case of the frog, is always likely to damage human eggs irreversibly.
Recently, however, the development of simple techniques for
fusing animal cells has raised the strong possibility that
further refinements of the cell-fusion method will allow the
routine introduction of human diploid nuclei into enucleated
human eggs. Activation of such eggs to divide to become blastocysts,
followed by implantation into suitable uteri, should lead
to the development of healthy fetuses, and subsequent normal-appearing
babies.
The growing up to adulthood
of these first clonal humans could be a very startling event,
a fact already appreciated by many magazine editors, one of
whom commissioned a cover with multiple copies of Ringo Starr,
another of whom gave us overblown multiple likenesses of the
current sex goddess, Raquel Welch. It takes little imagination
to perceive that different people will have highly different
fantasies, some perhaps imagining the existence of countless
people with the features of Picasso or Frank Sinatra or Walt
Frazier or Doris Day. And would monarchs like the Shah of
Iran, knowing they might never be able to have a normal male
heir, consider the possibility of having a son whose genetic
constitution would be identical to their own?
Clearly, even more bizarre
possibilities can be thought of, and so we might have expected
that many biologists, particularly those whose work impinges
upon this possibility, would seriously ponder its implication,
and begin a dialogue which would educate the world's citizens
and offer suggestions which our legislative bodies might consider
in framing national science policies. On the whole, however,
this has not happened. Though a number of scientific papers
devoted to the problem of genetic engineering have casually
mentioned that clonal reproduction may someday be with us,
the discussion to which I am party has been so vague and devoid
of meaningful time estimates as to be virtually soporific.
Does this effective silence imply a conspiracy to keep the
general public unaware of a potential threat to their basic
ways of life? Could it be motivated by fear that the general
reaction will be a further damning of all science, thereby
decreasing even more the limited money available for pure
research? Or does it merely tell us that most scientists do
live such an ivory-tower existence that they are capable of
thinking rationally only about pure science, dismissing more
practical matters as subjects for the lawyers, students, clergy,
and politicians to face up to?
One or both of these possibilities may explain why more scientists
have not taken cloning before the public. The main reason,
I suspect, is that the prospect to most biologists still looks
too remote and chancy -- not worthy of immediate attention
when other matters, like nuclear-weapon overproliferation
and pesticide and auto-exhaust pollution, present society
with immediate threats to its orderly continuation. Though
scientists as a group form the most future-oriented of all
professions, there are few of us who concentrate on events
unlikely to become reality within the next decade or two.
To almost all the intellectually most adventurous geneticists,
the seemingly distant time when cloning might first occur
is more to the point than its far reaching implication, were
it to be practiced seriously. For example, Stanford's celebrated
geneticist, Joshua Lederberg, among the first to talk about
cloning as a practical matter, now seems bored with further
talk, implying that we should channel our limited influence
as public citizens to the prevention of the wide-scale, irreversible
damage to our genetic material that is now occurring through
increasing exposure to man-created mutagenic compounds. To
him, serious talk about cloning is essentially crying wolf
when a tiger is already inside the walls.
This position, however, fails
to allow for what I believe will be a frenetic rush to do
experimental manipulation with human eggs once they have be
come a readily available commodity. And that is what they
will be within several years after Edwards-Steptoe methods
lead to the birth of the first healthy baby by a previously
infertile woman. Isolated human eggs will be found in hundreds
of hospitals, and given the fact that Steptoe's laparoscopy
technique frequently yields several eggs from a single woman
donor, not all of the eggs so obtained, even if they could
be cultured to the blastocyst stage, would ever be reimplanted
into female bodies. Most of these excess eggs would likely
be used for a variety of valid experimental purposes, many,
for example, to perfect the Edwards-Steptoe techniques. Others
could be devoted to finding methods for curing certain genetic
diseases, conceivably through use of cell-fusion methods which
now seem to be the correct route to cloning. The temptation
to try cloning itself thus will always be close at hand.
No reason, of course, dictates
that such cloning experiments need occur. Most of the medical
people capable of such experimentation would probably steer
clear of any step which looked as though its real purpose
were to clone. But it would be short sighted to assume that
everyone would instinctively recoil from such purposes. Some
people may sincerely believe the world desperately needs many
copies of really exceptional people if we are to fight our
way out of the ever-increasing computer-mediated complexity
that makes our individual brains so frequently inadequate.
Moreover, given the widespread
development of the safe clinical procedures for handling human
eggs, cloning experiments would not be prohibitively expensive.
They need not be restricted to the super powers. All smaller
countries now possess the resources required for eventual
success. Furthermore, there need not exist the coercion of
a totalitarian state to provide the surrogate mothers. There
already are such widespread divergences regarding the sacredness
of the act of human reproduction that the boring meaninglessness
of the lives of many women would be sufficient cause for their
willingness to participate in such experimentation, be it
legal or illegal. Thus, if the matter proceeds in its current
nondirected fashion, a human being born of clonal reproduction
most likely will appear on the earth within the next twenty
to fifty years, and even sooner, if some nation should actively
promote the venture.
The first reaction of most
people to the arrival of these asexually produced children,
I suspect, would be one of despair. The nature of the bond
between parents and their children, not to mention everyone's
values about the individual's uniqueness, could be changed
beyond recognition, and by a science which they never understood
but which until recently appeared to provide more good than
harm. Certainly, to many people, particularly those with strong
religious backgrounds, our most sensible course of action
would be to de-emphasize all those forms of research which
would circumvent the normal sexual reproductive process. If
this step were taken, experiments on cell fusion might no
longer be supported by federal funds or tax-exempt organizations.
Prohibition of such research would most certainly put off
the day when diploid nuclei could satisfactorily be inserted
into enucleated human eggs. Even more effective would be to
take steps quickly to make illegal, or to reaffirm the illegality
of, any experimental work with human embryos.
Neither of the prohibitions,
however, is likely to take place. In the first place, the
cell-fusion technique now offers one of the best avenues for
understanding the genetic basis of cancer. Today, all over
the world, cancer cells are being fused with normal cells
to pinpoint those specific chromosomes responsible for given
forms of cancer. In addition, fusion techniques are the basis
of many genetic efforts to unravel the biochemistry of diseases
like cystic fibrosis or multiple sclerosis. Any attempts now
to stop such work using the argument that cloning represents
a greater threat than a disease like cancer is likely to be
considered irresponsible by virtually anyone able to understand
the matter.
Though more people would initially go along with a prohibition
of work on human embryos, many may have a change of heart
when they ponder the mess which the population explosion poses.
The current projections are so horrendous that responsible
people are likely to consider the need for more basic embryological
facts much more relevant to our self-interest than the not-very-immediate
threat of a few clonal men existing some decades ahead. And
the potentially militant lobby of infertile couples who see
test-tube conception as their only route to the joys of raising
children of their own making would carry even more weight.
So, scientists like Edwards are likely to get a go-ahead signal
even if, almost perversely, the immediate consequences of
their "population-money"-supported research will
be the production of still more babies.
Complicating any effort at effective legislative guidance
is the multiplicity of places where work like Edwards' could
occur, thereby making unlikely the possibility that such manipulations
would have the same legal (or illegal) status throughout the
world. We must assume that if Edwards and Steptoe produce
a really workable method for restoring fertility, large numbers
of women will search out those places where it is legal (or
possible), just as now they search out places where abortions
can be easily obtained.
Thus, all nations formulating
policies to handle the implications of in vitro human
embryo experimentation must realize that the problem is essentially
an international one. Even if one or more countries should
stop such research, their action could effectively be neutralized
by the response of a neighboring country. This most disconcerting
impotence also holds for the United States. If our congressional
representatives, upon learning where the matter now stands,
should decide that they want none of it and pass very strict
laws against human embryo experimentation, their action would
not seriously set back the current scientific and medical
momentum which brings us close to the possibility of surrogate
mothers, if not human clonal reproduction. This is because
the relevant experiments are being done not in the United
States, but largely in England. That is partly a matter of
chance, but also a consequence of the advanced state of English
cell biology, which in certain areas is far more adventurous
and imaginative than its American counterpart. There is no
American university which has the strength in experimental
embryology that Oxford possesses.
We must not assume, however,
that today the important decisions lie only before the British
government. Very soon we must anticipate that a number of
biologists and clinicians of other countries, sensing the
potential excitement, will move into this area of science.
So even if the current English effort were stifled, similar
experimentation could soon begin elsewhere. Thus it appears
to me most desirable that as many people as possible be informed
about the new ways of human reproduction and their potential
consequences, both good and bad.
This is a matter far too important
to be left solely in the hands of the scientific and medical
communities. The belief that surrogate mothers and clonal
babies are inevitable because science always moves forward,
an attitude expressed to me recently by a scientific colleague,
represents a form of laissez-faire nonsense dismally reminiscent
of the creed that American business, if left to itself, will
solve everybody's problems. Just as the success of a corporate
body in making money need not set the human condition ahead,
neither does every scientific advance automatically make our
lives more "meaningful." No doubt the person whose
experimental skill will eventually bring forth a clonal baby
will be given wide notoriety. But the child who grows up knowing
that the world wants another Picasso may view his creator
in a different light.
I would thus hope that over
the next decade wide-reaching discussion would occur, at the
informal as well as formal legislative level, about the manifold
problems which are bound to arise if test-tube conception
becomes a common occurrence. A blanket declaration of the
worldwide illegality of human cloning might be one result
of a serious effort to ask the world in which direction it
wished to move. Admittedly the vast effort required for even
the most limited international arrangement will turn off some
people -- those who believe the matter is of marginal importance
now, and that it is a red herring designed to take our minds
off our callous attitudes toward war, poverty, and racial
prejudice. But if we do not think about it now, the possibility
of our having a free choice will one day suddenly be gone.
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