Thursday, April 25, 2002
Session 4: Human Cloning 10:
Ethics of Cloning for Biomedical Research
CHAIRMAN KASS: Could we come to order? Why don't
we begin? I think a few of our members have had to leave either for class
or had a conflict for this last session. I think we're just missing Dan
Foster at the moment and maybe he — ah, perfect. Good, thank you.
This is a session in which we return to the topic of our last meeting
and revisit our project on cloning. The specific questions are the ethical
issues of cloning for biomedical research and I would simply remind us
of the approach that we have adopted in full recognition that not that
we have failed to reach agreement, but we never expected to reach agreement
because this is a vexed, moral question where reasonable people put the
moral weight in different places, and that our effort is to explore these
differences with no expectations that they're going to be overcome, but
rather that they can be clarified.
The aspiration in this discussion and, if you will, on this part of
what we eventually produce, a common document owned by us all in the sense
that we agree that this is, in fact, a good representation of the state
of the question, while preserving and even sharpening our differences
so that no position held by any member of council or by some person not
in council that deserves to be represented in council isn't given its
fullest and fairest expression.
We have been proceeding as colleagues, as fallible human beings with
a certain, I don't like the term, but it's been used, with a certain kind
of epistemic modesty about our own claims, I mean, to encounter thoughtful
people who ought to know better than not to agree with us, ought to give
us somehow pause and make us a little more humble about where we stand
and that we are interested, maybe when we leave this room, we're interested
in victory, but at least for the sake of our meetings, we are adopting
the pretense we are interested in clarity and wisdom and not simply beating
the other side down.
I would suggest and so far, I think with some perhaps exceptions, we
have tried to recognize that the people with whom we disagree have something
vital to defend and if I might be so bold, vital to defend even for us
whether we know it or not, and therefore it behooves us to make sure that
we don't shortchange ourselves. And one formulation would be to say that
it would be — nobody would want to see us callous to the needs of suffering
humanity. Nobody would want to see us cavalier regarding the treatment
of nascent life at some stage or other and no one ought to be indifferent
to the effects on a society of doing A rather than B, or B rather than
A, or C or none of the above.
So I want to tell you where I think we stand in this discussion to see
whether I'm right in where we stand and then continue to have — to advance
the discussion. The question of the vexed status of this entity, the cloned
embryo, we're now back to the cloning topic. It's related, but not identical,
with the status of the embryo created by IVF, which will be, I think,
central to the question.
I want to remind us of something that we've gotten from Stephen Carter
in a message to us about the importance of upholding the distinction between
what's legal and what's moral, between the realm of what is permissible
legally and what is either good or bad, better or worse, noble or base,
right or wrong.
All too often and perhaps for understandable reasons, the question of
permission or ban hovers over the moral conversation, but it's certainly
possible that someone might conclude that this activity is morally dubious,
but ought to be permitted and there are all other kinds of possibilities.
So I would like us, as best we can, to have this conversation still on
the moral plane which is where we've had it before.
I would also make an observation and this has come also in some of the
conversations, that some of us have been adopting the language of competing
goods to describe the present situation before us. And I would at least
like to put before us that that might be a way of putting the question
that is congenial to some, but that there is another way of formulating
what's here and might help us understand why this is so intractable.
In moral philosophy there is a distinction made between the right and
the good in which the good is an object of desire. There are multiple
goods. They don't have any kind of absolute standing for us and you can
compromise them to get more of one for the sake of less of the other,
whereas claims of right or of justice are things which lay down a kind
of marker and at least there's a prima facie claim that they should not
be violated, that the burden of proof is on someone to show why they should
— why they can't be violated. And I have the sense, at least in some
of the previous discussions, that for those people who regard the embryo
as either one amongst us or enough like us to be entitled to some kind
of irreducible respect, that is not being treated as a category of a good
to be preserved, but as a matter of right. And therefore, arguments of
that sort are less likely to — people who hold that view are less likely
to want to put that into a pan balance of competing goods, but who want
to insist that this is one of those markers like "thou shalt not" because
there's something inviolable here.
I don't want to shape the discussion, but I at least want to introduce
that distinction as possibly being helpful to us and seeing what might
seem to be simply a matter if we talk long enough, we can find the right
balance, when in fact, for some people this is not a balancing operation
at all, but two different kinds of moral discourse.
I think that's — there are other things to be said, but I want to really
open the discussion with the following observation. We have tried in staff
conversations and in conversations with you all to stake out several moral
positions with respect to cloning for biomedical research and while two
of them seem to have come to the fore and have commanded at least some
support, I suspect that the two might indeed be enlarged to four. And
let me state them and see where we are.
It seems to me there are two possible grounds for approving or finding
morally acceptable cloning for biomedical research and two possible grounds
for disapproving. One would be to approve and to let's say approve with
eagerness and without qualification because one does not believe that
any harm is being done. This would be a view that held that the embryo
in question was beneath the status of having any moral worth and I don't
want to get into the language of person and things. I'm not sure that's
helpful, but it is not the sort of thing that ought to restrain us from
use when good might come of it. Let's call it the position of "approve
with zeal" or "approve without qualification."
The second would be to recognize that there is something in the embryonic
life here that one is at least agnostic about it or one thinks it has
some kind of standing, but that one engages in a balancing operation and
it approves with humility and is willing to accept some kind of restrictions
or restraint on what can be done, recognizes that there is a harm being
done to the embryo, but does not regard that as a moral wrong, that is
to say, a violation of some stricture of right. This has been put into
a balancing operation.
A parallel on the side of the disapprove, it seems to me I'm going upwards
in scale. You'd have a position that one could call disapprove with regret
or has been said, with tears. I'm sorry, the tears belong on the other
side. Approve with tears and here, disapprove but with regret, recognizing
that there might be certain kinds of benefits had, but making calculations
on prudential grounds or on certain kinds of moral considerations about
where this might lead, that one decides, on balance, that the goods to
be had are not worth the cost of the balancing operation. And there could
be the position that would disapprove as a matter of principle and without
qualification because it is immoral to treat even the earliest of human
embryos as anything but one amongst us, no matter how much good might
come from it.
I take it those are four positions that have been heard around the table,
not necessarily articulated in those ways. In the intermediate conversations
between the last meeting and this one, we've been mostly working in the
middle, that is to say, we have — I'm not exactly sure about that, but
we've had expressions of views that look like disapprove with regret and
positions that argue for approve, but with humility and the willingness
to accept some kind of restraint.
I think from some of the correspondence that there are at least some
amongst us who believe that their view of this matter is not adequately
represented and I think it turns on the question of whether we haven't
made all too much fuss about these little 7-day old embryos.
Let me see if I have correctly stated analytically where we are and
if so, then the question is where we can go to make sure that these viewpoints
are properly developed before we actually either try to persuade one another
to move from where we now are to some other place or we finally have to
choose and come down with what we really think about this.
I think I've said both too much and too little, but let that be — to
prime the state of our own discussion. I remind you, cloning for biomedical
research, the arguments of course overlap with the question of the embryos
used for research, but we're back on our more narrow topic and the larger
one is still in the offing though perhaps informed by some of the things
we've just been talking about.
Comments, questions, arguments, corrections?
PROF. MEILAENDER: Just very briefly, I
just want to note that it's not necessarily a question of whether someone
thinks his or her position has been kind of adequately represented in
that focus on the middle. For instance, as I recall, one of Frank Fukuyama's
comments that he sent in was really questioning whether the approve with
humility position was the right representation of the going argument in
a way and I, myself, had questioned whether it was really the strongest
form of the argument. So it's not — I think it's not just a question
of whether one thinks one's own position is represented, but just where
the balance of the argument should lie.
CHAIRMAN KASS: Mike, do you want to get in on this,
DR. GAZZANIGA: I'll take the bait. I think
we should do everything we do with great humility. You realize how often
in life you're wrong, it's a good model. But someone with I guess my particular
view would not see the need for the preceding two hours of torturous debate
of trying to shoehorn into this problem all of the issues that are trying
to be shoehorned into us. So I view the embryo by which we mean the blastocyst,
either formed by IVF or through somatic nuclear cell transfer as a thing
that deserves human respect like all human tissue, but provides me with
absolutely no moral dilemma to proceed into biomedical research on it.
CHAIRMAN KASS: Does someone join on that? This
is, in fact, I suspect, a not uncommon position. It might even be more
common in this body than simply Michael, so could we have some discussion?
DR. GAZZANIGA: I guess what I was — I don't
know what other people think and it's up to them to say. But I do like
what you've done here which is to broaden the spectrum of response to
the question at hand.
CHAIRMAN KASS: Right.
DR. GAZZANIGA: And I think that was an important
CHAIRMAN KASS: Right. Rebecca, please?
PROF. DRESSER: This isn't exactly in response
to what you were saying, but in thinking and reading about this, it seems
to me that people in both 1 and 2 categories, the approval categories
are affected by some notion of duty to rescue or duty to be a good Samaritan
and that it's not just some judgment about the value of the embryo or
the viability of the embryo, but it's a moral — a strong moral feeling
that this is what we ought to do to help people who are very ill. And
I just wondered if that is a concept worthy of exploring with these two
positions, that is, you know the moral philosophy on duty to rescue and
when do we have one and what are the considerations that ought to go into
determining whether people have a duty not just to refrain from harming,
but to actually act to rescue people who are in dire circumstances. So
I'll just throw that in.
CHAIRMAN KASS: Let me add one further thing. As
you know from the start we have been trying to place our limited moral
arguments in the larger context. In the case of cloning for producing
children, we tried to put it in the context of human procreation and with
the help of some comments from Michael Sandel and others, it's clear that
human procreation also means relations between parents and children. It's
not just the procreative act. We're trying to put these things — the
right context for this is not just what's the status of the embryo, but
the right context for this is what is the vocation of healing and what
is, in fact, the mission of biomedical research and these are not simply
technical activities. These are activities informed by deep moral commitment
and principles and the question is whether these duties are absolute or
relative and so on is, of course, for discussion. But I think it's absolutely
welcome. We can't simply hash this out over the status of these 100 cells.
We also have to think really about the moral principles that guide us
here. So that's, I think, very welcome.
DR. BLACKBURN: I've been grappling with
this and I think that I'm in position 2, as you've outlined it, approval,
but thinking seriously about it and for me a helpful metaphor was thinking
about, well, if one were, let's say, there with a blastocyst and you had
to do something to keep it alive and then you saw a child drowning, who
would you save, if it was a matter of you being in one or the other place
and you knew that if you went and helped the child drowning, and I'm using
a dramatic example, but if you helped the child drowning, you would have
to let the blastocyst die because you couldn't carry out whatever next
thing you had to do to keep it alive. So to me, then the choice — it
very much comes down to choosing between two things and making a choice
as to what is the more morally imperative, so equating research with its
goal of therapy isn't therapeutic benefit and other medical advantages
to the idea of saving an existing life in some way that is a fully formed
life. So to me, it sort of came down to an either/or. Which one does one
weight. So I think your category 2 seems to be fitted by that metaphor.
CHAIRMAN KASS: Please, Alfonso?
DR. GÓMEZ-LOBO:: I think that was a very nice
illustration, actually, and very helpful, although since both are duties
of care, I don't think that there is any really serious and deep moral
conflict. I think that it's perfectly legitimate to care more for one
than the other, if you can't save both. In fact, I would like to take
up the — perhaps the challenge sketched by Rebecca and I think it's a
general way of clarifying things or trying to clarify things. I think
we do have duties of care, moral duties of care, duties to take action
to preserve the goods or to promote them and doubtless, our duties involved
in health care are usually of that nature. I mean we make all sorts of
effort to say bring our child to the emergency room when the child is
sick, etcetera. And of course, that's a very, very important aspect of
our moral life.
On the other hand, we have duties of respect and we have duties not
to harm. Physicians of the older generation perhaps were quite familiar
with this, the "first, do no harm" principle. And now these duties have
to do with the impermissibility of taking action intentionally that will
deprive someone of a good. So in a way it's symmetrical with the other
one and the first case we have a duty to promote, protect a good, otherwise
would go unprotected and that would make it a moral obligation.
Now what happens when there's a conflict between the two because that's
what we're talking about. If there were no conflict we wouldn't have much
of a problem. Now I don't — I do agree that some things we have duties
of care, but duties of care are usually not that dramatic because if something
goes wrong with one of the options, we're really not 100 percent responsible
for it as in the case of letting the blastocyst die.
Now what happens when we have, I'm sorry, did you want to interrupt?
Okay. What happens when we have a conflict of care and we have a conflict
between care and respect? If I understand it correctly, the tradition
of moral philosophy tends to say well, if the duty of respect is such
that if you act intentionally, you would be producing an important harm
to human good, then that should take precedence over the care.
Let me give you an example, perhaps a trivial one, but one which appears
in ethics books very often. You have a bandit who has kidnapped 20 hostages,
an American college woman goes by and this man says look, if you kill
one, I'll let the other 19 go and of course, that is perceived as a conflict
because of course this woman has a duty of care, apparently, to save 19
people. But in order to achieve that goal she has to harm, that is, intentionally
kill one person. Since that is the primary action in which she is engaging,
it follows that the agent in this case should morally refuse to do it.
Now I'm sketching this argument because for me —
PROF. SANDEL: Excuse me, would you say
that even assuming that you know for sure that the villain will kill the
19 of the 20 if you don't?
DR. GÓMEZ-LOBO:: Yes. Well, first of all, you
never know for sure because there's another agent making another decision
there. I mean we're not as predictable. Bandits are particularly unpredictable
and in most ethics books the bandit is called "Pedro."
That says something.
PROF. SANDEL: The reason I asked is if
that condition did apply, then we would have the nothing is lost principle
to argue for killing the one.
DR. GÓMEZ-LOBO:: Sure. Well, I don't subscribe
to the nothing is lost principle by all means.
PROF. SANDEL: Nor do I.
DR. GÓMEZ-LOBO:: Don't sign me on on that one.
Plus, I don't think there was a good application of the principle of double
effect in our previous discussion. So I'm torn. I'm definitely in group
3 here because from the marvelous exposition this morning, I see that,
well, we had heard that from Dr. Weissman already. I see how promising
all of this is and I see that there are these duties of care, but if —
I know many of you will not concede the "if" clauses of the following
sentences, but if embryos are human beings at an early stage of the development,
and if we should not intentionally kill innocent human beings, it follows
for me that I should not violate the harm principle in this case and that's
why I'm on level 3. I do think that this is a morally impermissible action,
but I regret it and that's why my question is going to be whether the
scientist can't figure out a way of harvesting the stem cells without
doing harm and the reply, unfortunately, was no.
CHAIRMAN KASS: Gil Meilaender and then Paul.
PROF. MEILAENDER: Well, you're in charge.
CHAIRMAN KASS: No, go ahead. My rudeness and his
gentlemanliness give you the floor.
PROF. MEILAENDER: Well, a couple of things.
I just want to note with respect to the example that Elizabeth gives,
I mean I agree with what Alfonso says in the sense that it really brings
us back to your comments kicking off this session. Elizabeth's original
way of formulating it was a way of thinking about several goods, clearly
in competition since you could only save one. Alfonso's way of reformulating
it has to do with how he changed it into the question of respect and care,
but it's really — that's a form of the right and the good, in a way.
And it's worth noting that there might be other factors that would enter
in. I don't know what you'd say to this, but even thinking of it just
in terms of the competing goods model, suppose the blastocyst is mine
and the drowning child or whatever it was, is somebody else's? Does that
count? I mean there are all sorts of factors that enter in here, in fact.
So the notion that we've only got one kind of thing, namely stages of
development that makes a difference, when we weigh competing goods is
not the case, in fact. It's considerably more complicated.
We have obligations to try to do good as much as we can, but that means
within certain kinds of limits and it means taking account of a whole
range of factors, and so it's just worth noting that it's there.
Then the other thing I wanted to comment on was just to come back to
Michael's comment that basically what he was saying was he falls into
category 1, as you outlined, that there's not really a moral problem here,
but that doesn't get us very far to say that because we want to know then
what will give us a moral problem. If the early embryo doesn't, at what
point would we have a moral problem and why? In order to think about how
persuaded we are by that, we need some kind of characteristics or criteria
or something that will help us think about it. Otherwise, we only have
a position and we don't yet have a kind of a piece of reasoning that we
can go to work on. We just need more to do something with it there.
CHAIRMAN KASS: Michael has in previous meetings,
in fact, in the very first meeting if I'm not misremembering, articulated
what might be the criteria for moral standing and they were pretty much
neurological, but I wouldn't speak for him. Could we draw you out on this
because it would be welcome.
DR. GAZZANIGA: Sure. One hates to try to answer
impossible questions, but you can certainly take approximations. And the
approximation that is safe for all concerned who are concerned about your
question is that by 14 days the British line in the sand, we're dealing
with a system that is brainless and has no capacity for sentience. The
brain cells aren't even born and that's pretty raw, elementary biology
to — for me to draw the line at the 14th day and then people come back
and give you the potentiality argument and I also said something about
that which — so yes, I'm willing to draw for — where are we, 2002, that
a 14-day line in the sand is a pretty comfortable, keeps you free from
thornier issues and I'm going to let someone else draw the next line.
CHAIRMAN KASS: I'm sorry?
DR. GAZZANIGA: I'm going to let someone else
draw the next line.
PROF. MEILAENDER: Can we have 20 days
DR. KRAUTHAMMER: Michael, could I pursue that?
Michael, I just want to ask you, forget about the legal issue here. At
what point, clearly, you're not at all morally disturbed by working on
a blastocyst. At what point in the development of this entity are you
personally morally disturbed?
DR. GAZZANIGA: Well, you know, let's see how
she goes. One step at a time. What's before us in terms of what the scientists
are saying we can provide untold remedies, hopefully they can be provided.
For the time being, they would be happy and everybody would be happy with
the line that I've drawn. The line that I've drawn — a line. So in 10,
15, 20 years, if they come back to the meeting and say look, we need to
move that line, how much — how good their argument is, what people think
about it is for another time to be considered. I don't think we have to
think that far into the future. I think can we make a comfortable decision
in 2002 and I think we can.
DR. KRAUTHAMMER: But clearly, what you think
about when this organism deserves some respect has to have some influence
on your thinking on this, I would assume that you believe a newborn child
DR. GAZZANIGA: Of course.
DR. KRAUTHAMMER: And I understand that what
you're saying of the 7-day-old blastocyst is just a piece of tissue, clearly
there's a point at which if you were asked to do the research on this
organism, you would say no, and I'm just curious to know what that —
you certainly have thought about this.
DR. GAZZANIGA: Well, I don't know if I have.
DR. KRAUTHAMMER: Perhaps you could give it
DR. GAZZANIGA: I mean the obvious, from the
neurologic base, the obvious fact on the ground is that the organ that
is responsible for everything going on in this room is the brain. And
the discussions of the issues of human dignity, of human concern, piety,
sympathies, those are all constructs of the human mind and so that means
you need a brain around to enable those concepts to be used. So one could
say that you at least needed the presence of a nervous system and a nervous
system doesn't start forming for 4 or 5 weeks and that nervous system,
as you know, is impoverished, it's not ready to do the kinds of things
we're doing now. And then you start getting into all these unanswerable
questions and I just would rather set those aside because I don't have
those problems at 14 days.
CHAIRMAN KASS: Do you want to continue?
First of all, Michael is very good natured and he's not shy, if I may
speak for him. And I think that this, if we're here, let's pursue this
a little bit further and see if we can get some clarity on this, if people
don't mind. I'm taking advantage of your good nature.
DR. GAZZANIGA: We'll see how good natured
DR. ROWLEY: Have you checked with his wife?
DR. GAZZANIGA: Sure, go ahead, push me, push
CHAIRMAN KASS: Did you want to go further?
DR. KRAUTHAMMER: Well, I don't, as a former
psychiatrist, I'm guessing here, but I don't think I'm going to succeed.
The position I've taken which cut down a lot of trees to publish in The
New Republic this week, is based on basically a slippery slope argument.
It begins by trying to not assume any intrinsic worth to the 7-day blastocyst,
but asking were we to pursue this research, particularly in cloning where
you create for the purpose of using the blastocyst and destroying it,
what will we become? So I think it is relevant. If you think that it becomes
wrong to do the research at a fairly near point after that, and as I understand
what you're saying, Michael, it would be at the point where there's beginning
of neural development. But you seem to also be saying that you want to
draw the line at two weeks, so the slope here, I don't know how slippery
it is, but it isn't a big slope between 1 week and 2 weeks.
DR. GAZZANIGA: This is where I am in over
my head. I like to call up philosophers I know and say can you help me
with this slippery slope thing.
And they say oh, that's been written about and there's a pro side and
a con side. And I say okay.
I'll take the con side and we hang up. You can get a driver's license
when you're 16, right? Now someone said well, what about 15 years, 11
months, 30 days, is that really different than 16? Nah, it's not really
different. Well, about 15 years, 11 months, and 29 days. Pretty soon with
the slippery slope argument you can get down to where babies could be
getting driver's license. And of course, that's nonsensical. So what we
develop as a species is a capacity for form categories, categories of
action, what is generally acceptable. And all I'm suggesting is that we
have a category here that we can make a clear decision about and in that
way get around the slippery slope analogy which I think can find you in
some pretty slippery situations.
CHAIRMAN KASS: Bill?
DR. HURLBUT: Here's what it seems to me to
come down to. Some people would say that what you're talking about here
is not a license to drive, but a license to kill. Now I'm not a lawyer
and unfortunately, as I look around the room, it seems to me there aren't
Oh, good, right, okay. Rebecca, you're here. But my understanding of
the law concerning abortion is that it was not fundamentally a right to
take a life. That was a circumstantial secondary effect. The woman had
a right of privacy to evacuate her womb of this alien presence that was
not, she did not have an obligation to have. Okay? Maybe you can correct
me in a second, but let me keep going. So now we have — you say we have
this capacity to form categories. And I want to say parenthetically, I
have a lot of trouble figuring this out too, so I'm not trying to attack
in saying this, but I'd like clarification on it. You say we have this
capacity for categories. Well, one of our major categories is this distinction
between a life present or in process and its right to continue or whatever
you want to call it. I don't even want to use the language of rights,
but this is a major category, this position that you should never take
an innocent life in process.
Now here's what troubles me about all this from the slippery slope side
of the argument. I'm also troubled by the potential argument, but let's
put that one aside for the moment and here, Mike, I want to ask you a
So if you really go down and you talk to people about stem cell technology
as I've tried to do and by amazing circumstances I know quite a few of
the major figures in this field, my assessment of it is, yes, we might
be able to find the reagents and bathe the culture in them and get the
proper cells we want, but that in fact, we're more likely to get what
we want if we were to gestate it for a while, either in utero or artificially
of some kind of ectogenesis could be generated.
So now what I want to ask you —
DR. WILSON: Mike, what was that? What
could be generated? I didn't hear you.
CHAIRMAN KASS: Growth outside, ectogenesis. It
grows outside the womb.
DR. HURLBUT: It turns out that a lot of what
happens in the development process is highly circumstantial. So people
working with stem cells are beginning to appreciate how there are these
other little micro environments, that if surrounded in a semicircle by
one kind of cell which are sending a diffusible agent in in a particular
way, then another agent coming from the other side will cause the differentiation,
but you can't just bathe it in the reagents.
The point is that it seems more logical to me that you reasonably could
produce more useful therapeutic tissues by allowing gestation or some
kind of artificial gestation to go for a while.
So I want to take the opposition position for a moment and say why not
go beyond 14 days and why restrict ourselves to 14 days now if brain criteria
— I think even now my assessment is we could learn a lot and progress
faster with the science if we didn't draw that boundary. So I really feel
as though that boundary is really just shifting the question of not taking
an innocent life to 14 days instead of point of origin.
DR. GAZZANIGA: Are you in a position 1, we're
haggling price here?
DR. HURLBUT: No, because I said I'm prescinding
from the question of potential for the moment. So just on your principles,
I want to know why we would draw the line at 14 days. And why now?
DR. GAZZANIGA: I just told you. It is a line
that is comfortable for me to draw. It is a line that would allow the
research to go forward. I won't keep repeating myself.
DR. HURLBUT: But you said a minute ago that
you are comfortable with the fact that until there's a neurologic system
which you said was 4 to 5 weeks, that you didn't think there was any increased
moral standing, so why would you not set that boundary for the moment
at 4 to 5 weeks which would make science progress much faster.
DR. GAZZANIGA: I don't know enough to know
whether you're right or wrong. I leave it to the adjudicating regulatory
panels might inform us on that. I don't see this as a crucial point whether
it's 14 days or whatever. I'm comfortable with 14 days and I'm simply
stating my position of 14 days.
DR. HURLBUT: I'd also like to comment on —
I'm sorry Mary Ann is not here. Her summation of the last which is relevant
here that she seems to be moving towards a conservative position on this
issue because of the failure of — to see any demonstrable products or
line of research that are coming out of various stem cell efforts.
DR. GAZZANIGA: There's a wonderful article
in Science a couple of weeks ago entitled "Some History Should be Repeated."
And they review the claims and concerns of people about the recombinant
DNA research in 1976 where there was a group of people from Cambridge,
Massachusetts where a lot of this was going to go on at MIT that felt
funny little organisms were going to ooze out of the MIT labs and envelop
Cambridge and people were going to die of these horrible things, yadda,
And in a similar meeting held in 1970, the late 1970s, they set up this
regulatory agency and as a result of now going ahead with recombinant
DNA research, none of which was immediately envisioned at the time, we
now have, according to this article, 11 major drugs that are used in diabetes,
hepatitis, acute myocardial infarction, rheumatoid arthritis, stroke serving
and saving the lives of millions and millions of people.
So the notion that I think some people not scientifically trained don't
quite understand is that let the scientists roll. They'll figure it out.
They'll figure it out and they're the most conservative people in this
DR. GAZZANIGA: They beat each other up on
a daily basis as to whether what they're saying is correct or wrong. But
you can't project into the future what they'll find out. You have to just
understand the competencies that they're currently arguing for and then
let them go to work.
CHAIRMAN KASS: Dan.
DR. FOSTER: I just want to interrupt for one
CHAIRMAN KASS: Please.
DR. FOSTER: I want to say something a little
bit later, but I want to respond to Bill in one sense. We, ourselves,
as a council, tend to have different views. We can sort of sense what,
as Leon said, and he's come a long way to try to get us into thinking
about these things. I think it's critically important in terms of, as
Charles would say, building a fence, that we not try to expand what has
already been done already when — outside. I think it's critically important.
I myself would be perfectly happy to draw the line at the blastocyst level
because I think all the initial basic science can be worked out there
and to start moving beyond to the 20 days and so forth. Maybe that would
speed up the science. I don't know about that at all. We may find something
from the blastocyst in terms of mutation rates and all sorts of things,
going to pass away.
My own view is I'm starting to get — but I think it would just be crazy
from a practical standpoint to try to say the council wants to come up
and extend what we can't even agree on here ourselves. So that's not a
moral — the only reason I'm hesitating to say this, it's not a moral
issue, but sooner or later, we have to get off of the high standards of
moral things and talk about practical things as well. I think we're starting
to talk about very practical things this afternoon. I maybe want to come
back to that a little bit, my comments about that a little bit later,
but I sure would — Gil, I always learn things from what you say and write
and send me, but I think this time, you're wrong. I think it's wrong to
try to expand this thing out, both practically and in terms of trying
to get a consensus on some views, our views here in the council.
CHAIRMAN KASS: Let me say I think I understand.
I don't want to pretend to have mind reading capacities. But I've been
in a number of these discussions and I begin to get to know who's talking.
I think what's at issue in this conversation, let me see if I've got it
right. Mike Gazzaniga sees no moral difficulty with using blastocysts
because he does not regard them as being things of moral worth.
He was asked by several people to say well, all right, and he also enunciates
a powerful moral principle for going forward, namely, we're going to learn
good things and important things and people will benefit from it.
So no harm, and great good. What's the problem?
Then people want to know well, is there a place where you would have
a problem so that if we want to join you we want to know where this train
is going and where the limits are which is partly why Charles wants to
know, why Gil first of all wants to know what's the ground of this, where
is there going to be moral standing and then he gives the argument of
nervous system and then the question is well, is the 14 days merely a
prudential calculation because that's all we need right now and he's willing
15 years down the road to go some place else. I think that's what, in
effect, Michael was saying. But there are people who are nervous and who
want to hear the principled defense because what they hear here is something
like the duty to care and cure being treated as an unqualified imperative
beneath which everything else has to submit. And so part of the question
for those of us who would care about something, about not doing harm or
not violating that which should not be violated, they want to know is
there a place.
Now other people have used the 14-day marker not as a merely time saving
place for the time being, but who really think that 14 days is a transitional
point, whether it be implantation — I don't mean by that just transfer
into the woman, but actual physical implantation into the wall of the
uterus where you actually have the beginning of a pregnancy, until that
time, you don't — or who want to talk about the primitive streak or who
want to talk about the absence of twinning and who try to provide some
kind of biological foundation for saying ah, there's something here now
not fully one of us, but that's a biologically-based boundary, not in
a nervous system, but something else that might count for the discussion.
So for some of the people in the conversation who want to know, is there
something in the nature of things that would give us a guide if the blastocyst
is not it yet? I think that's part of the conversation.
And the other part of the conversation seems to be to test out what
actually is the limit of the moral imperative on the side of going forward
or are we simply going to say there are sick people out there who need
these things and until you come to newborn infants, which I think was
the implication of Charles' question, it's ultimately fair game because
we can't really, I think, and this is not my — this was an attempt to
summarize what I thought was going on in the conversation. I would add
a position of my own. Yes, we are faced with a certain practical decision
here and now, but we have to think about the meaning of the kinds of decisions
we take here and now for what it legitimates in the future. Yeah, and
therefore, we should try and find a good moral foundation as well as being
prudential and practically sensible here in trying to reach this and to
see whether we can find a place to rest our head, if we can. If not, I
think we're in danger of reaching an unprincipled kind of compromise which
offers no guidance to those who are going to come after and who might
look to this body which was invited to think about this with a view to
where this is going, admittedly with uncertain knowledge, but with some
power to predict some of the things that might be coming ahead.
DR. FOSTER: Leon, I always seem to start these
long speeches that I was not speaking to the issue that you posed before
us about the moral things. I was talking about a very practical thing
and I didn't want to divert off into some other thing. I want to get back
to this. I was not making any moral argument at all. I think it's perfectly
legitimate to do that. So if you were lecturing me, I was not attempting
to make a moral argument.
CHAIRMAN KASS: Excuse me, it wasn't a lecture to
DR. FOSTER: Well, it sounded like it.
CHAIRMAN KASS: No, sorry, Dan. It was heading off
what I thought were going to be people pouncing on you.
DR. FOSTER: I'm so delighted that you're going
to take care of me just like the fetus, you have to take care of me, right?
Okay, I'm just kidding.
DR. HURLBUT: Can I respond, Leon, just to
that because I have a very salient point to respond to that.
CHAIRMAN KASS: Okay.
DR. HURLBUT: And it ties to what you're saying.
CHAIRMAN KASS: Okay.
DR. HURLBUT: Dan, we were told this morning
that fetal primordial neural cells may be useful in Parkinson's disease,
DR. FOSTER: Some people believe that.
DR. HURLBUT: But let's assume it's right for
the moment. Now it's not abstract and it's not way off in the future.
It's here and now. So why then would we say, on what principle will we
say that a person should not clone himself, gestate or hire somebody or
gestate for themselves the embryo up to the age to harvest out those particular
very useful cells? This is right here, right now. And yet, the question
— and look, let me make two other points. I am a physician. I really
want to see the science go forward very, very, very much. I feel the weight
of this. I dream it actually, but I think if we define our principles,
we will allow the science to go forward because then we will, for example,
if we say, full, generative potential is not acceptable to violate, then
we've got the possibility of creating partial generative potential, perhaps,
and going around it, the moral problem in a moral way.
If we define our larger principles well, it will allow the science to
go forward. Otherwise, it's going to get stuck in this morass of conflict.
So what I see myself as saying here is something positive to try and set
the future in an open way.
Moral reality is a fragile reality in any given society and it's something
we have to contend with. We can't just ignore it. I think it's harder
to set a moral tone of cooperation in a society than it is to make scientific
progress. But hopefully, they can go forward together.
CHAIRMAN KASS: Paul McHugh. Thanks for your patience,
DR. MCHUGH: Well, I'm going to distract us,
I think, from that kind of conversation, but only to reiterate what has
been and to emphasize what has been the subject of the conversation between
you and me in our epistolary debate in the e-mails.
I feel that we will totally submerge into arguments of opinion over
actions if we don't agree or come to hear that the somatic cell nuclear
transfer clonote is different than the zygote. With Michael, I can partially
agree that the clonote should have — be the subject of study because
I think of it as an artifact and I think it different from a zygote. Where
I disagree with Michael is that dealing with a zygotic natural program
is equally okay. In fact, I wanted to make a point about Mary Ann Glendon.
I think she would say her argument was not conservative, but liberal in
the sense of wanting to encompass more people under the umbrella of our
protection, but the issue of the science here in what we're talking about
is an effort to bring science forward in the best way.
I want to emphasize what I said in those notes, that is, that the lived
experience of scientists making somatic cell nuclear transplants is not
that they are creating a new individual, that they are then going to destroy.
They are thinking that they are producing tissue that has a particular
program and that they're going to use that tissue at some time for the
benefit of everyone and I'm approving of that and I want to support that.
In fact, I do support it. I believe that the artifact can then be misused
if brought on into reproductive cloning, but the fact of it as a different
kind of thing permits different kinds of actions towards it.
CHAIRMAN KASS: Do you want to answer publicly one
question on this?
DR. MCHUGH: Yes.
CHAIRMAN KASS: You believe that the clonote is
an artifact different in kind because it's different in origin from a
DR. MCHUGH: Different in its origins and in
CHAIRMAN KASS: And in its constitution. And should
that cloned — should that become cloned at the blastocyst stage and should
it be implanted for reproductive purposes and should a child emerge, would
that be a human child or would that be an artifact?
DR. MCHUGH: Well, first of all, those actions
should not be done.
CHAIRMAN KASS: But —
DR. MCHUGH: That human person would be a different
person, although you would extend to him because he was tragically created,
natural rights to him, but you would see him as a person mistreated and
never to have been created.
CHAIRMAN KASS: But not a member of our species?
DR. MCHUGH: Not quite a member of our species
in the same way, yeah.
CHAIRMAN KASS: Even if capable of reproducing with
another member of our species to produce more members of our species?
DR. MCHUGH: He would be different.
DR. KRAUTHAMMER: Is Dolly not a sheep?
DR. MCHUGH: Dolly is a sick sheep.
DR. KRAUTHAMMER: But Dolly is —
DR. MCHUGH: But this would be a sick person
and we would have to take care of him.
DR. KRAUTHAMMER: But Dolly is a sheep, sick
or not, she's a sheep. I think she's a sheep, right?
CHAIRMAN KASS: The question has been joined. I
don't know if we can sort it out.
DR. MCHUGH: The point of saying that the clonote
has these potentials, that if they are illegally and I would believe that
this would be as illegal as slavery or as genocide, that because it has
those potentials, that therefore it should be treated as though only those
potentials characterize it or that it should be conceived of as only characterized
by potential would be an error, an error of logic and an error that would
hold back the advancement of science.
CHAIRMAN KASS: Instead of arguing, let me see if
I can put you on the map of positions, the moral positions on this question
so we know what homework we have to do.
If I now understand you, you do not regard cloning for biomedical research
to be a moral problem because the thing that is produced isn't on the
human moral scale and therefore —
DR. MCHUGH: I found it problematic to take
your spectrum because I was looking at where I would place myself.
CHAIRMAN KASS: You're in a fifth position.
DR. MCHUGH: To some extent I hold myself in
the place where — between 1 and 2, okay? I don't think any harm is being
done by creating a clonote. I think something good is being done by creating
a clonote. But because it is a special kind of new, a kind of biology,
I would therefore not permit it to be implanted in a uterus, so maybe
therefore I'm treating — approving with humility in some way because
I'm putting limits around what I would do with it.
CHAIRMAN KASS: Okay.
DR. MCHUGH: You see, if you take the point
that the clonote is something different, it's something manufactured rather
than begotten, then you would want to study, use its best potentials for
human kind and not let its potentials for error and slavery appear, okay?
CHAIRMAN KASS: I owe you a 5-page e-mail.
DR. MCHUGH: Yes.
CHAIRMAN KASS: You'll get it. Dan, please?
DR. FOSTER: I don't want any e-mail. I never
write e-mails in these things and the one that I sent I said don't circulate.
I'd rather talk personally, but that's okay.
Let me make a preliminary remark. Leon said a moment ago in passing,
he used a phrase that I think Adam Seligman popularized called epistemological
modesty that in the philosophy of studying knowledge that you looked at
limits and so forth. I think epistemological modesty means that you believe
certain things, but you're modest about these claims and you can be a
believer and yet say I'm not really sure. And that's sort of a fundamental
fault line here in the discussion.
I take seriously and I've been influenced by the people who occupy position
3 here and I'm not willing to agree with Paul that this is just an artifact.
I think there's serious issues here that make me nervous.
But if you live in what Alfred Shutz called paramount reality, that
is being wide awake in the every day world, that's what paramount reality
is, it seems to me that common sense shows that a 100-cell human embryo
with a potential to ultimately, if everything goes right, becomes a human,
has to be taken as serious, as being serious. But it seems to me from
this wide awake view that it's different and it doesn't have the same
demands for protection and respect as let's say something a little bit
later. But I don't know that for sure. And that's why I think one has
to occupy what I think I and what I know I occupy which will be position
It seems — I don't — I'm not comfortable with Rebecca's view that
there's some messianic demand to rescue people. I think there are great
virtues in suffering and death that come to humanity. I think none of
the things that are great in humanity would occur without threat and suffering
in the world. If there were not pain, there wouldn't be any need for mercy.
If there were not fearful things, there would be no room for courage.
One could go through the whole litany of what makes humans different and
great or the consequences of risk and suffering in the world. That does
not mean that when we're given these brains that we should not try to
make the world better. I'm distressed enormously by the fact that the
slope of evolution in science appears to be steadily upward and that the
slope of evolution for human kindness and beneficence and morality seems
almost not to have moved at all.
And therefore, I think there's an obligation for those of us who live
in this world and want it to be better to try to make wherever we can
the world better and if you take — I may be the only one in the room
that really actively takes care of patients and —
DR. MCHUGH: Hold on.
DR. FOSTER: I'm sorry, Paul. He's retired,
but he still takes care of them. Okay, forgive me for that.
But it is a daunting thing to deal with death. I just lost my long-term
colleague. We did 30 years of science together. We did good science together
and from a glioblastoma multi-form and there are papers, somebody read
the PNAS paper last year where you can mark, you can put human glioblastomas
in and then just infuse adult neural stem cells in the peripheral blood
targets, the glioblastoma, you can take the mass out, but they infiltrate,
you can just see pictures. There are two new articles in Nature and Medicine
just showing them infiltrating. But these adult cells clamp on to them
and you modified them so that you can give a small drug and convert it
into a chemotherapeutic agent across the blood-brain barrier. I mean we
tried to see if we could do anything for humans like that.
So myself, for myself, it's perfectly clear that we ought to try to
do better in terms of medicine and the relief of suffering and I don't
think the worry, although I'm very worried about it is sufficient to stop
Here's another point that I think I made —
DR. MCHUGH: Can I ask you a question then
about that, Dan?
DR. FOSTER: yes.
DR. MCHUGH: Can I ask you would you take a
blastocyst that was naturally formed, taking it out of a uterus, a natural
blastocyst and use it in the way you want to use the clonote?
DR. FOSTER: No.
DR. MCHUGH: Why wouldn't you?
DR. FOSTER: Because then I would clearly be
interrupting a progression, unless nature took it away.
DR. MCHUGH: Well —
DR. FOSTER: Let me answer it another way.
Everybody talks about if you use this, you're going to destroy it. Well,
I don't know what the figure is, but 30 to 70 percent of the embryos that
form normally are deleted by nature. So what do we say that God is destroying
DR. MCHUGH: Would you put a filter in a uterus
and pick up those and then use them the way you want?
DR. FOSTER: I would not.
DR. MCHUGH: I'm coming back to my artifact
which you wish to use as an artifact, but deny. That's what I'm saying
DR. FOSTER: Well, I guess —
DR. MCHUGH: You are saying that things which
occur naturally you wouldn't use, but things which come out by cloning
you would use and I believe that that's because you see an artifactual
nature to the clonote.
DR. FOSTER: Well, I don't think that's what
I believe —
DR. MCHUGH: Well, would you use a naturally
occurring blastocyst formed —
DR. FOSTER: You mean while it's in the uterus?
DR. MCHUGH: Yes, when it falls out of the
DR. FOSTER: You mean if you take it out of
DR. MCHUGH: yes.
DR. FOSTER: No, I wouldn't. I don't want to
get into —
PROF. SANDEL: that's not the only possibility.
DR. MCHUGH: No, that's not the only possibility.
DR. FOSTER: I don't want to get into one of
these long e-mail exchanges that you and Leon try to do. I'm just trying
to make a simple, succinct point and then I'm going to stop right here
in just a second, but I do think that we — that I feel a strong obligation
not to stop this and the only thing I was going to say and I argued this
with Charles a moment ago, I think if we allowed this to go forward, that
is biomedical research, if it turns out that it doesn't work, I agree
with Mike, the scientists would be the first to quit and so will biotechnology
companies because if it doesn't work, if it's got mutations in it we'll
end it. Or, if there are better ways to do this as I think there may well
be, it will be abandoned quickly. We've seen that all over in medicine
that we abandon things when they go through. So my view is, let's try
to learn from this and keep it very limited and I'll pay the price of
tears, if that's what it is, if it turns out that in some sense that the
universe thinks I've killed a child, which I hope we get rid of that murdering
and killing things. I mean there's some sort of an implication that scientists
are unethical or immoral or less ethical or less moral than people who
are not scientists and I want to try to get away from that. But if that's
wrong, then I'll try to tell the universe sometime, I'm sorry, I made
a bad mistake. But on the other hand, in the meantime I want to try to
see if we can't help a whole lot of humanity with what to me seems to
be a different sort of moral problem than the idea of beyond ending a
life that's not neurons and other organs and things of that sort.
I didn't mean to talk so long. I just was really trying to say that
I'm in the position of with a lot of concern as to whether I'm right or
not about that.
CHAIRMAN KASS: Charles?
DR. KRAUTHAMMER: I'm a 3 and I'm there for
prudential reasons. Mike says and I think if I have the quote correctly,
those not trained in science don't understand that what we need to do
is let science roll.
Well, we let science roll in the 20th century. We got eugenics. We got
the Tuskegee experiment. We had such horrors in mid-century that we needed
the Nuremburg Code. Humanity hadn't had to write it before, but it had
to write it after. So I'm a little skeptical about letting science roll.
Scientists are one of the great resources in any society. They do the
science, but they don't own the science. And the reason that we're here
is because we don't have a guild system in this society, we have a democracy.
We don't say to auto makers you know how to make cars, therefore you will
determine what safety standards will be in cars. No, it's the nonexperts,
it's the lawyers and the Congress who decide what are going to be the
safety requirements in cars and that is imposed on the experts who make
the cars and that's how we do it in a democracy and that's why we have
this council to advise the President and the country on what restrictions
might or might not be applied on what is undoubtedly a wonderful enterprise.
But we don't have a guild system in which all the rules are made internally,
not in a democracy.
The reason I'm against research cloning is not because of the reasons
underlying position 4 which is somehow attributing a worth to the blastocyst
equal or at least comparable to that of a human, but out of a prudential
consideration as to what happens if we don't.
The first slippery slope and I think an argument that in and of itself
would be enough for a person to oppose research of cloning is that I think
there can't be any doubt that if we sanction an industry — and it will
become an industry — for the creation of cloned embryos, it is absolutely
inevitable that we will begin to see those embryos implanted and we will
have the moral horror of having a cloned embryo in gestation which under
penalty of law would have to be destroyed and that is a moral certainty
that I think is intolerable. But as I wrote in my piece in The New Republic,
that is a little bit too easy. I think it would be reason enough to prudentially
oppose research cloning, but let's assume, put it aside. I think there
are other reasons and the reasons are that once you start on this, once
you start rolling along this road, it will lead us to places where I think
that we don't want to go. I may be wrong, obviously nobody knows exactly
how we will end up or where this will take us, but I think a prudent society
needs to make choices based on past history and some understanding of
The problem, Daniel, is not that the research might fail. The danger
is that it might succeed wonderfully and we will then have scientists
say as we just heard, give me three more weeks with this embryo. Why not
have a fetus where the organs are developed and use them for transplantation
rather than have a Rube Goldberg system of growing it into a blastocyst,
teasing out stem cells, tweaking them into developing into cell lines.
Why not let nature produce with that wonderful machine a fetus and let's
strip it apart for its parts? Most of us would say today that is unconscionable.
Well, I suspect that if we live in a society where we do this kind of
stuff at an earlier level, for a decade or two or three, it will be less
In the end, I think the major issue here is that we are crossing a new
barrier with research cloning and that is the creation of embryos solely
for their use and I'm afraid that once you do that and we create an industry
in which this will be the business of that industry, embryo creation,
that we will so desensitize ourselves to the use or misuse of this entity
that we will end up doing things that we don't want to do and don't want
a society to do.
I think that prudential argument is one on which we can argue about
well, what are the likelihoods of these things happening, but I think
we ought to be realistic, that once you start on that road, we will be,
as a society, far less able to resist the temptations that today seem
obvious that we ought to resist, but tomorrow, probably won't.
CHAIRMAN KASS: Jim Wilson?
DR. WILSON: I've listened for years
to Charles and read Charles for years without, I think, disagreeing with
a single word he's uttered until today. And my problem is with the slippery
slope argument. The slippery slope argument which we hear much of in the
literature although it's rarely defined, is kind of a warning sign that's
put up on a highway, don't go any further or unknown bad things will happen
to you. But rarely is it carried out to show that if you walk past that
sign, these unknown, soon-to-be-named bad things will, in fact, happen
to you. The slippery slope argument here does have a name as what's going
to happen to us if we permit the use of somatic cell transfer for the
purposes of creating clones for biomedical research. It is inevitable
that we will soon have cloning to make babies and perhaps cloning to produce
from fetal organs parts to be used by human beings and after that God
knows, perhaps organs taken from babies.
That's an argument that can be used against every advance in medical
science that has been made that I can think of. We must not invent surgery
because the use of the scalpel to take out an appendix will inevitably,
on the slippery slope, lead to organ harvesting and the selling of kidneys
and livers on the public market. We must not allow neurosurgery, even
to cure a terrible tumor because it will lead inevitably to lobotomy.
Now, in fact, lobotomies have occurred. And in fact, some instances of
organ harvesting have occurred, but the public's horror and the government's
horror at these things has quickly shut down those enterprises and penalized,
often severely, the people who did it. Or perhaps we shouldn't have automobiles
because we will have fatalities. Well, we do have fatalities, but then
we balance the value of the automobiles with the value of the fatalities.
Or we shouldn't — you can make an argument about any human innovation
and say we must not adopt it because we'll be on the slippery slope and
it is, in fact, a Luddite argument, unless you're able to show that sliding
down that slope is inevitable.
Now you might be able to say that sliding down that slope is inevitable
in the case of cloning because there will be such a huge financial demand
for the benefits of cloning that any form of cloning, however benign in
original intention, will lead to the worse forms of cloning to satisfy
that demand. But from all the scientific testimony I've heard so far,
there isn't this huge financial demand and there isn't because nobody
has found yet the exact techniques that competent, but ordinary physicians
can use to cure these diseases, so that I want us to back away from the
prudential or this particular prudential argument because I don't think
it's correct unless Charles is in a position to show that the slope is
so slippery, so covered with banana oil, that one step past the warning
line we have now drawn on the pavement will bring us down into chaos.
DR. KRAUTHAMMER: Well, let me give you a recent
and empirical example of that slope. The country had a debate on stem
cells about a year ago and the major argument by the proponents of stem
cell research — and I was one of them — was that we are using discarded
embryos, everybody understood that, and we were going to bring a benefit
from something that would otherwise bring no good. The understanding was,
in fact, Senator Frist made the presentation on the floor of the Senate
and he established conditions under which he would support stem cell research,
the regulations that we ought to institute in support of that research
and among them he listed very emphatically that the research would not
be done with embryos created for the purpose of using for stem cells.
That was what he said.
Now and here we are a year later and we're arguing over a technique
of cloning which can only be done in a manner in which an embryo is created
in order to destroy. So within a year, what we have is the ground shifting
on this debate on precisely a point that a year ago we had been assured
would be excluded by regulation and by law.
DR. WILSON: The Senator Frist example
is a good one, a particularly good illustration of the proposition that
Congress doesn't often mean what it says. You could use an even better
example with the 1964 Civil Rights Act and Senator Humphrey's assertion
to the Senate at large that it would never be used to establish quotas
or goals. These things do happen. But the fact that a year later, a year
ago or two years ago, whenever Senator Frist spoke, we now find ourselves
discussing this subject. It's very different from saying that the subject,
once having been discussed and some authorization once having been past,
we have now slipped down the slope to the point where we are creating
clones for the making of babies and harvesting organs from fetuses.
CHAIRMAN KASS: Janet, did you want to comment?
DR. ROWLEY: Well, let me first just respond
to Charles because I think though Senator First may have made some comments,
I'm sure that anyone in the field of cloning and embryonic stem cells
would not have supported his point of view. So it isn't as though we started
and we're downslope. I believe that individuals in embryonic stem cell
research had already envisioned that, so we haven't — that position has
not been changed of the people who are involved in it.
I would like to respond to the discussion that Leon framed as we began
this session and my points of view are certainly influenced substantially
by my view that we are really, we have the potential of being on the threshold
of some major biological discoveries that will be of enormous importance,
but I qualify that with the same statement I made when we began this discussion
in January, that this is a hope and at the present time we have no idea
as to how much that hope will actually be successful and that was reiterated
and confirmed again by both speakers this morning, that these are very,
very, very early days and the promise that many of us see in this kind
of research may — I think it's not fair to say that the promise will
not be realized, but I think that it is fair to say that the promise may
take a very long time. And I just want to point out that we began the
war on cancer in 1970 with the notion that it was all going to be over
in 10 or 20 years and we're far from it. We're far from it because we're
dealing with very complex systems in cells about which we are woefully
ignorant, but I think the part of the research that will be permitted
by going ahead with cloning and some of the aspects of experiments with
somatic nuclear cell transfer will enlighten us so much that we'll be
able to see better how to expand on these in the future. And I would only
echo our morning speakers by saying that I think that to ban this kind
of research which has the potential for therapy would be a great tragedy.
CHAIRMAN KASS: Michael Sandel?
PROF. SANDEL: I just wanted to pick up
on the last small uncharacteristic slip of Charles where he slipped back
into the polemical action description to use Professor Outka's phrase
of what cloning for biomedical research is. I thought following Paul's
and Leon's corrective which Outka accepted, we agreed that there are two
possible action descriptions for both of these practices. By both, I mean
creation of embryos for reproductive purposes and creation of embryos
for purposes of medical research, a charitable description and an uncharitable
one. The charitable description in each case describes the action in terms
of the end it's aimed at. So in the case of embryos created for reproduction
we point by the description to the end. Likewise, in the case of cloning
for biomedical research, the end there is the creation of an embryo for
the sake of promoting the curing of disease. There is an uncharitable
description available equally to both and if we want to compare them,
compare the moral status of these practices, we should use either the
charitable descriptions of each or the uncharitable descriptions of each.
The uncharitable descriptions in each case doesn't refer to the end being
aimed at, but instead to the foreseeable, though undesirable effect.
So it would be fair to say that with Charles and with Outka's paper
that in the case of creating an embryo for the sake of biomedical research
to describe that as creating an embryo in order to destroy it, but only
in the same sense that we should describe creation of embryos for reproduction
purposes as the creation of embryos in order to discard the inevitable
extras that will accompany the practice of IVF. So both activities admit
of charitable and uncharitable descriptions and if we're going to compare
their moral status, we should compare them either under one description,
the things they aim at or under the other description, the foreseeable,
but undesirable side effects that accompany both.
DR. KRAUTHAMMER: Michael, I'm surprised that
you also made an uncharacteristic slip when you said the inevitable destruction
of the embryos in IVF because you know, as I know, we could, in principle,
establish an IVF clinic tomorrow in which you assign only a single embryo
to a woman. So you would thereby have a process of IVF where you have
no inevitable, indeed, indeed no discarded embryos.
On the other hand, in cloning, it is absolutely inevitable that that
embryo, because it will be disassembled, will be destroyed.
PROF. SANDEL: Well, if the practice of
creating embryos for reproductive purposes involved no spares, no extras,
then it would have a different moral status and character from the practice
we currently have.
CHAIRMAN KASS: Elizabeth?
DR. BLACKBURN: It would be different
from natural which, in fact, if anything the majority of embryos naturally
are lost and destroyed —
DR. KRAUTHAMMER: We'd be improving on God.
DR. BLACKBURN: That's good.
PROF. SANDEL: What the natural case Elizabeth
raises is the — there's also an uncharitable description of natural procreation
which would be very odd, which is you're engaging in the inevitable creation
of spare embryos that will be sacrificed for the sake of having one that
DR. BLACKBURN: Well —
PROF. SANDEL: And there's no more warrant
for that description than for the contentious version of the description
in the cloning for medical research case.
DR. BLACKBURN: Well, I think it might
be helpful to return to somewhat more the homely and something Gil said
that he said to me, well, would you say the blastocyst, if it were yours
versus the child and I think I wouldn't be able to look the parents of
the child in the face if I hadn't made an attempt to save the child. And
I think that also addresses the issue of should we be trying to do cures,
even though we know that they're not inevitably going to work tomorrow,
next year, 10 years or 20 years. I think we have to try and so I think
this question of the fact that we don't have successful answers right
now for whether embryonic stem cells or somatic cell nuclear cloning is
going to work, I don't think that absolves us from the necessity to try
when we see real human disease and suffering that we should try to act
on, even though we know we may not be necessarily successful in every
CHAIRMAN KASS: Gil, and I then I think I would
like to put my oar in and I'll give rebuttals, but we should probably
wind up. We need a nap before we drink, right?
Gil, do you want to comment?
PROF. MEILAENDER: Well, just a couple
of things quickly. To pick up Elizabeth's point again. The hypothesis
was and I think it's worth thinking about, the hypothesis was that you
could only save one of the two entities, so that I don't know how we set
up this case the way the philosophers do it, but there's a fire and you
can go up one stair to save the newborn in the crib who's not yours or
you can go up the other stairs to save the blastocyst in vitro that is
CHAIRMAN KASS: That's a copy of your dead child,
if you want to make it —
PROF. MEILAENDER: Whatever. It's not —
it's not immediately apparent, kind of, that one choice must be made and
that suggests that there are other considerations and it's not just stage
of development. The other thing I just wanted to say in response to what
Michael — just — I mean Gene Outka can sort of take care of himself,
but as a matter of interpretation, I think he didn't quite grant what
you described him as granting. I think he granted that creating in order
to destroy was a tendentious description. He did not grant that the two
situations were the same where he had recourse or double effect line which
because he did still think that in the description of the one act, the
killing was inextricably involved and I take that's really what Charles
was getting at. So it isn't in terms of what he was granting, I want to
CHAIRMAN KASS: Okay, I'm winding up to — I want
to say a couple of substantive things, but come to a procedural suggestion
for what we should do next. First, since Jim Wilson began by being surprised
that he could disagree with Charles, I'm surprised that I have to disagree
with Jim Wilson with whom I've disagreed only once before and he since
told me that I've persuaded him, but I'm not going to do it again.
DR. WILSON: Not this time.
CHAIRMAN KASS: The slippery slope, to call something
a slippery slope argument is already to put it in a category where you
can abstract it and then say you like those arguments or you don't. Rather,
it seems to me, it's worth thinking about, not in general in the light
of other examples, but to think about it in the context of the particular
thing we are talking about.
I think I might have said once before that the reason that arguments
about continuity of action are so appropriate in the area that we are
here talking about is because development is itself a continuum and the
value of the thing being developed, never mind morally, but biologically,
increases with development and if it should turn out that tissues down
the road are really more valuable for the treatment of the same patients
we now want, the argument that's now being made for doing it will be very
hard to resist.
The real essence of the slippery slope argument is not a prediction,
an empirical prediction. It is a question of the logic of justification
and it's very important how you somehow justify what you're doing here
because if, as in this area, the continuity of development and the continuity
of research offers such great promise, you might, without even knowing
it, be countenancing the next sort of stages and in the end you will wind
up as Bertrand Russell said about pragmatism. It's like a warm bath. It
warms up so imperceptibly you don't know when to scream. Eventually, we
will get to some place that none of us would want to be and we therefore
have to be very careful. It's not a prediction of a certain kind of certainty,
although we have seen, I mean five years ago The Washington Post editorialized
on this question. No creation of embryos, especially for research — use
these others. The newspapers are no better than the Senators on this and
times change and there were no stem cells five years ago. The benefits
to be had were less.
I think it's very important that we, instead of calling this a slippery
slope argument, talk about the question of prudence and if we put it in
those terms, then the question is: Is it really prudent to head down this
road and I don't think you have to believe that the embryo is a full human
person, at least to be worried, not just about what's — the destruction
question. It may be a terrible thing to say in public, but I worry much
less about the destruction of the embryos as I worry about the exploitive
mentality on the part of not just the scientists, scientists are trying
to do good, but of a community that comes to accept as routine, the instrumentalization
of nascent life and in which we become sort of desensitized to this. This
is not a question about the ontological status of the embryo, but about
how we come to regard those earlier stages of our own being. I don't know
what they are, but that they're somehow part of a continuity with what
we are. Of that, as a biologist and not as a religious figure, I mean
I see the continuity.
Two other things, just for your thought. I don't want to harangue much
longer. The IVF case has been around a number of times, but let me suggest
one thing. The fact that there are a lot of embryos lost in normal sexual
procreation doesn't settle anything. It doesn't really settle anything.
And it seems to me one could say something like this with respect to that
in the IVF clinics. When a couple now undertakes to procreate by ordinary
sexual means, if they've learned the facts about this, they know that
they are saying yes to the sad fact that there will be a lot of loss.
That's just the way things are and without going Charles' route about
improving God's way, when a couple now goes to the IVF clinic even with
the extra embryos, they are saying yes in advance to the sad necessity
that some of these embryos are going to be frozen in perpetuity or put
to some kind of use. They're simply compressing into one month or into
one visible time what in ordinary biology might take months. Well, situations
are fairly comparable. I think it is a matter, somewhat different when
you undertake to produce the embryos for the purpose of exploiting them
for use in which the destruction is — I won't say a minor thing, but
it is the deliberate exploitive disposition is what bothers me.
Lastly, to Elizabeth, if I might, the lurid cases are wonderful for
focusing the mind and the examples, both of the business about the child
and the exchange we had last time between Michael Sandel and Robby George
about dismembering one's 2-year-old child for the organs and dismembering
a blastocyst for the cells spoke, it seems to me, volumes. It seems like
for my own sake a knockout case.
On the other hand, I'll give you another knockout case and we can wander
away and ponder it. Let's imagine that you've got the last couple on earth
and a couple of embryos and he has Alzheimer's disease. And the question
is, do you sacrifice the embryos for the sake of the cure of the living
or do you allow them to be what they in fact are, biologically speaking,
the seed of the next generation? We can force ourselves not to look at
that because there are so many extra seeds, but if you somehow focus the
question and ask, then the merely instrumental use of this seed, even
though it doesn't have a nervous system somehow begins to look rather
There's a lot there to be quarreled with and I probably abuse the privilege
of the chair, but there were a number of things floating around here that
only make the subject for me more complicated.
What we'll sort out finally is we have to move forward on this. I think
if I understand the discussion here and Paul, you and I will have to work
out a way to find room for your so far eccentric, that doesn't mean wrong,
but unique position in this conversation, whether you want to have a separate
DR. MCHUGH: I'm glad you say it doesn't mean
wrong. One could be —
CHAIRMAN KASS: On this point we agreed last time
that we don't want to simply decide on the basis of the wisdom of the
vote of the majority to silence any arguments sincerely held and properly
defended. It might very well be that an argument made and held by one
person is the best argument and we would deprive our readers of the benefit
of having to weigh that.
I'm serious about that.
DR. MCHUGH: I appreciate that.
CHAIRMAN KASS: And it goes across the board. I
think we have to tidy up our work on the ethics of this and move on to
the policy questions by the next time we gather.
I would like to ask everybody here, if they haven't already, if things
that haven't been passed before you don't already speak for you and there
are some people who we haven't properly, I think, taken care of. If you
would write from 3 to 5 pages and if it turns out that the argument is
shorter, less, a statement of your view not on the question of ban or
no ban, the policy question, but on the question of the morality of cloning
for biomedical research and let's have it in two weeks and then we can
put this particular part of our discussion in a form that can be circulated
for everyone's approval. I hope that's not too onerous. If there's anybody
who's writing another paper for another course, I'll give you an extension,
but tomorrow morning we meet at 8:30 to take up the enhancement discussion
and then the regulatory discussion. Thank you for your endurance, your
patience, your good will and we're adjourned.
(Whereupon, at 5:33 p.m., the meeting was adjourned.)