The President's Council on Bioethics click here to skip navigation

 


Thursday, January 17, 2002

Session 4: Human Cloning 1: Human Procreation and Biotechnology

Discussion of Cloning
Working Paper #1
Background: Cloning Working Paper #2


CHAIRMAN KASS: All right. This is the fourth session of a very crowded day and I want to express my gratitude to council members for living with this rather ferocious and compressed scheduled with insufficient time for breaks and easy conversation.

We will be breaking sharply at 3:00 o'clock to meet the buses outside the front of the hotel, which will take members of council to the White House. I will be accompanying you with some various logistical questions so we can sort out as we travel.

This is the first of three sessions on human cloning. One this afternoon, two tomorrow morning before we have the session for public comment at noon tomorrow, our seventh session.

We have prepared four staff working papers to support these discussions. In the first session Cloning Working Paper #1 entitled: Biotechnology, Procreation and the Meaning of Human Cloning. That is the paper primarily meant for discussion. And it is supported by a Cloning Working Paper #2, which is on the Scientific Aspects of Human and Animal Cloning.

I might mention again that I have learned through courteous information that the National Academy of Sciences report on the scientific and medical aspects of human cloning will be released tomorrow. That deals with the scientific and medical aspects. We look forward to having that report. It will help us a great deal on the scientific side learning where we stand.

The Academy has indicated that it has left — and I copied this down — I trust I copied this down — that the ethical, social and religious questions they hope will be the subject of vigorous public discussion and debate and we hope to help out in that respect.

We do not regard this as a competition but as complementary activities and we will welcome the opportunity to read that report, and I hope at one of our meetings soon to invite the members of that panel to our meeting so that we can discuss the science and its implications with us.

The subject of human cloning is the first specialized topic that we are investigating and the President has authorized us to look at the scientific, medical and ethical issues related to human cloning and to place it in the larger context of other growing capacities to influence the genetic endowment of future generations.

In keeping with the spirit that we have been following to this point rather than begin really with the question of arguments pro and con of human reproductive cloning, which is the subject of the Working Paper #3, which we will start with tomorrow morning, we thought we would begin really by trying to locate human cloning in its larger context, both technological and in terms of human procreation. The Working Paper that you have first discusses biotechnology and human procreation and shows how this has come to be a matter of growing moral and political concern placing human cloning in the context of previous innovations, technological innovations in human reproduction and genetics.

Second, and I will not rehearse this here, there is some discussion as to why it might be important for the council to take this question up not only because there is a public debate swirling and it would seem to be irresponsible for us not to be talking about it when we are going to be asked to, and where this is the — one of the major topics of pubic bioethics at the moment. But also a suggestion that the subject of cloning is not only timely but, as Charles indicated earlier, clonal reproduction may represent if it is successful — we should keep that proviso in mind — might represent — would represent an early first instance of assisted human reproduction in which the genetic endowment of the resulting child would be the subject of choice. Not just whether there is a child but precisely what genetic constitution that child is to have, whether that is going to play out the way the parents hope or not is beside the point. That certainly would be the intent. And that, therefore, this is — this represents an innovation worth thinking about, both in itself and what it might represent in principle for developments that might lie ahead.

And it also gives us an opportunity to think about — on the policy side — whether public control of biotechnology is possible, desirable, by what means and what cost. Vexing questions but something on which if we are going to be responsible to the policy side and not just the ethical/philosophical side we should pay some attention.

In the working paper the staff suggests that the proper point of departure for discussion of clonal baby making is to locate it in connection with some of the basic values that are, in fact, stressed in the discussion. On the one hand things having to do with the character of human procreation. On the other hand questions having to do with freedom of scientists, innovators, entrepreneurs, individual parents facing reproductive decisions. And also since the question of research cloning tags on to the question of reproductive cloning, the desire of scientists to use science and technology to cure disease and relieve suffering.

So on page 6 of the Working Paper the Working Paper sort of concludes with a series of questions on the two sides of this discussion. On the one hand cloning seems to fit in to the nexus of human procreation and all of its entailments, family relations, personal identity, questions of genetic make up to who one is.

What does it mean if reproductive activities become increasingly technological and commercialized, touching in part on a comment that Dan Foster raised this morning but in this particular area.

And questions of what does it actually mean to take responsible for or have the power to select, is it design, redesign in advance the genetic characteristics of the next generation and, if so, on the basis of what goals and standards on the one side.

But on the other side there are these pursuits of human freedom in all of its forms and the particular medical benefits touted not by reproductive cloning so much but by the experimental cloning and the research on cloned embryos where in a way the ethical questions fit more in the general category of research on embryos in general rather than research on cloned embryos but here it is and we will take it up because it is our's.

I thought, and this continues in part, Gil Meilaender's — grows out of the discussion this morning both about the question of freedom, which we touched on from one side and asked what of its — what possible things in the name of which might one conceive of limiting it. And also the section in his paper that we did not discuss exactly, though it was there much of the time, the question of the relations between the generations.

I mean, maybe the way into this would be to — picking up on any one of these smaller questions in the top paragraph of Part 6 to ask — speaking anthropologically in terms of what we value about human life. What is this thing, human procreation? And what of its humanity matters to us? I mean, Jim Wilson spoke a bit about it earlier today when he talked about the encounter with the mystery of new life, which is to replace us. You speak better than I but it seems to me before we take up cloning and whether it is threatening to human procreation one should try to talk positively about what those goods are, hard though it might be to do, to — in order to be able to see what it is that is at stake here and what we care about. Because if there is not anything at stake and some people want to do it, it seems to be perfectly reasonable to say why not.

So that was a rather long winded way to what should have been a short question.

What do you — when we talk about the humanness of human procreation in ways that we value, what is it that we care about here? What are the things that matter to us so that we would be in a better position to think about human cloning in relation to it?

(Pause.)

CHAIRMAN KASS: I know that is a good question.

DR. KRAUTHAMMER: (Not at microphone.)

CHAIRMAN KASS: I am sorry. Look, this is partly what it means to fumble with our intuitions and our thoughts not as experts but as people. When the public worries about these things, this is — they do not have the terms very often for expressing it but it is these kinds of things and we do people a service if we struggle to articulate what it is that we care about in these matters so that at least the debate can be conducted properly to say on the one hand there is this but on the other hand there is that. If you simply say, "Ugh," you are not really being terribly helpful.

Michael?

PROF. SANDEL: Well, I really just have a question that might help raise at least one of the issues. There seemed — as I understand what I have read here and I also had the benefit of reading this fine volume by Leon Kass and James Q. Wilson on the ethics of cloning, and a question that I came away with was this one: There seemed to be two different objections to human cloning at work in the discussions and I am wondering insofar as we are troubled by human cloning, are both of these objections really at play or is it one of them rather than the other?

The first objection — and, Leon, you emphasized this in your argument in the book about cloning — is cloning's character is an asexual mode of reproduction and a different objection, which also arises, has to do with where you were just mentioning that cloning involves a genetic copy. It makes the genetic characteristics the subject of choice.

And as a way of testing which of these features of cloning seems most closely or deeply related to our instinctive worries about cloning, would this thought experiment help just to isolate these two elements? Let's take a case of traditional sexual reproduction but where somehow there is a pill that people could take. Let's say a pill that the mother could take after conceiving a child that could select for the genetic — same genetic characteristics that the cloning could so you could do sex selection, you could — I do not know — program in all of the other characteristics we were discussing earlier today about IQ, about height, physical appearance and so on. Would that pill be objectionable in just the way that cloning is objectionable? Would our objections to that pill exhaust the objections we have to cloning? If so, then it is the selecting of genetic characteristics that would be the decisive objection and the asexual character would not be or would there still be some remaining worries?

CHAIRMAN KASS: Can I take the liberty of twisting your question this way? I would rather not start the discussion, if you do not mind, with objections to cloning. I would rather to try to start — we can use the exact materials that you have dealt with but try to put it in the positive terms of what is it in the relation — in procreation and the relationships that follow upon it and of the self-understanding that follows on it that matter to us?

And I would rather — I mean, I think tomorrow maybe, if it cannot be held back later in this particular session, we could take up the question of whether cloning is or is not an assault on these particular things but I would rather us not simply be reactive to it at first but to try to stake out the ground on which this innovation comes.

Cloning enters an already existing stream of human affairs and in order to understand its influence on that stream we should try to characterize that stream and why we — you know, why we like the water in it or if we like it.

So let me without — let me take the substance of your question and turn it not in terms — not raise it in terms of the objections to the cloning but in a way ask the question is it — does the fact that a child has two biological parents rather than being the product of one matter, which is a way of raising the question. What is the difference? What is the meaning of the fact that each of us at least to this point is the fruit of two lines coming together? Does that have human significance of worth or is that just an accident? Accident would be wrong.

I mean, it has got powerful deep natural selective roots if you read that book or biblical roots if you read the other. But it has been around for a long time and the question is does that natural fact also have some value for us? Is it of worth? Or would anything important be lost if, in fact, we came into being not by this path? That would be a way of taking up the question of sexual versus asexual.

The other question is, is it somehow compatible with the understanding of ourselves as parents of our children for whose existence we bear responsibility and for some of whose well-being, both for their being and for their well-being we bear some responsibility to also take on the responsibilities that would come from the power to choose in advance some of their genetic characteristics?

I think I split that — I think the sentence is parsed so I have got both of your points but if you do not mind could we take it up in a positive term before raising the objections? Is that all right?

PROF. SANDEL: Sure.

CHAIRMAN KASS: Does someone want to weigh in on either of those?

Jim?

DR. WILSON: Well, let me speak to the first question. What you are asking is a question that could be also asked about adoption. Is it important that the mother and father jointly produce the child or is it equally acceptable that the mother — that the child is borne by somebody else and taken over by two parents who did not create it?

All of the evidence I know of says that it does not make any difference. That is to say if both husband and wife jointly and enthusiastically seek out a child, whether it by sexual reproduction or, failing that, by an adoption, the devotion they give to the child and the pleasure they take in the child is equivalent.

Now I am sure there are a few exceptions. This is different from the case of stepfathers and stepmothers, which is a much more troublesome question. But it seems to me that if you agree with my argument then it is the family unit that is the central issue and not the sexual activity that produced the child.

CHAIRMAN KASS: Frank, please?

PROF. FUKUYAMA: Well, it seems to me that adoption is not a good analogy because adoption is natural parenting in the sense that there is an equal degree of relatedness on the part of both parents. It is either 50 percent in the case of a natural child or zero percent but it is shared equally for, you know, both parents.

What seems to me problematic about life in a family in which one child is a clone is that the child is a 100 percent related to one parent and zero percent related to the other and that is the kind of asymmetry which simply — I mean, there really is no precedent for it. If you want to think about this in just practical terms let's say that you have a family where the wife clones herself and then the daughter is brought up. The daughter is a physical copy of the mother except 30-35 years younger and this girl grows up and then it seems to me, you know, what is really problematic there that does not exist in the case of the adoptive family is that, you know, here is the father, the mother is getting older and this copy of this beautiful young woman that he married, you know, several decades ago is suddenly growing up but it happens to be his daughter. And it seems to me that what is very unnatural about this situation is the confusion of these roles of parent and child because the cloned child is both — you know, plays both of those roles simultaneously and the asymmetry in the degree of relatedness.

I mean, if you believe, you know, the conclusions in, you know, evolutionary biology of inclusive fitness, I mean you are, you know, instinctively your altruism is proportional to, you know, share genes and I think that is also one of the problems in step families is that the step parent does not share any of the genes compared to the 50 percent that is shared by the natural parent. So I think you will get some very problematic relations in that kind of a family.

DR. WILSON: I am sorry. I was not answering the question to which you provided the rebuttal, effective as your rebuttal was. I thought I was answering Leon's question which I thought was a different question. But you should restate the question because I obviously said something that only confused people.

CHAIRMAN KASS: Does it matter? You actually — you answered — I do not think you answered the question I asked but you answered one that was close. You answered that the effects in terms of child rearing if you study adoption indicate that it does not matter to the eventual well-being of children provided the children are adopted into good families. Therefore, whether they grow up with their biological parents or not is not decisive. The question was does it matter in any way that in the ordinary case, let's say, that what it means to be a human child is to come from a father and mother. Does that biological fact — by the way, whether done with in vitro fertilization, which is still sexual reproduction biological speaking, does that have some kind of meaning in terms of the identity of the child? And it seems to me — let me just add a small thing. What you say might be very true, Jim, but there are two things in the biology of this that are also — have to be part of the discussion. It is not accidental that lots of the adopted children insist on trying to find their biological parents as if those relations somehow mattered to who they were.

And on the other side, part of the engine for some of these new technologies, is people faced with the possibility of adoption or in vitro will be moved by what they say is the desire to have a biologically related child as if that kind of biological connectedness has human meaning quite apart from what social science tell us in the outcome as to whether we have done just as well otherwise.

DR. WILSON: Then I do not understand your question.

CHAIRMAN KASS: The question — well, Bill May, maybe he can — he may understand my question.

PROF. MAY: Trying to take a stab at it. I think at one point it does not matter that they biologically come from a mother and a father. In one of the papers, I am not sure whose, there is the observation that there is the element of surprise. Another way of putting that a little bit more traumatically, there is the element of the strange. I mean, there are exceptions. My older son is so much — seems a biological copy that an Irish playwright friend of our's, Dennis Johnson, laughed when he met Ted at ten and he said, "I am sorry, Bill, I apologize for laughing but in Ireland we would call him painfully legitimate because he looks so much like his old man." But still there is the element of the strange in birth. In advance of birth we expect a Gerber baby and then we get this prune and there is the jarring of the strange in the experience.

I would like to explore for a moment the element of the strange. I think it is a powerful continuing abiding problem in American life, all over the world I am sure but especially in American life the constant, chronic assault of the stranger. People came over sometimes in shipboard covenants and then they got over here and discovered there are already people here who were not there on shipboard with them and so you had the jarring experience of the strange.

And then you had the arrival of people who were not on your shipboard entering into your covenant and that is the second jarring experience. There goes the neighborhood, these latter immigrants.

And then the third jarring experience of the strange was the birth of your own children who were not on shipboard either. That is the ultimate stranger in a sense, the immigrant from the future and a future that is not simply a perfect biological copy of what was already there.

And so the problem of how to be open to the strange, it seems to me, is a long-term and abiding moral problem in American life.

Now at the same time parenting is not simply the birth of that which in various ways is strange but also the attempt to bring it into the orbit of one's own life. They carry a name. We subject them to education and so forth.

But we also discover, it was not just discovered, the generation gap, in the late '60s, that part of that bringing them into the orbit of our own life and making a part of bonded and connected community still requires ways of being open to the strange. And it seems to me that is very much involved in the moral challenge of generating that bears on — ultimately bears on the question of cloning.

CHAIRMAN KASS: Gil?

PROF. MEILAENDER: Yes. That was so good I almost hate to say anything after it but another way — a related way of getting at your question about the character of procreation is to think about the difference between making and doing. I mean, there are already and may be more — there are lots of ways to make a child. It is not clear that they amount to doing the same thing, that their human significance is the same, and what Bill just unpacked is, in fact, part of — one way of thinking about that significance that the making of a child through the sexual relation of a man and woman means that the child springs from their embrace is — grows from their giving of themselves to each other.

That is a certain kind of doing that — and we think it important and one of the reasons we do not think of a child just as our's or just as our product is precisely because it springs from that. So that it is possible at least to think that cloning, which eliminates that relationship, though making something that is the same is still not doing precisely the same thing and that is something human is lost there.

DR. WILSON: Is making — does your preference for doing a child or for making a child rule out in vitro fertilization in your mind?

PROF. MEILAENDER: Not necessarily but we would have to think about it.

DR. WILSON: Well, let's think about it. I mean, it is not the result of a normal male-female sexual embrace. It is the result of a surgical procedure. My experience is that children born in this way do very well and do not suffer from a lack of an emotional attachment to mother and father.

PROF. MEILAENDER: Are we talking about donor egg and sperm or not?

DR. WILSON: Well, either way. Yes.

PROF. MEILAENDER: Okay. Well, if we are then I think it may not be doing the same thing, that is right.

DR. WILSON: You do not think so. We will have to look into that. I have a different view.

PROF. MEILAENDER: The way we decide it would not simply be by looking at how the children do in your terms. We have to think about what it is — what the human significance of what we are doing is and how it teaches us to think.

DR. KRAUTHAMMER: But, Gil, another counter example is artificial insemination and a third counter example where a child can be loved even if there is no sexual embrace if you like is a child born of rape can be raised by say the woman and loved as any other child. So I am a little skeptical that the essential problem here is the lack of this sexual embrace that created the child. There are enough counter examples that I think the real issue is what kind of child is created and I think the essential characteristics here that we are — we ought to value is the uniqueness, the genetic uniqueness of the child.

And the other — it is a little bit harder to classify the second but the second has to do with the randomness and contingency of that uniqueness, that it is not planned manufactured. I mean what distinguishes a crafted good from a mass produced one is its uniqueness and in some ways its unplannedness.

And I think that is what we value as distinguishing individuals and that is what lost in cloning.

PROF. MEILAENDER: Leon, one comment?

CHAIRMAN KASS: Please.

PROF. MEILAENDER: The issue is not whether the child can be loved. I mean, the human capacity to love children of all sorts is enormous. The issue is what — how it teaches us to think about the relation between the generations. That is the issue I am trying to raise.

CHAIRMAN KASS: Rather than move on to complicate this with other questions and I know that Stephen and a few other people have indicated that they would like to speak, let's stay on this point for a little longer and see if we can make some progress on it, at least clarify it a little bit more.

Gil makes — offers us a distinction between making and doing about which he needs to say more to bring everybody along with him so there is an invitation to you to try to formulate that but there is also — why should I ruin this by trying to remember it — a poem that appeared in Gil's paper.

"In the half darkness we look at each other and smile and touch arms across his little, startlingly muscled body — this one whom habit of memory propels to the ground of his making..." it is poetry, it is not argument. But there is — there seems to be some suggestion, not that children who would be adopted could not come to the parent's bed and somehow be loved. I think Gil's point is that. But that there is something of great human significance in that symbol of the child going to the source and that the relations are somehow founded there and that that is known both to the child instinctively and especially known to the parents in the way they view that child.

I take it that that is part of what is under the discussion here about the difference between making or doing and the place of the embrace or sexuality in this discussion but I may have only muddled the water.

Stephen?

PROF. CARTER: Leon, I am glad you brought us back to the poem in a way because I think that one of the reasons that maybe we have had just in the last few minutes differences around the table not so much about the answer but about the question, the question is actually a very hard one to put, and it is a hard one to put because we are running up against a kind of central mystery, almost a totem. There is a sense in which so much of our reaction on this point is a matter that goes deeply to instinct, whether it is an instinct that is natural or trained into us is for the moment beside the point.

What makes that poem appealing is precisely its mysterious aspect that we cannot really give a proper name or a proper account of the relationship that is being described and yet for the most part we recognize it and many of us would value it and see its significance in a larger vision of the human story.

This leads me back to Bill May's point which I think is absolutely essential, whether in the end we endorse it or not, although I think I do, the strangerhood of the child, the encounter of the child as something, someone who is in important ways beyond our control, beyond our prediction, makes statements not only about love and our capacity to love, makes a statement not only about family, it makes a larger statement about what is truly important to the human, the importance of our diversity, the importance of the encounter with the stranger.

And I guess that is why for me at least, to confess a bias, at the instinctive level I would not claim this as a well reasoned position at all, when I think about the possibility of the child as the creation of human ingenuity and the loss of — I was thinking of the part of the strange — what comes to my mind is school segregation. What I really want to be around is people more and more like me or more and more like the people I want to be around. That is who I want my kids to go to school with, that is who I want to be around as opposed to people whose differences are surprising and often threatening to me and that which I hold dear.

But I say that I do not consider that a well reasoned position. That is simply an instinct. It is an instinct, I think, born of the respect for — indeed, I might even say an affection for the very mystery that this poem aptly describes without beginning to unlock (sic).

CHAIRMAN KASS: That is very lovely. Thank you.

Rebecca?

PROF. DRESSER: I would like to ask a question. If we are saying that creating a biological copy, making a child a copy, a biologic copy of someone else reduces the possibility of the child being a stranger and is that for that reason, are we then invest — are we saying biology is determined — determines the child's identity? That is I could imagine someone being a genetic copy and — I mean, with cloning they are not a complete genetic copy but nearly a genetic copy and turning out quite different — differently from the origin person.

So I guess I — it seems to me by worrying about these things to some extent we are saying, well, biology and genes makes us who we are and I know — I am not crazy about saying that completely.

PROF. CARTER: Can I answer that just very briefly since I take it was responding to what I just said? I want to make clear, of course, I do not believe that about genes. I am speaking again here of the rhetoric we use, the things we attempt to do, send messages without regard to whether the attempt is successful or even rational. So that even if you know and I know and it is commonly known around the table that biology is not a determinate of certain things, yet our desire to manipulate it suggests that we — that in some aspects of ourselves we believe what we wish otherwise.

CHAIRMAN KASS: Robby?

DR. GEORGE: I want to say a word on behalf of sex as something more than one among other possible equally valid means of bringing new human beings into being.

There is a kind of pragmatism or utilitarianism or some combination thereof that tries to deal with moral problems simply by way of evaluating the palpable consequences, how the world external to us is changed by this choice or that, and there are notorious problems with that as there are with competing ethical views let me admit, including my own. But I want to suggest that there is at least an alternative way of proceeding. It is not one that would dismiss a discussion of consequences like the question whether the child born of processes — brought into being processes other than sexual reproduction can be loved.

There is another way of approaching these things that does not focus on consequences in that kind of direct and exclusive way but rather proceeds dialectically by looking at principles that we believe securely to hold and to be true and then to examine possible choices with regard to their — that we just do not know the answer to yet — we are thinking about with regard to their conformity or lack of conformity to those other principles.

In relation to the precise topic at hand we might begin by asking why is it that parents do not own their children? They brought them into being. It was their choices and actions. Ordinarily if it is by virtue of our choices and actions that something is brought into being, it was our deliberate will, our resource was used, we consider that we own them but we do not consider that we own children. Now other — at other places and times there has been something like the view that children are property of their parents but we reject that. I would propose that is one of these principles we do hold securely so let's work from there dialectically.

Why don't we? Well, it is because we consider that children are not just objects, not just products, that they do have something special about them that makes them ends rather than means. Let's call it dignity just as a placeholder for now as we try to put more rigor in that notion in the months ahead.

Now I think we can ask what posture then is to be adopted towards such beings and does that posture — does the question of what posture — posture we should adopt apply to the case of the transmission of new life, to the transmission of life to those beings or can we simply with regard to the question of transmission consider the matter of bringing efficient — just consider the matter being simply one of bringing efficient means to bear to produce ends that we desire.

My own — to use a word I dislike and is misleading in philosophy but there just seems to be no way around it these days, my own intuitions say that we ougthen to dismiss the question of what is the proper posture toward new — human life when it is a question of how shall that new human life come into being.

I think we have to ask the question and we should ask the question is it possible — are we — and this applies, I agree with Jim Wilson, I think we cannot avoid the question, this applies to the question of IVF. It applies to the question of artificial insemination. With respect to all of these I think we should pause to ask the question is there in the posture we adopt, the posture we adopt implicit in choices to produce new life by these means, a treating of the new human being who is to be brought into existence as an object, as an product and, therefore, in principle as a means to parental satisfaction or what have you rather than as an end in itself.

It is not a question — here I agree with Gil. It is not a question about will we down the line be able to adopt in any individual case or even in a large number of cases, adopt an attitude of love towards them and treat them as an end in themselves and not a mere means down then — down the line then.

No, I think we have to ask how are we treating them, what posture are we adopting towards them now.

CHAIRMAN KASS: Let me try to reformulate and make sure that I have got it because it seems to me it is a rich suggestion if I understand it.

First, just in passing I observed that the question the way Robby put it is not in terms of is this good or bad, right or wrong, but talking about dispositions, attitudes and postures, right, which I think is a neglected — a sadly neglected notion and moral discourse. Some things you cannot simply settle by rules but dispositions and attitudes count decisively.

And if we are to adopt a certain attitude toward our children compatible with the view that whatever — that would explain — that would somehow reflect the fact that we cannot regard them as our property, is that posture — is that desirable posture toward our children influenced by the means that are used to bring them into being?

Jim, did I hear you answer soto voce?

DR. WILSON: I think no. No child born of a woman will be regarded as an object except in deviant and happily rare and largely deplorable circumstances. A child born of a woman will be regarded as a human being and will be cared for, ideally by two parents, at a minimum by the mother, however, the child happened to be planted in her uterus.

CHAIRMAN KASS: Let me sharpen this up if I can. I do not think the question — I do not think the implication was that it would be regarded — I was not happy, Robby, with giving us either person or object but let's say Jim is right that the child is regarded as a human being, you know, born of a woman. I would even be prepared to say should — forgive me, Janet — 100 years from now it become necessary that certain kinds of infertility be treated by extra-corporeal gestation en toto. I would say a child that came off that machine that looked like you and me, we would receive into the human community and it would — I mean, insofar as it functioned. We would be capable of loving such a child even if it was not born of woman. So that is to complicate the question further.

Granted that one looks at such a child as a human being, the question is are there any kinds of subtle differences in the disposition when to some extent — to speak sort of loosely — one has surrendered one's self to the possibility of there being a child and when one has chosen not only to have a child but to arrange for its coming into being by these means. That is not whether it is a human being or not but whether there are not subtle differences that might affect how we regard our relation to it.

I think I am walking in between the question —

DR. WILSON: Suggest what the differences are. We are getting a long way from the subject. Why don't you just tell us what you have in mind?

CHAIRMAN KASS: I do not really have something in mind — something clearly in mind.

DR. __________: Robby does.

CHAIRMAN KASS: I defer.

DR. KRAUTHAMMER: Jim, could we try this as a way to sharpen that question, make it hypothetical. You have got a society in which all children are produced from the genes of two parents in factories.

CHAIRMAN KASS: In?

DR. KRAUTHAMMER: In factories. Not through human gestation as we have it but they all come out of factories and are assigned to the original parents. The question is it is a brave new world but without the control of the state, without the alteration of the genes, and the question is — I guess it is the way to operationalize your question — will children — are children then seen, treated, understood differently in that society than in one in which they have the children naturally? That is, I think, the starkest way to put that question.

CHAIRMAN KASS: That is a way of putting it.

Robby?

DR. GEORGE: Again that is to put the focus on the consequences. I suspect, I mean this — I am guessing, anybody would guess here and our guesses may be made very sharply but my own guess would be we would be doing pretty bad things pretty quickly but that would be connected to the collapse of a view of the person that is anything like the one that I think today most of us would want to affirm.

But I think always down the line — always down the line the compromising of fundamental moral principles has bad consequence. Very frequently we do not see those when it is about to happen. They only become clear down the line.

But even more fundamentally I think that a sound ethics, and it is a perennially debated question I grant you, is not one that makes the consideration of the consequences just by themselves decisive. Rather it is one that looks at the principles that we hold securely and then asks with respect to any new choice whether there is a compromising of those principles or whether there is a compatibility with those principles.

DR. KRAUTHAMMER: So what is compromised in this case? I mean that is my question.

(Simultaneous discussion.)

DR. KRAUTHAMMER:: The general point Jim and Charles want to know —

(Simultaneous discussion.)

DR. WILSON: If it is not a consequence what principle is it? That is my question.

DR. GEORGE: Yes, I think it is the principle that the child as an end in himself and not a means to other ends should not be a product of manufacture. Now we may debate. Even if I am right about that and I grant that I understand you are not going to grant me that but even if I am right about that, I realize we could then have a debate about what does and does not constitute manufacture. But I know that there is an archetype. There is a central case if we can just use that old Aristelian idea of a central case and then the cases that fall away from it. There is a central case of what is not manufactured and that is the child begotten not made. That is the child where the sexual union of the parents is such that an accurate description of it could be put in terms of doing rather than making.

And Gil is just here appealing to a very ancient and, I think, defensible distinction and it is the distinction between techne and praxis, between doing something and making.

Now from there I am happy to have the debate but I wonder if even prior to that you guys get off the train and say, no, it really is just a matter of bringing efficient means to bear to ends that we have in mind. The end being let's have a child.

CHAIRMAN KASS: Michael Gazzaniga?

DR. GAZZANIGA: I think there is such a natural revulsion to the notion of reproductive cloning that what we are doing is fishing around for reasons why we have that revulsion. The — can you imagine the evening where you take your wife out and you say, you know, 'Honey, I think it is time to have a child, I pretty much decided to go with me.'

(Laughter.)

DR. GAZZANIGA: I cannot imagine the expense of that French dinner.

CHAIRMAN KASS: I hope to adjourn...

DR. GAZZANIGA: So since none of us really are carrying around our favorite person who wants to be cloned, and the pressure on us to do this and all the reasons that Janet spoke to earlier, this is so far off in the future and there is even maybe serious biologic reasons why it would not even work, forgetting all that, let's get back to this magnificent poetry of the nights of sexual embrace and your child was born story.

Now we know that the left brain, the left hemisphere has this great capacity to weave a story, tell a story. It tries to explain your own behavior. And no sooner does a behavior come out of us then we have a narrative about it.

I would venture to say that — as a matter of fact, I know somebody who — a couple of deer friends who — he is Italian, she is Irish, and they just adopted a Chinese baby, which went through an enormous process as you know. And they talk fondly in the same fond way you talk of the embrace of the evening they decided to do that and that will go down in their family history just as the personal evening that we — that other people enjoy.

So I think what we are faced with is a revulsion of the whole idea of reproductive cloning and then we are trying to find another reason for why that is when it is just kind of a revolting idea as opposed to therapeutic cloning.

CHAIRMAN KASS: Frank, and then Gil?

PROF. FUKUYAMA: Well, on that question of the great revulsion, I am actually surprised at the amount of legislative support there was for the reproductive cloning ban because if you had listened to the conversations certainly among professional bioethicists, you know, prior to that — I would say actually a majority of them said, "Well, why not? I mean, we can think of a lot of good reasons why you would want to do this and not that many reasons other than safety why we should not."

But I think it is very interesting that as far as I can tell not a single member of Congress has been willing to get up and, you know, argue against the reproductive cloning ban but I am curious to know why that is. And it is relevant to the discussion we have been having.

I mean, do people think that this violates some inherent, you know, principle, you know, of nature and that is why they feel a revulsion or do they just, you know, take the consequentialist argument or is it simply out of ignorance. I mean, people think that we are going to clone Hitler and, you know, have a very dangerous world if we allow this to happen.

But in a way I guess this is an empirical question that the staff can, you know, perhaps supply us with some more data on by the time we meet the next time.

CHAIRMAN KASS: Gil, and then Elizabeth?

PROF. MEILAENDER: You started us down this road, Leon, asking us to articulate what it is about procreation that is significant. And I want to — I may just repeat myself but I want to try to come back to that specific question. I certainly think it is true. I grant what Charles said and Jim said and so forth that we have the capacity and I think we will continue for some time to have the capacity to love children who come into the world in all sorts of ways.

It may be, though, that that variability is parasitic upon our normal understanding of the significance of children, that two people, themselves different, look out of themselves toward each other. That from their union arises a child, a third being, who is also other, who incarnates the union but does not sort of repeat either of them in the flesh and that, therefore, they cannot simply regard that third being as their own in any possessive kind of sense.

And that is part of the significance of human procreation. That is how we learn to think about children and it is from that central paradigm then that we are enabled to think about children and to love children whose presence perhaps does not quite fit the paradigm.

So the question is not whether we are or would be able to love other children but whether some other paradigm gradually teaches us to think in different ways, whether we can imagine ourselves having that kind of love for children in a world where sexual reproduction was not the norm if want those sorts of beings. That seems to me to be the question that you were pushing towards.

CHAIRMAN KASS: Very nice.

Elizabeth? Paul?

DR. MCHUGH: I just wanted to make a couple of brief points in relationship to what is at stake and what is our experience now. The issue of duality is so crucial, I think, to ordinary family life and ordinary experiences but that does not take away from the fact that as we have seen that adoption is possible and not only is adoption possible, it is also very rich.

I want to pick up what Mike Gazzaniga said about his friends. All of us now, it seems, have friends who have decided to adopt a Chinese baby. Almost all of us know such — and we love them. We love the — we think it is a very wonderful thing that they have done and they speak not only of the decision, as Mike said, but also they speak of the trip. The trip to sometimes the furthest reaches of China.

The babies are all girls. They are all girls because in China they are not accepting their girl babies. We accept them and love them and in my friend's case — I mean it is like a princess from a faraway land taken from the mouth of the dragon, you know, and you just feel love for her. All of us do. But what is going to happen — what are the consequences going to be when these thousands of girls grow up in America and think back on China and what will it be for us in our relationships to China that has had that view of women?

And I think that is a crucial matter to think about in relationship to the processes of adoption that need to be taken up if you want to have children but would, you know, have many, many very interesting, often unintended consequences.

CHAIRMAN KASS: Stephen, and then I think I want to shift back to the part of the discussion that was bracketed earlier. We have been on this business of doing and making and begetting and making, the question of sex for a while.

PROF. CARTER: Very briefly just to interject the "R" word, that is the religion word. Frank asked how come no member of Congress is willing to get up and say, 'Well, I personally think reproductive cloning is fine if people want to do that.' I think that there are probably millions and millions of Americans who for good reasons or bad find something deeply threatening their religious sensibility in the idea. Threatening somehow to some notion of creativeness, threatening to their notion of the relation between God and God's work.

There is a variety of different ways in which people are running up against that and not the sort of thing you can articulate so much in a discussion of why we ought to have this policy or that policy from the point of view of government but when members of Congress are thinking about their actual constituents and actual concerns they have they must take account of particular fears that — because after all they are driven by the incentive for reelection.

I do not mean that facetiously when I say they are driven by the incentive for reelection, that is democracy.

DR. BLACKBURN: I was going to leave it till later but I think it does fit in answering what Frank was saying and just extending what are the fears. You know, I think one of the other kinds of fears, not to negate the kind of fear you are talking about at all but another kind, is the fear of the terrible risks involved and people visage at the moment that this is currently seen as a very risky, risky procedure based on what is known in the animal studies.

And I would not be surprised, and I do not know the numbers but I would not be surprised if that was not for at least some people, you know, another aspect of it. They have seen and heard about this as risky and it would be, you know, very dangerous for the child to be affected if this were to happen now.

CHAIRMAN KASS: Let me return — we have got a little over 20 minutes. Let me return to the second of the issues raised by Michael Sandel when I sort of reformulated and shifted the gears. It is very hard to shift the gears because people want to talk about cloning and its threat to something rather than talking about the something, and that is instructive. I mean, that is very instructive because it is very hard as I think Stephen really beautifully said. You asked to talk about something sort of mysterious that we have access to it but it is very hard to articulate.

And the repugnance if I might say, Michael, especially when one is called upon — when someone says, "Well, what is really wrong with it?", and you say, "Yuck," at least in the Academy and in the professionalized academies that is regarded as the ignorance of the man on the street.

You need at least to come to the table with some arguments to back this intuition and the intuition is a cue that something might be wrong but we have had similar intuitions about other things which we have come to accept and, therefore, it is incumbent upon us to try fumblingly to say something because there are going to be people saying, "Well, look, I want to do it. It does not repel me. Is there any reason why I should not?" And, you know, some like chocolate and some like vanilla and there you go.

But Michael Sandel began by calling our attention to two things. One was the difference between sexual and asexual reproduction. We have been talking about whether the fact the child stems from one man and one woman biologically, how much that counts. The other was the question about whether or not there is a choice over the genetic inheritance of the child to be and what difference that might make and whether that is somehow compatible with the understanding of human procreation as we value it.

There will be people who will say in this discussion, Michael, that actually we practice eugenic choices all the time. We — there is mate selection and we do not do it on the basis of seeing the genotype but there is — you know, people who go to the ivy's marry people who go to the ivy's, et cetera, et cetera, and that people will say that is — how is that different from deliberate genetic intervention? The same analogous question, how is the genetic intervention different from the kinds of cultural emphases on the same things that we talked about in the last session?

So let's talk about this a bit and ask the question does the fact that parents might have, whether it be in preimplantation genetic screening negatively or more positively with respect to cloning the opportunity to determine and hence be responsible for some aspect of the genetic endowment of their children, never mind whether they are going to get exactly what they hope for? The responsibility will be there whether it turns out the way they intended or not.

Am I faithful to the question? Does someone want to open it up and maybe you would like to yourself?

PROF. SANDEL: Just to add one — in some ways we have already embarked on this discussion which is why I do not really think these were two separate questions. It is possible to a certain extent to ask in general what is the human meaning or worth of human procreation or loving children without asking about a practice that would challenge standard modes of human procreation.

But I am not even sure it is possible to articulate the human worth or meaning of human procreation, to pick it out except by considering the alternative cases because the different types of alternative cases will direct our attention to different features of what it is we prize maybe without even having been aware of it.

And I think that the evidence of the link between these two questions or even the dependence of the first affirmative question on the second imagined negative was brought out by what I thought was to my mind the most compelling answer to the first round of questions which was William May who talked about the jarring experience of the strange and the important human experience of being forced to confront the strange, to be jarred by it.

I thought that that was a very suggestive answer and it is an answer that I think reinforces the — well, if we go back to the two distinctions about objections to cloning, one that it involves asexual reproduction; two that it involves selecting genetic characteristics, what is so powerful to me about the account of the strange as constitutive of humanity, it explains exactly why the fact that we are exercising the mastery or a sovereignty in choosing gets at the kernel of the objection.

And that objection alone can fully capture and link up with this account, this beautifully articulated account about the constitutive human character, the strange, and we do not need anything to do — this will be maybe the controversial part of my claim — we do not need to draw at all on the first objection to cloning, that it is asexual, in order to do justice to the elaboration that, Bill, you may offer. They fit beautifully.

And the negative side of the affirmative vision that William described is that what we really — what bothers us about cloning, whether in the brave new world scenario that Charles raised or in more modest versions is that it is a kind of assertion of mastery or sovereignty that would destroy or fail to honor the constitutive human dimension of the strange, the encounter with the strange that William has described.

CHAIRMAN KASS: Bill, do you want a quick response?

PROF. MAY: Yes. As I see it, as it relates to the question of sovereignty, one way of seeing the strange is the one who constantly tests out the safeties that I build into my life. The stranger is the one who is the hemorrhage in my universe. We all know how we close in and talk with somebody and then the stranger comes up and suddenly it has to open up. The rhythms are no longer the same in conversation that used to be there with intimates. Or the husband and wife dealing with this, the birth of that child, and suddenly how you handled sleep and all sorts of other safeties need to go through some kind of accommodation. So it is not simply the original event of male-female but what happens in gestation, what happens after birth, and this immediately broadens out into a larger social problem.

The constant testing of a society's community is its resources and sustaining itself but it has to sustain itself in relationship to the strange, the unelected, that which cannot be totally subjected to control.

CHAIRMAN KASS: Jim?

DR. WILSON: I very much agree with what Michael just said and let me — since he was kind enough to mention the book that Leon and I wrote, and he was very kind, indeed, since it sold seven copies.

(Laughter.)

DR. WILSON: There is now eight in circulation. I have changed my mind since I wrote that book. In part in consultation with Leon and in part in brooding about this, and what I have changed my mind about is the issue of genetic selection. I am not concerned about how a child is produced in a female womb in order to be born, whether it is by a male embrace or artificial insemination or by projecting gamma rays. I think the essence of morality and the essence of society is that children come from mothers and out of that moral sentiments are formed that govern the whole life.

What concerned me about the issue of genetic selection were two things. First, instead of — to refer to my earlier phrase — the couple contemplating the mysterious gift, they would be contemplated a predictable certainty. They will not be wondering who it most looks like. They will be wondering why it does not look precisely like the person that was copied.

They will begin to worry that the mitochondrial DNA did not get there in the right amount so there is now some slight deviation from what the nuclear DNA would have predicted.

They will — the whole relationship of parents to children will be governed now by their anticipation that this is going to be a duplicative something they know. I think this radically alters the child rearing experience.

And then, secondly, duplicative of what? And I began to think about this after Leon and I put our essays together. Duplicative of relatives? Well, that creates the problem that if it is a male relative the father will grow up with somebody who is both his son and his brother. If it is a female daughter the mother will grow up with somebody who is both her daughter and her sister. If it is another relative, the combination of relationships between cousins and aunts and nephews becomes profoundly confused in a world that is — in a cultural world that is utterly governed by kinship relationships.

Now suppose they step out and find a stranger? Well, I suppose they could get a stranger from some egg bank somewhere. I think it is much more likely they will get a stranger that measures up to some evolutionary standard and now they are suddenly trying to recreate a smart Pamela Anderson.

(Laughter.)

DR. WILSON: If such is biologically possible.

(Laughter.)

DR. WILSON: A Michael Jordan, a Cal Ripkin. You can see the arena from which my heroes are drawn. Okay. I will change. Emmanuel Kant, David Hume.

And this it seems to me is deeply offensive that people are going to try to manufacture copies of people.

And then finally, though this is no cause of concern for the couple but it is a cause of concern for society, if we do try to duplicate successful people, we will reduce the evolutionary fitness of the human race. We will be less diverse and less able to accommodate ourselves to environmental changes. Now no one person has to pay a price for this but society will pay a very large price for it.

So I feel that the genetic identity question is the heart of the problem.

CHAIRMAN KASS: Bill?

DR. HURLBUT: It seems to me you are just backing the question up a little. I mean, you said as long as it comes from a mother. Well, why does it have to come from a mother? There have been studies with mice that show that if you — well, I do not want to exaggerate this but there were some hints that if you placed an embryo in the abdominal cavity of a male mouse and gave it the proper induction you could induce a pregnancy. And the head of OB/GYN at Stanford told me that she believes that eventually we will have exogenesis.

The question it seems to me is a deeper one. The question is what are the norms? What are the natural norms of our morality? To what extent do we derive our meaning from the way we have come forward into life?

I think that — whether you are a religious person and you believe God created the world or you are strict evolutionist and believe that we have evolved in a complex mix of biology, still it is possible that the question I asked of Professor Gazzaniga early in the day is a crucial question. Where do we get our minds? What does constitute the meaningful reality of our lives?

You know, when I was a medical student I realized that the introduction of contraception, which by the way was by Carl Geracci (?) in a program I teach in, invented the pill anyway, I realized that contraception was a strange new milestone in the history of medicine. Well, I did not know what to think of it but I wondered why the Catholic church is willing to abandon so many billions of dollars by offending their congregations by not allowing this.

So I went up and I listened to a discussion of this by a collection of Catholic people in San Francisco and I started to think more deeply. My gosh, this is the first time in medical history that medicine is being used to cure something that is not a disease. This represented — without regards to what you think about it, it was a change of natural reality.

So then a few years ago I read an interesting book by Ann Taylor Fleming called Motherhood Deferred and I started thinking about how many people have deferred pregnancy by contraception without kind of knowing the deeper wisdom of what desire was. In fact, even though the desire was sexuality, nature had in mind something deeper and perhaps richer for the individual. So she speaks of the unused magic of her body when she was unable to conceive.

And there are many tragedies. Many of the IVF patients today are people who deferred pregnancy until the slope of the curve of fertility.

Now we have a post — what is called — so-called the post-menstrual era on our map. There is a three month pill under development, including an intention that maybe we can create a no pill — no menstruation at all. Now look I do not want to say contraception — anything about contraception or menstruation in this. I do not have any personal experience with the latter and relatively little with the former.

But the real question here is what is the normative significance of the natural order? Where do we get our minds and where do we find a full satisfaction of our lives? And is it possible that in pursuing one desired end we might lose more fundamental, less conscious but more essential ones? And what is the prerogative of medicine anyway? What is the good use of human freedom?

In one of the papers, I cannot remember where it is, maybe it is this one, it talks about humility. Well, it is an interesting thing. Human and humility both share the Latin root of "earth" or "soil" and it is an interesting thing to think that we came forth from the earth. In that sense whether we were created by God that way or by evolution, the question is are the deepest significance of our lives somehow wrapped up in the natural order of things far more than just whether it comes from the mother or not but the whole meaningful construction of life.

DR. WILSON: Just one brief response. I believe that our fundamental moral sentiments are acquired from the early family experience and I think there is a lot of data to support that.

DR. HURLBUT: That is not good biology in my opinion.

DR. WILSON: It is good social science, though.

DR. HURLBUT: No, it is not good science. The mind is partly shaped —

DR. __________: Can anything good from social science.

DR. HURLBUT: — normative impressions. I do not think it is just coincidence that we do not respond to — that we respond more favorably to clear skin and, if it is true, the waist-hip ratio of a certain notion. I think we do have an evolved psychology to some extent without endorsing evolutionary psychology as a whole. I do not think it is all just social.

Simone de Beauvoir said, "Human nature is that species which by nature has no nature," but I think that is not proving to be true by more modern biological inquiry on that.

We — you know, disgusting — it is very interesting, perhaps Professor Gazzaniga can either affirm or correct me on this but I believe there are some studies now that show that the center for moral discernment or one of the related centers is located right near the center for taste and that we get this interesting connection, disgusting and gustation.

The interesting question is whether or not some kind of moral realities are built into our brains. I agree with most everything you are saying. It is just that there is this one little thing. Is it possible that we are going to walk ourselves right off the stage of the drama of our deepest significance as I said earlier?

CHAIRMAN KASS: Mary Ann, Gil, and then we will call all for the day because we have to —

PROF. GLENDON: I just want to mention another great human watershed that we have passed in the last century that seems relevant here. We went in the United States from a time when children were economic assets, absolutely necessary for the family farm and shop, to economic liabilities as many of us have learned in putting children through college.

Along with that shift has come, I think, a shift in attitudes. I do not know how widespread it is but it has caused me to scratch my head a bit as Gil and Leon and Robby were speaking about sexual reproduction.

I think maybe at a certain point a considerable proportion of the population that participates in ordinary sexual reproduction does so with a way of thinking about children that is rather distinctively modern. That is they are sort of like consumer goods. I will have one for my gratification. Not so much this openness to the strange and the mysterious but rather just a different way of thinking about and valuing children.

And I might say, also, as the parent of an adopted Asian girl and two daughters born the old-fashioned way, I am with the folks who say that it is all very mysterious.

CHAIRMAN KASS: Gil.

PROF. MEILAENDER: I just wanted to come back to the two questions Michael Sandel distinguished. It would take more conversation but I still think they are connected in a way and that it does not all turn on the one because it seems to me that the asexual reproduction also involves something about openness to stranger or lack thereof. So that it is not just the question of the control over the identity of the child that involves openness to the stranger but it may also be the nature of the reproductive act. It would take more but I think the two are connected in ways and we should not too quickly conclude that we can say everything we want to say with reference to just one of the two questions.

CHAIRMAN KASS: This has been a day of experiment, not only in the sense that this has not been tried on these particular guinea pigs before, though you have given your tacit consent, no forms were signed, but that we have tried to come at the bioethical questions not beginning with the technological but beginning with some reflections on crucial aspects and goods of our humanity.

The test will be, I think if not worked out quickly, the test in the long term will be whether our work when we get down to cases will, in fact, be as I hope richer for having moved so far away from what is common discourse even amongst — with the exception of people like Gil and Bill May and Robby who do this for a living, and Stephen Carter — whether this foray into the hard to talk about will bear fruit when we actually take up the cases and that discussion I hope would be richer for it.

Tomorrow morning we will resume at 8:30 here and the Working Paper, and I suspect it is the one for which the public members might — public — people from the public present might be especially interested — is where we actually take up the arguments for and against human reproductive cloning. We had staff members prepare what look like briefs and I put it to anybody who thinks there is bias in the house to show where it is because the briefs have been prepared, I think, in as strong a way as possible to make the best case on each side. We will try that out tomorrow morning.

The bus is waiting at the front door. That is a hope, not a fact. The bus should be waiting at the front door by 3:15 at the very latest and thank you all, and we will meet again in the morning.

(Whereupon, at 3:00 p.m., the proceedings were adjourned.)

 

  - The President's Council on Bioethics -    
Home Site Map Disclaimers Privacy Notice Accessibility NBAC HHS