March 4, 2005
The Sphinx Club
1315 K Street, NW
Washington, DC 20005
COUNCIL MEMBERS PRESENT
Leon R. Kass, M.D., Ph.D., Chairman
American Enterprise Institute
Benjamin S. Carson, Sr., M.D.
Johns Hopkins Medical Institutions
Rebecca S. Dresser, J.D.
Washington University School of Law
Daniel W. Foster, M.D.
University of Texas, Southwestern Medical School
Francis Fukuyama, Ph.D.
Johns Hopkins University
P. George, D.Phil., J.D.
William B. Hurlbut, M.D.
Peter A. Lawler, Ph.D.
Johns Hopkins University School of Medicine
Gilbert C. Meilaender,
Janet D. Rowley, M.D., D.Sc.
The University of Chicago
Michael J. Sandel, D.Phil.
Diana J. Schaub, Ph.D.
Q. Wilson, Ph.D.
University of California, Los Angeles
SESSION 5: ALTERNATIVE SOURCES OF
HUMAN PLURIPOTENT STEM CELLS
CHAIRMAN KASS: This fifth session of this 20th meeting is devoted
to a draft white paper of the President's Council on Bioethics
entitled "Alternative Sources of Human Pluripotent Stem Cells."
Just to remind everybody and also to put this on the public record,
this white paper, a reworked draft of an earlier staff working paper,
grew out of discussions that we had at the last Council meeting
where we had two presentations, one from Drs. Landry and Zucker,
Columbia; one from Bill Hurlbut of our own Council, on alternative
ways of deriving pluripotent human stem cells that would not require
the destruction of human embryos.
Subsequent to that meeting, staff, in researching the literature,
also discovered two other kinds of proposals, one the attempt to
derive stem cells by biopsying living embryos, analogous to the
biopsy of living embryos used in prenatal genetic diagnosis; and
also, activities in the realm of attempts to find ever more de-differentiated
or undifferentiated stem cells taken from children and adults, encouraged
by the findings now of, I think, three different groups in addition
to Catherine Verfaillie's group of multipotent cells found in
the bone marrow, some of them bearing markers normally associated
with embryonic stem cells.
And the Council prepared a paper reviewing all four of these proposals,
first of all, explaining what they are, then conducting an analysis
to ask whether each of these proposals were ethically sound, whether
they seem to be scientifically sound, whether it was realistic even
to consider these matters, and that meant whether these were likely,
if successful, to be met with scientific approval, whether they
might secondarily be eligible for federal funding.
We did not take up the question of whether these things should
be recommended for federal funding. That was a prudential judgment
that rested upon answers to the ethical questions and also the next
question of how much resources should be invested in these kinds
of, for the time being, still speculative proposals.
The major emphasis in this document, since this is an ethics council,
has been on the ethical analysis, and the thought was that we are
convened here like a body that's conducting a preliminary hearing.
The question is: do these proposals pass minimum ethical muster
and, second, are they of sufficient possible scientific interest
that we could recommend them for further public consideration?
That has been the spirit here.
And I want to say a couple of things about why we are doing this.
You'll recall that this is a council which is charged, indeed,
with upholding certain ethical norms and at least venting all of
the important ethical questions connected with biomedical advance.
We have been involved in issues that concern embryo research, and
early on in our cloning report we prided ourselves, I think rightly,
and all of us signed onto this particular part of that cloning report,
that we recognize that all parties to the debate about embryo research
had something vital to defend, not just for them, but for everybody.
Also, this Council distinguished itself, in my opinion, in our
finding common ground in the Reproduction and Responsibility report,
notwithstanding the remaining large differences amongst on the moral
status of early human embryos, and it seemed to me, and I think
this was the sense of the group the last time, that this was a wonderful
opportunity for this Council to demonstrate once again the desirability
and the possibility of trying to find common ground and also of
seriously considering ways that science might advance in ethically
uncontroversial ways, in which neither side would have to compromise.
And it seemed to me a public bioethics body that could help in attaining
such goals would have more than justified its existence.
There have been people who have looked at our discussions, and
our discussions have gotten a lot of press, and there are also papers
being published about these things even as we speak. There are
people who have been cynically saying that all of this is an attempt
to distract the country and to divert attention from the need to
pursue embryonic stem cell research by the conventional means and
that this is a disingenuous conversation.
I reject that in the name of all of us. If there are any of you
who are speaking disingenuously, you're free to confess, but
I've been in conversation with everybody here, and it has not
been my sense that that is the motive of anybody who has been participating
in this discussion.
That's a cynical charge which to my mind ranks really with
those who say the people who support embryonic stem cell research
over adult stem cell research are really motivated by the desire
to kill embryos or to defeat their pro life opponents. That's
a canard. I reject that, and similarly, I think we should reject
those who would caricature what we're trying to do here as somehow
disingenuous and an attempt to deflect research.
I think everybody ought to be interested in finding morally uncontroversial
ways for science to proceed if we can and ways that would respect
the seriously held ethical opinions of our fellow citizens whether
we agree with them or not. Whether these proposals finally pass
ethical muster on their own terms is, I think, the question we want
to consider. These are serious proposals advanced by morally serious
people who are, in fact, committed to scientific progress, and so
are we all.
With that as a kind of preface, this is a session in which all
of you have had a chance to see the draft white paper. This has
been reworked in the light of your comments made on an initial draft,
in the light of comments made by three outside researchers whose
expertise bears upon the feasibility of these proposals.
I want to thank especially Adam Schulman and Dick Roblin who worked
heroically to put together what I think is really a quite remarkably
thorough and clear document at least in terms of the analysis.
I think most of our time probably should be spent on the question
of the conclusion and what we want to say by way of conclusion,
but before doing so, let me see if, on the sort of more general
questions, in terms of the ethical analysis and the document as
a whole, whether people find this a fair and balanced document,
whether it presents a sober and sufficient analysis of the issues,
before we take up the particular questions of the conclusion.
Are there any comments about everything up to the sort of conclusion
just in terms of the analysis that's offered? I don't mean
line editing, but more serious reservations, serious omissions,
questions of balance.
DR. HURLBUT: Well, it's a small comment, but I think we should
take the issue of parthenogenesis a little more seriously than we
have because there are some serious scholars and scientists interested
in that subject, and notwithstanding its mention in the Dickey amendment,
I'm not sure that it has been properly analyzed ethically.
I'm not committed to one view or another on the outcome of
that ethical deliberation, but I just think that since we know that
there has been successful procurement of embryonic stem cells from
parthenogenic primates and now apparently from human productions,
I think we ought to recognize it as already having practical import
and, therefore, ethical worthiness to at least be discussed more
thoroughly rather than dismiss it.
CHAIRMAN KASS: On this very point, anyone else?
PARTICIPANT: Is there a page you could give us reference to or
is this just a general omission?
DR. HURLBUT: It's on page 21.
CHAIRMAN KASS: At the center of this is this thought: is a parthenogenetic
blastocyst-like entity an embryo? That's, in a way, the conundrum
Most people will say this is not an embryo because it cannot,
in fact, by your own criteria, Bill, cannot really develop and become
an organism. There's really only one experiment, I suppose,
that could prove that definitively. You would have to presume the
innocence, I think, of that experiment, I think, to try it, and
in the absence of this proof, there is a kind of doubt both on scientific
and moral grounds about just what this thing is.
And I'm not sure. Maybe there's more to be said on that
subject, but I thought we tried succinctly to say what the conundrum
is and why that conundrum is probably not going to go away. And
at the very least, as a practical matter, there is a certain bar
even to investigating this further, at least in this country.
Now, the Dickey amendment wasn't written at Sinai, and even
the things that are written at Sinai are under review, but I'm
not sure what more one would want to say here, but we will certainly
consider it, and if you have some specific suggestions for enriching
that discussion, I think we would be glad to have them afterwards.
DR. ROWLEY: Can I? Just for a point of clarification as to how
you plan this morning's discussion, it seems from the way it
has begun that we will consider the ethical issues and then at a
later time this morning go back and discuss some of the scientific
bases for some of these? I wasn't clear.
CHAIRMAN KASS: No. Thank you, Janet.
No, I thought that at least from the mail received before the
meeting that most of the discussion that people wanted to have was
— well, in fact, it stems really from Michael's comment on
the current draft that you have, namely, here we have this extensive
ethical analysis, and then it looked to Michael as if it were sort
of a cop-out to say, "Well, you know, some of us like this
and some of us like that," without our having actually had
So it was Michael's suggestion, and I concurred, that we try
to see where we are on a limited ethical question and it's also
a provisional judgment because some of these ethical judgments depend,
indeed, on certain empirical questions. I mean whether some of
these biological artifacts are or are not embryos might be discernable
from the animal research.
So I thought I would save the bulk of the time for the discussion
of the conclusions, and I'll cut this off if it gets too long
because the conclusions, I think, are the most important thing.
But if there are major difficulties with things prior to the conclusions,
this would be a good time to at least mention them.
And so if there are things earlier, Janet, this would be good.
DR. ROWLEY: Well, I think I indicated some of my concerns at
least in my first response to receiving a copy of the draft of the
white paper, and I do think that there are some serious issues,
and I will talk basically only about the Landry proposal and about
Bill's. And I think I was particularly troubled that we have
ourselves in what I find a quite unusual situation.
And on page 7 in the middle, under Item 3, "yet is important
to note that under the Landry-Zucker proposal embryos that divide
normally upon thawing but are allowed to die by a human decision,
that is, not to transfer them into a woman's uterus, would not
be eligible for donation."
So viable embryos are going to die at the same time one would
take those embryos that don't divide and, therefore, appear
dead for scientists then to be able to see if there's any way
to find within the few cells in those dead embryos something that
might then go on to be used for an embryonic stem cell line.
And I think that for me this is a strange way of solving an ethical
dilemma, that you let something that is useful die and then try
strenuously to rescue cells from a dead embryo.
So I think that in the apparently dead embryo it's clear,
and it's pointed out here in this discussion, they may have
chromosome abnormalities that would prevent their ever developing,
certainly not normally, and many of these chromosome abnormalities
lead to cell death.
So getting long-term embryonic cell lines out of these would be
I think with regard to Bill's proposal — and I realize
all of this is couched in the terms of this as at present a thought
experiment that has no basis in actual experiments — but I
think we do have to be very cognizant of the fact that this proposal
is based on using oocytes obtained from women, and it does include
the possibility that the women would be paid for it, though that's
going to be controversial and that's not central. So that it
says they can be donated. Women can be paid for them, but the feeling
of many individuals in the country and I think the proposal of the
National Academy of Sciences that is currently working on guidelines
will be that there be no payment for the donation of oocytes.
But I want to just point out what this really potentially means
in the real world, and we don't have very good evidence, but
based on the paper of Dr. Hwang from South Korea that was published
in Science in 2004, they used 176 oocytes for SCNT, somatic
cell nuclear transfer, and they got one stable cell line and that's
using a donor nucleus actually from the same individual who provided
the oocyte and under the best possible conditions.
And to say that you're going to go through a series of experiments
to identify a gene that will disable a human embryo or a human cell
such that it can't develop into an embryo, but it is otherwise
functioning, and to figure out which of several or probably quite
a number of genes might fulfill that requiremen, is going to take
many, many, many human oocytes, and I find that an extremely troubling
Moreover, once you get the embryo with this defective gene, you're
then going to do manipulations, presumably homologous recombination,
but there are several possible strategies, to rescue that defective
gene later in the course of the development of this cell line.
That, too, is fraught with a lot of problems.
So you're going to have enormous wastage all the way along
the line, and each wastage is the use of an oocyte donated by a
woman, and I think this is not a line of research that I at least
am prepared to support.
CHAIRMAN KASS: Let us move to the conclusions. I know a couple
of people have to leave early, and anyway, Janet has already begun
on the conclusions.
I can't, Janet, refrain from commenting just to the side that
ordinary SCNT, which a considerable number of members of this Council
were fairly enthusiastic and remain enthusiastic about, also involves
a rather large number of human oocytes as you began by indicating.
DR. ROWLEY: I don't deny that, but at least you're
giving them the best possible chance of developing into a usable
cell line. This takes that thing — and that's why I pointed
out the statistics from South Korea — one line from 176 oocytes
under the very best circumstances. We're going to talk about
one line probably out of 1,000 oocytes.
CHAIRMAN KASS: Bill, do you want to speak to that just briefly?
DR. HURLBUT: You know, Janet, I really welcome your well-expressed
concern about your oocytes. Coming from a prominent scientist in
our nation, to have such a serious concern about oocytes put forward
in plain English is very, very positive, I think.
I, too, share that concern, and in raising the prospect of altered
nuclear transfer, I am trying to draw on the best possible scientific
possibilities, while being sensitive to the moral concerns. And
one of the moral concerns I truly am concerned about is the procurement
I think if my project ends up inducing the superovulation of a
single woman to produce eggs, I will be disappointed. Now, there
are other possible ways to get eggs. There are leftover eggs from
the IVF clinics. There's talk of in vitro maturation
of eggs after ovaries are removed surgically or from cadavers.
There's talk of putting ovaries from such sources into animals,
and because of the conservation of the hormonal systems, there may
be ways to induce the formation of eggs.
All of that is science in rapid transition, and I think my project
would depend on morally acceptable ways to procure eggs. I completely
agree with you. The egg issue is a very, very serious issue, and
yet at the same time, the scientific community has promoted the
important possibilities of SCNT, has said that it's a far superior
technology to harvesting ES cells from IVF lines which cannot be
designed by genotype to serve as disease models, and so forth.
So the reason I put forward my proposal is because it seemed to
offer the greatest spectrum of possibilities while preserving the
moral notion. But I completely agree with you about the eggs.
So if that's a preemption for my project, it might also be
for all of SCNT, and then we're back to the starting block,
but I put forward my proposal in the spirit of defending both the
science and the ethics.
CHAIRMAN KASS: Let's proceed in the spirit of Michael's
suggestion that we see where we are on the individual proposals.
I'm going to say in advance that depending on how this discussion
goes, we would either modify the conclusion to express the sense
of the Council on these various proposals or go back to the more
wishy-washy formulation suitably modified to meet various people's
approval. I don't want to prejudge the wisest course until
we hear where people are in the discussion.
DR. KRAUTHAMMER: Well, perhaps I can just start it off
by saying where I stand on the proposals.
First of all, I endorse the effort. I read Mike Gazzaniga's
objection that it is a distraction. I don't think he meant
it as a disingenuous distraction, but a distraction from science,
and I think he's missing the point that we have a deep difference
in the country among large numbers of people over the ethics of
these procedures, and if we can find what's essentially a technical
fix, which is kind of a magical solution to an ethical issue, we
ought to pursue it, not to the exclusion of other research, but
we ought to pursue it.
So I think what you're proposing Leon is that at least we
look at the four proposals as extremely useful.
I'm rather inclined to support the first and the fourth, Landry-Zucker
and the de-differentiation. The last one is very obvious because
it's rather simple. It raises no ethical dilemmas, the de-differentiation
to the point of pluripotency, but not totipotency. So I think that
one is pretty obvious, and I'm sure there will be consensus
I'm intrigued by Landry-Zucker simply because it gets us around
the problem of destruction of embryos. If there are cells in what
we might call clinically dead embryos that can be used reliably,
there are tens of thousands of these embryos left over. It solves
our problem, and it would allow people who are not troubled by the
ethics of this to pursue traditional use of discarded embryos, live
embryos if they wish, perhaps without federal support, and those
who are troubled, to use the cells of the deal embryos.
And I say this as someone who has spoken here publicly and written
that I support the use of discarded embryos, living discarded embryos
in IVF clinics in stem cell research. I disagree with where the
President drew the line in his August 9th speech, 2001, although
I respect the reasoning behind it.
But even though I support the use of discarded embryos, I think
we ought to look seriously at whether or not Landry-Zucker could
work. If it does, it would allow us to pursue it in a way that
would be ethically untroubling to large numbers of Americans, and
I think that would be a great advance.
Oh, I might say on the others, too, that I'm a little bit
troubled by the biopsy notion, and also by the proposal that my
friend, Dr. Hurlbut, has proposed about the creation of what are
essentially teratomas. I find that troubling ethically.
I agree also with Janet's objection that, just on practical
grounds, it would involve the use of very large numbers of eggs,
but I think my objection is more that I'm not sure we ought
to be creating these bizarre organisms as a way to harvest stem
But anyway, I'll stop there. Thank you.
CHAIRMAN KASS: Someone want to respond or go next? Michael.
PROF. SANDEL: I agree with what Charles has just said, and I
think we should follow that suggestion.
I want to, having raised a question about a portion of the conclusion,
I want to say something about the analysis in the document prior
to the conclusion. I think it's superb and thoughtful and carefully
done. And I'm speaking here especially about the ethical analysis.
I'm less equipped to judge the scientific analysis, but I think
the ethical analysis of these four proposals in the white paper
is very powerful and extremely well argued, I would say the best
and most carefully and, to my mind, persuasively argued of the documents
that we've put out. So I think that's something we can
be proud of.
My objection was to the conclusion and to the lack of fit between
the ethical analysis presented in the white paper and the last paragraph
of the conclusion.
And what I would propose, and this is consistent with Charles's
suggestion just now — I would also want to draw attention,
by the way, to Leon's memo where he summarized as a point of
departure for our discussion the ethical evaluation of the four,
and I think that's a perfectly reasonable statement of the ethical
I'm referring here to Leon's memo, and I would much prefer
that we substitute for the last paragraph of the conclusion something
that captures Leon's summary of our ethical analysis in the
memo, and I actually have specific language drawn from the two to
suggest if it's of use, and it would embody, I think, the view
that Charles has just stated.
If we go to the last paragraph, the thing I objected to was simply
saying "where ethically appropriate," as if we were agnostic
on that question as a bioethics body, and I think that problem is
corrected precisely by Leon's memo.
So what I would suggest is that we amend the conclusion, beginning
in the second sentence, the one that begins "because the Council
is wholeheartedly committed to both the advancement of science for
the betterment of humankind and to the defense of human freedom,
dignity, and the value of life," comma, and then I would say,
"We encourage public discussion of any proposal to achieve
these ends," period, and then say, "Of the proposals we
consider in this paper, we endorse scientific exploration of Proposals
1 and 4," in line with what Charles has suggested, and then
drawing on what Leon has summarized in the memo something like the
For reasons stated in the ethical analysis, we consider Proposals
2 and 3 ethically unacceptable in humans at least for now.
CHAIRMAN KASS: Robby.
PROF. GEORGE: Yes. I'd like to say a word on behalf of the
altered nuclear transfer proposal that Bill has put before us.
I think it's important to understand what that proposal is,
as Bill described it to us in the last meeting of this Council.
It is not a proposal to go forward at this point with the use
of human cells. Rather, it is a proposal to conduct animal experimentation
precisely with a view to determining to a high degree of certainty
that we can create non-embryonic entities that are capable of generating
embryonic type, pluripotent stem cells.
Bill also said then what he has reiterated this morning in response
to Janet, that he would not like to see his proposal go forward
if it did involve having to obtain eggs by subjecting women to superovulation.
Now, I think what that means is that in endorsing Bill's proposal,
we are simply endorsing going forward with that basic animal research
to take things to the next step while at the same time hoping, as
those who support SCNT no doubt hope, that we will be able to come
up with ways to meet the need for eggs that don't involve subjecting
women to dangers and exploitations.
So I think with that understanding of Bill's proposal in mind,
we can add to what Michael has just said, an endorsement of the
continued discussion of Bill Hurlbut's proposal or continued
investigation of Bill Hurlbut's proposal as well.
CHAIRMAN KASS: In animals.
PROF. GEORGE: Yes, precisely in animals. I would reiterate what
Bill said last time on this score, that the only way that the proposal
is being put forward only on the assumption or in the hope that
what will be created, the teratoma-type entities that would be created,
are truly non-embryonic entities.
Bill himself said very clearly on the record that he would not
want the proposal to go forward. He would not want this to be practiced
if it turned out that what was being created was merely a defective
embryo or an embryo that's pre-programmed for an early death.
It would have to be a distinct non-embryonic creature for Bill to
— not "creature," but an embryonic entity — for Bill
to endorse it, and that would certainly be true for me and I suspect
for other members of the Council who share our view.
DR. KRAUTHAMMER: I'm afraid it was that slip that really
troubles me about this proposal.
CHAIRMAN KASS: Charles, would you speak up?
DR. KRAUTHAMMER: I'm afraid it was that slip of the tongue
which troubles me about this proposal. You call it an "entity."
I see it as a "creature," and I think that's a fundamental
difference, and that's why I'm repelled by it in principle,
apart from all of the issue of obtaining oocytes.
PROF. GEORGE: Could I ask Charles a question?
DR. KRAUTHAMMER: Yeah.
PROF. GEORGE: Yeah, just to be clear, do you consider
teratomas and complete hydatidiform moles created in nature to be
creatures as well?
DR. KRAUTHAMMER: I think it was a targeted missile that
went wrong. It was perhaps — look. It's philosophical
here. It's on point — it was an attempt at a human that
didn't go right. I'm not sure we ought to want to reproduce
I mean there are other ways to deal with our problem of obtaining
stem cells without killing embryos, and this one I find is simply
the most troubling.
It could be what Leon calls sort of the wisdom of revulsion, and
I haven't, you know, done an extensive philosophical analysis,
but if you've seen a teratoma or you think about development,
I'm not sure we want to be in that business.
PROF. GEORGE: Well, let me just point out in response to Charles
that I think that there are two distinct questions here. One is:
do we, in fact, have a creature or was my slip of the tongue telling?
And I think the answer to that is, frankly, no. We don't
have a creature here precisely in the same sense we do not have
a creature in the case of a teratoma or complete hydatidiform mole.
The second question is the one I think actually bothers you.
It's not the question of a creature. It's the question
of: is it ethically acceptable to create something that even in
nature is repugnant and weird.
Now, I don't share your principled ethical objection to that,
although I understand —
DR. KRAUTHAMMER: Repugnant, weird and somewhat human. If it's
just repugnant and weird, it's just an aesthetic issue. If
it's somewhat human, it's a moral issue.
PROF. GEORGE: Somewhat human in the sense of possessing a human
DR. KRAUTHAMMER: Yes, and is an aborted attempt to produce a
human essentially. I mean, it is an attempt to produce a human
that went wrong.
CHAIRMAN KASS: Just procedurally, because I think we have probably
started the discussion that is the one most to be sustained, let
me see if I can get agreement. Let's see if the Council agrees
on the other three things so that we can spend all of our time on
this and see where we are.
The provisional formulation which Michael has at least endorsed
on one, two, and four is as follows. And, by the way, I would like
to modify slightly that we don't recommend for scientific exploration.
That is not finally the judgment. Ethically acceptable for investigation
PROF. GEORGE: Yes.
CHAIRMAN KASS: — that's kind of a minimal threshold I think
we should say.
The rest is the matter of prudential judgment of resources and
the like, which I don't think we're in the position here
DR. KRAUTHAMMER: But couldn't we say that we encourage this
research in the name of finding some ethically consensually accepted
way of obtaining stem cells?
CHAIRMAN KASS: I think that's what —
DR. KRAUTHAMMER: It's implicit. So why not say it?
CHAIRMAN KASS: It's implicit partly because I think this
was a question raised by Janet already in the comments on the last
draft. Resources are going to be put into this.
DR. KRAUTHAMMER: But it would be stronger if we were explicit
in what is obviously implicit here, that this ought to be looked
at without giving it a dollar figure.
CHAIRMAN KASS: We now have a new question for deliberation.
Let me put that one last, but —
PROF. GEORGE: Leon, could I finish one remaining thread with
Charles just very quickly?
CHAIRMAN KASS: It won't be quick, but go on.
PROF. GEORGE: No, no, it will.
Charles, just to —
DR. KRAUTHAMMER: It's not fair. He was thinking on this
while you were talking.
PROF. GEORGE: On the objection to the creation of the entities,
just to be clear, your objection is precisely to creating such entities.
It's not the objection that I and others have to the use of
embryos in this regard where the objection is to killing the embryos.
You're not objecting to killing teratoma-type creatures.
Your moral objection is to creating them. So they're on a different
DR. KRAUTHAMMER: The answer is yes.
CHAIRMAN KASS: The first proposal, cells from organismically
dead embryos, it's ethically acceptable for investigation in
humans, but with the IRB-type caution about the need for observing
the stringent guidelines, Janet, we will deal with you directly
on that other question that you have raised about the way the text
reads at that particular point.
DR. ROWLEY: Yes, but I emphasize that because that's
exactly what's going to happen. So I think to be honest, you
have to say that perfectly normal, viable embryos, at least as determined
at the four-cell stage, will die, whereas you will then spend vast
efforts to try to rescue some cells, potentially normal, but potentially
abnormal, from these dead embryos.
I just raise the question: is this an ethically appropriate way
CHAIRMAN KASS: Okay. The somatic cell de-differentiation
studies, ethically unproblematic. Is there anybody who would disagree
with the conclusion on the second proposal, the blastomere extraction
from living embryos, ethically unacceptable in humans at least for
now owing to the reasons given in the unethical analysis?
Most especially, we should not impose risks on living embryos
destined to become children for the sake of getting stem cells for
research, not even for their eventual speculative benefit to the
donor child. Okay to study this in animals.
Is there anybody who would dissent from those sort of provisional
DR. ROWLEY: I don't want to dissent, but I think that one
should omit the last phrase because it's much more effective
to get cells that could be potentially useful to the child if they
were needed by that child in the future from cord blood, and this
is done as a standard procedure everywhere.
So to take a blastomere to set up a cell line that may be useful
for the child is not something I think that the Council should be
considering or endorsing because saving cord blood is much better
CHAIRMAN KASS: Thank you very much, and that will be added.
That's an important omission.
Are we okay on the others? Bill.
DR. HURLBUT: I'm not quite clear what we're doing here.
Are we — you sent the note at the last minute about evaluation
of each of the proposals individually. Are we now talking about
including that somehow in our white paper, adding it on as something,
or are we just discussing how we feel about things?
Because from a practical perspective, I think we're making
summary statements that are at this point in our deliberation on this,
whether we intend to go forward in it or not, we are not prepared
to make, and I would cite even just one and four, which have been
given a nice endorsement thus far. I personally think that many
of the same concerns that Charles has raised could be raised reasonably
about one and four.
I mean, take four, for example. De-differentiation; at first
glance we use a certain understanding of what's going on biologically
to say, "Oh, that's nice. We add a few chemicals and it
That's not at all clear what it would involve, de-differentiation,
that is. We don't know if there's a sequential patterning
like the building up of a building that's necessary for establishing
pluripotency. That is very likely, as *embryogenesis is a process.
We don't know whether we would need eggs, for example, to
do it because cytoplasmic factors from oocytes are probably the
chemicals you need to do that. So it might involve huge numbers
of eggs to do de-differentiation.
The objection that is sometimes raised about my proposal is that
it's very close to human, although indeed it would not be human
by the understanding that Robby and I share. Well, if you take
de-differentiation, you take it down to within one molecule of being
totipotent, then is that not close to human? Just because you came
I think, in fact, the little dialogue that went on there a few
minutes ago points to the difficulty of all of these discussions,
and just to step back for a moment to proposal number one, if you
read Janet Rossant's comments, she's not clear about the
moral meaning of proposal number one either. She says that the
scientific definition of the word "organism" is not at
Besides that, there are interesting and important ethical questions
about the practicality of actually knowing if a single cell is either
totipotent or if, when taken out of the culture and placed into
a womb, it might actually grow. If you talk to the people who work
in IVF clinics, which I've done extensively, they say it's
pretty hard to predict. As Janet Rossant clearly says, they've
been searching for this marker of lethality or no longer viability
of the embryo and they haven't found it yet.
That's not to say that's not an empirical study, but it
also involves a deeper ethical analysis than we've done here.
My understanding of our whole project was not that we were going
to do the natural process of a serious ethical Council like ours,
which would involve hearing proposals, taking testimony, doing serious
deliberation and then comprehensive moral analysis. We surely have
not done that yet for any of these proposals.
What we have done is a pretrial hearing to say whether there's
a case that merits serious consideration. I think we should say
that all four of these proposals do merit serious consideration,
and at this stage, nothing more for any of them really, except maybe
observing embryos; nothing in the way of humanly involved engagement
because we're not quite there yet.
If we end up by adding summary statements about individual views
of each of these proposals, we will be jumping way ahead of ourselves
as a serious ethics council into statements that will be taken by
the public and the press as being conclusions, and we're not
ready to make judgments.
We've done the pretrial hearing. We say there's something
worth investigating. To stop at this point would be to stop halfway
through the trial when we only have sort of hearsay and a few comments,
not cross examination, not cross-testimony.
I think many of the things that have been raised about my proposal
I think I can easily answer, but I've not had a chance to do
so, and that might change people's point of view. After all,
the whole point of this difficult debate is that we talk it through,
not just politically posture.
CHAIRMAN KASS: Jim Wilson.
PROF. WILSON: Would it be helpful if instead of revising the
last paragraph of our conclusions we cut it very short by ending
it with the first sentence? So that we would say, "Despite
these differences among us, and we recognize there are differences,
the Council shares the view that the proposals here discussed and
others like them that they may stimulate deserve careful and serious
consideration," period. Go no further.
CHAIRMAN KASS: Does someone want to speak directly to — no,
wait. It's Jim's point in response to Bill's concern.
PROF. FUKUYAMA: Well, I guess it kind of depends on what you
then expect to do afterwards. I mean, is this a prelude then to
another council meeting or two in which we actually do, you know,
what Bill suggests and do a much deeper analysis of each of the
four, or do we just throw it out there and say, well, someone —
because I do have some sympathy for the point that Michael made
that if we don't do this analysis, who's going to do it.
I mean, it does seem to be that that's kind of our charge here.
PROF. WILSON: Well, Michael, I believe, has said that,
given the present state of our knowledge, the ethical analysis of
these four proposals is, I believe he said, sharp, clear. I forget
the exact adjective, but it was quite positive. To do more than
that requires a substantial advance in scientific knowledge so that
we know what we're talking about.
We can't even adequately describe these things. We're
inventing names as we go along, and unless there is more research,
we can't have a trial. We are saying that there's probable
cause to go forward and look at these matters, but we don't
know whether any of them will pass the test of useful beyond a reasonable
doubt. And that can only come about when science has advanced much
further than it is.
So I'm saying all we can do at present, even if we spent another
ten days on this, is essentially the analysis we have because that's
based on all we know, and therefore, we should simply say these
matters deserve careful and serious consideration.
Now, at some point the Council should continue its existence,
may gather more information and you can come back and take a closer
look, if not us, then other bodies. But I don't imagine this
is going to happen for some time because the research is going to
DR. KRAUTHAMMER: May I just interject here, Leon?
But to be completely agnostic here, I think, is a little bit disingenuous.
In the absence of new scientific evidence, would we not here unanimously
agree that the removal of a blastomere from a living embryo in order
to produce these stem cells would be unethical. I mean, do we need
a lot of evidence on that one?
Is that number three or number two?
CHAIRMAN KASS: Two.
DR. KRAUTHAMMER: Number two. I mean, what's the scientific
evidence that's lacking that prevents an ethical decision here?
CHAIRMAN KASS: Gil.
PROF. MEILAENDER: It may just be that I'm sloppy, but I think
we've done a good bit actually. We haven't done everything
you might want, Bill, but it's not as if we haven't done
a decent amount.
And I think, therefore, that I agree with Michael's general
point that we should not simply punt at the end, but we should reach
I actually think — I mean, as you know, I'm not ordinarily
one who cares whether we reach consensus or not, but I think we're
not that far from a kind of consensus here. I don't have a
problem with language something like the language Michael suggested
that we're prepared to endorse two or three in humans right
I'd be happy to say something more positive about three with
respect to animal studies rather than just let it go as an assumption,
say, you know, it would be good to do the animal work in order to
try to determine what actually is happening.
So it seems to me that, whatever reservations different ones of
us may have with respect to one or four, those are not reservations
that lead us to say science should not conceivably go forward investigating
these more. I mean, after all, our mantra has generally been that
science proceeds on as many fronts as are ethically acceptable,
and we're trying to figure out whether there are insuperable
ethical objections here.
And it seems to me that, whatever differences we have with respect
to, well, three in particular, I can't see that there are insuperable
objections to our saying something positive about doing animal research
in connection with it while regarding it as for now unacceptable
in human beings.
So that, granting that there is more that could be done on discussing
any of these, I do work with the assumption that we have actually
done a good bit, that we've not done nothing, and that we're
not that far from conclusions which almost all of us could share
even with slightly different intonations about, you know, how we
feel about them.
CHAIRMAN KASS: Jim wants a brief response.
PROF. WILSON: Thank you, Gil.
I very much share your general view. Perhaps my effort to reach
a conclusion by getting rid of language led me to get rid of too
much of it. Perhaps we could take that first sentence in the last
paragraph and say that the Council shares the view that Proposals
1, 3 and 4 here discussed and others like them that they may stimulate
deserve careful and serious consideration, and then perhaps add,
if you wish, an explicit reference to animal studies.
If you all feel now that two is ethically dubious, I don't
believe three at the present stage is ethically dubious from the
point of view of further research. Two from my most elementary
scientific knowledge could fall on the other side of the line.
CHAIRMAN KASS: Dan Foster.
DR. FOSTER: Well, you know, I think we can have some statement
about animal research, but you know, the world of science, if it's
perceived that any of these ideas have potential, it will be explored.
I think Bill and a colleague are already planning studies. I think
I read it in some press. So those studies are going to go on whether
we say it or not if there's thought to be scientific viability.
I don't mind mentioning it as a guardian thing, but I don't
think that that is a big deal because that's what scientists
do, I mean, and this stuff, you know, has been in the papers and
so forth. So I think it's sort of automatic that that will
go on whatever we say.
I mean, if it is thought that somebody can do that whether they
have moral inhibitions or not, you know, they might go ahead and
do that. So —
PROF. WILSON: The science may go ahead, but our job is not to
direct science. Our job is to direct policy makers and the attitudes
they should have about science.
DR. FOSTER: I understand that, Jim, but I mean, you and
others have brought up about the fact that we need to encourage
or we should encourage scientific experiments in animals to see
where these things are going.
When altered nuclear transfer came up at the last meeting, I was
tremendously enthusiastic about it, and I still really admire Bill's
thought about it. The more I've thought about it and read about
it, I've somehow come a little more towards the view that Charles
And I wonder if in terms of the conclusion one might alter it
a little differently along what Michael has said, that with our
current understanding that we believe that one in four have no immediate
ethical restraints for potential use in humans; that the issue on
three is such that it may well move into this category, but because
of the number of questions that have arisen, some in my mind, some
are worried about making something that's — in a way,
I sort of thought that even though one understands why we use the
term "teratoma" and so forth, it might not have been the
best analogy to what we're trying to do, I mean, it seems to
So I would myself be in favor of the proposal that has come from
Michael and Charles to say that, at this state in our knowledge,
one and four appear to us to be ethically acceptable and that the
potential for three may well move into that category, but at this
point we are not willing to do that.
I think I'm in that stage, even though I probably was more
verbally supportive of Bill's idea, or somehow it has begun
to bother me a little bit. So I just raise that possibility.
CHAIRMAN KASS: Peter and then Paul.
DR. LAWLER: I like the image of the pretrial hearing, that we
really don't know enough to make a judgment about any of these,
and the more we move towards definite judgments, the more I back
I'm not sure I would segregate Bill's proposal, enough
though I have objections to it or concerns, and not so different
from the ones Dan has, and two big ones that have been mentioned.
I wonder about the prudence of engineering a third category that's
not life or non-life but kind of a near-life experience. This may
not be deeply morally problematic, but I wonder about the prudence
of doing that.
And I also wonder about using reproductive materials for reasons
having nothing to do with their natural purpose, which I think Bill's
proposal suggests he would do.
Having said this, this proposal still has promise. It merits
research in animals, and it merits Bill's persuasive work.
He hasn't persuaded us yet, but he's an energetic guy.
He will continue to try to persuade us.
From my point of view, it passes the pretrial hearing test. It's
ready to go to trial, and it's going to be a long trial, a difficult
trial, I hope a nationally televised trial.
DR. LAWLER: And I think all of the other proposals finally are
in that category, too. We don't endorse Bill's proposal
in terms of experiments on humans now, but he's not asking for
that. It's not like it's something he wants.
With respect to the dead embryos one, that demands investigation,
I mean, observation of human embryos.
Number four seems to me in such early stages of development we
don't know what we're talking about. Nonetheless, we can't
help ourselves, and number two, the ethical objection raised by
Charles and others, I think, is obvious for now, but that, too,
can change through further scientific development.
DR. FOSTER: Well, in terms of four, let me just interrupt there.
There are at least three and maybe four papers that I know about
that with small molecules you can at least with myotubules move
back to make a myotubule, you know, make fat and bone and so forth.
So I don't think that we're devoid of evidence that that
might work. I don't know about the issue of pluri- to totipotential
cells. I mean, I don't know, but I do think that there is enough
evidence on four that you could say that that's potentially
a useful thing.
CHAIRMAN KASS: Excuse me. Paul is next in the queue, but Charles
I know has to leave. Are you watching the time? Do you want a
last comment before you go?
DR. KRAUTHAMMER: I'm going to stay another 15 minutes
and then go. I'll wait a little bit longer then.
CHAIRMAN KASS: Thank you.
DR. McHUGH: Well, I want to come back really into the
discussion that Michael gave and make the issue of this product
more personal. I read it and thought it was a wonderful document,
very clear, very coherent. It included all of my concerns in relationship
to all of these, and I was so pleased with what it had done, Michael,
that I simply read the last paragraph as your sentence, Jim.
And then I think Michael made a wonderful pickup, in other words,
in a kind of editorial pickup that we would have, if it were sent
out the way we had originally, we would have been marked by other
people, and we might well have woken the next day and said, "How
did we forget that?"
And so I'm very interested in going beyond Jim's sentence
to express what Michael has proposed, and I think Charles and Michael
and I are seeing commonly these clear themes as being easily expressed
in terms that are the charge of this Council; that these are clearly
things — at the present time if new knowledge came around, we might
well change our mind in relationship to it, but one and four seemed
ethically coherent at the moment.
Two seems to me unless — two is on life supports. As far as
I'm concerned, in order to have two, you'd have to do something
very radical to save it.
And three, Bill's suggestion, I think, has sufficiently problematic
issues, sufficient red lights, as I put it before, to make us say
that has to be something that will go forward in animal research
to find out, just as Janet said, that no scientist — for example,
I share Charles's view about these things as being creatures.
I share the idea that it's also a kind of pollution of the human
genome that I have a yuk factor towards, and I am equally concerned
that fundamentally it has — since I think the SCNT normally
without fooling around with it also won't become human —
I think this is painting the lily, and I think scientists will soon
On the other hand, I think Bill has made a persuasive argument
to do more research. I come back fundamentally to supporting what
Michael said. The combination of what we did added to the thoughts
that Leon's memo had would be a very appropriate final product
for this session to achieve.
CHAIRMAN KASS: Bill, do you want a quick response? Yes.
DR. HURLBUT: You know, first of all, I want to say plainly that
in raising my proposal, I'm trying to defend the important goods
being defended by both sides of this issue and differently expressed
by all of us in this Council.
I personally believe that a decent society does not build the
foundations of its biomedical science on the intentional creation
and destruction of human embryos. That's a fundamental starting
point for me personally, but as a person trained in science, as
a physician, as a father of a handicapped child, as a person who
has seen the possibilities of the science, I also want to try to
open the science.
I think some of you are raising prudential concerns, and you have
to put into the balance of the prudential concerns about my proposal
the tremendous possibilities and positive goods that could come
Now, I know that, getting down to the crux, I resonate with what
Charles is saying and what you're saying. Red flags go up in
my mind, too, but as Leon expressed, some concepts of manipulation
of human life are unbeautiful.
Disease is also very unbeautiful, and we do things in medicine
that are strange and unintuitive. We give people a dose of disease
for vaccination. We send in reengineered cells like targeted toxins.
We grow great sheets of skin from cells harvested from foreskins.
We cut the body. We do things that are not easily and intuitively
aesthetically pleasing for the very purpose of a higher good, which
I, on the other hand, would never favor the creation of something
I thought was a living human being for its destruction, but the
very point of this difficult dialogue, and I think it was characterized
in this exchange here, is we have not as a society nor even as a
Council actually contended seriously with the question. We have
not reached a consensus conclusion, nor really even properly deliberated
on what is the definition of an organism, an embryo and the moral
thing we're trying to defend.
We are in a transition time. We are at the beginning. We've
gone from genomics to proteomics, the genes, the proteins they produce.
We are at the beginning of the era of developmental biology. From
here on out, those questions, what is an organism, are crucial questions.
I think it's going to be evident in our next session. What
are the boundaries of humanity with regard to chimeras? What are
parthenotes? What are you going to do with the products that you
produce with embryonic stem cell research? Once you differentiate
them, are you going to reaggregate them? Are you going to grow
human parts apart from bodies? Are we going to have factories of
kidneys? Are we going to grow brains in vats? It's just simply
challenging conceptual issues here that we have not yet contended
And just one final point. Paul, you yourself have argued and,
you know, with a certain sympathy from my side, that what we call
cloning for biomedical research, or SCNT, is not really a reproductive
process. It's a lab process. It's not really the production
of a new human being, you've said. It's an extension of
bodily being of the individual.
I have some sympathy with your perspective on that, but am uncomfortable
because it's clear that Dolly, if she was a sheep, Dolly was
once an embryo.
So I agree it's a proposal called altered nuclear transfer.
In fact, in July 2003, Rudy Jaenisch came to our Council and explained
that all cloning for biomedical research, all SCNT, in fact, involves
altered biology, and I've got the quote from you here, and these
are the words of Michael Sandel, who says, referring to Jaenisch's
comments and how your attitude had all along been right, and that,
in fact, this produces an entity that is not capable of becoming
a human being and, therefore, is moral.
Michael speaks of the vindication of Paul McHugh's attitudes.
Remember? And then he goes on to say of Rudy Jaenisch's comments,
"And he argued that there is a difference." He's
affirming now that this entity produced by cloning is not a human
being. "And he argued that there is a difference, a biological
difference, with a possible ethical significance between a zygote
and a clonote, between a fertilized embryo and an artifact created
in the lab, and he was told that this is an eccentric position,"
namely, you were told that it was eccentric.
Well, you argued this. Rudy Jaenisch confirmed it, and all I'm
trying to do is really confirm it biologically.
Janet Rossant has —
DR. McHUGH: Let me just say, maybe just finish that point. That's
a very good point, and my point is this then becomes making an ANT;
it becomes painting the lily, and no scientist will bother to do
it for all of the reasons that Janet has said, that is, that it
will consume eggs. It will ultimately — you know, it is my opinion
the SCNT does produce, in the primate, a nonviable organism.
Other people disagree with me on that, but I don't think that
the step to then poison it further .-
DR. HURLBUT: Poison it?
DR. McHUGH: — is even necessary.
DR. HURLBUT: What are you talking about? It has already
got five percent of its genome improperly expressed even in the
newborn form of clones. There's a massive reorganization of
the epigenetic factors. This is just adding a sure confirmation
DR. McHUGH: Okay. Well, I mean, there is our distinction. I
don't think you need to do more than is already damaged in it.
CHAIRMAN KASS: I'm going to try to hold a bit of order.
DR. KRAUTHAMMER: I'm sorry, but may I make just a final statement
because I'm going to need to go, if I could just respond? I
don't mean to interrupt.
CHAIRMAN KASS: Your final statement, not everybody else's.
DR. KRAUTHAMMER: Yes, I did mean mine. I wasn't speaking
on behalf of the Council.
CHAIRMAN KASS: No, thank you.
DR. KRAUTHAMMER: Look. I'm sympathetic to Bill's
seriousness and his attempt to bridge the difference between our
ethical concerns, our scientific concerns, and I happen to share
the principle that you enunciated, that we ought never create human
embryos in order to destroy them, which is why I support the use
of discarded embryos in IVF clinics, because I consider that a different
category, and why I oppose research cloning.
But I believe that a teratoma is a tragedy, and we ought not be
creating tragedies deliberately. That's just a shorthand.
Given that that view at least has some support here on the Council,
I'd suggest that we not be entirely agnostic; that we speak,
if we have a consensus, as I think we do on numbers one and four,
express it explicitly. I think it's an advance. It will help
to encourage that research and legitimize it.
I would also add the word "encourage." I think you
want to discuss that a little bit later, Leon, but I don't see
any reason why that ought to be only implicit.
We ought to explicitly rule out number two, which I think we have
a consensus on, and of course, when we preface all of this by saying
that the science is shifting, and if the science evolves in a way
that causes reconsideration, we're open to reconsider all of
these numbers one through four and perhaps end up with three.
I happen to oppose it in principle, but I'm speaking only
personally, but perhaps we could state consensually that there are
some ethical issues still unresolved, and we would, therefore, perhaps
permit it in animals and not in humans, although I would oppose
— I mean, I would not oppose, but I would be a little bit troubled
by pursuing it in principle.
But I would offer that as a way to perhaps bridge our differences,
have a statement that would be strong, and would launch an area
of thinking in research that I think would be extremely useful and
And I apologize for leaving in the middle of a brawl. It's
always interesting and enjoyable, but see you next time.
Thank you very much.
CHAIRMAN KASS: Thanks, Charles.
I have Ben Carson, Diana, Janet, Gil, Michael, Frank. I want
to hear from everybody. That means Rebecca and Alfonso, too, before
What did I say? Ben.
DR. CARSON: Okay. First of all, I thought the white paper was
well done. It was a good overview and very easily understood.
I think that's very important.
I would like to say that, you know, three years ago many of the
things that we're discussing in terms of these four proposals
would not have been on the table, and yet there was a raging debate
going on about stem cell research and its potential for good.
I think we need as a Council to make sure that we do ferret out
those things in these proposals that we agree with unanimously because
we want to maintain our relevancy, and we don't want to be so
tentative that nothing we say means anything.
But I think at the same time we need to recognize that there are
more than just these four proposals. There are going to be a lot
more than just these four proposals, and we don't want to give
anybody the impression that these are the only things that are being
looked at and considered.
CHAIRMAN KASS: Thank you very much.
DR. SCHAUB: Yeah, it seems that there are a number of suggestions
on the table about how to slice these, and some want to put one
and four in one category and two and three in another category,
a yes category and a no category. Others would slice it differently
and put one, three, and four in the yes category and two in the
I guess it seems to me that the way it's stated in Leon's
memo is pretty good. I would be in favor of not trying to lump
them into categories, but discussing each one separately.
And I think the statement that's given here is maybe pretty
accurate about what the consensus is. I would be in favor of somewhat
strengthening the endorsement of number three. I mean, the three
elements in there should remain that we think it's as of now
ethically unacceptable in humans, but despite the serious ethical
concerns that some folks have about the proposal, we do think it's
worthy of being pursued in animals.
I mean, I guess I'd sort of like to know is there a consensus
about that, about pursuing it in animals, and if there is, then
that could be stated somewhat more strongly in the assessment of
CHAIRMAN KASS: Thank you.
It is how to find the right balance that this discussion is supposed
to give guidance, and that was a very useful suggestion.
I have Janet, Gil, Michael. Michael, do you want a last word
before you go, too?
PROF. SANDEL: I apologize that I have to leave early.
First, two comments. First, on the moral arguments, I think it's
very difficult to read the pages 16 through 19, the ethical analysis
contained in the white paper unless one has, as Bill may feel he
has, persuasive arguments to each of those four ethical objections
and not to regard proposal number three as morally dubious.
Those are devastating arguments, I think. I'm talking now
about the ethical analysis in Proposal 3 on pages 16 to 19, not
about the conclusion.
And different of us weigh those, find those arguments some more
persuasive than others, but the one that I find most persuasive,
just to go to the moral merits for a moment, I think that regardless
of our other disagreement about the moral status of the embryo,
there were some of us who have an equal moral status view and others
who had an intermediate status view, and we had long arguments about
But it seems to me that even on the intermediate moral status
view, on that view to do the stem cell research and to destroy the
blastocyst does carry a certain moral burden that requires that
the use be restricted to lifesaving and morally weighty purposes
so that it couldn't be used, for example, to develop a new line
of cosmetics. That's the intermediate moral status view.
Even on that view, there is something, and here I speak just for
myself, something morally creepy about genetically engineering a
mutant embryo-like being and then saying with that being you remove
even the moral weight of justification that this must be used only
for especially important lifesaving purposes.
And so I think that's captured in Charles's invocation
of the kind of saying it's weird. If it's somewhat human,
Number three, objection number three doesn't depend on any
scientific discovery. Number three, it's the third ethical
objection laid out worries about it, regardless of what the creature
or the being or the thing created, the artifact.
So I just wanted at least to state why even — well, I don't
think it depends what moral status one attributes to the embryo;
that it's still possible to make sense and be moved by some
among the four moral objections laid out in the white paper.
CHAIRMAN KASS: Thank you.
On that point, I'm going to keep Bill from responding on this.
DR. HURLBUT: Please.
CHAIRMAN KASS: Very briefly, but I really want to keep — there
are people waiting to get in on this.
DR. HURLBUT: Michael, you're saying that the slight difference
between what I'm proposing and what Paul called the gilding
of the lily; you're saying that that is more of a mutant human
being in some sense, those loaded words? You're saying it's
more than what you've called for publicly, the endorsement of
And second —
PROF. SANDEL: Yes.
DR. HURLBUT: — I want to ask you. I assume you've
read my comments that I made for the President's Council's first
report. Have you, in fact, read through them carefully?
PROF. SANDEL: Yes.
DR. HURLBUT: And you don't find any of those — can you cite
back for me my arguments perhaps?
CHAIRMAN KASS: Bill, I think —
DR. HURLBUT: I mean, it's like I don't think you've
read them, frankly. I don't get the sense of —
PROF. GEORGE: Bill.
CHAIRMAN KASS: Bill, I'm going to intervene, and let me say
that I think Michael has pointed to the place in the analysis where
there are ethical objections to ANT itself, not depending on slippery
slope, not depending on the egg question, not depending upon the
question of whether answering this question which can only be empirically
or at least partly empirically answered. Is this artifact really
a defective embryo or something else?
There are people who have these kinds of concerns. Here is the
place where I think the document has been one-sided, and if Bill
has answers to these objections, as he says he does, then that document
has to be corrected so that those particular objections can be countered.
I think that's simply only fair.
We've made the slippery slope arguments and then finished
by remarking that, look, slippery slope arguments always presuppose
that people cannot find the means of finding some boundary where
you can hold the line between what's acceptable and what's
objectionable, and I think we ought to balance this up and similarly
add something on the egg question.
But I think, look, everybody has to acknowledge — Bill has to
acknowledge, and I think Michael is speaking for himself and perhaps
others — that there are some people who do find this particular
kind of practice aesthetically or morally troublesome to the point
of dubious and in some cases unacceptable, and that's a difference
of ethical perspective on this which we simply have to acknowledge.
Now, there are other people in the room who have already spoken,
who notwithstanding their worries about this are prepared to say
with you that we do lots of peculiar and aesthetically problematic
things in medicine, some of them even morally complicated, and that
doesn't necessarily rule them out, especially if the animal
research shows great human promise, and I think there's a way
of fixing this document to make sure that this particular kind of
— Michael reads that, and he says it's sort of devastating,
and it's partly devastating because the other side has not been
presented in that particular paragraph, and I think if Bill can
give us a response to that, that fills out this document and improves
I'm simply going to go to the queue.
DR. HURLBUT: May I —
CHAIRMAN KASS: No.
DR. HURLBUT: I'd like to withdraw my last comment to Michael.
CHAIRMAN KASS: No.
DR. HURLBUT: May I withdraw my last comment?
Michael, I'm sorry. I didn't meant to imply you hadn't
read my statement, but I do think that I have serious arguments
that have not been discussed properly.
CHAIRMAN KASS: Okay. I have Janet, Gil, Rebecca and who else
has been hiding out? Frank and Alfonso, and I'd better say
something, too, at the end.
So, Janet, please.
DR. ROWLEY: All right. Well, I'd like to deal with the issue
raised on page 19 under the rubric of is it scientifically sound
because I think Charles and several others in the text of this part
of the document talk about teratomas.
Teratomas are chromosomally very abnormal, and that's not
what we're talking about here. So I think the analogy with
teratomas is potentially an unfortunate one because the ultimate
goal of this research, of all stem cell research or most of it,
is to think about ways that stem cells can be used to treat very
devastating human disease.
And the proposal here is going to take a nucleus before it is
introduced into an oocyte or an oocyte-like cell. It's going
to change, potentially change only one gene that then prevents that
cell from developing into an embryo, but the critical thing, as
pointed out on page 19, is that this has to be fully reversible
without residual abnormalities in the derived cell.
So you want to make the smallest possible genetic change to prevent
the cells from forming an embryo and a change which will be fully
reversible so that the cells that you finally give to a patient
to treat a disease are, in fact, functional cells.
Now, that's like saying that an embryo that has a defect,
say, in the disease of hemophilia, for example, the embryo has 29,999
genes, all normal human, all going to lead to a normal developing
human with brain function and things of that sort, but one gene
is abnormal. The proposal to work has to be that a single gene
that is essential for developing an embryo is disarmed, if you will,
before the nucleus is inserted into the oocyte, but then is fully
And I don't see how one can look on the developing cell with
essentially all normal genes except one as any different from an
embryo carrying a defect that leads to hemophilia, that leads to
muscular dystrophy or something else.
So it's a fully human embryo with one gene defect, and for
me that's the equivalent of a human embryo.
CHAIRMAN KASS: Let me continue in the queue. Gil and then Rebecca.
PROF. MEILAENDER: As far as I can tell, everyone or almost everyone
agrees that the basic structure and analysis of this paper is very
good. I mean, everybody thinks it's well done.
And I've been trying to figure out sort of how to describe
what exactly it is that we're arguing about. I think in some
ways we're actually arguing about some old questions and not
about the question that's here.
I haven't heard any proponents of or any of those who are
favorable toward alternative three argue that it should for now
be done in human beings. I have not heard that.
I have not heard any of those who have reservations about it argue
that it would somehow be morally wrong to proceed to do it in animals,
though even if those studies proved to be promising, they might
still have the yuk factor and have a moral objection to proceeding
in human beings, but I haven't heard arguments that it shouldn't
be done in animals.
If that's right and, you know, subject to correction from
anybody who thinks differently, whether they're favorable or
unfavorable toward alternative three, it doesn't seem to me
that we have a deep disagreement. We may have a difference in tone
about how many exclamation marks we want behind the sentence that
says it would be fine to proceed with this in animals, but that's
about what it amounts to.
The only thing that would be disingenuous would be somehow to
say, while we normally say that science should attempt to proceed
on every ethically acceptable front, we know in advance that this
is not an ethically acceptable front. I mean, that, I think, would
be a mistake.
But if you say do the basic work in animals, see what happens
with however many exclamation marks we together want at the end
of the sentence, I don't think that we have a deep disagreement
So to me that's where it seems we are, and it doesn't
seem to me to be a bad place to find ourselves.
CHAIRMAN KASS: Why don't you hold off, Bill? Okay.
DR. HURLBUT: My one comment to Gil is I agree with you, but I
think that equally applies to all four proposals.
Until you are clear about what four is producing you certainly
can't say it's ready for human use, and in a way that's
true also of one. Until you're absolutely clear that the single
cell from an eight cell embryo is not totipotent, for example, you
can't say that you can go proceed with human use of this technique.
All four proposals, with maybe the exception of two, offer promising
prospects, but also are at the stage of being investigated.
CHAIRMAN KASS: I think I know how one could write such a conclusion
that makes it perfectly clear that these are provisional findings
of a preliminary hearing, and that this is not the end of the ethical
analysis or the ethical discussion. "On the other hand. .
There's a way to write this that begins from where Diana is
and where Gil is and takes into account your precautionary concern
that this ethical conversation, even about the ones that seem to
us relatively innocent, may turn out not to be so innocent on further
reflection, but that they pass a certain kind of minimal ethical
threshold to say these are things worth considering talking about,
and the Council is not just punting, having done this analysis.
I think there is a way to do this and find a kind of general acceptance
around the table, and I certainly welcome the chance to try to produce
such language, not here on the spot today, but in short order, and
the troops in the office know how to do this very well.
Rebecca, you've been very quiet.
PROF. DRESSER: Well, I don't have deep disagreement with
much of what I've heard. I don't have an objection to saying
it's permissible to go forward with these investigations in
I think we should acknowledge that science is always or often
very surprising, and it's not clear that any of these things
will develop to the point where people are seeing clinical applications.
If certainly three — and, of course, I share the concern about
two and the risk to any children who might be born from any procedure
— but for some of these others, especially three because it requires
eggs, if the science does go forward and prove to be promising and
then the question comes, well, should we try these in humans, I
think there will be very serious ethical considerations, just as
there will be and are with SCNT in the fact that you have to use
the human eggs.
So I would go along with the trend of your proposal in terms of
no ethical objections to looking at this in animals. There could
be some serious issues, depending on how the science turns out,
if the step toward humans occurs.
CHAIRMAN KASS: Thank you.
DR. GÓMEZ-LOBO: My apologies for coming in late today.
My overall inclination is to endorse the document. I find it
very good, very clear, and ultimately solid. But my main reason
for endorsing it is because, contrary to an E-mail circulated by
Michael Sandel, I don't think we're in a position of making
any definitive moral judgments, but I know that by now we have a
consensus on that.
Let me just mention this. Of course, there are questions of the
development of the science. If some of these proposals simply don't
work from a scientific point of view, of course, it's going
to be moot and, thank God, we're not going to have to worry
But we need time not only for the science, but also for the ethics
because I think that these are quite new ethical problems, and we
need time to consider externalities, if you will, or other aspects
that are not considered here.
Let me just give one example. I have very serious problems with
Proposal 2 because of the reasons just mentioned. It's a case
of battery really to go into the body of a human being and extract
But number one also has its problems because there are important
disanalogies between the practice of extraction of organs for transplantation,
say, after an accident and the circumstances of the waiting for
the death of an embryo in order to extract the organs.
I think that one can imagine several scenarios that would make
it morally very problematic. Up to now in transplantation ethics,
one of the key demands is that there be a drastic separation between
the physicians dealing with the person who has died and the team
of transplantation surgeons that move in to extract the organs,
whereas here we'd have practically the same team as if around
the deathbed of someone waiting for that embryo to die in order
to extract the cells.
Now, that's just one example which occurred to me is the kind
of problem that needs time. There may be others, or they may be
So basically, you know, I praise the document, and there may be
need to include some responses from Bill and then to modify the
CHAIRMAN KASS: Thank you.
PROF. FUKUYAMA: Well, I don't know. I guess I'm not
so sure I'm happy with the document just from listening to this
discussion today, and I'm not quite clear, Leon, what you think
the procedure from here is, that if we endorse the document, you're
just going to get some language from Bill to strengthen, you know,
Because as I'm listening to this discussion, I'm even
more confused about what I think about this issue because there's
a huge difference between creating something that looks like a teratoma
and creating something like what Janet suggested, which is basically
a complete embryo with just a kind of minimal, you know, number
of genes changed.
And I would think that it's also something where the scientist
creating this entity could actually use some ethical guidance because
I presume that there's a certain, you know, range of variation
in exactly how many genes they could change that would make it look,
on the one hand, more like a teratoma and, on the other hand, more
like a real human being.
So I don't think it's simply enough to say, well, we can't
say anything more ethically about this until the science goes ahead
and, you know, does a proof of possibility study in animals. I'm
just not at all certain that we've really explored this whole
set of issues adequately.
Second, just a brief comment I'd like to make. I know this
is an ethics council, and we're not supposed to deal with politics
more broadly, but the political landscape on this really has changed
since we first started discussing stem cells at the beginning of
this Council because this proposal back then was a way to break
this logjam at the federal level where the funding was blocked.
Now we're in a very different landscape where it looks like,
I mean, first of all Proposition 71 has opened the floodgates to
stem cell research in a much more straightforward way. Every state
is reacting to that. The university that three of us, you know,
teach for is under big threat because all of the postdocs now are
going to be heading out to a university in California to get, you
know, some of this, and some of the senior researchers may be departing
Maryland as well.
And what we're heading towards is actually — Gil and I were
discussing this yesterday off line — but a kind of blue state/red
state federalism in which different types of scientific research
under different ethical guidelines are going to appear in different
parts of the country because of the blockage and the inability to
get a federal policy.
And so it's something to bear in mind that, you know, I'm
not quite sure who we think we're giving guidelines to because,
in fact, the nature of the political landscape in this country is
such that we're actually going to have about 50 different, you
know, state policies on this issue.
And it does weigh a little bit in the ethical considerations because
if you think that stem cell research in a much more straightforward
way is going to be lavishly funded on a state level, then this as
a solution, you know, Bill's proposal, number three, as a solution
to the blockage, you know, it becomes a little bit less salient
because there is really an alternative way to get to the same, you
know, body of scientific knowledge. You just have to move jurisdictions
a little bit.
CHAIRMAN KASS: Thank you. Peter, I think, and I will have a
comment, and then we'll take a break.
DR. LAWLER: In light of what Frank just said, it's perfectly
true, right, that every thing we're doing today presupposes
this. It would be a good thing if we could acquire embryonic stem
cells without destroying embryos. That would be an improvement
in our present situation.
CHAIRMAN KASS: Pluripotent, not embryonic.
DR. LAWLER: Sure.
CHAIRMAN KASS: Okay.
DR. LAWLER: Pluripotent. It would be better if we could do that.
That would be an improvement on our situation. For some, that improvement
would be merely prudential. You could get funding. That may be
becoming irrelevant. I admit that.
But it may be good simply because the moral division in the country,
which is tragic in a certain sense because there are well- intentioned
people on both sides, would come to an end. It might be a good
thing; I think it would be a good thing if there could be a technical
solution to our moral problem, and it's reasonable to hope there
could be a technical solution to our moral problem simply because
the moral problem exists, it would seem, at a certain level of technology.
So there's a reason to hope that technology will cause us
to be able to overcome or surpass this problem, but we also have
to admit, I think, that none of these four possibilities are anywhere
close to being acceptable at this point. It remains to be seen.
It remains to be proven, and from that point of view I agree with
many of the criticisms or reservations expressed about Bill's
I'm not so clear it should be treated differently finally
from number one and number four because I think they're fairly
problematic in different ways, too. So I would encourage further
research in one, three, and four, with the acknowledgement that
none of this has been proven useful in terms of overcoming the moral
problem we have now. I mean it really is, to repeat, a pretrial
investigation. I think one, three, and four do give us probable
cause and we should go forward.
CHAIRMAN KASS: You want a comment and then I'm going to wind
DR. HURLBUT: I just want to make it clear I never proposed making
teratomas. Teratomas I drew as an example of how nature produces
an entity that is not in my mind a living being. I would not as
a physician have any problem doing a therapeutic preemption of that
I just used it as an analogy. What we're talking about is
something that is more like an inner cell mass. Janet Rossant in
her comments to us said, and I quote, "Each cell has its own
course of action and will continue to divide and differentiate even
if isolated from other cells."
It should be possible with a small change that has a very dramatic
effect on the coordinated coherence of the integrated unity of the
process of its organization to preempt the organismal nature of
We do not know yet how pluripotent cells or embryonic stem cells
are actually formed. Is it just a matter of having the cytoplasm
in the cell and then just waiting until it grows like Janet Rossant
implies, that each cell has its own trajectory, or does it need
the perfect and synchronized interaction of the entire organism?
That's an empirical question, however, one that can go below
our argument about whether or when the embryo had moral status to
whether or not it is an organism at all.
It's the idea that is to get below our problem. This is a
transition time in the history of science. In the end of the 19th
Century, we overthrew a simplistic vitalism in favor of studying
biochemistry. It's a little harder for us to understand and
to intuitively grasp with our natural moral sentiments that developing
trajectories, too, can be separated off from the totality of the
But we will learn that in our era of developmental biology, if
we're going to go forward at all in developmental biology, we're
going to have to do the same thing they did in biochemistry, that
is, break the parts apart from the whole so that we're not violating
human dignity while we have a tool to study it all.
I admit that my proposal, as with all of the other proposals,
raises interesting and important questions. My proposal also offers
a tremendous breadth of flexibility and could provide much or most
or all of what the scientists hope and I hope we can proceed forward
It raises important questions. Our role as a Council, given to
us by the President, was to engage and educate the public. This
document does that in that it initiates an important conversation.
It was never intended to be a comprehensive analysis. If that were
true, we would be at fault for having done an inadequate job, never
hearing testimony, never really having a proper deliberation.
But, in fact, what we've done is we've produced an initial
cursory view that raised some questions like little red flags for
sure, as does all of SCNT, as does all of harvesting of IVF embryos
that are left over, all these things, but just saying that in the
deadlock of our country, the serious question could be perhaps solved
by a third option that we hadn't really thought through carefully
enough yet, and wouldn't that be instead of red state medicine
and blue state medicine, instead of people having to come into the
hospital 20 years from now and checking a box and saying, "I
don't want anything developed in California," wouldn't
it be better if we found a way to go forward in a coordinated, collaborative
research on a national level, funded by the NIH with proper peer
review, proper ethical overview? Wouldn't that truly be a triumph
If that's true, then it makes it worthwhile doing the hard
work that we have initiated in this Council that should be taking
place on a broader level in our society, the hard work of thinking
through these serious proposals.
CHAIRMAN KASS: I'll try to be brief. I think I concur
with — well, let me say this. I think we should try to find
a way that the conclusion does a little more than what it does in
this particular draft where it says some of us this and some of
us that, et cetera, but do so in a way that indicates the strict
preliminary character of these judgments, since there's a great
danger that what is going to be written in the conclusion, especially
in this town, will be treated as dictum, and everything else, the
analysis, just disappears, and it will look like the Council recommends
That I don't think we are exactly in a position to do for
the reasons that have been so both well expressed and well reflected
in the comments. I think there is a way to go partly from this
second memorandum to the Council, to introduce certain kinds of
greater ethical cautions about the proposals that we think pass
the minimum test, to revise the way in which the discussion of the
biological artifacts — when you indicate that there are these serious
concerns, but to adopt something like Diana's approach so that
what's written at the end really reflects the diversity of opinion
here, the tentative character of the opinion here.
I think no one has answered Gil's challenge. No one here
has really said that Bill's proposal should not now be investigated
in animals, that we think that there's an ethical bar to doing
that, which was all that that proposal was in the beginning.
And I think if the Council is willing to trust me and the staff
to produce a revision of the conclusion for your consideration,
we could do the rest of this by mail. Is that an agreeable thing?
And of course, line edits and things of that sort are welcome,
but we had better have them soon.
PROF. FUKUYAMA: Okay, but then do we just drop the subject after
that? What happens subsequently?
CHAIRMAN KASS: Well, it seems to me let us undertake — let's
step back from what we've done here, think about it a while
and see where one wants to go next on this matter.
None of these individual proposals may pan out. Landry and Zucker,
by the way, have submitted their proposal for IRB approval at Columbia
and they are, I think, planning to go ahead with this. I know that
Bill is in collaboration with some scientists who meet already to
try to do some of his work in animals.
And to my astonishment, the various kinds of findings of these
multipotent cells now in multiple places has just not gotten the
kind of attention that I think it deserves simply from a scientific
point of view to try to understand why is it so easy to find these
multipotent cells in bone marrow, in addition to the mesenchymal
cells, in addition to the hemopoietic cells, and what do they mean?
But the interesting thing is, in fact, to suggest that there really
might be room for creative thinking, that these proposals might,
indeed, stimulate other ones, and no one is saying that we're
not going to continue to perhaps have our disagreements about embryonic
stem cell research. There will continue to be political battles
over it, I'm sure, in this session of Congress. The states
will do as they will.
Some of them will produce bans and other ones will, you know,
produce a windfall, and that's the way we are, but we do have
an audience here. We have monitored stem cell research. Here is
something that contributes to that discussion, and I think we do
a service if we put out this document suitably concluded, suitably
corrected, and then think further down the road what would come
Let's take a break. We're 20 minutes over, but I think
it was important that everybody get their views expressed.
Could we make this break short? I know people have to leave early.
Let's come back in 12 minutes or so, and we have a session on
(Whereupon, the foregoing matter went off the record at 10:20
a.m. and went back on the record at 10:34 a.m.)
SESSION 6: HUMAN-ANIMAL CHIMERAS COUNCIL
CHAIRMAN KASS: The last regular session
before the session for public comments is on human-animal chimeras
or hybrids, this time in the context of basic research in developmental
I remind you that the Council last discussed this topic in connection
with our recommendations in the reproduction and responsibility
report. You'll recall that we all agreed that there should
be restrictions on fertilizing human eggs by animal sperm and vice
versa, and on placing human embryos into the bodies of animals.
The question of producing chimeras by introducing human stem cells
or their derivatives, for example, neurons into animals or animal
embryos came up for discussion, but it wasn't fully treated.
There has been a fair amount of recent journalistic attention
to this topic, as well as presentations on chimeras at a workshop
of the National Academies of Science's Committee on Guidelines
for Stem Cell Research last October and an anticipated report from
the academies, I think to be released fairly soon, if I'm not
Janet would be able to tell us since she is a member.
We'll probably speak to this subject, and therefore, I thought
it was reasonable that we should have another look.
In preparation for this meeting, I should have suggested that
you do likewise. I went back and read the transcript of our meeting
in October of 2003, where it was on the plane of whole animals and
humanzees, but we didn't get down to the kinds of questions
which are of immediate research interest, but it turned out to be
for a first pass really one of the very rich and interesting conversations,
and I'm looking forward to the conversation that we have today
to see if we can make some progress on basically two questions.
If people say mixing the human and the animal, the general public
responds with some, to say the least, with some kind of unease or
disquiet, and the question is: what, if any, is the reasonable
basis of any unease over or objection to such kind of mixing? And
let's be clear: even at the very beginning of life in this
kind of developmental research.
And second, could one develop and articulate reasonable boundaries
between what would be acceptable and what would be objectionable;
what would be the acceptable and what the objectionable kinds and
degrees of mixing in this research.
To get the conversation started, we've asked several people
to open up with some comments, and first Diana and then Alfonso,
which I assume will be more on the first of these questions rather
than on the second.
So, Diana, please.
DR. SCHAUB: Leon asked me if I would make a few opening remarks
for this session in which we're considering human-animal mixing
and developmental research. In trying to figure out a way into
this topic, the standard approach seems to be to focus on human
dignity, the boundaries of the human and possible transgressions
of those boundaries.
But I want to start less anthropocentrically. Whenever human
dignity is involved, some humans at least get mighty concerned.
They get on their high horse about it. So I wanted to ease our
way into figuring out our unease or possible unease by reflecting
a bit first about animal-animal mixtures.
We should remember that the original mythological chimera was
altogether beastly, a she-goal with a head of lion and the tail
of a serpent. There were, of course, mythological human-animal
mixtures as well, like the Minotaur and the Manticore. But let's
take the chimera first, especially since she now gives her name
to these new biotech possibilities.
I did look back at the Council's earlier discussion from October
2003 when this topic was first broached, and the humanzee, our version
of the Minotaur, was much talked of, but the geep, the combination
of a goat and a sheep that is our rather less indominatable version
of the chimera, was not much mentioned. No one seemed too bothered
by the geep.
So let me just say that geeps do make me uneasy and uncertain.
I can state my confusion in the form of a somewhat tongue-in-cheek
question. When and if a geep behaves like an old goat, is he sheepish
DR. SCHAUB: In other words, does he feel sheepish about his goatish
What I mean to suggest is that species' integrity can be thought
of not just genetically, but characterologically. We know of the
identity struggles and dilemmas of transgender persons. I suspect
certain transgenic creatures would also feel themselves displaced
or find themselves displaced, uncertain of what form of animal happiness
to pursue. Maybe mules are mulish for good reason. Maybe they
aren't happy about their betwixt and between lot in life.
The hybrid I know the most about is the wolf-dog hybrid, and from
what I know, I would say that one does the animal no favor by mixing
the wild and the domesticated.
So of the readings for this session, I very much appreciated the
Midgley (phonetic) article for its sensitivity to the species specific
character of animal flourishing and for its warning about the consequences
of a wanton disregard of that character. Feeding sheep's brains
to cows is as much a violation of species integrity as breeding
sheep to goats.
There is an ethics of animal husbandry which ought to be a part
By contrast, I found the Cohen article much too facile in its
dismissal of the species argument. The authors want to take human
dignity seriously, but I don't see how you can make an argument
about human dignity without some fundamental understanding of what
it is to be a human being and what it is to be some other kind of
Nonetheless, I think I agree with the policy position laid out
in the Cohen article. I don't like the geep because it confounds
two creatures that make perfect sense in their own right, but as
far as I can figure out right now, I don't object to the creation
of human/non-human chimeras in neural stem cell research so long
as adult human stem cells are used.
The reason I don't object is that they aren't, strictly
speaking, chimeras. They are pseudo chimeras or, more accurately,
they're chimeras at the cellular level, but not at the level
of function or temperament.
According to the Kennedy Institute paper, and I am trusting here
that its authors are correct, the mixing that is being done so far,
introducing small numbers of dissociated human stem cells into non-human
animals or embryos, has not resulted in the emergence of altered
human-like features or functions in the non-human.
And interestingly, the reason why the new material has not produced
a new compound creature seems to be that species are to a certain
extent at least fairly impervious to tampering. Monsters aren't
so easy to create.
According to the paper, the overall architecture of the host animal's
brain would not be affected by the presence of these cells. It
did make me wonder how informative these experiments are if, quote,
the non-human host governs the way that these cells function, end
quote, and because of things like host mediated recruitment, the
human cells become, quote, the practical equivalent of mouse or
monkey cells, end quote.
And it seemed to me that the authors admit the limitations of
these experiments when they say that the human stem cell chimeras
are not so much a test of human neural characteristic development
as a proof of principle that human cells can contribute to a non-human
So transplanting human neural stem cells into a mouse no more
transforms the mouse than transplanting a pig heart valve into a
person transforms the person. All of the rules that the authors
recommend seems to me sensible, and although they don't acknowledge
it, those rules are based on preserving species integrity. Transfer
the smallest number of cells necessary; use dissociated human stem
cells rather than larger tissue transplants; and select host animals
carefully, preferring distant relations over our nearer primate
The Council has already spoken out forcefully in opposition to
any attempt to create a true human-animal chimera, like a humanzee.
It might be worth remembering that the Minotaur, that murderous
half man/half bull, was the offspring of Pasiphaë, the Queen
of Crete, and a beautiful bull. In other words, the Minotaur was
the monstrous issue of an act of bestiality.
In calling for a prohibition on the production of a hybrid human-animal
embryo by fertilization of human egg by animal sperm or of animal
egg by human sperm, the Council was simply calling for a ban on
high tech bestiality. One hopes that is one tabu still intact.
I do have a question. I had hoped that Mike Gazzaniga would be
here, but there may be other scientists present who can answer it.
In the Council's earlier discussion, Mike suggested that one
should view the mouse as simply a big, interesting, and better tissue
culture system, but if I understand the Cohen article correctly,
it sounds that this medium is an unusual medium in that it is not
neutral. The animal host is said to govern or rule the interaction
and to rule in its own favor, co-opting the human cells.
My question is: is that a help or a hindrance to learning what
we want to learn about human neurons?
And if it's a hindrance, will there be pressure to relax the
kinds of regulations recommended by Cohen so that the operation
of the human cells is given larger scope within the animal most.
In other words, would these regulations and limitations that they
recommend be readily accepted and observed or not?
CHAIRMAN KASS: Thank you very much.
Are there people who want immediately to put questions either
of clarification or comment on Diana's or shall we have Alfonso's
presentation and then proceed?
It looks to be the latter. Alfonso, please.
DR. GÓMEZ-LOBO: Thank you.
I guess there will be considerable overlap with what Diana has
presented, but my exposition is geared more towards the second question,
the aim to articulate reasonable boundaries, and this is just a
first attempt at it.
In thinking about ethical perplexities involving human-animal
chimeras, it is useful, I think, to start with the distinction between
two symmetrical cases: (a) the transplantation of animal stem cells
into human embryos and (b) the introduction of human cells into
animal embryos, and I'm leaving aside those other cases that
we have commented on right now.
The ethical concern about modifying a human embryo by inserting
into its cells from another species falls within the domain of the
ethics of embryo experimentation. It is one more experimental procedure
that must be judged in accordance with the principles that should
govern what is done to human embryos.
What principles apply will depend, of course, on the ontology
of human embryonic life, that is, on what a human embryo is taken
to be, and here, of course, the waters part. We know of three positions
here on the Council.
One, anyone who holds that an embryo is a kind of being that does
not deserve respect will be inclined to hold that to produce a chimera
presents on special difficulty, providing that such an embryo not
be implanted nor be allowed to develop to later stages of fetal
Then there's number two. For those who admit that a human
embryo is a human organism at an early stage of her life and hence
that she deserves respect, the introduction of foreign cells for
experimental purposes represents a serious violation of ethical
norms, in my view. It is analogous, again, to battery, to the violation
of the physical integrity of a person without her consent.
And number three, for those who hold the intermediate status of
human embryos and the thesis of special respect, I honestly do not
know what follows because of the indeterminacy of the position.
I suspect that many upholders of this position will give in to utilitarian
pressure and admit that this form of xenotransplantation may be
done for good reasons. Acceptable reasons will surely include some
reference to expected therapeutic results for a large number of
In the alternatives, just examined, what I had in mind were instances
in which the human embryo would remain basically what it is and
would receive dissociated animal cells that would be incorporated
into a human life. The resulting organism would still be human,
though modified to a lesser or greater degree.
I find this morally troubling because I think that human embryos
deserve respect. In other words, as you know, I uphold position
two above; and that an invasion of the body of this sort is, indeed,
a violation of respect.
But more troubling is the possibility of introducing undissociated
animal stem cells that replace the inner cell mass of the human
embryo so that they take over the whole organism, and Diana addressed
this. This would amount to a loss of identity, a loss of identity
of the host organism. That organism would cease to be human and
become animal, an animal of the kind to which the donor of the cells
It seems to me that intentionally transforming a human being into
an animal in this way would be an extreme instance of reducing humanity
to a mere thing that can be obliterated at will. Indeed, it seems
to me that this would violate even the weakest form of the special
Now, I move to Case B. The ethical considerations for the second
case, that is, transplanting human cells into animal hosts, do not
follow so neatly from the diversity of opinion concerning early
human life, and the reason for this is that the key moral features
of the action do not depend on the host organism, but on the manner
and type of transplantation of the human cells.
Let me start with the most extreme and highly unlikely case.
Suppose human neurological stem cells are transplanted into a primate
so that the animal acquired some key human features. It seems to
me that this would be morally troublesome in spite of the often
heard argument that there's nothing wrong with enhancing the
capabilities of an animal.
In my opinion, this procedure should be viewed the other way around.
It is not that an animal is thereby enhanced, but rather that what
is essentially human is really debased. It is closer to the production
of a human being in the wrong body.
And I often imagine what it would be like to wake up one day only
to realize that I have the body of a chimpanzee. Luckily, we're
told that this is virtually impossible because the human body as
we know it seems to be absolutely necessary for the development
of the human mind, and I'm thinking about size of the brain,
the cranial space, et cetera.
The insertion of human cells in a host animal does not produce
specifically human capabilities, but works in the manner of a genetic
magnification. If by xenotransplantation pigs are made to have
human blood flowing through their arteries and veins, I do not see
an equivalent moral problem.
If such chimeras are generated not arbitrarily, but with a clear
goal of benefitting human beings, for instance, by providing a source
of blood transfusions, they would be one more instance of putting
animals at the service of mankind.
Our dominion over animals, however, is not without moral boundaries.
If our stewardship of nature becomes a form of tyranny, we'll
not only be turning against our own humanity. We'll probably
risk initiating partial ecological disasters as well.
Even if there's uncertainty about the notion and status of
biological species — I'm making a little concession to the
Cohen paper here — even if one grants that, it seems reasonable
to respect species as they are, as we know them, because we know
too well that there are myriads of checks and balances in living
organisms that we do not quite understand. Upsetting those balances
often brings about undesirable consequences.
The generation of Chimeric animals by transplantation into them
of human cellular material with the aim of putting some of their
tissues and organs at the service of human health then seems to
me to be in principle morally correct. This includes the use in
research that should precede the therapeutic applications.
However, again, we also have a moral obligation to be cautious
and to bound ourselves to certain limits. Among them I would mention
the following. For instance, I think that the number of Chimeric
animals to be generated should be as few as possible, as few as
possible and, secondly, should be kept under strict surveillance
and, third, they should not be released into the environment.
Moreover, they should not be subject to avoidable pain. Their
use in experiments should be carefully scrutinized to determine
whether there might not be alternative research avenues, et cetera.
In other words, many of these boundaries would overlap with standard
principles for use of animals in research.
Mixing of animals from different species, on the other hand, with
no specific human good in sight, such as, for example, the production
of the geep, seems to me, as far as I'm informed, seems to me
arbitrary and really morally unjustifiable.
Maiming or deforming animals just to show that we can do it seems
to me deeply disturbing. It is simply an exercise in arrogance
and lack of respect for other living beings.
In sum, it seems to me that any Chimeric mixing in which human
organisms are made partly animal while retaining human identity
or are transformed into animals, losing their identity is objectionable.
The same holds, I submit for animal chimeras that run the risk
of acquiring human capabilities. On the other hand, the generation
of animals with tissues and organs that through early transplantation
of adult human stem cells makes them of service for human cures
seem to me to be acceptable.
Finally, the Chimeric mutilation of animals when no human good
is in sight can hardly be justified in my opinion.
CHAIRMAN KASS: thank you very much.
Let me just open the floor for comments on either of the presentations
or an elaboration of some of the arguments.
Robby and then Frank.
PROF. GEORGE: I want to begin by thanking both of our colleagues
for those splendid presentations. Very informative and thoughtful.
I have a question that I think is mainly for Diana, though I'd
be very happy to hear Alfonso's response or any reflections
that it generates in Alfonso, from Alfonso as well.
It's this, Diana. It goes to the question of species integrity
as a moral concern or principle. There is a conception of morality,
one that I happen to share, which is broadly speaking humanistic.
Under that conception, what moral norms do is specify the integral
directiveness of principles that, in turn, direct our action toward
things that are intrinsically worthwhile for human beings and away
from whatever is a contradiction or violation or whatever damages
things that are basic forms of human flourishing because they're
intrinsically good for us as humans.
Now, Alfonso, when he gets to the point in the analysis where
he's talking about species mixing in geeps and so forth, resolves
it in a way that does not go beyond that humanistic conception of
ethics. At the end of the day, the points that Alfonso adduces
against the mixing, where he thinks there are problems with the
mixing, have to do with the violation of human goods.
But I think you were different. I think your analysis is one
which holds before us the possibility that precisely something beyond
the humanistic concern is at stake here, is that species integrity
is itself the stuff at least of a moral principle, if not a moral
principle itself, because it gives us a reason for action or a restraint
quite independently of the impact on the human good; that there's
just something about species mixing itself that is troubling even
if moral goods are not at stake there.
I'm not suggesting at all that that's idiosyncratic.
I mean, there's a strong tradition that's contrary to my
own that says that the humanistic principle isn't the uniquely
correct touchstone of ethics.
But I wonder if you could say a word about why you would embrace
that, what argument you would give for treating species integrity,
if I've read you correctly, for treating species integrity quit
apart from any impact on human goods as providing something that
will morally constrain our actions.
DR. SCHAUB: Yeah, I don't know that I can give you an argument.
I mean, I think you're right that I am making a slightly different
argument than Alfonso. I think there's such a thing as animal
happiness and particular modes of animal flourishing, and that we
should come to understand and respect those modes.
PROF. GEORGE: For our sake or for theirs?
DR. SCHAUB: For both probably.
PROF. GEORGE: Is it because there's a sense in which our
fate is bound up with theirs? Do we have some kind of solidarity
or communion with them that is at least analogous to that which
we have with each other, which provides the foundation?
Dan Callaghan and I were getting into this a little bit yesterday,
the foundation for principles of justice and charity that govern
DR. SCHAUB: Yeah, I mean, I suppose if you began from a kind
of stewardship argument. I mean, that's why I mentioned about
animal husbandry being part of bioethics. That would be beginning
from what our responsibilities are toward the rest of creation.
PROF. GEORGE: I wonder if Alfonso would have a word on this.
DR. GÓMEZ-LOBO: Well, as my argument showed, I share your basic
humanistic approach, although I'm willing to argue that a case
can be made for the entirety of nature in terms of something, for
instance, like the internal tuteology (phonetic) that makes it questionable
that we should, for instance, mutilate animals in a way that they
would not acquire their usual flourishing.
But in this discussion, I prefer to keep it within these boundaries
and the reason is this: is that many people who have completely
divergent positions in ethics would totally reject that view. Many
people view nature simply as a big repository of genes or whatever,
where you can do whatever you want.
So I prefer to — but those people would accept, say, liberal
principles of respect for persons, and that's where I would
like to meet the challenge.
CHAIRMAN KASS: Frank.
PROF. FUKUYAMA: I would just like to say on that last question
if you're going to defend species integrity, then you're
going to have to take on the whole agro-biotech industry because
they're already doing things like inserting jellyfish genes
into corn plants and so forth, but that wasn't the main point
I wanted to make.
It does seem to me — I appreciated the two presentations — it
does seem to me that it's really not possible to take on this
issue systematically unless we revisit a question that we never
really came to closure on in the first term of the Council, which
was the whole question of what we mean by human dignity, and that,
of course, is a criticism that was made, you know, of various reports
that the Council issued without really defining, you know, what
the term meant.
And it's important in this respect, because, you know, that's
what's under threat by mixing human and animal, and there are
several things that can be said to it.
It is historically and culturally, I think, a byproduct of Western
Christian civilization. I mean, that's the historical origin
of the concept of dignity. If you look at most Eastern religions,
that boundary simply does not exist, the boundary between this bright
line between human and non-human, and it has a lot of interesting
ethical implications for how they think about human rights and also
the rights of non-human nature, but that's a separate discussion.
And what I think that we really need to have is a discussion about
what we mean by human dignity, and particularly those of us that
do not want to root it, you know, in Christian doctrine. I believe
that it is possible, you know, to retain a concept of human dignity.
In my mind, a non-religious version of this would be that human
dignity is in some sense an emergent property of higher creatures,
the highest of whom is a human being that cannot be explained in
terms of, you know, any kind of reductive reference to the biological
substrate, you know, that produces the animal.
So simply understanding, you know, the biology of the human brain
does not explain the origins of human consciousness, and I think
that then if you define human dignity in those sorts of terms, it
gives you some moral guidance because it could entirely be the case
that neurons, whether animal or human, are simply wires. You know,
that's all they are. They're just wires, and so if you
had a human brain built out of mouse neurons but organized as a
human brain, that you would get the same emergent properties of
consciousness and, you know, human emotion and experience.
We simply empirically don't know whether that's the case
or not, but it seems to me that's quite possible, and if you
define human dignity in those terms, then you know, you would actually
have no objection to a medical procedure that tried to use, let's
say, mouse stem cells to produce, you know, damaged human neurons
to replace, you know, some neurological disorder.
On the other hand, it may turn out that, you know, the material
substrate affects the emergent properties in ways we simply do not
understand, and so that's an area that, you know, we'll
just have to await further research.
But as I said, I really don't think that unless we come to
some kind of a further discussion of what it is, what we mean by
human dignity that we're trying to protect in these discussions,
that you can have any kind of systematic approach to this whole
question of mixing human and animal.
CHAIRMAN KASS: Let me just see if I can get another couple of
sentences from you. The paper that was distributed from the soon
to be published Kennedy Institute of Ethics journal, and our thanks
to the authors for permission to circulate this prior to publication.
They, in fact, do try to articulate something of what's to
be meant by human dignity, giving it a somewhat functional definition.
Most of the functions connected with things of the intellect and
consciousness and the like, and tend to short circuit or at least
to put down things that would be matters of species.
I think Diana alluded to that in her comment, however pointing
out at a certain point that — let me see if I can find the page
— it's very doubtful that a human brain could be developed
outside of the human body, which suggests that the human body is
not simply a contemptible vessel in which a human brain and, therefore,
personhood resides, but that something like the totality of the
human being given not in terms simply of these functions that especially
brainy people seem to elevate above all other things would be the
measure of human dignity.
So are you committed when you introduce that? I mean is your
intuition that we need an account in terms of the distinctive functions
that are somehow dignified, or would you go with Diana who seemed
to be suggesting that there is a kind of species being in which
the human body and the possibility of the embrace, as well as the
ability to write the B Minor Mass counts.
PROF. FUKUYAMA: Well, my instinct is always to assume that these
things are much more complicated than we ever imagine, and so any
simple functional list I am sure, you know, those functions will
actually depend on all sorts of things that we simply do not really
comprehend, including, you know, many aspects of the body that
may not seem immediately relevant.
So, yes, so I think that there probably is a certain thing like
species integrity, although, you know, species do evolve and you
can imagine the same kinds of functions being maintained under very
different kinds of somatic characteristics, and so I think you have
to be open to that also.
CHAIRMAN KASS: Thank you.
I have Jim and then Gil and Ben and then Peter.
PROF. WILSON: I think Frank is right that we have to come to
grips with the concept of human dignity. The animal world is filled
with if not geeps, then deliberately arranged mergers. Horses and
donkeys produce mules, and mules are very different from both horses
and donkeys. If you have ridden them, you know, what the differences
In zoos we have ligers and tions, and I'm not aware that an
important moral principle has been violated by these combinations,
though the one that occurs in nature, the production of mules, is
different from what occurs in zoos since what occurs in zoos would
not occur in nature, as Hertz Meyers pointed out.
In this paper they talk about humanity from a Kantian perspective.
That is to say they are moral agents whose actions can be imputed
to them. People, human beings have the ability to act on principles,
not simply on instincts, impressions, social pressures or the like.
And I think that's a very good place, and it is hardly a functional
argument. It is a profound argument to begin. There are, of course,
other religious arguments that one could make.
What I find troubling about the paper from the Kennedy Institute
is that when it tries to defend human dignity, however defined,
the definition I prefer or one that one of you prefer, it tends
to fall apart.
For example, on page 23, it says we can at least envision that
some investigators might attempt to transplant a whole adult human
brain into a non-human animal in order to study certain important
But then on page 30 it says the rule for Chimeric experiments
should be to limit to the smallest number necessary the number of
human brain cells that are required to reach a reliable scientific
Now, if they reject the idea of putting a human brain in a non-human
animal, it seems to me they have already rejected the principle
they state as the conclusion of their argument. So that though
I agree with their that human agency and human dignity are the crucial
principle, I don't think this paper does a very good job of
CHAIRMAN KASS: Thank you.
Gil and then Ben and then Peter.
PROF. MEILAENDER: Well, I originally got on the list to say something
about the exchange between Robby and Diana, and I still want to
say a word about that, though first may be just a word about Frank's
However one ends up characterizing human dignity, as emergent
property or whatever, one does with it, I think it's going to
be important to keep in mind that there I'll just say may be
— I think is — a significant distinction between whatever
the distinguishing characteristics or capacities are that constitute
this property of dignity which we ascribe to human beings, to the
species. There's a distinction between those characteristic
capacities and the criteria for membership in the species which
is so dignified.
That's going to be a crucial distinction because otherwise
a large number of members of the species will lack the quality of
human dignity. So, I mean, if we're going to sort that notion
out, that's an important distinction to keep in mind from the
Now, of course, everything is arguable, but it would be an important
issue to keep in mind.
Now, just a word on the Robby-Diana exchange because my own intuition
is that actually it may not be sufficient to just count on the dignity
language to handle the chimera problem, and we may need to get at
the other kinds of arguments that the paper that we had took up
only to dismiss, although I thought not always very persuasively.
In terms of your humanistic approach, as you called it, Robby,
the animals are the other animals. They're not just the animals.
They're the other animals because whatever else we are, we clearly
are animals as well.
And maybe you're going to think this is just a round about
way of bringing some human good in finally, but one might argue
that it is in some way degrading for the human animal to fail to
appreciate the bios, you know, the biological life of those other
And it's not that there's any particular human good that's
at stake there so much as it is imply that we don't act in a
way fully in accord with the fullness of our own nature, which is
animal as well.
I don't know. You know, I don't have that argument all
sorted out yet, and there would be more to say about it, but that's
the route I'd want to try to take if I were going to try to
tie into the suggestions Diana made. It seems to me that there's
something there worth trying to develop more fully, though I may
not be able to do it that well right now.
CHAIRMAN KASS: Ben Carson.
DR. CARSON: Well, first of all, as a brain surgeon, let me say
we don't have to worry about transplanting human brains into
other animals because we're already dealing with billions and
billions of neurons and hundreds of billions of interconnections,
and it's not going to happen.
Now, you know, in terms of, you know, the integrity of the different
species and why we should have respect for them, I think we have
to look at environmental factors. You know, when you look at environmental
stability, obviously it has a great deal to do with how the various
species interact, and when we begin to tamper with them, we'd
better know what we're doing in terms of what's going to
happen subsequently downstream.
I think in terms of let's say we got rid of all the snakes
because we all hate snakes. Well, we'd be overrun by rodents,
and that's just, you know, one small example of that. So we
obviously need to be extremely cognizant of what happens when we
interfere with natural environmental factors.
Now, is there, in fact, something different about human species
versus animals? And I guess some of that depends on where you think
humans came from. Obviously if we evolved as a matter of some promiscuous
biochemicals from a slime pit a long time ago and just gradually
changed until we reached the stage where we are, then perhaps there
is not a great deal of difference between a human species and other
If there is more to us than just our physical being and our mental
being, if in fact there is a spiritual being as well, which in fact
does allow us to compose the B Minor Mass and do a number of other
things, then maybe that is the thing that distinguishes us.
Why is it that if we're dealing strictly with physical beings
like animals, why is it that a human being going through a forest
seeing another human being that they don't know drowning will
jump into that river and try to save that person? That would make
no sense from a natural selection point of view.
So is there something different about us and other animals? And
I'm not sure that you can totally divorce that from a religious
or spiritual aspect.
CHAIRMAN KASS: Someone want to join this directly? Peter, please.
DR. LAWLER: First let me say something about animal happiness,
which to my shame I had never thought about before. Pardon?
Plant happiness which I'm not going to think about even now.
DR. LAWLER: I think Diana is onto something here, although it
is of no public policy consequence whatsoever. There are animals
which are dependent on us psychologically, like dogs. The happiness
of the dog is obviously arguably not purely physical, and we do
some moral violence to our nature and the nature of dogs when we
treat dogs as something other than dogs. If we treat dogs as less
than dogs, that is being torture and utterly slave to our whims,
and we do some violence to dogs when we treat dogs as more than
dogs, if we treat them too anthropomorphically, if we have pet cemeteries
and all of this.
So we are in a certain respect responsible for dog happiness.
We do a certain violence to our nature, although I'm not endorsing
a law that would punish people who somehow did violence to their
natures by sinning against dog happiness, but I think she's
right in some way.
But with respect to human beings, what Ben was just talking about,
the point that has been made and needs to be made again is we have
no idea what a human brain would be like apart from a human body.
It's unthinkable. The human brain and the human body are an
undifferentiated whole, and it's the whole, right? The brain
and body that make possible what is distinctive about human beings
and what arguably has dignity because, in fact, at the end of the
day, being human is an all or nothing affair. We can't imagine
what it would be to be semi-human.
Human beings are the beings with language, who are as a result
open to the truth about all things. Either you're human in
a certain way or you're not.
And so from this point of view, the difference between a human
being an a dolphin is infinitely greater than the difference between
a dolphin and an ant. And so we know what it means to be human,
a being with language and so all of the characteristics Ben was
talking about. This is observable. It doesn't require really
just faith really.
So if a human being had an animal body and nonetheless was a being
with language open to the truth about all things, then that being
would, in fact, be human. It wouldn't be a human giraffe or
whatever or some combination word, but it would be a human being.
And so the idea of designing a being that's partly human and
partly not is not really given to us. That designer point of view
implies that you're not an animal at all, that you're standing
outside natural life as Midgley points out, and so it's beyond
our imagination even to conceive what the function of this designer
being would be.
But if we could do it, here's something that we would know.
the thing that we would create would be the most dangerous thing
we could do to the environment imaginable because the truth of the
matter is if it weren't for human beings, there would be no
ecological crisis. Nature would be fine. If we were to disappear,
we're the beings that can do war against nature or the technological
beings, we're the beings who could kill for no good reason, dot,
dot, dot, and so we have all of these adverse qualities which we
have to try hard to keep under control.
Imagine what a being would be like that had a being with language
and a body that was not fit for that. Imagine the discontent of
this being. Imagine the perversity of this being. This being would
wreck havoc on nature. This would be the ultimate ecological catastrophe.
So we shouldn't do this, but fortunately, as Ben points out,
we can't do this.
CHAIRMAN KASS: I want to shift the gears slightly. The conversation
has been sort of up here at a very high, talking about mixing organisms
that would run around and also talking about, I think quite rightly,
to try to give some sense of what are the principles or the grounds
of the disquiet and the importance of trying to articulate some
notion of human dignity or the species integrity or their relation.
But I'd like to spend the rest of the time on the concrete
activities on which the science is now proposing to proceed, which
is not to produce things that run around, but is to use the possibility
of creating certain kinds of Chimeric organisms at early stage of
development for the purpose of understanding certain things about
development or transplanting, say, human cells into the developing
brains of mice to learn something about — and then you can fill
I mean, this is, I think, where the practical subject is, and
I don't know, Janet, whether it's appropriate to ask you
for comment on this since I know that the academy has had testimony
on sort of chimeras in relation to stem cell research.
Could you say something about how you as a scientist, and not
necessarily speaking on behalf of that committee, but how you would
begin to think about this question of limitations between what would
be perfectly appropriate, what becomes worrisome, and where the
boundaries would be in this kind of research?
DR. ROWLEY: Well, I'm hesitant to say too much. As Leon
has indicated, and this is not secret, the National Academy of Sciences
currently has a group that is preparing guidelines for the conduct
of human embryonic stem cell research. These, of course, would
be strictly voluntary, but it is hoped that if there were a thoughtful
set of guidelines available for people who are embarking on this
research, it might help to both set the bases for individual institutions
setting their own guidelines, and if the guidelines were acceptable
to institutions, they could be accepted as a whole.
The issue of chimeras has been discussed. It is clearly, along
with SCNT, one of the very thorny issues as to what should and shouldn't
be allowed. I think it's recognized by all members of the workshop
that this is an area that science has to proceed very cautiously
because some of these procedures are going to raise substantial
concerns in the broader community in which we live.
We realize that the greatest areas of concern — and that clearly
is reflected in the paper from Cynthia Cohen and her colleagues,
is the area of the brain and mixing human and animal neurons and
also any experiments that would allow human gametes to be produced
by or mingled with gametes of animals.
So those are really the two most serious concerns, and the provision
is made that any experiments that would be proposed in these areas
would be reviewed very, very carefully by committees at the institution,
and actually it's proposed that there be a special committee
that would be developed at individual institutions, particularly
those having a very active program in human embryonic stem cells,
such that this would be a committee composed of individuals who
were knowledgeable in the area, as well as ethicists and the public.
So the point is that individual research in this area is going
to be scrutinized from the standpoint of is it necessary. Are we
going to learn something important? Is there another way to do
it that would not involve the use of human embryonic stem cells
or stem cells differentiated down the neuronal pathway, and that
slow is better in this particular regard, at least as regards to
research that involves either neurons or the potential for gamete
CHAIRMAN KASS: Not to press too much further on this, and it
may be premature to day more, but you've identified certain
areas of greater caution, neuronal and things having to do with
gametes. You set, therefore, a certain higher bar of scientific
necessity before one considers these matters.
But then with respect to the ethical judgments, these are then
to be left to the individual IRBs to sort through, or are there
certain kinds of provisional, for the time being guidelines that
one would say — because, I mean, Cynthia Cohen's paper, it's
also partly — you know, it should be more of this. I don't
have the — it's a similar kind of quantitative rather than
qualitative kinds of boundaries, leaving room for judgment as to
what is too much and the like.
Is that the general spirit of the inquiry?
DR. ROWLEY: I think that's the general spirit right now,
in part because we are so ignorant, and there is the balance between
in a rapidly moving field that is changing so constantly. To be
very precise means either that you allow things that you ought not
to or you prevent things that would turn out to have some merit.
So at this stage at least it is left to each individual IRB to
consider and try to come to the best judgment that that particular
group comes to. You are absolutely correct, and we say this specifically
in the report, at least in its current state. It's still under
review and will be modified, but the report does say we're setting
a much higher bar than is normally set for research by a standard
So that's stated explicitly early on in the report, and I
think that to some extent it's going to be quantitative. All
of us are aware of the concern that we're going to have a human
brain in a mouse with a person saying, "Let me out."
And that clearly is not a state that we want to get into.
At the same time, there are individuals who feel that we could
learn a great deal by having human neurons within the brains of
experimental animals, and these would depend on the different experiments,
in trying to see how those neurons may function or may respond to
certain drugs, to certain hormones, to certain growth factors.
What would normal cells do in the brain of a mouse that has amyloid
deposits? Might it change the level, the position, et cetera?
So there are experiments that do have to take place in living
tissue, distinct from at least some of the papers here saying that
everything can be done in vitro. That's absolutely not
the case. You really have to have the interaction of living cells
in the environment because there is so much that we don't understand
about the communication between cells, which is extraordinarily
important in governing the behavior of those cells.
They respond to signals outside,a nd most of those signals are
unknown to us at the present time. So they think this is a balance,
and I think we've tried in our considerations to recognize the
concerns and to try to set fairly conservative limits at least in
the beginning on how we think this research should proceed.
CHAIRMAN KASS: Gil.
PROF. MEILAENDER: Yes, just a question of clarification on this.
In the paper from Cohen and the others, the three guidelines that
CHAIRMAN KASS: Page 30.
PROF. MEILAENDER: On page 30. The third of them is about dissociated
stem cells having to be used, and this may just be ignorance on
my part, but would you characterize that as a quantitative rather
than a qualitative guideline?
I would have thought that that was — whatever exactly those terms
mean, that was closer to a qualitative than a quantitative guideline,
unlike, say, the Guideline No. 1 about limiting the number of cells
to the smallest number, but maybe I'm just misunderstanding
CHAIRMAN KASS: No, I take your point. Yeah, I think that is,
if I understand it, as written, that looks to be different. It
seems to say that for the time being one should not use anything
other than the introduction of dissociated separate cells rather
than integrated tissues, not that the transfer integrated tissues
is necessarily going to integrate into the new host, which is a
point that Ben, I think, has already made powerfully.
PROF. MEILAENDER: Right, but it would be a little stronger, these
guidelines, what everyone thinks of the whole argument and so forth,
is a little stronger than just recommending some quantitative restrictions.
That was just what I was trying to get clear on.
CHAIRMAN KASS: There was a hand. Bill.
DR. HURLBUT: I want to underscore what Janet has said about this
scientific significance offered by these possibilities. I think
that we should take that very seriously and recognize it because
of the conservation of biology across phylogeny. You get useful
systems that can be in some ways compared or studied with parts
of human capacities, even partial trajectories of human development
in animal models could teach us a great deal without in any way
violating the integrity of human moral standing that we would want
to assign to a natural human being.
But I would also like to add another element of caution. Janet
has, I think, rightly identified the danger implicit in early mixing
of ES cells, and can develop very much into human characteristics.
I think we also have to be attentive to this concern with regard
to later what I sometimes call the architectural changes. It is
possible using certain technologies to transplant whole modules
of developing portions of the embryo from one species to another.
This has been done by Le Dourian and Balabon, where they actually
transplanted a portion of the developing brain, early neurologic
system at that stage, and got the crowing capacities of a quail
put into a chick.
And so he actually transplanted a unit of behavior. Just to draw
that a little farther, I think we should also be careful to not
do that with elements of human form. In other words, it isn't
just a matter of cognition that we're concerned about. The
categories of our world, the conceptual categories that organize
our world provide an intelligible world to us. These are not to
be taken lightly.
The way we understand our world is by the separations within the
world. For very serious purposes we might mix those, but I think
we should be careful not just to see that as a matter of inner psychological
or cognitive functions, but we need to preserve the human form,
the dignity of the human form.
So I would say as at least an additional principle that we've
been discussing, that later stage transplantation of human embryonic
stem cell derived tissues, cells or organs, or any other way of
deriving these things would be allowable until they manifest evocation
of defining human dimensions of function or form also. No unique
human neurological capacities, but also no human faces, larynx,
hands, or genitals, no characteristic body plans, postures, gaits
should be produced by such a project.
Now, in order to prove something is too human-like even if we
didn't assign it full human moral meaning, and certainly we
don't want any of those kinds of elements of animals placed
onto the human form either, no tails or antlers, for example.
I say that jokingly, because we wouldn't do it, but we need
to take seriously the notions of where our natural boundaries sustain
our understandable world, our intelligible world.
So it isn't just a matter of function. It also involves a
matter of preserving human dignity by preserving the uniqueness
of human form.
CHAIRMAN KASS: Diana.
DR. SCHAUB: Yes, can I ask Bill a question about that?
CHAIRMAN KASS: Yes.
DR. SCHAUB: I thought that some of that had already been
done. I thought I read something about, you know, a human ear on
the back of a mouse, and I also wondered what it would mean for
these possibilities that were distributed yesterday about growing
human kidneys within animals and then being able to transplant them.
I mean, what counts as form? Is the form the human kidney or
the respect in the way that the — if one of our ears is worthy
DR. HURLBUT: You know, that's a terrific question. This
morning earlier when we were talking about altered nuclear transfer,
I was thinking about how we're uncomfortable with anything that's
growing and seems to be alive. Is it a being?
I personally feel a certain queasiness about factories growing
kidneys, but nonetheless, I would think that it has such a good
possibility if we could do it, I think we probably ought to.
But growing human organs inside of animals, if we could do it,
does not strike me as the same as growing human forms in animals.
I mean, if you had a sheep with a human face or an animal that had
human hands of a very identifiable sort, I think you'd be doing
something that would involve violence.
The mouse with a human ear, I think everybody kind of understood
they put a — isn't the way they did that, they put a form and
the tissue grew around it? It wasn't really a human ear exactly.
I agree there was a weirdness to it, but I'm talking about
something a little bit more serious than that, I think.
DR. SCHAUB: But why would the hand be different than the kidney?
DR. HURLBUT: Because the kidney does not evoke for us the natural
moral sentiments that preserve the intelligibility of our world.
It's a functional agent, an internal organ. I think our external
manifestations — let me extend this to robots, too.
I don't think we should produce robots that are so indistinguishable
from human beings that they confuse our categories. That I think
is actually a serious issue, and so it doesn't even have to
be biological. I think we have to preserve the meaning of the human
form. And that's largely a visual phenomena.
The very word "species" is related to the word "to
look" and the appearance of a thing. And I think we have to
take these species separations seriously.
CHAIRMAN KASS: Could I? I think we should wind up and
go to public session fairly soon, in fact, in a couple of minutes.
But I want to come back to these currently proposed developmental
studies rather than producing things that are sort of visible grotesque
and strange and raise those kinds of questions.
And I'm sorry Charles isn't here because Charles had a
kind of intuition about what it means to be creating what he there
called certain monsters or creating teratomas. And I suppose for
people who don't think an early embryo is much of anything —
and Alfonso's comment, I think, prepared the ground for this
— something which is not much of anything into which you incorporate
an animal cell doesn't seem to be grotesque or weird if you
sort of guarantee that you're not going to sort of face it grown
And similarly, since we probably rightly or wrongly care less
for mice than we do for ourselves, putting a few human stem cells
into a mouse blastocyst, especially if you think it's not going
anywhere, one could sort of say, "Well, that's not really
very much of anything either."
But leaving aside the vexed question of what really is the ontology
and moral standing of the earliest stages of life, whether human
or animal, and even allowing that this research could be beneficial,
are there no people here who have some sense that we're engaged
in something strange and weird, even going in the direction of a
few human cells into the animal?
Now, Janet in her comment says we have to proceed cautiously because
— and I listened pretty carefully — it was not necessarily because
the people proposing to do these experiments themselves had qualms,
but that the public at large wouldn't somehow understand this
or would be nervous about it.
We are not altogether immune from being members of the public
at large, and the question is: is there some kind of — leaving
aside the gross things that we've been talking about, but just
staying with this very it looks like modest research, I mean, do
people like Charles or Dan or Paul or Peter who have expressed some
kinds of disquiet over creating teratomas or teratoma-like things
which are not organisms had any kind of disquiet about creating
these kinds of mixed species? And is that disquiet articulable
in some way? And does it make any sense?
I think if we could have a minute or two on that, that I think
is the practical question that we face at the moment and worth some
Ben, do you want to say at least something?
DR. CARSON: Yeah, just briefly. I think it's very important
as a Council that we make sure that we distinguish between using
human or animal parts across species, such as, you know, insulin,
heart valves, things of that nature, and mixing the genetic material
that has, you know, proliferative capacity.
I mean, there's a huge difference between those two things.
We need to make sure that the public understands that we are distinguishing
between those two things.
CHAIRMAN KASS: Well, thank you.
And I think in our last report we were very clear about that,
and I think as the conversation proceeded, we should absolutely
be clear about that.
Gil, do you want to have a comment?
PROF. MEILAENDER: I was just going to say, I mean, I think what
gives one pause, even if it doesn't finally lead you to object
to say the sort of thing that this paper we read talks about, is
that the sense that we are on our way to thinking about the human
being as much a collection of interchangeable parts or species as
just collections of interchangeable parts.
Now, I realize that once you start to press that, you can ask
questions about organ transplantation and so forth, too. Here
we're thinking mainly about much lower levels of organization,
but it's sort of the unity and integrity of the human person
that's really the issue there.
Yeah, I mean, I think that it's the sense that having set
foot on that path, it's not clear where there would be an exit
ramp that is troubling in a way.
And that is actually why I asked the question about whether that
one guideline was qualitative. I mean, I'd be more interested
in qualitative than quantitative guidelines because that would suggest
that there was some ability still to make important distinctions.
CHAIRMAN KASS: Last comment. Alfonso and then we should stop.
DR. HURLBUT: I completely agree with that, Gil, but that's
why we have to do the hard moral work of defining what we're
trying to protect because otherwise we're going to close off
great human goods with scientific investigation.
You didn't say we would close it off, but it seems to me that
we need to figure out what is it. What combination of fundamental
moral principle and natural moral sentiments, those things which
we're trying to preserve, what analysis can help us define this?
That's why this whole arena with developmental biology requires
that somebody do that hard work of figuring out what is the locus
of human moral standing and human dignity. It's not a simple
matter. It's the challenge of our era.
CHAIRMAN KASS: But it seems to me Diana's paper was very,
very useful because she didn't simply want to allow us to rest
with the concern about the human, and that there is a certain posture
with respect to the natural world, and at least raised the question
beginning with the geep.
And I don't think — I mean, there are, in fact, people interested
in proposing legislation that might seek to stop the creation of
chimeras in which animal cells are added to human embryos rather
than the reverse. There are people worried about that.
But Diana at least has raised the question: what does it actually
mean to start down the road to producing these admittedly merely
embryonic hybrids? Is it sufficient that we know that that they're
not going to grow up to somehow make the moral question sort of
disappear, or is there a certain posture toward either species integrity
or what is somehow owed to the animals in our relation to them?
That may not be the moral question of greatest interest to Robby
or to Alfonso, but it is, I think, part of what's a concern
for, quote, unquote, creating monsters, meaning something simply
the crossing between two different kinds.
I don't want to sweep that particular question away.
Frank and then Alfonso and then we'll stop.
PROF. FUKUYAMA: I would just like to point out that we eat all
of these animals. So I'm not quite sure what interest of the
animals we're protecting by this.
CHAIRMAN KASS: I think that's one question that leaving aside
the alternative that rejects the eating of animals, there are respectful
and disrespectful ways to treat the creatures who we exploit, and
DR. SCHAUB: Yeah, this is not an example of a chimera, but I
think it says something to it. Yeah, we eat pork or some of us
eat pork, but pigs should not be raised in a way that they gain
weight at such a rate and to such an extent that they all become
lame, and apparently for a while in the industry that's what
was happening. You had just, you know, all of these lame animals.
So that, you know, pigs should enjoy a kind of pig happiness before
the point at which we slaughter and eat them.
PROF. MEILAENDER: I just wanted to remind Frank that we would
be remiss if we did not call to his attention that, you know, he
could read the Hungry Soul and think about these matters.
PROF. MEILAENDER: Or read some of the reviews of the Hungry
Soul that we produced back when the Hungry Soul was
CHAIRMAN KASS: Alfonso, the last word on this.
DR. GÓMEZ-LOBO: Yes. Just a question of conceptual clarification
or for any other reason for my own mind. I think that from what
I read about chimeras there's a sense in which there are no
real chimeras, that there is an incorporation of something coming
from a different species into the life of whatever organism that
In other words, the geep, strictly speaking, is a goat, is a goat.
Now, this may prove to be useful in trying to draw boundary lines,
and as Ben just said, for instance, just using pig valves clearly
does not threaten the identity of the host.
So the real question is here what kinds of mixers are such that
the identity of the host is being threatened.
But that brings us back, of course to the need to identify in
humans what is that core.
SESSION 7: PUBLIC COMMENT
CHAIRMAN KASS: Thank you very much.
I think that should be it for this particular session. We have
one person who has asked to speak in the session for public comment,
and I'd like to ask Council members if they can to simply remain
seated as we are now and invite Father Thomas Berg of the Westchester
Institute to offer his public comment.
Welcome, Father Berg.
FATHER BERG: Thank you very much, Dr. Kass.
The Council will be grateful that I have a plane to catch shortly
which will require me to be brief and to the point. So I'll
just read the statement that I've prepared.
I'm a Catholic priest and an ethicist, and I'm also the
Director of the Westchester Institute, an ethics think tank located
in Farmwood, New York, and which organizes scholarly forums twice
annually here in Washington.
In what I'm about to say, while I speak only for myself, I
would wager that my views are shared by not a few Catholic moralists.
It is safe to say that the Catholic community, by and large, would
follow with great openness and interest the development of new technologies
that would allow science to harness the therapeutic potential of
embryonic stem cells by non-embryo destructive means were that possible,
and by means that in no other way would be detrimental to the integrity
and dignity of the human embryo.
I think it is also evident from the deliberations of this Council
and from preliminary scholarly comments upon the proposals that
all proposals are deserving, to use the language in the current
draft of the white paper and I hope language to this effect would
remain in the document, that all proposals are deserving of careful
and serious consideration, further public discussion and, where
ethically appropriate, a vigorous scientific exploration.
As a Catholic moralist, I heartily welcome the invitation to further
this process of sustained moral scrutiny of each of the proposals,
and I cannot stress enough that we are only at the beginning of
that process, at least from my perspective.
As one step in that process, our institute has organized a private
gathering of ethicists and scientists, moral theologians and philosophers
at the end of April here in Washington to give particular attention
to Bill Hurlbut's proposal, altered nuclear transfer, and I
expect that in the context of that collegial dialogue there will
also be some discussion of the other proposals.
Our objective is to give the proposal a fair hearing and to sustain
the kind of interdisciplinary dialogue that will be necessary for
moralists, most of us non-scientists, to obtain the information
we need to begin and carry on a process of moral discernment with
regard to the licitness of ANT.
As a Catholic moralist, I need the proponents of ANT to provide
me with a body of scientific data which can constitute a basis of
information sufficient for me to arrive at moral certainty that
the entity created by ANT would not be a severely disabled embryo,
indeed, would not be an embryo at all, nor could have the potential
to become an embryo.
I am convinced that such scientific data can only be assembled
through the further exploration of this theory in animal models.
Obviously, we would never endorse at this point laboratory experiments
with ANT involving the use of altered human nuclei and ova.
Lacking such a body of scientific data, we are simply not in a
position at this moment to arrive at a definitive ethical judgment
on ANT. I believe that the majority of us are eager to get our
hands on that body of scientific information that will enable us
to move toward a moral judgment on ANT and to get that ensemble
of information in the fastest way possible.
Not only should we commence as soon as possible with the animal
experimentation phase of ANT. We should pursue federal funding
to do so.
Thank you very much.
CHAIRMAN KASS: Thank you very much.
PROF. GEORGE: Yes, just a quick point since Father Berg in his
presentation mentioned the therapeutic potential of embryonic or
embryonic type stem cells, and having in mind what you said, Leon,
when we were discussing this about the way a report could be misinterpreted
or things can be read into the report and read out of it, I just
wanted to say that I think it would be a bad thing if anyone in
reporting on our deliberations about this suggested that our willingness
or the willingness of people like myself to do everything we can
to try to find what we consider to be ethically sound sources of
pluripotent stem cells, it would be a mistake to suggest that that
means that we have come to accept what I believe is the hyping of
the therapeutic potential of such cells.
I believe that it remains speculative what the therapeutic potential
is. I certainly hope that there is great potential there. I'm
not convinced that there is, but nevertheless, I believe that we
should go forward in trying to find ways to obtain these cells and
permit the research to go forward without the destruction of embryos.
CHAIRMAN KASS: Thank you.
I think the point is well taken. I'm fairly sure that the
document as currently written is sober on that point.
PROF. GEORGE: Yes. The document is absolutely fine. I just
make the point because we can't always count on people who are
reporting on the document to read it as carefully as they should.
CHAIRMAN KASS: Well, one of the things one learns in this business
is you cannot control what other people make of what you've
done. The best you do is you put it as carefully as you can and
hope for the best, but we'll do our best.
Thank you all for your attendance. Thanks to members of the public.
The meeting is adjourned.
(Whereupon, at 11:57 a.m., the meeting in the
above-entitled matter was concluded.)