Friday, May 17, 2013

Bringing In The Clones

Humanity crossed an amazing threshold just this last week, but the world seems mostly to have yawned. But in terms of the history not only of science but also of human culture itself, it seems to me that it will eventually sound just as odd to say that we barely took note of the event to which I am referring as it would sound now to say that at the time we hardly realized that Neil Armstrong’s first step onto lunar soil constituted a very big step forward in the history of human accomplishments. I am referring to the successful use of cloning to create human stem cells that was announced by scientists earlier this week at the Oregon Health and Science University in Portland. You could easily have missed it, however.

We live in an age of blasé attitudes towards everything. Perhaps the pace of technological advances in the last several decades has simply dulled our ability to be impressed: when I attempted the other week to have a video conference call with colleagues in Israel, the U.K., France, and California all at once and the picture was briefly distorted slightly, I found it far more natural to be irritated that the program wasn’t working properly than to be amazed that such a thing exists in the first place and that this kind of technology is available for free to normal people such as myself for the mere effort of downloading the program and clicking the “install” button.  But this announcement in Oregon was far more than a simple threshold over which some team of scientists finally figured out how to step; it seems to me that this achievement constitutes a real game-changer in the history not only of science but of human culture itself. Or, at the very least, that it constitutes a huge challenge for a society that must now make regarding innovative procedures that have the capacity to change the way we think of, and define, human life.

The scientists in Oregon were attempting to help an eight-month-old baby born with a genetic disease. (To protect the patient’s privacy, neither the child’s name or gender, nor the specific disease from which the child is suffering, have been made public.)  That much—doctors attempting to help sick children recover from debilitating conditions or illnesses—happens a million times a day in every country of the world. But it was the specific way in which they chose to attempt to help that is of note here: the scientists were successful in using simple skin cells from the baby to create several embryos that were the precise genetic doubles of the baby.  Then, having created these several embryos, the doctors were able successfully to extract stem cells from them which they will now use to “cure” the baby of its gene-based illness. Not long ago, this would have sounded like science fiction of the most unlikely variety imaginable. And yet it happened just this last week in Portland.

The key principle is that embryonic stem cells have the amazing capacity to turn into any kind of cell within the human body. Healthy ones, therefore, can be used successfully to replace unhealthy, genetically-diseased cells and that in turn can cure people suffering from the diseases brought on by some specific kind of genetic imperfection in the first place.  Today, these kinds of curative stem cells are generally derived from embryos created in vitro in laboratories from two gametes in a process that is merely the mechanical version of the normal human reproductive process. But those embryos are not—and cannot be—the exact genetic match of anyone at all, just as all babies, because they are the genetic heirs of both their parents, can never be the precise genetic matches of either. And it is precisely because the chances for rejection are far greater when recipient and donor are not exactly matched that this week’s achievement in Oregon, in the context of which a human embryo was created from single parent, is so important. It apparently no longer takes two to tango.

This is not unlike the way Dolly, the world’s most famous sheep, was created in Edinburgh in 1997. Yet although Dolly was born healthy and grew to ovine adulthood, the Oregon team, led by Dr. Shoukhrat Mitalipov, are insisting that the embryos they created would not be implanted in a human womb and, far more to the point, could not develop into human babies even if they were implanted. They did not say why not, or at least no news source I could located quoting them as explaining other than with reference to similar experiments with monkey embryos, none of which traveled successfully through the stages of gestation to birth. Still, this is surely a step in that direction, albeit one in need of further tweaking actually to create human beings from a single gamete. If this is a road down which society does not wish to travel, then this would clearly be the moment—and perhaps the last one, at that—to get off the bus.

The responses to the Oregon announcement were so predictable they could almost have been scripted in advance. The loved ones of people the most likely to benefit from the Oregon announcement—people suffering from Parkinson’s disease, Alzheimer’s, spinal cord injury, and diabetes—were thrilled. People who place supreme emphasis on the sanctity of human life were less enthusiastic. The distinction between therapeutic cloning (i.e., cloning for the sake of helping cure sick people of their illnesses) and reproductive cloning (i.e. cloning that has as its point the creation of human life) was trumpeted by those eager to support the former without feeling concomitantly obliged to support the latter, while others—myself included—found the distinction between the two a bit blurry, especially if the specific issue addressed by therapeutic cloning has to do with a couple’s fertility issues and leads to the creation of an embryo that would then be implanted in the uterus of a woman who would then give birth to the baby and become its mother. When put that way, how different is the use of cloning to help infertile couples become parents from the use of in vitro fertilization techniques to accomplish exactly the same thing? In that context, at least in my opinion, the fact that the embryo that grows through gestation to become that couple’s child was created from material harvested from one rather than two parents seems more like a detail than a crucial factor in evaluating the procedure’s moral acceptability. So the child is the genetic match of one parent rather than the genetic amalgam of both. So what?

Sheep have been cloned. Monkeys also have been cloned, as have been goats, cattle, mice, horses, pigs, frogs,  carp, fruit flies, rabbits, camels, rats, wolves, and at least one water buffalo. It feels inevitable that, at least eventually, someone is going to figure out how to clone human beings. And it will be specifically at that juncture that society is going to have to decide how to proceed. In the United States, federal law has since 1996 prohibited stem cell research that leads to the destruction of embryos. (It was just this last January, however, that the Supreme Court decisively declined to hear a lawsuit intended to forbid the federal government from financing any stem cell research at all.) But although there are no federal laws that ban cloning completely, there are laws on the books in thirteen states that specifically outlaw reproductive cloning. The distinction, as noted above, is not as absolute as it at first might sound. But more to the point is that, in the end, genies escape from bottles and can rarely, if ever, be successfully forced back inside. Somewhat in the same way the world cannot unlearn how to create nuclear weapons although there are many who wish this were not the case, this kind of technology, once developed and proven to work, will not be unlearnable…and people desperate enough to reproduce will always find ways to access the kind of technology they need to become parents. If, that is, that technology is permitted to be developed and perfected.

Society has long since accepted the principle that there is nothing inherently wrong with providing assistance to couples who would once have had no choice but to remain childless. Still, the whole concept of cloning raises the possibility of misuse in a way that “regular” IVF technology doesn’t and, as a result, the real question is how real those possibilities actually are. Yes, it is true that bereaved parents could attempt to create precise genetic replacements for their lost sons and daughters. The relatives of murder victims could attempt to create babies bearing their lost relations’ exact genetic code. Societies could respond to genocide by creating, or rather re-creating, legions of their formerly lost citizens to live on in their stead. Totalitarian governments could create armies of genetically pre-programed workers possessed of precisely the skills needed to perform some specific job. Of course, none of these cloned individuals would be the people they replaced. They would carry the same genetic code, but neither their memories nor their experiences. They would not be the same people, although, somewhat like Dr. Evil and Mini-Me, they would probably look very much alike…assuming they lived similar lives in similar places, spent similar numbers of hours in the sun or at the gym, and weighed roughly the same number of pounds. But, other than cosmetically, they would simply be possessed of the same genetic potential as their former iterations absent any of the actual results that that potential yielded.  The real challenge facing society in light of this week’s breakthrough, therefore, is to decide how seriously to take any of the above possibilities…and how to weigh it against the right of individuals to reproduce as they wish and can, and of scientists and physicians to seek to cure disease by whatever means suggests itself as feasible.

We don’t say, after all, that deaf people have some sort of moral obligation not—in cases where it is possible—to have surgery to restore their hearing because God created deafness in the world and undoing that aspect of creation would be tantamount to thwarting God’s will. We certainly don’t follow that line of reasoning with respect to the blind or the lame. So why should an individual who simply hasn’t married or found a partner with whom to create life be forbidden by law from reproducing merely because, up until now, the reproductive process has been always a pas de deux and never a pas seul. Things change! In my opinion, the challenge facing society is not to embrace or reject the kind of cloning techniques that can lead to healing for some and, eventually, families for others, but to figure out how to move forward in a way that is consonant both with our ever-evolving moral values and with the rights of any individual in a free society to chart a course forward in life that corresponds to that specific person’s wishes and desires.

One thing is clearly the case: it’s a whole new world out there, and it’s getting newer with every passing year!

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