# [Chapter Five]{.underline}

#### **The Ethics of Cloning-to-Produce-Children**

Cloning-to-produce-children has been the subject of two major national
reports in recent years---first by the National Bioethics Advisory
Commission in June 1997,[^1] and more recently by the National Academy
of Sciences in January 2002.[^2] Both reports concluded that attempts to
clone a human being "at this time" would be unethical, owing to
questions about the safety of the technique and the likelihood of
physical harm to those involved. But both reports also concluded that
the nation required much deeper reflection about the "ethical and social
implications" of cloning-to-produce-children beyond the scientific and
medical aspects of the procedure. As the National Academy of Sciences
report stated:

> Our present opposition to human reproductive cloning is based on
> science and medicine, irrespective of broader considerations. The
> panel stresses, however, that a broad ethical debate must be
> encouraged so that the public can be prepared to make decisions if
> human reproductive cloning is some day considered medically safe for
> mothers and offspring.[^3]

In this chapter we attempt to take up this charge to engage in a broad
ethical consideration of the merits of cloning-to-produce-children.

The prospect of cloning-to-produce-children raises a host of moral
questions, among them the following: Could the first attempts to clone a
human child be made without violating accepted moral norms governing
experimentation on human subjects? What harms might be inflicted on the
cloned child as a consequence of having been made a clone? Is it
significant that the cloned child would inherit a genetic identity lived
in advance by another---and, in some cases, the genetic identity of the
cloned child's rearing parent? Is it significant that cloned children
would be the first human beings whose genetic identity was entirely
known and selected in advance? How might cloning-to-produce-children
affect relationships within the cloning families? More generally, how
might it affect the relationship between the generations? How might it
affect the way society comes to view children? What other prospects
would we be tacitly approving in advance by accepting this practice?
What important human goods might be enhanced or sacrificed were we to
permit cloning-to-produce-children?

In what follows, we shall explicitly consider many of these questions.
But as we do so, we shall not lose sight of the larger and fundamental
human contexts discussed in Chapter One---namely, the meaning of human
procreation and care of children, the means and ends of biotechnology,
and the relation between science and society. Indeed, overarching our
entire discussion of the *specific* ethical issues is our concern for
the human significance of procreation as a whole and our desire to
protect what is valuable in it from erosion and degradation---not just
from cloning but from other possible technological and nontechnological
dangers. Readers of this report are encouraged to consider the
discussion that follows in a similar light.

We will begin by formulating the best moral case for
cloning-to-produce-children---describing both the specific purposes it
might serve and the philosophic and moral arguments made in its favor.
From there we will move to the moral case against
cloning-to-produce-children. Beginning with the safety objections that
have dominated the debate thus far, we will show how these concerns
ultimately point beyond themselves toward broader ethical concerns.
Chief among these is how cloning-to-produce-children would challenge the
basic nature of human procreation and the meaning of having children. We
shall also consider cloning's effects on human identity, how it might
move procreation toward a form of manufacture or toward eugenics, and
how it could distort family relations and affect society as a whole.

\* \* \*

##### I. The Case for Cloning-to-Produce-Children

Arguments in defense of cloning-to-produce-children often address
questions of reproduction, but they tend to focus on only a relatively
narrow sliver of the goods and principles involved. This certainly does
not mean that such arguments lack merit. Indeed, some of the arguments
in favor of cloning-to-produce-children appeal to the deepest and most
meaningful of our society's shared values.

***A. Purposes***

In recent years, in anticipation of cloning-to-produce-children,
proponents have articulated a variety of possible uses of a perfected
technology: providing a "biologically related child" for an infertile
couple; permitting reproduction for individuals or same-sex couples;
avoiding the risk of genetic disease; securing a genetically identical
source of organs or tissues perfectly suitable for transplantation;
"replacing" a loved spouse or child who is dying or has died; obtaining
a child with a genotype of one's own choosing (including one's own
genotype); replicating individuals of great genius, talent, or beauty,
or individuals possessing traits that are for other reasons attractive
to the cloners; and creating sets of genetically identical humans who
might have special advantages in highly cooperative ventures in both war
and peace.[^4] The desire to control or select the genomes of
children-to-be through cloning has charmed more than a few prospective
users, in the United States and around the world.

Although we appreciate that a perfected technology, once introduced for
one purpose, might then be used for any of these purposes, we shall
examine further only those stated purposes that seem to us to merit
serious consideration.

[1. Purpose #1: To Produce Biologically Related Children]{.underline}

Human cloning would allow individuals or couples with fertility problems
to have biologically related children. For example, if a man could not
produce sperm, cloning would allow him to have a child who is
"biologically related" to him. In addition, it would allow married
couples with fertility problems to avoid using donor gametes, and
therefore avoid raising children with genetic inheritances from outside
the marriage.

[2. Purpose #2: To Avoid Genetic Disease]{.underline}

Human cloning could allow couples at risk of generating children with
genetic disease to have healthy children. For example, if both parents
carried one copy of a recessive gene for the same heritable disorder,
cloning might allow them to ensure that their child does not inherit the
known genetic disease (without having to resort to using donor gametes
or practicing preimplantation or prenatal genetic diagnosis and
elimination of afflicted embryos or fetuses).

[3. Purpose #3: For "Rejection-Proof" Transplants]{.underline}

Human cloning could produce ideal transplant donors for people who are
sick or dying. For example, if no genetic match could be found for a
sick child needing a kidney or bone marrow transplant, and the parents
had planned to have another child, cloning could potentially serve the
human goods of beginning a new life and saving an existing one.

[4. Purpose #4: To "Replicate" a Loved One]{.underline}

Human cloning would allow parents to "replicate" a dead or dying child
or relative. For example, one can imagine a case in which a
family---mother, father, and child---is involved in a terrible car
accident in which the father dies instantly and the child is critically
injured. The mother, told that her child will soon die, decides that the
best way to redeem the tragedy is to clone her dying child. This would
allow her to preserve a connection with both her dead husband and her
dying child, to create new life as a partial human answer to the
grievous misfortune of her child's untimely death, and to continue the
name and biological lineage of her deceased husband.

[5. Purpose #5: To Reproduce Individuals of Great Genius, Talent, or
Beauty]{.underline}

Human cloning would allow families or society to reproduce individuals
of great genius, talent, or beauty, where these traits are presumed to
be based on the individuals' desirable or superior genetic makeups. For
example, some admirers of great athletes, musicians, or mathematicians,
believing that the admired attributes are the result of a superior
genetic endowment, might want to clone these distinguished individuals.
Just as the cloning of cattle is being promoted as a means of
perpetuating champion milk- or meat-producing cows, so
cloning-to-produce-children has been touted as a means of perpetuating
certain "superior" human exemplars.

####### B. Arguments

The purposes or reasons for cloning-to-produce-children are, as they are
stated, clearly intelligible on their face. When challenged, the
defenders of these purposes often appeal to larger moral and political
goods. These typically fall within the following three categories: human
freedom, existence, and well-being.

[1. The Goodness of Human Freedom]{.underline}

Strictly speaking, the appeal to human freedom is not so much a defense
of cloning itself as it is of the *right* to practice it, asserted
against those who seek to prohibit it. No one, we suspect, would say
that he wanted to clone himself or any one else in order to be free or
to vindicate the goodness of liberty. Nevertheless, human freedom is a
defense often heard in support of a "right" to clone.

Those who defend cloning-to-produce-children on the grounds of human
freedom make two kinds of arguments. The first is that because
individuals in pluralistic societies have different definitions of the
good life and of right and wrong, society must protect individual
freedom to choose against the possible tyranny of the majority. This
means securing and even expanding the rights of individuals to make
choices so long as their choices do not directly infringe on the rights
(and especially the physical safety) of other rights-bearing citizens.
In *Eisenstadt v. Baird* (1972), the United States Supreme Court
enunciated what has been called a principle of reproductive freedom: "If
the right to privacy means anything, it is the right of the individual,
married or single, to be free from unwarranted governmental intrusion
into matters so affecting a person as a decision whether to bear or
beget a child."[^5] Defenders of cloning-to-produce-children argue that,
in the event that the physical risks to mother and future child were
shown to be ethically acceptable, the use of this new reproductive
technology would fall under the protective umbrella of reproductive
freedom.

A second defense of human cloning on the grounds of freedom is the claim
that human existence is by its very nature "open-ended,"
"indeterminate," and "unpredictable." Human beings are always remaking
themselves, their values, and their ways of interacting with one
another. New technologies are central to this open-ended idea of human
life, and to shut down such technologies simply because they change the
"traditional" ways of doing things is unjustifiable. As constitutional
scholar Laurence Tribe has argued in reference to human cloning: "A
society that bans acts of human creation that reflect unconventional sex
roles or parenting models (surrogate motherhood, in vitro fertilization,
artificial insemination, and the like) for no better reason than that
such acts dare to defy 'nature' and tradition (and to risk adding to
life's complexity) is a society that risks cutting itself off from vital
experimentation and risks sterilizing a significant part of its capacity
to grow."[^6]

[2. The Goodness of Existence]{.underline}

Like the appeal to freedom, the appeal to the goodness of existence is
not an argument *for* cloning, but an argument *against* opponents who
speak up in the name of protecting the cloned child-to-be against the
harms connected with its risky and strange origins as a clone. This
argument asserts that attempts to produce children through cloning, like
*any* attempt to produce a child, will directly benefit the
cloned-child-to-be, since without the act of cloning the child in
question would not exist. Existence itself, it is argued, is the first
"interest" that makes all other interests---including the interests of
safety and well-being---possible. Even taking into account the
possibility of serious genetic or developmental disorders, this position
holds that a cloned individual, once born, would prefer existence as a
clone to no existence at all. There is also a serious corollary about
how, in the absence of a principle that values existence *as such*, we
will and should regard and treat people born with disabilities or
deformities: opponents of cloning might appear in a position of
intolerance---of saying to cloned individuals, "Better for us (and for
you) had you never existed."

[3. The Goodness of Well-Being]{.underline}

The third moral argument for cloning-to-produce-children is that it
would contribute in certain cases to the fulfillment of human goods that
are widely honored and deeply rooted in modern democratic society. These
human goods include the health of newborn and existing children;
reproductive possibilities for infertile couples, and the possibility of
having a biologically related child. In all these circumstances, human
cloning could relieve existing suffering and sorrow or prevent them in
the future. Those who take this position do not necessarily defend human
cloning-to-produce-children as such. Rather, they argue that a moral and
practical line can be drawn between cloning-to-produce-children that
serves the "therapeutic" aims of health (for the cloned child-to-be, for
the infertile couple, or for an existing child) and the "eugenic" aims
of producing or mass-producing superior people.

Underlying this argument is the belief that an existing generation has a
responsibility to ensure, to the extent possible, the genetic quality
and fitness of the next generation. Human cloning, they argue, offers a
new method for human control and self-improvement, by allowing families
to have children free of specific genetic diseases or society to
reproduce children with superior genetic endowments. It also provides a
new means for gaining knowledge about the age-old question of nature
versus nurture in contributing to human achievement and human
flourishing, and to see how clones of great geniuses measure up against
the "originals."

***C. Critique and Conclusion***

While we as a Council acknowledge merit in some of the arguments made
for cloning-to-produce-children, we are generally not persuaded by them.
The fundamental weakness of the proponents' case is found in their
incomplete view of human procreation and families, and especially the
place of children therein. Proponents of cloning tend to see procreation
primarily as the free exercise of a parental right---to satisfy parental
desires for self-fulfillment or for a child who is healthy or
"superior." Parents seek to overcome obstacles to reproduction, to keep
their children free of genetic disease or disorder, and to provide them
with the best possible genetic endowment. The principles guiding such
prospective parents are freedom (for themselves), control (over their
child), and well-being (both for themselves and what they imagine is
best for their child). Even taken together, these principles provide at
best only a partial understanding of the meaning and entailments of
human procreation and child-rearing. In practice, they may prove to
undermine the very goods that the proponents of cloning aim to serve, by
undermining the unconditional acceptance of one's offspring that is so
central to parenthood.

There are a number of objections---or at the very least limitations---to
viewing cloning-to-produce-children through the prism of rights. Basic
human rights are usually asserted on behalf of the human individual
agent: for example, a meaningful right *not to be prevented* from
bearing a child can be asserted for each individual against
state-supported involuntary sterilization programs. But the act of
procreation is not an act involving a single individual. Indeed, until
human cloning arrives, it continues to be impossible for any one person
to procreate alone. More important, there is a crucial third party
involved: the child, whose centrality to the activity exposes the
insufficiency of thinking about procreation in terms of rights.

In addition, rights are limited in the following crucial way: they
cannot be ethically exercised at the expense of the rights of another.
But the "right to reproduce" cannot be ethically exercised without at
least considering the child that such exercise will bring into being and
who is at risk of harm and injustice from the exercise. This obligation
cannot be waived by an appeal to the absolutist argument of the goodness
of existence. Yes, existence is a primary good, but that does not
diminish the ethical significance of knowingly and willfully putting a
child in grave physical danger in the very act of giving that child
existence. It is certainly true that a life with even severe disability
may well be judged worth living by its bearer: "It is better to have
been born as I am than not to be here at all." But if his or her
disability was caused by behavior that could have been avoided by
parents (for example, by not drinking or using drugs during pregnancy,
or, arguably, by not cloning), many would argue that they should have
avoided it. A post- facto affirmation of existence by the harmed child
would not retroactively excuse any parental misconduct that caused the
child's disability, nor would it justify their failure to think of the
child's well-being as they went about exercising their "right to
procreate." Indeed, procreation is, by its very nature, a limitation of
absolute rights, since it brings into existence another human being
toward whom we have responsibilities and duties.

In short, the right to decide "*whether* to bear or beget a child" does
not include a right to have a child *by whatever means*. Nor can this
right be said to imply a corollary---the right to decide what *kind* of
child one is going to have. There are at least some circumstances where
reproductive freedom must be limited to protect the good of the child
(as, for instance, with the ban on incest). Our society's commitment to
freedom and parental authority by no means implies that all innovative
procedures and practices should be allowed or accepted, no matter how
bizarre or dangerous.

Proponents of cloning, when they do take into account the interests of
the child, sometimes argue that this interest justifies and even
requires thoroughgoing parental control over the procreative process.
Yet this approach, even when well-intentioned, may undermine the good of
the child more than it serves the child's best interests. For one thing,
cloning-to-produce-children of a desired or worthy sort overlooks the
need to restrain the parental temptation to total mastery over children.
It is especially morally dubious for this project to go forward when we
know so little about the unforeseen and unintended consequences of
exercising such genetic control. For example, in trying by cloning to
circumvent the risk of genetic disease or to promote particular traits,
what different risks to health and fitness would be inadvertently
produced for the child by having forgone its chance at genetic novelty,
a known asset in the constant struggle against microbial and parasitic
diseases? Parental control is a double-edged sword, and proponents seem
not to acknowledge the harms, both physical and psychological, that may
befall the child whose genetic identity is selected in advance.

The case for cloning in the name of the child's health and well-being is
certainly the strongest and most compelling. The desire that one's child
be free from a given genetic disease is a worthy aspiration. We
recognize there may be some unusual or extreme cases in which cloning
might be the best means to serve this moral good, if other ethical
obstacles could somehow be overcome. (A few of us also believe that the
desire to give a child "improved" or "superior" genetic equipment is not
necessarily to be condemned.) However, such aspirations could endanger
the personal, familial, and societal goods supported by the character of
human procreation. We are willing to grant that that there may be
exceptional cases in which cloning-to-produce-children is morally
defensible; however, that being said, we would also argue that such
cases do not justify the harmful experiments and social problems that
might be entailed by engaging in human cloning. Hard cases are said to
make bad law. The same would be true for succumbing to the rare,
sentimentally appealing case in which cloning seems morally
plausible.[^7]

Finally, proponents do not adequately face up to the difficulty of how
"well-being" is to be defined. Generally, they argue that these matters
are to be left up to the free choices of parents and doctors. But this
means that the judgments of "proper" and "improper" will be made
according to subjective criteria alone, and under such circumstances, it
will be almost impossible to rule out certain "improvements" as
unacceptable.

In the sections that follow, we shall explain more fully why Members of
the Council are not convinced by the arguments for
cloning-to-produce-children, even in the most defensible cases. To see
why this is so, we need to consider cloning-to-produce-children from the
broadest possible moral perspective, beginning with ethical questions
regarding experiments on human subjects. What we hope to show is that
the frequently made safety arguments strike deeper than we usually
realize, and that they point beyond themselves toward more fundamental
moral objections to cloning-to-produce-children.

\* \* \*

**II. The Case against Cloning-to-Produce-Children**

## 

## *A. The Ethics of Human Experimentation*

We begin with concerns regarding the safety of the cloning procedure and
the health of the participants. We do so for several reasons. First,
these concerns are widely, indeed nearly unanimously, shared. Second,
they lend themselves readily to familiar modes of ethical
analysis---including concerns about harming the innocent, protecting
human rights, and ensuring the consent of all research subjects.
Finally, if carefully considered, these concerns begin to reveal the
important ethical principles that must guide our broader assessment of
cloning-to-produce-children. They suggest that human beings, unlike
inanimate matter or even animals, are in some way *inviolable*, and
therefore challenge us to reflect on what it is *about* human beings
that makes them inviolable, and whether cloning-to-produce-children
threatens these distinctly human goods.

In initiating this analysis, there is perhaps no better place to start
than the long-standing international practice of regulating experiments
on human subjects. After all, the cloning of a human being, as well as
all the research and trials required before such a procedure could be
expected to succeed, would constitute experiments on the individuals
involved---the egg donor, the birthing mother, and especially the
child-to-be. It therefore makes sense to consider the safety and health
concerns that arise from cloning-to-produce-children in light of the
widely shared ethical principles that govern experimentation on human
subjects.

Since the Second World War, various codes for the ethical conduct of
human experimentation have been adopted around the world. These codes
and regulations were formulated in direct response to serious ethical
lapses and violations committed by research scientists against the
rights and dignity of individual human beings. Among the most important
and widely accepted documents to emerge were the Nuremberg Code of
1947[^8] and the Helsinki Declaration of 1964.[^9] Influential in the
United States is also the Belmont Report, published in 1978 by the
National Commission for the Protection of Human Subjects of Biomedical
and Behavioral Research.[^10]

The Nuremberg Code laid out ten principles for the ethical conduct of
experiments, focusing especially on voluntary consent of research
subjects, the principle that experiments should be conducted only with
the aim of providing a concrete good for society that is unprocurable by
other methods, and with the avoidance of physical or mental harm. The
Helsinki Declaration stated, among other things, that research should be
undertaken only when the prospective benefit clearly outweighs the
expected risk, when the research subject has been fully informed of all
risks, and when the research-subject population is itself likely to
benefit from the results of the experiment.

Finally, the Belmont Report proposed three basic ethical principles that
were to guide the treatment of individuals involved as subjects of
scientific research. The first of these is *respect for persons*, which
requires researchers to acknowledge the autonomy and individual rights
of research subjects and to offer special protection to those with
diminished autonomy and capacity. The second principle is *beneficence*.
Scientific research must not only refrain from harming those involved
but must also be aimed at helping them, or others, in concrete and
important ways. The third principle is *justice*, which involves just
distribution of potential benefits and harms and fair selection of
research subjects. When applied, these general principles lead to both a
requirement for informed consent of human research subjects and a
requirement for a careful assessment of risks and benefits before
proceeding with research. Safety, consent, and the rights of research
subjects are thus given the highest priority.

It would be a mistake to view these codes in narrow or procedural terms,
when in fact they embody society's profound sense that human beings are
not to be treated as experimental guinea pigs for scientific research.
Each of the codes was created to address a specific disaster involving
research science---whether the experiments conducted by Nazi doctors on
concentration camp prisoners, or the Willowbrook scandal in which
mentally retarded children were infected with hepatitis, or the Tuskegee
scandal in which underprivileged African-American men suffering from
syphilis were observed but not treated by medical researchers---and each
of the codes was an attempt to defend the inviolability and dignity of
all human beings in the face of such threats and abuses. More simply
stated, the codes attempt to defend the weak against the strong and to
uphold the equal dignity of all human beings. In taking up the
application of these codes to the case of cloning-to-produce-children,
we would suggest that the proper approach is not simply to discover
specific places where human cloning violates this or that stipulation of
this or that code, but to grapple with how such cloning offends the
spirit of these codes and what they seek to defend.

The ethics of research on human subjects suggest three sorts of problems
that would arise in cloning-to-produce-children: (1) problems of safety;
(2) a special problem of consent; and (3) problems of exploitation of
women and the just distribution of risk. We shall consider each in turn.

# [1. Problems of Safety]{.underline}

First, cloning-to-produce-children is not now safe. Concerns about the
safety of the individuals involved in a cloning procedure are shared by
nearly everyone on all sides of the cloning debate. Even most proponents
of cloning-to-produce-children generally qualify their support with a
caveat about the safety of the procedure. Cloning experiments in other
mammals strongly suggest that cloning-to-produce-children is, at least
for now, far too risky to attempt.[^11] Safety concerns revolve around
potential dangers to the cloned child, as well as to the egg donor and
the woman who would carry the cloned child to birth.

*(a) Risks to the child.* Risks to the cloned child-to-be must be taken
especially seriously, both because they are most numerous and most
serious and because---unlike the risks to the egg donor and birth
mother---they cannot be accepted knowingly and freely by the person who
will bear them. In animal experiments to date, only a small percentage
of implanted clones have resulted in live births, and a substantial
portion of those live-born clones have suffered complications that
proved fatal fairly quickly. Some serious though nonfatal abnormalities
in cloned animals have also been observed, including substantially
increased birth-size, liver and brain defects, and lung, kidney, and
cardiovascular problems.[^12]

Longer-term consequences are of course not known, as the oldest
successfully cloned mammal is only six years of age. Medium-term
consequences, including premature aging, immune system failure, and
sudden unexplained death, have already become apparent in some cloned
mammals. Some researchers have also expressed concerns that a donor
nucleus from an individual who has lived for some years may have
accumulated genetic mutations that---if the nucleus were used in the
cloning of a new human life---may predispose the new individual to
certain sorts of cancer and other diseases.[^13]

*(b) Risks to egg donor and birth mother.* Accompanying the threats to
the cloned child's health and well-being are risks to the health of the
egg donors. These include risks to her future reproductive health caused
by the hormonal treatments required for egg retrieval and general health
risks resulting from the necessary superovulation.[^14]

Animal studies also suggest the likelihood of health risks to the woman
who carries the cloned fetus to term. The animal data suggest that
late-term fetal losses and spontaneous abortions occur substantially
more often with cloned fetuses than in natural pregnancies. In humans,
such late-term fetal losses may lead to substantially increased maternal
morbidity and mortality. In addition, animal studies have shown that
many pregnancies involving cloned fetuses result in serious
complications, including toxemia and excessive fluid accumulation in the
uterus, both of which pose risks to the pregnant animal's health.[^15]
In one prominent cattle cloning study, just under one-third of the
pregnant cows died from complications late in pregnancy.[^16]

Reflecting on the dangers to birth mothers in animal cloning studies,
the National Academy report concluded:

> Results of animal studies suggest that reproductive cloning of humans
> would similarly pose a high risk to the health of both fetus or infant
> and mother and lead to associated psychological risks for the mother
> as a consequence of late spontaneous abortions or the birth of a
> stillborn child or a child with severe health problems.[^17]

*(c) An abiding moral concern.* Because of these risks, there is
widespread agreement that, at least for now, attempts at
cloning-to-produce-children would constitute unethical experimentation
on human subjects and are therefore impermissible. These safety
considerations were alone enough to lead the National Bioethics Advisory
Commission in June 1997 to call for a prohibition of human
cloning-to-produce-children. Similar concerns, based on almost five more
years of animal experimentation, convinced the panel of the National
Academy of Sciences in January 2002 that the United States should ban
such cloning for at least five years.

Past discussions of this subject have often given the impression that
the safety concern is a purely temporary one that can be allayed in the
near future, as scientific advances and improvements in technique reduce
the risks to an ethically acceptable level. But this impression is
mistaken, for considerable safety risks are likely to be enduring,
perhaps permanent. If so, there will be abiding ethical difficulties
*even with efforts* *aimed at making human cloning safe*.

The reason is clear: experiments to develop new reproductive
technologies are necessarily intergenerational, undertaken to serve the
reproductive desires of prospective parents but practiced also and
always upon prospective children. Any such experiment unavoidably
involves risks to the child-to-be, a being who is both the *product* and
also the most vulnerable human *subject* of the research. Exposed to
risk during the extremely sensitive life-shaping processes of his or her
embryological development, any child-to-be is a singularly vulnerable
creature, one maximally deserving of protection against risk of
experimental (and other) harm. If experiments to learn how to clone a
child are ever to be ethical, the degree of risk to that child-to-be
would have to be extremely low, arguably no greater than for
children-to-be who are conceived from union of egg and sperm. It is
extremely unlikely that this moral burden can be met, not for decades if
at all.

In multiple experiments involving six of the mammalian species cloned to
date, more than 89 per cent of the cloned embryos transferred to
recipient females did not come to birth, and many of the live-born
cloned animals are or become abnormal (NAS Report, Figure 3). If success
means achieving normal and healthy development not just at birth but
throughout the life span, there is even less reason for confidence. The
oldest cloned mammal (Dolly) is only six years old and has exhibited
unusually early arthritis. The reasons for failure in animal cloning are
not well understood. Also, no nonhuman primates have been cloned. It
will be decades (at least) before we could obtain positive evidence that
cloned primates might live a normal healthy (primate) life.

Even a high success rate in animals would not suffice by itself to make
human trials morally acceptable. In addition to the usual uncertainties
in jumping the gap from animal to human research, cloning is likely to
present particularly difficult problems of interspecies difference.
Animal experiments have already shown substantial differences in the
reproductive success of identical cloning techniques used in different
species.[^18] If these results represent species-specific differences
in, for example, the ease of epigenetic reprogramming and imprinting of
the donor DNA, the magnitude of the risks to the child-to-be of the
first human cloning experiments would be unknown and potentially large,
no matter how much success had been achieved in animals. There can in
principle be no direct experimental evidence sufficient for assessing
the degree of such risk.[^19]^i^

Can a highly reduced risk of deformity, disease, and premature death in
animal cloning, coupled with the inherently unpredictable risk of moving
from animals to humans, ever be low enough to meet the ethically
acceptable standard set by reproduction begun with egg and sperm? The
answer, as a matter of necessity, can never be better than "Just
possibly." Given the severity of the possible harms involved in human
cloning, and given that those harms fall on the very vulnerable
child-to-be, such an answer would seem to be enduringly inadequate.

Similar arguments, it is worth noting, were made before the first
attempts at human in vitro fertilization. People suggested that it would
be unethical experimentation even to try to determine whether IVF could
be safely done. And then, of course, IVF was accomplished. Eventually,
it became a common procedure, and today the moral argument about its
safety seems to many people beside the point. Yet the fact of success in
that case does not establish precedent in this one, nor does it mean
that the first attempts at IVF were not in fact unethical experiments
upon the unborn, despite the fortunate results.[^20]

Be this as it may, the case of cloning is genuinely different. With IVF,
assisted fertilization of egg by sperm immediately releases a
developmental process, linked to the sexual union of the two gametes,
that nature has selected over millions of years for the entire mammalian
line. But in cloning experiments to produce children, researchers would
be transforming a sexual system into an asexual one, a change that
requires major and "unnatural" reprogramming of donor DNA if there is to
be any chance of success. They are neither enabling nor restoring a
natural process, and the alterations involved are such that success in
one species cannot be presumed to predict success in another. Moreover,
any new somatic mutations in the donor cell's chromosomal DNA would be
passed along to the cloned child-to-be and its offspring. Here we can
see even more the truly intergenerational character of cloning
experimentation, and this should justify placing the highest moral
burden of persuasion on those who would like to proceed with efforts to
make cloning safe for producing children. (By reminding us of the need
to protect the lives and well-being of our children and our children's
children, this broader analysis of the safety question points toward
larger moral objections to producing cloned children, objections that we
shall consider shortly.)

It therefore appears to us that, given the dangers involved and the
relatively limited goods to be gained from cloning-to-produce-children,
conducting experiments in an effort to make cloning-to-produce-children
safer would itself be an unacceptable violation of the norms of the
ethics of research. *There seems to be no ethical way to try to discover
whether cloning-to-produce-children can become safe, now or in the
future.*

# [2. A Special Problem of Consent]{.underline}

A further concern relating to the ethics of human research revolves
around the question of consent. Consent from the cloned child-to-be is
of course impossible to obtain, and because no one consents to his or
her own birth, it may be argued that concerns about consent are
misplaced when applied to the unborn. But the issue is not so simple.
For reasons having to do both with the safety concerns raised above and
with the social, psychological, and moral concerns to be addressed
below, an attempt to clone a human being would potentially expose a
cloned individual-to-be to great risks of harm, quite distinct from
those accompanying other sorts of reproduction. Given the risks, and the
fact that consent cannot be obtained, the ethically correct choice may
be to avoid the experiment. The fact that those engaged in cloning
cannot ask an unconceived child for permission places a burden on the
cloners, not on the child. Given that anyone considering creating a
cloned child must know that he or she is putting a newly created human
life at exceptional risk, the burden on the would-be cloners seems
clear: they must make a compelling case why the procedure should not be
avoided altogether.

Reflections on the purpose and meaning of seeking consent support this
point. Why, after all, does society insist upon consent as an essential
principle of the ethics of scientific research? Along with honoring the
free will of the subject, we insist on consent to protect the weak and
the vulnerable, and in particular to protect them from the powerful. It
would therefore be morally questionable, at the very least, to choose to
impose potentially grave harm on an individual, especially in the very
act of giving that individual life. Giving existence to a human being
does not grant one the right to maim or harm that human being in
research.

# [3. Problems of Exploitation of Women and Just Distribution of Risk]{.underline}

Cloning-to-produce-children may also lead to the exploitation of women
who would be called upon to donate oocytes. Widespread use of the
techniques of cloning-to-produce-children would require large numbers of
eggs. Animal models suggest that several hundred eggs may be required
before one attempt at cloning can be successful. The required oocytes
would have to be donated, and the process of making them available would
involve hormonal treatments to induce superovulation. If financial
incentives are offered, they might lead poor women especially to place
themselves at risk in this way (and might also compromise the
voluntariness of their "choice" to make donations). Thus, research on
cloning-to-produce-children could impose disproportionate burdens on
women, particularly low-income women.

[4. Conclusion]{.underline}

These questions of the ethics of research---particularly the issue of
physical safety---point clearly to the conclusion that
cloning-to-produce-children is unacceptable. In reaching this
conclusion, we join the National Bioethics Advisory Commission and the
National Academy of Sciences. But we go beyond the findings of those
distinguished bodies in also pointing to the dangers that will *always*
be inherent in the very process of trying to make
cloning-to-produce-children safer. On this ground, we conclude that the
problem of safety is not a temporary ethical concern. It is rather an
enduring moral concern that might not be surmountable and should thus
preclude work toward the development of cloning techniques to produce
children. In light of the risks and other ethical concerns raised by
this form of human experimentation, *we therefore conclude that
cloning-to-produce-children should not be attempted*.

For some people, the discussion of ethical objections to
cloning-to-produce-children could end here. Our society's established
codes and practices in regard to human experimentation by themselves
offer compelling reasons to oppose indefinitely attempts to produce a
human child by cloning. But there *is* more to be said.

First, many people who are repelled by or opposed to the prospect of
cloning human beings are concerned not simply or primarily because the
procedure is unsafe. To the contrary, their objection is to the use of a
*perfected* cloning technology and to a society that would embrace or
permit the production of cloned children. The ethical objection based on
lack of safety is *not* really an objection to cloning *as such*.
Indeed, it may in time become a vanishing objection should people be
allowed to proceed---despite insuperable ethical objections such as the
ones we have just offered---with experiments to perfect the
technique.[^21] Should this occur, the ethical assessment of
cloning-to-produce-children would need to address itself to the merits
(and demerits) of cloning itself, beyond the safety questions tied to
the techniques used to produce cloned children. Thus, anticipating the
possibility of a perfected and usable technology, it is important to
delineate the case against the practice itself.

Moreover, because the Council is considering cloning within a broad
context of present and projected techniques that can affect human
procreation or alter the genetic makeup of our children, it is important
that we consider the full range and depth of ethical issues raised by
such efforts.

How should these issues be raised, and within what moral framework?
Some, but by no means all, of the deepest moral concerns connected to
human cloning could be handled by developing a richer consideration of
the ethics of human experimentation. Usually---and regrettably---we
apply the ethical principles governing research on human subjects in a
utilitarian spirit, weighing benefits versus harms, and moreover using
only a very narrow notion of "harm." The calculus that weighs benefits
versus harms too often takes stock only of bodily harm or violations of
patient autonomy, though some serious efforts have been made in recent
years to consider broader issues. In addition, we often hold a rather
narrow view of what constitutes "an experiment." Yet
cloning-to-produce-children would be a "human experiment" in many
senses, and risks of bodily harm and inadequate consent do not exhaust
the ways in which cloning might do damage. As we have described,
cloning-to-produce-children would be a *biological* *experiment*---with
necessary uncertainties about the safety of the technique and the
possibility of physical harm. But it would also be an *experiment in
human procreation*---substituting asexual for sexual reproduction and
treating children not as gifts but as our self-designed products. It
would be an *experiment in human identity*---creating the first human
beings to inherit a genetic identity lived in advance by another. It
would be an *experiment in genetic choice and design*---producing the
first children whose entire genetic makeup was selected in advance. It
would be an *experiment in family and social life*---altering the
relationships within the family and between the generations, for
example, by turning "mothers" into "twin sisters" and "grandparents"
into "parents," and by having children asymmetrically linked
biologically to only one parent. And it would represent a *social
experiment* for the entire society, insofar as the society accepted,
even if only as a minority practice, this unprecedented and novel mode
of producing our offspring.

By considering these other ways in which cloning would constitute an
experiment, we could enlarge our analysis of the ethics of research with
human subjects to assess possible *nonbodily* harms of
cloning-to-produce-children. But valuable as this effort might be, we
have not chosen to proceed in this way. Not all the important issues can
be squeezed into the categories of harms and benefits. People can be
mistreated or done an injustice whether they know it or not and quite
apart from any experienced harm. Important human goods can be traduced,
violated, or sacrificed without being registered in anyone's catalogue
of harms. The form of bioethical inquiry we are attempting here will
make every effort not to truncate the moral meaning of our actions and
practices by placing them on the Procrustean bed of utilitarianism. To
be sure, the ethical principles governing human research are highly
useful in efforts to protect vulnerable individuals against the
misconduct or indifference of the powerful. But a different frame of
reference is needed to evaluate the human meaning of innovations that
may affect the lives and humanity of everyone, vulnerable or not.

Of the arguments developed below, some are supported by most Council
Members, while other arguments are shared by only some Members. Even
among the arguments they share, different Members find different
concerns to be weightier. Yet we all believe that the arguments
presented in the sections that follow are worthy of consideration in the
course of trying to assess *fully* the ethical issues involved. We have
chosen to err on the side of inclusion rather than exclusion of
arguments because we acknowledge that concerns now expressed by only a
few may turn out in the future to be more important than those now
shared by all. Our fuller assessment begins with an attempt to fathom
the deepest meaning of human procreation and thus necessarily the
meaning of raising children. Our analysis will then move onto questions
dealing with the effects of cloning on individuals, family life, and
society more generally.

## *B. The Human Context: Procreation and Child-Rearing*

Were it to take place, cloning-to-produce-children would represent a
challenge to the nature of human procreation and child-rearing. Cloning
is, of course, not only a means of procreation. It is also a technology,
a human experiment, and an exercise of freedom, among other things. But
cloning would be most unusual, consequential, and most morally
significant as a new way of bringing children into the world and a new
way of viewing their moral significance.

In Chapter One we outlined some morally significant features of human
procreation and raised questions about how these would be altered by
human cloning. We will now attempt to deepen that analysis, and begin
with the salient fact that a child *is not made, but begotten.*
Procreation is not making but the outgrowth of doing. A man and woman
give themselves in love to each other, setting their projects aside in
order to do just that. Yet a child results, arriving on its own,
mysterious, independent, yet the fruit of the embrace.[^22] Even were
the child wished for, and consciously so, he or she is the issue of
their love, not the product of their wills; the man and woman in no way
produce or choose a *particular* child, as they might buy a particular
car. Sexual reproduction can, of course, be assisted (as with IVF). In
such cases, it may become harder to see the child solely as a gift
bestowed upon the parents' mutual self-giving and not to some degree as
a product of their parental wills. Nonetheless, because it is still
sexual reproduction, the children born with the help of IVF begin---as
do all other children---with a certain genetic independence of their
parents. They replicate neither their fathers nor their mothers, and
this is a salutary reminder to parents of the independence they must one
day grant their children and for which it is their duty to prepare them.

Gifts and blessings we learn to accept as gratefully as we can. Products
of our wills we try to shape in accord with our desires. Hence,
procreation as traditionally understood invites acceptance, rather than
reshaping, engineering, or designing the next generation. It invites us
to accept limits to our control over the next generation. It invites us
even---to put the point most strongly---to think of the child as one who
is not simply our own, our possession. Certainly, it invites us to
remember that the child does not exist simply for the happiness or
fulfillment of the parents.

To be sure, parents do and must try to form and mold their children in
various ways as they inure them to the demands of family life, prepare
them for adulthood, and initiate them into the human community. But,
even then, it is only our sense that these children are not our
possessions that makes such parental nurture---which always threatens
not to nourish but to stifle the child---safe.

This concern can be expressed not only in language about the relation
between the generations but also in the language of equality. The things
we make are not just like ourselves; they are the products of our wills,
and their point and purpose are ours to determine. But a begotten child
comes into the world just as its parents once did, and is therefore
their equal in dignity and humanity.

The character of sexual procreation shapes the lives of children as well
as parents. By giving rise to genetically new individuals, sexual
reproduction imbues all human beings with a sense of individual identity
and of occupying a place in this world that has never belonged to
another. Our novel genetic identity symbolizes and foreshadows the
unique, never-to-be-repeated character of each human life. At the same
time, our emergence from the union of two individuals, themselves
conceived and generated as we were, locates us immediately in a network
of relation and natural affection.

Social identity, like genetic identity, is in significant measure tied
to these biological facts. Societies around the world have structured
social and economic responsibilities around the relationship between the
generations established through sexual procreation, and have developed
modes of child-rearing, family responsibility, and kinship behavior that
revolve around the natural facts of begetting.

There is much more to be said about these matters, and they are vastly
more complicated than we have indicated. There are, in addition,
cultural differences in the way societies around the world regard the
human significance of procreation or the way children are to be regarded
and cared for. Yet we have said enough to indicate that the character
and nature of human procreation matter deeply. They affect human life in
endless subtle ways, and they shape families and communities. A proper
regard for the profundity of human procreation (including child-rearing
and parent-child relations) is, in our view, indispensable for a full
assessment of the ethical implications of cloning-to-produce-children.

## *C. Identity, Manufacture, Eugenics, Family, and Society*

Beyond the matter of procreation itself, we think it important to
examine the possible psychological and emotional state of individuals
produced by cloning, the well-being of their families, and the likely
effects on society of permitting human cloning. These concerns would
apply even if cloning-to-produce-children were conducted on a small
scale; and they would apply in even the more innocent-seeming cloning
scenarios, such as efforts to overcome infertility or to avoid the risk
of genetic disease. Admittedly, these matters are necessarily
speculative, for empirical evidence is lacking. Nevertheless, the
importance of the various goods at stake justifies trying to think
matters through in advance.

Keeping in mind our general observations about procreation, we proceed
to examine a series of specific ethical issues and objections to cloning
human children: (1) problems of identity and individuality; (2) concerns
regarding manufacture; (3) the prospects of a new eugenics; (4) troubled
family relations; and (5) effects on society.

# [1. Problems of Identity and Individuality]{.underline}

Cloning-to-produce-children could create serious problems of identity
and individuality. This would be especially true if it were used to
produce multiple "copies" of any single individual, as in one or another
of the seemingly far-fetched futuristic scenarios in which cloning is
often presented to the popular imagination. Yet questions of identity
and individuality could arise even in small-scale cloning, even in the
(supposedly) most innocent of cases, such as the production of a single
cloned child within an intact family. Personal identity is, we would
emphasize, a complex and subtle psychological phenomenon, shaped
ultimately by the interaction of many diverse factors. But it does seem
reasonably clear that cloning would at the very least present a unique
and possibly disabling challenge to the formation of individual
identity.

Cloned children may experience concerns about their distinctive identity
not only because each will be genetically essentially identical to
another human being, but also because they may resemble in appearance
younger versions of the person who is their "father" or "mother." Of
course, our genetic makeup does not by itself determine our identities.
But our genetic uniqueness is an important source of our sense of who we
are and how we regard ourselves. It is an emblem of independence and
individuality. It endows us with a sense of life as a
never-before-enacted possibility. Knowing and feeling that nobody has
previously possessed our particular gift of natural characteristics, we
go forward as genetically unique individuals into relatively
indeterminate futures.

These new and unique genetic identities are rooted in the natural
procreative process. A cloned child, by contrast, is at risk of living
out a life overshadowed in important ways by the life of the
"original"---general appearance being only the most obvious. Indeed, one
of the reasons some people are interested in cloning is that the
technique promises to produce in each case a particular individual whose
traits and characteristics are already known. And however much or little
one's genotype *actually* shapes one's natural capacities, it could mean
a great deal to an individual's *experience* of life and the
expectations that those who cloned him or her might have. The cloned
child may be constantly compared to "the original," and may consciously
or unconsciously hold himself or herself up to the genetic twin that
came before. If the two individuals turned out to lead similar lives,
the cloned person's achievements may be seen as derivative. If, as is
perhaps more likely, the cloned person departed from the life of his or
her progenitor, this very fact could be a source of constant scrutiny,
especially in circumstances in which parents produced their cloned child
to become something in particular. Living up to parental hopes and
expectations is frequently a burden for children; it could be a far
greater burden for a cloned individual. The shadow of the cloned child's
"original" might be hard for the child to escape, as would parental
attitudes that sought in the child's very existence to replicate,
imitate, or replace the "original."

It may reasonably be argued that genetic individuality is not an
indispensable human good, since identical twins share a common genotype
and seem not to be harmed by it. But this argument misses the context
and environment into which even a single human clone would be born.
Identical twins have as progenitors two biological parents and are born
together, before either one has developed and shown what his or her
potential---natural or otherwise---may be. Each is largely free of the
burden of measuring up to or even knowing in advance the genetic traits
of the other, because both begin life together and neither is yet known
to the world. But a clone is a genetic near-copy of a person who is
already living or has already lived. This might constrain the clone's
sense of self in ways that differ in kind from the experience of
identical twins. Everything about the predecessor---from physical height
and facial appearance, balding patterns and inherited diseases, to
temperament and native talents, to shape of life and length of days, and
even cause of death---will appear before the expectant eyes of the
cloned person, always with at least the nagging concern that there,
notwithstanding the grace of God, go I. The crucial matter, again, is
not simply the truth regarding the extent to which genetic identity
actually shapes us---though it surely does shape us to some extent. What
matters above all is the cloned individual's *perception* of the
significance of the "precedent life" and the way that perception cramps
and limits a sense of self and independence.

# [2. Concerns Regarding Manufacture]{.underline}

The likely impact of cloning on identity suggests an additional moral
and social concern: the transformation of human procreation into human
manufacture, of begetting into making. By using the terms "making" and
"manufacture" we are not claiming that cloned children would be
artifacts made altogether "by hand" or produced in factories. Rather, we
are suggesting that they would, like other human "products," be brought
into being in accordance with some pre-selected genetic pattern or
design, and therefore in some sense "made to order" by their producers
or progenitors.

Unlike natural procreation---or even most forms of assisted
reproduction---cloning-to-produce-children would set out to create a
child with a very particular genotype---namely, that of the somatic cell
donor. Cloned children would thus be the first human beings whose entire
genetic makeup is selected in advance. True, selection from among
existing genotypes is not yet design of new ones. But the principle that
would be established by human cloning is both far-reaching and
completely novel: parents, with the help of science and technology, may
determine in advance the genetic endowment of their children. To this
point, parents have the right and the power to decide *whether* to have
a child. With cloning, parents acquire the power, and presumably the
right, to decide *what kind* of a child to have. Cloning would thus
extend the power of one generation over the next---and the power of
parents over their offspring---in ways that open the door,
unintentionally or not, to a future project of genetic manipulation and
genetic control.

Of course, there is no denying that we have already taken steps in the
direction of such control. Preimplantation genetic diagnosis of embryos
and prenatal diagnosis of fetuses---both now used to prevent the birth
of individuals carrying genes for genetic diseases---reflect an only
conditional acceptance of the next generation. With regard to *positive*
selection for desired traits, there is some practice of sex selection,
another example of conditional acceptance of offspring. But these
precedents do not thereby provide a license to proceed with cloning. It
is far from clear that it would be wise to proceed still farther in our
attempts at control.

The problem with cloning-to-produce-children is not that artificial
technique is used to assist reproduction. Neither is it that genes are
being manipulated. We raise no objection to the use of the coming
genetic technologies to treat individuals with genetic diseases, even in
utero---though there would be issues regarding the protection of human
subjects in research and the need to find boundaries between therapy and
so-called enhancement (of this, more below). The problem has to do with
the control of the entire genotype and the production of children to
selected specifications.

Why does this matter? It matters because human dignity is at stake. In
natural procreation, two individuals give life to a new human being
whose endowments are not shaped deliberately by human will, whose being
remains mysterious, and the open-endedness of whose future is ratified
and embraced. Parents beget a child who enters the world exactly as they
did---as an unmade gift, not as a product. Children born of this process
stand equally beside their progenitors as fellow human beings, not
beneath them as made objects. In this way, the uncontrolled beginnings
of human procreation endow each new generation and each new individual
with the dignity and freedom enjoyed by all who came before.

Most present forms of assisted reproduction imitate this natural
process. While they do begin to introduce characteristics of manufacture
and industrial technique, placing nascent human life for the first time
in human hands, they do not control the final outcome. The end served by
IVF is still the same as natural reproduction---the birth of a child
from the union of gametes from two progenitors. Reproduction with the
aid of such techniques still implicitly expresses a willingness to
accept as a gift the product of a process we do not control. In IVF
children emerge out of the same mysterious process from which their
parents came, and are therefore not mere creatures of their parents.

By contrast, cloning-to-produce-children---and the forms of human
manufacture it might make more possible in the future---seems quite
different. Here, the process begins with a very specific final product
in mind and would be tailored to produce that product. Even were cloning
to be used solely to remedy infertility, the decision to clone the
(sterile) father would be a decision, willy-nilly, that the child-to-be
should be the near-twin of his "father." Anyone who would clone merely
to ensure a "biologically related child" would be dictating a very
specific form of biological relation: genetic virtual identity. In any
case of cloning-to-produce-children, scientists or parents would set out
to produce specific individuals for particular reasons. The procreative
process could come to be seen increasingly as a means of meeting
specific ends, and the resulting children would be products of a
designed manufacturing process, products over whom we might think it
proper to exercise "quality control." Even if, in any given case, we
were to continue to think of the cloned child as a gift, *the act itself
teaches a different lesson*, as the child becomes the continuation of a
parental project. We would learn to receive the next generation less
with gratitude and surprise than with control and mastery.

One possible result would be the industrialization and commercialization
of human reproduction. Manufactured objects become commodities in the
marketplace, and their manufacture comes to be guided by market
principles and financial concerns. When the "products" are human beings,
the "market" could become a profoundly dehumanizing force. Already there
is commerce in egg donation for IVF, with ads offering large sums of
money for egg donors with high SAT scores and particular physical
features.

The concerns expressed here do not depend on cloning becoming a
widespread practice. The introduction of the terms and ideas of
production into the realm of human procreation would be troubling
regardless of the scale involved; and the adoption of a market mentality
in these matters could blind us to the deep moral character of bringing
forth new life. Even were cloning children to be rare, the moral harms
to a society that accepted it could be serious.

[3. Prospect of a New Eugenics]{.underline}

For some of us, cloning-to-produce-children also raises concerns about
the prospect of eugenics or, more modestly, about genetic "enhancement."
We recognize that the term "eugenics" generally refers to attempts to
improve the genetic constitution of a particular political community or
of the human race through general policies such as population control,
forced sterilization, directed mating, or the like. It does not
ordinarily refer to actions of particular individuals attempting to
improve the genetic endowment of their own descendants. Yet, although
cloning does not in itself point to public policies by which the state
would become involved in directing the development of the human gene
pool, this might happen in illiberal regimes, like China, where the
government already regulates procreation.[^23] And, in liberal
societies, cloning-to-produce-children could come to be used privately
for individualized eugenic or "enhancement" purposes: in attempts to
alter (with the aim of improving) the genetic constitution of one's own
descendants---and, indirectly, of future generations.

Some people, in fact, see enhancement as the major purpose of
cloning-to-produce-children. Those who favor eugenics and genetic
enhancement were once far more open regarding their intentions to enable
future generations to enjoy more advantageous genotypes. Toward these
ends, they promoted the benefits of cloning: escape from the uncertain
lottery of sex, controlled and humanly directed reproduction. In the
present debate about cloning-to-produce-children, the case for eugenics
and enhancement is not made openly, but it nonetheless remains an
important motivation for some advocates. Should
cloning-to-produce-children be introduced successfully, and should it
turn out that the cloned humans do in fact inherit many of the natural
talents of the "originals," some people may become interested in the
prospects of using it to produce "enhanced children"---especially if
other people's children were receiving comparable advantages.

Cloning can serve the ends of individualized enhancement either by
avoiding the genetic defects that may arise when human reproduction is
left to chance or by preserving and perpetuating outstanding genetic
traits. In the future, if techniques of genetic enhancement through more
precise genetic engineering became available, cloning could be useful
for perpetuating the enhanced traits and for keeping any "superior"
manmade genotype free of the flaws that sexual reproduction might
otherwise introduce.

"Private eugenics" does not carry with it the dark implications of state
despotism or political control of the gene pool that characterized
earlier eugenic proposals and the racist eugenic practices of the
twentieth century. Nonetheless, it could prove dangerous to our
humanity. Besides the dehumanizing prospects of the turn toward
manufacture that such programs of enhancement would require, there is
the further difficulty of the lack of standards to guide the choices for
"improvement." To this point, biomedical technology has been applied to
treating diseases in patients and has been governed, on the whole, by a
commonsense view of health and disease. To be sure, there are differing
views about how to define "health." And certain cosmetic,
performance-enhancing, or hedonistic uses of biomedical techniques may
already have crossed any plausible boundary between therapy and
enhancement, between healing the sick and "improving" our powers.[^24]
Yet, for the most part, it is by some commonsense views of health that
we judge who is in need of medical treatment and what sort of treatment
might be most appropriate. Even today's practice of a kind of "negative"
eugenics---through prenatal genetic diagnosis and abortion of fetuses
with certain genetic abnormalities---is informed by the desire to
promote health.

The "positive" eugenics that could receive a great boost from human
cloning, especially were it to be coupled with techniques of precise
genetic modification, would not seek to restore sick human beings to
natural health. Instead, it would seek to alter humanity, based upon
arbitrary ideas of excellence. The effort may be guided by apparently
good intentions: to improve the next generation and to enhance the
quality of life of our descendants. But in the process of altering human
nature, we would be abandoning the standard by which to judge the
goodness or the wisdom of the particular aims. We would stand to lose
the sense of what is and is not human.

The fear of a new eugenics is not, as is sometimes alleged, a concern
born of some irrational fear of the future or the unknown. Neither is it
born of hostility to technology or nostalgia for some premodern
pseudo-golden age of superior naturalness. It is rather born of the
rational recognition that once we move beyond therapy into efforts at
enhancement, we are in uncharted waters without a map, without a
compass, and without a clear destination that can tell us whether we are
making improvements or the reverse. The time-honored and time-tested
goods of human life, which we know to be good, would be put in jeopardy
for the alleged and unknowable goods of a post-human future.

# [4. Troubled Family Relations]{.underline}

Cloning-to-produce-children could also prove damaging to family
relations, despite the best of intentions. We do not assume that cloned
children, once produced, would not be accepted, loved, or nurtured by
their parents and relatives. On the contrary, we freely admit that, like
any child born of woman, they might be welcomed into the cloning family.
Nevertheless, the cloned child's place in the scheme of family relations
might well be uncertain and confused. The usually clear designations of
father and brother, mother and sister would be confounded. The cloned
child's relation to his or her grandparents would span one and two
generations at once. Every other family relation would be similarly
confused. There is, of course, the valid counter-argument that holds
that the "mother" could easily be defined as the person who gives birth
to the child, regardless of the child's genetic origins, and for social
purposes that may serve to eliminate some problems. But because of the
special nature of cloning-to-produce-children, difficulties may be
expected.

The crucial point is not the *absence* of the natural biological
connections between parents and children. The crucial point is, on the
contrary, the *presence* of a unique, one-sided, and replicative
biological connection to only *one* progenitor. As a result, family
relations involving cloning would differ from all existing family
arrangements, including those formed through adoption or with the aid of
IVF. A great many children, after all, are adopted, and live happy lives
in loving families, in the absence of any biological connections with
their parents. Children conceived by artificial insemination using donor
sperm and by various IVF techniques may have unusual relationships with
their genetic parents, or no genetic relationships at all. But all of
these existing arrangements attempt in important ways to emulate the
model of the natural family (at least in its arrangement of the
generations), while cloning runs contrary to that model.

What the exact effects of cloning-to-produce-children might be for
families is highly speculative, to be sure, but it is still worth
flagging certain troubling possibilities and risks. The fact that the
cloned child bears a special tie to only one parent may complicate
family dynamics. As the child developed, it could not help but be
regarded as specially akin to only one of his or her parents. The sins
or failings of the father (or mother), if reappearing in the cloned
child, might be blamed on the progenitor, adding to the chances of
domestic turmoil. The problems of being and rearing an adolescent could
become complicated should the teenage clone of the mother "reappear" as
the double of the woman the father once fell in love with. Risks of
competition, rivalry, jealousy, and parental tension could become
heightened.[^25]

Even if the child were cloned from someone who is not a member of the
family in which the child is raised, the fact would remain that he or
she has been produced in the nearly precise genetic image of another and
for some particular reason, with some particular design in mind. Should
this become known to the child, as most likely it would, a desire to
seek out connection to the "original" could complicate his or her
relation to the rearing family, as would living consciously "under the
*reason*" for this extra-familial choice of progenitor. Though many
people make light of the importance of biological kinship (compared to
the bonds formed through rearing and experienced family life), many
adopted children and children conceived by artificial insemination or
IVF using donor sperm show by their actions that they do not agree. They
make great efforts to locate their "biological parents," even where
paternity consists in nothing more than the donation of sperm. Where the
progenitor is a genetic near-twin, surely the urge of the cloned child
to connect with the unknown "parent" would be still greater.

For all these reasons, the cloning family differs from the "natural
family" or the "adoptive family." By breaking through the natural
boundaries between generations, cloning could strain the social ties
between them.

# [5. Effects on Society]{.underline}

The hazards and costs of cloning-to-produce-children may not be confined
to the direct participants. The rest of society may also be at risk. The
impact of human cloning on society at large may be the least
appreciated, but among the most important, factors to consider in
contemplating the morality of this activity.

Cloning is a human activity affecting not only those who are cloned or
those who are clones, but also the entire society that allows or
supports such activity. For insofar as the society *accepts*
cloning-to-produce-children, to that extent the society may be said to
*engage* in it. A society that allows dehumanizing
practices---especially when given an opportunity to try to prevent
them---risks becoming an accomplice in those practices. (The same could
be said of a society that allowed even a few of its members to practice
incest or polygamy.) Thus the question before us is whether
cloning-to-produce-children is an activity that we, *as a society*,
should engage in. In addressing this question, we must reach well beyond
the rights of individuals and the difficulties or benefits that cloned
children or their families might encounter. We must consider what kind
of a society we wish to be, and, in particular, what forms of bringing
children into the world we want to encourage and what sorts of relations
between the generations we want to preserve.

Cloning-to-produce children could distort the way we raise and view
children, by carrying to full expression many regrettable tendencies
already present in our culture. We are already liable to regard children
largely as vehicles for our own fulfillment and ambitions. The impulse
to created "designer children" is present today---as temptation and
social practice. The notion of life as a gift, mysterious and limited,
is under siege. Cloning-to-produce-children would carry these tendencies
and temptations to an extreme expression. It advances the notion that
the child is but an object of our sovereign mastery.

A society that clones human beings thinks about human beings (and
especially children) differently than does a society that refuses to do
so. It could easily be argued that we have already in myriad ways begun
to show signs of regarding our children as projects on which we may work
our wills. Further, it could be argued that we have been so desensitized
by our earlier steps in this direction that we do not recognize this
tendency as a corruption. While some people contend that
cloning-to-produce-children would not take us much further down a path
we have already been traveling, we would emphasize that the precedent of
treating children as projects cuts two ways in the moral argument.
Instead of using this precedent to justify taking the next step of
cloning, the next step might rather serve as a warning and a mirror in
which we may discover reasons to reconsider what we are already doing.
Precisely because the stakes are so high, precisely because the new
biotechnologies touch not only our bodies and minds but also the very
idea of our humanity, we should ask ourselves how we as a society want
to approach questions of human dignity and flourishing.

# *D. Conclusion*

Cloning-to-produce-children may represent a forerunner of what will be a
growing number of capacities to intervene in and alter the human genetic
endowment. No doubt, earlier human actions have produced changes in the
human gene pool: to take only one example, the use of insulin to treat
diabetics who otherwise would have died before reproducing has increased
the genes for diabetes in the population. But different responsibilities
accrue when one sets out to make such changes prospectively, directly,
and deliberately. To do so without regard to the likelihood of serious
unintended and unanticipated consequences would be the height of hubris.
Systems of great complexity do not respond well to blunt human
intervention, and one can hardly think of a more complex system---both
social and natural---than that which surrounds human reproduction and
the human genome. Given the enormous importance of what is at stake, we
believe that the so-called "precautionary principle" should be our guide
in this arena. This principle would suggest that scientists,
technologists, and, indeed, all of us should be modest in claiming to
understand the many possible consequences of any profound alteration of
human procreation, especially where there are not compelling reasons to
proceed. Lacking such understanding, no one should take action so
drastic as the cloning of a human child. In the absence of the necessary
human wisdom, prudence calls upon us to set limits on efforts to control
and remake the character of human procreation and human life.

It is not only a matter of prudence. Cloning-to-produce-children would
also be an *injustice* to the cloned child---from the imposition of the
chromosomes of someone else, to the intentional deprivation of
biological parents, to all of the possible bodily and psychological
harms that we have enumerated in this chapter. It is ultimately the
claim that the cloned child would be seriously wronged---and not only
harmed in body---that would justify government intervention. It is to
this question---the public policy question of what the government should
and can do to prevent such injustice---that we will turn in Chapter
Seven. But, regarding the ethical assessment, Members of the Council are
in agreement that cloning-to-produce-children is not only unsafe but
also morally unacceptable and ought not to be attempted.[^26]

###### ENDNOTES

[^1]: National Bioethics Advisory Commission, *Cloning Human Beings*
    Bethesda, MD, 1997.

[^2]: National Academy of Sciences (NAS) *Scientific and Medical Aspects
    of Human Reproductive Cloning* Washington, DC. National Academy
    Press, 2002. (Referred to in subsequent citations as NAS Report.)

[^3]: NAS Report, pp. 6-7.

[^4]: Lederberg, J. "Experimental Genetics and Human Evolution" *The
    American Naturalist*, September-October, 1966.

[^5]: Supreme Court of the United States. *Eisenstadt v. Baird,* 405 US
    438, 1972.

[^6]: Tribe, L. "On Not Banning Cloning for the Wrong Reasons" in
    Nussbaum, M., and C. R. Sunstein. *Clones and Clones: Facts and
    Fantasies about Human Cloning*. New York: Norton, 1998, p. 321.

[^7]: Consider the following analogy: We would not allow a rare
    sympathetic case for brother-sister marriage---where, say, the two
    children were separated at birth and later fell in love, ignorant of
    their kinship---to overturn the taboo on incest. Whatever their
    merit, the goals of well-being and health do not outweigh the moral
    and social harms that cloning would entail.

[^8]: Nuremberg Report *Trials of War Criminals before the Nuremberg
    Military Tribunals under Control Council Law No. 10, Vol. 2, pp.
    181-182.* Washington, DC: Government Printing Office, 1949.

[^9]: Helsinki Declaration. 18^th^ World Medical Association General
    Assembly *Ethical Principles for Medical Research Involving Human
    Subjects*, adopted in Helsinki, Finland, June 1964, and amended in
    October 1975, October 1983, September 1989, October 1996, and
    October 2000.

[^10]: Belmont Report. The National Commission for the Protection of
    Human Subjects of Biomedical and Behavioral Research. *The Belmont
    Report: Ethical Principles and Guidelines for the Protection of
    Human Subjects of Research*. Bethesda, MD: Government Printing
    Office, 1978.

[^11]: See, for instance, Chapter Four of the present report, as well as
    Chapter 3 of the NAS Report.

[^12]: These issues are discussed in the NAS Report (3-2) as well as in
    Wilmut, I., Roslin Institute, Scotland. "Application of animal
    cloning data to human cloning," paper presented at *Workshop:
    Scientific and Medical Aspects of Human Cloning,* National Academy
    of Sciences, Washington, DC August 7, 2001; and Hill, J., Cornell
    University. "Placental defects in nuclear transfer (cloned)
    animals," paper presented at *Workshop: Scientific and Medical
    Aspects of Human Cloning,* National Academy of Sciences, Washington,
    DC August 7, 2001.

[^13]: See, for instance, Chapter 3 of the NAS Report, and Kolata, G.
    "In Cloning, Failure Far Exceeds Success" *New York Times,* December
    11, 2001, p. D1.

[^14]: See, for instance, Rimington, M., et al. "Counseling patients
    undergoing ovarian stimulation about the risks of ovarian
    hyper-stimulation syndrome." *Human Reproduction,* 14: 2921-2922,
    1999; and Wakeley, K., and E. Grendys. "Reproductive technologies
    and risk of ovarian cancer." *Current Opinion in Obstetrics and
    Gynecology*, 12: 43-47, 2000.

[^15]: These issues are discussed in greater detail in Chapter 3 of the
    NAS Report.

[^16]: Hill J.R., et al. "Clinical and pathologic features of cloned
    transgenic calves and fetuses (13 case studies)" *Theriogenology* 8:
    1451-1465, 1999.

[^17]: NAS Report, 3-2.

    ^17^ Hansen, M., et al., "The Risk of Major Birth Defects after
    Intracytoplasmic Sperm Injection and In Vitro Fertilization," *New
    Eng. J. Med.* 346: 725-30 (2002).

[^18]: ^i^ See for instance the NAS Report, Appendix B, tables 1, 3, and
    4.

[^19]: ^ii^ It is of course true that there is always uncertainty about
    moving from animal to human experimentation or therapy. But in the
    usual case, what justifies the assumption of this added unknown risk
    is that the experimental subject is a likely beneficiary of the
    research, either directly or indirectly. And where this is not the
    case, risk may be assumed if there is informed and voluntary
    consent. Neither of these conditions applies for the child-to-be in
    human cloning experiments.

[^20]: ^i^ Surprisingly, there has been very little systematic study of
    the offspring of in vitro fertilization. One recently published
    study has suggested that IVF (and especially intracytoplasmic sperm
    injection \[ICSI\]) may not be as benign as we had thought.^17^

[^21]: Such improvements in technique could result in part from the
    practice of cloning-for-biomedical-research, were it to be allowed
    to go forward. This possibility is one of the issues we shall
    consider in evaluating the ethics of cloning-for-biomedical-research
    in Chapter Six.

[^22]: We are, of course, well aware that many children are conceived in
    casual, loveless, or even brutal acts of sexual concourse, including
    rape and incest.

[^23]: According to official Chinese census figures for 2000, more than
    116 male births were recorded for every 100 female births. It is
    generally believed that this is the result of the widespread use of
    prenatal sex selection and China's one-child policy, though it
    should be noted that even in a country such as South Korea, which
    has no such policy, the use of prenatal sex selection has skewed the
    sex ratio in favor of males.

[^24]: One thinks of certain forms of plastic surgery or recreational
    uses of euphoriant drugs, and the uses in athletics and schools of
    performance-enhancing drugs, such as anabolic steroids,
    erythropoietin, and Ritalin.

[^25]: And there might be special complications in the event of divorce.
    Does the child rightfully or more naturally belong to the "genetic
    parent"? How would a single parent deal with a child who shares none
    of her genes but carries 100 percent of the genes of the person she
    chose to divorce? Whether such foreseeable complications would in
    fact emerge is, of course, an empirical question that cannot be
    answered in advance. But knowledge of the complexities of family
    life lead us not to want to dismiss them.

[^26]: Not surprisingly, some of us feel more strongly than others about
    this conclusion. One or two of us might someday be willing to see
    cloning-to-produce-children occur in the rare defensible case, but
    then only if means were available to confine its use to such cases.