[Appendix]{.underline}

Personal Statements

The eight chapters, plus Bibliography and Glossary of Terms, constitute
the official body of this report. Though it contains expressed
differences of opinion, especially in Chapters Six and Eight, it stands
as the work of the entire Council. In the interest of contributing
further to public discussion of the issues, and of enabling individual
Members of the Council to speak in their own voice on one or another
aspect of this report, we offer in this Appendix personal statements
from those Members who have elected to submit them.[^1]

Elizabeth H. Blackburn, Ph.D., D.Sc.

Rebecca S. Dresser, J.D., M.S.

Daniel W. Foster, M.D.

Michael S. Gazzaniga, Ph.D.

Robert P. George, D.Phil., J.D. (joined by Alfonso Gómez-Lobo, Ph.D.).

William B. Hurlbut, M.D.

Charles Krauthammer, M.D.

Paul McHugh, M.D.

William F. May, Ph.D.

Gilbert C. Meilaender, Ph.D.

Michael J. Sandel, D.Phil.

James Q. Wilson, Ph.D.

\* \* \*

Statement of Professor Blackburn

Why a Moratorium on Cloning-for-Biomedical-Research

Is Not the Way to Proceed

There are several reasons why a moratorium on
cloning-for-biomedical-research (SCNT) is not a logical or productive
direction in which to proceed.

The goal of a moratorium is to wait until something happens, then make a
decision. For a moratorium on SCNT (cloning-for-biomedical-research),
waiting would have several consequences that I do not believe reflect
the spirit of much of the Council\'s opinion.

First, during any such proposed moratorium, patients will continue to
have currently incurable diseases---for which there is now no hope of
alleviation---and many will continue to die of them. Second, a
moratorium is used to gain more information. It may sound tempting to
impose a moratorium to get more information, since, despite very
promising results, it is true, at this early stage of the research, that
we still know only a little. But that information can *only* be gained
by performing the same research that the moratorium proposes to halt.

It has been proposed that other kinds of research will provide such
answers. One cannot find out the answers about oranges by doing all the
research on apples. Some kinds of research on apples will be useful,
because it will provide information about generalities that apply to
fruit in general. But diseases are very specific, and humans are very
specific. They share overarching features with other animals, but the
very nature of disease is to be particular. Thus, diabetes research does
not apply to Parkinson's research.

Furthermore, it has been proposed that the needed information can be
gained from research in animal models. However, it is of crucial
importance to be aware that human diseases are different, in certain
specific ways, from their counterpart models in animals. This is the
case just as the course of development in a mouse has overarching
similarities to, yet at the same time startling and highly specific
differences from, the course of development of a human. Hence, animal
models, while invaluable up to a point, cannot provide the needed
information for understanding and treating a human disease.

Currently, there are excess in vitro fertilization embryos, and it has
been proposed that biomedical research on these, if allowed by their
parents and those responsible for them, would be adequate for obtaining
the types of information that could be gained from research that
involves SCNT. But first, these excess embryos represent only a limited
set of genetic backgrounds. They do not represent the wide diversity of
genetic and ethnic groups that will be needed if the fruits of this
research are to be available to all. Second, the limited set of
available excess IVF embryos would not, of course, represent the very
genotypes of perhaps greatest interest: those representing the diseases
that are the rightful subject of research involving SCNT. A final point
concerns why these embryos are in excess. It is not only to attempt to
ensure success of IVF, but also, in current IVF practice, these excess
embryos are more often the ones that were judged by the IVF clinic
professionals as appearing less likely to develop well---which is why
they were not chosen for implantation in the first place. If they have a
higher chance of abnormality, this is not the group of embryos that is
ideal for obtaining the best, most relevant, information about
development and disease.

SCNT-derived stem cells could provide other crucial information, in a
way impossible for excess in-vitro-fertilized-embryo-derived stem cells.
Researchers could address, in a clear and experimentally controlled way,
a key unknown issue about the therapeutic value of stem cell use for
regenerative medicine: the immune rejection issue. There are excellent
in vitro investigations that could cast a lot of much needed light on
this area, and could be done only with cells derived from the same
genetic background---i.e., using stem cells from SCNT. Again, this
cannot be done with animal models alone, which have been the only source
of information on this topic to date, because we know that animal models
are not complete models for many particular biological questions in
humans.

In sum, reliance on excess IVF embryos would severely hobble efforts to
gain the information that is needed to be able to judge the promise of
cloning-for-biomedical-research. Further, the use of IVF embryos in no
way facilitates the most immediately promising areas of SCNT research,
which involve not tissue transplantation but rather the development of
laboratory tissue that has been grown from somatic cells with known
genetic mutations that are needed for study and for testing of new
pharmaceutical interventions.

Hence, a moratorium, imposed in order to wait for more information that
will give us a better informed set of facts from which to proceed, is
logically flawed.

The President\'s Council on Bioethics currently is proposing two
possible policy recommendations. Both would ban cloning to make babies.
One proposal is to proceed with cloning-for-biomedical-research (SCNT)
with appropriate regulations; the other is to put it under a four-year
moratorium. I support the former proposal.

Some have called for a moratorium pending development of elaborate
regulatory innovations, such as the creation of a new government body to
oversee all this research. Unfortunately, such regulations might well
never emerge, allowing opponents of research to accomplish by
administrative delay what they have been unable to accomplish through
legislation, that is, a de facto ban on SCNT research. Furthermore,
these proposals ignore the extensive regulation already in place.

Based on the Council\'s public deliberations, over half of the Council
do not have ethical problems with cloning-for-biomedical-research based
simply on the status of the embryo. The proposal of a moratorium on
SCNT, and not its outright ban, by the President\'s Council on Bioethics
certainly implies that the Council deems this research to be important
for medical science. A moratorium can only be counterproductive to the
good that can come out of this research. Rather, the thoughtful
application of current regulations to all SCNT research and
consideration of independent efforts to regulate the market in human
gametes will allow this research to proceed with its risks minimized and
its benefits maximized for all.

[Elizabeth H. Blackburn]{.smallcaps}

\* \* \*

Statement of Professor Dresser

Below are my reasons for agreeing with the First Proposal.

## I. Cloning to Have a Child

The ethical question presented today is not, "if cloning to have a child
were safe, should it then be permitted?" Instead, the question is
whether societies should allow scientists and physicians to conduct
research aimed at producing babies through cloning. Posing the question
this way highlights the research ethics issues raised by this form of
cloning.

A central ethical issue is whether studies of cloning to have a child
would present a balance of risks (to women, fetuses, children, and
society) and expected benefits (to the child, prospective parents, and
society) that justifies proceeding with human trials. The National
Academy of Sciences (NAS) report *Scientific and Medical Aspects of
Human Reproductive Cloning* observes that high numbers of human eggs
would be required for this research. Women serving as research subjects
would be exposed to the risks presented by fertility drugs and egg
retrieval procedures. Women would also be exposed to risks associated
with gestating a cloned fetus. As the NAS report notes, animals pregnant
with cloned fetuses have had miscarriages and other health
complications. If prenatal tests revealed problems in the fetus, women
would face decisions about pregnancy termination. At least initially,
human studies would expose children to the risk of disability and
premature death. Parents and society could face burdens associated with
caring for disabled children. Even if further cloning work in other
species leads to better outcomes, good outcomes would not be assured in
humans.

Added to these risks are the broader ethical concerns raised by cloning
to have a child, such as psychological harm and objectification of
children. Admittedly, many children today are born into environments
that expose them to serious physical, social, and psychic harms.
Prenatal and preimplantation screening allow parents to exercise
deliberate control over children=s genetic makeup. Confused and
difficult family relations can arise in "natural" family settings and as
a result of currently practiced assisted reproduction methods. Certain
social practices may allow and encourage parents to regard children as
projects or products.

What is different about cloning is the array of risks and worries it
presents, together with the relatively little that would be gained by
developing the procedure. Although there are a few cases in which
cloning to have a child might be morally acceptable, there are not
enough of those cases to justify exposing research subjects and others
to the harms that could accompany human testing.

Research on cloning to have children would also consume resources that
might otherwise be devoted to more worthwhile projects. The limited
resources available to support biomedical research should go to studies
relevant to serious human health problems. Responsible companies and
scientists ought to devote their efforts to research on important health
problems, rather than on cloning to have children.

### ***II. Cloning-for-Biomedical-Research***

Several U.S. court opinions and advisory panel reports assign an
intermediate moral status to the human embryo. According to these
statements, embryos should be treated with special respect---not the
respect we give to fully developed humans, but more respect than we give
to items of property. One difficulty with the intermediate status
position is that there is little clarity or agreement on what it means
to treat human embryos with special respect.

Special respect might mean that embryos ought not be created purely for
use as a research tool or a therapy to help others. Creating embryos for
these purposes would represent a significant step beyond allowing the
research use of donated IVF embryos that would otherwise be destroyed.
Creating embryos for research would require women to provide eggs for
research use. It is possible that payment would be necessary to attract
a sufficient number of egg-providers (this would depend on the number of
eggs needed and the number of women willing to donate for altruistic
reasons). In this context, women would be helping to produce a research
tool, rather than helping infertile people to have children.

Some people believe that creation of cloned and other embryos for
research would be consistent with the special respect view. In 1994, a
majority of the National Institutes of Health Human Embryo Research
Panel said that creating embryos for research "for the most serious and
compelling reasons" would be permissible. Former President Clinton
disagreed with this judgment, however. And because panel Members
themselves were concerned about the risks associated with egg donation,
they recommended that eggs for research embryos be obtained solely from
women already undergoing IVF for infertility treatment, women undergoing
gynecological surgery for other reasons, and deceased women based on
their previous consent or the consent of their next-of-kin. The
deliberations in 1994 concerned acceptable conditions for government
funding of human embryo research, but I do not think the participants
meant to suggest that privately funded research should be evaluated
according to wholly different moral considerations.

Because there are legitimate moral concerns raised by the practice of
creating human embryos for research, I believe it would be premature to
endorse research cloning. To approve cloning is to approve the creation
of embryos as research tools. Past advisory groups and others have
expressed sufficient reservations about this step to warrant more
extensive national deliberation about whether it is justified at all
and, if so, under what conditions.

I find it hard to reconcile the special respect view with a policy that
allows embryos to be created purely as a research tool. I also recognize
that some individuals assign a higher moral status to the early embryo.
I do not want to endorse a practice that many people believe is wrong in
the absence of compelling reasons to do so. At the same time, I can
imagine studies that would offer sufficient benefit to patients to
justify the creation of embryos for research through cloning or other
methods.

For me, an important consideration is whether there are or will be in
the near future alternative methods of investigating the relevant
scientific questions. With regard to potential stem cell therapies, the
question is whether cloning will be necessary to avoid the immune
rejection problem. The NAS report *Stem Cells and the Future of
Regenerative Medicine* repeatedly states that additional research in
many areas is needed to determine whether embryonic stem cells can
provide effective therapies to patients. A period of research focused on
stem cells from donated embryos remaining after infertility treatment
and on the immune rejection problem in animals could help to clarify
whether it is necessary to move to research on stem cells from cloned
human embryos. As for other types of research that might be conducted
with stem cells from cloned human embryos, I believe scientists need to
explain in more detail the significance of the research questions and
the reasons why they cannot be investigated using alternative methods.

The appropriate oversight system is another matter meriting further
analysis. In my view, proposals to create research embryos should be
evaluated by a group that includes scientific experts, members of other
professions, and ordinary citizens. The review group should include
individuals with different positions on the moral status of early
embryos. Approval should occur only after a rigorous and thorough
analysis of individual proposals. The review group should require strong
evidence that a proposal will generate information both relevant to a
serious human health problem and not available through alternative
research approaches.

I also believe that the temptation will be strong to extend the time
limits for permissible human embryo and fetal research. Events in the
past demonstrate that the desire to advance knowledge can lead to
immoral research practices. Because there is likely to be pressure to
allow destructive research on developing humans past the point at which
stem cells can be retrieved, our nation should establish a strong moral
and policy basis for drawing the line at a particular point in
development.

In sum, I believe that a four-year moratorium on research cloning is
justified for a variety of reasons. A moratorium gives scientists time
to gather data and develop a stronger account of why it is necessary to
obtain stem cells from cloned embryos. A moratorium allows Members of
this Council and others to consider embryo cloning in its broader
ethical and policy context and to deliberate about appropriate oversight
structures for cloning and related practices. I hope that the moratorium
also gives members of the public an opportunity to learn more about the
actual state of stem cell research.

This is truly a promising area, but it is far from certain that all or
even some of its projected therapeutic benefits will materialize.
Finally, I hope that future public and policy discussions will confront
the challenge of providing patients with access to any stem cell
therapies that may be developed. Millions of patients in the United
States lack access to established health care that could improve and
extend their lives. People in developing countries lack access to the
most basic medical assistance. Because helping patients is the ethical
justification for conducting stem cell and other forms of biomedical
research, improved access to existing and future therapies must be part
of the national discussion.

[Rebecca S. Dresser]{.smallcaps}

[\* \* \*]{.smallcaps}

Statement of Dr. Foster

*For Proposal Two*

I begin by saying that the deliberations of the Council have been from
the beginning serious, open and collegial. Although strong differences
exist amongst some members, these have been expressed in scholarly and
dignified fashion, without anger or personal attacks.

I support Proposal 2. The core issues in the discussion have been two.
The first is "the nature of the embryo" argument. Some supporting
Proposal 1 feel strongly that from the moment of conception, or the
moment of cloning, the germ of potential life is so powerful as to
render the nascent embryo deserving of protection equal to that of a
full human. Others believe that respect for the embryo, though it is not
yet fully human, requires a moratorium to see if alternatives might
render cloning unnecessary. There is no doubt that a five or six day
embryo is potentially human, but it cannot become a human by itself as
would occur in normal human conception. The one or two hundred cell
organism, the blastocyst, is neither viable nor feeling; there are no
organs and there is no brain. There is nothing it can do without
external help and implantation. From the standpoint of science it is
potentially human but biologically pre-human. The evidence for this
conclusion seems unarguable to me.

Proponents of Proposal 1, although they may agree with the biological
facts, focus on "what might be" for the embryo. If implanted, some of
the blastocysts from any source might become fully human, a child.
However, in natural conception many embryos, perhaps half or more, are
deleted in the first trimester. I calculated, using the World Health
Organization 2001 estimate of about 360,000 births in the world each
day, and assuming 50 percent implantation possibility, that more than
130 million embryos are lost naturally each year. Thus what any embryo
might become is far from certain. Obviously the philosophical/moral
argument of absolute or near absolute sanctity of any embryo cannot be
answered by the scientific/biological argument. But I hold to the
latter.

The "slippery slope" argument has been extensively discussed and
fundamentally devolves to the fear or belief that lessons learned in
cloning for research and therapy would make cloning for babies easier or
more likely to occur. That is a legitimate fear, hence the desire by all
of us for a ban on reproductive cloning and the demand for regulation of
all cloning.

I believe that biomedical science is a powerful good in the universe.
The achievements in the prevention and cure of human disease and
suffering over the past half century have been remarkable. What we know
about nature grows daily. Stem cell research has great potential to take
us further. Is it certain that dramatic health benefits will follow? Of
course not. Science is a discipline of uncertainty. That is why in my
view we should begin the research. I believe we have to compare the stem
cells side by side: adult stem cells versus IVF stem cells versus cloned
stem cells. Then we will know whether the potential is real and what the
advantages or disadvantages of each cell type might be. Supporters of
Proposal 1 also believe that research is necessary and argue that the
moratorium will allow research on adult and IVF stem cells. But it
eliminates a critical element, the direct comparison by controlled
experiments for all three types of potentially therapeutic cells.

I said above that science is a discipline of uncertainty that requires
experiments to answer questions of truth. It is also a discipline of
hope. I believe that Proposal 2 is a very good thing for all those who
suffer from disease. It is a decision for hope. It is for this reason
that I support it.

[Daniel W. Foster]{.smallcaps}

[\* \* \*]{.smallcaps}

#### Statement of Dr. Gazzaniga {#statement-of-dr.-gazzaniga .unnumbered}

Oscar Wilde\'s lament, "A man who moralizes is usually a hypocrite," is
a fairly rough statement. While I don\'t fully subscribe to it, I do
believe that it cuts to the heart of much of the problematic nature of
moralization: the divide that can exist between reasoning as reflected
in actions in the face of a collection of facts and reasoning grounded
on little more than a cultural belief system.

Of course, we are all free to have our views on everything from baseball
to embryos. This is a large part of what makes this country great. But
moralizers often go much further. Frequently, they want you to conform
to their views, an agenda that I find entirely disturbing, and
particularly troubling, when cast in the large, as a basis for social
and even scientific policy.

My personal view on these matters is driven by forty years of scientific
study on how the brain enables mind, which gives me a particular
professional perspective on how our species forms and maintains its
belief systems. This, for better or worse, is the lens through which I
see these deliberations.

I disagree with most of the moral reasoning argued in this report. For
me it is full of unsubstantiated psychological speculations on the
nature of sexual life and theories of moral agency. In what follows, I
state my position on the issue of both reproductive and biomedical
cloning in the form of a short essay. I try to capture my own passion
for what is at stake.

***Let Science Roll Forward***

It was a bright and wintry January day when President Bush convened his
advisory panel on bioethics in the Roosevelt Room of the White House. I
was excited to be there and our charge was, and is, to see, explicate,
and finally advise him how to respond to the flood of ethical
complexities unearthed by the torrent of new biomedical technology. The
President implored us to engage in that age-old technique of
intellectual dueling that is debate. I was confident that a sensible and
sensitive policy might evolve from what was sure to be a cacophony of
voices of scientists and philosophers, representing a spectrum of
opinions, beliefs, and intellectual backgrounds.

It was thus a surprise to me to hear the President\'s recent speech on
cloning. His opinions appeared fully formed, even though our panel has
yet to finalize a report and still awaits a vote on the singularly
crucial point of so-called biomedical cloning. While it is true that the
President\'s position is one held by some of the Members of the panel,
it is not unanimous, and the panel\'s charge, the public nature of our
panel\'s debate, and our national political process leave me wanting to
make public my own personal view at this time.

Most people are aware that we no longer see cloning in a simple
one-process-fits-all framework. At the very least there are two flavors.
"Reproductive cloning" is that process by which a new human being might
be grown from the genetic material of a single individual. At this point
in our history, no one supports reproductive cloning. It is, by
consensus, dangerous, probably not even attainable for years, and simply
an odd concept. Even if reproductive cloning did succeed in the future,
the idea of informing one\'s spouse, "Let\'s go with my genes, not
yours," is bizarre and socially a nonstarter.

In juxtaposition to reproductive cloning is "biomedical cloning." This
is another matter entirely. Biomedical cloning is carried out with a
completely different set of intentions from reproductive cloning.
Biomedical cloning is a bit of a misnomer, but it is the term the panel
wants to use instead of therapeutic cloning, for it is meant to cover
not only cloning for therapeutics (for such diseases as diabetes,
Parkinson\'s disease, and so on) but also that cloning now deemed
necessary for understanding all genetic disorders. This is cloning for
the sole purpose of enabling various types of lifesaving biomedical
research. Perhaps the Council should have called it lifesaving cloning.

Intentions aside, it is worth recalling the mechanics of biomedical
cloning. Scientists prefer to call this somatic cell nuclear transfer
for a simple reason. That is all it is. Any cell from an adult can be
placed in an egg whose own nucleus has been removed and given a jolt of
electricity. This all takes place in a lab dish, and the hope is that
this transfer will allow the adult cell to be reprogrammed so that it
will form a clump of approximately 150 cells called a blastocyst. That
clump of cells will then be harvested for the stem cells the clump
contains, and medical science will move forward.

The general public gets confused around this point in a discussion. The
confusions come from a conflation of ideas, beliefs, and facts. At the
core seems to be the idea, asserted by some religious groups and some
ethicists, that this moment of transfer of cellular material is an
initiation of life, and so is the moment when a moral equivalency is
established between a developing group of cells and a human being. They
believe this is true for a normally sexually produced embryo and now so
too for this new activated cell. This is the point of view that led to
the President\'s view that both reproductive cloning and biomedical
cloning should be outlawed. But in light of modern biological knowledge,
is the view that life and moral agency start at the same time reasonable
and true? Some think not.

First, consider embryos. We now know that as many as 50 to 80 percent of
all fertilized eggs spontaneously abort. Those fertilized eggs are
simply expelled from the body. It is hard to believe that under any
religious belief system people would grieve and/or hold funerals for
these natural events. Yet, if these unfortunate zygotes are considered
human beings, then logically they should. Second, the process of a
single zygote splitting to make identical twins can occur at least until
fourteen days after fertilization. Thus, how could we possibly identify
a person with a single fertilized egg? Additionally, even divided
embryos can recombine back into one. The happy result would be a person
who has emerged from two distinct fertilized eggs but is otherwise just
like you and me. The "person = zygote" theory would have to say that he
is two people! Finally, with respect to activated cells, there is no
real claim when it all starts because it is not known in any detail.

Because the fertilization process is now understood, it serves as the
modern scientific basis for the British position, which does not grant
moral status to an embryo until after fourteen days, the time when all
the twinning issues cease and the point where it must be implanted into
the uterus if development is to continue. Thus, in Britain, embryo
research goes on up to the blastocyst stage only and now, most recently,
attempts at cloning to the blastocyst stage will be permitted.

The laboratory-devised blastocyst to be used for biomedical cloning, the
biological clump of cells at issue here, is the size of the dot on this
"i." It has no nervous system and is therefore not sentient in any way
and has no trajectory to becoming a human unless it is re-implanted into
a women\'s uterus. And yet it likely carries the gold for the cure of
millions of people. My brother is a general surgeon. He has saved
hundreds of lives because he was able to transplant hearts and livers
and kidneys and lungs to others from clinically brain-dead patients. The
next of kin gave their loved one\'s tissue to help others, a practice
which is condoned by all of society, including Catholics. It seems only
right that those adults not needing leftover IVF embryos or eggs,
neither of which have a brain at all, should have the same right to will
them for use in biomedical research. The no-brained blastocyst that can
develop from these tissue gifts, from both IVF and biomedical cloning
technologies, is ready to help the suffering of brain-alive children and
adults.

The President asked us to debate on our opening day. He said, "That\'s
what I want. You haven\'t heard a debate until you have heard Colin
Powell and Don Rumsfeld go at it." He lets these two trusted aides have
it out, and I think he made a courageous and wise decision to send in
the troops to have at the terrorists who would destroy innocent women
and children. Disease does the same. I only hope he hears the debate,
and then I hope he decides to send in the stem cells to root out
disease. In the spirit of these times, I too say, "Let\'s roll."

[Michael S. Gazzaniga]{.smallcaps}

[\* \* \*]{.smallcaps}

**Statement of Professor George**

**(Joined by Dr. Gómez-Lobo)**

The subject matter of the present report is human cloning, the
production of a human embryo by means of somatic cell nuclear transfer
(SCNT) or similar technologies. Just as fertilization, if successful,
generates a human embryo, cloning produces the same result by combining
what is normally combined and activated in fertilization, that is, the
full genetic code plus the ovular cytoplasm. Fertilization produces a
new and complete, though immature, human organism. The same is true of
successful cloning. Cloned embryos therefore ought to be treated as
having the same moral status as other human embryos.

A human embryo is a whole living member of the species homo sapiens in
the earliest stage of his or her natural development. Unless denied a
suitable environment, an embryonic human being will by directing its own
integral organic functioning develop himself or herself to the next more
mature developmental stage, i.e., the fetal stage. The embryonic, fetal,
infant, child, and adolescent stages are stages in the development of a
determinate and enduring entity---a human being---who comes into
existence as a single cell organism and develops, if all goes well, into
adulthood many years later.[^2]

Human embryos possess the epigenetic primordia for self-directed growth
into adulthood, with their determinateness and identity fully intact.
The adult human being that is now you or me is the same human being who,
at an earlier stage of his or her life, was an adolescent, and before
that a child, an infant, a fetus, and an embryo. Even in the embryonic
stage, you and I were undeniably whole, living members of the species
homo sapiens. We were then, as we are now, distinct and complete (though
in the beginning we were, of course, immature) human organisms; we were
not mere parts of other organisms.

Consider the case of ordinary sexual reproduction. Plainly, the gametes
whose union brings into existence the embryo are not whole or distinct
organisms. They are functionally (and not merely genetically)
identifiable as *parts* of the male or female (potential) parents. Each
has only half the genetic material needed to guide the development of an
immature human being toward full maturity. They are destined either to
combine with an oocyte or spermatozoon to generate a new and distinct
organism, or simply die. Even when fertilization occurs, they do not
survive; rather, their genetic material enters into the composition of a
new organism.

But none of this is true of the human embryo, from the zygote and
blastula stages onward. The combining of the chromosomes of the
spermatozoon and of the oocyte generates what every authority in human
embryology identifies as a new and distinct organism. Whether produced
by fertilization or by SCNT or some other cloning technique, the human
embryo possesses all of the genetic material needed to inform and
organize its growth. Unless deprived of a suitable environment or
prevented by accident or disease, the embryo is actively developing
itself to full maturity. The direction of its growth *is not
extrinsically determined*, but is in accord with the genetic information
*within* it.[^3] The human embryo is, then, a whole (though immature)
and distinct human organism---a human being.

If the embryo were *not* a complete organism, then what could it be?
Unlike the spermatozoa and the oocytes, it is not a part of the mother
or of the father. Nor is it a disordered growth such as a hydatidiform
mole or teratoma. (Such entities lack the internal resources to actively
develop themselves to the next more mature stage of the life of a human
being.) Perhaps someone will say that the early embryo is an
intermediate form, something that regularly emerges into a whole (though
immature) human organism but is not one yet. But what could cause the
emergence of the whole human organism, and cause it with regularity? It
is clear that from the zygote stage forward, the major development of
this organism is *controlled and directed from within,* that is, by the
organism itself. So, after the embryo comes into being, no event or
series of events occur that could be construed as the production of a
new organism; that is, nothing extrinsic to the developing organism
itself acts on it to produce a new character or new direction in
development.

But does this mean that the human embryo is a human being deserving of
full moral respect such that it may not legitimately be used as a mere
means to benefit others?

To deny that embryonic human beings deserve full respect, one must
suppose that not every whole living human being is deserving of full
respect. To do that, one must hold that those human beings who deserve
full respect deserve it not in virtue of *the kind of entity they are*,
but, rather, in virtue of some acquired characteristic that some human
beings (or human beings at some stages) have and others do not, and
which some human beings have in greater degree than others.[^4]

We submit that this position is untenable. It is clear that one need not
be *actually* conscious, reasoning, deliberating, making choices, etc.,
in order to be a human being who deserves full moral respect, for it is
clear that people who are asleep or in reversible comas deserve such
respect. So, if one denied that human beings are intrinsically valuable
in virtue of what they are, but required an additional attribute, the
additional attribute would have to be a capacity of some sort, and,
obviously a capacity for certain mental functions. Of course, human
beings in the embryonic, fetal, and early infant stages lack immediately
exercisable capacities for mental functions characteristically carried
out (though intermittently) by most (not all---consider cases of
severely retarded children and adults and comatose persons) human beings
at later stages of maturity. Still, they possess in radical (= root)
form these very capacities. Precisely by virtue of *the kind of entity
they are*, they are from the beginning actively developing themselves to
the stages at which these capacities will (if all goes well) be
immediately exercisable. In this critical respect, they are quite unlike
cats and dogs---even adult members of those species. As humans, they are
members of a natural kind---the human species---whose embryonic, fetal,
and infant members, if not prevented by some extrinsic cause, develop in
due course and by intrinsic self-direction the immediately exercisable
capacity for characteristically human mental functions. Each new human
being comes into existence possessing the internal resources to develop
immediately exercisable characteristically human mental capacities---and
only the adverse effects on them *of other causes* will prevent their
full development. In this sense, even human beings in the embryonic,
fetal, and infant stages have the *basic natural* capacity for
characteristically human mental functions.

We can, therefore, distinguish two senses of the "capacity" (or what is
sometimes referred to as the "potentiality") for mental functions: an
immediately exercisable one, and a basic natural capacity, which
develops over time. On what basis can one require for the recognition of
full moral respect the first sort of capacity, which is an attribute
that human beings acquire (if at all) only in the course of development
(and may lose before dying), and that some will have in greater degree
than others, and not the second, which is possessed by human beings as
such? We can think of no good reason or nonarbitrary justification.

By contrast, there are good reasons to hold that the second type of
capacity is the ground for full moral respect.

First, someone entertaining the view that one deserves full moral
respect only if one has immediately exercisable capacities for mental
functions should realize that the developing human being does not reach
a level of maturity at which he or she performs a type of mental act
that other animals do not perform---even animals such as dogs and
cats---until at least several months after birth. A six-week-old baby
lacks the *immediately exercisable* capacity to perform
characteristically human mental functions. So, if full moral respect
were due only to those who possess immediately exercisable capacities
for characteristically human mental functions, it would follow that
six-week-old infants do not deserve full moral respect. If one further
takes the position that beings (including human beings) deserving less
than full moral respect may legitimately be dismembered for the sake of
research to benefit those who are thought to deserve full moral respect,
then one is logically committed to the view that, subject to parental
approval, the body parts of human infants, as well as those of human
embryos and fetuses, should be fair game for scientific experimentation.

Second, the difference between these two types of capacity is merely a
difference between stages along a continuum. The proximate, or
immediately exercisable, capacity for mental functions is only the
development of an underlying potentiality that the human being possesses
simply by virtue of the kind of entity it is. The capacities for
reasoning, deliberating, and making choices are gradually developed, or
brought toward maturation, through gestation, childhood, adolescence,
and so on. But the difference between a being that deserves full moral
respect and a being that does not (and can therefore legitimately be
dismembered as a means of benefiting others) cannot consist only in the
fact that, while both have some feature, one has more of it than the
other. A mere *quantitative* difference (having more or less of the same
feature, such as the development of a basic natural capacity) cannot by
itself be a justificatory basis for treating different entities in
*radically* different ways. Between the ovum and the approaching
thousands of sperm, on the one hand, and the embryonic human being, on
the other hand, there *is* a clear difference in kind. But between the
embryonic human being and that same human being at any later stage of
its maturation, there is only a difference in degree.

Third, being a whole human organism (whether immature or not) is an
either/or matter---a thing either is or is not a whole human being. But
the acquired qualities that could be proposed as criteria for personhood
come in varying and continuous degrees: there is an infinite number of
degrees of the relevant developed abilities or dispositions, such as for
self-consciousness, intelligence, or rationality. So, if human beings
were worthy of full moral respect only because of such qualities, and
not in virtue of the kind of being they are, then, since such qualities
come in varying degrees, no account could be given of why basic rights
are not possessed by human beings in varying degrees. The proposition
that all human beings are created equal would be relegated to the status
of a superstition. For example, if developed self-consciousness bestowed
rights, then, since some people are more self-conscious than others
(that is, have developed that capacity to a greater extent than others),
some people would be greater in dignity than others, and the rights of
the superiors would trump those of the inferiors where the interests of
the superiors could be advanced at the cost of the inferiors. This
conclusion would follow no matter which of the acquired qualities
generally proposed as qualifying some human beings (or human beings at
some stages) for full respect were selected. Clearly, developed
self-consciousness, or desires, or so on, are arbitrarily selected
degrees of development of capacities that all human beings possess in
(at least) radical form from the coming into being of the organism until
his or her death. So, it cannot be the case that *some* human beings
*and not others* are intrinsically valuable, by virtue of a certain
degree of development. Rather, human beings are intrinsically valuable
*in virtue of what (i.e., the kind of being) they are*; and *all* human
beings---not just some, and certainly not just those who have advanced
sufficiently along the developmental path as to be able to exercise
their capacities for characteristically human mental functions---are
intrinsically valuable.

Since human beings are intrinsically valuable and deserving of full
moral respect in virtue of what they are, it follows that they are
intrinsically valuable from the point at which they come into being.
Even in the embryonic stage of our lives, each of us was a human being
and, as such, worthy of concern and protection. Embryonic human beings,
whether brought into existence by union of gametes, SCNT, or other
cloning technologies, should be accorded the status of inviolability
recognized for human beings in other developmental stages.

Three arguments have been repeatedly advanced in the course of our
Council's deliberations in an effort to cast doubt on the proposition
that human embryos deserve to be accorded such status.

\(1\) Some have claimed that the phenomenon of monozygotic twinning
shows that the embryo in the first several days of its gestation is not
a human individual. The suggestion is that as long as twinning can
occur, what exists is not yet a unitary human being but only a mass of
cells---each cell is totipotent and allegedly independent of the others.

It is true that *if a cell or group of cells is detached from the whole*
at an early stage of embryonic development, then what is detached can
sometimes become a distinct organism and has the potential to develop to
maturity as distinct from the embryo from which it was detached (this is
the meaning of "totipotent"). But this does nothing to show that before
detachment the cells within the human embryo constituted only an
incidental mass. Consider the parallel case of division of a flatworm.
Parts of a flatworm have the potential to become a whole flatworm when
isolated from the present whole of which they are part. Yet no one would
suggest that prior to the division of a flatworm to produce two whole
flatworms the original flatworm was not a unitary individual. Likewise,
at the early stages of human embryonic development, before
specialization by the cells has progressed very far, the cells or groups
of cells can become whole organisms if they are divided and have an
appropriate environment after the division. But that fact does not in
the least indicate that prior to such an extrinsic division the embryo
is other than a unitary, self-integrating, actively developing human
organism. It certainly does not show that the embryo is a mere clump of
cells.

In the first two weeks, the cells of the developing embryonic human
being already manifest a degree of specialization or differentiation.
From the very beginning, even at the two-cell stage, the cells differ in
the cytoplasm received from the original ovum. Also they are
differentiated by their position within the embryo. In mammals, even in
the unfertilized ovum, there is already an "animal" pole (from which the
nervous system and eyes develop) and a "vegetal" pole (from which the
future "lower" organs and the gut develop).[^5] After the initial
cleavage, the cell coming from the "animal" pole is probably the
primordium of the nervous system and the other senses, and the cell
coming from the "vegetal" pole is probably the primordium of the
digestive system. Moreover, the relative position of a cell from the
very beginning (that is, from the first cleavage) has an impact on its
functioning. Monozygotic twinning usually occurs at the blastocyst
stage, in which there clearly is a differentiation of the inner cell
mass and the trophoblast that surrounds it (from which the placenta
develops).[^6]

The orientation and timing of the cleavages are species specific, and
are therefore genetically determined, that is, determined from within.
Even at the two-cell stage, the embryo begins synthesizing a
glycoprotein called "E-cadherin" or "uvomorulin," which will be
instrumental in the compaction process at the eight-cell stage, the
process in which the blastomeres (individual cells of the embryo at the
blastocyst stage) join tightly together, flattening and developing an
inside-outside polarity.[^7] And there is still more evidence, but the
point is that from the zygote stage forward, the embryo, as well as
maintaining homeostasis, is internally integrating various processes to
direct them in an overall growth pattern toward maturity.[^8]

But the clearest evidence that the embryo in the first two weeks is not
a mere mass of cells but is a unitary organism is this: *if the
individual cells within the embryo before twinning were each independent
of the others, there would be no reason why each would not regularly
develop on its own. Instead, these allegedly independent,
noncommunicating cells regularly function together to develop into a
single, more mature member of the human species.* This fact shows that
interaction is taking place between the cells from the very beginning
(even within the zona pellucida, before implantation), restraining them
from individually developing as whole organisms and directing each of
them to function as a relevant part of a single, whole organism
continuous with the zygote. Thus, prior to an extrinsic division of the
cells of the embryo, these cells together do constitute a single
organism. So, the fact of twinning does not show that the embryo is a
mere incidental mass of cells. Rather, the evidence clearly indicates
that the human embryo, from the zygote stage forward, is a unitary,
human organism.

\(2\) The second argument we wish to address suggests that since people
frequently do not grieve, or do not grieve intensely, for the loss of an
embryo early in pregnancy, as they do for the loss of a fetus late in
pregnancy or of a newborn, we are warranted in concluding that the early
embryo is not a human being worthy of full moral respect.

The absence of grieving is sometimes a result of ignorance about the
facts of embryogenesis and intrauterine human development. If people are
told (as they still are in some places) that there simply is no human
being until "quickening"---a view which is preposterous in light of the
embryological facts---then they are likely not to grieve (or not to
grieve intensely) at an early miscarriage. But people who are better
informed, and women in particular, very often *do* grieve even when a
miscarriage occurs early in pregnancy.

Granted, some people informed about many of the embryological facts are
nevertheless indifferent to early miscarriages; but this is often due to
a reductionist view according to which embryonic human beings are
misdescribed as mere "clumps of cells," "masses of tissue," etc. The
*emotional* attitude one has toward early miscarriages is typically and
for the most part *an effect* of what one thinks---rightly or
wrongly---about the humanity of the embryo. Hence it is circular
reasoning to use the indifference of people who deny (wrongly, in our
view) that human beings in the embryonic stage deserve full moral
respect as an argument for not according such respect.

Moreover, the fact that people typically grieve less in the case of a
miscarriage than they do in the case of an infant's death is partly
explained by the simple facts that they do not actually see the baby,
hold her in their arms, talk to her, and so on. The process of emotional
bonding is typically completed after the child is born---sometimes, and
in some cultures, months after the child is born. However, a child's
right not to be killed plainly does not depend on whether her parents or
anyone else has formed an emotional bond with her. Every year---perhaps
every day---people die for whom others do not grieve. This does not mean
that they lacked the status of human beings who were worthy of full
moral respect.

It is simply a mistake to conclude from the fact that people do not
grieve, or grieve less, at early miscarriage that the embryo has in
herself less dignity or worth than older human beings.

\(3\) We now turn to the third argument. Some people, apparently, are
moved to believe that embryonic human beings are not worthy of full
moral respect because a high percentage of embryos formed in natural
pregnancies fail to implant or spontaneously abort. Again, we submit
that the inference is fallacious.

It is worth noting first, as the standard embryology texts point out,
that many of these unsuccessful pregnancies are really due to incomplete
fertilizations. So, in many cases, what is lost is not actually a human
embryo. To be a complete human organism (a human being), the entity must
have the epigenetic primordia for a functioning brain and nervous
system, though a chromosomal defect might only prevent development to
maximum functioning (in which case it would be a human being, though
handicapped). If fertilization is not complete, then what is developing
is not an organism with the active capacity to develop itself to the
mature (even if handicapped) state of a human.

Second, the argument here rests upon a variant of the naturalistic
fallacy. It supposes that what happens in "nature," i.e., with
predictable frequency without the intervention of human agency, must be
morally acceptable when deliberately caused. Since embryonic death in
early miscarriages happens with predictable frequency without the
intervention of human agency, the argument goes, we are warranted in
concluding that the deliberate destruction of human beings in the
embryonic stage is morally acceptable.

The unsoundness of such reasoning can easily be brought into focus by
considering the fact that historically, and in some places even today,
the *infant* mortality rate has been very high. If the reasoning under
review here were sound, it would show that human infants in such
circumstances could not be full human beings possessing a basic right
not to be killed for the benefit of others. But that of course is surely
wrong. The argument is a *non sequitur*.

In conclusion, we submit that law and public policy should proceed on
the basis of full moral respect for human beings irrespective of age,
size, stage of development, or condition of dependency. Justice requires
no less. In the context of the debate over cloning, it requires, in our
opinion, a ban on the production of embryos, whether by SCNT or other
processes, for research that harms them or results in their destruction.
Embryonic human beings, no less than human beings at other developmental
stages, should be treated as subjects of moral respect and human rights,
not as objects that may be damaged or destroyed for the benefit of
others. We also hold that cloning for the purpose of baby making ought
to be legally prohibited. In our view, such cloning, even if it could be
done without the risk of defects or deformities, treats the child-to-be
as a product of manufacture, and is therefore inconsistent with a due
respect for the dignity of human beings. Still, it is our considered
judgment that cloning for purposes of research, inasmuch as it involves
the deliberate destruction of embryos, is morally worse than cloning for
the purpose of baby making. Thus we urge that any ban on "reproductive
cloning" be a prohibition on the practice of cloning itself, and not on
the implantation of embryos. Public policy should protect embryonic
human beings and certainly not mandate or encourage their destruction.
An effective ban on "reproductive cloning" would be a ban on all
cloning.[^9]

Although an optimal policy would permanently ban all cloning, we join in
this Council's call for a permanent ban on cloning to produce children
combined with a four-year ban (or "moratorium") on cloning for
biomedical research for the reasons set forth by Gilbert Meilaender in
his additional statement. It is our particular hope that a four-year
period will provide time for a careful and thorough public debate about
the moral status of the human embryo. This is a debate we welcome.

[Robert P. George]{.smallcaps}

[Alfonso Gómez-Lobo]{.smallcaps}

[\* \* \*]{.smallcaps}

**Statement of Dr. Hurlbut**

In joining with fellow Members of the Council in support of a moratorium
on cloning for biomedical research, I consider this recommendation not
an admission of ambivalence on matters of policy, but a recognition of
the difficulty of the moral issues involved and an affirmation of the
need for further discussion and deliberation. Throughout our proceedings
it has become increasingly apparent that without clear and distinct
moral principles, grounded in scientific evidence and reasoned moral
argument, no policy can be effectively formulated or enforced. Most
specifically, the proposed limitation of fourteen days for research on
human embryos and the prohibition against implantation appear to be
arbitrarily set and therefore vulnerable to transgression through the
persuasive promise of further scientific benefit. Clearly, a more
thorough and thoughtful consideration of the moral status of the human
embryo is warranted. It is in the spirit of this continuing discussion
that I offer the personal perspectives that follow.

***Introduction***

In pondering the ethics of cloning for biomedical research it is
apparent that as our science is changing, so is the nature of our moral
dilemmas. Each advance forces us to think more deeply about what it
means to be human. As the scientific focus on genomics moves on to
proteomics and now to the early stages of the study of developmental
biology, we are confronted with the challenge of understanding the moral
meaning of human life in its dynamics of change, as both potential and
process.

A reasonable anticipation of the likely course of science suggests that
concerns about cloning are just the beginning of a series of difficult
ethical issues relating to embryo experimentation and medical
intervention in developing life. In addition, advances in developmental
biology will open more deeply the dilemmas related to human-animal
hybridization, extra-corporeal gestation, and genetic and cellular
enhancement. Driven by the vast range of research applications and
opportunities for clinical interventions in disease and disability
(especially the open ended possibilities promised by regenerative
medicine) this technology will be powerfully propelled into the
forefront of medical science.

Given the complex course of science and the drive to its development,
any moral assessment of cloning for biomedical research (CBR) must
describe the central human goods it seeks to preserve, the range and
boundaries of these values, and the broad implications for science and
society implied by them. Such an assessment should serve the dual
purpose of helping to define the moral dangers while clearing the course
for the fullest and most open future for scientific investigation and
application.

***Moral Principles***

Although there are already numerous promising approaches for research on
human development even without cloning for biomedical research (CBR), I
believe this technology could provide valuable tools for scientific
inquiry and medical advance. In my judgment, the moral imperative to
foster an increase of knowledge and new modes of therapeutic
intervention weighs heavily in the equation of consideration.
Nonetheless, I believe that, as they stand, current proposals for CBR
will breach fundamental moral goods, erode social cohesion and
ultimately constrain the promise of advances in developmental biology
and their medical applications. However, there may be morally acceptable
ways of employing CBR that could both preserve our commitment to
fundamental moral principles and strengthen our appreciation of the
significance of developing life, while also opening avenues of advance
less limiting and more promising than the current scientific proposals.

The principle of human life as the fundamental good serves as the
cornerstone of law for our civilization. In no circumstance is the
intentional destruction of the life of an innocent individual deemed
morally acceptable. Even where a right to abortion is given, for
example, it is based on a woman's right not to be encumbered, a right of
privacy, not a right to directly kill the fetus.[^10] This valuing of
human life is indeed the moral starting point for both advocates and
opponents of CBR. This principle of the inviolability of human life is
the reciprocal respect that we naturally grant as we recognize in the
other a being of moral equivalence to ourselves. Although different
cultures and different eras have affirmed this recognition in varied
ways, I will argue that it is reasonable in light of our current
scientific knowledge that we extend this principle to human life in its
earliest developmental stages.

***Life as Process***

When looked at through the lens of science, it is evident that human
existence cannot be defined atemporally, but must be recognized in the
full procession of continuity and change that is essential for its
development. From conception, our unique genetic endowment organizes and
guides the expression of our particular nature in its species and
individual character. Fertilization initiates the most complex chemical
reaction in the known universe: a self-directing, purposeful integration
of organismal development. In both character and conduct the zygote and
subsequent embryonic stages differ from any other cells or tissues of
the body; they contain within themselves the organizing principle of the
full human organism.

This is not an abstract or hypothetical potential in the sense of mere
possibility, but rather a potency, an engaged and effective
potential-in-process, an activated dynamic of development in the
direction of human fullness of being. For this reason a zygote (or a
clonote) differs fundamentally from an unfertilized egg, a sperm cell,
or later somatic cells; it possesses an inherent organismal unity and
potency that such other cells lack. Unlike an assembly of parts in which
a manufactured product is in no sense "present" until there is a
completed construction, a living being has a continuous unfolding
existence that is inseparable from its emerging form. The form is itself
a dynamic process rather than a static structure. In biology, the whole
(as the unified organismal principle of growth) precedes and produces
the parts. It is this implicit whole, with its inherent potency, that
endows the embryo with its human character and therefore its inviolable
moral status. To interfere in its development is to transgress upon a
life in process.[^11]

The argument is sometimes made that potential should not be part of the
moral equation because of the low probability of successful development
of the early embryo.[^12] This, however, is itself an argument based on
potential, in this case the lack of potential to develop normally.[^13]
The fact that life in its early stages is extremely fragile and often
fails is not an argument to lessen the moral standing of the embryo.
Vulnerability does not render a life less valuable.

***Accrued Moral Status***

The major alternative to the view that an embryo has an inherent moral
status is the assertion that moral status is an accrued or accumulated
quality related to some dimension of form or function. Several arguments
have been put forward for this position.

[1. Gastrulation]{.underline}

One such accrual argument is based on the idea that before gastrulation
(designated as the 14^th^ day) the embryo is an inchoate clump of cells
with no actuated drive in the direction of distinct development.[^14] It
is argued that the undifferentiated quality of the blastocyst justifies
its disaggregation for the procurement of stem cells, while the evident
organization at gastrulation reveals an organismal integrity that endows
inviolable moral status to all subsequent stages of embryological
development. Scientific evidence, however, supports the argument that
from conception there is an unbroken continuity in the differentiation
and organization of the emerging individual life. The anterior-posterior
axis appears to be already established within the zygote, early cell
divisions (at least after the 8 cell stage) exhibit differential gene
expression[^15] and unequal cytoplasmic concentrations of cell
constituents suggest distinct cellular fates. This implies that the
changes at gastrulation do not represent a discontinuity of ontological
significance, but merely the visibly evident culmination of more subtle
developmental processes (at the cellular level) driving in the direction
of organismal maturity.

[2. Twinning]{.underline}

Another argument for accrued moral status is that as long as an embryo
is capable of giving rise to a twin it cannot be considered to have the
moral standing of an individual. There is the obvious objection that as
one locus of moral status becomes two it does not diminish but increase
the moral moment. But perhaps more substantially, this argument actually
supports the notion that crucial dimensions of individuation (and their
disruption that results in twinning) are already at work in the
blastocyst, the stage at which most twinning occurs. Monozygotic
twinning (a mere 0.4% of births) does not appear to be either an
intrinsic drive or a random process within embryogenesis. Rather, it is
a disruption of normal development by a mechanical or biochemical
disturbance of fragile cell relationships that provokes a compensatory
repair, but with the restitution of integrity within two distinct
trajectories of embryological development.[^16] In considering the
implications of twinning for individuation, one might ask the question
from the opposite perspective. What keeps each of these totipotent cells
from becoming a full embryo? Clearly, crucial relational dynamics of
position and intercellular communication are already at work
establishing the unified pattern of the emerging individual. From this
perspective twinning is not evidence of the absence of an individual,
but of an extraordinary power of compensatory repair that reflects more
fully the potency of the individual drive to fullness of form.

[3. Implantation]{.underline}

Some have argued that the implantation of the embryo within the uterine
lining of the mother constitutes a moment of altered moral status.
Implantation, however, is actually a process that extends from around
the 6^th^ or 7^th^ day to about the 11^th^ or 12^th^ day when the
uteroplacental circulation is established. This complex circulatory
exchange extends the earlier relationship between mother and embryo in
which physiological conditions, including the diffusion of essential
nutrients, sustained the life and nourished the growth of the developing
embryo. Although these early conditions can be artificially simulated as
in IVF, the delicate balance of essential factors and their effect on
development (as seen in Large Offspring Syndrome)[^17] is evidence of
the crucial contribution of the mother even in the first week of
embryogenesis. Changes in the intricate interrelations between mother
and infant cannot be viewed as an alteration of moral status, but as
part of the ongoing epigenetic process all along the continuum of
natural development that begins with conception and continues into
infancy. This continuity implies no meaningful moral marker at
implantation.[^18]

[4. Function]{.underline}

Arguments for a change in moral status based on function are at once the
most difficult to refute and to defend. The first and most obvious
problem is that the essential functions (even their minimal criteria and
age of onset) are diverse and arbitrarily assigned. Generally they
relate to the onset of sentience, awareness of pain, or some apparently
unique human cognitive capability such as consciousness.[^19] But if
human moral worth is based on actual manifest functions, then does more
of a particular function give an individual life a higher moral value?
And what are we to make of the parallel capacities in animals that we
routinely sacrifice for food and medical research? Furthermore, what
becomes of human moral status with the degeneration or disappearance of
such a function? While we might argue that our relational obligations
change along with changes in function, such as occur with senile
dementia, we would not sanction a utilitarian calculus and the purely
instrumental use of such persons no matter how promising the medical
benefits might be. The diagnostic requirements of "brain death" for
removing organs for transplantation, far from being a justification for
interrupting a developing life before "brain birth", actually point to
the moral significance of potential and the stringency of the criteria
for irreversible disintegration and death.

From a scientific perspective, there is no meaningful moment when one
can definitively designate the biological origins of a human
characteristic such as consciousness. Even designations such as 'the
nervous system' are conceptual tools, reifications of an indivisible
organismal unity. Zygote, morula, embryo, fetus, child and adult: these
are conceptual constructions for convenience of description, not
distinct ontological categories. With respect to fundamental moral
status therefore, as distinguished from developing relational
obligations, the human being is an embodied being whose intrinsic
dignity is inseparable from its full procession of life and always
present in its varied stages of emergence.

***A Bright Line at Conception***

If the embryo has an inherent moral status that is not an accrued or
accumulated quality related to some dimension of form or function, then
that moral status must begin with the zygote (or clonote). Anything
short of affirming the inviolability of life across all of its stages
from zygote to natural death leads to an instrumental view of human
life. Such a revocation of our most fundamental moral principle would
reverse a long and overarching trend of progress in moral awareness and
practice in our civilization. From human sacrifice,[^20] to slavery,
child labor, women\'s rights and civil rights, we have progressively
discerned and prohibited practices that subject the individual to the
injustice of exploitation by others. The reversal of such a basic moral
valuation will extend itself in a logic of justification that has
ominous implications for our attitude and approach to human existence.
This is not a mere "slippery slope," where we are slowly led downward by
the ever more desirable extension of exceptions to moral principle. It
is, rather, a "crumbly cliff" where the very utility of abrogating a
basic moral prohibition carries such convenience of consequence that the
subsequent descent is simply practice catching up with principle.

The inviolability of human life is the essential foundation on which all
other principles of justice are built, and any erosion of this
foundation destabilizes the social cooperation that makes possible the
benefits of organized society. Medicine is especially vulnerable to such
effects since it operates at the intrinsically moral interface between
scientific technique and the most tender and sensitive dimensions of
personal reality in the vulnerable patient. As we descend into an
instrumental use of human life we destroy the very reason for which we
were undertaking our new therapies; we destroy the humanity we were
trying to heal.

The promise of stem cells lies beyond simple cell cultures and cell
replacement thereapies. The 14 day marker will not hold up to logical
argument.[^21] The technological goal is to produce the more advanced
cell types of tissues, organs, and possibly even limb primordia.
Producing such complex tissues and organs may require the cell
interactions and microenvironments now available only through natural
gestation.[^22] The benefits of implanting cloned embryos (either into
the natural womb or possibly an artificial endometrium) so as to employ
the developmental dynamics of natural embryogenesis seem self-evident.
The implantation of cloned embryos for the production of
patient-specific tissue types to bypass problems of immune rejection
would further extend the logic of the instrumental use of developing
life. The public pressure that has already been brought to bear on the
politics of stem cells and cloning by patient advocacy groups has
provoked such a sense of promise that it may propel the argument for
allowing implantation of cloned embryos. Different people may have
different limits to the duration of gestation they find morally
acceptable, but in light of the current sanction of abortion up to and
beyond the end of the second trimester, it is difficult to argue that
creation, gestation and sacrifice of a clone to save an existing life is
a large leap in the logic of justification.

***A Speculative Proposal***

While maintaining a bright line at conception safeguards our most
fundamental moral principle, the challenge remains to find an acceptable
method of drawing on the great medical promise of CBR while precluding
its use in ways that degrade the dignity of human existence. Some
proponents of CBR maintain that the laboratory creation of the cloned
embryo makes it a "pseudo-embryo" or "artifact," a product of human
technological production.[^23] The problem with this assertion, is that
once created the cloned embryo appears to be no different than the
product of natural fertilization. But what if we could use the cloning
techniques of nuclear transfer to create an entity that lacks the
qualities and capabilities essential to be designated a human life in
process? By intentional alteration of the somatic cell nuclear
components or the cytoplasm of the oocyte into which they are
transferred, could we truly create an artifact (a human creation for
human ends) that is biologically and morally more akin to tissue or cell
culture?[^24]

The intention in creating such an intrinsically limited "clonal
artifact" would not be one of reproduction, but simply the desire to
draw on natural organic potential through technological manipulation of
biological materials. This intention is in keeping with the purposes of
scientific research and medical therapy in which many "unnatural"
manipulations are used for human benefit. In order to employ such an
entity for research, it must be capable of yielding stem cells while
lacking the capacity for the self-directed, integrated organic
functioning that is essential for embryogenesis. The intervention that
precludes the possibility of human development would be undertaken at a
stage before the development was initiated, and thus, no active
potentiality, no human life in process, would be violated. If the
created artifact were accorded a certain cautionary respect (as with all
human tissues), even though not the full protection of human life, the
consequences of such a program would not compromise any moral principle.

The project of creating these altered "clonal artifacts" for the
procurement of human stemcells could have many loci of scientific
intervention. Techniques might range from removing genes for
extra-embryonic structures, to the alteration of genes for angiogenesis
(such that the stem cells procured could produce differentiated cell
types with therapeutic potential, but would have to rely on the host
into whom they were placed for their vascular connections). If the
created stem cells could only form specific germ layers or limited
lineages of cell types, they still might be useful for the generation of
valuable research models as well as many cell lines, tissues and organs.
Furthermore, in bypassing the moral concerns associated with full
embryonic potential, the created cells might legitimately be developed
within artificial microenvironments beyond 14 days. This would allow the
production of more advanced cell types, the study of tissue interactions
and the formation of primordial organismal parts. Just as we have
learned that neither genes, nor cells, nor even whole organs define the
locus of human moral standing, in this era of developmental biology we
will come to recoginize that tissues with "partial generative potential"
may be used for medical benefit without a violation of human
dignity.[^25] The fact that one does not need full embryonic integrity
for these partial generative capacities is evident in the well-formed
body parts such as teeth, fingernails and hair seen in teratomas.[^26]

Clearly, there will be some point where partial generative potential is
so close to full human development that our basic moral principals would
be violated. We will need to carefully define the circumstances under
which it is acceptable for serious medical purposes to manipulate human
parts apart from their natural context in human development. Here the
fundamental principle of protection of human life must be affirmed,
while the more subtle moral issues concerning respect and natural
integrity are carefully explored.

At this early stage in our technological control of developing life, we
have an opportunity to break the impasse over stem cell research and
provide moral guidance for the biotechnology of the future. This may
require a constructive reformulation of some aspects of moral
philospophy, together with creative exploration of scientific
possibilities, but any postponement of this process will only deepen the
dilemma as we proceed into realms of technological advance unguided by
forethought. A moratorium will allow the cooperative dialogue that is
essential to frame the moral principles that can at once defend human
dignity and promote the fullest prospects for scientific progress and
its medical applications.

[William B. Hurlbut]{.smallcaps}

[\* \* \*]{.smallcaps}

**Statement of Dr. Krauthammer**

I oppose all cloning, reproductive and research. I would like to see
them banned. But I live in the real world. As I have explained, both in
the Council and in my writings, I oppose research cloning for prudential
reasons. Prudence dictates taking into account the real world, meaning
the realities of American democracy, and at present there is no
consensus for banning research cloning. I therefore strongly support a
moratorium. At this point in the history of this debate, a moratorium is
more than a compromise. It is an important achievement.

Let's remember. In a democracy, there is no such thing as a permanent
ban in any case. Any ban can be revisited at any time. Thus the
difference between a ban and a moratorium is simply this: Under a ban,
when the issue is reconsidered, the burden of proof is on those who wish
to lift the ban. With a moratorium, when the issue is reconsidered, the
burden of proof is on those who wish to maintain the ban. I have no
trepidation about remaking the case for a ban when the moratorium
expires.

In the interim, I vote strongly in favor of the moratorium over the
alternative proposal of regulation. First, because I am keenly aware of
the power of the scientific imperative to breach frontiers of ethics,
and deeply distrustful of the ability of society to resist those
scientific imperatives. I am highly skeptical about the ultimate
efficacy of regulation in preventing the breaching of further moral
barriers.

And second, because regulation is really just a nicely confectured way
of saying that we are prepared as a society today to utterly abolish a
crucial moral barrier, namely, the prohibition of the creation of human
embryos solely for the purpose of experimentation.

That is a serious moral barrier. The argument that we already crossed
that barrier when we permitted the use of discarded embryos from IVF
clinics for stem-cell research is simple sophistry.[^27] Creating human
embryos solely for their exploitation in research and therapy is new. It
is dangerous. It is something that we will live to regret. A moratorium
will prevent that for now, and allow a restatement of the case for its
unwisdom and its danger when the issue is later reconsidered.

I support the moratorium on research cloning for several additional
reasons. First, because the impasse on research cloning has led to
congressional failure to enact any anti-cloning legislation. That is
absurd. There is a unanimous national feeling that reproductive cloning
should be banned. Our proposal provides a compromise that both sides can
embrace so that cloning legislation can be passed.

Second, for those who support regulation, the moratorium is the only
effective way to move toward serious regulation. The vague call for
regulation, made by proponents of Position Two, has no political
traction. None of the relevant players has any incentive to prepare the
regulations. The scientific community is largely opposed to any
interference in this research. And while people are dithering, the
cloning research in the private biotech industries will put facts on the
ground that will be difficult to challenge. Only a moratorium can test
the good faith of those who say they want regulation. Moreover, Position
Two does not explicitly say that the existence of the strict regulations
it calls for is a precondition for allowing the research to go forward.
There is no talk here, as there was in the public Council sessions, that
this proposal amounts to a de facto moratorium.

Third, this proposal does not abandon the strong anti-cloning position.
It stops cloning at the very beginning, namely at the point of creating
a cloned embryo. It is thus much stronger than the pseudo-ban on cloning
proposed by those who want regulation, which would block only
implantation.

A ban on reproductive cloning and a moratorium on research cloning
allows the country to clearly express itself: definitively make law
regarding reproductive cloning and at least temporarily prevent the
launching of an industry whose business is the manufacture of (cloned)
human embryos purely for experimentation. And it allows the country to
engage now in a serious and extended debate on the virtues and pitfalls
of such an enterprise, on the promise and problems of regulation, and,
ultimately, on the question of not only where these cells come from, but
where these cells are taking us.

(I had intended, as a contribution to this debate, to append here what I
believe is the prudential case for opposing research cloning.
Limitations of space on individual statements prevent that. I would
therefore refer those interested in reading that argument to my article
"Crossing Lines" in *The New Republic,* April 29, 2002, pp. 20-23.)

[Charles Krauthammer.]{.smallcaps}

[\* \* \*]{.smallcaps}

**Statement of Dr. McHugh**

I am concerned that section (g) of Part I of Chapter Eight does not
adequately describe my views about somatic cell nuclear transfer (SCNT),
expressed at several meetings of the Council. That section says,
"Proposals to engage in cloning-for-biomedical-research necessarily
*endorse* the creation of human (cloned) embryos solely for the purpose
of such research. Public policy that specifically promoted this research
would thus *explicitly* and *officially approve* crossing a moral
boundary." (Italics in the text.) I believe (1) those words imply that
the prime effect of SCNT is the creation of a new individual human being
and (2) that implication prejudges the problem before us and does not
comport to my opinion of this matter.

I hold that SCNT rests on a major discovery in cellular biology, the
implications of which need much more discussion and debate than it
receives in Chapter Eight (and especially in section (g)). With this
discovery we now know that every one of our somatic cells not only has a
full complement of our genes but as well that every one of our somatic
cells, if manipulated in a particular fashion, has the power to
recapitulate in growth its own beginnings.

When a technician takes a donor's somatic cell and proceeds with it to
follow the method of somatic cell nuclear transplantation, he or she
evokes an intrinsic program present within that nucleus that brings
about cellular multiplication and differentiation. One need not hold
that a new and unique human individual starts up immediately as these
cells are made and multiply. One could see this process as an engineered
culturing of cells from the somatic nucleus that recapitulates embryonic
development but rests upon a potential for growth and replication
resident in and intrinsic to all somatic cells. The cellular products
are direct extensions of the donor as with other forms of tissue culture
and as such have some licit potentials for further use.

I agree with those who say that my argument---that the products of SCNT
and the products of impregnation are crucially different---places a
strong emphasis on origins of these products and less emphasis on
potentials that we deplore. But I would hold that the section (g) from
Part I of Chapter Eight places all the emphasis on potential and no
emphasis on origins. It thus ignores the fact that an overemphasis on
potential would lead us to the unreasonable position that since every
one of our somatic cells has "potential" for producing a human, it
should receive some reverence. I believe that in our presentation to the
American people we must acknowledge that some of the arguments in favor
of the use of SCNT rest upon the view that what is emerging here are
cells and not human beings. This very fundamental disagreement should be
thoroughly aired, as it carries with it quite different policy
implications.

[Paul McHugh]{.smallcaps}

[\* \* \*]{.smallcaps}

#### Statement of Dr. May

Substantial moral debate on cloning-for-biomedical-research focuses on
the question as to whether the preimplanted embryo is "one of us" or
not. The group in favor of unregulated research would define "one of us"
narrowly in order to exclude the microscopic material in the petri dish
from "one of us." Therefore we can do with it what we will. Proponents
of a ban define "one of us" broadly to include the preimplanted embryo.
Therefore they would refuse to clone/kill a preimplanted embryo used in
research, even at the expense of the relief that successful research
might offer some patients who are seriously impaired or face premature
death. Both parties seek to escape the stigma (and perhaps the
regulatory burdens) that might accompany therapy that owed something to
"one of us."

However, there is a way of thinking about the preimplanted embryo that
does not rely on the inclusionary/exclusionary language of "one of us."
The somewhat awkward language of the intermediate status of the embryo
(neither a mere thing nor a full human being) both *permits* research
but also *requires* regulation. The status of the preimplanted embryo
permits research because it does not hold such a claim on us as to ban a
line of inquiry that might thwart grave human suffering and premature
death. However, the *source* of this research in the human argues for
the necessity of regulations. The preimplanted embryo is more than a
yard lot of building materials; it is a cluster of cells moving toward,
if implanted, nourished, and protected, a human life. In removing it,
through research, from the circle of life, we cannot remove it from the
circle of human indebtedness.

This position has powerful implications for the *content* as well as the
necessity of regulations. Most discussion has centered on regulations as
they might bear on the generation of knowledge and therapies (for
example, the protection of women as the source of eggs, the time limit
on research to a fourteen-day period before the onset of the neural
streak, the development of licensing and monitoring procedures, and
extending the scope of regulations to private as well as publicly funded
projects). However, the acceptance of a human source for the conduct of
this research has equally powerful consequences for the distribution of
knowledge and therapies. Gratefully accepting a human source that makes
possible the conduct of this research requires the most inclusive
destination of its fruits in the common good. The element of gift in
origin requires common human access to benefits. It does not permit the
capture of knowledge and benefits in such a way as to thwart their
eventual arrival to all in need.

[William F. May]{.smallcaps}

\* \* \*

###### Statement of Professor Meilaender

Like some of my colleagues on the Council, I believe that a ban on all
forms of human cloning (including a ban on what in this report is called
cloning-for-biomedical-research) would be the optimal policy for this
Council to recommend and for our society to adopt. Nevertheless, because
other Council Members who have serious moral reservations about human
cloning are not at this time prepared to recommend a permanent ban on
all human cloning, we have joined with them to support a policy that
would ban cloning-to-produce-children and would place a four-year
moratorium on cloning-for-biomedical-research. Even if the policy I
regard as optimal is for now impossible, we need not settle for no
policy at all. Nor should we think of the majority recommendation as
simply a compromise position. On the contrary, we have found
genuine---though only partial---agreement with some of our colleagues on
the Council, and I prefer to try to use and build on that partial
agreement than to act as if it were unimportant or insignificant. Were
the majority recommendation enacted into law, it would prohibit all
human cloning (whether publicly or privately funded) for four years.
That would be a considerable achievement. It would give us a period in
which the optimal policy was in place, during which time we would hope
that further moral debate and advances in alternative forms of research
(that would not involve human cloning or destruction of embryos) would
persuade others to continue that optimal policy indefinitely.

In the Council's deliberations, those who oppose all human cloning have
worked very hard to respect and acknowledge the views of Council Members
with whom we disagree or do not fully agree. In particular, the
following points are worth noting:

\(a\) For the sake of continued conversation, we have acquiesced in
terminology that some of us do not fully accept and that to some extent
distorts our position. That is, any human cloning is morally
objectionable, and there is for some of us no crucial moral divide
between cloning-for-research and cloning-to-produce-children. Put
differently, research cloning is also reproductive cloning, since it
brings into existence a new human being (in the very earliest stages of
developing human life). Agreeing to converse in terms that do not fully
acknowledge this has inevitably been problematic; nevertheless, we have
accepted this burden so that the Council\'s work could proceed. I
believe that the definitions of cloning-for-biomedical-research and
cloning-to-produce-children given at the end of Chapter Three of the
Council\'s report make clear that, however the proximate or ultimate
purposes of those engaged in cloning may differ, the nature of the act
remains the same.

\(b\) In supporting a proposed four-year moratorium on research cloning
(even though some of us are quite prepared to support a permanent ban)
we have sought to make common cause with those Council Members who worry
more about reproductive than research cloning and for whom control of
the latter is chiefly a means to control of the former. I myself incline
to think, on the contrary, that an industry of routinized embryo cloning
(which would be the inevitable result of approval of
cloning-for-biomedical-research) would be an even greater moral evil
than the gestation and birth of a cloned human being. Nevertheless,
recognizing that some colleagues on the Council who support a moratorium
do not yet share this view, others of us have chosen to endorse the
partial agreement that we do now share.

\(c\) We have accepted in good faith the assertion---and it has seldom
been more than an assertion---that advocates of research cloning have a
principled commitment to drawing a line at a very early point in
embryonic development and permitting no research beyond that point. We
have accepted this in good faith even though we have been offered no
coherent argument to support the "developmental" view of human status
put forward by cloning proponents. Other Members of the Council have
offered a variety of arguments against that view. We have offered
evidence that embryologists do not make the sort of distinction on which
cloning proponents rely. We have noted that the embryo's "potential" is
something actual, something present in the developing human being, and
that it is a misuse of the idea of potential to describe the embryo as
merely a potential human being. We have argued that, while it is true
that we would be unlikely to feel the same grief at the death of an
embryo as we do at the death of a child, this hardly means that the
embryo's life should not be protected. We have noted that criteria for
"protectability" offered by at least one Council member (namely, the
presence of brain activity) would clearly permit research to a point
well beyond the development of the early embryo. Indeed, I do not think
that the Council has been fully willing to take up the question of the
moral status of the embryo. Nevertheless, despite the belief of some of
us that the morality of human cloning probably cannot be addressed
satisfactorily without doing so, we have agreed that the Council must
examine the morality of cloning in ways alert to the many other
important moral issues it also raises.

\(d\) Most of all, we have been willing to join in this report's
majority recommendation of a policy that would prohibit reproductive
cloning and prohibit for four years all research cloning, even though
such a policy is not, in our view, the optimal one. We have concurred in
this recommendation in order to join with some Council Members who,
because of their moral concerns about human cloning, endorse a
moratorium for reasons somewhat different from ours. I, for instance,
specifically decline to think of a moratorium as simply providing time
to put in place regulations---after which research cloning could
proceed. For me a moratorium is good because it prohibits all human
cloning for four years and provides opportunity to continue the argument
and the research that may, one hopes, make the case against cloning
still more persuasive four years hence. Although some of us would favor
a ban on all cloning, including research cloning, we have recognized
that such a policy proposal would, in effect, have said to fellow
Council Members who, for their own different reasons, support a
moratorium: "We're not prepared to continue this discussion." Rather
than adopt such a position, we have been willing to support a position
we regard as good even if less than optimal. As I noted above, however,
this is not simply a compromise position. On the contrary, it is a
partial agreement which may, I hope, give rise to still greater
agreement in the future.

Finally, I note the following about the moral (and not simply the
policy) aspects of the human cloning debate:

\(a\) A number of Council Members, of whom I am one, hold that the human
embryo is fully deserving of our moral respect and that such respect is
incompatible with its deliberate destruction in research. That judgment
about the status of the human embryo (whether cloned or resulting from
union of egg and sperm) is not, so far as I can see, based on our
religious beliefs. We have taken seriously what the science of
embryology teaches us. We have taken seriously what careful
philosophical reasoning about the meaning of "potentiality" teaches us.
We have taken seriously the lessons of human history in which the limits
of our sympathy for fellow human beings who seem "different" from us
have more than once had to be overcome in order to learn a more
inclusive and egalitarian respect for human life. This does not mean,
for me at least, that religious belief should play no role here. On the
contrary, Jews worship a Lord who favors the widow and the orphan, who
teaches us to speak on behalf of those no one else defends. And
Christians worship a crucified God who has himself accepted
vulnerability. Instructed by our religious traditions, we may see in the
weakest and most vulnerable of human beings---those unable to speak in
their own behalf---special objects of our care. Such care for the
vulnerable seems to me incompatible with an industry of routine
manufacture, use, and destruction of cloned embryos---even if the goal
is to help others who are also vulnerable.

\(b\) The position of those who support research cloning (while opposing
reproductive cloning) amounts, in effect, to criminalizing the
implantation of cloned embryos. Nothing could be more revealing of the
moral underpinnings of their position. In their view, moral status is
conferred not by belonging to the human species but by the will and
choice of some human beings (those like us who are stronger and in
control). We cannot pretend that being *un*implanted is somehow a
natural fact about an embryo; on the contrary, it is what we choose.
First we produce the cloned human embryo, then we decide to use it for
our purposes in research rather than to implant it, and then we argue
that until implanted it lacks the capacity for continued development.
This reasoning is specious, it should be rejected, and it can find no
support in the definitions given at the close of Chapter Three of this
report.

\(c\) Because the defense of cloning-for-biomedical-research rests
ultimately upon a view that the will and choice of some confers moral
status on others, and because no coherent defense of the "developmental"
approach to human dignity and worth has been offered by proponents of
research cloning, I think it very unlikely that research---if allowed to
proceed---can really be confined to the early blastocyst. With no
principled reasons to place limits on our will, and with the likelihood
that more developed embryos or fetuses will actually be much more useful
for researchers, I doubt whether the momentum of cloning research can be
stopped in any way other than by stopping all human cloning. Indeed, I
suspect that, if research cloning proceeds, the distinction between
research and reproductive cloning will come to seem artificial. Having
accustomed ourselves to use cloning techniques to shape and mold the
next generation, we will be hard-pressed to explain why we should not,
in fact, exercise an even fuller control by cloning-to-produce-children.
Our earlier opposition to it will seem to have been merely sentimental.

I am happy, therefore, to join with other colleagues on the Council in
recommending a policy that would prohibit for at least four years all
human cloning, whether for the purpose only of research or for the
additional purpose of producing children, but it is imperative to
emphasize that this good policy is less than optimal. We should hope
that four years from now our society will be able to do still better.

[Gilbert C. Meilaender]{.smallcaps}

\* \* \*

#### Statement of Professor Sandel {#statement-of-professor-sandel .unnumbered}

After six months of searching ethical and scientific inquiry, a majority
of this Council has rejected a ban on cloning-for-biomedical-research of
the kind passed by the House of Representatives last year. Among those
of us who reject a ban, some prefer a moratorium, while others would
permit such research to proceed subject to regulation. (See table in
Chapter Eight.)

I will first give my reasons for concluding that
cloning-for-biomedical-research should not be banned, and then explain
why I believe such research should be permitted subject to regulation.

Any ethical analysis of cloning-for-biomedical-research must address the
moral status of the human embryo. Before turning to that question,
however, it is important to place cloning-for-biomedical-research in the
broader context of embryonic stem cell research. Some who find
cloning-for-biomedical-research morally objectionable support stem cell
research that uses spare embryos left over from fertility clinics. They
argue that it is wrong to create embryos for research (whether cloned or
non-cloned) but morally acceptable to use excess embryos created for
reproduction, since these "spare" embryos would otherwise be discarded.
But this distinction is not persuasive. If it is wrong to carry out stem
cell research on embryos created for research, it is wrong to carry out
any embryonic stem cell research.

Those who oppose the creation of embryos for stem cell research but
support research on embryos left over from in vitro fertilization (IVF)
clinics beg the question whether those IVF "spares" should have been
created in the first place: if it is immoral to create and sacrifice
embryos for the sake of curing or treating devastating diseases, why
isn't it also objectionable to create and discard spare IVF embryos for
the sake of treating infertility? After all, both practices serve worthy
ends, and curing diseases such as Parkinson's, Alzheimer's, and diabetes
is at least as important as enabling infertile couples to have
genetically related children.

Those who would distinguish the sacrifice of embryos in IVF from the
sacrifice of embryos in stem cell research might reply as follows: the
fertility doctor who creates excess embryos does not know which embryos
will ultimately be sacrificed, and does not intend the death of any; but
the scientist who deliberately creates an embryo for stem cell research
knows the embryo will die, for to carry out the research is necessarily
to destroy the embryo.

But it is hard to see the moral difference between a practice that
typically sacrifices embryos (by the tens of thousands, in the case of
the IVF industry) and one that inevitably does so. If IVF as currently
practiced in the United States is morally permissible, its justification
does not rest on the idea that the sacrifice it entails is only typical,
not inevitable. It rests instead on the idea that the good achieved
outweighs the loss, and that the loss is not of a kind that violates the
respect embryos are due. This is the same moral test that must be met to
justify the creation of embryos for stem cell research and regenerative
medicine.

Comparing the range of practices that sacrifice embryos clarifies the
stakes: if cloning-for-biomedical-research is morally wrong, then so is
all embryonic stem cell research, and so is any version of IVF that
creates and discards excess embryos. If, morally speaking, these
practices stand or fall together, it remains to ask whether they stand
or fall. The answer to that question depends on the moral status of the
embryo.

There are three possible ways of conceiving the moral status of the
embryo---as a thing, as a person, or as something in between. To regard
an embryo as a mere thing, open to any use we may desire or devise,
misses its significance as nascent human life. One need not regard an
embryo as a full human person in order to believe that it is due a
certain respect. Personhood is not the only warrant for respect; we
consider it a failure of respect when a thoughtless hiker carves his
initials in an ancient sequoia---not because we regard the sequoia as a
person, but because we consider it a natural wonder worthy of
appreciation and awe---modes of regard inconsistent with treating it as
a billboard or defacing it for the sake of petty vanity. To respect the
old growth forest does not mean that no tree may ever be felled or
harvested for human purposes. Respecting the forest may be consistent
with using it. But the purposes should be weighty and appropriate to the
wondrous nature of the thing.

One way to oppose a degrading, objectifying stance toward nascent human
life is to attribute full personhood to the embryo. Because this view is
associated with the religious doctrine that personhood begins at
conception, it is sometimes said to be a matter of faith that lies
beyond rational argument. But it is a mistake to assume that religiously
informed beliefs are mere dogmas, beyond the reach of critical
reflection. One way of respecting a religious conviction is to take it
seriously---to probe and explore its moral implications.

The notion that the embryo is a person carries far-reaching
consequences, some of which emerged in the course of this Council's
deliberations. One is that harvesting stem cells from a seven-day-old
blastocyst is as morally abhorrent as harvesting organs from a baby.
This is a bold and principled claim, even if deeply at odds with most
people's moral intuitions. But the implications do not stop there. If
the equal moral status view is correct, then the penalty provided in
recent anti-cloning legislation---a million dollar fine and ten years in
prison---is woefully inadequate. If embryonic stem cell research is
morally equivalent to yanking organs from babies, it should be treated
as a grisly form of murder, and the scientist who performs it should
face life imprisonment or the death penalty.

A further source of difficulty for the equal moral status view lies in
the fact that, in natural pregnancies, at least half of all embryos
either fail to implant or are otherwise lost. If natural procreation
entails the loss of some number of embryos for every successful birth,
then perhaps we should worry less about the loss of embryos that occurs
in IVF and in stem cell research. It might be replied that a high rate
of infant mortality does not justify infanticide. But the way we respond
to the natural loss of embryos suggests that we do not regard these
events as the moral or religious equivalent of infant mortality.
Otherwise, wouldn't we carry out the same burial rituals and the same
rites of mourning for the loss of an embryo that we observe for the
death of a child?

The conviction that the embryo is a person derives support not only from
certain religious doctrines but also from the Kantian assumption that
the moral universe is divided in binary terms: everything is either a
person, worthy of respect, or a thing, open to use. But as the sequoia
example suggests, this dualism is overdrawn.

The way to combat the instrumentalizing impulse of modern technology and
commerce is not to insist on an all-or-nothing ethic of respect for
persons that consigns the rest of life to a utilitarian calculus. Such
an ethic risks turning every moral question into a battle over the
bounds of personhood. We would do better to cultivate a more expansive
appreciation of life as a gift that commands our reverence and restricts
our use. Human cloning to create designer babies is the ultimate
expression of the hubris that marks the loss of reverence for life as a
gift. But stem cell research to cure debilitating diseases, using
seven-day-old blastocysts, cloned or

uncloned, is a noble exercise of our human ingenuity to promote healing
and to play our part in repairing the given world.

Those who warn of slippery slopes, embryo farms, and the commodification
of ova and zygotes are right to worry but wrong to assume that
cloning-for-biomedical-research necessarily opens us to these dangers.
Rather than ban stem cell cloning and other forms of embryo research, we
should allow them to proceed subject to regulations that embody the
moral restraint appropriate to the mystery of the first stirrings of
human life. Such regulations should include licensing requirements for
embryo research projects and fertility clinics, restrictions on the
commodification of eggs and sperm, and measures to prevent proprietary
interests from monopolizing access to stem cell lines. This approach, it
seems to me, offers the best hope of avoiding the wanton use of nascent
human life and making these biomedical advances a blessing for health
rather than an episode in the erosion of our human sensibilities.

[Michael J. Sandel]{.smallcaps}

\* \* \*

#### Statement of Professor Wilson {#statement-of-professor-wilson .unnumbered}

# Regulated Cloning-for-Biomedical-Research {#regulated-cloning-for-biomedical-research .unnumbered}

I would allow regulated biomedical research on cloned embryos provided
the blastocyst is no more than fourteen days old and would not allow
implantation in a uterus, human or animal.

I take this position because I believe that research on human
blastocysts may have substantial medical value in finding ways of
improving human life. As our report indicates, such research may help
doctors deal with Parkinson's disease, Alzheimer's disease, juvenile
diabetes, and spinal cord injury. Members of the Council disagree as to
how best to do that research.

The group that favors a moratorium on the use of cloned embryos for such
research may think that the study of adult stem cells or in vitro
fertilized eggs that are not used to impregnate a woman will produce all
the knowledge we need to discover whether stem cells have therapeutic
value. The other group, of which I am a part, favors regulated research
on cloned embryos because it believes that all sources of stem cells,
including those produced by blastocysts, must be studied if we are to
discover whether great medical advances are possible. That is because
the use of cloned blastocysts may be the only important way of
overcoming the problems of immune rejection and learning more about
genetic diseases. If substantial medical benefit can be had from
research, then it is unlikely that those benefits will derive from
studying only stem cells derived from adult tissue or from leftover IVF
eggs. To follow the policy recommended by the majority of this Council
would be to do research with one hand tied behind our backs.

Moreover, I do not think there is any moral difference between a
fertilized egg created in an in vitro fertilization clinic and one
created by cloning an embryo. Both eggs are deliberately produced by
scientific intervention and both (except for the IVF egg used to
impregnate a woman) are destroyed.

Having said that there is no moral difference between these two sources
of eggs does not mean, I believe, that using either kind of egg does not
raise important and difficult moral questions. Every human begins as a
fertilized egg, even though not every fertilized egg becomes a human.
But the issue before us is not whether any human life should be
destroyed but whether every fertilized egg should be preserved. To
oppose the willful destruction of any fertilized egg is to oppose in
vitro fertilization (since all fertilized eggs beyond that needed for
successful implantation will be destroyed). Yet, in vitro procedures
have produced (as of 1999) about thirty thousand babies for otherwise
infertile couples. Initially, in vitro fertilizations were opposed by
many who have since changed their minds, because the great benefits
(many healthy new infants) so greatly outweighed the trivial costs (some
tiny cells frozen or destroyed).

A fertilized cell has some moral worth, but much less than that of an
implanted cell, and that has less than that of a fetus, and that less
than that of a viable fetus, and that the same as of a newborn infant.
My view is that people endow a thing with humanity when it appears, or
even begins to appear, human; that is, when it resembles a human
creature. The more a cell resembles a person, the more claims it exerts
on our moral feelings. Now this last argument has no religious or
metaphysical meaning, but it accords closely, in my view, with how
people view one another. It helps us understand why aborting a fetus in
the twentieth week is more frightening than doing so in the first, and
why so-called partial birth abortions are so widely opposed. And this
view helps us understand why an elderly, comatose person lacking the
ability to speak or act has more support from people than a
seven-week-old fetus that also lacks the ability to speak or act.

Human worth grows as humanity becomes more apparent. In general, we are
profoundly grieved by the death of a newborn, deeply distressed by the
loss of a nearly born infant or a late-month miscarriage, and (for most
but not all people) worried but not grieved by the abortion of a
seven-week-old fetus. Our humanity, and thus the moral worth we assign
to people, never leaves us even if many elements of it are later
stripped away by age or disease.

This fact becomes evident when we ask a simple question: Do we assign
the same moral blame to harvesting organs from a newborn infant and from
a seven-day-old blastocyst? The great majority of people would be more
outraged by doing the former than by doing the latter. A seven-day-old
blastocyst that is no more than one millimeter in diameter and contains
only a hundred or so largely undifferentiated cells does not make the
same moral claims on us as does a live infant. Unless everyone who makes
this distinction is wrong, then the moral status of a blastocyst is
vastly less compelling than that of a neonate.

Some people believe that human life begins at conception and ought to be
free from any human attack from that moment on. The difficulty with this
rejoinder is that a large fraction (perhaps one-third or one-half) of
fertilized cells fail to implant in the uterus or, if implanted, fail to
develop into an embryo. Knowing this, one who offers this rejoinder
would have to say that there is at best only a reasonable chance that
life begins at conception.

But even blastocysts and leftover IVF eggs deserve some protection,
because if society authorizes their destruction it has taken a dramatic
and morally significant step. It has intervened in a profoundly
important human process in ways that may lead future generations to take
what may then appear to be the easy next steps, such as implanting a
cloned embryo in a uterus or killing a fetus to extract some supposedly
beneficial substance.

To avoid this, I favor federal regulations that would ban implanting a
cloned embryo in any uterus, animal as well as human, and would insist
that every cloned embryo raised in a glass dish exist for no more than
fourteen days.

There is always some risk that allowing even strongly regulated research
will create conditions that lead some scientists to ask for access to
fertilized eggs beyond the blastocyst stage. But I do not believe we can
object to this by making a generalized slippery slope argument, since
virtually every medical procedure that involves entering or affecting
the human body would also be liable to such an argument, a conclusion
that would leave us (for example) without surgery. The slippery slope
argument, stated baldly, would lead us to oppose allowing doctors to
remove an inflamed appendix because they might later decide to remove a
kidney, and after that a heart, and to oppose as well doctors
prescribing a drug that will harm 0.5 percent of its recipients because
we suspect that, once they do this, they will later insist on
prescribing drugs that harm 1 percent, and then 10 percent, and possibly
50 percent of their patients. There may be good slippery slope
arguments, but they cannot rest simply on the phrase "slippery slope";
they must also point clearly to a serious moral hazard and contain some
reason for thinking that this hazard will become much more likely if we
take the first step.

[James Q. Wilson]{.smallcaps}

[^1]: This appendix contains only those personal statements that were
    submitted prior to the release of this prepublication version (July
    11, 2002). See the final version of the report for the complete set
    of personal statements.

[^2]: A human embryo (like a human being in the fetal, infant, child, or
    adolescent stage) is not properly classified as a "prehuman"
    organism with the mere potential to become a human being. No human
    embryologist or textbook in human embryology known to us presents,
    accepts, or remotely contemplates such a view. The testimony of all
    leading embryology textbooks is that a human embryo *is*---already
    and not merely potentially---a human being. His or her potential,
    assuming a sufficient measure of good health and a suitable
    environment, is to develop by an internally directed process of
    growth through the further stages of maturity on the continuum that
    is his or her life.

[^3]: The timing of the first two cleavages seems to be controlled by
    the maternal RNA within the embryo rather than by its new DNA (see
    Ronan O'Rahilly and Fabiola Mueller, *Human Embryology and
    Teratology* (New York: John Wiley & Sons, 1992), 23. Still, these
    cleavages do not occur if the embryo's nucleus is not present, and
    so the nuclear genes also control these early changes.

[^4]: ^?^ A possible alternative, though one finding little support in
    current discussions, would be to argue that what I am, or you are,
    is not a human organism at all, but rather a nonbodily consciousness
    or spirit merely inhabiting or somehow "associated with" a body. The
    problem with this argument is that it is clear that we *are* bodily
    entities---organisms, albeit of a particular type, namely, organisms
    of a rational nature. A living thing that performs bodily actions is
    an organism, a bodily entity. But it is immediately obvious in the
    case of the human individual that it is *the same subject* that
    perceives, walks, and talks (which are bodily actions), and that
    understands, deliberates, and makes choices---what everyone,
    including anyone who denies he is an organism, refers to as "I." It
    must be the same entity that perceives these words on a page, for
    example, and understands them*.* Thus, what each of us refers to as
    "I" is identically the physical organism that is the subject both of
    bodily actions, such as perceiving and walking, and of mental
    activities, such as understanding and choosing. Therefore, you and I
    are physical organisms, rather than consciousnesses that merely
    inhabit or are "associated with" physical organisms. And so,
    plainly, *we* came to be when the physical organism we are came to
    be; *we* once were embryos, then fetuses, then infants, and so on.

[^5]: Werner A. Muller, *Developmental Biology* (New York: Springer
    Verlag, 1997), 12 f. Scott Gilbert, *Developmental Biology* 5^th^
    edition (Sunderland, Mass.: Sinnauer Associates, 1997); O'Rahilly
    and Mueller, *Human Embryology and Teratology*, 23-24.

[^6]: ^?^ O'Rahilly and Fabiola Mueller, *Human Embryology and
    Teratology*, 30-31.

[^7]: ^?^ Ibid. 23-24; Keith Moore, and T.V.N. Persaud, *Before We Are
    Born: Essentials of Embryology and Birth Defects* (Philadelphia:
    W.B. Saunders, 1998), 41; William J. Larson, *Human Embryology*
    3^rd^ edition (New York: Churchill Livingstone, 2001), 18-21.

[^8]: ^?^ Gilbert, *Developmental Biology*, 12 f; 167 f. Also see
    O'Rahilly and Mueller, *Human Embryology and Teratology* 23-24.

[^9]: ^?^ A ban on implantation of an existing embryo or class of
    embryos would be subject to constitutional as well as moral
    objections. Such a ban would certainly be challenged, and the
    challenge would likely come from a powerful coalition of "pro-life"
    and "pro-choice" forces. A prohibition of the production of embryos
    by cloning would have a far better likelihood of withstanding
    constitutional challenge than would a ban on implantation.

[^10]: If the fetus is delivered alive during an abortion, there is a
    legal obligation to resuscitate and sustain its life.

[^11]: To recognize a potential as in some sense "actual" and worthy of
    protection, we need only consider how we would react to the
    intentional sterilization of a prepubescent girl when her fertility
    was only potential yet precious to her larger dignity and
    developmental integrity as a human person.

[^12]: Such an argument might hold some weight if one could argue that a
    given stage of development represents an emergent state in which a
    relational property is in ontological discontinuity with the
    material from which it emerged. At first consideration, this seems
    true of all biological systems where the whole reveals properties
    unpredicted within the parts. The problem in this line of reasoning,
    however, is that these properties are exactly that to which the
    whole is ordered and so are inherent powers, "actual" within the
    whole when seen across time. To know what a biological being is, we
    must observe it over time, understand it across its life span. It is
    the essence of life that it is ordered to employ these leaps to
    emergent states as an agency in development. New realities will
    emerge; this is established in the potency of the developing
    organism.

[^13]: A similar problem arises in clinical medicine. It is crucial that
    we not equate the statistical probability of a specific outcome with
    the actual prognosis of the individual patient involved.

[^14]: The differentiation of the trophoblast, which will form the
    extra-embryonic membranes, is generally considered as distinct from
    the embryo itself. More true to the nature of life, it might be
    recognized as an organ of embryogenesis used and discarded within
    the dynamic process of development. Throughout the continuum of
    human life, from the embryo to the adult, cells, tissues and organs
    are reabsorbed,, transcended and transformed. Examples include the
    umbilical vein and arteries (which become supporting ligaments),
    neurologic cells (more than half of which are culled by apoptosis
    and reabsorption), systems of reflexes (such as the moro reflex
    which is manifest only in infants), and immune organs and functions
    such as the thymus (which is inactive in an adult), and allergies
    (which change throughout life and generally wane in mid-life). We do
    not just develop and then age, but undergo a continuous
    transformation and fuller manifestation of our organismal nature
    present within the earliest embryo.

[^15]: In fact, the first several cell divisions after natural
    fertilization do not require a nucleus to be present and therefore
    may not involve gene expression from the newly united bi-parental
    genetic material. The mRNA essential for protein synthesis at these
    early stages appears to be placed into the egg cytoplasm by the
    granulosa cells during maturation of the egg. This may very well
    preclude the possibilities of the optimistic but simplistic proposal
    that merely by adding a recipe of cytoplasmic factors essential for
    reprogramming we could transform any cell into a functional zygote.
    Nonetheless, even without differential gene expression, cytoplasmic
    studies reveal unequal cytoplasmic distributions, and implicit
    differential cell fates, even at these early stages.

[^16]: The fact that these early cells retain the ability to form a
    second embryo is testimony to the resiliency of self-regulation and
    compensation within early life, not the lack of individuation of the
    first embryo form which the second can be considered to have
    'budded' off. Evidence for this may be seen in the increased
    incidence of monozygotic twinning associated with IVF by Blastocyst
    Transfer. When IVF embryos are transferred to the uterus for
    implantation at the blastocyst stage, there is a two to ten-fold
    increase in the rate of monozygotic twinning, apparently due to
    disruption of normal organismal integrity. It is also interesting to
    note that with Blastocyst Transfer there is a slightly higher rate
    of male births.

[^17]: ? In some animal studies, it has been noted that particular
    components in the culture medium in which embryo is nourished
    increase the size of the offspring during later stages of gestation.

[^18]: It should be noted that this argument could be used as a
    counter-argument against the disaggregation of the preimplantation
    embryo, or as a justification for the production of more advanced
    cells, tissues, and organs either through implantation into an
    artificial endometrium or through natural gestation.

[^19]: In fact, from a scientific perspective, we should have a measure
    of humility when drawing conclusions about moral status from
    evidence concerning consciousness or capacities involving subjective
    experience (qualia). The fact that consciousness and subjective
    awareness appear to be mediated by matter does not exhaust their
    mystery.

[^20]: The sacrifice of infants for the supposed larger flourishing of
    life bespeaks the potency ascribed to purity and generative
    potential.

[^21]: The designation of 14 days as the moral boundary for embryo
    experimentation is in the category of a "received tradition," almost
    a superstition in the sense that it is a belief in a change of state
    without a discernible cause. The validity of this designated moral
    marker has not been reexamined in the light of recent advances in
    our understanding of developmental biology. As a moral marker of
    ontological change 14 days makes no sense. Even if one disagrees
    with the discussion above, the date should be set earlier:
    implantation is complete by the 12^th^ day, the onset of
    gastrulation occurs between the 12^th^ and 14^th^ day and twinning
    is rare after the 9th day. Furthermore, it is worth noting that 14
    days is not of current scientific relevance since stem cells can be
    procured at the 4-5 day stage and, with present technology, human
    embryos can sustain viability in culture for only 8-9 days.

[^22]: Natural development proceeds within the context of a highly
    refined spatial and temporal niche of organized complexity of
    positional cues, signal diffusion and cell-cell contact between
    cellular lineages of diverse types. See for example the recent
    article, "Dominant role of the niche in melanocyte stem-cell fate
    determination" (*Nature* 25 April 2002).

[^23]: In fact, there will be several (and perhaps numerous) ways to
    produce cloned blastocysts from which stem cells can be harvested.
    These include: the current common method of cloning designated
    somatic cell nuclear transfer (SCNT) or nuclear transplantation,
    embryo splitting, use of animal oocytes as receptacles of nuclear
    transfer, fusion of adult of embryonic stem cells into existing
    blastocysts and possibly the production of artificial gametes for
    the transfer of adult nuclear material, (and probably others more
    difficult to anticipate or legally regulate).

[^24]: Such a procedure could be designated "Altered Nuclear Transfer"
    (ANT).

[^25]: Consider blood transfusions, organ transplantation, and the
    recombination of human genes into bacteria for the production of
    human hormones such as growth hormone and insulin. All of these
    raised initial moral controversy until it was recognized that the
    locus of human dignity lies, not it human parts, but in the full
    organismal integrity of a human life.

[^26]: These benign ovarian tumors, derived by spontaneous and
    disorganized development of activated ova, typically have a full
    array of primary tissue types and some well-developed body parts.
    The possibility that embryonic stem cells could be derived from
    entities lacking integrated developmental potential is given further
    support from recent studies in which cells from abnormal early
    embryos were fused with normal embryos and went on to produce normal
    tissues in the developed organism. (See \"Dependable Cells From
    Defective Embryos.\" *Science* 3 May 02 p. 841) and Byrne, Simons
    and Gurdon: *PNAS* online, April 23, 2002.)

[^27]: As I elaborated in "Crossing Lines" in *The New Republic,* April
    29, 2002, p. 23.