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Thursday, September 29, 2016
David Alton writes on 'therapeutic cloning'
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 GK Chesterton had some scathing things to say about parliamentary select committees. He said that they issued their reports on some difficult subject and after that "everything will be very nice - and political life, if you can call it life, will go on exactly as before." Parliament has just been debating the findings of the Select Committee which examined the use of embryonic stem cells for so-called therapeutic cloning. It was established under the chairmanship of the pro-embryo experimentation Bishop of Oxford. Just in case the select committee developed a mind of its own the Government took the precaution of passing the necessary orders permitting this form of cloning before (ital) the committee deliberated. They needn't have worried. The findings of the committee were every bit as predictable as this cynical process intended. When Parliament debated the Human Fertilisation (Research Purposes) Regulations in January 2001 and in particular the proposal to establish a retrospective Select Committee to look into the issues of stem cell research and human cloning I likened this to a situation where a judge were to give "out the verdict and sentence before hearing the defence, the prosecution and the witnesses." (Hansard; 22.01.01 Col. 23) During that debate even Baroness Warnock attacked the process being used: "I deeply wish that there had been time to set up a Select Committee ahead of our having to agree to the regulations. That has been a mistake. We have been bullied and pushed to do things more quickly than we should, which I deplore. It follows my reading of the moral obligation we have to society to follow every path that will alleviate suffering but at the same time to ensure that people who do not understand the issues, and, even more importantly, people who fear them, are given some hope that their fears may be listened to." (Hansard; 22.01.01 Col. 45) My first question, then, is have we listened? The failure to appoint anyone to the Select Committee who spoke in the debate against reproductive and therapeutic human cloning, and who argues the traditional case for the sanctity of human life, was unlikely to inspire much confidence or to strengthen the impression that anyone was listening. At one time there was an honourable tradition of allowing for robust minority reports and dissenting voices. Even that has been subverted. Determining questions of huge moment in this way will do nothing to convince public opinion; it will simply deepen public cynicism. All 26 witnesses who were called to appear before the Committee to give evidence from a scientific or medical perspective were from the pro- 'therapeutic,' cloning, pro-embryonic stem cell lobby. I wish it were indeed the case, as the report says at paragraph 3.21, that "of all the scientific issues relevant to our inquiry we have given more attention to recent developments in adult stem cell research than to any other." How can this be so when no scientists were specifically called to submit oral evidence from an exclusively adult stem cell perspective? I invited three such scientists to accompany me when I gave my oral evidence before the Select Committee on November 19th 2001 and professor David Prentice's evidence - he is a senior scientific advisor to the American Congress - is not even referred to.. My principle concerns about the select committee's report fall into five main areas. They might be categorised as: 1. Procedural 2. Ethical; 3. Scientific; 4. Regulatory; and 5. International. In September 1999 I debated the ethics and scientific necessity of human cloning in the Parliamentary Scientific Committee. The central issue I identified was the immorality of using human embryos if alternatives existed. The Bishop of Oxford intervened in that debate and accepted that if this could be demonstrated then it would indeed be wrong to use the human embryo. This would be compatible, too, with the view of Lady Warnock's Committee that the human embryos should at least be accorded "special status." Yet, the cursory way in which adult stem cell technology has been investigated was brought home to me by a question put by a member of the select committee at the final public hearing: It betrayed an alarming lack of understanding of adult stem cell science: "Are you saying that it is possible, certainly as you understand it, to understand the process whereby an adult stem cell, which, as I understand, it is not yet possible to isolate, can be used but not in isolation? Do you believe that it is possible purely by research on adult stem cells to understand the process whereby an adult stem cell could be brought to differentiate itself to the point it can do more that we are currently able to do with stem cells as we know them?" Not only can they be isolated, but as Professor Prentice, Professor Neil Scolding, Dr.Michael Antoniou argued in evidence, they offer greater potential than embryonic stem cells. Professor Prentice warned of " the dangers to public health" of using embryonic stem cells. So much for the science, but what about the ethics of what is proposed in this report.. It is often said that the human embryo is a potential life. This is not so. It is a life with potential; and, as at any other stage of our existence, the actions we take to protect, inhibit or even destroy will determine how far that life and its0 potential will be fulfilled. I remain profoundly concerned about the effect on society when we treat nascent human life as a natural resource to be mined, exploited and commodified and about so-called bioethicists who are happy to bestow their moral blessings on the latest innovation - to be sure, not for love, but for money. In a written answer to my parliamentary question the Department of Health recently confirmed that since the passage of the Human Fertilisation and Embryology Act 1990, 925,747 embryos have been created through in vitro fertilisation (IVF) treatment, 423,153 have been transferred for implantation, 225,627 stored for the patient's own use, 448 stored for the treatment of others and 53,497 given for research. 294,584 embryos remained unused during the course of IVF treatment cycles, including those considered non-viable for implantation and were therefore destroyed. In the light of these shocking figures, what remains of the 'special status' of the human embryo. Professor Leon Kass, Chair of the US President's Council on Bioethics, in an address he gave in London earlier this year that I was privileged to attend, said: "We are desensitized and denatured by a coarsening of sensibility that comes to regard these practices as natural, ordinary and fully unproblematic. People who can hold nascent human life in their hands unblinkingly and without awe have deadened something in their souls." I agree. I recognise that the Human Fertilisation and Embryology Act 1990 allows embryos to be created for research purposes and that we already accord an inferior value to the human embryo in its first 14 days of life. However, the absurdly arbitrary 14 day cut off point becomes ever more obsolete in the light of new research demonstrating the sheer wonder of the human embryo. The significance of conception as the starting point of our human existence is illustrated by an article in 'Nature' magazine dated 4th July 2002. Headed, 'Your destiny, from day one' the article states: "Your world was shaped in the first 24 hours after conception. Where your head and feet would sprout, and which side would form your back and which your belly, were being defined in the minutes and hours after sperm and egg united." Embryologists such as Alan Handyside from the University of Leeds are warning us that meddling with early human embryos might carry series adverse consequence. "It's possible you could be removing a cell with a predictable fate and causing damage." When reading the chapter in this report entitled 'The Status of the Early Embryo' one would thing that our understanding of the human embryo has not advanced one iota since 1990. The Bishop of Oxford, who has written engagingly on the subject of Aquinas' principles of a just war, is perfectly familiar with the precautionary principle of natural law and even if he does not accept the inviolability and sacredness of human life from conception he knows we are duty bound to err on the side of caution wherever there may be any doubt. I find it incredible that the select committee report makes no reference to an unprecedented written submission by an ad hoc group of eminent Christian theologians from the Anglican, Catholic, Orthodox and Reformed traditions on the ethical status of the human embryo. There is far more unanimity within the Christian tradition on sanctity of early human life than the Committee and its Chairman have led us to believe. The Bishop of Oxford has a love of CS Lewis. I would commend to him both "The Abolition of Man" (1943)where Lewis describes "the conditioners" who try to subvert truth and condition rather than educate, and, also, his 1945 novel, "That Hideous Strength" which foresaw a world in which our own species would be experimented upon, manipulated and tampered with; a world devoid of medical ethics and where highly intelligent and good people become collaborators. In explaining the purpose of the National Institute of Co-Ordinated Experiments, the director, Lord Feverstone, says it would do "quite simple and obvious things at first - sterilisation of the unfit, liquidation of backward races, selective breeding" ultimately creating "a new type of man." Lord Feverstone would feel at home in today's House of Lords. I was thinking of these two books as I read the chapter in the report on 'The Status of the Early Embryo'. Curiously it appears after, rather than before, the conclusion that additional destructive embryo research should be permitted. The chronology is seriously askew and demonstrates that the ethics of 'therapeutic', cloning and embryonic stem cell research have not been approached with the seriousness they merit. At paragraph 4.11 the report indulges in its own bout of "conditioning": "Claims that the embryo is a person from the moment of fertilisation are hard to reconcile with standard views of human and personal identity. Although a baby's mental capacity is undeveloped, there is a continuity of identity between the baby and the adult it will become. So we say, looking at a photograph. That was me as a baby. When it comes to the undifferentiated cells of the blastocyst, however, such a continuity of identity is less plausible." This is ridiculous. From the moment of conception, the starting point of our human existence, we are on a continual process of change and development that only terminates upon our death. I was once a blastocyst, just as I was once a baby. We are all former embryos. Contrary to what the author(s) of the report may assert, "standard views of human and personal identity" have traditionally accorded moral significance to an individual by virtue of them being a human being. Once we start according moral significance according to mental capacity, we embark on a slippery slope that categorises some individuals as sub-human. A utilitarian outlook dominates the report. The Committee's failure to effectively analyse the ethical issues surrounding embryo experimentation reinforces the perception that its conclusions were fixed from the outset and that tricky ethical questions would not be allowed to frustrate matters. Laymen are easily intimidated in staying out of this debate by the patronising view that the science is so complex that mere mortals cannot understand it or hold valid views about it. I knew that the science was disreputable when one peer with whom I was debating - and who runs his own institute for experimentation - displayed a number of photographs of disabled people and said that anyone who contradicted him was in favour of their suffering and pain, and anti-science. Everyone in this Parliament wants therapies that alleviate illness. But it is dishonest to suggest that the only way to make this progress is by the creation and destruction of human embryos; and that there can never be any fetters placed on science. The report inexplicably ignores or obscures the peer reviewed evidence provided on adult stem cells, and bases its opinions and conclusions on the current state and future potential of adult stem cell research on very outdated and inaccurate evidence. The report is already past its sell by date. In July this year 'Nature' magazine reported groundbreaking research by Dr Catherine Verfaillie and colleagues at the University of Minnesota. This research showed that bone marrow contains highly malleable stem cells which can be converted into all tissue types. Look at what the scientists are saying: "Like stuck records, ministers and policy makers continue to enthuse about therapeutic cloning even though the majority of bench scientists no longer think it's possible or practicable to treat patients with cells derived from cloned embryos. They have already moved on to investigating the alternatives." 'New Scientist, Editorial December 2001. "the idea of 'therapeutic cloning' seems to be on the wane..most now believe that it will be too expensive and cumbersome for regular clinical use." 'Nature, Magazine' December 2001. Even Professor Alan Trounson, once a leading proponent of embryonic stem cell research and so-called 'therapeutic' cloning says that stem cell research (both adult and embryonic) has advanced so rapidly in the past few months that 'therapeutic' cloning is now unnecessary. He said: "My view is that there are at least three or four other alternatives that are more attractive already. The report implies that no clinical or pre-clinical trials have been carried out with adult stem cells, despite the clear evidence provided from peer-reviewed journals of success in trials using adult stem cells in diabetes, severed spinal cord, demyelinated spinal cord, heart attack, stroke, traumatic brain injury, liver failure, Parkinson,s Disease, Alzheimer's Disease, various forms of blindness, full-thickness burns, severe bone disease, and so on. Last month, it was announced that it will soon be possible to use the body's own stem cells to repair the damage caused by heart attacks. The select committee report is based on information that was several years out of date. Inexplicably, the report ignores or obscures the large body of peer-reviewed evidence that was provided on adult stem cells for the years 2000 and 2001. Instead, it bases its opinions and conclusions on the current state and future potential of adult stem cell research on very outdated and inaccurate evidence. For example, the Wellcome Trust provided a bibliometric analysis of stem cell research from 1996 to 1999 in the UK and internationally. They state in the evidence that they sent to the Committee, that: "This shows which scientists are publishing papers in peer-reviewed journals and is an indication of who the leading scientists are in this field and where they are working." This is an absolutely extraordinary statement. They genuinely believe that the years 1996 to 1999 are the relevant years to look at it in terms of what is happening in the field of stem cell research This displays a lack of awareness of current research in this field. The adult stem cell research which demonstrates such profound capacity of these cells to heal an astonishing array of very serious diseases, virtually all occurred from the year 2000 onwards. Most of the adult stem cell research from 1996-1999 would have been related to the rather old-fashioned use of bone marrow to treat cancer and similar diseases. This is completely different from the research that has been carried out after 1999, which demonstrates profound levels of healing using adult stem cells as I have set out. The report ignores the known serious risks of tumour and cancer formation using embryonic stem cells and, despite all the available evidence and clear warnings from a number of witnesses, claims that embryonic stem cells are safe. The report obscures both the advances in adult stem cell research and the specific dangers and disadvantages of embryonic stem cells by ascribing specific, unique and profound advantages of adult stem cells also to embryonic stem cells, and ascribing the serious risks and disadvantages of embryonic stem cells also to adult stem cells. In the attempt to ignore the dangers of embryonic stem cells and to attribute the advantages of adult stem cells to embryonic stem cells, the report commends a procedure that would instantly result in tumour formation with embryonic stem cells, despite having received clear warnings of this. Even more alarmingly , the report expresses confidence in the work of the HFEA, an organisation in disarray, and entrusts regulation of embryonic stem cell research to this body. Even the HFEA,s most ardent supporters recognise that it is in trouble. The Committee chose to hear evidence from a succession of cheerleaders for the HFEA including Ruth Deech, Professor Henry Leese and Dr Anne McLaren. In July this year the House of Commons Science and Technology Committee, in its report, 'Developments in Human Genetics and Embryology' was highly critical of the HFEA: The Lords Stem Cell Research Committee reported that the HFEA is "highly regarded, both at home and abroad.. [and] has the full confidence of the scientific and medical research community. We are unclear on what evidence it based this assertion." Recent 'mix-up' scandals at IVF clinics that the HFEA is supposed to be monitoring, and the shocking disclosures from the embryologist Dr Sammy Lee in the Sunday Telegraph on 10th November demonstrate that the criticisms of the Science and Technology Committee are certainly not unfounded. Dr Lee wrote that he knew of at least six cases where the wrong embryos were put into women. He maintains that it is "galling that the HFEA, which purports to protect patients, has sought to brush aside any meaningful discussion of why mistakes occur in IVF clinics, and how frequently." Yet Ministers continue to insist to me that the HFEA still has the Government,s full confidence and that they have no plans to conduct an inquiry into the work of the HFEA? They are simply going to double the money they give the HFEA to 5 million. The report overlooks the fact that stem cell technology and human cloning are not extensions of assisted reproduction, but involve a multitude of scientific and medical fields which embrace nearly all aspects of disease. We need a new and completely independent organisation to monitor and assess developments in this field. My last point is that this report, taken with what is already one of the most liberal regimes for embryo experimentation in the world, leaves the United Kingdom isolated internationally. Article 18 of the European Convention on Human Rights and Biomedicine, which the Government has yet to sign, prohibits the creation of embryos for research purposes. The European Union, recognising the gravity of the issues involved in stem cell research and so-called 'therapeutic' cloning and aware of the rapid advances being made in the ethically unproblematic field of adult stem cell science, has adopted a one-year moratorium on research with supernumerary embryos from IVF cycles and on human embryonic stem cells. At the end of last month, the European Parliament voted for a total ban on cloning by a large majority of 271 to 154. The resolution passed read as follows: "[The European Parliament] Solemnly reaffirms that the life and dignity of all human beings, whatever their stage of development and state of health, must be respected and is opposed to any form of research or use of life sciences and biotechnology that runs counter to this fundamental principle." In the US, the majority of the President's Council of Bioethics recommended a ban on cloning-to-produce-children combined with a four-year moratorium on cloning-for-biomedical-research. Their conclusions are endorsed by the current US administration. I look on with a mixture of envy and admiration at the seriousness with which the current US administration and the previous one has sought to handle this sensitive issue. Rather than rush through ill-conceived regulations and then establish a retrospective Select Committee to rubber-stamp them, the President's Council on Bioethics in the US was convened to thoroughly investigate stem cell research and human cloning and then advise the President. Only then would a decision be made. Membership of the Committee is balanced, reflecting a number of scientific and ethical perspectives. Unlike us in the UK, our American allies are not afraid of disagreement and the publication of a minority report if unanimity amongst the members of the Committee proves impossible. In Germany destructive embryo research is prohibited. In Norway the Government has proposed legislation encompassing a ban on all destructive embryo experimentation including 'therapeutic' cloning. The UK has isolated itself from international opinion on this issue. It is therefore wrong to caricature opposition to the report and Government policy as restricted to a narrow group of pro-lifers and religious fundamentalists. I recognise the impossibility of reclaiming, at present, absolute status for the embryo. However, this does not excuse the inadequate consideration afforded to this vital issue by the Committee. We are right to express disquiet about the genesis of the select committee, about its attitude towards the ethical, scientific regulatory and international issues that are at stake. The scientific analysis of stem cell research is deeply flawed and misleading, particularly in its assessment of adult stem cell research. In the absence of unanimity on the ethical status of the human embryo there is a broad consensus that destructive embryo research should not be permitted if there is a viable scientific alternative. Government Ministers have said that "the 1990 Act already provides the answer to the question of what happens if and when research into adult cells overtakes research using embryos: embryonic research would have to stop because the use of embryos would no longer be necessary for that research." (Hansard; 22.01.01 Col. 120) Adult stem cell research is a viable scientific alternative and has clearly overtaken research using human embryos. It is delivering results, not merely demonstrating potential. As a result, three out of every four dollars of private investment in the US are going into adult stem cell research and technology. Embryonic stem cell research companies are struggling to survive. I hope that the Government will fulfil their undertaking to review the regulations; and if the 'special status' of the embryo, propounded by Baroness Warnock, stands for anything then we should devote our resources exclusively to adult stem cell research. Among its many flaws, the report,s failure to acknowledge this constitutes its biggest failing. I began this article by recalling some words of GK Chesterton. The process I have outlined more than justifies Chesterton's scepticism about the political process. But, sadly, although political life might now proceed just as it did before, many nascent lives will not have the same opportunity.
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