Every generation lives a little longer than the last — it’s the sign of an advancing society. A hundred years ago the average British life expectancy at birth was 45. Now it is 75, giving us a blissful free decade at the end of our working lives to spend fending off great-grandchildren and watching wide-screen television. The downside is that as we live longer and as doctors become better at warding off death, we pass an ever greater percentage of our lives suffering. Heart attacks, strokes, cancer, diabetes, liver failure, blindness, senile dementia, Parkinson’s disease, Huntington’s, Alzheimer’s, arthritis. Whereas we used to fall sick and die off quite quickly, most of us now spend our last 15 years ailing in one way or another — but what can we possibly do about it?
The short answer is to be found in stem cells — the basic blobs out of which every other sort of tissue develops. Since they were first isolated in a lab in Wisconsin in 1998, they have become the great hope of everyone suffering from a chronic or degenerative disease. Every week or so scientists are quoted in newspapers raving about newly discovered stem-cell potential. Only a few tests have so far been done on human cells, but experiments on mice show that at the very least stem cells can be turned into brain neurons, heart muscle, bone, insulin-producing pancreatic tissue, sparkling new corneas. They work biblical-style wonders: crippled rats have got to their feet and walked again after being injected with stem cells (best not to think about how they became crippled), near brain-dead rats have suddenly revived. Christopher Reeve, the paralysed actor who played Superman, has announced that he expects them to heal him too.
On Thursday last week, scientists in Boston reported that stem cells could even cure the menopause. Tests on mice showed that a dose of cells could extend childbearing years, prevent ovarian failure, reverse infertility caused by cancer treatment as well as ageing and help women stay young and energetic without risking illness from HRT. ‘It could be the most significant advance in reproductive medicine since the advent of IVF more than 25 years ago,’ said Dr Marian Damewood, the president of the American Society for Reproductive Medicine.
There are only two problems with stem cells, two related reasons why no one has yet made their billions selling patent stem-cell therapies to arthritic oil barons. The first is that the technology is very new; it still makes newspaper headlines if scientists manage to develop a stem-cell culture and we are a long way from being brave enough to try them on real people. The second is an ethical problem. Although adult stem cells can be extracted from bone marrow or umbilical-cord blood, these are thought to have limited potential. The exciting, panacea stem cells, the ones that can be transformed into any sort of tissue, must be harvested from early embryos which are, in the process, destroyed. It may be possible, in the future, to magic adult cells into stem cells, to turn back people’s biological clocks, but for now, if progress is to be made, it means snuffing out embryonic life.
You might have thought, with good reason, that we no longer give much of a hoot about early embryos (or blastocysts). We seem not to care too much because we actively encourage embryocide. Abortion, for instance, is thought of as a liberation, even though it means the deaths of about 55 million foetuses a year; the morning-after pill is seen as a good thing; the coil — a popular form of contraception — works by destroying fertilised eggs. Even screening for embryonic defects with a view to a kill is sanctioned. Unless you are a pro-life campaigner you probably don’t sit up late at night worrying about the embryos lost during the process of in vitro fertilisation (about 300,000 a year), because we approve of a childless woman’s right to try to reproduce artificially. Nor do most of us mind that it’s legal for scientists to experiment on the embryos left over from IVF — they’re going to die anyway; why not make good use of them?
It seems odd, then, that there’s an international outcry about the ethics of stem-cell research. Why has it become a contentious issue when we already allow IVF embryos to be carved up for the common good? The answer is that it’s all about cloning. The moral issues about embryos and science have made a comeback because the sort of stem cells scientists are keenest on are those harvested from cloned embryos.
Cloning embryos for stem-cell research, pioneered by the South Koreans last month, is a very difficult process, but it’s the one most likely to benefit you in your old age. A cloned embryo could prevent your heart attack, cure your Parkinson’s, regrow your brain and stop you putting your shoes in the fridge. Cloned embryonic stem cells are what Christopher Reeve has fixed his hopes on because, if all goes according to plan, the stem cells used to treat you will contain your own DNA. Whichever organ or tissue you need will have been custom-grown for you out of stem cells scraped from your tiny identical twin. It’s easy to see why scientists are so enthusiastic about it — cloned tissue will be accepted happily by your body, with no need for the usual toxic drugs that suppress your immune system, because it will be genetically identical to you.
Here’s how it’s done. First the nucleus (containing the mother’s genetic information) is scraped out of a donated human egg. Into the gap is inserted a ‘somatic’ cell from skin or organ tissue; this is known as cell nuclear replacement or CNR. Like all the other cells in the human body apart from eggs and sperm, this somatic cell contains two chromosomes, and so with the help of a little electricity the egg becomes an embryonic human clone. After a few days the embryo, about the size of a full stop, will have two layers of cells: an outer wall destined to become the placenta, and an inner collection of stem cells. The stem cells are extracted and the embryo dies.
The ethical objection to ‘therapeutic cloning’ is that blastocysts like the one just described are made deliberately in order to be killed. Even ‘pro-choice’ abortion supporters fret about the fact that cloned embryos are not created to serve some worthy cause, as the eggs discarded by fertility clinics are, nor are they created accidentally like aborted embryos, but are made simply to be murdered after four or five days. It’s a pretty fine distinction, a bit like the moral difference between fox-hunting and breeding pheasants to shoot, but it’s one that’s nonetheless deeply felt. In an address to the House of Lords in 2001, Lord Alton made the same point. ‘The process of CNR involves a form of technological cannibalism according to which your tiny twin and triplet siblings must pay with their lives on the altar of your “medical” treatment,’ he said. ‘This vampiric transfusion of life from the cloned sibling to the original sick patient is the paradigmatic example of using others as a means to an end. It is simply revolting and ethically beyond the pale.’ We’re playing God, according to Alton, without worrying about whether we have the right to do so.
The plight of the cloned blastocyst has caused international confusion. How does one weigh potential medical progress against the rights of a 100-cell cluster? Do blastocysts have rights at all? We seem to want the law to reflect our instinctive protectiveness towards embryos but with no practical cost to our way of life. We couldn’t face restarting the whole debate over whether an embryo is a human being or not — that would mean re-considering abortion — but if not fo r its humanness, why should a blastocyst be treated any differently from a toenail clipping?
Different countries have come to different conclusions. Anything goes in Belgium, but in America, the government forbids federal funding for CNR. The Italians have grown so concerned about embryos that last week a new law was passed restricting fertility treatment to infertile ‘stable’ couples, to protect IVF embryos. In Germany the 2002 Protection of Embryos Act prohibits all embryonic stem-cell research, and the Norwegian minister of health has proposed a similar law. In the UK, we have granted the embryo something called ‘symbolic moral status’, but have still decided cautiously to allow therapeutic cloning.
To add to the debate, there is also our ever present fear of creating Frankenstein monsters. Although ‘reproductive cloning’ is illegal in Britain, many people oppose cloning embryos on the grounds that scientists, once confronted with a blastocyst, will be unable to resist implanting it in a human womb. The resulting clone baby will then, they imagine, suffer hideous genetic defects and accelerated ageing in the manner of Dolly the sheep. ‘There is every reason to expect an expansion of the context of therapeutic cloning to include foetuses,’ says Dr Fleming, director of Southern Cross, an Australian bioethics think-tank. ‘Particularly given the fact that it would be much easier to allow organs to develop “naturally” in the cloned foetus before harvesting. There have, in fact, already been calls for the harvesting of organs from embryos and foetuses. If cloned foetuses were allowed to develop, the next “natural” consequence would be to allow cloned embryos to be implanted and develop until birth.’
It’s a horrible thought but I’m sure Dr Fleming is right. If it can happen, it will, and probably already has somewhere in an underground lab in Belgium. But here’s another horrible thought: isn’t the whole attempt to draw a wavy line between the sorts of embryocide we like and don’t like basically nonsense? Can we really persist in thinking that a tiny blastocyst has some sort of right to respect if we are in favour of aborting 24-week-old babies?
The government attempts to make sense of the issue by giving an embryo this ‘symbolic moral status’ — a term cooked up by the Warnock committee in 1990. ‘The special status of an embryo as a potential human being is accepted,’ says the Department of Health, ‘but the significance of the respect owed to developing human life is regarded as increasing in proportion to the degree of development of the embryo. At the very early stages of development, according to this view, it is morally justified to use embryos for research purposes in order to benefit others.’ It’s a comfort to think that the little blastocysts have some standing in the world even as the syringe approaches, but what exactly is a ‘symbolic moral status’? To what is an early embryo morally equivalent? A dog? You’d have the RSPCA in fits. An iguana? Perhaps something in-between a mouse and a skin cell? And what does its ‘special moral status’ entitle an embryo to, apart from the right to be scrutinised by the Human Embryology and Fertilisation Authority before it’s whacked?
Those who object to therapeutic cloning, but not to IVF or abortion, claim that there is a difference between creating an embryo just in order to nix it and killing it after an accidental pregnancy. But treating an embryo as a means to an end is only ethically problematic if it has human status. And if the intention of scientists doing the therapeutic cloning is to alleviate a considerable amount of suffering, then what’s the problem? Why is it better to abort a foetus for the sake of convenience than to kill a blastocyst in the interest of finding a cure for heart attacks, strokes, cancer, diabetes, liver failure, blindness, senile dementia, Parkinson’s disease, Huntington’s, Alzheimer’s and arthritis?
It’s pretty clear that the whole argument is only superficially about the embryo. What really has a ‘special moral status’ is our sentiment about embryos, not the blobs themselves. Perhaps we feel a little more squeamish about all the dead blastocysts, embryos and foetuses than we bargained for. Maybe it just helps to salve our collective conscience if we kick up a fuss about therapeutic cloning.