Technologies for good and ills
Why we have a moral obligation to develop therapeutic cloning.
The announcement that South Korean scientists have successfully cloned 30 human embryos signals an important step on the way to developing effective stem-cell therapies. We need to remind ourselves why this is so important.
It is difficult to estimate how many people might benefit from the products of stem-cell therapy – which uses cloning to match the genotype of an intended recipient, making tissues transplantable. Sources agree that the most proximate use of human embryonic stem-cell therapy would be for Parkinson’s disease – a common neurological disease, which increases in prevalence with age and has a disastrous effect on quality of life. The overall prevalence (per 100 population in persons 65 years of age and older) is 1.8 (1); the disease affects 120,000 individuals in the UK and an estimated 1-1.5million Americans. Untold human misery and suffering could be stemmed if Parkinson’s disease became treatable.
If the stem-cell researcher Roger Pedersen’s hopes for the therapy are realised, and treatments become available for congestive heart failure, diabetes and other afflictions – and if, as many believe, tailor-made transplant organs will eventually become possible – then millions of people worldwide will be treated using stem-cell therapy. As one source says: ‘three million Americans suffer from congestive heart failure…deaths related to this condition are estimated at 250,000 each year…27,000 patients die annually from liver disease…In Western Europe as a whole 40,000 patients await a kidney but only …10,000 kidneys [become available]’ (2). Nobody knows how many people fail to make it on to the waiting lists and so fail to register in these data. The following remains a chilling statistic: ‘Since 1 April 2003, in the UK: 1487 people have received transplants; 479 people have donated organs; 5782 people are still waiting for transplants.’ (3)
We have a strong obligation to pursue promising therapeutic research – failing to pursue research that might save these and many other lives would be both tragic and wrong. Two separate but complementary lines of argument lead to this conclusion. First, one of the most powerful obligations that we have is the obligation not to harm others. Where our actions will probably prevent serious harm, then if we can reasonably (given the balance of risk and burden to ourselves and benefit to others) we should act – failure to do so means accepting responsibility for the harm that will then occur (4). Second, there is a somewhat weaker but still powerful duty of beneficence, our basic moral obligation to help other people. Most if not all diseases create unmet needs in those who are affected, and because medical research is often a necessary component of relieving those needs, furthering medical research becomes a moral obligation.
We all benefit from living in a society in which serious scientific research is carried out, building on the insights from past research. It is beneficial to patients to be in a society that pursues and actively accepts the fruits of scientific investigation. We all also benefit from the knowledge that study is ongoing into diseases or conditions to which we may succumb. It makes us feel more secure and gives us hope for the future, for ourselves and our descendants, and others for whom we care. If this is correct, then we all have a strong general interest that there be research, and above all well-founded research. To turn our backs on research that might save so many lives is to acquiesce to participating in the sacrifice of those lives.
Pro-life groups, characteristically describing the prospect of saving so many lives in the future as ‘horrific’, have orchestrated opposition to the prospects opened up by cloned embryos. Why are so-called ‘pro-life’ supporters so ready to sacrifice these lives? It is difficult to see how those who, for example, objected to the separation of the Manchester conjoined twins, Mary and Jodie, even though they knew that if not separated both twins would inevitably die, while a separation would end the life of one but save the life of the other, could call themselves ‘pro-life’. ‘Pro-life’ supporters opposed the Hashmi family, who wanted to use pre-implantation diagnosis to create a sibling who would live and be happy – and whose cord blood could save the life of their existing child.
‘Pro-life’ supporters consistently oppose the use of condoms and other barrier contraception, even though failure to use condoms is known to cost millions of lives worldwide through the transmission of HIV. This is straight out of the Orwell school of doublethink: pro-life views actively promote and endorse the needless sacrifice of human lives. In the end, pro-life arguments cost lives.
Suppose that an effective treatment for Parkinson’s disease is developed in the UK using cloned embryonic stem cells. Would pro-life supporters say that it would be horrific to offer this treatment to Parkinson’s sufferers? Suppose in the future effective treatments for heart disease are developed using cloned stem cells. Would any sane person deny such therapies to their families, or any sane government deny them to their citizens?
John Harris is Sir David Alliance Professor of Bioethics in the School of Law, University of Manchester.
Ó John Harris 2004
(1) ‘Prevalence of Parkinson’s disease in Europe’, De Rijk MC et al, Neurology 54 (11 Suppl 5):S21-3, 2000
(2) Xeno, KC David Cooper and Robert P Lanza, Oxford University Press, 2000, p7-17
(3) ‘An ethical Market in human Organs’, Charles A Erin and John Harris, The Journal of Medical Ethics In Press 2003. Figures from the UK Transplant website
(4) I set out the arguments for and the basis of this duty in my Violence & Responsibility, Routledge & Kegan Paul 1980
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