April 05, 2004,
On Thursday, the President's Council on Bioethics issued a its latest report, "Reproduction and Responsibility: The Regulation of New Biotechnologies." Dr. Leon Kass, head of the commission who is a medical doctor, a professor on leave from the University of Chicago, and currently a fellow at the American Enterprise Institute, and author of books including Life, Liberty and the Defense of Dignity: The Challenge for Bioethics corresponded with NRO editor Kathryn Jean Lopez about the report this weekend.
NRO: Your latest report on assisted reproduction, issued this past week: What is the most useful recommendation to come out of it?
Dr. Kass: Two stand out. First, we call for a federally funded prospective study on the health and well-being of children born with the aid of assisted reproductive technologies. Over a million such children have been born worldwide, but to date we know next to nothing about how well they are faring. Second, we call on Congress to defend the dignity of human procreation by enacting moratoria on certain morally dubious reproductive practices: putting human embryos into animal uteruses; mixing human and animal egg and sperm; starting human pregnancies for purposes of research or growing body parts; conceiving children other than by union of egg and sperm (derived from adults); buying, selling, and patenting of human embryos; and limitless research on human embryos in the private sector.
NRO: Why tackle assisted reproduction more generally? Isn't cloning a tremendous enough battle?
Dr. Kass: Cloning is but a small part of a much larger concern: issues raised by the rapidly growing powers to intervene still further in human reproduction, adding techniques of genetic screening, genetic manipulation, and sex selection to existing and expanding techniques of assisted reproduction. This whole field is today largely unmonitored and unregulated. We need to find ways to govern these practices. While we seek them, we urgently need to legislate important moral boundaries and shift the burden of persuasion to those who would transgress them, while no one is paying attention.
NRO: In a nutshell, what are the council's recommendations on cloning? And how do they relate to the cloning report you released earlier?
Dr. Kass: To guarantee that children born with the aid of assisted-reproductive technologies not be denied the same links to human progenitors that children born naturally have (e.g., they should have no more and no less than two biological progenitors), we call for the prohibition of any attempt to conceive a child other than by the union of egg and sperm. (This provision would ban trying to conceive a child by parthenogenesis or by cloning.) The prohibited act is further defined as follows: the creation ex vivo of one of these asexually created embryos with the intention of transferring it to a woman's uterus to start a pregnancy. This recommendation repeats and clarifies the council's unanimous call, in our 2002 report "Human Cloning and Human Dignity," for a ban on cloning-to-produce-children. The current report, which propose only such recommendations that we agree on unanimously, takes no new position on cloning-for-biomedical-research. On this contested topic, the old report's majority recommendation for a legislative moratorium still stands. Nothing in the old report has been repudiated; and we have clarified and extended our unanimous recommendation and connected it with others with which it most definitely belongs.
NRO: Has the council said anything about federal funding of embryo research in this report?
Dr. Kass: No. Despite the attempt of some people to spin this report in that direction, this report says nothing at all on that subject. The council's recent report, "Monitoring Stem Cell Research," provides an update on developments in stem-cell science and in the ethical and policy debates. But it too offers no recommendations to alter the current federal policy.
NRO: What's your response to the critics who say the bioethics council is stacked in favor of opponents of biotechnology?
Dr. Kass: This is nonsense. The council was and remains diverse and divided by design, for we owe the president and the nation the best arguments on the various sides of all hotly contested issues. The critics said the same thing about the council even before it met. Yet when our meetings and our writings revealed that we are, in fact, more truly diverse and independent than any of the previous national bioethics commissions, no one retracted their slanderous remarks. Some critics apparently think that raising any ethical concerns regarding uses of biotechnology is tantamount to reviving the war of religion against science. They would rather have an ethics council that, after fussing a little, simply pronounced its blessings on the technologically inevitable. We, by contrast, mean to give the ethical issues preeminence, while trying always to be accurate about the relevant science and hearing always from all sides of the debates. Contrary to the allegations made by one of our departing members, the recent changes in council membership do not reflect any attempt to remove "dissident" opinion. The council remains extremely diverse.
NRO: Do you see Congress banning cloning in their next session? Does it depend on how the elections turn out, or, do you think events (i.e. scientific "progress") could wind up moving legislation, regardless of what happens in November?
Dr. Kass: It's very hard to say if this Congress or next will be able to pass a ban on cloning when the debate has been stuck for over two years now, and I'm certainly no expert in congressional politics. For myself, the ideal approach is the comprehensive one, which would ban all uses of cloning by banning the procedure as such. That's Senator Brownback's approach in the Senate. Certainly the Hatch-Feinstein approach, that ends up actively endorsing the cloning of embryos for research and requiring their destruction, is not acceptable. But if it turns out that the comprehensive ban is not achievable in practice after the election, then what we have offered in our council report offers a way forward. It bans creation, not implantation, if the intent is to produce a child, and it doesn't endorse creation of cloned embryos for research or require or support any embryo destruction. I personally would hope that it is combined with a ban or moratorium on cloning for research as well (as our council majority recommended in 2002) but as a first move what we now propose in this latest report which bans what can be banned and does not foreclose future options or abandon principle makes good practical and moral sense. It is only a partial step, but in the right direction.
NRO: The stem-cell debate seems stuck on embryonic-stem-cell research. But don't cord-blood, fat cells, and other sources of stem cells appear to be promising? Is the debate and actual biotech work headed in that direction?
Dr. Kass: Yes, there are promising preliminary results with non-embryonic stem cells, but those these cell lines are at present less well characterized than the embryonic lines. It is much too early to tell which sorts of stem cells are going to be useful for which sorts of diseases and disabilities. People should not allow their moral positions to encourage wishful thinking or to distort their view of the actual scientific and clinical evidence. We just do not know how this field will develop.
NRO: You've put out a great collection of literature, but, policy-wise, how much of an impact has the "Kass Council" made? Is it an advanced post-graduate seminar or practical guidance for those who are on the forefront of writing the laws and facing frontline choices regarding the use of biotechnology?
Dr. Kass: Washington journalists apparently take notice only when a council votes or tells Congress or the president what to do. But the president's executive order that created the council charged us "to undertake fundamental inquiry into the human and moral significance of developments in biomedical and behavioral science and technology" and "to facilitate a greater understanding of bioethical issues." These charges we have tried to fulfill. Lots of people are up to speed on the "life" issues. But regarding many other profound issues in bioethics, there has been next to no public education and awareness. Before there can be public policy in some of these areas, the public and its policymakers need to learn what is happening, what it means, and why it is important. Our report, "Beyond Therapy: Biotechnology and the Pursuit of Happiness," is a major contribution toward making clear where biotechnology may be taking us and why we should care. At the same time, we have issued two major reports with practical recommendations, one on human cloning, and the most recent one on "Reproduction and Responsibility: The Regulation of New Biotechnologies." The last addresses the vacuum of public oversight regarding a profoundly important field that is moving very rapidly into ethically ever-more-troubling waters. We have reason to hope that legislators and other policy makers will give our recent recommendations serious attention in the months ahead.
NRO: Where does the council head next?
Dr. Kass: Having produced five volumes in 26 months (completing all the projects of our first term), we are now slowly exploring a couple of new areas, looking for topics that are ripe for our attention. One is the treatment and care of the elderly (and the demented), an increasingly salient subject in our progressively age-heavy society. The other is the domain of neuroscience, brain, and behavior, where science and technology touch most directly many of the higher powers that make us human.