As Ira explained to us that night after dinner, it goes like this. Normally, an egg and a sperm come together in the Fallopian tube* to form a zygote, which usually travels down the tube and implants onto the wall of the uterus within fourteen days. After implantation, it is referred to as the embryo. The processes that commence to germinate the nervous system begin after day fourteen. The embryo develops and differentiates, and about eight weeks after fertilization, it is referred to as a fetus. That, everybody sort of knows.
Complicating this is what is not so well known: Twinning commonly occurs during those fourteen days, and chimeras may also be formed. A chimera comes about when two zygotes, the result of two different eggs being fertilized by two different sperm (fraternal twins), fuse back into a single zygote. The organism that develops can possess different sets of chromosomes in different organs! Still, the question is, once the sperm impregnates the egg, at what point is society supposed to confer on it all the rights of an adult human? Those who would bestow these at the beginning, that is, at the moment of fertilization and the appearance of the freshly minted zygote, are proponents of what is generally referred to as the potentiality argument. If the two-cell zygote were left alone (in its hostess, of course), it could be a human.
Ira went on to explain what this all meant in terms of stem cells. After the egg and sperm come together, the zygote divides into two cells, then four cells, then eight cells, then sixteen. All of these cells are called totipotent, which means any one of those cells could build the whole organism—a baby. This is what my daughter was referring to. As I said, she was well ahead of the game. As the cells keep on dividing, a subsequent stage appears, and that is called the blastocyst and is 70–100 cells in size. The blastocyst is a ball of cells with an outer layer and an inner grouping of cells. The inner group of cells consists of the much sought-after stem cells. They are referred to as pluripotent because, while they can’t grow into a whole organism like the totipotents can, they can become any organ in the body, which is why they are wanted by biomedical scientists. Hearts degenerate, brains degenerate, lungs, kidneys, cartilage, you name it. The idea is to grab those cells and strategically place them in patients who have a specific organ disease. The new stem cells would be there to help mend the part of the body they are injected into. That’s all you need to know about the biology if public policy is being decided. But that, as I found out, was only the beginning.
As I noted, lots of people on the council were Catholics. It would have been easy to assume that they would automatically be against stem cell research, because embryonic stem cell research did mean destroying the embryo, and that was against church doctrine. One doesn’t have to go very far back in church history, however, to see that its opinion on this matter hadn’t been settled until the late 1800s. The issue that captured the church was the issue of ensoulment and when it occurred during development. A church council decided to call it at conception, instead of the time frame St. Thomas Aquinas had argued in the thirteenth century, which was at around three months of gestation.
But none of that mattered. It was 2002 and what did the Catholic members of the council think? What did the Jewish members think, the secularists, the other Christians, the Republicans, the Democrats, the liberals, the conservatives, the women, the men, the scientist, the bioethicists, the humanists, the lawyers, the physicians, the . . . ? All of these professions and belief systems were in play and all were intently following the information being presented to the council. And the press was watching us, while we listened to all the expert testimony being presented on the nature of stem cell research, the nature and reality of what happens in normal routine, sexual union. It was intense and made my day job back at Dartmouth look like kindergarten.
It really was sink or swim as I began the process with no training. Suddenly, the feeling of having a point of view began to emerge. Sure, I hadn’t thought about the issues in a deep way before, but that didn’t mean I couldn’t start to think about them then. As I learned on the council, thinking about moral and ethical issues is at the very core of what it means to be human. In many ways it was an awakening for me. Simply mentioning concepts was no longer acceptable. While the lights and cameras were on, what did you actually think about the serious business of running a society? What was the moral fabric going to be? Was massive stem cell research going to rent the very fabric of human culture?
As we all sat there listening to various experts over a six-month period, several telling points emerged. At the second meeting in February, Irv Weissman, the distinguished stem cell expert from Stanford and the chair of the National Academy of Sciences’ new report on stem cell technologies, came and gave a presentation. We exchanged pleasantries before the session, and it turned out we were both in the Dartmouth Class of 1961. We hadn’t met back then, as he had left after three months to go back to his beloved Montana. He was a warm and extremely sure-footed advocate for stem cell research.
The National Academy of Sciences (NAS) report14 was an attempt to demystify the stem cell issue and to draw lines between various proposed processes, such as adult stem cell research, embryonic stem cell research, reproductive cloning, and something called “somatic cell nuclear transfer” (SCNT).* Weissman ran into a buzz saw right away, led by one of the council’s moral guardians of the Christian faith, Gil Meilaender. Gil was a professor of moral theology from a small midwestern college and a delightful, dry-humored provocateur. His concern captured a lot of the tensions that occur between reductionists like Weissman and humanists like himself. He basically asserted the NAS report had used different terminologies for the same thing, the thing that was at issue: the human embryo. Here is what Gil asked Irv:
The Academies [sic] report discusses two procedures which it says are very different from each other. First, human reproductive cloning and, second, nuclear transplantation to produce stem cells. Suppose we are shown externalized in the laboratory two cloned blastocysts X and Y. We are not told which is X and which is Y but we are told that X is the result of procedure one and Y is the result of procedure two, and we are asked to examine the blastocyst[s] and determine which is X and which is Y. On what basis could we make that determination?15
It was this exchange that got me thinking about the paradox, indeed the abundant misunderstandings, between the two. Gil was correct at the biological level. The biologic entity, the blastocyst produced either way, could go on to be a human organism if implanted into a uterus. Each of the blastocysts could have had its stem cells harvested for biomedical research. That is a simple fact.
At the same time, the processes were completely different through Irv’s eyes, because the intention of the person carrying out the process was totally different. Paradoxically, Irv the reductionist believed the blastocyst was nothing but a bunch of molecules lacking in any serious sense what a functioning human mental person entailed. A luscious heirloom tomato can be mashed up and put into pizza sauce or delicately sliced to be in caprese. What happens to it is all in the mind and hands of the chef. Similarly, the intention of the scientist was not to make a whole organism or more bluntly, a baby. It was to make lifesaving cells that could help a patient suffering from disease. At the time of the writing of the report, nobody wanted cloning for baby making. Scientists generally thought it was dangerous and potentially harmful. Others felt only God gave life, and that that process was not to be tampered with.
Clearly, the majority of scientists on the council and elsewhere viewed the blastocyst as a bunch of cells, and the moral question was centered on what was to be done with them. Gil’s view was that it wasn’t a bunch of cells; it was already human. It started to become clear to me that the issue to be understood, in a fundamental way, was not specifically, when does human life begin? It was: What moral status should be conferred to a blastocyst? Indeed, what does it mean to be human?
While those stirrings were going on, other experts kept on coming before the council. One of the most memorable was a gynecological rese
archer from the University of Utah. He provided data that was a showstopper to many. Thirty to 80 percent of fertilized eggs resulting from natural sexual unions were spontaneously aborted! During one of the breaks, one of the Catholics said to me, “My word, are women supposed to have funerals for those people?”
Other cracks in the armor were provided by some of the council members themselves. Michael Sandel, the famous political philosopher from Harvard, began to dissect the logic of President Bush’s position on stem cell research as not making any moral sense. On the one hand, Bush had ordered that no federal funding could be used on biomedical cloning because of the sanctity of human life, and that meant no embryos could be destroyed. But on the other hand, as Sandel pointed out, he didn’t object to biomedical cloning going forward with private funding. So, it’s okay to kill when privately funded?
During the council meetings, I started in with various metaphors that began to form in my own reasoning. From my point of view, the parts are not the whole, especially when the brain is not yet a part. The analogy I came up with: “When a Home Depot burns down, the headline in the paper is not ‘30 Houses Burn Down.’ It is ‘Home Depot Burned Down.’” The parts in the store are just that, not whole houses.
I also tried the analogy of the widely accepted “brain death” argument used when considering human organ transplantation. Clinical criteria had been established for brain death that proved solid and reliable. When there was irreversible brain damage yielding a flat EEG, the organs, including the heart, could be harvested and transplanted to keep someone else alive. None other than Pope Pius XII had supported this position. I reasoned, if brain death was accepted as a concept that allowed for the organs to be used for health goods, why couldn’t the cells of a brainless entity like a blastocyst?
I slowly realized I was becoming an advocate. I marshaled all of my arguments and wrote an op-ed for the New York Times.16 By late spring the lines had been drawn. At the June meeting, each member of the council had a public moment to say what he or she thought about the issues that had been swirling around. It came down to a vote on what each of us felt about reproductive cloning and biomedical cloning. The pressure had been building so much that Times columnist William Safire in mid-May wrote an article about the impending split in the council’s sentiments about cloning.17 The reporters were all over us for months, and various views, prejudices, perspectives, and more were being offered to anyone who would listen.
Kass offered us a choice at the June meeting. He had prepared some recommendations that reflected all the options discussed over the previous five months, and he wanted us each to indicate where we stood. The two main options:
Possibility three, ban on cloning to produce children . . . but under regulation of the use of cloned human embryos for biomedical research. Option three called ban plus regulation.
Option six, a ban on cloning to produce children with a moratorium . . . being understood to be a temporary ban . . . with a fixed time period on cloning for biomedical research. Option six, ban plus moratorium.18
Each of seventeen members spoke up on their preference and provided reasons as to why. Everyone’s view was clearly stated, even the three members who were struggling with their decision. It came down to this: All members were for the ban on reproductive cloning. While one could draw upon either scientific or religious reasons, basically everybody thought it was spooky and weird.
As I say, the June vote was clear. Seven voted to ban biomedical cloning as well, which is to say, this group wanted a moratorium. As they freely acknowledged, they could live with the term moratorium because they wanted the extra time to convince the world that biomedical cloning was simply wrong.
Seven others, including me, voted for regulation, which meant to go ahead but to put regulations in place. Thus, this group had no moral problem with the idea of biomedical cloning. And finally, three other members said after some back-and-forth that they were for the possibility of biomedical cloning as well. All in all, this meant ten were for biomedical cloning and seven were against it. All of this is right there in the public transcript of this meeting. I was ecstatic thinking that our six months of work had revealed a reasonable position that had involved a true cross section of society.
Leon had not been happy with the whole idea of voting a stance. He argued the council was a place to air ideas and that that should be its function. He was a true product of the University of Chicago. But Washington with its bottom-line philosophy doesn’t work that way. Subsequent to the June meeting, we were sent a form requiring a vote and our signature and were requested to quickly fax it back to the White House. One month later, at the July meeting, our report and the tally was published (Figure 47). Magically, in the intervening month, the sentiments of the council were represented as follows: Ten were for a moratorium and seven were for going ahead with regulation. Same vote, different spin.
FIGURE 47. On July 11, 2012, Leon Kass released the report on human cloning in a press conference in Washington, D.C. The press conference was exhausting, since Kass not only had to address those on the committee who disagreed with his position, but also had to acknowledge the political realities of both the White House and Congress and, of course, the press.
(Courtesy of the author)
During the weeks after the June meeting there must have been lots of politicking between the swing voters and those seeking a total ban. The seven of us who were clearly for going ahead were not involved. We had decided and were set. No point in wasting time on us. What was achieved from June to July was to lump the seven who wanted a total ban into the moratorium group and to add to that group the three who wanted to go forward with regulation and to convince them to be happy with the term “moratorium” instead of “regulation.” In this way, it somehow could be perceived that the majority of the council was for putting on the brakes. Here is how it was reported in the New York Times:
BUSH’S BIOETHICS ADVISORY PANEL RECOMMENDS A MORATORIUM, NOT A BAN, ON CLONING RESEARCH
Cloning for biomedical research should not be banned outright, but rather prohibited during a four-year moratorium that would allow time for more public debate, according to a long-awaited report by President Bush’s bioethics advisors. By endorsing a moratorium on research cloning, the President’s Council on Bioethics put itself slightly at odds with Mr. Bush, who supports a ban on all human cloning experiments. In a dissent, 7 of the panel’s 18 members went even further, recommending that research cloning proceed under government regulation. Even the majority was split, according to an executive summary of the report, a copy of which was obtained by The New York Times. “Some of us hold that cloning for biomedical research can never be ethically pursued, and endorse a moratorium to enable us to continue to make our case in a more democratic way,” the majority wrote. “Others of us support the moratorium because it would provide the time and incentive required to provide a system of national regulation.” As expected, the council—which spent seven months examining the social and ethical implications of cloning experiments—called for a ban on using cloning to produce babies that are genetic copies of adults. Despite the divisions on the panel, a senior administration official called the report “consistent with the president’s core view, which is that all human cloning is wrong and should not be authorized.” The official added that the majority opinion “clearly rejects the position of those who say we should ban reproductive cloning this year while authorizing research cloning.”19
Of course, it wasn’t consistent with the core view at all, and Kass heard about it. The council members were clear on the dodge. Gil Meilaender, writing a few months later in the New Atlantic, accurately noted:
On the actual policy question itself, the deep divisions were apparent. Ten members of the Council supported a moratorium on cloning-for-biomedical-research, and seven favored moving ahead with such research, though only after regulatory controls were in place. (One of the original eighteen members had resigned and not yet been replaced befo
re the report was released.) It was, however, possible for everyone to claim a victory, if such claims matter. Because three of the ten-person majority favored a moratorium but not a permanent ban on cloning-for-biomedical-research, its advocates could—and did—emphasize that a majority of the Council opposed a ban.20
It wasn’t long after the July meeting that the media pretty much lost interest in the council. The report was generally dismissed and relegated to that large hole in Washington where most reports are placed. Still, the media attention surrounding the preparation and publishing of the report brought to light how cool it would be if the biologists could figure out a way around the moral problem. That actually happened only four years later, thanks to the Japanese molecular biologist Shinya Yamanaka. Amazingly, he figured out how to take any cell in the body and turn it into a pluripotent stem cell by running its development back in time.21 No more blastocysts discarded, no moral dilemmas, only procedures to take any cell and turn it into a cell that can regenerate the type of organ cell a diseased patient might need. Science marches on steadily, and Yamanaka was deservedly awarded the Nobel Prize six years later.
The council itself moved on and tackled all sorts of issues for almost eight years. I became increasingly frustrated with the council’s portrayal of issues as slippery slopes, which I feel were accurately summed up by coolheaded Steven Pinker in 2008:
The sickness in theocon bioethics goes beyond imposing a Catholic agenda on a secular democracy and using “dignity” to condemn anything that gives someone the creeps. Ever since the cloning of Dolly the sheep a decade ago, the panic sown by conservative bioethicists, amplified by a sensationalist press, has turned the public discussion of bioethics into a miasma of scientific illiteracy. Brave New World, a work of fiction, is treated as inerrant prophesy. Cloning is confused with resurrecting the dead or mass-producing babies. Longevity becomes “immortality,” improvement becomes “perfection,” the screening for disease genes becomes “designer babies” or even “reshaping the species.” The reality is that biomedical research is a Sisyphean struggle to eke small increments in health from a staggeringly complex, entropy-beset human body. It is not, and probably never will be, a runaway train.22
Tales from Both Sides of the Brain : A Life in Neuroscience (9780062228819) Page 32
