H U M A N CLONING Papers From a Church Consultation Evangelical Lutheran Church in America October 13-15, 2000 � Chicago, Illinois Roger A. Willer, editor H U M A N CLONING Papers From a Church Consultation Roger A. Willer, editor Copyright ' 2001 Evangelical Lutheran Church in America. Produced by the Department for Studies of the Division for Church in Society, 8765 W. Higgins Rd., Chicago, Illinois, 60631-4190. Permission is granted to reproduce this document as needed provided each copy carries the copyright notice printed above. Scripture quotations from the New Standard Revised Version of the Bible are copyright ' 1989 by the Division of Christian Education of the National Council of Churches of Christ in the United States of America and are used by permission. Cover image ' copyright 1999 PhotoDisc, Inc. The figure found on page nine is adapted from the National Institute of Health, �Stem Cells: A Primer� at <www.nih.gov/ news/stemcell/primer.htm>. ISBN 6-0001-3165-8. Distributed on behalf of the Division for Church in Society of the Evangelical Lutheran Church in America by Augsburg Fortress, Publishers. Augsburg Fortress order code 69-1550. This publication may be found online in its entirety as a downloadable PDF (portable document file) at <www.elca.org/ dcs/humancloning.html>. Printed on recycled paper with soy-based inks. Contents Contributors 3 Preface 4 Introduction 5 Section One, The Science and the Public Debate Kevin Fitzgerald � Cloning: Can it be Good for Us? 8 Margaret R. McLean � Table Talk and Public Policy Formation in the Clone Age 14 Richard Perry � Broadening the Church�s Conversation 23 Section Two, Theological Resources Philip Hefner � Cloning: The Destiny and Dangers of Being Human 27 Richard C. Crossman � Cloning and Genetic Engineering: Human Mandate and its Context 32 Duane H. Larson � Lutheran Theological Foundations for an Ethics of Cloning 35 George L. Murphy � Improving the Species: A Sermon 42 Section Three, Specific Questions Should We Clone for Procreative Purposes? Hans O. Tiefel � In Our Image: Procreative Cloning and Faith 45 Tom D. Kennedy � Let the Church First be the Church: Thinking Theologically and Speaking Clearly about Reproductive Cloning 52 Robert Roger Lebel � Reproductive Cloning 55 Should We Clone for Therapeutic Purposes? Mark J. Hanson � Cloning for Therapeutic Purposes: Ethical and Religious Considerations 58 Cynthia B. Cohen � Ethical Questions about the Uses of Embryos and Women in Therapeutic Cloning 66 Nancy L. Reinsmoen � Reflections from the Lab on Cloning for Therapeutic Purposes 70 What Are the Legal Implications? Susan R. Martyn � Human Cloning: Law and Ethics 74 Section Four, Table Talk Roger A. Willer � Threads from the Conversation 83 Consultation Participants 87 Index 88 Additional Resources 94 Human Cloning: Papers from a Church Consultation 3 Contributors Dr. Cynthia B. Cohen is a Senior Research Fellow at the Kennedy Institute for Ethics. She has written widely on bioethical issues related to the beginning and end of life. She serves on the Committee on Science, Technology, and Faith of The General Convention of the Episcopal Church, U.S.A. Dr. Richard C. Crossman of Waterloo Lutheran Seminary was formerly president and now teaches theology there. He has written for the Canadian church on theological and ethical aspects of agricultural biotechnology. Dr. Kevin Fitzgerald, S.J., Loyola University Medical Center, Chicago, holds degrees in moral theology and genetics and is a Research Associate in Loyola�s department of hematology and oncology. Dr. Mark J. Hanson is the Executive Director of the Missoula Demonstration Project, Missoula, Montana as well as a research professor at the University of Montana�s Practical Ethics Center. He has published frequently on the moral and religious implications of the new genetics in his previous work for the Hastings Center in New York. Dr. Philip Hefner is Professor of Systematic Theology, Lutheran School of Theology at Chicago and has written widely on various aspects of theology and science. Hefner is also Editor of Zygon: Journal of Religion and Science and director of the Zygon Center for Religion and Science, Chicago. Dr. Tom D. Kennedy is Chair and Associate Professor of Philosophy at Valparaiso University in Indiana. He has taught courses, lectured, and written on various aspects of bioethics for a number of years. Dr. Duane H. Larson is President of Wartburg Theological Seminary, Dubuque, Iowa where he also teaches courses in theology. Larson has pursued dialogue between theologians and natural scientists throughout his teaching and publishing career. Dr. Robert Roger Lebel is a community-based Clinical Geneticist with Genetics Services, S.C. in the western Chicago area. He holds masters degrees in zoology, theology, ethics, and medical genetics as well as a M.D. from the University of Wisconsin Medical School, Madison, Wisconsin. Dr. Margaret R. McLean is the Director for Biotechnology and Health Care Ethics at the Markkula Center for Applied Ethics, Santa Clara University, Santa Clara, California. She serves on the California State Advisory Committee on Human Cloning and holds doctorates in both clinical pathology and ethics. Susan R. Martyn is Professor of Law at the University of Toledo in Toledo, Ohio. She has written widely on bioethics and law as well as consulting on several briefs on behalf of the ELCA. Rev. George L. Murphy holds a doctorate in physics and has written frequently on concerns related to science and theology. He currently serves as Pastoral Associate at St. Paul Episcopal Church in Akron, Ohio. Dr. Richard Perry is Assistant Professor of Church and Society and Urban Ministry at the Lutheran School of Theology at Chicago. He has written on various social justice topics and authored a chapter in the volume, The Promise of Lutheran Ethics. Dr. Nancy L. Reinsmoen is a Professor in the Department of Pathology at Duke University Medical Center where she serves as the Director of the Clinical Transplantation Immunology Laboratory. Her Ph.D. is in pathobiology and she has published numerous manuscripts and presented on related issues at many professional associations. Dr. Hans O. Tiefel is Professor of Religion and Ethics at the College of William and Mary, Williamsburg, Virginia. His work includes several contributions on bioethics for the ELCA and its predecessor bodies. Rev. Roger A. Willer is an Associate for Studies with the Division for Church and Society and also a Ph.D. candidate in theology at the University of Chicago. Evangelical Lutheran Church in America � October 13-15, 2000 4 Preface The possibility of human cloning fascinates, bewilders, and repulses people in church and society today. Jokes and cartoons voice our unease about what recent breakthroughs in cloning science and technology mean for the human future. Something new is happening, and we are not sure what to make of it. In the middle of our uncertainty, where might Lutheran Christians and others look for guidance? The present book is an excellent place to turn. It introduces readers to the science of cloning, draws upon Christian beliefs to frame the topic, and confronts the important ethical issues human cloning raises. The book takes a very complex aspect of science and makes it accessible to those of us with a layperson�s grasp of scientific topics. It encourages and prepares readers to think carefully and to enter into meaningful deliberation on human cloning. It is a book suitable for individual study and for educational purposes in congregations and other settings. Human Cloning: Papers from a Church Consultation offers an initial contribution from the Evangelical Lutheran Church in America (ELCA) on human cloning to the church ecumenical and to the wider society. This book contains papers given at a consultation on human cloning convened by the Division for Church in Society of the ELCA. It comes in response to a resolution from the Delaware�Maryland Synod that called upon the ELCA �to explore and assess all facets of human cloning.� The consultation, held in October, 2000, brought together persons working in genetics, theology, ethics, and the law to think through the issues surrounding human cloning with the understanding that their contributions would be published for use in and beyond the ELCA. They came together as Christians, united in faith, but from diverse disciplines, backgrounds, and settings and with sometimes different perspectives on how human cloning should be approached. On behalf of the Division, I thank the Rev. Roger A. Willer, Associate of the Department for Studies, for organizing the consultation, editing this book, and providing a overview of the lively discussion among the consultation participants. I thank also all those who prepared papers and took part in the consultation. Their generous giving of their time, expertise, and insight is bound to bear fruit throughout our church and beyond. Please note that the authors of these papers are expressing their own views. The book is not an official state- ment of the ELCA but is meant to promote deliberation within and beyond the ELCA. Human Cloning: Papers from a Church Consultation is one of three ELCA publications in the area of genetics. Readers of this book may also be interested in Genetics! Where Do We Stand as Christians? (2001) written by Willer and Genetic Testing & Screening: Critical Engagement at the Intersection of Faith and Science (Minneapolis: Kirk House Publishers, 1998), edited by Willer, a major study with nine essays by different authors. Information on ordering these publications may be found on page 94. The Rev. Charles Miller Executive Director, Division for Church in Society Human Cloning: Papers from a Church Consultation 5 Introduction The announcement of Dolly�s birth in February the scope and structure of this publication. Cloning, of 1997 (�the sheep heard round the world,� as it is in general, denotes various technological processes sometimes called) represents the milestone in public such as embryo splitting, nuclear transfer (Dolly), awareness of the challenges posed by the dawning of or others used to create copies of biological material. the age of biological control. This event created a The biological material involved could be sequences critical mass in public awareness about the revolu- of DNA, molecules, cells, or whole organisms. tionary impact of the new genetics. The term revo- (Whole organisms range from bacteria to primates.) lution is appropriate because the challenges are as In this general sense, the replication of a molecule or broad as the transformation of medicine and agricul- a cell is an instance of cloning, but these are not the ture, and as deep as fundamental questions about focus of this publication. Human cloning here desig- human identity and God�s loving intention for na- nates the social, ethical, and theological issues related ture. These challenges beckon the church�s involve- to cloning whole organisms, whether that involves ment. So do its members� questions. the technological procreation of a human clone or of animals for immune compatible organs. What does the Evangelical Lutheran Church in America (ELCA) think about cloning? That ques- Within this general concern for human cloning, tion was asked in 1997 by thoughtful church mem- we must make further distinctions, distinctions used bers and their requests prompted the Delaware� both in the literature about human cloning and here. Maryland Synod to call upon the ELCA to provide The cloning of human cells might serve either of two guidance. Its Division for Church in Society (DCS) distinct goals�reproductive or therapeutic. Repro- responded by authorizing a one-time consultation ductive goals include the desire for genetically related to �explore and assess all facets of human cloning in or genetically selected (for example, selecting a movie relation to Lutheran understandings.� A broad ex- star�s genome) children. Therapeutic goals include ploration was ensured by the designation of several the creation of immune compatible cells, tissues, and topics as explained below. It was also aided by invit- organs for transplant as well as the production of ing a range of participants working in genetic sci- human proteins in transgenic animals. The coupling ence, business, medicine, theology, or ethics. (The of cloning technology with the rapid development participants� roster may be found on page 87.) of stem cell research also falls under our purvey for obvious reasons. The promise represented by the The consultation took place October 13 to 15, 2000, combined use of these two technologies for treating in Chicago when twenty-five individuals (mostly ELCA everything from Alzheimer�s to Parkinson�s disease members, but with some intentionally invited ecumeni- lays a responsibility on us to consider carefully the cal partners) spent seven sessions discussing the issues issues of extensive medical use of human stem cells from a variety of perspectives. In each session a pri- that cloning might make possible. mary paper, prepared during the previous summer, kindled response in the form of short written reflec- These distinctions provide the rationale for the tions and periods of dialog. (Strangely, the conversa- scope and structure of this publication. In Section tion never failed to outlast the allotted time.) The pa- One Kevin Fitzgerald provides an introduction to pers (edited and sometimes revised) from this weekend scientific information about cloning, emphasizing of consultation are collected here. This publication is especially the somatic nuclear transfer cloning the first ELCA resource on human cloning and is in- (SNTC) breakthrough that produced Dolly and tended to promote learning and moral deliberation which could be the engine of widespread human clon- throughout our church. ing. This introduction aims to provide a working knowledge of the key aspects of what is the potential The terms �clone� and �cloning� are often used in of and the obstacles to human cloning. However, as overlapping and confusing ways, especially in the pub- both Margaret McLean and Richard Perry are quick lic domain. A specific definition of �human cloning,� to point, out human cloning does not exist in a then, can serve as the natural way to begin detailing vacuum. Rather the �fact set� about cloning must Evangelical Lutheran Church in America � October 13-15, 2000 6 include assessment of cloning�s impact on all seg- with the reader. His observations attempt to desig- ments of society, from that of people of color to the nate threads of the conversation that deserve further farm community. These two thinkers also raise so- attention. Some of these pointings simply lift up in- cial questions about justice and explore what might sights offered around the discussion table. Others characterize adequate public debate. suggest disagreement or where further dialog is clearly needed. Finally, some of these suggest �agree- The writers in Section Two explore the questions ments� culled from the tenor of the conversation. In and challenges that cloning brings to Christian this sense Willer shares a report about the direction Lutheran theology. Philip Hefner sketches the ques- and character of the conversation that should spark tions and resources that classical theological themes further reflection. bring to this discussion. Richard Crossman responds with additional reflections, emphasizing practical It is important to append the note here that the Octo- moral principles. Duane Larson offers an intriguing ber 2000 consultation was structured differently than constructive proposal for Lutheran ethical categories this publication. Further, the nature of papers for a con- by grounding them in a renewed understanding of sultation deviates somewhat from the nature of papers the Trinity. George Murphy�s sermon, given at the designed for written publication. These facts help ex- consultation, is included as an illustration of how plain some anomalies of this volume, such as the dis- one might preach on this topic in a thought-provok- parity between the number of papers in each section or ing way. the informal character of some of the writing. Section Three clusters together specific moral ques- What does the ELCA think about cloning? This set tions that serve as helpful locations for ethical, theo- of papers and materials only begin to chart that answer. logical, and practical reflection. The first topic is pro- However, if such questions are ever to be answered in a creative (reproductive) cloning, that is the �cloning� ev- definitive way, church members, congregations, and the eryday conversations usually have in mind. Hans Tiefel church as an institution must be equipped to think reflects on whether Christians could ever consider pro- through the issues. That is the point of this publica- creative cloning as the loving thing to do. In their re- tion. It does not attempt to stipulate a position on hu- sponses, Tom Kennedy challenges the church to claim man cloning, but it does intend to aid education, cata- its distinctive message in this issue, while Robert Roger lyze thinking, stimulate deliberation, and encourage Lebel, a clinical geneticist, shares questions and reflec- active participation in the needed public debate. Surely tions from his front line perspective. these goals are critical to pursue as we enter the age of biological control represented so unquestionably by a The second set of papers specifically probe the is- sheep from Scotland. sues of cloning for research and therapeutic purposes. Mark Hanson considers several of these in his paper, but properly devotes much of his thinking toward concerns around stem cell research. Cynthia Cohen and Nancy Reinsmoen engage Hanson�s work with pertinent questions informed by sharp analysis, women�s concerns, and researchers� hopes. Susan Martyn addresses the final topic from her vantage point as a professor of law. Since activities of human cloning necessarily intersect with legal issues, her systematic review offers important insights into an area sometimes neglected in conversations about cloning. It is important to point out that each writer of the primary papers here has concluded with spe- cific recommendations for church policy that is based on their normative work. They did so at the request of the convener in order to facilitate tangible delib- eration within the church. The presence of these rec- ommendations in this document should be under- stood in this light and do not represent any attempt to speak for the church. A critical moment in any consultation is the dia- log that follows the presentation of each paper. In the last section of this publication, Roger Willer as convener, shares observations about that conversation Human Cloning: Papers from a Church Consultation 7 Section One The Science and the Public Debate Evangelical Lutheran Church in America � October 13-15, 2000 8 Cloning: Can it be Good for Us? Kevin Fitzgerald Abstract Adequate answers to moral questions about cloning re- of medical treatments, to new options in reproduc- quire a working knowledge of the science and technology tive technologies for endangered species or for hu- involved, both present and anticipated. This paper presents man beings. Similarly, the claims of potential harm an overview of the current state of somatic cell nuclear also range widely. These claims move from concerns transfer technology (SCNT), the type of cloning that now for individual human beings that might be used as permits whole organism reproduction from adult DNA. This mere objects of research to social concerns focusing essay explains the basic science and technology and ex- on the exacerbation of the health care inequalities plores potential uses. It then notes remaining scientific ob- already plaguing our communities and nations. stacles and unanswered moral questions that must be re- The extent to which any of these postulated ben- solved before SCNT could be used for human reproduc- efits and harms may actually occur will depend sig- tion. Attention is also given to aspects related to cloning nificantly upon the real capacities of the cloning tech- for therapeutic and research purposes. nology itself. This paper will present an overview of the current state of this cloning technology, and a The Importance of subsequent evaluation of the likelihood of several of Understanding the Science the suggested benefits and harms cloning will bring In April of 1997, shortly after the announcement to humankind. of the cloning of Dolly the sheep, the journal Nature Genetics reported that Dr. Brigitte Boisselier, scien- Understanding SCNT tific director of Clonaid in the Bahamas, planned to When the new technology of cloning is mentioned, 1 offer human cloning for $200,000. Dr. Boisselier it is not always clear what is meant. After all, in some defended this offer on the grounds that parents have sense, cloning technology has been around for hun- the right to clone themselves. Since the Clonaid of- dreds of years. Gardeners and botanists have long fer, others, such as physicist Richard Seed of Chi- been cloning plants by transplanting cuttings. Even cago, have also made announcements in the media animals as complex as amphibians have been cloned about their intent to clone human beings. Such dec- for several decades. What, then, is the new cloning larations immediately bring to mind two questions: technology that was ushered in by the advent of the Can human beings be cloned? How should we use lamb named Dolly? this new technology? To be precise, the stunning scientific breakthrough In order to answer well the second question of what achieved in the cloning of Dolly was the application should or should not be done with this burgeoning of a technique called �somatic cell nuclear transfer� new technology, it is crucial to answer thoroughly (SCNT) to cells taken from an adult mammal. In the first question concerning what can be done both order to understand the significant nature of this now and in the near future. One reason this thor- breakthrough, one must place it within the context ough answer is crucial is to provide a solid founda- of the natural development of a mammal. tion for the analysis of the proposed benefits and harms of applying this new technology to the needs A new individual mammal usually begins with the and desires of human beings. fertilization of an egg by a sperm. Both sperm and egg each supply half of the new mammal�s genome Many potential benefits of cloning have been pro- (the DNA that makes up the genes which are pack- posed. They range from the possibility of simply aged into chromosomes). When the sperm penetrates providing new scientific insights into mammalian the outer protective layers of the egg, it triggers an embryonic development through many new types activation process in the egg. This process makes the Human Cloning: Papers from a Church Consultation 9 egg impermeable to further penetration by other will no longer need in order to perform their spe- sperm (in order to avoid too much male DNA enter- cific functions. Heart cells do not need the brain genes ing the egg) and sets up the egg to begin dividing. and vice versa. In all, it is an amazing process when Early on in the process of cell division (when the one considers how the DNA from an egg and a sperm embryo is only two, four, eight, or perhaps sixteen comes together, continuously copies itself in order cells) the functions of the cells are controlled prima- to make new cells, turns on all the genes needed to rily by the materials that were stored up in the egg. make an entire new organism, and then selectively At this time, the cells are capable of being separated turns off the genes that are not needed as the new from each other and each developing into a new em- cells become the different cells and tissues that make bryo. This ability of each cell to grow into a full or- up the body. ganism is called �totipotency.� Such a separation of The idea behind SCNT is to bypass the normal the cells in an embryo is often the reason for the birth reproduction process of combining DNA from a of identical twins, triplets, etc. These genetically identi- mother and a father, via egg and sperm, to create a cal siblings are natural clones of one another. new individual. Instead, one intends to create a clone Being relatively minuscule as compared to the egg, of another individual (similar to a delayed identical the sperm contributes very little to the egg cell other twin) by using a cell other than sperm or egg. The than the DNA it brings. The sperm DNA is pack- non-reproductive cells of the body are called �somatic aged very tightly in order to remain safe and secure cells� (from the Greek word for body, �soma.�). Two within its tiny cell. Consequently, it appears to take major obstacles must be overcome in order for SCNT some time before the DNA from the sperm is com- to work. After early embryo development, most of pletely unpacked and functional. In addition, the egg the cells of the developing individual become differ- DNA has been stuck in an inactive state in the egg entiated and no longer have all the genes required to since before the female mammal that produced the activate development of a full organism. Hence, the egg was born. Hence, perhaps due to these condi- first obstacle is to get all the required genes turned tions and other activation safeguards built into the on again (dedifferentiation). The second obstacle is egg, the DNA from the sperm and egg that com- somehow to trigger the dedifferentiated genome into prise the genome of the newly developing mammal acting like it is in a newly activated egg and begin the does not control the activities of the cell immedi- process of growth and development. ately after fertilization. Instead, it can take several Overcoming the second obstacle is fairly straight- cell divisions before the entire genome becomes ac- forward. If the genome to be cloned needs to act like tive and begins directing the functions of the cells in it is in a newly activated egg, then put it in a newly the developing embryo. Among mammals, mice activated egg. This step is the �nuclear transfer� part achieve a fully functioning genome at the early stage of SCNT [see figure below]. As techniques have im- of a two-cell embryo. Sheep, pigs, cattle and humans proved for the harvesting, culturing, and micro ma- appear not to have fully active genomes directing cel- nipulation of eggs and donor somatic cells, this part lular function until around the four-to-eight cell stage, 2 of the SCNT process has become much less trouble- at least. some than the first obstacle (dedifferentiation). Once the mammalian genomes become fully func- As the failure to produce clones from differentiated tional, they begin to direct the development of the mammalian cells continued during the past few decades, embryo. As the number of cells increases and the many scientists began to think that in mammals the embryo grows, the cells of the embryo begin to take process of differentiation moved only in one direction� on different characteristics and functions. They even- tually become the dif- ferent cells and tissues (Nucleus) Inner Fetus of the mammalian Cell body (heart, lung, Mass Blastocyct intestine, skin, brain Fusion and so forth). This process of developing specific characteristics and functions is called Somatic Cell Totipotent �differentiation.� Nuclear Transfer Cells During differentiation, the genomes of cells selectively turn off the Cultured various genes they Figure adapted from National Institute of Health �Stem Cells: A Primer� Pluripotent <www.nih.gov/news/stemcell/primer.htm>, May 2000 Stem Cells Evangelical Lutheran Church in America � October 13-15, 2000