Anatomy of a Decision: Ethics Panel's Wooly Work
Devising a policy on cloning represented a rare clash of science, religion, and medicine
BOSTON — The first clue that Alta Charo's world was about to change came on an aluminum-gray day in February. As the University of Wisconsin law professor scanned a copy of the Sunday paper, a sheep named Dolly stared out at her from the front page. The headline proclaimed simply: With Cloning of a Sheep, the Ethical Ground Shifts.
"I knew in an instant that my life had just changed," she recalls.
She wasn't alone. For the next 97 days, Dr. Charo and 17 other members of a federal advisory panel would wrestle with the ethical pros and cons of a technological feat potentially as profound as the first controlled nuclear chain reaction.
Out of the ensuing flurry of meetings, debates, e-mail, and FedEx packages would emerge a recommendation that President Clinton this week embraced in proposed legislation: that Congress ban any attempt to produce a child with the cloning techniques used to produce Dolly.
How the National Bioethics Advisory Commission (NBAC) arrived at its decision offers a rare look at the intersection of science, religion, law, and medicine over a technology that offers both tremendous promise and peril.
In producing Dolly, biologists in Scotland apparently succeeded where others had failed, giving the world the first mammal cloned from adult cells. In theory, other researchers said, the approach might work with humans as well.
Even before Mr. Clinton called on the commission to prepare a policy recommendation dealing with cloning, its wheels were turning - in fits and starts. Charo recalls the White House asking her to appear on "Nightline" the Monday night following the cloning breakthrough's announcement.
"I didn't know when I showed up at the studios that the president had announced he was going to bump this issue to NBAC," she says. "I found that out as I was having my make-up put on."
With the help of the Nightline crew, Charo got the unlisted phone number of the chair of the commission, Princeton University president Harold Shapiro, and called him to ask if there were any marching orders. "I'm on a cell phone with him as I'm sitting in front of the cameras, and Chris Wallace is beginning to talk," she says. "It was really kind of insane."
By the end of that week, however, Dr. Shapiro had convened a handful of NBAC members to help chart the committee's course over the 90 days the White House had given the panel to do its work.
Though the commission was set up on paper in 1995 to deal with a range of bioethical issues, its first full meeting didn't occur until last fall. Now, lacking staff and still facing budget uncertainties, it was being asked to tackle one of the thorniest bioethical issues imaginable - in a fraction of the time most presidential commissions are given.
All hands on deck
For panelists who had never served on a national commission, Shapiro's initial meeting was a jump-in-with-both-feet experience.
"For me it was a total mystery," says Carol Greider, a respected molecular biologist with the Cold Spring Harbor Laboratory in Cold Spring Harbor, N.Y. "Since I'd never been on one of these panels, I had no idea how one would put together a set of recommendations and a report in a short time."
"We had to decide pretty quickly what the scope of the report would be," adds Thomas Murray, director of the Center for Biomedical Ethics at Case Western Reserve University in Cleveland. The prospect of cloning human children "seemed to be at the core of the public reaction and the most novel use of it with profound moral implications. So we knew we had to address that."
But the commission also decided not to focus on other issues, such as the creation of cloned embryos strictly for research rather than for aiding infertile couples trying to have children.
"The president had declared in 1994 that there should be no use of federal funds to create any embryos for research," Dr. Murray says, "and whatever else the Dolly technique is, it's the creation of an embryo."
Another reason for not addressing it may have been a lack of consensus on the issue of cloned embryos and biomedical research, which became apparent at a meeting in mid April.
"We were getting a better idea of the applications in the biomedical area that would be at risk if we were to recommend something that shut this technology down broadly," Charo says. "For example, if I were a member of the National Firefighters Association, I would have been testifying in favor of maximizing the freedom to do research because an important application will be learning how to take cells from an individual and grow new skin."
The problem is that to do this kind of research involves creating embryos. "You immediately get yourself caught in the abortion debates about research on embryos," she says, "and you get yourself caught on the worst part of those debates because you're not just using embryos left over from in vitro fertilization procedures. You're making new embryos which you would then not permit to develop into a child."
Clones of contention
Efforts to build a consensus on the moral or ethical bases for a ban on cloning appeared to be just as elusive. Charo calls one ethics session she sat in on a "real bloodbath." Yet based on the problems the Scotland research team encountered during its attempts to clone sheep, science and ethics did converge on the issue of safety.
"We do not agree on all things. Nor did we agree on all the moral issues the Dolly technology raises if it were to be used to make human children," Murray says. Two things they did agree on: that the danger of harming a child born by the procedure is a compelling moral concern and other moral issues having to do with the nature of family, parenthood, and human identity deserve prolonged national debate.
In many ways, the report and recommendations represent a beginning, not an end point. "My hope was throughout this process that we would be able to do something that would bring the national discussion to a more informed level," says Shapiro.