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Religion, ethics and scientific knowledge in the post-secular society: A case study of the stem cell controversy. Part 3.

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36 (2017) Водещ броя: Гергана Попова
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Kalina Kamenova


Religion, ethics and scientific knowledge in the post-secular society: A case study of the stem cell controversy. Part 3.

Kalina Kamenova


4.                  Human cloning and the ethics of hESC research

The framing of hESC research as a moral issue closely related to human cloning played a significant role in sustaining the public controversy on both sides of the Atlantic. In the early years of hESC research, public fears were fueled by media hype and news stories about cloned human babies (Scott, 2006). The most controversial announcement came from the U.S. based-company Clonaid, established in 1997 by the Raelian cult. The Raelians, which believe that humanity was the end product of a genetic engineering project run by highly intelligent extra-terrestrials, claimed their scientists had produced the world’s first cloned baby, allegedly born by Caesarean section on December 26, 2002 to a 31-year-old American mother. Scientists quickly dismissed Clonaid’s claim of successful reproductive cloning as improbable and groundless, since at the time even most technologically advanced labs had not succeeded in producing a viable cloned human embryo. Investigations by journalists raised suspicions that the story was hoax, especially as Clonaid’s executives consistently refused to provide any evidence of cloning the baby, nicknamed Eve by the press, or even of her existence. Despite Clonaid and other human cloning advocates’ claims, the birth of Eve and cloned human babies had never been verified independently.

Although cloning advocates believe that reproductive cloning has the potential to improve the population vitality by maximizing favorable biologically-determined behavior and intelligence, it is universally rejected on ethical grounds since “reproductive cloning would amount to a procedure in which people were the experiment, the outcome of which could not be known until they were shown to posses the capacity of producing normal children” (Finlay, 2004, p. 15). Notwithstanding the general agreement that human reproductive cloning is morally reprehensible and should be banned, there are intense disagreements on the use of cloning technology for research purposes (e.g., for the development of patient-specific hESC therapies). In America, Christian activists and anti-cloning advocacy groups spread misconceptions that research cloning involved making cloned human babies, rather than innovative stem cell therapies. Religious made appeals for an anti-cloning ban by representing all types of cloning as a giant step toward turning human procreation into manufacture. In 2001, when the biotech company Advanced Cell Technology (ACT) from Worcester, Massachusetts announced they had partial success in cloning human embryos for stem cell research, a U.S. Orthodox Church leader compared cloning experiments to “crimes against humanity of a Nazi brand” and claimed that “the so-called therapeutic cloning is nothing other than the worst instrumentalization of a human being, sacrificed for the benefit of others” (News release by zenith.org, 27 November 2001). Public statements and media releases by opponents of hESC research not only blurred the differences between cloning for reproductive purposes and research cloning, but also questioned the latter’s viability for the production of hESC therapies. The founding statement of Americans to Ban Cloning shows this tendency to conflate hESC research and cloning:

“A ban on cloning as a means of producing live born human beings will prove to be unenforceable unless it also bans cloning for any other purpose - including the use of cloning to produce human embryos as sources of stem cells or for other experimentation. Referring to this latter use of cloning as “therapeutic cloning” is prejudicial and misleading, since it has not been shown that cloning is necessary for or useful in the production of human therapies”. (www.cloninginformation.org)

Similar concerns were voiced by Christian bioethicists on the PCBE such as Mary Ann Glendon and Gilbert Meilaender, as well as by neoconservatives with little experience in academic bioethics like Francis Fukuyama and Charles Krauthammer. The conservative minority on the Council strongly advocated a nationwide ban on both reproductive and research cloning. In his invariable critique of genetic engineering and biomedicine, Leon Kass, chairman of the Council from 2002 to 2005, repeatedly referred to the dystopian themes of Aldous Huxley’s Brave New World (1932) to characterize advances in human biotechnologies as an assault to human dignity. His essay “Preventing a Brave New World” in The New Republic in June 2001, utilized a similar rhetoric to diminish the effectiveness of cloning technology in developing new hESC-based therapies:  

“The technology of cloning is discrete and well defined, and it requires considerable technical know-how and dexterity; we can therefore know by name many of the likely practitioners. Nothing scientifically or medically important would be lost by banning clonal reproduction; alternative and non-objectionable means are available to obtain some of the most important medical benefits claimed for (non-reproductive) human cloning. The commercial interests in human cloning are, for now, quite limited; and the nations of the world are actively seeking to prevent it. Now may be as good a chance as we will ever have to get our hands on the wheel of the runaway train now headed for a post-human world and to steer it toward a more dignified human future” (Kass, 2001).

By and large, opponents of hESC research communicated their objections in terms of the intersection of the two technologies, emphasizing that research cloning can pave the way, scientifically and technically, for successful attempts at reproductive cloning.

While Christians and anti-abortion conservatives strongly opposed research cloning because it involves deliberate destruction of human embryos, some pro-choice liberals also felt uneasy about prospect of that becoming a step toward human reproductive cloning. There were ethical concerns that the acceptance of cloning technology could legitimize questionable moral practices such as the instrumentalization of children and new forms of genetic discrimination. The U.S. debate over human cloning had led to some unexpected political realignments, including a peculiar alliance between some pro-choice feminists and anti-abortion activists in support of the so-called Weldon-Stupak Human Cloning Prohibition Act (H.R. 2505) of July 31, 2001. Many feminists supported the anti-cloning legislation, as they feared that the engineering of cloned embryos would be a yet another step toward the creation of “designer babies” and would turn women’s eggs and wombs into commodities. The measure aimed to criminalize both reproductive and therapeutic cloning by establishing penalties of up to ten years in jail and a fine of not less than one million dollars for attempts to clone humans. The House approved H.R. 2505 by a vote of 265 to 162, while rejecting by a vote of 249 to 178 an amendment that would have allowed limited creation of cloned embryos for biomedical research. The bill never became a law since the Senate did not act upon it.

The potential of cloning technology for stem cell research has been intensely debated. In the United Kingdom, where research cloning was legalized in December 2000, despite strong opposition from the European Union, critics have questioned HFEA’s decision to grant licenses for “performing research of a preliminary nature with cloned human embryos before conclusively demonstrating the superior therapeutic prowess of embryonic stem cells derived by nuclear transfer or validating the rationale for the proposed work in animal studies” (Cobbe, 2005, p. 298). As published research indicated, a very limited progress had been made in human cloning experiments. Similarly, a number of animal studies have resulted in a failure of engraftment of stem cell transplants derived from cloned embryos which were attacked by the natural killer cells in the recipient mice, although one experiment has indeed achieved successful engraftment in parkinsonian mice of dopaminergic neurons derived from ES cells following nuclear transfer (Cobbe, 2005). These animal studies, however, did not seem to provide convincing evidence that the hESCs derived by nuclear transfer were in any way therapeutically more effective than other types of embryonic stem cells. Since cloning often results in altered patterns of gene expression, it is wise to remain cautious about the clinical potential of therapeutic cloning until research “demonstrated unequivocally that such epigenetic defects would not be responsible for problems associated with the transplantation of stem cells derived from cloned embryos (possibly due to misexpression of genes affecting an immune response)” (Cobbe, 2005, p. 299). Subsequently, there were concerns about exaggerations of the clinical potential of research cloning at the time research regulations were debated in the United Kingdom

 

5.                  Feminist perspectives on the ethics of hESC research

Feminists have argued that the ethical issues in hESC research extend beyond the issues of the contested moral status of the human embryo and the moral obligation to develop new medical treatments, with the key themes missing from public discussions being the role of women as the source of oocytes for the production of embryos and the health risks they face in embryo donation (Kitzinger &Williams, 2005; Dickinson, 2006, King, 2007). With the debate being presented as a strict binary opposition, little attention has been paid to the need to protect women who supply ova for stem cell and cloning technologies. Dickinson (2006) has argued that the new biotechnologies have led to the feminization of all bodies - regardless of our gender we are reduced to the status of objects, and both male and female tissue has equally become subject to commodification. Property rights in human tissue and in the human genome, she argues, have become the subject of a “new enclosures” movement by researchers, biotech corporations and governments. The ongoing commodification and objectification of human tissue has generated protests by patients’ rights coalitions, academic commentators, media and the general public, but only because it affects men and women equally. The stem cell debate, however, has in some ways rendered the bodies of women invisible. While there is almost no awareness in the mainstream media and bioethics literature about the commodification and objectification of female tissue, “in the stem cell technologies, by contrast, we see little outrage about the exploitation of female reproductive tissue” (Dickinson, 2006, p. 44). The fact that it is widely believed that stem cell research will become ethically acceptable if only scientists find ways to engineer embryonic stem cells without using human embryos further confirms the exclusion of women from the ethical equitation.    

This position has led to a reconsideration of the narrow ethical scope of stem cell debates in the United Stated and most EU countries. An example of such a shift from contested embryo politics towards more overarching concerns about the impact of recent advances in biomedicine on women’s reproductive rights and health was the public debate on stem cell research in Canada, which was conducted in the context of a larger effort to regulate human reproductive technologies. Public bioethics in Canada had stood in sharp contrast to the embryo-centrism that had permeated bioethical debates in the United States. Rather than framing the stem cell debate around the moral status of the human embryo and the ontological significance of human germ line, feminist analyses of Bill C-6, known as the Assisted Human Reproduction Act of 2004, deconstructed the dominant terms of the debate to draw the public’s attention to issues concerning women’s reproductive rights and reproductive health that are at stake with the development of stem cell technologies (Sullivan, 2005; King, 2007). Some Canadian bioethicists additionally opposed the practice of donating healthy, viable embryos for hESC research since it increased the possibility that women donors would afterwards undergo additional IVF cycles in order to complete their reproductive projects (Baylis, McLeod, Nisker, & Sherwin, 2007). Women’s reproductive work in hESC research involves specific health risks. Repeated ovarian stimulations and eggs collection surgery, which are part of the IVF treatments, entail physical risks associated with the ovarian hyperstimulation syndrome, including side effects such as lower abdominal pain, nausea, vomiting, diarrhea, rapid weight gain, and respiratory difficulty. Life-threatening complications are also possible, including renal failure, adult respiratory distress syndrome, hemorrhaging from ovarian rupture, and thromboembolism (Baylis et al., 2007).

Women have been the primary tissue donors in the stem cell industries. There has been a growing demand worldwide for continuous supply of oocytes, embryos, fetal tissue and umbilical cord blood. The expansion of new types of biomedical research has been largely dependent on the feminized productivity in the bioeconomy, with women in the developing countries being the major supplier of biological material for the stem cell and regenerative medicine industries (Waldby & Cooper, 2010). Concerns about the ethical implications of the global trade in human egg cells intensified after the UK Parliament’s decision to allow the use of cloned embryos in hESC research. Since the cloning process requires high volume of donated oocytes, the subsequent proposal by the Human Fertilization and Embryology Authority (HFEA), the UK regulatory agency for biomedical research, to relax rules on importing human eggs came as no surprise. Nonetheless, this decision was met with significant opposition by the EU, which resulted in a resolution on the trade in human egg cells passed by the European Parliament in 2005. The document seriously questioned the Authority’s attempt to facilitate a trade of human eggs from impoverish female populations in Romania. Questions about potential exploitation of women in developing countries have thus became implicated in the EU stem cell and cloning debate.

 

Conclusion

 

The value conflicts of the stem cell controversy have reflected increasing tensions between religious and secular worldviews in the public sphere of contemporary liberal states. A common concern in stem cell debates across the Atlantic was whether ethical arguments derived from religious traditions could be reconciled with scientific perspectives on human embryonic development. In his analysis of recent socio-political challenges brought by the process of secularization, Habermas (2006) has suggested that the clash between science and religion could be offset by adopting a new concept of ethical citizenship in the emerging post-secular society. He has argued that the ethics of citizenship in the conditions of post-secularism mandates a certain degree of epistemic flexibility by both religious and secular citizens, who ought to willfully engage in complimentary learning processes in order to transcend the inherent limitations of both unreflexive religious beliefs and narrow secularist worldviews. My analysis of the role of religion in the stem cell controversy, however, has indicated that the value positions of participants are deeply entrenched and ideological differences translate into conflicting epistemic claims about science. A meaningful and productive dialogue between science and religious traditions on the issue, as I have illustrated, is greatly dependent on how compatible are scientifically derived assessments of embryonic status with the respective religion’s fundamental theological tenets of the beginning of personhood. It is also contingent on the degree of openness of each religious tradition to both rival traditions and scientific knowledge.

My analysis of the ethics of hESC research has highlighted three major clusters of bioethical issues, in addition to the conflict between religion and scientific knowledge, around which stem cell debates have been framed: (1) secular perspectives on the contested moral status of the human embryo; (2) the ethics of human cloning technology; and (3) concerns about the exploitation of women, who have become the major tissue donors in the global stem cell bioeconomy. Perspectives on the moral standing of pre-implantation embryos used in stem cell research have varied between ethical defenses of its full human status and claims that at this stage of development the embryo has no particular moral status. In an attempt to balance these two conflicting positions, some have suggested that embryos have an intermediary moral status, which justifies their instrumental use for life-saving biomedical research but only under conditions that ensure their ethical treatment. This middle ground approach represents a way to assert the moral significance of early embryos as potential human life without accepting some far-reaching implications of the equal moral status view that render it implausible. The stem cell policy debate became deeply entangled with the cloning debate when scientists discovered that cloning techniques could be potentially utilized in the production of hESC therapies that would be compatible with a patient’s immune system. Stem cell proponents have attempted to appease public anxieties by setting up a clear dividing line between cloning for reproductive purposes and the use of cloning technology in stem cell research. In the US, the cloning controversy has created some unusual political alliances in support of anti-cloning legislation and also led to a proposal by the PCBE for a four-year moratorium on research cloning. The legalization of research cloning in EU countries with strong research agenda such as the United Kingdom raised concerns among critics about the public misrepresentation of its clinical potential in hESC research. The strong focus on embryos in the public discourse on hESC research has incited feminist critiques, which have deconstructed the dominant terms of the debate to draw attention to issues concerning women’s reproductive rights and reproductive health that are at stake with the development of stem cell technologies. It was claimed that popular framings of the ethics of this biomedical innovation around questions of what kind of entity the embryo is and when exactly life begins had rendered the bodies of women invisible and excluded them from the ethical equation. Feminists have lamented the reluctance of the mainstream media and bioethics literature to address concerns about the commodification and objectification of female reproductive tissue in stem cell research and, more specifically, the potential exploitation of women donors in developing countries.

 

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Dr. Kalina Kamenova is a Research Associate in the Institute on Ethics & Policy for Innovation (IEPI), Department of Philosophy, Faculty of Humanities, McMaster University in Hamilton, Canada. Her current research focuses on the ethics and public perceptions of genomic technologies in global health innovation and interventions, specifically the use of gene drives for elimination and eradication of mosquito-borne diseases such as malaria, dengue, chikungunya, and Zika. In 2015-2016 she was an Assistant Professor in the Interdisciplinary Bachelor’s Program in Arts & Science at Trent University in Peterborough, Ontario, where she taught courses in science and society, science communication, scientific controversies, and biomedical ethics. Dr. Kamenova has previously held academic positions at the University in Alberta as Research Associate in the Health Law Institute (HLI) at the Faculty of Law (2013-2015) and as the Inaugural Research Director of the Centre for Public Involvement (CPI) and Adjunct Professor in the Faculty of Extension (2012-2013). At CPI, she developed expertise in deliberative democracy and public engagement and led a project for the implementation of a citizens’ jury on Internet voting in Edmonton, Alberta. She received her PhD in Social and Political Thought from York University in Toronto in 2012 with a dissertation on the public communication and bio-politics of human embryonic stem cell research in the United States and the European Union. She also holds Master of Arts’ degrees in Comparative Literature and Ethnic and Pluralism Studies from the University of Toronto, Gender Studies from the Central European University, and Cultural Studies from Sofia University “St. Kliment Ohridski”. Her work in science communication, science policy and ELSI research (ethical, legal and social implications of the emerging technologies in biomedicine) has received international recognition through publications in top-rated academic journals and invited presentations at international conferences and workshops.

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