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28 August 2000

Time to deal with a typical British fudge

The ethics of embryo research have not been addressed

By Melanie McDonagh

It was what you might call an uneven contest. Radio 4’s Today programme kicked off its item on the Donaldson report on stem cell research with a moving interview with a man with Parkinson’s disease. He had shaky hands, rotten quality of life, and was understandably anxious for the boundaries of science to be pushed back in any way that might improve his condition. The Independent, by contrast, put a photograph of the human embryo on the front page, all 20-odd cells of it. It looked like a stunted, unripe blackberry, with a horrible yellow growth over it. Would you really put the interests of something that looks like this over the life chances of unfortunates such as him?

As ever, journalists had the job of turning science into something human, visual and intelligible. Yet the subject that the Donaldson report addressed was rather simple. How is stem cell technology to develop? Stem cells are early, unspecialised cells with an extraordinary capacity for developing in any direction, perhaps into nerve cells, or blood or liver cells. In laboratory conditions, they may be influenced to differentiate into tissue to treat, eventually, heart failure, Parkinson’s disease, muscular dystrophy, Alzheimer’s.

Embryos are a particularly useful source of these stem cells, but not the only one. They are also found in umbilical fluid and foetal tissue – even in human tumour tissue. The problem arises only when your stem cell source is human embryos. Where do you get the embryos from? One source is those created in the course of IVF treatments which are surplus to requirements; another is by creating them specifically for research purposes. The third and most exciting source of embryos is achieved by transplanting the nucleus from an adult human into a human egg from which the nucleus has been removed: cloning, to you and me. Cloning offers the possibility of growing made-to-measure human tissue that would be accepted by the body, being genetically almost identical with it.

The Donaldson report addresses all these methods, and concludes by recommending that all the options should be explored, that existing experimentation on human embryos should be liberalised and that human cloning for therapeutic purposes be permitted. But, for all the report’s clarity, the fundamental question – what is a human embryo and what protection does it deserve? – was not addressed.

As the report’s authors put it: “The Expert Group was not asked to review from first principles the ethical issues of research involving embryos . . . [it] was asked only to consider any new ethical issues that might arise from the creation and use of embryos for the extraction of stem cells for research into new therapies.” In other words, the authors were not being asked to consider the very question that has us most excited and quarrelsome: Is it right to create a human life for the purposes of research? Can we use a human being – however primitive – as a means to an end?

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The reason why the report doesn’t do so is quite explicit. That argument has been settled, put to bed, finished. The Warnock report on in vitro fertilisation back in 1984 approved the creation of embryos specifi-cally for the purposes of research. It also permitted licensed research on spare embryos created for IVF treatments. Yet the Warnock report itself is curiously equivocal about the essential principle. “Although the questions of when life or personhood begin appear to be questions of fact susceptible of straightforward answers, we hold that the answers to such questions in fact are complex amalgams of factual and moral judgements. Instead of trying to answer these questions directly, we have therefore gone straight to the question of how it is right to treat the human embryo.”

In other words, the moral question was fudged in favour of quintessential British pragmatism. Research on embryos was permitted with the informed consent of the parent-donors, up to a specified time limit of 14 days. Ireland and Germany, by contrast, legalised IVF treatment, but allowed doctors to fertilise only as many eggs as could be implanted in the mother. It made for less efficient fertility treatments, but it wasn’t a moral compromise.

Warnock’s legacy is as follows. Between 1991 and 1998, 763,509 human embryos were created under the Human Fertilisation and Embryology Authority. Of these, 237,603 were not used for any purpose and were destroyed; 48,444 were given for use in research; 118 were created in the course of research. In other words, human embryos have been brought into being, used for the purposes of experimentation, and created specifically for research for the past decade – and they did not so much as feature on the radar of British public sentiment. We now contemplate experimenting on embryos for a number of purposes, rather than for a few, harvesting the embryos for stem cells and producing them by cloning rather than fertilisation. But the principle is the same as in 1984.

Perhaps it is time to return to Warnock, to discuss the first principles all over again as the Donaldson report did not do. In the wake of the human genome project, is it not possible to assert that human life begins with the creation of a distinct genetic personality at conception? In this sense, a cloned embryo is not very different from an identical twin. The early human embryo has nil visual appeal and less sentimental pull than an aborted foetus, but in that unlovely state we all started.

It is time for the embryo debate to move from pragmatism to philosophy. The trouble is, that’s something the British are peculiarly bad at.