Embryo Splitting Is Fertile Ground for Ethics Debate
A growing furor over a doctor’s efforts to split human embryos is the latest sign of an accelerating revolution in human conception.
It is a field in which infertility specialists experiment, unregulated and often unnoticed, with the raw material of human life. They work at the edge of a medical frontier, never far from tabloid headlines or the limit of ethically acceptable research.
A so-called cloning experiment conducted recently at George Washington University is at the center of an international controversy over science’s efforts to intervene and manipulate the earliest stages of human life. The work arises from efforts to help childless individuals conceive.
Today, as a result of such embryo experiments, age, infertility, virginity and menopause are no longer bars to pregnancy. Now embryo research is picking up speed, and a public controversy over the ethics and morality of such experiments has been born anew.
Medical experts say researchers are approaching the day when they may attempt to alter the genes that control the development of a human embryo, changing the traits that would be passed on.
But in a way unique to U.S. medicine, all of these human embryo experiments have been conducted without federal funding or regulation, in a private compact between infertility specialists and their patients.
“We have no oversight by anybody, and the only ethic in sight when it comes to making babies is caveat emptor--let the buyer beware,” said the University of Minnesota’s Arthur L. Caplan, a national authority on biomedical ethics.
The controversy was triggered by an experiment presented at the American Fertility Society’s annual meeting earlier this month. A team of George Washington researchers, led by infertility specialist Jerry Hall, took 17 human embryos left over from in-vitro fertilization procedures, split them into individual cells and grew them in the laboratory. The experiment did not involve cloning as scientists understand it, in which a tissue cell from an adult is used to grow a duplicate of the person who donated it.
Instead, the embryos were split into single cells--an experiment that could be conducted by any first-year medical student with a razor blade, researchers said.
The result was 48 new human embryos--all genetically identical.
Hall said his experiment was the natural outgrowth of efforts to improve an infertile couple’s chances of conceiving a child. He wanted to multiply the number of embryos that could be implanted in a woman’s womb. Without any fanfare at the time--and with the approval of their university--Hall and his colleagues crossed what many medical authorities now consider an ethical line regarding the conduct of reproductive research.
Reports of the research in the popular press drew instant responses from those alarmed at the vision of science replicating human beings at the most basic level.
A Vatican theologian this week denounced the “cloning” experiment as “intrinsically perverse.” Biotechnology activist Jeremy Rifkin threatened to sue the National Institutes of Health unless officials halt funding to any institution conducting such research. Cynthia Cohen, head of the private National Advisory Board on Ethics and Reproduction, said embryo research had proceeded in “a total moral vacuum.”
Many medical experts called for a moratorium on all embryo research until a thorough public debate can be conducted.
But public discourse is unlikely to resolve any qualms over the direction in which the research is headed, according to medical and ethics experts.
In the 15 years since the birth of the first test-tube baby, at least 85 national bioethics and law reform commissions in 25 countries have reviewed the reproductive technologies developed as a result of embryo research. More than 125 reports have been prepared and printed.
In a Babel of conflicting ethical standards, regulations and laws, almost a dozen countries have set guidelines for embryo research to protect the couples involved in in-vitro fertilization and to safeguard the rights of the child being conceived.
U.S. efforts to regulate the new technology have fared far worse. The only congressional commission empowered to debate the new technology disbanded in 1990 without being able to bring itself to even discuss the issue publicly.
Until recently, the National Institutes of Health--the world’s largest biomedical establishment--refused to fund or monitor human embryo experiments or any other research into in-vitro fertilization techniques. Presidents Jimmy Carter, Ronald Reagan and George Bush each refused to appoint anyone to the institutes’ ethics panel, which had to approve the research proposals.
“In the reproductive area, in part because of the federal funding freeze, the research has been carried out in private facilities with patients’ money without much scrutiny,” said Alexander Capron, a leading authority at the USC Law Center on biomedical ethics. “Researchers have been on their own, with no national standard they could look to on the moral or ethical status of their research.”
Last summer, Congress quietly lifted the 20-year moratorium on federal funding for in-vitro fertilization research, raising the possibility that embryo experiments might become candidates for funding, said John C. Fletcher, director of the Center for Biomedical Ethics at the University of Virginia.
Infertility specialists are worried that the new controversy will mean that their work will again be banned from federal funding.
“The people who run things may just decide the field is politically too hot and ban the work,” said Dr. Joe Massey, an infertility specialist at Reproductive Biology Associates in Atlanta, a private clinic that has helped pioneer some of the newest embryo techniques.
Medical experts suggested that the embryos created through such artificial twinning could be donated or sold to infertile couples, just as some women today donate or sell their unfertilized eggs.
Others offered more improbable scenarios. For instance, some speculated that parents could arrange to bear one embryo and save the other identical twins for their child to use later as a source of organ or tissue transplants.
“It is clear that this whole idea of cloning has captured everybody’s fears and imaginations. They are starting to talk some crazy stuff,” Massey said. “That is why nobody in the field talks too much about what really can be done with the human embryo. It gets blown out of proportion.”
The original moratorium on federal funding, meant to quash embryo research, did nothing to stop private experiments with human embryos. The Cornell Center for Reproductive Medicine in New York and Reproductive Biology Associates in Atlanta are typical of infertility centers that are developing some of the newest embryo techniques designed to increase the chances of a woman becoming pregnant.
Many of the hundreds of men and women who seek to conceive a child at the clinics have volunteered for at least one experimental procedure designed to enhance the chances of a pregnancy. The experiments range from embryo microsurgery to “co-culture,” in which human embryos are grown on beds of animal cells in an effort to simulate womb-like conditions.
Earlier this month, researchers at the Cornell clinic announced the birth of the first U.S. children who, as eight-cell embryos in a laboratory dish, had been dissected and tested for signs of inherited diseases before being transferred to their mother’s womb. Last month, in an experiment designed to overcome male infertility, the Atlanta clinic announced the birth of the first U.S. child conceived by the injection of a single sperm cell directly into a human egg.
Like the George Washington University experiment, the embryo experiments in Atlanta and New York were conducted without federal funding or the kind of government oversight that other medical researchers in other specialties would consider routine. They did, however, follow voluntary guidelines set down by the American Fertility Society.
Several researchers this week said that unless Congress decides to actually make embryo research illegal, no renewal of the federal funding ban will slow the pace of private experimentation.
Some embryo specialists said the controversy stemmed from a fundamental misunderstanding of the experiment and the researcher’s poor choice of words.
“If they had chosen another word than cloning to describe what they did, nothing would have ever happened,” said Jacques Cohen, science director of the Cornell Center. “What they did was split an embryo. You can make identical twins.
“Twins are limited clones, I suppose, and people don’t have a problem with that,” he said. “People think twins are cute.”
To Clone Or Not To Clone
A experiment at George Washington University with human embryos has triggered a controversy over the possibility that human beings can be cloned. Actually, the experiment involved “twinning”--a far simpler procedure than the cloning of human cells, experts said.
Here is how the two are different:
TWINNING
1. A human embryo is allowed to grow until it contains about eight cells.
2. The embryo is physically cut into pieces with a scalpel. Embryo cells have the natural ability to generate into a complete human being.
3. When the new embryos have reached a stage when they contain about 32 cells, they could be transferred to a human host and carried to term in an otherwise normal pregnancy. (The recent experiment did not reach this stage.)
4. The result would be identical twins.
CLONING
1. An adult contributes a normal cell.
2. The adult cell would be somehow cultivated in the lab to duplicate itself. Unlike embryonic cells, normal adult tissue cells cannot regenerate into a complete organism on their own. (To date, no one has ever cloned a human cell.)
3. The result would be a living duplicate of the person who donated the original cell.
