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Human cloing: how close is it? An assessment by infertility doctors, a bioethicist and a geneticist...Note: the full interviews with these experts is available in the interviews section
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Lee Silver, Ph.D.
Silver is a Professor of Genetics at Princeton University where his laboratory is attempting to identify genes that influence personality and behavior.

You predicted, I think two years ago, that human cloning would be here with us, within two years.

I don't think I said that ... I predicted that human cloning would be with us in 10 years and I still believe that is the case, because there is a demand among a small number of people for this technology to have babies. It's being driven by the marketplace. I think that, ethically, one should not use this technology until they are convinced that it is safe and efficient, shown with the use of animals. But I don't think that physicians around the world are going to wait for the confirmation that it's safe and efficient in animals.

The best example I can give you why physicians are not going to wait as they should is with ICSI, an intracytoplasmic sperm injection. This was a new technology developed in the early 1990s to overcome severe infertility and physicians did not wait to prove that it wasn't going to cause birth defects before they embraced it wholly across the country. We can use that history to understand how cloning is going to go. I'm not advocating the use of cloning in this way. I think it is wrong, but it's going to happen.

Can you explain simply what cloning is, because [some] people think that it's the creation of an adult copy.

When biologists use the term cloning, they mean something very different than what the public views cloning as. In the case of Dolly, what happened is the genetic material was taken from an adult cell and that genetic material was placed into an egg whose own genetic material had been removed. Under the right conditions, that egg with a complete set of genes, with a complete genomic material, could develop into an embryo. It would divide into multiple cells and that embryo could be placed back into a uterus to develop into a fetus and ultimately into a baby.

What would happen in those relationships?

Well, in purely genetic terms, if a woman used this procedure to have a baby, the child, the daughter would actually be the genetic sister of the mother. But I don't think that the mother would treat the child as a sister. The social situation would make the mother treat the child as a daughter ... we already have confused examples of heritage right now. If a person's father has an identical twin brother, then that person's uncle is also their genetic father in purely genetic terms. So we don't look at things in purely genetic terms. We look at things most often in social terms.

We have these confused identities and new forms of family, but we don't deliberately create them very often. In this instance, we are creating them and we are creating them within a private, market-driven industry.

When it comes to cloning, people are over emphasizing the genes ... the genes are being blown out of proportion. The reason is because every day somewhere in the world there are children born who look just like one parent and who grow up and behave just like one parent.

A clone will be no different than children who are already born today. It will pretty much look like one parent and it will have many of the same behavior predispositions as the one parent. But that already happens, so nobody is going got be able to distinguish a cloned child from a child who happens to look and behave like one parent.

Do you think that the people who are proponents of using this new technology, that see some real excitement in it, and see some possibilities in it, will actually develop a new language for it?

... ultimately, when children are born with the use of this technology they will not be called clones. There is a technology that scientists developed called nuclear magnetic resonance. When this was used in medical scenarios, people were resistant to it, because the word "nuclear" was there. So we changed the name of the technology to MRI [magnetic resonance imaging] and now everybody accepts it. The same thing is going to be happening with the so called cloning technology. It's going to be called single parent children or some other innocuous phrase that is going to be used.

Can you tell me where this new technology will emerge from?

Cloning is certainly going to emerge from the fertility clinics that exist in this country and elsewhere around the world, because it's only in the fertility clinics where the technology exists from taking eggs out of a woman's ovary, developing the eggs in a petri dish and putting the embryos back into a woman's uterus. That is done at fertility clinics. It is not done at biotech companies or anywhere else. So when cloning happens it's definitely going to happen within the context of a fertility clinic.

So even if 99% of them say no, all it takes is one clinic somewhere to not talk about it and just to use the technology to give rise to children who are going to be genetically identical to one parent.

Do you think that there is something coy or slightly political about them saying no?

Oh, it's absolutely political. Fertility treatments are highly controversial in this country. One of the things that president Harold Shapiro, president of this university, and who is also the head of the national bioethics advisory commission, told me is that when they had hearings on human cloning in the United States about a year or two ago, he invited a whole series of fertility doctors to come testify, and they all refused. They are a profit making business. They're in the business of trying to help infertile couples have babies, and they have no reason to publicize themselves.

You know what the critics say about children as commodities, as products, as designer babies. What do you say to this ...

I don't think that these people who claim that we are commodifying babies have ever actually talked to any couple who has had a child by one of these assisted reproductive technologies. The vast majority of these couples desperately want to have children and they treat their children as children.

This word cloning, indeed, the practice as you see it on the horizon, does not greatly dismay you?

I am not dismayed by cloning, because I don't think that it's going to be used in all of the outrageous kinds of ways that people have thought up, like the egomaniac, for example, that wants to have a replica of him. Cloning does not achieve immortality. What the ego maniac will end up with is a baby that will kind of looked like he looked like a baby that will grow up into a boy that won't listen to him. So he's not going to get what he expected. He's not going to achieve immortality. He's just going to have a son. He's not going to be able to control the life of that son. When people understand the little that cloning does, most of these kinds of people will lose interest in the technology. It's not going to accomplish what they think it's going to accomplish.

So you may ask me, "Then why would anybody use it if you're not going to be able to guarantee the child is going to turn out in a particular way?" My answer is that the only people who will end up really using this are people who can't have biological children another way and are going to be using this to have biologically children, because what most normal people want is unpredictable biological children. They want this genetic link to their children. And if that's why they're doing it, not expecting anything except to have a child that may not listen to them, that I don't have a problem with that use of the technology.

You have raised the issue before about creating Madonnas, Michael Jordans and the critics say that is indeed what will happen. At first, one can dismiss that argument very quickly. But when you see how market driven this culture is, how many groupies swarm around people like Madonna, clasping at her clothes, at her hair ... it gives you pause, really...

Well, the question I have for people who worry about this star being cloned is to say to them, how often do you think a movie star has donated their sperm or eggs to a sperm bank today? I think the answer is none of them have put their sperm into a sperm bank. They're not interested in getting the $70 back to put their sperm or to donate their eggs, which is a serious protocol, into a bank ...

One of the issues that I raise in my book is that it might be done surreptitiously. That somebody will come up and take a scraping from Michael Jordan's skin and use that scraping to have a clone. I don't know how realistic that is. But I don't think it's very realistic, because the child that comes out of that cell, even though that child will be genetically identical to Michael Jordan, I can guarantee you that there is no way that child will ever make it into the NBA. Because Michael Jordan is more than his genes. Michael Jordan worked very, very hard and it was this hard work and this spirit that allowed him to reach the point that he reached. People forget that genes provide a framework and the potential, but unless you work very, very hard you're not going to get anywhere without it.

Can you describe where this technology could go that concerns you?

The most disturbing part of this technology is not the cloning, where you just have a child born who happens to be related to one parent instead of two. The most disturbing part of this technology is when parents are going to try to use genes to provide their children with serious advantages.

Now the problem is that all parents want to give their children advantages. In the United States, we have a market-based mentality, where we say that parents who have money can give their children more advantages than parents who don't have money. We all accept that. I think parents are going to keep going back to the genes and say, "I want to give my child every possible genetic advantage in the book."

That is troubling to me, for two reasons. One is that some of these genes really will provide advantages. Advantages of longevity, decreased risks of cancer and stroke and dementia, and so these children really will have health advantages, which means that the parents who are unable to afford this technology will have children who are disadvantaged. So I see this as greatly exacerbating the gap between have's and have-not's--much, much greater than it is today. That concerns me.

The other thing that concerns me is that parents will be giving their children genetic enhancements that they think are going to increase the behavioral, cognitive or talents of their children. And many times, they're going to be disappointed. It doesn't mean to say that the genes won't increase the probability that their child will have a particular talent, once we understand how genes affect talents, we don't yet. But I think that parents may be getting into this not realizing that all they're doing is increasing probabilities. You're not going to guarantee anything. So you worry about how parents are going to feel about children who don't express the genes that they got.
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Dr. Jamie Grifo
Grifo is Director of the Division of Reproductive Endocrinology at New York University Medical Center.

Do you think that in 20--50 years, whatever, cloning will be offered in a fertility clinic for a small number of patients?

It is an interesting question. Personally, I can't think of a clinical situation where cloning would be a better treatment than any other treatment that I could offer. I have no interest in cloning a human being. I don't think there is any need to do that.

Now, in spite of that, nature has already cloned. People don't realize it. Identical twins are clones. Nature has already done the experiment and what is the result of that experiment? Have you ever seen identical twins? They are very similar, their genes are much closer than yours and mine are, yet they are two very different people. They are two different individuals with two different souls. So I don't know that it necessarily would be something that bad, but I don't see any reason for us to be doing cloning. I don't see a clinical problem that is solved by cloning that we can't solve in other ways with assisted reproductive technology. So I have no interest in it. Can it be done? I guess it could be done. Is it going to be done? I doubt it. I don't think people are really working in that direction.

The fear is that somebody somewhere, a renegade probably will do it. Do you think that is science fiction?

I definitely think it is possible and if someone said, "You and your lab have to clone and could we do it," I bet we could, but I have no interest in that and I am not going to do that. Will somebody do it? Perhaps. How bad would that be? How terrible would that be? It probably wouldn't have very much of an impact at all, although it would be highly sensationalized, I am sure. But I don't see any need to do it and we are not working in that direction.

But I don't think fear of cloning is a reason to say, "We had better stop all this assisted reproductive technology because now look what they are going to do. Now they are going to clone." That is what a lot of people are doing. Well, if you do that, what about all these patients who need us ... Do we just say, "Forget it. Can't help you anymore because we are afraid that someone is going to clone?" It doesn't make sense ...

You said ... you don't have an interest in moving forward with cloning because you don't see a clinical use for it. Obviously, cloning technologies are, potentially, incredibly valuable scientifically ... Where do you think cloning will head?

Cloning technology, in terms of assisted reproduction, is not something that is really going to have much of a future. There aren't really clinical situations where that would be a better treatment than what we could already offer, so I don't think it is really something that is going to affect our field. But a lot of the research from it will help our field in terms of being able to do better embryology and micro-manipulation. So I don't think there is much of a need for cloning. In the animal industry, [there is] tremendous need and that's where it was developed and where it will probably continue to be used. But for treatment of disease, I don't see it as much of a discipline.
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George Annas
Annas is a bioethicist and Chair of the Health Law Department at Boston University School of Public Health.

Do you think the industry will be able to not clone a human being?

Well, it's very interesting. The only thing the industry has ever taken a position against is human cloning. The industry's consistent position is if a doctor wants to do it and an informed infertile couple agrees to it, you should be able to do it. The exception has been cloning. Now, that's because there was a public outcry against cloning, and the industry thought if it said it was going to clone, for sure, they were going to get heavy duty federal regulation.

On the other hand, forget motives. At least, I would say that was a responsible position. I think that because for the industry to say cloning is reproduction essentially eradicates the whole field of infertility, because everybody has got somatic cells that can be used to clone--asexual reproduction. If that was considered a cure for infertility, it would essentially put them out of business. [By] definition, at least, because nobody is infertile if asexual reproduction is reproduction. So I don't the industry is ready to talk about that yet.

Until they get a position on that, they have to be against human cloning and they are. And god bless them. Now, that doesn't mean that no one physician out there or one clinic might not go ahead and try human cloning, because again, there is no law against it. And I think that's right. It probably will be seen as just impossible to contain yourself if a couple really wants to use cloning and is willing to pay a lot for it. There certainly going to be at least one infertility clinic in the United States that would be willing to do it, if we don't pass a law against it.

Is that the place where we are most likely to see cloning -- in an infertility clinic?

Yes. It's almost or sure has to be inside of an infertility clinic, cause it has to be done with someone who knows how to manipulate embryos and how to implant embryos. It has to be a physician ... for it to have any chance to work at all, it's got to be a physician who is very knowledgeable in fertility treatment.

... Are the skills of the infertility doctor the necessary skills for cloning?

Yes. There's two specific skills that infertility doctors have that are necessary for cloning. One is micro-manipulation of embryos. In this case, to take a human egg, to remove the nucleus, and then to replace that nucleus with a nucleus from a somatic cell, a body cell of the person who is going to be cloned. That's a technique that infertility physicians use in manipulating embryos. They don't use that particular technique, but they use other micro-manipulations that would permit that to do that one, too.

Secondly, and as importantly, is taking that embryo and implanting in the woman's uterus. That's not as hard to do as the other, but it's a technique, again, that infertility physicians do everyday. Or if not everyday, very often. They know how to do that. And then monitoring it to see if you have a pregnancy. That's what they do.

Other doctors don't do that. It would be very hard, and certainly no non-MD could do it. It would be practicing medicine without a license. For sure, the implantation is a practice of medicine. So only physicians could do it. I think that only people who have experience with manipulating embryos are likely to have any success doing it. So if cloning is going to be done, it's going to be done in an infertility clinic by an infertility physician.

We've seen the micro manipulation of ICSI. We have talked about cytoplasmic transfer, all of that. How close is that stuff to cloning?

It's close. You can do it well, you can't even do it reliably, except perhaps in mice ... [one] experiment took 273 tries. It was inconceivable that we'd have 273 women line up to be impregnated with the clones of one person. So I don't think we're close today. Now, if you said could we do it in the next five years, the answer to that is almost definitely, yes. Is it going to be possible to do it? We'll still don't know that. It looks like it is, because we've done it in three mammals now. The mouse, the sheep and the cow. That doesn't mean it can be done in humans. But it certainly means somebody will likely try to do it in humans.

Unless there is kind of an international outrage, and we have an international ban on it, someone will almost necessarily try to do it. On the other hand, one has to ask, what's the point? I mean the best cloning can do is give you a genetic duplicate of something that already exists. And besides the question--just look, I'm going to do it, cause I'm interested to see whether it can be done.

Other than that it's pointless, as most people have pointed out ...because you can't make anything better than what you have now. It's a genetic dead end. Again, all you can do is duplicate something that already exists. It's hard to see any rationale for that.

But to the infertile couple that has tried everything else, and this would be a very small group, it seems like it could be the next logical step up in a long stairs that they have already been climbing and committed to.

Well, cloning is not ... the argument is that an infertile couple might want to use this to reproduce. The problem with that is, this has nothing to with couples. Only one person will be reproducing. Even that person won't really be reproducing, they'll be replicating. They'll be getting a genetic copy. They can get one or more genetic copies.

It has nothing to do with infertility ... no one is infertile with cloning, all right. It has nothing to do with couple, because you don't have to be a couple to do this. It's just a technique to make a genetic duplicate.

The embrace of infertility by the cloning crowd is to try to cover their tracks. To try to say there is some good can come out of this. Infertility community itself has rejected cloning ... because it's not a treatment for infertility. In fact, the argument has been made by geneticists, that the parents of the clone are not going to be the infertile couple. The parents of the clone are the parents of the person who is being cloned. So, for example, if I clone myself, I would not be the parent of my clone, rather the genetic make up of my clone would come from my mother and father.

... So what does that mean? That means if an infertile couple is trying to have a genetically related child, they can't do it through cloning. They can have their brother or sister. But, the child they're having will be the child of their parents.

Technically, that works right, but to some of these couples, it would be splitting hairs. They just want a child ... Say your husband or your wife can't contribute, why go outside the family?

Well, if they think it's splitting hairs, again, it's the ability to rationalize anything. This kind of self-deception that says, "I don't care what the geneticists say. I don't care what the facts are. I'm having my baby and it's genetically related to me." Well, it's just not true. The fact you want to believe that bad enough and are willing to pay any amount of money to believe it and for people not to tell you the truth, again, shows the problems in the industry. The desperation of couples and their willingness to do "anything."

The next question to ask them--well, let's take the embryo we make from your clone and implant in a cow and let the cow gestate and give birth to it. If all they want is a genetic connection, they could have no real objection to that. But I think most people would be horrified at that and should be horrified at that. It's got to be more than just a genetic connection at making babies.

In terms of cloning, the industry says it's not interested. Do you believe them?

Yes. I believe as an industry, because there is no money in cloning. There is no payoff in cloning. There may be a couple of people in the world who want to clone themselves. But virtually every couple that wants to have a baby wants a baby better than any of them. They really ideally want to mix their genes and have a baby that's a combination of the two of them.

I mean, that's how this industry got started and they know that. That's what they first try to do with in vitro fertilization. It's only later on if it turns out one of the two couples can't produce gametes that we go to trying to get donor egg or donor sperm or try to get somebody else's genetics involved. But you still try to get two people with genetics involved.

Just having a duplicate of one of the two in the couple, again, is not something there's a market for. There won't be a market for this until you can take the genetic duplicate and make it better. Take me, for example. Make me taller, you know, or stronger. Maybe someone will want to do that, but not just to make a duplicate.

There are some people, I guess, who are so self-absorbed that they'd like to see themselves be duplicated. But, so far, this guy [Seed] from Chicago is the only person to publicly say that. He'd like to duplicate himself. He says that he would like to see himself grow up and not make the same mistakes he made growing up. But that's certainly not a rationale to create a clone.

And again, if you look at it, as I think you have to, from the child's perspective, that's a terrible thing to do to a child. To have it born to someone who wants a duplicate and is going to try to raise that kid the way he should have been raised. To do the things that he should have done. Again, if you look at it from the child's perspective, you can't clone. You can't permit it.
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Dr. Mark Sauer
Sauer is an infertility specialist and Chief of the Division of Reproductive Endocrinology at Columbia University.

What do you see on the horizon?

...Certain aspects of cloning, especially the embryonic splitting. Being able to duplicate high quality embryos and bank high quality embryos along cloning lines, has some merit, despite the fact that no one wants to talk about cloning. So these are things are fairly easy to project, because we know the technology already exists, and the animal work has already been done that would tell us these things will indeed be successful.

Talk about the cloning issue. People have said that it's going to come out of the infertility work in some way.

It will. The groups that can do cloning, such as the Dolly sheep experiment, this is an IVF type of procedure. So it would normally occur in an IVF laboratory setting. Whether or not any of us would take that bold step is hard to predict. My gut feeling is when there's a challenge, and you put it in front of people like us, someone will always take that challenge and take it to the next step. When that will occur and under what circumstances, I really don't know, but I'm sure it will happen.

Are these things that are happening now around the egg, are we talking about cloning technology?

We are. Not so much intracytoplasmic transfer as the nuclear transfer. That requires a certain electrofusion type of an approach that is extremely similar to cloning methodology. It unfortunately gets a little confused along the way. People have looked askance at some of this research, thinking that it was a kind of smoke and mirrors for cloning, and I don't think that was the intent of people doing this kind of work. The idea is to try and change the dynamic of an aging egg, which there is certainly a great demand among age-related infertility patients, and that's somewhere between 5,000-10,000 women a year.

What do you think of cloning?

I see cloning, in general, as a major step in the right direction, but not necessarily along adult cell lines. I don't see much purpose in cloning adult cell lines. That, to me, is an exercise in supreme narcissism, to just want to have an identical twin that's so many years younger than yourself. I don't see any real purpose in that ...

We've taken sex out of the bedroom and put it into the petri dish or into the little tube, and with successful cloning, you actually take the man out of the picture, presumably. What do you feel about that as a profound change in sexuality and reproduction?

I suppose we're dealing with such a small, theoretical subset is not to be too disturbing. To be honest, sex will always be part of behavior as long as there's males and females, so I'm not too worried about that ...Certainly, the fabric of society gets changed by these types of paradigms, and taking males out of reproduction, which we do these days when we're dealing with lesbian couples and inseminating them with donor sperm. I don't think that's that troubling, because it's a small group of the population that we're servicing that way.

People would like to have this image that Americans are this "Ward Cleaver and his wife" type families, and they're not. There's all types of women and men wanting to have children. We see it first-hand because these couples come to us. Many times these couples are just single women. So if that became an option, and it was a reasonable one, and society accepting cloning, I would guess practitioners would probably not think that hard about it either. We're not there. I mean, there's no question that that's not where our heads are at right now. But then we weren't willing to probably put embryos into 50-year-old women 15 or 20 years ago, so who knows?

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