frontline: making babies

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interview: niel cameron, ph.d.
Nigel Cameron, Ph.D., trained as a minister and now teaches bioethics at Trinity International University where he is Senior Vice President for University Affairs. There are thousands of babies that have been born through assistance of reproduction technology. Yet, you have serious objections to this technology.

Well, part of the problem is that here we're using new means to make babies. Certainly, it's a wonderful thing for people to have babies they couldn't have otherwise. The problem is: Are these to means that at the end of the day [we] will want to use to make babies? Are they the kinds of means which are appropriate to baby human beings? This is the ultimate challenge to us in controlling technology, constraining technology to serve human dignity rather than to undermine it. And that's a discussion we've hardly begun to have.

What are the means that you think about in particular?

Well, of course, a striking one is that which has yet to be used to make a baby, which is cloning. The advent of cloning as a possibility for making human beings is putting into fresh focus these other technologies which cluster around the uterus fertilization. I mean, there are various ways this can be done and we should go back to artificial insemination, which was the first animal husband technique to jump the fire wall into human husbandry. We now have had two generations of using these techniques to enable human beings to have babies. Now is the time for fundamental assessment of whether these techniques are what we really want for human dignity to be preserved at the heart of our technology in society.

Why now?

Perhaps, because cloning has focused the issue in a fresh way. There was an incremental movement from artificial insemination into various in vitro fertilization [IVF] related techniques. Now, we have this quantum leap into a technology in which we no longer are replicating the nature process in a round about way, which they are in IVF; but using a wholly unnatural process, which essentially is a photocopy of reproduction rather than procreation reproduction. This sets new light on these old debates, which many of us thought were over with, [but] they aren't.

Take us back a number of years to assistant reproduction technology. Is there any point at which the alarm bells started ringing for you before cloning even entered the debate?

... for me, I first got involved in the conversations back 20 years ago when we had the first in vitro baby born ... back in Britain. We faced a round of debate which seemed to go not very smoothly ... people were all very scared by the new technology, but they came to adopt it. Now, of course, in vitro is rooted in our medical care, particularly here in North America, where there's often statutory requirements that insurers pay for this. It has become part of people's sense of respective rights.

What worries me is I meet religious people who have been through these procedures without a moral thought. And pastors and rabbis have encouraged them to go through them and who really have not reflected in any way on the kind of questions on which we are touching.  For me, I suppose I hope to become increasingly conservative as the technologies develop and [are] applied more routinely. One now meets people who will explain that this is a way to having a baby as if it were a matter of entirety. But this is simply a technique that has helped them. [They are] entirely unaware of the fact that here we are manipulating the next generation and setting up a precedent for the entire control of the next generation in the way in which knowledge of the known and our techniques focused on the cloning reproduction option are [going] to give us huge power. Of course, we see all those discussion now of advertising for embryos, for eggs ...

The technology is here. It's being interpreted in human dignity in a way which now becomes much more evidence, because everybody is doing it. When this was an unusual special case, highly constrained activity 20 years ago, it was hard to predict what would become of the technology. Now, that it's part of our routine; ironically, we have cause to have these discussions over again.

The practitioner to these technologies would say, "We are simply helping nature in a way we do with disease. For instance, in this case, we're helping the sperm meet the egg, and creating family and children as a result ... "

I suppose I want to respond in two ways. Partly what is happening here to the children? That is to say, who speaks for the child? In this whole discussion we've been focusing on dealing with the needs, the aspirations, the wants, the consumer wants of adults, the prospective parents. There's no advocacy for the child. The notion is to have had a child is a good thing and we wish the child well.

The other question applies to the particulars in the technology. This one is speaking about bringing together the sperm and the egg from a couple, so they can have their own child ... we are here [aiding] natural process, and that is in a different category from other uses of this technology, which, typically, bring together sperm and egg, who do not come from the ones who will be the social parents of the child.

Part of the achievement of in vitro technology and part of its potential scandal is in the way in which we separate the genetic parents, the birth parents and the social parents. So a child can now have up to six parents, depending how you want to count it. So the whole family, which you end up putting together, is families you have designed. You won't just be able to design the kind of child you want, but you're able to design the family structure ... So in the traditional model of the same set of parents, it becomes a matter of contrivance and control. These things seem to me to be inevitably against the interests child.

Why? Control isn't necessarily a bad thing. This is still a child born into often a very much loving family.

... Plainly children born in these situations can end up as happy and healthy children and parents. In almost every case, they are committed and well disposed to making a success of things for their children. But that is a different question from the responsibility which we have in setting up a situation, [when] there are curious fault lines built into the very identity existence of the children.

We find it hard enough in our culture to rear healthy, sane children, where we have the healthy, sane and normal family structures behind them. When we have a situation in which the egg and sperm may come from other couples, in which the egg may have been advertised for in a newspaper, and which the sperm may have been paid for in some lab in Southern California, which will get you sperm from an athlete or somebody who's musical.

I mean, you put these designer limits in there, whereas, the children may be very much wanted and planned for children, that's a control of children, who have become not simply gifts to their parents, which is one of the ways in which children retain their dignity and cease to belong to us as creatures ... these children also become manufactured. They become consumer products. This will inevitably mitigate against their dignity and their identity ... we're moving down a long road here into a situation in which children essentially are the manufactured. The creations of their parents' making ...

But, they can use the term manufactured commodity, but where does it actually come out in the reality of the child's life? ...

We're moving into a whole redefinition of the way in which children and parents relate, because children become people whom we can design, rather than if they just come to us as gifts. It would default the failings of which we have no control. Once you build in the controls and the constraints and design, we're talking about children who are also consumer products.

Specifically, secondly, in different kinds of cases, this will arise a different way. Take the example of surrogacy, where another mother carries a child, who may be the biological father, both the parents, or one of the parents. I mean, there are options there. A kind of good case of surrogacy is one in which a relative, maybe a sister ... or a friend will carry the child.

We go through commercial cases with large amounts of money is involved. Now in that situation, you get into the teen years and the kinds of stresses and strains in any family situation. The fact that this child was born ... [by] the grandmother or the woman down the street, you begin to see immediately how this isn't my child, or you aren't my real mother.

The tag lines from family arguments speak of something very deep in identity of who's involved. In the case of cloning, you have a child who will grow up as a model of somebody else. Who will never quite believe he or she is himself for himself or herself for herself ... but essentially is a copy as the person the parents chose to copy. This, which is very deep in the psyche, plainly will result in all sorts of patrimony.

You seem to vie here between assisted reproductive technology and cloning ...

It's very interesting when we look back, because in one sense, cloning helps give a new perspective on earlier attempts, earlier designs to assist with reproduction, and show something of the way they've been leading; therefore, helps to understand better the threats that they pose ... Conversely, cloning also shows us how natural the techniques are, because they're seeking to emulate natural process there in basically bringing together sperm, the egg. Whether this is in a lab or whether it's in the mother's fallopian tube, it's the same biological process.

Whereas cloning takes us, of course, across a great divide, into asexual reproduction, which is not natural for any in the many species and presents the capacity for control and design, which we've hardly begun to examine and consider. This is very much science fiction, all of a sudden, much sooner than anybody thought, becoming science fact; yet, there's a progression here.

One way of looking at the progression is seeing these essentially as steps in the process to remove the creation of a child from sex, so that sex is sanitized as a relational fun thing, and the production of babies becomes a manufacture thing. And in vitro cloning is a whole step in the direction.

Talk a little more about the divisions between sex and reproduction.

Well, when the history of the 20th century is written, surely one of the most significant chapters in that history will relate to this whole discussion on the way in which we have essentially succeeded in bifurcating sex and reproduction. That is to say we have developed, a generation or two ago, largely effective contraceptive techniques. So when properly used, contraception enables people to have sex without serious danger or expectation of procreation.

Now, in the next wave, we have been designing techniques to enable us to have babies without having sex. Looking at it in storybook perspective taken together, these two are of enormous significance, which isn't to say that there aren't good things on both sides of the ledger. I'm not wanting to suggest that using contraceptives is wrong, natural or unnatural in the techniques series, or that assisted reproduction is always necessarily wrong. But taken together they do give us an extraordinary perspective on the significance of what we're doing to the human race. The notion that we can do all these things without any implications to human values, is quite naive. Even if we can't quite see what those implications are yet, those implications are going to be enormous.

What do you think the implications are ... What are your concerns?

On the one hand, we have a plain concern for the health [of] the children. In cloning ... one of the examples, which was widely touted when the possibility of cloning human beings first broke surface a couple years ago, by those who wanted to defend the human beings share, one of the parents of a child who died, and they wanted to clone this child so that the next child will be the identical twin ... "[Isn't it] a wonderful thing?" One immediately wants to say, "Well, yes, of course, it's a wonderful thing," but they won't talk about it and this child will grow up either wearing the same clothes, in the same bedroom and with the same toys, maybe with the same or similar name of the child who died, or the opposite--deliberately contrived, different clothes, different room.

Either way, when this child begins to discover who he or she is at the age of a year or 18 months or 2 years, immediately he or she will be compromised because he or she will be a substitute for somebody else. That's a good case in point, but it illustrates only the pay off here. I mean this is a theoretical conversation ... what if you've got 5,000 Madonna clones born in one year, or whoever ... the heroes of the day will be replicated in the application of this technology, and make it fundamentally [distorted]. But I mean to take the good case and you begin to see what happens.

To some extent, people get the false conception that cloning is all about cloning Hitlers, Madonnas or Mike Jordans. But, in fact, a cloned child could arrive into a perfectly normal family and could look perfectly normal ...

Well, it seems to me that you can't distinguish one scenario from the other. I would anticipate, given the way in which the courts operate in North America ... if we have cloning, it would be difficult to confine this to good cases [because there is] a heavy commercial element here which would operate ... yes, focus on the good cases, focus on this simply as an alternative option to other infertility methods. I think distortions are nevertheless built in, because what we're doing here is enabling people to copy other people ...

We're building in a situation in which one is going to be creating identical twins dislocated in time, relatives, friends, heroes. One recent defender of cloning was having to argue for this reason, that there should be some sort national lottery involved with blind screening saying that cloning was only possible if you didn't know who the parents [were] ... but I think it's quite naive to believe that people would ever work within that kind of system, which is so heavily constrained, think of the nature of the case.

Presently, you can see how much money there is to be made in buying and selling eggs of bright, white women on Ivy League campuses. Think of what it would be if you want to be taking a chance of blending your sperm with somebody else's egg and you could see that the model of where it was coming from. But of the certainties involved in reproducing somebody's twin, when you think of the [ads] on the college campus newspapers. Think [of] them as a commercial interest in cloning heroes and heroines of the day. There's something inherently problematic here, in that this technology is so appealing and so reproduceful. I also say economic. This isn't atom smasher stuff. Any in vitro clinic can do these things once the techniques have been refined. So it seems to me it would be impossible to contain this to the good cases. Even the good cases can be problematic, because of the fault lines which are built in.

... The one thing which we so hardly ever recognize as happening here is that application of control are fundamentally inimical to the dignity of those who are in control. If you are a designed person--designed by your parent or designed by the government, designed by whomever--your very identity is compromised ...

How do you feel about selecting a sperm donor from the Internet?

I suppose I feel very disturbed that we have gone so far already in the direction of designing our children. It's one thing to suggest there should be some kind of screening to remove people who have disorders or HIV, and that kind of basic health screening, but once you get into the positive screening and choice of individuals, it seems to me we are running a mechanistic, dehumanized baby planning process ...

One of the problems here is if you have donating body parts, it seems to me to be a proper activity, when essentially a commercial market is operating, whatever you say about it, I think is an illicit ... activity. Here, in the case that you cite, where you have a combination of donors selling and people using the Internet to pick the characteristics that they want in the father of their children, we have a scandalous situation and that the dignity of the child is not center stage.

We've also taken a significant step down the road to the kind of abuses that which almost everybody agrees we don't want. I mean, 20 years ago, who would have said we want these things to happen that are now part of our routine? We've moved on and unless we do something dramatic about it, we're doing to carry on moving down the same road.

Some people would say that 20 years ago, we were very [wary of] the first IVF babies ... and what happened is not, in fact, scary. Monsters were not created in this process. That, in fact, a lot of healthy children have been brought into this world.

At the time of Louise Brown, among other things, people were raising health concerns. This seemed to be a wholly uncertain way of bringing human beings into existence at the most basic level. Certainly, there has not been a lot of research to show whether these children have more serious problems than other children do in their upbringing. I think one doesn't need to show that they do, to suggest that this is in principle a wholly new way of reproducing ourselves. And the further we go in this direction, the more these curious disparities and distortions will occur.

To take the sci-fi example of the birth of 5,000 Madonnas or Michael Jordans, plainly these children will have a unique and wholly distorted experience. Can you imagine being one of 5,000 identical twins? No one doubts that will be a wholly distinct experience, which is presently very hard for us to predict and which one would hope would be highly dehumanizing. Now, the fact that if you got that far down the road, you find things to be as dramatically different as they are suggests that to go a little way down the road, we need to realize the direction we're headed.

Regarding semantics, the terms "donor" and "selective reduction" that we hear in the IVF clinics when people have more fetuses than they want to carry. Do you see a kind of softening of the language?

Language is very important in this discussion and the way in which language is used to confuse and to obscure what is going on, rather than its proper function to clarify and illuminate what is going on, is very disturbing. What we have here, in the way in which the term donor is used, for example, which one really ought to be putting quotes around because we're talking here about vendors as much as about donors. The way in which terms such as reduction, which is, of course, even at one removed from termination which is one removed from abortion. We have this language.

Perhaps, the most blatant example of terminological manipulation in this whole discussion came back in the early '80s with the coining of the term, "pre-embryo," by which it was meant an embryo before implantation, up to around 14 days of human embryo. This term was invented in the middle of the debate about in vitro back in the early '80s. It's interesting to look at the official documents before and after to see that the term just wasn't there and then, one day, it was there. It was coined by people who wanted to be able to refer to a human embryo so they could say ... "We agree with you. We just want to research on pre-embryos." The way in which the hard corners here are being rounded off does ... obscure the facts.

Whereas, on the other hand, I don't think we should be picking scary terminology for its own sake. We shouldn't be over dramatizing what is going on. We hardly need to, because the facts are dramatic enough. It seems to me if somebody gives you something, you call them a donor. If someone asks something in exchange for what they give you, you call them a vendor ... If you really want to buy and sell in the market for making babies, at least be so kind as to be candid about what you're doing.

What do you think about the market? If people were candid about it they'd say, "This is America, things are bought and sold in America. These people have paid a real price, the women in particular, the egg donor, two or three shots a day for two weeks ... Why not do this?"

No one doubts that things can be bought and sold. I hope none of us doubts that persons should be not be bought and sold. The question is how we regard parts of our bodies. The public policy position in those countries has all along been-- you do not buy and sell body parts, let alone genetic body parts, genetic cells because it's ... dehumanizing.

There's a well-known book in the bioethics world with the enthralling title, If I Were a Rich Man, Could I Buy a Pancreas? One of the big scandals in the world, today, is the way in which people in Third World countries, India particularly, are selling parts of their bodies to people in the West, through essentially an illegal trade. These scandals are revealed from time to time, because we take the view that bodily integrity which we have is something which isn't ours to get rid of, for exchange purposes. If you can get rid of a part of your body and live a life, a weakened life, so you could put your kids through college, a lot of people would do that in the Third World, they'd be putting their kids through elementary school for it and they would do it gladly. Yet, we believe that human dignity require us to prevent us from doing that kind of thing.

So we take the view that things are bought and sold, persons should not be. Once we get into buying and selling body parts for the purpose of making babies, we find ourselves moving rapidly into the notion that children are chattel because we've designed them, we've bought the pieces to make them up. And you've gone so far away from the context of sexual love, as that within which the gift is given to us of a new child, that I think you've crossed the Rubicon and you've moved into whole new world in which babies are made and not procreated.

The real problem, aside from the sale of these organs, is that these are now a renewable resource. When somebody sells their kidney, another kidney is not produced; in terms of sperm, it certainly is, in terms of eggs, there is a rather large supply.

That's part of the problem. Part of it is that we don't exploit other people by buying their body parts, but one reason why we say that is because we do not regard body parts as being consumables, as being consumer items. We regard them as being part of the bodily integrity of those who possess them, which is why we speak in terms of donation. Of course, even in terms of what we do with bodies after people are dead, we are speaking in terms of donation, so the person has to give consent to organ use ... This is at the heart of the way we speak about these things.

Even after you can no longer benefit from parts of your body, your body never becomes a collection of chattel people to trade in. The intuitive concerns that lead us to this conclusion, in almost all the circles in which we move, are the same concerns that ought to lead to recognize that genetic tissue is a very special kind of human tissue. That once you can buy and sell the pieces that make up a baby, the notion that you will ever again regard that baby in the same way as you would a baby who was a product of your sexual love and who you had not bought and sold, to bring into being, is surely quite naive.

Again, when we have these conversations today ... we've got to see what's going to happen in 10 or 20 years time. We've got to see the direction this path is taking us, because we've already made some very determined steps along the path, which is very hard to see not resulting in a wholly technological manufacture context in which babies come to be.

You referred earlier to embryo research and there is a ban on federal funding of human embryo research. What do you think of that?

It's interesting that when we first began to be able to control human embryos in the lab 20 years ago, there were huge debates all over the world as to the way in which we should treat human embryos, because biologically, human embryos are tiny human beings. I mean, chimpanzee embryos are tiny chimpanzee beings. At the biological level, there's no dispute about this. The notion that we had embryos in the lab either to use for reproductive purposes or to use for research purposes was a wholly new experience for the human race. As a result of those anxieties, in many countries, embryo research ... was banned. The creation of embryos for such proposes was banned. A whole series of nations took this view.

Here in the States, there was a kind of compromise position in place in that federal funding for embryo research purposes was prohibited, so private funding can allow these things to happen. But the view was taken that here we are experimenting on our own kind. This essentially is vivisection of tiny human beings; therefore, it is repulsive.

Now, there are strong pressures at work to reverse or at least to get around this ban, partly because of the fruitfulness of human cloning research as a potential for science and indeed progress. So, at the moment, there is pressure for the NIH [National Institute of Health] essentially to get around this ban by allowing other people to produce stem cells for them, privately funded stem cells, so they can then do the research on the stem cells that came out of what would be cloned human embryos.

It seems to me extraordinary that this great achievement of the 20th century is that we should be able to isolate and then experiment upon the tiniest members of our own species. Whether or not we take the view that from the point of fertilization, we have to have somebody with full human rights and dignity, and some of us take that view and some of us don't, you don't have to take the view that a fertilized beginning human being is a full legal person.

Nevertheless, the notion that tiny human beings can be used for purposes of vivisection--this repels something deep inside us, because early embryos really are members of the human family tree. Here we have somebody who has uncles and cousins and grandparents. This is already a member of our species. It's extraordinary that we so glibly are moving into a situation in which the smallest members of our species become our own research objects.

People would say that the ban on human embryo research funding by the federal government has led willy-nilly into a privatization of this kind of research ... in a way that the federal government oversight no longer takes place ... a kind of ironic twist ...

It's inevitable when one takes the sort of appropriations route to public policy, that distortions of that kind occur. Of course, there's a special reason why federal funding in these cases is somehow [not considered] to be appropriate. Here we have a divisive issue of conscience; therefore, the notion that your tax dollars should be supporting somebody else's research on human embryos is wrong in itself and something we need to recognize as a community, quite apart from the distortion this creates.

... there has been a similar policy put in place in many European countries. The Council of Europe, which represents all the open democracies, recently agreed [on] a treaty on biomedicine and human rights. The coupling of biomedicine and human rights is very important, in which the standard position, and there are way in which countries can opt out of this, is that research on human embryos, the creation of embryos for research, is prohibited. Then there are recognitions of the situations in which jurisdictions take other views, but that is the fundamental policy position and there's an international discussion here in which there are different reasons and jurisdictions have agreed that we should be protecting human embryos.

So the way in which public policy here has been determined by the appropriations discussion is a partial approach. The discussions we're going to end up having about the whole relation of biotechnology to public policy, whether there are ways in which we can control biotechnology, or whether ultimately, it and the market behind it, will control us, is going to confront us with the need for positive statutory controls. There's going to be no easy way of resolving fundamental issues, because human dignity is what is at stake.

So what you're saying is that this ban wasn't thorough enough by half ...

It was what was available, what was possible, given that statutory regulation was not possible. Certainly, it is a way of indicating public policy, which itself [is a] hard public policy [where] there is a predisposition to disapprove certain kinds of activity. It isn't just an appropriations discussion, but there's a values question lying behind that ...

The proponents of this kind of research will argue very forcefully that there are great scientific advances to be made here, advances in cloning tissue, for instance ... that simply will not be made if we are not allowed to do any of this research.

There are two questions. One is whether these advances will be possible through other means. I mean, in the science community, the policy community, senior people spend a lot of time looking at grant proposals from researchers and institutions and nine out of 10 of these proposals are turned [down]. People don't get the money they want. Often the punch line is, "If we can do this, we can cure cancer. This is the most wonderful new avenue possible." People are used to taking the view that, "Maybe, but there are other ways in which we might attain that goal; therefore, you won't get your money." This is the way we respond in an everyday context to funding proposals for all sorts of research.

We need to look for a certain amount of backbone on the part of those who are faced with what seems to be an ultimatum on the part of research scientists, which is to say that if we cannot use stem cells from clone embryos or whatever it may be, then we will never cure cancer or we will never do whatever it is. There are always all sorts of other ways in which goals of this kind can be obtained. There are other ways in which stem cells can be obtained for this kind of research. The discussion is taking place now, but even if they weren't, we do have to take a view as to how we make moral decisions on public policy, whether we believe that abusing the dignity of human beings is appropriate in the interest of science and society ...

Unless we draw a line at human dignity, it is very hard to see how we shall maintain the dignity of anybody. The point is human dignity is indivisible. There is no way in which you can say, "Well, some people can be sacrificed for the good of others" ... The notion that now we should suddenly be saying that we'll be hostage to some people in the science and technology community, and we will abandon our commitment to human dignity, in the case of certain small human beings, is really very disturbing. It does suggest that our future is one in which technology ultimately will not serve us, but we will find ourselves serving it.

There are whole areas that are left out of this discussion of assisted reproductive technology. Is that one of your concerns?

... the central question here is that of the context of human dignity and ... the role of medicine, the role of technology. The problem is that we have highly trained people working in the sciences, indeed working in medicine, who are not trained to reflect upon these things. They're trained in narrow methods. They're trained in the case approach of medicine. They need to be drawn into these fundamental conversations about what it means to be human and what it means to live a good life.

The context of fertility is something other than what people want and they can find technologies to satisfy. You know, we have ceased to have these conversations. I can't remember when I was last asked to have a conversation about an issue like: What is the good life? What is the good of medicine? What is technology for?

It is a matter of great anxiety that the technologically-driven discussions are taking place on a very narrow front. If one raises fundamental questions like these, one is liable to be ignored, or worse, as raising irrelevancies or being vague or bringing out contexts which are of no immediate consequence for the conversation, because we are at a fundamental turning point, a series of turning points, in the application of biotechnology to human dignity.

Unless we are having these fundamental conversations, then we shall never be able to address the particulars ... Technological [advancements] will guile us and ultimately, we'll reinvent human beings and we will look back on the 20th century, not as a time of crisis, tragedy and advance, but as a time when human dignity flourished. Afterwards, technological controls, constraints, information run wild. Commercial considerations outside of the constraints of controls on public policy have begun to diminish the human spirit and undermine the flowering of human dignity for which we all, whatever our religious position, whatever our philosophical convictions of the different races around the world, for which we all of us intuitively aspire.

Many people would say this is an individual choice, this is reproductive freedom. Some conservative groups would argue very strongly against regulation. What are you arguing for?

Well, one can put this in different ways, but one way of expressing the concern here, which, indeed, should appeal directly to libertarians, those who are concerned about regulation of the free society, is that plainly the fundamental purpose of government is the defense of the citizens, is the defense of the individual, the defense of the capacity of the individual to flourish as a human being.

Most of the clinics, the best labs in the country, say that they are not interested in pursuing human cloning. It is not worth it; it doesn't ask the right questions. Do you believe they are not doing it?

Well, I have no reason to disbelieve this is their honest present opinion. I had a debate last year at the National Conference of State Legislatures with a prominent biologist who was arguing that most people [who] work in the field are more interested in research or in clinical work here and they have some volunteer moratorium in place. One may not doubt that, at the moment, they simply don't have interest ... but that, of course, is hardly the point.

The point is that they have to project what the market situation would be in five, 10 or 20 years time. Most of the institutions are for-profit institutions or they operate on this for-profit per units of not-for-profits ... It seems to me if the technology comes on the street ... Once we get the odds shortened, as they are rapidly being shortened now, once we get human cloning taking place in the lab ... then cloning will be served up as a clinical option, and then the market will determine ... I mean, I may be unduly pessimistic in my read of my fellow human beings, but if we can at least speak in terms of the tabloid culture and the tabloid consumer, it is very hard to believe there won't be really a considerable interest in essentially abusive uses of this technology.

... I am sure these clinics, even the most responsible of them, will be happy to add this as an option if it satisfies other of their clients, and enables them to increase their range of reproductive services. Whether most of them will get involved in what we might regard the scandalous side of the technology, remains to be seen. But the notion that there will be no market developing in which you can pick not just the sperm donor you want or the egg donor you'd want, but also but the clone whom you wish to clone, is also very naive. There will be huge commercial pressures uprising here, leading us to a generation of children who are carbon copied from the heroes whom their parents pick. Copied from favorite relatives or whoever it is. The critics will come along and they will take their heat ...

Your real concern about this is it that they have taken the soul, the divine, the more ephemeral parts of being a human out of this equation?

Well, I am not sure I would speak about the more ephemeral parts, it does seem to me that everything apart from the technology is being taken out of this occasion. Whereas, of course, you and I are flesh and blood; ultimately, we are clusters of cells, we're blobs. Whatever view you may take of the soul and of our divine existence, divine elements in our system, certainly whatever else we may know, we can be burned, we can be melted down and we can be rotten under the soil.

Yet, most of us would agree that those are not the central facts about human beings. That indeed these are merely the vehicles for the spirit. For the human spirit and speaking in purely secular terms for the genius of the human being: What makes us different from machines and different from animals? What makes us extraordinary creatures and not, least, what makes us worthy of the kind of dignity which we seek to preserve in these international human rights conventions? There is something remarkable here as a human being ...

Some patients talk about the excitement of breaking barriers ... Doctors also speak excitedly about breaking barriers, but to you it is a concern. You don't feel much excitement about it, do you?

Well, science is exciting and it is important. This is one of my practical concerns in this discussion, that we could have a backlash against science and technology and I don't want to do that. I think we need to run with these things. The explosion of contemporary science, including these technological applications is, in principle, a wonderful thing if it can serve human beings and human dignity. The tragedy is it is occurring at a time when we are less in a moral position to constrain and control those forces than we have ever been. Because when moral people in our country, we have lost consensus and we have lost the reason of what it is to begin with.

So I want to balance my concern. I certainly welcome the fact that, in some cases, these technologies have ... enabl[ed] people to have children who couldn't otherwise, but the further we move away from the unity of the genetic parenting, the birth parenting and the social parenting, that seems to me to be crucial criteria. The further we move away from the sperm and the egg from one couple producing one baby, the further we move from an assumption of human dignity.

We are going to move a long away from that in this baby-making technology. So I want, on the one hand, to welcome technology and to invite technology and its proponents to serve human dignity. It seems to me wonderful that we can use these DNA processes. We even get people at least involved in it in these appalling masquerades so we can try war criminals, because we believe human dignity is important and science can help us do that. The notion that we should allow science to undermine human dignity and take us forward into a world which would be governed by technology and suppress the human spirit is a tragedy.

These technologies really are going ahead ... There are 364 clinics now; there used to be 20 ... Voices like yours are crying in the wilderness, to a certain extent. As you say, there is a certain lack of moral vigor right now. Can these questions that are being raised actually lead to a public policy forum?

You raise a somewhat depressing reflection. It is not easy to get this discussion going. It is not even easy to get it going among religious people, among Christians and Jews who have a sort of propriety interest in some of these questions. What worries me is I meet religious people who have been through these processes without a moral thought. And pastors and rabbis have encouraged them to go through them and who really have not reflected in any way on the kind of questions on which we are touching. Oh, these people can take different views, but really they need to reflect upon them. So the possibility of people in general taking seriously these questions is limited ...

Have you seen ... this process of one sperm being injected into an egg? How do you view that when you consider that you can actually see the moment of conception?

Oh, it is very wonderful. One of the most wonderful things to come out of the last 20 years have been the way in which we now have visual access to many of the reproductive processes. What was simply a textbook idea a half a generation ago, is now ... becoming familiar. Because we can [see] these processes and I suppose what I think of when I put my reflective hat on is, "Am I seeing the fruit of sexual union, even with assistance, or am I seeing a creative exercise in which an egg has come out of an ad for $10,000 for a bright, young, white, musical and linguistically gifted woman on an Ivy League campus. And the sperm has come from a clinic in Southern California ad through the Internet and these two [were] brought together essentially by a mail order process?"

This miracle of human conception in which you and I began our own lives can be one thing and can be the other. Whereas, I believe the one thing should be as perfect as human dignity and the fruit from this [union], it seems to me the other is a scandal. It is a use of technique fundamentally to pervert the dignity of human kind. As you manufacture babies, ultimately, the human race destroys itself. It will not be through nuclear weapons. It will not be through famine and nutrition. It will not be through any of the more obvious things. It will be through destruction of the human spirit in a society in which technology has become king and in which human dignity has become suppressed.

But both situations create a little baby who is brought into a family.

Indeed so. This is what, [it] seems to me, deceives us. Because it looks like the same thing, but it is something which is fundamentally different. This ultimately is a set of delusions. You know, family trees, genealogies are very interesting. Go to the old graveyards and you see generations of people who have lived and were born and have died in a locality. Grandparents, grandchildren, the death of little children, the death of their elderly people. This is the human condition.

The notion that we can replicate the human condition with an egg from the East Coast and sperm from the West and the Internet and some advertising ... It may be a woman who doesn't want to carry a child because she has a busy job and somebody else, a surrogate carries a child and there is a fee involved there. Ultimately, on one level it is the same thing. You have a home and you have a baby and you have parents. But we have split apart the genetic and the carrying of the child and the social parenting of the child in a way which has profound consequences. The fact that those consequences aren't evident every day, with more evidence in some cases than others, doesn't mean to say they aren't really very profound. That here we are looking not at procreation and the continuity of the human race through genealogy as witnessed in records in the graveyards. We are looking here at something we put together as a project and we have built this baby. The more the biotech people advance in what they can do, the more we are going to build our babies and they are going to control them. And already design the next generation.

A wise man said a long time ago that man's final triumph over nature will be his triumph over his own nature and he said the questions will remain: Who exactly has won? Essentially what we see is the tyranny of one generation over the next generation. Ultimately, that is what we are talking about.

What is it that gives you some sort of sense of moral authority here?

I suppose moral authority comes with the probability of the questions one asks. One can speak out of a faith tradition as a Christian and one can speak among Christians and Jews and Muslims who share much in common in this discussion in which there are some ... convictions about the identity of what it means to be human. One can speak something more generally. But the questions are what count ... What does it mean to be human? How does it affect what it means to be human? What is the relative significance of our basic biological functioning and the human spirit? What possible significance is there in sundering ... the social identity of our family units?

These questions have a moral authority all of their own. In a sense, all I would seek to do in this conversation is to help to focus the debate in those terms. It seems to me if we can get away from ... the buying and sell things image, the metaphor that this really is a matter of commerce, consumer wants and commerce, if we can get away from that into a discussion about human dignity ... wherein human dignity lies things like the way in which the mystery of sex, sexual love and the uncertainties of the genetic process as it operates in nature protect and preserve the integrity of the child as one who is an other and who is an enigma herself. If we can get into that conversation, we are getting to the conversation that counts and it is a conversation that carries its own authority. Because it seems to make this conversation in which the integrity of human beings is center state.

You told a little story about speaking at a conference and having people come up to you.

It's interesting what one speaks at a conference and talks about some of his questions and than a couple comes up and says, "This is our baby, we've been through in vitro process and it's wonderful and what do you think about it?" In no way is one suggesting that this isn't a wonderful thing for those involved. This baby may well have every chance of a happy and successful life and in saying that there are fundamental problems with the technology and its implications. I'm not in any way saying the individual cases, we might not have wonderful babies and wonderful family situations.

However, one of the examples that I've come up against several times recently, which disturbs me a lot, is single women wanting to have babies. They don't want to have husbands and don't want to have sex, but they want to have babies. Of course, in vitro provides the answer, and this is becoming a trend. It seems to me ... we've moved from essentially a way of dealing with infertility into dealing with somebody who does not want to have the male component in a marriage or cohabiting relationship and so will design an experience of a child one removed from that context. Whereas, many of the single parents do wonderful things for their kids and can often be very effective; very few single parents with themselves say, "You know, it's better this way than if I were in a happy marriage." So to design a family situation which you've never had a father there, except through a sperm bank in California, is deeply alarming, and gives a rather good illustration of how we keep making progress down this regressive strip.

Including lesbian and gay parents?

Well, of course lesbians and gays have ideological reasons to want to reproduce in ways that don't involve traditional sexual relationships. Here you have a kit which you can use for this purpose ... gays could use a surrogate mother for a child. A lesbian woman can carry a baby this way and the only common they have with men is through the lab. This becomes a construction kit approach. It becomes particularly evident where you have people who have an ideological reason. This isn't infertility stuff. Here you have the infertility techniques being used to create a whole new kind of family set up, in which you've never had to have sexual relationships in order for the reproduction. This is strange to us, but it's only a sample of what lies down the road.

This technology has put us on the cusp of breaking many long-standing barriers, whether they be new families, new social structures ... Are you concerned that we are jumping over that divide too easily ...

I'm very concerned that without serious public reflection, we are sliding into a situation in which these technologies are being applied either without reflection or without illogical motivation in the recreation of our family structures. What alarms me most of all is that we aren't having these conversations. I mean, when was [there] a nation exercise for a year or two about this whole question of how reproduction technology in the family relate? It wasn't. These things take place in a few days. You've got a cover of a news magazine and then on to something else. Yet, of all the issues which are being determined in our own generation, it is very hard not to put this one, the first or second place in the way in which we are taking decisions which will effect the whole future of the human race.

It concerns me very much [that] individuals, and this a significant issue here, are going into these treatment processes and taking these options with little in the way of serious reflection for themselves on what it is they are doing. It raises for their informed consent that people would get into processes of counseling for infertility or they get into decisions about ideological options for themselves with little reflection on the significance what they're doing for them, and, of course, with even less on the significance it has for their children. The horror of this whole discussion is the dignity of the child.

A lot of people just fear that we are messing with the unknown and with the divine realm in some way. Do you see it as such?

Religious people have to be very careful of jumping to conclusions in the sort of public ethical discussions and into accusing people of playing God. That little phrase is so easy to use and so hard, often, to justify. Because much of what we do in medicine, particularly, is seeking to stop people dying and to give them healthy along the lines and to make them fit. You could call this playing God. I do, however, think that one of the reasons why religious people are often particularly attuned to the significance of these questions is because they have a deep awareness of the mystery of human life, which is easy for all of us to forget about.

Religious people have a much more immediate sense, that to be alive is a remarkable thing, a special thing. They're much more self-conscience about the significance of human life and that for the significance of all values, of human dignity. Therefore, in a sense, [they] play the role of the conscience of the culture. They're raising questions ... I mean, I'm a Christian, but I'm not raising these as questions specifically of concern for Christians. I'm raising them because they affect human dignity in which Christians have a special stake, but which is something we all believe in, we all think is important. It may be that through religious conscience there's a trip wire ... which has been jolted by this technological progress and by then reflecting a way in which public discussion has essentially taken us now down this road.

My own sense is that in the natural process [there] needs to be recognized as have normative significance and that is something around traditional religious people can come together. There is a certain harmony in appropriateness about heterosexual marriage, where there's notions of fidelity providing a context of rearing their children, which most people agree is quite the best way to do it. There's a certain normativeness to recognizing that if one introduces the gametes or celibacy from outside, one is undermining this natural process.

[This] isn't to say that some of these exception in relations can't work well, but it is to say we've got to recognize we're departing from the norm here, we are doing something we haven't been able to do before as a human community and we have to, at least, have these conversations before we baptize this as an appropriate new way of living as human beings. That's the kind of issue which needs to be brought into focus. More boldly, we are confronting the explosion of technological capacity to determine, to control and to make our lives over again. Those of us who have a special concern for human dignity need to be at the forefront of raising that question ...

Can you state for us what is human dignity that you are afraid is being threatened by this?

The human dignity question is central. Human dignity is indivisible; any assault on anyone's dignity around the world is an assault upon mine. These are assumptions which most of us share and hold very dear. The essence of human dignity lies in our being persons, not things. Our being ends, not means. In ... philosophical terms, the notion that things should serve humans and humans shouldn't serve things. Human dignity is preserved in the natural realm, but most specifically, in the mysterious process of human generation. That we procreate in the mystery of sexual love and with all the uncertainties and with also the certainties of the genetic process.

Now, therefore, for us to turn our manufacturing techniques and our capacity for control, for design, for our own determination, for us to use those techniques at the very onset of our human being, just as for us to use it [as a] means to control a human being on in life in the notion to police state, I mean all sorts of other images and knowledge has been used to undermine human dignity. But these are fundamental affronts to human dignity.

The burden of proof lies with those who believe that we can turn manufacturing processes into the techniques whereby we bring human being into existence, where at the same time, shattering the foundations of dignities as individuals. Thereby undermining, what for many of us, lies at the heart of our motion of human flourishing and the distinctive character of the human community. The stakes are as high as that.

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