America’s next ethical war
Apr 12th 2001 | WASHINGTON, DC
From The Economist print edition 

Politicians and regulators in America are floundering as they try to
understand the immense implications of genetic science. The first
human clone could mark a turning-point in man’s story

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IF YOU are looking for certainty in ethical politics, there are few
better places to find it than the annual “March for Life” in
Washington, DC, to protest against Roe v Wade, the 1973 Supreme Court
ruling that legalised abortion. Every hymn, prayer and speech repeats
the message: abortion is an evil that must be stopped. Protesters
wave a series of ghoulish placards showing bloody fetuses clasping
quarter-dollar coins: “Yes to the human treatment of animals. No to
the animalistic treatment of humans.”

In most other countries, politicians are seldom asked about their
views on abortion. In America it is a litmus test, with both sides
showing equal intolerance of dissent. Now this bitter, familiar
battlefield is being extended and confused by genetic politics, and
at breathtaking speed.

America has grown some 3.5 trillion genetically modified plants since
1994. The reading of the human genome has been completed. Patents
have been granted, linked to individual human genes. The first court
cases against companies using genetic information to discriminate
against employees have begun. 

Cloning is also forcing itself into the news. Americans are already
queuing up to freeze the DNA of their dead loved ones (including pets
and racehorses, the latter for $895 plus $100 a year for storage).
The underground movement to clone human beings is starting to
surface; an American professor and an Italian doctor announced their
plans in March. The Raelians, a slightly weird but rich and
scientifically sophisticated sect from Canada, are trying to
“recreate” a dead child at a secret location in the United States. 

Scientists tend to get pernickety about putting all these things
together. There are different timetables to consider: stem-cell
research, for instance, is already under way; genetically modifying
human character traits is a distant project. There is a difference
between purely reproductive technologies, such as in vitro
fertilisation (IVF), and genetic technologies, which try to change
the shape of future organisms.

All true, but for most non-scientists these things all seem to
involve fiddling around with nature to a greater or lesser extent.
And, taken together, they prompt a whole series of perplexing ethical
questions that will affect politics everywhere.

America is likely to be their most important battleground, for
several reasons. First, it has the most advanced biotech industry.
Second, some of these ethical questions overlap with the tortured
abortion debate. Third, Americans have always leapt at perfectionist
fads, whether plastic surgery or playing Mozart to educate babies in
the womb. Fourth, America’s legalistic culture makes the ethical
fudges that are common in Europe very difficult. And, fifth, despite
all these things, American politicians and regulators seem almost
completely unprepared for what is about to hit them.

Mention genetics to most politicians in Washington, and they assume
that you are talking about an industry, not a political issue. Unlike
their peers in Europe, they have faced no furore over genetically
modified foods. Asked for his views on cloning and gene patents, a
Republican senator often mentioned as presidential material waffles
for a while, then asks his aide to help him out. She can’t remember
either.



Legislative confusion
Even the abortion marchers in Washington seem a little less certain.
Asked about the use of embryos in stem-cell research, two ladies from
Missouri Right to Life appear opposed to it. They also dislike
cloning, and they seem a little nervous about genetically modified
food. (“It’s not natural, either.”) Did they know that their senator,
Kit Bond, a fervent anti-abortion Republican, is, strangely enough, a
leading supporter of GM foods? No, “but he’s a good Christian man.”

So far, the debate about genetic research has largely been a private
academic squabble. Most of the running has been made by enthusiastic
scientists who expect you to know what single nucleotide
polymorphisms are. The sceptics are a ragbag of unlikely allies: a
few academic political theorists, the Roman Catholic church, some
anti-abortion zealots, the anti-globalisation brigade and a few
mavericks (one American writer, Jeremy Rifkin, is working on a
multilateral “Treaty to Protect the Genetic Common”).

A good guide to the infancy of “biopolitics” is provided by Leon
Kass, an ethicist at the University of Chicago. First, he cannot name
any national politician who understands the subject. And, second,
experience has taught him that his side (he is one of the leading
sceptics) will always lose: it is fighting “against an enormous
amount of money, against the general liberal prejudice that it is
wrong to stop people doing something and, in many cases, against
everybody’s quite rational fear of death”. 

These two observations are linked. Congress has generally stayed
almost entirely clear of baby-making technology. A National Bioethics
Advisory Commission gives advice to the president, but there is no
formal overseer of the subject such as Britain’s Human Fertilisation
and Embryology Authority (HFEA). The Food and Drug Administration
(FDA) decides whether a particular machine or medicine is safe, but
says nothing explicit about the ethics of using it.

To the extent that limits have been put on the genetics industry,
these have often been self-imposed. In the 1980s, Monsanto famously
dictated the rules for the young GM foods industry. Since 1975,
various peer groups of academic scientists have laid down unofficial
guidelines. In practice, the various industries gathered around human
reproduction have been shaped by its customers—particularly infertile
couples trying to have babies.

Jeffrey Kahn, a bioethicist at the University of Minnesota, points
out that politics and the law always tend to react to science, not
guide it. Self-regulation has also produced few disasters. But will
laisser-faire last? Regardless of which side you are on in the
various arguments about genetics, the current non-debate has the
makings of a political disaster. First, because such life-and-death
issues need to be debated. And, second, because Americans are
probably nervous about letting the scientists have their way. 

The largely academic debate so far has produced no clear left-right
split. As it seeps into party politics it may cross party lines more
viciously than abortion. Among Democrats, it may well widen the gap
between leftish supporters of Ralph Nader and more business-minded
third-way New Democrats. Among Republicans, conservative
fundamentalists will clash not just with libertarians but also with
the party’s bedrock—big business. On genetics, the anti-abortion
movement’s real enemy is not feminists, but the Department of
Commerce.



The battlefield ahead
As you might have expected, the only biotechnology issue that has
really impinged on Capitol Hill is one that is linked to abortion:
stem-cell research. Congress has banned the use of federal money to
pay for stem-cell research that involves destroying a human embryo.
Under Bill Clinton, the National Institutes of Health (NIH) got round
this law on a slightly dodgy technicality, supporting stem-cell
researchers so long as the researchers themselves did not extract the
cells from the embryo.

The new overseer of the NIH is Tommy Thompson, the secretary of
health and human services. Mr Thompson opposes abortion, but he
supported stem-cell research in his native Wisconsin (something that
split the Right to Life movement over his nomination). Several other
Republican anti-abortion leaders, including Senators Gordon Smith and
Strom Thurmond, also support stem-cell research. They have reasons.
Mr Smith’s family has suffered from Parkinson’s disease. “Strom came
round partly because he has a daughter with diabetes,” says Arlen
Specter, a Republican. 

On the campaign trail last year George Bush hinted to anti-abortion
activists that he would ban stem-cell research. Business and
scientists reply that even the Clintonian regime puts them at a
disadvantage. In Britain, Parliament, advised by the HFEA, has
allowed “therapeutic cloning” of embryos to harvest more stem cells
(though the embryos can last only 14 days). Mr Bush’s team recently
said it would put off a decision until the summer, citing “a complex
question of ethics and the promise of science”. 

The abortion debate also affects the tussle over pre-birth genetic
screening. This is not new; a Jewish committee in New York that is
concerned to prevent genetic disease organises tests to discourage
Ashkenazi Jews who carry the Tay-Sachs mutation from marrying each
other. But it went further last year, with the specific selection of
“Baby Adam”, from among 15 healthy embryos, because he had the right
bone marrow to help his sister, who had a rare disease.

Such selection would have been illegal in Britain. In the United
States, it was not even in the regulator’s province, because there
was no public money involved. Technically, the FDA can poke its nose
into things if private-sector doctors use federally approved drugs
(this happened with Oregon’s euthanasia law). But in general, as Mr
Kahn bluntly puts it, the state’s attitude is that “capitalistic acts
between consenting adults are none of its business.” This has also
been the prevailing attitude to animal cloning and the IVF industry.

The Baby Adam case also touched on the re-emergence of eugenics. In
America as in Europe, this word has an unpleasant history. In the
early 20th century, more than 100,000 Americans were the victims of
compulsory sterilisation laws. In 1927, the Supreme Court upheld
Virginia’s eugenics law, enforcing the sterilisation of Carrie Buck,
who lived in a colony for epileptics with her mother and her
six-month-old daughter. “Three generations of imbeciles is enough,”
Justice Oliver Wendell Holmes bleakly explained.



Eugenics revisited
Many people now argue that science is allowing a healthier,
non-coercive version of eugenics, practised by caring parents as
opposed to a racist state. Ronald Dworkin, arguably America’s leading
leftish legal theorist, supports the idea on the basis that the full
potential of a life should be realised. Matt Ridley, the author of
“Genome” (HarperCollins, 2000) and a former writer on The Economist,
argues that genetically modifying a fertilised egg to fix, say, the
gene mutation that causes Huntington’s disease is surely preferable
to aborting the fetus or allowing the baby to be born with the
disease.

For many people, the difficulties come when biotechnology leaps from
stopping disease to adding advantages—enhancing the genes that make
you more intelligent, more musical or less homosexual (as it may yet
do: it can’t at present). Such “re-engineering of the human species”
worries William Galston, a leading figure on the Democrat Leadership
Council and a professor at the University of Maryland: “The species
should be how we are, not how we might be.” In “Remaking Eden”
(Hearst, 1997), Lee Silver, a Princeton biologist, foresees a
two-class system, with rich, genetically enhanced “GenRich” lording
it over poorer, inferior “Naturals”.

The sex of children is already up for sale. “Microsort”, a process
offered by the Genetics and IVF Institute in Fairfax, Virginia,
separates male from female sperm. It is particularly successful at
producing girls (because X-chromosome sperm are easier to mark). At
first, the institute helped couples with hereditary diseases that
tend to occur in boys. Now it offers “family balancing” to couples
who want to choose their next child from “the under-represented
gender”.

The institute treats around 60 couples a month, who pay around $3,000
a go; it plans to double production soon. Looking at surveys showing
that around one in four American couples might use sex-selection,
Fortune recently calculated that the market could be worth $200m a
year. Some of this money may go to the government, since the
Microsort process is based on a Department of Agriculture invention.
But the government’s regulatory input is fairly minimal.

Much of Americans’ unease with new genetic research stems from the
feeling that big business, or the government, may thereby gain more
control over their bodies. As long ago as 1995, Mr Rifkin organised a
coalition against patents on human genes that included virtually all
the main churches. For religious leaders, human bodies are God’s
property, not man’s. For leftish anti-corporate types, the idea of
big drug firms patenting bits of bodies is another example of the
evils of “Big Pharma”. Genetic information is not something that you
invent; it belongs to society, not companies. 

Drug firms reply that they need some payback for all their research.
The system grants patents only when advances are original,
non-obvious and useful. It also means that discoveries are made
public. The American patent office has issued about 1,000 patents to
companies that have identified genes producing specific proteins.
Tens of thousands of human gene patents are pending. Now it is
apparently being less generous.

As more and more is publicly revealed about the genetic composition
of humans, so people cling to the notion that their own genetic
make-up should be private. Recently, a long-simmering debate about
genetic privacy broke out at Burlington Northern. The railway company
had taken blood samples from employees who filed claims for
carpal-tunnel injuries, hoping apparently to find out whether they
had a genetic disposition to such ailments. The rail workers’ union
sued, backed by the Equal Employment Opportunity Commission, claiming
the railway had violated the Americans with Disabilities Act. 

Only around one in a hundred Americans has a genetic test in any
given year. Federal employees are already explicitly protected
against genetic discrimination. Private-sector employees have no
federal protection, but 18 states now have laws that limit
life-insurers’ ability to use genetic tests to reveal people’s
susceptibility to diseases. This is odd, since they are allowed to
discriminate on the basis of the gene that is most closely linked to
specific diseases and shorter life-spans, the SRY gene that makes
people male. 

Consumers would like more limits on genetic testing; but insurers
fret that these laws could put them out of business. As Lehman
Brothers recently warned investors, there is nothing to stop people,
having discovered that they have inherited the gene that causes
Huntington’s disease, going out and loading up with insurance. In
Britain, people who have such tests have to share the information
with their insurers. But the United States has no such law.

Of all the aspects of genetic research, none is more controversial
than human cloning. Although this still lies in the future, the
technique has already succeeded in mammals and is fairly simple. In
January, Panos Zavos, a professor at the University of Kentucky,
announced plans to clone a human being, working with Severino
Antinori, an Italian doctor best-known for helping post-menopausal
women to get pregnant.



Cloning and its enemies
In November, the ethics committee of the American Society of
Reproductive Medicine said that cloning for fertility treatment “did
not meet standards of ethical acceptability.” Last month, scientists
who have conducted animal cloning testified to a congressional
subcommittee that human cloning could involve hundreds of failures.
Yet it is not clear what deterrent exists to groups, like the
Raelians, that have teams of surrogate mothers ready to try.

In the wake of the cloning of Dolly the sheep, Bill Clinton announced
a moratorium on human reproductive cloning in March 1997. In fact,
this only stops federal money going to help the process. A mere five
states—California, Louisiana, Missouri, Michigan and Rhode
Island—actually have laws banning reproductive cloning (either
temporarily or permanently), though Texas is thinking about one.

When Bill Clinton issued his order, Senator Tom Harkin rather
magnificently told the president to “take your ranks alongside Pope
Paul V, who in 1616 tried to stop Galileo.” Mr Harkin aside, most
American politicians claim to be against cloning, but they are also
nervous about restraining their genetics industry. In Dolly’s wake,
Congress tried half-heartedly to pass an anti-cloning bill, but
failed to work out a law that would satisfy both the anti-abortion
camp and the drug firms. Bill Frist, a Republican senator from
Tennessee, who sponsored one of the failed attempts, says he has no
plans to try again.

A poll last month by Time/CNN found that 67% of people thought that
animal cloning was “a bad idea”; 90% opposed human cloning. There
were strong majorities even against cloning to produce vital organs
to save others (68%) and to help infertile parents to have children
(76%). But if you go to a website such as that of the Human Cloning
Foundation, the demand for cloning is obvious. It comes from people
desperate to bring back a dead sibling, from homosexuals anxious to
reproduce, and most of all from America’s 3.5m “infertile” couples,
those who have been trying to have a child for a year, but still
cannot conceive. 



Searching for an answer
Most of these debates come down to a fundamental division of opinion:
between seeing human life in terms of its intrinsic value, or in
terms of its utilitarian value. A gene is either life itself, or just
a useful piece of kit. Some people on the left regard it as part of a
growing war between commerce and culture.

The truth is that such clarity comes only at the extremes. The Roman
Catholic church tends to oppose most of the controversial things in
reproductive science (though that did not stop 160 of its bishops
meeting in Irving, Texas, last month to debate the subject). The
Raelians seem pretty enthusiastic about everything. But most people,
including most politicians, are stuck in the middle.

Adam Wolfson, who wrote a much-cited piece in Public Interest trying
to place genetic research within traditional conservative and liberal
thought, may come closest to the truth when he argues that the
underlying question is usually one of dignity, rather than right or
wrong. The University of Maryland’s Mr Galston predicts that genetic
science will end up in the Supreme Court—not as one issue, but as a
series of small cases that will together set a limit for what society
will tolerate in the field. 

Those judges may be swayed by public opinion (and the presidents who
appoint them certainly will be). A good bet is that attitudes to
genetic research will be defined by the first human clone. If a
cloned baby were to be born with terrible abnormalities, the public
outcry against genetic research could be immense, and bans could be
imposed on several fronts. On the other hand, if a totally healthy
cloned child appears, then quite possibly every fertility clinic in
the country will begin to offer the technique.