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Parental Expectations
and Cloning
by Dr.
Gregory E. Pence
Professor of Bioethics
at the
University of Alabama at Birmingham
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| The following article, which was
originally published in the APA Newsletters, is archived
on The Reproductive Cloning Network (www.ReproductiveCloning.net)
with permission from Dr. Pence. |
The main moral objection
to attempts to originate a child by nuclear cell somatic transfer (SCNT)
concern possible harm. Although some critics worry about vague harms such as
possible harms to society or to the institution of the family, the main worry
concerns harm to the resulting child.
This harm is of two possible kinds: physical, as a birth
defect or as a latent genetic dysfunction, or psychological. Psychological
harm is often claimed to be caused by erroneous parental expectations. In
particular, there is a widespread belief that any child originated by SCNT
would be harmed by unrealistic expectations created by his parents in
comparing his future to the life of his genetic ancestor. Call this the
argument from parental expectations; this is the subject of this piece.
One version of this argument claims that what is wrong about
SCNT origination is that it is wrong for a parent "to want a copy of
himself." Call this the wrongness of self-replication objection. This
popular objection is vulnerable on two points. First, the objection is not
about SCNT but about having the wrong motives for creating children. The
implied bad motives are those of vanity or narcissism. Some people may claim
that it is wrong to have such motives in creating any child, not just for
creating a child by SCNT. In any case, the criticism is not unique to SCNT.
Perhaps those who make this kind of objection think that the
only kind of child who would be created would be from the genome of one of the
parents. But if this were the real problem, then the objector should have no
problem if the parent chose the genome of someone else, say a favored uncle or
a brilliant aunt. Of course, the worry rarely goes away if this alternative is
suggested, allowing us to infer that the real objection here has to do with
the novelty of SCNT or something else.
The second problem with the objection concerning
self-replication is that it is based on a falsehood. It may be helpful at this
point to explain two key terms. The genome of an individual is the
complete set of his genes. How a genome is expressed in a particular
individual is his phenotype, the result of the interaction of the
genome with the environment. A phenotype is the resulting, entire physical,
biochemical and physiological makeup of the individual. Exposing the same
genome to different environments creates different phenotypes, e.g., where one
fetus receives inadequate nutrition during gestation and another superior
nutrition.
The idea that the phenotype of a girl originated by SCNT would
copy the phenotype of her genetic ancestor is false, and false in a myriad of
ways. Even in the most extreme example, we know that so-called identical twins
have tiny differences in their genomes - caused partly, probably, by how much
of the X chromosome is inactivated in fetal development, a random process in
each twin. Such differences, writ large twenty years later, may account for
why even conjoined twins, such as the famous Eng and Chang, may have opposed
personalities, to the extent of one being alcoholic and the other a
teetotaler.
We also know that the gestational mother of a SCNT-originated
fetus will contribute a small number of genes to the resulting child, meaning
that the final genome of the resulting child will differ slightly from that of
the genetic ancestor. Even at its most basic level, the SCNT child’s genome
will never be an exact copy of her ancestor’s.
Beyond the genome, the new child will have a different
environment from her ancestor in not just the obvious ways of place and years
of upbringing, specific parents, schools, and friends, but in less obvious
ways of what the gestational mother does or does not drink, does or does not
take as folic-acid and vitamin B supplements, and how much she talks to the
newborn during the first two years of her life (resulting, some think, in how
many neural pathways for language are formed). So the SCNT child would be
neither a genetic nor a phenotypic copy of the genetic ancestor.
Nevertheless, some people who want to originate a SCNT child
this way will believe they will get a copy of themselves. This raises a new,
but much more general question, "How important should such false beliefs
be in making public policy about bioethics?"
This question arose in the 1980s when many people had false
beliefs about HIV-infection. Some believed that HIV-infected children could
infect healthy children at school; some orderlies and hospital aides left food
outside the rooms of patients with AIDS, fearing infection if they entered;
other fears concerned contamination from public restrooms, mosquitoes,
communion cups, and coins.
Looking back, it was a mistake and wrong to base public policy
on such false beliefs. When it was, it made irrational fears seem legitimate.
The best way to deal with falsehoods is to act as if they are false, while
simultaneously educating people about the truth.
Similarly, and with false expectations about SCNT children,
prospective parents would need to be educated about what to realistically
expect. In this regard, there will be an important role for counselors in
clinics specializing in this kind of assisted reproduction.
Compare such counselors to genetic counselors, who often see
clients at risk for a dominant, autosomal genetic disease — such as
Huntington’s — clients who have a roughly 50-50 chance of having the gene.
When such clients come to be tested, their real motive is often to discover
that they do not have the gene. Yet the motive of such clients must,
unfortunately, be disappointed in approximately half the cases.
An important job of the genetic counselor is thus to make such
at-risk clients understand and feel what they will experience with an
unexpected result. When such counseling succeeds, people no longer have a
false belief and many don’t get tested. Such successful counseling explains
a recent report in the news expressing surprise that more Americans with such
diseases haven’t been tested. But that is no surprise, given the lack of
treatment for many genetic diseases and possible discrimination by American
insurance companies.
One important fact is that SCNT-origination cannot be done
outside clinics for assisted reproduction. There is a bottleneck and a social
check in this particular kind of human reproduction that is not possible for
most human sexual reproduction. Thus there is an opportunity to mandate
counseling and to make sure that most parents do not have false beliefs about
prospective SCNT children. Therefore, because it is generally a bad idea to
make public policy based on falsehoods, and because there is a practical way
to correct false expectations of prospective parents, this objection to SCNT
origination is not a good one.
The objection about the wrongness of self-replication has so
far been countered by saying that expectations about self-replication are
generally false. But let us now consider a form of this objection that
purports to be based not on false expectations but on true ones.
Some people at this point will object, "Yes, it is true
that the child would not be an exact genetic copy, and yes, the
expression as an adult would vary a lot, but still, there will be a lot of
similarity between the genetic ancestor and the child. And to that extent, the
parental expectations will be based on truth. But it would be wrong to create
a child this way because, to the extent that the child is similar to one who
has lived before, the parent will have expectations about him that could
become true."
This objection against SCNT-origination can be called the
argument for an open future. Because someone with this genome has lived
before, and because this child was created in part (or even mainly) because of
the characteristics of this particular genome, the future of the first SCNT-originated
child is claimed to be closed in a way not true for every other human child
who has ever been born.
This objection can be met in a variety of ways. First, a
general comment needs to be made about the general picture of child-creation
that this objection assumes, which is ultimately Kantian in its assumption
that a child should be valued in itself, not as a means to the satisfaction of
someone else’s desires. As such, a child should be wanted in itself, not for
the particular characteristics it might have. What is wrong about SCNT is that
every child should have a completely open, completely indeterminate future,
shaped not at all by his parent’s expectations.
In reply, it can be argued that this sets up a false ideal of
not only why people have children but also of how they ought to have them.
This passive ideal may stem from first earlier times in history when people
had no control over traits of children, and second, from a very recent trend
to put children almost on an altar to which the lives of parents are often
sacrificed by a myriad of developmental activities such as computer camps,
special schools, and participation in sports.
Important as these points are, what I want to focus on now
concerns what exactly is considered to be objectionable now about parental
expectations about SCNT. Now we can assume that parents have been counseled
and that, based on primate studies of SCNT, they have good evidence that a
child with 99% of the genome of Woody Allen or Elle MacPherson will be more
likely than normal to be intelligent or beautiful. Suppose also that
intelligence and beauty is, respectively, what is valued.
One thing that might be considered objectionable is to give
parents any choice at all about such characteristics. Many people seem to have
such beliefs. The objection here is of two kinds: that such choice is
intrinsically wrong or that such choice is indirectly wrong because it will
create undesirable consequences.
People who believe that choosing characteristics is
intrinsically wrong often believe that it is up to God, nature, or evolution
to determine who is born and with what characteristics, and that it is wrong
for humans to make such choices.
People who make this objection often get confused at this
point between objecting that: (1) human society should not make choices about
which human characteristics are desirable and try to bring about babies with
such characteristics, and (2) particular parents should not make choices about
which human characteristics are desirable and try to bring about babies with
such characteristics. The first objection is associated with eugenics and
dictatorial states taking away reproductive choice from couples; the second
objection opposes expansion of current reproductive choice for couples. Fears
and concerns about the first are not arguments for curtailing choice in the
latter, but the opposite; a strong and regularly-exercised right to reproduce
as one chooses is a good check on reproductive coercion.
Most people don’t really believe that (2) choosing
characteristics in future people is wrong. People send their children to one
school rather than another based on such beliefs. Prospective parents use
genetic tests to determine if embryos and fetuses have severe genetic disease
and abort those testing positive. Mothers avoid cigarettes and alcohol during
pregnancy to protect their fetuses from similar affects.
To argue that such choices are wrong ultimately is to accept
reproductive fatalism. Such a fatalism must also apply to who gets pregnant,
and it is not surprising that those who oppose genetic choice usually oppose
abortion and contraception. The Vatican at least is consistent.
In the Vatican’s consistency, there is an insight. On its
view, humans should view everything that happens as God’s will and attempt
to change nothing. Each pregnancy is as it should be, and God has a sufficient
reason for it. To oppose His will is sinful pride.
Once we let people choose to take contraception and to abort
because they don’t want to be pregnant, it is hard to justify not letting
them abort because a fetus has a genetic disease, because it will be deaf, or
because it will be very short. Once we allow for abortion to avoid extremely
short stature or deafness, it is hard not to allow medical treatments at birth
designed to overcome deafness, such as dosages of human growth hormone, or to
overcome extreme shortness, such as cochlear implants. Implicit in these
decisions is the judgment that being short and deaf is undesirable, being tall
and able to hear is good. Once those judgments are made, and it becomes
possible to choose children who are able to hear better or be taller, it
becomes difficult to say why it is wrong to allow parents to make these kinds
of choices. (Indeed, once this is granted and once it becomes possible to do
so so, it becomes difficult to say why parents should not be able to
permanently modify their germ cells to create taller or non-deaf children, but
that is another topic.)
Here it will be objected that some parents will put too much
weight on one characteristic, such as intelligence or the current ideal of
female beauty, and then be very disappointed when the child does not measure
up. We can put this point in a more general way: to emphasize a connection
between the value of the child to the parents and the particular
characteristics the child may have — characteristics which are
uncontrollable, unpredictable, and morally arbitrary — is to harm any child
who lacks the desired characteristics or who does not possess them to the
degree desired by the parents.
If a parent has such an obsession about one characteristic,
and believes that a SCNT-originated child will certainly have such a
characteristic, then what we have here is a variation on the first objection,
because it is very likely false that the child will have a particular
characteristic to the degree of the famous ancestor. Moreover, it will often
be a particular combination of traits that is desirable, such as physique or
skill in solving mathematical puzzles, and such a combination will very likely
be the result of the child’ s environment and education.
A different variation here concerns parents who focus on looks
in originating a SCNT-originated child. In the famous Baby M case of
commercial surrogacy in the United States, the Sterns chose the surrogate
mother, Mary Beth Whitehead, only because she had a physique that looked like
Mrs. Stern. In this, we all know now, they were very ill-informed, for they
disregarded the importance of personality, intelligence, and perhaps, mental
illness, in making their selection. Similarly, couples seeking embryos or eggs
for implantation in older infertile women in American often choose mainly on
the basis of the looks of the genetic ancestors. That, of course, is a
simple-minded way to choose.
The real truth of modern genetics is that everything is
complex. There may be no simple genetic test for breast cancer, because there
may be hundreds of variations, such that to tell a woman she has no genetic
risk, one must test for each and every variation. In the context of cloning,
the author of the scientific section of the NBAC ‘s Cloning Human Beings
summarized:
Indeed, the great lesson of modern molecular genetics is the
profound complexity of both gene-gene interactions and gene-environment
interactions in the determination of whether a specific trait or
characteristic is expressed. . . . recent scientific findings have revealed
that a "one-gene-one-disease" approach is far too simplistic. Even
in the relatively small list of genes currently associated with a specific
disease, knowing the complete DNA sequence of the gene does not allow a
scientist to predict if a given person will get the disease.1
And if a disease can’t be predicted, how much more difficult
will it be to predict traits such as wit or dexterity? Many qualities of the
phenotype will be multi-factorial at the genomic level and multi-factorial at
the level of gene-environment interaction, such that how any quality gets
created in a phenotype will be difficult to predict. Originating children by
cloning will not deprive them of an open future nearly as much as people
think.
But learning this will be a matter of education and
experience. People will need counseling. Personally, I have great faith in
prospective parents and what they are capable of learning. The learning curve
here will be short: a few well-publicized cases of silly parental expectations
will teach thousands, if not millions, about the basic lessons of Genetics
101.
To conclude, to the extent that the argument from parental
expectations is based on false beliefs, it can be countered first by saying
that we should not make public policy on false beliefs, and second, that
social mechanisms are available to counter the damage of these false beliefs
of parents to SCNT-created children. Even then, some small damage from
expectations may occur, but if so, it is likely to be no greater than any
other failed kind of expectation of parents about sexually-created children.
On the other hand, even if SCNT-created children correctly
fulfill parental expectations, e.g., the SCNT-originated child from Woody
Allen’s genome really is witty, this does not negate the free will of such
children to lead other kinds of lives.
In such matters, it is best not to be a priori, as so many
were in the past in condemning many forms of assisted reproduction that later
proved benign. Past critics claimed that amniocentesis would allow parents to
choose only perfect children, aborting any child who was not. What critics
then missed is that parents want a fetus that has been gestated for six
months, and only choose to abort by choosing against a terrible genetic
disease, not against having a child. Similarly, past critics claimed that in
vitro fertilization would be abused, in combination with embryo transfer, and
would allow parents to create only perfect babies. Again, such critics
underestimated how much such procedures cost and how most infertile couples
are content to get any baby at all in a process where only 14% of such
couples actually take home a baby.
If twenty years of experience with such new forms of assisted
reproduction have taught us anything, it is that we should be open-minded
about new techniques of human reproduction, skeptical about claims of
monstrous babies and about great harm to society, and think better of most
parents than to caricature them as selfish.
Notes
1. "The Science and Application of Cloning,"
National Bioethics Advisory Commission, Cloning Human Beings, 32-33.
Gregory Pence is a lecturer on philosophy and medical
ethics at the University of Alabama. The author can be contacted by
email (pence@uab.edu). See also: http://www.uab.edu/philosophy/faculty/pence/