Americas 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 mans story ---------------------------------- 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, Americas 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 cant 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. (Its 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 hes 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 everybodys 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 Britains 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 customersparticularly 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 partys bedrockbig business. On genetics, the anti-abortion movements 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 Smiths family has suffered from Parkinsons 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 Bushs 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 regulators 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 Oregons euthanasia law). But in general, as Mr Kahn bluntly puts it, the states 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 Virginias 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 Americas 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 Huntingtons 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 advantagesenhancing the genes that make you more intelligent, more musical or less homosexual (as it may yet do: it cant 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 governments 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 Gods property, not mans. 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 peoples 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 Huntingtons 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 statesCalifornia, Louisiana, Missouri, Michigan and Rhode Islandactually 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 Dollys 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 Americas 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 Marylands Mr Galston predicts that genetic science will end up in the Supreme Courtnot 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.