Journal ofMedical Ethics 1997; 23: 353-360

"Goodbye Dolly?"The ethics of humancloningJohn Harris The Institute ofMedicine, Law and Bioethics, University ofManchester

AbstractThe ethical implications of human clones have beenmuch alluded to, but have seldom been examined withany rigour. This paper examines the possible uses andabuses of human cloning and draws out the principalethical dimensions, both of what might be done and itsmeaning. The paper examines some of the majorpublic and official responses to cloning by authoritiessuch as President Clinton, the World HealthOrganisation, the European parliament, UNESCO,and others and reveals their inadequacies asfoundations for a coherent public policy on humancloning. The paper ends by defending a conc-eption ofreproductive rights or "procreative autonomy" whichshows human cloning to be not inconsistent withhuman rights and dignity.

The recent announcement of a birth' in the pressheralds an event probably unparalleled for two mil-lennia and has highlighted the impact of the geneticrevolution on our lives and personal choices. Moreimportantly perhaps, it raises questions about thelegitimacy of the sorts of control individuals andsociety purport to exercise over something, whichwhile it must sound portentous, is nothing less thanhuman destiny. This birth, that of "Dolly", thecloned sheep, is also illustrative of the responsibili-ties of science and scientists to the communities inwhich they live and which they serve, and of thepublic anxiety that sensational scientific achieve-ments sometimes provokes.The ethical implications of human clones have

been much alluded to, but have seldom beenexamined with any rigour. Here I will examine thepossible uses and abuses of human cloning and drawout the principal ethical dimensions, both of whatmight be done and its meaning, and of public andofficial responses.

There are two rather different techniques avail-able for cloning individuals. One is by nuclear sub-stitution, the technique used to create Dolly, and the

Key wordsCloning; Dolly; human dignity; procreative autonomy,human rights.

other is by cell mass division or "embryo splitting".We'll start with cell mass division because this is theonly technique for cloning that has, as yet, been usedin humans.

Cell mass divisionAlthough the technique of cloning embryos by cellmass division has, for some time been used exten-sively in animal models, it was used as a way of mul-tiplying human embryos for the first time in October1993 when Jerry Hall and Robert Stillman2 atGeorge Washington Medical Centre cloned humanembryos by splitting early two- to eight-cell embryosinto single embryo cells. Among other uses, cloningby cell mass division or embryo splitting could beused to provide a "twin" embryo for biopsy, permit-ting an embryo undamaged by invasive proceduresto be available for implantation following the resultof the biopsy on its twin, or to increase the numberof embryos available for implantation in the treat-ment of infertility.3 To what extent is such a practiceunethical?

Individuals, multiples and geneticvariationCloning does not produce identical copies of thesame individual person. It can only produce identi-cal copies of the same genotype. Our experience ofidentical twins demonstrates that each is a separateindividual with his or her own character, preferencesand so on. Although there is some evidence ofstriking similarities with respect to these factors intwins, there is no question but that each twin is adistinct individual, as independent and as free as isanyone else. To clone Bill Clinton is not to createmultiple Presidents of the United States. Artificialclones do not raise any difficulties not raised by thephenomenon of "natural" twins. We do not feelapprehensive when natural twins are born, whyshould we when twins are deliberately created?

If the objection to cloning is to the creation ofidentical individuals separated in time, (because thetwin embryos might be implanted in different cycles,perhaps even years apart), it is a weak one at best.

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354 "Goodbye Dolly?" The ethics ofhuman cloning

We should remember that such twins will be "iden-tical" in the sense that they will each have the samegenotype, but they will never (unlike some but by nomeans all natural monozygotic twins) be identical inthe more familiar sense of looking identical at thesame moment in time. If we think of expected simi-larities in character, tastes and so on, then the sameis true. The further separated in time, the less likelythey are to have similarities of character (the moredifferent the environment, the more differentenvironmental influence on individuality).The significant ethical issue here is whether it

would be morally defensible, by outlawing thecreation of clones by cell mass division, to deny awoman the chance to have the child she desperatelyseeks. If this procedure would enable a woman tocreate a sufficient number of embryos to give her areasonable chance of successfully implanting one ortwo of them, then the objections to it would have tobe weighty indeed. If pre-implantation testing by cellbiopsy might damage the embryo to be implanted,would it be defensible to prefer this to testing aclone, if technology permits such a clone to becreated without damage, by separating a cell or twofrom the embryonic cell mass? If we assume eachprocedure to have been perfected and to be equallysafe, we must ask what the ethical difference wouldbe between taking a cell for cell biopsy and destroy-ing it thereafter, and taking a cell to create a clone,and then destroying the clone? The answer can onlybe that destroying the cloned embryo would consti-tute a waste of human potential. But this samepotential is wasted whenever an embryo is notimplanted.

Nuclear substitution: the birth of DollyThis technique involves (crudely described) deletingthe nucleus of an egg cell and substituting thenucleus taken from the cell of another individual.This can be done using cells from an adult. The firstviable offspring produced from fetal and adult mam-malian cells was reported from an Edinburgh-basedgroup in Nature on February 27, 1997.4 The eventcaused an international sensation and was widelyreported in the world press. President Clinton of theUnited States called for an investigation into theethics of such procedures and announced a mora-torium on public spending on human cloning; theBritish Nobel Prize winner, Joseph Rotblat,described it as science out of control, creating "ameans of mass destruction",5 and the German news-paper Die Welt, evoked the Third Reich, comment-ing: "The cloning of human beings would fitprecisely into Adolph Hitler's world view".6More sober commentators were similarly

panicked into instant reaction. Dr HiroshiNakajima, Director General of the World HealthOrganisation said: "WHO considers the use ofcloning for the replication of human individuals to

be ethically unacceptable as it would violate some ofthe basic principles which govern medically assistedprocreation. These include respect for the dignity ofthe human being and protection of the security ofhuman genetic material".7 The World HealthOrganisation followed up the line taken by Nakajimawith a resolution of the Fiftieth World HealthAssembly which saw fit to affirm "that the use ofcloning for the replication of human individuals isethically unacceptable and contrary to humanintegrity and morality".8 Federico Mayor ofUNESCO, equally quick off the mark, commented:"Human beings must not be cloned under any cir-cumstances. Moreover, UNESCO's InternationalBioethics Committee (IBC), which has been reflect-ing on the ethics of scientific progress, has main-tained that the human genome must be preserved ascommon heritage of humanity".9The European parliament rushed through a reso-

lution on cloning, the preamble of which asserted,(paragraph B):

"[T] he cloning of human beings . . . , cannot underany circumstances be justified or tolerated by anysociety, because it is a serious violation of funda-mental human rights and is contrary to the principleof equality of human beings as it permits a eugenicand racist selection of the human race, it offendsagainst human dignity and it requires experimenta-tion on humans," And which went on to claim that,(clause 1) "each individual has a right to his or herown genetic identity and that human cloning is, andmust continue to be, prohibited".'0

These statements are, perhaps un-surprisingly, thinon argument and rationale; they appear to have beenplucked from the air to justify an instant reaction.There are vague references to "human rights" or"basic principles" with little or no attempt to explainwhat these principles are, or to indicate how theymight apply to cloning. The WHO statement, forexample, refers to the basic principles which governhuman reproduction and singles out "respect for thedignity of the human being" and "protection of thesecurity of genetic material". How, we are entitled toask, is the security of genetic material compromised?Is it less secure when inserted with precision byscientists, or when spread around with the character-istic negligence of the average human male? l l

Human dignityAppeals to human dignity, on the other hand, whileuniversally attractive, are comprehensively vagueand deserve separate attention. A first question toask when the idea of human dignity is invoked is:whose dignity is attacked and how? Is it the duplica-tion of a large part of the genome that is supposed toconstitute the attack on human dignity? If so wemight legitimately ask whether and how the dignity

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of a natural twin is threatened by the existence of hersister? The notion of human dignity is often alsolinked to Kantian ethics. A typical example, and onethat attempts to provide some basis for objections tocloning based on human dignity, was Axel Kahn'sinvocation of this principle in his commentary oncloning in Nature.'2

"The creation of human clones solely for spare celllines would, from a philosophical point ofview, be inobvious contradiction to the principle expressed byEmmanuel Kant: that of human dignity. This prin-ciple demands that an individual - and I wouldextend this to read human life - should never bethought of as a means, but always also as an end.Creating human life for the sole purpose of prepar-ing therapeutic material would clearly not be for thedignity of the life created."

The Kantian principle, crudely invoked as it usuallyis without any qualification or gloss, is seldomhelpful in medical or bio-science contexts. As for-mulated by Kahn, for example, it would outlawblood transfusions The beneficiary of blooddonation, neither knowing of, nor usually caringabout, the anonymous donor uses the blood (and its'donor) simply as a means to her own ends. It wouldalso outlaw abortions to protect the life or health ofthe mother.

InstrumentalizationThis idea of using individuals as a means to thepurposes of others is sometimes termed "instrumen-talization". Applying this idea coherently or consis-tently is not easy! If someone wants to have childrenin order to continue their genetic line do they actinstrumentally? Where, as is standard practice in invitro fertilisation (IVF), spare embryos are created,are these embryos created instrumentally? If not howdo they differ from embryos created by embryo split-ting for use in assisted reproduction?'3Kahn responded in the journal Nature to these

objections.'4 He reminds us, rightly, that Kant'sfamous principle states: "respect for human dignityrequires that an individual is never used . . . exclu-sively as a means" and suggests that I have ignoredthe crucial use of the term "exclusively". I did not ofcourse, and I'm happy with Kahn's reformulation ofthe principle. It is not that Kant's principle does nothave powerful intuitive force, but that it is so vagueand so open to selective interpretation and its scopefor application is consequently so limited, that itsutility as one of the "fundamental principles ofmodern bioethical thought", as Kahn describes it, isvirtually zero.Kahn himself rightly points out that debates

concerning the moral status of the human embryoare debates about whether embryos fall within thescope of Kant's or indeed any other moral principles

concerning persons; so the principle itself is notilluminating in this context. Applied to the creationof individuals which are, or will becomeautonomous, it has limited application. True theKantian principle rules out slavery, but so do a rangeof other principles based on autonomy and rights. Ifyou are interested in the ethics of creating peoplethen, so long as existence is in the created individ-ual's own best interests, and the individual will havethe capacity for autonomy like any other, then themotives for which the individual was created areeither morally irrelevant or subordinate to othermoral considerations. So that even where, forexample, a child is engendered exclusively to provide"a son and heir" (as so often in so many cultures) itis unclear how or whether Kant' principle applies.Either other motives are also attributed to the parentto square parental purposes with Kant, or the child'seventual autonomy, and its clear and substantialinterest in or benefit from existence, take precedenceover the comparatively trivial issue of parentalmotives. Either way the "fundamental principle ofmodern bioethical thought" is unhelpful and debatesabout whether or not an individual has been usedexclusively as a means are sterile and usually irresolv-able.We noted earlier the possibility of using embryo

splitting to allow genetic and other screening byembryo biopsy. One embryo could be tested andthen destroyed to ascertain the health and geneticstatus of the remaining clones. Again, an objectionoften voiced to this is that it would violate theKantian principle, and that "one twin would bedestroyed for the sake of another".

This is a bizarre and misleading objection both tousing cell mass division to create clones for screeningpurposes, and to creating clones by nuclear substitu-tion to generate spare cell lines. It is surely ethicallydubious to object to one embryo being sacrificed forthe sake of another, but not to object to it being sac-rificed for nothing. In in vitro fertilisation, forexample, it is, in the United Kingdom, currentlyregarded as good practice to store spare embryos forfuture use by the mother or for disposal at her direc-tion, either to other women who require donorembryos, or for research, or simply to be destroyed.It cannot be morally worse to use an embryo toprovide information about its sibling, than to use itfor more abstract research or simply to destroy it. Ifit is permissible to use early embryos for research orto destroy them, their use in genetic and other healthtesting is surely also permissible. The same wouldsurely go for their use in creating cell lines for thera-peutic purposes.

It is better to do goodA moral principle, that has at least as much intuitiveforce as that recommended by Kant, is that it isbetter to do some good than to do no good. It

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356 "Goodbye Dolly?" The ethics of human cloning

cannot, from the ethical point of view, be better ormore moral to waste human material that could beused for therapeutic purposes, than to use it to dogood. And I cannot but think that if it is right to useembryos for research or therapy then it is also rightto produce them for such purposes."5 Kant's prohibi-tion does after all refer principally to use. Of coursesome will think that the embryo is a full member ofthe moral community with all the rights and protec-tions possessed by Kant himself. While this is atenable position, it is not one held by any societywhich permits abortion, post-coital contraception,or research with human embryos.The UNESCO approach to cloning is scarcely

more coherent than that ofWHO; how does cloningaffect "the preservation of the human genome ascommon heritage of humanity"? Does this meanthat the human genome must be "preserved intact",that is without variation, or does it mean simply thatit must not be "reproduced a-sexually"? Cloningcannot be said to impact on the variability of thehuman genome, it merely repeats one infinitely smallpart of it, a part that is repeated at a natural rate ofabout 3-5 per thousand births.'6

Genetic variabilitySo many of the fears expressed about cloning, andindeed about genetic engineering more generally,invoke the idea of the effect on the gene pool or upongenetic variability or assert the sanctity of the humangenome as a common resource or heritage. It is verydifficult to understand what is allegedly at stakehere. The issue of genetic variation need not detainus long. The numbers of twins produced by cloningwill always be so small compared to the human genepool in totality, that the effect on the variation of thehuman gene pool will be vanishingly small. We cansay with confidence that the human genome and thehuman population were not threatened at the start ofthe present millennium in the year AD one, and yetthe world population was then perhaps one per centofwhat it is today. Natural species are usually said tobe endangered when the population falls to aboutone thousand breeding individuals; by these stan-dards fears for humankind and its genome may besaid to have been somewhat exaggerated.'7The resolution of the European parliament goes

into slightly more detail; having repeated the, nowmandatory, waft in the direction of fundamentalhuman rights and human dignity, it actuallyproduces an argument. It suggests that cloningviolates the principal of equality, "as it permits aeugenic and racist selection of the human race".Well, so does prenatal, and pre-implantation screen-ing, not to mention egg donation, sperm donation,surrogacy, abortion and human preference in choiceof sexual partner. The fact that a technique could beabused does not constitute an argument against thetechnique, unless there is no prospect of preventing

the abuse or wrongful use. To ban cloning on thegrounds that it might be used for racist purposes istantamount to saying that sexual intercourse shouldbe prohibited because it permits the possibility ofrape.

Genetic identityThe second principle appealed to by the Europeanparliament states, that "each individual has a right tohis or her own genetic identity". Leaving aside theinevitable contribution of mitochondrial DNA,'8 wehave seen that, as in the case of natural identicaltwins, genetic identity is not an essential componentof personal identity'9 nor is it necessary for "individ-uality". Moreover, unless genetic identity is requiredeither for personal identity, or for individuality, it isnot clear why there should be a right to such a thing.But if there is, what are we to do about the rights ofidentical twins?

Suppose there came into being a life-threatening(or even disabling) condition that affected pregnantwomen and that there was an effective treatment, theonly side effect of which was that it caused theembryo to divide, resulting in twins. Would the exis-tence of the supposed right conjured up by theEuropean parliament mean that the therapy shouldbe outlawed? Suppose that an effective vaccine forHIV was developed which had the effect of doublingthe natural twinning rate; would this be a violation offundamental human rights? Are we to foreclose thepossible benefits to be derived from human cloningon so flimsy a basis? We should recall that thenatural occurrence of monozygotic (identical) twinsis one in 270 pregnancies. This means that in theUnited Kingdom, with a population of about 58million, over 200 thousand such pregnancies haveoccurred. How are we to regard human rights viola-tions on such a grand scale?

A right to parentsThe apparently overwhelming imperative to identifysome right that is violated by human cloning some-times expresses itself in the assertion of "a right tohave two parents" or as "the right to be the productof the mixture of the genes of two individuals".These are on the face of it highly artificial and prob-lematic rights - where have they sprung from, savefrom a desperate attempt to conjure some rights thathave been violated by cloning? However, let's takethem seriously for a moment and grant that theyhave some force. Are they necessarily violated by thenuclear transfer technique?

If the right to have two parents is understood to bethe right to have two social parents, then it is ofcourse only violated by cloning if the family identi-fied as the one to rear the resulting child is a one-parent family. This is not of course necessarily anymore likely a result of cloning, than of the use of any

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John Harris 357

of the other new reproductive technologies (orindeed of sexual reproduction). Moreover if there issuch a right, it is widely violated, creating countless"victims", and there is no significant evidence of anyenduring harm from the violation of this supposedright. Indeed war widows throughout the worldwould find its assertion highly offensive.

If, on the other hand we interpret a right to twoparents as the right to be the product of the mixtureof the genes of two individuals, then the suppositionthat this right is violated when the nucleus of the cellof one individual is inserted into the de-nucleatedegg of another, is false in the way this claim is usuallyunderstood. There is at least one sense in which aright expressed in this form might be violated bycloning, but not in any way which has force as anobjection. Firstly it is false to think that the clone isthe genetic child of the nucleus donor. It is not. Theclone is the twin brother or sister of the nucleusdonor and the genetic offspring of the nucleusdonor's own parents. Thus this type of cloned indi-vidual is, and always must be, the genetic child oftwo separate genotypes, of two genetically differentindividuals, however often it is cloned or re-cloned.

Two parents good, three parents betterHowever, the supposed right to be the product oftwo separate individuals is perhaps violated bycloning in a novel way. The de-nucleated eggcontains mitochondrial DNA - genes from thefemale whose egg it is. The inevitable presence of themitochondrial genome of the egg donor, means thatthe genetic inheritance of clones is in fact richer thanthat of other individuals, richer in the sense of beingmore variously derived.20 This can be important ifthe nucleus donor is subject to mitochondrialdiseases inherited from his or her mother and wantsa child genetically related to her that will be free ofthese diseases. How this affects alleged rights to par-ticular combinations of "parents" is more difficult toimagine, and perhaps underlines the confusednature of such claims.

What good is cloning?One major reason for developing cloning in animalsis said to be4 to permit the study of genetic diseasesand indeed genetic development more generally.Whether or not there would be major advantages inhuman cloning by nuclear substitution is not yetclear. Certainly it would enable some infertile peopleto have children genetically related to them, it offersthe prospect, as we have noted, of preventing somediseases caused by mitochondrial DNA, and couldhelp "carriers" of X-linked and autosomal recessivedisorders to have their own genetic children withoutrisk of passing on the disease. It is also possiblethat cloning could be used for the creation of"spare parts" by for example, growing stem cells for

particular cell types from non-diseased parts of anadult.Any attempt to use this technique in the United

Kingdom, is widely thought to be illegal. Whether itwould in fact be illegal might turn on whether it isplausible to regard such cloning as the product of"fertilisation". Apparently only fertilised embryosare covered by the Human Fertilisation andEmbryology Act 1990.21 The technique used inEdinburgh which involves deleting the nucleus of anunfertilised egg and then substituting a cell nucleusfrom an existing individual, by-passes what isnormally considered to be fertilisation completelyand may therefore turn out not to be covered byexisting legislation. On the other hand, if as seemslogical, we consider "fertilisation" as the momentwhen all forty-six chromosomes are present and thezygote is formed the problem does not arise.The unease caused by Dolly's birth may be due to

the fact that it was just such a technique thatinformed the plot of the film "The Boys from Brazil"in which Hitler's genotype was cloned to produce afuehrer for the future. The prospect of limitlessnumbers of clones of Hitler is rightly disturbing.However, the numbers of clones that could beproduced of any one genotype will, for the foresee-able future, be limited not by the number of copiesthat could be made of one genotype (using serialnuclear transfer techniques 470 copies of a singlenuclear gene in cattle have been reported),22 but bythe availability of host human mothers.23 Mass pro-duction in any democracy could therefore scarcelybe envisaged. Moreover, the futility of any suchattempt is obvious. Hitler's genotype might conceiv-ably produce a "gonadically challenged" individualof limited stature, but reliability in producing an eviland vicious megalomaniac is far more problematic,for reasons already noted in our consideration ofcloning by cell mass division.

Dolly collapses the divide between germand somatic cellsThere are some interesting implications of cloningby nuclear substitution (which have been clear sincefrogs were cloned by this method in the 1950s)which have not apparently been noticed.24 There iscurrently a world-wide moratorium on manipulationof the human germ line, while therapeutic somaticline interventions are, in principal, permitted. 13However, inserting the mature nucleus of an adultcell into a de-nucleated egg turns the cells thusformed into germ line cells. This has three importanteffects. First, it effectively eradicates the firm dividebetween germ line and somatic line nuclei becauseeach adult cell nucleus is in principle "translatable"into a germ line cell nucleus by transferring itsnucleus and creating a clone. Secondly, it permitssomatic line modifications to human cells to becomegerm line modifications. Suppose you permanently

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358 "Goodbye Dolly?" The ethics ofhuman cloning

insert a normal copy of the adenosine deaminasegene into the bone marrow cells of an individual suf-fering from severe combined immuno-deficiency(which affects the so called "bubble boy" who has tolive in a protective bubble of clean air) with obviousbeneficial therapeutic effects. This is a somatic linemodification. If you then cloned a permanentlygenetically modified bone marrow cell from thisindividual, the modified genome would be passed tothe clone and become part of his or her genome,transmissible to her offspring indefinitely throughthe germ line. Thus a benefit that would haveperished with the original recipient and not beenpassed on for the protection of her children, can beconferred on subsequent generations by cloning.25The third effect is that it shows the oft assertedmoral divide between germ line and somatic linetherapy to be even more ludicrous than was pre-viously supposed.'5

Immortality?Of course some vainglorious individuals might wishto have offspring not simply with their genes butwith a matching genotype. However, there is no waythat they could make such an individual a duplicateof themselves. So many years later the environ-mental influences would be radically different, andsince every choice, however insignificant, causes alife-path to branch with unpredictable conse-quences, the holy grail of duplication would bedoomed to remain a fruitless quest. We canconclude that people who would clone themselveswould probably be foolish and ill-advised, but wouldthey be immoral and would their attempts harmsociety or their children significantly?

Whether we should legislate to prevent peoplereproducing, not 23 but all 46 chromosomes, seemsmore problematic for reasons we have alreadyexamined, but we might have reason to be uncom-fortable about the likely standards and effects ofchild-rearing by those who would clone themselves.Their attempts to mould their child in their ownimage would be likely to be more pronounced thanthe average. Whether they would likely be worsethan so many people's attempts to duplicate race,religion and culture, which are widely accepted asrespectable in the contemporary world, might welldepend on the character and constitution of thegenotype donor. Where identical twins occurnaturally we might think of it as "horizontaltwinning", where twins are created by nuclear sub-stitution we have a sort of "vertical twinning".Although horizontal twins would be closer to oneanother in every way, we do not seem much dis-turbed by their natural occurrence. Why we shouldbe disturbed either by artificial horizontal twinningor by vertical twinning (where differences betweenthe twins would be greater) is entirely unclear.

Suppose a woman's only chance of having "her

own" genetic child was by cloning herself; what arethe strong arguments that should compel her toaccept that it would be wrong to use nuclear substi-tution? We must assume that this cloning techniqueis safe, and that initial fears that individualsproduced using nuclear substitution might age morerapidly have proved groundless.26 We usually grantthe so called "genetic imperative" as an importantpart of the right to found a family, of procreativeautonomy.27 The desire of people to have "theirown" genetic children is widely accepted, and if wegrant the legitimacy of genetic aspirations in so manycases, and the use of so many technologies to meetthese aspirations,28 we need appropriately seriousand weighty reasons to deny them here.

It is perhaps salutary to remember that there is nonecessary connection between phenomena, attitudesor actions that make us uneasy, or even those thatdisgust us, and those phenomena, attitudes, andactions that there are good reasons for judgingunethical. Nor does it follow that those things we areconfident are unethical must be prohibited by legis-lation or regulation.We have looked at some of the objections to

human cloning and found them less than plausible,we should now turn to one powerful argument thathas recently been advanced in favour of a tolerantattitude to varieties of human reproduction.

Procreative autonomyWe have examined the arguments for and againstpermitting the cloning of human individuals. At theheart of these questions is the issue of whether or notpeople have rights to control their reproductivedestiny and, so far as they can do so without violat-ing the rights of others or threatening society, tochoose their own procreative path. We have seenthat it has been claimed that cloning violates princi-ples of human dignity. We will conclude by brieflyexamining an approach which suggests rather thatfailing to permit cloning might violate principles ofdignity.The American philosopher and legal theorist,

Ronald Dworkin has outlined the arguments for aright to what he calls "procreative autonomy" andhas defined this right as "a right to control their ownrole in procreation unless the state has a compellingreason for denying them that control".29 Arguably,freedom to clone one's own genes might also bedefended as a dimension of procreative autonomybecause so many people and agencies have beenattracted by the idea of the special nature of genesand have linked the procreative imperative to thegenetic imperative.

"The right of procreative autonomy follows from anycompetent interpretation of the due process clauseand of the Supreme Court's past decisions applyingit.... The First Amendment prohibits government

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Jfohn Harris 359

from establishing any religion, and it guarantees allcitizens free exercise of their own religion. TheFourteenth Amendment, which incorporates theFirst Amendment, imposes the same prohibitionand same responsibility on states. These provisionsalso guarantee the right of procreative autonomy."30

The point is that the sorts of freedoms whichfreedom of religion guarantees, freedom to chooseone's own way of life and live according to one'smost deeply held beliefs are also at the heart of pro-creative choices. And Dworkin concludes:

"that no one may be prevented from influencing theshared moral environment, through his own privatechoices, tastes, opinions, and example, just becausethese tastes or opinions disgust those who have thepower to shut him up or lock him up."31

Thus it may be that we should be prepared to acceptboth some degree of offence and some social disad-vantages as a price we should be willing to pay inorder to protect freedom of choice in matters ofprocreation and perhaps this applies to cloning asmuch as to more straightforward or usual pro-creative preferences.32The nub of the argument is complex and abstract

but it is worth stating at some length. I cannotimprove upon Dworkin's formulation of it.

"The right of procreative autonomy has an import-ant place . . . in Western political culture more gen-erally. The most important feature of that culture isa belief in individual human dignity: that peoplehave the moral right - and the moral responsibility -to confront the most fundamental questions aboutthe meaning and value of their own lives for them-selves, answering to their own consciences and con-victions.... The principle of procreative autonomy,in a broad sense, is embedded in any genuinelydemocratic culture. `33

In so far as decisions to reproduce in particular waysor even using particular technologies constitute deci-sions concerning central issues of value, thenarguably the freedom to make them is guaranteed bythe constitution (written or not) of any democraticsociety, unless the state has a compelling reason fordenying its citizens that control. To establish such acompelling reason the state (or indeed a federationor union of states, such as the European Union forexample) would have to show that more was at stakethan the fact that a majority found the ideas disturb-ing or even disgusting.As yet, in the case of human cloning, such

compelling reasons have not been produced.Suggestions have been made, but have not been sus-tained, that human dignity may be compromised bythe techniques of cloning. Dworkin's argumentssuggest that human dignity and indeed democratic

constitutions may be compromised by attempts tolimit procreative autonomy, at least where greatervalues cannot be shown to be thereby threatened.

In the absence of compelling arguments againsthuman cloning, we can bid Dolly a cautious "hello".We surely have sufficient reasons to permit experi-ments on human embryos to proceed, provided, aswith any such experiments, the embryos aredestroyed at an early stage.34 While we wait to seewhether the technique will ever be established assafe, we should consider the best ways to regulate itsuptake until we are in a position to know what willemerge both by way of benefits and in terms ofburdens.

AcknowledgementsThis paper was presented to the UNDP/WHO/WorldBank Special Programme ofResearch, Development andResearch Training in Human Reproduction Scientificand Ethical Review Group Meeting, Geneva 25thApril 1997 and to a hearing on cloning held by theEuropean parliament in Brussels, 7th May 1997. I amgrateful to participants at these events for manystimulating insights. I must also thank JustineBurley, Christopher Graham and Pedro Lowensteinfor many constructive comments.

Jfohn Harris is Sir David Alliance Professor ofBioethics and Research Director of The Centre ForSocial Ethics and Policy, University ofManchester anda Director of The Institute of Medicine, Law andBioethics.

References and notes1 The arguments concerning human dignity are devel-oped in my Cloning and human dignity in TheCambridge Quarterly of Healthcare Ethics [in press].Theissues raised by cloning were discussed in a special issueof the Kennedy Institute of Ethics J7ournal 1994; 4,3 andin my Wonderwoman and Superman: the ethics of humanbiotechnology. Oxford University Press, Oxford 1992,especially ch 1.

2 Human embryo cloning reported. Science 1993; 262:652-3.

3 Where few eggs can be successfully recovered or whereonly one embryo has been successfully fertilised, thismethod can multiply the embryos available for implan-tation to increase the chances of successful infertilitytreatment.

4 Wilmut I et al. Viable offspring derived from fetal andadult mammalian cells. Nature 1997; 385: 810-13.

5 ArlidgeJ. The Guardian 1997 Feb 26: 6.6 Radford T. The Guardian 1997 Feb 28: 1.7 WHO press release (WHO/20 1997 Mar 11).8 WHO document (WHA50.37 1997 May 14). Despite

the findings of a meeting of the Scientific and EthicalReview Group (see Acknowledgements) whichrecommended that "the next step should be a thoroughexploration and fuller discussion of the [issues]".

9 UNESCO press release No 97-29 1997 Feb 28.

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360 "Goodbye Dolly?" The ethics ofhuman cloning

10 The European parliament. Resolution on cloning.Motion dated March 11 1997. Passed March 13 1997.

11 Perhaps the sin of Onan was to compromise thesecurity of his genetic material?

12 Kahn A. Clone mammals ... clone man. Nature 1997;386: 119.

13 For use of the term and the idea of "instrumentaliza-tion" see: Opinion of the group of advisers on theethical implications of biotechnology to the EuropeanCommission No 9. 1997 28 May. Rapporteur, Dr AnneMcClaren.

14 Kahn A. Cloning, dignity and ethical revisionism.Nature 1997; 388: 320. Harris J. Is cloning an attack onhuman dignity? Nature 1997; 387: 754.

15 See my Wonderwoman and Superman: the ethics ofhuman biotechnology. Oxford University press, Oxford1992: ch 2.

16 It is unlikely that "artificial" cloning would everapproach such a rate on a global scale and we could, ofcourse, use regulative mechanisms to prevent thiswithout banning the process entirely. I take this figureof the rate of natural twinning from Moore KL andPersaud TVN. The developing human [5th ed].Philadelphia: WB Saunders, 1993. The rate men-tioned is 1 per 270 pregnancies.

17 Of course if all people were compulsorily sterilised andreproduced only by cloning, genetic variation wouldbecome fixed at current levels. This would halt the evo-lutionary process. How bad or good this would be couldonly be known if the course of future evolution and itseffects could be accurately predicted.

18 Mitochondrial DNA individualises the genotype evenof clones to some extent.

19 Although of course there would be implications forcriminal justice since clones could not be differentiatedby so called "genetic fingerprinting" techniques.

20 Unless of course the nucleus donor is also the eggdonor.

21 Margaret Brazier alerted me to this possibility.22 Apparently Alan Trounson's group in Melbourne

Australia have recorded this result. The Herald Sun1997 Mar 13.

23 What mad dictators might achieve is another matter;but such individuals are, almost by definition, imper-vious to moral argument and can therefore, for presentpurposes, be ignored.

24 Except by Pedro Lowenstein, who pointed them out tome.

25 These possibilities were pointed out to me by PedroLowenstein who is currently working on the implica-tions for human gene therapy.

26 Science and technology: The Economist 1997 Mar 1:101-4.

27 Universal Declaration of Human Rights (article 16).European Convention on Human Rights (article 12).These are vague protections and do not mention anyparticular ways of founding families.

28 These include the use of reproductive technologiessuch as surrogacy and Intra Cytoplasmic SpermInjection (ICSI).

29 Dworkin R. Life's dominion. London: Harper Collins,1993: 148.

30 See reference 28: 160.31 Dworkin R. Freedom's law. Oxford: Oxford University

Press,1996: 237-8.32 Ronald Dworkin has produced an elegant account of the

way the price we should be willing to pay for freedommight or might not be traded off against the costs. See hisTaking rights seriously, London: Duckworth, 1977: ch 10.And his A matter ofprinciple, Cambridge, Mass: HarvardUniversity Press, 1985: ch 17.

33 See reference 27: 166-7.34 The blanket objection to experimentation on humans

suggested by the European parliament resolutionwould dramatically change current practice on the useof spare or experimental human embryos.

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