Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-26T21:50:32.569Z Has data issue: false hasContentIssue false
  • English
  • Français

Ethical and Policy Issues in Human Embryo Twinning

Published online by Cambridge University Press:  29 July 2009

Andrea L. Bonnicksen
Andrea L. Bonnicksen
Affiliation:
A professor of Political Science, Northern Illinois University, DeKalb, Illinois, where she teaches classes in biomedical and biotechnology policy.
Get access Rights & Permissions [Opens in a new window]

Extract

In 1993, investigators from George Washington University (GWU) Medical Center separated the cells of 17 human embryos and produced 48 embryos, an average of three embryos for each original. The method, variously called twinning, cloning, embryo splitting, and blastomere separation, demonstrated that human embryos could be split to create genetically identical entities during conception. When publicized, however, the experiment brought to mind a different view of cloning repeated since the beginning of the new reproductive technologies. In the early 1970s, when research on in vitro fertilization (IVF) was in its infancy, commentators worried that cloning–defined as the duplication of persons–would be next, leading to a scenario of “boys genetically exactly like the father, girls like the mother, or individuals like some true or false hero of art, science, or sports, or like some demagogue or some saint.”

Type
Special Section: Designs on Life: Choice, Control, and Responsibility in Genetic Manipulation
Information
Cambridge Quarterly of Healthcare Ethics , Volume 4 , Issue 3 , Summer 1995 , pp. 268 - 284
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Kolberg, R. Human embryo cloning reported. Science 1993;262:652–3, at p. 652.CrossRefGoogle ScholarPubMed

2. Editorial, Stern, C. quoted in Genetic engineering in man: ethical considerations. Journal of the American Medical Association 1972;220:721.Google Scholar

3. Ferguson, MWJ. Contemporary and future possibilities for human embryonic manipulation. In: Dyson, A, Harris, J, Eds. Experiments on Embryos. London: Routledge, 1990:6–26.Google Scholar

4. Elmer-Dewitt, P. Cloning: where do we draw the line? Time 1993;11 8:64–70, at p. 67. I owe the distinction relating to the varying degrees of moral concern over body cell replication, adult replication, and twinning to Carson Holloway.Google Scholar

5. Brumby, M, Kasimba, P. When is cloning lawful? Journal of In Vitro Fertilization and Embryo Transfer 1987;4:198–204, at p. 198.CrossRefGoogle ScholarPubMed

6. See note 5. Brumby, , Kasimba, . 1987;4:199, quoting from a medical dictionary.Google Scholar

7. See note 5. Brumby, , Kasimba, . 1987;4:199.Google Scholar Another level of cloning is the replication of genes, Or molecular cloning. Cohen, J, Tomkin, G. The science, fiction, and reality of embryo cloning. Kennedy Institute of Ethics Journal 1994;4:193–203, at p. 195.CrossRefGoogle ScholarPubMed

8. Watson, JD. Moving toward the clonal man—is this what we want? Congressional Record 1971 04 29:12751–2, at p. 12751.Google Scholar

9. Voelker, R. A clone by any other name is still an ethical concern. Journal of the American Medical Association 1994;271:331–2, at p. 332CrossRefGoogle ScholarPubMed; Warnock, M. A Question of Life: The Warnock Report on Human Fertilisation and Embryology. Oxford: Basil Blackwell, 1985Google Scholar; see note 2. Editorial. 1972;220:721Google Scholar; see note 8. Watson, . 1971;April 29:12751–2Google Scholar; see note 3. Ferguson, . 1990;6:23.Google Scholar

10. See note 3. Ferguson, . 1990;6:23.Google Scholar

11. See note 3. Ferguson, . 1990;6:22–4.Google Scholar

12. See note 9. Voelker, . 1994;271:332.Google Scholar

13. Kolata, G. Researcher clones embryos of human in fertility effort. New York Times 1993 10 24:1, 12.Google Scholar

14. Jones, HW Jr, Edwards, RG, Seidel, GE Jr. On attempts at cloning in the human. Fertility and Sterility 1994;61:423–6, at p. 424.CrossRefGoogle ScholarPubMed

15. See note 13. Kolata, . 1993;October 24:1, 12.Google Scholar

16. See note 9. Warnock, . 1985:72.Google Scholar

17. Polyspermy is a condition in which more than one spermatozoan enters the egg and the fertilized egg has three or more pronuclei. It has been observed in 2–12% of embryos observed in IVF. Polyspermic embryos are not normally transferred to the uterus because of “potentially patholog ical consequences.” Angell, RR, Templeton, AA, Messinis, IE. Consequences of polyspermy in man. Cytogenetics Cell Genetics 1986;42:1–7, at p. 2.CrossRefGoogle ScholarPubMed

18. Hall, JL, Engel, D, Gindoff PR, Mottle GL, Stillman RJ. Experimental cloning of human polyploid embryos using an artificial zone pellucida. Paper presented at the 1993 annual meeting of the American Fertility Society [Program supplement].Google Scholar

19. Robertson, JA. The question of human cloning. Hastings Center Report 1994;24:6–14, at p. 6.CrossRefGoogle ScholarPubMed

20. Embryos split at the two cell stage cleaved to 32 cells at most, embryos split at the four cell stage cleaved to 16 cells at most, and embryos split at the eight cell stage cleaved to eight cells at most. See note 1. Kolberg, . 1993;262:652.Google Scholar

21. See note 18. Hall, et al. 1993.Google Scholar

22. See note 18. Hall, et al. 1993.Google Scholar

23. See note 14. Jones, et al. 1994;61:423Google Scholar; see note 4. Elmer-Dewitt, . 1993;November 8:67–8.Google Scholar

24. See note 14. Jones, et al. 1994;61:423.Google Scholar

25. Quoted in Fackelmann, KA. Cloning human embryos. Science News 1994;145:92–5, at p. 92.CrossRefGoogle ScholarPubMed

26. See note 19. Robertson, . 1994;24:7.Google Scholar

27. See note 14. Jones, et al. 1994;61:423–6.Google Scholar See note 19. 1994;24:6–14. Robertson, uses the term “embryo splitting.” See note 7. 1994;4:196.Google Scholar Cohen and Tomkin note that blastomere separation occurs when a four or eight cell embryo is divided, and embryo splitting occurs when an embryo at the blastocyst stage is divided.

28. See note 1. Kolberg, . 1993;262:652.Google Scholar

29. See note 9. Voelker, . Stillman, RJ quoted in. 1994;271:331.Google Scholar

30. See note 18. Hall, et al. 1993.Google Scholar

31. See note 9. Voelker, . 1994;271:332.Google Scholar

32. See note 1. Kolberg, . 1993;262:653.Google Scholar

33. See note 14. Jones, et al. 1994;61:425.Google Scholar

34. See note 1. Kolberg, . 1993;262:652.Google Scholar

35. See note 9. Voelker, . 1994;271:332.Google Scholar See also National Institutes of Health. Final report of the human embryo research panel. 1994;September 27:70. The report concluded that blastomere separation for research purposes is “particularly sensitive” and warranted additional ethical review.Google Scholar

36. Norman Fost quoted in Kolata, C. Cloning human embryos: debate erupts over ethics. New York Times 1993;10 26:B7.Google Scholar

37. See note 19. Robertson, . 1994;24:12.Google Scholar

38. McCormick, RA. Blastomere separation: some concerns. Hastings Center Report 1994;24:14–16, at p. 15.CrossRefGoogle ScholarPubMed

39. See note 38. McCormick, . 1994;24:15.Google Scholar

40. See note 1. Kolberg, . Quoted in. 1993;262:653.Google Scholar

41. See note 14. Jones, et al. 1994;61:426. As they put it, “A genetic Hitler born at another time and raised in a different environment could be a different person from the original.”Google Scholar

42. Kass, LR. Toward a More Natural Science: Biology and Human Affairs. New York: Free Press, 1985:66–9Google Scholar; see also note 36. Kolata, . 1993;10 26:B7, referring to Arthur Caplan.Google Scholar

43. See note 38. McCormick, . 1994;24:16.Google Scholar

44. See note 38. McCormick, , 1994;24:15.Google Scholar

45. See note 1. Kolberg, . 1993;262:653Google Scholar; see note 36. Kolata, . 1993;October 26:B7. Both refer to Arthur Caplan.Google Scholar

46. Jacoby, S. Entitled to the embryo? New York Times 1993 11 1:A19.Google Scholar

47. See note 36. Kolata, . 1993;October 26:87Google Scholar; see note 19. Robertson, . 1994;24:11.Google Scholar

48. See note 46. Jacoby, . 1993;November 1:A19.Google Scholar

49. Ramsey, P. Shall we “reproduce?” 1. The medical ethics of in vitro fertilization. Journal of the American Medical Association 1972;220:1346–50, at p. 1349.CrossRefGoogle Scholar

50. See note 14. Jones, et al. 1994;61:425.Google Scholar

51. See note 19. Robertson, . 1994;24:7.Google Scholar See also National Institutes of Health. Final Report of the Human Embryo Research Panel. 1994;September 27:40. Still, if the twinned embryo is of high quality, transferring several opens the prospect for improved implantation rates.Google Scholar

52. See note 14. Jones, et al. 1994;61:425.Google Scholar

53. Callahan, D. What Kind of Life?: The Limits of Medical Progress. New York: Touchstone, 1990:160.Google Scholar

54. Jabbari, D. The role of law in reproductive medicine: a new approach. Journal of Medical Ethics 1990;16:35–40, at p. 37.CrossRefGoogle Scholar

55. For a summary of European laws on assisted conception, see Morgan, D, Nielsen, L. Prisoners of progress or hostages to fortune? Journal of Law, Medicine & Ethics 1993;21:30–42.CrossRefGoogle ScholarPubMed

56. Fletcher, JC. Germ-line gene therapy: the costs of premature ultimates. Politics and the Life Sciences 1994;13.Google ScholarPubMed

57. Royal Commission on New Reproductive Technologies. Update. 1993;December:5. See also Royal Commission on New Reproductive Technologies, Proceed With Care: Final Report of the Royal Commis sion on New Reproductive Technologies. Ottowa: Minister of Government Services Canada, 1993:636–7, 741, where cloning is defined as nuclear substitution.Google Scholar

58. See note 5. Brumby, , Kasimba, . 1987;4:198–204.Google Scholar

59. Law no. 68 of 12 June 1987 on artificial fertilization. International Digest of Health Legislation 1987; 38: 782–5.Google Scholar

60. Law no. 35/1988 of 22 November 1988 on assisted reproduction procedures. International Digest of Health Legislation 1989;90:82–93.Google Scholar

61. Human fertilisation and embryology act 1990. International Digest of Health Legislation 1991;42:69–85.Google Scholar

62. See note 9. Warnock, . 1985:73–4.Google Scholar

63. Ethics Advisory Board, Department of Health, Education, and Welfare. Appendix: HEW Support of Research Involving Human In Vitro Fertilization and Embryo Transfer. Washington DC: US Government Printing Office, 1979:173–5.Google Scholar

64. For public opinion polls regarding twinning, see By large margin, Americans oppose cloning of humans. New York Times 1993 11 1:A16Google Scholar; see note 4. Elmer-Dewitt, , 1993;November 8:64–70.Google Scholar

65. Davis v. Davis, 1992 Tenn. Lexis 400. Tenn. S. Ct. June 1, 1992; York v. Jones, 717 F. Supp. 421. E. D. Va 1989.

66. Kingdon, JW. Agendas, Alternatives, and Public Policies. Boston: Little, Brown and Company, 1984:99–100.Google Scholar

67. See, for example, Rifkin, J. Declaration of a Heretic. Boston: Routledge & Kegan Paul, 1985:53. “It is the first experiment that legitimizes the process.”Google Scholar

68. Wandersman, H, Hallman, WK. Are people acting irrationally? Understanding public concerns about environmental threats. American Psychologist 1993;48:68–86.CrossRefGoogle Scholar

69. See note 19. Robertson, . 1994;24:6–14.Google Scholar

70. See note 53. Callahan, . 1990:160.Google Scholar

71. See note 42. Kass, . 1985:118.Google Scholar

72. Juengst, ET. The NIH “Points to consider” and the limits of human gene therapy. Human Gene Therapy 1990;1:425–33, at p. 431.CrossRefGoogle ScholarPubMed

73. See note 38. McCormick, . 1994;24:16.Google Scholar

74. A detailed report on twinning from the National Advisory Board for Ethics in Reproduction (NABER) is published in an issue of the Kennedy Institute of Ethics Journal devoted to cloning. National Advisory Board on Ethics in Reproduction (NABER). Report on human cloning through embryo splitting: An amber light. Kennedy Institute of Ethics Journal 1994;4:251–82.CrossRefGoogle Scholar

75. Ethics Committee, American Fertility Society. Ethical considerations of the new reproductive technologies. Fertility and Sterility 1990;53(Suppl. 2):1S–109S, at p. 63S.Google Scholar

76. For a criticism of the use of professional ethics committees, see Annas, GJ. Regulatory models for human embryo cloning: the free market, professional guidelines, and government restrictions. Kennedy Institute of Ethics Journal 1994;4:235–49, at pp. 241–2.CrossRefGoogle ScholarPubMed

77. For example, delegates on the Council on Ethical and Judicial Affairs at the annual meeting of the American Medical Association supported “pre-embryo splitting.” American Medical News 1994;37:9.Google Scholar

78. See note 19. Robertson, . 1994;24:8.Google Scholar

79. See also Macklin, R. Splitting embryos on the slippery slope: ethics and public policy. Kennedy Institute of Ethics Journal 1994;4:209–25, at p. 224.CrossRefGoogle ScholarPubMed

80. See note 14. Jones, et al. 1994;61:426.Google Scholar

81. Trounson, AL. Preimplantation diagnosis—Counting chickens before they hatch? Human Reproduction 1992;7:583–4Google ScholarPubMed; See note 2. Editorial. 1972;220:721.Google Scholar

82. See, for example, Evans, MI, Fletcher, JC, Zador, IE et al. Selection first trimester termination in octuplet and quadruplet pregnancies: clinical and ethical issues. Obstetrics and Gynecology 1988;71:289–96.Google Scholar

83. For a discussion of the symbolic importance of human embryos, see Robertson, JA. Embryo research. University of Western Ontario Law Review 1986;24:15–37.Google ScholarPubMed

84. In late 1994, President Clinton directed the National Institutes of Health to not fund projects in which human embryos are created for research purposes. Marshall, E. Clinton rules out some studies. Science 1994;266:1634–5.CrossRefGoogle ScholarPubMed

85. See note 79. 1994;4:223. Macklin concludes that it “might be ethically prudent to limit the number of identical embryos that may be cloned from the original one.” See note 74. 1994;4:276. NABER recommends that only up to four embryos be produced from one embryo.

86. See note 74. 1994;4:276. NABER concluded it was not acceptable to freeze twinned embryos for the sole purpose of producing spaced twins. The group was divided on whether frozen twinned embryos should be transferred to the uterus if they were twinned to reduce the number of egg retrievals in in vitro fertilization and a birth had already occurred.

87. See, for example, Munson, R, Davis, LH. Germ-line gene therapy and the medical imperative. Kennedy Institute of Ethics Journal 1992;9:137–58.CrossRefGoogle Scholar

88. Callahan, D. The Troubled Dream of Life: Living With Mortality. New York: Simon & Schuster, 1993:63,67.Google Scholar

89. See note 88. Callahan, . 1993:61.Google Scholar

90. Boone, CK. Bad axioms in genetic engineering. Hastings Center Report 1988;18:9–13, at p. 10.CrossRefGoogle ScholarPubMed

91. See note 9. Voelker, . 1994;271:332.Google Scholar

92. Hanna, KE, Cook-Deegan, RM, Nishimi, RY. Bioethics and public policy: still seeking a forum. Politics and the Life Sciences 1994;13:102–5, at p. 102.CrossRefGoogle ScholarPubMed

93. See note 14. Jones, et al. 1994;61:423.Google Scholar

94. See note 35. 1994;September 27:70. The Human Embryo Research Panel of the National Insti tutes of Health recommended that no funding should be given to twinning studies in which embryos are transferred. This is an indirect limit that withholds legitimacy from twinning while not outlawing it.