5.1.1 The implications of the embryo's status as a human moral subject do not stop with the duties of those individuals who are personally involved in the creation of an embryo. There is a wider question of how society should respond to issues surrounding research on human embryos. It is instructive to consider how society responds to the moral rights of children and the mentally impaired. The most basic of these rights, such as the right to life (that is, the right not to be deliberately attacked or lethally neglected) are seen as enforceable by law, while other rights are, at least, promoted as a matter of public policy.
5.1.2 Moral principles regulating medical or other research on human subjects were laid down at Helsinki in 1964 and subsequently revised at Tokyo (1975), Venice (1983), Hong Kong (1989), Somerset West, SA (1996) and Edinburgh (2000). Three paragraphs are pertinent to the use of human embryos for research: 3, 5 and 8.
5.1.3 The Declaration of Geneva of the World Medical Association binds the physician with the words, "The health of my patient will be my first consideration," and the International Code of Medical Ethics declares that, "A physician shall act only in the patient's interest when providing medical care which might have the effect of weakening the physical and mental condition of the patient." (para. 3)
5.1.4 In medical research on human subjects, considerations related to the well-being of the human subject should take precedence over the interests of science and society. (para.5)
5.1.5 Medical research is subject to ethical standards that promote respect for all human beings and protect their health and rights. Some research populations are vulnerable and need special protection. The particular needs of the economically and medically disadvantaged must be recognized. Special attention is also required for those who cannot give or refuse consent for themselves, for those who may be subject to giving consent under duress, for those who will not benefit personally from the research and for those for whom the research is combined with care. (para. 8)
5.1.6 Several points may be noticed. First, in the 1964 declaration (and until 1989) these paragraphs, or their analogues, occurred in a section entitled “Non-Therapeutic Biomedical Research Involving Human Subjects'. As mentioned above (1.3.3) research for medical reasons but not for the benefit of the subject of the experiment is properly described as non-therapeutic. Research on a human subject without the subject's consent, where the research would cause serious harm to the subject, where the benefits to science and society take precedence over the life and well being of the subject, are forbidden on every count. If research on human embryos is correctly described as “research on human subjects”, then it stands in square contradiction to the principles laid down with so much care at Helsinki and elsewhere.
5.1.7 The right of vulnerable individuals not to be attacked always outweighs the long-term benefit to others of medical research. However, what are we to do in cases of doubt, where it is not clear whether the research is harmful, or where it is not even clear that there is a human being who will be harmed? Take the case in which it is not clear whether a patient is dead and where a research team wishes to use his organs. If the patient is dead then removing his organs will not harm him as there is no human individual present. However, if the patient is alive then removing his organs will kill him. In such cases the death of the patient must be established beyond reasonable doubt before it is legitimate to act.
5.1.8 In the case of human embryos, there is no social consensus as to their human or moral status. Many people, not all of whom have interests in the research community, do not believe that the early embryo is a human individual with an interest in being born, and in not being harmed. The matter is fiercely debated in respectable academic journals of philosophy, theology and social policy. The argument presented in this paper is a contribution to that debate, giving public reasons why the human embryo should be acknowledged as a human moral subject. However, even if there are other reasonable people who disagree on this matter, this does not nullify the existence of a large body of respectable and well-reasoned opinion holding that the human individual begins at the single cell stage. This body of academic opinion37 constitutes at the very least, a reasonable doubt within the community as a whole concerning the status of the embryo. If the case is unproven then the only ethical course is not to risk killing the innocent, even for the sake of benefit to others.
5.1.9 There is no reason why society should tolerate destructive research on human embryos, any more than similar research on older children. It is important not to set a precedent of lethal research on human subjects, however worthy the motive. Even if society as a whole is not sure if the embryo is a human individual, as a society we should at least admit that this is a strong possibility, and so exclude research on what may well be human beings.
5.2.1 If there is a serious moral doubt, which continues to exist within the national and international community, then morally questionable research should not be permitted. However, Parliament and popular opinion has clearly been influenced by the argument that this research is morally necessary because it offers the only hope of finding a cure to serious diseases such as Parkinson's, Alzheimer's and multiple sclerosis. Yet the haste with which this decision was made gave little time to weigh the scientific evidence in what has been an unusually fast moving field. Far from supporting the necessity of embryonic stem cell research, the evidence from current research suggests that there are great difficulties with embryonic stem cell therapy, comparable in magnitude, if not greater, than those associated with adult stem cell therapy.
5.2.2 It is not the case that embryonic stem cell research offers a real chance in the near future of revolutionary therapy for the diseases mentioned. Nor is it the case that there are no alternative and promising avenues of research. The pluripotency of early embryonic cells, which is the reason they are thought attractive, is at the same time the greatest obstacle to their use. The flexibility of these cells makes them unpredictable in the kinds of cells they produce, in a way which could endanger the patient if they were ever used in transplants.
5.2.3 Clinical promise in this area is currently being shown by adult stem cell research. Use of adult stem cells poses no ethical problem in principle and, if the patient's own cells are used, avoids the problem of rejection. Such treatment, which is already underway, is morally acceptable to the vast majority of patients. To the extent that it is thought necessary, embryonic stem cell research can be carried on in morally acceptable ways, on cells taken from animal embryos or, with the permission of the parents, from foetuses who have spontaneously miscarried.38
5.2.4 Researchers have a vested interest in stressing the prospects of their own research, but in the case of embryonic stem cell research there is reason to doubt these prospects and the necessity of adopting this particular approach. All things being equal, no scientist wishes to be restricted in which methods may be employed, but social responsibility sometimes makes legal limits right and important. We would suggest that the public has been much misled as to the prospects of embryonic stem cell research in relation to the (scarcely mentioned) prospects of adult stem cell research.
5.2.5 As there are ethical alternatives which offer similar or better immediate and/or long term prospects, the government should give serious reconsideration to the moral doubts which have been expressed and the public unease surrounding the use of embryos for research, and especially the licensing of human cloning for research purposes. Stem cell research on clone and other embryos has been made legal without necessity at the very time when adult stem cell research is making most progress.39
5.3.1 The statutory instrument which permitted cloning for research purposes was greeted with dismay by the rest of Europe. The prohibition of cloning recommended by the European Parliament covers cloning for research as well as cloning for birth. Indeed, if cloning for research is permitted it seems difficult to imagine how cloning for birth could be resisted.
5.3.2 It was only one week after the passing of the statutory instrument by the House of Lords that Severino Antinori hosted a conference in Rome to announce his intention to bring a clone baby to term. As so often, it seems that the technical challenge represented by an unprecedented step (in this case, cloning a human being) is incentive enough to impel any scientific project. The legitimacy of this form of research is a matter of global and not merely national concern, for research forbidden in one country will move to another. It is imperative that the Select Committee inform itself on the grave misgivings expressed in other scientifically developed nations in Europe, America and Australasia, so as to reach a common mind on what are matters of global ethical importance.
5.3.3 Not only would the acceptance of cloning for research make cloning for birth inevitable, in the judgment of many, but it would also make inevitable a further extension of research on human embryos beyond 14 days. There are places where logically and politically a line can be drawn, and cloning is one of few such lines. A ban on cloning is supported by a great mass of people internationally and could provide a bulwark against further erosion of ethical standards within medical research. If society is not able to resist the attraction of this research, when the benefits are uncertain and international opinion is against it, it is hard to imagine what, in the future, it would be able to resist.
5.3.4 If stem-cell research on human embryos and cloning for research go ahead, this will seriously compromise many physicians and patients if and when treatments based on this research become available. In contrast, if research funds are diverted to develop treatments that all can accept, patients and doctors will not be placed in this invidious situation.
5.4.1 It is not too late to reconsider this matter. Although the findings of the Select Committee have no weight in law, and the statutory instrument has already been passed, if the Committee were to argue strongly against permitting cloning for research, in particular, it would be difficult for the government to ignore its findings. The legislation might yet prove a dead letter, with the HFEA unwilling to give licenses, or further legislation might be introduced to prevent all human cloning. A moratorium on using clone or IVF embryos in stem cell research would help adult stem cell research attract more of the available research funds so as further to prove its case as scientifically as well as ethically superior. Research on clone or other embryos contravenes basic principles of justice and seriously threatens international ethical standards in research. This is an opportunity to prevent a step being taken that need not and should not be taken. It is a question of having the prudence to know when a line must be drawn, and the courage to draw it.
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