By Elliot Cannell, Comment on Reproductive Ethics (CORE)
The Human Fertilisation and Embryology Authority (HFEA) has today issued a cloning licence to the University of Newcastle. Elliot Cannell, himself a diabetic, produced the following commentary on the licence application for the bioethics organisation Comment on Reproductive Ethics (CORE). An in-depth briefing on diabetes research is available on the CORE website (www.corethics.org).
Last month, Dr Alison Murdoch, of the Newcastle Centre for Life, submitted the first application to conduct human cloning in the UK. In her summary Dr Murdoch describes a link between human cloning and curing diabetes. Cells taken from embryos, she claims, ‘offer a great potential for therapies for diseases such as diabetes’. But in order to fulfil this goal, she continues, ‘we need to derive stem cell lines which are genetically similar to the recipient’. This would require human cloning.
Dr Murdoch’s suggestion, that diabetics may be among the principle beneficiaries of human cloning, is highly controversial. Not only does it raise a series of profound ethical dilemmas, but the science behind her claim is highly questionable. There is certainly no consensus among those researching diabetes that sufferers stand to gain if human cloning proceeds. To add to these concerns, the UK’s 2.5 million diabetics lack any representation in the debate. Given that they now find themselves at the centre of a highly specialised dispute, diabetics are in more need of guidance then ever before.
The decision whether or not to issue a licence for human cloning rests with the Human Fertilisation and Embryology Authority (HFEA). The primary role of the HFEA is the regulation of fertility treatments. It also adjudicates on issues relating to research on human embryos, passes judgement on matters relating to ‘saviour’ siblings, acts as the country’s inspectorate of IVF clinics, and maintains a register of all children born of such technology.
But what exactly does the HFEA know about diabetes? Its 18 member panel of fertility experts, embryologists, gynaecologists, journalists and lawyers have no expertise in the condition. Nor do its advisors. Their duties concern the embryo: not the diabetic. Without this specific expertise, it is impossible to see how the HFEA could judge whether human cloning is in the interest of diabetics, and importantly whether such a licence would conform with current legislation.
Has any properly qualified voice given an opinion on this matter? Diabetes UK is the country’s largest diabetic interest group. You might think they would provide diabetics with a voice in the debate on human cloning. Sadly not. They don’t even issue minimal guidance. In a statement outlining their position, Diabetes UK explains they ‘cannot comment on this specific project (Murdoch’s application) until the Human Fertilisation and Embryology Authority (HFEA) makes its ruling.’ However, they add, ‘We await the outcome with interest’. So not only do Diabetes UK make no attempt to represent their members, they don’t even express an opinion on the matter. Rather, they wait passively for the application to be processed without their direct involvement.
And what about the NHS? Surely they might have something to say about diabetes. Not only do the medical profession possess great expertise, they would be the first port of call for diabetics seeking qualified advice. Alas, no. Neither the NHS, nor the Department of Health have issued any statement offering a view on whether diabetics would benefit from human cloning. To add to this list, the British Medical Association also remain mute. The very groups who could offer diabetics good advice are silent. Instead of providing intelligent comment, these professional organisations have chosen to sit this one out and leave it to the unqualified HFEA to pass judgment. The experts wait on the ignorant!
So what should diabetics believe? Alison Murdoch’s proposal relies upon the premise that cells harvested from embryos could one day be induced to develop into cells that release insulin. These insulin releasing cells could then be implanted into diabetics, restoring their health. But why then does anyone want to produce clones?
The answer lies in the science of immunology. Patients who receive transplanted tissue need to undergo general immunosuppression. This involves a continuous regimen of drugs which, while they protect the implanted material, are damaging to the patient’s health. Dr Murdoch’s solution would be to clone each patient. By cloning each diabetic, she claims, it would be possible to manufacture embryos which are genetically identical to the patient. The proposal is that these embryos would provide cells which, when induced to secrete insulin, could be implanted into diabetics without the need for immunosuppressive medication.
To many diabetics, eager to be cured of their condition, this proposal may seem logical enough. Indeed, perhaps at first glance it sounds almost plausible. But experts disagree. Upon closer scrutiny it becomes clear that Dr Murdoch’s plan is undermined by two serious problems. Firstly, much of the technology required to achieve the plan is either at the initial stages of development or non-existent. No one has ever successfully managed to induce embryonic cells to develop into cells that reliably produce insulin. Nor have scientists perfected the technique of animal cloning. Worse still, no one has ever safely implanted embryonic cells into animals without the risk of tumour formation.
Perhaps these techniques will improve over time? Well, perhaps they will. But until such time as it has been demonstrated that embryonic stem cells can be induced to produce insulin, it is not necessary to clone human embryos. If Dr Murdoch values cloning so highly, should she not seek to perfect her art on animal models? Since when were humans used before guinea pigs? Surely if cloning isn’t good enough for a lab rat, it’s not good enough for a diabetic!
Aside from these technological hurdles, which may or may not be overcome, Dr Murdoch’s proposal is undermined by a set of pragmatic issues. Firstly, we live in a world with 175 million diabetics, 2.5 million of whom reside in the UK. We also live in a world which has a drastic shortage of donor eggs. And you can’t make clones without eggs. Even if the technology progressed so far that scientists only needed one egg per diabetic, there would still be no chance of providing an effective mass treatment. As an embryologist, Dr Murdoch should be well aware of this pitfall.
In addition to the egg shortage, there remains one final flaw in the Murdoch plan: cloning itself. Cloning, carried out successfully, would produce embryos genetically identical to the patient. So by cloning diabetics, as Dr Murdoch proposes, she would transfer an exact copy of the gene which causes diabetes, over to the clone. Just like the patient, the cloned embryo would also be diabetic. It is impossible to see how one could then be used to cure the other. As clones, they both carry exactly the same genetic flaw. Any insulin producing cells derived from the embryo would be as useless as their counterparts already within the patient. The result? Diabetes.
The scientific flaws in Dr Murdoch’s proposal are so substantial it is hard to imagine a world in which she could be allowed to initiate human cloning in the name of curing diabetes. But there is huge cause for worry. We have a regulatory body who have no expertise in diabetes, experts who are unwilling to speak, diabetics interest groups who appear disinterested and 2.5 million sufferers in need of a cure. Unless the sufferers of diabetes bring on the genuine experts and reclaim this debate, the lunatics will take over the asylum.
