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J R Soc Med. 2002 August; 95(8): 421–422.
PMCID: PMC1279973

The Future is Now

Reviewed by A W Bates

Editors: W Kristol, E Cohen
355 pp Price £14.95 ISBN 0-7425-2196 (p/b)
Oxford: Rowman and Littlefield, 2002 .

Is the desire to prevent or cure disease an ethical trump card that overcomes any moral objection to the methods used? Or are there ethical boundaries that ought never to be transgressed, even for the best of reasons? These are the questions underlying the debate on cloning and stem cell research, which burgeoned in 1997 after the cloning of Dolly the sheep. This anthology, a chronological series of essays by politicians, lawyers, academics and journalists, follows the debate over whether the United States Government should ban human cloning and the harvesting of stem cells from human embryos.

The sixty contributions—from Brave New World to the terrorist attacks of 11 September—have been sparingly edited. Consequently, one is left wondering at what stage some of the errors were introduced: did President Bush really say that stem cells have the potential to develop in (rather than into) all tissues? As the debate becomes more polarized, it is easy to lose sight of the facts. Annotations would have been invaluable: as it is, the reader has only very brief biographical details of the contributors to help place their work in context. In the case of Rael, we learn that he ‘believes he was contacted in 1973 by aliens’, and from this we might deduce that his testimony to the House of Representatives is not the most reliable source of information, but bias in other contributions is less obvious. The claim that conjoined twins form by partial separation of two primitive streaks goes unchallenged (there is at least as much evidence that they form by partial fusion); as does the statement that toads can be cloned from mature intestinal cell nuclei, despite later work that failed to replicate these findings. Some ill-informed pieces of journalism are included (perhaps to show the different levels of debate).

Arguments against experimentation with human embryos are essentially emotional: it is morally repugnant, barbarous, and against nature. J Bottum writes in ‘The Pig-Man Cometh’:

‘You can't say we weren't warned. This is the island of Dr. Moreaux. This is the brave new world. This is Dr. Frankenstein's chamber. This is Dr. Jekyll's room. This is Satan's Pandemonium, the city of self-destruction the rebel angels wrought in their all-consuming pride.’

As Leon R Kass, Chairman of the President's Council on Bioethics, observes in one of several perceptive essays, feelings such as these cannot be dismissed lightly: even people who accept the unlimited use of embryos for research would recoil from the idea of eating them—human tissue commands a certain (though perhaps irrational) respect.

Proponents of stem cell research with the courage of their convictions argue that the need to find new cures justifies any reasonable means, a case passionately made by and on behalf of those with neurodegenerative diseases. Most people, they argue, will accept some loss of human life in a just cause such as a war: why not then use ‘surplus’ embryos for the best of all causes—the alleviation of human suffering. James D Watson (the Nobel Prize often seems to confer a licence to say what one really thinks) advocated ‘no limits’ to ‘negative eugenics’. Nothing less than the total elimination of genetic disease is the target.

Some pro-research writers attempt to evade the problem by redefining the early embryo as legally non-human. If this can be achieved, consciences are mollified—the embryos are not really human after all (by a similar strategy a pill that prevents implantation, but not conception, is legally a contraceptive). But this is dangerous ground: the road to medical experimentation on human subjects has always begun with their reclassification as subhuman. As the editors William Kristol and Eric Cohen suggest in their concluding essay, might ‘an absolute devotion to health... invite civilised nations to tolerate, even celebrate, morally questionable pursuits (like cloning human embryos for research or harvesting organs)?’

Although the debate summarized by these essays sometimes seems overly politicized, at least there was a debate, culminating in President Bush's address to the American people in 2001 (and a compromise solution—stem cell research is permitted, but not publicly funded). Perhaps the most telling question is why a comparable level of debate has not occurred in the UK. The Future is Now does not contain enough background information to enable the general reader fully to understand the problems, but for those who already know the science it is a good introduction to some of the wider issues. It may not be long before therapies derived from embryo research become available, and as James Watson wrote: ‘if we do not think about it now, the possibility of our having a free choice will one day suddenly be gone’.

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press