Questions and Answers on Human Cloning

Sporadic announcements over the past two years from a number of groups in Asia, Europe, and North America that women under their care have given birth, or are about to give birth, to a "human clone" have not only produced doubts about the credibility of such claims but have also reactivated the public debate in this area and raised questions about the facts and ethics of what might be involved in human cloning. Public attention has also been stimulated by reports from scientists in several countries that they have either succeeded in creating stem cell lines from "cloned embryos" or are planning to do so.  

The following information is intended to provide background on the topic and the position of the World Health Organization.

1. What is a clone?

The term clone, from the Greek for “twig,” denotes a group of identical entities; in recent years, “clone” has come to mean a member of such a group and, in particular, an organism that is a genetic copy of an existing organism. The term is applied by scientists not only to entire organisms but to molecules (such as DNA) and cells. 

2 . Can cloning occur naturally? 

Yes, cloning occurs in nature and can occur in organisms that reproduce sexually as well as those that reproduce asexually. In sexual reproduction, clones are created when a fertilized egg splits to produce identical (monozygous) twins with identical DNA. While this is a relatively rare event, many species produce their descendants asexually, that is, without the combining of the male and female genetic material that occurs in sexual reproduction; such offspring are clones of their parent. Since mammals do not normally reproduce asexually, the birth of the lamb Dolly at a research institute in Scotland in 1996 was the first reported mammalian clone produced asexually.  

3. How does “Dolly type” cloning occur? 

To produce Dolly, the researchers used an improved version of the technique of somatic-cell nuclear transfer (SCNT) first used 40 years ago in research with tadpoles and frogs. SCNT begins with an adult somatic cell, for example, a skin cell. “Adult” means a fully differentiated cell from an organism that had passed the embryonic stage of development, and “somatic” denotes a body cell (rather than an egg or sperm cell), which possesses the full complement of chromosomes, rather than the half contained in gametes. The nucleus from the somatic cell is transferred to an enucleated egg (that is, one from which the nucleus has been removed). The egg is then activated with electric current or chemicals in order to stimulate it to divide. When the blastocyst stage has been reached, the embryo is transferred into the uterus of a female host, where – if implantation occurs – it can lead to a pregnancy and eventually to the birth of an individual that carries the same nuclear genetic material as the donor of the adult somatic cell. Animals created through SCNT are not precise genetic copies of the donors of their nuclear DNA, however, since a small amount of DNA resides in the mitochondria outside the egg's nucleus; mitochondrial DNA is normally passed on to children only from their mothers. Since a clone would derive its mitochondrial DNA from the egg, not from the donor of the nucleus, the clone and its progenitor would be genetically identical only if the egg came from the progenitor or from the same maternal line. 

4. Would cloning produce identical people? 

It is not possible to answer this question with certainty because the experiments required to answer this question have not been carried out, but experience with mammalian cloning suggests that the answer is “no”. If successful, SCNT could allow the production of one (or many more) individuals who are, genetically, virtually identical to one another and to the individual whose cell nucleus was used to produce them. This does not mean they would be identical physically or in personality, just as monozygous twins are not identical either, because the development of an organism is influenced by the interaction of its genes and its environment. In the case of human clones, this environment would differ from the moment that each was created, implanted in a uterus, gestated, and born. Furthermore, in all of the species of mammals cloned thus far—including mice, rabbits, pigs and cattle as well as sheep—unpredictable genetic and epigenetic problems have arisen which have not only led to a high rate of abnormalities and prenatal death but have also created health problems for most of the animals born alive, problems which differ from one clone to another.

5. Why did scientists develop cloning techniques? 

Scientists were initially interested in SCNT as a means of determining whether all the genes in an organism’s genome remain functional even after most of them have been switched off as a developing organism’s cells assume their specialized functions as blood, bone, muscle, and so forth. The ability of scientists to stimulate the DNA in a nucleus from a fully differentiated cell to revert to a condition comparable to the DNA in a newly fertilized egg and to begin the process of embryonic development demonstrated that all the genes remain viable in differentiated cells even though only a few genes are actually expressed in each cell. Commercial interest in animal cloning centres on replicating large numbers of genetically identical animals, especially those derived from a progenitor which has been modified genetically. In this fashion, mice or other laboratory animals that exhibit particular conditions can be created for specialized studies, or herds of farm animals (such as goats, sheep, or cows) can be created all of whom produce pharmaceutically useful proteins in their milk. 

6. Does the term “ human cloning” have a single meaning? 

No. Current controversy about the creation of a "human clone" concerns the possibility of replicating a human being (living or deceased) through the SCNT technique used to create Dolly, but the term is used in several other ways. 

First, “human clone” can also be applied to the creation of genetically identical siblings, such as those which occur naturally in identical twins or artificially through the splitting of embryos in the laboratory at the two to eight cell stage of development (sometimes called “pre-embryo”). Embryo-splitting has been used for some time in artificial breeding programs for farm animals like cattle. In a 1993 experiment, scientists in Washington, D.C, turned 17 human embryos into 48. These embryos (which had been chosen for research because they were considered non-viable) were cultured for some days and then discarded. If viable embryos created through such splitting were implanted and brought to term simultaneously in the same uterus, they would be comparable to monozygous twins. If the blastomeres, i.e. the cells that result from the cleavage of a fertilized egg, were split and one of the resulting embryos were brought to term while the others were frozen (cryopreservation being a common technique in fertility clinics) and then implanted and born at a later date, the result would be “serial twins.” Although genetically identical, such individuals would differ from ordinary twins because they would be born at different times (and perhaps even to different mothers); moreover, the decision to implant the later-born serial twin(s) might be based on evaluating the “fitness” or other characteristics of the first-born, and predictions about the life course of the later-born twin(s) might be based on experience with the pre-existing one.

The term “human cloning” can also be applied to the creation of embryos through SCNT not to produce offspring but for use as a scientific tool. In particular, such non-reproductive use of cloning—sometimes termed “research cloning” or “therapeutic cloning” to differentiate it from cloning for reproductive purposes—is being pursued as a means of creating human embryonic stem cells for scientific study and eventually for therapeutic purposes. Once cloned embryos have reached the blastocyst stage (approximately 5 days after fertilization), the inner cell mass, from which stem cell lines are derived, is removed; in the process, the embryo is destroyed. Some scientists engaged in this work prefer to describe it using the term “somatic-cell nuclear transfer to create stem cells,” because they feel that the term “cloning” connotes the creation of a child. Critics of this position say that “cloning” is the appropriate term because the suggestion that the procedures differ is spurious; it is better to say that the same technique—the creation of embryos through SCNT—can have two different outcomes, the production of embryonic stem cells and the production of babies. 

7. What justifications are offered for non-reproductive human cloning? 

Scientists engaged in cloning for research argue that it presents a unique method for studying genetic changes in cells derived from patients suffering from such diseases as Parkinson’s disease, Alzheimer’s disease, and diabetes. In February 2004, South Korean scientists reported the creation of a stem cell line from a cloned human embryo. The scientists enucleated 242 oocytes from 16 donors into which they transferred the DNA of ovarian cells from the same donors. Thirty embryos reached the blastocyst stage; from these, the scientists extracted the inner cell mass for the cultivation of stem cell lines, one of which was successfully established. Six months later the U.K. Human Fertilsation and Embryology Authority (HFEA) granted the first license in Europe to allow researchers to use SCNT cloning for embryonic stem cell research. Scientists who are interested in such research look ahead to the day when they believe that embryonic stem cells will be used to assist drug development and evaluation, for diagnostic purposes, and to create cells and tissues for transplantation. For the latter, if the stem cells used in transplantation were derived from embryos cloned from the patient needing the transplant, they might be less subject to rejection than cells, tissues or organs from another person, since the DNA in the cloned cells would be nearly identical to the patient’s own. Whether human embryonic stem cells hold unique therapeutic promise—as opposed to stem cells from adult tissues—and, if so, whether the creation of cloned embryos as a source of stem cells would add to their therapeutic value—are matters of ongoing debate in scientific circles.  

8. What uses are suggested for human reproductive cloning? 

Proponents of human reproductive cloning argue that it would enlarge the current spectrum of assisted reproductive techniques. In particular, men who do not produce gametes could have children who inherit their genome. In such a case, if the egg came from the wife, the couple would not have to involve a third “parent” (the sperm donor) in producing their child. Women who do not produce eggs could also have children carrying their genetic information (although they would need a donor egg) and the child would not receive a genetic contribution from the male partner. (In the case of lesbian couples, one might provide the egg, with its mitochondrial DNA, and the other the nuclear DNA). Other reasons offered for using SCNT to create children include: to produce a child with certain genetic features (who could, for example, serve as a bone marrow donor for a diseased sibling); to “replicate” a deceased child or other loved one; to fulfill the desire for a child based on an admired “prototype”; or to achieve “immortality” by living on through one’s clone. All of these scenarios raise ethical, legal and social issues. 

9. What ethical arguments have been raised concerning human reproductive cloning? 

Although widespread consensus exists internationally among the public, scientists, and policy makers against reproductive cloning, arguments pro and con have been presented. The main arguments brought forward against human reproductive cloning are: 

• Physical harm: Experience with animal cloning has shown substantial risks of debilitating and even lethal conditions occurring in the fetuses produced using these techniques; moreover, these problems cannot be individually predicted and avoided at this time. Some of these conditions also present a considerable risk for the gestational mother carrying the cloned animals to term. On the basis of this information, human reproductive cloning would—at this point—constitute a risky experiment that is not sufficiently backed up by successful laboratory and animal research. It would clearly not meet the usual ethical standards in biomedical research. Indeed, the risk-benefit ratio in current preclinical studies of reproductive cloning in animals is so grave that in any other biomedical field, such as the development of a new pharmaceutical product, no responsible researcher would contemplate proceeding to a human trial.
• Research Standards: Responsible biomedical researchers not only engage in thorough laboratory and animal studies before proceeding with human subjects but also submit each step of their work to scientific appraisal through open dissemination of their results in scientific meetings and peer-reviewed journals. Such transparency, which is especially important when scientists operate in private institutions—without day-to-day interaction with colleagues and institutional leaders who are able to bring independent judgment to the design and conduct of the research—has been largely lacking in the human reproductive cloning experiments announced thus far.
• Autonomy: Any child created through SCNT would be unable to give consent to the experiment. Although the same problem arises in any research on the unborn or young children, cloning research is different because, unlike situations in which parents give permission for an experimental intervention that aims to correct an existing problem in a fetus or child, no patient (and hence no medical problem which needs to be remedied) exists prior to the cloning experiment. An issue of autonomy would also arise if a person’s DNA were used to create one or more copies without that person’s permission or perhaps even without his or her knowledge.
• Conflicts of interest: Special ethical problems would arise when researchers have a financial interest in the outcome of the studies they conduct with human subjects; for this reason, such interests are usually disallowed by ethical standards or, where they are unavoidable, special expectations of openness and independent review of research are required.
• Psychological/social harm: The cloned individual may suffer psychological harm from its status as a "genetic copy” of somebody else. The clone might be dominated by the person who creates him or her, unduly constrained by expectations based on the abilities or life course of the donor, or stigmatized by society. It remains uncertain whether these concerns can be effectively addressed by education and legislation.

• Dignity: The Universal Declaration on Human Genome and Human Rights (UNESCO 1997) as well as many other documents state that reproductive cloning is contrary to human dignity. This position is mainly based on the following ethical considerations:
• a. cloning is an asexual mode of reproduction, which is unnatural for the human species; a cloned individual will not have two genetic parents; generation lines and family relationships would be distorted.
• b. cloning limits the lottery of heredity, which is an essential component in ensuring that each human life (or lives, in the case of monozygous twins) begins as something that has never existed before.
• c. cloning furthers an instrumental attitude toward human beings, that is, that people exist to serve purposes set by other people. When cloning is used in this fashion, dignity is undermined in two different but related ways—first, a clone’s right to an individual life-course will be constrained by others’ expectations that he or she will behave in certain ways (based on experience with the genetic progenitor’s life), and second, the clone may not (or may not wish to) behave in those ways, because behavior is not shaped by genes alone, and will hence disappoint others’ expectations and suffer the consequences.
• d. especially in conjunction with other means of genetic modification, cloning risks turning human beings into manufactured objects; this is not only contrary to human dignity but unwise, as human beings lack the prescience to meddle successfully with evolution and genetic diversity in this fashion.
• Justice: Health care resources should be devoted instead to other health or research needs that address more urgent problems than any associated with reproductive cloning; furthermore, not only are there few if any people for whom reproductive cloning would offer the only means of establishing a family, but if cloning became established as an assisted reproductive technology, it would probably only be available to a small group of privileged individuals with the financial resources to afford it.

The main arguments brought forward for human reproductive cloning are: 

• Beneficence: A new treatment option could be offered to infertile couples. Predetermining the genetic make-up of children would allow selection of desirable traits and bestow advantages on them.
• Autonomy: People should be free in their reproductive decisions; the state or international organizations do not have the right to interfere with reproductive autonomy.

10. What regulations exist on cloning? 

There are a variety of national laws on cloning; many other bills have been submitted and are currently under consideration. As of now, approximately 35 nations have adopted laws forbidding reproductive cloning. Some, including Germany, Switzerland, and some jurisdictions in the United States prohibit all forms of human cloning, whereas others, among them the United Kingdom, China, and Israel and other jurisdictions in the United States prohibit only “reproductive” cloning, but allow the creation of cloned human embryos for research. International documents, such as the Universal Declaration on Human Genome and Human Rights (UNESCO, 1997) and the World Medical Association’s Resolution on Cloning (1997), have addressed the issue, but lack binding legal force. The United Nations discussed an international convention against the reproductive cloning of human beings during the General Assembly in November 2002; the debate on whether to adopt a treaty banning human cloning is still ongoing, with the principal issue being whether the ban should include research as well as reproductive cloning. 

11. What is WHO’s position on cloning to replicate a human being (“human reproductive cloning”)? 

The Member States of the World Health Organization (WHO) consider that developments in human reproductive cloning have unprecedented ethical implications and raise serious concerns for the safety of individuals and subsequent generations of human beings. The World Health Assembly has therefore resolved that the use of cloning "for the replication of human individuals is ethically unacceptable and contrary to human dignity and integrity."