Submission to the House of Representatives Standing Committee on Legal and Constitutional Affairs Inquiry into the Scientific, Ethical and Regulatory Aspects of Human Cloning On behalf of The Anglican Church of Australia By The Revd Dr Bruce Kaye General Secretary of the General Synod of The Anglican Church of Australia Anglican Moral Theology and Cloning Anglican moral theology draws upon a variety of sources in grappling with the ethical issues associated with cloning. There is no definitive statement in the Anglican Communion with regard to cloning. However, there is well-established significant Anglican theology1 associated with various forms of modern reproductive technology. 2 This work of course reflects a diversity of opinion within the church just as there is such diversity within society as a whole as to the moral status of foetus, embryo and zygotes.3 Above all, however, Anglican ethics upholds the dignity of the human person.4 Contemporary Anglican theology seeks to be incarnational, that is testifying to the presence of God in the world and therefore as a theology it seeks also to operate within the world, as opposed to seeking to cut itself off from the world.5 Accordingly, we recognise the diversity of opinion in Australian society with regard to the moral status of the embryo, foetus, zygotes and human body parts. We recognises that in a plural society, regardless of our own beliefs God gives us free will and some choose not to adopt a theological perspective in asking those fundamental ethical questions: “What should I do, and how am I to live in society?” The fact that there is so much debate about issues to do with genetics and cloning reflects the importance we place on human life and human body parts, even if there is no consensus as to their moral status. Recognising the secular nature of society6 we would recommend that the 1 For a useful summary of theological approaches by one of Australia’s foremost Anglican moral theologians see: Morgan, J. “Theology, Medicine and Health” in Bryne, P & Houlden, L. (Eds) Companion Encyclopedia of Theology, Routledge, London, 1995, pp 817-842. See also a helpful commentary: Smith, D.H. Health and Medicine in the Anglican Tradition, Cross Road, New York, 1986. 2 For specifically Australian Anglican content, see especially: Nichols, A & Hogan, T. (Eds). Making Babies: The Test Tube and Christian Ethics. Acorn Press, Canberra, 1984. 3 It is worth noting the diversity and richness of sources of Anglican theology. See for example: Evans, G. R. & Wright, J. R., Ed. The Anglican Tradition: A Handbook of Sources. Fortress Press, London, 1991. 4 For specifically Anglican contributions regarding this important concept and the notion of the human person, see Rodgers, M. & Thomas, M. ( Eds). A Theology of the Human Person, Collins Dove, North Blackburn, 1992. See also its discussion in a General Synod Social Responsibilities Commission endorsed publication: Newell, C. & Pullin, C. Death, Dying and Euthanasia: An Anglican Resource, General Synod Social Responsibilities Commission, Sydney, 1998. ISBN 1-86459-043-2. 5 For a discussion of this and the role and future of Anglicanism in Australia, see for example: Kaye, B. A Church Without Walls: Being Anglican in Australia. Dove, North Blackburn, 1995. 6 Operating within an Anglican tradition, Newell has recently proposed that it is possible to engage in ethics and public policy despite difference in approaches. See Newell, C. “Whose Community: Which Values?” in Davies, L. & Sullivan, F. (Eds) Civilising Community for us all, Australian Theological Forum, Adelaide, 1999.His approach proposes shared spirituality and humanness as the starting point for our discussions rather than religious difference. 2 Committee recognises the reverence in which the human person and the human body as constituent parts are held from a variety of religious and secular perspectives and adopts social policy and legislation which reflects the sacredness and inviolability of the human person. The Anglican Church also recommends that the relevant United Nations declarations and instruments be referred to, which again recognise diversity but also the inalienable dignity to be accorded to the human person. We are special, and indeed sacred, and this should be recognised in social policy and legislation. It is also recommended that the Committee consider the spiritual concerns of people regarding cloning. Spirituality7 is after all central to religious expression.8 For Christians, we are made in God's image, upholding a holistic notion of being, in which inter -relationship with others is vital. People are sacred and have a spiritual dimension. Evelyn Crotty talks of spirituality in terms of “What it means to live, feel, see, experience and touch more authentically the sacred around me.”9 This submission is made by The Revd Dr Bruce Kaye, General Secretary, on behalf of the General Synod of The Anglican Church of Australia. It is recognised however that various Anglican dioceses around the country may choose to make submissions. For example, this submission is written in recognition of the fact that the Diocese of Melbourne’s Social Responsibilities Commission is making a substantial submission. That submission will attend to the biological facts confronting the Committee in far greater detail, whereas this submission will focus on issues of regulation in the area of bioethics. The Bible provides important images with regard to the utilisation of technological power and especially in terms of the adoption of a Christian ethic of cloning. In particular this will be seen with regard to the images of Eden and Babel. In the Book of Genesis (1: 26, 2: 15) the human creature is not just given “dominion” over the garden but a responsibility “to till and to keep it”. This is not a boundless dominion and does not extend to the Pleiades and Orion (Amos 5: 8) and likewise the Book of Job (39: 41) places other limitation on dominion by human kind. These are important reminders that while this world was not created for us or by us, we do have a sacred responsibility within it. Likewise, within Genesis chapter 11, we encounter the image of Babel where the desire to be god-like and the use of technological power brought about chaos. 10 Quite clearly these two images are not about the right use of genetics but they do help us to seek balance in undertaking the work of caring, nurturing and healing creation. 7 There is of course an issue here. For example in a recent ABC TV “Compass” Program ( 21 February, 1999 “The S-Word”), Phillip Adams argues that “If I were spiritual, and this may happen even during the course of this program, I’ d want to shout it from the rooftops. I’d want to in fact aspire to sainthood. But those of spiritual persuasion or at least religious credentials hush it up…” In this program he uses the words “spiritual” and “religious” interchangeably, failing to acknowledge that they are markedly different concepts. Certainly based on the definitions of spiritual I embrace, Adams may be seen to reflect a spiritual dimension in his life. Interestingly, he also makes the astute observation later in this program that “I rarely conclude a long interview without asking whoever it is their attitudes to life and to death. I usually ask them directly what their cosmology, their theology, is, because I find that everyone is interested and the fact that this is concealed in our public life I think demeans and diminishes it.” 8 The Anglican theologian John Macquarrie is cited by Cecilia Francis thus: “fundamentally spirituality has to do with becoming a person in the fullest sense … Spirit is the active, formative, lifegiving power … shared by (humankind) with the Spirit of God’. The Trinity is inseparable from such thinking – and for me a formative model of interdependence – of identity and of activity; no one has fullness of being without the others.” Francis, C. “Spirituality and Leadership”, Ministry, Society & Theology, Vol. 12, No. 2, November, 1998, p.79. 9 Crotty, E., “Spirituality and Justice”, Ministry, Society & Theology, Vol. 12, No. 2, November, 1998, p.65. 10 This section is inspired by Cole-Turner, R. Ed. Human Cloning: Religious Responses, Westminster John Knox Press, Louisville, 1997, p 117. 3 Likewise the New Testament upholds similar points to such images with its expectation of a new creation. We shoould not that this new creation is the work of God not auntonomous or unbridled “science” or “technology”. If anything the insights from the Bible show the importance of due care, the importance of exercising responsibility, and a reminder that we are not to seek to be god-like. On the other hand it is quite clear that entailed in the notion of responsibility is the idea that we would nurture and promote the health of creatures within God’s dominion.11 In this way we can see that the Bible and the Christian ethics derived from it can have applicability to all social and ethical issues. Indeed, it is noteworthy that many of the insights of secular humanism can be seen to be derived from Judeo-Christian principles. The Australian Health Ethics Committee Report The Anglican Church wishes to provide broad support for the recommendations of the Report of the Australian Health Ethics Committee on “Scientific, Ethical and Regulatory Considerations relevant to Cloning of Human Beings”. In particular, this is a matter which requires explicit regulation as opposed to just guidelines. For example, whilst NHMRC guidelines have some moral pressure and are required to be adhered to by bodies receiving NHMRC funding, it is quite clear that there are significant issues associated with privately funded researchers/bodies who are not in receipt of NHMRC funding. Legislation in this area should seek to serve the common good and must of course seek to achieve the balance affirmed by Anglican theology. That balance in this issue is to be found in the middle ground between the extremes of neo-Luddism and technological determinism. Accordingly, it is important that the Committee recognises the fact that this country has not responded well to the challenges of uniform regulation with regard to reproductive technology. For example, the Australian Health Ethics Committee, motivated again by issues of concern with regard to the welfare of all human beings in the Commonwealth of Australia, recommended uniform legislation with regard to reproductive technology in its 1997 report. 12 Complimentary legislation has not eventuated. The Anglican Church also supports the prohibition on the cloning of human beings and embryos found in the above-mentioned guidelines as well as the prohibition of experimentation with the intent to produce two or more genetically identical individuals, including development of human embryonal stem cell lines with the aim of producing a clone of individuals. The clear intent of the above cited NHMRC guidelines and relevant state legislation has been circumvented by the well-known practice of border-hopping, including not just moving from one state to another to undertake particular practices. It is also well known that at least one Australian scientist and associated team is now undertaking work outside of Australia, so as to avoid restrictions in Australia associated with reproductive technology and cloning. 11 It is worthwhile noting that the Committee on Medical Ethics of the Episcopal [ie Anglican]Diocese of Washington recently published a book on genetic testing that addresses some issues associated with cloning and genetic engineering. It is entitled, Wrestling with the Future: Our Genes and Our Choices, and is published by Morehouse Publishing, Harrisburg, PA , 1999. We had not yet received a copy of this document when making this submission. 12 National Health and Medical Research Council. Ethical Guidelines on Assisted Reproductive Technology. Australian Government Publishing Service, Canberra, 1996. 4 It is noteworthy that since the Australian Health Ethics Committee report there has been a significant amount of attention in the press to the issue of cloning and a significant number of Australian perspectives from a variety of scientific interests favouring development of human cloning. One of the dominant messages which has been forthcoming has been that there is a clear difference between therapeutic and reproductive cloning and that therapeutic cloning (aimed at therapy) should be allowed. In many respects this can be likened to earlier debates to do with reproductive technology and the false distinction made between embryo and preembryo in some literature. Clearly this sought to address particular moral issues but served only to fudge rather than to facilitate clear understanding and ethical guidelines. Of course, the problem with the notion of so-called “therapeutic cloning” is “therapeutic from whose perspective?” It is also recommended that the Committee gives some substantial consideration to the issue of intent in its discussion of regulation. Of course, Christian theology has always placed great weight upon intent. Whilst there have been differences of emphasis, a fundamental focus on intent has also led to a rejection of consequentalist ethics, and especially those which are geared towards utilising people as a means to an end rather than as end in themselves. (It is also worth noting that such a religious ethic has also been formulated by such philosophers as Kant.) One of the significant gaps in the AHEC Report is that there certainly would appear to be potential for cloning in the future without the use of embryos or foetus to be achievable. Whilst supporting a ban on the cloning of people, there is no doubt that the issue is more complex when addressing issues to do with cloning human parts. However, it would appear that this is more an area of science fantasy than science fact at this stage. Likewise, there is little discussion of the cloning of body parts/organs, although this still seems to be a projected rather than a present reality, and is likely to involve tissues with significant moral status in the community. Accordingly, as these possibilities have not been widely discussed by the broader community, and in the light of the major ethical questions raised by cloning of body parts/organs there should be a moratorium on the cloning of human body parts and tissues and the use of human embryonic stem cells, to be reviewed in five years following extensive public discussion. Science operates in our community, not apart from it. In addition to supporting the NHMRC guidelines with regard to reproductive technology, we would also make some comment with regard to the idea of there being spare embryos and foetuses and their use in experimentation. It is here that we would refer to issues of reverence for the human person at various stages of development. It is perhaps helpful here to refer to the fact that when someone has died we still have a reverence for his/her body and Christians attach significance to the reverent disposal of the body which remains after life. The notion of reverence should also be attached to foetuses and embryos. It is quite clear that for many people with a variety of religious views an aborted foetus, for example, has a status of reverence associated with it and is not to be used as a means to an end. Likewise, embryos are clearly seen as having moral significance in our society, and should not be freely utilised, even though many reproductive technology programs have so-called “spares”. The number of failures prior to the so-called “successful” cloning of Dolly should lead us to be careful of any form of cloning, whether for whole persons or even body parts. Likewise, the sheer number of failures prior to Dolly also leads one to express concern at the significant potential harm to animals associated with experimentation in cloning. There should be clear benefit and minimal harm, from a variety of perspectives, associated with any form of biotechnology rather than the technological imperative driving technology. 5 It is quite apparent that there are particular restrictions placed upon the Commonwealth with regard to legislation. However, it would be fortunate if your legal advice does suggest that there is the power for the Commonwealth to legislate in this area and/or there is sufficient agreement possible between the states/territories. Certainly, this is in an area which is important with regard to the welfare of Australia’s citizens and where there are relevant international instruments called into play safeguarding the dignity of the human person. It is also apparent that this is an area which cannot be left merely to self-regulation or to NHMRC guidelines. Utilising the USA as a good example, it is quite clear that privately financed interests are quite capable of undertaking research in Australia, including states/territories where there is no legislative prohibition. Legislation can take the form of prohibition of particular actions, which is easy with regard to many practices associated with cloning. Although with technological developments it may well be that any legislation would be out of date almost as quickly as legislation is passed. Accordingly, in addition to legislation which prohibits particular practices it is worthwhile exploring the benefits associated with either having an opportunity for a body such as the Australian Health Ethics Committee to consider and make decisions regarding some future issues not totally prohibited or covered by cloning regulation, or allowing particular sites/laboratories to operate in areas not adequately dealt with via any legislation. Such sites could be subject to close regulation by such a body as the Australian Health Ethics Committee. Clearly this Committee would need to be given some formal capacity to enforce the results of its deliberations, and to ensure eventual accountability to the Parliament, given the clear intention of the National Health and Medical Research Council Act 1992, and the debate regarding its functions in Hansard. It is also quite clear that there is a need for more than the action taken by the Australian Health Ethics Committee pending state and territory legislation. In particular, whilst the Anglican Church would welcome the notion of an Expert Advisory Committee to assist Human Research Ethics Committees regarding scientific issues in cloning, much more is needed. The expertise of such an Expert Advisory Committee should reflect the skills and expertise associated with a Human Research Ethics Committee, as detailed in the recent National Statement on Research Involving Human Beings. As we discovered in seeking to research this submission, there has been less than adequate consideration of the ethical and scientific issues from religious, legal, ethical and social perspectives. For example, we affirm the importance of having these areas of expertise represented, perhaps through a minister of religion or a similarly qualified person on a human research ethics committee. It seems likely that other categories of expertise affirmed in the composition of human research ethics committees would also have similar problems. We ask the Committee to consider why we would wish to invest resources in various forms of cloning, given that disease and death will still occur for people and that there are significant issues associated with who will be able to afford to gain routine access to the increasing hi-tech technologies associated with cloning. In particular we would point to the importance of funding less popularised but vital primary health care measures. Such measures, from clean drinking water to addressing social and spiritual issues associated with indigenous health, have less of the technological imperative associated with them. Yet they are likely to provide more benefit to the health of millions of people around the world than some of the exotic promises of cloning some time in the future. Likewise there are real issues of unmet need in aged and disability support. It is quite clear that a lot more research on animals is necessary prior to any form of cloning on human beings being defensible scientifically, let alone ethically. Current debate in the media regarding cloning seems to be driven by technologically optimistic futurism, with many vested interests being prominent in promoting particular forms of cloning technology. There is no doubt that when we discuss cloning we are talking about the origins and 6 sacredness associated with the human person. This is very properly within the domain of parliaments and of legislation. Such legislation should affirm the principle of reverence and respect for the human person as unique, and not to be treated as a means to an end. It is also worth reflecting that despite the glossy promises of certain forms of genetic and cloning technology it will not lead to eternal life and that we still have to face the spiritual issues associated with our common humanness, frailty, mortality and relationship with God. These are really the questions we all face as individuals and as a community. RECOMMENDATIONS 1. That the Committee recognises the reverence in which the human person and the human body as constituent parts are held from a variety of religious and secular perspectives, and adopts social policy and legislation which reflects the sacredness and inviolability of the human person. 2. That the relevant United Nations declarations and instruments be referred to, which again recognise diversity but also the inalienable dignity to be accorded to the human person. 3. That the recommendations of the Report of the Australian Health Ethics Committee on “Scientific, Ethical and Regulatory Considerations relevant to Cloning of Human Beings” be supported but complimented with suggestions made elsewhere in this submission. 4. That the significant issues associated with privately funded operators/bodies who are not in receipt of NHMRC funding and required to be in adherence with Guidelines from this body be addressed. 5. That legislation regarding cloning should seek to serve the common good, and this good includes the value commitments of the religious traditions in Australia. 6. That the Committee seek to address the importance and challenges of uniform Australian regulation via legislation. 7. That the cloning of human beings and embryos be prohibited as well as experimentation with the intent to produce two or more genetically identical individuals, including development of human embryonal stem cell lines with the aim of producing a clone of individuals. 8. That the practice of avoiding NHMRC guidelines and relevant state legislation by the practice of “border-hopping” be addressed. 9. That in its discussion of regulation, the Committee reject the false distinction between socalled therapeutic and reproductive cloning. 10. That in light of the major ethical questions raised by cloning of body parts there should be a moratorium on the cloning of human body parts and tissues and the use of human embryonic stem cells, and that this be reviewed in five years following extensive public discussion. 11. That foetuses and embryos should be treated with reverence. For example, an aborted foetus is not to be used as a means to an end. 12. That the Committee move beyond the formulation of an Expert Advisory Committee to assist Human Research Ethics Committees regarding scientific issues in cloning. The expertise of such an Expert Advisory Committee should reflect the skills and expertise 7 associated with a human research ethics committee as detailed in the recent National Statement on Research Involving Human Beings. 13. That the Committee give due consideration to issues of resources allocation, considering issues of distributive justice, and unmet need in many areas including primary health care and aged and disability support. 14. That the Committee address the spiritual issues associated with cloning identified in this submission. The Reverend Dr Bruce N Kaye 1 November 1999