Franco Furger and Francis Fukuyama
Beyond Bioethics
A Proposal for Modernizing the
Regulation of Human Biotechnologies
Reproductive medicine and biomedical research are advancing quickly—though
few seem to notice outside the medical and scientific communities. According to
the Centers for Disease Control, In 1995 Sopra 280 fertility programs were operat-
ing in the United States. Nine years later, In 2004, this figure had risen by 47%, A
411. An additional 50 clinics were also operating but not reporting their success
rates, according to the CDC.1 Should this trend continue, procreation by techno-
logical means could become a serious option for a significant fraction of the
American public. Nel frattempo, investments in biomedical science, which includes
several fields of research that involve the manipulation of reproductive tissue such
as animal embryos, eggs and sperm, have grown significantly. The NIH budget rose
from $12 billion in 1996 A $28.5 billion in 2006.2
What are we to make of all this progress? In this essay we argue that scientific
and medical progress related to reproductive medicine and biomedical research is
Franco Furger is President of Politik- & Technologie-Beratung, a consulting firm spe-
cializing in science and technology policy based in Lucerne, Svizzera. Between
2001 E 2004 he was Research Professor at the School of Advanced International
studies in Washington DC (SAIS). He holds an MA in electrical engineering and
Ph.D. in environmental sciences from the Swiss Federal Institute of Technology in
Zürich. He is the author of several articles and three books.
Francis Fukuyama is Bernard L. Schwartz Professor of International Political
Economy at the Paul H. Nitze School of Advanced International Studies (SAIS) Di
Johns Hopkins University, and the director of SAIS’ International Development pro-
gram. He is also chairman of the editorial board of a new magazine, The American
Interesse. He is the author of numerous books and articles, notably including The End
of History and the Last Man (1992), Trust: The Social Virtues and the Creation of
Prosperity (1995), and Our Posthuman Future: Consequences of
IL
Biotechnology Revolution (2002). He received his B.A. from Cornell University, E
his Ph.D. from Harvard in Political Science. He was a member of the Political Science
Department of the RAND Corporation from 1979-1980, then again from 1983-89,
and from 1995-96. From 1996-2000 he was Omer L. and Nancy Hirst Professor of
Public Policy at the School of Public Policy at George Mason University. From 2001-
2005 Dr. Fukuyama was a member of the President’s Council on Bioethics.
© 2008 Franco Furger and Francis Fukuyama
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Franco Furger and Francis Fukuyama
a mixed blessing. It promises to reduce pain and suffering for millions of people
and to cure many hitherto incurable diseases. At the same time scientific and med-
ical progress in this area raises many disturbing ethical questions. Some of these
questions go at the heart of what it means to be human. We believe these questions
shouldn’t be answered by market forces or by the logic of the scientific inquiry
alone. Nor is it appropriate for the government to take a wait-and-see attitude.
Scientific and medical trajectories are shaped as much by internal debates as they
are affected by external political forces. What rules should govern reproductive
medicine and biomedical research is a question that should vigorously be debated.
This essay is a contribution to this debate.3 In the next section we examine
some of the ethical questions raised by recent developments in reproductive med-
icine and biomedical research. We then turn our attention to possible societal
responses, their justifications and criticisms. In the third and final section we sug-
gest that a new federal regulatory institution is needed and we outline its main ele-
menti.
WHAT ARE WE CONCERNED ABOUT?
We begin with a prosaic but important question: how safe are assisted reproduc-
tive technologies (ARTs)? ARTs practitioners are quick to point out the excellent
safety record in their field, but on closer examination doubts emerge. The indus-
try has never implemented a robust system for monitoring the health of newborn
babies. Some data is available, but as pediatricians point out, many medical condi-
tions do not become apparent before six months of age. This means that to assess
the health and safety record of ART procedures all ARTs babies should have thor-
ough medical examination around their first birthday, but this is not being done,
at least in the United States. Thus for lack of longitudinal data the industry cannot
reliably assess the health of children born through ARTs.
Spurred by an alarming article published in the New England Journal of
Medicine, a panel of medical experts recently conducted a thorough review of the
medical literature on this subject, on behalf of the American Society for
Reproductive Medicine (ASRM), and found no reason for concern.4 Unfortunately
the study was never published; ASRM communicated its main findings to the pub-
lic by means of press releases. It is also worth noting that the committee consisted
exclusively of industry insiders and that critical parties were not invited to partic-
ipate in the review—facts that raise questions about its credibility. In sum, as long
as “we don’t know what we don’t know,” categorical statements about the safety of
ARTs procedures seem premature.
ART technologies are raising more than just health and safety concerns. Nuovo
ethical questions also arise as medical practitioners resort to innovative treatments
in their quest to meet the desires of potential parents. Such treatments involve
novel, and usually untested, medical techniques designed to increase a couple’s
chances of having a baby. Per esempio, In 2001 an ARTs clinic experimented with
ooplasm transfer, a reproductive procedure that relies on the reproductive tissues
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Beyond Bioethics
of three individuals: the mother, the father, and a second, younger woman. 5
Children born through this procedure in fact have three biological parents,
although the child inherits only mitochondrial DNA from the third parent (IL
younger woman).
Human embryos that are grown for several days on cow tissues—a technique
known as co-culture—are another instance of an experimental procedure that dis-
regards several basic rules of medical research. By definition the child cannot give
his or her informed consent for what amounts to human experimentation with
unknown health and safety risks.6 As a news story reported in 2003, this technique
occasionally has been used to treat particularly difficult cases of infertility. IL
woman’s eggs are retrieved, fertilized in vitro, and grown for several days on tissue
obtained from a cow uterus. The embryos are then transferred back into the
woman’s uterus. The story provides an excellent illustration of both parental des-
peration and of the risky choices parents and their doctors are willing to make.
And what should we make of advances in the cryopreservation of eggs? Many
women will welcome the chance to pursue a professional career while maintaining
intact their chances to have a baby, but the consequences for society may be pro-
found, and not necessarily be positive. The average birth age would slowly but
steadily increase and the nature and form of family relationships will undergo sig-
nificant change. This suggests we should carefully examine them before declaring
this technology as unambiguously desirable.
The arsenal at the disposal of ARTs practitioners is rapidly expanding from
basic forms of assisted reproduction, such as in vitro fertilization, to medical tech-
nologies designed to give prospective parents increasing control over the process
and the end result. This kind of reproductive technology is designed not merely to
facilitate procreation, but to let the parents manipulate certain (mostly biological)
attributes of a future child. Pre-implantation genetic diagnosis (PGD) is a good
esempio. This technique was initially developed to prevent the transmission of
dreadful and fatal diseases. A cell is removed from an early-stage embryo and its
genetic material tested for certain medical conditions. Depending upon the test
risultati, an embryo is either selected for implantation or discarded. Over the years
the number of conditions that parents and the medical profession consider to
merit discarding of the embryo has expanded considerably, including non-fatal
conditions and late-onset diseases. PGD was recently used to screen for congenital
fibrosis of the extraocular muscles (CFEM), a hereditary eye movement disorder. 7
ARTs doctors also rely on PGD to select children for tissue matching—that is, chil-
dren intended to be tissue donors for older siblings affected by severely debilitat-
ing conditions. Until now, tissue matching has been used only to help siblings, Ma
the procedure could also be used to cure a parent or a relative.
PGD affords prospective parents a very limited control over the procreative
processi, if by control we mean the ability to select specific biological and higher
traits. But even these limited possibilities are becoming quite popular, According
to a recent survey conducted by the Genetics and Public Policy Center at Johns
Hopkins University, PGD is increasingly being used to select the baby’s sex. 8 IL
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survey also documents several instances in which researchers used PGD to create
babies with specific disabilities, such as hearing impairments, which some parents
in the deaf community have seen as necessary to promote “deaf culture.” As
prospective parents gain increasing control over the reproductive process, we may
see not only a culture of procreative perfectionism but also the opposite tendency:
the desire of parents with disabilities to have children in their own image.
As prospective parents gain
increasing control over the
reproductive process, we may see
not only a culture of procreative
perfectionism but also the
opposite tendency: the desire of
parents with disabilities to have
children in their own image.
Medical researchers are not only learning to extend reproductive options, Ma
are also changing the biological foundations of human reproduction. Consider
two European
research
findings reported by the
media in 2006. Primo, in the
UK, scientists are seeking a
license from the Human
Fertilisation
E
Authority
Embryology
(HFEA) to create human-
9 They
animal hybrids.
believe that hybrid embryos
IL
can help overcome
problems associated with
collecting human
eggs.
Large numbers of human
eggs are a basic requirement
for conducting research
cloning experiments. IL
hybrid embryo results when an animal egg is cloned with human DNA. The chro-
mosomal DNA of a hybrid embryo would be human, but the mitochondrial DNA
would be inherited from the animal egg. On its face, this approach seems promis-
ing indeed, but as for other promising scientific experiments, the transition from
the lab to clinical settings raises serious ethical concerns: we do not know what the
consequences of this kind of experimentation may be on the patients.
Secondo, scientists at the University of Milan report successfully deriving
human stem cell lines from eggs stimulated to divide without sperm.10 This
processi, known as parthenogenesis, produces so-called parthenotes. Parthenotes
normally do not survive more than a few days, but the team managed to keep the
parthenotes alive until they reached the blastocyst stage when stem cells could be
extracted. The scientists showed that, like ordinary embryonic stem cells, their cell
lines can differentiate into neurons. The fact that parthenotes can be kept alive
could open up new reproductive options, including asexual reproduction.
These experiments have no immediate clinical application at present because
they have been conducted only on animal models. But why should we believe that
scientific research will stop there? As the efficacy and reliability of these procedures
improve over time, researchers will be tempted to apply them to human beings. Noi
suspect that use of these techniques on human beings will be hugely controversial,
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Beyond Bioethics
and should not be undertaken until there is a broader public discussion about their
ethical implications. Which new reproductive possibility will eventually material-
ize is impossible to say with any degree of confidence, but the options are clearly
many.
Nor should we think that commercialization will lag far behind. Last year, an
entrepreneur in Texas began offering “made-to-order” human embryos.11 At his
clinic prospective parents can choose both egg and sperm donor, based on physi-
cal characteristics. If the present trend continues, human eggs may become an
important source of revenue for low-income women and students. That the price
for human eggs is rising suggests that demand is high and increasing and supply is
not keeping up. And the sale of sperm can almost be considered an American cul-
tural tradition. Not surprisingly, news reports on these developments have focused
exclusively on possible health risks for the donors. While this is certainly an impor-
tant consideration it is hardly the only one. It may be worth pondering whether
these practices will undermine our view of children as a gift, or whether they are
pushing us towards regarding children as made-to-order objects.
Against this background, we believe a discussion of possible societal respons-
es, including legislative and regulatory interventions, is warranted. Before examin-
ing regulatory options however, we address some of the most common criticisms
against regulatory action.
IDENTIFYING APPROPRIATE SOCIETAL RESPONSES
To libertarians, the examples just described may not be severe enough to justify
regulatory intervention. In their view, government regulation is acceptable only
when an activity can be definitively shown to cause harm, narrowly construed to
mean physical and immediate harm. The excesses of the regulatory state offer
many cautionary tales of ineffective or misguided regulatory interventions, E
tend to reinforce a very cautious stance towards new interventions. But the liber-
tarian position fails to consider another important fact: in reproductive matters,
individuals are not making decisions just for themselves. Their choices have many
potential consequences for a future human being. As is clear from the fierce oppo-
sition to PGD among advocates of the disabled, the debate about the consequences
of new procreative technologies extends well beyond physical and immediate
harm. One cannot really appreciate the full impact of these technologies on dem-
ocratic politics without taking a more expansive view of harm.
Advocates of unencumbered medical and scientific progress also criticize fears
of a slippery slope in which near-term precedents pave the way for longer-term
abuses. But the examples above demonstrate that in the area of reproductive med-
icine and biomedical research we have already moved a considerably way down
some slippery slopes already. Over time, we can expect more effective reproductive
techniques and new cures to become available. Allo stesso tempo, ART technologies
will continue to evolve from purely assistive techniques to tools of reproductive
control and customization. The term “reproductive customization” should be
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understood literally: couples, and even individuals, will have access to a range of
reproductive techniques that will let them make specific choices about the health,
the sex and—eventually—other attributes, physical or cognitive, of a baby. More
generally, it is hard to see how we can dismiss the notion of the slippery slope if we
fail to renounce to its counterpart, the virtuous slope, which expresses an exagger-
ated and unwarranted optimism about the beneficial effects of scientific and tech-
nological progress. The notion of the slippery slope simply reflects a cautious
approach to momentous medical developments.
Existing federal agencies do
not have the capability to
carefully work through
complex ethical dilemmas.
Most people organize their daily lives on the assumption that the future indeed
can bring undesirable consequences. That is why we take precautions even if we are
in no position to prove beyond
doubt that a given activity will have
a harmful impact on us. We buy
earthquake
insurance, without
knowing whether or not an earth-
quake will actually destroy our
casa. Noi
regularly
because we know that a sedentary
life may have serious negative
health effects. We quit smoking,
even though only about one smok-
er in ten will suffer serious negative consequences. And we wear helmets while rid-
ing bicycles, though we are not likely to have an accident on a given day. In all these
cases we are taking precautions, even though no one can give us definitive proof of
actual and immediate harm. Governments in all liberal democracies have been
operating in a similar vein for a long time. Recognizing that laissez-faire attitude
may be just as harmful, if not more so, than early regulatory interventions, govern-
ments often adopt regulatory actions even in the absence of immediate harm. In
addition to recognizing that excessive regulatory intervention may be harmful, it is
also important to consider the (possibly negative) consequences of government
inaction and to do so on the basis of an appropriate notion of harm.
exercise
Virtually all other industrialized countries have already moved to create regu-
latory institutions to manage the ethical and safety dimensions of reproductive
biomedicine. We believe the existing arsenal of laws and regulations in the United
States will not provide adequate legal responses. As we discuss in some detail in our
report,12 the federal statutes in this area are patchy at best. Existing federal agencies
do not have the capability to carefully work through complex ethical dilemmas. In
particular, the Food and Drug Administration, the prime candidate for taking on
new regulatory responsibilities, is permeated by an organizational culture that
focuses on safety and efficacy rather than broad ethical concerns. Nor are state-
level laws a good substitute for federal legislation. Very few states have enacted leg-
islation pertaining to reproductive medicine, and none of them are designed to
resolve ethical dilemmas. And as the history of the regulatory state clearly demon-
strates, adopting reactive, sweeping legislation like bans on specific types of proce-
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Beyond Bioethics
dures would most likely be counterproductive, making it impossible to draw the
kind of fine distinctions that many biomedical developments require. Finalmente, self-
regulation is not likely to succeed: conflicts over the use of novel reproductive tech-
niques need to be resolved by public institutions, not by the medical profession
and patient groups.13
THE NEW REGULATORY ARCHITECTURE
For all these reasons we believe that a new regulatory architecture is needed. Nostro
regulatory proposal, which we outline below and discuss in much more detail in
our report, consists of a set of ethical principles and a new regulatory institution
responsible for interpreting and applying these principles.14 The Congress for its
part would be charged with resolving the most important controversies—such as
the moral status of the embryo—by identifying those medical procedures that
should be banned outright. It will be up to Congress to say, Per esempio, whether
research cloning is prohibited, allowed, or regulated. It would identify which activ-
ities can be performed under suitable regulatory oversight, and would establish in
some detail the structure of the new regulatory institution. Finalmente, it would adopt
IL
several procedures, above and beyond the usual requirements of
Administrative Procedure Act, to ensure that the agency is independent, and to
prevent administrative drift, what legal scholar describe as “arbitrary and capri-
cious regulatory decisions.”
The ethical principles outlined below touch upon several basic aspects of the
human experience. They reflect what we believe are widely shared values, not only
in the United States but also in many other Western democracies.15
• The well-being and health of children should be protected.
•Biomedical procedures involving human embryos must respect their intermediate
moral status.
•Access to ARTs for infertile couples should be promoted.
•The well-being and health of women should be protected.
•Free and informed consent must be required from everyone making use of ARTs.
•Therapeutic uses of biomedicine should be favored over enhancement uses.
•Limits should be imposed on the commercialization of eggs, sperm, and embryos.
Some of these principles, like informed consent, and protecting the health and
well-being of women, are hardly controversial. Others, such as ensuring children’s
health and well-being, should not be considered controversial, though some may
eye them with suspicion. Still more controversial is the idea of requiring regulators
to favor therapeutic over enhancing applications. We realize that our set of guid-
ing principles is just that: an obligation to make determinations that in reality may
be arduous and fraught with ambiguity. But these determinations are no different
from those the courts are called upon to make every day. As a matter of practice,
even uncontroversial ethical principles such as assessing the effectiveness of a drug
or medical device can raise difficult interpretive questions. Yet the Federal Drug
Administration, the agency responsible for ensuring the safety and effectiveness of
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drugs, biological materials and medical devices, makes such determinations on a
daily basis—without access to analytical, unambiguous definitions. 16
Based on these principles, we believe Congress should ban several activities,
including reproductive cloning, germ-line genetic modifications, and certain
forms of human-animal chimeras and hybrids. It should regulate research cloning
(i.e. somatic cell nuclear transfer for research purposes), pre-implantation genetic
diagnosis, and biomedical research involving early-stage embryos, among other
things. These suggestions are neither exhaustive nor definitive. Infatti, one could
easily imagine prohibiting research cloning, at least for a certain period, or strictly
regulating certain forms of germ-line genetic modification. And perhaps elective
sex-selection should at least be regulated. In our view, the legal and ethical stance
that Congress takes on any of these
issues is ultimately less important
than establishing a precedent for
making legally binding distinctions
between acceptable and unacceptable
reproductive practices.
Neither scientific
competence nor moral
authority can stand alone.
Assuming that Congress takes
control of such issues, how would its
intent be implemented? We suggest a
regulatory agency that operates according to a few basic principles. Primo, all affect-
ed constituencies should perceive it as independent, not as unduly influenced by
interest groups. A second basic requirement is accountability: regulators should
not be able to make what lawyers call “arbitrary and capricious” decisions. Third,
the agency should be seen as authoritative by all interest groups, and the general
public: regulators should be technically competent and regarded as morally credi-
ble. Neither scientific competence nor moral authority can stand alone.
Efforts to reconcile independence and accountability may appear mutually
exclusive, since an agency with a great deal of independence would seem to be less
accountable, but independence, in the jargon of administrative law scholars, has a
fairly specific meaning. An independent agency is afforded considerable autonomy
by the Office of the President—but it is not outside Congressional reach. Despite
statements to the contrary, Congress often uses its budgetary authority to control
and influence independent agencies. Formalmente, these agencies may be more inde-
pendent than executive agencies, but some organized interest groups and affected
parties may not see an independent agency as truly independent.
The new independent agency should be led by a commission, and not by a
head of agency. An independent commission has several attractive attributes. Its
members are selected by the president but confirmed by the Senate. Their appoint-
ment is staggered, and the president can remove them from office only in special
circumstances. It also operates in a deliberative way. These facts make an inde-
pendent commission particularly well-suited to perform a quasi-judicial function,
particularly important in light of the need to interpret Congressional intent as
expressed by the ethical principles laid down in the enabling legislation.
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Beyond Bioethics
To protect an independent commission from regulatory capture—that is,
undue influence from Congressional and interest groups—and also ensure
accountability will require that the Administrative Procedure Act (APA) be com-
plemented by a a novel procedure. The APA mandates that before regulatory agen-
cies finalize a new rule, they must publish the proposed rule in the Federal Register
and solicit comments from all interested and affected parties. This provision, sim-
ply known as notice-and-comment, was intended to ensure a measure of account-
ability: agencies must consider, and respond to, all substantive comments submit-
ted by the public. The courts have repeatedly underlined the importance of regu-
latory agencies pro-
viding extensive and
detailed justifications
for their regulatory
interventions.
judicial
These
known
decisions,
collectively as
IL
hard-look doctrine,
several
have had
unintended conse-
quences. Primo, Essi
have forced regula-
tors to consult exten-
sively with
quelli
organized groups most likely to make use of the court system. In the context of
reproductive medicine and biomedical research, consultation with organized
interest groups is likely to produce the kind of political gridlock we have seen at
the Congressional level over the last several years. This outcome would be partic-
ularly problematic since, as we show in our report,17 the general public is far more
centrist on many controversial issues than either the pro-science or the pro-life
camp. This kind of gridlock indicates a special kind of political failure: our current
administrative system cannot ensure that all societal perspectives are being heard,
and not just those of organized interest groups.
For the first time in the history of
modern administrative law it is
becoming possible for the public to
take on an active role in politics
outside regular elections and
referenda, a possibility that should be
taken seriously.
To prevent regulatory gridlock, in our report we propose complementing
notice-and-comment with a robust procedure of public consultation.18 One can
envisage different ways to implement a consultative process, but we see three
requirements that should always be met. The consulted sample of the public
should be representative of the population at large. The consultation should be
deliberative, and based on two-way communication. And the outcome of a consul-
tation should reflect informed opinions. In addition, the process should be
designed to avoid polarization: it should promote reciprocal understanding among
all participants and help reduce pre-deliberation prejudices. By contrast, a process
of public consultation is not designed to produce a consensus, though it is certain-
ly intended to promote consensual views.
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The results of such a consultative process would not be binding. Regulators
would be free to propose a new rule that departs significantly from the recommen-
dations emerging from a public consultation, but they would be required to pro-
vide a detailed rationale for their decision to ignore informed public opinion. Questo
requirement represents a strong disincentive for regulators who might favor a spe-
cial interest group over a clear consultative outcome. In its decision-making
process the agency would have to consider the possibility that the judiciary could
review this rule. Inoltre, in particularly controversial cases a blatant abuse of
administrative authority would likely attract wide public attention, eventually trig-
gering intense Congressional scrutiny. In most cases, the combined risk of judicial
review and public scrutiny should deter the agency from heeding special interests.
Note that a public consultation also protects an agency against Congressional
influence: an agency facing an unambiguous consultative result would be very
reluctant to consider Congressional demands informed by specific constituencies.
In sum, a process of public consultation provides one more mechanism by which
a formally independent regulatory agency can be held accountable, thereby hope-
fully reducing “arbitrary and capricious” decisions to a minimum.
The kind of political failure we have identified in our report19 is not limited to
reproductive medicine or biomedical research; it is quite common across the reg-
ulatory state. Regulatory agencies, ranging from the Environmental Protection
Agency to the Department of Energy to the Occupation, Safety and Health
Administration, have a long history of producing regulatory decisions driven by
the most influential interest groups, to the detriment of the public at large. Questo
phenomenon is certainly not new, but commentators and practitioners have long
ignored it, for two main reasons. When the theory of public choice arrived in the
1960s scholars of the administrative state largely abandoned explanations of polit-
ical action based on the notion of a general public interest, and started to see
administration and politics as based merely on the aggregation of self-interested
motives. The economic analysis of politics, which some consider to be excessively
cynical, has succeeded extremely well in illuminating many administrative and
political phenomena. D'altra parte, it has prevented scholars and practition-
ers alike from focusing on some serious shortcomings of our regulatory system.
The kind of political failure we have discussed here is a case in point. Our discus-
sion suggests that, conceptual difficulties notwithstanding, it is quite easy to iden-
tify cases in which the public interest is being systematically ignored. A tal fine,
no formal definition of public interest is needed, merely the empirical observation
that on an issue of national import a key constituency—the public—is not being
heard.
A second important reason for ignoring the kind of political failure discussed
in this essay is the lack of practicable corrective measures. Until recently, no viable
options were available to mobilize a large, unorganized political constituency.
Information technologies are changing this situation. For the first time in the his-
tory of modern administrative law it is becoming possible for the public to take on
an active role in politics outside regular elections and referenda, a possibility that
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should be taken seriously.
The regulatory institution we propose seeks to break out of this kind of admin-
istrative deadlock. More importantly, it seeks to move decisions about reproduc-
tive ethics out of the realm of bioethics and individual choice, and into the politi-
cal realm where they can be debated by the broader political community. Because
these decisions can help shape the future of humankind, they should not be left
simply to individuals and the market.
1. NOI. Department of Health und Human Services, Centers for Disease Control and Prevention
(1995): Reproductive Technology Success Rates. National Summary and Fertility Clinics Reports.
Atlanta, Georgia. NOI. Department of Health und Human Services, Centers for Disease Control
and Prevention (2004): Reproductive Technology Success Rates. National Summary and Fertility
Clinics Reports. Atlanta, Georgia.
2. Vedere
3. For a full account of this discussion see Francis Fukuyama and Franco Furger, “Beyond Bioethics:
A Proposal for Modernizing the Regulation of Human Biotechnologies”, Paul H. Nitze School for
Advanced International Studies, Washington DC, 2006. Available at http://www.biotechgov.org.
4. Michèle Hansen et al., “The Risk of Major Birth Defects after Intracytoplasmic Sperm Injection
and in Vitro Fertilization,” New England Journal of Medicine 346, NO. 10 (2002).
Tracy Hampton, “Panel Reviews Health Effects Data for Assisted Reproductive Technologies,"
Journal of the American Medical Association 292, NO. 24 (2004).
5 .In this procedure, the mother’s ooplasm, the tissue surrounding the egg’s nucleus, is replaced with
the ooplasm of a younger woman before being fertilized.
6. Rebecca Skloot, “Sally Has 2 Mommies and 1 Daddy,” Popular Science, Marzo 1, 2003.
7. The Sunday Times 6/5/2007 ‘Doctors screen embryos to avoid babies with squint’.
BBC News Online 8/5/2007 ‘Embryos to be screened for squint’.
8. Baruch, Susannah, David Kaufman, and Kathy L. Hudson. 2006. Genetic testing of embryos: prac-
tices and perspectives of U.S. IVF clinics. Genetics & Public Policy Center, Johns Hopkins
Università, Washington DC.
9. New Scientist 11/8/2006 ‘Debate rages over animal-human chimeras’.
The Guardian 5/10/2006 ‘Stem cell experts seek licence to create human-rabbit embryo’.
10. Nature 29/6/2006 ‘Human eggs supply ‘ethical’ stem cells’.
New Scientist 1/7/2006 ‘’Virgin birth’ stem cells bypass ethical objections’.
11. The Daily Mail 22/1/2007 ‘Couple pay £9,000 to have first British web baby’.
Christian Science Monitor 18/1/2007 ‘’Embryo bank’: new hope or too far?’.
12. Supra, footnote 3, ch. 5.
13. Supra, footnote 3, ch. 5.
14. Supra, footnote 3, ch 10-12.
15. Supra, footnote 3, ch 3.
16. While we believe that it is up to the political process to make the ultimate determination about
the moral status of the embryo, our own view is that the embryo as neither a mere clump of cells,
nor the moral equivalent of an adult individual. We do not believe an embryo deserves the same
legal protection as someone already born. At the same time we believe an embryo is more than
just biological material and deserves some measure of respect. This position is consistent with
the view expressed in 1999 by the National Bioethics Advisory Commission in its report on stem
cell research. It will not satisfy pro-life advocates, but it is defensible and creates a much-needed
space for political compromises. (National Bioethics Advisory Commission (1999): Ethical Issues
in Human Stem Cell Research, Vol. 1. Rockville, MD)
17. Supra, footnote 3, ch. 8.
18. Supra, footnote 3, ch. 12.
19. Supra, footnote 3, ch. 10.
innovazioni / autunno 2007
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