Two rival groups are fighting over the legal status of cloning in Israel: one sees it as a legitimate technique that will help infertile couples, the other sees it as a danger to humanity. Intermediate result: a draw (ie, not for now, but maybe in the future)
Tamara Traubman, Haaretz
Illustration: Michal Bonano * From the left: Shlomo Shoham: "I don't understand why a clone is needed. The scientists rush forward to intervene in nature even before the various consequences are clear to us. There is also something very macho here" Photo: Guy Reivitz
For the past four months, a campaign has been conducted in the Knesset on the question of the legal status of human cloning. Until the beginning of the year, cloning was prohibited under a temporary law (moratorium) for five years, which expired. A few weeks before, in November 2003, the Knesset's Science Committee began to discuss extending the validity of the law, and encountered strong opposition. "I have already had dozens of meetings," says the chairman of the committee, MK Mali Polishuk, who asked to make the ban on cloning permanent. "Dozens of people gather at each yeshiva. In no field have there been such intrusive and unpleasant meetings, with a group of researchers aggressively trying to stamp out everything else. All opinions are legitimate, but in no meeting have I seen such aggressive behavior. They take advantage of their position as experts, but in ways that are inappropriate in my opinion."
In the 80s, Prof. Yosef Shankar was one of the first to produce test-tube babies in Israel. Then he was one of the pioneer doctors who froze fertilized eggs and the first to use egg donation to create a baby. Now, after years in which he managed the women's department at the Hadassah Ein Kerem Hospital and performed countless fertility treatments, Prof. Shankar has come to the conclusion that there is no escape from starting to breed babies. In the eyes of many, cloned humans are still seen as a twisted dream from science fiction or as evidence of science out of control. Prof. Shanker, on the other hand, sees cloning as a completely legitimate technique. According to him, the cloning should be an additional tool, one of the variety of fertilization methods offered to couples who cannot give birth to children naturally. According to him, he simply "sees things in a practical way".
The intention of the chairman of the science committee to cancel the temporary nature of the law and perpetuate the ban alarmed Prof. Shankar and some of his colleagues, and they appeared before the committee to convince the members of the Knesset that such a permanent ban would seriously harm the progress of science and medicine. The pressure finally had an effect, and at a meeting held on March 1, the Science Committee decided to submit to the Knesset plenum for approval a version of a law that only temporarily prohibits the reproduction of humans. The temporary law was accepted in the plenum with the votes of 37 Knesset members and without opposition.
The group of doctors and scientists who support Schenker's position are not people working on the sleepy fringes of the scientific community, in contrast to the American gynecologist Dr. Panos Zavos, who claimed last month (without presenting evidence) that the embryo is cloned in a woman's uterus, or the chemist Dr. Brigitte Boislier from the movement Haralit, who announced last year that a team led by her led to the birth of a cloned baby girl (she also did not provide proof). In Israel these are recognized and experienced doctors and scientists, who are considered highly respected by their colleagues.
One of the prominent opponents of a permanent law against cloning is Prof. Michel Rebel, a biologist from the Weizmann Institute and winner of the Israel Prize in Medicine. According to him, his position coincides with "Israeli-Jewish ethics", and is a unique position to be proud of and presented at every opportunity in international forums. Human replication, he said, may one day "enable an infertile couple to give birth to a genetic twin to the father or mother." This position does not "harm human dignity", in his opinion, but is "a medical procedure for cases where there is no method of reproduction
Photo: Guy Raivitz
Other".
The opponents are a small but powerful group of scientists and doctors, backed by some rabbis, who believe that cloning is not necessarily a bad thing. Although at the moment they do not want to allow the creation of cloned babies, because of the high rate of abortions and birth defects expected in cloned offspring; But if the method is perfected and becomes safer to use, they see it as a legitimate future means. In their view, in some cases cloning is even better than adopting a baby, or using a sperm or egg donation.
Abroad the situation is different. Some of the world's most senior and prominent ethicists and jurists see the reproduction of babies as a violation of human dignity and even propose to define it as a crime against humanity. According to their approach, human cloning is inherently bad. This is also the opinion of retired judge Shlomo Shom, the Commissioner for Future Generations in the Knesset, whose role it is to examine the consequences of the new and existing laws on future generations.
"The difficulty with the issue of cloning is that it will always come from a place of ego," says Shoham. "The ego of scientists who want to do research that no one has done, and the ego of people who want to clone themselves. It is therefore essential to have a very clear normative message, in the form of a permanent law prohibiting the cloning of humans for reproductive purposes. The scientists rush forward to intervene in nature even before the various consequences are clear to us. There is also something very macho here. I don't understand why cloning is needed: either there is a racial theory of genetic improvement here, or, in the worst case, a matter of ego."
Stormy meetings
The discussions in the Knesset on renewing the cloning law started late, only about a month before the temporary law expired. According to attorney Nira Lamai, from the Commission for Future Generations in the Knesset, "the whole idea of deciding on such a fundamental issue in such a narrow time frame, in advance did not allow for a serious discussion. Many of the possible effects of cloning have not been examined: on women, on eggs, on society, on the children that will be born."
At the meetings, the clone fans had an overwhelming numerical advantage. Even though this is a fundamental question for the human nature of society, the chairman of the committee, MK Polishuk (Shinoi), was the only MK in the hall in most of the meetings. Even for the decision at the crucial meeting, out of the 13 members of the committee, only Polishok arrived. She decided that the law against cloning would be permanent. The bill was already ready to go to a second and third reading, but after the meeting, the committee's legal advisor noticed that in the objective section of the draft law, the words "for a fixed period" remained.
Legal advisors from other committees in the Knesset say that from the spirit of the discussion there was no doubt that the intent was to enact a permanent law, and therefore the legal advisor had full authority to make the change herself and delete the two words, without convening the committee once more. But in the middle of January the committee met again. This time, with the encouragement of MK Leah Ness (Likud), several members of the Knesset, who were not present at the previous meetings (or came in for a short time), came and voted against the bill that was formulated and in favor of returning it for further discussion in the committee.
Conversations with committee members make it clear that the information on which they based their vote is partial and biased. "I received a lot of material," says MK Yigal Yesinov (Change). "I admit that I didn't really read it, I just looked at it." He has not been exposed to any of the critical positions that support a permanent law, but he also does not rule out giving permission for all kinds of research on the bodies of dead women and the wombs of living women to produce "replacement organs".
MK Aryeh Eldad (National Union), who is a professor of medicine, voted against a permanent law that would ban cloning, but in a conversation with him it becomes clear that he is in general strongly opposed to cloning, "from now and forever", as he defines it. So why did he vote against? Because he wants two separate laws: one that prohibits the cloning of humans for reproductive purposes, the second that regulates and permits the cloning of embryos for research purposes. MK Gila Gamliel (Likud) sees no difference between a temporary law and a permanent one. "I don't think there is a problem with the law being temporary," she says.
Looking at the minutes kept from the discussions on the previous cloning law, the discussions of the current committee also appear to be a clone of the previous meetings. The composition of the participants is similar: ruling scientists and doctors, two philosophers (Prof. Asa Kosher from Tel Aviv University and Prof. David Head from the Hebrew University) who find reasons to support the scientists' position, a handful of Knesset members, and the same inflammatory language. Attorney Hagi Marom, a former MK in the Labor faction and the initiator of the original law, recalled that the scientists then demanded that there be no law at all. It is not possible for society and the politicians to determine for us what will be done inside our laboratories, they were shocked.
Some of the scientists and doctors who came to the meetings presented themselves as objective and disinterested representatives of science. Prof. Yosef Itzkovitz, for example, praised cloning for research purposes: "This technology will actually make it possible to bring about one of the biggest revolutions in the history of medicine and biology, which will actually make it possible to take every cell in the human body and turn it into heart muscle cells, brain cells, insulin-producing cells. The meaning is far-reaching."
The same Itzkovitz provided a research group from the University of Wisconsin with embryos from the Rambam Hospital for an experiment in which "rows" of human embryonic stem cells were produced for the first time. Today he is one of dozens of researchers in the world who own lines of human embryonic stem cells, and has already submitted to the US Patent Registrar three applications for patents related to stem cells.
Analysts predict that the future market value of embryonic stem cell-based therapies will be more than $30 billion a year, and some are projecting twice that number. Big profits will be raked in by the patent holders who control the technology. Prof. Itzkovitz wants to clone embryos also to produce new lines of stem cells from them, and came to the committee meeting to make sure that the legislator does not put an obstacle in his way.
Prof. Benjamin Raubinoff is a gynecologist and scientist at Hadassah Ein Kerem. He attended two meetings of the committee, introducing himself as a researcher of embryonic stem cells. A few years ago he went to Monash University in Australia to isolate stem cells from human embryos. Since this research was deemed unethical and prohibited in the province of Victoria, where the university is located, Raubinoff traveled to Singapore to perform the experiments on embryos there. He is currently associated with at least one commercial embryonic stem cell company and stem cell related patents.
Dr. Aharon Zuckert, who participated in three meetings of the committee, manages the research and development division of Hadassah Ein Kerem. A major part of the private investments attracted by Hadassah's implementation company, "Hadisit", comes thanks to the intellectual property in the attractive research of stem cells. "The whole issue of cloning has tremendous financial potential," said Dr. Nurit Babnik, a representative of the Bar Association, at one of the meetings. "People who are not connected in this way in any other way and have no touch on future profits that may be in this field should be brought in here."
without the public's knowledge
UNESCO has defined human cloning as "contrary to human dignity", and in the last two years a convention that would prohibit human cloning has been discussed at the UN. In Israel cloning is not considered a taboo and in some cases it is even considered a desirable act. This is expressed on many levels:
* In all countries that enacted laws against human cloning, cloning was permanently banned; In Israel, the law is temporary.
* Doctors, such as Prof. Shanker, openly express their desire to use a certain cloning method for the sake of having children. The prohibition in the law only applies to methods like the one used to create Dolly the sheep, which allow a person to be duplicated in the image of another adult person. Prof. Shanker wants to be allowed to use another cloning method, known as "embryo splitting": in the first step, an embryo is created by in vitro fertilization between a sperm and an egg; In the next step, when the fertilized egg divides into several cells, it is split in two. In theory, each part can develop into a whole embryo. The resulting embryos, which are genetic twins of each other, will be implanted in the mother's womb. Israeli law does not refer to the splitting of embryos at all, and hence this is not prohibited.
* The Helsinki Committee for Genetic Experiments of the Ministry of Health has already determined that, in principle, it is permissible to clone human embryos in order to carry out research on them and derive stem cells from them. Other studies on embryos are also allowed: for example, it is allowed to take "surplus embryos", left in in vitro fertilization clinics, to extract embryonic stem cells from them. Such a cell can develop into any of the cell types in the body. Many scientists estimate that in the future it will be possible to use stem cells to cure diseases such as Parkinson's, Alzheimer's and diabetes.
The method proposed by Shankar involves significant risks. For now, until the legal status of cloning by splitting embryos is clarified, Prof. Shanker refrains from offering it to his patients. But he is convinced that as soon as they allow it, there will be women interested. "The method is especially good for older women who don't get eggs, or in other words, you get one embryo, so the chance of pregnancy is low. If you can double the embryo you obtained, it goes without saying that you have a greater chance of having children from the same treatment cycle. You can duplicate many embryos from the same embryo, so you also need restrictions: it is forbidden to create more than two embryos from the same embryo, and the children that will be created from them are forbidden to be born more than five years apart from each other."
And don't you think it's strange that a child will grow up and look exactly like his older brother?
"Yes, otherwise we wouldn't talk about it at all, but if we talk about two, and no more, it can be accepted."
Prof. Shankar is also convinced that in the future, adult humans will be able to clone people in their own image, just as they cloned Dolly. "when will it happen? I don't know, but it will happen and it will happen gradually."
To understand how unusual the situation in Israel is, one must check what has been done in other Western countries. From a review prepared by attorney Gilad Goldenberg, a researcher in the Ethics and Health Rights Unit at the Gartner Institute for Health Policy Research, who is completing a thesis on the legal aspects of cloning, it becomes clear that in many countries in Europe and the United States, and in international bodies such as the United Nations and the Council of Europe, efforts are being made to ban Embryo cloning for research purposes.
Goldenberg cites a report published in 2003 on behalf of the European Community Commission, according to which only in Great Britain is there a legal possibility to conduct research on embryo cloning, also subject to clear and strict rules. In Sweden today there is a general ban on creating embryos for research, however a parliamentary committee has re-examined the ban and recommends allowing it. A similar bill is also being discussed in Belgium, which would allow the creation of embryos for research.
In contrast to Israel, in all countries that have allowed or are considering allowing the cloning of embryos for research, the limits of the research are regulated by law and a series of restrictions have been established, including a ban on raising the embryo beyond 14 days and a ban on paying for eggs or importing them. In all these countries there is also a permanent law prohibiting the cloning of humans for reproductive purposes. Research in embryos is also done in Australia and China. In the United States there is no ban on researching embryos with private research funds, and one commercial company has announced that it is engaged in attempts to clone embryos.
The law in the UK was prepared with strict transparency in mind. Prior to the legislation, an in-depth examination was conducted and a detailed report prepared by a committee was submitted to the public and parliament for review. The regulations allow embryos to be cloned only under very restrictive conditions, and a state authority strictly supervises all research on embryos and fertilization treatments.
In Israel this happened without an actual public debate taking place. The "Helsinki Supreme Committee for Genetic Experiments on Humans", a committee of the Ministry of Health in charge of approving genetic experiments, decided to "approve in principle" also the cloning of embryos for research purposes. Apart from one public representative and two lawyers who deal with bioethics, all the other 15 members of the committee are doctors, scientists and government officials (most of whom are also doctors or scientists). They decided that it is more "in principle" for the members of the scientific community to carry out the most controversial research, which provokes a stormy public debate all over the world, and this without any public consultation, without even giving the information about it to the public, and before a mechanism for supervision and control has been established.
"We approve the requests or make comments on them and we have no follow-up on what happens after that," previously warned the chairman of the committee, Prof. Boleslav Goldman. "We don't know if the experiment was carried out or not, if it was carried out in accordance with what was approved or if changes were made." He asked to give the committee, or another state body, powers and resources that would enable supervision of the studies.
The "public debate" in Israel has remained for the last five years an intimate conversation between scientists, doctors and a very limited number of ethicists and jurists. He almost didn't break out beyond that, into society. Three committees are currently involved in the field of cloning. Six of the members of one committee are also members of another committee. For example, the biologist Prof. Rebel serves as the chairman of the bioethics committee of the National Academy of Sciences, and is also a member of the other two committees. The three decided that the temporary cloning law should be extended, and not become a permanent law.
"Not everyone shares this position," says a doctor who is a member of the Helsinki Committee, who asked to remain anonymous, "but that pressure group, which appeared in the Knesset to deal with the cloning law, is so strong that there is no possibility of passing other decisions."
On their way to breaking through more and more limits set by nature, the scientists and doctors appropriated to themselves the decision on the issue of cloning. "I heard from some of the people who sit on the committees that they are adamantly against cloning," MK Polishuk said. "I heard from some of them, in the letters I received and in personal conversations, that those who had a different opinion - shut their mouths."
"A five-year moratorium gives scientists control," says attorney Nira Lamai, from the Commission for Future Generations in the Knesset. "The scientists who came to the meetings challenged the right of elected officials to make their own moral decisions. Today this place belongs only to scientists."
The main problem in the discussion about cloning in Israel, says Prof. Hagit Maser-Yeron from Tel Aviv University, former chief scientist of the Ministry of Science, is that the public is not involved in decision-making. "Human cloning is not a biological question, it is a moral and social question. We as scientists do not have any advantage in formulating a position on the matter than any other citizen, our conscience is no more or less good in this matter."
Who authored the report?
"The way the decisions were made was contrary to all logic and proper administrative order," says Dr. Babnik from the Bar Association, which supports a permanent ban on cloning. "The members of the committee, who were supposed to determine the law that changes world order and the way of nature, did not come to the crucial meeting where they discussed the nature of the ban that would be imposed. By virtue of what did they vote?"
According to Dr. Babnik, "The moratorium did not work, and no public discussion that could be called adequate was held. The moratorium only postponed the discussion for five years, so there is no reason to extend such a law again." The Helsinki Committee for Genetic Experiments was required to submit an annual report to the Minister of Health. In practice, a partial report was submitted only in 2002 and the full report was submitted only in December 2003.
In response, the deputy chairman of the committee, Dr. Zelina Ben Gershon, from the Office of the Chief Scientist of the Ministry of Health, says: "There was not much to report on. We work without resources." If so, who compiled the report and how? The answer was given in one of the last meetings by Prof. Michel Rebel, who is also connected to at least one commercial company and patents in the field of genetics.
According to Rebel, he was approached by the Helsinki Committee to volunteer and write a report. He did this on his own accord and selected the articles, which he believed had relevant scientific significance. At least five members of the committee said they did not receive the report for review before submitting it, and it was submitted as is, on behalf of the committee. Apart from references to the conservative position of the Catholic Church, which opposes human cloning, there is no mention of the multitude of critical positions of those opposed to human cloning.
The moratorium has not proven itself, they and Amai from the Commission for Future Generations also say. "The in-depth discussion did not take place," Lamai warned in one of the last meetings. "The same sword of the expiration of the law actually forces us to make this discussion a quick and urgent discussion, a discussion that in the end does not bring to the door of the decision makers everything they need to know."
Human cloning is not yet possible and it is not certain that it will ever be possible. No one has succeeded in cloning even a monkey. The greatest success in the field of human cloning was the creation of embryos, which only reached the most initial stages of human development, with only a few cells. Despite this, Dr. Zuckert, head of the research and development department at Hadassah, is convinced that if a permanent law against cloning was passed, a major disaster could have occurred. "If today you prohibit something by law, it immediately affects all research in the field and there is no allocation of funds."
But the law does not explicitly prohibit research in the field of cloning. It does not refer to cloning for research purposes at all.
"These subtleties are beautiful and good for those who sit in the committee discussion. The scientists also know that there is a ban, and not everyone is aware of the ease with which a law can be changed, so they will not reach this area in advance. Look what happened to the field of embryonic stem cells in the United States. It is allowed to do research in embryonic stem cells even with federal funding, but the result itself, look what it did to research in the United States. A scientist knows that he can go to area A and area B, why does he need to enter an area that has prohibitions in advance? Everyone secretly wants to get the phone from Stockholm, so always strive for a much higher and more distant goal. The calibers in the field will say, 'Why do I need all this?'"
Prof. Rebel feared that a law permanently prohibiting the cloning of humans would demonize science, and encourage the public to see science as the "devil." Dr. Sharga Belzer, director of the neonatal unit at Rambam Hospital and chairman of a committee of the Ministry of Health "to determine the status of the human fetus in medical sciences", also claims that if the permanent law was accepted, "an entire branch of science and research" could have been eliminated.
These, by the way, are original Israeli reasons. The scientists and doctors who appeared in the Knesset did not bring even one such quote from abroad to strengthen their position, perhaps because this type of reasoning was not voiced elsewhere.
A cynical and demagogic argument
According to Dr. Belzer, "We, the doctors, faced exactly this situation 15 years ago when they started in vitro fertilization. The same arguments that it is against nature and interfering with the act of creation came up even then, and today who even remembers them? To make the law now state that the State of Israel says that we have already determined that the subject is forbidden forever, is both an injury to scientists and may have significant consequences for healing people. A scientist goes after things that have a chance in the future. For us, this statement has a tremendous meaning. The permanent law says, 'We consider this whole technique to be invalid'".
The permanent bill did not ban the cloning method itself, or the development of healing methods, it only banned one of the potential applications of the method: human cloning for reproductive purposes.
"it is the same thing. There are few scientists who deal with this in the world. When the United States banned federally funded stem cell research, many laboratories moved to England. The scientists don't want to mess with something they put a veto on."
Referring to claims of this type, MK Ofir Paz-Fines (Labor), a member of the Science Committee who stated that he is in favor of a permanent law, said that the same arguments can also be examined from the opposite point of view. According to him, "When you say that the law is temporary, you are not conveying a scientific message, but a moral message, that in fact it is forbidden, but not really forbidden."
When she also sought to propose a permanent law, Dr. Belzer accused the chairman of the Knesset's science committee of acting "contrary to the majority of the scientific community." "The scientific community in Israel is a responsible community," says Belzer. "The Committee for Determining the Status of the Fetus, which I chair, demanded that the punishment for scientists who break the law be toughened. We demanded that the Helsinki Committee be given the tools to check what is happening. We want the State of Israel to have a balanced law that says 'prohibited' but does not break the dialogue."
But laws can also be changed, sometimes too easily.
"This is a cynical and demagogic argument. By moratorium we say 'ban cloning for reproductive purposes, but continue to talk', the other side says 'ban and not talk'. What is the fear? In a democratic and enlightened country, why not talk? Why shut up now forever? It is necessary to continue the dialogue between the legislator and the scientist".
In what cases does Dr. Belzer believe that the clan would be justified? "In very specific cases", he says. "For example, infertile couples who use sperm donation. Some people are not ready to accept a sperm donation, there is a fear of bastards, a donation is sperm from someone you don't know, you don't know what diseases he has. Why risk it?"
So actually you are not talking about "rare cases". Today, thousands of couples in the world use sperm donations.
"No. I say that in the example of sperm donation, there are people who want to donate and there are people who don't. We are not talking in general, but about individual cases. We are talking about a respectable community here, not about people who will go and clan in the dark with armies of soldiers, like in the science fiction movies. 'Clone' is not a good term. It reminds of the word tribe, and gives the impression that cloning is like creating a tribe. But that's not what cloning is about, it's much easier to find girls who will do it for free."
What is allowed, what is not allowed
The "Prohibition of Genetic Intervention Law (Human Cloning and Genetic Modification of Reproductive Cells)" entered into force in 1999. The law, the result of the initiative of MK Hagai Marom, prohibited for five years creating a person in the image of another person and making genetic changes in reproductive cells (eggs and sperm cells). . He obliged the "Supreme Helsinki Committee for Genetic Experiments on Humans" to submit to the Minister of Health every year a report reviewing the developments in the field of cloning. The committee submitted only one report.
The new law extends the prohibition period on human cloning for reproductive purposes for another five years, and does not mention embryo cloning for research purposes at all. There is more emphasis in it on the continuation of the thinking and discussion on cloning: the Helsinki Committee is obliged to submit the annual report not only to the Minister, but also to the Science Committee, which will conduct an annual discussion on the matter (instead of one discussion every five years) and make sure that the reports are indeed made. The new proposal also clarifies some vague points that were in the previous law. For example, the old law prohibited only the "final product" - a cloned person, but did not prohibit all actions that could be done on the way to it, such as implanting a cloned embryo in a woman's womb. Now that too is expressly forbidden. The punishment was also made worse: the perpetrators now face four years in prison, instead of two years.
Scientists: no conflict of interest
Scientists and doctors respond to the claim that they have financial interests in the cloning law.
Prof. Yosef Itzkovits, Director of the Women's Department at Rambam: "The claim is imaginary, pathetic and reflects an incredible lack of understanding. Every sane person, who wants to continue promoting medicine and saving people, wants this research to be possible. It is clear that every academic institution has a financial interest in its research, it is also an interest of the state. But here we are talking about research that will continue for years to come. The research is not yet applied at all."
Prof. Binyamin Raubinoff, gynecologist and scientist from Hadassah Ein Kerem: "I come to the committee as a consultant who deals in this field. I don't think there is any thought that I come to the committee as an objective public representative, but as a scientist working in the field. I think the huge potential that embryonic stem cells have in terms of basic science and clinical applications is huge. That's my main motivation, not the financial issue. I am interested in seeing ourselves, as a country, engaged in the field and continue to lead in it.
"The development of the field of cloning as 'medical cloning' is scientifically and clinically important, so it is very important that we continue to promote it. As for the commercial side, the involvement of commercial parties in research is today a part of scientific practice, because in many cases funding from commercial sources is the only way to advance many fields to clinical realization. It is accepted today all over the world. It seems to me quite detached from reality to think that we are motivated by material considerations. The purpose of our relationship with industry is to promote research and development."
Dr. Aharon Zuckert, Head of the Research and Development Division of Hadassah Ein Kerem: "I am not responsible for 'Hadisit', which is a separate entity, even though I sit on its board of directors. Research and development in hadassah has no direct connection to 'hadassith' in the sense of personal and institutional profit. I wish (that the research) would attract more investments, I don't see anything wrong with developing an area that has more private investments than institutions. But between that and seeing fruits from it, the road is long and most likely neither I nor the next in office will see fruits from it. Beyond that, cloning is not related to stem cells at all."
