Bioethics

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Bioethics

Bioethics is the study of the ethical issues emerging from advances in biology and medicine. It is also moral discernment as it relates to medical policy and practice. Bioethics are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine and medical ethics, politics, law, theology and philosophy. It includes the study of values relating to primary care and other branches of medicine ("the ethics of the ordinary"). Ethics also relates to many other sciences outside the realm of biological sciences.

Etymology

The term Bioethics (Greek bios, life; ethos, behavior) was coined in 1926 by Fritz Jahr in an article about a "bioethical imperative" regarding the use of animals and plants in scientific research. In 1970, the American biochemist Van Rensselaer Potter used the term to describe the relationship between the biosphere and a growing human population. Potter's work laid the foundation for global ethics, a discipline centered around the link between biology, ecology, medicine, and human values. Sargent Shriver, the spouse of Eunice Kennedy Shriver, claimed that he had invented the word "bioethics" in the living room of his home in Bethesda, Maryland in 1970. He stated that he thought of the word after returning from a discussion earlier that evening at Georgetown University, where he discussed with others a possible Kennedy family sponsorship of an institute focused around the "application of moral philosophy to concrete medical dilemmas."

Purpose and scope

The field of bioethics has addressed a broad swathe of human inquiry; ranging from debates over the boundaries of life (e.g. abortion, euthanasia), surrogacy, the allocation of scarce health care resources (e.g. organ donation, health care rationing), to the right to refuse medical care for religious or cultural reasons. Bioethicists often disagree among themselves over the precise limits of their discipline, debating whether the field should concern itself with the ethical evaluation of all questions involving biology and medicine, or only a subset of these questions. Some bioethicists would narrow ethical evaluation only to the morality of medical treatments or technological innovations, and the timing of medical treatment of humans. Others would broaden the scope of ethical evaluation to include the morality of all actions that might help or harm organisms capable of feeling fear.

The scope of bioethics can expand with biotechnology, including cloning, gene therapy, life extension, human genetic engineering, astroethics and life in space, and manipulation of basic biology through altered DNA, XNA and proteins. These developments will affect future evolution, and may require new principles that address life at its core, such as biotic ethics that values life itself at its basic biological processes and structures, and seeks their propagation. Panbiotic seeks to secure and expand life in the galaxy.

Historian Yuval Noah Harari sees an existential threat in an arms race in artificial intelligence and bioengineering and he expressed the need for close co-operation between nations to solve the threats by technological disruption. Harari said AI and biotechnology could destroy what it means to be human.

Principles

Hippocrates Refusing the Gifts of Artaxerxes by Anne-Louis Girodet-Trioson

One of the first areas addressed by modern bioethicists was that of human experimentation. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was initially established in 1974 to identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects. However, the fundamental principles announced in the Belmont Report (1979)—namely, respect for persons, beneficence and justice—have influenced the thinking of bioethicists across a wide range of issues. Others have added non-maleficence, human dignity, and the sanctity of life to this list of cardinal values. Overall, the Belmont Report has guided research in a direction focused on protecting vulnerable subjects as well as pushing for transparency between the researcher and the subject. Research has flourished within the past 40 years and due to the advance in technology, it is thought that human subjects have outgrown the Belmont Report and the need for revision is desired.

Another important principle of bioethics is its placement of value on discussion and presentation. Numerous discussion based bioethics groups exist in universities across the United States to champion exactly such goals. Examples include the Ohio State Bioethics Society and the Bioethics Society of Cornell. Professional level versions of these organizations also exist.

Many bioethicists, especially medical scholars, accord the highest priority to autonomy. They believe that each patient should determine which course of action they consider most in line with their beliefs. In other words, the patient should always have the freedom to choose their own treatment.

Medical ethics

Ethics affects medical decisions made by healthcare providers and patients. Medical ethics is the study of moral values and judgments as they apply to medicine. The four main moral commitments are respect for autonomy, beneficence, nonmaleficence, and justice. Using these four principles and thinking about what the physicians’ specific concern is for their scope of practice can help physicians make moral decisions. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.

Medical ethics tends to be understood narrowly as an applied professional ethics; whereas bioethics has a more expansive application, touching upon the philosophy of science and issues of biotechnology. The two fields often overlap, and the distinction is more so a matter of style than professional consensus. Medical ethics shares many principles with other branches of healthcare ethics, such as nursing ethics. A bioethicist assists the health care and research community in examining moral issues involved in our understanding of life and death, and resolving ethical dilemmas in medicine and science. Examples of this would be the topic of equality in medicine, the intersection of cultural practices and medical care, and issues of bioterrorism.

Perspectives and methodology

Bioethicists come from a wide variety of the backgrounds and have training in the diverse array of disciplines. The field contains individuals trained in philosophy such as H. Tristram Engelhardt, Jr. of Rice University, Baruch Brody of Rice University, Peter Singer of Princeton University, Daniel Callahan of the Hastings Center, and Daniel Brock of Harvard University; medically trained clinician ethicists such as Mark Siegler of the University of Chicago and Joseph Fins of Cornell University; lawyers such as Nancy Dubler of Albert Einstein College of Medicine or Jerry Menikoff of the federal Office of Human Research Protections; political scientists like Francis Fukuyama; religious studies scholars including James Childress; and theologians like Lisa Sowle Cahill and Stanley Hauerwas. The field, formerly dominated by formally trained philosophers, has become increasingly interdisciplinary, with some critics even claiming that the methods of analytic philosophy have had a negative effect on the field's development. Leading journals in the field include The Journal of Medicine and Philosophy, The Hastings Center Report, the American Journal of Bioethics, the Journal of Medical Ethics, Bioethics, the Kennedy Institute of Ethics Journal and the Cambridge Quarterly of Healthcare Ethics. Bioethics has also benefited from the process philosophy developed by Alfred North Whitehead. Another discipline that discusses bioethics is the field of feminism; The International Journal of Feminist Approaches to Bioethics has played an important role in organizing and legitimizing feminist work in bioethics.

Many religious communities have their own histories of inquiry into bioethical issues and have developed rules and guidelines on how to deal with these issues from within the viewpoint of their respective faiths. The Jewish, Christian and Muslim faiths have each developed a considerable body of literature on these matters. In the case of many non-Western cultures, a strict separation of religion from philosophy does not exist. In many Asian cultures, for example, there is a lively discussion on bioethical issues. Buddhist bioethics, in general, is characterized by a naturalistic outlook that leads to a rationalistic, pragmatic approach. Buddhist bioethicists include Damien Keown. In India, Vandana Shiva is a leading bioethicist speaking from the Hindu tradition.

In Africa, and partly also in Latin America, the debate on bioethics frequently focuses on its practical relevance in the context of underdevelopment and geopolitical power relations. In Africa, their bioethical approach is influenced by and similar to Western bioethics due to the colonization of many African countries. Some African bioethicists are calling for a shift in bioethics that utilizes indigenous African philosophy rather than western philosophy. Some African bioethicists also believe that Africans will be more likely to accept a bioethical approach grounded in their own culture, as well as empower African people.

Masahiro Morioka argues that in Japan the bioethics movement was first launched by disability activists and feminists in the early 1970s, while academic bioethics began in the mid-1980s. During this period, unique philosophical discussions on brain death and disability appeared both in the academy and journalism. In Chinese culture and bioethics, there is not as much of an emphasis on autonomy as opposed to the heavy emphasis placed on autonomy in Western bioethics. Community, social values, and family are all heavily valued in Chinese culture, and contribute to the lack of emphasis on autonomy in Chinese bioethics. The Chinese believe that the family, community, and individual are all interdependent of each other, so it is common for the family unit to collectively make decisions regarding healthcare and medical decisions for a loved one, instead of an individual making an independent decision for his or her self.

Some argue that spirituality and understanding one another as spiritual beings and moral agents is an important aspect of bioethics, and that spirituality and bioethics are heavily intertwined with one another. As a healthcare provider, it is important to know and understand varying world views and religious beliefs. Having this knowledge and understanding can empower healthcare providers with the ability to better treat and serve their patients. Developing a connection and understanding of a patient's moral agent helps enhance the care provided to the patient. Without this connection or understanding, patients can be at risk of becoming "faceless units of work" and being looked at as a "set of medical conditions" as opposed to the storied and spiritual beings that they are.

Islamic bioethics

Bioethics in the realm of Islam differs from Western bioethics, but they share some similar perspectives viewpoints as well. Western bioethics is focused around rights, especially individual rights. Islamic bioethics focuses more on religious duties and obligations, such as seeking treatment and preserving life. Islamic bioethics is heavily influenced and connected to the teachings of the Qur'an as well as the teachings of Prophet Muhammad. These influences essentially make it an extension of Shariah or Islamic Law. In Islamic Bioethics, passages from the Qur'an are often used to validate various medical practices. For example, a passage from the Qur'an states "whosoever killeth a human being … it shall be as if he had killed all humankind, and whosoever saveth the life of one, it shall be as if he saved the life of all humankind." This excerpt can be used to encourage using medicine and medical practices to save lives, but can also be looked at as a protest against euthanasia and assisted suicide. A high value and worth is placed on human life in Islam, and in turn human life is deeply valued in the practice of Islamic bioethics as well. Muslims believe all human life, even one of poor quality, needs to be given appreciation and must be cared for and conserved.

In an effort to react to new technological and medical advancements, informed Islamic jurists regularly will hold conferences to discuss new bioethical issues and come to an agreement on where they stand on the issue from an Islamic perspective. This allows Islamic bioethics to stay pliable and responsive to new advancements in medicine. The standpoints taken by Islamic jurists on bioethical issues are not always unanimous decisions and at times may differ. There is much diversity among Muslims varying from country to country, and the different degrees to which they adhere by Shariah. Differences and disagreements in regards to jurisprudence, theology, and ethics between the two main branches of Islam, Sunni and Shia, lead to differences in the methods and ways in which Islamic bioethics is practiced throughout the Islamic world. An area where there is a lack of general consensus is brain death. The Organization of Islamic Conferences Islamic Fiqh Academy (OIC-IFA) holds the viewpoint that brain death is equivalent to cardiopulmonary death, and acknowledge brain death in an individual as the individual being deceased. On the contrary, the Islamic Organization of Medical Sciences (IOMS) states that brain death is an "intermediate state between life and death" and do not acknowledge a brain dead individual as being deceased.

Islamic bioethicists look to the Qur'an and religious leaders regarding their outlook on reproduction and abortion. It is firmly believed that reproduction of a human child can only be proper and legitimate via marriage. This does not mean that a child can only be reproduced via sexual intercourse between a married couple, but that the only proper and legitimate way to have a child is when it is an act between husband and wife. It is okay for a married couple to have a child artificially and from techniques using modern biotechnology as opposed to sexual intercourse, but to do this out of the context of marriage would be deemed immoral.

Islamic bioethics is strongly against abortion and strictly prohibits it. The IOMS states that "from the moment a zygote settles inside a woman's body, it deserves a unanimously recognized degree of respect." Abortion may only be only permitted in unique situations where it is considered to be the "lesser evil."

Feminist approaches to bioethics

Feminist approaches to bioethics critiques the fields of bioethics and medicine for its lack of inclusion of women’s and other marginalized group's perspectives. This lack of perspective from women is thought to create power imbalances that favor men. These power imbalances are theorized to be created from the androcentric nature of medicine.  One example of a lack of consideration of women is in clinical drug trials that exclude women due to hormonal fluctuations and possible future birth defects.  This has led to a gap in the research on how pharmaceuticals can affect women. Feminist bioethicists call for the necessity of feminist approaches to bioethics because the lack of diverse perspectives in bioethics and medicine can cause preventable harm to already vulnerable groups.

This study first gained prevalence in the field of reproductive medicine as it was viewed as a "woman's issue". Since then, feminist approaches to bioethics has expanded to include bioethical topics in mental health, disability advocacy, healthcare accessibility, and pharmaceuticals. Lindemann notes the need for the future agenda of feminist approaches to bioethics to expand further to include healthcare organizational ethics, genetics, stem cell research, and more. 

Notable figures in feminist bioethics include Carol Gillian, Susan Sherwin, and the creators of the International Journal of Feminist Approaches to Bioethics, Mary C. Rawlinson and Anne Donchin. Sherwin's book No Longer Patient: Feminist Ethics in Health Care (1992) is credited with being one of the first full-length books published on the topic of feminist bioethics and points out the shortcomings in then-current bioethical theories. Sherwin's view point incorporates models of oppression within healthcare that intend to further marginalize women, people of color, immigrants, and people with disabilities. Since created in 1992, The International Journal of Feminist Approaches to Bioethics has done much work to legitimize feminist work and theory in bioethics.

Ethical issues in gene therapy

Gene therapy involves ethics, because scientists are making changes to genes, the building blocks of the human body. Currently, therapeutic gene therapy is available to treat specific genetic disorders by editing cells in specific body parts. For example, gene therapy can treat hematopoietic disease. There is also a controversial gene therapy called "germline gene therapy", in which genes in a sperm or egg can be edited to prevent genetic disorder in the future generation. It is unknown how this type of gene therapy affects long-term human development. In the United States, federal funding cannot be used to research germline gene therapy.

Education

Bioethics is taught in courses at the undergraduate and graduate level in different academic disciplines or programs, such as Philosophy, Medicine, Law, Social Sciences. It has become a requirement for professional accreditation in many health professional programs (Medicine, Nursing, Rehabilitation), to have obligatory training in ethics (e.g., professional ethics, medical ethics, clinical ethics, nursing ethics). Interest in the field and professional opportunities have led to the development of dedicated programs with concentrations in Bioethics, largely in the United States and Europe, offering undergraduate majors/minors, graduate certificates, and master's and doctoral degrees. Every medical school in Canada teaches bioethics so that students can gain an understanding of biomedical ethics and use the knowledge gained in their future careers to provide better patient care. Canadian residency training programs are required to teach bioethics as it is one of the conditions of accreditation, and is a requirement by the College of Family Physicians of Canada and by the Royal College of Physicians and Surgeons of Canada.

Criticism

As a study, bioethics has also drawn criticism. For instance, Paul Farmer noted that bioethics tends to focus its attention on problems that arise from "too much care" for patients in industrialized nations, while giving little or no attention to the ethical problem of too little care for the poor. Farmer characterizes the bioethics of handling morally difficult clinical situations, normally in hospitals in industrialized countries, as "quandary ethics". He does not regard quandary ethics and clinical bioethics as unimportant; he argues, rather, that bioethics must be balanced and give due weight to the poor.

Additionally, bioethics has been condemned for its lack of diversity in thought, particularly with regards to race. Even as the field has grown to include the areas of public opinion, policymaking, and medical decisions, little to no academic writing has been authored concerning the intersection between race–especially the cultural values imbued in that construct–and bioethical literature. John Hoberman illustrates this in a 2016 critique, in which he points out that bioethicists have been traditionally resistant to expanding their discourse to include sociological and historically relevant applications. Central to this is the notion of white normativity, which establishes the dominance of white hegemonic structures in bioethical academia and tends to reinforce existing biases. However, differing views on bioethics' lack of diversity of thought and social inclusivity have also been advanced. Thought historian Heikki Saxén has argued that the diversity of thought and social inclusivity are the two essential cornerstones of bioethics, albeit they have not been fully realized.

These points and critiques, along with the neglect of women's perspectives within bioethics, have also been discussed amongst feminist bioethical scholars.

 

Life extension

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Life_extension

Life extension is the concept of extending the human lifespan, either modestly through improvements in medicine or dramatically by increasing the maximum lifespan beyond its generally-settled limit of 125 years. The technology to achieve such dramatic changes, however, does not currently exist.

Several researchers in the area, along with "life extensionists", "immortalists" or "longevists" (those who wish to achieve longer lives themselves), postulate that future breakthroughs in tissue rejuvenation, stem cells, regenerative medicine, molecular repair, gene therapy, pharmaceuticals and organ replacement (such as with artificial organs or xenotransplantations) will eventually enable humans to have indefinite lifespans (agerasia) through complete rejuvenation to a healthy youthful condition. The ethical ramifications, if life extension becomes a possibility, are debated by bioethicists.

The sale of purported anti-aging products such as supplements and hormone replacement is a lucrative global industry. For example, the industry that promotes the use of hormones as a treatment for consumers to slow or reverse the aging process in the US market generated about $50 billion of revenue a year in 2009. The use of such products, however, has not been proven to be effective or safe.

Average and maximum lifespan

During the process of aging, an organism accumulates damage to its macromolecules, cells, tissues, and organs. Specifically, aging is characterized as and thought to be caused by "genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication." Oxidation damage to cellular contents caused by free radicals is believed to contribute to aging as well.

The longest documented human lifespan is 122 years, the case of Jeanne Calment who according to records was born in 1875 and died in 1997, whereas the maximum lifespan of a wildtype mouse, commonly used as a model in research on aging, is about three years. Genetic differences between humans and mice that may account for these different aging rates include differences in efficiency of DNA repair, antioxidant defenses, energy metabolism, proteostasis maintenance, and recycling mechanisms such as autophagy.

The average lifespan in a population is lowered by infant and child mortality, which are frequently linked to infectious diseases or nutrition problems. Later in life, vulnerability to accidents and age-related chronic disease such as cancer or cardiovascular disease play an increasing role in mortality. Extension of expected lifespan can often be achieved by access to improved medical care, vaccinations, good diet, exercise and avoidance of hazards such as smoking.

Maximum lifespan is determined by the rate of aging for a species inherent in its genes and by environmental factors. Widely recognized methods of extending maximum lifespan in model organisms such as nematodes, fruit flies, and mice include caloric restriction, gene manipulation, and administration of pharmaceuticals. Another technique uses evolutionary pressures such as breeding from only older members or altering levels of extrinsic mortality. Some animals such as hydra, planarian flatworms, and certain sponges, corals, and jellyfish do not die of old age and exhibit potential immortality.

Strategies

Diets and supplements

Much life extension research focuses on nutrition—diets or supplements— although there is little evidence that they have an effect. The many diets promoted by anti-aging advocates are often contradictory.

In some studies calorie restriction has been shown to extend the life of mice, yeast, and rhesus monkeys. However, a more recent study did not find calorie restriction to improve survival in rhesus monkeys. In humans the long-term health effects of moderate caloric restriction with sufficient nutrients are unknown.

The free-radical theory of aging suggests that antioxidant supplements might extend human life. Reviews, however, have found that vitamin A (as β-carotene) and vitamin E supplements may increase mortality. Other reviews have found no relationship between vitamin E and other vitamins with mortality.

Hormone treatment

The anti-aging industry offers several hormone therapies. Some of these have been criticized for possible dangers and a lack of proven effect. For example, the American Medical Association has been critical of some anti-aging hormone therapies.

While growth hormone (GH) decreases with age, the evidence for use of growth hormone as an anti-aging therapy is mixed and based mostly on animal studies. There are mixed reports that GH or IGF-1 modulates the aging process in humans and about whether the direction of its effect is positive or negative.

History

The extension of life has been a desire of humanity and a mainstay motif in the history of scientific pursuits and ideas throughout history, from the Sumerian Epic of Gilgamesh and the Egyptian Smith medical papyrus, all the way through the Taoists, Ayurveda practitioners, alchemists, hygienists such as Luigi Cornaro, Johann Cohausen and Christoph Wilhelm Hufeland, and philosophers such as Francis Bacon, René Descartes, Benjamin Franklin and Nicolas Condorcet. However, the beginning of the modern period in this endeavor can be traced to the end of the 19th – beginning of the 20th century, to the so-called "fin-de-siècle" (end of the century) period, denoted as an "end of an epoch" and characterized by the rise of scientific optimism and therapeutic activism, entailing the pursuit of life extension (or life-extensionism). Among the foremost researchers of life extension at this period were the Nobel Prize winning biologist Elie Metchnikoff (1845-1916) -- the author of the cell theory of immunity and vice director of Institut Pasteur in Paris, and Charles-Édouard Brown-Séquard (1817-1894) -- the president of the French Biological Society and one of the founders of modern endocrinology.

Sociologist James Hughes claims that science has been tied to a cultural narrative of conquering death since the Age of Enlightenment. He cites Francis Bacon (1561–1626) as an advocate of using science and reason to extend human life, noting Bacon's novel New Atlantis, wherein scientists worked toward delaying aging and prolonging life. Robert Boyle (1627–1691), founding member of the Royal Society, also hoped that science would make substantial progress with life extension, according to Hughes, and proposed such experiments as "to replace the blood of the old with the blood of the young". Biologist Alexis Carrel (1873–1944) was inspired by a belief in indefinite human lifespan that he developed after experimenting with cells, says Hughes.

Regulatory and legal struggles between the Food and Drug Administration (FDA) and the Life Extension organization included seizure of merchandise and court action. In 1991, Saul Kent and Bill Faloon, the principals of the organization, were jailed for four hours and were released on $850,000 bond each. After 11 years of legal battles, Kent and Faloon convinced the US Attorney's Office to dismiss all criminal indictments brought against them by the FDA.

In 2003, Doubleday published "The Immortal Cell: One Scientist's Quest to Solve the Mystery of Human Aging," by Michael D. West. West emphasised the potential role of embryonic stem cells in life extension.

Other modern life extensionists include writer Gennady Stolyarov, who insists that death is "the enemy of us all, to be fought with medicine, science, and technology"; transhumanist philosopher Zoltan Istvan, who proposes that the "transhumanist must safeguard one's own existence above all else"; futurist George Dvorsky, who considers aging to be a problem that desperately needs to be solved; and recording artist Steve Aoki, who has been called "one of the most prolific campaigners for life extension".

Scientific research

In 1991, the American Academy of Anti-Aging Medicine (A4M) was formed. The American Board of Medical Specialties recognizes neither anti-aging medicine nor the A4M's professional standing.

In 2003, Aubrey de Grey and David Gobel formed the Methuselah Foundation, which gives financial grants to anti-aging research projects. In 2009, de Grey and several others founded the SENS Research Foundation, a California-based scientific research organization which conducts research into aging and funds other anti-aging research projects at various universities. In 2013, Google announced Calico, a new company based in San Francisco that will harness new technologies to increase scientific understanding of the biology of aging. It is led by Arthur D. Levinson, and its research team includes scientists such as Hal V. Barron, David Botstein, and Cynthia Kenyon. In 2014, biologist Craig Venter founded Human Longevity Inc., a company dedicated to scientific research to end aging through genomics and cell therapy. They received funding with the goal of compiling a comprehensive human genotype, microbiome, and phenotype database.

Aside from private initiatives, aging research is being conducted in university laboratories, and includes universities such as Harvard and UCLA. University researchers have made a number of breakthroughs in extending the lives of mice and insects by reversing certain aspects of aging.

Ethics and politics

Scientific controversy

Some critics dispute the portrayal of aging as a disease. For example, Leonard Hayflick, who determined that fibroblasts are limited to around 50 cell divisions, reasons that aging is an unavoidable consequence of entropy. Hayflick and fellow biogerontologists Jay Olshansky and Bruce Carnes have strongly criticized the anti-aging industry in response to what they see as unscrupulous profiteering from the sale of unproven anti-aging supplements.

Consumer motivations

Research by Sobh and Martin (2011) suggests that people buy anti-aging products to obtain a hoped-for self (e.g., keeping a youthful skin) or to avoid a feared-self (e.g., looking old). The research shows that when consumers pursue a hoped-for self, it is expectations of success that most strongly drive their motivation to use the product. The research also shows why doing badly when trying to avoid a feared self is more motivating than doing well. When product use is seen to fail it is more motivating than success when consumers seek to avoid a feared-self.

Political parties

Though many scientists state that life extension and radical life extension are possible, there are still no international or national programs focused on radical life extension. There are political forces staying for and against life extension. By 2012, in Russia, the United States, Israel, and the Netherlands, the Longevity political parties started. They aimed to provide political support to radical life extension research and technologies, and ensure the fastest possible and at the same time soft transition of society to the next step – life without aging and with radical life extension, and to provide access to such technologies to most currently living people.

Silicon Valley

Some tech innovators and Silicon Valley entrepreneurs have invested heavily into anti-aging research. This includes Larry Ellison (founder of Oracle), Peter Thiel (former PayPal CEO), Larry Page (co-founder of Google), and Peter Diamandis.

Commentators

Leon Kass (chairman of the US President's Council on Bioethics from 2001 to 2005) has questioned whether potential exacerbation of overpopulation problems would make life extension unethical. He states his opposition to life extension with the words:

"simply to covet a prolonged life span for ourselves is both a sign and a cause of our failure to open ourselves to procreation and to any higher purpose ... [The] desire to prolong youthfulness is not only a childish desire to eat one's life and keep it; it is also an expression of a childish and narcissistic wish incompatible with devotion to posterity."

John Harris, former editor-in-chief of the Journal of Medical Ethics, argues that as long as life is worth living, according to the person himself, we have a powerful moral imperative to save the life and thus to develop and offer life extension therapies to those who want them.

Transhumanist philosopher Nick Bostrom has argued that any technological advances in life extension must be equitably distributed and not restricted to a privileged few. In an extended metaphor entitled "The Fable of the Dragon-Tyrant", Bostrom envisions death as a monstrous dragon who demands human sacrifices. In the fable, after a lengthy debate between those who believe the dragon is a fact of life and those who believe the dragon can and should be destroyed, the dragon is finally killed. Bostrom argues that political inaction allowed many preventable human deaths to occur.

Overpopulation concerns

Controversy about life extension is due to fear of overpopulation and possible effects on society. Biogerontologist Aubrey De Grey counters the overpopulation critique by pointing out that the therapy could postpone or eliminate menopause, allowing women to space out their pregnancies over more years and thus decreasing the yearly population growth rate. Moreover, the philosopher and futurist Max More argues that, given the fact the worldwide population growth rate is slowing down and is projected to eventually stabilize and begin falling, superlongevity would be unlikely to contribute to overpopulation.

Opinion polls

A Spring 2013 Pew Research poll in the United States found that 38% of Americans would want life extension treatments, and 56% would reject it. However, it also found that 68% believed most people would want it and that only 4% consider an "ideal lifespan" to be more than 120 years. The median "ideal lifespan" was 91 years of age and the majority of the public (63%) viewed medical advances aimed at prolonging life as generally good. 41% of Americans believed that radical life extension (RLE) would be good for society, while 51% said they believed it would be bad for society. One possibility for why 56% of Americans claim they would reject life extension treatments may be due to the cultural perception that living longer would result in a longer period of decrepitude, and that the elderly in our current society are unhealthy.

Religious people are no more likely to oppose life extension than the unaffiliated, though some variation exists between religious denominations.

Aging as a disease

Mainstream medical organizations and practitioners do not consider aging to be a disease. David Sinclair says: "I don't see aging as a disease, but as a collection of quite predictable diseases caused by the deterioration of the body". The two main arguments used are that aging is both inevitable and universal while diseases are not. However, not everyone agrees. Harry R. Moody, director of academic affairs for AARP, notes that what is normal and what is disease strongly depend on a historical context. David Gems, assistant director of the Institute of Healthy Ageing, argues that aging should be viewed as a disease. In response to the universality of aging, David Gems notes that it is as misleading as arguing that Basenji are not dogs because they do not bark. Because of the universality of aging he calls it a "special sort of disease". Robert M. Perlman, coined the terms "aging syndrome" and "disease complex" in 1954 to describe aging.

The discussion whether aging should be viewed as a disease or not has important implications. One view is, this would stimulate pharmaceutical companies to develop life extension therapies and in the United States of America, it would also increase the regulation of the anti-aging market by the FDA. Anti-aging now falls under the regulations for cosmetic medicine which are less tight than those for drugs.

Research

Theoretically, extension of maximum lifespan in humans could be achieved by reducing the rate of aging damage by periodic replacement of damaged tissues, molecular repair or rejuvenation of deteriorated cells and tissues, reversal of harmful epigenetic changes, or the enhancement of enzyme telomerase activity.

Research geared towards life extension strategies in various organisms is currently under way at a number of academic and private institutions. Since 2009, investigators have found ways to increase the lifespan of nematode worms and yeast by 10-fold; the record in nematodes was achieved through genetic engineering and the extension in yeast by a combination of genetic engineering and caloric restriction. A 2009 review of longevity research noted: "Extrapolation from worms to mammals is risky at best, and it cannot be assumed that interventions will result in comparable life extension factors. Longevity gains from dietary restriction, or from mutations studied previously, yield smaller benefits to Drosophila than to nematodes, and smaller still to mammals. This is not unexpected, since mammals have evolved to live many times the worm's lifespan, and humans live nearly twice as long as the next longest-lived primate. From an evolutionary perspective, mammals and their ancestors have already undergone several hundred million years of natural selection favoring traits that could directly or indirectly favor increased longevity, and may thus have already settled on gene sequences that promote lifespan. Moreover, the very notion of a "life-extension factor" that could apply across taxa presumes a linear response rarely seen in biology."

Anti-aging drugs

There are a number of chemicals intended to slow the aging process currently being studied in animal models. One type of research is related to the observed effects of a calorie restriction (CR) diet, which has been shown to extend lifespan in some animals. Based on that research, there have been attempts to develop drugs that will have the same effect on the aging process as a caloric restriction diet, which are known as Caloric restriction mimetic drugs. Some drugs that are already approved for other uses have been studied for possible longevity effects on laboratory animals because of a possible CR-mimic effect; they include rapamycin, metformin and other geroprotectors. Coenzyme Q, resveratrol, and pterostilbene are dietary supplements that have also been studied in this context.

Other attempts to create anti-aging drugs have taken different research paths. One notable direction of research has been research into the possibility of using the enzyme telomerase in order to counter the process of telomere shortening. However, there are potential dangers in this, since some research has also linked telomerase to cancer and to tumor growth and formation.

Nanotechnology

Future advances in nanomedicine could give rise to life extension through the repair of many processes thought to be responsible for aging. K. Eric Drexler, one of the founders of nanotechnology, postulated cell repair machines, including ones operating within cells and utilizing as yet hypothetical molecular computers, in his 1986 book Engines of Creation. Raymond Kurzweil, a futurist and transhumanist, stated in his book The Singularity Is Near that he believes that advanced medical nanorobotics could completely remedy the effects of aging by 2030. According to Richard Feynman, it was his former graduate student and collaborator Albert Hibbs who originally suggested to him (circa 1959) the idea of a medical use for Feynman's theoretical nanomachines. Hibbs suggested that certain repair machines might one day be reduced in size to the point that it would, in theory, be possible to (as Feynman put it) "swallow the doctor". The idea was incorporated into Feynman's 1959 essay There's Plenty of Room at the Bottom.

Cloning and body part replacement

Some life extensionists suggest that therapeutic cloning and stem cell research could one day provide a way to generate cells, body parts, or even entire bodies (generally referred to as reproductive cloning) that would be genetically identical to a prospective patient. Recently, the US Department of Defense initiated a program to research the possibility of growing human body parts on mice. Complex biological structures, such as mammalian joints and limbs, have not yet been replicated. Dog and primate brain transplantation experiments were conducted in the mid-20th century but failed due to rejection and the inability to restore nerve connections. As of 2006, the implantation of bio-engineered bladders grown from patients' own cells has proven to be a viable treatment for bladder disease. Proponents of body part replacement and cloning contend that the required biotechnologies are likely to appear earlier than other life-extension technologies.

The use of human stem cells, particularly embryonic stem cells, is controversial. Opponents' objections generally are based on interpretations of religious teachings or ethical considerations. Proponents of stem cell research point out that cells are routinely formed and destroyed in a variety of contexts. Use of stem cells taken from the umbilical cord or parts of the adult body may not provoke controversy.

The controversies over cloning are similar, except general public opinion in most countries stands in opposition to reproductive cloning. Some proponents of therapeutic cloning predict the production of whole bodies, lacking consciousness, for eventual brain transplantation.

Cyborgs

Replacement of biological (susceptible to diseases) organs with mechanical ones could extend life. This is the goal of the 2045 Initiative.

Cryonics

Cryonics is the low-temperature freezing (usually at −196 °C or −320.8 °F or 77.1 K) of a human corpse, with the hope that resuscitation may be possible in the future. It is regarded with skepticism within the mainstream scientific community and has been characterized as quackery.

Strategies for engineered negligible senescence

Another proposed life extension technology would combine existing and predicted future biochemical and genetic techniques. SENS proposes that rejuvenation may be obtained by removing aging damage via the use of stem cells and tissue engineering, telomere-lengthening machinery, allotopic expression of mitochondrial proteins, targeted ablation of cells, immunotherapeutic clearance, and novel lysosomal hydrolases.

While many biogerontologists find these ideas "worthy of discussion" and SENS conferences feature important research in the field, some contend that the alleged benefits are too speculative given the current state of technology, referring to it as "fantasy rather than science".

Genetic editing

Genome editing, in which nucleic acid polymers are delivered as a drug and are either expressed as proteins, interfere with the expression of proteins, or correct genetic mutations, has been proposed as a future strategy to prevent aging.

A large array of genetic modifications have been found to increase lifespan in model organisms such as yeast, nematode worms, fruit flies, and mice. As of 2013, the longest extension of life caused by a single gene manipulation was roughly 50% in mice and 10-fold in nematode worms.

"Healthspan, parental lifespan, and longevity are highly genetically correlated"

In July 2020 scientists, using public biological data on 1.75 m people with known lifespans overall, identify 10 genomic loci which appear to intrinsically influence healthspan, lifespan, and longevity – of which half have not been reported previously at genome-wide significance and most being associated with cardiovascular disease – and identify haem metabolism as a promising candidate for further research within the field. Their study suggests that high levels of iron in the blood likely reduce, and genes involved in metabolising iron likely increase healthy years of life in humans. The same month other scientists report that yeast cells of the same genetic material and within the same environment age in two distinct ways, describe a biomolecular mechanism that can determine which process dominates during aging and genetically engineer a novel aging route with substantially extended lifespan.

Fooling genes

In The Selfish Gene, Richard Dawkins describes an approach to life-extension that involves "fooling genes" into thinking the body is young. Dawkins attributes inspiration for this idea to Peter Medawar. The basic idea is that our bodies are composed of genes that activate throughout our lifetimes, some when we are young and others when we are older. Presumably, these genes are activated by environmental factors, and the changes caused by these genes activating can be lethal. It is a statistical certainty that we possess more lethal genes that activate in later life than in early life. Therefore, to extend life, we should be able to prevent these genes from switching on, and we should be able to do so by "identifying changes in the internal chemical environment of a body that take place during aging... and by simulating the superficial chemical properties of a young body".

Mind uploading

One hypothetical future strategy that, as some suggest, "eliminates" the complications related to a physical body, involves the copying or transferring (e.g. by progressively replacing neurons with transistors) of a conscious mind from a biological brain to a non-biological computer system or computational device. The basic idea is to scan the structure of a particular brain in detail, and then construct a software model of it that is so faithful to the original that, when run on appropriate hardware, it will behave in essentially the same way as the original brain. Whether or not an exact copy of one's mind constitutes actual life extension is matter of debate.

However, critics argue that the uploaded mind would simply be a clone and not a true continuation of a person's consciousness.

Some scientists believe that the dead may one day be "resurrected" through simulation technology.

Young blood injection

Some clinics currently offer injection of blood products from young donors. The alleged benefits of the treatment, none of which have been demonstrated in a proper study, include a longer life, darker hair, better memory, better sleep, curing heart diseases, diabetes and Alzheimer. The approach is based on parabiosis studies such as Irina Conboy do on mice, but Conboy says young blood does not reverse aging (even in mice) and that those who offer those treatments have misunderstood her research. Neuroscientist Tony Wyss-Coray, who also studied blood exchanges on mice as recently as 2014, said people offering those treatments are "basically abusing people's trust" and that young blood treatments are "the scientific equivalent of fake news". The treatment appeared in HBO's Silicon Valley fiction series.

Two clinics in California, run by Jesse Karmazin and David C. Wright, offer $8,000 injections of plasma extracted from the blood of young people. Karmazin has not published in any peer-reviewed journal and his current study does not use a control group.

 

Human cloning

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Human_cloning 

 

Diagram of the ways to reprogram cells along with the development of humans.

Human cloning is the creation of a genetically identical copy (or clone) of a human. The term is generally used to refer to artificial human cloning, which is the reproduction of human cells and tissue. It does not refer to the natural conception and delivery of identical twins. The possibility of person cloning has raised controversies. These ethical concerns have prompted several nations to pass laws regarding human cloning and its legality.

Two commonly discussed types of theoretical human cloning are therapeutic cloning and reproductive cloning. Therapeutic cloning would involve cloning cells from a human for use in medicine and transplants; it is an active area of research, but is not in medical practice anywhere in the world, as of July 2020. Two common methods of therapeutic cloning that are being researched are somatic-cell nuclear transfer and (more recently) pluripotent stem cell induction. Reproductive cloning would involve making an entire cloned human, instead of just specific cells or tissues.

History

Although the possibility of cloning humans had been the subject of speculation for much of the 20th century, scientists and policymakers began to take the prospect seriously in 1969. J. B. S. Haldane was the first to introduce the idea of human cloning, for which he used the terms "clone" and "cloning", which had been used in agriculture since the early 20th century. In his speech on "Biological Possibilities for the Human Species of the Next Ten Thousand Years" at the Ciba Foundation Symposium on Man and his Future in 1963, he said:

It is extremely hopeful that some human cell lines can be grown on a medium of precisely known chemical composition. Perhaps the first step will be the production of a clone from a single fertilized egg, as in Brave New World... Assuming that cloning is possible, I expect that most clones would be made from people aged at least fifty, except for athletes and dancers, who would be cloned younger. They would be made from people who were held to have excelled in a socially acceptable accomplishment.

Nobel Prize-winning geneticist Joshua Lederberg advocated cloning and genetic engineering in an article in The American Naturalist in 1966 and again, the following year, in The Washington Post. He sparked a debate with conservative bioethicist Leon Kass, who wrote at the time that "the programmed reproduction of man will, in fact, dehumanize him." Another Nobel Laureate, James D. Watson, publicized the potential and the perils of cloning in his Atlantic Monthly essay, "Moving Toward the Clonal Man", in 1971.

With the cloning of a sheep known as Dolly in 1996 by somatic cell nuclear transfer (SCNT), the idea of human cloning became a hot debate topic. Many nations outlawed it, while a few scientists promised to make a clone within the next few years. The first hybrid human clone was created in November 1998, by Advanced Cell Technology. It was created using SCNT; a nucleus was taken from a man's leg cell and inserted into a cow's egg from which the nucleus had been removed, and the hybrid cell was cultured and developed into an embryo. The embryo was destroyed after 12 days.

In 2004 and 2005, Hwang Woo-suk, a professor at Seoul National University, published two separate articles in the journal Science claiming to have successfully harvested pluripotent, embryonic stem cells from a cloned human blastocyst using SCNT techniques. Hwang claimed to have created eleven different patient-specific stem cell lines. This would have been the first major breakthrough in human cloning. However, in 2006 Science retracted both of his articles on clear evidence that much of his data from the experiments was fabricated.

In January 2008, Dr. Andrew French and Samuel Wood of the biotechnology company Stemagen announced that they successfully created the first five mature human embryos using SCNT. In this case, each embryo was created by taking a nucleus from a skin cell (donated by Wood and a colleague) and inserting it into a human egg from which the nucleus had been removed. The embryos were developed only to the blastocyst stage, at which point they were studied in processes that destroyed them. Members of the lab said that their next set of experiments would aim to generate embryonic stem cell lines; these are the "holy grail" that would be useful for therapeutic or reproductive cloning.

In 2011, scientists at the New York Stem Cell Foundation announced that they had succeeded in generating embryonic stem cell lines, but their process involved leaving the oocyte's nucleus in place, resulting in triploid cells, which would not be useful for cloning.

In 2013, a group of scientists led by Shoukhrat Mitalipov published the first report of embryonic stem cells created using SCNT. In this experiment, the researchers developed a protocol for using SCNT in human cells, which differs slightly from the one used in other organisms. Four embryonic stem cell lines from human fetal somatic cells were derived from those blastocysts. All four lines were derived using oocytes from the same donor, ensuring that all mitochondrial DNA inherited was identical. A year later, a team led by Robert Lanza at Advanced Cell Technology reported that they had replicated Mitalipov's results and further demonstrated the effectiveness by cloning adult cells using SCNT.

In 2018, the first successful cloning of primates using SCNT was reported with the birth of two live female clones, crab-eating macaques named Zhong Zhong and Hua Hua.

Methods

Somatic cell nuclear transfer (SCNT)

Diagram of SCNT Process

In somatic cell nuclear transfer ("SCNT"), the nucleus of a somatic cell is taken from a donor and transplanted into a host egg cell, which had its own genetic material removed previously, making it an enucleated egg. After the donor somatic cell genetic material is transferred into the host oocyte with a micropipette, the somatic cell genetic material is fused with the egg using an electric current. Once the two cells have fused, the new cell can be permitted to grow in a surrogate or artificially. This is the process that was used to successfully clone Dolly the sheep (see section on History in this article). The technique, now refined, has indicated that it was possible to replicate cells and reestablish pluripotency-"the potential of an embryonic cell to grow into any one of the numerous different types of mature body cells that make up a complete organism"

Induced pluripotent stem cells (iPSCs)

Overview of iPS cells

Creating induced pluripotent stem cells ("iPSCs") is a long and inefficient process. Pluripotency refers to a stem cell that has the potential to differentiate into any of the three germ layers: endoderm (interior stomach lining, gastrointestinal tract, the lungs), mesoderm (muscle, bone, blood, urogenital), or ectoderm (epidermal tissues and nervous tissue). A specific set of genes, often called "reprogramming factors", are introduced into a specific adult cell type. These factors send signals in the mature cell that cause the cell to become a pluripotent stem cell. This process is highly studied and new techniques are being discovered frequently on how to better this induction process.

Depending on the method used, reprogramming of adult cells into iPSCs for implantation could have severe limitations in humans. If a virus is used as a reprogramming factor for the cell, cancer-causing genes called oncogenes may be activated. These cells would appear as rapidly dividing cancer cells that do not respond to the body's natural cell signaling process. However, in 2008 scientists discovered a technique that could remove the presence of these oncogenes after pluripotency induction, thereby increasing the potential use of iPSC in humans.

Comparing SCNT to reprogramming

Both the processes of SCNT and iPSCs have benefits and deficiencies. Historically, reprogramming methods were better studied than SCNT derived embryonic stem cells (ESCs). However, more recent studies have put more emphasis on developing new procedures for SCNT-ESCs. The major advantage of SCNT over iPSCs at this time is the speed with which cells can be produced. iPSCs derivation takes several months while SCNT would take a much shorter time, which could be important for medical applications. New studies are working to improve the process of iPSC in terms of both speed and efficiency with the discovery of new reprogramming factors in oocytes. Another advantage SCNT could have over iPSCs is its potential to treat mitochondrial disease, as it utilizes a donor oocyte. No other advantages are known at this time in using stem cells derived from one method over stem cells derived from the other.

Uses, actual and potential

Stem cell treatments

Work on cloning techniques has advanced our basic understanding of developmental biology in humans. Observing human pluripotent stem cells grown in culture provides great insight into human embryo development, which otherwise cannot be seen. Scientists are now able to better define steps of early human development. Studying signal transduction along with genetic manipulation within the early human embryo has the potential to provide answers to many developmental diseases and defects. Many human-specific signaling pathways have been discovered by studying human embryonic stem cells. Studying developmental pathways in humans has given developmental biologists more evidence toward the hypothesis that developmental pathways are conserved throughout species.

iPSCs and cells created by SCNT are useful for research into the causes of disease, and as model systems used in drug discovery.

Cells produced with SCNT, or iPSCs could eventually be used in stem cell therapy, or to create organs to be used in transplantation, known as regenerative medicine. Stem cell therapy is the use of stem cells to treat or prevent a disease or condition. Bone marrow transplantation is a widely used form of stem cell therapy. No other forms of stem cell therapy are in clinical use at this time. Research is underway to potentially use stem cell therapy to treat heart disease, diabetes, and spinal cord injuries. Regenerative medicine is not in clinical practice, but is heavily researched for its potential uses. This type of medicine would allow for autologous transplantation, thus removing the risk of organ transplant rejection by the recipient. For instance, a person with liver disease could potentially have a new liver grown using their same genetic material and transplanted to remove the damaged liver. In current research, human pluripotent stem cells have been promised as a reliable source for generating human neurons, showing the potential for regenerative medicine in brain and neural injuries.

Ethical implications

In bioethics, the ethics of cloning refers to a variety of ethical positions regarding the practice and possibilities of cloning, especially human cloning. While many of these views are religious in origin, for instance relating to Christian views of procreation and personhood, the questions raised by cloning engage secular perspectives as well.

Advocates support development of therapeutic cloning in order to generate tissues and whole organs to treat patients who otherwise cannot obtain transplants, to avoid the need for immunosuppressive drugs, and to stave off the effects of aging. Advocates for reproductive cloning believe that parents who cannot otherwise procreate should have access to the technology.

Opposition to therapeutic cloning mainly centers around the status of embryonic stem cells, which has connections with the abortion debate.

Some opponents of reproductive cloning have concerns that technology is not yet developed enough to be safe – for example, the position of the American Association for the Advancement of Science as of 2014, while others emphasize that reproductive cloning could be prone to abuse (leading to the generation of humans whose organs and tissues would be harvested), and have concerns about how cloned individuals could integrate with families and with society at large. Some opponents will raise questions on whether clones have rights. "Cloning's Future" raises serious questions as to whether the embryos have any rights or if the right to life of an embryo is superseded by the will of the donor.

Members of religious groups are divided. Some Christian theologians perceive the technology as usurping God's role in creation and, to the extent embryos are used, destroying a human life; others see no inconsistency between Christian tenets and cloning's positive and potentially life-saving benefits.

Current law

In 2018 it was reported that about 70 countries had banned human cloning.

Argentina

Human cloning is banned by the Presidential Decree 200/97 of 7 March 1997.

Australia

Australia has prohibited human cloning, though as of December 2006, a bill legalizing therapeutic cloning and the creation of human embryos for stem cell research passed the House of Representatives. Within certain regulatory limits, and subject to the effect of state legislation, therapeutic cloning is now legal in some parts of Australia.

Canada

Canadian law prohibits the following: cloning humans, cloning stem cells, growing human embryos for research purposes, and buying or selling of embryos, sperm, eggs or other human reproductive material. It also bans making changes to human DNA that would pass from one generation to the next, including use of animal DNA in humans. Surrogate mothers are legally allowed, as is donation of sperm or eggs for reproductive purposes. Human embryos and stem cells are also permitted to be donated for research.

There have been consistent calls in Canada to ban human reproductive cloning since the 1993 Report of the Royal Commission on New Reproductive Technologies. Polls have indicated that an overwhelming majority of Canadians oppose human reproductive cloning, though the regulation of human cloning continues to be a significant national and international policy issue. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity.

Colombia

Human cloning is prohibited in Article 133 of the Colombian Penal Code.

Council of Europe

The European Convention on Human Rights and Biomedicine prohibits human cloning in one of its additional protocols, this protocol has been ratified by 25 states.

European Union

The Charter of Fundamental Rights of the European Union explicitly prohibits reproductive human cloning. The charter is legally binding for the institutions of the European Union under the Treaty of Lisbon and for some member countries of the Union implementing EU regulations.

India

India does not have specific laws regarding cloning but has guidelines prohibiting whole human cloning or reproductive cloning. India allows therapeutic cloning and the use of embryonic stem cells for research purposes. There are legal implications in this case. India has already succeeded in mammalian cloning. From a cultural and religious perspective it is interesting to note that Hinduism is replete with instances of reproductive biotechnological interventions. 

Pakistan

Council of Islamic Ideology of Pakistan has declared human cloning as an un-Islamic act and Islam acts as a deterrent to scientific progress. Howsoever paradoxical it may sound, but according to the Council of Islamic Ideology, Pakistan research and thinking is not banned in Islam and new innovations are allowed but within the limits of the religion.

Poland

Human cloning forbidden by article 87 of Act of 25 June 2015.

Russia

The Federal Assembly of Russia introduced the Federal Law N 54-FZ "On the temporary ban on human cloning" on April 19, 2002. On May 20, 2002 President Vladimir Putin signed this moratorium on the implementation of human cloning. On March 29, 2010 The Federal Assembly introduced second revision of this law without time limit.

Serbia

Human cloning is explicitly prohibited in Article 24, "Right to Life" of the 2006 Constitution of Serbia.

South Africa

In terms of section 39A of the Human Tissue Act 65 of 1983, genetic manipulation of gametes or zygotes outside the human body is absolutely prohibited. A zygote is the cell resulting from the fusion of two gametes; thus the fertilised ovum. Section 39A thus prohibits human cloning.

Singapore

Section 5 of the Human Cloning and Other Prohibited Practices Act 2004 prohibits placing human embryo clone in body of human or animal.

United Kingdom

On January 14, 2001 the British government passed The Human Fertilisation and Embryology (Research Purposes) Regulations 2001 to amend the Human Fertilisation and Embryology Act 1990 by extending allowable reasons for embryo research to permit research around stem cells and cell nuclear replacement, thus allowing therapeutic cloning. However, on November 15, 2001, a pro-life group won a High Court legal challenge, which struck down the regulation and effectively left all forms of cloning unregulated in the UK. Their hope was that Parliament would fill this gap by passing prohibitive legislation. Parliament was quick to pass the Human Reproductive Cloning Act 2001 which explicitly prohibited reproductive cloning. The remaining gap with regard to therapeutic cloning was closed when the appeals courts reversed the previous decision of the High Court.

The first license was granted on August 11, 2004 to researchers at the University of Newcastle to allow them to investigate treatments for diabetes, Parkinson's disease and Alzheimer's disease. The Human Fertilisation and Embryology Act 2008, a major review of fertility legislation, repealed the 2001 Cloning Act by making amendments of similar effect to the 1990 Act. The 2008 Act also allows experiments on hybrid human-animal embryos.

United Nations

On December 13, 2001, the United Nations General Assembly began elaborating an international convention against the reproductive cloning of humans. A broad coalition of states, including Spain, Italy, the Philippines, the United States, Costa Rica, and the Holy See sought to extend the debate to ban all forms of human cloning, noting that, in their view, therapeutic human cloning violates human dignity. Costa Rica proposed the adoption of an international convention to ban all forms of human cloning. Unable to reach a consensus on a binding convention, in March 2005 a non-binding United Nations Declaration on Human Cloning, calling for the ban of all forms of human cloning contrary to human dignity, was adopted.

United States

The Patients First Act of 2017 (HR 2918, 115th Congress) aims to promote stem cell research, using cells that are "ethically obtained", that could contribute to a better understanding of diseases and therapies, as well as promote the "derivation of pluripotent stem cell lines without the creation of human embryos".

In 1998, 2001, 2004, 2005, 2007 and 2009, the United States Congress voted whether to ban all human cloning, both reproductive and therapeutic (Stem Cell Research Enhancement Act). Divisions in the Senate, or an eventual veto from the sitting President (George W. Bush in 2005 and 2007), over therapeutic cloning prevented either competing proposal (a ban on both forms or on reproductive cloning only) from being passed into law. On March 10, 2010 a bill (HR 4808) was introduced with a section banning federal funding for human cloning. Such a law, if passed, would not have prevented research from occurring in private institutions (such as universities) that have both private and federal funding. However, the 2010 law was not passed.

There are currently no federal laws in the United States which ban cloning completely. Fifteen American states (Arkansas, California, Connecticut, Florida, Georgia, Iowa, Indiana, Massachusetts, Maryland, Michigan, North Dakota, New Jersey, Rhode Island, South Dakota, and Virginia) ban reproductive cloning and three states (Arizona, Maryland and Missouri) prohibit use of public funds for such activities.

Ten states, California, Connecticut, Illinois, Iowa, Maryland, Massachusetts, Missouri, Montana, New Jersey and Rhode Island, have "clone and kill" laws that prevent cloned embryo implantation for childbirth, but allow embryos to be destroyed.

Penalties for human cloning

State	Penalties
	Reproductive cloning	Therapeutic cloning
Arkansas	Criminal and civil	Criminal and civil
California	Civil	N/A
Iowa	Criminal and civil	Criminal and civil
Louisiana	Criminal and civil	N/A
Michigan	Criminal and civil	Criminal and civil
North Dakota	Criminal and civil	Criminal and civil
Rhode Island	Criminal and civil	N/A
Virginia	Civil	Unclear

In popular culture

Science fiction has used cloning, most commonly and specifically human cloning, due to the fact that it brings up controversial questions of identity. Humorous fiction, such as Multiplicity (1996) and the Maxwell Smart feature The Nude Bomb (1980), have featured human cloning. A recurring sub-theme of cloning fiction is the use of clones as a supply of organs for transplantation. Robin Cook's 1997 novel Chromosome 6 and Michael Bay's The Island are examples of this; Chromosome 6 also features genetic manipulation and xenotransplantation. The series Orphan Black follows human clones' stories and experiences as they deal with issues and react to being the property of a chain of scientific institutions. In the 2019 horror film Us, the entirety of the United States' population is secretly cloned. Years later, these clones (known as The Tethered) reveal themselves to the world by successfully pulling off a mass genocide of their counterparts.