Same genes strain family affairs

Human reproductive cloning is rife with physical and social dangers, argues Ian Wilmut.

Since we announced the birth of Dolly the sheep in February 1997, much has been written on the potential use of cloning to produce children. Many have expressed concern about the effect on children of being genetically identical twins of an existing person, whereas others have argued that cloning would offer important potential benefits and should be available to those who want it. Suggested applications included the overcoming of infertility and "bringing back a lost child". Hardly any of these opinions came from people with professional training in either child development or indeed any aspect of psychiatry.

As this book was written by a psychiatrist who has a clinical practice and conducts research, it is very welcome. Philadelphia-based Stephen Levick systematically assesses the possible effects on cloned children and bases his conclusions on his own clinical experience and the published research literature. There are many different facets to this exercise because cloned children could have a bewildering array of unusual relationships to relatives.

In a genetic sense, the parents of the person copied would also be the "parents" of the clone. By contrast, the birth mother of the clone might make no genetic contribution if, for example, the child were a clone of a male or female partner.

Of course, the fundamental difficulty facing the author is that there are no cloned children, so his assessment must be indirect. All he can do is ask if some unusual aspect of families in which cloned children might be brought up would have any similarity with children in other families.

Compare stepchildren. As in cloning of one of the "parents", a stepchild is genetically related to only one parent. Levick cites the case of a patient of his who was traumatised by the arrival of a stepfather. Some of the information startled me, for example the evidence that suggests that stepchildren are much more likely to be abused than are children raised by both parents.

Levick points out several factors that might distinguish a stepchild from a cloned child, such as that both "parents" are involved in the decision to produce a clone, whereas only one is involved in the conception of a stepchild. But he concludes the chapter by judging that the higher incidence of abuse of stepchildren may reflect the absence of a loving attachment to the step-parent; and he expresses concern that similar risks might face a clone. Other chapters, concerned with overcoming infertility, consider similar effects of being produced by established methods of assisted reproduction, or entering the family through adoption and the possible effects of a strong resemblance to a parent.

Then he moves on to assess possible effects of a clone's resembling someone other than a parent. A clone might be derived from a dead child or a famous person whom the parents have chosen to clone. It seems inevitable that relatives and friends would expect the clone to be like the original person (I cannot begin to estimate how many times I have been asked if my children are biologists). This is despite the fact that we know that each person is an individual and different from everyone else. There is still a strong expectation that we will be like our genetic forebears; surely the expectation would be even greater for a genetically identical twin?

Levick considers eight model situations that might be expected to be revealing. In each case, he points out not only the similarities but also reasons why cloning might differ from the model situation. Then he integrates these insights by summarising the likely effect at each stage of life, using the eight-stage system of describing psychosocial development established by Erik Erikson. (Details of this system can be found on the web for those like myself who are not familiar with the concepts.) He comes to the conclusion that "a clone would be likely to face extra difficulties in negotiating every stage of psychiatric and psychosocial development".

In the final section, Levick considers the implications for social policy.

Despite his concerns over the likely ill-effects of being a cloned child, he does not recommend prohibition. He advances several reasons for this.

First, a ban would stigmatise any cloned child who would have had no say in its creation. Second, a ban would hamper research into deriving cells from cloned embryos. By contrast with Levick's position, the UK's approach is to distinguish between the two uses of nuclear transfer and to prohibit only production of cloned children while permitting research on cells from cloned embryos under appropriate regulation.

This scholarly book provides an analysis of cloning that is far wider in scope than any other I know of, presenting in great detail the observed or potential effects of entering a family in a variety of different ways, including through cloning. It provides the first framework for detailed analysis of the ethical, psychological and social consequences of human reproductive cloning. It should inform discussion of any proposal to produce children by nuclear transfer who are genetically identical twins of another person.

Those of us who campaign for the prohibition of reproductive cloning raise two concerns. The present techniques are very inefficient and the probable outcome of any such attempt would include late abortions, the birth of dead children and live children born with an abnormality. This alone should lead to the prohibition of human reproductive cloning at the present time, even if improvements to methods of nuclear transfer may one day overcome these limitations. Our second concern is with the psychological effects on the clone. Levick believes that the psychological risks would be profound.

We should be comfortable to live in one of the countries that have made reproductive cloning illegal.

Ian Wilmut is head of the department of gene expression and development, Roslin Institute, Edinburgh.