YU Medical Ethics: Creating in God’s Image? Cloning in Jewish Law

THESE NOTES ARE UNOFFICIAL AND UNEDITED. ANY MISTAKES ARE MY FAULT.

Full recordings of the speeches available here.

Introduction:

Good evening and welcome to the YU Medical Ethics Society’s spring event. There is a paper being passed around, please sign your name and place your email address on this list if you want to be contacted about future events.

The YU Student Medical Ethics Society is a student-run society- especially focused on issues of medical ethics related to Torah and Judaism- it is meant to be a medical resource for patients, doctors, laymen, etc.

The issue of cloning is introduced by Dr. John Loike of the Center for Bioethics at Columbia University, followed by Rabbi Moshe Tendler. Cell phones should please be turned off.

Dr. John Loike:

I first have to apologize for what I’m going to say now- it’s my first time speaking at YU; it was four years ago (misheard?) almost that I had R’ Tendler as my Physiology professor; it’s a privilege to speak with him and write articles with him- the strengths of R’ Tendler is that he is not only a posekwho gives you the halakha and reason behind the halakha but also hashkafic process- and this applies to science as well.

The way the program will work in the present case is we’ll discuss the science behind the case, the hashkafic lessons if appropriate- then I’ll ask you to identify some of the halakhic issues, and R’ Tendler will discuss the halakhic implications.

Case: Using embryonic stem cells (from a human) to constitute a human brain in a mouse or monkey- in which case, is this a human, or a monkey?

It all began with the cloning of Dolly in 1997. Ian Wilmut did this remarkable experiment, took memory epithelial cell- He wrote a paper that should have gotten the Nobel Prize but probably won’t- he is the catalyst for today- the issues being raised are sometimes irresolvable from ethical/ philosophical perspective.

If religious belief is that a fertilized egg is the beginning of human life, then no matter how hard the scientist tries, I can’t convince you.

Scientists engage in scientific ways to circumvent the issue- early zygote, very new- the transformation in bioethics has been taking place in the last seven years.

Why use this technology specifically to clone Dolly? Understand- synthetically to clone cells it would be about 1000 (dollars?) a pound- if could genetically ____ a milk reduce cost. Factor to ____ a pound. (Point is, it’s cheaper to use the human cells than synthetic ones) Took epithelial tissue, genetically altered it, compounds, nuclear transport tissue- able to clone sheep or cow to make these proteins on their own.

Why are you doing this? As it applies for commercialization of drugs, is what the cloner of Dolly (Ian Wilmut) first said, claiming that he’d never use this for humans, it was too risky, too unethical. But now he heads the Scottish Institute in Europe, has a large government budget, doing human stem cells. Now, I know him personally and know he is a very honest man and believe he has high motives but you see that he has changed. Now, you have someone like him, but then you have someone like Dr. Webber (misheard?) in South Korea- who published in 2005 cloning of human embryonic stem cells, claiming he’d cloned a human- worldwide attention, everyone excited about it for thereapeutic cloning. Then, December of 2006 revealed that all of his research was fraudulent. What motivates him to do something like this? My thought, my opinion is that he thought he would be the first to publish his paper, and then another person would come along and prove/ discover the same thing, but everyone would look back to his paper, forget his was fake, and give him the credit.

A few months after reading the papers, I spoke to ______. I said great job, Dolly’s a clone, but you forgot to _______ so could you give us some samples of DNA and we could identify/ locate it for you. So he said that sure, he’d be willing to give us the samples. As soon as he said that, I knew his research was true- once he said I’m going to share the samples, it must be true, while Dr. Webber, never to my knowledge gave samples to his colleagues.

There’s a concept of Cheimera Technology- using stem cells to create human organs- discovered in 1980s, Michael Kewler (spelling?), graduate of Harvard, Irving Weissman Lab at Stanford- had loads of mice, mutant mice, and did an assessment of the mutant mice, then found a mouse without an immune system and said, “THIS is an answer to AIDS.” Now, we all know the HIV virus doesn’t affect mouse cells- so what he did was reconstitute a human immune system in the mouse and inject it with AIDS. He used stem cells to do it (through putting human bone marrow in the mouse.) Now wants to reconstitute other organs. Now, Irving Weissman put human stem cells into the mouse- put 1% human cells in mouse, now I think they’ve got it to 2%- now, any experiment using mice and human genes has to go up for review, so they took it to the Stanford Review Board, who said it was too complicated an issue for them. So they went to the National Academy (association?) of _____ who deliberated for over a year, and today there is still a debate going on, but they decided to go ahead with it.

Other people have used stem cells to reconstitute lungs/ liver in a sheep- no ethical problem with that, because then you can serve people who need a liver transplant- inject into fetus of a sheep, the sheep will have a liver that is 99% human, and therefore the human’s body won’t reject it. Why does the fetus not reject the cells? Immunological tzimtzum; in order for a pregnant woman to carry a fetus, which is a foreign body, it has to be that this happens, where the woman/ fetus does not reject the foreign bodies. You can even inject her husband’s skin and the woman won’t reject it till 4-5 weeks after delivery. Question as follows- examples of using for organ transplants/ why would you want to do this?

Where will you get the embryonic stem cells? Unlike the Christian Church, halakha states that:

1. Human life begins 40 days after conception
2. You need implantation

These are the two major criteria. Now really look at the halakhic development of a fetus- at 40 days it is not completely human; there are different gradations.

To take a liberty, take the Gemara Menachos which has something interesting to say about this- the Torah was given over in 40 days, the soul is formed within/ during 40 days as well- the transmission of Torah requires 40 days to Moshe- not a one-step process when dealing with this technology.

Why would you want to use this technology to study the human brain/ neuroscience- why reconstitute the human brain in a mouse or monkey?

(Answers from the audience made into this list)

1. Alzheimer’s Disease- We could reengineer certain human cells which we know are very important to this process and see if we could make them more able to remove the Alzheimer’s plax (misheard? He seemed to suggest there’s some kind of buildup, and that maybe the cells could remove it)

2. Study the development of the brain- early circuitry formation- can only do that within an animal model

3. What determines brain cells? Why are mouser brain cells small, large in human brains?

This is very powerful technology we are dealing with…

4. Can understand stem cell development- precursors for neurons/ different parts of the brain, all have different functions- see how they develop, how we can develop different stem cells- very important because many diseases like Parkinson’s are found in ___ neurons. Stem cell ___nicity.
5. Cancer- cancer of the brain. If you transplant mouse stem cells into a rat brain, this only generates benign tumors, but if you transfer very early mouse stem cells to mouse brains, this generates malignant tumors. Very hot area of research today.

Irving Weiss not interested in trying to look at the behavioral effects—main interests are these reasons. Believes this technology is the best way- will it confer human characteristics on monkey/ cow?

What are some of the halakhic issues that will arise here? Or do you think it’s all fine and we can just go home now?

1. Are they considered human or monkey? (Criteria of defining the species)
2. Engaging in experimentation beyond our domain/ permission- do we have carte blanche to do this?
3. Dignity of the human being
4. Tza’ar Ba’alei Chayim - Causing pain to animals

And there’s other criteria you can think of.

[He now asks us in the audience whether we’d be comfortable going ahead with this technology. Hands-down the audience is in favor of approving the technology. He finds this interesting.]

We can transplant germinal cells to mice- can make mice produce sperm/ ova- could theoretically have cows give birth to humans- certainly doable to have a factory of artificial incubators. Now, do you find this disgusting? And yet, is putting a premature baby in an artificial incubator any worse? Any less disgusting?

[Introduces R’ Tendler]

R’ Tendler:

Stem cells and cloning are the same issue. Closing somehow captured the imagination when they produced Dolly- people beginning to make movies of making copies of Batman and Einstein- human cloning was once a hot topic, but now it has paled in significance because nobody wants to do it. But why should we not do it? You could so quickly.

I know of cases where the only way to produce a child with the genetic makeup of the father is through cloning. The last survivor of a family which was utterly destroyed during the Holocaust is a man and he has proved to be infertile. To save a Jewish family’s genome by reproducing the cell- I would not hesitate to do it.

--

Reproductive cloning- so what. Nobody wants to do it because there’s no money in it- you know, unless someone wants to see himself walking down the street- but there are certain circumstances where it could prove very useful- I have to move quickly, there’s a time limit here- the time limit goes until you begin to yawn.

If indeed there is a medical potential to be achieved, we have a Biblical Command to do so.

1.
יט אִם-יָקוּם וְהִתְהַלֵּךְ בַּחוּץ, עַל-מִשְׁעַנְתּוֹ--וְנִקָּה הַמַּכֶּה: רַק שִׁבְתּוֹ יִתֵּן, וְרַפֹּא יְרַפֵּא. {ס} 19 if he rise again, and walk abroad upon his staff, then shall he that smote him be quit; only he shall pay for the loss of his time, and shall cause him to be thoroughly healed. {S}

~Exodus 21: 19

This negates faith healing- it is our obligation to go to the doctor.

2.
ב וְאִם-לֹא קָרוֹב אָחִיךָ אֵלֶיךָ, וְלֹא יְדַעְתּוֹ--וַאֲסַפְתּוֹ, אֶל-תּוֹךְ בֵּיתֶךָ, וְהָיָה עִמְּךָ עַד דְּרֹשׁ אָחִיךָ אֹתוֹ, וַהֲשֵׁבֹתוֹ לוֹ. 2 And if thy brother be not nigh unto thee, and thou know him not, then thou shalt bring it home to thy house, and it shall be with thee until thy brother require it, and thou shalt restore it to him.

Deuteronomy 22: 2

Personal obligation for everyone who observes biblical law is required to do it. If you have the ability to restore someone’s health, you must do this.

3.
טז לֹא-תֵלֵךְ רָכִיל בְּעַמֶּיךָ, לֹא תַעֲמֹד עַל-דַּם רֵעֶךָ: אֲנִי, יְהוָה. 16 Thou shalt not go up and down as a talebearer among thy people; neither shalt thou stand idly by the blood of thy neighbour: I am the LORD.

Leviticus 19: 16

If you can’t heal him, pay for someone else to heal him- and this is the source of the idea of modicum of personal risk- healthcare for all. This pasuk supports the fact that there must be universal healthcare.

You don’t have to drive the same car as I do, but you need to have the same medical insurance as I do- the same capacity and ability to have and use that medical insurance.

-

We’re not afraid of playing God. We play man

כח וַיְבָרֶךְ אֹתָם, אֱלֹהִים, וַיֹּאמֶר לָהֶם אֱלֹהִים פְּרוּ וּרְבוּ וּמִלְאוּ אֶת-הָאָרֶץ, וְכִבְשֻׁהָ; וּרְדוּ בִּדְגַת הַיָּם, וּבְעוֹף הַשָּׁמַיִם, וּבְכָל-חַיָּה, הָרֹמֶשֶׂת עַל-הָאָרֶץ. 28
And God blessed them; and God said unto them: 'Be fruitful, and multiply, and replenish the earth, and subdue it; and have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that creepeth upon the earth.'

~Genesis 1: 28

“Be fruitful and multiply and master my world.”

God gave us an unfinished world and said we are to master it- research and science are the areas in which we are to continue to finish the world, [looks at his powerpoint screen, where the verse appears very blurrily], despite the money we spend at Yeshiva, good technology we haven’t seen- we need a better screen than that. (laughter)

Now, look at the Gemara in Shabbos daf Ayin-Hei (75)

This is your wisdom in the eyes of the nations- NOT teaching Talmud, but the obligation to study nature and master nature- here it talks about astronomy, the science of the time, have to study God, not only through Torah but also how He reveals himself in nature.

[next slide]

Now, there are 10 reasons the scientific literature contains not to do cloning. Some of these reasons are good reasons; some are just strawmen.

1) Playing God
2) Abortion
3) Report for the Procreative ___ of the Zygote
4) Self-Injury: Risk without Benefit for the Ovum Donor
5) Commodificationa nd Exploitation of Ovum and Donor
6) Macro-Triage: Allocation of Source Resources Available for Biomedical Research
7) Justice: Sharing benefits from ESC Therapy with all members of society

(These were the only ones he had time to address)

[He had already addressed playing God, but went on to tell a very moving personal story about his wife, who had cancer, and the cure for her cancer was discovered through the use of experiments made on mice and cloning- as he put it, “God made man, man came and made a mouse-man.” The name of the medicine is Ritoxin and apparently she just took her last dose last Thursday.]

The issue in halakha is the 4th point- Self Injury: Risk without Benefit to Ovum Donor- the egg is provided by healthy women, and it is not provided for herself but for the sake of research- this is the point we still have to try to get around.

Now, 2220 human eggs were used by this Dr. Webber to produced a false report. The truth is, this man was actually cloning 40-60 animals a week at Wonks Lab (misheard?) So he figured, how hard can it be to actually clone a human; he sat down and wrote about how he would clone a human.

We will clone a human when God lets us take one more peek under the veil of ignorance.

Now, #5- Commodification and Exploitation- this is a big deal but saving human lives takes precedence. We don’t like buying organs for people; we feel that it is demeaning and exploits the person, but most halakhic authorities allow for it for the sake of saving a life.

6) Justice- (made a quip about how the scientist wakes up in the morning and tries to practice various traits, and the last one he says and that sticks in his mind is justice, which is why he makes a big deal about it) So one might say that more people are served giving money to baby clinics rather than spending money on this high science which will only benefit a few. But there’s nothing happening because you shut the purse-strings, so people run to other countries where cloning is available.

Okay, we’re going to skip some of these points for time reasons.

[He’s going through the slide show now]

“The Birth of Cloning” (headline of an article) is from the 90s- began a long time ago but never made the papers- they took an adult cell from the webbed foot of a frog and put into the frog the egg without a nucleus and tadpoles were born- maturation can be reversed, you know that. How do you deprogram, that is the question, how do you make a cell go backwards, how do you take a diploid adult cell- if I can get it to start behaving like a newly-fertilized cell, I can make a new human being.

The Pope should know that every cell has the ability/ capacity for life. That makes you think twice before cutting your nails too short. (laughter)

[next slide]

“Dairy Gene”- Dr. Loike mentioned this- Fusing human cells with goat cells to produce human byproduct of cell- of human significance

[next slide]

“Whose Self is it Anyway?” Issue of individuality- can you clone a human being reproductively? Why not? Answers given to that question are unacceptable. The answer given is that there will be no individuality.

Now, we have clones all the time- identical twins who are raised in the same environment, they are clones, but still they are clearly not the same and have different interests- even Siamese Twins who are always together, yet developed their own personalities- this is a false statement, claiming this is destroying individuality.

Question whether human beings would ever be acceptable- identified with time and place- there’s a time and place where human cloning would be recommended and desirable. Firstly, it would have to be SAFE- we hear about Dolly (the success story)- what about those times they failed? They had a lamb with 7 legs and 4 heads, or half a lamb- when you can clone 100 lambs in 100 tries, then we can discuss it [human cloning.]

[next slide]

Now the problem of the unavailability of human eggs. In England, they are using rabbit eggs- stick human nucleus in egg shell of rabbit eggs after having pulled out the rabbit nucleus- it’s the shell that makes it go back to its growing days (that makes the cell behave as a new cell, deprogramming). So if I can start off a human cell and get stem cells- I an use stem cells to make a heart stronger, a liver more functional, can use for a cure…

The date on this is December 28, 2006, and the headlines is “Cow-Human Chimera for Stem Cells Faces UK Ban.”

Female human, bovine, same thing- but there’s been a tremendous objection/ emotional reaction to the thought of producing a human cell in a nonhuman organism- looks like they’ll forbid it in England.

I don’t know why.

--

Now I hear Dr. Loike mutter under his breath “Kilayim” (Mixtures.) So maybe there’s a halakhic issue of Kilayim. God gave species an identity. Now, Kilayim is no issue unless it’s reproductive mixing cells of species- has no halakhic significance unless organism reproduced (and even asexual reproduction counts.)

[next slide]

Here’s a wonderful teshuva from Rav Elchanan Wasserman- pollinate plant/ tree using pollen- now, the Talmud didn’t know about pollen- they talk about grafting. So the question is with regard to kilayim, nowadays would pollen be a problem for kilayim? He says yes, nowadays pollination WOULD be a problem for kilayim.

So it depends on the normal way- k’darko vs. shelo k’darko (what is natural vs what is not natural.) If the normal thing to do is grafting, then pollination would not be kilayim, it’s “lo k’darko” and vie versa.

[next slide]

Now, we have to circumvent the Bush blockade by President Bush- the only Bush you listen to is the burning one (tremendous laughter)- This blockade by President Bush had broken down the divide between Church and State- he’s introducing a theological outlook into this technology, forcing the scientific community to circumvent his objections.

[next slide]

Using amniotic fluid cells to duplicate stem cells- “Versatile Stem Cells without the Ethical Baggage” refers to special ones- behave right away- stem cells themselves can produce stem cells, can be modified to produce muscle cells, etc.

[next slide]

Unbelievable success story- “Stem Cell Experiment Yields Heart Valves”- produced heart valve of human cells- doesn’t have all the advantages yet- would be perfectly compatible with pregnant woman and fetus- one thing to note is that the patient who needs help must provide the DNA in order to produce these cells.

[next slide]

Unbelievable study- Japanese scientist has shown he can isolate four genes from a mouse, can be put into any cell of a mouse and produce stem cells- hope is then there is no need for an egg.

[next slide]

June 29, 2006 in “Nature”

A philosophical solution to the problem by Pope/ Bush- they are bothered by the idea that there is potential for a human to develop from these cells- so what about finding/ creating cells where they CANNOT develop into humans but CAN develop into stem cells- they’re trying to develop that.

But why do that? The halakhic approach doesn’t need to circumvent the edict of the pope.

[next slide]

Stem cells for males- “Pluripotency of Spermatagonial cells…”

[next slide]

And this is where we are up to today:

Australia lifts the ban on cloning about last month.

In Germany, stem-cell technique is “contrary to public order,” making it a felony to do it.

So all the brains are running to Australia, and Germany, where the question is if they ever had any to begin with…

[next slide]

JC- Jewish Chronicle article saying that Cloning is allowed under Halakha- this is referring to therapeutic cloning specifically, however.

--

Now, cloning can be misapplied. An ego trip is not right and just cause, just because someone wants to see what he looked like when he was young- this is wrong and no scientist would agree to help this man. But to help the infertile survivor of a family destroyed by the Holocaust- anyone with decency and empathy would do it.

There is a wonderful statement in Midrash Rabbah on Devarim [last slide]:

“The Book and the Sword came down from Heaven intertwined. Do what it says in the Book, and the Sword won’t hurt you- do contrary to this and the Sword will kill you.”

God made the scalpel, but He didn’t make you into a murderer or a great surgeon. You can be Jack the Ripper or a great surgeon saving many lives with the same scalpel. The same technology can be used for good or bad. This is not what God ordains, but what man ordains- all things can be used for good or evil.

(This last statement was extremely powerful, and I unfortunately have gotten it out of order. It was poetic, beautiful and very strong.)


QUESTIONS:

(One I couldn’t completely catch having to do with giving money to different resources and what R’ Tendler suggested should be done)

ANSWER: By posing that as a conflict of 2 goods, solution is not to choose BETWEEN them but to make them both possible- no excuse for America to have 25 million people uninsured or to have a lack of well-baby clinics in certain places. But one cannot give money to support these goods at the expense of research- they don’t have to give money to the Museum of Modern Art- they don’t have to buy new pictures; they can just turn the pictures upside down! (laughter)

Not doing stem cell research because the money is supposed to go to well-baby clinics, well this year they’re also not giving to that so (insinuation is they might as well give to us!)

--

QUESTION: The sin of Dor Ha’Haflaga (the Generation of the Dispersion) was technological advancement. So does God want this?

ANSWER: The problem is that man did NOT want to conquer the land- Nimrod build cities to contain man and keep him underneath him- the sin of Dor HaHaflaga was rejection of technological advancement. Man is supposed to go out into the jungles and see what he must do for the sake of mankind.

---

QUESTION: Issues of clone having a neshama (soul) ?

ANSWER: R’ Tendler gives a deep, emphatic sigh. Then-

Husband, wife and God. The husband and wife take care of the body parts when it comes to the creation of a child- the reason the husband and wife don’t deal with the neshama is because God handles the neshama- this is not your business, and we are not to worry about it. Except for Crick- he is attempting to discover the chemical basis of the soul, and most think he has a serious mental illness.


Member of Medical Ethics Comitte: Thanks to the speakers, thanks to Dr. John Loike. R’ Moshe Tendler, Dr. Ash director of Center for Ethics at YU for attending, the Student Medical Ethics Board Members