Be Careful of What You Ask For: In a fit of religious zeal, is the US giving away its economic future?

A Geneforum interview with Ronald M. Green
Chair, Dartmouth College Department of Religion
Chair, Advanced Cell Technology Ethics Advisory Board

by Mark Compton, February 2004

Among market makers and watchers, it's widely believed that the biotechnology industry may generate wealth and growth throughout the 21st century that's roughly akin to what we saw emanating out of Silicon Valley over the last two decades of the previous century. Little wonder, then, that the US, Britain, Israel and China are locked into what's sometimes described as "a horse race" to claim the prize.

It now appears, though, that the US is dropping back in the field - and on purpose at that. Strange as that is, what makes it truly odd is that - despite a culture that utterly hates to lose and is, in fact, renowned for its "win at all costs" ethos - the country's current Administration seems determined to drive biotechnology research away in response to organized opposition from religious leaders.

To explore some of the underlying motivations and issues, Geneforum asked Ron Green, one of the nation's foremost bioethicists to share his thoughts. In addition to chairing the Department of Religion at Dartmouth College, Ron heads up a private Ethics Advisory Board for Advanced Cell Technology. Work in both of these roles has afforded him a rare perspective on both sides of the unfolding debate. So we asked Ron to draw on those insights to explain how it is we managed to get ourselves into the current standoff and what he sees ahead for biotechnology research in the US.

[The views and opinions expressed by the participants in this interview are not necessarily those of Geneforum, and the publication of this interview should in no way be construed as an endorsement of those views.]

[Mark Compton]: As we approached the new millennium, Time magazine dubbed this the "Biotech Century." We're of course now a few years into that century, and yet the United States still offers no federal guidelines on human embryo research, cloning techniques, in vitro fertilization, or any other related reproductive technology simply because there is no federal funding for any of these activities. Does this suggest a hope on the part of our current administration that by ignoring the reproductive sciences, perhaps they'll just go away?

[Ron Green]: I don't think the government has ignored the reproductive sciences. I think it's tried to shut them down. And therefore they probably will, in fact, go away.

Away from our shores at least.

Exactly. Literally go away. I think the government realizes that Great Britain—along with Singapore, Israel, India and China—are probably going to pick up the slack. But I think people in this Administration feel they've accomplished their domestic political purposes by banning funding for the reproductive sciences. They would also love to ban this work in the private sector, but there simply is not enough of a political consensus to accomplish that.

And of course, if this is in fact to be the Biotech Century and this Administration is successful in its attempt to drive this research elsewhere, we're sure to experience a significant brain drain. Can the US really afford that?

My own view is that this is a bit like it would have been to tell the Recombinant DNA people back in 1978, "Hey, don't do that work here!" The consequences of that would have been devastating for the development of American biotechnology. And I think we're doing something very much along those same lines right now. We're giving the greatest gift imaginable to the Universities of Edinburgh, Cambridge, Oxford and Tel Aviv. We're making sure that those locations are the likely centers of future Biotech Valleys. And in doing so, we're giving up a significant part of our economic future.

And it would seem that what you're talking about is not hypothetical either. There are a fair number of people who've already relocated, it seems.

Roger Pedersen of the University of California, San Francisco, has already gone over to Britain. And research is also actively going on in China, Singapore, India and Israel. Much depends on the progress of this research and technology. But my sense is that right now it's slow but accelerating. I personally believe that the research we're currently driving away is going to be the basis of a tremendous amount of economic activity throughout the 21st century. I just don't think there's any doubt but that the 21st century will be the century of biotechnology and that we are in fact, to some extent, giving up our leadership.

In contrast to the current US Administration, the British government, of course, is very much in the thick of this action, having formed the Human Fertilisation and Embryology Authority to govern both private and public sector research. How is it that, at least in terms of government policy, the US and Great Britain have become two nations separated by a common genome?

I think it's as simple as our respective religious cultures. You can map global responses to this issue against a map of religious loyalties. Let me illustrate: Israel, which has a completely different view of the early embryo since Judaism does not weigh the embryo heavily over the first 40 days or so of development, has one of the most aggressive programs in terms of utilizing embryos for research purposes. The same applies in Singapore—as well as throughout the whole Chinese cultural area. Confucianism and the like is not particularly concerned about embryo status. Similarly, almost all the Scandinavian countries are supportive of these research directions, except for Norway, which has a public culture dominated by a very conservative, evangelical Lutheran church. Similar forces to those are also at work in Germany. And, of course, because of the special features of German history, they also have some unique concerns about genetics research. But I would say it's more a matter of conservative Lutheranism being allied with conservative Roman Catholicism to drive cultural attitudes—and thus policy directions—on these issues.

Then you go across the Channel to Great Britain and you find the Anglican tradition, which is actually fairly permissive about early embryonic life. You also find a relatively small percentage of evangelical Christians and a relatively small percentage of Roman Catholics. Hence, the British position on embryonic stem-cell research. Then you come over to the US and run up against a culture that's divided between liberals and an increasingly strong evangelical presence that's allied on this particular issue with a strong Roman Catholic presence. And by "Roman Catholic" here, I don't mean to refer to most Roman Catholic believers, who I think are largely out of the picture on this issue. Rather, I'm talking about an organized church presence—a lobbying presence in Washington. In my work in Washington, I have learned that between the various evangelical groups and the Roman Catholic Bishop Secretariat for Pro-Life Activities, you have quite a powerful lobbying force that is able to essentially stall federal support for this research. But it's not quite strong enough at this point to prevent private embryonic stem-line research.

It's interesting that so many polls seem to indicate that the vast majority of American citizens share the same liberal attitudes on the embryo that you suggest are prevalent throughout Scandinavia and Britain. But, of course, those views may not be represented quite so forcefully as the points put forward by the highly organized evangelical and Roman Catholic opposition.

I have some very liberal friends whose opinion I very much respect, but I nevertheless consistently disagree with them whenever they say we should have something along the lines of Britain's HFEA—the Human Fertilisation and Embryology Authority. In a perfect world, I think the Brits have got it nearly right. They have an authority that, first of all, oversees the infertility industry—which is the sort of oversight we badly need here in this country. At the same time, they're able regulate the sources of gametes and embryos for research purposes. And they have a program that provides for the licensing of research. All of which makes perfect sense and works quite well, providing oversight that's flexible enough to let research flourish. So it's quite reasonable that people should say, "Well, why don't we have an HFEA ourselves?" But my experience tells me that the first people in the door will be those well-organized opposition groups that are so effective at blocking essential research. And they're even organized to block clinical activities. Thus, an American HFEA would almost certainly preclude couples seeking in vitro fertilization from transferring more than one embryo. And anyone who works in this area knows that one-embryo transfers are simply not efficient. So this would only serve to increase the costs and the burdens placed on these couples. And the existence of an American HFEA would only serve to promulgate and reinforce these sorts of limitations and restrictions.

But the lack of adequate regulatory controls over the infertility industry has also had some unintended consequences, hasn't it?

Some very serious consequences. We have an epidemic of high-order multiple births in this country. But actually most of that problem doesn't come from the infertility clinics, but rather from private medical practitioners who are employing ovulation-inducing medications. And half the time, those doctors don't have any idea of what they're doing.

So clearer guidelines would be useful?

Clear guidelines—professional guidelines—are much needed ... as is some real leadership in this area. The problem is that all this is only going to get tied up with our convoluted abortion politics. And you're going to hear from the anti-abortionists who will argue that it's immoral to elicit more than one embryo because when you hyper-stimulate people, you're creating embryos that are doomed right from the start. And you're going to get all tangled up in those sorts of arguments. So between poor regulation, frustrating regulation and no regulation, I actually opt for no regulation in spite of the undeniable costs.

I see. Of course, as you know all too well, ethical considerations can be quite complex and while the evangelicals have one way of looking at what's ethical and what's not ethical, it seems to me that there's a reasonably broad consensus throughout the medical research community that embryonic stem-cell research might well hold the key to the development of effective therapies for millions of patients suffering from a broad array of catastrophic diseases. So, in light of that, resistance to any progress whatsoever in this area strikes me as being difficult to defend ethically.

But you have to understand that those who resist and oppose embryonic stem-cell research believe that the early human embryo is the moral equivalent of you or me—and that, just as we would not permit research that involved eviscerating an adult, we likewise should not permit the destruction of an embryo.

Of course. And I presume this applies from the moment of conception.

Well, actually, I find the very phrase "moment of conception" rather amusing because there really is no such thing. But, yes, that's the view. Still, there's no single moment of conception. There's a process of conception. And this popular misconception just goes to illustrate the relatively naïve approach to biology that dominates the discussion here.

How inconvenient that these biological processes are too complex to be comfortably encapsulated in simple catch-phrases.

And even less conveniently, it points up the role that decisions play in all this. But one of the things that characterizes the opposition to embryonic stem-cell research is that they don't want to think of decisions as being part of the process. As far as they're concerned, these matters are simply bright lines in nature. But there really are no bright lines in nature. In fact, the more you ratchet down your microscope and improve your ability to measure, the more you see that the bright lines become spectra.

But for certain individuals, it would seem that life is extremely simple. You're either with us or you're against us. You're either good or you're bad. You're either saved or you're not. And perhaps it's because of absolutist views such as this that Bush's moratorium on stem-cell research has caused some people to question the role that religious views should play in the formation of public policy—particularly in a country such as ours, where the notion of a separate Church and State is embedded in our Constitution. In exerting tremendous political pressure on the Bush administration to oppose all manner of reproductive technology research, has the Religious Right finally managed to step over the line?

Actually, I think the Bush position is a work in progress. It certainly has exposed itself as far more obstructive than I expect the President initially thought it would be.

Oh really?

Yes. There are only a few stem-cell lines available. That is, the 60 or so lines that were initially proclaimed as available have since been whittled down to a mere handful of viable lines. And even those are only being made available to researchers at a maddeningly slow pace.

So Bush felt he was employing the wisdom of Solomon, but actually it proved to be something else altogether?

I think so. Actually, had I been an advisor—given my understanding of the conservative impulses—I would have encouraged them not to limit availability to 60 lines, but rather to just those embryos parents had already consented to donate for research purposes. Because on those grounds, those embryos were already essentially doomed. Even if you accept the claim that "life begins at ---," couples are free to designate what's to be done with their embryos. And by limiting research only to those embryos already donated for scientific pursuits, the Administration would have provided access to perhaps a thousand stem-cell lines. As it is, though, the Bush guidelines have had the effect of seriously restricting research.

It certainly seems to be a solution rooted in politics rather than science, in any event.

Absolutely. It's a solution rooted entirely in politics.

Also, it could be said that in abdicating its role in shaping and enforcing appropriate research guidelines, the US government has actually created a public policy vacuum. How is that now to be filled?

I think partly through voluntary efforts by researchers, companies and professional societies. I think you know that I head the Ethics Advisory Board on a pro bono basis for Advanced Cell Technology? And I think Geron has an Ethics Advisory Board as well. That's the sort of thing I'm talking about. Basically, people who feel this research should go forward, but only with appropriate supervision, are now beginning to participate in these sorts of bodies. I know the charge is that these boards serve only as rubber stamps for industry, but I simply don't believe that's true. I think they can be significant actors if they're founded on proper principles and the people involved work together to come up with appropriate best practices.

But it's understandable how the perception that these groups are nothing more than industry sanitizers might arise.

Yes, I understand that. But I think that perception can be combated through better organization, better communication, better standards and better guidelines. For example, there's the matter of compensation. Our board has basically refused to take compensation of any sort. And I think that should be broadly adopted as a standard best practice. Or, at minimum, the compensation should be so modest as to not be a factor in anybody's psyche. I'd like to see some sort of guarantee—a Better Housekeeping Seal of Approval, if you will—so people would have some better basis for knowing where they could place their trust.

Those sorts of assessments could perhaps come from the American Medical Association, I suppose.

Or some other professional society. The American Society of Bioethics and the Humanities, for example, could pull together a working group to determine the standards that an industry or organization must meet in order to receive the seal of approval. I think that could be done. Americans have achieved a great deal through self-regulation and the adoption of professional standards over the years. So I definitely think that's one of the ways we could go here. I'd like to see that approach applied to infertility programs as well, actually.

Still, do you find yourself on occasion having to defend the Ethics Advisory Board for Advanced Cell Technology to those who suspect it really is nothing more than a rubber stamp?

Not only have I had to defend the board, I personally have been vilified. An individual whose name will go unmentioned here resigned from the board without ever having participated in it. And that person then saw fit to publicly criticize the board as being compromised and so on. I was astonished at how the press responded to that—and from an individual who was never even actively involved as a member of the board. The reality here is that people automatically assume that any association between private industry, reproduction and biotechnology must of necessity be bad, bad, bad. That's the mindset we've gotten ourselves into. So if you're putting together a film like Arnold Schwartzenegger's "The Sixth Day", and you're looking to include some bad guys that everyone is sure to hate, what do you suppose those bad guys will be portrayed as?

Hmmm. Lawyers and biotech researchers, perhaps?

That's it exactly. Because those are the guys everybody loves to hate. And in that particular film, the nefarious foil was indeed depicted as the head of a biotechnology cloning company. Also, back when I worked for the NIH and the Human Genome Research Institute, a geneticist friend once told me he was sitting at a dinner party when he was asked by someone at the table what he did for a living. When he told her, "I'm a geneticist," she responded, "Wow, that's scary." I mean, there's a definite mind set in this country that genetics, biotechnology and reproductive medicine are dark arts of some sort.

Well, it is scary going into the unknown, I suppose. And of course, this is all deeply personal.

Yes, we're talking about reproduction and life here—the sacred zone.

Perhaps because it is such a loaded area, I've gathered from your own writings that building public confidence in the workings and influence of Ethics Advisory Boards such as the one you head at Advanced Cell Technology is perhaps one of your greatest challenges. You've already made reference here to some best practices that might serve to allay some of those public concerns. Can you offer some examples? You've already addressed compensation, of course, but perhaps there are some other instances as well.

Conflict-of-interest rules are also important—particularly with regard to the rights and prerogatives of board members.

Is this in reference to those instances where board members are inclined to take issue with something the company has set its sights on doing?

Right. And there is a peculiarity here with regard to corporations that one must understand. That is, no business leader can give over authority to an independent board because, legally, company leadership must remain responsible to its Board of Directors.

Which, in turn, must remain accountable to the shareholders—at least to some degree.

Or to whoever it is that owns the corporation—whether it's a private or public entity. That's just what US law dictates. Thus, a company cannot extend to some external Ethics Advisory Board veto power over its internal business practices. All those decisions rest ultimately with the Board of Directors and, by extension, with the owners or shareholders they represent. But what can be offered to outside advisors, as in the case of Advanced Cell Technology, is the power of the pen. Michael West, the CEO, told us that if it ever came down to the point where we disagreed with what the company was doing, we would have the right to quit, resign, or stay on and publish whatever we wanted so long as we avoided revealing proprietary information. And that limitation, as it turns out, is only a fairly narrow one that refers to patents, formulas and the like. So we're otherwise free to proclaim to the world that we advised against undertaking some particular research and yet the company decided to plow ahead with that work anyway. And that, it turns out, serves as quite a restraint—as well as an important liberty for anyone who signs on as a member of the Ethics Advisory Board.

You were speaking earlier of the need for a Good Housekeeping Seal of Approval or something of the sort that can help engender greater public confidence in private Ethics Advisory Boards. But do you believe, even with that, private Ethics Advisory Boards can ever be as effective as government regulation in terms of inspiring public confidence?

Government regulation is the gold standard. The FDA, the Recombinant Advisory Committee for Gene Therapy—that's the gold standard. I just don't think we're going to see that in this area.

And, if I understand you correctly, that's not Administration-specific. It's actually the overall political climate in the US that's driving that. Is that what you're saying?

Yes, it is. Administration-by-Administration, these conservative pressures intrude.

It almost seems as though a conservative Administration could actually do more to put appropriate regulatory controls in place—assuming it had the political will to do so. A more moderate Administration, of course, would be absolutely slaughtered if it tried to do something like that.

It's just never worked that way. You take something like fetal tissue transplant research back in the late '80s. The Reagan and Bush Administrations created a panel to draft recommendations. The panel met and produced a thoughtful report that included a number of dissents but basically recommended going forward with the research, but the report was not accepted. Right now, similarly, it's fairly clear that Karl Rove's office is driving biomedical ethics policy for this Administration.

Now, that is a truly scary notion.

And it's also the truth. That's just how important, right now, the conservative religious vote is in the political calculus of this Administration.

Well, certainly, this is a President who has felt right along that you don't get ahead by alienating your base.

Right. And that base is absolutely crucial to Bush's re-election efforts. And the biomedical arena represents low-hanging fruit since not that many people know about—nor care about—biomedical policy.

Except for all the anti-abortionists, for whom it's the only issue that really matters.

It certainly is a high-profile issue for them. And this president can go before the electorate next year and say, "I passed a law against partial birth abortion. I worked to squelch the physician-assisted suicide law in Oregon. I blocked stem-cell research and the destruction of the innocent. And you can believe he means to make major political hay out of all that.

A majority of the people in this country don't even agree with him on most of those issues, but that rock-solid Religious Right base certainly does.

That's right. And more than that, the other side doesn't care. To me, that's the saddest thing of all. Biotechnology as an industry is strong enough to block restrictive measures where it is concerned. It has a very strong lobby. But the populace as a whole is indifferent to the fact that Bush has de-funded the United Nations population fund in China. Ask your neighbors, "Say, are you up in arms over the fact that the major organization providing reproductive health and maternal and child health and population control has been deprived of $35 million in US funding? Do you care about that?" And they'll say, "They have? I never even thought about it." Then you can ask if that's going to cause them to vote against Bush. And they'll say, "That's just not an issue with a big enough profile to sway me one way or the other."

No, the opposition in this election is clearly going to galvanize around the war and the economy.

Right. So you get an asymmetry here. Whereas the Religious Right is very concerned about these issues, for the liberals it's largely peripheral.

Except where abortion is concerned. That might very well prove to be a red-letter issue in this election cycle.

But probably not enough of one to make a difference. Notice that Congress felt fairly safe in voting overwhelmingly for that unfortunate partial-birth abortion ban. Which, by the way, is quite likely to be overturned at the court level.

That makes it ideal for the conservatives. Not only do they get to wear that vote as a badge of honor, but they're also spared the responsibility—and potential political liabilities—of having to live with the consequences.

And because the ban will likely be overturned, they'll also be able to blame everything on the courts—which should serve to fuel the on-going effort to force changes in the judicial system.

Actually, that all sounds depressingly prescient. Perhaps it's time now to turn to another topic having more to do with ethics in general ... Ian Wilmut, in describing the science behind the creation of Dolly, the world's first cloned mammal, closed his remarks to an AAAS audience in 1997 by observing "I believe it is important that society decides how we want to use this technology and makes sure it prohibits what it wants to prohibit." Do you feel this is a view that's widely embraced in the boardrooms of most biotech firms?

No. Speaking quite frankly, I think what most biotechnology companies want is the maximum liberty to do just as they please.

No surprise there.

Right. It's not in any company's nature to seek to limit itself. Now, where there's some more progressive leadership, such as at Advanced Cell Technology or Geron, there's a realization that the organization is operating in a highly controversial area. So they can see the value in having respected people on board to monitor what they're doing. Monsanto may also have learned that valuable lesson, albeit somewhat belatedly.

As you point out, Monsanto surely could have benefited from the oversight of a panel of worthies and probably should have even taken additional steps to obtain some sense for the values or views of those people most likely to be directly affected by the new products Monsanto hoped to release. But, as a practical matter, are policy discussions regarding matters as complex and technical as stem-cell research all that likely to be informed by tremendous insights from ordinary members of the mainstream populace? Or is it the case that genetic policies, by and large, are simply beyond the intellectual grasp of the general public?

I don't think they're beyond the grasp of the general public. I think people can be educated. I think they're open-minded. And I think Americans are generally technologically favorable. That is, as a culture, I think we are quite open to technological developments. But people don't want to be blindsided. They don't want to be deceived. And they want to be involved. Let me give you a concrete example. Right now, there is an issue before the FDA regarding the introduction of cloned animals into the food chain. I'm reasonably confident that once the FDA has a chance to look at that closely, it will be approved. That's because, while cloned animals have problems that create difficulties for themselves, those problems don't appear to have any real impact on the food chain. Those animals themselves may have some imprinting problems that lead to enlarged organs and impaired functioning of their immune systems and so on. But, ultimately, the cells in those animals are just like any other cells that can be cooked and eaten. There's nothing there that can be considered toxic.

But, of course, for some people, science doesn't offer the last word on the matter. There are those who probably are concerned that animals created through a bit of genetic diddling might have cooties in their cells.

Well, but that just doesn't withstand careful examination. And when you have an expert committee from something like the FDA looking into the matter and offering its blessings, most people in the American public are going to be willing to trust that.

Ah yes ... the gold standard.

It really is—and that's important. In fact, the credibility of the FDA has much to do with why we've been spared the terrible experience of, say, Great Britain —with its mad cow disease episode. In that instance, the expert British panels said repeatedly that there was no problem ... nothing at all to worry about.

And so now they have no credibility whatsoever.

That's right. Whereas in the US, we remain fairly trusting of our expert panels because we haven't had the same scarring experience the Europeans have. Nor do we have some of the same vested interests that impede technology in many European countries. I'm thinking here of the small farm interests in Europe that are extremely resistant to genetically modified foods largely because of the impact on small farming. In contrast, America has something of a pro-technology bias, which I consider one of our assets right now. But that can always be destroyed by poor leadership and a substandard regulatory environment.

And then where can those regulatory bodies go to get their credibility back?

Once it's gone, it's very hard to restore. Right now, we have a significant asset in the form of our credible regulatory structure. But that's always at risk.

So extrapolating from that a bit, it sounds as though—absent credible regulatory controls—you feel the biotech industry is not doing an adequate job yet in terms of educating the public about the possible risks—as well as the potential upside to, say, embryonic stem-cell research.

That's true, but I also think they haven't paid enough attention to just how precious the public trust is. Because, otherwise, they'd pay more attention to developing good relationships with regulatory bodies. Full disclosure and working to preserve the trust already placed in our existing oversight structures are both vitally important—to industry as well as to society. And in the reproductive area, for all the reasons I've already signaled, I think we really need to enhance our regulatory structures.

Within the context of your role on the Advanced Cell Technology Ethics Advisory Board, I'm imagining you've found it tremendously challenging to get the officers and board members of a profit-driven enterprise to take a long, hard look at their actions through the prism of ethics. Certainly, ethical contemplation seems rather at odds with the pressures of a world dominated by impatient investors, tremendous time-to-market pressures, and massive financial risks. How is it that you work to get the management team at Advanced Cell Technology to look away from the bottom line long enough to take a higher-level, ethical view of the technologies, techniques, and therapies they're developing?

That's an interesting question. I think an Ethics Advisory Board such as the one at Advanced Cell Technology serves as a kind of self-created sea anchor for an organization. Once they've created it, they're responsible to it. And this organization understands that. Sometimes, from their perspective, I must admit it probably seems as though they've created a Frankenstein. But it's something that works. We found that once they told us they were not going to do things unless we approved of them, they've really taken that commitment to heart. And it has, in fact, slowed the progress of research significantly. We even had one crisis around the title of an article that one of the researchers was trying to publish. We felt the title was very unfortunate, but the article was already in proofs by the time we got involved. And the researcher really bridled at our objections, saying, "I didn't think the purpose of this board was to tell me how to title my articles." And we responded, "But the title is erroneous, misleading, and dangerous." And he grumbled quite a lot as he took leave of us. But a week later we got an email message saying, "I persuaded all of my co-authors to change the title." So they may scream and kick from time to time, it's been my experience that they do listen.

That's especially impressive in biotech, where when it comes to bringing therapies to market, the scores are kept in a rather stark manner: either you win or you lose. So even if the Ethics Advisory Board only impedes progress for five days, that could make the difference between obtaining a patent or losing it—which, for a drug discovery company, could be utterly devastating.

Definitely, because competitors are poised to leap ahead all the time. On the other hand, an Ethics Advisory Board can be fairly flexible. In our case, we try to be available to do business by conference calls at moments of urgency. I'll give you a concrete example, in fact. The company has decided it needs to seek out a second source for the human eggs used in its research. We've always worked with one source that's well established and well monitored. But the researchers feel they need a second source for a variety of reasons. And we're trying to assess the potential alternative they've identified by way of conference calls. So there are times when an Ethics Advisory Board can be quite responsive, taking into account the competitive needs of a company. That can only work, however, if you've managed to build trust on both sides.

We've definitely looked at the reasons for the company to take your efforts seriously, but I'm not sure that's quite the same as thinking ethically for themselves. Is that something they're not really equipped or prepared to do? Which is to say: Does that help explain the need for an Ethics Advisory Board?

To an extent, yes. I certainly don't think scientists are monsters. But I do know they have their scientific imperatives and that, in the case of biotechnology, in particular, a lot of that is driven by the demands of proprietary intellectual property and the patent process. But mostly I think it's just that scientists aren't trained to look at the ethical issues. So you really need to have people trained in ethics involved in the process.

As you get into dialogues with these researchers, do you see moments of epiphany where they suddenly are able to view things from your perspective and realize why some certain ethical concern is so very germane to their business and the way they're perceived by society at large?

Absolutely. I'll give you a concrete example that I've actually written about. You'll probably remember that Dolly was cloned by transferring fertilized, reconstructed oocytes to the fallopian tubes of other sheep for a period of time to culture them. So the researchers took the donor egg, put a nucleus from another sheep into it and then stitched it back into a fallopian tube for a number of days to allow the egg to stabilize and grow. Then they took the egg out and transferred it to another womb. So, drawing from that example, some researchers proposed culturing human embryos in a similar way—by putting them into rabbit fallopian tubes to develop for a period of some period of time. But as we looked at that, we said: "Oh, my god! A human-cloned embryo developing inside a rabbit in a laboratory?"

Although I must say the idea of using rabbits for reproductive processes is certainly an appealing one.

Yes, but what happens if the rabbit gets out of the lab and then you have a human clone running around the forest? I said quite apart from the sheer public relations travesty that could come of that, you're surely not going to put a human embryo into an animal you cannot monitor with 100% certainty. The chances of that embryo fully developing would have been quite slim, of course, but it certainly made for a ghastly prospect. The researchers at first didn't quite see what we were getting at because this was a state-of-the-art procedure they were contemplating. And that's just how things are done with animal cultures. They didn't perceive the ethical dimensions of what they were considering—and it's fair to say they were startled once they were made to see those dimensions. And once they did, they immediately agreed not to proceed down that path.

A pity ... that could have proved to be the first child truly born in a cabbage patch. Now I wonder, in this experience you've had in working with Advanced Cell Technology, are there any lessons you feel can be derived in terms of how to stimulate ethical discussions within the community at large? That is, what have you found it takes to fire people's imaginations and engage them in the process of ethical deliberation? And taking that a step further, what do you suppose it will take to engage them actively in the process of democracy?

I think the single most important conclusion I've come to has to do with the innate need for dialogue between the scientists, the businesspeople, the ethicists and members of the community. We all really need to listen in good faith to one another more because we have so much to learn from one another. The scientists have a tremendous amount to contribute. And management at the biotech companies can also contribute much. But they need to hear concerns from other perspectives in a spirit of dialogue—not dictation. Nobody wants to be dictated to. In the form of a dialogue, views could be openly exchanged and the conversation could even allow for points of respectful disagreement. This is only possible, though, when the dialogue is both serious and respectful.

And what are the appropriate forums for that dialogue?

Well, a good Ethics Advisory Board is certainly one. That offers a responsible public forum.

What about town hall meetings—that sort of thing?

Yes, I think so. But not the sort where people come out to scream and yell at each other and call the researchers "baby killers" or "Frankensteins". I'm talking about real dialogue. For example, with regard to genetically modified organisms, I'd like to see the people from Monsanto approach farmers to find out how their products appear to be affecting the food chain and to learn more about what's being done to manage any perceived risks. I was at a forum at the Salzburg Seminar where a farmer who uses Monsanto products stood up and said, "I wouldn't be here today if it weren't for Monsanto." And we all blinked and looked at him as he proceeded to explain that by using Roundup-ready soybeans, he'd managed to cut his time in the fields in half, which had given him time to think and do things he'd never had time to do before.

And that doesn't even speak to improvements in yield.

Right. He was just talking about timesavings. But it was still a bit startling to hear a farmer supporting biotech products in terms of what they can do to improve the quality of life for those who live on farms. And having that kind of intelligent dialogue around these products is precisely what we need to see more of—in lieu of all the yelling and screaming at each other.

Another consideration is that the American public has been described on occasion as "deeply, deeply uneducated" where the new genetic sciences as a whole are concerned. Given that the technical, ethical, and economic dimensions of the research in this arena are not the sort that might be satisfactorily explored using the sound bytes so favored by popular media, what role can—or should—the Internet play in helping to create a more informed electorate?

There again, it's a question of building trust and credibility. Web sites that offer reliable, unbiased information and support open dialogue can be extremely valuable.

One final question, then: On the chance that people end up failing to actively participate up front in the policy formation process, how might their values ultimately be accounted for? Will that expression come solely in the marketplace—where all of us, as consumers, remain free to vote with our pocketbooks? And if so, will that be sufficient?

I'm not really sure. I don't think the marketplace offers an adequate polling mechanism, to be honest.

Although, of course, the marketplace has operated as a very effective feedback mechanism in Europe on the issue of GMOs, for example.

It has, but I think that feedback has come along a misguided vector in some cases. And while Europe purports to support a free marketplace, it's hardly that. There are all sorts of vested interests at play there. Thus, what is available in the marketplace often proves to be a matter predetermined by certain select power groups and voting blocks. So I don't regard the marketplace as a perfect barometer of anything. It's one input you can factor into the overall equation, but it has to be supplemented by information and education and deliberation.

So would you describe yourself as reasonably optimistic as you look to the future?

Well, let me be frank: I strongly support biotechnology in the private sector without having any personal vested interest in it. And yes, I truly believe that this will be the Biotechnology Century. I think we're going to see some incredible discoveries and developments. But it's also clear that everybody is going to have to act responsibly. Currently, there are tremendous forces pushing us towards irresponsibility, and our challenge is to temper those impulses without being obstructive or standing in the way of progress. And the only way I can see to do that is to foster better education, knowledge, and dialogue—while at the same time, of course, enhancing our current mechanisms for providing responsible oversight.

About the Interviewer

Mark Compton monitors trends in information technology and biotechnology from a comfortable perch midway between the Silicon Valley and Oregon's Silicon Forest.