It has become a commonplace to observe that the people of the world will soon be divided into two classes—the technologically literate and everyone else. While such a situation certainly has unfortunate economic effects—for everyone else—how much worse it would be if we made a slight alteration in our description. How much worse it would be if the vast majority of people were possessed of too little information to allow them to make informed decisions about their own lives, health, and genetic inheritance. Unfortunately, this is the reality. And as scientific advances rocket far ahead of both our bemused journalistic establishment and our limping regulatory apparatus, the reality becomes ever more pernicious.

Dolly, as we all know, is a sheep. And a very remarkable sheep. Not because of what she is, but because of the mode by which she appeared in our midst. Dolly was cloned in a laboratory by a technique called nuclear transfer; she is virtually genetically identical to a sheep born six years before she was. And we—and the ways in which we view the world and each other—will never be the same again.

The possibility of human cloning first surfaced in the 1960s, stimulated by the report that a salamander had been cloned. James D. Watson and Joshua Lederberg, distinguished Nobel laureates, speculated that the cloning of human beings might one day be within reach; it was only a matter of time. Bioethics was still at that point in its infancy—indeed, the term “bioethics” was not even widely used then—and cloning immediately caught the eye of a number of those beginning to write in the field. They included Paul Ramsey, Hans Jonas, and Leon Kass. Cloning became one of the symbolic issues of what was, at that time, called “the new biology,” a biology that would be dominated by molecular genetics. Over a period of five years or so in the early 1970s a number of articles and book chapters on the ethical issues appeared, discussing cloning in its own right and cloning as a token of the radical genetic possibilities.

Dolly is a lamb that was cloned by Dr. Ian Wilmut, a Scottish embryologist. But she is also a Rorschach test. The public response to the production of a lamb by cloning a cultured cell line reflects the futuristic fantasies and Frankenstein fears that have more broadly surrounded research in genetics and especially genetic engineering. Cloning was a term originally applied to a botanical technique of asexual reproduction. But following early experiments in the manipulation of the hereditary and reproductive process during the mid-1960s, the term became associated with human biological engineering. It also became a pervasive theme in horror films and science fiction fantasies. Appearing to promise both amazing new control over nature and terrifying dehumanization, cloning has gripped the popular imagination.

The majority of adults in Britain cite the mass media as their main source of information about developments in science and technology. This alone makes it worth studying how the press covered the story of Dolly the cloned sheep. However, the media's reporting of Dolly revealed serious difficulties in the relationship of science to society. Although there were failures of journalistic accuracy and balance, these should not be allowed to obscure the deeper issues.

One of the arguments that is often put forward in the discussion of human cloning is that it is in itself wrong to create a copy of a human being.

The panic occasioned by the birth of Dolly sent international and national bodies and their representatives scurrying for principles with which to allay imagined public anxiety. It is instructive to note that principles are things of which such people and bodies so often seem to be bereft. The search for appropriate principles turned out to be difficult since so many aspects of the Dolly case were unprecedented. In the end, some fascinating examples of more or less plausible candidates for the status of moral principles were identified; central to many of them is the idea of human dignity and how it might be affected by human mitotic reproduction.

On Sunday morning, 23 February 1997, the world awoke to a technological advance that shook the foundations of biology and philosophy. On that day, we were introduced to Dolly, a 6-month-old lamb that had been cloned directly from a single cell taken from the breast tissue of an adult donor. Perhaps more astonished by this accomplishment than any of their neighbors were the scientists who actually worked in the field of mammalian genetics and embryology. Outside the lab where the cloning had actually taken place, most of us thought it could never happen. Oh, we would say that perhaps at some point in the distant future, cloning might become feasible through the use of sophisticated biotechnologies far beyond those available to us now. But what many of us really believed, deep in our hearts, was that this was one biological feat we could never master. New life—in the special sense of a conscious being—must have its origins in an embryo formed through the merger of gametes from a mother and father. It was impossible, we thought, for a cell from an adult mammal to become reprogrammed, to start all over again, to generate another entire animal or person in the image of the one born earlier.

Everybody recognizes that most of the problems in medical ethics arise, these days, from innovations in medical technology. We would not have had to lay down laws or ethical guidelines about assisted reproduction had it not been for the new technology of in vitro fertilization, which produced the first IVF baby in 1978. We would not be currently anxious about the ethics of possible human cloning, had it not been for the production in Edinburgh of Dolly, the lamb whose birth resulted from the removal of a mammary gland cell from an adult sheep. So the question is whether there is some research into developing technology that is too dangerous, that will lead to consequences too dramatic for humanity, for the research itself to be permitted. Should there be control over what technological innovation should be permitted?

On 5 July 1996 a sheep named Dolly was born in Scotland, the result of the transfer of the nucleus of an adult mammary tissue cell to the enucleated egg cell of an unrelated sheep, and gestation in a third, surrogate mother sheep. Although for the past ten years scientists have routinely cloned sheep and cows from embryo cells, this was the first cloning experiment that apparently succeeded using the nucleus of an adult cell.

The following points aim to shed light on the cloning debate by giving information on the scientific aspects of cloning and the ethical problems relating to them.

In Lewis Carroll's Alice Through the Looking-Glass, Humpty Dumpty said: “When I use a word, it means just what I choose it to mean—neither more nor less.” One may not agree with this approach, but it may well be preferable to using a word: (a) with only a vague idea of its meaning, or (b) with many possible meanings.

The Opinion addresses the genetic modification of animals brought about by DNA technology, including transfer of genes (transgenesis) and the deletion of genes (“knock-out”).

At an international workshop on Transgenic Animals and Food Production in Stockholm in May 1997 Peter Sandoe, a Danish philosopher, characterized the difference between Europe and the United States in attitudes toward biotechnology as a difference between “why?” and “why not?” To do so, of course, sins against the eleventh commandment, “Thou shalt not generalize,” but the distinction he draws is a concise way to highlight the differences in policymaking in matters of biotechnology.

Like many other locals, I was unprepared for the global media's invasion of Roslin. The former mining village just outside the southern city limits is best known to most Edinburgh citizens for its tiny, ornately carved medieval chapel. Constructed for Crusading Knights and long associated with Freemasons, Rosslyn Chapel was made famous by Sir Walter Scott's Lay of the Last Minstrel. Nowadays it is visited, in coachloads, by devotees of less literary and historically more dubious esoterica, many of whom believe that the Holy Grail and/or a ‘true’ version of the gospels are buried beneath it. In the local media, demands for the chapel's foundations to be excavated in search of secret clues to the meaning of life, death, and everything, have figured just as prominently as articles agonizing over scientific developments at the Roslin Institute, half a country mile away.

The critical look at hospice care by Felicia Ackerman in Vol. 6 of the Cambridge Quarterly requires a response, since the author presents her view as having major implications for health policy. As a healthcare executive with over 25 years experience, and as a spokesperson for both my own program and others in the National Hospice Work Group, twelve of the nation's largest nonprofit hospices, I submit that her analysis of hospice care is naive. Ackerman's lack of practical understanding concerning the care of the terminally ill results in a discussion that misses the key policy issues.

What motivates a polemic like Felicia Ackerman's “Goldilocks and Mrs. Ilyich: A Critical Look at the ‘Philosophy of Hospice’”? Ackerman announces that in addition to analyzing and criticizing hospice principles as embodied in the National Hospice Organization's “Philosophy of Hospice,” her article will also present “some discussion of hospices in actual practice …” She presents, in fact, two examples of hospice practice: one is a dubious anecdote, the meaning of which she apparently misunderstands, and the second is a description of a twenty-year-old policy of St. Christopher's Hospice in England, which, I believe, is no longer strictly adhered to.

The patient was a 19-year-old man who was the victim of an accidental head injury. The attending neurosurgeon felt that, due to uncontrollable and repeated elevated intracranial pressures, the patient would die within 48 hours. The patient's mother requested that the neurosurgeon contact a urologist to collect the patient's sperm for implantation into the patient's girlfriend. The neurosurgeon felt that the situation raised a number of ethical issues and requested that the hospital's bioethics committee consider the case.