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分类数据的统计分析Statistical Methods for Categorical Data Analysis 1999

分类数据的统计分析Statistical Methods for Categorical Data Analysis 1999

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分类数据的统计分析StatisticalMethodsforCategoricalDataAnalysis1999LETTEROFTRANSMITTALTOTHEPRESIDENTixMEMBERSOFTHEPRESIDENT’SCOUNCILONBIOETHICSxiiiCOUNCILSTAFFANDCONSULTANTSxvPREFACExviiEXECUTIVESUMMA ...
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分类数据的统计分析Statistical Methods for Categorical Data Analysis 1999

LETTER OF TRANSMITTAL TO THE PRESIDENT ix
MEMBERS OF THE PRESIDENT’S COUNCIL ON BIOETHICS xiii
COUNCIL STAFF AND CONSULTANTS xv
PREFACE xvii
EXECUTIVE SUMMARY xxi
Human Cloning: What Is at Stake? xxii
The Inquiry: Our Point of Departure xxii
Fair and Accurate Terminology xxiii
Scientific Background xxv
The Ethics of Cloning-to-Produce-Children xxvii
The Ethics of Cloning-for-Biomedical-Research xxx
A. The Moral Case for Cloning-for-Biomedical-Research xxx
B. The Moral Case against Cloning-for-Biomedical-Research xxxii
Public Policy Options xxxiv
The Council’s Policy Recommendations xxxv
Majority Recommendation xxxv

Minority Recommendation xxxviii

HE MEANING OF HUMAN CLONING: AN OVERVIEW 1
1. T
Human Cloning in Context 4
Cloning and Human Procreation 6
Cloning and Biomedical Science 10
Cloning and Public Policy 14
The Report 17


2. HISTORICAL ASPECTS OF CLONING 19
Scientific Milestones 19
Human Cloning from Popular Literature to Public Policy: From
Brave New World to the Birth of Dolly 22
The Human Cloning Debate: From Dolly to the Present 28

Endnotes 33

N TERMINOLOGY 37
3. O
Introduction: The Importance of Careful Use of Names 37
Tools of Analysis 40
Cloning: Toward an Appropriate Terminology 42

iv


Cloning-to-Produce-Children; Cloning-for-Biomedical-Research 43
Cloned Human Embryo: The Product of SCNT 46
Conclusion 54

Endnotes 55

CIENTIFIC BACKGROUND 57
4. S
Introduction 57
Some Basic Facts about Human Cell Biology and Sexual
Reproduction 58
Cloning (Asexual Reproduction) of Mammals 59
Epigenetic Modification and Reprogramming 62
Cloning-to-Produce-Children 64
Stem Cells and Regenerative Medicine 65
Human Cloning-for-Biomedical-Research 69
Parthenogenesis (Another Form of Asexual Reproduction) 71
Endnotes 71

5. THE ETHICS OF CLONING-TO-PRODUCE-CHILDREN 75
I. The Case for Cloning-to-Produce-Children 78
A. Purposes 78
1. To Produce Biologically Related Children 79
2. To Avoid Genetic Disease 79
3. To Obtain “Rejection-Proof” Transplants 79
4. To “Replicate” a Loved One 79
5. To Reproduce Individuals of Great Genius, Talent, or Beauty 80
B. Arguments 80
1. The Goodness of Human Freedom 80
2. The Goodness of Existence 81
3. The Goodness of Well-Being 82

C. Critique and Conclusion 83
II. The Case against Cloning-To-Produce-Children 87
A. The Ethics of Human Experimentation 87
1. Problems of Safety 89
(a) Risks to the child 89
(b) Risks to the egg donor and the birth mother 90
(c) An abiding moral concern 91
2. A Special Problem of Consent 94
3. Problems of Exploitation of Women and Just Distribution of Risk 95

4. Conclusion 96
B. The Human Context: Procreation and Child-Rearing 99
C. Identity, Manufacture, Eugenics, Family, and Society 101
1. Problems of Identity and Individuality 102
2. Concerns regarding Manufacture 104
3. Prospect of a New Eugenics 107
4. Troubled Family Relations 110
5. Effects on Society 112

v


D. Conclusion 113

Endnotes 115

HE ETHICS OF CLONING-FOR-BIOMEDICAL-RESEARCH 117
6. T
I. The Manner and Spirit of This Inquiry 117
II. The Human Meaning of Healing 123
III. The Moral Case for Cloning-for-Biomedical-Research 128
A. The Medical Promise of Cloning-for-Biomedical-Research 129
1. Cloning to Improve Understanding of Human Disease 130
2. Cloning to Devise New Treatments for Human Diseases 131
3. Cloning to Produce Immune-Compatible Tissues for Transplantation 132
4. Cloning to Assist in Gene Therapy 133
B. Possible Moral Dilemmas of Proceeding 133
1. Position Number One 133
(a) What is owed to the cloned embryo? 134
(i) The possibility of twinning 136
(ii) The moral significance of pregnancy and implantation 136
(iii) The significance of the developed human form 137
(iv) The meaning of “special respect” 138
(b) The problem of deliberate creation for use in research 140
(c) Development and use of cloned embryos beyond the earliest
stages 142
(d) Exploitation of women who are egg donors 143
(e) The connection to cloning-to-produce-children 144
(f) Conclusion 146
2. Position Number Two 147
IV. The Moral Case against Cloning-for-Biomedical-Research 150
A. What We Owe to the Embryo 152
B. What We Owe to Society 159
1. Asexual Reproduction and the Genetic Manipulation of Embryos 160
2. The Complete Instrumentalization of Nascent Human Life 161
3. Opening the Door to Other Moral Hazards 163
4. Conclusion: What Prudence Requires 166
C. What We Owe to the Suffering 167
V. Conclusion 170
Endnotes 170

7. PUBLIC POLICY OPTIONS 173
I. Science and Society 174
II. Public Policy Options: General Considerations 177
A. The Scope of Policy 177
B. A Legislative Complication 180
III. Public Policy Options: Specific Alternatives 182
A. Federal or State Jurisdiction? 183
B. Seven Basic Policy Options 185

vi


Policy Option 1: Professional self-regulation with no legislative action (“self-
regulation”) 187
Policy Option 2: A ban on cloning-to-produce-children, with neither endorsement nor

restriction of cloning-for-biomedical-research (“ban plus silence”) 188
Policy Option 3: A ban on cloning-to-produce-children, with regulation of the use of
cloned embryos for biomedical research (“ban plus regulation”) 189
Policy Option 4: Governmental regulation, perhaps by a new federal agency, with no
legislative prohibitions (“regulation of both”) 192
Policy Option 5: A ban on all human cloning, whether to produce children or for
biomedical research (“ban on both”) 193
Policy Option 6: A ban on cloning-to-produce-children, with a moratorium, or tempo-
rary ban on cloning-for-biomedical-research (“ban plus moratorium”) 195
Policy Option 7: A moratorium, or temporary ban, on all human cloning, whether to

produce children or for biomedical research (“moratorium on both”) 196
Endnotes 198

8. POLICY RECOMMENDATIONS 199
I. The Council’s Points of Departure in Formulating Policy
Recommendations 200
II. First Proposal: Ban on Cloning-to-Produce-Children,
Moratorium on Cloning-for-Biomedical-Research (Policy
Option 6 of Chapter Seven) 205
A. Strengths of the Proposal 206
1. Bans Cloning-to-Produce-Children 206
2. Provides a Highly Effective Means of Preventing Cloning-to-
Produce-Children 206
3. Calls for and Provides Time for Further Democratic Deliberation 207
(a) Seeking consensus on crossing a major moral boundary 207
(b) Gaining needed scientific evidence 208
(c) Promoting fuller and focused public debate, leading to a better-
informed decision 208
(d) Preserving a decent respect for the deep moral concerns of
our fellow citizens 209
4. Provides Time and Incentive to Develop Adequate Regulation regarding
Human Cloning 209
(a) Comprehensive scope 210
(b) Protections for egg donors 210
(c) Transparency and accountability 210
(d) Equal access to benefits 211
5. Calls for and Provides Time for a Comprehensive Review of the Entire
Domain of Related Biotechnologies 211
6. Provides Time to Garner Long-Term Respect and Support for
Biomedical Research and to Reaffirm the Social Contract between
Science and Society 212
B. Some Specifics for the Legislation 213
1. Broad Coverage 213
2. Narrowly Drafted 213

vii


3. Temporary 213
C. Conclusion 214
III. Second Proposal: Ban on Cloning-to-Produce-Children, with
Regulation of the Use of Cloned Embryos for Biomedical
Research (Policy Option 3 of Chapter Seven) 218
A. Strengths of the Proposal 218
1. Bans Cloning-to-Produce-Children 218
2. Provides an Effective Means of Preventing Cloning-to-Produce-Children 219
3. Approves Cloning-for-Biomedical-Research and Permits It to Proceed
without Substantial Delay 219
4. Establishes Necessary Protections against Possible Misuses and Abuses,
Thus Paying the Respect Owed to Embryos Sacrificed in the Research 220
(a) Prevent cloned embryos from being used to initiate
pregnancies 221
(b) Provide enforceable ethical guidelines for the use of cloned
embryos for research 221
(c) Protect the adult participants in this research 222
(d) Promote equal access to the medical benefits that flow from this
research. 222
5. Who Should Regulate This? 222
6. Calls for a Comprehensive Review of the Entire Domain of Embryo
Research 222
B. Some Specifics for the Legislation 223
1. Broad Coverage 223
2. Narrowly Drafted 223
C. Conclusion 223

IV. Recommendation 227

GLOSSARY OF TERMS 229
BIBLIOGRAPHY 235
APPENDIX: PERSONAL STATEMENTS 245
Elizabeth H. Blackburn 246
Rebecca S. Dresser 249
Daniel W. Foster 253
Michael S. Gazzaniga 255
Robert P. George (joined by Alfonso Gómez-Lobo) 258
William B. Hurlbut 267
Charles Krauthammer 277
Paul McHugh 286
William F. May 287
Gilbert C. Meilaender 288
Janet D. Rowley 292
Michael J. Sandel 294

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