Whether AS cells can be obtained in adequate quantity from elderly patients must also be clarified. In comparison to ES cells the risk of malignancy in therapeutic use is presumably lower in view of the more limited ability to proliferate.

in law and in amendment of the law. The determination of the status of the embryo created in vitro in the initial phase of its development, i.e. up to the formation of the primitive streak and nidation in the uterus, is a particularly controversial matter.

philosophical premisses, when it comes to defining the beginning of human life. For this reason, the scope of being protected by human rights must include every human being from the very beginning of his/her physical existence, i.e. from fertilization on.27

can decide on possible further use after the termination of pregnancy. A clear separation of the decision to terminate pregnancy and the decision to donate the embryonic or foetal tissue is possible only if the decision on tissue donation is taken independently of termination of pregnancy.41

      N.B. The names of those present at the meeting are printed in italics

1 Dissenting opinion: Mr O’Hara whished to have recorded his opposition to certain paragraphs in the explanatory memorandum.

2 Obscure sects and a few scientists have for years been predicting the birth of the first cloned child and are clearly bent on creating a fait accompli.

3 Embryos are defined as the early forms of human beings up to the end of organogenesis, i.e. in the first three months of development.

4 Thomson, J. A. et al., Embryonic stem cell lines derived from human blastocysts, Science, 282, 1998, pg. 1145-1147.

5 Wobus, A. M. & Brüstle, O., Humane Stammzellen: Eigenschaften, Forschungsstand und Verwendung. Stellungnahme zur Expertenanhörung der Enquete-Kommission „Recht und Ethik der modernen Medizin“ am 23. April 2001.

6 European Science Foundation (ESF), European Science Foundation Policy Briefing: Human stem cell research: Scientific uncertainties and ethical dilemmas, 2001.

7 Fuchs, E., Segre, J.A., Stem cells: A new lease on life, Cell, 1000, 2000, pg. 143-155. Odorico, J.S. et al., Multilineage differentiation from human embryonic stem cell lines, Stem Cells, 19, 2001, pg. 193-204.

8 Thompson, J. A., Marshall, V. S., Primat Embryonic Stem Cells, Current Topics in Developmental Biology, 38, 1998, pg. 133-165.

9 The possibility of developing trophoblast cells distinguishes primate cells from those of the mouse and is

10 Wilmut, I. et al., Viable offspring derived from fetal and adult mammalian cells, Nature, 385, 1997, pg. 810-813. Wakayama, T. et al., Mice cloned from embryonic stem cells, Proceedings of the National Academy of Sciences of the United States of America, 96, 1999, pg. 14984-14989. Bethauser, J. et al., Production of cloned pigs from in vitro systems, Nature Biotechnology, 18, 2000, pg.1055-1059. Polejaeva, I. A. et al., Cloned pigs produced by nucleous transfer from adult somatic cells, Nature, 407, 2000, pg. 86-90.

11 Dolly, the cloned sheep, was the only animal born after 277 cell nucleous transfer procedures (Wilmut et al.

12 Colman, A., Kind, A., Therapeutic cloning: Concepts and practicalities, Trends in Biotechnology, 18(5), 2000, pg. 192-19.

13 The human EG cell lines described to date were derived from embryos or fetuses at 5 to 11 weeks of pregnancy. Shamblott, M. J. et al., Derivation of pluripotent stem cellsfrom cultured human primordial germ cells, Proceedings of the National Academy of Sciences of the United States of America, 95 (23) 1998, pg. 13726-13731. Shamblott, M. J. et al., Human embryonic germ cell derivates express a broad range of developmentally distinct markers and proliferate extensively in vitro, Proceedings of the National Academy of Science of the United States of America, 98(1), 2001, pg. 113-118.

14 Wobus/ Brüstle 2001.

15 Ordemann, R. et al., Dresdner Nabelschnurbank, Erfahrungen der Nabelschnurbank in Dresden, unterstützt durch die Deutsche Knochenmarkspenderdatei, Deutsche Medizinische Wochenschrift, 125(47), 2000, 1424-1428.

16 Laporte, J. P. et al., Unreleased mismatched cord blood transplantation in patients with haematological malignancies: a single institution experience, Bone Morrow Transplant, 22(1), 1998, pg. 76-77.

17 Wils, J.-P., Stammzellen-Transplantation aus Nabelschnurblut: ethische Probleme, in: Kreß, H. (Hg.) Menschenwürde, Medizin und Biotechnologie: heutige Fragen medizinischer und ökologischer Ethik, Münster, 2000, 58-75.

18 Emura, M., at al., Stem cells of the respiratory epithlium an their in vitro cultivation, In vitro animal cellular & developmental biology, 33(1), 1997, pg.3-14. Ahmad, I., et al., Identification of neural progenitors in the adult mammalian eye, Biochemical Biophysical Research Communication, 270(2), 2000, pg.517-521. Gronthos, S., et al., Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo, Proceedings of the National Academy of Sciences of the United States of America, 97(25), 2000, pg. 13625-30. Eriksson, P.S., et al., Neurogenesis in the adult human hippocampus, Nature medicine, 4(11), 1998, pg.1313-17.

19 Bjornson, C. R., et al., Turning brain into blood: a hematopoietic fate adopted by adult neural stem cells in vivo, Science, 283, 1999, pg. 534-537. Clarke, D. L., et al., Generalized potential of adult neural stem cells, Science, 288, 2000, pg.1660-1663. Krause, D. S., et al., Multi-organ, multi-lineage engraftment by a single bone marrow-derived stem cell, Cell, 105(3), 2001, pg. 369-377.

20 Watt, F.M. & Hogan, B. L. M., Out of Eden: Stem cells and their niches, Science, 282, 2000, pg. 1145-1147.

21 Schöler, H.R., Hübner, K. et al., Derivation of oocytes from mouse embryonic stem cells, Science, 300, 2003, pg. 1251-1256.

22 The possibility has been discussed that even with ES cells from cell nucleous transfer ("therapeutic" cloning),

23 Kaihara, S. & Vacanti, J. P., Tissue engeneering: towards new solutions for transplantation and reconstructive surgery, Archives of surgery, 134, 1999, pg. 1184-1188.

24 Strauer, B. E. et al., Intrakoronare, humane autologe Stammzelltransplantation zur Myokardregeneration nach Herzinfarkt, Deutsche Medizinsche Wochenschrift, 126, 2001, 932-938.

25 Kant himself expresses this argument in the Metaphysics of Morals, §28 Science of Right, where he says : “For what is thus produced is a person and it is impossible to think of a being endowed with personal freedom as produced merely by a physical process. And hence, in the practical relation, it is quite a correct and even a necessary idea to regard the act of generation as a process by which a person is brought without his consent into the world and placed in it by the responsible free will of others. This act, therefore, attaches an obligation to the parents to make their children- as far as their power goes- contented with the condition thus acquired. Hence parents cannot regard their child as, in a manner, a thing of their own making; for a being endowed with freedom cannot be so regarded. Nor, consequently, have they a right to destroy it as if it were their own property, or even to leave it to chance; because they have brought a being into the world who becomes in fact a citizen of the world, and they have placed that being in a state which they cannot be left to treat with indifference, even according to the natural conceptions of right.“ (translated by W. Hastie) Kant, I, Metaphysik der Sitten, Rechtslehre § 28, A/B 112f., Königsberg 1797.

26 Occationally the idea has been formulated, that one could create an anencephalus by biomedical manipulation. According to the people who plead for this idea, the so created beings would not be able to act morally or develop a contiousness of themselves and would therefore have no human dignity. Following this idea humans would be created with the purpose to eliminate arbitrarilly their mental abilities in order to treat them like objects of instrumentalisation. To avoid even such approaches of instrumentalisation, the concept of human dignity must apply to all members of the human species.

27 The German philosopher Wolfgang Wieland explains this argument as follows: „If one takes the principle of ‚indisponibility‘ of human dignity serious, a sole consequence remains: it has to be granted to every human being because of every humans essential capacity for morality from the very beginning of his natural individual life on (also including the embryonal phase) not as a momentary but rather as a persisting disposition. This is however not an arbitrary decision but a mere consequence gained from the insight in the necessity to refrain from making such decisions in this kind of questions once and for all times and to search for a solution qualified by the outmost distance to an actual decision..“ Wieland, W., Pro Potentialitätsargument: Moralfähigkeit als Grundlage von Würde und Lebensschutz, in: Der moralische Stauts menschlicher Embryonen, Damschen, G. u. Schönecker, D. (Hg.), Berlin, NewYork, 2003, 149-168.

28 For example change of mind, illness or death of the woman.

29 These embryos are described as „supernumerary“ embryos in the following text. The use of the terms „orphande“ embryos or embryos with no prospect of life also used in the discussion could be judged as to obscure the issue.

30 Lanzendorf, J.P., et al., Use of human gametes obtained from anonymous donors for the production of human embryonic stem cell lines, Fertility and Sterility, 76(1), 2001, pg. 132-137. For example, the investigation of hereditary diseases would be possible with the use of ES cells with a defined genetic make-up.

31 Department of Health 2000, pg. 6. Relates to all types of research in embryos legal in Great Britain – not

32 Gametes were used from pseudonymised donors who had given their informed consent for this use and were financially remunerated. From twelve women, 162 mature egg cells were harvested and fertilised with sperm from two donors. Of the 40 embryos successfully produced, three stem cell lines were developed. Cf. Lanzendorf et al. 2001, pg. 135.

33 The decision as to when an embryo is "supernumerary", that is, when there is no longer any question of achieving further development, depends on the personal estimation of the individuals and social circumstances involved, which are not always clearly assessable.

34 Reproductive cloning is unanimously rejected internationally, but has only been banned by law in a few countries and is not yet prohibited under international law. This, however, does not exclude the pursuance of this objective by individual researchers as demonstrated by reports from the gynaecologist Severino Antinori/Panayiotis Zavos (Scientists want to clone humans. 2001) and Brigitte Boisselier of the Raelian Sect (Boisselier 2001).

35 Apart from applications in humans, the technique of cloning by cell nucleous transfer is also being developed for animal breeding.

36 Contribution of Otfried Höffe, Klonierung beim Menschen? Der Streit um die ethischen und rechtsethischen Grenzen, lecture held on the international conference: Cloning in Biomedical research and reproduction, 14-16 May 2003, Berlin. Höffe, O, Menschen fortpflanzen, heilen und - klonen? Eine rechtsethische Zwischenbilanz, in: NZZ, 19.05.03.

37 Genetic differences between various clones from cell material from the same donor may arise as a result of

38 Pichlhofer, G., Groß, J. & Henke, Ch., Medizinische, rechtliche und soziokulturelle Aspekte der Eizellspende, Gutachten für das Bundesministerium für Gesundheit, Bonn, 2000, 11 ff.

39 Not a few critics regard this as a contravention of basic requirements of social ethics such as equality and the prohibition of discrimination. According to R. Dworkin (Dworkin, R., Die falsche Angst, Gott zu spielen, in: Die Zeit, 1999, 39) we are dealing here with process that intervenes deeply in the connection between nature and nurture that is constitutive for the human make-up. J. Habermas regards reproductive cloning as an intervention in the natural ‘Selbstsein” (literally, selfbeing), resulting in asymmetry of the conditions of recognition that constitute the moral subject and therefore affects generic ethics. Habermas, J., Die Zukunft der menschlichen Natur, Auf dem Wege zu einer liberalen Eugnik?, Frankfurt/Main, 2001.

40 Burtchaell, J.T., University policy on experimental use of aborted fetal tissue, Institutional Review Boards (IRB), 10(4), 1988, pg. 7-11.

41 Cf. The situation relation to transplantation: Ach, J.S., et al., Ethik der Organtranplantation, Erlangen, 2000, 155f.

42 Schneider, I., Föten, Der neue medizinische Rohstoff, Frankfurt/Main, New York, 1995, 229.

43 Gordijn, B. & Olthuis, H., Ethische Fragen zur Stammzelltherapie aus Nabelschnurblut, Ethik in der Medizin, 12, 2000, 16-29.

44 Gordijn/ Olthuis 2000.

45 Gordijn/ Olthuis 2000.