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Thursday, November 01, 2001

Health

Playing God in God’s Service: An Interview with Panayiotis Zavos


The road to Dr. Panayiotis Zavos’s office from “downtown” Lexington is one of those indistinguishable suburban commercial stretches that give you the impression that you could be anywhere in America. If I was expecting an upscale office complex, with announcements heralding the imminent birth of the first cloned baby, and offering people low financing to take advantage of the new developments in reproductive medicine, I was greatly disappointed. If not for the little sign on the door – ZDL, Inc. (Zavos Diagnostic Laboratories) – the office could have been any office, anywhere in the country. The entire place left me with the impression of trying hard to blend in, justifiably so, given the scrutiny encasing the prospect of human cloning. All appearances, however, of a low-key image were immediately exploded when I finally met Dr. Zavos.

His unqualified singleness of purpose, his acidic criticism of animal cloners, his quick dismissal of the scientific community’s concerns, as well as of all other ethical arguments and considerations, and his undisguised readiness to debate all these issues publicly, suggest a conscious attempt to stand out, rather than blend in. During the interview, Dr. Zavos’s insistence on arguing that he knows how to do this “right” initially left me with the impression of someone who is very vulnerable. But as the interview continued, it became evident to me that I would be deluding myself to think so. I simply wasn’t talking to someone who was just another voice in the debate on human cloning, but to someone who was fully aware of how close he is in to cloning a human being – or, even more to the point, to someone who perhaps had already done so.

Q. I’d like to begin by asking you to comment on the fact that, for those of you involved in human cloning, there’s not much emphasis put on your role as scientists. There’s a perception that you are functioning more like entrepreneurs or members of religious cults rather than scientists. You are referred to as a scientist/entrepreneur and Dr. Brigitte Boisselier as a member of a religious cult, the Raelians, which considers human cloning to be one of their goals.

A. I am a man of various missions in this world. I don’t feel that I can be defined just as one type of person, or that I fit in any one particular description or category. My scientific accomplishments are substantial, well-known, and need no defense. But then this whole issue of entrepreneurship comes into play. There is a view that anyone who has entrepreneurial ambitions is a compromised scientist. My answer to that is that every doctor, whether in Greece or in the United States, is a businessman. You are in this to make a living. Without exploitation, but by using the means that are given to you to earn a living, to which, of course, you are entitled. As long as you do not step over the fine lines that are established, and do not turn to science for the sake of money.

Q. At a meeting of the National Academy of Sciences a few months ago, you announced that you would succeed in cloning a human being within the next year. Do you still stand by this statement?

A. Yes. We do have some very aggressive agendas that we want to meet and, if all goes well, we could do that. However, I think that the world needs to understand that, when dealing with human lives and human beings, deadlines are made to be postponed, to be broken. We have every intention of postponing things, even if we don’t look good in the eyes of a few people who expect us to meet our deadlines. We are not in the business of making pizza, or delivering food, or selling cars, where delivery within a certain period can be guaranteed. Unless we are sure that what we are doing is absolutely correct, and right, with no dangers or risks to the life of the unborn child, to the child that will be born from such effort, we have no intention of doing this. We want to be absolutely sure that we will deliver the first healthy cloned child to this world.

Q. There are two methods of cloning. One is produced by fission, which is the cutting of the embryo, and the other by fusion, which is nuclear transfer. In fusion, the nucleus of an unfertilized egg is removed and replaced by genetic material from the cell of an animal donor. Fusion was used to create Dolly, the first successfully cloned sheep. Which one of the two is the method that you and your team are employing in developing a human clone?

A. We research in both modalities, and I believe that this is the right thing to do. I can’t tell you right now which one we prefer. Whether you transfer subzonally in the case of the oocyte, or introduce the nucleus via nuclear transfer, you require electrofusion material, or electrical charges, in order to allow complete recognition and physical interaction between the ooplasmic materials, or the nuclear interaction between two cells at the subzonal orientation of the cell. So, both methods are effective. I can’t say, however, which one produces the best results in humans. Under various circumstances, one can be more favorable than the other in animals. But again, this technology has not been investigated really well in the animal world. Some prefer one against the other, and I can tell you why. It is an issue of the instruments available. Each method requires the use of different instruments, and nuclear transfer uses cheaper instruments than cell fusion. We are researching both methods, and we have both sets of equipment necessary to do so.

Q. There have been five species of mammals cloned since Dolly: sheep, goats, pigs, mice, and cows. Survival rates, however, are low, and there have been many cloned offspring with severe disabilities. Many people are concerned that we will experience the same issues in cloning a human.

A. My team finished writing an article yesterday regarding this particular issue, which will be submitted for publication to Science. As you may or may not know, most of those animal cloners, who became famous overnight (including Dr. Ian Wilmut), were successful in being at the right place, at the right time, under the right circumstances, and they achieved good results. But most of them have been very lucky in terms of having a good accident make them famous. Wilmut is one of these people. He took 277 eggs, created 29 embryos, transferred them into 13 female sheep, and had one Dolly born. Most experiments performed by animal cloners are of the hit-and-miss type. I don’t take seriously the people who take such an approach, and I debate them all the time.

For example, four months ago, I was involved in a debate on Swiss television with an Italian scientist. He began to tell me that he has been trying to clone a mouse subspecies without success for the last two years. He asked me, “If I am unable to do it with a mouse, how can you be successful or guarantee success with a human?” My reply was that we were not there to debate his incompetence. My point is that there are a lot of incompetent scientists around, desperately trying to become famous by accident, and thus make history. This world is loaded with such people, and I meet them all the time. I have a track record. We are going to do this correctly. This is not an egotistical statement. I feel that this can be done correctly, it will be done, and we are the right people to do it. We know much more about this than your average scientist, and we know a lot about reproductive medicine – more than most of the cloners put together. We have been doing in vitro fertilization (IVF) for the last 20 years. We have been treating male and female infertility for the last 23 years. Therefore, we feel that our team is qualified to be doing this type of experimentation.

Q. One of the most serious anomalies with cloned animals is LOS (large offspring syndrome). There is great concern within the scientific community that LOS will also be a major issue in human cloning. However, Dr. Randy Jirtle of Duke University Medical Center, who has worked exclusively on LOS, believes that cloned humans would be unlikely to have LOS, and that people might be easier to clone than animals.

A. We knew about LOS before we began working on this. Cows and mice have exhibited LOS. But goats, pigs, and other domestic species have not. Pigs are of particular importance in this case since, genetically, they are more related to humans than any other domestic species. At the National Academy of Sciences, a scientist presented accurate data of IVF embryos incubated in two different environments. He was able to show that in one of these, there was a much higher rate of LOS than in the other. This suggests that LOS can be initiated as a result of a particular environment, which can start the epigenetic expression of the LOS gene. We have studied issues like this. We have been incubating human embryos for 23 years, and we have yet not seen an offspring with LOS born from IVF. We are talking about 350,000 IVF offspring worldwide every year. We have more data on the human industry today than on all other species put together. We know what we are doing.

Q. You said, “If we cannot do it right, we will not do it…”

A. ...That’s right…

Q. ...However, how can you anticipate problems that might appear much later in the life of a cloned human?

A. You never say never in this world. When you took a plane to fly here, you took a risk. There is no such thing as an absolute guarantee in this life. When we reproduce naturally, we have a 3.5% chance of abnormalities. When we perform IVF, there is an additional 1.5 to 2% chance. The number increases slightly when we do an intracytoplasmic sperm injection (ICSI). The question is a good one. We are going to make sure that things go well. The technology we are developing will be fine-tuned. Nobody knew what the first IVF baby would look like when she was born, and what kind of problems might appear down the road. When the first ICSI baby was born, there were no human experiments done. So, unless we do human experiments, there are no absolute guarantees. There is a fine line here that we have to negotiate. People in the National Academy of Sciences, such as Wilmut and [Rudolph] Jaenisch, have said that unless we can guarantee that we can clone animals with 100% success rate, we should never begin to clone a human being. Which means that I would be 100 years old, and still unable to move forward, because there would still be no 100% success rate with animals. Their logic falls apart simply because today we have established very clearly that animal data do not apply in this particular instance to human cases. They are telling me: “You have no numbers to support this. Where are your numbers?” But if I do it, they will say, “You are unethical, Dr. Zavos.” My answer to them is that we have our numbers, and that we will do it.

Q. Cloning can be defined in two ways. First, as the asexual production of organisms from one stock or ancestor, and, second, as the production of a person or a thing regarded as identical with another. It is the second definition that results in the public’s strong condemnation of cloning, since it alludes to the “photocopying” of human beings. The first definition results in a rather milder reaction from an ethical perspective since asexual reproduction has become common practice today in IVF. How would you define cloning?

A. I am not an ethicist, but I can tell you that I have been more ethically correct than some of these bioethicists who are debating us today. They are all up for sale, and I have established that already. As a matter of fact, you can buy some of these bioethicists. They will say anything you want them to say. We do not operate that way. We are driven by a set of ethics different from theirs. My ethics are different from yours. What is ethically correct by your standards may not be by my standards and vice-versa. Therefore, we are debating an issue about which we will never agree on anything. We are dealing with issues that concern human beings here.

A clone is merely a person that has been put together or made out of the DNA material of the two parents, either one or the other, and more likely will carry the genetic label of the mother or the father, instead of both. Now, she or he will look like the mother or the father. That is the case today when we reproduce sexually. People take this very seriously. They expect their children to look like them. Therefore, the argument that a cloned baby will look like the mother or father does not concern me. So be it. No parent of a cloned child will take it back because it resembles the mother or father. It is never going to be an issue. These children need to be loved, and they will be loved.

Q. Can someone have identical genetic material with one of the parents and still be considered an individual?

A. He or she most likely will not look exactly like the father or mother, and definitely will not exhibit the same behavioral patterns due to special circumstances and different environmental factors that will be superimposed on the child.

Q. France and Germany are seeking a measure from the United Nations that will ban worldwide human cloning for reproductive purposes. The House of Representatives also passed a bill that intends to ban all human cloning. How would these measures affect you?

A. They would have no effect on what we do. I have said this publicly, and I will say it again. We are not doing this in the US. We are not doing it in Germany or France either. Those who introduced the bill in the House did not know the facts. They were not interested in knowing the facts. They were driven by religious beliefs, and gut feelings, which should never enter the picture, simply because this is not a religious issue. Just because I am of a certain religion, which prohibits the application of cloning, that doesn’t mean that I should impose my views on you, and prevent you from having access to this technology. This is not what this country is all about. I have a feeling that even if the president signs the bill, it will be challenged at the Supreme Court. The Supreme Court, based on the First Amendment, will probably throw it out, because the right to reproduce is by definition a human right, and a First Amendment right. It has been challenged before. I believe that a number of rulings by different courts in this country indicate that. Having said that, I have no intention to challenge the system in any way, shape, or form. My intention is to do it.

Q. You said that you are doing this to help infertile couples that cannot conceive in any other way. However, if you succeed in six months or in a year, there are going to be other applications of this technology. Undoubtedly, there is an incredible range of possibilities. What do you think will happen?

A. The sky’s the limit. That’s why I encourage the governments of the world to sit around the table and discuss this. Looking the other way is a very irresponsible form of dealing with an issue of this magnitude. When I was in Cyprus a few days ago, the chairman of the Medical Association of Cyprus confronted me. He asked me if I was creating another atomic bomb. We have no intention of doing that. But if the world continues to avoid dealing with this issue, and looks the other way, this technology can become another atomic bomb. There are many possible abuses that can occur. That’s why I have been very vocal about the need to discuss comprehensively how to avoid the tremendous abuses that remain a possibility in employing this technology. My colleagues and I have no control over this. Countries like Germany and France need to get serious on this and raise questions. What would happen if we ban this technology? Would someone dangerous pick it up? Haven’t we learned any lessons? As for the US, it is paramount to think of the scientific and financial consequences of being left out of such a development. IVF was banned in this country for six years after Bob Edwards began employing it in England. Today, IVF is sliced bread.

Q. I would like to go back to reactions resulting from religious perspectives. One of the biggest issues here is that people feel that you are playing God in the process of cloning a human. On the other hand, every medical intervention constitutes such an act. Every time we do something medically, we are essentially playing God. As an Orthodox Christian, do you feel that you are playing God in attempting to clone a human? Do you have any sense of hubris?

A. The world evolves, therefore religion needs to evolve. We play God when we do heart transplants today. We play God when we prescribe a new line of antibiotics. The question rather must be, should we be playing God? Yes. We are not gods, but maybe we are playing gods because God wants us to do that. I will be more than happy to play God since God put me in this world to help my fellow human beings. I don’t really see any other reason for being here. I feel that our role as human beings is to help our fellow human beings have a better life. If this is perceived as playing God, I do not have a problem with it. Anyway, the term, “playing God,” is misleading, since we are made in God’s image.

Q. I’d like to quote Leo Kass, who was appointed recently as head of the National Bioethics Committee. His concern with human cloning rests on a philosophical rather than ethical perspective. According to Kass, “a clone is a product made and not begotten. It severs procreation from sex, love, and intimacy, and thus it is dehumanizing.”

A. That is his gut feeling, and I respect it. That’s the way he approaches this issue. However, he does not speak to my patients every day. Kass turned off the light one night, made love with his wife, and, two weeks later, his wife said, “I’m pregnant, honey. We’re going to have a child.” What Kass says sounds wonderful, but he’s never experienced infertility in his life. He’s never had to spend a fortune, mortgage his house to have a child, and still be denied. When he says that cloning is a dehumanizing process, that’s his feeling about it. I respect his feelings, but I also respect and listen to people who have needs. He doesn’t have any needs. The people I work with do, however. Therefore, I don’t need to help him, but I will help my patients. I will go to any length to help my patients, as long as I’m doing this in a lawful and mutually acceptable fashion. As long as I explain to my patients what I am doing for them, and have their consent, and am operating within the guidelines of the American Medical Association and the American Society of Reproductive Medicine, I’m okay.

In addition to being a co-founder of greekworks.com, Stelios Vasilakis is a classical philologist and a former associate of the Speros Basil Vryonis Center for the Study of Hellenism.
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