It has finally happened – the technique used in 1996 to make Dolly, the world’s first cloned mammal, has finally been used in 2013 to make the world’s first cloned human embryo. Despite a history in the years after Dolly of nuts, crackpots, frauds and charlatans announcing that they had either cloned embryos or cloned babies--who can forget the Raelians with their star fleet uniforms announcing the creation of multiple clone baby births to a credulous press core—we have an announcement that is the real deal. A team of experts in cloning at Oregon Health Sciences University who have extensive experience and success with primate cloning have announced the cloning of human embryos.

This announcement is sure to set off a heated debate about the morality of what they have done and what could be done with cloned human embryos. But while there is some reason for concern, there is more reason for excitement.

The Oregon team has been trying to clone human embryos for many years. Why? Not to produce cloned people but to have a source of stem cells useful for the treatment of diseases.

Those who oppose manipulating embryos to generate stem cells -- and their number is huge -- will be blasting away at what has been achieved.

But before they try to freak you out with terrifying images of clone armies directed by despots (think “Star Wars: Episode II - Attack of the Clones”), the unmourned dead coming back to life via cloning (think Osama bin Laden) or the creation of multiple copies of particularly odd or dangerous people (think of dozens of versions of Lindsay Lohan or Charlie Sheen in your neighborhood), remember that the whole point of cloning research is to come up with stem cells that have the same genetic makeup as the person who needs them.

Stem cells can be obtained from human embryos at fertility clinics. But the cells that are made from them will not match those to whom they might be transplanted to repair macular degeneration, spinal cord injury or diabetes. Through cloning you can take a disabled or sick person's DNA from one of their body cells, insert it into a human egg from which the DNA has been removed, fuse the cell electrically (the technique used in Oregon) and create an embryo from which cells can be grown that are identical matches to what the sick or disabled person needs.

There are certainly crucially important ethical issues that cloning raises.  Should anyone be allowed to try to make people using cloning? Most assuredly not until cloning efforts with animals prove far safer then they currently are. Many animals made via cloning die in utero, are stillborn or have a variety of serious health issues as did Dolly, the first cloned sheep. For now, banning human reproductive cloning—not cloning for stem cell research, as many nations have already done -- ought to be a legislative priority in the U.S. and around the world.

If we are going to need eggs to clone human embryos, then where are they coming from? Most likely in the short run from donors who will have to fully understand what their eggs will be used to create. Whether paid sellers of eggs will be needed in the future remains to be seen, but that is not yet likely to be a problem.

And some will say we don’t need to make cloned embryos to get stem cells because there are other ways to get them. There are other ways but this may prove to be the best way medically to get the regenerative cells that so many could benefit from.

Cloning a human embryo to create stem cells has been a dream for many scientists since Dolly was born. Cloning a human embryo has been a source of ethical nightmares for many theologians, ethicists and scientists since Dolly was born. It has now time to decide if we can manage a technology that holds great promise while assuring those who fear its abuse that their concerns will be fully addressed.

Arthur Caplan, Ph.D., is the head of the Division of Medical Ethics at NYU Langone Medical Center.

Related stories:

Cloning technique produces human stem cells for first time

Ethicist: Fixing genes using cloning technique is worth ethical risk

A test to determine if you are infected with HIV should be made available over-the-counter, a federal advisory panel to the Food and Drug Administration has recommended. 

Having a home test kit available would seem to be a good idea for cutting down on new cases. About 1 in 5 people with HIV don't know they are infected, according to the Centers for Disease Control, and could be passing the virus on to others.

And early treatment seems to help diminish the virulence of HIV so a home test kits sounds like a better idea.  And given that it was just recently announced by another FDA advisory panel that the drug Truvada ought to get the FDA’s blessing as a way to prevent HIV transmission, would seem to be a great idea.

But is an HIV home test kit really a great idea? On the whole yes, but, there are some big ethical holes facing home testing.

First, there is no mandatory counseling to go along with the test. You can get some counseling by phone if you want it but you do not have to do so. Shouldn’t counseling be mandatory? After all, if you test positive don’t you need to hear some information about getting medicine fast, telling sexual partners, changing any risky behavior you are engaged in and what to do if you are pregnant or have a serious disease?  When you test at home shouldn’t you have to contact someone who can tell you the facts you need to know?

Having a home test kit for HIV is a bit like relying on a bathroom scale in the battle against obesity. Both tests can tell you important information. That information may well save your life. But, unless someone discusses the significance of the test result with you telling you what can be done to battle the problem, there is a pretty good chance you will either say “Thank goodness I did not test positive” and keep doing whatever it is you are doing even if it is bad for you --  or test positive and say “I have a problem and I am so ashamed or frightened I won’t do anything at all about it.”

There is another problem facing the home HIV test kit.  It is not 100 percent accurate. A negative result can occur by error, misusing the test or because the infection is too recent to register. A positive result needs reconfirmation by a blood test.

Another concern is that a home test kit can be used surreptitiously. The screening test relies on a simple swab of the gums. Someone could get your DNA while you are sleeping or under false pretense or even from a toothbrush.  You might get tested without your knowledge or consent.

It is still true that finding ways to let people know they are infected is better than doing nothing. Home testing will cut the rate of infection and that is good. Still, to get the most out of home testing it is important that someone from outside the home be involved in discussing the results.

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