Will it deliver designer babies to the wealthy or eradicate disease among the poor? Stephen Phillips ponders biotechnology's potential to shape our future, Francis Fukuyama (below, left) urges restraint and Gregory Stock (below, right) anticipates a brave new world.
We have employed technology extensively to reshape the world around us. For the most part, we are comfortable with this infusion of technology into our lives. But as our power grows, we are turning it back on ourselves to adjust and modify our biology, and this is more worrisome.
As we come to understand our underlying workings more deeply and begin to move beyond mere therapy, many people, fearing we are entering a dangerous realm, think we should try to halt progress until we can figure out the best course. But giving in to our anxieties would be a mistake.
We face two types of risks with emerging medical technologies. The first is obvious: we might injure ourselves. But the second - that too much caution could delay beneficial advances - may endanger far more people. If trends hold, more than 100,000 will die of cancer in Britain in 2015, so there will be direct consequences for many people if some treatments arrive in 2020 instead of 2010.
The US Senate's proposed ban on all cloning procedures shows how overblown fears can drive legislation in unfortunate ways. Given that thousands of nuclear-transfer procedures on rhesus monkeys have still not created one viable primate embryo, no responsible scientist would suggest that cloning humans is safe at this time. But does this mean that we need a ban on the procedure when there are already robust institutional mechanisms to discourage reckless human experimentation?
When the procedure becomes feasible and someone somewhere clones a child, will this threaten our way of life? It would be a decade or two more before the procedure became cheap and safe enough to be a clinical option for many couples, and even then its appeal will remain narrow. We will have ample time then to enact any restrictions we wish, so why all the hand-wringing now?
If concern about the safety of children were our major motivation, added attention to childhood nutrition or alcohol abuse in pregnancy would be far more effective uses of our energy. Our fears are not about safety, but rather about values, philosophy and religion, about nightmarish images of the human future. Visions of organ farms and armies of clones evoke memories of reactions a generation ago to the first "test-tube babies" and tell us more about ourselves than about the true challenges ahead.
There is, of course, little immediate danger in banning a non-existent technology such as human cloning. The real threat is that such bans will begin to inject religion and politics into broad areas of basic biomedical research, thereby delaying the medical advances we all applaud.
As research unravels the processes of life, it will grow ever easier to use this knowledge in challenging ways. But we would have to halt scientific progress itself to stop this. Britain was wise not to outlaw therapeutic cloning of pre-embryos because the action would hardly stop fringe figures such as Severino Antinori, but it would stifle embryonic stem-cell research on Parkinson's, diabetes and other diseases and thereby harm real people with real suffering.
Some argue that safe, reliable procedures that injure no one directly must be carefully regulated to ensure that they have no undesirable social consequences. I disagree. We should be leery about restricting technologies that merely challenge concepts of family or conjure loose notions of social danger because such arguments are easily abused. Sex selection by parents is a good example. Who is injured when a couple chooses to have a girl (or a boy)? The problem of sex imbalances in developing countries is not relevant because no gender imbalances arise from these choices in the West.
Embargos on victimless procedures are more than an unwarranted intrusion by the state into private life. They drive the practices underground and deny us information about any subtle medical dangers associated with them. We must keep in mind that reproductive technologies are not like nuclear weapons, where one false move can vaporise millions of innocent bystanders. Early users, not bystanders, bear the risks and buy us all valuable information.
New technologies emerging from the biotech revolution will be central to our future, revolutionising healthcare, altering the way we have children, changing how we manage our emotions and moods, and perhaps even extending the human lifespan. Some say such claims are extravagant because the technologies will always be too dangerous and ineffectual. If they are right, the present debate will simply fade away.
But the real fear of critics is not that these technologies will fail, but that they will succeed. In this case, tight restrictions will be destructive, for they will not only delay the benefits, they will reserve them for the rich, who find ways to circumvent restrictions.
Our best approach is modest, pragmatic monitoring that responds not to anxieties about the future but to concrete problems. We must avoid rigid, dogmatic legislative forays that will be difficult to alter in response to new data and knowledge. We must legislate cautiously and thoughtfully, balancing the risks of accidents with the risks of lost or delayed benefits.
And we must not forget that our next frontier is not space, but ourselves, and this exploration will not be risk-free. Ultimately, the question will not be how we handle cloning, genetically modified foods or any other specific technology, but whether we continue to embrace the possibilities of the future or pull back in fear, allowing other braver souls elsewhere to take them on.
Gregory Stock is director of the programme on medicine, technology and society at the School of Medicine, UCLA and author of Redesigning Humans: Choosing Our Children's Genes, Profile Press, £17.99.