Heath Robinson (Rube Goldberg, for American readers) could perhaps draw a diagram that made sense of the legislative and regulatory structure Bonnicksen describes in this book. However Heath Robinson machines, no matter how baroque, actually achieve something: in the four years covered by this contemporary history the American “system” seems to have achieved very little. That we have not yet (at the time of writing) seen a confirmed cloned child produced in the USA or elsewhere does not seem due in any part to the activity that Bonnicksen describes. This is not a history of America’s progress towards crafting a policy; it is an account of its failure to make one.

The bulk of this book details the legal and regulatory responses to emerging reproductive technology in America following the announcement of the birth of Dolly the cloned lamb in 1997. The remainder gives an overview of the position of other countries around the world, and a brief concluding chapter outlines the options open to the US in the future. Lest anything that follows might suggest otherwise, I found this book interesting and informative, and admirable in its clarity, depth of detail, and strictly neutral tone. The arguments presented are reported in brief but highly informative summaries, without any hint of judgement. The care and attention to detail is impressive, and the concluding chapter presents the future policy options in a manner that gives clear guidance without any noticeable preference expressed.

That said, this is not aimed at an audience outside the USA, and although it is a good historical account there are perhaps few who would rate this as essential reading. Even the chapter on the attitudes of the rest of the world is US centric, comparing and contrasting with the US only in order to show how the US position could be improved, (although members of the UK Human Embryology and Fertilisation Authority will be gratified to see that their flexible, considered, and informed approach is considered to be an example of best practice). For the rest of the book Bonnicksen is deeply immersed in the minutiae of the American legislative and regulatory system. It is to be expected that her account is often quite technical, and given the nature of the subject unavoidably repetitious, as the same figures presenting the same arguments reappear in front of the same or similar committees year after year. Perhaps the most off putting aspect of the book is the (again difficult to avoid) frequent use of acronyms. Hardly a page does not have one, many have more than 10. Bonnicksen has provided (on page xii) a list of 34 of the most commonly used acronyms and their translations, but having constantly to refer to it did not fully relieve the frustration and occasional confusion. This is perhaps a petty point—those familiar with the American system of two letter state codes, law report references, and the various committees, offices, departments, and commissions will find it less opaque, but the general reader may choke over sentences like “During the NBAC cloning hearings for example, one witness told of the ending of the EAB, which had been created in the DHEW.”

Despite this I found the story that unfolds fascinating, although often incredible, for although the author maintains a strictly non-judgemental tone throughout, this bare statement of the facts is a gently horrifying indictment of the American political and public policy system. To many readers the failure to achieve very much may be welcome, as lack of regulation may be preferable to the badly justified (or just plain bad) controls that some legislators proposed. To others the failure will be lamentable, because any control would be better than none. Either way it is clear from this account that for all the sound and fury (and there seems to have been a good deal of both) the arguments so far presented are generally poor, predictable, and not persuasive. The debate seems to have been largely based on moral panic, false assumptions, and political bandwagon jumping. In the midst of this unphilosophical and unscientific morass it is refreshing to find Bonnicksen’s careful exposition of the science behind Somatic Cell Nuclear Transfer, Embryo Stem Cell, and Adult Stem Cell harvesting and cloning. This clear statement of the facts does much to deflate many of the more ridiculous fantasies on both sides, but as she points out the heart of the argument is not about the facts, it is the values that are carried over from the abortion debate. In the end it all turns on the status of the embryo, and the value of human life, people, and genetic uniqueness.

Yet these arguments are not responsible for what is happening in practice. It is notable that with a few publicity seeking exceptions, all of the medical and scientific researchers involved in the debate agree that the technology is not advanced enough to safely produce a human clone even now, and that it would be wrong to try until possible harms are minimised. It is this responsible consensus among the scientists and healthcare professionals that has guided the actions of the medical/biotechnology industry, rather than the few state laws and the restrictions on federal funding which have been put in place. Despite the accusations of “playing God” and the suggestion that the biotechnology industries are more interested in money than people, the integrity, humility, and humanity of the scientific and medical community shines through this account in sharp contrast to the scaremongering and misinformation peddling politicians and pressure groups who criticised them.

However, as it is sadly unlikely that policy makers will be prepared to leave them to it, I would recommend that all public officials and politicians who are involved in making decisions about the future of reproductive or therapeutic cloning, embryo stem cell research, or assisted reproductive technologies should regard this book as a “must read”.