Since it has come up in the comments on my review of Kazuo Ishiguro’s novel Never Let Me Go, I’m going to go ahead and discuss some of the issues around cutting-edge biomedical technologies in the book that might, or might not, be plausible when pondered. (As Bill points out, the scientific details in the novel itself are pretty minimal — the focus is squarely on the interactions between characters — so plausibility is only an issue if you’re not good at suspending disbelief.)
WARNING: This post will be packed with spoilers!
Unless you’ve already read the book, or you have sworn a blood-oath never to read the book, you really should skip this post.
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Purpose-bred cloned humans as ready sources of vital organs for donations:
It’s plausible enough that eventually, the technical challenges to successfully cloning humans will be worked out. So that part didn’t bug me.
The part I worried about a little had to do with the feasibility of organ transplantation from the clones. First off, from what I know about cloned livestock (like Dolly the sheep), they haven’t always been the healthiest; it seemed to me that might be as much a worry with the cloned humans, too. Also, there was an issue of compatibility between organ donor and recipient. So for a good part of the novel, I was guessing that Kathy and Ruth and Tommy and the other Hailsham kids had been created as sources of “back-up organs” for particular people from whom they’d been cloned. You’d think that would take care of many, if not all, of the rejection issues. Except, when you think about that way of doing things, it means you have the costs of supporting a whole extra human (although the society in the novel wasn’t actually seeing the clones as humans) just in case affluent person needs a new kidney or liver or heart. That wouldn’t be terribly cost effective.
As it turns out, the Hailsham kids were cloned as general-purpose organ donors, a sort of shared resource for all the people in society. So, there would still be the issues of finding the donor who best matches the recipient. However, in the world Ishiguro creates in the novel, the people needing organs don’t need to wait around until a potential donor is in a motorcycle accident — the clones’ organs are always there ready to be harvested.
Providing the genetic material for clones as an activity roughly equivalent to selling blood:
Near the middle of the book, as Kathy and Ruth and Tommy are talking about the possibility that friends of theirs have seen the woman from whom Ruth could have been cloned, it comes out that these “donors” of materials are most likely down-and-out members of society who are short on cash — junkies, pornographic models, and the like. It’s not totally implausible that young and poverty-stricken folks might have the right genetic endowment to produce excellent candidates for organ donation. However, the part I didn’t entirely believe was that there would be a serious pay-out for the required genetic material. Wouldn’t we be talking something more along the lines of a cheek swab than an egg donation? (I suppose there might be a lot of preliminary labwork before the cheek swab to make sure the donor would produce suitable clones, but still.)
You’ve got to gestate those clones somewhere, don’t you?
There’s not even a passing discussion of the women who have to have been part of the clone-production scheme, and where they fit in with the dregs of society. (I’d imagine that gestating a clone would be where the big compensation would be available, but there’s a pretty significant time commitment, not to mention the imposition on one’s dietary and other lifestyle choices.) No word, either, on the source of the enucleated ova.
But possibly we don’t hear about this part of the process because it’s just not on the Hailsham kids’ radar.
Why are the cloned humans sterile?
Kathy and her friends seem always to have been aware that they can’t have kids. We’re never given an explanation for why. Some people might read Ishiguro as suggesting that this is a built in side-effect of being a clone. I’m inclined to think, however, that the kids were surgically sterilized at a young age.
Serial organ donation versus wholesale harvest:
Some readers may worry about the plausibility of having the cloned humans donate an organ, then go through a long recovery before donating the next organ, with some clones making it to a fourth donation before they “complete” (i.e., end up with too few organs of their own to keep living and thus, one assumes, have the rest of what’s useful harvested). How efficient is that? My guess is that this is a matter of trying to balance supply with demand. Until there’s a definite recipient for a particular organ, it’s better to keep that organ in play in a (reasonably) healthy body, harvesting it “fresh” when it’s needed.
Another plausibility issue, for me, was why society at large would assume the clones had no souls and were less than fully human, but I take it that’s not really a question of scientific plausibility.
So, if you have any biomedical nitpicks with Never Let Me Go that you’d like to add to the pile, leave them in the comments.