Vol. 12, No. 4 August-September 2001
Special Edition: The Human Embryo as Research Commodity
Two events of the past month have intensified the public debate on research involving the creation and destruction of human embryos.
On July 31, the U.S. House of Representatives voted 265-162 to ban all human cloning. The House rejected a competing bill that would have permitted cloning human embryos for research so long as scientists allow none to survive to birth.
On August 9, President Bush announced his decision to fund research on cell lines derived from human embryos who were destroyed for their stem cells prior to 9 p.m. EDT, August 9, 2001.
In the ensuing weeks, news and talk shows have addressed these developments and many hundreds of articles, editorials and formal statements from interested parties have been published. It's no easy task to make sense of the sometimes conflicting reactions, claims and counterclaims within the scientific, political and journalistic communities. Having attempted that task, we now share some observations.
Positive aspects of the debate and federal actions
Public education: In one recent survey, more than half of respondents said they had paid close or fairly close attention to the debate over stem cell research. This is encouraging, both for framing sound public policies on biotechnology and for broader pro-life objectives.
Because abortion is linked politically and emotionally to the question of a mother's "rights" and interests, many Americans, sympathetic to women's sometimes difficult circumstances, try to avoid thinking about the other party to the abortion and his or her rights as a human being. Consideration of human embryos created and destroyed in labs, however, raises straightforward questions--uncomplicated by the abortion context--such as these: When does human life begin? Are human dignity and rights inherent or do they spring up only at some arbitrary size or age in human development? Is it fair to exclude some members of the human family from the equal protections accorded others?
Americans have been compelled to confront several discomforting realities. First, it has been accepted as true by the overwhelming majority of commentators that a new human life begins at the one-cell stage, properly called an embryo even then--although some prefer more dehumanizing terms like "fertilized egg," "activated egg" (favored by Dartmouth bioethicist Ronald Green to describe cloned embryos) or "clump of cells."
It surely will be harder for those contemplating abortion to think of a 6-week-old embryo as mere tissue. In fact, polling conducted by the Gallup organization soon after President Bush's policy announcement revealed, for the first time, that equal numbers of Americans identify themselves as pro-life and pro-choice (46% each). Six years ago the pro-choice margin was 53% to 33%.
Another revelation: In the past two decades, fertility clinics have gained broad public acceptance for providing a "solution" to fertility problems, while operating with virtually no federal oversight or public scrutiny. How many Americans knew before the current debate that an estimated 180,000 human beings, in the U.S. alone, are being kept frozen in storage tanks? Few probably were aware that doctors routinely create many embryos by in vitro fertilization (IVF) in excess of those they attempt to implant in a given cycle, because the odds of a successful implantation and live birth are so low.
Some advocates of stem cell research that relies on the destruction of these "excess" embryos who are slated to be "discarded anyway" accuse their opponents of callousness toward those afflicted by diseases such research aims to cure. With a little reflection, however, one can see that the fault lies not in opposing their manipulation and destruction, but in manufacturing hundreds of thousands of children, leaving them and society with only bad choices for their future: risky, albeit potentially life-saving, implantation in the womb of their mother or an adoptive mother; existence indefinitely in suspended animation; certain death when unfrozen and discarded; or being deliberately killed in scientific research.
Some, like Dr. Howard Jones, co-founder of the Jones Institute for Reproductive Medicine, absurdly claim that being manipulated and destroyed in important research confers dignity and purpose on the lives of "excess" embryos. (Szabo, "EVMS doctors question awkward silence on stem-cell research," Pilot Online, Aug. 25, 2001.)
Cloning: One house of Congress and the Bush Administration stand firmly opposed to human cloning--whether as a means of creating babies for infertile couples (and others seeking replicas of themselves or loved ones) or as a means of creating embryos to provide genetically matched stem cells for clinical use.
As many have noted, biotechnology has rapidly progressed beyond the public's ability to evaluate its ethical implications and impose moral limits and guidelines. A sizeable majority of Americans opposes cloning to create babies. It is profoundly wrong to subject human beings to the risks encountered in cloning farm animals and mice. The death rate--before or soon after birth--due to abnormal gene expression approaches 99%, and even "survivors" may have gross or subtle abnormalities.
But even if it were possible to create perfectly healthy human clones on each attempt, cloning a child would burden his or her life with unnatural and unhealthy family relationships and with the expectations of those who pre-selected his or her genetic makeup, depriving the child of a sense of individuality, uniqueness and personal worth. It is lunacy.
And yet, at least two men are determined to be the first to successfully implant cloned human embryos this year. Dr. Panos Zavos, working with Italian fertility pioneer Severino Antinori, M.D., claims to have received requests to clone a child from one thousand couples. Nothing, apparently, will deter them from their goal. To the argument that the almost certain outcomes of abnormality and death make attempts to clone humans unethical, Dr. Zavos replies: "I have a track record second to none. Those experiences cannot be diluted by just a few dead cattle out there in Texas" (quoted in "House Weighs in on the Fight to Prevent the Clone Age," National Catholic Register, Aug. 12-18, 2001, p.7).
One biotechnology firm already may have stepped into the brave new world of cloning humans for experimental purposes. Dr. Michael West, president of Advanced Cell Technology, Inc. (ACT) announced in July that his firm began work a year ago on cloning humans for research use. The company's website boasts: "ACT's research team was the first to develop a successful method for producing human embryonic stem cells through nuclear transfer techniques [cloning] by fusing a human somatic cell with a bovine egg cell from which the nucleus had been removed" (http://www.advancedcell.com/profile.asp).
Clearly the time is ripe for a total ban on human cloning (although it is likely to face an uphill battle in the Senate) to prevent such abuses of human beings and to establish, as Professor Francis Fukuyama puts it, "the principle that our democratic community has the authority and power to make science the servant of human ends rather than their master" (op-ed, Wall Street Journal, Aug. 2, 2001).
Creating human embryos solely for research: A consensus seems to have developed that it is unethical to create human lives for the sole purpose of research which will destroy them. Even strong advocates for embryonic stem cell research, notably President Clinton and the editors of the Washington Post, drew the line at creating embryos for research, preferring instead that research proceed only with "excess" embryos created for reproductive purposes and slated to be "discarded."
President Bush's proposal to fund research using embryonic stem cell lines explicitly excludes funding research in which the cell lines were derived from embryos created for research. We don't know to what extent scientists are now doing this, but last April, the Jones Institute, a privately-funded fertility clinic affiliated with Eastern Virginia Medical School, announced the derivation of three stem cell lines. To obtain the three lines, scientists harvested freshly donated eggs from young healthy women, creating 110 embryos through standard IVF procedures. The 110 embryos were then killed to make 3 cell lines.
Have we ceded this battle through the public's long-standing acceptance of IVF? Can we not do more as a society than simply deny federal funding to those who treat nascent human lives as nothing more than pharmaceutical products? The President's advisers have expressed a willingness to consider looking into IVF practice with a view toward possible regulation. Such discussion is overdue.
Denial of funding for research involving embryonic stem cells harvested after 9 p.m. EDT, August 9, 2001: The President's "compromise" was greeted with relief by supporters of destructive embryo research, and by many opponents of such research who had expected funding to include even research directly involving the continuing destruction of human lives. It could have been worse, and for that one is grateful. The moral implications and drawbacks of the compromise position are discussed below.
Appointment of Dr. Leon Kass: Technologies used to create and destroy human beings in the earliest stage of life--practices which the average person finds repellent--have been able to proliferate due to the lack of public awareness, understanding and moral evaluation of what's at stake. Reasoned, serious discourse must take place, preferably outside the political arena of Capitol Hill where, too often, sound-bites, emotional appeals and partisan accusations of indifference to the suffering of one or another interest group substitute for logic.
It was welcome news, therefore, that President Bush appointed Leon Kass to head the new President's Council on Bioethics. Kass has both a medical degree and a doctorate in biochemistry, but his greatest contributions arguably have been in the field of ethics, as a profound and prolific writer and University of Chicago professor. He was among the first to write, comprehensively and with stunning foresight, on the perils of human cloning some thirty years ago. Here is how he describes the job of the Council on Bioethics: "Our task really is to find a way to reap the benefits of medical science without undermining human dignity or human decency. We want to bequeath to our children a world in which human dignity no less than human health can flourish." Our country will surely benefit from the wisdom and decency he brings to discussions of bioethical issues.
Some troubling aspects of the debate and developments
Lack of moral reasoning: Public discussion of human cloning and embryonic stem cell research has confirmed what any astute observer of the American scene already suspected. Americans today are not well prepared for substantive moral reasoning on difficult issues. There was a time when we held certain moral truths as self-evident, when public policy formulation involved serious exploration of the merits and drawbacks of proposals.
Today many in political life seem to reason backwards, staking out a position mandated by party affiliation or chosen to suit some other agenda. For example, some will not admit that there's anything wrong in destroying embryos in labs because that might call into question the destruction taking place in abortion clinics.
Once a position is chosen, one can craft appealing slogans which substitute for reasoning. The most effective slogans appeal to sentiment and cut off rational analysis. Most supporters of destructive embryo research framed the issue as a stark choice between curing, or denying a cure to, people who suffer from debilitating conditions. Those who opposed such use of human embryos have been labeled as heartless zealots who irrationally claim sanctity for clumps of frozen cells, to the detriment of real, flesh and blood people.
Jerrold Nadler (D-NY), for example, said during House debate: "We must not say to millions of sick and injured human beings, 'go ahead and die, stay paralyzed, because we believe the blastocyst, the clump of cells, is more important than you are.' ... It is a sentence of death to millions of Americans."
Peter Deutsch (D-FL) spoke in opposition to the cloning ban: "No one knows who is going to get Alzheimer's or Parkinson's or cancer. ... What this legislation would do would be to stop this research ... [needed] so that you could survive, so that someone who is a paraplegic could walk ..." and so on.
Zoe Lofgren (D-CA) warned: "If your religious beliefs will not allow you to accept a cure for your child's cancer, so be it. But do not expect the rest of America to let their loved ones suffer without cure."
The end justifies the means: The principle underlying these appeals is that one may seek a good end through immoral means. The utilitarian principle asks not whether an action is morally good, only whether it will work. One can scarcely imagine an ethic more contrary to Judeo-Christian teaching, to the advancement of human rights and dignity or to the common good than this. Yet we hear this argument voiced everywhere by perfectly nice people.
Those who have exaggerated the potential of embryonic stem cell research to provide imminent cures--claims repeated endlessly by the media--ought to have anticipated one very predictable result. People anxiously awaiting cures for loved ones were cruelly deceived. On August 26, safely after the President's funding decision was announced, the New York Times ran a long, cautionary feature on Geron Corporation. The author states: --Desperate people with incurable diseases are beseeching the company for treatments, though none will be ready for years, if ever" (Pollack, "The Promise in Selling Stem Cells," on-line edition, Aug. 26, 2001). And the August 20 issue of TIME describes an incident recounted by Presidential advisor Karl Rove: "On a trip to Georgia a young couple came up to him and pleaded for stem-cell research to continue for another six months so it might save their ailing child." These parents had not been told that any treatments from this research are a decade or more in the future.
Anti-Catholicism: Lurking just below the surface of some recent moral debates, anti-Catholic sentiment is not hard to find. Congressman Jim McDermott (D-Wash) compared the President's July audience with Pope John Paul II to an alleged inquiry made to the Pope by a 16th century Spanish king, asking if coffee consumption were permissible. He, and CBS's Bob Schieffer, threw in a Galileo reference for good measure.
Pete Hamill, New York Daily News columnist, suggests that we who are critical of destructive embryo research "can 'vow never to take advantage of the possible cures' and 'various churches' can declare cures via stem cell research as 'mortal sins, to be punished in hell for eternity'"(Hamill, New York Daily News, Aug. 13, 2001, reprinted in Kaiser Daily Reproductive Health Report, Aug. 15, 2001).
The pro-cloning Philadelphia Daily News editorialized about the cloning debate: "We'd feel better if it [the policy decision] were taken up by people who actually have souls, and not just their notions of how to save ours" (Aug. 2, 2001).
More faulty logic: Supporters of this research used another, apparently persuasive, argument that also dissolves on closer scrutiny--that the embryos "are going to die anyway," so what harm could there be in precipitating their demise or simply making good use of their remains? We've heard these same arguments from no less a personage than Jack Kevorkian. He explained the motives behind his serial "mercy" killing not only as a desire to relieve his victims' suffering and protect their autonomy, but also to supply freshly "donated"organs. In fact, he often espoused harvesting the organs of condemned prisoners because they are going to die anyway. While this practice may be common in China, it has won acceptance nowhere else. Now, as a rule of thumb, China is not the best guide in matters of human rights. And we recall that when Kevorkian offered to give away the vital organs of one of his euthanasia "clients," everyone knew it would be wrong to take him up on the offer"even though the donor was "dead already anyway."
We're also told that the research will continue with private funds anyway, so it's better to disburse tax dollars and obtain a measure of regulatory control. That's the route taken in England where since 1991, a total of 925,747 embryos have been created in laboratories, of whom only 50,000 have been born. Because embryos created by IVF in Britain can legally be stored for only five years, since 1991 records show that 294,584 frozen embryos have been discarded and 53,497 have been used for research.
Deception: It has been written that "a nation ... will more easily fall victim to a big lie than to a small one" and that "only constant repetition will finally succeed in imprinting an idea on the memory of a crowd" (Mein Kampf, 1933). It is by now received wisdom that embryonic stem cell research "holds far more promise than adult stem cell research." It is said that adult (including cord blood, placental, and cadaveric) stem cells are not found in all cell types, are limited in number, are difficult to harvest and grow for clinical use, are likely to pass on genetic defects, and are not able to multiply as well as embryonic stem cells. Each of these claims is cited in testimony by David Prentice, Ph.D., Professor of Life Sciences at Indiana State University and Adjunct Professor of Medical and Molecular Genetics at its School of Medicine. Citing scores of published studies, Dr. Prentice exhaustively refutes each of these assertions. (See www.stemcellresearch.org).
Notwithstanding the facts known to scientists working in the field, and known also to readers of the prestigious scientific and medical journals where their studies on adult stem cell research are published, one still can find misleading and erroneous claims like these on websites maintained by the National Institutes of Health, the University of Wisconsin (where researcher James Thomson was the first to derive cell lines from human embryos), and most recently in TIME.
While the stream of misinformation continues unabated, reports of research breakthroughs and actual clinical cures of human patients through use of non-embryonic stem cells arrive almost every other day. In the past two weeks alone, the following successes have been reported:
- Doctors at Northwestern Memorial Hospital in Chicago successfully treated two patients afflicted with Crohn's disease, a potentially disabling bowel disease. The first patient experienced painful, bloody, watery diarrhea about ten times a day from the age of 13 until her treatment at 22. Now, 2 ½ months later, she is doing "phenomenally well," eating normally and is symptom-free. The lead physician noted that patients with other auto-immune disorders, such as lupus and multiple sclerosis, have also shown progress through adult stem cell therapies. The therapy for lupus surprised doctors by repairing prior damage to organs, in addition to arresting further damage (Reuters Health, Aug. 13, 2001).
- Doctors at the University of Texas treated a man with a rare and potentially fatal skin disorder, scleromyxedema. He was so severely afflicted that he was unable to eat or close his eyes. Three months after receiving a transplant of adult stem cells from his own bone marrow, he is symptom-free and able again to close his eyes and open his mouth to eat. He has regained more than 25 pounds (Reuters Health, Aug. 17, 2001, citing August 2001's Archives of Dermatology).
- The August 2001 "Early Edition" of Proceedings of the National Academy of Sciences reports findings by scientists at New York Medical College and the NIH that by stimulating production of stem cells in the bone marrow of adult mice, one can repair heart damage. Researchers witnessed "a remarkable recovery" in the heart's pumping ability following an induced heart attack.
- A Reuters story, carried in The Philadelphia Inquirer on August 25 reports the successful treatment of seven heart patients at Düsseldorf's Heinrich Heine University using their own adult stem cells. Ten weeks after the first patient was treated, "the strength of the 46-year-old man's heart had significantly increased." The heart specialist in charge added, "The results of the treatment show the huge potential of adult stem cells."
- The Washington Times ran a Reuters report on August 18 detailing research at the Weizmann Institute of Science in Israel. Rats with severe spinal cord injuries were treated by injecting immune cells from their own blood into the site of the injury. The procedure "prevented the development of complete paralysis by limiting the spread of damage from the trauma point to surrounding nerve cells and fibers." The rats were able to walk again.
Why, then, will the U.S. fund research made possible only by the killing of human embryos prior to 9 p.m. EDT on August 9, 2001?
The political art of compromise: The President's decision is understandable in light of his sincerely held pro-life convictions coupled with his political frame of reference. In a society with divergent views, all issues seem amenable to compromise. The President often refers to his ability to bring partisans together to hammer out beneficial legislationBnot the best or the most each side wants, but workable solutions everyone can live with. The problem is that, in the case of destructive embryo research, not everyone can live with it.
Killing innocent humans--like slavery or child abuse--is one of those moral issues that do not readily lend themselves to compromise. Killing humans and then reaping financial rewards for having done so is reprehensible. When we help provide those rewards, we risk becoming complicit in this moral wrong and even legitimizing it to others.
The President emphasized two points to justify his decision. First, he stressed that the use of cell lines from embryos destroyed prior to August 9 "will not sanction or encourage the destruction of additional human embryos" (White House Fact Sheet, Aug. 9, 2001). Second, he compared research using these cell lines for possible future health benefits to the use of vaccines whose origin was tainted, having been derived using tissue from aborted fetuses.
But can federal funding of research using the approved cell lines be so totally divorced from the destruction that produced them? These human embryos did not die of natural causes; nor were they killed for an unrelated purpose. They died precisely for the sake of this research, which now will receive federal funding.
Who will reap a financial windfall from taxpayers for having cell lines available for research? Primarily the researchers and companies that did the killing to derive the cell lines. The fact that embryos were destroyed with private funds does not solve the problem. Once the Clinton administration said it would fund research on cell lines derived from embryos killed with private funds, provided certain NIH standards were followed (informed consent of parents, limited to embryos created for reproductive purposes and previously frozen, etc.), the race was on to create as many cell lines as possible, meeting just these criteria, to qualify for federal grants.
The companies who jumped early into the field of destructive embryo research will in some cases be rewarded directly with federal grants. In other cases they will receive federal funds indirectly from researchers newly entering the field, who will use taxpayer dollars to pay them for access to their cell lines. In the unlikely event that any useful therapies develop from this research, patent holders (especially Wisconsin Alumni Research Foundation and Geron, its licensee which controls stem cell lines of six tissue types) will benefit richly.
A number of research entities in the biotechnology field are for-profit corporations. The decision to allow federal funding will likely encourage private sector investment, raising stock prices and the value of stock held by the companies' principals.
A catalyst for private killing: Perhaps even more troubling is the fact that federal funding, even for limited embryonic stem cell research, will encourage more privately funded research that does not observe these limits. Tax dollars paid to Geron et al., to work with already existing cell lines, will free up equivalent private funds to continue destroying embryos to create more cell lines for privately funded research. For example, the University of California--San Francisco "decided to set up a privately funded laboratory off campus where researchers can work on new cell lines, while lab facilities on campus comply with federal guidelines limiting them to existing cell lines" (Krieger, "UCSF continues stem cell move," San Jose Mercury News, Aug. 22, 2001). Guess who's funding the off-campus research? Geron. A university spokeswoman explained why they believe outside, privately funded research is important: "By establishing hundreds or even thousands of cell lines from spare embryos, it may be possible to match the immune system of many potential recipients" (Ibid.). Recall that 30-40 or more embryos might be destroyed in the effort to obtain a single useful cell line.
These financial rewards, the government's removing some of the stigma associated with embryonic stem cell research, its implied expectation of potential success in finding cures, already has attracted new researchers to this field in the two weeks since the announcement, all of which contribute to scandal.
And according to the Bush Administration, this is exactly what the President intended. Says Health and Human Services spokesman Bill Pierce: "As we've said all along, the President's decision has stimulated great interest in the issue, and we expect will stimulate greater opportunities for research in the private sector. This is what federal funding of basic research is supposed to do --provide seed money that is followed by private sector money if the research is promising" (Washington Post, Sept. 1, 2001; emphasis added).
The vaccine analogy is invalid: Catholic moralists have concluded that individuals, when they have no practical alternative, may use vaccines to protect their health and the health of their loved ones, even if the vaccines may have been cultured in fetal cells that came from an elective abortion. However, Catholic teaching rejects all complicity in abortion and the Church opposes collaboration with abortionists-- including government collaboration--to obtain tissue for vaccines or other research. A recipient of a vaccine from a morally unacceptable source has taken no part in decisions to base the vaccine on such source, but is coping with the results of immoral decisions made by others.
The Bush Administration has compared this to its own proposal to fund research using cell lines from embryos destroyed prior to August 9. But that proposal is quite different. Here the federal government is choosing to cooperate with, and reward, researchers who have destroyed human embryos. The link between the government's actions and the destruction of human embryos is even stronger here than in the case of vaccine companies using fetal tissue from abortions. In the present case, human lives were taken in order to provide cells for research and, in some cases, precisely to qualify for federal grants; in the case of vaccines, tissues were taken following abortions performed for unrelated reasons.
Perhaps a better analogy for the stem cell research funding proposal can be found in U.S. criminal law, a doctrine known as "the fruit of the poisonous tree." To protect people from unreasonable searches and seizures, and discourage any such abuse by law enforcement officials, evidence obtained through an unconstitutional search is inadmissible at trial. Police are not allowed to reap benefits from their violation of the defendant's rights.
The Bush decision justifies funding because the wrongful act was already done, but allows those who violated the rights of the human embryos to enjoy the fruits of their misdeeds.
What Catholic doctrine says about destructive embryo research and embryonic stem cell research:
In 1987, the Sacred Congregation for the Doctrine of the Faith issued Donum Vitae (Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation: Replies to Certain Questions of the Day). It states in part:
To use human embryos or fetuses as the object or instrument of experimentation constitutes a crime against their dignity as human beings having a right to the same respect that is due to the child already born and to every human person. ...
The corpses of human embryos or fetuses, whether they have been deliberately aborted or not, must be respected just as the remains of other human beings. ... Furthermore, the moral requirements must be safeguarded, that there be no complicity in deliberate abortion and that the risk of scandal be avoided (I.4).
It is a duty to condemn the particular gravity of the voluntary destruction of human embryos obtained 'in vitro' for the sole purpose of research. ... (I.5)
And in August 2000, the Pontifical Academy for Life considered and answered the question below, in its Declaration on the Production and the Scientific and Therapeutic Use of Human Embryonic Stem Cells:
Is it morally licit to use ES [embryonic stem] cells, and the differentiated cells obtained from them, which are supplied by other researchers or are commercially obtainable?
The answer is negative, since: Prescinding from the participation--formal or otherwise--in the morally illicit intention of the principal agent, the case in question entails a proximate material cooperation in the production and manipulation of human embryos on the part of those producing or supplying them (Libreria Editrice Vaticano, p. 17).
What the future holds
Researchers and dollars drawn to destructive embryo research: The Wall Street Journal is predicting a "juggernaut." Former NIH director Dr. Harold Varmus has said that "hundreds of researchers would get into the field, even under limited federal funding. ... [and] predicted that the federal government would spend tens to hundreds of millions of dollars per year in this field" (Meckler, "Debate far from over, researchers gear up on embryonic stem cells,"Associated Press, Aug. 11, 2001).
The director of the University of Minnesota Stem Cell Institute had been dissuaded from seeking federal funding because of the "political turmoil" surrounding human embryonic stem cell research. Now that "the matter appears settled," she plans to submit a grant application. The front page banner headline of the August 11 edition of the Richmond Times-Dispatch reads: "Researchers at the Ready: Virginia schools, firms to seek stem-cell grants." The article begins: "Now that the controversial field of embryonic stem-cell research has won the presidential green light, some Virginia research universities and biotech companies plan to enter the field and win the taxpayer greenbacks." Researchers at both Virginia Commonwealth University and George Mason University said scientists at their schools now plan to enter the field.
Boston IVF, an organization of fertility clinics based in Waltham, Massachusetts, announced on August 25 that it will give human embryos to Harvard for research, after obtaining permission from the parents of "thousands of frozen embryos" in its possession.
The similar example of the University of California--San Francisco has already been described above.
Will funds and expanded research produce cures?: We have been fed a year's steady diet of claims as to what fabulous and thrilling things embryonic stem cells are capable of doing, and how miracle cures are just around the corner if only the President would free up funds for these wonders. But the tune changed dramatically once funding was assured. Now every day brings new revelations about the drawbacks and inadequacies of embryonic stem cells, and new comments as to how it's far too early even to speculate about their potential. The day after President Bush's announcement, The Washington Post reported that these cell lines have "a rather precarious existence" and are liable to "'crash' at any time, disappearing into a shriveled gelatinous mass beyond hope of resuscitation"(Washington Post, Aug.10, 2001, p.A12).
Former NIH director Harold Varmus and Harvard professor Douglas Melton explain: "[T]ruly useful lines are hard to develop, even from animal models. ... In practice, some lines lose their vigorous growth patterns for unexplained reasons, get contaminated ... or differentiate spontaneously into one lineage or another without apparent cause" (op-ed, Wall Street Journal, Aug. 14, 2001).
Although Professor Melton has access to 6 cell lines developed in Israel, he uses only one of them for most of his work, explaining: "Only one works well. The others, they have all kinds of different problems. They either don't grow well or they differentiate spontaneously, kind of like popcorn popping before you've added heat (Brown, "Stem Cell Decision Examined," The Washington Post, Aug. 12, 2001, p.A8). Based on his experience with mouse stem cell cultures losing their totipotency the more times the batch is thawed and allowed to divide, Melton added: "In my view [human embryonic stem cells'] properties will degrade with time. Everyone is fearful that the more you grow them in the dish, the more they'll lose their properties" (Ibid.)
Suddenly, cures are said to be decades away and sixty cell lines are not nearly enough to produce therapies that will work for every ethnic group, unable to "match the genetic diversity of the population" (Stolberg, "U.S. Acts Quickly to Put Stem-Cell Policy in Effect," The New York Times, Aug. 10, 2001). In case you missed the import of that quote, it is an admission of the greatest obstacle to developing therapies using embryonic stem cells: when injected into patients they pose the same tissue rejection problems as occur with organ transplants. There are two possible solutions. Researchers could establish embryo farms, destroying thousands upon thousands of human embryos to develop enough cell lines to match mankind's diverse genetic makeup. Or one could create "Mini-Mes" for each patient, little cloned replicas whose stem cells could be used for therapy, eliminating transplant rejection problems. This is the course being pursued in England and the one advocated by Michael West, a founder of Geron and now president of Advanced Cell Technology. A third alternative, of course, is to use the patient's own "adult" stem cells, a practice currently achieving cures far surpassing the expectations of physicians and patients.
Other hurdles: Much has been made of patent issues, which complicate access to cell lines controlled by various private companies and research foundations. Owners are quite willing to parcel out colonies of cells for a price, but naturally want to have the lion's share of any future profits from commercial therapies regardless of who develops them. It's an unusual situation. As long as the Bush policy is in place, no one can obtain federal funds to experiment on lines other than those identified as being in existence before the August 9 deadline. Thus a monopoly of sorts has been given to the earliest entrepreneurs in destructive embryo research. These questions may be resolved in time, however.
A second hurdle is more difficult to overcome. "Most or all of the human embryonic stem cell colonies approved for research funding ... have been mixed with mouse cells" (Gillis and Connolly, "Stem Cell Research Faces FDA Hurdle," The Washington Post, Aug. 24, 2001, p.A1). After cells are extracted from a human embryo, they are grown "atop embryonic mouse cells, known as 'feeder' cells. The latter excrete some unknown nutritional or growth factor that helps the human cells stay healthy. Because they have been in close contact with mouse cells, the human cells pose a small but real risk of transferring potentially deadly animal viruses to people." Under Food and Drug Administration (FDA) guidelines "designed to prevent the accidental creation of a new plague, transplants of these embryonic cells into people would be treated as though they were 'xenotransplants,' or transplants of animal tissue" (Ibid.).
"Some laboratories that work with stem cells appear to be unaware of the policy; others are operating under the assumption that it will be a large hurdle in creating treatments from any of the existing cell lines. 'It could be a real killer,' said George Daley, a stem cell researcher ..." (Ibid.).
A final difficulty will be political. Senators Specter, Daschle, Boxer, and Kennedy among others have stated their determination to relax the Bush funding restrictions on embryonic stem cell research legislatively. President Bush has vowed to veto any relaxation of his guidelines.
In all the discussions of research techniques, medical risks and benefits, potential cures, regulatory standards, and strategies, we risk losing sight of the core issue at stake in destructive embryo research. Few have articulated that issue as eloquently as John Mallon, contributing editor of Inside the Vatican magazine:
These embryonic human beings are alive, now, and involved in a terrible dilemma utterly beyond their control. They are human, innocent and helpless, and therefore deserving of love and the protection of the state. They are dependent on civilization but civilization is perhaps even more dependent on them, as we consider their fate. In considering their fate, we are determining our own.
Perhaps this is the real precipice on which we stand: the notion (again) that certain human beings can be considered so insignificant as to be unworthy of love and protection solely on the basis of their size and stage of development. ...
That we are even considering this question of human medical experimentation is already the result of the disastrous turn we took with Roe vs. Wade, the ruling that a developing (but fully human) child's life was less important than a woman's convenience or difficult circumstances, circumstances that could be vastly improved with simple love and acceptance, offered and received with a good outcome for all, including the child. ...
... The questions at stake ... strike at the very foundation of civilized society. The choice is between justice and truth, where love and civility are safe to flourish, or a descent into chaos, barbarism, anarchy, tyranny and death. (Mallon, "Embryos are human," The Washington Times, Aug. 20, 2001, p.A15).
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