The promise of human embryonic stem cell research has placed Bush administration policy-makers in an irresolvable quandary.
|
"Theres no way to satisfy both parties on this one," said LeRoy Walters, Ph.D., professor of Christian ethics, Georgetown University, Washington, D.C.
The existence of stem cells has been known for decades, but it was only in 1998 that ways to culture these cells from human embryos for long periods and through many cell divisions were developed. These embryonic stem cells have been shown to differentiate into most of the cells and tissues of the body, and so they may have the potential of replacing or repairing damaged or diseased organs.
They "hold enormous promise for new approaches to tissue and organ repair," and are "fueling a rebirth in stem cell biology," said a report from the National Institutes of Health sent in June to Tommy G. Thompson, secretary of Health and Human Services.
The report, "Stem Cells: Scientific Progress and Future Research Directions," is available on the NIH Web site. It is a thorough review on the status of the science of stem cell research.
If such research is given the green light, the most likely policy to be followed would be that recommended 2 years ago by the National Bioethics Advisory Commission, Walters believes. This was to use only fertilized human ova left over from in vitro fertilization procedures. Privately funded institutions have already developed fertilized human ova solely for research purposes, but this is unlikely to be permitted under federal financing.
In the meantime, efforts are under way to harness these cells with the goal of devising new and more effective treatments for a variety of disorders. Although any clinical use of these cells lies in the future, there is, as the NIH report notes, an impressive list of potential uses and this has stimulated wide support for stem cell research. Clinical uses include rebuilding the nervous system, repairing damaged hearts, developing functional pancreatic islet cells in diabetics, and managing autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, and systemic lupus erythematosus. Stem cells may also be used to develop targeted therapies for cancer.
The issue facing policy makers and the public is whether this research should be funded by the taxpayer. Initially, the administration was against it. An important part of its constituency opposes embryonic stem cell research because it destroys the embryo.
"Human life is a continuum from the one-cell stage to death. At every stage human life has dignity and merits protection," said Edmund Pellegrino, M.D., professor of medicine and director of the Center for the Advanced Study of Ethics, Georgetown University, Washington, D.C. He expresses the official Roman Catholic view that moral status is not a garment to be put on or taken off at societal convenience.
At the same time, given the potential therapeutic benefits, support for the research is growing and, recognizing this, the administration is now trying to find acceptable ways to fund it.
One approach is to restrict stem cell research to the use of adult stem cells, such as those from blood or bone marrow. This would avoid the use of embryonic cells and hence overcome objections to their use on the grounds that human life is being destroyeda frequent argument by those opposed to the use of embryonic stem cells.
At a meeting on stem cells held by the National Academy of Sciences in June, the differences between the two sources of cells was debated at length. David Prentice, Ph.D., professor of life sciences, Indiana State University, Terre Haute, noted that although there was a large amount of experience with adult stem cells in medicine, there was none with embryonic stem cells in humans and very little in mice. So their potential for medical use remains conjectural. However, others at the meeting maintained that adult stem cells are not as versatile as the cells obtained from 5-day-old fertilized ova.
While the value of adult stem cells was not in question, "its clear from the discussions that embryonic stem cells can do things that adult cells cannot," said Bert Vogelstein, M.D., professor of oncology, Johns Hopkins University School of Medicine, Baltimore. Nobel Prizewinner Paul Berg, Ph.D., professor of biochemistry, Stanford University, pointed out that both adult stem cells and embryonic stem cells are promising and both should be used. "Its unconscionable to make a choice," he said.
|
As the administration attempts to grapple with the arguments pro and con of funding stem cell research, a growing number of legislators on Capitol Hill have become concerned. If the administrations decision about using embryonic stem cells does not square with popular opinion, Congress will almost certainly introduce legislation on the issue.
Some in Congress are opposed to embryonic stem cell research. In July, three Republican leaders of the House of Representatives wrote President Bush, describing the research as "an industry of death." In July, Senate Minority Leader Trent Lott (R-Miss.) urged the use of adult cells, saying that he thought this was a way of obtaining the potential advantages of stem cell research without "getting into this embryonic area."
But other members of Congress support the research. "It is worth noting that a number of them include members whom you might not have expected to do so," said Walters.
One such individual is Orrin G. Hatch, the Republican senator from Utah and a strong pro-life spokesman. In a 10-page memorandum to Secretary Thompson, he said that he agreed with the interpretation of the current law issued by the departments Inspector General in 1999, which allows federal funding for human stem cells.
The NIH had been preparing to make grants for stem cell research under this ruling when the administration ordered it to halt. Noting that the NIH had in place regulations and guidelines to govern stem cell research, Hatch said they would be likely to survive legal challenge.
Sen. Bill Frist, M.D., (R-Tenn), a surgeon and a pro-life supporter, has produced a 10-point program under which the research could proceed and maintains that under proper conditions it can be conducted ethically. He recommends setting up a public oversight system and a Presidential advisory panel to monitor the research. He would limit the number of cell lines that could be used, although he cites no precise number. He supports the use of adult cells as well as embryonic cells from fertilized ova left over from in vitro fertilization, the position taken by the National Bioethics Advisory Commission in September 1999.
Many of those opposed to stem cell research regard the destruction of the fertilized ova as equivalent to abortion. This is the position taken by Richard Doerflinger of the National Conference of Catholic Bishops, for example. But Hatch takes exception to this view. "To me a frozen embryo is more akin to a frozen unfertilized egg than to a fetus naturally developing in the body of a mother. In in vitro fertilization extraordinary human action is required to initiate successful pregnancy while in the case of an elective abortion an intentional human act is required to terminate pregnancy. These are polar opposites. The purpose of in vitro fertilization is to facilitate life, while abortion denies life."
Hatch sent a copy of his memorandum to the President and, in a skillfully worded covering letter, alluded to the stem cell issue as an opportunity "to provide the personal leadership required to see that your administration will be remembered as the beginning of the end for such deadly and debilitating diseases such as cancer, Alzheimers, and diabetes."
He noted that Republican pro-life senators Strom Thurmond and Gordon Smith and former senator Connie Mack supported his position. He added: "I have rarely, if ever, observed such genuine excitement for the prospects of future progress than is presented by embryonic stem cell research. The best course of action is to lead the way for this vital research."
![]() |
||||
|
Oxford University Press Privacy Policy and Legal Statement |