By: James Meeker
Human Embryonic Stem Cells have captured the imagination of investigators, clinicians, and patients alike, but the subject has also stirred one of the great ethical controversies of this generation. Embryonic Stem Cells (ESCs) are unique possess the ability to differentiate into any cell type in the body, and they also can divide indefinitely (in vitro). James Thomson and his colleagues first isolated human ESCs (hESCs) in 1998 by removing and culturing the inner cell mass from blastocysts. This event gave rise to great hope that ESC research would develop novel treatments for degenerative diseases, and additionally that these cells could unmask some of the mysteries of aging. Nevertheless, the enthusiasm for advancing hESC research has provoked ethical objections from both religious and political figures.
It would appear that ESC research has taken on much of the stigma associated with abortion, at least in the sense that opponents abhor the notion of human interference in the process of conception. While on the surface, abortion and hESC research appear to share few similarities, hESC opponents have argued that stem cell research is tantamount to deprivation of life. When George Bush announced in 2001 that the NIH would fund certain extant cell lines, Jerry Falwell voiced his displeasure saying, "On this question of stem cell research, you know and I know, scientifically, that we are exterminating a human life in order to obtain the elements for potential research." In a more circumspect statement, the late Pope John Paul II shared these reservations, "Experience is already showing how a tragic coarsening of consciences accompanies the assault on innocent human life in the womb, leading to accommodation and acquiescence in the face of other related evils such as euthanasia, infanticide and, most recently, proposals for the creation for research purposes of human embryos, destined to destruction in the process." These statements relay the misgivings of individuals deeply concerned about the possible infringement upon life caused by hESC research. The debate over when life actually begins may be too broad for this discussion, but indeed many in religion and politics have taken the viewpoint that life begins at the physical union between sperm and egg. Given such a perspective, it would be difficult for pro- lifers to accept the study of hESCs. Perhaps though, our society can find a way to entrust stem cell research to individuals who will behave responsibly.
Indeed, President Bush has spoken publicly on the topic of hESC research, "To destroy life to save life is -- it's one of the real ethical dilemmas that we face. There is going to be hundreds of experiments off the 22 lines that now exist that are active, and hopefully we find a cure." Here, Bush expresses eagerness for science to develop meaningful hESC therapies so that there will be justification for the desecration of what he believes is life. However, he made this statement during a debate and it must take its place in the context of Bush's policy on hESC research. His policy allows only the use of cell lines isolated prior to 9 P.M. on August 9 th , 2001 if they are to be funded by the government.. This has imposed a significant impediment on hESC investigation by limiting the number of cell lines available for research.
It should be noted that the sources of hESCs are blastocysts created for reproductive purposes (i.e. in vitro fertilization) and that the prospective parents no longer wished to use them for implantation. Essentially, hESC research utilizes cells obtained from unwanted fertilized eggs being stored cryogenically at a fertility clinic. These clumps of frozen cells are present in relative abundance, and hESC advocates argue that the current restrictions on stem cells are excessive and inflexible. Indeed, many researchers wish they could have access to many more lines than the limited number now available, but to what end? How many cell lines will suffice, and what will be their added benefit? Religious and social conservatives often cite these questions to make the argument that hESC research progresses down a slippery slope towards an unacceptable misuse of living tissue.
In the face of this, the scientific community must now take steps to assuage these fears. To that end, a recent report from the National Academy of Sciences has called for guidelines regarding hESC research. Their recommendations include specific language about the ethics of isolation, usage, and application of hESCs. The NAS advocates implementing standards in order to avoid actual or perceived impropriety on the part of stem cell researchers. It is important to keep the public aware that researchers recognize the sensitive nature of working with hESCs. The guidelines include language forbidding the sale of embryos for profit and use of human ESCs in primates. The NAS document suggests that their standards apply to researchers receiving government and private funding alike, whereas previously privately funded hESC research had little regulation. There is little coincidence that this report has arrived shortly after California voted to allocate three billion dollars to independently funded stem cell research. By outlining guidelines on what practices are acceptable in hESC research the field may gain even more public acceptance; additionally the government may feel more comfortable relaxing some of their restrictions.
In all fairness though, the actual potential of hESCs to produce meaningful therapies remains unknown. The interest in using hESCs for regenerative purposes has garnered great theoretical interest for organogenesis. Substantial enthusiasm also exists in using stem cells to re-grow neurons in the setting of cord injury, to produce insulin in diabetics, and to treat Parkinson's disease as well. While hypothetically possible, the actual feasibility of such therapies will rely on a great deal of work and resources.
Nevertheless, the notion that stem cells could some day cure some of medicine's worst diseases does deserve our attention. Indeed, California deserves praise for the passage of proposition 71 that established the California Institute of Regenerative medicine. More recently, Massachusetts has passed legislation permitting stem cell isolation from cloned embryos as opposed to those obtained by IVF. While opponents condemn hESC research as barbaric and ill conceived, we ought to take heart in California's example of an optimistic vision towards the future. History has demonstrated that the authors of great scientific advances have suffered great resistance to their ideas. Admittedly, the medical community is partly to blame since we are stocked with a conservative group of critical minds; however we ought to recognize and support the possibilities for scientific advancement rather than confining ourselves to a static world. We in medicine ought to give this topic serious attention; are we as reluctant to accept stem cell research as those who hesitated in accepting Semelweiss's theory about bacterial disinfection. Or conversely, have we placed too much stake in the promise of hESC research? Regardless we should strive for the truth in this matter. History has shown numerous examples of the medical establishment being slow to embrace progress, and while there is no guarantee that hESC research will yield anything to treat human diseases, oughtn't we explore all its potential benefits to the fullest? We need to nurture the possibility of harnessing stem cell technology, and not acquiesce to politicians who are worried about ruffling their constituents' feathers. Even if hESC therapies are totally unsuccessful, at a minimum we will have obtained a greater understanding of cells that constitute a cornerstone of biology itself.
Presently, Stem Cell research holds great interest for conversation, but politically it may have has lost some momentum. The websites of representatives Dole, Burr, and Price offer no mention of a position statement, much less an opinion on the topic of hESC research. While our congressmen certainly have numerous other weighty concerns, they ought to recognize that government holds many of the purse stings for experimental research. The present policy of restricting research on stem cells in existence before 2001 handcuffs our researchers, and ought to be reconsidered. Relaxing regulations on hESC research might ruffle political and religious feathers, but nevertheless we ought to embrace the American ideal that great rewards are available to those who dream on a grand scale. hESC Research must proceed with great sensitivity to ethical considerations, but it should be accompanied by all reasonable support and diligence. If you feel strongly about this and you wish to express your views on the subject of hESC research, contact your congressman ( http://burr.senate.gov/ , http://dole.senate.gov/ , http://price.house.gov/).
CNN Talkback Live, Is Embryonic Stem Cell research Moral ? Aired August 9, 2001 - 15:00 ET
Excerpt from the Pope's address to President Bush at Castel Gandolfo, Italy, July 23, 2001
Excerpt from the transcript of the Second Presidential Debate; Washington University, St. Louis, Mo.
October 8, 2004 Committee on Guidelines for Human Embryonic Stem
Cell Research, National Research Council. Executive Summary: Guidelines for Human Embryonic Stem Cell. Research. ISBN: 0-309-09653-7, 240 pages (2005)