Stop stemming the research
For stem cell research to fulfil its potential, US scientists need to develop more backbone.
What is embryonic stem-cell research? Read Embryonic stem cell research and therapy, by Stuart Derbyshire.
Human cloning – an issue the US Senate had pretty much abandoned in the aftermath of 11 September – is now back on the agenda (1). When the biotechnology company Advanced Cell Technology (ACT) announced on 25 November 2001 that it had successfully cloned a human embryo for research purposes – and that it hopes to harvest stem cells from similarly produced embryos in the near future – the US authorities could no longer avoid the stem cell question.
The Bush administration has been keen to talk up the benefits of stem cell research, while at the same time flagging up the dangers. On 9 August 2001, President Bush appeared on US TV to explain the new regulation of embryonic stem cell research. ‘Research using stem cells offers great promise that could help improve the lives of those who suffer from many terrible diseases’, said Bush – before going on to describe embryos as ‘the seeds of the next generation’ and talking of ‘the need to protect life in all its phases’.
Bush’s decision was that federal funds for research on existing stem cell lines, ‘where the life and death decision has already been made’, would be allowed – but any research to create new embryo stem cell lines or work on lines created privately after 9.00am on 9 August 2001 would be ineligible for federal funding.
For scientists and researchers, this was certainly better than an outright ban, but it was way below anything even barely acceptable. And coming on top of the House of Representatives’ decision to ban all forms of human cloning, a decision welcomed by Bush, Bush’s 9 August TV speech made the future of biological science look very chilly.
Now, ACT president Dr Michael West has emphatically denied that he or his company has any intention of creating a cloned baby. In an interview with Larry King, West drew a distinction between ‘cellular life’ and human life – and in an interview with CNN he explained that ACT’s only aim was to help patients with currently incurable disorders:
‘We’ve taken the first step towards what we hope will be a whole new era of medicine. It’s been called regenerative medicine. The idea is to be able to do something we’ve never been able to do before, as simple as it sounds, to give replacement cells and tissues. [For example] if you lose cells in the pancreas that regulate sugar levels [and you develop] diabetes, we can’t cure that today. We can help make it better with insulin. But to make replacement cells or tissues is the goal of [this] medicine.’ (2)
West is right to point up the potential benefits of stem cell research for the chronically ill – but in so doing, it is easy to neglect the more basic fact that development of this science in the here and now has already broadened our understanding of cell function. An improvement in understanding is always useful even if medical breakthrough and helping the ill lags behind. After all, the first heart transplant followed the first description of heart anatomy by 400 years – but the understanding of the heart provided by its description was part of many investigations that gradually parted us from superstitious and nonsense views of bodily function.
But West is wrong to try to sidestep the debate about embryo research by making a distinction between cellular life and human life. ‘We’re talking about making human cellular life, not a human life’, said West. ‘A human life, we know scientifically, begins upwards, even into two weeks of human development, where this little ball of cells decides, “I’m going to become one person or I am going to be two persons.” It hasn’t yet decided.’ (3)
West does not allow for the fact that his distinction between different stages of ‘life’ is one of the main controversies in this discussion. Some consider life to begin at conception, others see it starting with development of the primitive streak, while others believe life starts with birth. The ethical issues that surround stem cell technology will not be resolved by West’s distinction between cellular life and human life, or by denying the obvious potential of this science for developing a cloned human being.
- The arbitrary nature of morality
Writing in Nature Reviews: Genetics, John Robertson usefully divides the ethical objectors to embryonic research into two groups (4). There are those who view the human embryo as a person or subject with rights and interests, and who therefore consider any destruction of an embryo as murder.
Then there are those who believe that, even though the embryo lacks the capacity to be considered a ‘person’, it still has the potential to become a person and therefore has a special symbolic value, needing to be protected in respect of human life generally.
There is a third view; that the embryo is simply a collection of cells that are no more alive or human than a tumour, a virus or something that grows on cheese.
The message from the world’s religions on these issues is confused. While head of the Roman Catholic Church Pope John Paul II has come out against embryo research, the Unitarian-Universalists, the Episcopal Church, the Evangelical Lutheran Church, the United Methodist Church and the Church of Jesus Christ of Latter Day Saints have no official position. In a report to the White House in 1999, Rabbi Dorff concluded that Jewish law could allow stem cell research because it serves a common good – combating disease. Muslim law perceives abortion as wrong but holds that life does not begin until the fertilised egg attaches to the womb wall – seeming to imply that stem cell research could be acceptable.
But to arrive at a sensible consensus on the morality of embryo stem cell research, or any other form of embryonic intervention, we should start with what we know for sure. We can be absolutely certain that, whatever the moral worth of an embryo may be, it is clearly below that of an actual living person. Actual living persons generally have independence, hopes, fears, aspirations and dreams that an embryo does not.
Even human beings severely limited through mental or physical disability have capacities for thought and action that outstrip those of an embryo, with an actual existence that must logically trump the potential existence of an embryo. There is a reason we do not give names to embryos and put unused ones into an incinerator rather than a grave.
Once the actual existence of persons is considered against the potential future person from an embryo, it becomes much more difficult to explain why the potential life provided by an embryo is more important than the potential improved understanding and treatment of disease. From the perspective of actual persons it is obviously desirable to pursue understanding and knowledge to improve actual life. Those who argue that embryos have symbolic value should be asked what kind of symbolism does a society that protects embryos, but avoids work that could improve humanity, provide?
President Bush has demanded that biomedical progress be ‘humanised’. I agree – but what is the humanising influence behind actions that condemn future generations to ignorance and premature death?
- Cloning humans
The argument that cloning human embryos will be for therapeutic purposes only has gone some way towards damping opposition to cloning even though no actual therapies yet exist. There is, however, no similar get-out when considering reproductive cloning – a procedure made possible once therapeutic cloning is developed (See Embryonic stem cell research and therapy). Opponents of cloning have seized on this perceived ‘slippery slope’ to bolster their case, with Florida Republican and doctor Dave Weldon telling CNN: ‘If you start allowing all these labs all over the place to create human clones, then it’s only a matter of time before somebody tries to bring a baby to birth because the implantation of those cloned embryos would occur within the privacy of the doctor/patient relationship.’ (5)
But it is not at all clear why bringing forth human life from cloning would be such an abhorrent act. There would no doubt be some ‘strangeness’ associated with being an almost exact genetic replica of a parent, but then there is ‘strangeness’ associated with being an identical twin and considerable novelty for those first born from in vitro fertilisation (IVF). We got used to IVF and we don’t see identical twins as representing a moral dilemma – so why should the joy that cloning technology might bring to infertile couples be denied? There is no reason to expect that cloned children will be any less loved than any other child.
Some have dodged the morality issue by appealing to concerns about safety. Cloning technology is very new, and it is unlikely to proceed without some stillborn children, deformities and other calamities. Dr Art Caplan of the Centre for Bioethics at the University of Pennsylvania has argued for a ban on human cloning, ‘purely on safety grounds’:
‘Put aside whether it’s good to be a clone, whether it’s odd to be a clone, whether it’s strange to be made in someone else’s image, the way this science is right now, not working well in animals, you absolutely don’t want to do it in people. It’s just barbaric human experimentation.’ (6).
Certainly these considerations are not unfounded, and much more development is needed to make human cloning a basic alternative, like IVF, for couples facing fertility problems. But Caplan stretches the point. It is precisely because we have such development of IVF that any cloning procedure in humans is likely to be much more successful than similar procedures with animals, unless there is a significant intrinsic difference between the species’ cell nuclear and developmental characteristics.
There is always bound to be an element of risk with new technologies. But who is Caplan to decide what lengths a person should or should not go to in order to fulfill their desire for a child? At some point in the future, once a certain amount of knowledge and technical capacity has been amassed, such decisions should be intimate ones, for people to make in private.
- Scientists cave in
It is unfortunate that scientists here in the USA are so unwilling to take these arguments on. Dr Don Wolf of the Oregon Regional Primate Research Centre was quoted in New Scientists as condemning thoughts of human cloning as ‘sheer nonsense’ because of the potential risks involved:
‘Fetuses that look robust at 60 days may die at 61. And a clone that dies after five days of life can have normal chromosomes and genes while still in the womb. “How in the world”, asks Wolf, ”will they screen out problems when they don’t know what to look for?”’ (7)
The end result is that the pursuit of human cloning is being left to more maverick groups – like the group of scientists organised by Dr Panos Zavos – who are then easily demonised and presented as a danger to society. Instead of attempting to claim cloning as a mainstream process and resource for all, scientists are cherry picking the least problematic areas within stem cell work while generally going along with the political compromises being provided.
Commenting upon Bush’s decision to allow the use of 60 existing stem cells back in August, Irving Weissman, professor of pathology and developmental biology at Stanford University, told the New York Times: ‘We shouldn’t pooh-pooh Bush for going only so far and shouldn’t think that we as scientists should be the only ones to make that decision.’ (8). Scientific societies previously hostile to any compromise also capitulated – with both the American Society for Cell Biology and the Federation of American Societies for Experimental Biology issuing statements supporting Bush’s policy.
Nobody seemed to be prepared to step forward and tell Bush that the normal progress of science is through multiple failures. Most stem cell research in mice, for example, is now conducted using just five healthy and productive lines, which were only discovered after sifting through hundreds of created lines. Andras Nagy, a mouse stem cell researcher at Mount Sinai Hospital in Toronto, points out that ‘if somebody had limited the mouse stem-cell research to 60 lines back in 1985, the knowledge and promises in this field would not have been close to what we have now’ (9).
When Tommy Thompson, Bush’s secretary of health and human services, held a news conference to explain how and when grant money would become available for stem cell research, he was flanked by some of the NIH’s leading scientists hailing Bush’s decision as ‘courageous’. Included in this group was Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who predicted ‘some real good for humankind’.
All of this has disastrous consequences for scientists. Failing to win the argument that stem cell research is beneficial to humanity – broadening our understanding of cell function and expanding the possibility for disease control – allows the public to continue viewing embryonic researchers as, at best, of morally dubious character.
Who wants to work under that kind of cloud? What student in his or her right mind wants to enter a field where they might be tagged as evil? In today’s anti-embryo research climate, many promising graduate students and post-docs will no doubt go for less troublesome research areas. Furthermore, given all the limits on funding and the potential negative publicity, universities are likely to pass over embryo research and encourage their scientists to pursue something less controversial.
And the problems of a relative lack of new people in the field and faltering institutional support will be compounded by the lack of embryo stem cell lines to work with.
It will take longer and will be harder to provide an embryonic stem cell candidate for therapeutic use. And even if scientists in the USA get that far, they will then face further restrictions in developing a therapeutic cell line because of the forthcoming ban on somatic cell nuclear transfer. Nuclear cell transfer enables researchers to remove the nucleus of the human egg (oocyte) and replace it with a nucleus derived from the patient’s own cells – otherwise known as therapeutic cloning because it produces an embryo that has almost the exact genetic make-up of the patient. This is an important step, as any replacement tissue, blood or neural product that is developed from the resulting stem cell will not face immunological rejection by the patient. Development of transplant tissue without nuclear cell transfer is possible but will be more difficult and may result in greater clinical side effects (See box).
Legal and societal hurdles to embryonic research will make the success of such research less likely – at precisely the time that scientists have made the future development of the science dependent on success. As each day goes by without a breakthrough, the field will be pushed into promising more and more to justify continued work and the argument will narrow down to emotive carping about the ‘slaughter of innocents’ v ‘needless death and suffering’.
At best, scientific progress will be sufficient to continue the uneasy détente – at worst, the lack of progress will be wielded in the pursuit of greater regulation. In his August address, President Bush showed that he was already thinking along these lines when he said: ‘While we’re all hopeful about the potential of this research, nobody can be certain that the science will live up to the hope it has generated. Eight years ago, scientists believed fetal tissue research offered great hope for cures and treatments – yet, the progress to date has not lived up to its initial expectations.’
- An unlikely brain drain
Instead of making these tough arguments and putting the case for unfettered embryonic research, some scientists have started to sulk about a brain drain from the USA to countries with a more liberal policy on stem cell research. When Dr Roger Pedersen, a human embryologist at the University of California in San Francisco, ‘defected’ to Cambridge University in England, the UK Guardian newspaper talked of him as a ‘Pilgrim in reverse’, who sought British shores to free himself from religious extremists in the USA.
Yet, expectations of a big brain drain are probably exaggerated. No other high-profile scientist has declared a move abroad, and even Pedersen’s long-term commitment is doubtful, given that his funding sources remain largely stateside through the Geron Corporation.
As ACT has demonstrated, embryo research in the USA can still push forward. Despite having no access to federal funding, US scientists were the first to procure human embryonic stem cells. For some time, researchers in the USA have been separating their federal and private research to reach their goals and this continues to be the norm. So the University of California in San Francisco is moving its embryonic stem cell programme off campus, so it can continue with private money without the risk of becoming entangled with federally funded projects.
The more limited research that private industry can afford to fund compared with what federal funding could provide may eventually put the USA behind countries that have a more liberal policy – like Britain, Japan, Australia, Canada. But that won’t happen overnight and research using human embryos is hardly celebrated in other countries any more than it is in the USA. As has been argued on spiked before, the UK government may have approved embryonic work but it did so with great reluctance and a heavy heart (12).
And scientists in countries outside the USA have not been any more forthright, persuasive or enthusiastic about stem cell research than those in the USA. Robert Winston, professor of fertility studies at Hammersmith Hospital, wrote a piece apparently in favour of embryonic stem cell research where he argued that the use of nuclear transfer is impractical and all but apologised for the destruction of embryos (13). With supporters like this, human embryo research doesn’t need many detractors.
Japanese scientists will also soon be able to establish their own embryonic stem cell lines for research purposes – with Dr Norio Nakatsuji, a developmental biologist at Kyoto University, likely to be one of the first in Japan to establish such lines. The Japanese public is relatively relaxed about stem cell research, and Nakatsuji and the Japanese authorities have an opportunity to educate their population about the exciting benefits such research promises. But instead, the Japanese government is proposing tough guidelines and Nakatsuji has said that ‘strict regulation is necessary to obtain public support’ (14).
There is no hiding from the fact that society is distrustful of scientific research – especially research that involves reproduction or genetics. But hoping that the breakthroughs of tomorrow will wash away the problems of today is just whistling in the wind. Unless we make the case for research today, the breakthroughs of tomorrow may never come.
Stuart Derbyshire is an assistant professor in the University of Pittsburgh Department of Anaethesiology. He is a contributor to Animal Experimentation: Good or Bad?, Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)).
(1) Stem cell, cloning bills dropped, CNN, 2 November
(2) West: ‘I’m just trying to help people who are sick’, CNN, 25 November 2001
(3) West: ‘I’m just trying to help people who are sick’, CNN, 25 November 2001
(4) ‘Science and Society: Human embryonic stem cell research: ethical and legal issues’, Nature Reviews: Genetics, 2001; 2: 74-78
(5) Bush: Human cloning ‘morally wrong’, CNN, 26 November 2001
(6) Bioethicist says human cloning is scary, CNN, 6 August 2001
(7) The awful truth, New Scientist, 19 May 2001
(8) ‘Scientists Divided on Limit Of Federal Stem Cell Money’, New York Times, August 16, 2001
(9) ‘Bush compromise raises doubts over stem-cell resilience’, Nature 2001; 412: 665
(12) Let stem cell research begin, by Toby Andrew
(13) ‘Embryonic stem-cell research – the case for…’, Nature Medicine 2001 7: 396-397
(14) ‘Japan readies rules that allow research’, Science 2001, 293: 775