Hot-button health issues
during this frenetic political season include spiraling health care costs,
importation of drugs from foreign countries, and the feds' war on obesity.
Rapidly heating up is the controversy over stem cell research.
On one hand, we have John Kerry and fellow Democrats portraying President Bush
as, for ideological reasons, blocking advances in research and treatments for a
range of debilitating diseases, including Parkinson's, Alzheimer's, heart
failure, and some forms of cancer. Kerry's message is that, if he is elected,
the United States will be catapulted to world leadership in stem cell
research, with a dazzling array of miracle cures (and saleable products) to
show for it. "We're going to lift the ban on stem cell research. We're
going to listen to our scientists and stand up for science. We're going to say yes
to knowledge, yes to discovery, and yes to a new era of hope for
all Americans," he promised in a radio address on August 7.
On the other, we have the president and many of his supporters arguing --
seemingly from the campaign's talking points -- that the Bush administration
was the first to provide funding for stem cell research.
Paradoxically, many of these same people remonstrate that the prospects for
cures are grossly overstated, that federal funding is not needed, and that the
real potential for finding cures lies not in embryonic stem cells (ESCs) but in
applications of adult stem cells (ACSs). As Laura Bush said in dismissing as
"ridiculous" Senator Kerry's criticism of the administration's
policies: "We don't even know that stem cell research will provide cures
for anything -- much less that it's very close" to yielding major advances.
Stem cell research and therapy -- particularly using embryonic stem cells --
are, for many, highly emotive issues. ESCs are obtained via the destruction of
early-stage embryos, and many social conservatives who object to this
technology describe the technology using the inflammatory rhetoric of the
debate over abortion, referring to "killing" and "tearing
apart" babies, and "culling" their cells.
Such emotion and passion often lead partisans to obfuscate and speak in a kind
of code. Far better, surely, for the critics of ESC research simply to say
forthrightly, "I oppose this for religious and moral reasons" --
which is clearly their right -- and to forgo the quasi-scientific
rationalizations.
It is curious, and also inconsistent, that embryo wastage in other contexts has
been far less controversial (and also far less political). For decades in the United
States and elsewhere, as part of treatment for
infertility, embryos have been created and then destroyed, discarded, or kept
frozen, when procedures fail or when another embryo leads to a successful
pregnancy. Why don't individuals who demand an end to embryonic stem cell
research on the grounds that it "kills potential babies" object as
strenuously to the destruction of embryos or their indefinite storage at
fertility clinics?
Politicians on both sides of the aisle who are trying to use stem cell research
for partisan advantage commonly misrepresent and confuse the issue.
Democrats would have us believe that miracle cures for debilitating diseases
are right around the corner -- if only the Bush administration would repeal its
onerous restrictions. "Some of the most pioneering cures and treatments
are right at our fingertips, but because of the stem cell ban, they remain
beyond our reach," Kerry said in August.
Republicans argue that potential ESC therapies are simply a mirage and that the
Democrats are cruelly manipulating and deceiving desperate patients. Some,
including Laura Bush, emphasize the early nature of ESC research, that no
medicines have yet been derived from ESCs, and that no clinical trials are
under way. "Embryonic stem cell research is very preliminary. . . The
implication that cures for Alzheimer's are right around the corner is just not
right, and it's really not fair to the people who are watching a loved one
suffer with this disease," said the First Lady in August.
The truth lies somewhere in between. Research is indeed in its infancy: Mouse
ESCs have been induced to differentiate into a variety of blood cells but not
yet the relatively immature ones that researchers want. Similarly, mouse ESCs
have been induced to grow into nerve cells used to treat Parkinson's disease in
mice; the cells did produce the deficient chemical, dopamine, but not in
amounts sufficient to reverse the disease. Nevertheless, and although
successful therapies may be a decade or more away, most scientists conversant
with the field believe that this technology offers enormous potential. Most
technology goes through a phase in which the product or process is imperfect,
often profoundly so. It is useful to recall that bone marrow transplantation
was a dismal failure for about the first decade that it was used clinically.
Republicans claim that President Bush, the first American president to
authorize federal spending on ESC research, is really a champion of the field.
Well, yes and no. On August 9, 2001, the president authorized federal spending
on human embryonic stem cell research -- but only on 64 cell lines which were
then in existence (and only about 21 of which are currently available for
research purposes). His supporters characterized this decision as a sound
"compromise." Actually, it was a better example of arbitrariness and
inconsistency.
In essence, the president argued that, although he was against the use even of
early embryos (which are about the size of the period at the end of this
sentence) for research because it involved the destruction of human life,
federal funding was OK for research using stem cell lines that had already been
created from embryos for which "the life and death decision had already
been made." But if it is morally acceptable to use cell lines from embryos
created before that somehow magical date of August 9, 2001, why is it not also
right to use federal funds to create new stem cell lines from the estimated
half-million unused embryos now relegated to the freezers of infertility
clinics and slated for destruction? For these as well, the life-and-death
decision has been made.
President Bush's decision to ban federal funding of ESC research (except on
existing lines) was based on his belief that embryonic cell research destroys
life. But there is an inherent inconsistency here as well. If harvesting stem
cells from an early embryo is truly tantamount to harvesting organs from a
baby, then the morally responsible policy would be to ban it entirely, not
simply to deny it federal funding. But -- contrary to charges by the
president's political opponents -- there is no ban, merely the prohibition on
federal support of research on embryonic stem cell lines created after August
9, 2001.
On this issue, the president has lost some of his usual political allies,
including conservative Republican stalwarts Senators Orrin Hatch and Trent
Lott. Congressman Dana Rohrabacher (R-CA), who has a 100 percent rating from
the National Right to Life Committee, intimates that he personally confronted
the dilemma of what to do with spare embryos after his wife became pregnant
with triplets through in vitro fertilization. He remains conflicted about what
to do with his family's unused frozen embryos, but says it would be a
"horrible waste" to discard them rather than use them for research.
This issue blurs many of the usual polemical lines. Despite the Catholic
Church's firm objections to embryonic stem cell research, for example, an
August Wall Street Journal/NBC news poll showed that many Catholics
think that President Bush's policy is either questionable (53 percent) or wrong
(37 percent); a previous poll by the same organizations found that 72 percent
of white Catholics favor stem cell research.
One strategy might have satisfied most stakeholders and also provided some
political cover to President Bush on this issue. When he made his August 2001
policy announcement, the president could have surrounded himself with senior
representatives of various philanthropic organizations (such as the Gates,
Hughes, and Moore Foundations, for example) that, if they chose to, could fill
the funding void for stem cell research left by the restrictions on federal
funding. Money is fungible, after all, and these foundations are prodigious
supporters of scientific and medical research, and sufficiently wealthy to pick
up the slack in a single discrete scientific area. The federal government would
thus have been able to claim the moral high ground (arbitrarily and artfully
defined though it might be), and embryonic stem cell research would not have
been hindered.
Democrats claim that if John Kerry is elected president, he will lift all
restrictions on ESC research, putting us back in the race to produce medical
miracles.
Actually, it is not quite as simple as that. In the New England Journal of
Medicine, Dr. George Q. Daley observed that there exists "an even more
restrictive element of government policy [than presidential edict that]
prohibits the use of funds for the creation of a human embryo or embryos for
research purposes" -- namely, a piece of legislation known as the Dickey
Amendment, passed in 1996 and renewed every year. Simply electing Senator Kerry
will not, therefore, give the green light to such research. Congress bears much
of the responsibility for retarding research; thus, President Bush should not
be the sole target for criticism, although currently he is perceived as
occupying a position of leadership on the issue.
Some commentators who clearly have a moral objection to using ESCs are now
aggressively promoting the idea that adult stem cells (ASCs), rather
than those from embryos, offer the greatest hope for cures. (Indeed, ASCs are
already being used experimentally to treat some blood disorders, leukemias, and
other conditions.) Some advocates of this position even accuse the Democrats
and their allies in the media of suppressing reports of ASC successes and
hyping those derived from ESC research. But why exactly would one reject ASC
research if it has such great potential? (Perhaps to keep a political football
in play?)
Again, there is some truth on both sides. The NIH acknowledges that ASCs have
recently shown greater flexibility or "plasticity" (the ability,
under the right conditions, to differentiate into a variety of cell types) and,
thereby, to exhibit more therapeutic potential than demonstrated previously.
But the NIH also argues that ASCs are more likely to have DNA abnormalities than
embryonic ones and may be more difficult to isolate and purify, and that
embryonic cells are thought to have much greater developmental potential than
adult stem cells.
The NIH's answer to the controversy over adult versus embryonic stem cells is
that we should "simultaneously pursue all lines of research to determine
the very best sources of these cells." In other words, instead of arguing
about which type is better on the basis of insufficient data, we should pursue
research using both, an approach that we find sensible. Competition in medical
research, as in commerce, is constructive.
Some on the right of the political spectrum argue that the private sector, not
the federal government, should fund expanded ESC research. Certainly, there is
a major role for private investors and other funders, especially as the
developments in the field move closer to commercial products or processes. But
the reality is that, for decades in the United States, fundamental,
pre-commercial scientific research of this sort has been dominated by funding
from the National Institutes of Health; and if the United States is going to
compete in the worldwide race to find stem cell-based cures, NIH funding (or,
as suggested above, private foundations' picking up the shortfall) will likely
be necessary. If there is consensus, or near consensus, among American
scientists (and there surely seems to be) that both adult and embryonic stem
cell research offer enormous potential to improve the lives and health of
Americans, scientists in this country should not be held back. In the face of
uncertainty, we advocate a course that offers the real possibility of palpable
benefit to large numbers of actual -- not potential -- people.
We are not so naive as to expect that this continuing debate will lead to a
convergence of views, but we would plead for a greater degree of candor,
clarity and consistency in discourse. Given the stakes, is that too much to
ask?
Elizabeth M. Whelan, Sc.D., M.P.H., is president of the American Council on
Science and Health. Henry I. Miller is a physician, fellow at the Hoover
Institution, and the author, most recently, of "The Frankenfood Myth: How
Protest and Politics Threaten the Biotech Revolution" (Praeger, 2004).
TCS Daily
Politics and the Debate Over Stem Cell Research
By Elizabeth M. Whelan - September 22, 2004 12:00 AM
Categories:
Elizabeth M. Whelan








