The cutting blob of ethical politics
Jul 5th 2001 | WASHINGTON, DC
From The Economist print edition

America’s complicated argument about stem-cell research could be
a forerunner of bigger fights to come

GEORGE BUSH has come face to face with the first policy dilemma
of the new world of human genetic engineering: should the federal
government finance research into stem cells derived from human
embryos? Stem cells can transform themselves into the many
different cell types that go to make up a body. They hold out the
promise of new therapies for diseases like Parkinson’s
or Alzheimer’s. But because such cells are derived from embryos,
their extraction upsets many (though, crucially, not all) anti-abortion
people .

The stem-cell issue, the first to divide publicly members of Mr
Bush’s government, dates back to 1998, when researchers at
the University of Wisconsin isolated stem cells from embryos.
But because Congress attached a special provision to a budget
bill in 1995 banning the use of federal money for research in which
human embryos are created or destroyed, no public money
is involved.

In its last year in office, the Clinton administration proposed new
guidelines to get round this restriction on the basis that it applied
to embryos not stem cells: scientists could get federal money to
conduct research into stem cells, as long as they personally did not
destroy embryos to do it. The effect of this change was limited
as there was little money available, so Mr Bush could have fulfilled
his campaign promise to ban federal spending fairly painlessly if
he had done it immediately (just as Mr Clinton reversed a ban on
fetal-tissue research on his first day in office).

Instead, influenced by Connie Mack, a former Florida senator
who is Catholic, conservative, strongly anti-abortion and
a supporter of stem-cell research, Mr Bush said he would take
a decision based on a new review of the scientific and ethical
issues. Part of that review, from the National Institutes of Health
(NIH), came out last week and affirmed the promise of “a dazzling
array” of possible treatments. As The Economist went to press,
the president’s decision was rumoured to be imminent.

Federal funding matters partly because of the cost of the research.
John Gearhart of Johns Hopkins University, one of the pioneers
of the science, says it could cost $100m or so over the next five
years to conduct the research properly. The leading private
company involved, Geron, of Menlo Park in California, had sales
of just $6m last year.

Just as important is the signal federal approval sends. The
complexity of stem-cell research means it would be best conducted
by many laboratories bombarding the stem cells with as many
different tests as possible. The network of federally financed
laboratories is better suited to that work than competing private
ones. And federal backing might attract bright sparks into the field,
and prevent others from going to places like Britain (where the
government has recently permitted new embryos to be created
through cloning for the specific purpose of cultivating stem cells).

Critics say stem-cell research is immoral, illegal and unnecessary

Critics of federal funding make three arguments. First, they say,
stem-cell research is immoral. Embryos are human life. You cannot
(yet) reliably extract stem cells from them without killing them. The
fact that research into embryonic stem cells will initially be
conducted on cells from embryos discarded in the course of in
vitro fertility treatments is irrelevant. These are still potentially
human beings, and anyway they doubt whether scientists would
content themselves with “discarded” embryos only.

Second, they say, stem-cell research is illegal—that is, against
the terms of the 1995 provision. The Clinton guidelines are merely
trying to subvert the law.

Third, they argue that embryonic stem-cell research is unnecessary.
Stem cells can also be found in small quantities in many adult tissues,
such as the brain. The same benefits can be realised through research
on “adult” stem cells, which do not involve killing the donor. These
cells, they claim, show the same ability to reproduce repeatedly as
embryonic stem cells, and can also differentiate themselves into a
variety of cell types.

Supporters of federal funding differ on all three counts. It is simply
not true, they say, that adult stem cells are an adequate substitute.
For obvious reasons, adult stem cells are difficult to harvest routinely
from some living organs, such as the brain or liver. They are harder to
grow in the laboratory in the quantities needed for transplantation
and, especially, tougher to push into becoming a variety of cell types.
Because of that, even adult stem-cell work may have to depend on
instructions learned from embryonic stem cells. The scientific
consensus, exemplified by the recent NIH report, supports this view.

Next, supporters of funding naturally accept Mr Clinton’s legal
definition, and make a further point about the legal advantages
of federal involvement. Now, stem-cell research, like a good deal
of genetic science in America, is conducted in private laboratories
(and thus barely regulated). Given the unease about things like
cloning, would it not be better if there was more public oversight,
which federal money would entail?

Third, the supporters differ on the moral issues. The stem-cell
debate is much more complex than that hardy perennial of
American ethical dispute, abortion. The abortion debate hinges
solely on your attitude to the cells that make up an embryo or fetus.
 Supporters of abortion rights, who think embryos are not
meaningfully persons, can carry the same logic forward to stem
cells effortlessly. But for anti-abortionists, the issue is harder,
since it requires balancing two “pro-life” goods: the life of the
embryo against the potential lives saved from research based on
its stem cells.

Not all anti-abortion activists think that balance comes down
against research. Connie Mack is one. Orrin Hatch, a senator from
Utah who opposed research on fetal tissue on pro-life grounds,
and Tommy Thompson, Mr Bush’s health and social services
secretary, are in the same group of pro-stem-cell Republicans.
And the polls show around 58% of Americans and 54% of Catholics
 support stem-cell research.

But one group does not: regular church-going Catholics. Deal
Hudson, the editor of a magazine, Crisis, who advised Mr Bush
on Catholic voters during the campaign, points out that Catholics
who go to mass once a week are seven to ten points more
“conservative” on moral issues than other Catholics. That would
suggest a majority of those who take mass once a week oppose
the research—and since there are 14m of them, and since Mr Bush
 polled extraordinarily well among all Catholic voters in the election,
they are not simply to be ignored. No wonder Karl Rove, the
president’s chief strategist whose job it is to make these raw
political calculations, has emerged as the main opponent of
stem-cell research in the White House.

Two compromises have thus emerged. One would confine federal
money for research into “discarded” embryos already in fertility
clinics. Conservatives oppose this, saying these embryos could
still give life. The other more likely one would allow federal
funding—but only on those stem-cell “lines” already derived
from embryos. Scientists dislike this. Mr Gearhart worries that it
restricts research to a narrow genetic pool (there are only a dozen
or so such stem-cell lines) and points out that no one really knows
whether stem cells can replicate themselves endlessly without any
deterioration in quality.

Jeffrey Kahn, the director of the Centre for Bioethics at the
University of Minnesota, argues that this solution does not
resolve the moral issue anyway because these are embryonic
stem cells, so public money would still be spent on research that
depends on destroyed embryos. To that, Mr Hudson replies that
at least no new life would be destroyed, and most scientists
would probably say that some federal money is better than none.

If that were the shape of the compromise, it would speed up
stem-cell research to some extent, which is necessary because
the work is in its infancy. But if the hopes of the scientists are
realised, and stem cells do indeed promise a medical revolution,
then the compromise would merely postpone the toughest
decision: whether to allow the creation of new embryos—by
“therapeutic cloning”—to create the millions of stem cells needed
to realise the full potential of the research. Whatever Mr Bush
decides this week, the arguments are only going to get more bitter.

http://www.economist.com/world/na/displayStory.cfm?Story_ID=684390

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