Hi All, I just watched the 18 minute CBC Documentary: Stem Cells - The Promise & Protest on the National.... Here is the text transcript.... The National Online - Transcripts 01/06/05 Title: Introduction Host: PETER MANSBRIDGE Date: 010605 Time: 22:00:00 ET - 22:30:00 ET CBC-TV THE NATIONAL Title: Stem Cell Therapy PETER MANSBRIDGE: They are tiny cells, but their potential is huge. Scientists say stem cell research could some day unlock the cruel mysteries of Alzheimer's Disease, Parkinson's, Multiple Sclerosis, cancer, heart disease, paralysis, the list goes on and on. But some of the best stem cells, the most versatile ones come from human embryos and the embryos are destroyed in the process and there is the rub. Some people say that's too high a price to pay for progress and that our society should not pay it. The CBC's Leslie MacKinnon now with a documentary look at cell therapy, the promise and the protest. LESLIE MACKINNON: What must seem particularly unfair to Marc Bergeron is that he's very young to have what for anyone is a dreadful affliction. Now just 38, he was diagnosed four years ago with Parkinson's disease, a disorder that usually strikes people who are over 60. His whole left side is slowly becoming rigid and uncontrollable. There is no way to predict Parkinson's disease or to prevent it or to cure it. But this could be the magic bullet, too small to be seen, a human fertilized embryo captured in a glass straw. Here lies the power to remake tissue destroyed by disease or injury. MARC BERGERON: If that research succeed it's sure that myself, I will be able to have some benefit of it. MACKINNON: But this is controversial because in the process of procuring its cells, called stem cells, the embryo must be destroyed. There are those who believe it should be accorded all the rights of a human being. SUZANNE SCORSONE (Former Royal Commissioner): We cannot do things that are inherently evil to bring about a good. MACKINNON: The moral line defined by that good might mean no relief in his lifetime for Marc Bergeron. Even though his leg and foot constantly seize, he's still in the early phase of this disease. BERGERON: Every month and every year it gets worse and worse and one day it will affect both sides of my body. MACKINNON: He begins taking medication as soon as he gets up and then he waits for the drugs to stop the cramping and spasms. With the help of these drugs, many Parkinson's patients reach a stage where they exhibit no symptoms at all. But not Marc Bergeron. As the pills kick in, his arms start trembling. BERGERON: I don't like very much that shaking of the arm and the shaking, it affects also my face. MACKINNON: There's no comfort zone for him. The side effects of the drugs cause dyskinesia, the involuntary twitching of muscle. BERGERON: This movement, the energy that is required is the same as if it was voluntary. And if you do it yourself for two hours, you will get your arm tired. MACKINNON: Inside a Parkinson's patient's brain, the cells that produce dopamine, the regulator of nerve and muscle movement stop functioning and die. Drugs that mimic dopamine don't halt the disease's progress. But what if brand new dopamine producing nerve cells could be transplanted into the brain? Inside an embryo, this is the promise of the microscopic stem cells. Stem cells are a blueprint, an instruction manual for life itself, they can morph into a muscle cell, bone cell, brain cell, or whatever the body needs. In the world of science, their power is almost mythical. ROGER GOSDEN (Royal Victoria Hospital): Stem cells are exciting because they're going to usher in a new phase in medical research and treatment. We're going to be able to treat degenerative diseases like Parkinson's disease and cancer using regenerative medicine by transplanting the stem cells to make new cells which have been lost in the disease. MACKINNON: Recognizing the hopes in this novel medicine called cell therapy, Health Minister Allan Rock recently proposed to allow research on human embryos to obtain stem cells. This legislation will lead Canadians into a new era in medicine as momentous as the mapping of the human genome. In stem cell work, Canadian scientists are leading the field. Michael Rudnicki is a molecular geneticist in Ottawa and a stem cell pioneer. Stem cell research is a new rontier in science even though embryonic stem cells were isolated only three years ago. MICHAEL RUDNICKI (Ottawa Health Research Institute): Over here we have clump of neurons, nerve cells. There are many, many different cells forming a spidery network. Each one of this little round parts is a, is an individual neuron. So they're thinking in the dish, I don't know what they're thinking. What am I doing here? Nerve cells are produced in the petrie dish, into the brains of a patient, for example, who either has Parkinson's or a patient who suffered a stroke could replace the neurons that have been lost due to damage. Those neurons would grow and thrive in the brain. They'd make the appropriate connections and essentially replace the cells that have been lost. MACKINNON: And has this been tried in animals with any success? RUDNICKI: Absolutely. The studies that have been done in mouse and rats suggest that the transplanted nerve cells do n fact connect in appropriate ways, at least in a limited way with their surrounding neighbor cells. MACKINNON: Rudnicki has also taken the stem cells from mouse embryos and crafted them into mouse heart cells in his lab. RUDNICKI: Okay, let's go find the cardiac cells. How's that? Isn't that cool. This is a clump of cardiac tissue. Cardiac tissue will beat all by itself. That's the nature of heart cells. MACKINNON: Here are single heart cells. In this big clump is a pile of several thousand cells which beats in a petrie dish very much like it's a small heart. These could be injected right into a heart muscle. RUDNICKI: Hearts do not regenerate themselves. So these are potentially the cells that could repair that damage following a heart attack, for example. MACKINNON: Canadian scientists want to expand soon from mice to human embryos to help people like Marc Bergeron. Stem cell treatment for him is still something he can only dream about, but it gives him the kind of hope Parkinson's patients in the past haven't had -- to be freed from his drug regimen. In a sense, to have his own body back. BERGERON: If nothing new happens in the therapy of the disease, I will have to live with Parkinson's disease for the rest of my life which means I won't be able to make much because this disease is turning you into a statue. GOSDEN: Here we're talking about a cell transfer to replace cells that are damaged. MACKINNON: Roger Gosden is a research scientist at the Royal Victoria Hospital in Montréal. Stem cells, once nature's secret could supply body parts and fend off death. He sees this as a revolution in medicine. GOSDEN: We may be able to treat these diseases one by one, no longer just by drugs but perhaps by giving cells. And remember, that if we were able to replace the cells, it will be presumably a healthier situation because rather than having the side effects of drugs, we would be able to have the body regulating its own supply of the nerve transmitter substances or insulin and other hormones which would be a much healthier state. MACKINNON: Could this be a fountain of youth? I mean, could it reverse the effects of old age? GOSDEN: I'm sure that this technology will be able to blunt the effects of aging. It's not going to slow down the basic process of aging, but aging brings a host of pathological diseases, degenerative diseases and we want to treat degenerative diseases with regenerative medicine. And so embryo stem cell research is ideally placed to treat diseases of old age. MACKINNON: But there's still the dilemma of destroying a human embryo. Suzanne Scorsone was a member of the Royal Commission on Reproductive Technology. Like many of the religious groups, she isn't so cruel as to advise sick people to just forget about stem cell therapy. SCORSONE: There are other ways we can do the good things that are being sought. We can use adult stem cells. We can use stem cells from umbilical cord blood, from the placenta which are plura-potent, which can become many different kinds of tissue. So we should be able to do the good things that are desired in ways that don't have ethical problems. MACKINNON: In fact, every part of the human body has stem cells. They're active in bone marrow where they make new blood and in the epidermis of the skin, repairing the normal wear and tear of daily living. But when it comes to mending a damaged heart or replacing a lost limb, they seem to hibernate. No one's sure why. Recently scientists have learned that adult stem cells can be manipulated to form new tissues to do most, although perhaps not all the things embryonic stem cells can do. Embryonic stem cells can become literally any cell. Adult stem cells haven't yet proven to be as versatile but they have an edge in being morally unassailable. Most scientists would like to work with both. RUDNICKI: I agree with that, that adult stem cells look very, very promising at his point in time. But we cannot say that embryonic stem cells are useless. And by excluding the study of embryonic stem cells, we are really ghettoizing ourselves intellectually and hurting the research effort. SCORSONE: One of the things that we learned in the period during which we fought World War II was sure, there's research that can be done on human beings and sure, it gives you results but it's not ethical to do it. And that isn't just something that was done by nazi Germany. It was done in North America, as I'm sure you know, with the Tuskegee Institute research on syphilis that was, that withdrew treatment from black males just to see what would happen. Was knowledge derived from that, that was useful? You betcha. Was it wrong? Oh yes. MACKINNON: And you would compare that with research in human embryos? SCORSONE: Yes I would. It's still doing, it's making objects out of entities that are human. It's reducing human dignity. MACKINNON: But the fact is the disposal of human embryos has been going on for years in in-vitro fertilization clinics, ever since freezing embryos became an option. Inside this tank are many dozens of frozen human embryos. And in the straw, a few ready to be thawed and placed inside a woman who wants to have a baby. First the embryos are examined and any flawed ones are discarded. So are any surplus ones left over after the couple completes their family. So the moral line of destroying a human entity has been crossed without any ethical debate. Perhaps because the intent is noble. The freezing technology ups the chances of pregnancy. It's suggested that these spares left to thaw out and expire could, with the parents consent, be saved for stem cell research. Because, the rationale goes, they're going to die anyway. SCORSONE: It's one thing to say that a human being, because that's what these are, you know, may die. It's another thing to say well, because they may die, we can use them as industrial raw materials and that's not acceptable. GOSDEN: It seems to me that it's better to do some good than no good. For instance, if you got embryos that are going to waste, the patient no longer wants and is prepared to donate them, rather than just destroying them, it is better to try to use them for some good for a patient, to convert them into embryo stem cells to treat some dread disease. MACKINNON: Dalhousie University bio-ethicist Françoise Baylis points out that there are ways of respecting the humanness of the embryo and still allowing some scientific research. FRANCOISE BAYLIS (Dalhousie University): It is a human being biologically. Is it a person which is now a moral category and it's with persons that we look at issues of the moral rights and the right to life. And what we're doing is we're saying that this isn't just any kind of tissue, that there is something special about the embryo and most people do tie that specialness to the potentiality of it becoming a person, because it already is a human being. And that in recognition of that, we are going to hold ourselves accountable in terms of how we interact with, engage or destroy the embryo. And so I think it's in that context that it makes sense to say out of respect in the context of accountability, we'll put limits on what we can or can't do. MACKINNON: Some limits that Canada is proposing in its draft legislation. First, although using leftover embryos from IVF clinics would be allowed, after that, there would be severe restrictions. No embryo could be created from donated egg and sperm just for research. And no embryo could be created by cloning. Canada isn't just proposing to ban these procedures, it wants to criminalize them with heavy fines, even jail terms. Setting up a kind of regulatory regime that research scientists just haven't seen before. RUDNICKI: I think it, it sends a chill down my spine that we can in Canada have big brother controlling what is a research activity that is, we're not talking about creating life. We're not talking about cloning human beings. We're talking about a research endeavor that would never leave the petrie dish. This is unprecedented that research activity becomes criminalized. It's absolutely ludicrous. SCORSONE: There have to be sanctions that will in fact indicate that this is unacceptable, that it is not to be done. Full stop. Only the criminal sanctions will do that. MACKINNON: But sanctions don't take into account changing social norms. Back in 1978, the birth of Louise Brown, the world's first test tube baby shocked and horrified many critics. Britain, which had pioneered this technique came very close to outlawing it altogether. After more than 20 years, IVF has worked so well that it's produced half a million babies. In that spirit, Britain has just given approval to the creation of embryos, either by cloning or by IVF to produce stem cells just for research. But not Canada. Ethicist Françoise Baylis thinks it's too hasty to impose sweeping bans. BAYLIS: Right now, as it's put forward, you could only do research on embryos that are leftover, so the spare embryos, embryos that are going to be discarded in any case. Well, it's conceivable that you could run into a situation whereby that in the context of ongoing research, there aren't enough embryos in this way leftover from these various treatments in order for you to pursue the research. Well, then you have, I think, a very interesting and difficult question. Do you go back and try to change legislation? RUDNICKI: The thing in 2001 we cannot foresee all the possible situations that may arise. So a moratorium now is reasonable, but to criminalize it for, for the foreseeable ten or 20 years, we may really regret that's done. And it may be very difficult to change. MACKINNON: In the end, no matter what the ethical debate, it's likely stem cell research will be largely driven by patient demand by people like Marc Bergeron who's facing a life sentence. BERGERON: What I see from where I am now is that at the speed the science is developing, I'm convinced that I'm young enough to see the day where that disease will be history. MACKINNON: In the meantime, he can just wait for the debate, for the long delayed legislation and maybe the possibility of a cure. For The National, I'm Leslie MacKinnon in Montréal. MANSBRIDGE: Now the legislation that Leslie mentioned is still in the early stages. Hearing are expected to begin sometime around year's end and after that will come first reading. http://tv.cbc.ca/national/trans/T010605.html ******* ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn