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FROM : PLoS Biology (Public Library of Science)
Volume 2 | Issue 4 | April 2004

 Reason as Our Guide
Elizabeth Blackburn , Janet Rowley

Elizabeth Blackburn is a recent member of the President's Council on
Bioethics and is in the Department of Biochemistry and Biophysics at the
University of California, San Francisco, in the United States. Janet
Rowley is a current member of the Council and is in the Section of
Hematology and Oncology at the University of Chicago in Chicago,
Illinois, in the United States. E-mail: [log in to unmask] (EB)

Published March 5, 2004

DOI: 10.1371/journal.pbio.0020116

Copyright: © 2004 Blackburn and Rowley. This is an open-access article
distributed under the terms of the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited.

"We are two of the scientist members of the President's Council on
Bioethics. In late 2001, we were invited by the President of the United
States to serve on this Council. The Bioethics Council was appointed by
the President to “monitor stem-cell research, to recommend appropriate
guidelines and regulations, and to consider all of the medical and
ethical ramifications of biomedical innovation…. This council will keep
us apprised of new developments and give our nation a forum to continue
to discuss and evaluate these important issues.”

This was a difficult invitation to accept. On the one hand, the
President's views on the use of human embryonic stem cell research and
somatic cell nuclear transfer techniques were well-known and in conflict
with our own beliefs about the costs and benefits of the use of
progressive technologies to advance biomedical research. On the other
hand, we were grateful that the President, despite his views in
opposition to these therapies, was willing to invite serious biomedical
scientists to help formulate advice to him—and ultimately to contribute
to the development of national policy—on these critically important
advances.

We knew that on this originally 18-member (but for most of the past two
years a 17-member) Council, as scientists we would be in the minority in
our belief of the good to be gained through these and other areas of
biomedical research. We were also aware that some others on the Council
had strong opposing views. Thus, it was only with the assurances of the
Council chairman, Leon Kass of the University of Chicago, and of the
President of the United States himself that we were persuaded that our
voices would be heard and integrated into the statements of the Council.
Furthermore, we felt, and continue to feel, that bioethical issues are
important not only to all biologists, but also to society at large, and
thus especially worthy of engaging debate and discussion.

Two recently issued reports of the Council, “Beyond Therapy:
Biotechnology and the Pursuit of Happiness”
(bioethics.gov/reports/beyondtherapy/index.html) and “Monitoring Stem
Cell Research” (bioethics.gov/reports/stemcell/index.html), are therefore
of deep concern to us. We discuss them in turn below.

Concerns about the “Beyond Therapy” Report

The “Beyond Therapy” report deals with issues of direct concern for every
thoughtful person. However, in the interests of setting straight the
record of our views, as Council members and scientists, on the content of
this report and for a proper assessment of the scientific content of the
“Beyond Therapy” report, we feel it is important to point out aspects of
the report for which we had requested revisions and for which those
requests were declined.

In the discussions of preimplantation genetic diagnosis, the specter of
designer babies is raised by implying that selecting embryos for
intelligence and other traits, such as temperament is a possibility.
Scientifically, this simply is highly unlikely and indeed may not even be
feasible. While such scientific unlikelihood is mentioned in passing in
the report, it is easy to take away from the report the feeling that such
genetic manipulation will happen and is even imminent.

The report also claims that “the underlying impulse driving
age-retardation research is, at least implicitly, limitless, the
equivalent of a desire for immortality.” Furthermore, the title of
Chapter 4 of the report, “Ageless Bodies,” implies that immortality is
the goal of this research, despite all reliable scientific evidence to
the contrary. Such a title is not consistent with the knowledge, stated
in that chapter, that there is no scientific basis for immortality and
implies that, by seeking to maintain and extend “youth,” research into
aging, including stem cell research, is predominantly to serve vanity.
Also, without presenting scientific or reliable evidence, the report
presents the opinion that research into prolonging healthy life may
result in a lifetime obsession with immortality. Hence, this chapter in
the report falls short of explaining the serious challenge of preventing
and curing age-related disease to extend health—very different from
attempting immortality.

The same chapter offers a sensational quote from a researcher that “the
real goal [of aging research] is to keep people alive forever.” The
request that quotes from researchers more representative of the
biomedical research community also be included was declined. This leads
to a misleading misrepresentation of the motivation of reputable
researchers in the field of aging.

In suggesting that slowing biological aging may increase the disjunction
between “social aging” (the age at which children are exposed to “adult”
images and concepts) and “biological aging” (expected lifespan), only one
view, a conservative one, of the supposed “best” way to raise children is
presented. The report also suggests, with no clear reasoning behind it,
that longer lives will somehow undermine human determination to
contribute as much as one can during a lifetime. Despite requests for
inclusion of material that would allow for a balanced treatment of these
topics, the report minimized discussion of potential positive aspects of
slowing biological aging, such as prolonged good health.

Finally, the report repeatedly emphasizes a “profound and mysterious”
link between longevity and fertility, thereby leaving the reader with the
distinct but erroneous impression that anything done to extend healthy
life will be traded for decreased fertility, despite the fact that
current scientific literature, which was made available for inclusion in
the report, shows a lack of any necessary mechanistic linkage of the two.

Concerns about the “Monitoring Stem Cell Research” Report

With respect to the “Monitoring Stem Cell Research” report, we feel that
some facts that would help the public and scientists better assess the
content of the report were not brought out clearly or were omitted
entirely. First, from the published scientific literature in
peer-reviewed journals on stem cells, a major message can be distilled:
namely, the vast difference that currently exists in our understanding
of, and the potential utility of, embryonic versus adult stem cells as
sources of material for research and clinical purposes. In brief, human
stem cells have been isolated from a variety of embryonic, fetal, and
adult tissue sources. However, enormous differences exist in purity,
properties, data reproducibility, and understanding of cells from these
different sources. Much of our ignorance is related to the relative
paucity of funding for research using embryonic stem cells.

Years of rigorous and careful research in animal models have documented
that embryonic stem cells have great utility for scientific studies. This
work has also rigorously and reproducibly established the great
plasticity of these cells and supports the opinion that human embryonic
stem cells possess the greatest broadest potential and promise for
clinical applications. As well as therapeutic uses, important potential
applications include studies of embryonic stem cells bearing complex
genotypes susceptible to poorly understood common human diseases and
testing and screening drug efficacy.

The report does not make clear that the best-characterized adult stem
cells are hematopoietic stem cells. Currently, major difficulties and
inadequate understanding exist with most other types of adult stem cells
reported to date. In addition, many experiments suggesting that adult
stem cells have broad plasticity may be incorrectly interpreted owing to
an error caused by an experimental artifact of cell fusion present in
some unknown proportion of the experiments. Research on some of the
reported adult stem cell preparations may conceivably in the future
demonstrate that they, too, like hematopoietic stem cells, can also be
prospectively identified, “single cell cloned,” expanded considerably by
growth in vitro with retention of normal chromosome structure and number,
and preserved by freezing and storage at low temperatures. But it should
be strongly cautioned that this has not been done for most adult stem
cell preparations, and, even if possible, it is not clear that any of the
just-mentioned procedures will be accomplished in the near future, owing
to the technically very demanding nature of such experiments.

We feel it is important to emphasize a point that the report mentioned,
that the reported isolation and properties of multipotent adult
progenitor cells (MAPCs) must be reproduced in additional laboratories
for any reliable interpretation of the results reported with these cells.
After considerable effort, this has still not been achieved. Thus, in the
reported results, the possible significance of the reported isolation and
properties of human MAPCs is left unclear, as is their potential as a
source of stem cells for clinical purposes. Hence, a strong overall
caution is that many of the reports on the properties of cells
differentiated from adult stem cell preparations are to date preliminary
and incomplete. If results with any isolated and characterized adult stem
cells are validated, it will then be very important to compare their
properties—and those of any more differentiated cells that can be derived
from them—with other stem cell sources, such as the well-characterized
hematopoietic stem cells, and with human embryonic stem cell
preparations.

Two major considerations argue strongly for non-commercial, federal,
peer-reviewed funding to be made available for this work. The first is
the sustained effort this work will require. The second is the importance
of reliable and unbiased design of experiments and of open, public
availability of the complete findings.

Reasons for Our Concern

In being concerned about the content of these reports, neither of which
makes any recommendations for legislative or policy actions, are we
worrying too much? We think not. Indeed, already, sadly as a result of
the way the sections on aging research in the report were written, the
myth that longevity has an inevitable tradeoff of diminished fertility is
now gaining a further foothold: witness the January 26, 2004, issue of
the The New Republic. In it, an article about this report of the Council
falls right into the trap: it states, “But changes come with longer life.
Worms and mice that are altered for extended lifespans become sterile, or
barely reproduce.” The public is done a disservice when science is
presented incompletely; myths are then perpetuated.

This is but one example of the dangers that three of the Council members
who are scientists (the two of us along with Michael Gazzaniga of
Dartmouth College) pointed out, in a Commentary within the edition of the
“Beyond Therapy” report published by the Dana Foundation in November
2003. In that Commentary, we stated that “Our concern … is that, moving
forward, the debate carry on with all of the scientific evidence—or as
much as such a widespread public discussion can include—and take care not
to leave an erroneous impression as to the nature of the potential
problems at hand.” We ended the Commentary by saying “We urge both good
reading and critical reading!” (our italics).

These reports had as their premise the aim of neutrality in the
scientific analysis of the issues addressed. But our concern is that some
of their contents, as in the few examples outlined above, may have ended
up distorting the potential of biomedical research and the motivation of
some of its researchers. Continuing discussions will form the basis for
future decisions on these topics; keeping such discussion open and
balanced is of paramount importance.

References

President's Council on Bioethics (2003) Beyond therapy: Biotechnology and
the pursuit of happiness With introduction by William Safire and
commentary by Michael S. Gazzaniga, Elizabeth Blackburn, and Janet D.
Rowley. New York: Dana Press. 400 p.

President's Council on Bioethics (2003) Beyond therapy: Biotechnology and
the pursuit of happiness. Available at
bioethics.gov/reports/beyondtherapy/index.html via the Internet. Accessed
29 February 2004.

President's Council on Bioethics (2004) Monitoring stem cell research.
Available at bioethics.gov/reports/stemcell/index.html via the Internet.
Accessed 29 February 2004.

Box 1. President's Council on Bioethics
The President's Council on Bioethics was created on November 28, 2001.
Its mission includes: to “advise the President on bioethical issues that
may emerge as a consequence of advances in biomedical science and
technology. In connection with its advisory role, the mission of the
Council includes the following functions:

to undertake fundamental inquiry into the human and moral significance of
developments in biomedical and behavioral science and technology;

to explore specific ethical and policy questions related to these
developments;

to provide a forum for a national discussion of bioethical issues;

to facilitate a greater understanding of bioethical issues; and

to explore possibilities for useful international collaboration on
bioethical issues.”

From Executive Order 13237

George W. Bush

The White House, November 28, 2001

Federal Register date: November 30, 2001

Federal Register page: 66 FR 59851

The members of the President's Council on Bioethics at the time these
reports were written included Leon R. Kass, M.D., Ph.D. (Chair), American
Enterprise Institute; Elizabeth H. Blackburn, Ph.D.*, University of
California, San Francisco; Rebecca S. Dresser, J.D., M.S., Washington
University School of Law; Daniel W. Foster, M.D., University of Texas,
Southwestern Medical School; Francis Fukuyama, Ph.D., Johns Hopkins
University; Michael S. Gazzaniga, Ph.D., Dartmouth College; Robert P.
George, J.D., D.Phil., Princeton University; Mary Ann Glendon, J.D.,
M.Comp.L., Harvard University; Alfonso Gómez-Lobo, Dr. Phil., Georgetown
University; William B. Hurlbut, M.D., Stanford University; Charles
Krauthammer, M.D., syndicated columnist; William F. May, Ph.D.*, Southern
Methodist University; Paul McHugh, M.D., Johns Hopkins Hospital; Gilbert
C. Meilaender, Ph.D., Valparaiso University; Janet D. Rowley, M.D.,
University of Chicago; Michael J. Sandel, D.Phil., Harvard University;
and James Q. Wilson, Ph.D., University of California, Los Angeles.

* These members had their Council terms terminated by White House
directive on February 27, 2004.


http://www.plosbiology.org/plosonline/?request=get-document&doi=10.1371/j
ournal.pbio.0020116

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