Stem cell decision time
Nature Genetics 28, 99 - 100 (June 2001)
Date accessed: 6 June 2001
The rapid march of modern biology doesn't give society much
time to figure out a coherent response to its discoveries.
Cultures of human embryonic stem cells were first created in the
laboratory in 1998 (Science 282, 1145; 1998). In 1999 and
2000, the implications of the discovery were mulled, and
interested parties began to mobilize opinion for and against
further pursuit of the research. Now it is 2001 and, for research
agencies and governments around the world, decision time has
arrived.
Embryonic stem cells are pluripotent, or capable of developing
into many different types of cells. They can differentiate into any
type of tissue or organ, presenting the enticing prospect that
they could one day be used to replace diseased or damaged
cells and tissue. But questions about the genetic make-up of the
cells and about the extent to which their apparently limitless
potential can be harnessed remain manifold. These will only be
addressed by more research on the cells, which can, of course,
only be extracted from human embryos.
Given the moral implications of this extraction and the sanctity
attached to embryos by many groups and individuals around the
world, it is unsurprising that the question of how the research
should proceed has spawned an energetic debate (see
http://www.stemcellfunding.com for the case in favour,
http://www.stemcellresearch.org for the arguments against). And
although it can be difficult for researchers to recognize the fact,
it is in the real interests of both science and society that
research should pause for a short time while such a debate
unfolds.
In this case, the pause has been punctuated by increasingly
strident claims for the potential of adult stem cells to
demonstrate at least some of the characteristics that make
embryonic stem cells of such special interest. In the last few
weeks, every finding concerning adult stem cells has been
jumped upon by opponents of embryonic stem cell research as
evidence that the latter is unnecessary.
Against this background, society as a whole is struggling to
reach consensus on the rules that should guide the research.
The struggle has been least pronounced in basically secular
countries such as Britain, where a law was passed in January
that will permit not only research on the stem cells themselves
but also the creation of embryos expressly for research
purposes by means of therapeutic cloning.
Elsewhere in Europe and in the United States, consensus on
the issue is more elusive. Therapeutic cloning has been
rejected as "premature" by an ethics panel advising the
European Union, and is not likely to be permitted (at least using
federal research dollars) in the United States.
In much of Europe, governments are gradually moving towards
an arrangement that will allow only surplus embryos (left over
from attempted fertility treatments) to be used for stem cell
research. But political opposition to such an arrangement
remains powerful.
Germany's situation brings out the basic character of the
debate. Last month, after due consideration, the country's main
research agency, the Deutsche Forschungsgemeinschaft
(DFG), was all set to give a general go-ahead to embryonic
stem cell research, and even to fund its first grant, to a
neuroscientist at the University of Bonn. However the federal
government, which is facing election next year, took the
unprecedented step of declaring its disagreement with the
DFG's decision, and seems to have encouraged the
nominally-independent research agency to sit on its grant, at
least for a few more months (see Nature 411, 119; 2001).
It is in the United States, however, that the debate continues to
generate the most heat. It began auspiciously enough, at least
from the scientists' point of view, under the Clinton
administration. In a carefully-finessed legal ruling released early
in 1999, the Department of Health and Human Services (which
oversees the National Institutes of Health NIH) said that
research on embryonic stem cells would be exempt from a US
law banning the federal government from supporting embryo
research—subject to a several conditions being met.
The ruling would have allowed the research to be supported,
providing that the government wasn't paying for the derivation of
the embryonic stem cells. Like most compromises, this one
drew fire from all sides. It might appear unseemly for the
government to support the research while saying that it would
not support the dirty deed, as it were, of deriving the cells in
question from human embryos.
However the health department ruling was supposed to deal
with the world as it is, rather than we would like it to be. There is
a large body of opinion in the country that will resist the
government's involvement in the destruction of embryos. And
there are scientists and, most importantly, patient advocates
who will demand that the limits of human knowledge should be
pressed in order to address the tragedy of disease.
So the compromise, which would have resulted in the NIH
considering its first grant applicants for stem cell research in
March of this year, was one with which North America –
including many foes of abortion in Republican-controlled
Congress – could have lived.
But as Nature Genetics went to press, the administration of
George W. Bush was considering its position on this matter,
and the portents for the survival of the compromise did not look
good. Tommy Thompson, the health secretary and former
governor of Wisconsin, has supported stem cell research earlier
in his career and enthusiastically praised some of its pioneers,
who did their work in his state.
However the abrupt cancellation, apparently on orders from
above, of an April meeting at which the NIH would have
considered its first embryonic stem cell grant applications,
suggests that the administration is preparing to take a position
that will bar human embryo research from receiving US public
funds.
Such an outcome would be regrettable on a number of levels.
Unlike in Europe, the decision taken by the US government is
likely to reach only as far as publicly-funded research. If it bars
stem cell research, it will simply drive it into the private sector,
where its outcomes will be heavily patented, minimizing their
impact on science and on patient therapy.
By turning its back on stem cell research, in the face of
considerable medical and scientific support for it, the
administration may deter scientists of the top rank from
accepting senior scientific positions – including the directorship
of the NIH – because of their reluctance to publicly support a
policy with which they disagree.
And most importantly, by excluding the NIH, the largest
biomedical research agency in the world, from joining in the
scientific effort to learn more about embryonic stem cells, the
Bush administration would diminish the otherwise bright
prospects that their remarkable properties can be used in the
treatment of disease.
Category: 30. Xenotransplantation, 31. Stem Cells