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This essay
originally appeared here:
http://www.nationalreview.com/comment/cohen200405251335.asp
National Review Online
May 25, 2004, 1:35 p.m.
Inflated Promise,
Distorted Facts
As senators make moves, a walk through the stem-cell fray.
By Eric Cohen
[ Eric Cohen is editor of The New Atlantis, resident scholar at the Ethics
and Public Policy Center, and a consultant to the President's Council on
Bioethics. The views expressed here are his own. ]
A few weeks ago, 206 congressmen sent a letter to President Bush demanding
increased federal funding for more embryonic-stem-cell lines, and all but
accusing the president of single-handedly standing in the way of curing many
terrible human diseases. A group of senators is apparently planning to send
a similar missive making similar demands in the near future. These senators
would be wise to check the facts before they sign, instead of getting
dragged into a political campaign that seems to show little regard for the
data.
Of course, the question of embryonic-stem-cell research is a puzzling and
contentious one. There are many who honestly believe that the possibility of
medical progress in the future outweighs any respect owed to nascent human
life in the present, and that the federal government should override the
moral objections of many citizens and publicly fund research that involves
embryo destruction. This is a misguided view; it risks making us users of
life in the very effort to be savers of life, and it undermines the ethical
pluralism that presently exists, by making the nation support this practice.
But it is an often heartfelt position -- one that Congress and the country
can debate.
The trouble is that many stem-cell advocates press for this view by
distorting the facts about the policy as it now exists, the facts about the
promise of embryonic-stem-cell research, and the facts about where the
embryos for such research will come from. For senators on the fence —
especially Republicans and pro-lifers -- a sober review seems in order to
clear away some of the confusion.
Origins of the Current Policy
In accordance with the "Dickey Amendment," passed each year since 1995,
research involving the destruction of human embryos cannot be funded with
taxpayer dollars. This is not Bush's policy; it is the law of the land,
passed annually by Congress and signed by both Presidents Clinton and Bush.
This law does not ban embryo research, and it does not fund embryo research.
It is a policy of public silence.
In 2000, the Clinton administration discovered a loophole that would allow
the NIH to provide some federal funding for embryonic-stem-cell research
without asking Congress to overturn the Dickey amendment. By law, the
government could not fund research "in which" embryos were destroyed. But if
the destruction itself were funded privately, the government could offer
funds for subsequent research on embryonic-stem-cell lines derived from the
destroyed embryos. In other words: A researcher could destroy endless
numbers of embryos in his private lab, and then use the fruits of such
destruction to get public funding. This would not violate the letter of the
law, but surely the spirit.
When he took office in 2001, President Bush put implementation of the
Clinton guidelines on hold. He wanted a way to support potentially promising
research, but he also did not believe the federal government should create
an ongoing incentive for the destruction of human embryos. On August 9,
2001, President Bush announced his new guidelines: federal funding for
research using stem-cell lines that existed before the announcement, but not
for those created after. In this way, federal money would not act as an
incentive for destroying human embryos in the future, but stem cells derived
from embryos already destroyed in the past could be used with federal money
to explore the basic science.
This was the fundamental bargain of the policy: no limits on
embryonic-stem-cell research in the private sector (unlike much of the
world, which regulates this practice), but no public subsidies to encourage
a limitless industry of embryo destruction.
The latest campaign by proponents of more federal funding rejects this basic
bargain, and thus rejects the very pluralism that liberalism so often claims
is its highest value. Although hundreds of millions of dollars in private
funds support embryonic-stem-cell research, and tens of millions in public
dollars are spent on it each year under the Bush policy, the scientists and
their advocates in Congress want more public money with fewer ethical
limits, even if it means forcing those who believe embryo research is wrong
to pay for embryo destruction.
Confusion and Distortion
To get those subsidies, stem-cell advocates have pulled out all the stops:
distorting the facts, exaggerating the promise of the research, and
confusing the public debate. The letter sent by 206 House members to
President Bush last month is just the latest example. It is worth dissecting
in some detail, lest senators make a similar error.
First, the letter exaggerates the state of embryonic-stem-cell science. "As
you know," begins the House letter to President Bush, "embryonic stem cells
have the potential to be used to treat and better understand deadly and
disabling diseases that affect more than 100 million Americans, such as
cancer, heart disease, diabetes, Parkinson's, Alzheimer's, multiple
sclerosis, spinal cord injury, and many others." But these claims are
irresponsible given the preliminary nature of the research, offering false
hope to whole classes of patients now suffering under the burden of these
diseases. The promise of embryonic-stem-cell research is very real but
wholly speculative. No human therapies of any kind have yet been developed
or tested, and none are on the horizon. And the notion that embryonic stem
cells will cure "cancer" and "heart disease," broad categories of disease
that encompass a complex array of particular ailments, is unsupported by
even informed conjectures. The use of a hard number -- 100 million -- is
pandering of a sort that no good scientist should tolerate.
At a May 11 hearing of the Senate Health, Education, Labor and Pensions
Subcommittee on Aging, for example, Johns Hopkins Alzheimer's Disease expert
Peter Rabins and Washington University Alzheimer's researcher John Morris
both told the senators that they do not expect embryonic stem cells to play
a role in Alzheimer's treatment. Experts on other diseases speak with
similar restraint. In the end, the research may bear therapeutic fruit and
it may not -- we cannot know in advance. It may cure some diseases and not
others. But by seeming to promise medical salvation without limits,
stem-cell advocates risk blurring the difficult ethical questions that
surround this new science.
Second, the letter distorts the facts surrounding the availability of human
embryos for research. "The IVF process results in more embryos than are
needed by the couple," the House members wrote to the president. "There are
estimated to be more than 400,000 IVF embryos, which are currently frozen
and will likely be destroyed if not donated, with informed consent of the
couple, for research." This implies that while the Bush policy funds
research on only a few dozen lines, hundreds of thousands of embryos are out
there for scientific use. But this is simply false. The same 2003 study that
arrived at the 400,000 number made it clear that only about three percent of
these frozen embryos are actually available for research — the others remain
in the custody of the parents who created them, and are specifically
designated for future use in initiating a pregnancy. Whether the parents
really plan to implant them or not — some parents simply cannot bear to let
them go -- these embryos are not public property. The study further did the
math, and concluded that if all available frozen embryos were used only for
embryonic-stem-cell research, they would yield about 275 lines of stem
cells. Not thousands, let alone hundreds of thousands, but 275 is all
scientists can expect to get from frozen IVF embryos.
This points to a serious question about the intentions of
embryonic-stem-cell advocates. In the May issue of Scientific American,
prominent embryonic-stem-cell researchers Robert Lanza and Nadia Rosenthal
wrote that the actual therapeutic use of embryonic stem cells would be
hampered by immune-rejection problems that could only be overcome by cell
treatments compatible with the immune system of patients. "Hundreds of
thousands of ES-cell lines might be needed to establish a bank of cells with
immune matches for most potential patients," they wrote, and "creating that
many lines could require millions of discarded embryos from IVF clinics."
We will likely never have "millions of discarded embryos," and nothing the
president can do could change that. Moreover, the article suggests how far
we might be from any workable treatments using embryonic stem cells. Does
the House letter mean to call for a national project whose end is millions
of embryos created for research? How many of the 206 signers understood that
this might be necessary? And while it is true that many scientists believe
we can find cures with fewer embryos, what will they do if Lanza and
Rosenthal are right? Will they declare that "left-over" embryos are likewise
"not enough"? Will they demand, for example, that the federal government
also support the creation of cloned embryos solely for research? What
limits, if any, will they accept as absolute, even if it means forgoing
promising areas of research?
When the letter turns to the Bush policy itself, the House members do no
better. "While it originally appeared that 78 embryonic stem cell lines
would be available for research under the federal policy," they wrote to the
president, "now, more than two years after August 9, 2001, only 19 are
available to researchers." In fact, the number of available stem-cell lines
has been increasing as more of the 78 eligible lines are developed to the
point that they can be distributed to scientists. Just days before the
congressional letter went out, the number of lines had been 18, three weeks
earlier it had been 17, in January there were 15, and a year ago there were
less than 10. The number of lines has been growing so quickly that an
earlier version of the letter, stating that only 15 lines were available, is
still posted on the websites of some of the signers. It is true that not all
78 existing stem-cell lines will develop successfully and become available.
But the claim that only 19 can ever be expected to exist is disingenuous. At
least for now, the number continues steadily to increase.
Next, the congressmen's letter says that, "All available stem cell lines are
contaminated with mouse feeder cells, making their therapeutic use for
humans uncertain." But the fact is that almost all currently available
human-embryonic-stem-cell lines (including those that are noteligible for
federal funding) were created with mouse feeder layers, and there is no
clear evidence that this means they are "contaminated" in any way that would
affect their usefulness. Perhaps more important, and unmentioned in the
congressional letter, is the fact that a number of the Bush-approved
stem-cell lines have not been developed with mouse feeder cells. These lines
have so far not been developed at all -- they are frozen in an undeveloped
form, for use when techniques that do not rely on mouse cells are perfected.
As NIH director Elias Zerhouni said last fall, "there are at least those,
which is about 16 lines, I believe, that have not been exposed to either
mouse or human cell -- human feeder cells." These lines are not included
among the 19 currently available.
Finally, the letter offers no evidence that the number of available lines
has already proven to be a barrier to any particular researcher's specific
work at this point. No other advocate or scientist has offered such evidence
either. It is certainly true that more money for more lines could mean more
work would get done. But that is not the same as saying that ongoing work
has hit a wall because of the limited number of lines now available for
federal funding, or that it will soon hit such a wall.
Stepping back, a pattern of facts emerges. Embryonic-stem-cell research is
promising but so far purely speculative; the federal government in no way
limits such research in the private sector; supporters of the research
believe they can obtain hundreds of millions of dollars in private funding
in the next few years, as the creation of new stem-cell institutes at
Harvard, Stanford, and the University of Wisconsin demonstrates; and yet,
despite the ethical objections of a very substantial portion of the public,
stem-cell advocates insist that Congress should compel every American to
support the research with tax dollars, and to make that happen they inflate
the promise and distort the facts surrounding the research.
For those who believe advancing stem-cell research is the only human good at
issue in this debate, the Bush policy obviously makes no sense. But for
those who see the ethical and political complexity of the stem-cell question
-- involving the possibility of curing terrible diseases, the ethical perils
of turning nascent human life into a resource, and the need to balance and
respect the deeply held moral views of a diverse country — the Bush policy
continues to make great sense. And whatever the nation decides to do about
embryo research over the long term, we should do it with our eyes wide open
-- knowing the unavoidable ethical costs of proceeding, the potential human
costs of not proceeding, and the great uncertainty that surrounds any new
area of science. It is these hard questions that senators -- and all
Americans -- should keep in mind before entering the stem-cell fray.
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