Destructive Embryo Research Plan Being Readied for "Public Comment"
By Richard M. Doerflinger
Even as evidence mounts that destructive embryo research is unnecessary for medical progress in "stem cell" research, the Clinton Administration is stepping up its efforts to force taxpayer support for such experimentation.
Since stem cells are primitive cells which multiply quickly and are not completely specialized to serve one function, researchers hope to harness their potential to grow a variety of new tissues as needed by the body. Most scientists agree that stem cells can revolutionize efforts to repair and regenerate human tissue, promising new treatments for illnesses such as Parkinson's disease and perhaps even the ability to grow new organs.
However, since November when three sets of researchers announced progress toward isolating human embryonic stem cells, it has become increasingly obvious that such cells need not be obtained by destroying embryos [see February 19 NRL News]. On January 30 the British Medical Journal went so far as to observe that "the need for fetal cells as a source of stem cells for medical research may soon be eclipsed by the more readily available and less controversial adult stem cells."
In the month of April alone, several events underscored the truth of this statement:
· The April 2 issue of Science announced new progress in obtaining stem cells from adult bone marrow and in directing them to form new bone, cartilage, and other needed tissues.
· In an article titled "Tissue Engineering: The Challenges Ahead," the April issue of Scientific American reported that adult stem cells and other new techniques will have "more immediate" benefits than embryonic cells, which researchers are not yet able to manipulate to create particular types of adult tissue. Since adult stem cells are versatile, but not as completely unspecialized as embryonic cells, they are easier to direct down a specific path of development.
· The April 13 Wall Street Journal summarized several recent advances showing that adult stem cells actually have an "advantage" over embryonic cells in battling disease.
· Finally, on a related issue, on April 21, Dr. Curt Freed of the University of Colorado released final results from his four-year federally funded study in using fetal tissue transplants to treat Parkinson's disease. The results were very unimpressive: No improvement in Parkinson's patients over 60 years old; among younger patients there was some improvement, but similar improvements were found in some patients in the "control" group who received surgery without any fetal tissue.
Ironically, on the same day it announced these results, the New York Times also reported on a new treatment described in the April issue of Neuron. Researchers transplanted monkeys' own "carotid cells" from their necks into their brains to relieve Parkinsonian symptoms. These cells may produce 35 times as much of the active ingredient dopamine as fetal cells do. The results in monkeys are extremely promising and researchers are now planning human trials.
In short, science is indeed marching toward a new world of repair and renewal for human organs - - but it might well be marching right past human embryo researchers.
Despite these other promising avenues of research, on April 8 the National Institutes of Health (NIH) released draft "guidelines" for funding embryonic stem cell research, and sponsored a public meeting where the guidelines were discussed by a "working group" of advisors. NIH's plan is to prepare revised guidelines, then publish them in the Federal Register for 60 days of public comment.
After further revision the guidelines will be reviewed by the Advisory Committee to the Director of NIH, and issued in final form by NIH Director Harold Varmus - - unless, of course, Congress votes to stop this misuse of the taxpayers' money in the meantime.
NIH's working group seems hand-picked to ensure complete agreement on moving forward with the guidelines. Three of the 13 members - - embryologist Brigid Hogan, philosopher Carol Tauer, and law professor Patricia King - - are veterans of the NIH Human Embryo Research Panel that unanimously recommended federal funding of lethal experiments on human embryos in 1994. The rest of the group is largely made up of researchers and organizations with a vested interest in pursuing this research.
The NIH named Dr. Ezra Davidson as co-chair, possibly to show how strong is its disdain for critics in Congress. It was Dr. Davidson's unethical experimentation on unborn children that provoked Congress to tighten federal standards on fetal research in the early 1980s. He had wanted to test a new diagnostic tool, the fetoscope, to see how often it risked causing a miscarriage. He tried it out on poor black and Hispanic women in south central Los Angeles who were planning abortions, reasoning that there was no harm done if the children involved were aborted a bit early by his federally funded experiment.
The NIH says the draft guidelines are in accord with Congress's current ban on funding research in which human embryos are harmed or destroyed, because federal funds will not be used for the specific act of dissecting embryos, but only for research on the useful cells which result. Yet at the same time, to assure critics that every precaution against abuse will be taken, the NIH will regulate the entire process of donating and destroying embryos for this research.
For example, stem cell researchers will have to present documentation to NIH showing that parents in fertility clinics gave their informed and voluntary consent to surrendering their "spare" embryos for destruction. (The NIH refers to these tiny victims of its policy as embryos "in excess of clinical need.")
The guidelines also obey an executive order issued by President Clinton in 1994, which said that federally funded embryo research must not use embryos specially created for research purposes. But there is a contradiction here. Beginning in 1995 and continuing to the present day, Congress has affirmed the President's ban on using specially created "research" embryos, but has broadened the ban to include experiments on "spare" embryos as well. If the President's policy applies here - - because embryonic stem cell research is really a form of embryo research - - then how can Congress's more authoritative and complete ban on the same subject be irrelevant?
At its April 8 meeting, the NIH working group also showed its lack of interest in alternatives that do not require the destruction of life. In fact, NIH declared that its guidelines cover all "pluripotent stem cell research" - - and then defined a pluripotent stem cell as one obtained from an aborted unborn child or a human embryo. When public witnesses pointed out that adult stem cells may also be "pluripotent" - - that is, they may be able to produce many different kinds of body cells - - the working group attempted some amazing sleight-of-hand with definitions.
Some members argued that adult stem cells are only "multipotent," and so are not as useful as "pluripotent" cells. But when they turned to another member, embryologist Brigid Hogan, to define the difference between "multipotent" and "pluripotent," she said the main difference was that "multi" is Latin and "pluri" is Greek!
In other words, there is no clear scientific difference between embryonic and adult cells to ground a judgment that only the former offer medical promise.
Finding itself somewhere in the middle is the National Bioethics Advisory Commission (NBAC), which was established by President Clinton in 1995. In November the President asked NBAC to study the ethical issues involved in embryonic stem cell research, especially its most bizarre variation, in which a human cell nucleus and a cow's egg are fused to produce an embryo that can be grown for a week and then destroyed for its stem cells.
NBAC has discussed the issue at several meetings, and may issue a final report in June. Yet the NIH is proceeding with its plans regardless, and may issue its guidelines before NBAC has a chance to say whether it finds them ethically acceptable.
At its April 16 meeting in Charlottesville, Virginia, NBAC did seem uneasy with some aspects of the NIH working group's approach. Several commissioners found the NIH's neat distinction between dissecting embryos and using the resulting cells to be unconvincing.
According to law professor Alexander Capron, a member of NBAC, it is "disingenuous" to say that using these cells does not involve the government in embryo research. To be sure, Capron's own view was that Congress's current ban should be changed to allow both embryo destruction and use of the resulting cells in some cases. But at least he and other NBAC members want this policy to be tested by an honest moral and political debate, not insinuated into place by an evasive reading of current law.
Most NBAC members seemed to lean toward approving stem cell research in the same two circumstances favored by the NIH:
harvesting primordial germ cells (the precursors of egg and sperm) from aborted children at about eight weeks' gestation, and killing "spare" embryos to obtain their stem cells. Like the NIH, NBAC members think it would be too controversial to harvest cells from embryos specially created for the purpose.
But some members seemed genuinely concerned about evidence that the distinction between "spare" and "research" embryos may be meaningless in practice. This author, testifying for the National Conference of Catholic Bishops, pointed out that in vitro fertilization clinics can simply create more embryos "up front" for each couple receiving fertility treatment, to make sure they will have more "spares" for research later. Professor Capron said he worried about this, but wondered if it could not be prevented by tighter regulation.
Another witness, Edward Furton, Ph.D., of the National Catholic Bioethics Center, raised a different problem: If cells obtained by destroying human embryos become the basis for future medical treatments, many Americans may have to refuse such treatments or compromise their consciences. Therefore it would be unfair to devote all taxpayers' funds to such an approach, and would even have less practical benefit than funding morally acceptable alternatives that all patients can accept. NBAC members said they would take this concern, and the prospect of morally acceptable alternatives generally, into account in framing their final report.
On the very day that it received strong testimony from two respected Catholic organizations, however, NBAC announced that it would hold an additional hearing soon to hear "religious perspectives" on stem cell research. This hastily assembled gathering, which only a few NBAC members bothered to attend, took place on May 7 in a library at Georgetown University.
Three Catholic witnesses were invited: Dr. Edmund Pellegrino of Georgetown, who opposes lethal embryo research; Father Kevin Wildes of Georgetown, whose testimony was more ambivalent; and Professor Margaret Farley of Yale University, a supporter of "abortion rights" who favors funding the research. The invitation to Professor Farley was interesting in light of the fact that she co-authored the American College of Obstetricians and Gynecologists' position paper in favor of destructive embryo research in 1994.
Protestant and Jewish ethicists with different views were also heard, as was a single Muslim scholar who acknowledged no moral status for the early human embryo. In soliciting a "full range" of religious views, including the most radical, NBAC clearly hoped to neutralize churches' opposition by declaring a lack of consensus.
Even as NBAC prepares its report, however, it seems obvious that the central debate will occur in the legislative arena. As the NIH prepares its guidelines for public comment, and Congress considers whether to amend this year's Labor/HHS appropriations bill to prevent this de facto override of its own embryo research ban, much will depend on how strongly Americans on either side of this issue voice their convictions.
Mr. Doerflinger, a frequent contributor to NRL News, is associate director for policy development at the Secretariat for Pro-Life Activities, National Conference of Catholic Bishops.