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Monday, May 23, 2005

Stem-cell research and today's vote

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History is watching Congress today. Coming to a vote on the floor of the House are two stem-cell bills that, taken together, are indicative of the scientific progress and ethical dilemmas that have defined the modern era.

About one, the Stem Cell Therapeutic and Research Act, there is little controversy. The bill would establish a national umbilical-cord blood bank to allow researchers to continue study on adult stem-cell therapies. The other, the Stem Cell Research Enhancement Act, or HR 810, would allow federally funded researchers to use discarded embryos from fertility clinics to develop new stem-cell lines. Both bills are expected to pass. President Bush supports the former; he has promised to veto the latter.

The cord-blood bill has wide support for a number of reasons. First, adult stem-cell research avoids the ethical quandary involved with embryonic stem cells. As opposed to their counterpart, adult stem-cells are not harvested from human embryos. It's a field of research that has already produced proven therapies. So far, scientists have treated 57 diseases with stem cells extracted from umbilical cords. Among these are leukemia, Hodgkin's disease and other forms of lymphoma and sickle cell disease. Even more promising is a medical process being performed in Portugal, where Dr. Carlos Lima has successfully regrown spinal cord tissue using adult stem cells taken from a patient's nasal cavity. One young woman, Susan Fajt, who was paralyzed from the chest down, underwent the procedure and can now walk with the assistance of leg braces.

Embryonic stem-cell research, on the other hand, has not yet produced a therapy. Proponents often point to countries like Israel, China, Britain and South Korea, where researchers enjoy ever-increasing funding and a degree of scientific license not available in the United States. The argument is that the United States faces losing a substantial and potentially devastating number of scientists and industry leaders if it doesn't ease its research restrictions. This argument would be more compelling if these countries were actually producing therapies. This is not to suggest that embryonic stem-cell research will never produce a cure; there can be no certainty in these matters. The best judgment currently is that adult stem-cell and umbilical-cord based therapies offer great prospects for success, and that embryonic stem cells, because they can form a much broader range of specialized cells, offers the hope of successes not possible from any other source. The increasing investment in such research worldwide -- including the private sector -- suggests expectations of eventual success.

Moreover, last week South Korean scientists reported that they had developed a way to efficiently produce human embryos through cloning in order to extract stem cells. While HR 810 does not address cloning -- indeed, cloning is widely opposed by both Congress and the American people -- the report from South Korea shows that the rest of the world will not wait for the United States to resolve ethical questions. Embryonic stem-cell research will continue, with or without America's technological leadership.

Recently, there have been proposals, specifically from the President's Council on Bioethics, to bridge the ethical divide. We encourage the scientific community to continue studying these proposals. But as the debate moves forward we cannot accept certain claims to bypass our ethical concerns. For instance, proponents of H.R. 810 contend that because embryos from fertility clinics will be discarded anyway, we should let scientists study -- and destroy -- them. But we cannot so easily slip off the ethical hook. What others do is one thing, but if Congress and the American taxpayers are part of the process, we must justify our affiliation with such conduct -- regardless of whether the embryos would be destroyed anyway.

Just as the opponents of federally funded embryonic stem-cell research are on weak scientific ground in claiming that it isn't necessary because of adult stem-cell and umbilical-cord therapies, so supporters are on weak ethical grounds in saying they can vote for such policies without ethical consequence. Nor is such an important decision justifiable by a quick glance at public opinion polls.

In the final analysis, opposition is an ethical, not technological, judgment. Those whose religious or ethical values prohibit the extinguishing of a life will be fully justified in opposing federal funding for embryonic stem-cell research. Reduced American participation in an emerging technology will be the likely price of such conviction.

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