Author: Victor Yee
Date: September 2007
Once and still almost heralded at a panacea, advances in stem cell research have come reasonably far in the past few decades, illuminating our understanding of how our bodies can continually renew and heal itself. With each step further in understanding ourselves, however, we have yet to begin to understand where to draw the line between bioethics and science.
Unfortunately, this lack of understanding has proven to be a formidable obstacle, transforming into a bitter political web extending from far left to far right, complete with Congressional wrangling, Presidential vetoes, presidential candidates, and ultimately an uncertain and unpredictable rocky road for stem cell research.
The advent of stem cell research began in the 1960s, when evidence of adult neurogenesis, the development of new neurons in the brain, challenged the old belief that neurogenesis in adults was impossible. Following this discovery came evidence that some types of cells were able to self-renew in mouse bone marrow and human cord blood, blood obtained from the umbilical cord at birth.
The first embryonic stem cells were isolated in 1981 from mice. Human embryonic stem cells were successfully isolated in 1998. These cells were obtained from donors who had undergone in vitro fertilization, a process in which sperm can fertilize eggs outside the womb for infertile women, that can produce excess embryos.
Embryonic stem cells hold vast potential because of their pluripotency, a state in which they can differentiate into any type of cell in the body. In a developing embryo, these stem cells hold the key in multiple tissue development. Embryonic stem cells are collected three to five days after the fertilization of the egg and before differentiation into specialized cells. Successfully collected stem cells continue to divide, becoming what is called an embryonic stem cell line.
Enter adult, cord blood, and amniotic stem cells proposed alternatives to embryonic stem cells. Adult stem cells are valued also because of their abilities to differentiate into specialized cells. However, adult stem cells are naturally multipotent, in which a given stem cell may differentiate only into closely related cells.
One such example include the capability of hematopoietic stem cells to differentiate only to myeloid, which include red and general white blood cells, and lymphoid cells, which are specialized white blood cells. Stem cells have also been found in cord blood and amniotic fluid, though potential of stem cells derived from these sources are still under debate.
The potential to recreate any type of specialized cell in the body is tantalizing and advocates of stem cell research champion it as the closest route to curing diseases such as Alzheimer's and Parkinson's, both neurodegenerative diseases, severe muscle and spinal cord damage, both permanent disabilities, and cancer.
The bioethical premises on stem cells mirror that of the abortion debate: when life begins, and whether we should act for the benefit of people today or the potential of tomorrow.
Arguing that life begins at conception are opponents of embryonic stem cell research. While the embryo is still as only large as a pinpoint, consisting of not more than 200 undifferentiated cells, they insist that embryonic destruction is equivalent to depriving a human of life. Many of these opponents also include anti-abortionists, who draw comparisons between the two, though of these, some, like Bill Frist, former Republican Senate leader, do support embryonic stem cell research.
Proponents of embryonic stem cell research counter that the majority of embryos created via in vitro fertilization are destined to die. These embryos could easily be put to better use by providing sources of hope for new medical treatments. Fertilization clinics throughout the nation have already piled up thousands of frozen embryos, awaiting the next piece of legislation.
Even trickier is nuclear transfer technology.
Scientists envision that stem cell treatment in the future will not require any procedure directly involving embryos but rather a sample of cells from a patient's skin. Termed somatic nuclear transfer and used to clone Dolly the sheep, nuclei from the skin cells can be inserted into an empty egg, from which stem cells will eventually grow. From this technique, there may possibly never be any need for blood donations or desperate searches for donor matches.
But this begs the question: if organs can be simply grown in the lab, what is there to prevent the cloning of an entire human (or an army of clones)?
Economics and Politics
Stem cell research is perhaps one of the most pressing issues in today's times. Its promise is undeniable and success almost inevitable. Its implications may far exceed even our most liberal expectations today. If stem cell therapy indeed succeeds, human life expectancy will skyrocket, leading to profound changes in world economics to human social interactions.
However, the road to such change is rocky, with economic and political pitfalls.
The National Institutes of Health (NIH) first began funding stem cell research under President Clinton who authorized the federal funding for stem cell research in 1993 via the NIH Revitalization Act, which also established an advisory panel on stem cell research.
The majority of biomedical research labs in the nation receive federal funding in one form or another from National Institutes of Health (NIH), which grants about $20 billion per year for biomedical research.
In just a few years, however, the Republican-majority Congress of 1995 passed the Dickey-Wicker Amendment, forbidding the creation or destruction of human embryos in federally funded labs.
After the passage of this legislation, researchers instead sought embryonic stem cells from privately-funded labs. These cells would then be used in government-funded labs, circumventing the Amendment.
But, finally, on August 9th, 2001, the new Bush Administration cut off this detour by declaring research with any and all embryonic stem cells created after that day banned, though funding for research involving existing embryonic stem cell lines would continue to flow, as "the decision for life and death had already been made". These stem cell lines, initially numbering over seventy, Bush contended, would be enough for researchers, though many now say that much fewer, nine at worst, are actually readily available without degradation.
After six years, this is basically still the same situation today, as bills, including H.R. 810 of 2005, S. 2754 of 2006 and S. 5 of 2007 have failed.
Both H.R. 810, the Stem Cell Research Enhancement Act of 2005, and S. 5., the Stem Cell Research Enhancement Act of 2007, were vetoed; S. 2754 failed in the House of Representatives. The passage of H.R. 810 would have reversed the Dickey Amendment and allowed NIH funding of research involving knowing destruction of embryos; S. 2754, proposed by Senator Santorum, would have furthered research into pluripotent stem cells in the place of embryonic stem cells.
S. 5, vetoed June 20th, 2007, was a combination of H.R. 810 and S. 2754, in which both embryonic and pluripotent stem cell research would be funded.
Federal research funds are implicitly understood to be the lifeblood of scientific research in America, with a proposed 136,850 million dollars allocated to research and development in fiscal year 2007, according to the National Science Foundation. Of these research funds, health is the largest nondefense research category, with 29,025 million dollars.
However, none of this can be used for research involving embryonic stem cell lines created after August 9th, 2001 a major blow. In addition, efforts to reverse this policy continue to seem fruitless, as bill after stem cell bill fail.
In light of such politics, the area of stem cell research has become increasingly hazardous where research proposals or even current federal research funds can be discarded or frozen at any time.
Furthermore, it almost seems that, as Democrats and Republicans further increase the exposure of stem cell research in their political platforms, stem cell research is becoming increasingly tied to the political tidal waves with issues not even remotely connected to stem cells. Democratic and Republican wins and losses are now almost synonymous with whether stem cell legislation passes or fails.
This means embryonic stem cell research in the U.S. will be closely tied to the Presidential elections of 2008.
Perhaps we can further our understanding of stem cell bioethics before then.
- By Victor Yee.