Half a Loaf is Not Good Enough

President George W. Bush announced on Aug. 9 in a nationally televised address to the nation that he had decided to restrict public funding for embryonic stem cell research to only those cell lines already in existence as of that day. He said at the time that there were 60 cell lines in existence around the world and that these should prove adequate to allow embryonic stem cell research to proceed (See also, "Stem Cells: Steady Momentum for Funding"). He also made it very clear that he would oppose any research that required the destruction of embryos or any research on embryos actually being disposed of at infertility clinics in the United States. In essence his position was there are 60 stem cells lines already in existence that have been created from human embryos that already have been destroyed. He regretted the destruction of those embryos, but what was done was done. Scientists may use cells from those human embryos in publicly funded research. But, since the derivation of any new cell lines would require the destruction of more human embryos, no other cell lines--not now and not ever--can be used. Bush's position was presented as a compromise. And many in the media, in the religious community, and in high political office accepted it as such. So have many in bioethics. The Bush compromise is no compromise. It is an absolute ban on embryonic stem cell research. The cells lines that exist are not readily available for research. And if the president is to be taken at his word, he will oppose any derivation of new cell lines. Does anyone in the scientific community really believe that it will be possible to see what human embryonic stem cells can do in the battle against disease and disability using the cell lines that currently exist? And if not, why aren't those in leadership positions saying so loudly and clearly? Existing cell lines will never be adequate to see what the potential is of human embryonic stem cells. Many of the cell lines are in other nations where private companies control them. They may or may not want to make them available to publicly funded scientists here since they may see American researchers as potential competitors. Many of the cell lines are of unknown quality. Still others are tied up by patents that promise to delight lawyers who represent organizations such as Geron, Advanced Cell Technology, and WiCell, but to frustrate researchers who may not be able to navigate the restrictions imposed on them by private concerns as a condition of working with these cell lines using public funds. Recently it was revealed that many of the existing cell lines have been grown on beds of mouse cell lines, raising the prospect that any clinical experiments made with such cells might have to be treated as xenografts, requiring extremely tight safety controls if they are allowed to be used at all. The scientific community knew most of this soon after Bush offered his compromise. Yet little was said in the way of protest either of the patent inadequacy of the 60 cell lines or the president's statement that the further derivation of more stem cell lines is ethically wrong by professional scientific associations or by leaders in the scientific community. Some organizations were remarkably restrained in their reactions, saying little more than that they were pleased to have the chance to do some stem cell research although concerned that Bush's compromise might slow the pace. Not much was heard from other societies and organizations in medicine, biology, and nursing. Similarly bland reactions echoed through the mass media from leading scientific voices who normally have no reservations about speaking bluntly where science is at issue. This "half a loaf is better than none" response is, to put it bluntly, pathetic. To base the kind of effort that needs to be undertaken on the utilization of stem cell lines that are all in private hands--many of which are not even in this country, none of which have been assessed for their stability or quality, and many of which may have been exposed to agents and manipulations that make them unsuitable for either basic or clinical research--is a pipedream. And allowing the president's assertion to stand unchallenged that it is immoral to destroy embryos for research or to use embryos destined for destruction or disposal in research is simply to accede to the view that human embryonic stem cell research ought not proceed. The American people do not support the view that it is wrong to use embryos that already exist but are going to be destroyed for scientific research as long as there is consent for their use. And while it is not certain exactly how many embryos doomed for destruction might be donated for research, it is most certainly the case that there will be far more embryos available from such sources than there will be from the already existing cell lines the president has said must suffice. The scientific community is not especially adept at politics. There is no reason that it should be. But the scientific community is adept at science. And the realities of the science required to permit a sustained and serious publicly funded effort to explore the potential of embryonic stem cells have not been adequately presented to the American people and its elected officials. If the American people do not want to pursue embryonic stem cell research on ethical grounds, so be it. They may be content to let private industry pursue this research and accept the secrecy and slower pace that will be the inevitable consequence. But, it is absolutely wrong for the scientific community to let stand the dual illusions that the cell lines already extant from human embryonic sources are sufficient to undergird a sustained research effort and, that there will not soon be a pressing need to derive more stem cells from human embryos if publicly funded clinical research is to advance. Arthur L. Caplan, Ph.D. (caplan@mail.med.upenn.edu), is director, Center for Bioethics, University of Pennsylvania.

Half a Loaf is Not Good Enough

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