Friday, April 4, 2008
How to Break the Stem Cell Logjam
BY JESSE REYNOLDS

The embryonic stem cell research controversy may finally be moving to a new stage, and perhaps closer to a good outcome. For years, those afflicted with chronic disease have seemingly been pitted against those who consider stem cell research immoral due to the destruction of embryos. Each side has become entrenched, exaggerating or dismissing the latest scientific development as it suited their perspective.

A few months ago, the development of a new method to derive stem cells provided the opportunity to shake up these divisive politics. In fact, the first signs of a cooling in the stem cell wars may be visible. But both sides need to take this opportunity seriously or risk being marginalized as extremists.

In November, stem cell lines that appear to be as potent as those from embryos were derived from normal body cells. Significant scientific progress since then has made the new cells, called induced pluripotent stem cells (iPS), appear quite promising.

But unfortunately, a protracted political struggle can sometimes take on a life of its own. Each side comes to believe that it can benefit more from the continued existence of the debate than from resolving or even winning it. Its public prominence, political clout, and financial support begins to depend on the divisive nature of the argument. A political-organizational complex develops, and then ossifies.

The embryonic stem cell front has become bogged down in this dynamic. Advocates of stem cell research are downplaying iPS cells as “hype” after years of routinely exaggerating the potential of embryonic stem cells. Responding to commentators who voice hopes that the stem cell wars could be drawing to a close, these enthusiasts have focused on the shortcomings and early stage of research with iPS cells while ignoring the many remaining uncertainties of embryonic stem cells.

Granted, to some degree the research advocates are right about iPS. This is certainly not the time to end embryonic stem cell research. Much of what we know about pluripotency – which is what makes stem cells potentially useful for therapies – is known from research on embryonic stem cells. At the very least, they continue to be needed as a standard to which iPS cells can be compared. And it may turn out that embryonic stem cells have capabilities lacking in the new alternative.

Fortunately, there are also signs that the debate is cooling, and there may be a set of policies that will help achieve the potential of embryonic stem cell research while closing the door to the worst abuses. The prospective new approach is one that’s in line with public opinion, and that could be supported by policy-makers and candidates from both parties.

The potential first area of détente in the stem cell wars is over the use of the cloning technique known as somatic cell nuclear transfer (SCNT). In theory, stem cells derived from clonal embryos would not only be pluripotent but also genetically matched to the patient and the disease. The belief is that cell lines produced with SCNT would enable extensive and precise testing of new drugs. Some advocates hope that this method will someday yield patient-specific therapies. Yet after almost a decade of work, stem cells have never been derived from human clonal embryos, while iPS cells, which are also genetically matched to the tissue donor, have already been isolated.

Furthermore, cloning-based stem cell research raises complications unconnected to the moral status of the embryo. It requires large numbers of fresh human eggs, whose extraction poses health risks to women. And its development lays the technical foundation for reproductive cloning, a practice that is almost universally abhorred yet remains legal in most of the United States.

The lack of progress in cloning-based stem cell research and its problematic social consequences, as well as the appearance of a more promising alternative, led prominent cloning researcher Ian Wilmut to put it on the back burner. Within days of November’s iPS announcement, he told the media that he was abandoning cloning after ten years of work, due to the difficulty of the technique, the questions about its social consequences, and the appearance of a more promising alternative.

Now there is a sign of progress from the other political side. Leon Kass, former chair of the President’s Council on Bioethics and a long-time opponent of embryonic stem cell research, recently softened his stance. In a recent essay in The Weekly Standard, Kass suggested a four- or five-year moratorium on the creation of embryos for research purposes by any means, including by cloning. His intention is to allow enough time for iPS to mature, and his hope is that its success would make cloning-based stem cell research pointless when the moratorium expires. But if iPS does not fulfill its potential, then Kass is implying that he would find cloning for research acceptable, as long reproductive cloning is prohibited.

This is a reasonable proposal, and research advocates should respond appropriately. Refusing to do so runs the risk that stem cell advocates will come to be seen as a recalcitrant interest group that is unwilling to acknowledge changing facts on ground. In fact, surveys have shown that the majority of the American public, while generally supportive of stem cell research that uses surplus embryos from fertility procedures, is uncomfortable with, if not opposed to, cloning-based stem cell research. Furthermore, by voluntarily suspending cloning-based stem cell research, scientists and their advocates can diffuse calls for legislative moratoria or bans.

Conservatives must also give up some ground. Realism counsels that they concede that President Bush’s funding restriction on embryonic stem cell research is both unpopular and – even from their perspective – a failure. It has actually led to an increase in embryo research by creating the political momentum for state-level programs. In fact, the federal government would be better able to ensure that the research is ethically conducted if it is publicly funded. And in any case, the political viability of the Bush policy will soon expire, since it is opposed by a majority in the current Congress and by all the major presidential candidates.

The final piece of the policy package should be easier. Debate participants from all political corners should be able to agree on an issue closely related to stem cell research: regardless of the fate of research cloning, the United States should impose a ban on human reproductive cloning. It is one of the few industrialized nation without one.

These proposals could break the stem cell logjam. The entrenched partisans in the debate would each need to yield in largely symbolic ways. After all, it seems that cloning-based research is unlikely to yield much, and the revocation of Bush’s funding restrictions is inevitable. Policy would come closer to reflecting public opinion, and most importantly, allow society to reap the benefits of stem cell research while drawing lines to prevent the worst of abuses.

Jesse Reynolds is a policy analyst and director of the Project on Biotechnology in the Public Interest at the Center for Genetics and Society.

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