The Stem Cell Hope, page 13
Adult stem cells had become the foundation of the pro-life movement against ES cell research. Why support the killing of embryos, these groups argued, when adult stem cells, obtained without the need for embryos, could prove just as scientifically and medically useful? Open questions about how relevant they were to finding cures for disease, and how equivalent they were to their embryonic counterparts, made them questionable stand-ins in most scientists’ view, but for those opposed to destroying embryos for research, they represented a logical solution to the stem cell debate.
That was the case for Richard Doerflinger, who oversees pro-life activities at the United States Conference of Catholic Bishops and became a vocal critic of embryonic stem cell studies. An effective speaker with a graying beard and avuncular demeanor, Doerflinger had been one of the few pro-life representatives attending the public meetings of the Human Embryo Research Panel in 1994, and, as they did for many of the panel members themselves, those discussions helped to shape his own views on the morality of using embryos for stem cell studies. While the scientists and many bioethicists were arguing from a utilitarian perspective that it was better to conduct potentially lifesaving research on IVF embryos that would be discarded, Doerflinger and the pro-life movement, including the Family Research Council and National Right to Life, were attempting to make a more philosophical assertion. “Catholic morality is largely based on the understanding that the first result of acts is the result they have on us, the people who do them,” he says. “They have an effect on our character. So we are involving ourselves in taking this step against life in a new way. It’s not just about ‘Is this embryo going to die anyway?’ ”
Doerflinger himself admits to coming to this perspective via personal experience. As a teen, his older brother was involved in a car accident that left him in a coma for several months. Told by the doctors that he would likely not wake up, Doerflinger’s family agonized over whether to keep his brother on life support. As they struggled with the decision, his brother regained consciousness, and while confined to a wheelchair, continues to enjoy a full life. It was nearly impossible after that experience, says Doerflinger, who had aspirations of becoming a doctor, to support any reason for taking a life. “We can never take a life, an innocent life, to help another life,” he tells me.
But are adult stem cells as potent as their embryonic predecessors? Without denying the utility of adult cells in treating disease, scientists argued that in order to truly harness the power of stem cells, they should be allowed to unlock the developmental potential of embryonic as well as adult versions of the cells. But the political rhetoric was forcing an artificial divide between the two, as if the government had to choose one or the other.
In an attempt to break down that barrier, HHS Secretary Thompson commissioned the NIH in spring 2001 to conduct a thorough review of existing knowledge of both embryonic and adult stem cells. The report was the most comprehensive analysis of the science on stem cells to that point, and listed an impressive roster of eighty-three leading experts who were interviewed during the two-month process. Ariff Bongso, the Singaporean scientist who isolated the first human embryonic stem cells but failed to keep them alive, was consulted, as were experts in Israel, Japan, Australia, and the United States. They, along with the NIH authors, combed through dozens of scientific papers in the field. “To date,” the report concluded, “it is impossible to predict which stem cells—those derived from the embryo, the fetus, or the adult—or which methods for manipulating the cells, will best meet the needs of basic research and clinical applications. The answer clearly lies in conducting more research.”
For stem cell scientists, it was hardly astounding or headline-grabbing stuff—it was simply a restatement of the argument they had been making all along. But the report was tailor-made for the nonexperts who now found themselves in the position of making critical decisions about the science. The report contained color diagrams of the process required to isolate and grow up embryonic stem cells; it touched on the latest science in how stem cells might help to yield new treatments in diabetes, neurological disorders, and heart disease. But perhaps most important, it laid out, for the first time in one place, the benefits and disadvantages of embryonic stem cells and adult stem cells—based solely on the science. Thompson had specifically asked the group not to weigh the ethical considerations, because other panels, including the Human Embryo Research Panel in 1994 and the National Bioethics Advisory Commission, had already attempted to wrestle with that aspect.
Adult stem cells, the authors wrote, were more difficult to obtain from patients since they were rarer. And once isolated, they tended to be more finicky on the culture plates; it was hard to grow adult stem cells in sufficient quantities to eventually transplant them, say, into an ailing heart or a diabetic’s pancreas. And that was assuming that the cells could be coaxed into developing into the specific cell types that a patient would need.
Embryonic stem cells, on the other hand, possessed remarkable plasticity and, in stem cell lines established thus far, appeared to grow more happily and robustly in the lab. The cost of this pluripotency, however, was the tendency to form tumors known as teratomas, the otherworldly mixture of a variety of differentiated cells. But according to the experts consulted, that danger could be averted with careful and proper culturing of the stem cells to keep them in their controlled, pluripotent state.
Rather than resolve differences between those for and those against embryonic stem cell research, however, the report only galvanized those on either side of the debate. On Capitol Hill, senators, representatives, and experts interpreted the report in their own pro or con ways. Testifying at the Senate hearing at which the report was released, Senator Orrin Hatch asked, “Why shouldn’t these embryos slated for destruction be used for the good of mankind? . . . To me, the morality of the situation dictates that these embryos, which are routinely discarded, be used to improve and extend life. I do not believe it would be wise to cut off support for embryonic stem cell research.”
Stepping to the microphone shortly after Hatch, Doerflinger reiterated his group’s position that funding such studies would be illegal, immoral, and unnecessary. Citing growing studies on the promise of adult stem cells in treating disease, Doerflinger took particular umbrage at the ethical ease with which some condoned research on excess IVF embryos that would be destroyed anyway. Calling such reasoning “sophistry,” he testified, “We do not kill terminally ill patients for their organs, although they will die soon anyway, or even harvest vital organs from death row prisoners, although they will be put to death soon anyway.”
The pressure was mounting—from both sides—for President Bush to take a position. Weeks before the report was released, Senator Hatch had penned a twelve-page letter to the president, addressing the apparent contradiction of his antiabortion position and support of stem cells head-on. “Stem cell research facilitates life,” he wrote. “Abortion destroys life; this is about saving lives.” It was possible, Hatch urged Bush, to be both pro-life and to support the study of embryonic stem cells originating from excess IVF embryos. Relying on a position that many bioethicists were beginning to take—that the moral status of an embryo is not equal across its entire development—Hatch told reporters, “I just cannot equate a child living in the womb, with moving toes and fingers and a beating heart, with an embryo in a freezer.”
Thirty-eight House Republicans wrote their own appeal to Bush, countered by an equally intensive effort by anti–stem cell House members urging the president to withhold federal support for the field. The party’s House leaders—Richard Armey, the majority leader; Tom DeLay, the majority whip; and J. C. Watts, the Republican conference chairman—released a statement questioning the moral soundness of the Rabb decision. “The federal government cannot morally look the other way with respect to the destruction of human embryos,” they said, “then accept and pay for extracted stem cells for the purpose of medical research.”
And it wasn’t as if the scientists were standing by idly, either. For academic researchers, dependent as they were on government funding through NIH to support their studies, no new work was planned with embryonic cells. Universities that relied on federal grants to support an entire campus’s worth of careers and experiments could ill afford to allow their one or two stem cell scientists to push on in defiance of the moratorium and put an entire facility in jeopardy of losing its government dollars.
Private researchers, on the other hand, could only see green—green lights to proceed where their ivory tower colleagues could not, and a potential financial windfall if their efforts panned out. At the very least, if they could successfully and reliably generate embryonic stem cells, they would hold the key to a sought-after resource—stem cell lines—if government regulations opened up to welcome taxpayer-funded studies. As it turned out, two private facilities took advantage of the regulatory limbo and did exactly what legislators and pro-life groups had worried they would do: They created human embryos specifically for research purposes, without any government or public oversight.
The first attempt came from a fertility clinic in early July. Paying women to provide eggs, and men to give sperm, scientists at the Jones Institute for Reproductive Medicine, in Norfolk, Virginia, mixed the two gametes together in a dish and allowed the fertilized embryos to grow for four to five days, at which point they scraped off the embryonic stem cells bundled inside the hollow blastocysts. From 162 fertilized eggs, only fifty embryos began to divide and grow, forty of which yielded three successful stem cell lines. (There was a certain irony that these pioneering research embryos were generated at Jones. It was a team of physicians at the Virginia clinic that had created the first American test tube baby, in 1981; while the skill set of the doctors there certainly made them naturals for manipulating embryos for stem cells, none of those early physicians could have imagined they would be working so assiduously to create embryos that someday would not help a woman to become pregnant at all.)
Not to be outdone, researchers at Advanced Cell Technology (ACT), in Marlborough, Massachusetts, now led by Michael West, who had by this time been forced out of Geron, revealed a day later that it had been working for a year on generating the first human clone. The project was not, stressed West, an effort to make clones of people, but to facilitate a method for obtaining patient-specific stem cells. Using the same technique that Ian Wilmut had used in cloning Dolly, West’s team was hoping to clone adult skin cells and grow the resulting embryos just long enough to extract their stem cells from them. Aware of the moral uneasiness that the work engendered, West reported that the days-old embryos had their own bodyguards, as well as constant video surveillance, to ensure that they would not be implanted into a woman’s womb to generate the first human clone.
Neither company, however, had achieved resounding success; Jones’s foray had resulted in a less than 0.2 percent success rate in culturing a stem cell line, while ACT had yet to see its first cloned embryo live long enough to yield the cells. But the impact of their announcements was clear—the science was here, and if the government wouldn’t fund or oversee it, then there were plenty of privately supported companies that would.
To proponents, these advances were a warning shot, a glimpse of the wild west culture to come if private enterprises, guided by good intentions and financial mandates, hijacked control of the technology. “This type of research is indicative of the problems we will continue to encounter if we don’t allow federal funding with strict research guidelines for embryonic stem cell research,” Hatch warned. “Without stringent, NIH ethical requirements, we are opening the door to an array of different research standards, which I believe could create some serious consequences.”
For Bush, the stunning announcements only meant that the chorus was getting louder. “People started calling in, and members of Congress wanted to be heard on the issue,” says Lefkowitz. “But we kept it very, very quiet. Even though everybody knew the president was thinking about this issue, it was a very small group of people—four to five people in the White House—who were actually involved in discussions with the president. It was really just Karl, Karen, Andy, and myself.”
“Which one of my children would you kill?” John Borden asked members of a packed House as his wife held up an image of three bundles of cells. Two of those bundles were now sitting in their parents’ arms, nine months old and wiggling under the scrutiny of their theatrical congressional debut. “Which one would you take?”
As a new father, Borden was testifying to prevent the government from funding research on embryos. One of the embryos in the picture, Borden explained, did not survive. But all three were destined to die until John and his wife, Lucinda, decided to adopt them from another couple that had frozen them and no longer needed them. Luke and Mark Borden were the human face that conservatives had been desperately looking for in their fight to ban embryonic stem cell research. While their opponents paraded a seemingly endless line of patients suffering from diabetes, spinal cord injuries, Parkinson’s, heart disease, and other conditions—along with an increasingly visible celebrity contingent, with the likes of Christopher Reeve and Nancy Reagan, whose husband, the former president, suffered from Alzheimer’s—stem cell critics had as their poster child only a faceless, nearly invisible embryo that barely filled the tip of a pin.
But now, thanks to Nightlight Christian Adoptions, those opposed to stem cell research also had a face for its cause. Several very adorable faces, as it turned out, of which the Borden babies were only the vanguard.
All the lobbying from both sides only heightened the intensity of Lefkowitz’s job, which was to keep President Bush informed of the science and ethics of stem cell science. Drawing upon scientific as well as literary resources to prepare the president, at one point, recalling a passage from Brave New World that would make his point about the hubris in controlling reproduction, Lefkowitz even brought his copy of the novel into the Oval Office for a dramatic reading. He found himself driving to work earlier and earlier to keep up with the president’s barrage of questions and requests for more information. A notorious advocate of the early to bed, early to rise philosophy, Bush, Lefkowitz admits to me with a smile, started his calls quite early.
“He would sometimes call me early in the morning to follow up on something he had read overnight in a memo I had given him, or a conversation he had had,” Lefkowitz says. “I didn’t want to get calls from him at seven o’clock in the morning. I was still coming out of the shower in Chevy Chase, Maryland, and he’d say, ‘How soon can you be here?’ I’d say, ‘Twenty minutes,’ and I could hear the dejection in his voice because by then he’d be going on to something else already.”
By mid-July, the press was percolating with rumors of a compromise position rather than an outright ban. Bush, some officials speculated, was toying with allowing federal funding of only existing stem cell lines. For scientists, however, it was less of a compromise and more of a concession that would limit their ability to create, study, and compare as many ES cell lines as possible. Buttressing this position, a report by MIT’s Rudolph Jaenisch detailed a startling range of genetic variability in mouse embryonic stem cell lines—and mouse clones grown up from the cells. Different lines had different tendencies to stay undifferentiated and, presumably, would generate slightly different types of specialized cells if they were allowed to develop fully. The science was so new, Jaenisch argued, that it didn’t make sense to limit study to just a few cell lines.
Outside the White House, proponents and opponents continued their pressure on the “agonizing” decision facing Bush. Nancy Reagan, having watched for almost a decade the devastating effects of Alzheimer’s disease on her husband, an icon of the antiabortion, pro-life conservative view, wrote a letter to Bush urging him to support stem cell studies. Michael Deaver, a Reagan loyalist and friend of Bush, hand-delivered the one-page letter to the White House.
Even the Pope weighed in, albeit indirectly, during a visit with Bush in July, noting in his formal statement to the president, “A free and virtuous society, which America aspires to be, must reject practices that devalue and violate human life at any stage from conception until natural death.”
As the stem cell summer of 2001 wound its way into the dog days of August, members of the House on opposite sides of the issue laid down one more ultimatum. With 260 members voicing their support of federal funding of ES cell research, opponents of the science introduced legislation that would ban human cloning.
Cloning had been a long-standing thorn in the side of the stem cell debate. Critics of ES cell research opposed any form of human cloning, including cloning that would create only days-old blastocysts never intended to become a human being but instead provide a source of human stem cells. Proponents of ES cell research urged a more refined view of the technology—most, including the leading scientists in the field such as Melton, Thomson, and Wilmut, opposed cloning for reproductive purposes—that is, cloning an embryo to implant into a woman’s womb so that it could develop into a baby. What they advocated instead was therapeutic cloning, which allowed cloned blastocysts to survive to five days, only long enough to yield embryonic stem cells.
By raising the cloning issue, however, those against stem cell research highlighted the slippery moral slope that they predicted would lead from stem cell studies to embryo farming and baby-making clinics. With such dangers front and center in the debates over the cloning bill, these critics hoped to convince more members of Congress—and the public—of the hazards of the science. The outcome might also influence the president as he continued to struggle with his own decision about what to do about stem cells. “There are certainly people who are not with us on the stem cell issue who are with us on cloning,” noted Doerflinger in a New York Times interview.
