The End of the Stem-Cell Wars
A victory for science, for the pro-life movement, and for President Bush.
Dec 3, 2007, Vol. 13, No. 12 • By RYAN T. ANDERSON
Nonetheless, there are serious challenges to overcome before pluripotent stem cells--whatever their source--will be ready for clinical therapies. All pluripotent stem cells carry a risk of tumor formation. And no one has yet figured out how to convert these stem cells into transplantable cells usable for therapies. Markus Grompe, professor in the department of molecular and medical genetics at the Oregon Health and Science University, director of the Oregon Stem Cell Center, and a board member of the International Society for Stem Cell Research, told me that "the therapeutic potential of all human pluripotent stem cells, including those generated by direct reprogramming, remains uncertain. No immediate cures should be expected from human pluripotent stem cell-based therapy, either embryo-derived or iPSC. First, the tumor risk of such cells must be harnessed, and second, the efficient conversion to transplantable cells must be mastered."
But scientists are hopeful that these hurdles will be overcome. Grompe points out that stem cells have important uses beyond therapy, and for these uses, too,
iPS cells are clearly superior to embryo-derived stem cells. They can be used to study how human organs and tissues form. And the insights gained are likely to lead to the development of new drugs and strategies to benefit human health. Direct reprogramming techniques make it possible to generate pluripotent cells from specific individuals with particular diseases. For example, it will be possible to make pluripotent stem cells from children with Fanconi's anemia, a devastating genetic disease, and study the effects of candidate drugs on the formation of human blood. Another example, favored by Ian Wilmut, is motor neuron disease (Lou Gehrig's disease). Here it will be of interest to examine the formation of nerves and motor neurons from patients with the actual disease, in an attempt to discover ways to help the cells survive and function better. These kinds of experiments are now immediately possible and will likely be the first application of iPS cells.
Thus, iPS cells may very well help us discover therapies for some of the most daunting genetic diseases. And they should be able to do so at last without controversy.
The ethicists I spoke with had only praise for the new developments. While some Catholic moral theologians had previously worried that reprogramming methods "mimicked conception" and might produce disabled embryos, the new technique should alleviate all fears. Concerns that scientists might "go too far back" and reprogram a cell to a totipotent stage--making an actual embryo, not a stem cell--are quickly settled once one understands the science. To be an embryo requires not only a particular nuclear state, but also certain organizational factors that the oocyte cytoplasm provides. But no egg or cytoplasm is used in this method. Furthermore, two of the genes used for reprogramming--Nanog and Sox2--are never found in embryos, only in stem cells. Their expression in reprogramming precludes totipotency.
When I asked Father Thomas Berg, the executive director of the Westchester Institute for Ethics and the Human Person, about this concern, he replied, "From a Catholic perspective, reprogramming clears the bar in terms of reasonable concern for human dignity in biotech research: Never at any point in the process of reprogramming is there ever a danger of involving--even accidentally we might say--techniques that could bring about a human embryo, as would happen in cloning. The science of pluripotent stem cell research can move forward toward therapies and cures in a manner that is free of any ethical concerns."
What about all of those antiscience religious fanatics who used to scold about "playing God"? They don't exist. They're a media-conjured fantasy. Of all the many people I have talked with about stem cells, none has ever expressed any antiscience or antimedicine inclinations.
Princeton's legal philosopher Robert P. George, who also serves on the President's Council on Bioethics, told me, "From the beginning we have been arguing that we must do everything we can to advance the cause of stem cell science but without sacrificing our respect for nascent human life and the principle of the inherent and equal dignity of each and every member of the human family. This latest news just goes to show that it really is possible."
It also is illustrative of the politics of science. Had a President Gore or a President Kerry allowed the science to go forward without regard for moral principle, it would have set a terrible precedent. A Gore or Kerry presidency would have bestowed federal blessing and taxpayer funds on laboratory work predicated on the assumption that embryonic human beings can be treated as spare parts and that cloning to kill is acceptable.
But because President Bush stood his ground, we have avoided that moral catastrophe. Had Bush lost either election, or had he caved to pressure from those who slandered him as "antiscience," it is very possible that the new method of stem cell production--the new gold standard, in all likelihood--would never have been found. Most likely, science and the public would have accommodated themselves to the mass production and mass killing of human embryos.
Indeed, it is not Bush alone, but the entire pro-life movement, that has been vindicated. For the petition-signers and the direct-mail organizers, the philosophers and the scientists who have defended the sanctity of human life, the Cell and Science stories come as a reward. When I spoke with Robert George, he praised Leon Kass, the former chairman of the President's Council, together with William Hurlbut, as the driving intellectual force against embryo-killing and in favor of finding alternative methods of obtaining pluripotent stem cells. "All along," George reports, "it was Dr. Kass who said that reprogramming methods would, if pursued vigorously, enable us to realize the full benefits of stem cell science while respecting human dignity."
George downplays his own role in shaping the president's thinking. After Congress passed a bill funding embryo-destructive stem cell research, Bush sought counsel. His approval ratings were in the cellar, and the general public largely supported the bill. Shortly before announcing his response to the legislation, the president invited George and Grompe to the Oval Office to discuss it with him. George presented the scientific and philosophical case for respecting the human embryo, while Grompe assured the president that alternatives such as reprogramming, if given time, would win the day. The president agreed and announced his veto. He was right.
And Congress was wrong. Considering the realities of Washington, it is no surprise that the pro-embryo-destruction forces in the House of Representatives actually teamed up to defeat a bill that would have funded research on reprogramming, which they dismissed as a distraction. President Bush then issued another executive order, this one instructing the National Institutes of Health to promote reprogramming research. As it turns out, the breakthrough Thomson study was partially funded by NIH.
Stem cell research wasn't a prime issue during the 2000 campaign. Politically, the controversy wasn't yet ripe, though it became so just months into Bush's first term. Similarly, now, we don't know what the next biotech breakthrough will be. Whatever it is, we can be certain that some people will demand we pursue it. Having political leaders of principle who insist on ethical standards in scientific research, then, is always of the utmost importance.
At present, people on all sides of the old stem cell debate should be able to celebrate. The recent news gives scientists a better method of producing embryonic stem cells while retaining our nation's commitment to the equal and inherent dignity of all human beings. Richard Doerf-linger of the U.S. Conference of Catholic Bishops pointed out the happy irony: "The scientist who gave us human embryonic stem cell research has helped find the way to go beyond embryo-destructive research, and in response to these new findings, the scientist who gave us cloning tells us that the cloning agenda is on the way to being obsolete."
Ryan T. Anderson is an assistant editor at First Things. A Phillips Foundation fellow, he is the assistant director of the Program in Bioethics at the Witherspoon Institute of Princeton, N.J.