www.StemCellResearch.org

by Kelly J. Howell

The following is an analysis of the letter sent to President Bush on February 21, 2001, signed by 80 Nobel laureates, urging Federal funding for research using human embryonic stem cells.

To the Honorable George W. Bush,

President of the United States

We the undersigned urge you to support Federal funding for research using human pluripotent stem cells.

The term “pluripotent stem cell” is used with emphasis to imply that human embryonic stem cells (ES cells) can form all human tissues except “trophoblast” tissue. The trophoblast is an essential outer layer of cells in the early embryo, which allows implantation of the embryo into the mother’s uterine wall. To harvest embryonic stem cells, scientists must first remove this outer layer of the embryo. Therefore, the term is deliberately intended to imply that embryonic stem cells cannot reform an embryo because the trophoblast needed for implantation cannot be reformed.

The truth is, James Thompson, who led the effort that first isolated and grew embryonic stem cells in the laboratory at the University of Wisconsin, stated in the original paper (Science, 1998) that human embryonic stem cells may be able to form trophoblast in culture even after months of continuous proliferation of the cells. That implies, similar to the process of twinning, which is nature’s way of cloning a human life, the stem cells grown to confluence and allowed to pile up in an array of culture dishes, hold the potential to form multiple identical embryos or human clones of the originally destroyed human life.

So use of the term “pluripotent stem cell” is not only deliberately confusing but also inaccurate scientifically. Human pluripotent stem cell research is effectively a form of human cloning. This is a scientific fact that the signatories of this letter, as well as Harold Varmus, former director of NIH, ignore and in some cases deny. It is also worth noting that human pluripotent stem cell research is foundational to two other forms of human cloning: 1) therapeutic cloning and 2) reproductive cloning.

Therapeutic cloning creates a human embryo from an adult to duplicate and harvest cells that will be used to stave off disease, illness or the effects from sudden and serious injury. For example, an individual with Parkinson’s disease can be treated through stem cells. First a clone of the patient is made. The stem cells are harvested and then transplanted into the patient’s body. This would be considered a wholly curative procedure despite the creation and destruction of a human life in the process. We may already be on this road (e.g., Adam Nash).

Reproductive cloning creates a later born twin from a single cell of an adult by transplanting that cell into a human egg whose nucleus has been removed. The process is also known as somatic cell nuclear transfer. In this procedure, the resulting embryo is implanted in a woman and carried to birth. Proponents say this is a logical extension of infertility treatments. Interestingly, the infertility treatment known as in vitro fertilization or IVF is the source for embryos targeted for stem cell research.
Somatic cell nuclear transfer is, of course, used in both therapeutic and reproductive cloning. The end result for the embryo is the real difference. For reproductive cloning, the embryo is intended to live; for therapeutic cloning, the embryo is created to be killed.

We join with other research institutions and patient groups in our belief that the current National Institutes of Health (NIH) guidelines, which enable scientists to conduct stem cell research within the rigorous constraints of federal oversight and standards, should be permitted to remain in effect. The discovery of human pluripotent stem cells is a significant milestone in medical research. Federal support for the enormous creativity of the US biomedical community is essential to translate this discovery into novel therapies for a range of serious and currently intractable diseases.

Therapies and cures are frequently the emphasis that veils more sinister applications of otherwise unacceptable human experimentation. It is hard to say “No” when people we know and love are suffering visibly from diseases that scientists claim are curable with new research. Nonetheless, it has never been acceptable to sacrifice one set of human lives for the potential benefit of others. This is an issue entirely ignored in this letter.

The therapeutic potential of pluripotent stem cells is remarkably broad. The cells have the unique potential to differentiate into any human cell type. Insulin-producing cells could be used to treat – or perhaps even cure – patients with diabetes, cardiomyocytes could be used to replace damaged heart tissue, chondrocytes could be used for arthritis, and neurons for Parkinson’s, Alzheimer’s, ALS and spinal cord injuries to name a few examples. There is also the possibility that these cells could be used to create more complex, vital organs, such as kidneys, livers, or even entire hearts.

The “possibility that cells could be used to create more complex and vital organs” is likely to occur in the form of human reproductive cloning. Human reproductive cloning will be unstoppable if stem cell research and therapeutic cloning are allowed.

Such an inevitability will result in NO distinction between the technologies. The “early” embryos could be used for harvesting of embryonic stem cells. The “later” embryos/fetuses might become desirable sources of fully formed “young organs.”

It is questionable whether the casual blurring and switching of subjects between stem cell research, therapeutic cloning, and reproductive cloning technologies is intentional.

Some have suggested that adult stem cells may be sufficient to pursue all treatments for human disease. It is premature to conclude that adult stem cells have the same potential as embryonic stem cells — and that potential will almost certainly vary from disease to disease.

Studies done with adult stem cells do, in fact, show that adult stem cells have the capacity to form essentially any tissue. Unfortunately, more research dollars and effort are put into embryonic stem cell research than adult stem cell research because they have been held up as the panacea for disease and a fountain of youth. This occurs despite the scientific and ethical advantages of using adult stem cells.

Current evidence suggests that adult stem cells have markedly restricted differentiation potential. Therefore, for disorders that prove not to be treatable with adult stem cells, impeding human pluripotent stem cell research risks unnecessary delay for millions of patients who may die or endure needless suffering while the effectiveness of adult stem cells is evaluated.

It may be true that adult stem cells have some “restricted differentiation potential.” This disadvantage can be overcome with appropriate research dollars and effort. The results of Clarke et al. (“Generalized potential of adult neural stem cells,” Science 288, 1660-1663, June 2, 2000) provide striking evidence of unrestricted differentiation potential of adult stem cells (essentially replicating the experiments done in mice to show that mouse ES cells are totipotent).

Moreover, there are distinct advantages to using adult stem cells over embryonic stem cells. For example, one advantage is that there would be no rejection from transplanting one’s own isolated adult stem cells into one’s tissues. Use of human embryonic stem cells requires lifelong use of drugs to prevent rejection of the tissue.

By contrast, one grave disadvantage to using embryonic stem cells is that, injected into the body, embryonic stem cells can produce tumors from rapid growth. In the words of Michael Shamblott, a researcher in John Gearhart’s lab at Johns Hopkins, “Injected into the body, stem cells can produce tumors.” (See press release at: hopkins.med.jhu.edu/press/2000/DECEMBER/001225.HTM)

The therapeutic promise of pluripotent stem cells is based on more than two decades of research in mice and other animal models. This research confirms that pluripotent stem cells are capable of generating all of the cell types of the body. Most importantly, the therapeutic potential of these cells has already been demonstrated. Cardiomyocytes generated in the laboratory from these cells have been transplanted into the hearts of dystrophic mice where they formed stable intracardiac grafts. Nerve cells have successfully reversed the progression of the equivalent of multiple sclerosis in mice and have restored function to the limbs of partially paralyzed rats and insulin-secreting cells have normalized blood glucose in diabetic mice.

In fact, the work with insulin-secreting cells was done with adult stem cells not embryonic stem cells. (Ramiya, V. K. et al.; “Reversal of insulin-dependent diabetes using islets generated in vitro from pancreatic stem cells”; Nature Medicine 6, 278-282; March 2000.) Those who drafted the letter for the Nobel laureates were either grossly misinformed or purposely deceptive.

These findings suggest that therapies using these cells may one day provide important new strategies for the treatment for a host of currently untreatable disorders.

While we recognize the legitimate ethical issues raised by this research, it is important to understand that the cells being used in this research were destined to be discarded in any case.

Apparently, one of the “legitimate ethical issues” the laureates did not consider was the morality of using one group of powerless people to serve the medical needs of another group of powerful people. To suggest that it is permissible to use embryos for research purposes because an already tragic decision has been made to destroy them represents an absolutely chilling lack of moral conscience.

This mentality is consistent with Nazi medicine. Taken to its logical conclusion, prisoners on death row, the elderly, patients in chronic comas, mentally retarded persons, and others destined to die or be cast away from society could and should be used for experimentation in the name of furthering research to save others.

What is truly frightening is that there are a number of ethicists and other academics that already advocate this position. While Princeton professor Peter Singer is usually cited in this regard, others also hold a “utilitarian” view of human beings. See, “Is Bioethics Ethical?” by Wesley J. Smith, The Weekly Standard, April 3, 2000. www.weeklystandard.com/magazine/mag_5_28 00/smith_feat_5_28_00.html).

Under these circumstances, it would be tragic to waste this opportunity to pursue the work that could potentially alleviate human suffering. For the past 35 years many of the common human virus vaccines — such as measles, rubella, hepatitis A, rabies and poliovirus — have been produced in cells derived from a human fetus to the benefit of tens of millions of Americans. Thus, precedent has been established for the use of fetal tissue that would otherwise be discarded.

Note the use of legalese to create the appearance of an established position, despite knowing that a bad precedent only leads to another bad decision.

Alternatives to embryonic stem cell research not mentioned include the following. The best sources of stem cells are (1) from our own organs — termed adult stem cells or tissue stem cells; (2) cord blood (the small amount of blood left in an umbilical cord after it is detached from a newborn); (3) bone marrow stem cells which have been demonstrated to make more than blood but also bone, muscle, cartilage, heart tissue, liver, and even brain cells; (4) and neuronal stem cells which can be stimulated to make more neurons, or to take up different job descriptions as muscle and blood.

Bone marrow and cord blood are already successfully being used clinically, while clinical use of embryonic stem cells is years away. Current clinical applications of adult stem cells include treatments for cancer, arthritis, lupus and making new corneas, to name a few.

We urge you to allow research on pluripotent stem cells to continue with Federal support, so that the tremendous scientific and medical benefits of their use may one day become available to the millions of American patients who so desperately need them.

Please note that human embryonic stem cell research is illegal. It is illegal because federal law bars federal funding of any research that involves destroying a human embryo.

NIH Funding Guidelines sereptitiously evade the ban by permitting federally funded scientists to conduct research on cells removed from embryos by privately funded scientists. Nevertheless, complicity in the act of destroying the embryos for research purposes cannot be avoided by fiat. If NIH funds human embryonic embryo research they make taxpayers accomplices in the act of embryonic destruction.

Therefore, a first step may be to examine whether the Clinton administration exceeded its legal authority in deciding that the government should fund such research.

Yours respectfully,

Interestingly, while none of the Nobel laureates are ethicists, they attempt to make the case for the moral imperative for human embryonic stem cell research. While all of these men may be eminent scientists, they are less than qualified to render ethical judgments about the morality of such research.

Even more telling perhaps are the non-laureates whose names are found on the list of signatories. Included among the names are several researchers with Advanced Cell Technology, Inc. (ACT), the Worcester, Massachusetts biotechnology firm. Robert Lanza is identified, in fact, as a “corresponding author” of the letter.

“What,” one might ask, “is ACT’s stake in this matter?” Since the NIH Guidelines regulate government-funded research, why would they want to go on record on this issue? And why three of them?

Clearly, ACT and other biotechnology companies have a huge financial stake in how the public views their research. The fortunes of private biotech companies rise or fall on the public’s trust in the morality and safety of their research projects. If public sentiment turns against human embryonic stem cell research and its close cousin human cloning, ACT and other biotech firms stand to lose millions of dollars in potential investment.

Sadly, as with many contemporary moral issues, one only needs to follow the money to see how one’s ethical convictions are formed.

Analysis by Kelly J. Hollowell, JD, PhD with grateful assistance from David Prentice, Ph.D. of Indiana State University and C. Ben Mitchell, Ph.D. of The Center for Bioethics and Human Dignity.