Although the issue of embryonic stem cell research has only recently become a topic of widespread public and political discussion in the US, the debate has been simmering on the back burner for months pitting pro-abortion and disease advocacy groups on one side against pro-life groups on the other.

Since the announcement in 1998 that human pluripotent stem cells—or cells taken from unborn children that maintain the ability to develop into virtually any cell in the body—had been successfully derived, private biomedical companies have considered US federal funding of embryonic stem cell research a key component to scientific breakthroughs, while politicians and researchers have been testing the public waters for reaction on the issue. Although stem cell research has vast potential for progress in treating diseases such as diabetes or Alzheimer’s, there is still the question of whether harvesting such cells from embryos is legal or ethical — or even necessary.

Geron, the company that licensed and funded research at both the University of Wisconsin and the Johns Hopkins School of Medicine, where the first derivation of pluripotent stem cells took place, called for public money to be spent on the idea, saying it “welcomes this conclusion because [National Institutes for Health] funding of research will broaden and accelerate progress in this important field.”

The enthusiasm for federal NIH funding is also widespread among disease groups, clinicians, foundations, and medical schools. Giving testimony on behalf of advocates of federal funding of embryonic stem cell research before the US Senate Health Appropriations subcommittee, paralyzed actor Christopher Reeve said:

It is our responsibility to protect the quality of life of the present and future generations. A critical factor will be what we do with human embryonic stem cells. These cells have the potential to cure disease and conditions ranging from Parkinson’s and multiple sclerosis to diabetes and heart disease, Alzheimer’s, Lou Gehrig’s disease, even spinal-cord injuries like my own. They have been called the body’s self-repair kit.

It is true that research using embryonic stem cells could prove very promising — but those who oppose federal funding of such research do not think that any potential in the biomedical field should have as its price tag human life.

Opponents maintain that the NIH proposal is both illegal and unethical. According to National Right to Life Committee (NRLC) Legislative Director Douglas Johnson, “This proposal would result in federal sponsorship and funding of experiments in which living human embryos are dissected and killed — a clear violation of federal law and of ethical standards governing non-consenting human subjects.”

The Republican pro-life senator from Kansas, Sam Brownback used an even stronger response during the hearings. He said the rationale of those championing the cause of embryonic stem cell research echoes that of the Nazis. After all, they thought that as long as Jews were being exterminated, they might as well use them for experimental research. And so for those who oppose funding of embryonic stem cell research, they hold that it is worse to perform a procedure that will kill an embryo so that its cells can be used and then discard it as garbage. For them, the dilemma is a simple one: it is never ethical or legal to kill one member of the human family to aid another.

The history of NIH funding
In the United States, beginning in 1975, human embryos, from the time of implantation in the womb, have been protected by federal law from any harmful research. Embryos in utero were considered human subjects and as such had protection under the law. No federal funding was to be given to research that harmed the embryo in utero.

Since 1996, Congress has also banned all federal funding for “research in which a human embryo or human embryos are destroyed, discarded, or knowingly subjected to risk of injury or death greater than that allowed for fetuses in utero”—with the passage of the Dickey-Wicker law. Thus the protection afforded to fetuses in utero was extended to all embryos outside the womb.

As recently as November of 1999, the National Bioethics Advisory Commission affirmed “wide agreement exists that human embryos deserve respect as a form of human life.” That same month President Clinton signed the Appropriations Act for the year 2000, which continued to ban the use of federal funds for research on embryos under the terms of Dickey-Wicker.

The issue
Days after Clinton signed the Appropriations Act, the NIH published its proposed guidelines for human pluripotent stem cell research (defined by the NIH as cells “derived from early human embryos or fetal tissue”). According to the NIH’s fact sheet explaining the legality of their guidelines, “The [Department of Health and Human Services] has determined, . . . that the Congressional restriction does not prohibit funding for research utilizing human pluripotent stem cells because such cells are not embryos. DHHS funds cannot be used for the derivation of stem cells from embryos.”

Thus the DHHS has made a distinction between using federal funds to derive embryonic stem cells and using federal funds for the subsequent research using those stem cells. Proponents maintain, then, that there is no federal law prohibiting NIH funding of such stem cell research. The Dickey-Wicker law only specifies that federal funding cannot be used in experiments that harm the human embryo.

Opponents of embryonic stem cell research see the legal matter in a different light. They call attention to the fact that the extraction of stem cells from an embryo causes its death—a fact admitted in the NIH guidelines themselves. According to the guidelines, those parents donating excess embryos are advised that their “early human embryos . . . will not survive” the process of extracting the stem cells. There is no effort on the part of the NIH to deny that embryonic stem cell research kills the subject, the embryo—it is the nature of the act of extracting the stem cells that causes death. The NIH asserts the legality of such research by pointing out that the extraction itself will not be funded with federal money—but all preceding preparation and the resulting research can be. According to the right to life advocates, it is clear that embryonic stem cell research protocol requires that harm be done to an embryo, an embryo currently protected from such harm under US law.

Thus it is that NRLC’s Johnson maintains, “Everything that precedes and follows the killing of the embryos is federally approved and federally funded, and it is a transparent and shameful pretense for the Administration to claim that the killing itself is not federally sponsored.”

What’s at stake
In the promise of embryonic stem cell research, proponents see the possibility for developing cures for countless diseases. The pluripotent stem cells have two enormous advantages over other cells used in research: they have the ability to divide into more and more cells indefinitely and, more importantly, they can be manipulated to form many different types of cells of the body. Thus these stem cells have been dubbed “building block” cells which one day researchers may be able to customize to replace damaged cells and tissues in individuals.

The NIH describes these pluripotent cells as being a “unique scientific and medical resource”—one that should be utilized—but other proponents have made a stronger case for their use. A group of American Nobel laureates, in a letter to the US President and Congress stated:

There are serious negative consequences of not allowing federally funded scientists to work with human pluripotent stem cells. . . . Stem cell research has enormous potential for the effective treatment of human disease. There is, therefore, a moral imperative to pursue it. Those who seek to prevent medical advances using stem cells must be held accountable to those who suffer from horrible disease and their families as to why such hope should be withheld.

And there is a growing concern that, if the government approves funding through the NIH on the argument that stem cells are not themselves embryos protected under the law, the floodgates will be open. What will the future bring? The NCCB asks:

On what basis, for example, would the NIH now refuse to fund research using hearts and livers harvested from . . . condemned prisoners who were executed by the excision of vital organs from their living bodies? Logically the policy would have to be that such research can use federal funds, because “a heart or liver is not a human subject.” The NIH’s claim that stem cells are not embryos proves nothing . . . opening up a broad arena for government-sanctioned abuse of human subjects.

Is this research necessary?
With a growing body of evidence indicating the viable potential of research using stem cells from adults, the NIH has had to answer concerns that embryonic stem cell research is not really necessary. After all, taking stem cells from adults can be done without causing harm to the subject. And, such research would avoid the whole debate over the ethical and legal implications of using embryos.

In response to this body of evidence, the NIH maintains that,

It is important to note that scientists who are leading the way in studying adult stem cells present compelling arguments why we must pursue research on both pluripotent and adult stem cells. While some stem cells are present in adults, there may not be an adult stem cell for every type of cell in the body, and they may be present in only minute numbers. In addition, they may be very difficult to isolate; for example, in the case of adult neural stem cells, they may be confined to certain regions of the brain that are not easily accessible. More importantly, pluripotent and adult stem cells are not qualitatively alike. In light of these limitations, it is important that we pursue research on both pluripotent and adult stem cells simultaneously.

The debate heard round the world
While the congressional debate over embryonic stem cell research continues, other countries in the industrialized world are having to address the issue.

The 1999 Annual Report of the UK’s Human Fertilization and Embryology Authority indicates that Britain is ready to embrace embryonic stem cell research. The HFEA is seeking to expand its current regulations to include issuing licenses for research to develop “therapeutic treatments for diseased or damaged tissues or organs” — which would include using stem cells derived from embryos. In publishing its recommendations, the HFEA added that, “One must, of course, respect the views of those who believe it is wrong to create embryos outside the body for either treatment or research. Yet we believe that for many years now, a clear majority of both the public and politicians has supported such work. . . .”

Parliamentary opponents to the expansions to current regulations (which include not only embryonic stem cell research but cloning using nuclear substitution into egg cells) have pointed out that the HFEA act may only grant licenses for research if the use of embryos is “necessary for the purposes of the research.” They maintain that the use of embryonic stem cells is a questionable necessity, as stem cells can be derived from adult tissue. But the bottom line in the argument is that harming one subject to aid another is always wrong. “The implication that research on human embryos involves some degree of moral wrong, but that this may be traded against possible benefits, is not only incoherent but contrary to all accepted principles of medical ethics as applied to research on human subjects,” said the All-Party Parliamentary Pro-Life Group, a caucus of pro-lifers in Parliament, in a 1999 position paper.

In Japan the Life Ethics Committee of the government released a draft report earlier this year stating that “with the future development of life sciences, formation of organs for transplantation from embryonic stem cells will become possible and applications to medical treatment including that of incurable disease are expected.” Thus it appears that the Japanese government is ready to endorse embryonic stem cell research. However, the report also suggested that using human embryos as a source of embryonic stem cells would necessitate the construction of a framework of regulations governing such research. The government invited the public to make its opinions known before a final report was submitted.

The case in Germany, however, is somewhat different. Current law “prohibits any research on and with embryos if the embryo is not the immediate beneficiary. Accordingly, removal of pluripotent cells from an embryo is prohibited in Germany. The preparation of embryonic stem cells . . . is carried out for reasons other than those aimed at preserving the embryo.” Thus the Deutsche Forschungsgemeinschaft (DFG)—Germany’s public funding organization for academic research—made its position on the matter clear and to the point.

While the DFG does not deny that such research might be of benefit, “the great potential . . . cannot be assessed yet precisely in its entirety . . . also . . . legal and ethical reservations exist against currently known methods of preparing pluripotent stem cells.” Still, the German government realizes that the debate on the issue is just beginning. Certainly that last word is not in on public opinion on the issue. And yet the DFG expresses the hope that any European standard “will include also a due assessment of existential values such as human dignity and health which are fundamental and guaranteed by the constitutional law.”

And so the legal and ethical debates continue — and will probably continue long after each country has “settled” the issue. If one considers the battle that continues between pro-life and pro-abortion contingents — and admittedly these are two strong, opposed factions in the embryonic stem cell research arena — it is a safe bet that the discussion is far from over.

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