Embryonic Stem Cell Research: Background, History, Current Policy, and Ethical Concerns
J. Benjamin Smucker
Fall '99, Biology Senior Seminar
Goshen College, Goshen IN
Thesis: Embryonic stem cell research should be Federally funded. Furthermore, Federal funding must be for both the extraction and use of embryonic stem cells, as the two are inseperable.
Stem cells are the newest "hot" topic in biological research. Very few other ongoing areas of research have been the focus of numerous articles, Presidential and Congressional scrutiny, and numerous ethical debates played out in the national media. This ongoing focus on stem cells is due in part to their amazing potential and in part to the controversial nature of one type of stem cell—the embryonic stem cell. The key question that is being dealt with is the issue of Federal funding for research with embryonic stem cells; the underlying issues of this simple question cause strong opinions and necessitate serious ethical considerations.
This study is intended to shape a personal position on the subject of Federal funding for embryonic stem cell research and a critique of the current status of such funding. However, outlining a position on this subject requires a background on all types of stem cells. In particular, some idea of the nature of various types of stem cells and the potential and realized uses of stem cells is necessary. Before outlining a personal position, an overview of the spectrum of positions and the evolution of the stem cell debate will also be required. Thus, the majority of this paper will outline the nature of stem cells, a history of the ongoing embryonic stem cell debate, and current policy regarding stem cell research. My personal position will then be juxtaposed alongside supporting and opposing opinions on the matter of Federal funding of embryonic stem cells.
Stem cells are a pluripotent cell type, able to differentiate into multiple cell types. There are many kinds of stem cells in the human body, though some are more differentiated to a particular function than others. Thus the term stem cell "commonly is used to refer to the cells within the adult organism that renew tissue."1 First isolated in 1997 by researchers at the Johns Hopkins Medical Institutions,2 the embryonic stem cell is a fairly recent addition to the list stem cell types. Embryonic stem cells are unlike any adult stem cell. They are only found naturally in the early stages of embryonic development and are totipotent—i.e. they can form ANY type of adult cell or adult cell precursor. Another type of stem cell which has properties similar to the embryonic stem cell is the embryonic germ cell, derived from the primordial reproductive cells of the developing fetus. Too often stem cells are lumped together into one category. However, all stem cells do not share common characteristics or sources and it is important to distinguish between various types of stem cells.
Embryonic stem cells can be derived by a number of methods.1
Of the above sources, only types A and B have been utilized. Type C represents a real option based on the knowledge that embryonic stem cells can be extracted from embryos and Type D would involve a similar process utilized in the well-known "Dolly" sheep example. As all the methods of obtaining stem cells are somewhat controversial, why is such extraction of cells and research being done?
There are a great many possibilities for the use of stem cells. Perhaps the most exciting is in the area of treatment of diseases and disorders. The ultimate hope for embryonic stem cells is for their use as a "universal human donor cell" an "in-stock item that could serve as raw material for new liver cells…or new spinal cord cells"2. The key here is that stem cell stock of various immunotypes could be stocked, allowing replacement of dysfunctional cell types in the body without need for cross matching immunotypes to a donor or suppressing the immune system. Such treatments have been proposed in particular for juvenile-onset diabetes, Parkinson's disease, and other disorders involving problems or defects in one or a few isolated cell types.3 Along this same line, treatments could be developed for AIDS by generating CD-4 immune cells from embryonic stem cells to replace those disabled by the HIV virus. Such approaches could also be used in regenerating tissue. For example it might be possible to repair damaged heart muscle by injecting new cardiomyocytes.4
Another possible use for embryonic stem cells include using the cells to study early embryonic development after implantation of the embryo into the uterus. Though embryonic stem cells are not capable of implanting into the uterus and creating an organism, they could be used to understand the factors required for onset of organ formation. Such studies have not been possible before, but many now see the use of embryonic stem cells as a way to study such developmental issues without needing to "grow" an actual human organism. Perhaps the most immediate use of embryonic stem cells would be to serve as "an unlimited quantit[y] of normal human cells of virtually any tissue type" for use in drug screening.5 This possibility arises because embryonic stem cells seem to be immortal when in culture (unlike cells taken from differentiated tissues) yet do not show the cancerous characteristics of most immortal cells. Current processes of obtaining and testing pure populations of cells with chemicals of medical importance is much more time consuming and expensive than would be the derivation of such populations from embryonic stem cells.
Unfortunately, many of the benefits outlined above are only theoretical or based on limited research. Lack of data to support the above possibilities is due to the lack of sufficient federal funding to explore such areas and the "newness" of the field of embryonic stem cell research. In order to understand this "newness" and the issue of federal funding, the history of the embryonic stem cell must be examined.
As previously mentioned, embryonic stem cells are new to the research scene. Though human embryonic stem cells were first isolated in 1997, little research with human cells was carried out due to federal restrictions on the use of embryonic tissues for research. These restrictions are placed in the by-laws of funding for the National Institutes of Health by the Congressional Appropriations Committee. The most recent update to this law was part of a 4,000 page appropriations bill passed on October 20, 1999. As quoted in Science,4 this law stated
"U.S. Funds may not be used for ‘the creation of a human embryo’ for research purposes, or for ‘research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death….’ The embryo is defined as any organism not protected as a human subject under other laws (such as those applying to fetal tissue) ‘that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes or diploid cells."
By this definition, the extraction of embryonic stem cells from embryos using federal funds is disallowed. Also, embryonic stem cells that were able to be isolated could only be multiplied 10 to 100 times, meaning quite a few embryos would need to be destroyed in order to obtain enough cells for routine use in clinical settings.6 Thus, the use of stem cells was clearly out of the question for federally funded research. However, a new method of culturing the cells soon changed the entire picture and created the heated debate which continues today. An outline of events within the last year is presented below in order to show the effect of new methods of culturing stem cells in changing views and polarizing interest groups.
Current policy regarding stem cells remains somewhat up in the air. To my knowledge, it is currently still deemed legal to use embryonic stem cells in federally funded research and illegal to fund the extraction of embryonic stem cells. Such policy is likely to remain, as it seems unlikely that either extreme (full funding for ALL research and extraction or no funding at all) will be able to gather enough votes to put their policy into law. However, the arguments over this single issue did slow the appropriation of funds to NIH and will continue to be a sticking point in governmental funding of research.
When I began researching this topic, I found myself comfortable with the status quo stance—I believed the government ought to fund the use of embryonic stem cells for research but not the extraction. My belief was based on a number of reasons. I believed that not funding the extraction of embryonic stem cells avoided the most controversial aspects of embryonic stem cells—destroying the embryo. I also believed that there were no obvious benefits to the extraction of stem cells using Federal money as opposed to private funds. As these beliefs broke down during my research, I found my opinion changing.
After spending time researching embryonic stem cell research and putting a good deal of thought into the subject, I have come to the belief that the current governmental position is untenable. Federal funding of stem cell research is an all or none issue. This belief is one that is echoed by many individuals on both sides of the debate. Frank Young, a strong opposition to research involving embryonic stem cells, made the point, "To say, on the one hand, that you cannot support the deliberate destruction of living human embryos to harvest their stem cells, but that you will, on the other hand, pour millions of dollars in support of research that you know can only take place using materials derived from that destruction, is an exercise in sophistry, not ethics."14 The National Bioethics Advisory Commission delivered an opinion supporting both the extraction and the use of embryonic stem cells. They delivered such an opinion because they found the separation of the two fields impossible. "Although some may view the derivation and use of embryonic stem cells as ethically distinct activities, we do not believe that these differences are significant from the point of view of eligibility for federal funding…. [The] separation rests on the mistaken notion that the two areas of research are so distinct that participating in one need not mean participating in the other." 1
In addition to finding the moral stance of the current Federal policy untenable, I believe that private funding is not beneficial to the research. This belief is echoed by the National Bioethics Advisory Commission. Public funding is desirable because it keeps a spotlight on the issues and ensures public participation and ethical considerations. Though the company that has funded research in extraction of stem cells—California based Geron—did establish a panel of ethical advisors,4 they also did the majority of their work outside of the public eye. Also, some news reports hint that Geron may be looking in to creating human embryos solely for the extraction of embryonic stem cells,15 a practice rejected by all individuals who have made public stances so far—from the most liberal to the most conservative in regards to the issue.
Furthermore, separation of extraction into the private sector with research in the public sector would take away from federally funded researchers "a detailed understanding of the process of embryonic stem cell derivation" which is crucial because "properties of embryonic stem cells and the methods for sustaining the cell lines may differ depending on the conditions and methods that were used to derive them."1 Derivation of embryonic stem cells in the same institutes and laboratories where they will be used allows a more detailed knowledge of embryonic stem cell use. Furthermore, private funding of embryonic stem cell extraction may entail more expensive treatments, as companies often retain some rights to experiments in which their product was necessary.
After coming to the realization that federal funding ought to be all or none (as outlined above), I found myself leaning to the "all" side. I believe that Federal funds should be made available for research involving both the derivation and the use of embryonic stem cells. I find the line of argument that one ought not kill one human being (the embryo) to save another (the patient) to be valid; however, the embryos used in obtaining embryonic stem cells are those that will be destroyed anyway. Since a source of embryonic stem cells exists, it ought to be used. Having said this, I am strongly opposed to the formation of embryos solely for the purpose of providing a source of embryonic stem cells.
I believe Federal funding of all areas of stem cell research will allow more expeditious development of treatments. In coming to this belief, I was swayed by the testaments of individuals who believe embryonic stem cell treatments will be of great benefit to them or those they love. Jordana Sontag has a 3-year-old-son suffering from Canavan disease, a disease which causes degeneration of the brain, leaving victims unable to move, speak, or see and causing death before adolescence. She says, "If anything’s going to cure my child, it’s going to be this."11 Michelle Puczynski, 15, who suffers from juvenile diabetes says, "If they don’t do this they are taking lives away from people, and they are pretty much taking my life away, too."15
As for the argument that adult stem cells provide enough possible research alternatives that embryonic stem cells are not necessary, very few people in the scientific community support such a conclusion. "Because important differences exist between embryonic and adult stem cells, this source of stem cells should not be considered an alternative to embryonic stem cell research."1The main difference is that adult stem cells are limited in their ability to form various types of cells; they are not totipotent. Furthermore, the entire field of stem cell research, adult and embryonic, is so young that we should not limit the areas of research until more discoveries have been made. If, at some point in the future, types of adult stem cells are found that are able to differentiate to form all different types of cells and tissues, the use of embryonic stem cells may become unnecessary. Unfortunately, it is too early to tell if such adult stem cells do exist and considerable progress can and should be made using embryonic stem cells from sources that would be destroyed anyway.
The debate over research on embryonic stem cells is a new, yet heated topic. An informed look into such a topic necessitates an understanding of the nature of stem cells, the history of the debate over stem cell use, and the current policy regarding stem cell research. After examining each of these areas, I have come to the conclusion that embryonic stem cell research should be Federally funded. Furthermore, Federal funding must be for both the extraction and use of embryonic stem cells, as the two are inseparable. This topic is not one that will go away and is not one that should have a law set in stone. Ongoing research may change the need for embryonic stem cell use—this is a topic that will require constant review and therefore must remain in the public eye.