Tamara Davis and Karen Greif
Prepared by Anne Dalke
(with assistance from Paul Grobstein)
Additions, revisions, extensions are encouraged in the Forum
Tamara and Karen suggested that the conversation focus on current
stem cell controversies, considering first the nature of stem cells
and ways they can be obtained, then issues of ethics related to
acquiring stems cells, and finally on the impact of these ethical
controversies on current and future stem cell research.
Stem cells are, in general, relatively non-specific cells that are
capable of forming the more specific cells that together make up the
various tissues, organs, and parts of the body (e.g., the various kinds
of cells in blood, the muscle/connective tissue/skin cells that make
up an arm). Embryonic stem cells are, it is presumed, capable of
giving rise to most or all of the different kinds of cells that make
up an organism (are "totipotent" or at least "pluripotent"); adult
stem cells seem more restricted in the kinds of cells to which they
can give rise. It was noted that there is a important distinction
between being able to create the various kinds of cells that exist in
parts of the body and being able to assemble them in the complex
three-dimensional shapes they need to be in to yield normal function ; recent advances relate largely to the former rather than to
the latter problem. It was also noted that the potency distinctions
among cells may well relate to how much one knows (and doesn't know)
about what external factors are necessary to cause cells to
differentiate in particular directions and may change with future
research in this area. The actual therapeutic use ("promise") of
stem cells also largely awaits ongoing explorations in this area.
Ethical issues arise because the original procedures to obtain
"totipotent" or "pluripotent" human stem cells involved destruction
of the embryos from which they were obtained.
The answer to questions about the "moral status of human embryo" depends on one's views about the nature of reality. If one has an understanding of developmental biology, a stem cell might be "just a ball of cells." If one believes that life begins at conception, destroying an embryo will involve destroying a life (mention was made of the "snowflake babies," children conceived from adopted frozen embryos). The "yuck factor" is ethically problematic:
the main road block is not scientific, but ideological.
Are there procedures that might be less problematic? If the motivation for biomedical scientists to "do the ethically troubling thing" is, in the long run, to create a source for cells which will repair bodily damage, is it possible--even preferable--for the stem cells to come from the individual organisms who need the cells? For example, there is a technique used in in-vitro fertilization, called "pre-implantation genetic diagnosis," in which a cell is "plucked out" and screened for genetic disease. Might we similarly "pluck out a cell" and develop an embryo from it, from which cells might then be taken? (Would this be creating, then destroying, a "twin"?) How about creating embryonic stem cells out of one's own body, by removing a nucleus, making a new embryo, taking stem cells (which are "in theory, unbiased") from it, and then generating cells to replace other parts of the body--that is, cloning or repairing the self? How about creating a mutuation that cannot develop--has no potential of becoming human (something with "a bodily presence," but, "like the brain dead, is legally dead")--then harvesting cells from that? There's "no hurry here"; we can take on different problems.
Well, there is a hurry. Nobody wants to die. None of the stem cell research is "near therapeutic usefulness," and will not be for at least five years. The federal government is refusing to fund research that is "potentially usable down the line," but is not now. Since the government will neither fund stem-cell research or allow scientists to use the same lab for independently funded stem cell research and federally funded research on other projects, other sources of funding are being generated. For instance, the recent passing of California Proposition 71 authorized $3 billion in state funding for
an institute on stem cell research.
Our conversation had been focusing on "national peculiarities." The fact of the matter is that many countries outside the U.S. are not prohibiting this research. It's "going to happen"--and if we don't change our policies restricting the sorts of research that can be done, we are going to experience a "brain drain": the research will go elsewhere.
Will "science and truth ultimately win," as they did when the story of the earth-centered solar system was replaced with a heliocentric view? Or will self-interest instead win out? The argument for the "sanctity of life" may be challenged, for instance, as more people get Alzheimer's, which will exacerbate the push to find cures. There is a "practical edge" to the emerging solution; it will no longer seem "evil" to try and stop this disease; "at a certain point," people will be "forced to give up their ideology." Our current legal standards about the termination of abortion, for instance, are not reconcilable with restrictions on stem cell research. So, too, with in-vitro fertilization, which is anathema to many Christians (although using technology "seems like cheating," 15% of the population has problems with infertility). There is also an obvious inconsistency between the arguments that human cells are precious, and that the death penalty is necessary. Connections between stem cells and cancer are also being explored, although it is clear by now that "cancer has no single cause"; "no magic bullet" will explain how cancer is activated.
But it is not clear that the development of medical technology has increased human happiness. What is the larger good? What sorts of scientific projects will "make humanity happier"? Might there be "better ways to spend our time and money" than on stem cell research ? If we decide that this is where our investments lie, then we have to deal with our political system, in which people are entitled to vote based on their beliefs. Should politicians trust scientists' belief that general good will come out of this research? Or might scientists acknowledge that "our bet and their bets" are based on the same evidentiary claim: a belief that what we believe is right? We have fundamentally different views of the big picture: some of us attend to randomness; others believe that "all that has happened was meant to happen." Where do we draw the line? Is there picketing around clinics that keep frozen embryos? Is is better to destroy those embryos, or to leave them cryo-preserved? And what's the difference?
This conversation is invited to continue on-line.
The brown bag discussion will continue in person next Friday, November 4, when Drew Mirante of the Geology Department will lead a conversation on nuclear energy. Nuclear power is the harnessing of energy from sustained, controlled nuclear reactions. Despite the potential for an inexpensive, clean source of electricity, the specter of a technology that was originally designed to kill scores of humans limits the use of nuclear power for providing energy. Should claims of the inherent danger associated with nuclear power (accidents, storage, disposal, theft of fissile material, etc.) outweigh the growing needs for power in the United States and emerging nations? Is nuclear power a necessary evil?