http://interactive.wsj.com/archive/retrieve.cgi?id=SB996439681144384148.djm

July 30, 2001
Commentary
By David Baltimore. Mr. Baltimore, president of the California Institute of Technology, received a Nobel Prize in Medicine for his work on cancer.

Once in a long while, medical science comes up with a wholly new way to attack disease. A few years ago, such an opportunity presented itself with the discovery that human embryonic stem cells can be grown in large amounts. This provided science with a tool whereby new cells, tissues and organs could be grown that could replace diseased ones. No other technology offers such an opportunity. But nonetheless the Bush administration is considering banning federal funding of this very promising area of investigation.

Critics of stem-cell research allege that the embryos (which could come from either abortions or in vitro fertilizations) should be accorded all the protections available to a fully formed person. To me, a tiny mass of cells that has never been in a uterus is hardly a human being -- even if it has the potential to become human. By treating the use of such stem cells as akin to murder, we would lose a great deal.

Only embryos harbor cells with the potential to become every part of the human body. Such stem cells could be used to make up for the deficits in brain and pancreas cells that cause Parkinson's disease or diabetes. It is the only present hope that those who suffer from these ailments have. But curing their diseases will require a great deal more research -- research that a federal funding ban would disrupt.

Persuading stem cells to become tissues involves the work of many types of scientists. Some of these scientists need to be involved in learning to direct stem cells to adopt particular fates. This research involves using the use of inducing molecules, few of which are yet known. Once we know how to induce particular cell types, we will need to integrate them into various organs. If we can direct stem cells to form the insulin-producing cells of the pancreas, they could then be implanted directly because there is an existing organ structure in diabetic patients. The brain is a particularly important target because of Alzheimer's and Parkinson's diseases.

But even if we can direct stem cells to form the different types of neurons lost in these diseases, we will still need to learn how to make them wire up correctly with the rest of the brain after they are transplanted. The regeneration of organs like the liver presents even more challenges because it would have to be built from scratch. This requires not only producing the multiple cell types that it contains, but also precisely organizing these cells into a three-dimensional tissue structure. Scientists in the developing field of tissue engineering are concerned with how to build such structures.

If the president bans federal funding of stem cell research, no building supported by federal funds could be used for such work. Thus, a scientist working in a university -- where indirect cost recovery permeates all structures -- could not simply get funds from a company or a private foundation, and do the work in his or her laboratory. The work would have to be done in space physically removed from other labs. But the need for integrating the highly specialized work of scientists with different skills suggests that the work will proceed most effectively in the existing buildings.

It has been suggested that adult tissues might provide an alternative source of stem cells. This is simply false. Adult tissues are not known to have cells with the potential to become all parts of the body. In adults, certain tissues (e.g., skin, blood and brain) do contain specialized types of stem cells, but they are not generic stem cells with the same properties as those derived from embryos.

Critics of embryonic research point to the remarkable capabilities of adult bone marrow stem cells. Not only can they reconstitute blood, but, a flurry of recent papers suggest, if transplanted into other organs, they may be able to generate neurons, muscle, liver and perhaps other cells, albeit inefficiently. It would be wonderful if these reports held up, but they are a long way from being definitive.

For adult stem cells to be a viable alternative to embryonic cells, at least three uncertainties would have to be resolved in their favor. First, when adult stem cells take on a new fate, they would have to provide the complete range of function. This has not been demonstrated. Second, the few types of adult cells that can be grown in laboratories would have to be able to make all of the many cell types in the body. No one has even claimed such an ability. Third, the process of changing fates, which is at best a very rare event, would have to be made efficient and controlled enough to regenerate whole organs. We are not close to achieving this. While research on adult stem cells should be pursued, we would be mad to trade their great uncertainty for the clear and exciting potential already evident in embryonic stem cells.

It has been suggested that, as a compromise, President Bush could allow work to go forward on existing cell lines but that federal support of work with new lines be banned. Unfortunately, we will probably need new lines because existing lines do not necessarily provide all of the capabilities needed for therapeutic stem-cell derivation. Also, more than 30% of all pregnancies spontaneously abort, making it hard to know if even the few existing lines come from nonaborted embryos. And to complicate matters further, the existing lines are largely tied up by commercial interests. This is a compromise that will anger many and satisfy few.

Embryonic stem cells hold remarkable promise for reversing the devastations of human disease. If the U.S. government does not fund this work, it will progress slowly in private laboratories and in foreign ones. The publicly funded American academic research effort is far and away the most effective research enterprise in the world. To refuse to allow it to participate in this exciting research would be an affront to the American people, especially those who suffer from diseases that could one day be reversed by these miraculous cells.

Copyright © 2001 Dow Jones & Company, Inc.

Don't Destroy Human Life

http://interactive.wsj.com/archive/retrieve.cgi?id=SB996439308950259199.djm

July 30, 2001
Commentary
By Robert P. George, a professor of jurisprudence at Princeton University.

The debate over "harvesting" stem cells from human embryos has forced policy makers to think about a question that they would rather avoid: When does a new human being begin? Of course, this is a question that policy makers should have been thinking about in the context of the debate over abortion. They were relieved of that task by the Supreme Court's misbegotten decision to legalize abortion by judicial fiat. This time no court will let them off the hook.

Still, they are wriggling. White House advisers and members of Congress are looking for a solution or compromise that will enable them to avoid the question whether the destruction of human embryos is in fact the killing of human beings.

They won't find one.

The most recent attempt is by William Frist -- the highly respected pro-life Republican senator from Tennessee who happens also to be an eminent physician. The Frist proposal would ban the funding of research involving the creation of embryos for stem cell harvesting, while permitting the harvesting of stem cells from "excess" embryos created by in vitro fertilization. The argument is: If they will be disposed of anyway, why not make good use of them by dismembering them and obtaining their stem cells?

The trouble with the proposal is that it assumes, on the one hand, that embryos are human beings and therefore should not be brought into being for purposes of destructive research -- no matter how great the possible scientific and medical benefits. Yet it allows the destruction of some embryos.

We would, I hope, never permit or fund the harvesting of organs from retarded human infants, demented or terminally ill patients, or even death row prisoners. It wouldn't matter that death was expected in five months or five minutes. Nor would it matter that a dying patient, for example, was unconscious, even permanently unconscious as a result of a coma. Nor would we factor into our deliberation any consideration of the promise of what science or medicine could do with the organs. We wouldn't tolerate killing for purposes of harvesting body parts because it is inconsistent with the inherent dignity of all human beings.

So there is no avoiding the question: Are embryos, or are they not, human beings?

What is a human being? He or she is a whole, living member of the species Homo sapiens. Plainly gametes (sperm cells and ova) are not human beings. They are parts of other human beings. They lack the epigenetic primordia for internally directed growth and maturation as a distinct, complete, self-integrating, human organism. The same is true of somatic cells (such as skin cells).

Modern science shows that human embryos, by contrast, are whole, living members of the human species, who are capable of directing from within their own integral organic functioning and development into and through the fetal, infant, child, and adolescent stages of life and ultimately into adulthood.

It is not that a human embryo merely has the potential to "become a life" or "become a human being." He or she (for sex is determined at the beginning of life) is already a living human being. In this crucial respect, the embryo is like the fetus, infant, child, and adolescent. The being that is now you or me is the same being that was once an adolescent, and before that a toddler, and before that an infant, and before that a fetus, and before that an embryo. To have destroyed the being that is you or me at any of these stages would have been to destroy you or me.

In the current debate, the question whether a human embryo is a human being is usually ignored or evaded. When it has been faced, the arguments advanced for denying that embryos are human beings have been astonishingly weak. (Understandably, proponents of destructive embryo research have tied to shift the focus to its potential benefits.)

Some commentators say that human embryos don't "look like" human beings. The answer is that they look exactly like the human beings they are, that is, human beings in the embryonic stage of their existence. Others try to make something of the fact that embryos are tiny, or very immature, or dependent for full development upon implantation. Sen. Orrin Hatch has gone so far as to make the location of an embryo -- in a dish or refrigeration unit rather than in a mother's womb -- determinative of its moral status. But anybody who gives the matter some thought should recoil from the idea that factors such as size, stage of development, location, and state of dependency can be a basis for denying rights to human beings.

Then there is the claim that the argument for the human status of the early embryo depends on controversial religious premises about "ensoulment." It does not. The question is not about embryos' eternal destiny. That is a religious matter. (One on which the Catholic Church, by the way, has no official position.) There is no need for those of us who oppose embryo destruction to appeal to religion. The science will do just fine. We would be very pleased if those on the other side would agree that the scientific facts about when new human beings begin should determine whether government should fund research requiring their deliberate destruction.

Of course some proponents of stem-cell research are willing to concede the embryos are human beings. My Princeton colleague Peter Singer and other outright utilitarians deny that there is a principle of inherent human dignity that stands as an absolute bar to killing some people for the sake of a putative "greater good." So they typically see no moral reason not to dismember living embryos for their stem cells. By the same token, they see no moral reason not to kill human beings at any stage of maturity when, as they suppose can happen, some calculus of utility tips the scales in that direction. Hence, Mr. Singer's notorious defense of infanticide of handicapped newborns.

The concept of the "human non-person" -- a human being whose life can be deliberately destroyed, or who can be mutilated or enslaved, to serve the interests of others -- richly deserves the ignominy in which it has come to be held. Let us not accept the devil's bargain of reviving in the mere hope of scientific advances.

Copyright © 2001 Dow Jones & Company, Inc