More MS news articles for May 2001

Separating Good Biotech From Bad

http://interactive.wsj.com/articles/SB990576415291206404.htm

May 23, 2001

By Francis Fukuyama. Mr. Fukuyama, a professor of public policy at George Mason University, is writing a book on the politics of biotechnology.

The Bush administration will soon be facing a decision on whether to continue the existing ban on federal funding for stem-cell research, or to accept guidelines established by the National Institutes of Health that would permit such research, while seeking to minimize the need for embryos derived from abortions.

Sources within the administration, as well as a number of conservatives, have argued for keeping the ban, on the ground that stem-cell research can proceed using adult stem cells. This position is misguided and sidesteps the serious long-term issue raised by stem cells, which is the need for an institutional framework for the regulation of all human biotechnology, and not just research funded by the federal government. The administration ought to permit federal funding of stem-cell research, but extend the guidelines to all research done in the U.S.

Organs and Tissues

Stem cells are the undifferentiated precursors to the body's various organs and tissues. Adult stem cells have already begun a partial process of differentiation; those that exist in the walls of the intestines, for example, can turn into the various tissues of the gut, but not into nerve cells or a new heart. Stem cells derived from embryos, by contrast, are said to be pluripotent because they have the potential to develop into every other kind of cell in the body. Research on stem cells is expected to yield an ability to regenerate tissues and even entire organs. Since such regenerated cells can come from the patient's own body, the latter is much less likely to reject these than it is organs donated by another individual.

There are two types of concerns motivating the current ban on federal funding for research on embryonic stem cells. The first arises out of a fear that the cells will come from aborted fetuses, and thereby either encourage abortion or else retroactively justify the decision to have an abortion. The second has to do with the very fact that embryos are destroyed when stem cells are derived from them, which is itself seen as an affront to their dignity as human beings.

The guidelines that the NIH has suggested for embryonic stem-cell research more than adequately answer the first concern over abortion. They forbid the use of aborted fetuses for such research, forbid the deliberate creation of an embryo for research purposes, and seek to derive stem cells from the extra embryos produced by in-vitro fertilization clinics that were destined for destruction or indefinite storage.

The fact is that scientists will not need a lot of embryos to proceed with this research, since a stem-cell "line," once isolated, can be propagated almost indefinitely. One such line has already been isolated by University of Wisconsin biologist James A. Thomson, working with private funding. The likelihood that future research will create a demand for aborted fetuses or encourage any more abortions than currently take place is very small.

The second objection is harder to answer if you believe that destroying a 32-cell blastocyst is morally equivalent to infanticide. (I personally do not, but take seriously the concerns of those who do.)

But those who accept that premise must ask themselves why it is also legal for an in-vitro fertilization clinic to destroy these embryos, but impermissible to use them for research. Or to put it another way, if their concern is the deliberate destruction of embryos, why are they not bending every effort to ban in-vitro fertilization altogether rather than focusing on stem cells, since the former leads to massively greater levels of harm to embryos? Could it be that they are motivated by a utilitarian concern that voters would never abide banning in-vitro fertilization? And if so, why not concede the utilitarian interest we all have in future stem-cell research?

It is perhaps to avoid having to face such questions that advocates of the ban have sought refuge in the argument that the use of embryonic stem cells is not necessary, and that whatever benefits stem cells will provide can come from adult cells, or the stem cells in umbilical cord blood. To date, adult stem cells have indeed produced some dramatic results. Researchers have used stem cells to successfully treat mice specially bred to have strokes, and to grow a kind of white blood cell that is resistant to the HIV virus.

By contrast, there have been recent setbacks in therapies using embryonic stem cells. The New England Journal of Medicine has reported on an experiment in which fetal-cell transplants into the brains of patients during a clinical trial yielded extreme and irreversible side effects such as uncontrollable writhing and jerking. Pluripotent stem cells may in fact be too powerful, and, like the cancer cells to which they bear a certain resemblance, difficult to control.

Nevertheless, the argument that adult stem cells will provide all the benefits expected of embryonic ones is a dodge. It may be that they are right, but neither they nor anyone else will know this for certain until the research is done.

As Charles Krauthammer has pointed out, American conservatives, with their single-minded focus on abortion, are missing the boat on what is really at stake in contemporary biotechnology by worrying about the source of stem cells rather than their ultimate destiny. We should instead be asking whether we really want to manufacture new human body parts in the chest cavities of pigs, or whether immortality is in fact the appropriate goal of stem-cell research, as some of its proponents suggest.

Another issue that Congress has thus far failed to address is the need for a comprehensive regulatory framework for human biotechnology. Such rules as exist regarding issues like stem cells, germ-line engineering, human cloning, and human experimentation more broadly have focused on federally funded research.

This was fine in an age when the NIH funded the vast majority of biotech research. But today, there is a huge private biotech industry and hundreds of millions of loose research dollars seeking all sorts of morally questionable objectives. A couple of years ago, a small biotech company named Advanced Cell Technologies reported that it had successfully implanted human DNA into a cow's egg, and that that egg had successfully undergone a number of cell divisions into a viable blastocyst before it was destroyed.

It might come as a surprise to many that biotechnology is in a position to produce creatures that are part human and part animal, and that the law is indifferent as to whether it does so. If the Raelians or some other crackpot cult fund a human cloning experiment that results in the birth of a 15-pound, deformed infant, it is not clear that any U.S. law would have been broken -- as long as they had not accepted any federal research dollars. Nor is it clear which government agency, if any, would have jurisdiction over such a case.

Congress is working to fix the latter problem with the introduction of a law, sponsored by Rep. Sam Brownback (R., Kan.), that bans human cloning altogether. This step is a positive one, insofar as it courageously seeks to reassert some control over the development of morally questionable technologies. It is important for society to draw certain red lines about the limits of our own self-modification. But in many prospective areas of research, total bans on particular technologies will not be the right answer.

Complex Discriminations

As in the case of stem cells, most future developments in biotechnology will be ones in which positive developments will be intertwined with questionable ones. We will need to be able to make complex discriminations between the two. The same technology that will allow us to eliminate genes for cystic fibrosis or sickle-cell anemia from the human germ line may one day enable us to enhance competitively the intelligence or height of our children.

This implies the need for a standing regulatory structure that will be able to make and enforce distinctions between good and bad uses of biotechnology, on broader grounds than the safety criteria currently used by the Food and Drug Administration. And in the near term, it suggests the grounds for a possible compromise between those who want the current ban on federally funded research on stem cells to be lifted, and those who are concerned about encouraging further abortions. Why not accept the NIH guidelines for stem-cell research, but have them legislatively broadened to cover all research performed in the United States?