Aug. 9, 2004 - The U.S. ban on embryonic stem cells is making America miss out on medical advances, a prominent researcher argues.
The editorial, by George Q. Daley, MD, PhD, appears in the Aug. 12 issue of The New England Journal of Medicine. It comes three years after President George W. Bush's ban on federal support for research on embryonic stem cells created after Aug. 9, 2001.
The 21 embryonic stem cell lines created before that had to be grown with nonhuman animal products. This makes them unsuitable for medical use. Since then, scientists in other nations, notably Singapore, have created fully human embryonic stem cell lines. But researchers who accept federal support can't take advantage of these breakthroughs.
"The President's policy has severely curtailed opportunities for U.S. scientists to study the cell lines that have since been established, many of which have unique attributes or represent invaluable models of human disease," Daley writes.
Daley is associate professor of pediatrics at Children's Hospital and Dana-Farber Cancer Institute and associate professor of biological chemistry and molecular pharmacology at Harvard Medical School in Boston. He's also a member of the board of directors of ViaCell, a firm that banks and finds uses for stem cells taken from umbilical cord blood.
Not Just the President
The president's policy isn't the only problem, Daley says. A 1996 rider to the HHS appropriations bill forbids use of federal funds for any "research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death." This amendment, written by Rep. Jay Dickey (R-Ark.) has been renewed every year since then.
"Although most embryos created in vitro during fertility procedures are discarded, federal funds may not be used to ascertain what went wrong," Daley writes. "The Dickey Amendment prohibits federally funded scientists from deriving lines that model human disease. ... Such studies have an immediate, compelling medical rationale, yet they cannot be pursued with federal grants."
Rep. David J. "Dave" Weldon Jr., MD, (R-Fla.) is a strong opponent of human embryonic stem cell research. In his January 2003 testimony before a Senate committee, he argued that embryonic stem cell research has not been adequately explored in animal models and that nothing currently justifies the use of human embryonic cells for research. He advocates using adult stem cells, which do not require the use of embryos created during in vitro fertilization or by cloning.
"In fact, the real successes and advances are being made in the area of adult stem cells," Weldon testified. "Adult stem cells can be harvested from many areas of your body such as the marrow, fat tissue, even your nose. There are no immune rejection issues with their use, no moral or ethical objections."
But Daley says international researchers have already created about 50 new embryonic stem cell lines from in vitro fertilizations that, upon genetic testing, carried genetic diseases. These discarded embryos, he says, carry the genes that cause several deadly diseases. Yet U.S. researchers can't study them with federal funds.
"Many opportunities are being missed," he writes.
An Issue of Funding
Weldon has noted that nothing stops U.S. researchers from studying human embryonic stem cells. They just can't get the federal government to pay for it.
Daley argues that this is a big problem.
"Funding from private foundations or philanthropic sources ... seldom provides predictable, long-term support," he writes.
Daley and those who feel as he does may have to wait a while. Americans simply may not be ready to fund human embryonic stem cell research, bioethicist Carol Tauer, PhD, told WebMD in a July 2004 interview. Tauer is emeritus professor of philosophy at the The College of St. Catherine, Center for Bioethics, University of Minnesota, Minneapolis.
"Maybe we have to live with the situation for a while," Tauer said. "There is more private funding going into this, and there is money at the state level. At the federal level, I don't think the population of the U.S. as a whole agrees enough that this is a good thing to fund. I would not want to see it prohibited, but whether they should federally fund a great deal more research, I wouldn't want to push too hard on that."
Politics, Not Ethics
Arthur Caplan, PhD, says he's getting lonely. Caplan is chairman of the department of medical ethics and director of the center for bioethics at the University of Pennsylvania. With all this talk of stem cells, you'd think he'd be getting a lot of calls. But Caplan says nobody is interested in ethics any more.
"We are not having an ethics fight anymore, we are talking about a politics fight," Caplan told WebMD in a July 2004 interview. "People are digging their feet in. It is not a fight about ethical principals, it is who has got the votes. Nancy Reagan is not interested in an ethics discussion -- she wants to see research move forward."