But while scientists are able to make great strides with tiny four-legged rodents, regulatory hurdles and institutional caution have slowed parallel human work to a crawl. To Daley, the delays caused by the Bush administration’s opposition to stem cell research are as much of an ethical issue as the handling of human embryos themselves, because it actively impedes progress on research that might benefit millions of Americans. The atmosphere of hypersensitivity surrounding the research, he says, has resulted in local institutions creating layer upon layer of oversight committees. “The sensitivities have really been ratcheted up,” he said.
Doug Melton points to “nonpresidential” equipment at the Harvard Stem Cell Institute. If this sticker were red, it would be forbidden to Melton, Daley, and their team.
Daley knows, because for several years his lab has been seeking approval to collect human eggs and embryos from several Harvard-affiliated institutions. As a result of the hypersensitivity, each medical center is a regulatory player, with its own institutional review board to oversee human biomedical research and its own embryonic stem cell review and oversight committee to monitor the ethical conduct of this controversial research. Mindful of public sensitivities, Daley opted to pursue experiments using what he considers the least controversial human materials to create new nonpresidential stem cell lines—poor quality embryos and oocytes that, in his words, “otherwise would have been disposed of as medical waste.”
Despite the low quality of this starting material, Lerou has made reasonably good progress. But the scientific challenge has been only part of the problem. “Every time concern is raised about one sentence on the consent form, it has to go back to four or five committees to get approval,” Daley said. “If the climate was different, if the president had said this is the science of the future, believe me, everyone all the way down the line would have been more comfortable getting this work moving. The president’s stance has had an incredible chilling effect on the pace of the research.”
Weissman of Stanford argues that the political and bureaucratic delays imposed upon stem cell research have interfered with a medical scientist’s ability to honor the Hippocratic oath, which places the health of patients above all other concerns. He has been making that point since 2004, when in testimony to the U.S. Senate, he warned embryonic stem cell opponent Sam Brownback of Kansas, “Those in a position of advice or authority who participate in the banning or enforced delays of biomedical research that could lead to the saving of lives and the amelioration of suffering are directly and morally responsible for the lives made worse or lost due to the ban, or even of a moratorium that would deny such treatments in that short window of time when it could help or save them.” It is “morally unacceptable,” he said in a recent interview, to make patients wait in order to satisfy religious and political opposition.
If delay is a moral issue, it is one that has been built into the stem cell debate from the beginning. Michael Sandel, a Harvard professor of political science who served for four years on President Bush’s bioethics panel, said the committee’s prolonged discussion of alternative methods of isolating embryonic stem cells could be viewed as an effort to diminish public support for the research.
Those alternatives have included an attempt, encouraged by panel member William Hurlbut of Stanford University, to create genetically maimed embryos that, because they were incapable of developing, could not technically be killed. In 2005, Rudolf Jaenisch’s laboratory at Whitehead reported preliminary success with this strategy, using mouse cells. But religious conservatives did not appear to be morally mollified by this technique, and even many scientists have taken a dim view of the experiments. In an editorial in The New England Journal of Medicine, developmental biologist Davor Solter dismissed such efforts, saying “manipulating science for the sake of politics is usually a waste of time.”
In his recently published book, The Case Against Perfection, Sandel concluded that President Bush’s stem cell policy does not even make ethical sense. “It is morally inconsistent to condemn the destruction of embryos in stem cell research,” Sandel said, “while permitting the destruction of embryos in the IVF clinics.” In contrast, Sandel argues that the opposition to stem cell research voiced by people like Richard Doerflinger of the United States Conference of Catholic Bishops is “morally consistent and principled” because they oppose any activity that promotes the destruction of human embryos, including in vitro fertilization. (IVF procedures inevitably create embryos that will later be discarded; there are an estimated 400,000 such “spare” human embryos in the United States alone.)
If the president’s philosophy—to restrict federal funding to research on cell lines created prior to August 9, 2001—lacks a principled moral basis that amplifies the view that the governmental obstacles imposed on stem cell research, and the delays they have caused, themselves represent an ethical problem. “The delay created by the president’s policy carries great costs that can only be justified if the right-to-life position is morally correct,” Sandel said. “But if it is not, then delaying the progress of stem cell research is morally indefensible.”
At any rate, Sandel believes that both the scientific community and the public at large have mostly come to a different moral conclusion than the Bush administration. “Despite the Bush veto, the opponents of embryonic stem cell research have lost the national debate,” he said. “It is virtually certain that the next president, Democrat or Republican, will ease the restrictions on funding.”
Even if that is true, it is little consolation for patients right now. George Daley, speaking of potential therapeutic testing of parthenote-derived stem cells (the sort that his lab reported isolating last December), said it was “reasonable” to assume that the technology wouldn’t be ready for human testing for another seven years.
Doing good science may turn out to be the best revenge of scientists struggling against these political impediments. Even as Congress lurches to and fro in its efforts to emancipate stem cell research, biologists continue to weave through the obstacles.
Kevin Eggan’s lab in Cambridge has been busy demonstrating the clinical potential of the research—and finding novel ways to create stem cells. Last May in Nature Neuroscience, his lab and a team at Columbia University reported that embryonic stem cells could be used to shed light on the origins of amyotrophic lateral sclerosis (ALS), the progressive neurodegenerative disease in which motor neurons in the brain die. Using embryonic stem cells, Eggan and his colleagues demonstrated that, at least in some cases of ALS, the affected neurons do not self-destruct but rather are poisoned by neighboring neural cells known as astrocytes.
