Several stories in the news recently have come from the field of embryonic stem cell research. U.S. District Judge Royce Lamberth issued an injunction against such research because a pending lawsuit seeking to ban it is likely to show such research to be illegal under a law called the Dickey-Wicker amendment. Dickey-Wicker is passed every year in budget legislation, and makes it illegal to use government funds to destroy human embryos. The lawsuit is being brought by two researchers who use adult stem cells and supported by various right-to-life groups.
George W. Bush opened federal funding for embryonic stem cell research limited to 21 stem cell lines started before his decision in 2001. Barack Obama opened research up to new lines, but required that they come from embryos conceived in vitro which would otherwise be discarded, and with the full informed consent of the woman or couple involved. Both they and Bill Clinton kept funding to research using derivative lines, and not for the initial culling of the embryos. All three believed that using these lines did not violate Dickey-Wicker.
On the other side of the tale, a first human trial using embryonic stem cells to treat spinal cord injuries has been approved by the FDA. In this trial, embryonic stem cells will be injected into 10 to 12 patients who have suffered spinal cord injuries within the two weeks prior to treatment, before scar tissue has formed. Another human trial, this one for patients with Stargardt’s macular dystrophy, a disease that begins in childhood and causes progressive loss of vision, is awaiting FDA approval.
The ruling, which the government is appealing, puts additional importance on the outcome of these trials.
Medical research is often fraught with ethical questions. Are we justified in using innocent animals to study diseases and to test potential treatments? How do we deal with trials on human subjects? Historically we have not always considered these issues. Notorious medical experiments have been carried out on human subjects without their knowledge, causing intense suffering and even death. Injecting human beings with disease or subjecting them to radiation requires considering them as less than human, and the groups used were often seen that way – black men in the Tuskegee experiments, or prisoners or inmates of institutions.
Moreover, our ethical considerations do not keep up with our technology. The very fact that we have so many embryos left over from fertility treatments and after a period of time discard them raises ethical questions. In other countries, fewer embryos are created for the same treatments. Personally, I think using them for medical research that could save lives shows more respect for the human potential in the embryos, and I think that the woman or couple in each case should be able to decide.
The area of stem cell research has been especially controversial. Stem cells are cells that have not yet become differentiated into a particular type of cell, such as a neuron or bone or skin. The most prolific source of such cells is of course an embryo, which in its earliest stages is completely undifferentiated. All the cells in an embryo have the potential to become any part of the body. There are some stem cells in adults, but they can only become a limited number of cell types.
The therapeutic potential of stem cells is in treating illnesses where replacing diseased tissue with healthy tissue, such as juvenile diabetes, or regenerating damaged tissue, as in spinal cord injuries. Degenerative diseases like Parkinson’s or muscular dystrophy could potentially be cured with treatment derived from embryonic stem cells. Some of the strongest advocates for embryonic stem cell research are those who suffer from such diseases, including famous people like Christopher Reeve and Michael J. Fox, or who have cared for those affected, like Nancy Reagan.
There are serious ethical considerations, including the potential saving of lives that could come from embryonic stem cell research, the risks involved, protecting the human subjects and making sure there is full informed consent without undue pressure. This is always an issue where the subjects are not facing immanent death without treatment, as is the case in many cancer or AIDS treatment trials. Careful oversight is necessary at all points. I believe that the legitimate questions are only obscured by the people who insist that an embryo that will never become a person, which will never even be implanted in a uterus, has all the rights of the people already alive and suffering from devastating diseases.