Embryonic Stem Cell Research Policy

Rob Stein’s article in yesterday’s Washington Post was one of the few reports to recognize that in announcing his support for federal funding for embryonic stem cell research, President Obama left several big questions unanswered.

According to Stein, NIH insiders were caught off guard. They had expected Obama to say that cell lines derived at any date from donated embryos would be eligible for research dollars. That step removes the barrier set by Pres. Bush, who made funds available but only for cells from donated embryos and derived before August 2001.

But Obama’s statement raised new questions:

First, will federal funding be available for research involving embryonic stem cells taken from embryos that were created specifically for research? Second, will funding be available for cells taken from cloned embryos?

The first of these questions is of course the more urgent of the two. A majority of Americans appear to support the view that research using cells taken from donated embryos is morally acceptable. These embryos already exists by the hundreds of thousands in storage in the nation’s fertility clinics. Most seem to think that it is better donate them for research that could lead to medical breakthroughs than destroy them.

But is it right for scientists to create the embryos, just for research that will not help the embryo but will instead destroy it? Here’s where many draw a line. It will be interesting, to put it mildly, to see if NIH agrees. What NIH will need to do, of course, is to assess carefully the impact of funding research on cells from donated embryos but not on cells from embryos created specifically for research. Will such a line really hold back science?

My own view is that, within strict limits and only if there is a need that cannot be met another way, it is permissible to create embryos for research. I believe that position can be argued on the basis of Christian theology and ethics. I also know that I am in a minority, and I am willing to recognize that policy in this field must be respectful of the deeply-held moral views of the majority. Recognizing that this area of research is contentious, I think it might be wise for NIH not to press too far in changing the guidelines. Unless it can be shown that science is seriously compromised by limiting federal funds to cells from donated embryos, it would be wise to put the limit right there.

The second question—whether federal funds will be available for research on cells from cloned embryos—is a bit more speculative. One of the great hopes for cloned embryos is that researchers could develop patient-specific stem cell lines, first to test drugs on human cell cultures but perhaps to implant in patients without provoking the immune system. Now these hopes are largely addressed with the 2006-2007 breakthroughs in induced pluripotency. Whether cloning still provides a significant scientific advantage over induced pluripotency is something that will have to be argued.

If the argument for the need for cloned stem cells is compelling, then perhaps NIH should recommend that these cells be eligible for use in federally funded studies. But if not, then it would be best, I think, for the NIH to exclude this source of cells.

In his statement yesterday, President Obama was clear that he did not wish to open the door to reproductive cloning. Reproductive cloning is, of course, a far different thing that using cloning (more precisely, nuclear transfer) to create a cloned embryo for research. Even so, many in the general public link the two and object equally to both. Perhaps the most convincing way to close the door to reproductive cloning is to exclude funding for work on cells from cloned embryos.

On top of everything else, NIH will need to consider rules for informed consent, first of all for couples who donate embryos for research, but also for anyone who donates cells that are induced to become pluripotent stem cells. If that’s not enough, NIH and other agencies need to move forward to get ready to oversee clinical trials in this field.

All this is to say that the NIH will be doing two things at once. It will be closing the first stem cell debate (the Bush-era debate over the embryo as the source) and opening a whole new era of stem cell ethics, centered around the pluripotency of cells and of what they might become—in the laboratory, in the body of patients, and in the future of regenerative medicine