We have all witnessed the transforming power of hope—the focus and sustenance hope provides when strength and reason fail to pull us through a difficult situation. Facing tragedy and loss, hope is often the only thing standing between us and the void. Life-threatening illnesses or injuries provide some of the most poignant occasions for hope. We hope that a loved one will survive a critical surgery. We hope that cancer will respond to chemotherapeutic drugs. We hope, often against all odds, that this time, for this one precious and irreplaceable person, death will be thwarted and life will go on.
When medical science offers no legitimate hope for a cure, desperation and grief can drive people to grasp at any straw that might offer hope to them or to their loved ones. For many, herbal medicine or other “alternative” therapies become the vehicle for hope when medical science has done all it can do. For others, hope comes from beyond the realm of medicine. Faith often takes up at the limits of hope, to turn the eyes of the desperate to the source of all life, all hope, and all salvation. Facing death with dignity requires us to accept our mortality and find peace beyond the hope possible in this world.
It is precisely the power of hope, the ability of hope to provide solace and motivation in the most desperate situations, that makes the manipulation of hope such an appalling offense. The selling of false hope is a contemptible exploitation. Whatever comfort a false hope temporarily offers, it is far offset by the damage that is caused when the illusion is crushed by reality. Not only do bitterness and resentment replace the optimism a false belief once supported, but for the terminally ill it is often too late to go beyond bitterness and arrive at any kind of peace. To die an angry death, betrayed by hope and cursing those who have lied to you, is a fate few would wish on even their worst enemies.
It is difficult to imagine anyone so hardened by malice that he would intentionally mislead the desperate merely for the pleasure of watching a false hope deflate when it collides with the truth. Yet desperation is a powerful motivator, and the ranks of the desperate have more than once been exploited for the political, social, and economic gain of the unscrupulous. People with nothing to lose, who view a contest as a matter of life or death, tend to make formidable combatants. Marshaling armies of such “desperados” has been a strategy employed to great effect throughout history. No less so today in some fields of medical science.
Patients suffering from incurable medical conditions have been repeatedly used to influence the public and legislative debate over embryonic stem cell research. Setting aside the significant moral objections to experimenting on human embryos, there are very real problems with embryonic stem cell research on purely scientific grounds. As I recently discussed in these pages (The Basics About Stem Cells, January), employing embryonic stem cells as a therapeutic treatment for human illness faces the serious challenge of immune rejection by the patient. One of the proposed resolutions to this problem has been to replace the genetic information of the stem cell with that of the patient to generate a copy or “clone” of the patient that could be used as a source of replacement tissue.
In the face of strong public opposition to human cloning, proponents of embryonic stem cell research have advanced a tried-and-true tactic from the realm of product marketing: when people reject a product, repackage it and sell it under a different name. Thus human cloning has been effectively reborn as “somatic cell nuclear transfer” (SCNT), in the hope of selling a failed product under a different brand name to a public that is understandably hesitant to endorse the cloning of people for spare body parts. The contemptible aspect of this particular marketing scheme is the nature of the target audience and the role of false hope in the sales pitch.
I recently had a series of conversations with a woman dying of multiple sclerosis (MS). MS is a particularly cruel and painful disease that progressively robs a person of the ability to walk, to talk, and eventually even to swallow and breathe. The woman, by all measures a bright and well-educated person, was still in the early stages of her illness and was highly motivated to devote every last shred of her energy to promoting the “cure” offered by embryonic stem cell research. In a very real sense, this was to be her life’s work, her legacy. The rage and frustration she expressed at those opposed to human cloning was intense. How, she asked, could people deny her and others in her situation their last, best, and only hope for a cure?
How, indeed. In the face of such an emotional attack, many are driven to accept the imagined “need” for human cloning. The tragic irony, of course, is that the cure so many desperately hope for is based on nothing more than bald assertion. Proponents of embryonic stem cell research and human cloning have enlisted the ranks of the terminally ill not only to lend credibility to their claims, but to provide the valuable emotional trump-card of “How can you deny me a cure?” Those opposed to human cloning can be readily vilified as standing in the way of a cure—a cure that exists only in the hopes of the desperate and the speculations of a small number of scientists.
Perhaps the most distressing aspect of the current turn in the embryonic stem cell debate is that there are few constraints on where emotional exploitation can lead us. A year ago, the American public was asked to accept federal funding of research on human embryonic stem cells, based on the unsupported assertion that such research would cure human disease. Less than one year later, we are now being told that generating human clones is required in order for the true therapeutic potential of embryonic stem cells to be realized. At both junctures, patients with debilitating medical conditions were brought before the public to provide highly emotional testimony regarding their hope for a cure, and many Americans, swayed by compassion, reluctantly stomached their reservations.
What will the next twelve months bring? Will we next be asked to accept the need to “culture” therapeutic clones in artificial wombs for a few months until tissue-specific stem cells can be obtained from growing embryos? Perhaps the cloned embryos will need to be grown even longer, until usable organs for transplant can be “harvested.” While these scenarios may seem implausible (and would undoubtedly be dismissed as “preposterous” by embryonic stem cell advocates), the generation of human clones in the laboratory appeared to be equally preposterous one short year ago. The point is simply this: in the absence of credible scientific evidence documenting precisely how embryonic stem cells and cloned human embryos will cure disease, one can assert anything one chooses and all things can be equally justified by hope.
Proponents of embryonic stem cell research and human cloning are well aware that the future of this research cannot be debated solely within the realm of science policy. They have not succeeded in garnering public support on the basis of the scientific evidence, largely because there is no compelling evidence in support of their assertions. Even if strong scientific evidence existed, the equally strong moral objections to this research would undoubtedly persist. Advocates have also not succeeded in defining the matter solely in terms of scientific freedom and the pursuit of knowledge; the history of the last century amply illustrates the need to restrict scientific inquiry in some circumstances. In the face of these failures to recruit the public to their cause, advocates of human cloning and embryonic stem cell research have attempted to recast the issue as one of compassion and hope by marshaling the ranks of the desperate. The strategy appears to be: when you can’t win on legitimate grounds, win by any means possible. Such a strategy does not preclude outright deceit and emotional manipulation, all in the name of “hope.”
To offer false hope to the desperate as a means of advancing a political, social, or economic agenda is worse than merely cruel, it is objectively evil. Valuable resources are being diverted from other, perhaps more promising, areas of research, and, in the meantime, patients and their families are serving as pawns in a political arena. People facing the prospect of suffering and death deserve better than this. As patients, they deserve the best that science and medicine can offer. As human beings, they deserve honesty. No amount of false hope can alter the fact that after more than twenty years of unrestricted research on animal embryonic stem cells, this field has failed to yield a single cure for any human illness.
Embryonic stem cell research and human cloning go to the heart of how we view human life, both at its earliest and its final stages. As is the case for all matters of life and death, this research raises issues that are both painful and profound. Resolution of these issues should certainly not be based on unfounded speculation and emotional exploitation of those desperately hoping for a cure.
Maureen L. Condic is Assistant Professor of Neurobiology and Anatomy at the University of Utah, working on the regeneration of adult and embryonic neurons following spinal cord injury.