The issue of research involving stem cells derived from human embryos is back in the news after a federal judge clarified that the government cannot use federal funds for such immoral research. Although the debate has been ongoing for almost ten years, the complexity of the issue and the peculiar terminology used often prevents many citizens from developing a fully informed opinion on the matter. To help, in some small way, redress that problem, I’ve compiled a brief primer, a “least you need to know” guide, that helps clarify and explain the questions most frequently asked about stem cell policy.
To those unfamiliar with the topic, this should provide brief non-technical answers to many of the important questions surrounding the policy. For those who are well versed in the controversy, I hope this will be a useful reference source to help you explain the issue to others.
What are stem cells?
The term stem cells refers to a diverse group of primitive cells that are themselves relatively undifferentiated and unspecialized. These cells are multipotent, meaning they can give rise to several other differentiated and specialized cells of the body (for example, liver cells, kidney cells, brain cells). All specialized cells arise originally from stem cells, and ultimately from a small number of embryonic cells that appear during the first few days of human development.
How are stem cells different than other types of cells?
Stem cells have two unique characteristics: (1) an almost unlimited capacity for self-renewal (they can theoretically divide without limit to replenish other cells for as long as the person is alive) and (2) they retain the potential to produce differentiated and specialized cell types. As stem cells within a developing human embryo differentiate within the cell, their capacity to diversify generally becomes more limited and their ability to generate many differentiated cell types also becomes more restricted.
Why are stem cells so important to research?
Stem cells are of interest to both scientific and medical research. First, stem cells provide a valuable tool for studying both normal and abnormal cellular processes. By learning how stem cells differentiate and become specialized, scientists hope to gain a better understanding of how cells in general work and what can go wrong. Second, stem cells may prove to be an indispensable source of transplantable cells and tissues for repair and regeneration. If stem cells can used to produce new and differentiated cells that are damaged because of disease (e.g., Parkinsons) or injury (e.g., spinal cord damage), it would transform regenerative medicine.
What are embryonic stem cells?
Embryonic stem cells (ESCs) are stem cells taken from from the inner cell mass of a blastocyst, a preimplantation embryo of about 150 cells. (Embryos are humans in the stage of development between fertilization and the end of the eighth week of gestation whereupon it it referred to as a fetus until the time of birth.)
Where do the embryos for ESC come from?
Currently, all embryonic stem cell lines have been derived from “spare” embryos created from in vitro fertilization (IVF) (i.e., embryos that have been conceived by a combination of egg and sperm occurring outside the body). However, because there are not enough embryos in existence to carry out the research, some scientists have been pushing for the use of human cloning (somatic cell nuclear transfer) to create the embryos that will then be killed and harvested for their cells.
What are adult stem cells?
The term adult stem cells simply refers to any non-embryonic stem cell, whether taken from a fetus, a child, or an adult. Adult stem cells are also referred to as somatic stem cells.
What is a stem cell “line”?
A stem cell line is a stem cell culture that can be grown indefinitely in the laboratory.
Why is there a controversy over ESC research?
The process of obtaining stem cells leads to the destruction of the human embryo from which the cells are taken. For those who believe that life begins at conception, embryo destruction is immoral even when it leads to beneficial research. Even those who do not believe that human embryos are deserving of full moral status worry about what the effects of normalizing such practices may have on society.
Advocates of ESC research, however, argue that it is unethical to impede potential advances that could heal disease and relieve the suffering of fully developed human beings. They believe that the moral status of a 150-to-200-cell early human embryo should not take precedence over scientific inquiry.
Didn’t the Bush administration ban funding of ESC?
No, but the Congress implemented its own ban. In 1995, Congress attached language to an appropriations bill prohibiting the use of any federal funds for research that destroys or seriously endangers human embryos, or creates them for research purposes. This provision, known as the Dickey Amendment, has been attached to the Health and Human Services appropriations bill each year since 1996. This law only prohibits federal funding of such research and does not affect either private funding efforts or private research that involves the destruction of embryos.
If the Dickey Amendment banned funding of embryo destruction, how was Bush able to allow such research to be federally funded?
In 1999, the General Counsel of the Department of Health and Human Services argued that the wording of the law might permit an interpretation under which human embryonic stem cell research could be funded. If embryos were first destroyed by researchers supported by private funding, then subsequent research employing the derived embryonic stem cells might be considered eligible for federal funding. The research would follow the prior destruction of human embryos but would not itself involve that destruction.
President Bush, seeking to find a way to fulfill the letter if not the spirit of the law, instituted a policy that made it possible to use taxpayer funding for research conducted on preexisting ESC lines, but would prohibit the funding of any lines created after August 9, 2001, the date of the policy’s announcement.
However, U.S. District Judge Royce Lambert recently rejected the government’s attempt to distinguish between the destruction of the embryo and research on the destroyed embryo as distinct “pieces of research”—one ineligible for funding and one eligible. They “cannot be separated,” the judge said. “ESC research is clearly research in which an embryo is destroyed,” Lamberth wrote. “To conduct ESC research, ESCs must be derived from an embryo. The process of deriving ESCs from an embryo results in the destruction of the embryo. Thus, ESC research necessarily depends upon the destruction of a human embryo.”
Since the government doesn’t prohibit private funding why does it matter if tax dollars are used for the research?
Besides making and enforcing law, the federal government is a major distributor of resources. When the decision to fund an activity is made, it is an official declaration of national support for an activity. When something is done with public funding, it is done, so to speak, in the name of the country, with its blessing and encouragement. Because there is no general consensus on the morality of ESC research, the federal government had chosen—prior to Obama’s inauguration—to withhold its full support even though it does not wish to entirely prohibit the activity.
Has embryonic stem cell research ever resulted in therapeutic treatments?
No.
Has adult stem cell research ever resulted in therapeutic treatments?
Yes, currently there are 73 treatments that have been derived from adult stem cells.
Are there any restrictions on adult stem cell research?
No. Because there are no moral issues surrounding that type of research, adult stem cells are available for funding. In fact, over the past ten years the NIH has allocated hundreds of millions of dollars to fund adult stem cell research.
August 24th, 2010 | 2:35 pm
Didn’t the Bush administration ban funding any research involving the creation of any new “lines” taken from live embryos, however? I am not saying that is a completely non-problematic position, I’m just saying that unless I’m mistaken about that, it doesn’t create quite the same impression as “the Bush administration didn’t prohibit funding but the Congress did.”
August 24th, 2010 | 6:39 pm
[...] ExplainedThe NS NewsEmbryonic Stem Cell Ban: Does It Matter?Politics Daily (blog)Reuters -First Things (blog) -HULIQall 1,363 news [...]
August 24th, 2010 | 11:58 pm
I’m not an advocate of embryonic stem cell research, but remain troubled by references to the list of “73 treatments” cited at stemcellresearch.org. These are presented as scientifically established and generalizable findings, certainly aren’t standard of care, and lack serious analysis of significance or proven benefit. Sloppily, the site’s simplistic insinuation of efficacy isn’t necessarily supported by the publications listed. Dubious hyperbole cuts both ways.
There’s also a potentially myopic strategic error in arguing that the basic flaw in ESC research is its lack of success thus far; the moral problem lies in the possibility that if it does succeed in providing applicable treatments (a reasonable expectation given time and resources), this “success” would stoke — and to many folks, necessitate — a practical appetite for the raw materials involved.
August 25th, 2010 | 1:52 am
One issue I have wondered about is not addressed here. As I understand it, with in vitro fertilization it is not uncommon for embryos to be produced which are never implanted, whether due to health issues for the mother, inability to afford a second implantation procedure, etc. In my mind the use of those embryos which would otherwise be discarded for stem cell research is different than creating new embryos for research.
Also, it seems to me that those who so strongly oppose stem cell research should equally be in opposition to in vitro fertilization if the possibility exists of embryos being produced which are not then implanted, but I don’t hear anyone discussing that issue.
August 25th, 2010 | 2:05 am
Questioning In my mind the use of those embryos which would otherwise be discarded for stem cell research is different than creating new embryos for research.
I agree that it’s different, but they are both unethical. Consider a analogy to organ harvesting.
Scenario #1: Since someone on death row is “going to die anyway” we decide to go ahead and harvest their organs, even though it will hasten their deaths.
Scenario #2: We create a baby to harvest its organs.
The two scenarios are different, but both are unethical.
Also, it seems to me that those who so strongly oppose stem cell research should equally be in opposition to in vitro fertilization if the possibility exists of embryos being produced which are not then implanted, but I don’t hear anyone discussing that issue.
Actually, that is a common complaint about IVF. Although IVF does not require that excess embryos be created, that is often what happens. I’ve spoken out about this quite often. If a couple has to create extra embryos that they will not be implanting then they should not choose IVF.
However, I agree with you that this is an issue that gets far too little attention.
August 25th, 2010 | 6:37 am
Is Scenario #2 as raised by Joe above not already relatively common?
Scenario #1 is of course barbaric, though not exclusively because of the organ harvest.
August 25th, 2010 | 7:18 am
Regarding therapeutic use of embryonic stem cells, it’s true that there is currently none.
What this fails to note, however, is that there has not to date been a randomized controlled trial which is most rigorous process by which we determine whether a treatment has therapeutic use.
There is currently an RCT scheduled to begin on people with severe spinal cord injuries after a trial involving lab mice showed promising results. Only after this and similar trials are actually done will we know whether or not embryonic stem cells have therapeutic usage.
August 25th, 2010 | 7:41 am
[...] Joe Carter gives us a good refresher course—or introduction, for some—on stems cells and the controversy. Here is an outline of the questions he briefly answers: [...]
August 25th, 2010 | 8:55 am
[...] here: A Brief Primer on Stem Cell Research » First Thoughts | A First … Share and [...]
August 25th, 2010 | 9:18 am
Money is better spent on creating real jobs, not this fantasy stem cells crap. They spend a billion dollars on research and all you get is scientific reports which are worthless.
August 25th, 2010 | 10:43 am
Don’t forget IPSCs: http://en.wikipedia.org/wiki/Induced_pluripotent_stem_cell
August 25th, 2010 | 11:30 am
People certainly do sometimes have (additional) children because they are likely to be compatible bone marrow or organ donors. It’s not that common but does happen.
I think the point Questioning was raising is not analogous to harvesting all the organs from someone who we haphazardly assume is going to die anyway. It would be unethical to pick a random person on death row and harvest their organs — they might be going through appeals still, or they might get pardoned. But if we knew that we could administer the death penalty in one way that would destroy all the person’s internal organs, or another way that would allow those organs to be given to and used by people who would die without them — shouldn’t we use the latter method?
Similarly, these are embryos that will be discarded already. If they are not used for stem cells, they will go in a waste bin. It seems sick and twisted to refuse to use them for scientific progress that could better humanity — just as it would seem sick and twisted to use an execution procedure that would fry all of a criminal’s organs and prevent them from ever being transplanted.
August 25th, 2010 | 11:39 am
One other thing. Orleyspal above raises concerns about the “73 treatments” claimed as resulting from adult stem cells. This is very important to remember. But additionally — it seems incredibly disingenuous to talk about major barriers to getting funding for embryonic stem cell research, and then claim that a lack of existent therapies is an argument against funding the research. Perhaps if there had been funding, and a social attitude that this was something worth looking into, there would be more results we could point to now. I mean, come on, this is a terrible argument.
Please also remember that not all of this research is solely about “therapeutic treatments.” Sometimes, science is about learning things, gaining knowledge. We don’t always know right off how those things might be put to use in the future, but the more we learn and understand, the more we’ll be able to do. Embryonic stem cells are being used as a model system to understand human genetic disorders, which has already led to some early diagnosis methods, and is likely to lead to treatment options in the future.
August 25th, 2010 | 11:46 am
Right, but it’s sick and twisted to “discard” them (i.e. leave them to die) in the first place, so really, this is no better than touting the great scientific advances we could derive from Mengele’s work, if only we were willing to pursue it.
August 25th, 2010 | 12:01 pm
The general public is not opposed to IVF. If you want to fight that fight too, go for it, but you can’t just presume it and pretend an intelligent argument has been made. The fact remains that IVF is still legal and commonly involves more eggs being fertilized than are ultimately used. By opposing the use of those extra fertilized eggs, you are throwing scientific progress (and potential lives saved) into the waste bin with them.
We use the organs from murder victims for needed transplants. Yes, it’s sick and twisted that someone committed murder and that this resulted in a corpse. But it’s a lot more sick and twisted to let that stop you from saving lives. And using those organs doesn’t mean that we are doing the moral equivalent of going out and stabbing people to death, nor does it encourage people to do so. Think of it as turning lemons into lemonade, if that helps you.
August 25th, 2010 | 4:50 pm
First, I doubt murder victims actually ARE used for transplants, unless the murderer somehow delivers the victim to the transplant center and confesses committing the lethal act before the person actually expires, so that the organs are still usable in time for a transplant without the need for any examination to gather forensic evidence. Normally, the body can’t be made available fast enough for organs to be transplantable, due to not dying in hospital conditions, needing an autopsy, and so forth.
However, even if I’m wrong about that, the parallel doesn’t hold unless the people responsible for discarding IVF embryos are prosecuted for murder and the practice is legally discouraged, rather than condoned.
“The general public is not opposed to IVF. If you want to fight that fight too, go for it, but you can’t just presume it and pretend an intelligent argument has been made. The fact remains that IVF is still legal and commonly involves more eggs being fertilized than are ultimately used. ”
All of which I was previously aware of, and none of which changes the moral calculus of destroying the embryos by any means, for any side benefit, or none.
September 1st, 2010 | 9:47 am
[...] Here is an outline of the questions he briefly answers: [...]
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