From stem cells to genetically-modified embryos, technology is outpacing ethical rules, and secular ethicists are at a loss what to endorse.
The decade-long tug-of-war between advocates of embryonic stem cells and adult stem cells continues. The retraction of Obokata’s quick-and-easy STAP method (Science, Nature; see 1/30/14 entry) for producing induced pluripotent stem cells (iPSCs) leaves other production methods unharmed. In fact, researchers are finding out that there’s untapped potential in the human body, Medical Xpress reported: “adult pluripotent stem cells are located throughout the body and are able to become every tissue, provided these cells receive the right instructions.” These cells act as a “reserve army for regeneration” in the body. The Editor of the FASEB journal is optimistic: “As the intersection between cancer and stem cell research becomes closer and clearer, all of today’s medical treatments will begin to look as crude as Civil War medicine.”
The CIRM Chronicles
With this arsenal of ethically-clear cells at the cutting edge of research, why work with human embryos at all? Proponents of embryonic stem cell research continue their quest—with nothing to show for it. Nature reports today that the California Institute for Regenerative Medicine, funded with $3 billion after a hyped ballot initiative promised medical breakthroughs with embryonic stem cells, is “on the line” to back up that hype with hope. In “Stem cells: hope on the line,” Erica Check Hayden reports,
A decade ago, voters in California changed the biomedical research landscape by directly funding embryonic stem-cell research. Now the organization they created needs a hit to survive.…
Californians voted CIRM into existence in 2004, making it the largest funder of stem-cell work in the world. The money — the proceeds of bond sales that must be repaid with $3 billion in interest by taxpayers — helped to bring 130 scientists to the state, and created several thousand jobs there. It has funded research that led to the publication of more than 1,700 papers, and it has contributed to five early clinical trials.
The institute has navigated a difficult path, however. CIRM had to revamp its structure and practices in response to complaints about inefficiency and potential conflicts of interest. It has also had to adapt its mission to seismic shifts in stem-cell science.
A decade later, no successful medical treatment has arrived. The real-estate developer, Robert Klein, who wrote and promoted the initiative and became CIRM’s first chairman of the board (till 2011), is at it again, because CIRM is running out of money. Promoting “CIRM 2,” he is depicting stem cell funding as warfare between science (i.e., pro-Obama liberalism) and religion (i.e., conservative ethics): “we will protect the freedom of science to ethically pursue knowledge in this country outside of religious ideology.” (It’s clear he thinks ethics can detach itself from religion.) With this angle, he hopes to tap another $2 billion from taxpayers to keep CIRM alive past 2017.
To stay alive, though, CIRM has had to latch onto the bandwagon of non-embryonic sources: iPSCs and other adult stem cells. That’s where the real progress has been made outside of CIRM (such as growing cornea tissue from adult stem cells; see Massachusetts Eye and Ear Center). Despite all the funding to CIRM, “they haven’t cured a patient,” a critic noted. Klein is backtracking, claiming that his Proposition 71 never promised cures in ten years. Hayden, though, retorts by quoting ads from the time that promised “curing diseases and saving lives.” One disillusioned voter says in a callout in the article, “I’m telling you, pal, I would have a hard time voting for it again.”
CIRM will “need a home run” to stay viable, Hayden says. Meanwhile, they’re shifting their hype from hope to attack on the religious right, using fear tactics. CIRM’s current chairman, Jonathan Thomas, put it this way: “If we don’t take a position now, the next ten years may see a theocratic government at the state and federal level that restricts scientific research in this country for the next 50–100 years.” So hand over another $2 billion, taxpayers.
One would hope that successful research that leads to tangible cures would not have trouble raising money without relying on the government dole. As for what he and Klein meant by working to “ethically pursue knowledge,” Hayden didn’t say.
Earlier in June, two scientists in Nature warned that researchers need to “sell help not hope” by regulating the stem cell industry. “Stem cells are being used as a wedge in calls to allow unproven medical interventions onto the market, warn Paolo Bianco and Douglas Sipp.” They view with alarm the charlatans in foreign countries who use the phrase “stem cells” as a draw. Nature’s editors could not point to a single treatment using human embryonic stem cells in its editorial, “Good practice,” advocating freedom to use them.
UC San Diego claims that cloned stem cells are better than iPSCs. The researchers claim that embryonic stem cells are the gold standard; cloned cells (somatic cell nuclear transfer), “in which genetic material from an adult cell is transferred into an empty egg cell” are almost as good, and iPSCs are third best. Since they involve extraction of an egg, cloned stem cells (championed by Mitalipov last year; see 6/12/13) have some of the same ethical issues as embryonic stem cells, which “have long been limited by ethical and logistical considerations.” Nature, though, says that “Nuclear transfer is ethically, logistically and technically more difficult” than iPSC work. “It requires young women to provide eggs and creates an embryo that is then destroyed for research.”
One letter-writer to Nature in June made it clear he knows what embryonic research is about. Even though he supports it, he admitted, “Central to the debate is the ethical status of the human embryo between fertilization and implantation.” Joep Geraedts wrote because he is irked by the “democracy carousel” of citizen campaigns that try to restrict research on human embryos.
Nature printed an article by an Arab, Rana Dajani, promoting Jordan’s new policy on research with human embryos:
There is no consensus on when human embryonic life begins, but the majority of Muslim scholars consider it to start 40–120 days after conception and therefore hold the view that a fertilized egg up to 5 days old has no soul — it is not ‘human life’ but ‘biological life’. So for many, there is no ethical problem in the Islamic faith with using an early embryo to produce stem cells.
There is a problem, of course, in Jewish and Christian theology. Why, then, should Nature consider this a policy that can “guide the Middle East” where many citizens do not concur with the views of “the majority of Muslim scholars”?
Three Parents and a Baby
Embryo researchers continue to push the line. New to the technology is the concept of “three parents and a baby” – using donor cells to bypass defective mitochondria in biological parents. The BBC News reported that the technology may be available within 2 years in the UK, making it hard for ethicists to contain a potential Pandora’s box. “Ethical concerns have been raised and some campaign groups are worried it could be the thin end of the wedge to genetic modification of people,” the article says. A headline from the University of Veterinary Medicine, Vienna says, “Three parents and a baby — Scientists advise caution with regard to artificial insemination method”. Even staunchly secular New Scientist asked, “Is the UK being too hasty over three-parent babies?” In that article, two bioethicists, Donna Dickenson and Marcy Darnovsky, think society needs time; at a recent public conference, “All those who spoke on the issue thought that allowing human trials would be premature.”
Key worries include remnants of mutant mitochondrial DNA that persist despite the treatment, and the disruption of complex interactions between mitochondrial genes and those in the cell nucleus. There are also daunting challenges in terms of designing meaningful trials, or safe ones, because pregnancy and childbirth pose major health risks for women with serious mitochondrial disorders.
Furthermore, MPs were troubled by a lack of proposals to legally require follow-up studies for a technique that may have implications not only for the children born as a result of it, but for their descendants.
Perhaps the headline on an unrelated topic is apropos: “Because we can, does it mean we should?” (The Conversation). PhysOrg reminds readers of the decades-long negative impacts of China’s forced one-child policy; now the country is attempting to “rebalance” the gender inequality, but it looks like too little, too late. Two letter-writers to Nature wrote about Germany’s ongoing skittishness with any practices that arouse “residual suspicion of genetic diagnostics after the sinister history of Nazi eugenics” (embryo screening being the current concern). The long-term impacts of bad ethical choices cannot be ignored.
Ronald Reagan famously said that the scariest words in the English language are, “I’m from the government, and I’m here to help you.” Some might want to replace “government” with “science lab.”
If citizens do not keep watch on them, their government and their scientists will get away with whatever they feel like doing. We are not lab rats for elites. While there are many honest men and women in these institutions, we need to realize that government officials and scientists act often with mixed motives. Government should exist by the consent of the governed. Similarly, scientific research should proceed by the consent of the society. Only an informed public, well-taught in the principles of ethics, can rein in mad scientists who treat embryos as personal playthings. And ethics without Biblical theology is like a ship with a short anchor. It provides some drag, but drifts wherever the helmsman wishes to go. Some secular “ethicists” don’t even provide drag; they speed up the route to the rocks.