Little Cells, Big Issues

The Real Facts of the Debate on Stem Cell Research

By Cindy Province

Recent media attention has focused heavily on the issue of human embryonic stem cell research, due in part to the recent death of former President Ronald Reagan of Alzheimer’s disease, and statements in support of such research made by Nancy Reagan and Ron Reagan Jr. The issue has also become a political

football. Amazingly, at the recent Democrat national convention, the phrase “stem cells” was mentioned from the podium 20 times -- more than the words “unemployment” and “abortion” combined! A great deal of confusion surrounds the issue of stem cell research, which is understandable, since much of the language used to discuss the issue is very technical. Also, the proponents of embryonic stem cell research have done little to explain their research in terms that are easily understood by the general public. Why? -- because they don’t want you to understand it, they just want you to pay for it! Now please, bear with me as we begin with a few definitions that will help in trying to understand the issues surrounding human embryonic stem cell research. It may seem ridiculous to define the term “human embryo,” but for this discussion, it is necessary to re-visit even this very basic term. All of us, of course, learned in high school biology that a human embryo exists when the sperm of a human male and the egg of a human female unite. The new human embryo possesses a full set of 46 chromosomes, which means it is genetically human. Cell division then begins that will eventually yield a human fetus, then a human infant, then a human child and eventually a human adult. The normal course of events is that most of this process takes place inside the body of a human female.

Cindy Province

   However, advances in science and reproductive technology have changed this “birds and bees” scenario. You are probably familiar with the term in-vitro fertilization, which is the bringing together of sperm and egg outside the body (“in-vitro” literally means “in glass” but for our purposes, “outside the body”) for attempts at implantation inside a human female’s uterus. “Excess” embryos produced by in-vitro fertilization are often stored in freezers for future attempts at implantation. Through this kind of reproductive technology, society has become somewhat familiar with and accepting of the idea of human embryos being “produced” outside the body.

Even in-vitro fertilization still involves the “old-fashioned” way of reproduction in that a human sperm and human egg must still be brought together. The human embryos produced by in-vitro methods also have 46 chromosomes and begin to divide and grow just as in the “regular” reproduction example. Both the “regular” and in-vitro methods of human reproduction are termed “sexual” reproduction because of the bringing together of sperm and egg. (Note: sperm and egg cells are termed germ cells. All other cells are termed somatic cells.)

Enter human cloning, which is another means of reproduction. Dolly, the famous Scottish sheep, whose birth was announced in early 1997, was produced by this new “non-sexual” means of reproduction. Cloning involves the placement of the chromosomes from a somatic (body) cell into an egg cell which has had its nucleus (containing its chromosomes) removed. In the case of humans, this combination forms a human embryo, containing 46 chromosomes. The cells of the human embryo then begin to divide, just as they do in either “regular” or “in-vitro” fertilization. This cloning procedure is often referred to as somatic cell nuclear transfer. The resulting embryo can then be implanted into a uterus (this has been termed “reproductive” cloning), where it can develop and grow into a human baby, or it can be allowed to grow and divide for a period of time after which it is destroyed, and its cells harvested. This is what is done in human embryonic stem cell research (also sometimes referred to as “therapeutic cloning”). A “stem cell” is simply a non-specialized cell that has the capacity to divide indefinitely and to “differentiate” into more mature cells with specialized functions such as muscle, nerve, skin, etc.

Myth vs. Fact

Myth: “No embryos are created in human embryonic stem cell research.”

Fact: It is somewhat bizarre that anyone would claim that “embryonic” stem cells don’t come from “embryos.” Yet, through substituting less well-understood terms for the word “embryo,” sometimes this simple biological fact is obscured.

It is important to understand that in human embryonic stem cell research, human embryos are both: 1. produced, and 2. destroyed.

This fact isn’t emphasized -- and is often denied or concealed -- by proponents of human embryonic stem cell research. Of course, this is because these features of the research are very controversial, with many people concerned that human embryos are being produced for the specific purpose of being destroyed for their stem cells. This concern is not limited to only those commonly thought of as “pro-life” or “anti-abortion,” but extends to many other people who are simply concerned about the morality of research that is destructive of human life.

The Nuremberg Code as well as the Declaration of Helsinki and all human research subject protections came about as a direct result of lessons that history has taught about the dangers of research that does not adequately protect human life. While some may argue that the human embryo at such an early stage is not deserving of full research protection, these documents make no such distinction according to human developmental stage. In fact, the Declaration of Helsinki

notes that such protections apply to all human beings, and that “some research populations,” including those who cannot give consent for themselves “need special protection.” In any event, probably most people would agree that the argument that the early embryo is not deserving of protection begins to break down as we move farther along developmentally toward the time a human baby would be viable. Since we have no way at present of knowing exactly where such research might lead, it is entirely appropriate that we seriously consider all possible research and ethical scenarios now rather than at some future time, perhaps after other ethical abuses have already occurred. Despite the reluctance of human embryonic stem cell research proponents to engage in discussions of the morality of such research, the debate should and must take place now. Myth: “The benefits that society will reap through human embryonic stem cell research outweigh any moral considerations.” Fact: The Declaration of Helsinki specifically states “In medical research on human subjects, considerations related to the well-being of the human subject should take precedence over the interests of science and society.” This safeguard is necessary for all civilized societies that conduct human research, all

of which have adopted some form of this precaution. The reason for this protection is very simple. While there are many research endeavors that might benefit society, not all of them are ethically permissible because some would involve harming one human being for the benefit of another. The Declaration of Helsinki acknowledges the need to extend this protection even to those on the “margins.” If these protections are denied for one group, they can more easily be denied to others.

Myth: “Human embryonic stem cell research is not cloning.” (Variation: “Somatic cell nuclear transfer is not cloning.”)

Fact: It is very important to understand the meanings of terms related to human embryonic stem cell research in order to be able to effectively engage in dialogue on these issues.

Confusion, obfuscation and substituting one term for another have all been used to try to turn the debate away from the ethical issues. The facts are clear; if human embryos are being produced through the methods we have mentioned, such as somatic cell nuclear transfer, then cloning is taking place. Somatic cell nuclear transfer is a method of cloning. This is the same procedure that produced Dolly, the cloned sheep. If human embryos are obtained through in vitro fertilization (frozen “excess” embryos), then cloning is not involved, although the human embryo is then still destroyed in the process of harvesting its stem cells.

Myth: “Science must be allowed to progress without any boundaries.” (Variations: “Politics should stay out of science,” “Only scientists should decide where science goes.”)

Fact: While this sounds quite noble when taken at face value, very little thought is necessary to realize that no one would really want science “without any boundaries.” Documents such as the Nuremberg Code and later the Declaration of Helsinki, which has already been mentioned several times, are well-accepted “boundary-setting” documents that specifically limit what is permissible to do in the name of science. Civilized societies accept that there are necessary boundaries that must be placed around human life when humans are the subjects of research. So the only real question is not whether there should be any boundaries, but rather, where should those boundaries be placed? These documents set very high standards for the protection of all human research subjects. Researchers are never allowed to harm research subjects, no matter what the potential benefit may be. To allow one particular group to be harmed for some possible benefit to others is to turn the Nuremberg Code on its head.

For their part, scientists are, and always have been impatient with limits and boundaries on their work. But this does not eliminate the need for those boundaries. No field, be it medicine, agriculture, construction or any other, is a law unto itself. Societies come together to create laws that govern each of these fields. The work of scientists is important to all of us -- we all have a stake in it. Therefore, it is entirely appropriate for societies, through their legislative mechanisms, to place “boundaries” for the protection of human life.

Keep in mind that private funding of embryonic stem cell research is currently legal. The debate is over public funding, i.e. our tax dollars. There is nothing to stop the research now -- except that private investors tend to shy away from highly speculative, highly risky investments. This is key to understanding why embryonic stem cell research proponents are so desperate to turn on the government money stream!

Myth: “The human embryo derived through somatic cell nuclear transfer cannot develop into a human baby.”

Fact: In 1996, the sheep embryo derived through somatic cell nuclear transfer developed into Dolly the sheep. There is really no logical reason why a human embryo derived through somatic cell nuclear transfer could not similarly develop into a human baby.

Myth: “Amazing cures derived through human embryonic stem cell research are right around the corner.”

Fact: Proponents of human embryonic stem cell research are fond of making claims that there are many cures for terrible diseases that will soon be realized through such research. Science, like all other fields is subject to a tendency toward the “trendy.” Money and fame tend to follow those who are working on the latest trend. The media has picked up on the novelty and hype that surrounds this issue, and have made highly speculative claims regarding potential cures and treatments. Voluntary health organizations and celebrities have jumped on the bandwagon, and added to the general level of inflated expectation. The fact is that there are no present therapeutic uses for human embryonic stem cells, and any future benefit to be derived from this research is speculative at best.

Myth: “Human embryonic stem cell research is the only way to obtain stem cells.”

Fact: Stem cells are present in adults and children as well as in the umbilical cords of infants. Such cells are referred to as “adult” stem cells, in this case, meaning “not embryonic.” It is thought that embryonic stem cells may be capable of becoming more different types of cells than adult stem cells can. No one knows whether this capacity (called “pluripotency”) will eventually be a therapeutic benefit or a disadvantage in every possible treatment scenario. Adult stem cells are already being used therapeutically with success. Research use of adult stem cells is promising as well. Such cells are readily available and of course, eliminate the moral problem involved in destroying human embryos.

A Few Closing Thoughts

There is a slogan in real estate, “Location, location, location.” As any real estate agent will tell you, location is paramount. But is that true of human life? Dr. Nigel Cameron has noted that perhaps the pro-life movement has done too good a job at sloganeering about the protection of “life in the womb.” This has led, it seems, to a willingness to accept affronts to human life on the basis of the physical location of the human embryo.

Have “pro-life” legislators and the “pro-life” movement in general really thought about why we are pro-life? Is it simply a reaction to the revulsion we feel at seeing something destroyed that “looks like us?” Or is it a deeper reason, having to do with the worth of all human beings, even those at the margins of life? Advances in science challenge us to do more than develop slogans, but to think through the hard questions about what it means to protect human life, even (especially) at its margins. Only then will we be able to effectively engage in the moral dialogue that must now take place.

For additional information regarding stem cell research visit the following sites: http://www.stemcellresearch.org and http://www.thecbc.org.

Cindy Province, R.N., M.S.N., M.A. (Bioethics) received her Bachelor’s degrees in Nursing and Psychology from Saint Louis University in 1981; a master’s degree in Medical Surgical Nursing from Saint Louis University in 1985; and an M.A. in Bioethics from Trinity International University in 2004. She is a co-founder and Associate Director of the St. Louis Center for Bioethics and Culture and has been active in social concerns and in politics for over a decade, serving as chairman of a political action committee and providing consultation services to political candidates since 1994. Cindy served for six years on the Missouri Baptist Convention’s Christian Life Commission and is currently serving as a trustee at Southeastern Baptist Theological Seminary in Wake Forest, NC. In addition, she has been serving as a lobbyist for Families for Home Education since January 2000. Her and her husband Stan, a trauma surgeon, have four sons and live in Defiance, Missouri.