Thursday, July 20, 2006

For the Record: The Stem Cell Debate

President Bush used his first ever veto to shoot down a bill intended to open up federal funding to research on new embryonic stem cell lines.

The House tried to override the veto yesterday, but came up short. As expected, Mark Green and the rest of the Republican delegation from Wisconsin sided with the president.

Conservatives have tried their best to obscure some key points about the stem cell debate over the past few weeks in order to make their side appear somewhat in the mainstream on this issue. Although these points have all been highlighted by other bloggers and those in the media at various times, I want to reiterate them here just to have them all in one place.

  • New lines of embryonic stem cells are developed from embryos that are left over from fertility clinics that practice in vitro fertilization. Embryonic stem cell research is not the deciding factor in whether embryos are destroyed, in vitro fertilization is that deciding factor -- thus, opposition to the destruction of embryos should be aimed at in vitro fertilization, not embryonic stem cell research. Fertility clinics often create more embryos than they need; not by accident, but in order to ensure a better chance of pregnancy due to the relatively low success rate of single embryo tranfers. The excess embryos are essential for the clinic's mission to help families get pregnant. Patients are usually given three options for the leftover embryos, if there are any: 1) destroy them, 2) donate them to other families, or 3) donate them to research. Since it’s often difficult to find families that are interested in accepting the leftover embryos (people tend to want to create their own whenever possible), many people opt to donate their leftover embryos to research rather than simply have them destroyed. However, due to federal restrictions instituted by President Bush in 2001, federal funds cannot be used for research on these donated embryos or any research that even pertains to lines that were created from these donated embryos – the bill vetoed by the president this week sought to overturn those restrictions.
  • Stem cell lines don’t remain viable research avenues forever. While there were 70 embryonic stem cell lines available in 2001 when Bush first restricted federal funding for research, there are currently only around 20 due to spontaneous mutation over time. In this sense, the bill vetoed by Bush was just as much intended to sustain the research as it was to enhance it. What’s more, in 2001 researchers didn’t have a good grasp of the techniques that could be used for embryonic stem cell research because it was still very new (UW scientist James Thomson first isolated human embryonic stem cells in 1998). Since then, however, techniques have improved and made the research far more viable, but the drop in stem cell lines available for federal funding threatens that viability in spite of the advances.
  • Federal funding for embryonic stem cell research is necessary, despite the private funding that goes into it. Currently the federal National Institute of Health (NIH) funds just under 1/3 of the total biotechnology field. The federal research restrictions, therefore, prevent research on new stem cell lines from accessing any of this funding, thereby separating it from 28 percent of the funding for the entire biotech field. Also, by restricting research that uses federal dollars to certain lines (everything down to the purchase of beakers is restricted), researchers have been forced to completely separate their research into two parts. In some cases, researchers have even needed to build two separate labs to do research – one for the research that uses federal dollars and one for the research that does not. Needless to say, these requirements greatly increase the total cost and adversely affect the efficiency of the research. Additionally, federal dollars tend to be more stable than private funding, which makes federal funding very valuable to research that can take years to develop.
  • Cloning is not currently a part of embryonic stem cell research in the US. There are two purposes for cloning: reproductive and therapeutic. Reproductive cloning seeks to create an animal that is identical to another animal (think Dolly the sheep). There is no possible use for reproductive cloning in embryonic stem cell research; therefore, it's not an issue in the debate. Therapeutic cloning, on the other hand, is aimed at creating cells that match those of a particular patient. While therapeutic cloning is not currently used in embryonic stem cell research in the US, there’s a possibility that in the future it could be necessary for creating stem cells that match a patient and, therefore, have a reduced chance of rejection. To see if therapeutic cloning is even necessary, however, more research is needed.
  • Adult stem cell research is a viable avenue of research, but it cannot take the place of embryonic stem cell research. Since adult stem cells are already defined, they have more restrictions on them than embryonic stem cells that still have the ability to be defined into any type of cell. And while there has been some research into returning adult stem cells to their embryonic state, that research is far from being applicable and it will require additional embryonic stem cell research to perfect (if it’s even possible to perfect – at a Senate committee hearing in June, NIH stem cell expert James Battey referred to such research as “pie in the sky”). Since adult stem cell research is over 30 years old and has no funding restrictions (it currently receives significantly more federal funding than embryonic stem cell research) it has a longer list of accolades than the 8 year old embryonic stem cell research. Yet, in spite of federal restrictions on funding, embryonic stem cell research has made some strong strides. Last month, researchers at Johns Hopkins used embryonic stem cells to revitalize the nerve circuitry in a paralyzed mouse allowing it to walk again, and less than a month later researchers at UCLA used embryonic stem cells to create T-cells that could be used to combat AIDS. Again, in spite of these advances, federal restrictions reduce the likelihood that these breakthroughs can be taken to the next level and, eventually, made viable.
  • Mark Green, President Bush, and others like to claim they support embryonic stem cell research because they didn't vote to eliminate it completely in 2001 and, instead, just put restrictions on it. Bush has even gone so far as to argue he is the first president to provide federal funding for embryonic stem cell research. This is just not true. By signing the National Institutes of Health Revitalization Act in 1993, Bill Clinton actually became the first president to allow federal funding for embryonic stem cell research. While the Dickey-Wicker amendment that was attached as a rider to a 1996 Department of Health and Human Services (DHHS) appropriations bill prevented federal funds from going to research that either created or destroyed a human embryo (and the amendment has been re-issued by Congress every year since), the Clinton Administration's interpretion of the amendment allowed for unfettered federal funding for embryonic stem cell research on all available lines because the actual research on the embryonic stem cells doesn't involve the creation or destruction of embryos. In other words, under Clinton the creation of new lines was restricted to private funding only because it involves the destruction of embryos (as required by the Dickey-Wicker amendment), but the actual research on those lines could still be funded federally. When Bush came into office in January 2001, he immediately had the DHHS review the Clinton Administration's interpretation of the Dickey-Wicker amendment and had the NIH freeze applications for funding until the review was complete. Then, in August 2001, Bush announced his decision to not allow any federal funding for either the creation of or research on new stem cell lines, thereby reversing the stance of the Clinton Administration and putting the field in the bind that exists today.

Outlined here are just a handful of the key points surrounding the debate in general. There are other issues more specific to Wisconsin and the gubernatorial race (such as how the state plays a role in either enhancing or restricting embryonic stem cell research through funding, building projects, allowance of various procedures, etc., and who is governor impacts which direction the state heads), but I’m going to stop here for now.

UPDATE: Some alterations have been made to language in two spots -- the substance, however, is the same. See comments for details.


Anonymous Anonymous said...

"there are two forms of cloning"

Wrong - cloning to create an embryo, whether human or animal, is done using a process called Somatic Cell Nuclear Transfer (SCNT). The difference between what is referred to Reproductive and Therapeutic Cloning is simply the stated intent for creating said embryo. The science, process, or "form" is exactly the same in either case, with the planned outcome being a healty embryo. In other words, the difference is in what the lab says they plan to do with the resulting embryo once created.

It's true that cloning is not currently part of the current research and this is probably because researchers have so far had a devil of a time perfecting SCNT for humans. Most observers agree that it is just a matter of time.

July 20, 2006  
Blogger Seth Zlotocha said...

Thanks for the clarification. Perhaps I should've said "there are two purposes for cloning" rather than "there are two forms of cloning," although my description of the two is still accurate.

But, nonetheless, I'll go ahead and change the wording in the post just to be clear.

July 20, 2006  
Anonymous Anonymous said...

You wrote:

"Fertility clinics will often create far more embryos than necessary to impregnate a patient."

It's a bit of a semantic nit but as written it implies that IVF clinics are being wasteful. I'd suggest ammending your post to say that the clinics create excess embryos due to the low rate of successful pregnancy with single embryo transfers. More embryos are needed to increase the chances of a successful pregnancy.

I realize you were not knocking the clinics for doing this but thought clarification would be helpful in understanding why these excess embryos came to be.

July 20, 2006  
Blogger Seth Zlotocha said...

Good point. The phrasing sounded a bit rough to me, too, when I wrote it, but I never went back to correct it. I'll do that now.

July 20, 2006  

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