Stem Cell Research: Medical Miracle or Moral Morass?
They have been likened to the dot at the top of an “i” and to tiny soccer balls. Some see them as the beginning of life, others as building blocks for medical miracles and still others as medical debris. And while most politicians would be hard pressed to define or spell blastocyst, these tiny bits of matter sit at the center of one of the most contentious policy disputes of our time – the fight over embryonic stem cell research.

Now the fight has come to New York. Ever since President George Bush banned most federal funding for most embryonic stem cell research in 2001, some states have sought to pick up the slack and so entice researchers and possible new industry. New York seems a likely location for this kind of research. Almost 55,000 people in the state work in the pharmaceutical and bio-tech industries, and the city is home to many top research institutions. With the construction of a new bio-tech center on the East Side, the Bloomberg administration hopes many private companies will bring their cutting-edge bio-tech businesses to New York.

To keep New York in the forefront of bio-technology, some members of the state legislature, including most prominently Assembly Speaker Sheldon Silver, hope to obtain state funding for embryonic stem cell research. On the other side, the Catholic church, which has spearheaded opposition to embryonic stem cell research here, argues that embryos used for stem cell research are a form of human life. The governor, meanwhile, remains somewhere in the middle – in favor of biotechnology in general but reluctant to support embryonic stem cell research explicitly.

As New York continues to mull the issue, some of its neighbors have moved ahead, threatening New York’s future as a center of bio-technology and, some say, delaying the day when sick people will get cures they desperately need.

WHAT IS STEM CELL RESEARCH
Although embryonic stem cells have not yet cured a single disease, it is hard to overstate the hopes that many experts have for them. Supporters of the research liken it to where antibiotics were 50 or 75 years ago. No one knows when, how, where – or even if – the major breakthroughs will come. But said Robin Elliott, the executive director of the Parkinson’s Disease Foundation, who also serves as chairman of New Yorkers for the Advancement of Medical Research, “The same could be said of any frontier of medicine…This is an area of science that is potentially one of the most exciting in the history of medicine.”



The controversy over embryonic stem cell research involves balancing hopes for improving the lives of millions against fears of a Brave New World Society where human beings will be just another manufactured product.

Most embryonic stem cells used by scientists today are a byproduct of in vitro -- literally “in glass” -- fertilization, which has led to the births of hundreds of thousands of babies since 1978. The process involves surgically removing mature eggs from a woman – generally she takes drugs to enable several eggs to mature simultaneously – and joining the eggs with sperm in a laboratory rather than in the woman’s body. The fertilized egg is then implanted in a woman’s uterus where, if all goes well, it will develop into a healthy baby about nine months later.

Women trying to become pregnant through in vitro fertilization often have to undergo several implants before the procedure works. So most women store surplus fertilized eggs, and today thousands, perhaps hundreds of thousands, of these small spherical blastocysts remain in clinics around the country.

For years, there was little use for most of the embryos, and ethicists debated what to do with them. Then in November 1998, James Thomson, a biologist at the University of Wisconsin, Madison, reported that he had isolated human embryonic stem cells. These stem cells could renew themselves, by dividing again and again. With each division, scientists could create one differentiated cell – a blood cell, say, or a brain cell – and one stem cell, which could then be used to generate more cells. These related cells -– the offspring of the original cell -– constitute a group of cells, which scientists call a "line", that share the same DNA.

To create these lines, scientists have to separate the embryo into individual cells, thereby destroying it. They must then put the individual cell in a dish and provide it with nutrients and growth factors that will both encourage it to divide and create the differentiated cells. According to one count, there are about 240 human embryonic stem cell lines around the world.

Scientists hope the lines’ ability to create specific types of cells will enable researchers to understand a variety of diseases and eventually treat illnesses that entail lost or damaged cells, such as diabetes, some cancers, Alzheimer’s disease, and spinal cord injury.

For example, in people with Parkinson’s disease the cells of their brains cannot produce enough dopamine, which is essential to the functioning of the central nervous system. Brain cells created from embryonic stem cells could replace the deficient cells, enabling the patient’s brain to again produce dopamine and the nervous system to resume functioning normally.

This potential for possible cures has won embryonic stem cell research some prominent supporters, including Nancy Reagan, whose husband had Alzheimer’s disease; Michael J. Fox, who has Parkinson’s disease; and the late Christopher Reeve, who was paralyzed as the result of a spinal cord injury.

Since the 1970s, scientists have been studying adult stem cells, extracted from blood and bone marrow, as well as from organs taken from dead bodies. Working with such cells is not particularly controversial, and they are already used in areas such as bone marrow transplants and in treating eye injuries. But these older stem cells may be more set in their ways – scientists differ (in pdf format) over how versatile they might be -- and so unable to develop into some other types of cells. And the supply of these cells, particularly those from donated organs, is limited.

Because embryonic stem cells can keep dividing and renewing themselves for long periods of time, they could exist in greater supply. The problem, though, is where to get them in the first place. For now – and this is where in vitro fertilization enters the picture – most embryonic stem cells derive from blastocysts, several-day-old embryos that have not been implanted in a uterus. And these blastocysts come from in vitro fertilization clinics.

Scientists are trying to develop other methods to produce cells with the properties of embryonic stem cells. But for now, the cells come from embryos that are destroyed in the process.

THE ETHICAL ISSUES
This troubles many people, including leaders of the Catholic Church, members of the Christian right, and some, though certainly not all, anti-abortion advocates. They see the blastocyst as a human life and believe that destroying it – even to save someone from disease — is wrong. “We don’t think a human life should ever be a means to an end,” said Dennis Powst, director of communications for the New York State Catholic Conference. “It’s not an ethical way to go about curing disease.”

To underscore the link between the blastocysts and human life, President George W. Bush last year hailed the birth of 81 children from “adopted” embryos – dubbed “snowflake babies” -- and told a gathering of the families, “There is no such thing as a spare embryo. Every embryo is unique and genetically complete, like every other human being…. These lives are not raw material to be exploited, but gifts.”

The blastocyst legally belongs to the family that created it. A small number of these families turn their embryos over for adoption or for more medical research. But most of the embryos are now simply destroyed. Supporters of stem cell research argue that using the blastocysts to help find a cure for debilitating diseases would be far more ethical than just throwing them away.

Opponents of embryonic stem cell research also fear that the need for a steady stream of stem cells for research and treatment could lead scientists to try to create human embryos by cloning. “If cloning is not part and parcel of embryonic stem cell research,” said Powst, “we question why human cloning research is part of every bill” supporting embryonic stem cell research.

While most advocates of stem cell research say they oppose cloning for reproductive purposes they do support so-called “therapeutic cloning.” In this procedure, the nucleus of an adult cell is placed in an unfertilized human egg. Development would advance until the egg became a blastocyst but, advocates say, could go no further. There is, they stress, no way such an egg could ever become a human being.