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Splitting babies or splitting hairs?

Colorado has yet to weigh in on stem cell debate

By Leigh E. Rich

“He tried to be Solomonic,” Deborah Price Nagler said last week of President George W. Bush’s 2001 policy limiting federal funding for embryonic stem cell research to a handful of existing cell lines.

But like the ancient king who threatened to split a baby in half when two women claimed to be the rightful mother, Nagler, the national director of Hadassah’s Leadership, Education and Training Center based in New York, says the president’s decision doesn’t quite satisfy either side.

Those in favor of such research, albeit under strict guidelines and governmental oversight, point to the fact that the number and quality of existing stem cell lines are but a fraction of the “more than 60” Bush said were available. Those who oppose it, such as the Colorado Right to Life, do so on the belief that the five-day-old blastocyst—a fertilized egg from which stem cells may be obtained—is a “human not yet in the womb” that should not be sacrificed for the greater good.

Regardless of where one stands in the debate, Bush’s 2001 edict has shaped the future of stem cell research in the United States: It has forced the issue to the state level.

“There’s not a federal ban on the research,” Nagler said during last week’s “Date with the State” event sponsored by Hadassah, a nonprofit Jewish women’s organization that helps fund health-related and educational endeavors in the United States and Israel. Nagler visited Colorado’s Capitol as part of a nationwide effort to push for state-level legislation that would allow and fund stem cell research in the United States.

More of a compromise, Bush’s policy merely limits federal dollars, and it does not prohibit state governments or the private sector from funding such research.

And the issue is hardly new for lawmakers and the general public alike.

“Almost every state in the country is considering some type of legislation”—whether for or against it—said Linda Chalat, a Hadassah member and a Denver-based attorney who organized the Colorado event.

In last November’s election, for example, California voters passed its Proposition 71, which establishes and funds a medical research institute charged with investigating and regulating stem cell research in the West Coast state. In 2003, New Jersey was the first state to pass a bill allowing medical researchers to use excess fertilized eggs from infertility procedures, with appropriate consent, for therapeutic research.

And pro-stem cell research bills are currently being considered in other state legislatures, including New York, Virginia, Connecticut, Illinois, Maryland, Massachusetts, Minnesota, Nebraska and Wisconsin.

On the other hand, some states have banned embryonic stem cell research and a few are attempting to go so far as to criminalize it. According to the National Conference of State Legislatures, South Dakota and Louisiana forbid such research. Moreover, bills have been proposed in the Missouri and Texas legislatures that would make embryonic stem cell research a criminal offense.

The topic is so newsworthy that even fictional lawmakers in last week’s episode of The West Wing devoted a significant amount of energy to it—with characters debating scientific and political nuances of the issue as part of the primetime drama’s storyline.

But Colorado has yet to weigh in.

“It is a viable sphere, but it is one that has not come up on the radar in Colorado,” Chalat said.

‘Wild West’ science?

While a few of the state’s lawmakers expressed interest in introducing a stem cell bill after speaking with the Hadassah members, who were introduced on the Senate floor before meeting one-on-one with legislators, U.S. Rep. Diana DeGette has continued to push for action at the federal level.

Last month, the Democratic congresswomen for Colorado’s 1st CD, along with Delaware Republican Rep. Michael Castle, introduced HR 810, the “Stem Cell Enhancement Act of 2005.” If passed, the act would allow stem cells for medical research to be derived from human embryos if they “have been donated from in vitro fertilization clinics, were created for the purposes of fertility treatment, and were in excess of the clinical need of the individuals seeking treatment.”

Additionally, the individuals donating the embryos must provide written consent, indicating that the embryos “would never be implanted in a woman and would otherwise be discarded,” and that donors have not received “any financial or other inducements to make the donation.”

Though the bipartisan bill has 173 co-sponsors, including Colorado Congressmen Mark Udall, D-2nd CD, it is unclear how far it will progress in the current session. DeGette introduced a comparable bill last year that died on the House floor, and related legislation fared similarly in 2003. After being introduced this Feb. 15, HR 810 was referred to the House Committee on Energy and Commerce.

In a statement released the following day, DeGette accused the Bush administration’s policy of forcing the National Institutes of Health (NIH) “to sit on the sidelines as embryonic stem cell research—one of today’s most promising areas of medical science—progresses.” She also said it constrains American scientists, who must either compete for “very limited private funding” or “use only the 22 contaminated lines created before August 9, 2001.”

Though there is some discrepancy as to the number of viable embryonic stem cell lines currently available that meet Bush’s criteria for federal funding—anywhere between 15 and 22—the scientific community emphasizes that it is far fewer than Bush estimated four years ago.

Moreover, “private funding is nowhere near as significant or available” as public dollars, Nagler says, though she is also concerned that privately funded research lacks state or federal oversight.

This apprehension is shared by DeGette, who says Bush’s policy is “creating a Wild West-era of science” where “there is no coordinated sharing of information, no ethical or community standards and no federal controls on research. This is unacceptable.”

Pluripotential for cures?

For his part, President Bush acknowledged in his 2001 address that “(f)ederal dollars help attract the best and brightest scientists” and “ensure new discoveries are widely shared at the largest number of research facilities and that the research is directed toward the greatest public good.”

But, he added, “I also believe that great scientific progress can be made through aggressive federal funding of research on umbilical cord, placenta, adult and animal stem cells which do not involve the same moral dilemma.”

And that seems to be where the crux of the matter lies.

Adult stem cells, which may be found in tissues such as the blood, bone marrow and skin, also have therapeutic potential—though they are only “multipotent” (cells that can give rise to other, though limited, cell types), unlike embryonic stem cells that are “pluripotent” (cells that can eventually specialize into any type of bodily tissue but cannot themselves develop into a human being).

For example, blood stem cells may be teased into developing into several types of blood cells, but not, say, brain or neural cells. According to the NIH, “(a)dult stem cells such as blood-forming stem cells in bone marrow … are currently the only type of stem cell commonly used to treat human diseases.”

While researchers also are investigating whether multipotent cells can be persuaded to become pluripotent, it may be too early to tell to what degree both adult and embryonic stem cells will offer in terms of clinical medical treatments.

According the Colorado Right to Life, which passed out leaflets to state legislators after Hadassah members were introduced on the Senate floor last week, a handful of individuals have been helped with adult stem cells: “Fifteen people with serious Type I (juvenile) diabetes became ‘insulin free’ after adult pancreatic islet cell transplants. … A young woman rendered paraplegic by a car accident can move her toes and legs after injection of her own immune-system cells into her severed spinal cord. … Two children born without immune systems (‘bubble boy’ syndrome) have left their sterile environment and lead normal lives after bone marrow stem cell treatment.”

But the NIH cautions that the clinical potential of adult stem cells has only been demonstrated in “studies with a very limited number of patients.”

Those opposed to using embryonic stem cells in research often take issue along two lines: a belief that life begins at fertilization and the fact that the process to extract stem cells from a blastocyst destroys the embryo.

But whether life begins at fertilization is a philosophical or religious tenet, and the ability to create endlessly self-propagating stem cell lines limits the number of blastocysts needed for research.

Even President Bush admitted in his 2001 decision that his “position on these issues is shaped by deeply held beliefs.”

And such beliefs vary, across and within religious and philosophical perspectives.

For many followers of the Jewish faith, for example, the soul is thought to enter the embryo only after 40 days—past the five-day blastocyst stage from which stem cells are extracted and developed into cell lines. Such lines may then be distributed to many research institutions or frozen for future research.

While Bush based part of his 2001 decision on the propagating nature of stem cell lines, proponents of lifting some of his administration’s sanctions on such research say that the 22 available lines are either contaminated or limited by the type of media in which they were cultured.

“They wouldn’t be usable for direct therapy,” Nagler said, because “they just were not cultured in a way that they could be introduced in a human body.”

Thus, some new lines would need to be cultivated.

A matter of philosophical perspective?

Not every embryonic stem cell need be derived from a fertilized egg, however.

Scientists, through a process called somatic cell nuclear transfer (SCNT), can create a blastocyst by inserting the nucleus of an adult body cell—which has a complete set of a human’s 46 chromosomes—into an unfertilized egg.

Sometimes referred to as “therapeutic cloning,” this method also helps circumvent rejection issues, because the stem cell has the exact genetic makeup as the person from which the nucleus was taken.

And unlike embryos from infertility clinics, no fertilization has occurred.

“Proponents argue the two are fundamentally different,” Chalat said.

Of course, if given the right stimulus and implanted into a womb, this theoretically could develop into a cloned human being. But no state allows such “reproductive cloning,” and current and proposed legislation—such as that advocated by Hadassah or California’s Prop 71—explicitly ban it.

Instead focusing on potential treatments for diseases such as diabetes, Parkinson’s, Alzheimer’s, multiple sclerosis, cancers and spinal cord injuries, proponents also argue that such stem cell initiatives prevent a “brain drain” of scientists who will take their research to other states or other countries; allow the United States to take a leading role in the oversight and control of a sensitive and worldwide issue; offer a means of reducing America’s hefty health care price tag in the long-term; and encourage business development within a state’s technology sector.

This is “not a free-for-all,” promised Nagler, who advocates for “very strict guidelines” and “controlled” research—a kind of governmental oversight that may not occur in some countries. But, she says, the current federal limitation in access and funding is tying the hands of American scientists.

“There will be a brain drain.”

An additional benefit to state-level stem cell legislation is the influx of research dollars and infrastructure to stem cell friendly states. For many state legislatures, this has been or may be a selling point, though Chalat notes that Hadassah—which owns six of the existing stem cell lines that can be investigated with federal research dollars—supports such research from a philosophical, not an economic, perspective.

One of Judaism’s main tenets is pikuah nefesh— the ethical deed of saving a life—and Hadassah members emphasize an imperative to alleviate human suffering via medical advances such as organ transplantation, tissue donation and stem cell research.

Opponents also say their view is a matter of principle. According to a statement issued by Connie Pratt, president of the Colorado Springs Right to Life, stem cell research is akin to scientists “turning their labs into biological chop shops, ‘dismantling’ living little human beings for their ‘valuable parts.’”

She calls it “cannibalistic research” and says proponents are “manipulating words and splitting hairs.”

But Nagler says Hadassah’s goal in advocating for stem cell legislation is to encourage state legislators “to learn more” and “to consider (it) carefully.”

It is important, Chalat adds, “that we not allow executive action from 2001 to stand in the way.”

And while researchers with Hadassah’s Goldyne Savad Institute of Gene Therapy “are making strides,” particularly in the case of Parkinson’s, Nagler warns that “it will take time. The essence of it requires the investment of time and research.”

Right now, “it’s impossible for us to envision the number of lives that can be affected,” she said.

But “we’re not taking no for an answer.” 

Rich, L. E. (2005, March 11). Splitting babies or splitting hairs? Colorado has yet to weigh in on stem cell debate. The Colorado Statesman, pp. 1, 6, 9.

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