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an online version of the magazine Fall 2005

Our Plea to Congress

Edward D. Miller, M.D.
By Edward D. Miller, M.D.

By now, you all know that at this very moment basic biomedical science stands on the threshold of a new kind of research: Scientists are learning to re-engineer stem cells and manipulate them to repair damaged parts of the human body. What's so amazing about these basic human cells is how they accept “coaching” that turns them into any of the body's more than 200 cell types—heart muscle, kidney, spinal cord, etc. Researchers feel certain that this characteristic will one day allow medicine to regenerate nerves, reverse heart diseases or cure conditions like Parkinson's disease.

And yet, all of you know too, that this research is enmeshed in tough ethical issues. To obtain stem cells to study, scientists, in a good many instances, must take them from a discarded human embryo. That single step has left some Americans with deep moral and religious conflicts. It has also convinced our federal government to curtail funding for this research and limit the supply of stem cells available for laboratory study. And so, at the very moment scientists are ready to fathom the secrets of these basic building blocks of the human body, they find themselves stymied.

It isn't often you'll find Hopkins researchers abandoning their test tubes to take part in a heated political debate. Yet that's just what's happening on the issue of stem cell funding. Over the spring and summer, John Gearhart—whose groundbreaking discovery of basic human stem cells in 1999 kicked off this whole field of study—and stem cell and cancer biologist Curt Civin, walked the halls of Congress. They testified before committees as they tried to persuade senators and representatives that the 22 embryonic stem cell lines approved for federal funding by President George W. Bush must be expanded. They were just two of the Hopkins leaders who have taken a national stand. As an institution, we've gone all out to help pass the Stem Cell Research Enhancement Act in the House and lobbied the Senate to ease restrictions on this research.

But stem cell science hits trigger points with people, so even as we cry out for federal funds to study additional, non-contaminated stem cell lines, we appreciate the power of the doubters. As I listen to their arguments, I realize we can only influence the political process by basing our own reasoning on sound ethics as well as solid science. By working with medical ethicists in our Berman Bioethics Institute, science and logic should be able to proceed hand in hand and make an impact on legislation.

Even the most informed scientists in our national government have come to appreciate this approach. At a Senate hearing this spring, Elias Zerhouni, our former faculty member who helped establish the Institute for Cell Engineering here, and now heads the National Institutes of Health, admitted, “From a purely scientific standpoint, more stem cell lines may well be helpful.” Then Elias was quick to add that he understands that such research raises “moral concerns” for many people.

If our federal government continues to hold back stem cell research, one of my greatest fears is that it will create a situation similar to Prohibition days. The research will continue despite the government. It will be driven into settings—overseas or into the hands of private labs—where federal agencies won't be able to control it. Our government will have no idea of what's going on as this work moves forward. Then, who will ensure that unethical things don't happen?

Already, a troubling “brain drain” has begun among U.S. biomedical researchers as leadership in stem cell research shifts to Singapore , Great Britain and South Korea . Washington has one way to stop this: It must restore control of stem cell research to NIH by funding projects that involve diverse new lines of stem cells extracted from frozen embryos stored in fertility centers and donated by couples who no longer need them. Our own NIH is in the best position to evaluate this science, assess the outcomes and decide if funding for specific projects should continue.

Finally, a comment on the fact that the President's restrictions have encouraged states—unwisely, I think—to jump into the stem cell pool. California and New Jersey have established large funds to lure cellular researchers. Other states, including Maryland , are eager to mimic these economic initiatives. My experience tells me that science funding on the state level can be fickle. Maryland , for instance, has exhibited shrinking support for cancer research. I'm troubled by the prospect of 50 states with 50 different sets of stem cell regulations. It's one of the best arguments I've heard for strong federal leadership. Politicians want results before the next election, but medical science doesn't work that way.

Medicine is on the cusp of a scientific revolution that could transform the way physicians practice. But there's a long, winding road ahead with thousands of mysteries to unravel. As John Gearhart puts it, We're only “at the end of the beginning.” We, as healthcare providers, are desperate not to lose this rare opportunity.
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