Our Plea to
|By Edward D. Miller,
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
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.