Ellington

This week, the Democratic Congress is likely to pass expanded federal funding for embryonic stem-cell research, although President George W. Bush will almost certainly veto the bill. The Republican Congress passed similar legislation this summer, but President Bush used the first veto of his administration to kill that bill last September.

Although we have long heard fantastic descriptions of all that stem cells might do to save human life, few members of the public are familiar with how far stem-cell research has come.

In the last two years, researchers have made startling discoveries about the role stem cells play in cancer. In fact, scientists now believe that malfunctioning stem cells are responsible for many cancers, including leukemia, breast cancer, brain cancer, prostate cancer and colon cancer, among others.

The reason stem cells play this role is that most of the cells in our body are regularly replaced. Your skin is completely replaced every month, the lining of your gut every two weeks and the platelets in your blood every 10 days. Most cells in your body are born to die in weeks, and they can only divide so many times. Stem cells, by contrast, last all your life, and they can divide without limit. Every part of your body was born of a stem cell.

The body operates this way to protect us from cancer. If all cells in your body reproduced like stem cells, then a mutation in any one of them might lead to cancer. Because most cells are restricted in how they divide, however, an individual cell might become "cancerous" only to die after a few divisions.

The problem is when stem cells suffer mutations. Instead of acting as the source of new cells to replenish your body, cancerous stem cells become the source of tumors, breeding generation after generation of cancer cells. Even if doctors remove or kill all visible traces of a cancerous tumor, missing just one stem cell could lead to a relapse, which is one reason why cancer that seems eradicated can return.

What's more, new research published in the journal Nature this September indicates that stem cells may hold the key to understanding how and why we age. As stem cells age, the chances that they will accumulate cancer-causing mutations grows. This is the underside to how stem cells protect us—most cells die before their mutations can cause disease, but stem cells live as long as we do. After decades of life, it is almost inevitable that stem cells will become damaged by free radicals and other mutagens. (See this issue's cover story for examples of how free radicals and other mutagens are boosting levels of cancer.)

The body's response is to slow down stem cells as we age, reducing how often they divide. This helps to protect us from cancer, but it also means that our tissues deteriorate because they are no longer replenished by new, young cells from our stem cells. Our skin becomes papery and our organs frail. The alternative: rampant cancer. About 40 percent of people will develop some form of cancer at some point, usually in old age. Colon cancer is the third most common form, but the average age of people who develop colon cancer is 70.

If we want to understand cancer, we must understand stem cells. If we want to understand aging, we must understand stem cells.

In 2001, President Bush limited federally funded research to 60 stem-cell lines, though only a handful of those were viable. Since then, researchers have discovered that the lines Bush approved were contaminated by the mouse "feeder cells" used to nurture the cells, making them worthless for use in human therapy.

Scientists have tried to sidestep controversy by developing stem-cell lines from another source, such as umbilical or amniotic fluid, and social conservatives have twittered over the potential of the amniotic variety. Yet, even the scientists who discovered these cells do not claim that they have the same potency as embryonic stem cells, and their research has not yet been duplicated by other scientists.

The only reason scientists have bothered with amniotic fluid at all is that some people think harvesting stem cells from a handful of the 400,000 unused embryos stored in fertility clinics is murder. Social conservatives claim that every embryo is a person, and even though fertility clinics are going to throw away every embryo, using any of them to understand human disease is a crime.

When President Bush vetoed the stem cell bill this September, he surrounded himself with "snowflake" children—that is, children who came from frozen embryos, embryos that were "adopted" by evangelicals. He did not mention that only 128 embryos out of 400,000 have been adopted.

As we are battered by sermons about the sanctity of life, it's easy to forget that calling an embryo a person is only a metaphor. That's why few women have adopted frozen embryos—there are so many actual children who need our care and love. An embryo does not go hungry. An embryo does not scream in soiled diapers. We know real people when we see them.

Morality is more than conviction—morality requires wisdom, and wisdom abhors hypocrisy. If the 400,000 frozen embryos in our country are truly people, then fertility treatments should be illegal, as they produce so many "people" doomed to die. But embryos are not people, and the reason why social conservatives have not tried to ban fertilization treatments is that most people just won't do that to a couple who are desperate to bring new life into the world.

That is, people won't vote to ban fertility treatments because they know that one actual child means more than a thousand "potential" children, just as they know that real morality means real people. Cells in a frozen tank aren't children, and stern speeches about the Lord's wrath are not the Lord's word.

Previous Comments

ID

74287

Comment

Good article. I'm illiterate on IVF, so I hope somebody can correct me if I'm wrong, but am I to understand that these frozen "embryos" are actually nothing more than fertilized eggs that have not yet been implanted in the uterus? Because in the United States, those aren't generally called embryos; that's British terminology. Furthermore, those fertilized eggs are also produced--and rejected from the uterus--as the result of birth control technology. Technology such as IUDs, maybe EC (though the jury's out on whether it does anything but prevent fertilization), and, oh, right...the rhythm method, which probably kills many times more fertilized eggs than any other form of contraception on Earth. No freezing required, or even provided as an option. If the Bush administration really believes that a pre-uterine-implantation fertilized egg is the same thing as a live infant, then it needs to look back on how Christianity has encouraged a virtual Holocaust over the centuries by encouraging use of the rhythm method rather than sheepskin. But surely these are post-implantation embryos we're talking about, right? Because social conservatives aren't stupid, and the Bushites aren't that cynical...are they? Cheers, TH

Author

Tom Head

Date

2007-01-11T09:23:54-06:00

ID

74288

Comment

Interesting point regarding the rhythm method, Tom. I'm a little confused by your point about implantation--obviously, these eggs have not been implanted in the uterus. They have been fertilized by sperm and then frozen in liquid nitrogen. It is enough for social conservatives that you have a new set of human genes (new in the sense of being a novel combination). It is as if the second the chromosomes come together, the soul leaps into that little cell. It's such a reductive, mechanistic view of "the divine spark" that it's almost irreligious. While I was thinking about this column, I thought, "Whatever happened to fundamentalism?" I mean, people who object to stem cell research do so almost exclusively on "ethical" grounds, by which they almost always mean "religious" grounds. They tend to be of the evangelical persuasion. But shouldn't a fundamentalist be "Biblically" neutral on this question? After all, not only does the Bible say nothing about stem cells, it says nothing, so far as I know, even analogous. Obviously, you can construct an argument as for how the Bible forbids stem cell research, but you're going to have to do some heavy-duty interpretation--gasp!--in order to get there. (Obviously, so-called fundamentalists already interpret the Bible, but this seems like a glaring example.)

Author

Brian C Johnson

Date

2007-01-11T10:17:33-06:00

ID

74289

Comment

I didn't think they had, but I have a hard time wrapping my head around the idea that if they're nothing more than fertilized eggs, the media feels comfortably consistently referring to them as "embryos." Because in U.S. terminology, blastocysts only become embryos after they've implanted. I think objection to stem-cell research boils down to the idea that life begins at the moment of conception, when God squirts a soul into the new blastocyst. This is also the basis of objections to first-trimester abortion--when you're talking about something the size of a grain of rice, that has no neocortex or anything close to it, then the only way you can really say it's an "itty-bitty baby" (to borrow a favorite phrase of a local right-wing activist) is if you believe that personhood rests in an immaterial soul that God implants at an unknown time, presumably the moment of conception. 'Course if you read the story of Onan and take into account the whole seed/soil metaphor, eggs have no souls, but every sperm cell does, no implantation or even fertilization needed--the woman's body is just there to provide fertile soil in which the soul-bearing seed can grow (this is why women who can't bear children are called "infertile," by the way--it hearkens back to that old understanding of reproduction). Which, I guess, means death on the order of Stalin's Great Terror every time somebody has a wet dream. Cheers, TH

Author

Tom Head

Date

2007-01-11T10:35:29-06:00

ID

74290

Comment

Agreed. Is there any way to argue that harvesting fertilized eggs is wrong without making reference to the soul? It's hard for me to imagine how you could make the argument otherwise. Talking about the sanctity of life just side-steps the question, because no one believes that other single cells are sacred--you slough off a tremendous number of cells every day. The egg does not experience pain. It cannot feel anything, in fact. It does not have a heart or a brain or any organs at all. The alternative to using it for science is to throw it away--the snowflake children are rhetorical. If someone has an argument that does not rely on the soul, or even if they would just like to try to build that argument, I would like to see it. I am genuinely curious.

Author

Brian C Johnson

Date

2007-01-11T10:56:07-06:00

ID

74291

Comment

I've seen an anti-EC argument made based on personhood being equivalent to DNA uniqueness, but I think that's a little specious--I mean, then we end up letting people with correctable genetic abnormalities die off because of the sanctity of their flawed DNA. The truth is that many of the anti-stem cell people don't like the fact that people have premarital sex--that's what this boils down to--and so they've created this very intricate and precarious idea of personhood that makes sex equal murder if a woman uses birth control, or uses EC, or gets an abortion. These are by and large the same people who say countries with AIDS pandemics should be subject to gag rules that reduce condom use. The stem cell business is just being done for the sake of consistency. But there are still a few people left who honestly believe that God implants the soul at the moment of conception, and I tend to put them into a much higher moral category than the people who just pretend to believe that God implants the soul at the moment of conception because they're trying to sell abstinence. Cheers, TH

Author

Tom Head

Date

2007-01-11T11:05:21-06:00

ID

74292

Comment

Brian said: "If someone has an argument that does not rely on the soul, or even if they would just like to try to build that argument, I would like to see it. I am genuinely curious." I would start by asking what criteria you would use to define the sanctity of human life, and then ask at what point during gestation does that criteria become applicable. Any, most importantly, how sure are you of when that is? Our society is built on the premise that human life is sacred, but we have never collectively come to terms with what that means. My argument has always been that we don't know WHEN this fertilized egg shoudl be considered human, but we do not that eventually it will. And because we don't knwo, we should err on the side of caution. I think that is the most rational approach. Incidentally, I am opposed to fertility treaetments, the storage of embryoes, and the like. I think itis hypocriticial to support that process for those who want to have kids, but to oppose other uses of those embryoes. I don't believe people are entitled to have an abortion, but neither to I believe they are entitled to have children. I'm not talking about legal entitlement here. I'm talking about my own beliefs about the issue.

Author

GLB

Date

2007-01-11T12:37:52-06:00

ID

74293

Comment

Tom, I agree, both with the notion that the anti-stem cell position is mostly a matter of consistency and especially with what you wrote about people and their beliefs: But there are still a few people left who honestly believe that God implants the soul at the moment of conception, and I tend to put them into a much higher moral category than the people who just pretend to believe that God implants the soul at the moment of conception because they're trying to sell abstinence. I could not put that better myself.

Author

Brian C Johnson

Date

2007-01-11T13:02:04-06:00

ID

74294

Comment

Fortunately, GLB is of the better variety, i.e. I believe he's sincere. I don't think there's any easy answer to how we set the boundaries of human life--there is no "empirical answer," to borrow from an earlier thread. I think part of why regarding a fertilized egg as a "person" at least in the sense of it being due protection is appealing to some is that it seems to draw the line less arbitrarily. That is, you can pretty comfortably that a fertilized egg is the earliest stage at which it is even possible to argue for personhood. No one would take seriously claims that unfertilized eggs, to say nothing of sperm, are due protection. Great Terror, indeed. GLB, you preach "caution" on setting the boundaries of life, but you must be clear about the moral consequences. Your "caution" is very costly. It would deny women control over their own bodies; it would deny fertility treatments to desperate couples; it would deny potential "cures" to people who suffer from disease. You say that "caution" is the "most rational" approach, but I don't think you're being strictly rational when you decide that the life of an actual child and that of a frozen egg have equivalent value. People would have very different reactions to you pouring an egg down the sink and you shooting a girl in the head. If you put people in a forced choice--either the kid or the egg gets it--everyone but sociopaths would choose to save the child. This is not because they are having an emotional response. It's because they're having a rational response based on a rational assessment of the different values of the egg and the child. I make that argument, in part, to interrogate the idea that "all life" is "sacred," meaning of equivalent value. Most of us would have a very hard time choosing between two actual children, but when it comes to an egg and a child, the choice seems easy. In other words, being reductive is not the same as being rational. More to the point, the only way to grant an egg "personhood" is to adopt a certain mysticism about genes, because a fertilized egg has only one of the many criteria we usually use to define personhood: a novel genetic code. It does not think or feel pain. We are not interfering with its development by failing to implant it--the egg's fertilization itself was the "interruption" in the sense that letting nature take its course doesn't even mean anything here. I am comfortable destroying fertilized eggs (for a good cause) because a novel genetic code is not sufficient to confer "personhood," in my view. I cannot provide a mathematical formula for determining whether or not someone is a person, but consciousness--the ability to think and feel--has something to do with it. That does not mean that we have the right to kill people in a coma, etc. The definition is meant to be pragmatic and "fuzzy," which may not satisfy your desire for rigorous definitions, but I think it is more moral to be practical rather than precise in this case. Practically speaking, the traditional standard of viability, i.e. the baby's ability to live outside the womb, is just about good enough for me. It's still ambiguous, because babies can live through premature births, but we can say with certainty that no baby is viable in the first trimester. To say nothing of a fertilized egg.

Author

Brian C Johnson

Date

2007-01-11T14:38:52-06:00

ID

74295

Comment

Brian: Very well said. I want to respond, but I am pretty busy, and I have some personal stuff that is distracting me pretty badly from the ability to think systematically. It takes me time and energy to formulate a decent post on a topic like this. All that is to say, I wil try to respond soon, but it may be a few days. Anway, thanks again for taking your time and energy to articulate your thinking on this for me.

Author

GLB

Date

2007-01-11T16:45:51-06:00

ID

74296

Comment

Thanks for the enlightenment, Brian. I now have a better understanding of stem cell research. Like abotion this topic is too tough for me. I'm a conflicted pro choice person. I don't know where I stand on this except to say I want what's best for society as long as it is tempered/coupled with morality and doesn't needlessly do harm to others or potential others. In summary, I guess I'm conflicted about this too.

Author

Ray Carter

Date

2007-01-11T17:11:34-06:00

ID

74297

Comment

You guys discussion is really a mute point after the news on stem cells this week. At least in a few years it will be. Very soon they will no longer need embryos for stem cell study. That they have determined that Plancentas and amniotic fluid will work as good if not better. That 100 Placentas obtained after child birth will take care of 99% of all Stem Cells needed. http://www.msnbc.msn.com/id/16514457/

Author

herman

Date

2007-01-12T15:36:00-06:00

ID

74298

Comment

Herman, I addressed your point in the column. First of all, the research you're talking about is reputable but has not yet been duplicated. Second, amniotic stem cells do not have the same pluripotency as embryonic stem cells. Pluripotency means the capacity to reproduce and differentiate. The scientists who have put forward the amniotic cells actually cite this as an advantage because although the amniotic cells can differentiate into various tissue cells, they are less likely to become cancerous using current techniques. But obviously, they are not alike. I guess I'll just use your own article to make the point, however, which is the opposite of yours (hint: read your own links): But Dr. Anthony Atala, head of Wake Forest’s regenerative medicine institute and the senior researcher on the project, said the scientists still don’t know exactly how many different cell types can be made from the stem cells found in amniotic fluid. The scientists said preliminary tests in patients are years away. The cells from amniotic fluid “can clearly generate a broad range of important cell types, but they may not do as many tricks as embryonic stem cells,” said Dr. Robert Lanza, chief scientist at the stem cell company Advanced Cell Technology. “Either way, I think this work represents a giant step forward for stem cell research.” ... Nonetheless, Daley said, the discovery shouldn’t be used as a replacement for human embryonic stem cell research. “While (amniotic stem cells) are fascinating subjects of study in their own right, they are not a substitute for human embryonic stem cells, which allow scientists to address a host of other interesting questions in early human development,” said Daley, who began work last year to clone human embryos to produce stem cells.

Author

Brian C Johnson

Date

2007-01-17T18:09:05-06:00

ID

74299

Comment

I aggree with you. My point was SOON we may not need embryos for it.

Author

herman

Date

2007-01-18T11:03:10-06:00