[1] Our heated summer-time debates over human embryonic stem
cell research were all but forgotten until we were jolted over the
sleepy Thanksgiving weekend by an announcement from researchers at
Advanced Cell Technology (ACT), a small biotech company in
Massachusetts. On TV screens, in the pages of "U.S. News &
World Report," and online in "e-biomed: The Journal of Regenerative
Medicine," ACT staked its claim to the creation of the first
"cloned human embryos," tentative preludes not to cloned children
but to tissues for transplant. ACT's sojourn into so-called
"therapeutic cloning"-an ambiguous term at best-is aimed at
producing stem cells containing a patient's own genetic
material.
[2] ACT is searching for the miracle of regenerative medicine.
Being able to develop stem cells that match a patient's tissue type
clears the formidable hurdle of immune rejection inherent in
transplants that use cells or tissues the body identifies as
foreign and subsequently destroys. Scientists hope to discover how
pluripotent embryonic stem cells, capable of developing into all
cell types of the adult human, can be chemically tweaked to give
rise to perfectly matching tissues for transplant. The awaited
miracle is the development of tissue-based treatments for a host of
diseases-everything from diabetes to paralysis-absent rejection and
damaging immunosuppressive therapy.
[3] The ACT team employed the same nuclear transfer technique
used to create Dolly the sheep. The procedure requires a donor
human egg from which the nucleus has been removed. Then, DNA from
another person's skin or other cell is slid into the egg. Following
an electric jolt, the nuclear DNA is reprogrammed and the egg
divides as if a sperm had just fertilized it. Division continues in
culture until the ball of cells forms a small cavity containing a
couple hundred pluripotent stem cells. This blastocyst forms in 5
days and is split apart when stem cells are obtained.
[4] ACT researchers added new genetic material to each of 19
donated human eggs. But, only three of the 19 eggs divided before
dying-a paltry "success rate" of 16%. More importantly, this cell
division stopped within a few hours at the 4 to 6 cell stage, well
short of the 200-plus stem cell-rich blastocyst which the company
claims is their goal-a "success rate" of zero. Why cell division
stopped is unknown.
[5] "A critical stage of development is the kicking in of
genes," said Harry Griffin of the Roslin Institute, which cloned
Dolly. "They didn't get over this threshold." The added genes may
not have functioned at all.
[6] Although an ACT news release claimed that "this work sets
the stage for human therapeutic cloning as a potentially limitless
source of immune-compatible cells for tissue engineering and
transplantation medicine," many scientists were not impressed,
calling ACT's work "a complete failure," a "nonevent" and "things
not to do." Under such circumstances, many researchers would head
back to the lab to discover "what went wrong," rather than to seek
the international spotlight. Although ACT denies "any ulterior
motives," the company relies on major breakthroughs to attract
investors.
[7] What are we to make of this? Has history been made by ACT's
creation of a "human clone?" I, for one, think not. At best, they
have reported results that should be labeled as premature; at
worst, they have grossly overstated the case.
[8] I continue to be struck by the sea change in how some
scientists report experimental results since the birth of Dolly the
sheep. Her creation first came to our attention on newspaper pages.
While Dolly's cloners published their work days after in a
peer-reviewed journal, a troubling precedent was set that has since
spawned such media events as ACT's announcement. One wonders
whether their report reflects solid science or a publicity
pitch.
[9] Certainly, innovative and responsible science occurs in the
private sector. Privately-funded science can often tackle problems
more quickly and with greater efficiency than science dependent
solely on government funds. At their best, both "public" and
"private" science function in an arena of openness and
methodological rigor. But, at its worst, science in the private
sector can succumb to the lure of publicity and profit. ACT seems
to have trumpeted a scientifically empty experiment in order to
capture front pages and investor interest. Such much ado about
nothing erodes the candor and trust so necessary to the pursuit of
science in service to human health and threatens legislative
retaliation in Washington.
[10] Prudence would dictate following the precautionary
principle. In cases such as this, where the stakes are high and the
unknown deep, we ought to go carefully and openly where no one has
gone before. Research on stem cell biology and "therapeutic
cloning" ought to be subject to prospective public scrutiny and
debate irrespective of who foots the bill. Experimental results
should weather peer review before the media blitz.
[11] ACT's headline grabbing aside, the scientific potential to
create stem cells bearing a patient's genetic material raises what
Ian Barbour calls "limit-questions"-questions that science alone
cannot answer. Whether funded privately or publicly, the
application of cloning technology to human beings challenges
deep-seated beliefs about what it means to be created by God and
the limits of human freedom and responsibility. The possibility of
"therapeutic cloning" pushes the limits of our experience, raising
serious ethical questions:
[12] What is the moral status of the blastocyst created in the
laboratory? Is it protected human life or a cellular ball that may
be used under certain circumstances in the pursuit of human health
and well-being?
[13] Does the commandment to love the neighbor include pursuing
"therapeutic cloning" in order to heal the neighbor?
[14] Is there reason to believe that "therapeutic cloning" will
slide down the slippery slope to the birth of a cloned baby-a
possibility that could commodify human life and that most Americans
find morally repugnant?
[15] And, significantly, what does justice require of us? Like
the rich man ignoring Lazarus suffering at the gate, we are often
blind to questions of justice in our pursuit of the good life.
Justice requires that society make certain that the benefits of
medical research are distributed fairly-paying particular attention
to those marginalized by the current health care system. The health
benefits that stem cell research promises must not be bought at the
expense of basic health care nor widen the gap between those who
enjoy consistent access to quality health care and those who do
not. Our penchant for long lives, quick fixes, and immediate
gratification must be balanced with the costs and benefits to
others, both now and in the future.