Unquestionably, research on human embryonic stem cells is moving forward. A conspicuously missing partner in that progress is the U.S. government. In August 2001 President George W. Bush allowed the use of federal funds for work on embryonic stem cells but only on those from sanctioned samples. Those cells lines, far fewer than were promised, have many limitations and may be unsuitable for future therapeutic applications.
As policy, the current rules are unsatisfying. The federal government simultaneously encourages stem cell research and treats it as odious. It has effectively ceded the tough moral decisions about work on embryos to private interests, states and other countries--although it might reverse course at any time. The federal funding restrictions present the illusion of compromise, but they are really a fig leaf for befuddlement.
Making a bad situation worse, policies on embryonic stem cells are bound up with the equally contentious debate over human cloning. The biomedical community has repudiated reproductive cloning--the creation of individuals who are genetic facsimiles. For some envisioned therapies, it might nonetheless be useful to briefly create an embryonic clone of an adult for the purpose of extracting stem cells. Investigators want this kind of therapeutic cloning to be legal. Many people, however, oppose human cloning in any form as unnatural. Because of legislative deadlock over therapeutic cloning, the U.S. has left itself without the reproductive cloning ban that everyone wants.
The stakes of dithering on these issues are high. If other countries jump ahead of the U.S. in stem cell therapeutics--and several have declared that intention--then both the biotechnology industry and patients will suffer. American companies might lose billions in revenue. Our government will have to decide whether to approve stem cell treatments developed overseas and also whether to allow Medicaid and Medicare to pay for them. Denying lifesaving treatments to the poor and elderly would be neither ethical nor politically popular. Yet approving the treatments would be morally inconsistent: the U.S. would be saying that it is wrong to conduct the research but fine to benefit from it.
If the administration has been looking for moral guidance out of this quandary, some can be found in "Reproduction and Responsibility," a report issued in March by the President's Council on Bioethics (available at www.bioethics.gov). Among other reforms, the council recommends that reproductive cloning be strictly banned, along with any other techniques for human procreation except by the fusion of human egg and sperm. It also urges that experiments on human embryos should be acceptable if the embryos are not maintained past a very early stage of development (no more than 14 days, for example). Those guidelines would neatly separate reproductive and therapeutic cloning while allowing investigators to collect the needed stem cells.
We hope that President Bush will take those recommendations to heart and support appropriate legislation to enact them. The government needs to commit to more meaningful policies on this research. The report's proposals are the best ones on the table.
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