We are two of the scientist members of the President's Council on Bioethics. In late
2001, we were invited by the President of the United States to serve on this Council. The
Bioethics Council was appointed by the President to “monitor stem-cell research, to
recommend appropriate guidelines and regulations, and to consider all of the medical and
ethical ramifications of biomedical innovation…. This council will keep us apprised of new
developments and give our nation a forum to continue to discuss and evaluate these
important issues.”
This was a difficult invitation to accept. On the one hand, the President's views on the
use of human embryonic stem cell research and somatic cell nuclear transfer techniques were
well-known and in conflict with our own beliefs about the costs and benefits of the use of
progressive technologies to advance biomedical research. On the other hand, we were
grateful that the President, despite his views in opposition to these therapies, was
willing to invite serious biomedical scientists to help formulate advice to him—and
ultimately to contribute to the development of national policy—on these critically
important advances.
We knew that on this originally 18-member (but for most of the past two years a
17-member) Council, as scientists we would be in the minority in our belief of the good to
be gained through these and other areas of biomedical research. We were also aware that
some others on the Council had strong opposing views. Thus, it was only with the assurances
of the Council chairman, Leon Kass of the University of Chicago, and of the President of
the United States himself that we were persuaded that our voices would be heard and
integrated into the statements of the Council. Furthermore, we felt, and continue to feel,
that bioethical issues are important not only to all biologists, but also to society at
large, and thus especially worthy of engaging debate and discussion.
Two recently issued reports of the Council, “Beyond Therapy: Biotechnology and the
Pursuit of Happiness” (http://bioethics.gov/reports/beyondtherapy/index.html) and
“Monitoring Stem Cell Research” (http://bioethics.gov/reports/stemcell/index.html), are
therefore of deep concern to us. We discuss them in turn below.
Concerns about the “Beyond Therapy” Report
The “Beyond Therapy” report deals with issues of direct concern for every thoughtful
person. However, in the interests of setting straight the record of our views, as Council
members and scientists, on the content of this report and for a proper assessment of the
scientific content of the “Beyond Therapy” report, we feel it is important to point out
aspects of the report for which we had requested revisions and for which those requests
were declined.
In the discussions of preimplantation genetic diagnosis, the specter of designer babies
is raised by implying that selecting embryos for intelligence and other traits, such as
temperament is a possibility. Scientifically, this simply is highly unlikely and indeed may
not even be feasible. While such scientific unlikelihood is mentioned in passing in the
report, it is easy to take away from the report the feeling that such genetic manipulation
will happen and is even imminent.
The report also claims that “the underlying impulse driving age-retardation research is,
at least implicitly, limitless, the equivalent of a desire for immortality.” Furthermore,
the title of Chapter 4 of the report, “Ageless Bodies,” implies that immortality is the
goal of this research, despite all reliable scientific evidence to the contrary. Such a
title is not consistent with the knowledge, stated in that chapter, that there is no
scientific basis for immortality and implies that, by seeking to maintain and extend
“youth,” research into aging, including stem cell research, is predominantly to serve
vanity. Also, without presenting scientific or reliable evidence, the report presents the
opinion that research into prolonging healthy life may result in a lifetime obsession with
immortality. Hence, this chapter in the report falls short of explaining the serious
challenge of preventing and curing age-related disease to extend health—very different from
attempting immortality.
The same chapter offers a sensational quote from a researcher that “the real goal [of
aging research] is to keep people alive forever.” The request that quotes from researchers
more representative of the biomedical research community also be included was declined.
This leads to a misleading misrepresentation of the motivation of reputable researchers in
the field of aging.
In suggesting that slowing biological aging may increase the disjunction between “social
aging” (the age at which children are exposed to “adult” images and concepts) and
“biological aging” (expected lifespan), only one view, a conservative one, of the supposed
“best” way to raise children is presented. The report also suggests, with no clear
reasoning behind it, that longer lives will somehow undermine human determination to
contribute as much as one can during a lifetime. Despite requests for inclusion of material
that would allow for a balanced treatment of these topics, the report minimized discussion
of potential positive aspects of slowing biological aging, such as prolonged good
health.
Finally, the report repeatedly emphasizes a “profound and mysterious” link between
longevity and fertility, thereby leaving the reader with the distinct but erroneous
impression that anything done to extend healthy life will be traded for decreased
fertility, despite the fact that current scientific literature, which was made available
for inclusion in the report, shows a
lack of any necessary
mechanistic linkage of the two.
Concerns about the “Monitoring Stem Cell Research” Report
With respect to the “Monitoring Stem Cell Research” report, we feel that some facts that
would help the public and scientists better assess the content of the report were not
brought out clearly or were omitted entirely. First, from the published scientific
literature in peer-reviewed journals on stem cells, a major message can be distilled:
namely, the vast difference that currently exists in our understanding of, and the
potential utility of, embryonic versus adult stem cells as sources of material for research
and clinical purposes. In brief, human stem cells have been isolated from a variety of
embryonic, fetal, and adult tissue sources. However, enormous differences exist in purity,
properties, data reproducibility, and understanding of cells from these different sources.
Much of our ignorance is related to the relative paucity of funding for research using
embryonic stem cells.
Years of rigorous and careful research in animal models have documented that embryonic
stem cells have great utility for scientific studies. This work has also rigorously and
reproducibly established the great plasticity of these cells and supports the opinion that
human embryonic stem cells possess the greatest broadest potential and promise for clinical
applications. As well as therapeutic uses, important potential applications include studies
of embryonic stem cells bearing complex genotypes susceptible to poorly understood common
human diseases and testing and screening drug efficacy.
The report does not make clear that the best-characterized adult stem cells are
hematopoietic stem cells. Currently, major difficulties and inadequate understanding exist
with most other types of adult stem cells reported to date. In addition, many experiments
suggesting that adult stem cells have broad plasticity may be incorrectly interpreted owing
to an error caused by an experimental artifact of cell fusion present in some unknown
proportion of the experiments. Research on some of the reported adult stem cell
preparations may conceivably in the future demonstrate that they, too, like hematopoietic
stem cells, can also be prospectively identified, “single cell cloned,” expanded
considerably by growth in vitro with retention of normal chromosome structure and number,
and preserved by freezing and storage at low temperatures. But it should be strongly
cautioned that this has not been done for most adult stem cell preparations, and, even if
possible, it is not clear that any of the just-mentioned procedures will be accomplished in
the near future, owing to the technically very demanding nature of such experiments.
We feel it is important to emphasize a point that the report mentioned, that the
reported isolation and properties of multipotent adult progenitor cells (MAPCs) must be
reproduced in additional laboratories for any reliable interpretation of the results
reported with these cells. After considerable effort, this has still not been achieved.
Thus, in the reported results, the possible significance of the reported isolation and
properties of human MAPCs is left unclear, as is their potential as a source of stem cells
for clinical purposes. Hence, a strong overall caution is that many of the reports on the
properties of cells differentiated from adult stem cell preparations are to date
preliminary and incomplete. If results with any isolated and characterized adult stem cells
are validated, it will then be very important to compare their properties—and those of any
more differentiated cells that can be derived from them—with other stem cell sources, such
as the well-characterized hematopoietic stem cells, and with human embryonic stem cell
preparations.
Two major considerations argue strongly for non-commercial, federal, peer-reviewed
funding to be made available for this work. The first is the sustained effort this work
will require. The second is the importance of reliable and unbiased design of experiments
and of open, public availability of the complete findings.
Reasons for Our Concern
In being concerned about the content of these reports, neither of which makes any
recommendations for legislative or policy actions, are we worrying too much? We think not.
Indeed, already, sadly as a result of the way the sections on aging research in the report
were written, the myth that longevity has an inevitable tradeoff of diminished fertility is
now gaining a further foothold: witness the January 26, 2004, issue of the
The New Republic . In it, an article about this report of the Council
falls right into the trap: it states, “But changes come with longer life. Worms and mice
that are altered for extended lifespans become sterile, or barely reproduce.” The public is
done a disservice when science is presented incompletely; myths are then perpetuated.
This is but one example of the dangers that three of the Council members who are
scientists (the two of us along with Michael Gazzaniga of Dartmouth College) pointed out,
in a Commentary within the edition of the “Beyond Therapy” report published by the Dana
Foundation in November 2003. In that Commentary, we stated that “Our concern … is that,
moving forward, the debate carry on with all of the scientific evidence—or as much as such
a widespread public discussion can include—and take care not to leave an erroneous
impression as to the nature of the potential problems at hand.” We ended the Commentary by
saying “We urge both good reading and
critical reading!” (our italics).
These reports had as their premise the aim of neutrality in the scientific analysis of
the issues addressed. But our concern is that some of their contents, as in the few
examples outlined above, may have ended up distorting the potential of biomedical research
and the motivation of some of its researchers. Continuing discussions will form the basis
for future decisions on these topics; keeping such discussion open and balanced is of
paramount importance.
