Ethical Alternatives
Keeping a focus on ethics in medical research.
An NRO Q&A
© National Review Online 2006-2007. All Rights Reserved.
Dr. David Prentice, senior fellow for life sciences at Family Research Council and founding member of Do No Harm, the Coalition of Americans for Research Ethics. A stem-cell expert, he's been closely involved in the recent congressional action on stem-cell research. As President Bush prepared to veto legislation that would federally fund embryo-destroying stem-cell research for the first time, Dr. Prentice spoke to NRO editor Kathryn Lopez about the debate.
KATHRYN JEAN LOPEZ: Do adult stem cells have more promise than embryonic stem cells?
DR. DAVID PRENTICE: They certainly hold more promise for helping patients with diseases and injuries. Their normal function in the body is repair, and we're seeing more and more examples of their utility in this respect. Embryonic stem cells are difficult to control, tending to grow out of control as tumors, or not form the necessary tissue and integrate to repair damage.
LOPEZ: What do you have to say about that recent letter that appeared in Science magazine on you and your work?
DR. PRENTICE: It's easy for someone to put words in your mouth and then claim that those words are false, which is exactly what the Science letter's authors did. Do No Harm has not claimed that current adult-stem-cell treatments are "cures" or "generally available" at this time. We have consistently said these are examples where patients have been helped by adult-/cord-blood stem cells and shown some benefit and improvement, something that can't be said to be even remotely close for embryonic stem cells.
In fact, if you look in the supplement to that letter, you find the authors repeatedly noting that the references in our list show "improved long-term survival," "disease remission," "extended disease-free period," "alleviate the symptoms," etc. They actually validate precisely what we've been saying.
As far as "FDA-approved clinical trials," if people would like to see what's out there, they should go here to see what trials are available. This is the list of all FDA-approved trials, all phases, currently recruiting patients. If they click the little box in the upper left of that page, they'll get the list that includes trials where they're done recruiting. As of July 19, it was 571 and 1,178, respectively. Keep in mind these are not results, these are trials under way at various phases of investigation. But they're all adult stem cells.
LOPEZ: Can you stand by your list of 72 adult-stem-cell successes?
DR. PRENTICE: Certainly. The Do No Harm list is based on published results where people have shown some benefit from use of adult stem cells.
LOPEZ: As you listen to the debate in Washington - what's most misunderstood about stem-cell research?
DR. PRENTICE: 1) The hope of stem cells vs. the reality of what's really been shown with various types of stem cells, embryonic vs. adult.
2) The idea that current "approved" lines of embryonic stem cells are "disintegrating" and "contaminated."
Good cell-culture technique includes saving back cells in the freezer so that you can replenish growing cells. As an example, a human cell line started in the 1960s was used for decades by researchers. It's hard to believe NIH technicians wouldn't be using good laboratory practices. And at least two publications, one just months ago by James Thomson (of University of Wisconsin-Madison, who first successfully cultured human embryonic stem cells in the lab) documents that any contamination can be removed from the current lines.
LOPEZ: Would surplus embryos get thrown away if they weren't used for research?
DR. PRENTICE: Unfortunately at this time in the U.S. some would be discarded, though the numbers are much smaller than the public claims of proponents of embryo research. The Rand survey a couple years ago showed that there are around 400,000 embryos frozen in the U.S., but it also pointed out that only a small percentage of those were discarded or available for research, and the number of potential embryonic-stem-cell lines (dishes of cells) is far less than proponents say they want for research and would not meet their "need" for genetic diversity in the cell lines.
And of course they don't need to be discarded; there are other options such as embryo adoption (e.g., the Snowflake program).
LOPEZ: Are both Santorum bills that passed the Senate Tuesday - the alternatives one and the fetal farming one - necessary?
DR. PRENTICE: The fetal-farming bill is definitely necessary legislation. Though there are no documented examples yet of human fetal farming, some scientists have done "proof of principle" experiments to grow cloned animal embryos to later stages for harvest of more mature cells and tissues. And legislation that could encourage that practice in humans has popped up in several states.
The alternative-pluripotent-stem-cell legislation is designed to encourage research on ethical alternatives for flexible stem cells. We do need more emphasis on ethical stem-cell research.
LOPEZ: Considering there is already private embryo-destroying research going on, is the fight against federal funding ultimately a losing battle?
DR. PRENTICE: No, there is still an ethical and practical line to be drawn regarding use of taxpayer funds and allocation of important resources.
LOPEZ: Did the president's August 2001 announcement prove to be a mistake?
DR. PRENTICE: While people on both sides of this debate were upset with the decision, it drew an ethical line on use of federal funds, and provided direction, cells, and funding for the research.
LOPEZ: What's most winnable in holding back a brave new world? What's most necessary to win?
DR. PRENTICE: Looking ahead and trying to channel research along ethical lines; the fetal farming legislation is a good example. It's important to continue to hold the ethical line that no human life, at any age, should be used as raw material or be under the threat of government-sanctioned destruction.
LOPEZ: Some of the rhetoric is vicious, as you know. What do you say when you're told you're anti-science and want to stomp all over people's hopes?
DR. PRENTICE: My colleagues and I are pro-science, and that's why we want to see the ethical science flourish.
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