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Ethics and Science

August 10, 2001 at 12:00 AM EST
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TERENCE SMITH: And for that reaction we’re joined by Leon Kass, a bio ethicist at the University of Chicago; he will head the new commission announced last night by President Bush to monitor stem cell research issues; Dianne Krause, a stem cell researcher and professor at the Yale University’s School of Medicine; Alta Charo, Professor of Law and Bio Ethics at the University of Wisconsin; and Richard Doerflinger, Deputy Director of pro-life activities at the U.S. Conference of Catholic Bishops. Welcome to all of you.

TERENCE SMITH: Professor Krause, let me begin with you. You just heard Secretary Thompson say that there are 60 viable lines, entirely enough, he says, to carry out basic research. As somebody who works in this field, are you persuaded?

DIANE KRAUSE: No, I’m not persuaded. Certainly for some uses, 60 cell lines will be sufficient, but for other scientists that won’t be enough.

TERENCE SMITH: For example?

DIANE KRAUSE: For example, for immuno biologists, who work on immunology, as you know, every human being has a different immune systems, so if we’re trying to study the complexity of the immune system using these cells, just 60 won’t even begin to give us a flavor of the whole spectrum of humans in our society.

TERENCE SMITH: All right. Professor Kass, what’s your view of that?

LEON KASS: Well, I think that’s – that’s a question, which is much debated. The scientists with whom I have spoken are delighted to have these existing cell lines, and they’re quite surprised to discover how many they are. Whether down the road people will find this sufficient is an empirical question and only time will tell. But I think, if I might, I think the most important thing is not the question on which the media likes to focus on: Did he or didn’t he or will he or won’t he or how many cells there are, but that the President has used his first primetime address to the nation to make visible the deep and important moral questions that are connected with biomedical advance.

And he made a statement in which he established the principles on which he made this judgment and principles which he upheld and at the same time tried to do medical good. This, it seems to me, is our challenge, and the challenge that he has put to the President’s Council on Bioethics, namely to find a way to reap the benefits of medical science but without undermining human decency, human dignity and the respect for life. That, I think, is the message that should be carried away from the speech and less the question of whether we’ve got enough cells or not.

TERENCE SMITH: Professor Charo, I wonder what your view is and whether you think the President drew the right line in terms of research.

R. ALTA CHARO: I think the President gave us the beginning. He gave us the first federal funding we’ve had in many, many years and an opportunity to begin to see whether the promise of embryonic stem cells is fulfilled. Whether the particular kind of research he’s supporting will be sufficient for scientists to do all the necessary work is yet to be seen. The most important thing, from my point of view, is that the President has recognized that there’s a balance to be made here, a balance between the needs of patients and the needs of those who are concerned about embryos, and that the needs of patients cannot be ignored and cannot be given second place. If in a subsequent time we find we need to change these rules to protect those patients’ interests I would certainly hope the President would revisit his thinking and his decision.

TERENCE SMITH: Richard Doerflinger, what’s your view of all this?

RICHARD DOERFLINGER: Well, I certainly agree with the principles that Dr. Kass has talked about and I’m very pleased with the President’s decision to name him as head of the commission. I hope he gives the commission some real clout to monitor this. But there is a principle that’s been abandoned here. There’s a moral line that’s been crossed by the President, and it was an important one, I think. And that was a principle that has even been upheld in our federal laws on fetal tissue research after abortions; that it was never the policy to say you could fund research where life was destroyed at any stage for the sake of that research. And I’m sure these stem cell lines were created by these researchers in anticipation of just this funding and with the idea that in some cases that they better make these stem cell lines in time for this decision so they could be grandfathered in. The question about the number of cell lines, well, sure, 60 may be enough for basic research.

We’re facing the decision down the road. Are these cells going to be useful for real treatments for these millions of patients who have diseases or not? And, if not, then we’ve thrown away some money to find out it didn’t work. And destroyed some embryos for nothing. But if they do work, people are talking about needing tens of thousands, hundreds of thousands, maybe millions of genetically diverse cell lines not only for the volume but for minimizing tissue rejection problems. So the president may be, I’m afraid, setting the stage for a much broader policy in which destruction of life will become integrated into medical practice.

TERENCE SMITH: Professor Krause, do you see a distinction either ethical or practical, between research or actually stem cell line that was destroyed before a given date, August 9 and one after it?

DIANE KRAUSE: Absolutely not. The distinction doesn’t exist. If these are made from a human embryo that needed to be destroyed in the process, whether they were made last week or they’re made next week, there are going to be the same cell line that could be available to federally funded researchers, so it seems somewhat ethically inconsistent to say that we can use the 60 that already exist and not the 61st that’s made next week.

TERENCE SMITH: Leon Kass, ethically inconsistent?

LEON KASS: No, I don’t think so. It’s a subtle point, it would take some doing, but it seems to me there’s a long tradition of talking about when one might benefit from some badness or evil that has been done. Here there has been no cooperation in the destruction of those embryos. Here there has been no enabling of the destruction of those embryos. Here there has been not even the least bit of inducement for the destruction of those embryos.

And therefore, if you take advantage of the benefits that come from it but in the process reassert the principle that has been violated, which the President did, then it seems to me you’re not simply complicit in the evil that’s been done. This is the way we have all decided to benefit from the chicken pox vaccine; even people who opposed research on fetuses will use the vaccine produced from fetal tissue obtained in abortion. The embryos that will be produced from now on will be… Can be considered to be produced with the inducement of the President’s decision, and if that is the case, then he is, in fact, in some way complicit in their destruction. That, I think, would be the moral analysis that would uphold this distinction. You may not like it. You may find it splitting hairs but I think it is a principle.

TERENCE SMITH: Professor… I’m sorry, Richard Doerflinger, you wanted to say something. The President, after all, argues that this would be using stem cell lines where the life-and-death decision to use his phrase has already been established.

RICHARD DOERFLINGER: Well but I think that the inducement came from the issuance of these NIH guidelines in the first place last August which said, if you get these embryos and destroy them for their cells and do it in certain ways, there’s a federal pot of gold waiting at the end of the line for this research. And during this administration, Tommy Thompson said keep those applications coming in. I think that was an inducement as well. So I think the analogy to vaccines from fetal tissue is strained because this is a case where we are directly rewarding, in some cases, the people who actually destroyed the embryos for these cell lines and they were destroyed for the purpose of this research.

It was not an elective abortion done by somebody else for some other reason. You know, given all that, I hope with Dr. Kass that limits can be placed. And I think it’s going to be very difficult to place a morally principled limit once you’ve started down the road. We’re certainly going to be working with the President as much as we can to support certainly a ban on human cloning that’s halfway through Congress now and to try to prevent any further broadening of this. But we are disturbed by the principle behind the original decision.

TERENCE SMITH: Professor Charo, I wonder, Richard Doerflinger is making an assumption here about the motive and message of researchers prior to this date. Do you agree with that? Do you think they did this in anticipation of this sort of a distinction being drawn?

R. ALTA CHARO: No, I don’t share his belief about the motivations of either the researchers or the patients who agreed to have their embryos discarded. I think it’s important that we remember, whether we’re working with existing cell lines or cell lines in the future, we’re working with cell lines that come from embryos whose progenitors, the people who supply the egg and sperm, had decided they didn’t want to use the embryos, had decided they didn’t want to give them up for adoption, had decided they wanted to discard them. The prospect of research is not what causes the destruction of these embryos. It’s the choice of these adults to discard the embryos.

And while there is much room for legitimate debate about whether that is something that we should be happy about or tolerate — and there are medical reasons why this comes about — that embryonic destruction is a part and parcel of the infertility procedure. And the only question, whether it’s existing or future cell lines, is whether we gain any research value from those embryos in the process of their destruction. I don’t see the inducement. I recognize that at an emotional level, there is an instinct that there’s less complicity with that act of destruction if we’re talking about long discarded long-ago killed embryos. And to that extent I appreciate the President’s reasoning but I don’t think it’s fair to assert that there are motivations, unsavory motivations, on the part of patients, doctors or researchers without any evidence to support that.

TERENCE SMITH: All right. Professor Krause, paint the future for us, if you will, now that this decision has been taken. Do you anticipate accelerated research in both the public and the private sectors?

DIANE KRAUSE: Well, acceleration isn’t quite the proper term because this is now the first time that federally funded researchers are free to submit applications in which they propose to use embryonic stem cell research in federally funded work. So, yes, it will accelerate. It will take it from 0 to something. This is just the beginning of what federally funded researchers can do. How this will affect the pace at which privately funded researchers move forward is unclear.

TERENCE SMITH: Leon Kass, tell us a little about this commission that you’re going to head, as you understand it. What’s it supposed to do and does it have an enforcement role?

LEON KASS: It does not have an enforcement role as far as I understand it. And I think it has been slightly mischaracterized in suggesting that it is going to be simply confined to the stem cell research question. The President said in his speech that the stem cell research debate is at the leading edge of a whole array of moral hazards. And he has also charged this Council on Bioethics with considering the whole range of medical and ethical issues raised by other aspects of biomedical advance. I think it’s very important– and this has been the concentration on the stem cell question, important though it is, has blinded us to the fact that this is part of a much larger set of questions. We are acquiring the power to intervene in the human body and mind in new and drastic ways, many of them for good. But these same powers, if we are not careful, can also take us down the road in the direction of brave new world where no one wants to go. And the task for us, and the task for this Commission, is in part to provide a public forum for discussion of these questions so that we can make wiser decisions and avoid the degrading possible consequences of this research we so dearly love.

TERENCE SMITH: So the task is huge. I want to thank all four of you very much.

LEON KASS: Thank you very much for having us.