ALL-PURPOSE CELLS

November 6, 1998
		New cellular research may hold the key to replacing diseased or damaged tissues in humans. This breakthrough, while offering vast medical benefits, has also sparked an intense ethical debate. Following an interview with the biotechnology company that funded this research, two medical ethicists debate the concept. *If animation does not play or you do not have Flash 3, please click here.

Nov. 6, 1998: An interview with the company that funded the cell research. Oct. 30, 1998: Brain cells do indeed multiply. Feb. 24, 1997: The beginning of Dolly, a cloned sheep. More NewsHour Health and Science coverage.     University of Wisconsin features the discovery. Graphics of embryonic stem cells. The full report in Science Magazine	ELIZABETH FARNSWORTH: And now for the ethical issues we're joined by Dr. Kevin Fitzgerald, a geneticist and Jesuit priest at Loyola University Medical School in Chicago, and Dr. Norman Fost, director of the program in medical ethics at the University of Wisconsin in Madison. Dr. Fost was chairman of the advisory committee that reviewed the stem cell research reported today. Thanks for being with us. Starting with you, Dr. Fitzgerald, what's your reaction to what you just heard Dr. Okarma say?
	Embryonic issues.
	DR. KEVIN FITZGERALD, Loyola University Medical School: Well, good evening, Elizabeth. My reaction is not just to Dr. Okarma's words but also I got a chance to look at the article today in Science, and I mean, I have to admit, the science is very interesting. It's fascinating. I'm not quite sure it's as clean cut an advance, perhaps, as Dr. Okarma - in trying to simplify it - may have come across. The idea - the telomerase and all - it's a much more complex issue than just the activity of one gene, one enzyme telomerase. There are other aspects of this - other genes that are active in regulating it. So there's some scientific questions still to be answered. In that light, there is the important ethical issue, because this research is being done on human embryos. And, as Dr. Okarma said, human embryos are recognized to have some level of moral authority. Exactly what that level is, is not exactly clear. There has been a great deal of effort on the federal level and in universities in other areas to try and begin to delve into that area and explore what it is that we use to justify our granting ethical value or ethical moral respect to certain stages of human life. My particular emphasis is to say that I don't think we've really gotten very far in that discussion. I think we have a great deal more that we can do. And so while the science is still young, while there still are alternatives that can be used, if you look in the Science article today, they talk about using embryo stem cells from rhesus monkeys as a possible model for what's going on in the human. Now, we realize that animals too in research have a certain moral respect. The question is: Do rhesus monkey embryo stem cells have the same moral respect as human embryos do? ELIZABETH FARNSWORTH: Okay. Before we go into that, I want to go back up to your original point and go to Dr. Fost on this. Your committee recognized the special moral authority, as I understand it, of these embryonic stem cells, right? How did you deal with that question? DR. NORMAN FOST, University of Wisconsin: Well, I think, Elizabeth, the major concern was with the moral status of the embryo. I don't know that the cells, once they're growing, have the same kind of status. These are no longer cells that are capable of developing into a full human organism. ELIZABETH FARNSWORTH: You mean the stem cells, themselves, once they've been isolated? DR. NORMAN FOST: Exactly. ELIZABETH FARNSWORTH: Well, on the original question, though, on the status of the embryo from which they were taken. DR. NORMAN FOST: Right. I think there's general agreement that there should be some limits on research done on embryos that might grow into full, developed babies or persons or embryos that might develop to have neurologic structures, but I think there's also been wide agreement that embryos that are clearly going to die, that are going to be discarded, that it's widely accepted in several countries that have reviewed this to take cells from those now dying and about to be discarded embryos and use them for this kind of research.
	Is research moving too quickly?
	ELIZABETH FARNSWORTH: Dr. Fitzgerald. DR. KEVIN FITZGERALD: Yes. The issue at hand - the argument is that we have a particular medical or scientific benefit, and we use that benefit and weigh it against the moral authority that's given to the embryo. The problem I think here is one of translation. The fact is the way we value ourselves as humans, the way we value ourselves at various stages of our existence, is not based only on biological information. Neither, in fact, are our concepts of health and disease. But what happens is at times I think with this kind of research is that we get pulled and reduced into just using the genetic or the biological information as the crucial information. What I'm afraid happens in that regard is that we lose a great deal of richness in our own understanding of ourselves as human beings and the ways in which we wish to manipulate ourselves or not. When it comes to questions of what can be done and can't be done, I think too we need to broaden our scope because we look at things presently in the United States and in other countries where this kind of research can be done. But this research, if successful, will not be retained within those countries, but it will spread out and presumably be used throughout the world. What if there are places in the world where male human embryos are considered to be of more value than female fetuses, or maybe even young female children? What happens then when this sort of technology gets into a different sort of ethnical or cultural framework? Have we even begun to address these possibilities? ELIZABETH FARNSWORTH: So let me just interrupt you one second - so you're concerned not only with the fact that these cells came from embryos, but that the implications of it for research on embryos around the world, even if we control it in some way in this country, we can't control it elsewhere? DR. KEVIN FITZGERALD: Well, I think it has a great deal of ramification not only just for research on embryos but even how people value themselves, how people are seen. I think there are sociological ramifications possible, and we're just really beginning to scratch the surface of investigating some of these ramifications. ELIZABETH FARNSWORTH: Okay. And I'm going to get into the applications in a minute, but, Dr. Fost, respond to that about this research being used in other ways perhaps around the world. DR. NORMAN FOST: Well, I think Dr. Fitzgerald is referring to other kinds of research that could be done with embryos that might be problematic. I'm not clear what it has to do with this research. I think this research is well within guidelines in the United States, Canada, Great Britain, broad public opinion. I mean, there are many other kinds of studies that would be more troublesome, but I'm not sure what that has to do with Dr. Thompson's research, which is well within the mainstream. ELIZABETH FARNSWORTH: So what was your committee's main concern, Dr. Fost? I mean, you're a bioethicist. You were on this committee that looked over this research. What were you most worried about?
	DR. NORMAN FOST: Well, several things. One -- things that Dr. Okarma has already referred to - first that there was clearly full, informed consent and that the couples who were donating these embryos were fully informed of what they were doing. They got no incentives to do so. Second, that these were embryos that were not going to develop with any neural structures, that is, they were being discarded long before they developed into anything that could experience any sensation. Third, that the cells that Dr. Thompson worked with from the time he got them were not themselves embryos, and that's very important to understand. He was working with cells that had no capability of developing into a full human or into any other organism. They were just cells like many other kinds of cells that science has worked with - unusual in ways that Dr. Okarma described but didn't have the moral problems associated with cells that have the capability of developing into a full organism. So those were some of the key issues that made us comfortable that he was working within widely accepted guidelines.
	Do the ends justify the means?
	ELIZABETH FARNSWORTH: All right. Dr. Fitzgerald, moving on to the applications, what concerns you about the applications these, this research could lead to? DR. KEVIN FITZGERALD: Well, I think some of the applications - the idea of tissue regeneration and healing, transplantation, all those sorts of things, are certainly excellent targets to shoot at. The question would be, is this the only way to go, would there be perhaps less ethically problematic approaches? Do we-I mean, research is being done presently into looking at taking the tissue, itself, and attempting to have those cells recover some of their ability to reproduce, to replicate, to repair the tissue. The idea there, of course, is then you don't have to do a lot of this genetic engineering that Dr. Okarma talked about because it would be a person's own tissue. What here it would be more is investigation into controlled de-differentiation. Is there a way to take cells and have them suddenly regain some of these earlier characteristics they have for making more than one perhaps cell type in tissue, and for proliferating, for dividing, for creating more tissue. ELIZABETH FARNSWORTH: Is your concern partly that we're moving ahead so quickly on this and that the country hasn't really dealt with all the questions involved in a way that permits a proper base for moving ahead? DR. KEVIN FITZGERALD: Well, I think that the evidence is there to indicate that. One of the things that was brought up earlier today - someone said, well, you know, there are no restrictions on this sort of research. That's true in the private sector. But we do have a moratorium on federal funding for human embryo research. So why do we have this - you know - bifurcation? Why this sort of contradiction within our own social structure. And I think that indicates there again some really deeper issues that we need to wrestle with. ELIZABETH FARNSWORTH: What about that, Dr. Fost, as a bioethicist do you think we're not really ready for this research? DR. NORMAN FOST: I wouldn't use quickly to describe how we're moving ahead. Of course, Dr. Thompson and others have been working on this for a decade or more. On the ethical issues there have been very well constituted, balanced review panels in the United States, Canada, Great Britain, looking at this for almost a decade. These issues have been discussed, embryo research issues, for a long time. I think there's been a great deal of discussion and thought and agreement that this kind of research is quite within the mainstream. And on the applications I think by conservative estimates that's another decade away. So I don't think quickly is the word for either the way the science is progressing or the consideration that's being given to the ethical issues. ELIZABETH FARNSWORTH: All right. Well, thank you both very much. I think we'll return to this sometime soon. DR. KEVIN FITZGERALD: You're welcome, Elizabeth. DR. NORMAN FOST: Thank you.