by Fritz Baumgartner, M.D.
Five years ago, California voters were asked to decide whether $3 billion tax dollars should be spent for human embryonic stem cell research (Proposition 71). In the days prior to the vote, my scrub tech in the operating room commented how great the ad- vances would be in the cure of human disease by such research if it weren’t for the Church being such an obstacle. Horrified, I corrected him saying the Church is not opposed to stem cell research but rather en- courages it as a legitimate means to alleviate human suffering. It is, rather, human embryonic stem cell re- search that the Church opposes because it results in the destruction of a living human embryo.
My scrub tech works in the O.R. and has some scien- tific background; one can only imagine the rampant misconceptions held by the general public. His com- ment is sadly indicative of the public’s widespread ignorance on the wisdom of the Church’s teaching on this important subject.
Well, Proposition 71 did pass with the shameful help of nearly two-thirds of Catholic voters. Now, five years later, what human embryonic stem cell treatments are there for human disease? Despite the promises, the answer is none. Zero. However, the opposite is true for other, morally legitimate forms of stem cell research which the Church approves and which have resulted in thousands of practical treatments and cures for human disease.
Stem cells are the body’s “master” cells since they can regenerate into cells that form all other tissues and organs in the body. There are two general types of stem cells – embryonic and non-embryonic. The non- embryonic stem varieties include “adult” stem cells (from bone marrow, brain, fat, etc.) and umbilical cord/placental stem cells (obtained during childbirth). The embryonic form was touted as the “holy grail” of research, since the totipotent embry- onic stem cells were the most immature and could differentiate into any organ system needed. Adult stem cells were originally felt to be less useful in developing into a wide variety of target tissues.
It was recognized, however, that clinical use of embryonic stem cells had at least two major obstacles.
The first obstacle was the host-graft immunologic rejection of the cells by the recipient patient. The problem is avoided when a patient’s own adult or cord stem cells are used since these cells are not immunologically foreign to the patient. Human embryonic stem cell researchers tried to tackle the problem by creating human “clones” – biologically new, genetically complete embryos. These clones are created by inserting the patient’s cellular nucleus into a donor ovum; since these new beings had the same immunologic complement as the patient donor, the harvested stem cells would not be rejected. This type of “therapeutic cloning” was a major component of California’s Proposition 71; however for political and public relations reasons, it was renamed as “somatic cell nuclear transfer (SCNT)” to differentiate it from “reproductive cloning” to produce a term baby.
A second clinical problem with human embryo stem cell research is the development of malignant tumors in the patient-recipients. The embryonic stem cells apparently develop wildly and unpredictably when removed from the checks and balances of their natu- ral embryonic environment, limiting their therapeutic application. Again, adult/cord stem cells do not near- ly have this problematic proclivity for tumor develop- ment.
In the earlier part of this decade, it was a presump- tion in the scientific and popular media that human embryonic stem cell research held far more promise than the adult stem cells in curing human disease, despite the problems with rejection and tumors. Hence, former President Bush’s 2001 decision to with- hold federal funding for new lines of human embry- onic stem cell research was met with hostility in many scientific and popular sectors. The New England Journal of Medicine rabidly vowed that the “editors will do our part” to influence the political debate “by seeking out highly meritorious manuscripts” extolling the virtues of human embryonic stem cell research and cloning.1
Starting the very next year, South Korean researcher Hwang Woo Suk published research claiming to have developed remarkable technologies for generat- ing cloned human embryos and harvesting their stem cells.2,3 Editorials glowed with praise for the research and its clinical potential as a model for the U.S.4 – un- til it was discovered that his research was a fraud and the work discredited.
Over the ensuing years, it became increasingly clear among scientists that it was the non-embryonic stem cells from adults and cord blood that held far more practical clinical applications compared to the em- bryonic variety. This observation was strangely com- municated in only the mutest tones to the general public by the scientific and popular media. The direct clinical application of adult/cord blood stem cells quietly continued unabated resulting in tangible ben- efits for untold thousands of patients worldwide. The ever-expanding list of illnesses treated include acute and chronic leukemia, lymphomas and other malig- nancies, inherited metabolic disorders, myeloblastic syndromes, autoimmune diseases and deficiencies, neuronal diseases and injuries, etc. One of the most spectacular recent benefit was for a 30-year old woman in Barcelona, Spain, who underwent replace- ment of her tuberculosis-damaged mainstem bronchus with a donor trachea lined with her own stem cells.
The final axe for the pop-cultural clamoring for human embryonic stem cell research came from its own instigator – Oprah Winfrey. Last year, in front of Winfrey and Parkinson-afflicted stem cell activist Michael J. Fox, thoracic surgeon Dr. Mehmet Oz stat- ed to shocked listeners, “I think, Oprah, the [human embryonic] stem cell debate is dead.” To his credit, Dr. Oz boldly stated what science knew but what the popular media selectively and only obliquely implied.
Therapies derived from human embryonic stem cells have not worked despite years of research and billions in investments. Conversely, adult/umbilical cord stem cell therapies morally acceptable to the Church do work. And that’s only the beginning. Over the past three years, Japanese and U.S. researchers have made breakthroughs allowing specialized adult cells (e.g. from mouse and human skin) to be geneti- cally reprogrammed to an embryonic stem cell-like state. These “induced pleuripotent stem cells (iPSCs)” hold dramatic clinical promise (Figure 1), unlike the morally objectionable human embryo research.
Despite the scientific evidence, within a few weeks after becoming president, Barrack Obama rescinded the ban which restricted federal funding of human embryonic stem cell research. From even a merely utilitarian standpoint, it is baffling that any champion of science or apostle of reason would promote an inferior technique which, compared to its alternative, appears unworkable, unreliable, and unnecessary, let alone unethical.
Despite all the above important practical points, we still need to address the real ethical issue: if practi- cal cures could someday truly be discovered utilizing human embryonic stem cell research, is there moral justification for the requisite destruction of these human embryos? Does the end justify the means? Do the moral arguments in the human embryonic stem cell debate have historical precedent? And how are the Hippocratic Oath, Nuremberg Medical Trials, and Geneva Declaration of Physicians reflected on in this question? These questions will be analyzed in Part 2 of this series in the next Spirit of Carmel magazine.n
- Drazen, J.M. 2003. Legislative myopia on stem cells. New England Journal of Medicine 349:300. 2. Hwang, W.S., Ryu, Y.J., Park, J.H., et al. 2004. Evidence of a pleuri- potent human embryonic stem cell line derived from a cloned blastocyst. Science 303:1669-74. RETRACTED.
- Hwang, W.S., Roh, S.I., Lee, B.C., et al. 2005. Patient-specific embry- onic stem cells derived from SCNT blastocysts. Science 308:1777-83. RETRACTED. 4. Bonchek, Lawrence I. 2004. Federal funding of stem cell research, and the war against disease. The Cardiothoracic Surgery Network, Oc- tober 9, In My Opinion section. http://www.ctsnet.org/doc/9510.