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Scientific BreakthroughsROBERT P. GEORGENational Review Online Editor Kathryn Lopez recently asked Robert P. George, a member of the President's Council on Bioethics, to talk a little about the future of stem-cell research and some of the heated rhetoric surrounding the issue. | Robert
P. George
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In a recent Wall
Street Journal opinion piece (registration required), Princeton's Robert
P. George teamed up with Dr. Markus Grompe — "a professor of genetics at
the Oregon Health and Science University, director of the Oregon Stem Cell Center
and a member of the International Society for Stem Cell Research" — to herald
the promise of an alternative to ethically challenged embryonic-stem-cell research.NRO
Editor Kathryn Lopez recently asked George, a member of the President's Council
on Bioethics, to talk a little about the future of stem-cell research and some
of the heated rhetoric surrounding the issue. National
Review Online: Last week in the New York Times, Mario
Cuomo wrote "So far neither Mr. Bush nor religious believers have convinced
a majority of Americans that the use of embryonic stem cells inevitably entails
the murder of a human being. Most Americans, vividly aware of the millions of
tragic victims of Alzheimer's, Parkinson's, cancer and spinal cord injuries, believe
that embryonic stem cell research may provide cures. They will demand that Congress
act to realize that potential." You must have been fuming. Robert
P. George: One really does wish that Governor Cuomo would defend his
views with arguments. If he really thinks that human embryos are something other
than human beings at the earliest stage of their natural development, he should
state his reasons for believing such a thing. He should explain to us the basis
of his judgment, if it is indeed his judgment, that every major text in the field
of human embryology is simply in error on the point. After all, the question of
whether a human embryo is or is not a whole living member of the species Homo
sapiens is not one to be resolved in the mind of any conscientious citizen or
morally serious policymaker by examining public-opinion polling data. At
the same time, it should be noted that Cuomo doesn't even manage to do justice
to public-opinion polls on the question of embryo-killing. For what it is worth,
polls stating the question in an unbiased fashion tend to show that a majority
of Americans do not support the practice of destroying human embryos for biomedical
research, and certainly oppose the creation of embryos by cloning for research
— so-called "therapeutic cloning" — or any other purpose. 
NRO: Is he
just ignoring reality ?
George:
Yes. In dodging the moral argument against embryo killing, he is ignoring
the basic facts of human embryology and developmental biology. There is no mystery
about when the life of a new human individual begins. It is not a matter of subjective
opinion or private religious belief. One finds the answer not by consulting one's
viscera or searching through the Bible or the Koran; one finds it, rather, in
the basic texts of the relevant scientific disciplines. Those texts are clear.
Although none of us was ever a sperm cell or an ovum, each of us was, at an earlier
stage of development, an embryo, just as each of us was an adolescent, a child,
an infant, and a fetus. Each of us, by directing his own integral organic functioning,
developed himself (sex is determined from the beginning) from the embryonic, into
and through the fetal, infant, child, and adolescent stages, and into adulthood
with his unity and determinateness intact. One's identity as a human being does
not vary with or depend upon one's location, environment, age, size, stage of
development, or condition of dependency.
We cannot say with certainty that embryonic
cells will never prove therapeutically useful in treating other diseases, but
as a matter of sheer fact not a single embryonic-stem-cell therapy is even in
clinical trials.
| Of course, science cannot by itself
settle questions of value, or dignity, or morality. And there are, to be sure,
people such as my colleague Peter Singer who understand the science, but who deny
the ethical proposition that human beings have inherent dignity and equal
rights. They are willing to license the killing of certain innocent human beings
(the very young, the severely retarded, the gravely debilitated), distinguishing
those whom they regard as "persons" from those whom they believe are not, or are
not yet, or are no longer "persons." Hence, Singer's notorious advocacy not only
of abortion but of infanticide and euthanasia as well. But I would have thought
that Mario Cuomo would want to stand with those of us who affirm the inherent
and equal dignity of every member of the human family. Surely he would wish to
uphold against the Singers of the world Jefferson's "self-evident" proposition
that all human beings are created equal. But that leaves him with only one option
if he is to rationalize his support for abortion, embryo-destructive research,
and their public funding: He must disregard scientific reality and pretend that
basic embryological facts remain shrouded in mystery.
There is another
piece of reality that Cuomo is ignoring. He is imagining — or at least encouraging
others to imagine — that embryo-destructive research holds the key to curing
horrible diseases, such as Alzheimer's, Parkinson's, and cancer. The truth is
that we do not know when, or even whether, embryonic stem cells will prove
to be useful in treating any disease. Leading authorities on Alzheimer's
disease, including many scientists in the field who personally favor embryonic-stem-cell
research and its public funding, say that Alzheimer's will almost certainly never
be treated (much less cured) by embryonic-stem-cell therapies. A recent story
in the Washington Post quoted a leading Alzheimer's researcher as saying
that the belief that embryonic stem cells will be used to treat Alzheimer's is
a "fairy tale."We cannot say with certainty that embryonic cells will never
prove therapeutically useful in treating other diseases, but as a matter of sheer
fact not a single embryonic-stem-cell therapy is even in clinical trials. No one
knows how to prevent tumor formation and other problems arising from the use of
embryonic stem cells. No one knows whether these problems will be solved or solved
before other research strategies render embryonic research obsolete. Like John
Kerry, John Edwards, and Ron Reagan, Cuomo is elevating the hopes of suffering
people and their families who are desperate for cures and eager to believe that
if only embryonic-stem-cell research were federally funded they or their loved
ones would be restored to health. Indeed, Cuomo supposes that the American
people are about to rise up and demand that the Congress open the money faucet.
He imagines that the voting public will not tolerate politicians who stand their
ground against the funding of embryo-destructive research. But, again, the former
governor is disregarding reality. Kerry, Edwards, and company made the issue of
embryonic-stem-cell-research funding a central feature of their campaign. They
hammered President Bush on the issue at every campaign stop and, via Ron Reagan,
in prime time at their national convention. They thought they could ride the issue
to the White House. They lost.
NRO:
Cuomo aside, is a silence starting to be broken about adult-stem-cell
research and other alternatives to embryonic-stem-cell research?
George:
Yes, the word is getting out about actual therapeutic breakthroughs
using non-embryonic stem cells, such as cells harvested from umbilical cord blood,
bone marrow, fat, and other sources. There are people suffering from a variety
of diseases who have been helped and even cured by adult-stem-cell therapies.
Many such therapies are well along in clinical trials. Word is also getting out
about alternative methods of obtaining pluripotent (i.e., embryonic-type) stem
cells. Even those of us who oppose embryo killing and reject the hype about possible
embryonic-stem-cell therapies recognize that research involving pluripotent cells
is desirable if the cells can be obtained without killing or harming human embryos
or violating any other ethical norm. Even if they do not someday prove to be therapeutically
useful, pluripotent cells may nevertheless be used in basic science and the construction
of disease models. Recently, the President's Council on Bioethics issued a white
paper outlining several promising avenues for obtaining these cells without violating
the ethical norm against taking innocent human life. I joined the overwhelming
majority of my colleagues on the President's Council, including many who do not
share my ethical objections to embryo killing, in endorsing further exploration
and research into some or all of these methods. There are some exciting possibilities
here, especially those involving epigenetically reprogramming ordinary body cells
to the pluripotent state.
NRO:
What has been keeping the media from talking about these ethical alternatives?
George:
Most people in the mainstream media favor embryonic-stem-cell research
and have no objection to killing human embryos to obtain the cells. They are in
the Cuomo camp. They view the opponents of embryo killing as "religious conservatives"
and even "fundamentalists" who are trying to "impose their morality" on others
and who are, in this case, trying to block advances in biomedical science. They
think that talking about alternatives to embryo-killing (or successes with adult
stem cells) only serves the interests of their political opponents. So many simply
keep mum. There are, however, honorable exceptions. Neither Rick Weiss of the
Washington Post nor Gareth Cook of the Boston Globe would appear
on anybody's list of reporters secretly harboring sympathy for the pro-life cause.
Yet both have published important, carefully researched stories telling the truth
about possible alternatives to embryo-destructive research.
NRO:
In layman's terms, what is OAR and what is the big deal about it?
George:
Oocyte assisted reprogramming (OAR) is among the most exciting proposals
for obtaining pluripotent stem cells without killing or harming human embryos.
OAR is a variation of a broader concept known as "altered nuclear transfer." It
combines basic cloning technology with epigenetic reprogramming. I'll explain.
Oocyte assisted reprogramming (OAR) is among
the most exciting proposals for obtaining pluripotent stem cells without killing
or harming human embryos.
| In cloning, the nucleus of
a somatic cell (such as a skin cell) is transferred to an egg cell whose nucleus
has been removed. An electrical stimulus is administered in a way that, if all
goes as planned, triggers the development of a new and distinct organism, an embryo,
that is virtually identical in its genetic constitution to the organism from which
the somatic cell was taken. In OAR, however, the somatic-cell nucleus or the egg
cytoplasm or both would first be altered before the nucleus is transferred. The
modifications would change the expression of certain "master genes" — transcription
factors that control expression of many other genes by switching them on or off.
These genetic alterations would permit the egg to reprogram the somatic-cell nucleus
directly to a pluripotent, but not a totipotent (i.e., embryonic) state. The altered
expression of the powerful control gene would ensure that the characteristics
of the newly produced cell are immediately different from, and incompatible with,
those of an embryo. For optimal reprogramming, master genes known to control the
pluripotency of embryonic stem cells would be used, for example the transcription
factor known as "nanog." Thus, we would reasonably expect to obtain precisely
the type of stem cells desired by advocates of embryonic stem-cell research, without
ever creating or killing embryos. The cells used would not be embryos and would
at no point go through an embryonic stage. Embryogenesis would never occur. (A
technical description of OAR is posted on the website of the Ethics and Public
Policy Center here.)
NRO:
Is this in any way similar to Dr.
Hurlbut's research? Is that something science should also be pursuing —
with policymakers' backing?
George:
William Hurlbut of Stanford University and the President's Council on Bioethics
has been the leading voice urging scientists and policy makers to explore altered
nuclear transfer as a possible method of obtaining pluripotent stem cells in an
ethically unimpeachable manner. OAR represents a variation of Dr. Hurlbut's basic
proposal. It emerged from discussions involving Dr. Markus Grompe of the Oregon
Health and Science University, Dr. Maureen Condic of the University of Utah, and
others. It represents an important step forward because it does not involve the
production of non-embryonic entities from which stem cells are harvested; rather,
it employs techniques of epigenetic reprogramming of somatic cells to produce
stem cells directly. Previously discussed versions of altered nuclear transfer
left some pro-life advocates with concerns about whether we could really know
whether altered nuclear transfer was producing truly non-embryonic entities as
opposed to damaged or defective human embryos or human embryos pre-programmed
for an early death (because, for example, they could not implant). OAR relieves
that concern. Still, I and others advocating exploration of OAR want to begin
with research using animal cells and proceed to the use of human cells only after
OAR is proven to be technically feasible and ethically beyond reproach. We believe
that this can be accomplished quickly and at modest cost. I certainly hope that
policymakers will back this exploration.
NRO:
When you advocate "creative science" — as you did in the headline of
your recent Wall Street Journal — can't that get dangerous? I mean,
we don't have a ban on a lot of stuff, especially when it comes to private research.
George:
Science is a wonderful enterprise. It has served the cause of humanity
in myriad ways. It has improved the average length and quality of our lives, and
will continue to do so. Like countless others today, I'm a cancer survivor. Science
made my survival possible. I can't begin to tell you how grateful I am for that.
Yet, every sober person recognizes that great harm can also be done in the name
of science and even in the cause of science. As in every other domain of life,
in the sciences people can be tempted to do things that are morally wrong for
the sake of what advocates of the wrongdoing will present as a "greater good."
That kind of utilitarian thinking should always be resisted. Good ends do not
justify bad means. The fact that a particular practice or strategy promises to
advance scientific knowledge or even lead to cures for dreaded diseases cannot
in itself justify otherwise unethical conduct. Even science is subject to moral
norms. These norms — including above all the norm against killing innocent
human beings at any stage or in any condition — place rational limits on
what science may legitimately do. Killing, even in the cause of healing, compromises
the moral foundations of biomedical sciences and cannot be justified.
NRO:
Where would you specifically like to see attention focused? On one
type of research in particular or spread out a bit?
George:
Various areas of adult-stem-cell research are clearly promising. As I mentioned
earlier, some have produced actual therapeutic results already. The cord-blood-stem-cell-research
bill recently passed in the House of Representatives is a good thing, and
I hope that the Senate will now pass it and send it along to the president for
his signature. I'm hopeful about the research being done by a team at Griffiths
University in Australia using stem cells obtained from nasal mucosa. In addition,
I'm very interested in Dr. Catherine Verfaille's research on multipotent adult
progenitor cells obtained from bone marrow and in Dr. Yuri Verlinski's research
using embryonic stem cells derived from existing stem-cell lines approved for
research under President Bush's funding policy to reprogram somatic cells to the
pluripotent state. As I've already mentioned, I certainly want to see research
into OAR and similar epigenetic reprogramming strategies generously funded. But
I'm optimistic about other possibilities, too. I would urge people who are
interested in this general question to look at the White Paper issued by the President's
Council on Bioethics and the Council's Report on Monitoring Stem Cell Research.
Both are available online at www.bioethics.gov.
NRO:
Does the federal government need to finance this — OAR or other
research? What are the rules you'd advocate for private research?
George: Because
of its proven therapeutic promise, a great deal of adult-stem-cell research is
being funded by private investment. That's great. But, as a practical matter,
in the system we have developed over the past several decades, government funding
— particularly federal funding — plays a major role. That's reality.
So I would like to see NIH funding for OAR. The initial round of funding to test
the method would, as I said earlier, involve only modest amounts of money. If
everything checks out, a bigger investment would be required, but it would be
an investment we should be happy to make.
NRO:
Most people's eyes glaze over when the topic of stem-cell research
comes up. Are there just a few basic fundamentals people can grab onto that will
serve them well in the midst of spin and worse?
George:
Don't trust claims about magic cures.
NRO:
You don't seem as anti-science as
I'm told you (and I) are — what's that about? George:
The claim that people like you and me (and President Bush and Leon Kass and Charles
Krauthammer) are anti-science is all about politics. It is so manifestly silly,
though, that it can be safely ignored.
ACKNOWLEDGEMENT
Kathryn Jean Lopez. "Scientific Breakthroughs." National
Review (June 29, 2005). This article is reprinted with permission from
National Review. To subscribe to the National Review write P.O.
Box 668, Mount Morris, Ill 61054-0668 or phone 815-734-1232. THE
AUTHOR Robert
P. George is McCormick Professor of Jurisprudence and Director of the James Madison
Program in American Ideals and Institutions at Princeton University. He is the
author of Making
Men Moral: Civil Liberties and Public Morality
(1993) and In
Defense of Natural Law (1999), and editor of Natural
Law Theory: Contemporary Essays (1992), The
Autonomy of Law: Essays on Legal Positivism (1996), and Natural
Law, Liberalism, and Morality (1996), all published by Oxford University
Press. He is also editor of Great
Cases in Constitutional Law (2000) and co-editor of Constitutional
Politics: Essays on Constitution Making, Maintenance, and Change (2001),
from Princeton University Press. His most recent book is The
Clash of Orthodoxies (2002). Robert George is a member of the Advisory
Board of the Catholic Educator’s Resource Center. Copyright © 2005
National Review
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