Non, je ne regrette rien

Remember the slogan "ethics is playing catch-up with science"? It was one of the trusty clichés of science journalists in the heated debates five or six years ago over embryo research, "therapeutic cloning" and embryonic stem cells.

From a layman's point of view, the nub of the issue was this: adult stem cells were ethically acceptable but multipotent; embryonic stem cells (hES) were ethically contentious but pluripotent. There is obviously a desperate need for cures for dread diseases, so why operate with a pen knife when you have a Swiss Army knife?

In the hyperventilated language of a 2003 article in the New England Journal of Medicine, "the Promethean prospect of eternal regeneration awaits us". One of President Obama's first official acts was to loosen restrictions on the use of hES cells. Reflecting the near-unanimous advice of his scientific advisors, he praised "these tiny cells [which] may have the potential to help us understand, and possibly cure, some of our most devastating diseases and conditions".  

In 2004 in California, voters passed an amendment to the state's constitution to fund research with human embryonic stem cells and to create the California Institute for Regenerative Medicine (CIRM). They knew that this was going to cost them at least US$3 billion, but it was a good bargain. These cells would lead to treatments for incurable and devastating diseases like cancer, diabetes, heart disease, Alzheimer's, Parkinson's, spinal cord injuries, blindness, ALS, HIV/AIDS, mental health disorders, multiple sclerosis, and Huntington's disease.

When push came to shove, the consensus was that ethics had to take a back seat to science. At the time, the scientific case for allowing "therapeutic cloning" and research on human embryos was overwhelming. There were politicians and voters who had qualms about the commodification of human life involved in killing embryos, but the experts assured them that the medical potential was dazzling. The loss of a few human embryos was a small price to pay.

In effect, there was an implicit pact between the public and stem cell scientists: we'll swallow our misgivings and provide the funding; you provide the cures.

But what happens when the pact falls apart? Because this seems to be what is happening. Embryonic stem cell research is looking increasingly like a dead end. Last week, after many false starts and a year after launching a human trial for spinal cord injuries, the California-based biotechnology firm Geron pulled the plug on all of its embryonic stem cell research to focus on cancer drugs. It had to: it was going broke.

This is a landmark moment in the stem cell debate. Geron was the leading company in embryonic stem cell research. It had been the focus of media attention for years. The National Institutes of Health directed readers to its website. A cure for spinal cord injury would have been the ultimate vindication of hES cell research.

But these hopes have crashed and burned. There have been no cures. The main development for therapeutic cloning in the past decade was a gigantic fraud by a Korean scientist Hwang Woo-suk who suckerpunched the world's leading science journals. Nowadays there is only one other company conducting a clinical trial with hES cells.

History seems to have passed this technique by. In 2007 a Japanese scientist, Shinya Yamanaka, published a technique for morphing ordinary skin cells into pluripotent cells. Most of the leaders in embryonic stem cell research jumped ship overnight because the new cells were both pluripotent and ethical. It was like moving from vacuum tubes to semiconductors. The CIRM now looks like a white elephant which cash-strapped Californians can hardly afford.

Most stem cell scientists still argue that human embryo research is needed to understand how organisms develop. But they did not sell their research to the public as blue sky science. They sold it as cures for devastating diseases.

Is there any hope left after the hype?

Yes, said New Scientist, in its response to Geron's failure. Without a smidgen of remorse or irony, it said: "Treatments based on adult stem cells are undoubtedly in the lead, with some very encouraging results this year… So at the moment, adult cells are leading the way clinically? Absolutely… In terms of sheer numbers and commercial potential, they are way in front."

Five years ago, some scientists were ridiculed for saying precisely this. Writing in the leading journal Science in 2006, a leading stem cell scientist, William Neaves, sneered: "It's bad science and bad ethics to misrepresent adult stem cell treatments in an effort to mislead the public about the potential benefits of research with embryonic stem cells." The object of his scorn, David Prentice, has been vindicated.

What about the implicit pact? Will Nature, Science orthe New England Journal of Medicine issue mea culpas for having demanded new ethical standards for dealing with human embryos? Perhaps they are hoping that no one will notice how misplaced their hopes were. But is this the way to keep faith with the public? The Bush Administration lost its credibility over non-existent weapons of mass destruction. Scientists risk something similar over medicines of mass therapeutics.