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QUOTE]AARP Bulletin
July-August 2005
Stem Cells: The Rush Is On

With states and scientists boldly advancing stem cell research-no
matter what the federal government does-now is the time to set the
rules

By Susan Jacoby

A scientific breakthrough in South Korea and political initiatives
from Washington to California could make it easier for American
researchers to explore the life-saving potential of embryonic stem
cells. And though treatments may be at least a generation away,
proponents are now moving quickly to confront the thorny ethical and
financial issues that surround stem cell research.

In late May scientists in South Korea reported in the journal
Science that they had devised a streamlined method for reproducing
embryos and extracting stem cells. They stressed that the procedure,
known as therapeutic cloning, is intended not to clone babies but to
replicate cells that may be able to repair or replace tissue damaged
by injury or disease.

Within days, the House of Representatives passed a bill, with
bipartisan support, that would allow the use of embryos discarded
from fertility clinics. President Bush pledged to veto the measure,
which would overturn his policy banning research on embryonic stem
cell lines that did not exist before Aug. 9, 2001.

Supporters of the research, who believe stem cell therapies can
treat conditions such as diabetes, Parkinson's and multiple
sclerosis, hailed the latest developments. "All of this shows that
you can't bury your head in the sand and stop medical progress,"
says Daniel Perry, executive director of the nonprofit Washington-
based Alliance for Aging Research. "We're thrilled to see a
bipartisan consensus in Congress. Ideally, our country should once
again become a research leader rather than a follower-with all of
our experiments conducted under strict nationally mandated ethical
standards. The public has the right to expect nothing less."

But opponents stood firm against research in which embryos are
destroyed. Alfonso Gomez-Lobo, a member of the President's Council
on Bioethics and professor of metaphysics and moral philosophy at
Georgetown University, says, "Once you have a cloned human embryo,
you can do two different things with it-implant it or destroy it. Do
we want a society in which laboratory technicians make that
decision?"

In an e-mail to the New York Times, council chairman Leon Kass,
M.D., described the Korean breakthrough as "morally troubling,"
arguing that the research not only makes it easier to clone babies
but "exploits women as egg donors not for their benefit."

In fact, the National Academies, an independent group of top
scientists and ethicists who advise the government on science and
public health policy, addressed some of those concerns in April when
it issued the first comprehensive ethics guidelines for stem cell
research. The guidelines are intended for states and private
institutions that are financing such studies. Though voluntary, the
rules were welcomed by institutions that are normally advised by the
National Institutes of Health.

The guidelines prohibit not only the cloning of human beings but
payments to egg donors or the use of eggs without the donor's
informed consent. But therapeutic cloning to culture new stem cells-
along the lines of the South Korean research-is permitted. Only the
earliest embryonic cells have the potential to turn into almost any
type of tissue. Adult stem cells are useful but believed to be less
versatile and thus less promising for research.

Therapeutic cloning is permitted under Proposition 71, a landmark
initiative passed last November in California. Voters there agreed
to spend $3 billion of their tax money for embryonic and adult stem
cell research. They also spurred other states-Connecticut, Illinois,
Massachusetts, New Jersey, New York and Wisconsin among them-to set
up their own programs or increase their spending for stem cell
studies. Although profits are still far in the future, regions that
take the lead in high-tech research stand to make millions, even
billions, when jobs, construction of research institutes and new tax
revenue are taken into account.

Miriam Piven Cotler, a medical ethicist at California State
University in Northridge and the University of California at Los
Angeles, who supported Proposition 71, says the amount of money at
stake, as well as the politicization of the issue, "makes it crucial
to step back and talk about these issues not in terms of special
interests but [within] a broader concept of justice."

That's exactly what the drafting committee for the National
Academies had in mind. In announcing the guidelines, committee co-
chair Jonathan D. Moreno, director of the Center for Biomedical
Ethics at the University of Virginia, said that in many instances
the Academies had set the bar higher than existing ethics
regulations on research.

Even in the absence of federal guidelines, states and the private
sector have forged ahead. The urgency of California's effort was
underscored by a study conducted by the Salk Institute in La Jolla,
Calif., and the University of California at San Diego. In a report
published in Nature Medicine in January, researchers concluded that
all the Bush-approved cell lines are contaminated with mouse
molecules that could set off an attack by the human immune system-
and thereby render treatments with those lines useless and
dangerous.

What sets the California research effort apart from other state
programs, which are typically established by legislation or
executive order, is that voters approved it, thus creating strong
public pressure to get the new California Institute for Regenerative
Medicine up and running as soon as possible. The first research
grants were expected to be awarded in May but were delayed until
some of the most prickly issues are addressed. Some of the questions
in California are sure to arise in other states as well. Among them:

* Who owns the intellectual property rights to discoveries based on
publicly funded research-and who will profit from any future
therapies that emerge? Supporters and critics agree that the state
must receive a share of profits from taxpayer-financed research.

* How can conflicts of interest be minimized in the awarding of
research grants, given the close ties among scientists, biotech
companies and universities? Members of grant-reviewing committees in
California are prohibited from voting on research proposals that
would benefit their own institutions. But Terry Francke, general
counsel for Californians Aware, a citizen watchdog group, says
that's not good enough. "The web of connections in this world is
just too cozy when you're talking about this much tax money," he
says.

* How public should the process be? Do taxpayers have the right to
know the nature of specific scientific research projects and the
reasons for their approval?

Perhaps the most important question is whether the possibility of
swift cures for serious diseases has been oversold to a public
strongly influenced by the deaths of Ronald Reagan and Christopher
Reeve. Opponents of the California program predict that voters will
eventually regret spending money on research for what may be a
distant payoff.

David A. Shaywitz, M.D., an endocrinologist and stem cell researcher
at Harvard University, says that scientists, the media and health
advocacy groups should urge the public to be patient.

"In contrast to the tidy tableau of television's CSI, science in the
real world is often slower and messier than we'd like," Shaywitz
says. "Ultimately, however, I suspect that embryonic stem cells will
evolve into a therapeutic tool even more useful than anything we can
now envision. By developing this technology today, we can hopefully
establish therapies that will benefit our children and grandchildren
in the years to come."[/QUOTE]