By Lisa Seachrist
VIENNA, Va. ¿ President Clinton¿s National Bioethics Advisory Commission favors recommending that Congress modify its ban on embryo research to permit federally funded scientists to create and use embryonic stem-cell (ES) lines under certain circumstances.
The recommendation, should it survive to the final report (requested by the president and due in June), would advise Congress to remove the rider preventing federal funding of research that either creates or destroys embryos. That rider has been attached to National Institutes of Health (NIH) appropriations since 1995.
¿In the report, we would consider [certain embryo research] as appropriate for federal funding,¿ said NBAC Chairman Harold Shapiro at a commission meeting on whether there is an ethical basis for federally funding the creation and use of pluripotent ES cells.
The ethical questions concerning research using human ES cells comes not from the cells themselves, which aren¿t embryos, but from their origin. The cells that will likely be made available to federally funded researchers come from two ethically difficult sources: aborted fetuses, or embryos left over following successful in vitro fertilization attempts.
In addition, as somatic cell nuclear transfer is developed, it may be possible and desirable to create embryos and ES cell lines from these embryos. NBAC is considering how to deal with this eventuality, as well as the fact that much of the research related to in vitro fertilization concerns finding methods to reduce the number of spare embryos that are created. As a result, the supply of leftover embryos may dwindle.
Lori Knowles, an invited speaker and an associate for law and bioethics at the Hastings Center in Garrison, N.Y., said that, ¿in considering this issue, you need to anticipate changing science and articulate guiding principles that can be used as the technology develops.¿
The NBAC is considering recommending that Congress permit federally funded scientists to create and use ES cells derived from fetal sources and leftover embryos. As for creating embryos for research ¿ either by somatic cell nuclear transfer as means for creating therapies that have no immunogenicity, or by fertilizing an egg with sperm ¿ NBAC remains divided on how to proceed.
In any event, speakers at the meeting urged the NBAC to face the issue of embryo research head-on.
¿I would urge you to avoid manipulating the language surrounding the issue,¿ said Knowles. ¿One of the dangers of manipulating language is the look of skirting the issue. It is the fertilized human egg that is the locus of concern, whether you call it that or not.¿
Philip Noguchi, director for cellular and gene therapies at the FDA, concurred, telling the panel that the safety issues are the purview of the agency, whereas the FDA won¿t consider ethical issues.
¿I would echo the concern that you not shy away from the issue of the embryos, how they are made and their ethical and moral status,¿ Noguchi said. ¿There are plenty of safety issues surrounding this research, but the FDA is not going to be speaking about the moral status of embryos or the products created from them.¿
The acrimony of the human-embryo research debate has left some commissioners wary of plunging into it again. Nevertheless, the ES cell lines have opened a whole new set of therapeutic possibilities, which may make the public more likely to embrace the research under certain circumstances.
¿You will have to weigh moral costs of not permitting research versus the moral costs of doing the research,¿ said Knowles. ¿Those costs are intrinsically in the human embryo, and its connection to the human race. Even so, I believe you will see the tone of the debate change to the benefits of the research, as more is learned about it.¿
In the interim, NIH Director Harold Varmus has asked his general counsel to weigh in on whether NIH can legally fund research using the existing ES cells. In January, he told the NBAC that the general counsel had decided the law didn¿t prohibit such funding.
However, 70 members of the House and five senators have written to U.S. Health and Human Services Secretary Donna Shalala, protesting that Varmus is circumventing the will of Congress with the ruling. n