The Stem Cell Debates: Lessons for Science and Politics
February 14, 2012
In December 1994, a committee that advises the director of the National Institutes of Health met on the NIH campus in Bethesda, Maryland. The meeting focused on the recent recommendation of the NIH’s Human Embryo Research Panel that the federal government should fund a range of research involving human embryos.
The chairman of the panel told the committee about the “extremely high level of public ignorance” about human reproduction, which “invites exploitation by those who, for moral reasons, object to human embryo research.”
That ignorance, he warned, could be “manipulated into public hostility” toward embryo research.
The conversation became frankly political, as several committee members voiced concern that the incoming Republican majority in the U.S. Congress would restrict funding for the research, including expected developments with human embryonic stem cells. The committee began to brainstorm ways to shape the policy and influence public reaction so that embryo research could receive government funding with minimum opposition. One committee member proposed a sophisticated strategy of political lobbying: “have us do our homework to determine which people in Congress … have family members with which particular illnesses and make individual visits to them to ‘background’ them and brief them and discuss their particular family history concerns. Scientists would respond to ethical objections against the destruction of nascent human life by entering the political arena; to make their case, they would rely not only on scientific facts but on emotionally charged appeals.
Fast-forward a dozen years. Embryo research became a hot-button political issue, and strikingly, just as had been anticipated in 1994, public officials and candidates for office regularly spoke about the issue in terms of their family health problems. So it was that, in considering legislation to fund embryonic stem cell research in April 2007, a series of Senators, one after another, described illnesses suffered by relatives, constituents, and themselves — a parade of maladies, from cancer to Parkinson’s to diabetes to asthma. One Senator, explaining his vote in favor of using taxpayer dollars to fund embryonic stem cell research, recounted his mother’s physical and mental decline due to Alzheimer’s disease: “When I look at her empty gaze and shriveled body, I cannot help but wonder, if we had started embryonic stem cell research years ago, would she still be suffering today?” While these Senators understandably focused on the face of the suffering that might be relieved if human embryos were destroyed for the sake of delivering a panoply of hoped-for cures, the imperative to relieve suffering was never in dispute, and they failed entirely to attend to the nature of the human embryo and its moral status — the ethical issue that was the very center of the debate.
These two remarkable snapshots — a government scientific advisory board strategizing about political lobbying, and politicians making passionate personal pleas about science policy — give us a glimpse of the strangeness of the debates about embryonic stem cell research from the 1990s through today. The stem cell debates have shown American politics at its best and its worst, with examples both of principled democratic discourse and plainly dishonest demagoguery. And stem cell research itself has shown us science at its most noble and its most debased, with examples both of brilliant researchers pursuing cures for terrible afflictions, and others committing egregious scientific fraud in the hunt for glory. As a result, the stem cell debates have helped to reveal the knotty and complicated relationship between science and politics.
This report examines the stem cell debates in hopes of better understanding the relationship between science and politics. It lays out for the public record the most important facts and arguments, some of which have been long neglected or distorted, so that we might better understand the purpose and limits of science in a self-governing society, the proper role of scientists in American political life, and how citizens and policymakers should think about both. This report examines when, how, and why the stem cell debates sometimes lapsed into error and exaggeration. It also reflects on the value of public deliberations about the fundamental questions of bioethics.
A comprehensive history of every aspect of the stem cell debates is beyond our present purposes, although the five appendices following the body of this report, each of which can be read as a standalone chapter, offer up-to-date explanations of the science of stem cells, the medical promise of stem cells, the ethical questions raised by stem cell research, the relevant policy and legal history, and other nations’ stem cell research policies.
From Discovery to Debates
Stem cells are cells that have the ability to differentiate into one or more of the types of cells of an organism’s body, as well as the ability to self-renew, creating more stem cells like themselves. “Adult” stem cells — which are found not only in adults but also in children, babies, and fetuses — are typicallymultipotent, meaning that they are capable of producing multiple (but not all) cell types. Some adult stem cells have been used in medical therapies for decades. For example, bone marrow transplantation has been used to treat patients since the 1950s, years before scientists understood that it was specifically the presence of blood-forming adult stem cells in the marrow that made the treatment work…
Science, Policy, and Politics
Before focusing on the interplay of science and politics in the stem cell debates, it is useful to step back and consider how they relate in general. Broadly speaking, we can distinguish between two ways science and politics relate to one another in the United States. First, government funds, regulates, organizes, directs, endorses, and prohibits different aspects of the scientific enterprise. Second, science provides policymakers with information and advice regarding natural phenomena, technology, and other matters relevant to public policy. These different relationships between science and policy correspond to two distinct senses in which we use the term “science.” When we speak of science policy as the way government supports or limits science, we are speaking of science as a project or practice, carried out by members of our society and subject to democratic political authority like any other activity. When we speak of the way government seeks science or scientific advice, we speak of science as a kind of knowledge concerning the natural world, knowledge that is subject to critical analysis and debate but not to political authority or regulation.
Although the policy questions in the stem cell debates chiefly concerned the first sort of relationship between science and politics, namely how the government ought to support or regulate this medically promising but ethically controversial field, the second sort of relationship has also been integral to the stem cell debates: scientific knowledge concerning the nature of the human embryo has been essential in informing policymakers and the public in their moral reasoning on the topic.
Historically, the federal government has provided considerable support for the scientific project. The classic articulation of postwar science policy in the United States is found in Vannevar Bush’s 1945 report to President Franklin Roosevelt, Science, The Endless Frontier. In this influential report, Bush (no relation to President Bush) argued that government funding for science, particularly for what he dubbed “basic research,” was essential to ensuring that America continue to enjoy the technological progress necessary for the nation’s strength and prosperity. Vannevar Bush’s model of scientific progress held that basic research leads to applied research which leads to the development of useful technologies and products. Following this model, the U.S. government has since the end of the Second World War provided considerable funding for scientific and medical research, with consistent public approval.
During the latter half of the twentieth century, the U.S. government also came to recognize the importance of regulating scientific research, particularly biomedical and behavioral research conducted on human subjects. The horrific scientific experiments performed by Nazi doctors during the Second World War, along with other cruel and unethical experiments performed in the United States and around the world, clearly demonstrated the need for ethical oversight of scientific research. Governments around the world instituted policies on research ethics and the protection of human subjects, based on the principles articulated in such documents as the Nuremberg Code and the Belmont Report.
Meanwhile, science, understood as our most reliable source of knowledge about the natural world, rightly enjoys a great measure of authority. In our political life, we rely on science to settle questions regarding purely physical phenomena: the toxicity of different chemicals, the efficacy of medical treatments, the sturdiness of bridges, the effects of pollution, and so on. In crafting policy, we weigh these scientific facts against other facts, interests, and values. Scientific knowledge can also inform our moral reasoning. A scientifically accurate description of biological death, for instance, is critical for determining the ethics of organ donation, and for developing sound policies to regulate organ donation…