Biomedical Research Goes Where Candidates Dare Not
Rick Weiss / Washington Post 29oct00

When political revolution erupted in Yugoslavia earlier this month, Vice President Gore and Texas Gov. George W. Bush spoke forcefully about U.S. interests there.

The presidential candidates also have addressed a different revolution, the high-tech one, which has overturned the "old economy" and rewritten the rules of the global marketplace.

But biomedical researchers, patient advocates and antiabortion activists say there is another revolution underway that has just as much potential to transform voters' lives and is testing the nation's moral mettle, yet somehow has remained outside the bounds of election-year discourse.

In work that may literally redefine what it means to be human, scientists are teasing apart human embryos and fetuses to learn how to heal, rejuvenate and even enhance human bodies and minds--in short, to redesign the species from the inside out.

Some of these advances are expected to move from the lab bench to the bedside during the next administration, and many more could do so within the following decade, long before the much-feared bankruptcy of the Social Security fund, the minutiae of which have so dominated this fall's political debates. Of necessity, the work will involve human embryos and embryo cells, whose genetic codes are most malleable in scientists' hands.

But are some of those experiments too ethically questionable to conduct? Should the federal government pay for research that might save countless lives but is morally offensive to some? Do individual cells taken from human embryos deserve special protections? And should companies be granted exclusive patent rights for biological creations that are, to some extent, human?

These are just a few of the future-shaping questions that the American public will face in the next few years. Yet despite the leading candidates' outspoken support for basic biomedical research generally (both have promised to double the budget of the National Institutes of Health over the next few years), and the unabashed interjection of religious themes in this year's election, hardly a word about this most profound intersection of science and ethics has crossed either of the leading candidates' lips.

"We are the world's most powerful science nation and I think we have an ethical obligation to use that power wisely, and I'd like to know how they intend to wield that power," said Eric Meslin, executive director of the presidentially appointed National Bioethics Advisory Commission, one of several experts who expressed frustration with the lack of scientific and medical ethics discourse in this election.

The science isn't waiting for an answer. Researchers in Massachusetts are making test-tube embryos that are part human and part cow from which they are growing new living tissues from scratch. In California, researchers working with human embryo cells are manipulating the molecular pathways related to aging and have begun to put a few of them into reverse. Researchers in Maryland are plucking cells from aborted human fetuses and turning them into nerve cells for transplantation into the brains of patients with Parkinson's disease and other ailments.

And in Illinois, Michigan and other states, scientists are using new genetic tests to select the most desirable human test-tube embryos, setting the stage for what some believe will become a marketplace in designer babies.

That the candidates have said so little about these and related projects is perhaps not surprising given the complicated economic and political context within which the genetic revolution is occurring.

For one thing, as Federal Reserve Chairman Alan Greenspan noted in recent remarks, scientific advances--notably those in biotechnology--are very much at the core of this nation's global dominance and economic boom. If U.S. progress wanes or if the country does not cope well with the cultural and ethical crossroads the science is leading to, the economic repercussions could be big.

Indeed, some scientists are saying that Britain is poised to overtake the United States in the potentially lucrative business of human embryonic and fetal cell research because U.S. studies on these controversial cells have been bogged down in the politics of abortion.

But ignoring what one bioethicist has called the upcoming "train wreck" between embryo cell-based medicine and public policy also is not an option. Abortion is one of this country's most intractable issues, and its opponents have historically been uncompromising. "We could probably get cells from freshly killed newborns that might save lives," said Douglas Johnson, National Right to Life Committee legislative director. "But that's not an argument for infanticide."

Only once during the campaign have the two major candidates felt compelled to mention the issue of human embryo cell research. That was in August, when the NIH released ethics guidelines under which it now will fund, for the first time, experiments on human embryonic "stem" cells retrieved from spare fertility clinic embryos slated for destruction.

In brief statements, Gore expressed support for the NIH move and Bush said he opposed it.

That split has left researchers and patient advocates concerned that Bush, if elected, might promptly sign an executive order killing federal funding for the blossoming field--a move that would relegate embryo cell studies to private companies not subject to the new federal ethics rules.

It wouldn't be the first time a new president acted quickly on such an issue. President Clinton, during his first week in office, passed a presidential memorandum lifting a long-standing federal moratorium that had precluded the use of tax revenue for human fetal cell transplant studies. "Today I am acting to separate our national health and medical policy from the divisive conflict over abortion," Clinton said on Jan. 22, 1993.

That separation could easily be reversed. Indeed, given Bush's open displeasure with the Food and Drug Administration's recent approval of the abortion pill RU-486, some observers said, it's not hard to imagine a very different speech and memorandum coming from a Bush White House in January.

"A lot of my colleagues think we'll have our backs to the wall if Bush is elected," said Daniel Perry, executive director of the Alliance for Aging Research and the founder of Patients' CURe, a coalition of disease advocacy groups that support human embryonic stem cell research.

Some people, at least, will be casting their votes Nov. 7 with this issue in mind.

"We've had about 20 calls in the past few weeks from Republican volunteers telling us they will not vote for Bush because of the stem cell issue," said a representative of a nonprofit disease support group, who refused to name her organization because of concern that her words could be construed as illegal political lobbying. "We think that's representative of a growing tide of people who have diseases, diabetes, cancer, ALS [Lou Gehrig's disease]. There's a lot of people out there who are very upset that [Bush] does not support stem cell research."

But a Bush adviser said people should not be so quick to assume that Bush would block federal funding for all kinds of embryo cell research. "I think the NIH announcement heavily politicized the issue, and what you got was a response that spoke to some of the political realities that the candidates were facing," said Robert Walker, a former House Science Committee chairman and a science adviser to the Bush campaign.

In fact, Walker contended, although Gore postures himself as a man guided by science and ethics, there is an abortion-rights political agenda underlying his position on embryo cell research that is no less ideological than Bush's.

Even if Bush decides to leave the new NIH guidelines alone, the political and ethical debate over the course of medical research won't end there.

Those guidelines allow federal funding of human embryo cell experiments only if the actual destruction of the embryos is performed by privately funded researchers, without federal support. But pressure is building from researchers and patient advocates to allow federally funded scientists to work directly on living, discarded human embryos--a position endorsed by the National Bioethics Advisory Commission and already the practice in Britain.

There, government scientists can conduct experiments on embryos up to 14 days old, when the earliest evidence of a developing nervous system first appears. And Parliament is considering granting British scientists the much-desired option of mass-producing cloned human embryos just for research purposes--an activity never before made explicitly legal in any country--to foster more sophisticated efforts to grow replacement tissues for patients.

Whether that is a critical research advantage the United States must have too, or just the next step in a slippery slope of moral compromise, is a question that the nation, and its chief executive, may soon have to answer.