By Bernadine Healy, M.D.
You can still hear the popping of the champagne corks. President Obama, surrounded by an exuberant and celebratory crowd peppered with notables of all political persuasion, has lifted former President Bush's ban on federal funding of research on human embryos for stem cell work. But Obama's remarks left the door open for embryo research that involves more than the frozen embryos left over from in vitro fertilization that Congress and most of the public seem to support: After all, these would be discarded anyway. What's on the table now is whether scientists should be able to use federal dollars to create human embryos for the sole purpose of laboratory research, including harvesting their stem cells.
Embryo creation is already going on privately in stem cell research labs throughout the country. Since public money is not involved, however, there is limited information on its scope or success. Leftover IVF embryos from fertility treatments that couples donate for scientific use are not what they have been cracked up to be; they can be damaged, often don't grow, and are inadequately characterized in terms of disease susceptibility. Stem cells from a freshly created embryo will be healthier and give scientists more of a "designer" tool, but they come at a cost: Donated human eggs are not easy to come by, and those eggs are simply the starting point. An embryo still must be created by fertilization with sperm, or by cloning in a process called somatic cell nuclear transfer. And there is considerably more resistance from an ethical perspective.
President Clinton said no to the use of federal funds for embryo creation. During his administration, the National Institutes of Health developed guidelines to stringently oversee the use of frozen IVF embryos that were created for the purposes of fertility treatment, specifically because of ethical and legal issues that go beyond scientific peer review.
At the same time, the Clinton guidelines laid out areas of research that are ineligible for NIH funding. Embryo creation, using stem cells taken from created research embryos, and making chimeras (that is, animal-human embryos) were all banned. Now that the Bush restrictions have been lifted, the Clinton guidelines are a good starting place. And embryo creation is still the thorniest issue.
President Obama made it clear that he is open to having full public discussion on human embryo research for all its many promises, and he has asked the NIH once again to come up with new or revised ethical and legal guidelines for expanding its human embryo research portfolio. Obama did, however, lay out one restriction of his own: Scientists should not be allowed to clone embryos for human reproduction. He left unresolved the question of human cloning for research and therapy.
A question remains as to whether the public will get behind creating human embryos in the laboratory for research. Virtually all the previous advocacy has focused on frozen IVF embryos that would otherwise be discarded. Embryo creation is the discussion the public must have during these next 120 days as the NIH is drafting new guidelines for embryo research.
With the many advances in stem cell research of the past eight years because of both private and public dollars, this is a good time to critically analyze the promise of embryonic stem cells, particularly as replacement cells to cure dread illnesses like diabetes, Parkinson's, and Alzheimer's. That evaluation must be done without bias and be based on the best science available. But science itself must remain within the bounds of a society that trusts and supports it. In that sense, its research has always been constrained by an ethical, legal, and social framework that reflects far more than the needs and perspectives of scientists.