Reason as Our Guide

[ Take note of the CC Attribution License used.  Right on. -d ]

Reason as Our Guide

Elizabeth Blackburn , Janet Rowley

Abbreviation: MAPC, multipotent adult progenitor cell

Elizabeth Blackburn is a recent member of the President's Council on Bioethics
and is in the Department of Biochemistry and Biophysics at the University of
California, San Francisco, in the United States. Janet Rowley is a current
member of the Council and is in the Section of Hematology and Oncology at the
University of Chicago in Chicago, Illinois, in the United States. E-mail:
[email protected] (EB)

Published March 5, 2004

DOI: 10.1371/journal.pbio.0020116

Copyright: © 2004 Blackburn and Rowley. This is an open-access article
distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.

We are two of the scientist members of the President's Council on Bioethics.
In late 2001, we were invited by the President of the United States to serve
on this Council. The Bioethics Council was appointed by the President to
“monitor stem-cell research, to recommend appropriate guidelines and
regulations, and to consider all of the medical and ethical ramifications of
biomedical innovation…. This council will keep us apprised of new developments
and give our nation a forum to continue to discuss and evaluate these
important issues.”

This was a difficult invitation to accept. On the one hand, the President's
views on the use of human embryonic stem cell research and somatic cell
nuclear transfer techniques were well-known and in conflict with our own
beliefs about the costs and benefits of the use of progressive technologies to
advance biomedical research. On the other hand, we were grateful that the
President, despite his views in opposition to these therapies, was willing to
invite serious biomedical scientists to help formulate advice to him—and
ultimately to contribute to the development of national policy—on these
critically important advances.

We knew that on this originally 18-member (but for most of the past two years
a 17-member) Council, as scientists we would be in the minority in our belief
of the good to be gained through these and other areas of biomedical research.
We were also aware that some others on the Council had strong opposing views.
Thus, it was only with the assurances of the Council chairman, Leon Kass of
the University of Chicago, and of the President of the United States himself
that we were persuaded that our voices would be heard and integrated into the
statements of the Council. Furthermore, we felt, and continue to feel, that
bioethical issues are important not only to all biologists, but also to
society at large, and thus especially worthy of engaging debate and discussion.

Two recently issued reports of the Council, “Beyond Therapy: Biotechnology and
the Pursuit of Happiness” (bioethics.gov/reports/beyondtherapy/index.html) and
“Monitoring Stem Cell Research” (bioethics.gov/reports/stemcell/index.html),
are therefore of deep concern to us. We discuss them in turn below.

Concerns about the “Beyond Therapy” Report

The “Beyond Therapy” report deals with issues of direct concern for every
thoughtful person. However, in the interests of setting straight the record of
our views, as Council members and scientists, on the content of this report
and for a proper assessment of the scientific content of the “Beyond Therapy”
report, we feel it is important to point out aspects of the report for which
we had requested revisions and for which those requests were declined.

In the discussions of preimplantation genetic diagnosis, the specter of
designer babies is raised by implying that selecting embryos for intelligence
and other traits, such as temperament is a possibility. Scientifically, this
simply is highly unlikely and indeed may not even be feasible. While such
scientific unlikelihood is mentioned in passing in the report, it is easy to
take away from the report the feeling that such genetic manipulation will
happen and is even imminent.

The report also claims that “the underlying impulse driving age-retardation
research is, at least implicitly, limitless, the equivalent of a desire for
immortality.” Furthermore, the title of Chapter 4 of the report, “Ageless
Bodies,” implies that immortality is the goal of this research, despite all
reliable scientific evidence to the contrary. Such a title is not consistent
with the knowledge, stated in that chapter, that there is no scientific basis
for immortality and implies that, by seeking to maintain and extend “youth,”
research into aging, including stem cell research, is predominantly to serve
vanity. Also, without presenting scientific or reliable evidence, the report
presents the opinion that research into prolonging healthy life may result in
a lifetime obsession with immortality. Hence, this chapter in the report falls
short of explaining the serious challenge of preventing and curing age-related
disease to extend health—very different from attempting immortality.

The same chapter offers a sensational quote from a researcher that “the real
goal [of aging research] is to keep people alive forever.” The request that
quotes from researchers more representative of the biomedical research
community also be included was declined. This leads to a misleading
misrepresentation of the motivation of reputable researchers in the field of
aging.

In suggesting that slowing biological aging may increase the disjunction
between “social aging” (the age at which children are exposed to “adult”
images and concepts) and “biological aging” (expected lifespan), only one
view, a conservative one, of the supposed “best” way to raise children is
presented. The report also suggests, with no clear reasoning behind it, that
longer lives will somehow undermine human determination to contribute as much
as one can during a lifetime. Despite requests for inclusion of material that
would allow for a balanced treatment of these topics, the report minimized
discussion of potential positive aspects of slowing biological aging, such as
prolonged good health.

Finally, the report repeatedly emphasizes a “profound and mysterious” link
between longevity and fertility, thereby leaving the reader with the distinct
but erroneous impression that anything done to extend healthy life will be
traded for decreased fertility, despite the fact that current scientific
literature, which was made available for inclusion in the report, shows a lack
of any necessary mechanistic linkage of the two.

Concerns about the “Monitoring Stem Cell Research” Report

With respect to the “Monitoring Stem Cell Research” report, we feel that some
facts that would help the public and scientists better assess the content of
the report were not brought out clearly or were omitted entirely. First, from
the published scientific literature in peer-reviewed journals on stem cells, a
major message can be distilled: namely, the vast difference that currently
exists in our understanding of, and the potential utility of, embryonic versus
adult stem cells as sources of material for research and clinical purposes. In
brief, human stem cells have been isolated from a variety of embryonic, fetal,
and adult tissue sources. However, enormous differences exist in purity,
properties, data reproducibility, and understanding of cells from these
different sources. Much of our ignorance is related to the relative paucity of
funding for research using embryonic stem cells.

Years of rigorous and careful research in animal models have documented that
embryonic stem cells have great utility for scientific studies. This work has
also rigorously and reproducibly established the great plasticity of these
cells and supports the opinion that human embryonic stem cells possess the
greatest broadest potential and promise for clinical applications. As well as
therapeutic uses, important potential applications include studies of
embryonic stem cells bearing complex genotypes susceptible to poorly
understood common human diseases and testing and screening drug efficacy.

The report does not make clear that the best-characterized adult stem cells
are hematopoietic stem cells. Currently, major difficulties and inadequate
understanding exist with most other types of adult stem cells reported to
date. In addition, many experiments suggesting that adult stem cells have
broad plasticity may be incorrectly interpreted owing to an error caused by an
experimental artifact of cell fusion present in some unknown proportion of the
experiments. Research on some of the reported adult stem cell preparations may
conceivably in the future demonstrate that they, too, like hematopoietic stem
cells, can also be prospectively identified, “single cell cloned,” expanded
considerably by growth in vitro with retention of normal chromosome structure
and number, and preserved by freezing and storage at low temperatures. But it
should be strongly cautioned that this has not been done for most adult stem
cell preparations, and, even if possible, it is not clear that any of the
just-mentioned procedures will be accomplished in the near future, owing to
the technically very demanding nature of such experiments.

We feel it is important to emphasize a point that the report mentioned, that
the reported isolation and properties of multipotent adult progenitor cells
(MAPCs) must be reproduced in additional laboratories for any reliable
interpretation of the results reported with these cells. After considerable
effort, this has still not been achieved. Thus, in the reported results, the
possible significance of the reported isolation and properties of human MAPCs
is left unclear, as is their potential as a source of stem cells for clinical
purposes. Hence, a strong overall caution is that many of the reports on the
properties of cells differentiated from adult stem cell preparations are to
date preliminary and incomplete. If results with any isolated and
characterized adult stem cells are validated, it will then be very important
to compare their properties—and those of any more differentiated cells that
can be derived from them—with other stem cell sources, such as the
well-characterized hematopoietic stem cells, and with human embryonic stem
cell preparations.

Two major considerations argue strongly for non-commercial, federal,
peer-reviewed funding to be made available for this work. The first is the
sustained effort this work will require. The second is the importance of
reliable and unbiased design of experiments and of open, public availability
of the complete findings.

Reasons for Our Concern

In being concerned about the content of these reports, neither of which makes
any recommendations for legislative or policy actions, are we worrying too
much? We think not. Indeed, already, sadly as a result of the way the sections
on aging research in the report were written, the myth that longevity has an
inevitable tradeoff of diminished fertility is now gaining a further foothold:
witness the January 26, 2004, issue of the The New Republic. In it, an article
about this report of the Council falls right into the trap: it states, “But
changes come with longer life. Worms and mice that are altered for extended
lifespans become sterile, or barely reproduce.” The public is done a
disservice when science is presented incompletely; myths are then perpetuated.

This is but one example of the dangers that three of the Council members who
are scientists (the two of us along with Michael Gazzaniga of Dartmouth
College) pointed out, in a Commentary within the edition of the “Beyond
Therapy” report published by the Dana Foundation in November 2003. In that
Commentary, we stated that “Our concern … is that, moving forward, the debate
carry on with all of the scientific evidence—or as much as such a widespread
public discussion can include—and take care not to leave an erroneous
impression as to the nature of the potential problems at hand.” We ended the
Commentary by saying “We urge both good reading and critical reading!” (our
italics).

These reports had as their premise the aim of neutrality in the scientific
analysis of the issues addressed. But our concern is that some of their
contents, as in the few examples outlined above, may have ended up distorting
the potential of biomedical research and the motivation of some of its
researchers. Continuing discussions will form the basis for future decisions
on these topics; keeping such discussion open and balanced is of paramount
importance.

References

President's Council on Bioethics (2003) Beyond therapy: Biotechnology and the
pursuit of happiness With introduction by William Safire and commentary by
Michael S. Gazzaniga, Elizabeth Blackburn, and Janet D. Rowley. New York: Dana
Press. 400 p.

President's Council on Bioethics (2003) Beyond therapy: Biotechnology and the
pursuit of happiness. Available at
bioethics.gov/reports/beyondtherapy/index.html via the Internet. Accessed 29
February 2004.

President's Council on Bioethics (2004) Monitoring stem cell research.
Available at bioethics.gov/reports/stemcell/index.html via the Internet.
Accessed 29 February 2004.
Box 1. President's Council on Bioethics

The President's Council on Bioethics was created on November 28, 2001. Its
mission includes: to “advise the President on bioethical issues that may
emerge as a consequence of advances in biomedical science and technology. In
connection with its advisory role, the mission of the Council includes the
following functions:

   1.

      to undertake fundamental inquiry into the human and moral significance
of developments in biomedical and behavioral science and technology;
   2.

      to explore specific ethical and policy questions related to these
developments;
   3.

      to provide a forum for a national discussion of bioethical issues;
   4.

      to facilitate a greater understanding of bioethical issues; and
   5.

      to explore possibilities for useful international collaboration on
bioethical issues.”

>From Executive Order 13237

George W. Bush

The White House, November 28, 2001

Federal Register date: November 30, 2001

Federal Register page: 66 FR 59851

The members of the President's Council on Bioethics at the time these reports
were written included Leon R. Kass, M.D., Ph.D. (Chair), American Enterprise
Institute; Elizabeth H. Blackburn, Ph.D.*, University of California, San
Francisco; Rebecca S. Dresser, J.D., M.S., Washington University School of
Law; Daniel W. Foster, M.D., University of Texas, Southwestern Medical School;
Francis Fukuyama, Ph.D., Johns Hopkins University; Michael S. Gazzaniga,
Ph.D., Dartmouth College; Robert P. George, J.D., D.Phil., Princeton
University; Mary Ann Glendon, J.D., M.Comp.L., Harvard University; Alfonso
Gómez-Lobo, Dr. Phil., Georgetown University; William B. Hurlbut, M.D.,
Stanford University; Charles Krauthammer, M.D., syndicated columnist; William
F. May, Ph.D.*, Southern Methodist University; Paul McHugh, M.D., Johns
Hopkins Hospital; Gilbert C. Meilaender, Ph.D., Valparaiso University; Janet
D. Rowley, M.D., University of Chicago; Michael J. Sandel, D.Phil., Harvard
University; and James Q. Wilson, Ph.D., University of California, Los Angeles.

* These members had their Council terms terminated by White House directive on
February 27, 2004.


_______________________________________________
heads mailing list
[email protected]
http://ballistichelmet.org/mailman/listinfo/heads/
http://ballistichelmet.org/donate/