Stem cell research continues to be a divisive issue

Scientific and political activity related to California's voter-approved commitment to spend $3 billion in stem cell research promises to spread well beyond the state's borders in 2005.

Lawmakers in more than 20 states and Congress introduced stem cell-related bills this year. Some forces want to replicate California's action; others seek to close the door on embryonic stem cell research or direct state-funded research toward adult stem cells.

In Illinois, for example, legislation calls for a special tax on elective cosmetic surgery to fund embryonic and adult stem cell research. An Arkansas bill promotes the use of adult stem cells found in umbilical cord blood, and a Texas bill would prohibit state money from being used to fund embryonic stem cell research.

Experts acknowledge that each state has the right to pursue its own agenda, but some view the current landscape as one of chaos and conflict.

"It will lead to a patchwork of policies," said William B. Hurlbut, MD, a member of the President's Council on Bioethics and a Stanford University human biology consulting professor. "We're going to end up with red-state medicine and blue-state medicine."

Before momentum can swing to embryonic stem cell research supporters, conservative groups are making sure their views are known.

Leon Kass, MD, PhD, chair of the President's Council on Bioethics, is leading conservative bioethicists in promoting an agenda that aims to fight "the destructive exploitation of nascent human life" and the "degradation of human procreation."

"The 'agenda' is an effort to erect certain moral boundaries, and to break through the political stalemate of the past four years, so that we do not remain a country with no moral limits on human cloning, embryo destruction or other misguided experiments at the beginning of human life," said Eric Cohen, a consultant for the President's Council and director of the Biotechnology and American Democracy program at the Ethics and Public Policy Center in Washington, D.C.

Promoters of embryonic stem cell research met the conservative bioethics agenda announcement with a "so what else is new?" response.

"This is an area where scientists are trying to do cutting-edge research that some people object to," said Bob Zalisk, spokesman for the Harvard Stem Cell Institute in Cambridge, Mass. "All we can do is push on with what we're doing."

Massachusetts has become a battleground state for stem cell science. Gov. Mitt Romney has criticized a state bill promoting stem cell research, but the Massachusetts Medical Society has endorsed it.

Massachusetts-based attorney M.C. Sullivan, who serves as executive vice president of the Center for Practical Bioethics in Kansas City, Mo., has been working to reshape the debate. Sullivan said each side needs to tone down its rhetoric and have more substantive discussions before lawmakers pass measures that could have an unintended negative impact on an evolving science. "Why would we create legislation that is bulky and difficult to amend for a science that is still undefined?" she asked. The center has not picked a side in the debate.

Looking for common ground

The Center for Practical Bioethics is holding a series of programs that bring together people with divergent views to discuss stem cell issues.

"I couldn't say minds have been changed," Sullivan said. "But, for the very first time, people have said they're able to understand and respect the opinion of people who were the polar opposite of them."

Dr. Hurlbut also has sought to bring divergent views together by proposing that -- through a process called altered nuclear transfer -- an entity be created that produced stem cells couldn't become a human being.

The idea has people talking. In an essay and letter published in the New England Journal of Medicine, Harvard Stem Cell Institute leaders criticized the proposal's science and moral reasoning. Cohen called Dr. Hurlbut's idea interesting, but said it raised the possibility of "harvesting endless thousands" of human eggs.

Dr. Hurlbut, who opposes destroying embryos for research, said his idea has captured the attention of Gov. Romney and Catholic church leaders. He remains optimistic that it will be discussed further.

"With constructive conversation and creative science," Dr. Hurlbut said, "I believe we can find an answer to our ethical impasse."

The AMA supports research on adult and embryonic stem cells and encourages public funding for it.