Elections seen as turning point for stem cell studies

The next president will be faced with the question of whether to overturn President Bush's 2001 executive order banning federal research funding for new human embryonic stem cell lines.

Sens. Barack Obama (D, Ill.) and John McCain (R, Ariz.) have pledged to overturn Bush's restrictions. But prominent supporters of embryonic stem cell research have raised concerns about what they see as mixed signals from the McCain campaign.

Recent breakthroughs showing it is possible to develop pluripotent stem cells -- ones that can develop into any of the body's fully functional cells -- without destroying human embryos. This has sharpened calls to steer clear of the days-old blastocysts.

Stem cell scientists at the World Stem Cell Summit in Madison, Wis., in September said all promising avenues of research should be pursued. They questioned McCain's commitment to changing the Bush policy.

Ten years ago, James A. Thomson, PhD, led the University of Wisconsin, Madison, research group that first reported successfully isolating human embryonic stem cell lines. In a news conference at the summit, he said he saw "a little water-muddying" from McCain on embryonic stem cell funding. First came McCain's pick of Alaska Gov. Sarah Palin, who opposes embryonic stem cell research, as his running mate. Then, the Republican Party revised its platform to call for a total ban on research using embryos.

"Whoever gets elected, there will be a dramatic improvement over the last eight years," Thomson said. "But I'm concerned about the shift from Sen. McCain in the last couple of weeks."

In oral and written responses to questions in the Saddleback Civil Forum in August and Science Debate 2008 in September, McCain said he is "wildly optimistic" that new ways of developing pluripotent stem cells without using embryos will render the debate "academic."

McCain is "trying to use a techno fix to escape the argument," said bioethicist R. Alta Charo, a keynote speaker at the summit and co-chair of the National Academies' Human Embryonic Stem Cell Research Advisory Committee. "By signaling that he was going to say [embryonic stem cell research] is not really a big deal anymore, it tells me that if he gets enough pushback from the people that he needs to answer to before or after election, he might change his mind."

The McCain campaign did not respond to AMNews requests for comment by press time in early October. In late September, the campaign issued a statement in response to an Obama radio ad airing in the Philadelphia area charging that McCain "has stood in the way" of stem cell research.

"The fact is John McCain has been a champion for stem cell research," Sen. Arlen Specter (R, Pa.) said in the statement. "John McCain bucked the majority of our party in standing strong with me in urging the Bush administration to lift restrictions on stem cell research and last year voted to overturn the Bush policy."

Opponents of embryonic stem cell research have pleaded their case directly to McCain. J.C. Willke, MD, former president of the U.S. National Right to Life Committee, said he has met with McCain several times, most recently in August, to talk up the promise of stem cell research that does not destroy embryos.

"The only way you get an embryonic stem cell is to kill a 5-day-old human," said Dr. Willke, a retired obstetrician and family physician, referring to the blastocysts used in research. "I'm not saying [McCain] won't support embryonic stem cells, but it looks to me like he's certainly hedging his bets on this and moving in our direction."

A fight at the state level

The top of the ticket is not the only place where the stem cell battle is being waged. A Michigan ballot initiative seeks to overturn a state law that threatens scientists who create new embryonic stem cell lines with up to 10 years in prison and $10 million in fines. Stem cell researchers see overturning the law as critical to maintaining momentum in allowing research using embryos. Arkansas, North Dakota, South Dakota and Louisiana have restrictions similar to Michigan's. Eight states explicitly permit embryonic stem cell research.

A Michigan loss could mean "a swing of the pendulum back" toward greater restrictions in other states, said Doug Engel, PhD, chair of the University of Michigan Medical School's Dept. of Cell & Developmental Biology.

David Doyle, a spokesman for Michigan Citizens Against Unrestricted Science & Experimentation, said the ballot initiative goes too far because of a provision to "prohibit state and local laws that prevent, restrict or discourage stem cell research, future therapies and cures."

Research developments also have shifted the debate. Late last year, a team of Japanese scientists and Thomson's group in Wisconsin simultaneously reported successfully reprogramming adult skin cells to behave like embryonic stem cells.

These cells -- known as induced pluripotent stem cells, or iPS cells -- are "the future of stem cell research," Thomson said at the World Stem Cell Summit.

Some argue iPS cells obviate the need to conduct embryonic research, but Thomson said the technique would never have been developed without access to embryos. He said it is too early to judge which cell lines will be most effective in understanding and treating diseases.

"We've been spectacularly wrong about a lot of things in the last 10 years or so," he said. "The fundamental principle of science is to see where we are wrong and change that worldview accordingly."

The AMA in 2003 adopted policy supporting "federal funding for research involving human pluripotent stem cells."