“You put your finger on one of the peculiarities of the bifurcated system of ethics in our country—one set of principles for public funding and another for private funding. Embryo ethics straddles two moral universes, and scientists have had to navigate through that thorny divide. They must establish a firewall between publicly funded and privately funded laboratories.”
In the following dialogue from Stem Cell Dialogues: A Philosophical and Scientific Inquiry Into Medical Frontiers, the book’s central character Dr. Franklin talks with Bernard Stein about different president’s policies regarding stem cells:
Scene: The White House. Bernard Stein, M.D., is an ethics advisor to President George W. Bush, head of a national bioethics think tank, and a leading scholar on reproductive ethics. Dr. Franklin obtained an appointment with Dr. Stein to discuss President Bush’s policies on human embryonic stem cells.
FRANKLIN: [To Dr. Stein] Thank you for inviting me to your office. As you know from our correspondence, I am an editor of the Journal of Bioethics and Medicine, and we are preparing a special issue on stem cells. Dr. Stein, can we begin by you helping me understand how U.S. policy on stem cells evolved? Did it arise in the Bush administration?
STEIN: The federal policy on human embryos was catalyzed largely after two events: first, the Supreme Court decision on abortion in 1973 and the first baby (Louise Brown in England) born after in vitro fertilization in 1978. After the Roe v. Wade decision, which made early stage abortions legal, a moratorium was placed on government funding for embryo research. Then in 1979 an Ethics Advisory Board to the U.S. Department of Health, Education and Welfare issued a report on the ethics of research involving human embryos. This advisory board said it was ethically acceptable to do research on embryos used for IVF purposes but postponed any recommendations on research involving the collection and culture of early human embryos fertilized naturally— not used for IVF. But they had one major caveat: the embryos could not be sustained in vitro beyond fourteen days after fertilization.2
FRANKLIN: Why did they set the boundary at fourteen days? That sounds quite arbitrary. stein: At the fourteenth day of its development, an embryo exhibits a “primitive streak”—a faint white trace that is the first evidence of the embryonic axis. It is a precursor of the neural tube and the nervous system. Without a neural tube, there is no spinal cord, and the embryo cannot have feelings or exhibit any level of consciousness.
FRANKLIN: So the primitive streak is some kind of Maginot Line for bioethicists and shouldn’t be crossed.
STEIN: In 1979 the hope was that establishing a moral boundary would allow scientists to continue with their embryo research, as long as they stayed within that limit.
FRANKLIN: Between 1979 and 1980 there was a change in administration. Jimmy Carter had lost the election to Ronald Reagan. Were the advisory board’s recommendations adopted?
STEIN: Hardly. By 1980, the charter of the advisory board ran out and was not renewed. As you point out, Ronald Reagan was elected president. He and his administration opposed any research on embryos of any age. Republicans were, on the whole, more critical of research involving embryos than Democrats. But there were many Democrats who supported the moratorium.
FRANKLIN: Dr. Stein, let me see if I get this. The Supreme Court ruled that embryos are not persons, and therefore abortion was not murder, and established a fundamental right of women over their bodies, at least for the first trimester of pregnancy. And then a president opposed any federal funding for embryo research on the grounds that embryos could not be harmed. Why didn’t Congress get into the act?
STEIN: Well, Congress did act, but not until another advisory committee was convened. In 1994, during the administration of President Bill Clinton, a federally appointed nineteen-member Human Embryo Research Panel issued its report. The panel concluded that embryos do deserve some moral consideration, but do not have the same moral status as persons because they lack specific capacities such as consciousness, reasoning, and sentience—at least, early embryos. The panel approved the use of federal funds for research on early embryos under specific guidelines.
FRANKLIN: Did that clinch it for President Clinton? After all, he is a Democrat and not doctrinaire on the issue. So he must have been receptive.
STEIN: No, it didn’t work out that way. In 1994 NIH convened a Human Embryo Research Panel to draft guidelines on the use of federal funding for research on human embryos. The panel recommended that funding for creating embryos for research be permitted.3 Clinton disagreed, but he was personally in favor of funding for scientific studies of embryos left over from IVF procedures. Nevertheless, responding to the political climate, Clinton wanted more deliberation and chose not to allocate federal funds to support research on leftover embryos until he could get a recommendation from a presidential ethics advisory committee. Perhaps he was anticipating congressional action.
FRANKLIN: Well, did Congress act then?
STEIN: Soon after the president made his preliminary decision to withhold funds, Congress closed the door on any research involving the destruction of a human embryo. The Dickey-Wicker Amendment (sponsored by Representative Jay Dickey, House Republican from Arkansas, and Roger Wicker, Senate Republican from Mississippi), which Clinton signed into law, has been attached to appropriations bills every year, starting in 1996. It essentially prohibits the Department of Health and Human Services from using appropriated funds for the creation of human embryos for research purposes or for research in which human embryos are destroyed.
FRANKLIN: It seems to me there could be ways around the amendment. Suppose private money is used to create and destroy embryos and public funds are used to experiment on the cells removed from them. In many countries, like Germany, when a moral decision on embryo research is reached, it applies to everyone, not only those receiving funds from the government.
STEIN: You put your finger on one of the peculiarities of the bifurcated system of ethics in our country—one set of principles for public funding and another for private funding. Embryo ethics straddles two moral universes, and scientists have had to navigate through that thorny divide. They must establish a firewall between publicly funded and privately funded laboratories.
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