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Testimony of Richard M. Doerflinger on behalf of the Committee for Pro-Life Activities United States Conference of Catholic Bishops before the Subcommittee on Labor, Health and Human Services, and Education Senate Appropriations Committee
Hearing on Stem Cell Research
July 18, 2001
I am Richard M. Doerflinger, Associate Director for Policy Development at the Secretariat for Pro-Life Activities, United States Conference of Catholic Bishops. I am grateful for this opportunity to present the Catholic bishops' grave concerns on this critically important issue.
In our view, forcing U.S. taxpayers to subsidize research that relies on deliberate destruction of human embryos for their stem cells is illegal, immoral and unnecessary.
It is illegal because it violates an appropriations rider (the Dickey amendment) passed every year since 1995 by Congress. That provision forbids funding "research in which" human embryos (whether initially created for research purposes or not) are harmed or destroyed outside the womb.(1) National Institutes of Health guidelines approved by the Clinton Administration nonetheless give researchers detailed instructions on how to obtain human embryos for destructive cell harvesting, if they wish to qualify for federal grants in "human pluripotent stem cell research."(2) Clearly, obtaining and destroying embryos is an integral part of this project, even if the specific act of destroying embryos does not directly receive federal funds. By implementing these guidelines, the federal government would encourage researchers to conduct destructive embryo experiments that are punishable as felonies in some states.(3)
This proposal is immoral because it violates a central tenet of all civilized codes on human experimentation beginning with the Nuremberg Code: It approves doing deadly harm to a member of the human species solely for the sake of potential benefit to others. The embryos to be destroyed by researchers in this campaign are at the same stage of development as embryos in the womb who have been protected as human subjects in federally funded research since 1975.(4) President Clinton's National Bioethics Advisory Commission (NBAC) and its 1994 predecessor, the NIH Human Embryo Research Panel, conceded that the early human embryo is a form of developing human life that deserves our respect(5). Treating human life as mere research material is no way to show respect.
Finally, this proposal is unnecessary because adult stem cells and other alternatives are already achieving some of the goals for which embryonic stem cells have been proposed, and new clinical uses are constantly being discovered.(6)
In our view, human life deserves full respect and protection at every stage and in every condition. The intrinsic wrong of destroying innocent human life cannot be "outweighed" by any material advantage -- in other words, the end does not justify an immoral means. Acceptance of a purely utilitarian argument for mistreating human life would endanger anyone and everyone who may be very young, very old, very disabled, or otherwise very marginalized in our society. However, even the Clinton Administration's bioethics advisors, who denied human embryos the moral status of "person," concluded that they could only be destroyed for research as a last resort, if no alternative course existed.(7)
It cannot be denied that these alternatives are available. To be sure, further study will be needed to determine their full potential. But to fund destructive embryo research now, alongside these morally acceptable alternatives, would be to deny any moral status at all to human embryonic life. For that is what we would do if there were no moral issue at stake. Funding embryonic stem cell research here and now will force all taxpayers to act as though they agree with the international chairman of the Juvenile Diabetes Foundation that human embryos have no more value or dignity than a goldfish.(8)
This view of the human embryo as a goldfish has apparently garnered support from some members of Congress who have generally opposed abortion. Their claim is that human life does not begin until placed in a mother's womb. Biologically, however, this is an absurd claim. An embryo's development is directed completely from within -- the womb simply provides a nurturing environment. Scientists tell us it would be technically possible to nurture a human embryo in a man's body by abdominal pregnancy, or in a mammal of another species, or even (someday) in an artificial womb.(9) Upon being born could such a person morally be killed for his or her stem cells, because he or she never lived inside a woman's womb?
A subtly different argument has also emerged to try to justify using embryos from fertility clinics for destructive experiments. While human embryos ordinarily deserve respect, goes this argument, these particular embryos do not, because they "would be discarded anyway" by their parents. But this is, to say the least, fallacious reasoning. If parents were neglecting or abusing their child at a later stage, this would provide no justification whatever for the government to move in and help destroy the child for research material. We do not kill terminally ill patients for their organs, although they will die soon anyway, or even harvest vital organs from death row prisoners, although they will be put to death soon anyway. Federal law prohibits federally funded researchers from doing any harm to an unborn child slated for abortion, though that child will soon be discarded anyway (see 42 USC §289g). If people's value depends entirely on the extent to which other people "want" them, they have no inherent value at all. So on reflection, this argument ultimately reduces to the argument of "embryo as goldfish."
The argument also rests on a false premise. The embryos slated for destructive research under the NIH guidelines are those deemed to be "in excess of clinical need" by fertility clinics. This simply means that they are not needed or wanted by their parents for reproduction at present. Parents in this situation are routinely offered several options, including: saving the embryos for possible later use (by far the most frequently chosen), discarding them, or donating them to another couple so they can have a child. The NIH guidelines require that these parents be asked to consider donating their embryos for destructive cell harvesting at the same time that they are offered these other options.(10) Some couples who would otherwise have allowed their embryonic children to live -- in their own family or another -- will instead have them killed for government research. That is why the adoptive couples of some of these former "frozen embryos" have filed suit against the guidelines.(11)
We have presented our position on this issue at length in other testimony.(12) In the remainder of this testimony we would like to comment on recent developments, including new evidence that proponents of destructive embryo research have misrepresented or distorted the facts to serve their political goal.
New developments in alternatives to embryonic stem cell research
Since we testified before this subcommittee in 1999, startling advances have been made in adult stem cell research and other non-embryonic avenues for repairing or replacing damaged organs and tissues. The field of "tissue engineering" using adult cells has exploded as researchers move toward rebuilding ears, tracheas, and even hearts.(13) Adult stem cells have successfully treated hundreds of thousands of patients with cancer and leukemia; they have repaired damaged corneas, restoring sight to people who were legally blind; they have healed broken bones and torn cartilage in clinical trials; they are being used to help regenerate heart tissue damaged by a cardiac arrest.(14) Adult bone marrow stem cells were responsible for the first completely successful trial of human gene therapy, helping children with severe combined immunodeficiency disease to recover an immune system and safely leave their sterile environment for the first time.(15) Adult cells from a young paraplegic woman's own immune system, injected into the site of her spinal cord injury, have apparently cured her incontinence and enabled her to move her toes and legs for the first time – "generating hope for those with spinal-cord injuries around the world," as one news report observes.(16)
Finally, adult pancreatic islet cells from cadavers have been used to reverse juvenile diabetes in fifteen patients, and further human trials are being planned at several centers in the United States. At the annual meeting of the American Diabetes Association on June 24, researchers announced that all patients benefitted from the transplants, and nine have remained "insulin free" for a median period of eight months – with some patients requiring no injections for up to two years.(17)
Hailed by experts as a "remarkable advance," this breakthrough has also received enthusiastic attention from Lee Ducat, founder of the Juvenile Diabetes Foundation (JDF). "There's still a lot to be learned, but this is the most optimistic I've been in 30 years," she says. "To take patients who are terribly ill and going in and out of shock and give them a normal life... this is an unbelievable result. They say they never knew what feeling normal is all about."(18)
Yet this good news has gone largely unnoticed by the current leadership of the JDF. Instead the organization is focused on diverting funds toward a misleading ad campaign to persuade Americans to support killing human embryos for their stem cells.
Neglect – even misstatement – of recent scientific data was also evident in last year's testimony before this subcommittee by the Christopher Reeve Paralysis Foundation. Mr. Reeve, on behalf of the Foundation, testified that adult stem cells are no substitute for embryonic cells because they cannot be "pluripotent" but are confined to a narrow range of specialization. Yet a few weeks after that hearing, researchers funded by the NIH and the Christopher Reeve Paralysis Foundation published a study indicating that adult bone marrow stem cells "may constitute an abundant and accessible cellular reservoir for the treatment of a variety of neurologic diseases." The first sentence of the published study states: "Pluripotent stem cells have been detected in multiple tissues in the adult, participating in normal replacement and repair, while undergoing self-renewal."(19) The authors cite eleven other studies in support of this observation. Their article, prepared under the aegis of Mr. Reeve's foundation, was received for publication in March 2000, before Mr. Reeve testified in April that adult stem cells cannot be pluripotent.
An author of that study, Dr. Darwin Prockop, told this subcommittee last year that the implications of his work should not be overstated and that he himself supports funding both embryonic and adult stem cell research. However, medical and patient groups have now tilted the pendulum so far toward outright denial of the facts about the promise of adult stem cell research that Dr. Prockop recently felt obliged to correct the record. Responding to an article that questioned the benefits of adult stem cells, he notes:
More than 20 years ago, Friedenstein and then others grew adult stem cells from bone marrow called mesenchymal stem cells or marrrow stronal cells (MSCs). MSCs differentiate into bone, cartilage, fat, muscle, and early progenitors of neural cells. Human MSCs can be expanded up to a billionfold in culture in about 8 weeks. Preliminary but promising results have appeared in the use of MSCs in animal models for parkinsonism, spinal cord defects, bone diseases, and heart defects. Also, several clinical trials are in progress. In addition, there are promising results with other adult stem cells that perhaps we may yet learn how to grow effectively.(20)
Perhaps the most troubling and unwarranted fixation on embryonic stem cells to the exclusion of all other approaches has been exhibited by the Parkinson's Action Network (PAN). This group has declared that it actively opposes a new bill introduced by Congressman Chris Smith, which would authorize $30 million a year in new funding for stem cell research and establish a national stem cell bank for research and possible treatments (Responsible Stem Cell Research Act of 2001, H.R. 2096). While this bill places no restrictions on embryonic stem cell research – indeed, does not mention such research one way or the other – PAN believes that this much-needed additional funding for promising medical research must be rejected because it does not include stem cells obtained by destroying embryos. By this logic PAN would have to oppose all current NIH funding for Parkinson's research, which has never included funding for embryonic stem cell research.
New disappointments in embryonic stem cell research
In the past two years, initial enthusiasm over embryonic stem cells has been dampened in the scientific community by some sober realizations, even as patient groups organize public campaigns based on earlier assumptions.
First, these cells are not as easy to maintain in the laboratory as once thought. Researchers call them "tricky" and "more tedious to grow" than their mouse counterparts, as well as "really difficult" to direct toward more specialized cells.(21) The dream of "immortal" cell lines that will easily provide unlimited supplies of any kind of tissue remains a dream.
Second, a new study of problems in cloning suggests that embryonic stem cells are "surprisingly genetically unstable" in mice and perhaps in humans as well. This "may complicate efforts to turn the cells into cures," and interfere with efforts to produce all-purpose cell lines that could reliably become tissue of any desired type. "You may have to establish hundreds of lines to get the few you'd want to have," Dr. John Gearhart of Johns Hopkins University now says. Establishing hundreds of these cell lines could require destroying many thousands of human embryos, and replenishing them with thousands more when the original cell lines become too unstable for further use. Perhaps most troubling is the news that these researchers deleted from their final paper a reference to this problem, believing that any public acknowledgment of such setbacks has become too "politically sensitive."(22) We can only wonder how much of this kind of information is being withheld without detection. We have reached a stage in this discussion where, on the side supporting destructive embryo research, science is becoming subservient to politics.
Third, the chief advantage universally cited for embryonic stem cells -- their ability to grow and differentiate into all the more than 200 kinds of cells and tissues in the human body -- is proving to be a major disadvantage for transplantation into living bodies. For it is very difficult to make these cells stop turning into all kinds of cells and tissues. In recent studies, embryonic stem cells (or partially differentiated cells arising from them) "stayed in a disorganized cluster, and brain cells near them began to die."(23) Says bioethicist Glenn McGee, who supports of embryonic stem cell research:
The emerging truth in the lab is that pluripotent stem cells are hard to rein in. The potential that they would explode into a cancerous mass after a stem cell transplant might turn out to be the Pandora's box of stem cell research.(24)
By contrast, though non-embryonic stem cells seem harder to direct to form tissues of different categories, they seem much more docile to their environment. Upon reaching a particular kind of tissue, they receive signals as to the kind of tissue needed and produce only that tissue. They may be "easier to manage," and therefore far safer for clinical use in humans, than embryonic cells.(25) After all, adult stem cells are already found throughout the human body, already provide a built-in repair kit for repairing and regenerating human tissue, and have already safely treated hundreds of thousands of patients. Understanding and stimulating this natural ability may be a far more promising avenue than efforts to harness and control cells that simply do not belong in an adult body in the first place -- cells with a tendency to form tumors, in an apparent effort to turn back into a complete embryo.
The kind of exaggerated claims now made for embryonic stem cells have been seen in this Congress before. A decade ago it was fetal tissue from abortions that was hailed as the magic bullet that might cure diabetes, Parkinson's disease and many other conditions in a few years if only federal funds were provided. By the time such funds were approved in 1993, however, it was already becoming clear that fetal tissue from abortions would be largely useless in treating diabetes. Millions of taxpayers' dollars were diverted toward fetal tissue transplant trials for Parkinson's disease – and the final results were not only disappointing but "devastating," according to the New York Times. The implants "failed to show an overall benefit," and in 15% of the patients actually produced "nightmarish" symptoms as the immature cells produced dopamine in uncontrollable amounts.(26) The chief result of the campaign for fetal tissue research by some Parkinson's disease groups is that a significant number of Parkinson's patients may now be incurably worse off than before.
Will embryonic stem cells prove to be equally disappointing or even disastrous? No one knows. However, a tragic occurrence following one particular fetal tissue transplant for Parkinson's disease should give us pause. Some of the tissue placed in this man's brain may have been from an earlier gestational age than is customary in American clinical trials – that is, it may have been more embryonic than fetal in nature. Within two years after the transplant this man died mysteriously – and an autopsy revealed that masses of "nonneural tissue" such as skin and hair had filled the ventricles of his brain and cut off his breathing. Researchers theorized that this tissue may have remained "pluripotent" and differentiated uncontrollably to cause the patient's death.(27)
At the very least, past experience argues in favor of greater humility than some researchers and organizations are now showing in their campaign for destructive embryo research. To quote two bioethicists who do not oppose such research on moral grounds, "much of the hype that surrounded the debate about the clinical value of fetal tissue implants was exactly that – hype. This ought to be kept in mind by those now engaged in the debate over stem cell research."(28)
The slippery slope in action
Finally, recent developments highlight a point made by opponents of embryonic stem cell research for years: Once our consciences are numbed to the moral wrong of using so-called "spare" human embryos for research, our society will move on to even more egregious abuses. The Jones Institute for Reproductive Medicine in Virginia has announced that it is using donated eggs and sperm to create human embryos solely to destroy them for stem cell research.(29) Moreover, Advanced Cell Technology (ACT) in Massachusetts has announced it is trying to make human embryos by somatic cell nuclear transfer (cloning) for the same purpose.(30)
In the past, this further step – that of creating life in the laboratory for the sole purpose of destroying it – was supported by the NIH, but widely condemned even by abortion supporters in Congress and editorial boards across the country. President Clinton refused funding for this approach, and the Washington Post editorialized:
The creation of human embryos specifically for research that will destroy them is unconscionable... [I]t is not necessary to be against abortion rights, or to believe human life literally begins at conception, to be deeply alarmed by the notion of scientists' purposely causing conceptions in a context entirely divorced from even the potential of reproduction.(31)
Despite this strong consensus against creating embryos to destroy them, those actually involved in embryo research no longer see any serious ethical problem in it. Now the American Society for Reproductive Medicine (ASRM), which published the Jones study in its journal, says the study is "not inappropriate" and is in accord with ASRM's ethical guidelines. Some even argue that such research is morally superior to the use of "spare" embryos, because the egg and sperm donors understand from the beginning what the embryos will be used for.
Similarly, when ACT testified before this subcommittee in December 1998, it was virtually alone in insisting that success in embryonic stem cell research would require moving on to human cloning to make genetically matched tissues for each patient. However, the nation's leading for-profit group promoting embryonic stem cell research, the Geron Corporation, soon acquired the Roslin Institute in Scotland to combine its own expertise in embryonic stem cell research with Roslin's expertise in cloning.(32) The president of Geron recently testified to a House subcommittee that allowing the special creation of human embryos by cloning will be "essential" to the future of embryonic stem cell research.(33)
These groups have engaged in embryo research long enough to deaden all sensitivity to the fact that they are dealing with human life. If the federal government funds even a limited amount of research that relies on destroying human embryos, this deadening of consciences will occur on a wider scale and with government approval.
The Coalition for the Advancement of Medical Research, which favors federal funding of embryonic stem cell research, has argued that these developments actually show that the Bush Administration should proceed with the funding. To stop such abuses, goes the argument, the federal government must fund embryo research so it will have the authority to set limits.(34)
But the first groups to make this claim were groups that favor destructive embryo research, including groups closely associated with the Jones Institute's abuses. ASRM, which has given the ethical "green light" to the Jones study and published the results in its own journal, is an active member of the Coalition for the Advancement of Medical Research. So we are being told how to prevent special creation of embryos by the leading groups that favor and even perform it!
The argument that one must fund this research to regulate it is also absurd on its merits. The Jones study was done entirely with private funds, because for five years Congress has clearly prohibited funding of all destructive embryo research. If the federal government begins to fund some destructive research, it will be able to set standards for the research it chooses to fund, but the privately funded Jones study will remain untouched. In fact, such a policy change will signal that the government is moving in the Jones Institute's direction on this issue. It will soon become apparent that the government must fund research involving special creation of embryos for research -- that is, must fund the very abuse it claims to oppose -- in order to set standards for such research. Even then, those choosing not to obey such standards will simply conduct that part of their research with private funds -- and encourage the federal government to catch up with their advanced thinking, as it already will have done on the subject of destroying "spare" embryos. Indeed, supporters of embryo research in Congress have already introduced legislation that could fund research using specially created "research embryos," to take this next step (Stem Cell Research Act of 2001, S. 723).
We know that destructive embryo research can be regulated or even prohibited without funding it. As noted earlier, nine states now ban all such research, whether publicly or privately funded.(35) The state of Virginia itself has banned the use of cloning to make human embryos for research, and is considering a response to the Jones Institute's project for making research embryos by in vitro fertilization.(36) And the Food and Drug Administration, without funding any part of in vitro fertilization, recently wrote to in vitro fertilization clinics engaged in new reproductive techniques to remind them that such technologies, albeit privately funded, are subject to federal regulation.(37)
Like the argument that human embryos are not members of the human race, arguments that destroying them is necessary for medical progress or that funding such destruction is needed to prevent broader abuse cannot be sustained. With these arguments out of the way we can return to the real issue at stake: Should the federal government subsidize – and force millions of morally opposed taxpayers to subsidize – research that requires the destruction of innocent human life? We hope that the President and Congress will answer that question in the negative, and will unite instead to support promising medical research that everybody can live with.
Section 510 of the Labor/HHS appropriations bill for Fiscal Year 2001, H.R. 5656 (enacted through Section 1(a)(1) of H.R. 4577, the FY '01 Consolidated Appropriations Act, Public Law 106-554).
National Institutes of Health Guidelines for Research Using Human Pluripotent Stem Cells, 65 Fed. Reg. 51976-81 (August 25, 2000).
See Fact Sheet, "The NIH Proposal for Stem Cell Research Is a Crime," www.usccb.org/prolife/issues/bioethic/states701.shtml.
Federal regulations on Protection of Human Subjects include protections for the human fetus, "from the time of implantation." 45 CFR §46.203 (c). Implantation generally begins about six days after fertilization, at the blastocyst stage of human development.
"We believe that most Americans agree that human embryos should be respected as a form of human life..." National Bioethics Advisory Commission (NBAC), Ethical Issues in Human Stem Cell Research (September 1999) at 2.
See Fact Sheet, "Current Clinical Use of Adult Stem Cells to Help Human Patients," www.usccb.org/prolife/issues/bioethic/adult701.shtml.
"In our judgment, the derivation of stem cells from embryos remaining following infertility treatments is justifiable only if no less morally problematic alternatives are available for advancing the research." NBAC, note 5 supra at 53.
"The embryos that are being discussed, according to science, bear as much resemblance to a human being as a goldfish." Mary Tyler Moore, Testimony on behalf of the Juvenile Diabetes Foundation before the Senate Appropriations Subcommittee on Labor, Health and Human Services and Education, September 14, 2000.
Testimony of Lee M. Silver, Ph.D., before the House Government Operations Subcommittee on Human Resources and Intergovernmental Relations, July 14, 1988; R. Rowland, Living Laboratories: Women and Reproductive Technologies (Indiana University Press 1992) at 288-9.
Parents must be asked about having their embryos destroyed for federally funded stem cell research "only at the time of deciding the disposition if embryos in excess of the clinical need." National Institutes of Health, note 2 supra at 51980 (emphasis added). Proponents seem to assume that the option of destructive research is to be offered after parents have decided to have the embryos discarded. Read strictly, the guidelines actually forbid clinics to do this.
Nightlight Christian Adoptions v. Thompson (D.D.C. filed March 8, 2001).
For past testimony, including our public comments on the NIH guidelines and our testimony before this subcommittee in December 1998 and January 1999, see: www.usccb.org/prolife/issues/bioethic/biotest.shtml.
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