Where Frist Comes Down
Stem-cell statesman or political cynic?

By Wesley J. Smith, author of Culture of Death: The Assault on Medical Ethics in America
July 20, 2001 8:40 a.m.

uch ado has been made in the media of Sen. Bill Frist (R., Tenn.) coming out for federal funding of embryonic-stem-cell research (ESCR), "with limits," as the New York Times's headline put it. While most of the media emphasis has been on the funding aspect of the story — no surprise since that angle undermines the opposition to ESCR — precious little media focus has been placed on the actual "limits" Frist proposed. That may be a huge mistake in interpreting the real meaning of this latest development in the great stem-cell debate.

There is no question that Frist's decision — he is a close ally of President Bush and the Senate's only physician — adds to the immense pressure-squeeze on President Bush to approve federal funding of ESCR, an act that would put the American people on record as approving the use of human life as a mere natural resource to be destroyed and harvested. Indeed, one is sorely tempted to ask, with friends like Frist (and Orin Hatch, and John McCain, and Connie Mack, and Gordon Smith, etc. etc, ad nauseam), who needs enemies? But there may be more to this story than appears on its face.

The actual policy limitations Frist advocates — "Frist Principles on Human Stem Cell Research" — have not been extensively reported. I suspect the reason for this is that if the Bush administration takes them seriously, the federal government will not, in the end, fund ESCR.

Before we review the Frist Principles, let's review the current state of great stem-cell debate. Polls show that the American people do not approve using public money to destroy human embryos in medical research, an act that is currently outlawed by a federal law known as the Dickey Amendment. A recent CNN/USA Today poll revealed that a whopping 57 percent of the American people do not know enough about the issue of ESCR to express an opinion. Other polls show that the American people appear to support ESCR in the context of using embryos, but only on the condition that they would have been discarded anyway as being in excess of need from IVF fertilization procedures.

This "IVF barrier" gambit — so far, the driving force in the entire stem-cell debate — is effective because it appeals to the deep pragmatism in the American character. If the embryos are doomed anyway, the argument goes, then why not get some good out of them? Indeed, it is this last point that supporters of ESCR funding are adeptly using as a battering ram to smash past the people's oft-expressed squeamishness about destroying human life in medical research.

Opponents of funding ESCR have argued vehemently against this stark utilitarianism, unfortunately with little effect. I will not repeat those arguments here. We have also argued that the IVF-barrier argument is actually a bait and switch tactic to desensitize the people to the harvesting human life. Once that slide down the slippery slope is accomplished, we believe, scientists will quickly shift to making human embryos for the purpose of destruction and harvest in human experimentation and will eventually push for federal funding of human cloning.

Our fears on that score were validated last week when the Jones Institute for Reproductive Medicine bragged that they were already creating and destroying embryos in privately funded ESCR. The Jones scientists claimed that this act was "as ethical" as using embryos destined for being discarded. They also suggested that freshly made embryos might be "superior" to embryos thawed from the deep freeze. Not only that, the biotech industry has been lobbying hard against pending legislation designed to ban all human cloning because, industry lobbyists claim, cloning will be a necessary part of embryonic-stem-cell medical therapy in order to avoid transplanted embryonic tissue from stimulating the body's immune system.

It is thus quite clear that once ESCR receives the imprimatur of federal funding, the IVF barrier will simply not hold. Federal funding would neither prohibit nor regulate the creation of embryos for research or experiments so long as private money were used. Thus, rather than inhibiting such research, as Sen. Hatch has claimed, it would merely free up private money now used in IVF experiments for more Jones Institute-type research and efforts to begin human cloning.

With the above in mind, let's now review the Frist Principles. Frist states, "Federal funding for stem cell research should be contingent on the implementation of strict new safeguards and public accountability governing this new, evolving research." (My emphasis.) He then lists the following ten principles, which he calls "essential components" of stem-cell policy:

1. "Ban Embryo Creation for Research: "This would outlaw acts, such as those committed by the Jones Institute.

2. "Continue Funding Ban On Derivation:" This means the Dickey Amendment banning federal funding of actual destruction would remain in place. (President Bill Clinton — never one to permit the plain meaning of words to impede him--sought to get around the Dickey amendment by permitting federal funding of ESCR only after the embryo had been destroyed and the stem cells harvested. That is the policy President Bush suspended early in his administration, sparking the great stem-cell debate.)

3. "Ban Human Cloning:" Frist would prohibit all human cloning to "prevent the creation and exploitation of life for research purposes."

4. "Increase Adult Stem Cell Research Funding:" Here, here! This should be done even before we reach the denouement of the great stem cell debate.

5. "Provide Funding for Embryonic Stem Cell Research Only From Blastocysts That Would Otherwise Be Discarded:" This is the IVF-barrier gambit.

6. "Require a Rigorous Informed Consent Process:" The regulations would be patterned after organ donation protocols that require detailed consent procedures.

7. "Limit Number of Stem-Cell Lines:" This would seek to ensure that a very limited number of embryos would be destroyed for ESCR. 8. "Establish a Strong Public Research Oversight System:" Naïve, at best. The federal government doesn't even adequately oversee research using born human subjects.

9. "Require Ongoing, Independent Scientific and Ethical Review:" The worth of such a step would depend on who does the reviewing.

10. "Strengthen and Harmonize Fetal Tissue Research Restrictions:" This would strengthen existing rules about fetal tissue research (experiments using the bodies of aborted fetuses) to equal those that Frist seeks over ESCR.

The crucial question presented is this: Is the senator serious when he states are these principles are "contingent" on his support and "essential components" required to justify support for federally funded ESCR? In other words, would the senator require the Frist Principles to be enacted into federal law as a condition precedent to federal funding of ESCR? Or, as many opponents fear, are the Principles proposals merely to be advocated following a decision to federally fund ESCR?

If Frist intends the former scenario, then the Frist Principles are designed as a "put up or shut up" to supporters of ESCR that would require them to lock the IVF barrier into federal law as proof of their good faith. Thus, failing to ban human cloning, failing to limit the number of stem cell lines, failing to retain the Dickey Amendment, and failing to outlaw the creation of embryos for research purposes — even with private money — would doom federal funding of ESCR under the Frist Principles.

This is a political hook that President Bush could hang his Stetson on. True, it would fall far short of the principled rejection of federal funding of ESCR for which opponents deeply yearn from the president. But any port in a hurricane. Sometimes a political approach is required to implement important principles — just ask Abraham Lincoln.

Should Bush adopt the Frist Principles as administration policy, I do not believe we will ever see federal funding of ESCR. Sen. Arlen Specter, the Senate's premier voice in favor of strip mining human life, has previously made it abundantly clear that he wants to destroy the Dickey Amendment (which would violate the Second Frist Principle). Moreover, at the subcommittee hearing at which Frist unveiled his proposal, Specter stated that he is not willing to limit the number of cell lines that would be created by ESCR. I also doubt that he would ever vote to outlaw all human cloning, much less vote to prohibit private creation of embryos for use in research.

If the rest of the ESCR crowd follows Specter's lead--and I have little doubt that most will--it will doom the Frist Principles. Once it is clear that his proposal will not be enacted, Frist should come out and say that he tried to reach a "good faith" compromise on federal funding, but failed. He should then announce that he supports the existing ban on funding of ESCR because it is now obvious that the IVF barrier was never intended to be a wall separating us from Brave New World but rather, was designed to be a door opening to it.

Such an act would demonstrate that when he lays out crucial public-policy principles, he really means it. If, however, after Frist's Principles are rejected or are stalled in the legislative process, he supports federal funding of ESCR anyway — while voicing the vague hope that his "principles" will be put into effect someday--then Frist will have shown himself to be merely another cynical politician looking for cover on a highly controversial issue.

Who is the real Sen. Bill Frist? We will soon find out.