Barry Goldwater remarked years ago that filling in as a “guest host” for Johnny Carson was rather like jury duty: At some point almost every American would have to do it. In our own day, the equivalent may be appearing on Larry King Live. That task fell to President Bush and his wife earlier this month.
King could not resist raising the issue of the supposed “ban” on research involving stem cells while interviewing the First Couple. Of course, there has been no ban on that research; there has been only a reluctance on the part of the president and Congress to promote such research with public funds when it involves the destruction of human embryos. Larry King has rubbed shoulders with Nancy Reagan and her son Ron in taking up this cause, claiming that research on embryos will deliver other people from the Alzheimer’s disease that afflicted our late president. President Bush, bless him, spoke from his heart in conveying his concern for the “culture of life” and explaining his reluctance to cross certain moral boundaries. But the conditions of speaking on Larry King Live, with compression, before a mass audience, does not exactly lend itself to extended explanations. What may be needed is a kind of five-minute account that even Larry King and Ron Reagan can understand. And so let’s try it.
In the first place, even Larry King is not likely to hesitate when the problem is framed in this way: Given a choice between a therapy that happens to be lethal for human subjects and one that is not, wouldn’t we be inclined to favor the therapy that is not lethal? Wouldn’t that be even more the case if that non-lethal therapy turns out to be vastly more promising, and far less speculative, than the lethal therapy? Stem cells drawn from adults have already yielded some striking achievements, and they do not require the killing of the person from whom they are drawn. The extraction of stem cells from human embryos does, however, result in the destruction of the nascent human being in the stage of an embryo (as opposed, say, to his stage as an undergraduate).
By now we have all absorbed the familiar complaints against the kind of science performed so directly, and without inhibition, by German doctors during the Second World War: If we want to know how long pilots could survive in the cold waters of the Atlantic, why not just dunk some human beings in water brought to that temperature and find out directly? As it so happens there were Jewish prisoners at hand who, as the saying goes, were “going to die anyway.” Why not use them to find out what science was keenly interested in knowing?
Yet the fact that the prisoners were marked to die did not dispose of the question of whether they were being sent to their deaths rightly or wrongly. And even apart from that question, the scientific community seemed to recoil from the prospect of performing, on non-consenting human subjects, experiments highly likely to be lethal.
As everyone used to understand, then, there were moral constraints that properly limited the passion of science to “know.”
Of course, the argument arises over the question of just why the human embryo should be regarded as a human being, with the same human standing as those human beings we see all about us. If this were merely a matter of “belief,” then for John Kerry the issue could be settled already. For he has already affirmed his belief–fortified, he claims, by his religion–that life begins at conception.
But happily there is a truth of this matter that does not hinge merely on “beliefs.” What Kerry curiously affirms as a matter of mere personal belief happens to be the plain fact contained in every textbook on embryology and gynecology. Twenty years ago the Senate Committee on the Judiciary undertook a survey of the leading books in the field, and quite remarkably found a thorough consensus on the science of the matter. Twenty years later the consensus remains the same: Human life begins with the union of the male and female gametes to form a unique being, with a genetic definition quite separate from that of the mother and father. When we refer to the “human” embryo, we’ve already answered most of the question: The organism never undergoes a change in species. The offspring of homo sapiens is homo sapiens, or a human being, from its first moment to its last. And as the late Paul Ramsey once remarked so tellingly, there is nothing you and I have, genetically, that we did not have when we were that zygote, no larger than the period at the end of this sentence.
Try it another way: If I wanted to strike at that person known as John Kerry, when is the earliest I could have struck and removed the memorable person we have come to know? When he was merely boy-baby Kerry, before he was even named John, he was clearly the same being. Two days, two weeks, two months, several months earlier, in utero, it was the same being filling out to the form that would later be recognized as boy-baby Kerry. If we traced that being back, we would be dealing with the same entity, with the same distinct genetic makeup, all the way back to zygote Kerry. And one would think any graduate of Yale would know at least this: If that zygote John Kerry had been destroyed, the one we have come to know as John Kerry would not have sprung from the next pregnancy of Mrs. Kerry. That zygote, and only that zygote, was the one we have come to know as John Kerry.
All of this should be enough to settle the question, if indeed it seems clear to both sides of the debate that we would choose a form of therapy that is not lethal for other human beings. That leaning in principle would be further strengthened by the results we have already seen. Embryonic stem cells, in being so unformed, are highly versatile. And yet they are also harder to control in their effects, sometimes generating tumors and other less-than-welcome surprises. Adult stem cells seem more stable, and when they are used to treat the person from whom they are drawn they have signal advantages: There is a vanishingly small risk of rejection, and virtually no risk of transferring genetic and viral diseases. The differences are also borne out dramatically in the record. One of my own students at Princeton, Cason Crosby (now Cason Crosby Cheely), collected some of the more striking examples in her senior thesis. Were she not unavailable now, on her honeymoon, I would give the rest of the story over to her. In her absence, I’ll simply report the examples she collected:
Adult stem cells healed broken bones and torn cartilage in a clinical trial.
They were responsible for the first completely successful trial of human gene therapy, helping children with severe combined immunodeficiency disease to leave their sterile environment for the first time.
Adult cells from a young paraplegic woman’s own immune system, injected into the site of her spinal-cord injury, cured her incontinence and enabled her to move her toes and legs for the first time. (Reported in congressional testimony in July 2001.)
In June 2002, research confirmed that adult stem cells are more effective than embryonic stem cells in blood formation; and a month later, Canadian and Japanese scientists saw adult bone-marrow cells show significant immune tolerance. The cells were not only incorporated into bone marrow, but also into damaged hearts to help in repair.
In July 2002, bone-marrow stem cells were incorporated and differentiated into retinal neutral cells in an injured retina. Researchers have used bone-marrow stem cells to grow new blood vessels in the eyes of mice–a procedure that they hope might lead to treatment for some forms of blindness in humans.
Around the same time, scientists implanted adult bone-marrow stem cells into children with osteogenesis imperfecta, a severe bone and cartilage disease, and the stem cells stimulated bone growth.
In the summer of 2002, researchers at the Massachusetts General Hospital successfully turned adult stem cells into insulin-producing cells that could reverse diabetes.
In February 2003, researchers showed convincingly that stem cells transplanted from a patient’s muscle tissue to the heart may be able to take over for cardiac muscle damaged by a heart attack.
The experience since then has amplified these findings and given further hope to this line of research. In the face of such developments, we must wonder just what fuels the passion for heating up the presidential campaign by raising, to a high pitch, the issue of embryonic stem cells. The motives must be various, but it seems clear that for many of the partisans the drive to use stem cells from embryos does not arise from a sober consideration of the prospects for that research. For many, it appears, the passion for sweeping away the moral reservations about stem cells is bound up with the argument over abortion. The prospects for research are evidently far less important than the possibility of proclaiming, once again, that the human embryo, or the nascent human life, has no standing, and no rights, that the rest of us need to respect.
–Hadley Arkes is the Ney Professor of Jurisprudence at Amherst College and a senior fellow at the Ethics and Public Policy Center in Washington.