President’s Council on Bioethics
, is a physician and a consulting professor in the Neuroscience Institute at Stanford Universit
y. An opponent of stem-cell research that uses surplus embryos created by in-vitro fertilization, he supported President Bush’s veto in July 2006 of a Senate bill that would have expanded federally funded research on IVF-derived embryonic stell cells. Hurlbut has proposed an alternative method for obtaining embryonic stem cells, called Altered Nuclear Transfer, which was one basis for an alternative bill, S. 2754
, sponsored by Senators Arlen Specter and Rick Santorum of Pennsylvania. He recently spoke to Beliefnet senior editor Alice Chasan about the president’s veto, the scientific promise and the moral peril of stem-cell research, and his vision of how to resolve the current controversy.
President Bush recently vetoed legislation passed by the U.S. Senate that would have authorized expanding the lines of embryonic stem cells available for federally funded research. Did you support his veto of that legislation?
I wasn’t asked to make a political judgment on that veto, but I do have moral concerns about the use of in-vitro fertilization embryos for obtaining embryonic stem cells for research to be funded with federal funding.
Can you explain what your concerns are about that research?
You have to understand the history of this. When abortion came up as a very difficult national debate, we were really unable to resolve it. The Supreme Court ultimately issued a so-called right of abortion based on the idea that there was a private issue of the mother’s body, a right not to be encumbered with the pregnancy. That placed abortion and all the associated issues in the private realm.
When in-vitro fertilization came up about 10 years later--the first in-vitro fertilization baby was born in 1978--Congress debated again when is the beginning of life and what is the role of the federal government in funding research and clinical practices that involve the endangerment of embryos. Again, this was a bitter debate. It’s hard to define clearly what the biology of the beginning of life is and the moral assignment of worth to that is contested.
The government ultimately resolved this by the Dickey Amendment in 1996, which forbids federal funding for anything that endangers or destroys human embryos. That’s what’s at stake here. It’s long-standing federal policy and that’s why the president vetoed it along with his personal conviction, which is shared by many Americans, that it is wrong to use embryos as a kind of instrumental means toward medical ends.
Do you believe that embryonic stem cells could hold a key to the solution to various forms of human suffering from disease or genetic disorders?
I do believe that embryonic stem-cell research, from a scientific perspective, is interesting and worth studying. There are many things in medicine and science that we would like to study that we can’t because there are moral problems associated with doing so.
The key is to find a way to do it that doesn’t violate basic moral principles and upholds the positive scientific purposes of the research. That way we can go forward as a united society with our biomedical science funded with full support of the nation as a part of our identity as a noble and progressive society.
I’m interested in what you see as both the potential and the moral peril of stem cell research. First, what is the potential?
That is somewhat speculative, because we’ve had many phases of medicine where we put all our hopes on one thing. Embryonic stem cells represent the starting point for the human organism. It’s thought that they have the potential to form all the tissues and maybe organs of the body. They do that in the natural context of the embryo itself, but whether we can do that in a dish is a whole other question.
I do believe this is very worthwhile studying, but there are moral problems with doing it. I think that it’s exploratory sciencebut I don’t think it’s worth exploring at the cost of deep social conflict and overriding traditions of moral concern that have held our society together.
Science needs social cohesion as its core. You see what happens when you don’t have it in places like Europe where there’s such opposition to genetically modified foods, or in our own country and in England, where there’s a deep division concerning use of animals in research.
What is the moral dilemma about research with embryos created through the process of in-vitro fertilization that are discarded in the hundreds of thousands every year?
Federal legislators recognize that a large number of the people that they represent believe that human life begins at fertilization. It’s self-evident. Biologically human life begins at fertilization. I don’t see how anybody could argue with that. It’s not an issue of whether it biologically is alive. It’s a question of when we assign moral worth to something.
My personal feeling, after agonizing over this as a member of the President’s Council on Bioethics, is that we should assign moral worth to the full continuity of human organismal existence from natural fertilization to natural death.
If that’s so, should we be worrying about the very process of creating embryos in a laboratory at all, and the other consequences that flow from the mechanization of the process of conception? Have we already crossed that moral line through in-vitro fertilization?
Yes, we have. I remember the day Louise Brown [the first baby born as the result of in-vitro fertilization, in 1978] was born. I’m not Catholic by the way, but the pope made a very poignant statement. He said, while we welcome Louise Brown into the world, we have to express grave concerns about the way she came into the world.
All of us trained in medicine understood at that point that we had now entered a realm where we were going to create embryos that would be living human organisms that would then be discarded because they’d be surplus. I felt sad and worried about that. Some countries out-and-out rejected it. Germany will not let you create more embryos than you’re going to implant, and Italy is the same. And I think we should import such a goal.
If you create embryos and then use them for medical research you will open a terribly dangerous question of "how much and how far and what uses?" I don’t think it’s just purely a slippery slope kind of argument. It’s a crumbly cliff. Once you’ve decided you can use human life instrumentally at any of its stages, you’ve basically made a huge conceptual leap downward. Our ideals have always been framed around the idea that human life is inviolable.
You’ve proposed a novel solution to avoid destroying a viable embryo in order to obtain embryonic stem cells--a process you’ve called altered nuclear transfer.
Yes. That’s right. Except that it’s not a matter of creating a nonviable embryo. It’s creating a laboratory construct that is not an embryo at any stage.
The word “viable” is used to connote something that is alive, but it can’t live by itself. What we would create is more like a tissue culture that doesn’t have the integrated unity of an organism. It works very well in mice, and we just have to translate the studies into humans now.
Can you describe what this is?
Altered nuclear transfer uses the same basic procedure as somatic cell nuclear transfer, which is sometimes called therapeutic cloning, but no clone at all is produced. Let me make that plain: No embryo and not even an organism are produced, but it does use the procedure called nuclear transfer.
The way nuclear transfer works is, you take an egg and you take out its nucleus and you replace it with the nucleus from an adult cell, any cell of the body; we have a hundred trillion cells in the adult human body and theoretically the nucleus from any one of those cells would work. Once it’s placed in the egg, the egg factors re-program and re-organize that nucleus, so that it becomes like the nucleus of an early embryo.
That’s how Dolly the sheep was formed. Except, with altered nuclear transfer we would alter the genetics of the nucleus from the adult cell before transferring it into the cytoplasm, the soup substance of the egg, so that no embryo could be produced. In other words, it’s like starting to make something, but not adding in all the necessary ingredients for its presence. There’s no good mechanical analogy, but if you can imagine trying to make popovers without the yeast or something like that. It just never rises to the level of a living being
Recent scientific discoveries have shown that there is a factor in the egg itself produced during its formation that is absolutely essential for the formation of one of the two lineages of cells that are crucial for the formation of an embryo. There’s a way now to go in and silence that. This is a form of altered nuclear transfer. You alter the egg itself, rather than the nucleus, or you do both and that’s what we would do: both.
By doing this, you essentially produce instead of a single cell that divides and forms two different cell lineages, you start with a single cell adequately constituted only for the formation of one of the cell lineages. That happens to be the cell lineage that forms embryonic-type stem cells, which we call “pluripotent,” because they’re not coming from embryos. So this is truly a one-cell type tissue culture. It’s no more an embryo than one hand can clap or one voice can sing a duet.
Has anyone actually followed this plan that you’ve set forth and created such entities?
Like all medical science, it’s done first in animals, and so it has been done, yes. Rudolph Jaenisch at MIT did preliminary studies with altered nuclear transfer. By silencing a particular gene, the crucial gene, the same one I was just talking about that’s also involved in the egg, he produced fully functional embryonic-type stem cells, pluripotent cells, from a laboratory construct that was radically different in its developmental potential than an embryo.
And more recently there have been studies in Germany at the Max Planck Institute by Hans Schoeler that show what I described a minute ago, that this can be done even earlier and more fundamentally by altering components in the egg.
Are there any legal barriers to this being done on a wider scale?
No. There currently are no legal barriers to it, but to get federal funding for it, we needed the encouragement of the bill [S. 2754
] that was proposed by Senators Santorum and Specter, two senators with very different views on the moral issues of embryonic stem-cell research, but they joined together in a bipartisan effort, put forward a bill in the Senate to fund this kind of research.
It passed the Senate on July 18 one hundred to nothing, and then it went to the House and was rejected by the House. I worked with Senators Santorum and Talent and Coburn and Congressman Roscoe Bartlett to try and make the bill happen, so this was a very wrenching kind of reality for me. It was one of those moments in the history of this debate where those who promote the science side of the issue actually voted against promising science. This seems more like politics than good policy, and the President made them look bad by promising to fund the research into these hopeful alternative sources [like ANT] in spite of the rejection of the bill by the House.
What’s the next step?
The next step is I think possibly to reintroduce it in the House. The reason they rejected it had nothing to do with the projects themselves, but for political reasons that had to do with the other bill.
As you probably know, Specter is one of the major proponents of using the IVF embryos and Rich Santorum, also from Pennsylvania, has taken leadership in trying to find an answer to this. They finally joined forces in a very positive spirit to solve this, at least to go forward.
When I testified at Senator Specter’s hearing a year ago, I pleaded with everybody, let’s have a bill for what we can agree on. Let’s have a bill unencumbered with other political agendas. Let’s go forward with one small island of unity in our sea of controversy. But, in the end for all my efforts and all the efforts of others, this ended up getting caught up in the epicenter, in the worst moment of partisan politics on this issue.
You are a devout Christian, is that correct?
Well, I'm a Christian. Devote is a description of depth of dedication, and I would like to be considered a good Christian. But you don't proclaim yourself a devote Christian, do you?
Do your perspectives on the ethical dimensions of research with embryonic stem cells derive from your religious faith, or did they develop independent of religious faith?
That’s a very good question. I do not believe that my religious convictions were the crucial factor in deciding anything on this issue. In fact, I’ve made an entirely scientific argument for why human life, from its beginning, is in continuity with all stages. I f we’re going to value it at one stage we should value it at all stages. I’ve not done a moral analysis on this that required any religious assumptions.
Of course, my religion frames the approach I take to the world. It’s only my religious faith that kept me going in the midst of all this conflict to try and seek an answer. It’s only my religious faith that finally in the end is willing to sacrifice a degree of my own peace and happiness for working on a solution that would be good for others as well.
I've read statements that you've made and the descriptions you've given scientifically for the nature of an embryo in which you say, all the elements of human life are present in potential. Your description has a mystical quality, in the sense that you describe something quite ineffable. And yet, you're arguing from science. I see the two things in your writings as being bound up with one another.
You said that very well, but I'd put it back to you in a positive sense. Talk to any physicists about the elementary particles of the cosmos and they get a little mystical about that. I know very profound scientists who are religious. In fact, Francis Collins, who's head of the Human Genome Project, is a very strong evangelical Christian. I know Charles Townes, who got the Nobel Prize for discovering the laser. He's a very deeply Christian man. I'm personal friends with Baruch Blumberg, who discovered Hepatitis B and got the Nobel Prize for that. He's a deeply religious Jew.
Religions sustain society during times of transition. When we're talking about embryonic human life, religion is doing us a service by holding us true to that which human beings have always known everywhere and across time--that life begins with small beginnings and issues forth into that which we recognize as self-evidently human.
Now, different religions have taken different positions on when an embryo is fully human, but those have usually not been related to issues like when to use them in laboratories. It's been related to when to punish somebody for pushing a woman over who's pregnant and then she has a miscarriage. Tthe Jewish perspective on this issue of embryonic stem-cell research is more liberal than the Protestant and Catholic perspectives.
I had a three-hour conversation with the chief rabbi of France several years ago, and when we talked long about therapeutic cloning and laboratory creation of embryos he said, no, that's not what the Babylonian Talmud was talking about when they said life begins at 40 days, the embryo is a viable human at 40 days. That has nothing to do with it. He said it was based on issues of purity and penalty. It was not based on an endorsement of the instrumental use of developing human life. So, different people will have different views, but religion overall has supported the sanctity of life as it unfolds even in its more vulnerable and primary beginnings.
Beliefnet has published an article by a man who is a paraplegic, and he's also the child of Holocaust survivors, who argues that discarding embryos created in vitro is in itself an immoral act when they could be used for research that could help him and others suffering from disease or paralysis. How would you respond to somebody who is a Jew and a child of survivors who believes that the current attitude toward these embryos is profoundly inconsistent?
One of the best things about this debate over embryonic stem-cell research is that it has brought into the forefront of America's public consciousness the need for more research and serious concern for those among our fellow citizens who are suffering spinal cord injuries and so forth. It's a scandal of priority that we spend so much on trivial entertainment, pornography, self-indulgent behaviors while people are suffering so deeply. So, I truly acknowledge the positive good that he's trying to promote in the advancement of medical science. I am a doctor. I know how much people are suffering, and I have a handicapped child of my own.
But he's weighing one moral good against another and basically declaring that one is more important than the other. I would turn it around and say that the best way forward is going to be a way that acknowledges both goods and finds a way to preserve and advance them both. Medicine can't go forward simply on the argument that there are lots of people that need cures. He may not think that the early human embryo is a human being, but it is self-evidently the early stages of a human life. Once we, as a nation, provide federal funding for this research, we, in effect, also provide an institutional endorsement for the instrumental use of human life.
I was in the White House the other day when the president vetoed this bill, and announced that he was going to fund the alternative methods in spite of the fact that Congress denied him the bill to sign in favor of it. He spoke powerfully, and no matter who you were and what you thought of the president, you would have had to feel the weight of this, not just as a personal conviction, but as a statement of the man who felt he was doing the best thing for our civilization.
He said that some have argued for this with the same argument that you just gave me. He said, it would require the government to reverse a long-standing policy and then he said, I'm not going to do it.
And when he said that the electricity in the room was powerful. You felt like you were looking at a man who simply did not care [about] the political consequences of what he had done, who was going to uphold the principles that he thought were the true principles on which the positive future for our society would be built. [He] said he believed that we could find positive ways forward if we would just try. That struck me as a powerful moment.
As much as I want the [paraplegic] man to be cured, and I truly sympathize with him, we can answer his needs while at the same time acknowledging these other issues.
Embryonic stem-cell research may turn out to be important in the future of medicine. If it does, it will be the foundation on which a great deal of the future of medicine is built, so every patient going into the hospital would be affected by this research. We should do this in a way so that nobody enters the hospital at the most sensitive and vulnerable moment in their life with the feeling that their cures or their treatments are built on research that they think is fundamentally immoral.
Dr. William B. Hurlbut, a member of the