Stem Cell Research

An Interview with Mr. George J. Annas

Mr. George J. Annas is the Edward R. Utley Professor and Chair of the Department of Health Law, Bioethics & Human Rights of Boston University School of Public Health, and Professor in the Boston University School of Medicine and School of Law. He is the co-founder of Global Lawyers and Physicians, a transnational professional association of lawyers and physicians working together to promote human rights and health. He has degrees from Harvard College (AB, economics '67), Harvard Law School (JD '70) and Harvard School of Public Health (MPH '72).

The biggest controversy in stem cell research deals with the sources of the stem cells. Given each of the following sources of stem cells, what are your opinions of the ethics of each and why or why not?

• Excess stem cells from in vitro fertilization at fertility clinics

In my opinion, taking leftover embryos from fertility clinics - the leftover embryos that couples do not want to use anymore - is fine as long as the couples consent to that kind of donation.

• Embryonic germ cells from aborted fetuses/embryos

I think it is okay to use those to do stem cell research; I do not, however, think it is okay to try to make a baby out of those.

• What about therapeutic cloning (somatic cell nuclear transfer)

I think that it is okay to use that technique to make stem cells to use for research, but again, not to make a baby.

Do you think that adult stem cells hold enough potential to avoid having to worry about using embryonic stem cells?

I think adult stem cells have enough potential to warrant research and research funding into that area on the part of the federal government, but I do not think they have enough potential to foreclose embryonic stem cell research altogether.

Is that because of the limited potential for the adult stem cells to develop into different kinds of cells?

The reason is that we do not know very much about them. Actually, we do not know very much about either type of cell yet. I think we are right at the beginning of research here, and it would be premature to actually close off one whole area of research. On the other hand, I think that the people who say that we may be able to do whatever we want with adult stem cells and with umbilical cord stem cells may be right; the truth is, we just don't know.

So, you would say that more research in both areas is a necessity?

Yes. It would not bother me if we spent more money on adult stem cells than we do on embryonic stem cells in pursuing that research.

Regarding President Bush's 2001 regulations regarding stem cell research that was eligible for federal funding, do you feel that his decision was appropriate, too strict, or too lenient?

I actually do not think his decision made any sense at all. It is either right or wrong to use embryonic stem cells. Setting an arbitrary date on when they were created does not change that situation at all. Also, that decision seems to have been based on a misunderstanding as to how many stem cell [lines] were going to be available and whether that was going to be sufficient to do the high-level research that people have in mind.

What direction should he have taken? What regulations would you have imposed?

I would have permitted National Institutes of Health funding for embryonic stem cell research under pretty heavy regulation. It would have to be done in the public, all protocols would have to be approved by a national body, a national review board that met in public. The research would have to be done only in designated, approved laboratories. It would have to be totally separate from any in vitro fertilization clinic or any fertility clinic. There would have to be no possibility of using those embryos for anything other than research. There could be no freezing of embryos made for research, and there could be no commerce of those embryos. It would be similar to the regulations* coming out of the Clinton Administration, right at the end of his term. I actually thought that those were pretty good.

Will his decision to restrict federal funding for only existing cell lines push a lot of research into the private sector and what are the implications of this?

Well, I think it is more likely, in the United States at least, to discourage scientists from doing research in this area at all. Most researchers, especially those affiliated with academic institutions, actively seek out federal funding from the National Institutes of Health, and really, areas of research that are not funded by NIH are tainted – they just seem to be illegitimate or less preferred. So it is just going to be less likely that anyone in the public view is going to be doing this kind of research.

What about other countries? Do you think that they will benefit from having more relaxed rules than we have, and that this will put the United States behind in stem cell research?

It is hard, to know, but certainly research has been approved, although it has not started yet, in England and China and Singapore. Sweden has indicated that it is going to go ahead with this research. So, it is certainly not going to help our competitive position.

Do you think that there should be an international consensus on what stem cell sources are acceptable?

I would certainly like to see an international consensus. I actually would like to see them propose an international treaty that outlaws the use of cloning technologies to make babies, and outlaws the genetic engineering of embryos to make "better babies." On the other hand, making stem cells to do research should be permitted, but if individual countries outlaw that, I have no problem with that. However, I think we should develop international rules about all human research, including this type of research.

How do decisions about the ethical uses/sources of stem cells affect decisions about cloning, or vice versa?

They are related for practical reasons, in that, once you make an embryo using the so-called Dolly cloning technique (somatic cell nuclear transfer), you could use that embryo to try to begin a pregnancy, rather than destroying it to try to make stem cells. So, they are related in that practical manner, and that does mean that if you want to permit embryonic stem cell research and prohibit making babies with those embryos, you would have to highly regulate this area of research, and I think that is highly desirable.

What do you think the future of stem cell research will be? Will the world see much benefit from it, or is there going to be too much controversy around it for anything useful to come of it?

I think it is too soon to say. There is a lot of hype about regenerative medicine and the hope, of course, is that we are going to be able to regrow new tissues – new heart tissues, new nerve tissue, new pancreatic tissue – to repair injured tissues and organs. I join in that hope, but I think, right now, it is very premature to say if and when that is ever going to happen. On the other hand, we have enough theoretical basis for that hope that we should pursue research in this area. But I would not oversell it; I think it is irresponsible to oversell this technology.

Do you think that the direction that we are moving in with stem cell research, and the sources that we are trying to get them from, is becoming too open and is going to violate a lot of long-held beliefs about protecting human life?

It is moving slowly, and I think we certainly want to move slowly. I think we are trying to develop an international consensus, and we have some. We have international consensus about making a baby with cloning – no one wants to do that. It is almost universally condemned. There is no international consensus, however, on the use of embryonic stem cells to do research. I think that, if it were put to a vote, the majority of industrialized countries, at least, would be in favor of using embryonic stem cells for research. I happen to agree with that position, so I am not terribly upset about that direction, but certainly, people who believe that the human embryo should not be used for research are right to be upset. They are not winning the day on this one.
Submitted by: Kyle Gracey, Rensselaer Polytechnic Institute, 2003 Fall Intern