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Stem Cell Research
An Interview with Kevin T. FitzGerald
Kevin T. FitzGerald, SJ, PhD, is the Dr. David
Lauler Chair in Catholic Health Care Ethics at Georgetown University
and a Research Associate Professor in the Department of Oncology
at Georgetown University Medical Center. He received a PhD in molecular
genetics and a PhD in bioethics from Georgetown University. He has
published both scientific and ethical articles in peer-reviewed
journals, books, and in the popular press.
Fr. FitzGerald has given presentations nationally and internationally
and has often been interviewed by the news media on topics such
as human genetic engineering, cloning, stem cell research, and the
Human Genome Project. For the past ten years he has served as an
ethics consultant for the National Society of Genetic Counselors.
He is a consultant to the Juvenile Diabetes Research Foundation,
the United States Catholic Conference, and is a member of the American
Association for the Advancement of Science Program of Dialogue on
Science, Ethics, and Religion.
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 embryos from in vitro fertilization
at fertility clinics
Embryonic germ cells from aborted
What about therapeutic cloning (somatic
cell nuclear transfer)
Well, what do you mean when you say embryo? Let
us look at it this way I would say right now that this is
a term that nobody really and truly has a clear grip on. Oftentimes
when you are talking to scientists, for instance, they might say
to you that anytime sperm and egg come together, you have an embryo.
The problem is that we also know from science and medical research
that sperm and egg can come together and you can end up with something
called a complete hydatidiform mole [the product of an egg with
no maternal DNA being fertilized by a sperm], which, as far as I
am concerned, is not the kind of thing that people are conceptualizing
when we are having this debate about the destruction of embryos.
Nobody worries about the destruction of a complete hydatidiform
So, we have to be very very careful with the language here, because
it often gets thrown around with great emotion and not a great deal
of understanding or precision. So, when I am talking about embryos,
particularly from a moral perspective, I think the easiest way to
conceptualize it is: That which we all once were. In spite of the
fact that some people would want to say that you can use somatic
cell nuclear transfer and get something other than an embryo - a
clonode or whatever they want to call it. Then you would also then
figure that that means that Dolly was not a sheep.
Now, everybody agrees that Dolly was a sheep, and if Dolly was sheep
then she was a fetal sheep and if she was a fetal sheep than she
was an embryonic sheep. So Dolly was an embryo. Whether or not you
create a human being from an egg or by cloning or some other way,
it is that which we all at one point once were. Now, looking at
it that way, if one considers the sorts of restrictions and protections
that we build in to human subject research, and we all presume that
they are human subjects, and we are to protect human subjects in
research, then I would argue that anything that violates the protections
that we supposedly have in place even though we in this country
have a lot of problems doing that (and doing that well) then
anything that violates that would be something not to do.
In different parts of the world one might be able to say, looking
at prisoners on death row, "They are going to die, you know
they are going to die, you in fact know when they are going to die,
so why not take advantage of them before they die?" Similar
kinds of reasons, you see, are being used. Well, if we treat these
as human subjects, then what you do to an embryo is no less of a
violation than what you do to a fetus, what you do to a child, what
you do to an adult.
So, in that sense, it rules out all of the options that you have
here. Now, that is not to say that everything that you destroy is
an embryo in that sense. The problem right now is that it is not
possible to tell which is which. So, using a different analogy,
if you walk into a field after a battle and there are dead soldiers
all over the field, and you are worried because that field is quite
near a town and the people in the town might be at an increased
risk for disease or other problems because of the dead bodies in
the field, the quickest and easiest thing you could do would be
to just bulldoze all of them into a large ditch and bury them. But,
you haven't had a chance to go through the field to see if
they are really all dead. Now, are you justified to bulldoze them
all because it would take so much time and it might add to the risk
to the living people in the town?
Now, we might say no, you have to give benefit of the doubt that
there might be somebody out there, and you have to go through the
whole process [to find them]. So, I would argue similarly that you
have to give benefit of the doubt that even though the entities
(biological embryos) that are all frozen away, many of them might
not be embryos in the sense that we at one point all once were.
Just because one would say "Well, this embryo will only live
four weeks or eight weeks or eight months," that doesn't
matter. Length of life does not matter. Just like those prisoners
on death row. You have two weeks to live, so what? Just because
you have two weeks to live, that makes you less of a human being?
No. So, even if they only live two weeks, that does not make each
one less of a human being. As I said, some of them are not embryos
in that sense; they are something else. But since we cannot tell
the difference, we give benefit of the doubt.
Do you think that adult stem cells hold enough potential
to avoid having to worry about using embryonic stem cells?
Going back to my original point, if we are talking about human subject
research protection, it does not much matter what the potential
is - there are certain things that you cannot do. But, I understand
that for other people, it is an important issue to wrestle with.
The problem that I see here is that it is an incorrect analysis
when one compares embryonic stem cells to adult stem cells. The
point is oftentimes to do this research in order to get to certain
therapeutic goals - to help people back to health, to treat disease,
bring healing, all those sorts of things. If those are indeed the
goals, then one has to include not just adult stem cells, but every
other type of research that is going on right now genetic
research, pharmacological research, genomic research, proteomic
research, all that other research has to be included in weighing
that balance if indeed they are going to do it accurately.
What they are talking about is whether you can justify doing this
controversial and contentious research, destroying embryos or fetuses,
by arguing that you have to have this in order to get to those goals.
The only way to argue that is by measuring it against everything
else that we can do, not just adult stem cells. Otherwise, I would
say that it is just not a logical comparison. People can say, "Well,
we're talking about developmental biology, and stem cells
are the only way to do that developmental biology." True, but
human [stem cells] are not [the only way]; you've got animal
research in there, too. And really, the developmental biology research
is to understand what the mechanisms are behind all of this - the
molecular mechanisms - because cellular research is much more black
box research, and we want to figure out the details. Again, you
are talking about molecules and things like that and that might
be able to be done in some other way.
So, looking at it that way, sure, with all the other research that
one could combine, one could say that [adult stem cells] certainly
has the potential to get to these goals. One might argue, "Yes,
but it wouldn't get there as quickly." But there are
a lot of things that we do already, choices that we make that mean
we aren't getting some place as quickly. In fact, if one looks
at the amount of money and time and energy that are being spent
on the diseases that kill most of the people in the world, including
just diseases that are a result of inadequate sanitation, you don't
have to do research there, we have the technology for adequate sanitation.
So, if the goal is to cure people and to help people who are in
need, then we have already chosen not to do that. So do not tell
me that we cannot choose to not go forward as fast as possible,
because we have already done that, and maybe in ways that we can't
Regarding President Bush's 2001 regulations regarding
stem cell research that was available for federal funding, do you
feel that his decision was appropriate, too strict, or too lenient?
I thought his decision was politically very clever and astute, and
in a sense, a stopgap which will not work. It cannot work. On the
one hand, it does not give the one side what they want, which is
as much research as possible. On the other side, it does not give
them what they want, which is to stop this kind of research. Even
if you limit the research with federally funded moneys to [those
stem cell lines] that happened before the decision, you are still
exacerbating the situation because the information that can be gained
from doing that research can be used with private funds to do embryo
research. So, it really does not work either way. That is, if indeed
the goal was to find a solution to this problem. If the goal was
to find a politically astute stopgap measure, then yeah, it was
Will his decision to restrict federal funding for only existing
cell lines push a lot of research into the private sector?
I do not know if that is necessarily the case. My guess would be
that if the government had allowed federal funding for this research,
then the private money would have been put elsewhere. In fact, there
probably would have been more private moneys because the federally-funded
research would have supported more privately-funded research, would
have provided the bedrock for that, so I would say that it did not
make more private money go into this research, it probably reduced
What direction should President Bush have taken? What regulations
would you have imposed?
My area is not public policy, and I am not a legal expert, and I
do not deal with regulations from that perspective. But from an
ethical presentation, I think we should choose as a society, and
not just as a society but as a global village, voluntarily not to
do this research until we understand better what it is that we are
doing. So, what is an embryo, and are there ways of getting to the
goals that we want that do not rely upon research that is contentious
and controversial in society? Now the problem here is that we have
a variety of different religious traditions, ethical traditions,
cultural traditions and political traditions, and we must deal with
the power and the pace of research, the advancing wave of research.
So, with that incredible, diverse mix coming together, there is,
I would argue, even from a moral point of view, there is a great
deal of need to be careful, to be sensitive, and to try and do this
in a constructive way that does not necessarily do a great deal
of damage to any particular groups' interests or values or
justifications; yet we must still try our best to get to those therapeutic
goals and answers that everybody wants, including the answers that
we already have but are just not distributing well.
We have to acknowledge that, we have to take that into consideration,
because that argument keeps getting brought up time and time again:
"How can you deny my patient this research?" Well, that
raises a very interesting question who counts? For [that
doctor], it is [his or her] patients. But there are many, many doctors
out there and they work all over the world. U.S. patients get represented
in Congress or the media, but who is representing this other doctor's
patients who happen to be in Ethiopia and are facing much, much
different health care concerns? The concerns are all crying out
for research distribution when we have scarce resource distribution.
Are reproductive technology needs the same as life and death starvation
needs or needs of avoiding pathogens in inadequately sanitized water?
These are the kinds of things that we are not balancing. We are
not taking the time to sort these out as well as we should. Instead,
there is a kind of yelling match that is going on.
Well, [Student Pugwash] is in the media, in a sense, so what sells?
Balanced, careful analysis, trying to weigh a variety of things,
careful listening to various groups, trying to integrate and put
together a great deal of this information with age-old traditions
and values, and valuing people? Or yelling and screaming matches
where people say incendiary things? Of course, we know what sells
in the media. One has to take that into consideration, too. I am
not saying that media is evil, I am just saying that that is what
the media does, and it is not necessarily going to facilitate this
other thing that I think needs to be done. In fact, I think it facilitates
So, all those things have to be taken into consideration when you
say how should we go forward. I do not think we can unilaterally
say we are just going to have these regulations, because what happens
in other parts of the world? This technology affects everyone, no
matter what your beliefs are, where you are form, what your cultural
background is - this technology works on you. In fact, the beauty
of it is, in one sense, it works on all living things. If there
is anything that is going to pull us together, I would think that
that would be the one thing. Now, we can use it for different ends,
but it does affect everyone, so that is why I say we still need
that international deliberation. And yes, that will slow things
down, but let us make sure that, in the process of slowing things
down, people who might get hurt get the extra needed attention.
That brings us to another whole issue: What is healing? Too much,
particularly in our society, we look for technological solutions
to healing. In part, medicine is a science, but in part, medicine
is an art, and healing requires more than just technological intervention.
It requires a relationship, it requires trust, it requires care,
it requires love, commitment, all those things. Those are not technical
solutions, but there are many ways in which our pursuit, of technical
solutions is actually undermining those other aspects of healing.
And when people do not get those, they scream for what they think
will be the answers more technical solutions. So, I would
say that even in that regard, we are somewhat out of balance, and
that skews this debate.
Would you say that discussions regarding the ethics of using/obtaining
stem cells have a lot of interplay with cloning and genetic engineering?
Will trying to determine the proper ways to conduct stem cell research
affect how we go about research in those other areas?
Absolutely. In fact, all of that stuff is really only the tip of
the iceberg. Another aspect of this that does not get enough emphasis
is that these are big issues, they are big challenges, and people
kind of look at these and think, "Oh, it's too big, let's
break it down into smaller pieces." The problem is, the way
that you deal or attempt to deal with the smaller pieces sets precedents
for the future. What we are talking about now is really just the
tip of the iceberg, because really, these things represent all the
different sorts of manipulations that will be available at a physiological
level to manipulate ourselves as human beings, and to manipulate
All these powerful, powerful tools are going to be more and more
available to us, and how we deal with these so-called "isolated
issues" directly affects how we will continue to do things
in the future, because we set precedents, we set trajectories along
which we start to move. So, I think that just raises the importance
of doing this now, and taking into consideration these greater global
concerns now. If we suddenly decide down the road, twenty years
from now, that was not a very good trajectory to take, that means
we have to turn around, we have to backtrack, perhaps, or at least
make up some of that ground, and that means there are costs, and
costs in human lives. People talk about the cost in human lives;
absolutely, I am concerned about the cost in human lives. I think
that is critical.
Given the precedents that we are starting to set today, what do
you think of the future of stem cell research will be? Will the
world see much benefit from it, or is there going to be so much
controversy around it that we will never get anything useful out
of it? Will we end up overstepping long-held beliefs about protecting
human lives and do something awful in the process? What can we do
to move along what you consider to be the right path?
Well, to move along the right path, we have to do what I have already
said about having the international deliberations and getting these
different groups together in a way where people feel like they are
heard. Everybody has got to feel like they are heard, and I do not
believe that is [happening now]. Everybody is screaming to be heard,
so that you just have a cacophony and hopefully your voice gets
singled out somehow. [It would be better to have] a more structured
approach to try to listen to everyone. In addition, stem cell research,
depending on how you define it, what exactly you're talking
about, is where certain research trajectories are at this point
in time. Things are moving very fast, so, I think the move right
now is to get away from the cellular level down to the molecular
level, where the interventions would be much less drastic in a sense.
More elegant, more possibility of finer tuning, all that sort of
So, again, will stem cell research be successful? Well, what is
the success one is looking for? If stem cell research, particularly
with adult stem cells or animal research or something like that,
leads us to a greater understanding of these molecular mechanisms,
then we could say scientifically that has been successful. If stem
cell research leads us to a more sensitive, balanced, sane, inclusive
discussion on these issues, then I would say that is very successful,
maybe not from a scientific point of view, but certainly from a
societal point of view. These are the things that we have to hope
for and work for. Right now, I would say that the difficulty is
that things are very fractured. You have a variety of groups that
are working at cross-purposes in part, coming out of different sorts
of traditions and beliefs, with different goals.
Some say the big goal is to cure all of these people, or the big
goal is to make money or become famous or whatever. So, there are
different goals, different interests. You hear people saying, "You
cannot restrict scientific investigation and the advancement of
scientific knowledge." What do you mean we cannot? We already
do. We do it, in part, because we claim it is for societal good
to do it. So, that dichotomy gets set up scientific advancement
versus societal good. But whose societal good? That is the big question.
Who counts in this discussion, and how much voice do they have.
This is another conflict. First world versus third world if you
want to be cruel about it. So you have all of these fracture lines,
and it is important to be aware of them and it is important to try
and come up with a process, a system, a methodology that helps us
cross these fracture lines. We cannot deny them - they are there
- but we can build superstructures across them that are stable and
help us, build for the future, because this stuff is not going to
slow down; it is only going to speed up.
Submitted by: Kyle Gracey, Rensselaer Polytechnic Institute,
2003 Fall Intern