Stem Cell Science and the Future of Medicine Two years ago, South Korean researcher Hwang Woo Suk published a scientific paper describing how he created the first human embryonic stem cells by cloning. Last month, his university found that all Dr. Hwang's research was faked. What does that mean for the field of stem cell research? This is a live broadcast from the annual meeting of the American Association for the Advancement of Science.
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Stem Cell Science and the Future of Medicine

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Stem Cell Science and the Future of Medicine

Stem Cell Science and the Future of Medicine

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From NPR News in St. Louis, this is TALK OF THE NATION SCIENCE FRIDAY. I'm Ira Flatow.

It's been nearly two years since South Korean researcher Hwang Woo Suk first received world acclaim for his revolutionary success in creating the first human embryo stem cells by cloning. It's now clear that Dr. Hwang's research was faked. What does that setback mean for the field of stem cell research in general? Is it a detour or a derailment? This hour we'll put cloning and stem cells in context. Embryonic versus adult stem cells, federal funding versus state. With no cures yet in sight, has embryonic stem cell research been over-hyped? Stem cells and the future of medicine coming up after this break for the news.

You're listening to TALK OF THE NATION SCIENCE FRIDAY. I'm Ira Flatow. We're broadcasting today from the site of the annual meeting of the American Association for the Advancement of Science here in St. Louis, Missouri, where in Missouri the battle over stem cell research is heating up. Voters will decide in November whether to amend the state constitution to safeguard stem cell research and treatments here.

At the same time, a bill in the state senate would ban research on human embryonic stem cells and impose a hefty fine and a long-term jail sentence on scientists breaking the law. Since President Bush's 2001 ban on federal funding for most research using human embryonic stem cells, many states have acted independently to promote it, either by providing funding or passing state laws allowing this research. And because the federal government is not taking the lead in regulating embryonic stem cell research, scientific organizations like the National Research Council and the Institute of Medicine have picked up the slack and will continue to offer guidelines.

So this hour, we're gonna be talking about stem cells. It's been in the news a lot. We'll cover the latest research with adult and embryonic stem cells. We'll talk about efforts to fund stem cell research in the absence of federal support. We're gonna talk about the ethics of stem cell research, from questions about the use of human embryos to how stem cell therapies can be administered fairly.

And now that it's clear that the highly touted embryonic stem cell breakthrough in South Korean was faked, does that mean that all research in the field has been tainted and all researchers? What will the fallout be, in other words, from this worldwide scientific scandal? So if you'd like to join our discussion, give us a call. Our number is 1-800-989-8255, 1-800-989-TALK.

And of course, if you're here in the audience at the meeting, we invite you, beseech you to step up to the mike with your question or comment.

Let me introduce my guests. Larry Goldstein is an investigator at the Howard Hughes Medical Institute and professor of cellular and molecular medicine at the University of California, San Diego School of Medicine in La Jolla. Welcome back to the program.

Dr. LAWRENCE GOLDSTEIN (Cellular and Molecular Medicine, School of Medicine, University of California, San Diego): Thank you, Ira. Hello.

FLATOW: It's good to see all my guests in person. I've spoken to all of you by remote. We have you all now here to put the faces with the voices. Sean Morrison also is an investigator of the Howard Hughes Medical Institute and Director of the University of Michigan Center for stem cell biology at the University of Michigan in Ann Arbor. Welcome to the program.

Dr. SEAN MORRISON (Director, Center for Stem Cell Biology, University of Michigan): Hi, Ira.

FLATOW: Good to see you. Leonard Zon is an investigator also at Howard Hughes. He's director of the stem cell program at Children's Hospital and the Grousbeck Professor of Pediatrics at Harvard Med School in Boston. Welcome to the program.

Dr. LEONARD ZON (Director, Stem Cell Program, Children's Hospital): Hi, Ira. It's a pleasure to see you in person.

(Soundbite of laughter)

FLATOW: And back with us on the phone again is Laurie Zoloth, who is director of the Center for Bioethics, Science and Society and professor of medical ethics and humanities and of religion at the Northwestern's Feinberg School of Medicine out there in Northwestern University in Chicago, and she joins us today by phone from the St. Louis Airport on her way back.

Well, thanks for hanging around, Dr. Zoloth, for being with us.

Dr. LAURIE ZOLOTH (Director, Center for Bioethics, Science and Society): Oh, a pleasure to be here.

FLATOW: Let me ask all my guests, I'll start here with the panelists. Let's talk about the South Korean stem cell scandal. Has it affected the field? Or is it really devastating to research?

Dr. ZON: Well, I think that it's certainly been a black mark on the field. We have always felt that scientists will behave in a truthful fashion, and this is really a deceitful type of approach that Dr. Hwang has shown, that there really is no nuclear transfer of stem cells at all.

So that sets the field back a number of years, actually, if you're thinking about therapies, and probably a number of months if you're thinking about the basic science of how nuclear transfer can work.

FLATOW: Would you all agree on that?

Dr. MORRISON: Yeah, I think that's true. But one important thing to bear in mind is that while this does set us back, it doesn't dim the promise. None of the reasons why we thought it was so important to do this work have changed, and one way of looking at this is that it reiterates the importance of the United States being involved in this process and having this work done in the public sector, subject to public regulation, in the light of day. Because as long as this can't be done according to the kinds of standards we normally operate under in the United States, it will be pushing behind closed doors, done in other countries or done in private.

FLATOW: So by enlarging and legalizing it, you make it regulative.

Dr. ZON: Exactly.

FLATOW: Regulated, Dr. Goldstein.

Dr. GOLDSTEIN: Yeah. No, I think that's right. I mean when the public funds something, then the work that's done is subject to full public disclosure. It's transparent, it's open, and honest.

You know, the things like the Hwang thing are very regrettable. It was very unfortunate. But at the end of the day, I agree with Dr. Morrison. There's great promise to what needs to be done. Many of us were moving ahead independently of Hwang, in any event, and we will continue to do so.

FLATOW: Dr. Zoloth, your opinion.

Dr. ZOLOTH: So this is all very good, and it's important to say both those things, both the tremendous optimism about the future and the sense that stem cell research really proceeds in many different directions and many different countries, along a lot of different lines, sort of to make a pun, meaning both scientific lines and with other sorts of lines of stem cells. But in addition to this, this revealed a serious problem in science.

It's not like something just befell the field. A great error was committed on several levels, and it has to be carefully reflected on so that when we go forward, and I know we will, we'll do so not only with new optimism and determination, but with a new kind of care, care for subjects, care for patients, care for the story itself. I think reporters will be more cautious. Bioethicists certainly will be more cautious.

The important thing about somatic cell nuclear transfer, which we saw very vividly displayed in today's papers, this morning's exquisite scientific papers, calling on the need to continue this work, there still is a problem, even if we fully believe in that need, which is we don't yet know how to encourage and support and decently ask and decently obtain eggs from real women who have to be convinced that their scientists are trustworthy and that the goals are good and that basic research is worth donating one's gametes to.

I believe it is. That has to be, that notion of the altruism of that gesture is considerable, and we have to think about ways to do it so that women are safeguarded when they take that step.

FLATOW: Do you think that this scandal has made it, made women maybe think two or three more times now before saying yes to that?

Dr. ZOLOTH: Yes.

FLATOW: Dr. Zoloth?.

Dr. ZOLOTH: Yes, I don't think there's any other way to spin it.


Dr. ZOLOTH: I think it's a, it was a grave mistake on the part of those, of research abuse on all levels. And much was promised, much was promised, and many of us were exquisitely optimistic about the stem cell hub, and that too was a lie. The informed consent forms were forged. The IRB was shown a fake document. So many people now have to take a serious look on how to do that in the way that we really best envision it with much more exquisite care.

FLATOW: Dr. Zon, you wanted to jump in.

Dr. ZON: I would say that it's important to realize that in the United States we have the National Academy guidelines, which are the ethical guidelines for allowing us to proceed with this type of research, and in every academic institution in the country you have to have IRB approval and a special committee called an escrow committee to move forward. So there is a significant amount of regulations in the United States, and with that no U.S. researcher has actually moved forward in those studies because of all that regulation. So there's a lot of care going on before we can move forward.

FLATOW: One of the criticisms also heaped by skeptics on stem cell research is that you have nothing to show for it, that it has been oversold, Dr. Zon. How do you answer that?

Dr. ZON: Well, I think that scientists have to be very careful not to oversell and to give an accurate view, and that's one of the reasons we started this International Society for Stem Cell Research, was that a group of us felt that it was important to give accurate information. So it's important to realize that we're many, many years away from having this done, and it's gonna take very careful science and medicine all the way through until we're successful.

FLATOW: Mm hmm. Did you want to say something, Doctor?

Dr. MORRISON: I think it's just important to recognize the fact that we can't say right now exactly what diseases we're going to be able to treat effectively with stem cells or which stem cells will be most useful for which applications.

But the point is that unless we get started now with all the weapons at our disposal we're never going to get there. And right now in some senses were operating with one arm tied behind our back because of the legislative restrictions that are placed on the field.

FLATOW: And even in places where the money has been okayed by the people, like in California, that money is tied up now also, isn't Dr. Goldstein?

Dr. GOLDSTEIN: Yeah. No, I mean California is a real good news/bad news story. The good news was that the public gave a really ringing endorsement to wanting to proceed and wanting to invest money in this important area of science and medicine.

And then a small minority went to court and has so far managed to block any use of those funds. And we're probably at least another year away before the court cases are resolved. It's sort of a terrible outcome.

And I mean I agree with the caution that my colleagues have said we should exercise here. And that's true, there's a great deal of very hard work that needs to be done before we can bring the fruits of this research to people with disease.

But we have to start now. It's going to be a long road and to tangle it up in court is just a terrible thing.

FLATOW: But do you have anything concrete? Let's talk about the research, basic research, what kind of concrete things can you point to and say it may be years down the line but it's showing some possible results now in our work?

Dr. MORRISON: Well, I think that in terms of diseases there's a number of diseases that can be pointed to as some of the first targets for embryonic stem cells.

Certainly I'm a hematologist, oncologist at Children's Hospital and I think that blood diseases is one of those area. We know that bone marrow transplantation can work but only a third of patients have a matched donor for those tissues.

And so I think that embryonic stem cells could be differentiated into blood stem cells and then used therapeutically.

But still it's going to take years of basic research to get us to the point where we're ready for that. So again, I think that's one area. Diabetes is another one that's being worked on very well, and also Parkinson's disease.

So those are some things that are early targets, mostly because there's a single cell that's affected in each of those types of diseases.

FLATOW: How do you know when something is ready to even be tested on a human person?

Dr. MORRISON: I think that animal models are going to have a very important role here. Certainly mouse experiments and perhaps some large animal models will be necessary to move something.

One of the lessons that we've learned from things such as gene therapy is that we have to take into consideration patient safety. And so again, all those tests need to be done before we're ready to go through clinical studies.

FLATOW: I bring that up because there was news today about the Geron Corporation has a therapy they want to try out on people for suffering from nerve damage.

And people are saying, well, the critics are saying that's not ready to try yet. How do we know, you know? Dr. Goldstein?

Dr. GOLDSTEIN: Yes, I would jump in there. I mean, one never knows for sure. One can do all the pre-clinical work in the world, but at the end of the day the FDA, enabled by Congress, is the one that decides whether or not it's appropriate to move into human clinical trials.

And the way the FDA works is a company that would like to move forward needs to provide lots of data that demonstrate that this is likely to be safe first, and then second have some likelihood of success.

And the very first trials will just be safety trials. They won't be efficacy trials.

FLATOW: All right, we'll talk more about this when we come back here in St. Louis. We're going to take a quick break, talk more about, as I say, stem cells, take your calls.

Stay with us, we'll be right back.

I'm Ira Flatow, this is TALK OF THE NATION, SCIENCE FRIDAY from NPR News.

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FLATOW: You're listening to TALK OF THE NATION, SCIENCE FRIDAY. I'm Ira Flatow. We're talking this hour about stem cell research, the latest findings in research, the ethical problems and the fallout from the scandal.

Our number: 1-800-989-8255.

When I rudely interrupted Dr. Goldstein to go the break, you were talking about what's required to get new therapies passed for human trials.

And you were saying the FDA would have to pass on any kind of application first, right?

Dr. GOLDSTEIN: That's right. I mean any therapy that is developed in a reputable institution or reputable company will first be subject to FDA guidance.

I mean there are always those shady practitioners who are sending people outside the boarders of the United States. And I'd urge people to be very cautious about falling into those traps.

But Geron Corporation is proceeding in a very responsible way. It'll be subject to FDA approval and then a clinical trial is in fact an experimental therapy, we'll see.

Dr. ZOLOFT: I mean one of the things that's important to remember is all clinical trials are an experiment. That's the whole story of the clinical trial.

They're done on a small number of people trying out a hunch that worked well in animals. And they have to all pass approval with an institutional review board, patients who signed up, and the only way to try it is to do it.

The only truth is in the thing itself, is the phrase and philosophy. And you have to really give it a chance. And you know what? A lot of it's going to fail.

And that ought not discourage us either. Many, many things in medicine that turn out to be important successes were utter failures when they first started. And we're going to have to give this a chance because the first guesses are going to be that. They're going to be guesses.

And that's why there's a tremendous amount of courage that's involved in science. And a tremendous amount of courage, I might add, and altruism that's involved in being a research subject.

But to really tackle these very, very, very serious diseases, it's going to take a serious kind of intent and a serious level of experimentation and risk and surprise, in this as in any sort of science.

FLATOW: Dr. Zon?

Dr. ZON: Well, one of the things I want to point out about some of the upcoming trials, a lot of these are actually improving tissue repair, but actually not changing into the tissue that's defective. And it's been found in animal models, for instance, putting in embryonic stem cell derived tissues can help the repair from a spinal cord injury. But it doesn't necessarily mean that those make the neurons, the actual cells that are the problem.

And so along the lines of those experiments are hard experiments, for instance people getting marrow after a heart attack. And the idea is that the cells actually go in and may help repair, but there really is very little evidence that they actually change into heart cells and improve that heart attack.

FLATOW: Yeah, go on, Dr. Morrison.

Dr. MORRISON: Let's not forget that there are thousands of patients out there who believe that this stem cell research represents their best hope, and that ultimately what the FDA has to balance is all the kinds of safety concerns that we're talking about with the fact that some of these technologies offer possibilities for easing suffering or curing disease that don't exist otherwise.

FLATOW: We've seen that politically, in Congress people who would be normally on the conservative side of medicine now stepping up and saying, we would like this because it hits them at home, they have relatives who might benefit from it.

1-800-989-8255, what do you think? Let me go to this gentleman here with a question in the audience. Yes sir.

MR. WILLIAM IDLEWILD(ph) (Audience Member): William Idlewild. I was present last year when the group from South Korea made their announcements. And I was sitting in the front row. It was very exciting and I brought it back to my students.

And I was able to bring a lot of excitement from that announcement. And so when I heard all of these things later on, I felt somewhat deceived. And that's not to say that I don't think there's a great potential in stem cell research, nor do I think that it shouldn't go on. I'm very supportive of the potential there.

It's just that feeling of deception that I'd rather avoid.

Dr. GOLDSTEIN: I think you're telling us a lot of what our feelings are also. I certainly felt that we had solved the problem of nuclear transfer and that we were going to adapt that into the basic research that we're doing to try to cure blood diseases.

And then finding out that this was just a hoax and really not true set us back. And I felt also deceived and I think Dr. Wong really created fraud and that's the answer.

I think there's a tremendous enthusiasm and excitement about stem cell research right now. There are many young investigators going into the field and I hope you can recreate that enthusiasm as you go forward.

FLATOW: Tell us what you're working on. You're working with fish, right?


FLATOW: Zebra fish.

Dr. ZON: Exactly. So we've been trying to understand the genes that are necessary to make blood stem cells during embryogenesis. And the idea is if we could discover those genes we would actually be able to teach embryonic stem cells to become blood stem cells.

And so the model that I use is the Zebra fish. The embryos are completely transparent, and an embryo at nineteen hours of life is equivalent to a 28-day old human embryo. And then each mother fish has 300 babies a week. So it's a great way of looking at embryos. So we make mutant zebra fish that don't have blood stem cells. And then we understand what the gene is that's responsible.

And then recently with a collaborator, George Daly, we've put that gene into embryonic stem cells in the mouse system, and they seem to convert to blood stem cells. So for the first time we can take cells and transplant them into a mouse that has an immune problem and it fixes the immune problem.

And so that's what we ultimately want to do clinically. So there's two basic avenues of research. There's nuclear transfer, but then there's this also idea of changing embryonic stem cells into tissues and organs. And that's the area that we're focusing on by understanding the normal genes that a fish actually has.

FLATOW: So would that apply to a human let's say with bone marrow? You would learn how to change that?

Dr. ZON: That's exactly right. So the idea, what we want to do is to take a patient, let's say with sickle cell anemia, who has a single mutation in the globin gene, which makes hemoglobin.

And we want to basically take a skin biopsy from the patient, do nuclear transfer, create embryonic stem cell lines, fix the genetic defect in the embryonic stem cell lines, convert those cells to blood stem cells, and then transplant them back in the patient.

And that would in theory get rid of the disease. We know that bone marrow transplants work for those sickle cell patients, but only a third of the patients have a match donor. So this would help the other two-thirds of patients.

FLATOW: Sean Morrison, I know that you also study blood-forming stem cells. What have you learned about them and what are you working towards?

Dr. MORRISON: My laboratory goes back and forth between blood-forming stem cells and nervous system stem cells, that is studying stem cells that most people refer to as adult stem cells. Learning, trying to understand the basic mechanisms that allow stem cells to do the remarkable things that they do.

And so for example we study the mechanisms that allow stem cells to divide and make more stem cells and the kinds of environmental mechanisms that regulate stem cell function, and as we do that we learn things that would help us to better use stem cells in cell therapies, or to better understand diseases where something goes wrong.

And so the kinds of insights that we get give us new ways of potentially understanding or treating cancer, birth defects and regenerative therapies.

FLATOW: Dr. Goldstein, fill us in on what you're working on.

Dr. GOLDSTEIN: Well, I've worked for a number of years on neurons and how things move around in them. And more recently I've become curious about human neurodegenerative disease, such as Alzheimer's disease, where we have a great many ideas about what might be going wrong, but we're not sure.

And if you think about the problem of how do you solve a human disease such as Alzheimer's disease, there's a fundamental problem.

If I were to ask you, Ira, to donate your brain to my experiments today it's likely that the response I would get is...

FLATOW: It's a tiny brain, it's not enough to work with.

Dr. GOLDSTEIN: Well, that would be a very serious problem. And so I'd have to find a way A) to grown more, B) I'd have to persuade you to give it to me in the first place.

FLATOW: Right.

Dr. GOLDSTEIN: And of course I don't know if you're going to develop Alzheimer's disease or not.

FLATOW: Right.

Dr. GOLDSTEIN: Eventually. And so I need to have a way of having human brain cells in large quantities, sorry, with defined genetic changes that I know will inexorably lead to Alzheimer's disease or that in a living patient led to that disease, so I can test what's going on.

FLATOW: And how close are you?

Dr. GOLDSTEIN: Well, we're beginning the experiments, we're starting to use human embryonic stem cells in the lab to make human brain cells. It's the beginning of the path to that and we're beginning to develop ways of introducing those genetic changes.

FLATOW: Let's go to Bob in Belvedere, Illinois. Hi Bob.

Let's see if we can get Bob on there. Hi Bob, are you there? Bob in Belvedere? No.

Dr. ZOLOTH: Okay, let me jump in instead of Bob.

FLATOW: All right, go ahead.

Dr. ZOLOTH: I want to say one thing. And you were worried.

FLATOW: I'm sorry, Doctor. Yeah.

Dr. ZOLOTH: So here's the thing. Because of what we just heard and what we heard this morning, shows that that in fact they are on the road to really knowing enough to start some clinical trials at some date, who knows when.

But there's not an indefinable future. And that means that those of us who do research in ethics need to begin working on some new source of problems.

Not that there weren't other problems to think about, but we spent a lot of time thinking about moral status of the human embryo. It turned out we couldn't really finally get complete consensus on that for very good reasons.

And we've thought about organ, we've thought about donations and how tissue is given and donated, we're working on that and coming up with some good ideas about that.

The third thing we need to really be thinking about is when the talented men on your panel come forward with their therapies, how are they going to be distributed? In the program hour just before this, you were talking about the gap between what's available to us in the first world versus what's available to the poor of the world. How do we do good and just research in a world that's as fundamentally unjust as you were describing with your previous guest?

So, the issue of the distribution, just as it became important in organ distribution and transplantation, will be of signal importance in this research as well, and that many of us involved in bioethics have begun to turn our attention to the issue of what theory of justice should under-gird how the goods of this stem cell research ought to be distributed, most especially for people who are poor, who may not be able to afford exquisitely high-priced therapies.

FLATOW: We've been seeing debate about just new medicines coming out that don't involve stem cell research that could cost tens of thousands of dollars a year.

Dr. ZOLOTH: Right. The Avestin case that was in the press yesterday was $100,000 a year for a very, very effective drug. It's terrific that the drugs are effective and that the cures are within our grasp. But until we find a way to get this sort of access to the people who don't even have healthcare insurance in this country and to millions who still don't have a way to get basic healthcare services, it won't mean what we want it to mean. And what we want it to mean is something fundamentally different about changing the human condition. So, both of those pieces have to be worked out.

FLATOW: All right. 1-800-989-8255 is our number. Let's go to this lady standing by the mic.

ERICA (Audience Member): Hi. I'm Erica from Bloomington, Indiana. Stem cells are something that's always in the news. It's very newsworthy. It's about humans. It's about ethics, as Dr. Zoloth mentioned. Is it maybe that there is too much media coverage and that there are too many people that know a little bit about it and don't really know enough to make the opinions that you've made? Or is it that there's not enough media coverage, not enough education about the topic, for us to move forward with this on a government level?

Dr. ZON: Well, my opinion is that there's a lot of talk and a lot of misinformation that's out there. And so public education is very important. And I think shows like this are very important to continue because there is so much misinformation. You know, often people will come up to me and say, I know you're a stem cell researcher and I know that stem cells come from aborted fetuses. And I say that's absolutely not true. And it's just wrong.

And then once they realize that that's an incorrect concept, they actually are accepting of embryonic stem cell research. So, I do wish that there wasn't so much hype about the research. I'd rather us do science and most of us would rather not deal with the press at the level that we're dealing with it. But, on the other hand, I think that it's very important to educate the public. And this is our major way of doing it. The Stem Cell Society has actually produced a video that we have on our website,, and this is an 18-minute video that you can download with very accurate information about stem cells. It's another way of trying to, you know, teach the American public what's going on.

FLATOW: We're talking about stem cells this hour on TALK OF THE NATION SCIENCE FRIDAY from NPR News.

But to a lot of people, they know what it is. They just ethically or morally just don't accept it.

Dr. MORRISON: You know, a lot of people don't know what it is. All of us have spent a lot of time, for example, on Capitol Hill, explaining these issues. And we frequently see that there are, that once people understand what we're really proposing to do and what's really at stake, we encounter very few people that are really opposed to it. And sure, there are people with moral points of view, for example, who just don't believe an embryo, human embryo, should be discarded under any circumstances. And we respect that point of view.

But the fact is that we had that debate 30 years ago in this country and we decided to in vitro fertilization. And having gone down that route and having something, I think, on the order of a million children in this country that have been born by in vitro fertilization that would not have been born otherwise, you can't get around the fact that thousands of embryos are routinely discarded by fertility clinics. All we're proposing to do, is to be able to use some of those embryos that are already being discarded to try to create cell lines that could one day help patients.

Dr. ZOLOTH: Let me make that point even more clearly.

FLATOW: Dr. Zoloth, go ahead.

Dr. ZOLOTH: Here's how it goes. We decided, we collectively as a society, decided in the 1970s, actually earlier, that infertility was not a moral situation, or an event that could be dealt with by adoption or fostering children or other sorts of gender activity, but infertility was a disease that needed a medical solution, and supported a research direction that involved creating embryos on an experimental basis outside of a woman's body, some of which would be destroyed in the process of trying to implant them in a woman's body, to create babies.

We decided to treat infertility by the creation and, yes, inevitable destruction of many, many, many human embryos. That's just true. It's been true ever since the field was developed. Right now, the scientists who do IVF are better. They create a bunch of embryos and they only implant, instead of five, they traditionally implant two, or perhaps one, in some rare cases, and people have babies. And there's a lot of babies have been born, meaning we have treated infertility successfully in up to a quarter of the cases where it occurs routinely in women.

But nevertheless, all the embryos are still created and they're frozen. And they're frozen until they're either discarded or they, you know, they begin to deteriorate. In some countries, after five years they're just thrown away. It's a fiction to think that we're not creating and destroying embryos to treat a disease. It's just that the only disease we treat is infertility. There's literally, for a moral philosopher, no difference between deciding to create and destroy embryos to treat infertility than to create and destroy embryos to treat Parkinson's or Alzheimer's or many of the diseases, you know, juvenile diabetes, that were listed in today's presentation.

FLATOW: Do you think it's an education problem or do you think it's just something that people are not going to accept? Dr. Zoloth?

Dr. ZOLOTH: I think it's both. I think to some extent thinking about it in that way, in creative new ways in which the science is explained and the premises are explained and the details are explained, will change peoples' minds. Surely if any one of these interventions becomes a real therapy, that will change many, many, more minds. It will make the consequentialist or utilitarian argument stronger.

Many people are driven just by the duty to try, an absolute duty for healing. But for some people, there are intractable and valid moral differences on what's permitted and not permitted for manipulation of nature and for the use of the human body and for the creation of this unenabled embryo in the first place.

For instance, the Catholic Church doesn't support IVF because of the creation and destruction of these human embryos. And we go forward, in other words, treating infertility, despite the very morally warranted objections of the Catholic Church.

FLATOW: All right. We're going to take a short break and come back, talk lots more about stem cells, human embryonic stem cells, also, with Larry Goldstein, Sean Morrison, Leonard Zon, and Laurie Zoloth, and your questions. So, don't go away. We'll be right back after this short break.

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I'm Ira Flatow. This is TALK OF THE NATION Science Friday from NPR News.

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FLATOW: You're listening to TALK OF THE NATION SCIENCE FRIDAY. I'm Ira Flatow. We're talking this hour about stem cell research, science, policy, and ethics with my guests Larry Goldstein, Sean Morrison, Leonard Zon, and Laurie Zoloth. Our number, 1-800-989-8255. Let's go to the audience. Gentleman? Yes?

ALEXANDER (Audience Member): Alexander from San Francisco. I think science and marketing are usually thought of as polar opposites. And there's a very good example, and marketing's about the message and the vocabulary. There's a very good example, nuclear magnetic resonance imaging, you know, they were very proud of that when they came out with it. But that word, nuclear, people were afraid. Patients didn't want to go into this nuclear device.

So, merely by removing the word nuclear, and we now know MRI, magnetic resonance imaging, all the patients were happy. So just, that's a very, very good example that the word embryo is so loaded to the public. So, I think the issue in science, and particularly in biological science, is we need to partner with people who have really good marketing skills. And it can be very helpful.

FLATOW: Well, Laurie Zoloth, you called it something different before, did you not?

Dr. ZOLOTH: Yes, I really want to avoid this as a marketing device. I want to create this idea that we are for each other. And we are for each other not only in the moral plain, in terms of neighbors and citizens and people who heal others, the suffering presence of the other who is in need, in a Levinathian(ph) philosophic sense.

We are actually literally made for each other in that our cells might be rather exchangeable. We're born into this world with an incredible surplus of gametes, of many, many, many more eggs and many, many, many more sperm than we could possibly use to create babies. And that's a curious but real truth about our human existence. And I'm interested in thinking about why some things, blood, gametes, bone marrow, are both abundant, renewable, and desperately needed, in curing human disease. And how could we then shape a response based around the altruistic gift relationship? This could be at the core of a good human society.

FLATOW: Gentlemen?

Dr. GOLDSTEIN: I'm a little bit concerned about the nomenclature that you bring out. And there was a movement among some researchers, actually, to call nuclear transfer, embryonic stem cells, pluripotent cells for just this reason that they wouldn't be embryonic. And I really think that if we're going to be honest with the American public and that you do create an embryo during this process. And I think that it's reasonable to call them embryonic stem cells. If we're just honest and careful with what we're saying, I think that people understand what it is.

FLATOW: Dr. Morrison, go ahead.

MORRISON: We do periodically get accused of not being good enough at marketing. But our first and foremost responsibility is to be a trusted source of information for the public. We want to be able to deliver the best and most accurate information to the public so people can make, can combine those facts with their own life history and moral experience and make up their own minds about how they feel about this work.

And I think it's, to Len's credit, one of the values that he instilled into the International Society for Stem Cell Research was the idea that the organization be first and foremost a source of information and it would attempt to stay above the fray and just providing the facts for people to make up their minds.

FLATOW: The president's bioethics committee concluded that if we just give it a little more time, we could find regular stem cells, or we could find a way to make regular stem cells as good as embryonic stem cells. If I was going to sum it right, Dr. Zon. Is that about, are we there? Can we do that if we...

Dr. ZON: Well, I think the research is progressing to that point. And I think in mirroring system we're getting close to that realization. I think that we need to move it to the human embryonic stem cells. I think that one of the problems with proposing a moratorium on the research as the original president's bioethics council did is that the research was ripe at this point, and there's a large number of scientists that are moving this forward in animal models.

And when you see the research, the extension to humans is obvious. And so allowing us to move that research forward into humans and realize some of the potential, with the caveats of being accurate and not over-hyping, I think that's the important part. So, I think that it was really not a reasonable thing to stop the research in its tracks. It was moving forward at light speed.

FLATOW: Dr. Morrison, okay, Dr. Zoloth, go ahead.

Dr. ZOLOTH: Well, I just want to be careful whenever we say the word hype because I want to take responsibility in bioethics as well for our propensity to hype on our side, too. And the reason it was stopped by the president's council was because of fears that I think were hyped and overblown about the loss of our human souls. That if we proceeded with this research, that our souls would be lost to us in some way. And a lot was said, a lot was claimed about the dangers of the research that has to be given the same sort of sober reflection that's given to scientific hype. So, it's important when we speak, we speak in a much more modest, humble, and limited sense of what the future might bring to us on both sides.

One of the things that's always important about the researchers of ISSCR, and the colleagues who are here today, is that they're very careful, if you'll note, to say, it's a long way from cures, it's a long way from the clinic, we're just beginning to learn. We have a long way to go. And that kind of caution really does need to be maintained on all sides of the debates.

FLATOW: Mm-hmm. Dr. Morrison?

Dr. MORRISON: I just want to be very clear that adult stem cells can't do the same things as embryonic stem cells, and the reason why people were so excited about embryonic stem cells, even as somebody who works every day on adult stem cells in my laboratory is that embryonic stem cells offer capabilities that adult stem cells don't offer. And so, the idea that we should, if we're really serious about tackling the kinds of major public health problems that Americans suffer from, like juvenile diabetes, then we have to be proceeding using all of the stem cells at our disposal, to try to use all of the weapons in the fight against disease.

FLATOW: Dr. Goldstein, any comment?

Dr. GOLDSTEIN: Well, I would, I think the thing I would add here is that the problem with moratoria, or the problem with saying, well, eventually something else might work better, is that you always add delay. And the problem with delay is, even if you have a disease now I wouldn't begin to say to you that we can develop a therapy in three to five years. However, if we delay three to five years now, you have to add that on at the end. So, if it's going to take a total of ten years, and you delayed three to five years, that means you're going to look at thirteen to fifteen years. You just add it on.

And those people who would've gotten the disease ten years out, they're the ones who will suffer. And perhaps the ones who have it now who survive that long will suffer as well. So, it's real people we're talking about eventually.

Dr. MORRISON: I also think that delaying, at a certain point actually causes a ripple effect even later, because it takes much longer to actually discover those things.

FLATOW: Let's go to the gentleman at the mic.

TJ (Audience Member): TJ, from Denver, Colorado. I'm wondering if you could perhaps comment, not just from the perspective of an established researcher, but maybe of a post-doc or graduate student, in our newfound concern about our competitiveness, in terms of science and mathematics, this very volatile debate may be having some broader implications, and I'm wondering if you'd have any personal concerns. And, concerns about young scientists, as well.

FLATOW: That they're not entering the field, or they're going overseas?

TJ: Going abroad, going overseas is what I was implying.

FLATOW: Dr. Goldstein?

Dr. GOLDSTEIN: Yeah, TJ has raised a great point, that I think I would address on a couple of fronts. First of all, for the past many years, the best and brightest from around the world have tended to come to American laboratories in most cases to be trained. And I think that's a wonderful thing. I'd love to have the best and the brightest come to the United States, for purely selfish reasons.

The second thing I would note, however, is that we're at a real crisis point in American science. Our government, for reasons that could certainly be debated, has in the past few years tremendously under-funded science, and we are seeing cuts being made in both the physical sciences as well as in the medial research that we just spent years doubling the capacity of. And it's all being eroded.

And that's not just stem cells, which are obviously an important part of the science portfolio, it's all science. And if we're going to train the next generation of scientists, attract the very best American youth into the scientific community to do research in the future, and if we want to have the economic benefits that will accrue to us from developing new understanding and new things that other people in the world want to buy, we cannot under-invest now. And that's exactly what we're doing, unfortunately.

Dr. ZOLOTH: This sort of change, too, has implications not only for right now, but for a decade from now. In fact, a whole generation of young scientists has made the prudent decision to say, you know, I just want to do ordinary science. As much as I like Ira Flatow, I don't want to spend my time talking to him all the time, and talking to the press all the time. I just want to go to the lab, you know, and do my work.

And they've watched in horror as the publicity and the politics has just swirled around this field, and young undergraduates and graduate students have said to me, you know, is there something just less ethically controversial but still really interesting? And we've lost those, the best and brightest minds who might have chosen it because it's such exciting research. And that's why ISSCR, and the impulse behind building ISSCR, as an academic and non-profit center for that discourse has been so important for many people, to say, no, this is the place to do fundamentally interesting, and fundamentally good science, one that has the potential to really address human disease, at its core.

And unless it's robustly supported by NIH funding, it will be effectively cutting off a pipeline right on through to the next generation, just when we're getting old and really need this regenerative medicine.

FLATOW: Dr. Zon?

Dr. ZON: Yeah, it's interesting that about forty percent of the ISSCR, the stem cell society, actually are junior faculties of post-doctoral fellows or graduate students. And we've set up within this society, actually, a group that meets regularly to support them and mentor them. And I think that's going to be very important, not just in stem cell research, but in all aspects, that we really need to take a leadership in American science to mentor our students and tell them it will be alright. These things have a habit of going through cycles, and you just have to ignore the cycles and get down to the science. And I think that's going to work.

FLATOW: Do the foreign scientists look across the pond at us and say, I just can't understand what's going on with your, you know, with your research, with your attitudes?

Dr. ZON: I think it's not understandable in a lot of ways that we have people visit the laboratory and just can't understand why we can't proceed with the research that we want to do. And also in terms of training opportunities, it's now more difficult for foreign students to get visas and other opportunities to come to meetings, so this is really affecting American scientists and our ability to be competitive.

FLATOW: We're talking about stem cell research this hour on TALK OF THE NATION SCIENCE FRIDAY from NPR News. Dr. Morrison?

Dr. MORRISON: It's also important to remember that there's great inequality within the country, because in the sense of stronger federal leadership in this area the states have been left to develop their own policies, and states have gone in very different directions. So, if my laboratory were in California, or Illinois, or New Jersey, the state would pay me to derive new human embryonic stem cell lines. But in the state of Michigan I would go to jail for doing the same thing.

And so, you see some states that are moving as fast as they can to encourage this research, largely because in areas where legislators have taken the time to learn what's really at stake and what's really involved, there has been broad bipartisan support for loosening the restrictions on stem cell research. But it's taking time, and that's not the case everywhere, and so there's issues with unequal access to these technologies within the country.

FLATOW: And I also, would I be arrested for taking medicine that would be derived from stem cells...

Dr. MORRISON: ...that is an issue that has arisen as well, within the federal debate, where some have proposed legislation that, even if treatments for diseases using embryonic stem cells became available out of the country, and that were therefore not available to Americans, some legislation that has been proposed federally would criminalize Americans even getting those therapies abroad and coming home.

FLATOW: Dr. Zoloth?

Dr. ZOLOTH: Actually, that has been passed by just the lower house of Congress, by the House of Representatives, several years ago when that same bill came before the Senate, the Brownback bill, the bill was defeated, but not completely. It's still been tabled and some versions of it have been ongoing for consideration. So, there is the idea that in some states, you know, in particular some states in the upper Midwest, there have been proposals to criminalize the activity. Not to just un-fund it, bad enough, but to actually make some of these activities a criminal act.

Now I just want to say something important here. Pretty much everyone agrees that cloning to make human babies, right, would be that kind of an act, should be prohibited, there's no question among the vast majority. I'm willing to say 100% of legitimate scientists do not think that cloning for human reproduction should ever be permitted. That being said, this whole other arena of ways of transferring nuclei from cell to cell can be permitted and can go forward, except in these states that tend to mix up those two kinds of discourses. And there are threats as in the State of the Nation that all forms of this very important arm of research would be banned.

FLATOW: Dr. Zon? Dr. Morrison? Do you actually see this as a threat to your research?

Dr. MORRISON: Well, let me say one thing, and that is that sometimes people in the general public can get the impression that they're presented with a choice of either supporting stem cell research for the benefits it offers, or protecting human embryos, and in fact, that's not the case. The federal restrictions that exist and the state restrictions that exist don't save a single embryo from destruction. All they do is delay medical research that thousands of Americans believe represents their best hope. Because these embryos are already being discarded at fertility clinics.

FLATOW: Dr. Goldstein?

Dr. GOLDSTEIN: Yeah, I mean, that's just completely true. I mean, the restrictions have saved no embryos, nor is it likely that future restrictions will save any. And, as Dr. Zoloth pointed out earlier, we routinely in the United States and in other countries, create and destroy embryos to treat infertility. And having these kinds of restrictions has not changed that, and nobody's talking about changing it, actually.

FLATOW: Dr. Zon?

Dr. ZON: Yeah, I think one of the interesting parts of the stem cell world has been its interaction with politics. And I think all four of us have actually spent a significant amount of time, not only in the federal, in Congress, but also at state legislatures trying to convince people what the appropriate way of going should be.

And what I've learned about that is that it's very important for the public to talk to their congressman and congresswomen or the local state legislature, because that is a way that you can influence these types of decisions. And at the end of the day, it's the people who vote. And what we found, at least in Massachusetts, was that the majority of Massachusetts, the citizens, really wanted the research to move forward. So, in Massachusetts we're allowed to do what we want at this point.

FLATOW: Okay guys, we have 30 seconds to make your point.

TERRY GIBSON (Audience Member): Quick one then. Terry Gibson, St. Louis Science Center. Historically, new scientific information or concepts have come up against government and religious beliefs, Galileo would kind of go along with that. What do you think is it going to take to change, a major breakthrough? Would Wong's research, if it had been proven accurate, been enough to change that?

FLATOW: Any, Dr. Zon...?

Dr. ZON: I think any success therapeutically will change everybody's opinion, and I think...

FLATOW: There'll be a floodgate opening.

Dr. ZON: Exactly. Until that happens, then it won't. But I think that we'll make steady progress as time goes on.

Dr. ZOLOTH: I want to add one thing too, is that...

FLATOW: I've got ten seconds Dr. Zoloth.

Dr. ZOLOTH: It's not religion versus science, its some aspects of some religions versus some aspects of science. So, pay attention to the complexity of that reception, I think, as well.

FLATOW: All right, we've run out of time. Dr. Laurie Zoloth of Northwestern University, Dr. Leonard Zon of Harvard, Sean Morrison of the University of Michigan Ann Arbor and Larry Goldstein of UCC San Diego. Thank you all for taking time to be with us today.

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