States Adopt New Strategies for Stem-Cell Research The Senate passes a bill to fund embryonic stem-cell research, but President Bush threatens to veto. In the meantime, states are gearing up with their own efforts to fund the research.
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States Adopt New Strategies for Stem-Cell Research

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States Adopt New Strategies for Stem-Cell Research

States Adopt New Strategies for Stem-Cell Research

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IRA FLATOW, host:

This is TALK OF THE NATION: SCIENCE FRIDAY. I'm Ira Flatow.

It's been nearly 10 years since scientists first pulled stem-cells from human embryos. Stem-cells are those master cells, cells with the ability to turn into all the tissues and parts of the body. And with stem-cells scientists say, who knows, we may one day be able to cure diseases such as diabetes, Parkinson's and others.

But human embryonic stem-cell research has been controversial. Even though a majority of Americans approve of funding embryonic stem-cell research, some people, including President Bush, say it's wrong to use embryos for research, even the so-called leftover embryos in in vitro fertilization clinics. Some federal funding for the work is available, but only for work using a handful of cell lines, lines that existed when the president first approved the funding. Critics say the president's policy has tied the hands of researchers, and in response some states have created their own pools of money to conduct the research that Washington will not fund.

This hour, a look at the state of stem-cell research and stem-cell research in the states, in this case focusing in on a town and state heavily endowed with research scientists: Cambridge, Massachusetts. Could having more stem-cell lines available for research move us faster toward a cure? Will it be up to the states to provide the money that the federal government won't? What about the folks who don't believe in using human embryos for research? That's what we'll be talking about this hour, and we want to know what you think. If you're here in the auditorium, I invite you to step up to the microphone right there on the left side and ask a question. And if you're listening on the radio or on the Web, give us a call. Our number is 1-800-989-8255, 1-800-989-TALK. And as always, you're invited to head over to our Web site at sciencefriday.com.

Let me introduce my guests. Rudolf Jaenisch is a founding member of the Whitehead Institute and professor of biology at the Massachusetts Institute of Technology. Thank you for being with us today, Dr. Jaenisch.

Dr. RUDOLF JAENISCH (Co-Founder, Whitehead Institute): Thank you.

FLATOW: You're welcome. Douglas Melton is an investigator with the Howard Hughes Medical Institute. He's also professor of natural sciences at Harvard, co-director of the Harvard Stem-cell Institute. Thanks for being with us today.

Dr. DOUGLAS MELTON (Investigator, Howard Hughes Medical Institute): Thank you.

FLATOW: George Q. Daley is associate professor of biological chemistry and molecular pharmacology and pediatrics at Children's Hospital. He's also at Brigham and Women's Hospital, the Dana-Farber Cancer Institute, and the Harvard Stem-cell Institute. Thank you for being with us today.

Dr. GEORGE Q. DALEY (Biological Chemistry and Molecular Pharmacology, Children's Hospital): My pleasure.

FLATOW: And Michael Sandel is the Anne T. and Robert M. Bass Professor of Government at Harvard. He's also the author of a new book, "The Case Against Perfection: Ethics in the Age of Genetic Engineering." Thank you for being with us today.

Prof. MICHAEL SANDEL (Author, "The Case Against Perfection: Ethics in the Age of Genetic Engineering"): Good to be with you.

FLATOW: Let me begin with you, Dr. Melton. Do you agree that everybody -scientists generally agree - what the aim of embryonic stem-cell research is or stem-cell research in general?

Dr. MELTON: I don't know if everyone agrees with it, but certainly the scientific community's united in thinking that stem-cells have a lot of potential in sort of two contexts. One would be to find if it's possible to replace cells in our body that have been destroyed or injured, and the other is to use stem-cells as reagents to understand the root causes of disease. So the public, in general, hasn't heard so much about the latter...

FLATOW: Yeah.

Dr. MELTON: ...which is how to use cells in a Petri dish, and that's what I think scientists are perhaps most excited about.

FLATOW: Well, tell us about that, for people who've never heard about that idea.

Dr. MELTON: It's not all that complicated. I mean I could remind people that degenerative diseases are caused by many genes and environmental signals, and there's often a long time between cause and effect. So something could happen to you when you're a teenager that causes you to get Alzheimer's 60 years later, and that's why it's been so difficult for scientists to study those problems and really understand their root cause. Scientists like my colleagues here at the table, and others, think that we have an idea about how to get at the cause of those by transferring nuclei from skin cells into unfertilized eggs, creating stem-cell lines, and then studying the degeneration or the defects in a Petri dish. So we're very excited about that idea to study diseases in a dish.

FLATOW: So, Dr. Jaenisch, if you have a line of stem-cells that has the dish, you can figure how the line transforms from normal to abnormal? Would that we correct?

Dr. JAENISCH: Well, I mean if you have a stem-cell, an embryonic stem-cell, you can - you have to figure how you get the cells which are functional, which you want to study. In the case of Doug's example, let's say cells which degenerate in Alzheimer's, can you generate these cells in the dish? And if they come from an Alzheimer patient, would they have a different survival or differentiation potential than those coming from a normal individual. So you have to study how to differentiate these cells, and it would be the same problem if you want to use these cells generated from embryonic stem-cells for potential therapy.

FLATOW: Do you use any of the stem-cell lines that the president has approved for federal funding?

Dr. JAENISCH: Yes, we do. So those stem-cells have been, of course, generated more than eight years ago and before, and I think they're useful. But we know also...

FLATOW: You don't sound very positive about this.

Dr. JAENISCH: No, they have limitations. And we know now that there are various ways to isolate these stem-cells, and there have been new ways to isolate them. And I think it would be very restrictive if all the research on stem-cells have to be based on this handful of so-called presidential lines which have been isolated prior to 2001. I think it would enormously restrict us.

FLATOW: Mm-hmm.

Dr. JAENISCH: I don't think they're not useful, but it's clear that there are other ways to isolate these stem-cells. There are probably better ways, and we have to understand what is the real, if you want, the prototype of a stem-cell by altering the way we do isolate them?

FLATOW: So you would need other lines to study other diseases (unintelligible).

Dr. JAENISCH: Yes, absolutely, and there are several laboratories - and Dr. Melton's one of the first ones - who isolated new embryonic stem-cells which are freely available to everybody in the community, in contrast to many of these established lines. And it clearly turns out there are differences between the established ones. Of course in the laboratory of Dr Melton he had to use private funds to do that, and in many places in this country that is not possible or very difficult. So the restriction we have from the federal government on using NIH funds, I think, impedes very severely this research.

FLATOW: Dr. Daley, you're a medical doctor. You must hear from patients, gee, when are stem-cells going to be ready, what can I do with them, all the time, I'd imagine.

Dr. DALEY: Yes, I mean there's a tremendous hope on the part of most patients. I mean essentially everyone is touched by disease in some way, and I think one of the noblest efforts that we make in our country is to invest in biomedical research in hopes of improving human health. And here we now have this enormously valuable new platform of technology, being able to study stem-cells, using them to give us insights into disease, and perhaps one day to give us a whole new way of treating patients. And so patients come with remarkable expectations and hope.

It's important that we educate those patients about what's realistic. This is a fledgling field. The real clinical impact might not be felt for a decade or more. It may take many decades for us to realize the full potential of stem-cells. But we in the scientific and medical community are convinced that they will be valuable, and we'd like to get cracking.

FLATOW: You study blood diseases, and what would be a prime blood disease a stem-cell might (unintelligible).

Dr. DALEY: Well, you know, we already use blood stem-cells in a very productive therapy called bone marrow transplantation.

FLATOW: Mm-hmm.

Dr. DALEY: And you will hear often that it's said, well, we have this fabulous method which has been used to treat dozens of diseases, why do we need embryonic stem-cells? The reality is that bone marrow transplantation remains a heroic therapy. It's a highly morbid, toxic therapy. We can make major improvements. I care for patients with leukemia, blood cancers, genetic disorders of the blood, and the fact is most of those patients don't get the advantages of bone marrow transplantation because they don't have a match or because they might not be able to tolerate the toxicity of this therapy.

Embryonic stem-cells give us an alternative. We could potentially make patient-specific cells which would allow us to repair genetic defects in the patient's on cells, and those patient's cells would be rejection-proof.

FLATOW: Mm-hmm.

Dr. DALEY: So there're many, many ways of seeing the future of blood diseases transformed by embryonic stem-cells.

FLATOW: Michael Sandel, you write about it in your book about the opposition to using embryonic stem-cells, the ethical, moral opposition to it. Has it - is it constant? Has it changed as people have been hearing - potential for stem-cells?

Prof. SANDEL: Well, there is a principled, moral opposition to embryonic stem-cell research that is held by people who consider that the early embryo, or the blastocyst, is morally equivalent to a person, to a human being, to a child. If that view is right - and that view stems very often from religious convictions, and some people defend it on other grounds - if that view is right, then embryonic stem-cell research, which destroys the blastocyst, is like yanking organs for transplantation from a child to save other people's lives. But what's interesting about the president's policy is that it doesn't really rest - it can't rest on that idea because it bans federal funding for new embryonic stem-cell research, but it does nothing to try to ban it. And if we really believed that that blastocyst were morally the same as a baby, it would be like a kind of infanticide, and we wouldn't say - no one would say, well, yanking organs from babies should not enjoy federal funding but it should be allowed to continue in the private sector. So the - even the president's...

(Soundbite of audience laughter)

Prof. SANDEL: ...even the president's policy, which seems to rest on the idea that that early embryo is a person, can't rest on it because he's done nothing to either ban embryonic stem-cell research in the private sector or to shut down the creation and discarding of excess embryos, so-called, in fertility treatments.

FLATOW: You might even argue that if you did believe this way, about, you know, the sanctity of these embryos, why aren't you doing everything you can to preserve them forever...

Prof. SANDEL: Well...

FLATOW: ...feeding and nourishing them and making sure they're not being thrown down the drain?

Prof. SANDEL: Well...

FLATOW: Wouldn't that be the logical conclusion if you believed that way?

Prof. SANDEL: Well, it is - it's a fair question, and it's a question that should be put in all seriousness to people who do in good conscience hold that view. Now there are some people who are morally consistent who would shut down not only all embryonic stem-cell research, but would shut down all fertility treatments that create and discard embryos. That's a morally consistent position, whether one agrees with it or not.

FLATOW: Right.

Prof. SANDEL: But that is not the president's position, and there are very few of the opponents now, those opponents in Congress of federal funding of embryonic stem-cell research, very few of them are calling for the full range of sanctions that should be taken if you really did believe that the early embryo were like a baby.

FLATOW: All right, we're going to have to take a break. We'll come back and talk lots more about stem-cell research: promises, hurdles, what's the state of stem-cell research, and how the states have taken over some of that funding. So stay with us. We'll be right back after this short break.

(Soundbite of music)

FLATOW: I'm Ira Flatow. This is TALK OF THE NATION: SCIENCE FRIDAY from NPR News.

(Soundbite of music)

FLATOW: You're listening to TALK OF THE NATION: SCIENCE FRIDAY. I'm Ira Flatow.

We're here in Cambridge, Massachusetts, talking with the best and the brightest scientists in Cambridge about stem-cell research. Our number - 1-800-989-8255 is our number. Talking about - taking your questions about stem-cells and embryonic stem-cells.

Gentlemen, what about these new research results we're seeing about using, for example, stem-cells derived from embryonic fluid? Not derived from embryos, but the embryonic fluid. Dr. Daley?

Dr. DALEY: Well, there was recently a report that you could extract cells from amniotic fluid...

FLATOW: That's what I - I'm sorry. I meant amniotic.

Dr. DALEY: ...right - and that these cells really showed very broad differentiation potential. But I think it's very, very fair to say that a critical analysis of the paper, the single paper that's been published, shows them not to be equivalent to embryonic stem-cells. It's very interesting, with all the different claims of these so-called multi-potent or pluri-potent or embryonic-like cells, the gold standard remains the embryonic stem-cell. So there's no doubt that there are many exciting fronts, alternative areas of research in adult-types of cells, amniotic cells. We would support moving forward in studying those cells, but not at the expense of studying embryonic cells. All of these other forms seem to be restricted in some way. The embryonic cells remain the ones that are able to give rise to any tissue in the body.

FLATOW: Dr. Jaenisch, you agree?

Dr. JAENISCH: I absolutely agree with this, that this is where the embryonic stem-cell is the only one which have been proved to be really pluri-potent (unintelligible)...

FLATOW: Because we keep hearing the opponents saying, hey, we can, you know...

Dr. JAENISCH: Yes.

FLATOW: ...we don't need to have them.

Dr. JAENISCH: Right.

FLATOW: Just let research play itself out.

Dr. JAENISCH: I believe there was enormous push to find alternatives. And, of course, if you can find in the adult organism stem-cells which are pluri-potent, that would solve the ethical dilemma, and many, many papers have appeared. But when you've closely scrutinized these papers, they're often not really convincing. There are flaws in design or flaws in the interpretation. So I totally agree with George, the only pluri-potent cell which really can do any cell type are the embryonic stem-cells at this point.

FLATOW: Mm-hmm, 1-800-989-8255. Please, step up to the microphone if you have question here, or we'll go to the phones. Let's go to - let's take a phone call. Let's go to Charles, in Salt Lake City. Hi, Charles. Well, I'll try it again. I think if I click it just the right way.

CHARLES (Caller): (unintelligible) with your guests about the inconsistency of President Bush's position and the morality. I oppose federal funding on a different grounds, though, that - here's a question that doesn't seem to be brought up in this debate is does Congress actually have authority to fund those types of things? They have authority to promote the arts and sciences through copyright, patent, trademark, etc., but not necessarily dishing out money to people. Don't get me wrong. I'm all - I think stem-cell research is a marvelous frontier, and I think it's great, but it should be in the private sector.

FLATOW: All right, Dr. Melton, what do you think?

Dr. MELTON: Well, I think that looking back on the last few decades of major medical advances - let's take the area of cancer research - it's generally agreed that most all of those advances come from the National Institutes of Health and the public funding of research. So I think it would be a mistake to put the public's interest solely into the private sector when it comes to doing research on potentially life-saving new cures.

FLATOW: Mm-hmm, what about the states taking over now? We've seen California, other - California's leading the way, other states now - Massachusetts. Dr. Jaenisch, is this the trend? Are they going to be taking up the bulk of the fight here?

Dr. JAENISCH: I guess that's the reaction on the federal policy. I think it's a mistake to have to states do this. I mean science in America is the best science in the world because of this funding system we have in place for several decades, based on peer review and from NIH. So don't just say, we as federal government, we don't do this anymore and you states can do that. I do not think that's a good solution.

FLATOW: Mm-hmm, 1-800-989-8255. The Senate voted just a few days ago to try to override the president on the banning of the researchers and federal funding. Do we think that's going survive a veto? Is there enough power in the Senate to override a veto? Gentlemen, any comment?

Dr. DALEY: I think the numbers are counted and counted again, and the Senate is very close. There are 66 votes. They're one from being able to override a veto. The House is not as close. So I think what is - we've really seen is the philosophical stand taken by a very, very broad bipartisan majority in both Houses, and that it's really the president who is standing in opposition to nearly 70 percent of the Congress and 70 percent of the American people.

FLATOW: Hmm, 1-800-989-8255 is our number. Michael, did you want to jump in on that?

Prof. SANDEL: Well, I think it is - just to add about the debate as it's unfolded nationally, but also in the Congress - this is a very different debate from another pro-life debate with which we're familiar, the abortion debate, which is why I think many of the pro-life senators - Orrin Hatch, for example - are in favor of federal funding. It's important in - we talk about an embryo, very often people picture - when they heard the word embryo, they picture a fetus. We're not talking here about a fetus, we're not talking about even an embryo that's implanted and growing in a woman's uterus. We're not talking about anything with a human feature or form. This is a blastocyst, a cluster of cells in a Petri dish, not growing, not implanted, which I think is why there are a good number of senators and congressmen and women who support embryonic stem-cell research funding, even though they may, among themselves, disagree about what should be done on the abortion issue and other pro-life questions.

FLATOW: Because you find that many of the senators have relatives - it effects their families - have diseases, illnesses that could be potentially treated with stem-cells, and suddenly they've crossed over from the conservative line, right? Orrin Hatch, people like that.

Prof. SANDEL: That's right.

FLATOW: Let's go to the audience. A question here, yes.

Unidentified Man: Yeah, I have a question for Michael Sandel. He's made a very convincing case, I think, that the president's opposition to human embryonic stem-cell research being funded federally can't rest on the idea that the early embryo is morally equivalent to a child. It does raise a question for me, and maybe others, what then does the president's position, and those who support that position, what does it rest on? What is the argument that's being presented here against the use of human embryonic stem-cells?

Prof. SANDEL: Good question. Well, I don't have a good guess about the president's motives. My hunch is that this is a morally difficult issue and that the president hasn't fully thought through the moral implications that the position that he holds. Because if he did, then he would want to shut down all embryonic stem-cell research, including the kinds that my colleagues here at the table are doing. He hasn't even spoken - it's interesting - he has not even taken to the bully pulpit and asked Doug Melton not to do what he's doing in his privately funded lab. He hasn't even called upon scientists to desist from this, much less made an attempt to shut down fertility clinics that create and discard embryos. There are 400,000 embryos languishing in freezers in fertility clinics. So I can't really speculate about motivation, but I think it's at best a failure, really, to think through the full moral implications and basis of the policy.

FLATOW: Doug Melton, no one has called you from the White House?

(Soundbite of laughter)

Dr. MELTON: No. No, but the discussion reminds me that it's curious for scientists to be asked questions about these metaphysical issues because it's not our area of expertise. I think I can say with some confidence that the scientific community is united in seeing the potential of this sort of research, and we're not really asking for any special favors, for any special funding. We'd just like to be able to vie for funding from the NIH as all other areas of research do. We're convinced that this research can stand on its own merits and prove its potential. But I'm reminded of George's comment earlier when he said it could take decades or longer. And for me that's sad to think that with the present policies it's just guaranteed to take a long time. The work will get done. It'll just take twice or three times as long as it needs to.

Dr. DALEY: And be twice as expensive.

FLATOW: What was that?

Dr. DALEY: And be twice as expensive.

FLATOW: Mm-hmm, let's talk about some of the specifics of the work that needs to be done. I'll ask Dr. Jaenisch and Dr. Melton. Dr. Jaenisch, where are - what do you need to know? To me it's a technology that needs to be tinkered with. Would that be correct?

Dr. JAENISCH: Yes, I agree. So what nuclear transplantation has show us is I think an amazing result. You can take an adult cell, let's say a nerve cell or a skin cell, place the nucleus into an egg and get out a pluri-potent embryonic stem-cell which now can generate Dolly, an animal. I think that's amazing that you can do this. So this is the proof of principle experiment, let's say the gold standard. And when you try to do this in humans, if you think about even that you could use this technology for generating customized cells for therapy...

FLATOW: But the analogy you gave us was creating Dolly. You're not talking about creating a human person.

Dr. JAENISCH: I'm coming to this. No. When you think about therapeutic approaches that you generate customized embryonic stem-cells it would involve routinely human eggs. I think this will be a major problem.

So what is the issue of the field? I think the issue of the field is to understand how does the egg accomplish this what we call reprogramming. It's not a miracle. It's a biochemical reaction. So we have to understand that with a goal to do it without the egg.

And so, I think that is a very important issue. And we need the nuclear transfer to learn that. And there have been rather very promising and exciting results recently that indeed, in some instances, we can do that. People have been able to do that.

FLATOW: Such as?

Dr. JAENISCH: Such as it was a publication last year from a Japanese group who showed that you're adding four factors. These are some of pure potency. We called it pure potency factors, as well as two oncogenes - these are cancer genes - to a fibroblast, to a skin cell growing in the paper dish and with a rather elaborate selection scheme.

What arose from this was a (unintelligible) potent cell, an embryo stem-cell-like cell.

This is an extremely exciting finding because if this could be now refined, if we can learn the steps much as we learned in the most, then I think it gives the principle how we would, maybe in the future, in decades or so, to do this in the clinic, take the skin cells from a patient and reprogram them in the culture dish.

FLATOW: And what is stopping you or anyone - or Dr. Melton or anybody from doing this again in your lab or showing how, you know, to improve it? What is the step? Is it hard to redo what they did?

Dr. JAENISCH: No. I don't think it's very hard. I think it's a very rare event. We have to learn enormous amount of background biology or background molecular biology behind that, and the major issue to transfer this to a human system. And that is a huge technical challenge. And I think in order to do this we have first to know what is a normal human embryonic stem-cell, and how does a human somatic cell get reprogrammed to an embryonic stem-cell by nuclear transfer. I think these things all go hand in hand.

FLATOW: Dr. Daley, you're shaking your head a lot.

Dr. DALEY: Yeah. This is bound to be one of the most exciting developments in science in recent years. There's rampant rumors that several groups have reproduced this work. It's very, very exciting. But I get back to the point that it doesn't obviate the need or the interest in studying embryos and embryonic stem-cells.

At the Children's Hospital, one only needs to spend a short period of time in the lobby in seeing the kids that are coming in and out and the kinds of devastating developmental conditions that we have the vaguest understanding of.

And I would argue in part that it's because our federal government has not, for the last several decades, been funding research into early human development, into research that works directly on human embryos because there's a prohibition written into law approved every year that prohibits the expenditure of any NIH funds on research which would lead to the harm or destruction of human embryos.

And because of that we have our head in the sand on many of these issues. And we don't have an understanding of the chromosomal dynamics of the early embryo development, and this is a stage of human development when many chromosomal abnormalities creep in.

And so I would say even though we are going to learn an enormous amount about how to take adult cells and make them into embryonic counterparts, we still as a scientific and medical community should be using these resources that are coming from fertility clinics, these hundreds of thousands of embryos that will be otherwise discarded as medical waste. These pre-implantation clusters of eight to 100 cells, we should be studying them because it will teach us enormously valuable lessons about human development and abnormal human development.

FLATOW: Talking about embryonic stem-cell research this hour on TALK OF THE NATION: SCIENCE FRIDAY from NPR News. I'm Ira Flatow in Cambridge, Massachusetts.

Dr. Melton, do you believe - do you agree with this that this basic knowledge is still lacking?

Dr. MELTON: Yes, I think Rudy and George have made two good points. I might amplify one of them by saying that the stem-cell is sort of like - the embryonic stem-cell is sort of like the discovery of the transistor. It's a little bit hard to predict what we're going to learn from it. But we know after the transistor we have iPods and cell phones and personal computers.

And George and Rudy are talking about studying the basic biology really of how does the cell know what to become. But if you think a few years or decades ahead and imagine that we understood the programs that tell cells what to do, how to become a pancreatic beta cell that makes insulin or a muscle cell, that's going to be deeply informative in allowing us to make our bodies heal themselves and replenish themselves.

And that really is why we're so excited about this research. We have in our hands this reagent, this like transistor which is going to teach us about, as George said, how cells develop and how humans develop. And it's a shame that we're not able to fully and kind of enthusiastically study that material.

FLATOW: Let me get a quick question from the audience before we have to go to the break. Yes, sir?

Unidentified Man #1: Elias Zerhouni is a physician and prominent Presidential Bush scientific appointee who, for years, supported the limitations on stem-cell research and recently reversed course. I wondered if you could explain what might have changed his mind and what that might say about the progress in understanding this issue in the country.

FLATOW: Michael, do you have any idea about that?

Prof. SANDEL: Well I think he was giving his - Dr. Zerhouni was giving his best and honest scientific judgment. But I do think it reflects a gradual change in the shape of the public debate.

I think whether or not the veto is overridden that those who oppose federal funding have sensed that they have lost the debate before the public in the country as a whole.

And one measure of this is that the arguments now are based less - if you listen, say, to Senator Brownback on the Senate floor, he has a principled moral opposition. But he's reaching. He's reaching to the argument that adult stem-cell research is actually more promising and that embryonic stem-cell research is not needed, which is really too bad that in a way it shows that he knows that his moral view has not been persuasive.

And so there's a kind of reaching, an implausible reaching about whether it's really needed. So I think there is a sense that the public debate essentially, and public opinion, has shifted.

And I think by the next administration, whether we have a Democratic or a Republican president, I think there's little doubt that the funding ban will be lifted by then, if not before.

FLATOW: Talking about embryonic stem-cell research in Cambridge, Massachusetts. We're going to take a short break, come back, take some more questions if you've got them for us. The mic's waiting there. Your phones are on the line. So stay with us. We'll be right back after the short break.

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 the state of stem-cell research here in Cambridge, Massachusetts. My guests are Rudolph Jaenisch, who is researcher at the Whitehead Institute, Douglas Melton, co-director at the Harvard Stem-cell Institute, George Q. Daley, associate professor at Children's Hospital in Boston, and Michael Sandel, author of "The Case Against Perfection: Ethics in the Age of Genetic Engineering."

Our number, 1-800-989-8255. Dr. Jaenisch, you have shown in your research that it is possible to get stem-cells from an embryo without harming the embryo, at least in mice, correct?

Dr. JAENISCH: Yes. It was a suggestion, an idea, which was proposed by Bill Hilbert(ph) who is an ethicist from Stanford. The idea was, if you can genetically change the skin cell you use to do nuclear transfer in a way that the product of this nuclear transfer could never ever make an embryo because it was damaged in its ability to generate a placenta, then, the argument goes, you would not kill potential human life and the ethical problem would be a lesser one.

So it was a proposal. And we just did this experiment in mice and showed, indeed, if one does genetically modify the fibroblast before nuclear transfer in a way, you can generate indeed a product of nuclear transfer which can generate embryonic stem-cells - normal embryonic stem-cells - but cannot under any circumstances implant into the uterus and generate a fetus.

FLATOW: And what practical applications does that have for us?

Dr. JAENISCH: Well that is not clear because, I mean, this proposal was - when it was proposed a couple years ago it was controversial not only among ethicists and lay people, but also among scientists because it would add some complications to an already complicated procedure. And it was of course not done.

Now it was done and approved of principles done in mice. And of course after that it remained controversial. So is it really solving the issue? I wonder.

FLATOW: Are we - did you want to jump in there, Michael Sandel?

Prof. SANDEL: Yes. I think some of these proposals who were made really as a way to try to suggest that it's possible to make progress without funding embryonic stem-cell research. So there was a political agenda behind some of those who were advocating it.

And from an ethical point of view it's not clear that if you believe that the early embryo is like a child, is it really morally better if you believe that? Deliberately to design a disabled or stunted embryo guaranteed to die and then experiment on it?

So even from an ethical point of view I think there's actually - the question can be asked whether - if you believe the embryo's a person - that's a morally acceptable way out.

FLATOW: You talk about - we decided it's okay to create embryos to treat infertility. Is there an ethical difference in using these embryos for research?

Prof. SANDEL: Right. I mean, in a way, there is a moral question there. Consider the diseases and conditions that we've heard described, the patients, the children George sees in his hospital, the diabetes and other kinds of diseases that Doug and others are targeting.

Treating and curing those diseases, is that morally less important than treating infertility? It's far from clear that it is less important, and yet we accept as a society the sacrifice of embryos in the course of fertility treatments.

So it's very difficult to see how treating and trying to cure these grave diseases would carry less moral weight.

FLATOW: 1-800-989-8255. Lewis(ph) in Cleveland. Hi, welcome to SCIENCE FRIDAY.

LEWIS (Caller): Yes. First of all, I take issue with the whole program because, I mean, why would NPR put on a program where - I mean such a discussion where there are people that are opposed to embryonic stem-cells we should - there's nobody on the panel who feels that way. I mean, this is a completely - seems to me like a completely biased panel.

I mean if you're going to have an objective discussion about something, shouldn't there be an opposing viewpoint represented on the panel?

FLATOW: Well we've done many programs of opposing viewpoints on a panel. And this is not a topic we've discussed only once. We've talked about this for the last 10 years and had many opposing viewpoints on the matter.

LEWIS: OK. I also for one…

FLATOW: Tell us your opposing viewpoint.

LEWIS: Well, okay. I believe an embryo, first of all, is a human being. I believe the questions - we've answered so many different points of view about permissions for different things regarding - like, you know, similar to like the abortion issue.

But when you come right down to the question of when does life begin - when does life begin? And I personally believe that life begins at conception. When that egg is fertilized, we have a life. And we are not allowed to play God and say this life can exist for somebody else. We are not allowed to be the judge and say, you know, I'm going to sacrifice this life for somebody else's. That's not our position. We shouldn't be doing that.

FLATOW: Do you believe that those 400,000 embryos that are sitting frozen, you know, in the infertility clinics are human lives, equivalent to anyone else's life?

LEWIS: Yes. I believe that those embryos are fertilized eggs and they should not be experimented on.

FLATOW: Do you believe that you have a moral responsibility then to make sure none of them get destroyed?

LEWIS: Absolutely.

FLATOW: So why aren't you doing something about it?

LEWIS: I am.

FLATOW: What?

LEWIS: Well, first of all, I pray a lot. And secondly, when I get the opportunity, I write to a congressman or to somebody that's - has, you know, a viewpoint that is opposed to mine.

FLATOW: But if you really think these are human lives, why are you not out to doing something to make sure they're never destroyed?

LEWIS: I am. I am. I said, I…

FLATOW: Do you think prayer is enough? You think writing for your congressman - if these were your children in a classroom, would you be doing more than praying for them and writing to your congressman?

LEWIS: They're children in my classroom…

FLATOW: These were adult children and they were going to be destroyed - would you be doing more than praying and writing to your congressperson?

LEWIS: Why, sure. Any destruction of life is not justified.

FLATOW: Michael Sandel, you want to...

Prof. SANDEL: It is. It is a serious and a sincerely held view. And - I'm sorry, tell me your name again?

LEWIS: Lewis.

Prof. SANDEL: Lewis. So, Lewis has a sincerely held conviction that is shared by a sizeable number of Americans. Here's one - here are a couple of ways of taking serious - seriously, Lewis, your view - but also putting to you a certain challenge. Let me mention one. In natural pregnancy, put aside labs and fertility treatments. In natural pregnancy, over 50 percent of fertilized eggs in the course of natural pregnancy are lost for one reason or another. Would you say that that - that natural pregnancy is a source of kind of rampant infanticide? That would be one way of kind of testing your view. What would you say about that case, Lewis?

LEWIS: Well - like I said, I don't understand that. (Unintelligible) me - if they're in terms like say a baby is born and is born dead, for example…

Prof. SANDEL: No. No. I mean that once the egg is fertilized in natural pregnancy - in the majority of cases…

LEWIS: Does it get implanted in the uterus?

Prof. SANDEL: Well, some are lost before implantation and some are lost shortly after implantation, within the early weeks of natural pregnancy. A huge - a high percentage - over half are lost. Would you consider really that that's a kind of rampant infanticide?

LEWIS: No, I don't. I mean…

Prof. SANDEL: Why doesn't it - why would you say then that that's…

LEWIS: If you're talking about…

Prof. SANDEL: …or infant mortality - it wouldn't be infanticide because we're not actively killing. But would you consider that to be an instance of infant mortality of over 50 percent?

LEWIS: If you got a husband and wife, a normal relationship, a marriage and they conceived normally, they're married, you know, they have a child and something happens in the pregnancy, like, what I suppose you're talking about, and it's just, naturally, it doesn't work out for some reason.

Prof. SANDEL: Right. The embryo - the fertilized egg dies. This happens very often in…

LEWIS: Yeah. I mean, not through in vitro or anything. I was just - just husband and wife and, you know, something happens. I mean…

Dr. DALEY: Perhaps I can interject…

FLATOW: Dr. Daley?

Dr. DALEY: Perhaps I can interject a slight variation on the question. I, as a physician, been thinking a lot about this phrase: life begins at conception. And as a physician, we're often called upon to pronounce patient, dead. What does that mean? That means that there's a loss of integrated organ function, either of the heart or the brain. And we have a very firm understanding of what it means when a person dies. I think when we talk about the life of a cell - and now I'll talk as a biologist - we have a very different concept of what that means.

And yet this phrase, life begins at conception, really confuses those two desperate concepts. All cells are living. The sperm cell was a living cell. The egg cell was a living cell. And when they come together as a new genome, a new combination of DNA and a zygote, it's a living cell. But that concept of life is very, very distinct from the concept of life that we apply to patients and persons. And so…

FLATOW: But not to Lewis.

Dr. DALEY: Well, I want someone…

FLATOW: Your concept of life is something just at - can something that happens at conception?

Dr. DALEY: I mean, to challenge the way people think about that term, so that they think more deeply about it. Because, the question should not be when does life begin, because all human cells have been alive and we've been immortal as a species by passing down the living cells generation to generation. It's when does a person exist - a person with enough integrated function that we as a society should take an interest in that person's state of being.

FLATOW: Lily said - I would - are you still there, Lewis?

LEWIS: Yes.

FLATOW: I don't think there's anything Dr. Daley could say to you that would convince you otherwise, is there?

LEWIS: I don't think so. I don't - no…

FLATOW: Because that's a religious sort of moral belief that you have and I respect that belief. I'm just saying that no amount of arguing can convince some people to - global warming is happening. No amount of arguing can convince some people. Evolution is happening. No amount of arguing can convince some people that life doesn't begin at conception. I mean - or human life begins at conception. Well, maybe a - let me just ask - Lewis, basically that's correct.

LEWIS: Yeah. Basically that's correct. I mean, it's my opinion. Opinions, I think, can change -you know, new information and facts. But as it is right now -

FLATOW: All right, hang on a sec. I have to remind everybody that this is TALK OF THE NATION: SCIENCE FRIDAY from NPR News. I'm sorry. Go ahead, Dr. Daley. Did you want - go ahead. Jump in though.

Dr. DALEY: Yeah.

FLATOW: I'm sorry.

Dr. DALEY: No, no. That's all right. Now, I wanted to come a little bit to Lewis's defense here, Ira. I think that the - whether or not Lewis holds his belief for reasons - religious or otherwise - I don't think we should assume that they're an arguable or irrational. I think that we should take those views seriously and probe them, and engage with them and challenger them as this discussion has been doing. I don't think that they should be beyond the pale of public discourse. I think that Lewis has, you know, responded to our challenge.

I'd like to leave him with one final challenge where she could try to take up here or reflect on after the program. And it's this, Lewis, if there's - here's a philosophers hypothetical question. In which is one way of testing the view that you've advance. If there were a fire in a fertility clinic and you hade time to save either a 6-year-old girl who is in that clinic or a tray of 20 frozen embryos. Which would you do?

LEWIS: Yeah I'd had to make a judgment…

Dr. DALEY: One person from it.

LEWIS: Yeah. I had to make a judge. I meant o ask the who's life is more important. And I would try - if I was like a fireman or something, I'd make the decision to do whatever I could. Yeah, I mean, if we meant to save the girl or the embryos - I mean, whoever has a better chance of making it so to speak, you know. I mean that's a decision I would make as a fireman. And, you know, and judge who, you know, who's closer to the door so to speak, who's closer to getting out.

Dr. DALEY: There're 20, Lewis. There are 20 in that tray.

LEWIS: Yeah.

Dr. DALEY: 20.

LEWIS: Yeah. Well, like I said, it's like - I think what you're saying is like when a doctor perform a cure on a woman that's pregnant and has to decide who's life is more important. The life of the woman or the life of the embryo, you know? And the important thing is to save life. A doctor saves life and he decides whose life he's going to save. And indirectly, indirectly the embryo might die or, and, yeah. Well then, that's - there's nothing wrong with that. If indirectly, you know, the embryo dies or the girl dies or something, indirectly, what I'm speaking about is a direct intervention on an embryo.

FLATOW: All right, Lewis. Thanks for calling. Dr. Melton?

Dr. MELTON: All right. I just wanted to make a comment on something you said in sort of respectfully disagree. You compared to this question in the issue that Lewis is struggling with the question of global warming.

Global warming is a scientific question to which there's a scientific answer. One can have evidence-based decision on global warming. This is a question that scientist can't answer. It's a metaphysical or a theological question, as George says, when does a person begin. So I wouldn't equate…

FLATOW: Well, the point I was trying to make has been my experience that once people had made up their minds about something, it's very hard to change anybody's mind. It takes a paradigm shift. And we are seeing a paradigm shift in global warming now. I mean, where we hadn't seen before.

Dr. MELTON: Based on scientific evidence.

FLATOW: But you're right. I will value - you're right, that was not the most eloquent analog. But I didn't think about - do you think about evolution is the same way in the same sort of, like, here - Dr. Daley, did you want to say something?

Dr. DALEY: Well, I just think that over time, there has been an enormous amount of attention paid to this issue. And I think it's been a huge service to the American public that the media has taken so much interest and PR has taken so much interest. And the person off the street is often very aware of stem-cells and very basic aspects of Biology. I think it's healthy. I think this is healthy part of the debate. But we won't answer all of the critiques because fundamentally it is a very challenging issue.

FLATOW: And we've run out of time. I want to take all of you for taking time to be with us. George Q. Daley, associate professor of Children's Hospital. Rudolf Jaenisch, researcher of Whitehead Institute. Douglas Melton, co-director of the Harvard Stem-cell Institute and Michael Sandel, professor of Government at Harvard and also author of the new book, "The Case Against Perfection: Ethics in the Age of Genetic Engineering." Thank you gentlemen for taking time to be with us today.

I'm Ira Flatow in Cambridge, Massachusetts.

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