Monday, August 07, 2006

A Pox on Stem Cell Research

In vetoing legislation that would have supported medical research using embryonic stem cells, President Bush described his decision as moral rather than scientific, an act of conscience opposed to the taking of the “innocent human life” represented by embryonic stem cells. The potential of using these cells to develop life-saving medical cures, Mr. Bush said, was a temptation to be resisted.
The president’s veto appears to create an intractable problem for stem cell researchers and their advocates. How is the research to advance from hopeful to helpful when national policy inhibits the work from being done? Discouraged proponents have suggested that the president’s decision, which was applauded by conservative religious groups, has the potential to keep American science locked in the past.
The past, however, seems to encourage a more optimistic outlook. Medical progress has stirred religious and moral objections throughout history — objections that were overcome as the benefits of medical advances became overwhelmingly obvious. In the 11th century, European church leaders warned monks that treating illness with medicine showed such a lack of faith in God that it violated holy orders. When 19th-century doctors began using chloroform to alleviate the pain of childbirth, the Scottish Calvinist church declared it a “Satanic invention” intended to frustrate the Lord’s design.
An illuminating case study is the late 18th-century controversy over inoculation against smallpox. Condemned by clerics as both immoral and blasphemous, smallpox inoculation offers some surprising parallels to our current impasse over research using embryonic stem cells.
The word “smallpox” once implied all the horror of a murderous infection against which people had little remedy. A 19th-century historian called it “the most terrible of all the ministers of death.”
Smallpox’s legacy of misery obsessed the English doctor Edward Jenner. Born in 1749, Jenner spent years hunting for ways to conquer, or at least prevent, the dread disease. He gathered anecdotal evidence from patients and strangers, including milkmaids, who appeared protected from smallpox by their exposure to a related, but milder, infection called cowpox. He also studied the folk medicine practice of inoculation, in which pus from smallpox pustule was rubbed into an opening scratched in the skin of an uninfected person.
Other doctors were also exploring the idea of inoculation, but Jenner went further, conducting experiments in the mid-1790’s. He designed a procedure using fluid from cowpox lesions to inoculate against smallpox. His approach was untested, but Jenner believed it offered the potential to become “essentially beneficial to mankind.”
The religious authorities of Jenner’s day viewed smallpox inoculation as an affront to God and man. A widely published British sermon was titled “The Dangerous and Sinful Practice of Inoculation.” American clergy warned that inoculation usurped God’s power to decide the beginning and end of life. Only hypocrites would undergo the procedure and still pray to God, one theologian declared.
Jenner responded with a risky demonstration of his idea. In 1796, the doctor persuaded his own servant to allow the man’s 8-year-old son to be inoculated with cowpox material; two months later, Jenner exposed the child to smallpox.
The experiment was a success. Moreover, the child remained immune to smallpox even after the doctor exposed him to it a second time. The doctor himself, however, was reviled. Clerics denounced him as a tool of the devil. Newspapers ridiculed him as “a presumptuous man” overselling his results; one cartoonist portrayed him as a country bumpkin surrounded by patients sprouting cow parts.
Even some of his medical colleagues questioned whether he might have gone too far. In retrospect, one can easily imagine Jenner’s brilliant idea sinking under the combined weight of moral antipathy and scientific disdain.
Instead, the doctor persevered and triumphed. Not by hyping the potential of his ideas, as some stem cell supporters occasionally have done, but by doggedly gathering more evidence based on more inoculations. Fueled by his success, the practice spread, and smallpox rates plummeted. In time, the life-saving merits of inoculation eventually overwhelmed all doubt; the evidence, Jenner wrote, became “too manifest to admit of controversy.”
I hope we’re headed in a similarly pragmatic direction with regard to stem cell research. We still have not ventured much beyond the promising preliminaries; there is no multitude of saved lives to serve as a moral counterweight to the use of embryos, even unwanted ones.
For now, the breakthroughs may well occur in another country. To the dismay of the Vatican, the European Union recently agreed to expand investment in embryonic stem cell research. But in time, the promise of treatments made possible through embryonic stem cell research may prove impossible to resist in the United States, as well.
The fact is that stem cells — especially the amazingly versatile cells evident in early human development — have the potential to hold off our own ministers of death. And history suggests that’s a proposition too powerful to remain shackled by the moral strictures of the moment.
Deborah Blum is the author of the forthcoming “Ghost Hunters: William James and the Search for Scientific Proof of Life After Death.”
From August 1 issue of the New York Times.

No comments: