July 17, 2008

The Case For Embryonic Stem Cell Research: An Interview with Jonathan Moreno

Scientists largely agree that stem cells may hold a key to the treatment, and even cure, of many serious medical conditions. But while the use of adult stem cells is widely accepted, many religious groups and others oppose stem cell research involving the use and destruction of human embryos. At the same time, many scientists say that embryonic stem cell research is necessary to unlock the promise of stem cell therapies since embryonic stem cells can develop into any cell type in the human body.  

In late 2007, researchers in the United States and Japan succeeded in reprogramming adult skin cells to act like embryonic stem cells. The new development offers the possibility that the controversy over the use of embryos could end. But many scientists and supporters of embryonic stem cell research caution that this advance has not eliminated the need for embryos, at least for the time being.

Recently, the Pew Forum sat down with University of Pennsylvania professor Jonathan Moreno to discuss the ethical and moral grounds for supporting embryonic stem cell research. Moreno is the David and Lyn Silfen University Professor and Professor of Medical Ethics and of History and Sociology of Science at Penn as well as a senior fellow at the Center for American Progress in Washington, D.C. Previously, he was president of the American Society for Bioethics and Humanities and served as a senior staff member for two presidential advisory committees.

A counterargument explaining the case against embryonic stem cell research is made by Yuval Levin, author of Tyranny of Reason, and Hertog Fellow at the Ethics and Public Policy Center in Washington, D.C.

Featuring:
Jonathan Moreno, David and Lyn Silfen University Professor and Professor of Medical Ethics and of the History and Sociology of Science, University of Pennsylvania; Senior Fellow, Center for American Progress

Interviewer:
David Masci, Senior Research Fellow, Pew Forum on Religion & Public Life


Question & Answer

Recently, scientists in the United States and Japan succeeded in turning adult skin cells into cells that appeared to behave like embryonic stem cells in that they could be programmed to act like any cell in the body. When this breakthrough was announced, some pundits and commentators said that it essentially ends the debate over whether to destroy embryos for stem cell research. Is this true?

From the very beginning of this controversy, there has been a tendency for non-scientists to talk as though they were scientists. If you talk to any of the stem cell biologists, they’ll tell you that the need for human embryonic stem cells continues and will continue for the foreseeable future for a number of reasons. For one thing, in order to know what those alternatives can do, they’ll need to be compared with something, and the gold standard continues to be human embryonic stem cells. For another, there may be some biological limits to the utility of alternative sources, such as these skin cells. And, of course, the techniques now being used involve a genetic factor that is carcinogenic. At this point it is still too early to tell exactly what this news means.  

There is some work about to be published suggesting that adult stem cells are less capable of being reprogrammed to become like embryonic stem cells if they come from older people, which would obviously greatly compromise their utility for therapeutic purposes for that donor. I think all the evidence suggests that, for the foreseeable future, human embryonic stem cell lines will be needed to continue this research.

Do you believe a human embryo has intrinsic worth? And if it does, what sort of rights should we accord it?

First, it is important to note that not all Abrahamic religions universally agree with the notion that a human embryo has any moral status at all. Orthodox Jews, imams in the Islamic tradition and many Protestant denominations do not equate the embryo with the moral status of a born human person. The Roman Catholic Church did not traditionally attribute personhood to the embryo, and this view only started to change in the middle of the 19th century. Even now there are many people who are pro-life who support human embryonic stem cell research.

So I think there is not, in fact, a neat division between people who are pro-life and pro-choice on this question, nor is there a neat division between people who ascribe a great deal of moral status and relatively little moral status to a human embryo. There is a lot of variation here, which is one of the reasons the debate has been so complicated. It is not a bumper-sticker debate. 

I don’t consider myself a great moral theologian. I am trained in philosophy, and I’m an observer of those thinkers. In this country, at least, the consensus among people who think about these things, like theologians and philosophers, seems to be that the human embryo has a greater moral status than a sperm and egg alone, but the embryo does not necessarily have rights. That being said, I would say that the embryo that is intentionally created has to be respected. This means that, for purposes of medical research, before one can justify the destruction of an embryo, one must give a sound argument that existing human embryonic stem cell lines are not adequate for this research purpose and demonstrate the importance of the research purpose – for example, something related to a serious disease. I would say that we are at the stage of what the theologians and philosophers call “weighing and balancing.” 

Of course, there is another view.

Yes, there are people who attribute the absolute same moral status to an embryo as they would to you or me. These people believe – and I think many of the bioconservatives fall in this category – that unless we ascribe a very high level of respect to the human embryo, biotechnology will take us down a very dark road, a kind of slippery slope or revival of eugenics. I don’t see that as the course that we are on. It seems to me that our empathy for people who suffer has become greater in the last 2,000 years rather than less, and that medical science is an expression of concern about suffering and an attempt, as the rabbis put it, to heal the world. 

If a child dies from a disease that might have been preventable if we had been able to research that disease using embryos already slated for destruction or persistent refrigeration – such as embryos used at in vitrofertilization clinics – I don’t see how the death of that child contributes to human dignity. 

You dismissed the slippery slope argument. But what if we get to the a point where genetic manipulation for therapeutic purposes reaches a level of sophistication where we can really begin to alter who we are as human beings? 

I don’t mean to suggest that I don’t think we will have strenuous, vigorous debates about which kinds of genetic interventions to entertain in the next decades. I think we will. But I don’t think that the course of those debates is so settled that we can give up the potential for improving the opportunities for human flourishing. I certainly don’t dismiss those concerns, but I also think we should be very careful to ground these debates in facts.

When we look at these questions, we have to be careful not to mystify the power of science by thinking that these discoveries will take us in the direction of our wildest imagination. If we do that, we really damage the opportunities that science gives us to expand our consciousness. 

There are people of faith on both sides of this debate. Do Judeo-Christian teachings inform your views on this issue? If so, how?

It would be hard to say that the Judeo-Christian tradition doesn’t inform, in some sense, everybody’s views about everything. But after five-plus thousand years of Judaism and a couple thousand years of Christianity, that tradition does not speak with a single voice. I’m very leery of those who purport to offer the univocal interpretation of that tradition. As I’ve already mentioned, there is variation within traditions about the nature and significance of the human embryo. 

As for myself, there is one concept in the Judeo-Christian tradition that I find particularly important: the sense that we are all basically made of the same stuff and have an overwhelming obligation not to be cruel to each other. Cruelty can manifest itself in all sorts of ways, including – in my view – a failure to take advantage of the opportunities for the human good that medical science can provide.

What about the idea, taken from both Judaism and Christianity, that there is essential human dignity based on God’s care for each individual in his creation? Has this notion of God-centered concern for each individual made Western societies, in particular, more careful about ethical issues than countries with different traditions, such as China or Korea?           

I think one has to be careful. You know, one country that is especially vigorous in the stem cell research field is Israel, which is, of course, the birthplace of both Judaism and Christianity. So I would be reluctant to generalize based on geography.

The Pew Forum and the Pew Research Center for the People & the Press have done polling on the stem cell issue over the last six or seven years and have found that Americans generally favor embryonic stem cell research. Today, a slim majority supports it. Opponents of embryonic stem cell research often say this support indicates a public that is misinformed about the research and its potential benefits. In particular, they criticize celebrities, politicians and others who claim that stem cell research will soon cure many of the most dreaded diseases. Is that criticism fair?

There’s certainly plenty of hyperbole on both sides. There have been descriptions of disemboweling embryos as though they were fetuses, exploiting the fact that most Americans don’t have a Ph.D. in embryology or fetal anatomy. I think that opponents of stem cell research are losing the American people because Americans don’t like to see an area of potentially important medical research or science closed off.

Recently, I’ve been reading a history of science policy in the United States, and it is fascinating to be reminded that virtually every one of the founders considered him- or herself a scientist or a natural philosopher. John Quincy Adams, the sixth president, gave a very vigorous speech at the beginning of his term of office advocating vast internal improvements including not only canals and roads but also scientific improvements. The main objection at the time was that such activities should be undertaken by individual states rather than the federal government – it was a states’ rights issue.

That’s interesting, because the states are helping to drive policy on stem cells in a way that they don’t in many other research endeavors.

That’s right. I think having the states take the lead is a good thing in the short term. In the long term, however, we will rue having states drive policy because it’s going to make other issues a lot more complicated, such as policies on intellectual property rights. Without greater federal involvement, there will be a huge coordination problem. Ironically, it was that coordination problem that led the federal government to build canals and roads because the big states insisted that they needed them, and the federal government was in the best position to coordinate these projects. The same is true today for stem cell research.

Regardless of who wins the upcoming presidential election, do you anticipate the federal government becoming much more involved in embryonic stem cell research in the coming years as a result of the change in administration?

I think that there is a real impetus for change because the science is taking us there and the public feeling is taking us there. So, I think the federal government will get more involved no matter who wins. The devil is in the details, but, on the whole, I think the next administration will change policy. The important questions now are how much of a leadership role will the next administration take and how efficiently will the government be able to push this very promising field of scientific research forward?

This transcript has been edited for clarity, spelling and grammar.