Debate:Embryonic stem cell research, US federal funding for

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Should the United States provide federal funding to all forms of embryonic stem cell research, including ones that involve the destruction of embryos?

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Background and Context of Debate:

The basics of the debate: The debate over stem-cell research incorporates a number of social, ethical, and religious considerations. On one hand, medical researchers point to the potential scientific and medical benefits of researching and utilizing stem cells. They argue that these benefits warrant federal funding, and many of them believe that the destruction of an embryo at the stage at which stem cells are extracted, is not the destruction of "human life." On the other hand, opponents point out a number of health risks accompanying many of these potential stem cell therapies, allegedly overblown social benefits stemming from research, as well as ethical concerns regarding what many of them perceive to be the destruction of "life" in embryonic stem cell research. The detailed arguments, studies, and facts of this debate are laid out below.

Also see these Wikipedia articles to get a more in-depth background on stem cell research and the history of the controversy:

• Stem cell controversy
• Stem Cell
• Somatic cell nuclear transfer

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Health promise: Does embryonic stem cell research have substantial promise for advancing public health?

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Yes

Claim that embryonic stem cells have extraordinary potential in treatments of all kinds:

• See Wikipedia's Stem Cell Treatments article, which presents the range of potential benefits being claimed by various sources - The "Potential Treatments" listed in this article are: Brain damage, cancer, spinal cord injury, muscle damage, heart damage, low blood supply, baldness, missing teeth, deafness, blindness and vision impairment, ALS (Lou Gehrig's disease.
• Professor Hans Kierstead of UC Irvine repairs rat's spine with stem cell injections: Christopher Thomas Scott (Head of Stanford University's Program on Stem Cells and Society), Stem Cell Now (2006) - "The 'before' videotape shows a rat with a recently damaged spinal cord. Staggering inside a circular Plexiglas container, the animal drags its hindquarters along the runway, its tail trailing limply behind. The next segment shows the same rat after an injection of oligodendrocytes made from a line of embryonic stem cells. It sniffs the air and stands on its rear legs. Dropping down, it takes a lap around the cage with only a slight suggestion of a limp -- once disabled, now cured. The revived rat is compelling visual evidence that Professor Hans Kierstead uses to wow audiences of scientists, patients, and news reporters...Repairing damaged human nerves can be a major medical victory -- the success would ripple far beyond spinal injury to demyelinating diseases, such as multiple sclerosis."
• "Embryonic Stem Cell Therapy Shows Steady Benefits In Rebuilding Infarcted Heart" Mayo Clinic research published in American Journal of Physiology-Heart 8/18/04 - "Using embryonic stem cells, Mayo Clinic researchers transformed these master cell types into fully functional cardiac cells and transplanted them into damaged regions of the myocardium, where the cells integrated into the infarct and showed rapid and robust improvements, which were stable over an extended period post-therapy....Despite improvements in earlier diagnosis and treatment, cardiovascular disease is far and away the leading cause of death in the U.S. and the world. According to the latest posted statistics, heart disease causes 700,000 deaths in the U.S. each year, with the number of adults diagnosed with heart disease exceeding 23 million, or 11.5% of the adult population."
• Stem Cell Foundation - "Stem Cell Research: Benefits and Future Hopes"

The health and social impact that some maintain would result from findings of a treatment and cure for the below ailments and diseases

• A cure for diabetes would have a massive social impact, according to some sources: A 9/25/06 CNN article regarding President Bush's veto of federal funding for embryonic stem cell research, pointed out the potential impact a cure to diabetes would have noting that there are 20.8 million American children and adults with diabetes (roughly 6% of the population). It is the sixth leading cause of death, lowering average life expectancy by up to 15 years. It is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness, and adults with diabetes have heart disease death rates two to four times higher than persons without diabetes. The estimated total financial cost for diabetes in the U.S., including costs of medical care, disability, and premature death, was $132 billion in 2002. This all makes the potential health and social benefits of stem cell research substantial, if it were to lead to something of a cure for diabetes.
• The current cost of Alzheimer's disease to American society, which some sources argue would be eliminated through the discovery of a cure through stem cell research: US Dep of Health and Human Services - "Approximately 4.5 million Americans currently have AD, with annual costs for the disease estimated to exceed $100 billion. Moreover, the rapid aging of the American population threatens to increase this burden significantly in the coming decades. Demographic studies suggest that if current trends hold, the annual number of incident cases of AD will begin to sharply increase around the year 2030, when all the baby boomers (born between 1946 and 1964) will be over age 65. By the year 2050, the number of Americans with AD could rise to some 13.2 million, an almost three-fold increase."

Potential medical benefits claimed to exist beyond transplant therapies and treatments:

• Drug Development: According to the BBC 9/5/05, Professor Roger Pederson of the Cambridge Stem Cell Initiative "said it was important to consider benefits beyond just transplant therapies. He said he expected, for example, drug development to make big strides by allowing pharma companies to test novel compounds on specific tissue types derived from stem cells." The Australian embryologist and stem cell biologist Alan Trounson, a pioneer of in vitro fertilization said in 2006, "If you had a reliable supply of neuronal cells...you could study them to understand exactly how Alzheimer's disease causes them to die."[1] Christopher Scott, "Stem Cell Now" (2006) - "Discovering drugs is an important application of hESC technology. Potential drugs made of chemical or biological compounds can be tested in cultures of pure populations of cells that are specifically related to or affected by the disease. For example, the dopamine-producing neurons implicated in Parkinson's disease might be made from hESC lines and stored in quantity. Treating the neurons and measuring their response would quickly sort out which chemicals work best. Thousands of potential drugs tested in this fashion would speed up drug discovery. Existing pharmaceuticals could be refined and improved in the same fashion."
• "Gene therapy can be improved by using stem cells" - Christopher Scott "Stem Cell Now" (2006) - "Gene therapy is a relatively recent and highly experimental approach to treating disease. Although most drugs are manufactured outside the body, gene therapy takes a different approach: a gene is delivered into the affected cells in the body, where it produces a protein that acts as a therapeutic agent. The potential success depends not only on the gene's delivery into the appropriate cells, but also on the gene's ability to function properly. Both requirements pose considerable technical challenges. Noninfectious viruses are used to deliver the gene, just like ordinary viruses infect cells. Unfortunately, this method is imprecise and also limited to the specific types of cells the virus can infect. If the proteins aren't produced efficiently or the transformed cells eventually die of old age, then repeated rounds of therapy are needed. Gene therapy can be improved by using stem cells. Because stem cells self-renew, they can reduce the need for repeated rounds of therapy. Blood-forming stem cells are especially good choices for delivering drugs because they are easily removed from -- and reintroduced into -- the body, and once in the body they home in on certain organs and structures such as marrow, spleen, and thymus. Dozens of human clinical trials have used HSCs to deliver therapeutic agents such as interferon to patients suffering from blood and solid-tumor cancers (as opposed to cancers of the blood), anemias, and immune diseases such as SCID and HIV. In some cases the results have been promising, extending the lives of terminally ill patients. Cell-to-cell fusion -- one of the phenomena behind apparent stem cell plasticity -- might also be a way to deliver a therapeutic gene."
• "Stem cells are being used to diagnose disease" in a process called Preimplantation Genetic Diagnosis - Christopher Scott "Stem Cell Now" (2006) - "At a growing number of in vitro fertilization clinics, single-gene defects that cause Huntington's, Tay Sachs, sickle cell anemia, cystic fibrosis, and dozens of other disorders are being detected via an embryo-sampling technique called preimplantation genetic diagnosis, or PGD. Four days after fertilization, while still in a laboratory dish, an eight-cell embryo is grasped gently by light suction and a single cell is removed with a pipette. The embryo recovers with a quick round of cell division. The DNA in the cell is extracted and then tested with a genetic probe for the disease in question. The test ascertains whether the embryo has no disease genes, is a 'carrier' with one disease gene and one normal gene, or has both copies of the gene and will therefore develop the disease. Only embryos with no disease genes are chosen for implantation. Parents who carry the gene, or who have family histories of the disease, can use PGD to avoid having an affected child...PGD has emerged as a tool for parents whose only other option would be to test abnormalities during fetal development. In most cases, PGD enables the family to avoid the difficult decision of whether or not to end a late stage pregnancy."
• Helping the understanding of human biology and disease processes, and the development of drugs therefore: John Gearhart, of Johns Hopkins University said, "I personally feel that the beauty of these cells is that we'll learn a lot about human biology and disease processes, and that that information will be more important than the cells themselves."[2] Christopher Scott, "Stem Cell Now" (2006) - "PGD can help study disease. Rather than discarding donated embryos that test positive for defects, a clinic at the Reproductive Genetics Institute in Chicago has developed over 30 hESC lines by transferring the defective nucleus into enucleated eggs. These stem cell lines, each with a different genetic disease, are now available to researchers who can use them as an in vitro model. Observing how these cells behave compared to normal cells will help identify how certain diseases begin, progress, and affect healthy tissue. Not only are the disease-causing genes and their proteins identified, this also opens up possibilities for designing drugs that reverse or treat the problem."

Countering high costs - arguments that market forces and the elimination of downstream costs will make treatments affordable to individuals and the government: From Chapter 7 of Christopher Thomas Scott's book "Stem Cell Now" - "Other experts contend that individual treatments are feasible, and that once competition heats up, market forces will conspire to bring down prices. If a stem cell therapy can cure, they argue, then all the downstream costs of caring for chronic illness go away. A high initial price for injecting stem cells would be more than offset by future medical savings."[3]

Other proposed strategies that could reduce the costs substantially and that would widen the potential benefits of stem cell research: [Chapter 7 of Christopher Thomas Scott's book "Stem Cell Now": "Rather than developing a custom stem cell line for each person, nationwide banks of several thousand hESC lines could be developed [to reduce costs]. The banks would use a test called HLA (histocompatibility antigens) typing to match donor and recipient genes, minimizing tissue rejection. The closer the HLA match (either from family members or from outside donors), the less the chance that rejection will be a problem. A similar list of donors already exists. Over 6.5 million individuals have already been HLA-typed for bone marrow registries."

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No

Some scientist may be "over-promising" the benefits in the broader field of stem cell research (not just embryonic stem cell research):

• Shirley Tilghman, Princeton University president and geneticist, said in November 2004 - "some of the public pronouncements in the field of stem-cell research come close to over-promising at best and delusional fantasizing at worst."
• According to the BBC 9/5/05, Lord Winston, a fertility expert and current president of the British Association for the Advancement of Science, cautioned against the "hype" surrounding potential treatments to the BBC and warned of public backlash against stem cell research if it fails to deliver on these expectations.

There may be major obstacles to stem-cell use in therapy and transplant treatments, according to Lord Winston, the current president of the British Association for the Advancement of Scienceneurological disorders to the BBC. He said in 2005 that unless a number of issues are resolved, stem-cells with "result in unsuccessful therapies" (BBC's wording). The BBC summarized the problems he presented, writing "He points to their low cell-cycle time, leading to slow replication in culture and the fact there might be selective pressure for the faster growing, but possibly abnormal cells, to dominate a culture system. He also highlights the instability of embryonic cells in general and "their remarkable propensity to produce abnormal numbers of chromosomes." He concluded by saying that he had a "growing scepticism" regarding the use of stem cells and transplant treatments.

Alzheimers may be "insoluble" with stem cell treatment - BBC Lord Winston to the BBC - "I was concerned that parliamentarians - particularly in the House of Commons - have been convinced that it was just a matter of a few years before we would be able to transplant stem cells and cure a lot of neurological disorders, like Alzheimer's disease, for which I think it is going to be a hugely difficult problem and probably completely insoluble by stem cells." -

Fetal tissue research "has not lived up to its initial expectations", possibly making it a cautionary example against expectations that stem-cell research will deliver: President Bush's speech that initiated the restrictions on federal funding to embryonic stem cell research in 2001 - "While we're all hopeful about the potential of this research, no one can be certain that the science will live up to the hope it has generated....Eight years ago, scientists believed fetal tissue research offered great hope for cures and treatments -- yet, the progress to date has not lived up to its initial expectations."

Any social and health benefits may only come in the long-run - 14 years by one estimate: In Chapter 7 of Christopher Thomas Scott's book Stem Cells Now, he draws a hypothetical timeline of the testing, development, and final application of stem cells in treatments, concluding that it would take 14 years from 2006 for that process to be completed and for the the FDA to approve the first cell therapy for use in clinics. While this point does not necessarily degrade the potential benefits of embryonic stem cell research, it was aimed to quel views that the benefits would arrive quickly.

Argument that some non-stem cell treatment approaches have been growing rapidly, which some have maintained may reduce the marginal benefit stem cells provide:

• Alzheimer's - Non-stem-cell treatment methods are growing rapidly, possibly lowering the net benefit from stem cells to treating this disease: US Dep. of Health and Human Services - "NIA [National Institute of Health] is currently supporting 25 AD clinical trials, including large-scale prevention trials, which are testing agents such as hormones, anti-inflammatory drugs, statins, homocysteine-lowering vitamins, and anti-oxidants for their effects on slowing progress of the disease, delaying AD's onset, or preventing the disease altogether. Other intervention trials are assessing the effects of various compounds on the behavioral symptoms (agitation, aggression, and sleep disorders) of people with AD. As imaging and laboratory studies reveal more about AD's pathology, we are identifying a number of novel molecular characteristics that may prove to be targets for future treatment of the disease."
• Diabetes - US DHHS - "Preventing diabetes is the key to controlling the growing diabetes epidemic". This may reduce the net value of stem cell treatment methods: The US DHHS points out that 90 to 95 of the 20 million Americans with diabetes have type 2 (formerly called "adult onset") diabetes, which is preventable. More than 80% of people with type 2 diabetes are overweight or obese. It is for this reason that DHHS prioritizes prevention over treatment options approached by stem cell research. This is also the logic behind a program developed by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Centers for Disease Control and Prevention (CDC) entitled: "Small Steps. Big Rewards: Prevent Type 2 Diabetes."[4]

Argument that stem cells are involved in assisting cancer's proliferation. In addition, some stem cells may even act as cancer stem cells (CSC).[5] This was first revealed in 1997 when Leukemia was shown to originate from a haematopoietic stem cell.Wikipedia

Unhealthy stem cells "are how many cancers get started" -Scientific America - "Normal stem cells' power to self-renew already exempts them from the rules limiting life span and proliferation for most cells. Stem cells' ability to differentiate into a broad range of cell types allows them to form all the different elements of an organ or tissue system. A hallmark of tumors, too, is the heterogeneity of cell types they contain, as though the tumor were a very disorderly version of a whole organ. Hematopoietic stem cells have been shown to migrate to distant parts of the body in response to injury signals, as have cancer cells. In healthy stem cells, strict genetic regulation keeps their potential for unlimited growth and diversification in check. Remove those control mechanisms, and the result would be some-thing that sounds very much like malignancy. These commonalities, along with growing experimental evidence, suggest that failures in stem cell regulation are how many cancers get started, how they perpetuate themselves, and possibly how malignancies can spread...A stem cell's enormous proliferative capacity makes it an ideal target for malignancy...Several possible paths to malignancy become apparent":

1. ..."In one model, mutations occur in the stem cells themselves, and their resulting loss of control over self-renewal decisions produces a pool of stem cells predisposed to malignancy. Subsequent additional oncogenic events that trigger proliferation of the malignant cells into a tumor might happen in the stem cells or in their descendants, the committed progenitor cell population."
2. ..."A second model holds that oncogenic mutations initially occur in stem cells but that the final steps in transformation to cancer happen only in the committed progenitors. This scenario would require the progenitors' lost self-renewal capacity to be somehow reactivated"

..."Intriguing experiments have shown [] that when transplanted into a new niche, stem cells predisposed to malignancy because of oncogenic mutations will nonetheless fail to produce a tumor. Conversely, normal stem cells transplanted into a tissue environment that has been previously damaged by radiation do give rise to tumors....Many of the same genetic pathways identified with signaling between stem cells and their niche have been associated with cancer, which also suggests a role for the niche in the final transition to malignancy. For example, if malignant stem cells were being held in check by the niche but the niche was somehow altered and expanded, the malignant stem cell pool would have room to grow as well. Another possibility is that certain oncogenic mutations within cancer stem cells could permit them to adapt to a different niche, again letting them increase their numbers and expand their territory. Still a third alternative is that mutations might allow the cancer stem cells to become independent of niche signals altogether, lifting environmental controls on both self-renewal and proliferation." - Scientific America -

• "Stem Cell Work Shows Promise and Risks", Washington Post 10/23/06 - "Nerve cells grown from human embryonic stem cells and injected into the brains of rats with a syndrome mimicking Parkinson's disease significantly reduced the animals' symptoms, but the treatment also caused tumors in the rodents' brains, scientists reported yesterday."

Price tag may limit potential scope of stem cell treatment, according to some, particularly if treatments are individually customized, which may be necessary: From Chapter 7 of Christopher Thomas Scott's "Stem Cell Now" (2006) - "Customized treatments that can't rely on economies of scale are likely to be very expensive. For an adult stem cell regimen, the tissue in which the stem cells reside must be biopsied -- perhaps more than once -- surgeries that can put elderly patients at risk. For any cell therapy the methods for isolating, growing, and expanding the cultures must be perfected -- complications not yet perfected for adult stem cells. The procedures must produce millions upon millions of homogeneous, long-lived cells that exhibit stemness. Like any transplant, the cells must be free of contamination with unwanted viral, bacterial, or chemical agents. To avoid "homegrown" protocols and to ensure quality, companies and hospitals will need to standardize laboratory, manufacturing, and clinical practices. Health professionals will need training to provide proper informed consent and oversight of the procedures. Some researchers assert that for each patient, between 10 and 20 technicians will need to work full-time in specialized laboratories. The costs for such individualized treatments, they say, would be astronomical."

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Vs. adult stem cells: Does embryonic stem cell research greater potential than adult stem cell research?

Federal funding has been channeled into adult stem cell research, but the question is whether that money would be better spent on embryonic stem cell research. Or, whether both have value and should be pursued.

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Yes

Argument that both adult stem cell and embryonic stem cell research should be pursued equally aggressively because they both have unique characteristics and possible applications: Stem Cell Foundation "Benefits and Future Hopes" - "Embryonic stem cells have properties which adult stem cells do not and it is critically important that we pursue both research avenues in parallel if we are to benefit fully from the potential which stem cells hold."

• Time "Stem Cells: The Hope and the Hype" 7/30/06 - "Scientists who are having surprising success with adult stem cells find their progress being used by activists to argue that embryo research is not just immoral but also unnecessary. But to those in the field, the only answer is to press ahead on all fronts. 'There are camps for adult stem cells and embryonic stem cells,' says Douglas Melton, a co-director of the Harvard Stem Cell Institute. 'But these camps only exist in the political arena. There is no disagreement among scientists over the need to aggressively pursue both in order to solve important medical problems.'"

Arguments that adult stem cells have certain drawbacks that make embryonic stem cell research greater in potential:

• Adult stem cells produce only a limited number of cell types, according to Time 7/30/06.
• Adult stem cells are more difficult to grow in culture, according to Time 7/30/06. World of Stem Cells - "One major disadvantage is that culturing adult stem cells in-vitro is very difficult and has not been possible for some types. Also they have a very short life, when cultured in-vitro as compared to embryonic cells."
• Claim that adult stem cell research may be misleadingly advanced, according to Religious Tolerance.org, "because of its four decade head start over embryo stem cell studies." Stem Cell Foundation "Benefits and Future Hopes" - "To date, adult stem cell research has yielded a greater number of clinical trials and applied treatments than embryonic research. In part because adult stem cells have proved easier to manipulate in the laboratory but also because the stigma associated with embryonic research has deterred investors."
• Umbilical-cord stem cell drawbacks: Scott's "Stem Cell Now" (2006) - "Cord blood has only a few primitive blood stem cells because of the small volume of blood found inside [due to the shortness of an umbilical cord] -- a disadvantage when transplant success is tied to the number of cells infused. The small quantity means that such transplants are suitable only for children or small adults." Limited transplant applications: They can only be used for "transplanting blood stem cells to treat some malignant and nonmalignant blood diseases." - Scott (2006)

Evidence that the Orlic and NIH 2001 tests were not repeatable, reducing the credibility of the claim that certain adult stem cell can help repair heart tissue: Scott (2006) - "Two laboratories working independently at the University of Washington in Seattle and Stanford University could not repeat the Orlic lab experiments. The Stanford group injected highly purified populations of blood stem cells with a genetic tag into the heart muscle of 23 mice. The transplanted cells did not increase the survival rate in mice, did not persist in the heart muscle more than 30 days, and did not produce the signature proteins of heart cells (and instead continued to produce those of blood cells)."

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No

Adult stem-cells avoid the moral controversy over the destruction of embryos for research:

Argument that adult stem cells have a capacity to "dedifferentiate" and then become a wide range of tissues, similar to the wide ranging possibilities of embryonic stem cells: Wolfgang Lillge "Case for Adult Stem Cell Research" (2001) - "Evidently, tissue-specific stem cells have the ability – as has been impressively demonstrated in experiments with animals - to 'transdifferentiate' themselves when in a different environment – that is, to take on the cell functions of the new tissue. Thus, neuronal stem cells of mice have transformed themselves into blood stem cells and produced blood cells. Indeed, there are indications of another capability of adult stem cells: Apparently they have the potential to be 'reprogrammed.' Not only can they adjust to the specific conditions of a new tissue environment, but they can even assume more generalized, earlier levels of development, so that it even appears possible that they become totipotent again."

• United States Conference of Catholic Bishops (2001) - "While embryonic stem cell research may be a popular idea, there are other exciting therapies that are much further along in development and that do not require the destruction of embryonic human beings. To cite a few recent examples: adult rat brain cells successfully generated rat muscle tissue; stems cells from umbilical cord blood became "brain tissue [when injected into rats' brains], maturing into the type of cell appropriate for that area of the brain"; cow skin tissue was reprogrammed to its stem cell state and then transformed into heart tissue; human thigh muscle from a patient has been turned into contracting heart muscle cells; and researchers have converted human fat cells obtained through liposuction into bone, muscle and cartilage cells."
• Bone marrow stem cells are used to repair heart tissue in November, 2006 Daily Mail 11/7/06 - "Emergency heart attack patients will be injected with their own stem cells in a dramatic new treatment. The procedure, being pioneered by British doctors, holds out hope of a 'cure' as the stem cells repair damaged heart muscles. The low-cost treatment, which involves removing stem cells from the patient's bone marrow, could be given within a few hours of a heart attack. It is intended to stop patients suffering further attacks and developing heart failure, something existing treatments fail to do in many cases."
• According to an NPR program called "Defining the Ethics of Stem Cell Research" 6/6/06 Scientists in California reported in September, 2005 that injecting human neural stem cells into injured mice, appeared to repair their spinal cords. The therapy helped partly paralyzed mice walk again.
• Chistopher Thomas Scott's "Stem Cell Now" (2006) - "Donald Orlic, an associate investigator at the Genetics and Molecular Biology branch of the National Institutes of Health and his collaborators reported in 2001 that, in heart-injured mice, massive numbers of bone marrow cells repaired the damaged tissue. He interpreted the results as stem cell plasticity: blood stem cells changed into heart cells called cardiomyocytes. The desperate medical need and reasonably safe procedure of injecting heart patients with their own blood (containing hematopoietic stem cells) spurred a clinical trial in Brazil, and by 2003, ten trials in clinics around the world had enrolled hundreds of subjects with end-stage heart disease. Clinicians reported cases where formerly bedridden patients were jogging and climbing stairs after the procedure. In 2003, the British medical journal Lancet reported that patients receiving their own bone marrow enriched for stem cells had improved cardiac function and blood flow. The FDA reviewed the Brazilian and European data and moved to approve American trials in hospitals in Texas and Massachusetts in 2004 and in Maryland in 2005. The foreign trials did show a modest (and statistically significant) improvement in heart function. The percentage volume of blood pumped out of damaged ventricles into the aorta increased up to 8.5 percent."
• Wolfgang Lillge "The Case for Adult Stem Cell Research" (2001) - "Laboratory Virola in Ukraine has demonstrated that bone marrow stromal cells in culture are pluripotent–that is, they are able to differentiate into cells of liver, bone, fat, cartilage, and so on. Researchers at this laboratory have developed techniques to differentiate in vitro mouse bone marrow stromal cells into different types of neuronal and glial cells."

Claim that adult stem cells can be better controlled and targeted to create desired tissues: World of Stem Cells "Advantages and Disadvantages of Adult Stem Cells over Embryonic Stem Cells" - "Since they normally differentiate into a narrow set of cell types, directing them to a desired fate is easier [than with embryonic stem cells]."

• Nancy Gibbs, "Stem Cells: the Hope and the Hype" Time 7/30/06 - "some scientists believe adult stem cells may prove to be a powerful source of therapies. 'In some cases, you may not want to go all the way back to embryonic stem cells,' says [ Dr. Joanne Kurtzberg's program at Duke University Medical Center ]. 'You may want something more specific or less likely to stray. You wouldn't want to put a cell in the brain and find out later that it turned into bone.'"

Argument that adult stem cells taken from patients themselves avoids immune rejection better than embryonic stem cells, and that this could be a more cost effective approach to treatment: Christopher Scott "Stem Cell Now" (2006) - "When asked about whether making customized organs and tissues [from stem cell implantation] patient-by-patient will be cost effective, [Anthony] Atala [a Researcher and Physician at Wake Forest University who in 1999 created the first human organ -- a bladder -- using tissue engineering] replies, 'you can't argue with autologous.' His point is that making organs from a patient's own cells is the best way to go, regardless of cost...There are too many immune genes that make us different, and more are discovered every year. I don't believe that we'll solve immune rejection in my lifetime, or perhaps ever."

• World of Stem Cells "Advantages and Disadvantages of Adult Stem Cells over Embryonic Stem Cells" - "Adult stem cells offer the opportunity to utilize small samples of adult tissues, to obtain an initial culture of a patient's own cells for expansion and subsequent implantation in the same person (that is called an autologous transplant). This process avoids immune rejection by the recipient and also protects the patients from viral, bacterial or other contamination from another individual (donor) in case of allogenic transplant."

Contention that because adult stem cells are already in clinical use, they may be more practical than embryonic stem cells to move forward with: World of Stem Cells "Advantages and Disadvantages of Adult Stem Cells over Embryonic Stem Cells" - "With proper quality control and testing, allogenic adult stem cells may be practical as well. Autologous and allogenic transplants of hematopoietic stem cells that are isolated from mobilized peripheral blood or from bone marrow by positive selection with antibiotics are in clinical use."

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Human beings? Are embryos NOT "human-beings" at the point at which they are destroyed for stem cell research, making their destruction OK?

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Yes

Argument that "life" can only begin in the womb, not in a laboratory, making the destruction of embryos that never existed in the womb acceptable. According to Post-Gazzette.com 5/29/05 Some of the most prominent of these figures that argue this point include Arlene Specter, Utah Sen. Orrin Hatch, and Oregon Sen. Gordon Smith. To them, embryos created in a laboratory, opposed to in a woman's womb, can be destroyed without crossing any moral boundaries. For these reasons, they are often anti-abortion ("pro-life"), while simultaneously pro-stem cell research.

• Some of them have used Genesis 2:7 to support this claim:[6] In the article "Senators use Bible for lessons on life in stem cell debate", Gordon Smith, a Mormon Republican senator of Oregon, who normally opposes abortion, is reported as providing the following exegetical "insight" on Genesis 2:7: "After reading the passage, Smith said it described a 'two-stage process' for creating humans: First, God formed man from the dust of the ground. Then, the verse says, God breathed into man’s nostrils 'the breath of life; and man became a living soul...Cells, Smith said, are like the dust of the earth, giving form to man but not the 'breath of life'. To gain that spirit, he said, the cells must be placed in the mother’s womb. 'I believe that life begins in a mother’s womb, not in a scientific laboratory', Smith said, according to the Post-Gazzette.com. Smith’s fellow Mormon Republican senator, Orrin Hatch of Utah (also pro-life) has also made this biblically-based argument, according to the Post-Gazzette.

Argument that life only begins when humans take their first breath, claiming that a destruction of an embryo or fetus before this point is not the destruction of life: Biblical passages that have been used to support this claim: Many are gathered from the ABC's of Abortion Rights' "Relevant Biblical Passages" page:

• Genesis 2:7 - "And the Lord God formed man of the dust of the ground and breathed into his nostrils the breath of life; and man became a living soul." - According to the ABC's of Abortion, "this Clearly states that life as a human being begins at first breath [rather than at conception or in the womb]".
• Job 33:4 [7] - "The Spirit of God has made me, and the breath of the Almighty has given me life." ABC's of Abortion - "Reinforces the Genesis 7:2 statement that breath is the place where God acknowledges His creation as being alive."
• Ezekiel 37:1-10 - "Thus says the Lord God to these bones: Behold, I will cause breath to enter into you and you shall live…"
• See the ABC's of Abortion's extended list of biblical passages used by pro-abortionists to argue that life begins only at birth - [bring additional passages and arguments into Debatepedia].

Jonathan Sarfati writes that in "Senators use Bible for lessons on life in stem cell debate", The Greenville News, 7/19/01 Zitmer, A. "cites claims that it is ethical to research embryos up to 14 days, because there is the possibility of forming identical twins. This supposedly means that it is ‘illogical … to treat an embryo as an individual if it could still become two people’, and claims that a minority of Roman Catholic philosophers reason ‘that the soul, the hallmark of the individual, could not enter an embryo that has the capacity to divide in two.’"

Some supporters of research ask, if destroying an embryo is "murder" then why isn't it outlawed - that it is highly unlikely that it will be outlawed and that the private funding of the destruction of embryos for research continues unabated may undermine the argument that it is "murder": Graeme Laurie, an expert in the legal side of medicine from Edinburgh University, said to BBC 7/20/06 that there was an "underlying hypocrisy" in President Bush's position. "The stated reason for President Bush's objection to embryonic stem cell research is that 'murder is wrong'; why then does he not intervene to regulate or ban [embryonic] stem cell research carried out with private funds and which is happening across the US?"

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No

Argument that human "life" begins at "conception", when a sperm fertilizes an egg cell, making the destruction of an embryo at any point beyond "conception" the destruction of "human life": United States Conference of Catholic Bishops, "The Case Against Funding Human Embryonic Stem Cell Research, Anton-Lewis Usala, M.D. 2001 - (Secular argument) - "Replication of specific tissue requires cells to receive an enormous number of specific signals. What defines a human life is the cellular mass that is able to produce and integrate this enormous number of sequences, that occurs shortly after fertilization. The cascade of specific cellular differentiation begins, and continues throughout the adult life of the person. It can be argued when the reasoning of the fetal organism begins; it cannot be argued when it is human...the developing human entity, cannot give consent to be sacrificed–hence using precepts of natural law, the State should not subsidize and promote that sacrifice."

• President George Bush supports this view that life begins at conception.

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Frozen embryos: Should frozen embryos in in vitro fertilization be opened to research and funding?

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Yes

The vast majority of the 400,000 frozen embryos in the United States will either be stored indefinitely or destroyed at some point - causing some to argue that they should be used for stem cell research: According to a Washington Post article "400,000 Embryos Frozen in the US" 5/8/03, "About 3 percent were earmarked for research; 2 percent for destruction and a like number for donation to women; and 1 percent for quality-assurance studies. Most of the rest -- about 87 percent of the total -- were reserved for ongoing fertility efforts. The survey, detailed in the May issue of the journal Fertility and Sterility, did not ascertain how long embryos had been in storage -- a detail some experts said would make clear that most embryos saved for further fertility work are unlikely to be used for making babies. Frozen embryos can remain viable for a decade or more, but with each passing year, couples are increasingly unlikely to use them, because they have either given birth or given up." Because these embryos would die in any case, some maintain that they would be more ethically applied toward a cause that could help or save lives.[8]

Argument that the parents of at least 11,000 of these 400,000 embryos have given explicit permission for their embryos to be made available for stem-cell research, a nationwide survey cited by the Washington Post found. Such permission, some argue, favors allowing federal funding for stem-cell research on these embryos.

Argument that the Senate gave clear support for allowing research on these embryos The US Senate voted on July 18, for a bill that would have legalized federal funding to research on embryonic stem cells left over from in vitro fertilization procedures.

Sen. Arlen Specter (R-Pa.) bill would have given direct federal funding to using these embryos for research: - In January of 2000, Specter introduced legislation with his co-chairman on the subcommittee, Iowa Democrat Sen. Tom Harkin, that would have allowed the government to finance embryonic stem cell research with embryos that would have otherwise been discarded at in vitro fertilization clinics. He has been one of the most consistent and vocal supporters and sponsors of this approach to embryonic stem cell research. He has said, "it is a clear-cut question to use embryos to save lives, because otherwise they will be destroyed." He pointed out to the Washington Post that "Fertility clinics hold about 400,000 unneeded embryos, he said, and only 128 have been "adopted" by couples who played no role in creating them." He said, "A century from now, people will look back in amazement that we could even have this debate when the issues are so clearly cut."[9]

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Claim that these 400,000 embryonic stem cells are weaker stem cells, devaluing their potential usefulness: According to Time 7/20/06, 1. The freezing process may make it harder to extract stem cells from these particular embryos; 2. Some of these embryos were the weakest ones created by infertile couples, and subsequently may not yield high-quality stem cells.

Argument that the eventual death of the majority of these 400,000 stem cells is not a justification for destroying these 'lives': President Bush 8/9/01 quoting an ethicist - "there's no such thing as excess life, and the fact that a living being is going to die does not justify experimenting on it or exploiting it as a natural resource."

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US approved lines: Are the embryonic stem cell lines currently approved for federal funding inadequate for substantial progress in research?

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Yes

General assessments that the 'presidential' stem cell lines available for research under federal funding are inadequate for substantial progress in stem cell research: Nancy Gibbs, "Stem Cells The Hope and the Hype" Time 7/30/06 - "For scientists who choose to work with the approved 'presidential' lines, the funding comes wrapped in frustration. Today there are only 21 viable lines, which limits genetic diversity. They are old, so they don't grow very well, and were cultured using methods that are outdated. What's more, the chromosomes undergo subtle changes over time, compromising the cells' ability to remain 'normal.' Back in the late '90s, when the lines were created, 'we didn't know much about growing stem cells,' says Kevin Eggan, principal faculty member at the Harvard Stem Cell Institute. 'They can't do what the newer cell lines can do.' Curt Civin, a cancer researcher at Johns Hopkins, has spent the past several years trying to differentiate the presidential lines into blood cells that could be used to treat leukemias and other blood-based cancers. But the age and quality of the cells have been a constant hindrance. "We want to study normal cells," he says. 'We're working with Version 1.0. I'd like Version 3.3.' organs...The presidential lines, scientists say, are wasting money as well as time. Larry Goldstein's lab at the University of California at San Diego is a life-size game of connect the dots. Each machine, cell dish, chemical and pretty much every major tool bears a colored dot, signaling to lab workers whether they can use the item for experiments that the government won't pay for. Goldstein's team is working on a cancer experiment that relies on a $200,000 piece of equipment. They can use either an approved cell line that will yield a less reliable result or a freshly created line that would require the purchase of another machine with private funds. "It's a ball and chain," Goldstein says. "It's goofy. Imagine if your kitchen was a mixture like that, where you can't use those pots with that soup."

• "Bush 'Out of Touch' on Stem Cells" BBC 7/20/06 - "US researchers say that sticking to these lines restricts progress. Jeffrey Balser, associate vice-chancellor for research at Vanderbilt University in Nashville, said US institutions were 'on the threshold of phenomenal progress in stem cell research. But we are being slowed by these federal restrictions."

Argument that the 'presidential lines' are difficult to keep alive: Washington Post 10/29/04 - "[A] study has concluded that at least a quarter of the Bush-approved cell colonies are so difficult to keep alive they have little potential even as research tools."

Claim that the 60 'presidential' lines are commonly rejected by the human immune system, undermining their potential in treatments: Washington Post 10/29/04 - "All of the human embryonic stem cells available to federally funded scientists under President Bush's three-year-old research policy share a previously unrecognized trait that fosters rejection by the immune systems, diminishing their potential as medical treatments, new research indicates."

Claim that the 'presidential' lines are inadequate because they lack variety, which is important to developing a diversity of treatments: Nancy Gibbs, "Stem Cells The Hope and the Hype" Time 7/30/06 - "In the wake of Bush's original order, Harvard decided to use private funding to develop about 100 new cell lines from fertility-clinic embryos, which it shares with researchers around the world. Scientists, desperate for variety, snap them up. 'Not all embryonic-stem-cell lines are created equal,' says Dr. Arnold Kriegstein, who runs the Institute for Regeneration Medicine at the University of California, San Francisco. 'Some are more readily driven down a certain lineage, such as heart cells, while others more easily become nerve. We don't understand how it happens, but it does mean we need diversity.'"

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Write Subquestion here...

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Map of state funding to stem cell research as of 8/23/06 (some things changed since the November elections)

In general, Democratic states tend to support stem-cell research.[10]

New Jersey: The nation's first state-supported stem-cell research institute was established in New Jersey in mid-2004. However, since then, efforts to make the institute a reality have largely stalled. A referendum authorizing $230 million for stem-cell research has been stalled as well, although it was slated to appear on the Nov., 2006 ballot. In addition to the referendum, a bill that would use up to $250 million in excess cigarette-tax revenue to fund stem-cell research is moving through the legislature.[11]

California: In 2002, California became the first state to officially endorse human embryonic stem cell research, along with experiments that involve cloned embryos (although it banned creating a cloned baby). California voters approved of proposition 71 in November 2004, creating a US $3 billion state taxpayer-funded institute for stem cell research, the California Institute for Regenerative Medicine. It plans to provide $300 million annually to research.[12] On July 21, 2006, Governor Arnold Schwarzenegger (R-Calif.) authorized $150 million in loans to the Institute, attemption to jump-start the progress of funding research.[13]

Arnold Schwarzenegger - “I remain committed to advancing stem-cell research in California, in the promise it holds for millions of our citizens”.[14]

Connecticut: In June 2005, Connecticut Gov. Jodi Rell signed legislation that will provide $100 million in funding over 10 years for adult and embryonic stem-cell research in the state. The state's stem-cell research program announced its intention to fund as much as $20 million in research projects this year.[15]

Delaware: In June 2005, the Delaware Senate approved a bill that would allow embryonic stem cells to be used for research. Embryos available for research would be limited to ones considered "surplus" by fertility clinics. Written consent would be required from the couple that created the embryo, and the the sale of embryos would be outlawed. The bill also requires the formation of an 11-member panel to set up guidelines to govern research. The Delaware House put the bill on hold in late June 2005. In January 2006, it voted to pass an amended version of the bill that removed the original language about imposing research guidelines and regulations. The new version must now return to the Senate for consideration.[16]

Florida: The Florida House and Senate were considering bills in the summer of 2006 that would provide $150 million in state funding for stem-cell research over 10 years. If passed, the bill would allow embryos discarded by in vitro fertilization clinics to be used for research. Yet, the outlook is uncertain, and two opposing propositions may be placed on the 2008 ballot, one supporting and one opposing state funding for stem-cell research.[17]

Illinois: In July 2005, Democratic Gov. Rod Blagojevich bypassed the Illinois state legislature to create a stem-cell research institute with an initial $10 million by executive order. Illinois Gov. Rod Blagojevich has also invited Missouri stem-cell researchers to bring their work to his state.[18]

Maryland: In March, 2006, the state legislature passed a bill approving an initial $15 million of state funding for embryonic stem-cell research.[19]

Missouri: Republicans, including Gov. Matt Blunt - who considers himself one of the nation's staunchest pro-life governors - supports embryonic stem-cell research on the grounds of its potential to help treat disease.[20]

Missouri November, 2006 stem-cell research funding proposition - passed by a margin of 51% to 49%:[21] Missouri US Senator elect Claire McCaskill (D) supported its stem-cell research funding proposition on its November, 2006 ballot.[22] Michael J. Fox became a major proponent of this proposition, as well as McCaskill due to her backing of the issue.[23]

Montana: In the November elections, Democrat Jon Tester, a strong supporter of government funding for embryonic stem cell research, won over Republican Senator Conrad Burns, an opponent of state funding. While the election was very close, this appears to indicate a substantial base of support for state funding exists in Montana, a traditionally Republican and relatively conservative state.[24]

Tennessee - nearly split: Former Senate Republican Majority leader Bill Frist supported federal and state funding for stem-cell research. Democratic Senate candidate Harold Ford supported it as well.[25]

Virginia: Newly elected Senator James Webb voted in favor of the Stem Cell Research Enhancement Act of 2005 (HR 810) as a member of the House. Former Republican Senator George Allen voted against it. It became a prominent issue in the election run-off between these two. Webb won, but only by roughly 7,000 votes, which may indicate that the Virginia populous is somewhat divided on this issue.[26]

Other states that have expressed interest in providing funding for research:[27]

• Massachusetts[28]
• New Hampshire[29]
• New York[30]
• Pennsylvania