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Cure May Be Dream, But 'Promise Is Powerful'

July 30, 2005

Answering fundamental questions about human life is seldom easy. For example, to realize the promise of my own field -- heart and lung transplantation -- and at the same time to address the moral concerns introduced by the new science, we had to answer a fundamental question: What is death?

With time and a lot of discussion, a lot of careful thought and a lot of courage, a lot of boldness from many people who believe in the promise of transplant medicine but also understood the absolute necessity for a proper ethical framework, we answered that question and allowed science to advance and have since saved tens of thousands of lives.

So when I, as a heart transplant surgeon, remove that human heart from someone who is brain-dead and I place it in the chest of someone whose heart has failed them in order to give them new life, I do so within an ethical construct that honors dignity and respect for the individual, both the donor and the recipient.

Like transplantation, if we can answer the moral and ethical questions about stem cell research, I believe we will have the opportunity to save many lives and make countless others' lives more fulfilling.

As we know, adult stem cell research is not controversial on ethical grounds, although embryonic stem cell research is.

Right now, to derive these embryonic stem cells, an embryo or a blastocyst, which many, including myself, consider nascent human life, must be destroyed.

But I also strongly believe, as do countless other scientists and clinicians and doctors, that embryonic stem cells uniquely hold specific promise for some therapies and potential cures that adult stem cells just cannot provide.

My comprehensive set of 10 principles, as outlined, again, over four years ago, are as follows.

No. 1, ban embryo creation for research; 2, continue funding ban on derivation; 3, ban human cloning; 4, increase adult stem cell research funding; 5, provide funding for embryonic stem cell research only from blastocysts that would otherwise be discarded; 6, require a rigorous informed consent process; 7, limit the number of stem cell lines; 8, establish a strong public research oversight system; 9, require ongoing independent scientific and ethical review; 10, strengthen and harmonize fetal tissue research restrictions.

That is what I said four years ago, and that's what I believe in today. After all, principles are meant to withstand the test of time, even when applied to a field so rapidly changing like that of stem cell research.

I'm a physician. My profession is healing. I've devoted my life to attending to the needs of the sick and suffering and promoting health and well-being. That's me.

Now, adult stem cells meet certain medical needs. But embryonic stem cells, because of these very specific, these unique characteristics, meet other medical needs that I believe simply cannot be met today by adult stem cells. They especially offer hope -- and, again, still very early -- for treating a range of diseases that require tissue to regenerate or have function restored.

On Aug. 9, 2001, shortly after I had outlined my principles, President Bush announced his policy for embryonic stem cell research. His policy is fully consistent with the 10 principles that I just outlined, and so I have, as most people know, strongly supported it.

In my policy, as you've heard, I also propose restricting the number of cell lines, but I did not propose a certain cutoff date.

And I guess the question we must ask [is]: Over time, with a limited number of cell lines, would we be able to realize the full promise of embryonic stem cell research?

Now, when the president announced his policy four years ago, it was widely believed, and stated again and again, that there would be 78 embryonic stem cell lines available for federal funding.

This has proven not to be the case. Today, only 22 lines are eligible. Moreover, those lines, unexpectedly, after several generations, are starting to become less stable and less replicative than initially thought. They're acquiring and losing chromosomes. They're losing what is called the normal carrier type and are potentially losing growth control.

They're also grown on mouse feeder cells, which we have learned since will likely limit their future potential for clinical therapy in humans. And in part that's because of the potential for viral contamination or retroviral contamination.

While human embryonic stem cell research is still at a very, very early stage, the limitations that were put in place in 2001 will over time slow our ability to bring potential new treatments for certain diseases.

Therefore, I believe the president's policy should be modified. We should expand federal funding and the accompanying NIH oversight and current guidelines governing stem cell research, carefully and thoughtfully staying within ethical bounds.

I am pro-life. I believe human life begins at conception. It's at this moment that the organism is complete; yes, immature but complete.

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