Why Stem Cells Are 2012’s Sleeper Issue

Stem cell research was, along with marriage equality, the culture war issue of the Bush years. Embryonic stem cell research — which involves pushing malleable cells taken from a human embryo to develop into cells that can be used to treat ailments — continues today with the help of federal dollars, a policy on which President Obama and Mitt Romney differ sharply. So why isn’t anyone talking about it?

The answer appears to be part science and part politics. Several alternatives to embryonic research have been developed in recent years and, though they haven’t yet completely replaced embryonic research (more on that later), the promise of medical advancement without raising ethical hackles has attracted a great deal of the available dollars, lowering the salience of embryonic research as a political issue. Further, Republican radicalism prevents any legislative action. Though federal support for embryonic stem cell research was a bipartisan issue as recently as 2007, the 2010 elections swept in a wave of Republicans more likely to push their own hardline laws on the issue than pass a bill cementing federal research funding.

This means the status quo, where the President determines whether government dollars subsidize embryonic research through executive order, seems likely to continue for the foreseeable future. Which is a bigger deal than you might think: a 2011 review of recent scientific work found that the most promising alternative to embryonic stem cell research, induced pluripotent (iPS) stem cell research, depends heavily on continued embryonic research to remain viable. Further, federal funding is becoming increasingly important to the field as support from cash-strapped states dries up. In other words, November’s election decides the fate of a significant source of funding for research that, according to the NIH, could “offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Alzheimer’s diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.” And no one’s really talking about.

So what do the candidates think? in 2009, President Obama repealed President Bush’s executive order banning federal funding for research that creates new stem cells lines, an integral part of embryonic research that involves destroying an embryo to acquire new cells for laboratory use. The Bush ban on the creation of new lines crippled research receiving federal funding, while Obama’s repeal funneled funding to more scientifically viable embryonic research.

Romney, by contrast, appears to want to go back to Bush’s policies or, worse, ban federal funding of embryonic stem cell research altogether. Though his campaign is slippery on what he’d do once elected (it did not return request for comment on this piece), Romney said during his first run for the Presidency that he opposed the use of federal dollars to support the creation of new lines. The remarks didn’t clarify whether President Romney would simply return to the Bush policy of only funding research on existing stem cell lines or whether, as Yale bioethics expert Steven Latham suggests, “he opposes the public funding of any embryonic stem-cell research.” Romney’s more recent public remarks aren’t helping: when asked this year if he was “100 percent pro-life, meaning embryonic stem cell research” he simply said “I’m pro-life. I’m in favor of protecting the sanctity of life. I will cut off funding to Planned Parenthood.” His campaign site does not clarify his position beyond saying “Quite simply, America cannot condone or participate in the creation of human life when the sole purpose of its creation is its sure destruction.”

Pro-life groups believe Romney supports their maximalist position on stem cells. Mallory Quigley, a spokesperson for the Susan B. Anthony List, told ThinkProgress that “The SBA List has endorsed Governor Romney for President and is 100 percent confident in his pro-life position on stem-cell research. As a pro-life candidate, Governor Romney has pledged to advance research using morally unproblematic adult stem cells and other non-destructive alternatives.” In short: Romney supports some sort of anti-science policy on embryonic stem cell research. It’s just not clear which one.

Romney has argued, in line with Quigley’s position, that alternatives like iPS cells render further embryonic research unnecessary. However, it’s near-impossible in practice to separate federal funding for embryonic research from funding for iPS work, as many iPS research today uses embryonic research as a compliment. Implementing Romney’s position would severely limit the iPS research he claims to support.

But even if you grant the practicability of Romney’s position, the science is far too unsettled to make clear determinations about which research is most likely to yield medical results. John Gearhart, a pioneer in the stem cell field who was on the first team to report successfully derive embryonic stem cells back in 1998, told ThinkProgress that “we are still learning things from the basic science.” In his view, it’s near-impossible to make hard-and-fast determination as to what method of stem cell research will be necessary to make medical breakthroughs. That’s in itself strong reason to allow federal dollars to go to whatever research the NIH believes to be the most promising.

Further, Gearhart said, there are some compelling reasons to believe that embryonic stem cells are particularly critical to scientific progress given the state of the current science. Embryonic stem cells are the only human cells that naturally differentiate into new types — i.e., heart tissue cells that could be used to repair damaged areas. All alternative stem cell research essentially attempts to create artificial equivalents, and may fail to do so in an effective or safe fashion unless they can be tested against embryonic cells. That’s why iPS researchers today still use embryonic stem cells as a point of comparison. Moreover, according to Gearhart, embryonic cells are (to date) the only sort of stem cell that can be grown at the scale required to develop treatments for humans. “If you put a couple thousand cells into [a mouse] heart you can see some remarkable improvement,” he said. “To do the same thing in a human, you need millions.” This view isn’t limited to Gearhart — a number of prominent stem cell scientists have recently reiterated the importance of continued embryonic research even in light of developments in iPS research.

“We need money in this area. Badly,” Gearhart told me.