Thursday, January 11, 2007

Bill on Embryonic Stem-Cell Research Clears the House

The only bill that President Bush vetoed so far, in July 2006, probably a record of sorts for any presidency, was on federal funding for new stem-cell research. But following the result of the November 2006 election, the impact of emotional statements from actor Michael J. Fox and others suffering from intractable diseases, the House of Representatives considered the bill once again on January 11, 2007 now renamed "Stem Cell Research Enhancement Act of 2007" and voted to approve it.

Similarly, there is likely to be majority support in the Senate, the body that moves with less frenetic pace, or some would say, with plodding efficiency and with the possibility of adding amendments to this bill. But whenever a unified House-Senate bill reaches the President, will he veto it again? And, as in the case of some previous President-Congress tussles, observers wait with bated breath to see if there are the necessary votes to override the veto -- the Constitution specifies 2/3 majority in both the House and Senate to override a presidential veto.

In this bill, consideration is given to research on stem cells derived from human embryos that have been donated from in vitro fertilization clinics, and were created for fertility treatment, and were in excess of the clinical needs of individuals seeking such treatment; and also that they were slated to be discarded, never to be implanted, and donated with informed written consent without any financial or other incentive.

What are stem cells? In any growing embryo, stem cells differentiate into the various specialized tissues in the body. There are some 200 different cell types in the body, and they all owe their origins to the embryo. Adult stem cells function as a repair system for the body. Sources of stem cells include the umbilical cord blood, bone marrow, amniotic fluid, and embryos destined to be discarded. At this time, private and philanthropic funding is legal in the US for new embryonic stem cell line research. Only Federal funding is prohibited, and the purpose of the bill is to enable new embryonic stem cell lines to be eligible for Federal funding as well.

Stem cell research is racing ahead in several countries, ranging from the UK to Singapore, threatening America's preeminent position in biomedical R&D. Even a senior executive branch official confided to me, privately, that in the case of stem cells "science lost and politics won."

Hopes were raised that science could serve to circumvent the entrenched dueling positions by providing another source of stem cells that may be as potentially useful as embryonic stem cells. Indeed, some in the minority appeared to be grasping at that, hoping to avoid the wrath of a booming aging population that is yearning for cures for Parkinson's, Alzheimer's, spinal cord injuries, cancers, diabetes and other diseases for which stem-cells hold promise. This was through the publication in the journal Nature Biotechnology of the scientific paper "Isolation of amniotic stem cell lines with potential for therapy " by De Coppi et. al. Senior author Anthony Atala of Wake Forest University was all over the airwaves in interview after interview, clearly the media were hoping that the newly published research might help to avoid the emotional, morally and scientifically-charged fight that almost everyone wants to avoid so that R&D progress can occur within the bounds of societal, ethical and funding approval. But this newly publicized amniotic fluid source cannot yet be a definitive future supply of all types of tissues because it is still so early in the research cycle. The paper reveals that only about 1% of the cells derived from amniocentesis for prenatal genetic diagnosis comprise stem cells (technically, those cells that express the surface antigen indicating the receptor for stem cell factor).

The Debate

Rep. Barney Frank (D-MA) chaired the debate. The bill was co-sponsored by Rep Diana DeGette, Democrat from Colorado, Chief Deputy Whip of the Majority in the House of Representatives, and Rep Michael Castle, Republican from Delaware. Rep. James Langevin (D-Rhode Island) a pro-life congressman who is paraplegic because of spinal cord injury made a powerful impact with his speech urging support for the bill delivered from a wheelchair on the House floor. At the age of sixteen, Congressman Langevin was injured while working with the local Police Department in the Boy Scouts Explorer program. A gun accidentally discharged and a bullet struck, leaving him paralyzed. Rep. Jason Altmire (D-Pennsylvania) said that he was supporting the bill as a pro-life democrat because stem cells have the potential of preserving and enhancing life for those suffering from serious debilitating diseases. He mentioned his prior work-experience at a tertiary academic medical center to where patients with the most serious illnesses are referred. Rep. Anna Eshoo (D-California) who represents Silicon Valley pointed out that the only type of stem cell research lacking federal support is the embryonic, and urged a reversal of that ban. Rep. Joe Barton (R-Texas) Ranking Member of the House Energy and Commerce Committee, with a strong pro-life record, supported the bill stating that the issue was a choice between medical waste or medical research. Rep. Hilda Solis (D-California), health chair of the Congressional Hispanic Caucus, pointed out that Hispanic-Americans suffer from a range of debilitating diseases, bringing into focus the parallel issue of health insurance, cost of care, and access to treatment, all factors that add to the problem of the absence of break-through medical treatments for certain chronic diseases. Rep. Stephanie Tubbs Jones spoke about her father, now suffering dementia, who she said was a baggage handler for many years for United Airlines, and now can only barely recognize her. She hoped that stem cell research could offer some hope for her and others like her. Rep. Eliot Engel (D-NY) stated that there are an estimated 400,000 frozen embryos, many of which may be discarded over time.

For the opposition, Rep. Michael Burgess (R-Texas) an Obstetrics and Gynaecology physician, along with Minority Leader John Boehner (R-Ohio) and Rep. Christopher Smith (R-New Jersey) led the attempts to defeat the bill with the claim that any use of embryonic stem cells for research and development is objectionable and that in effect throwing them away is preferable. They made a series of assertions that stem cells from bone marrow, cord blood, amniotic fluid and placenta are sufficient because they do not involve "destruction of life" and that embryonic stem cells are tumorigenic. These are scientific and ethical controversies that presumably will be thoroughly vetted in Senate committee hearings in the coming months. So, the acrimony likely will continue for some more time.

There was a procedural maneuver by Rep. Burgess to recommit the bill to a committee hearing, but that attempt was defeated. At the end of the voting, Speaker Nancy Pelosi announced that the bill passed the House by a vote of 253 in favor and 174 against. So it is now on to the Senate.

By: Sunil Chacko