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A Retrospective of the Stem Cell Debate

By Michael Cook

Ten years ago embryonic stem cells were set to transform medicine. Ethics took a back seat to science, but the cures never came.

Let’s wind the clock back to 2003. In January, wheelchair-bound quadriplegic actor Christopher Reeve visited Australia to promote the legalisation of “therapeutic cloning”. This was absolutely necessary, he said, or patients would die needlessly. Scepticism about the potential of embryonic stem cells was utterly unwarranted. “That’s a myth. That’s not true. Don’t let anyone tell you it is a pipedream.”

In July the New England Journal of Medicine, the world’s leading medical journal, published a review article about the “promise of universal healing” in embryonic stem cells. “The Promethean prospect of eternal regeneration awaits us, while time’s vulture looks on,” the hyperventilating author wrote.

In short, people were excited. So excited, in fact, that in 2005 Australia passed legislation enabling “therapeutic cloning” for research purposes.

It’s hard to recapture the intensity of the debate at the time, both here and elsewhere. On the one hand stem cell scientists insisted that therapeutic cloning would lead to cures for Parkinson’s, Alzheimer’s and diabetes. On the other hand, dissenters contended that embryos were human beings and that it was moral madness to treat human life as a research tool. The stakes were immense; the dissenters lost. Ethics took a back seat to science. The loss of a few embryos was a small price to pay for cures, the public was told.

But the cures never came.

In the past 10 years the most significant event in stem cell research has been a colossal fraud. Science published two papers by Hwang Woo-suk, a South Korean scientist who claimed that he had successfully isolated human embryonic stem cells. He was feted as an international celebrity – but he was a fraud, his results were bogus and he had obtained human eggs unethically.

In 2011, after many false starts and a year after launching a human trial for spinal cord injuries to cure people like Christopher Reeve, the California-based biotechnology firm Geron pulled the plug on all of its embryonic stem cell research to focus on cancer drugs. It had to: it was going broke.

The latest sign of the times is that the leading lobby group for “therapeutic cloning” in the heady days of the US debate, the Coalition for the Advancement of Medical Research, wound itself up in May and merged with another organisation.

The reason why the prospects for embryonic stem cell research are so bleak is that it has been superseded by “induced pluripotent stem cells”. In 2007 Japanese researcher Shinya Yamanaka showed that it was possible to create stem cell lines from skin cells, without destroying embryos. Almost immediately, leading stem cell scientists abandoned embryonic stem cell research.

For various reasons some scientists continue to champion the cause of human embryonic stem cells. In May researchers at the Oregon Health and Science University announced that they had cloned human embryos and successfully extracted embryonic stem cells. The study was published in the journal Cell after a lightning peer review. It was a “tour de force” and “an unparalleled achievement”, said George Daly of the Harvard Stem Cell Institute.

The jubilation was short-lived. The main effect of this paper was to evoke the nightmare of the Hwang scandal. Some images had been duplicated and the editors of Cell had obviously jumped the gun. “It’s a degree of sloppiness that you wouldn’t expect in a paper that was going to have this high profile,” an expert told Nature. “One worries if there is more than meets the eye and whether there are other issues with the work that are not as apparent.”

So this is the sputtering end of the greatest bioethical battle of the 21st century: just another blip of embarrassment in the 24/7 news cycle. As the Boston Globe pointed out: “The emergence of reprogrammed stem cells, the difficulty of the involved method, and the obstacles to obtaining donor eggs for the procedure all make the advance more an important technical feat than a game-changer for stem cell scientists or a platform for new therapies”.

Isn’t it about time to establish a Stem Cell Truth and Reconciliation Commission? Governments around the world have passed laws enabling scientists to play God with human embryos. They are unlikely to be repealed. Foes of embryo research were called troglodytes and fundamentalists. Their scientific credentials were questioned. They were accused of being callous and indifferent to the suffering of patients with chronic illness.

And yet they were right. Not one person has been cured with embryonic stem cells. The solution, when it came, did not require the destruction of embryos.

Isn’t anyone prepared to say: “Sorry”?

Michael Cook is editor of the bioethics newsletter BioEdge.