Attorney R. Martin Palmer, Hagerstown, Maryland, contacted me on 4 October, 2004 relative to oral arguments before the Fourth Circuit Federal Court of Appeals in the case of Mary Doe, et al. v. Donna Shalala (C.A. No. PJM-99-2428). Attorney Palmer is the Counselor of record for Mary Doe, a frozen "spare" embryo. He wished to have clarification of a statement from the NBAC (National Bioethics Advisory Commission) "Ethical Issues in Human Stem Cell Research, Executive Summary" (September, 1999) ("NBAC Report").
Specifically, the wording in the report on which he wished me to comment was the following: "At this time, human stem cells can be derived from, among other sources, human fetal tissue following an elective abortion, and human embryos that are created by in vitro fertilization that are no longer needed by couples being treated for infertility."
My answer follows:
13 October, 2004
R. Martin Palmer
Attorney at Law
21 Summit Ave.
Hagerstown, Maryland 21740
First of all, the way some proponents for human embryonic stem cell research throw the terminology around makes me wonder if they really know what they are talking about. Let me say, flat out, that some of them simply do not.
This was true about the NBAC, a reflection of the fact that no human embryologist was a member of that Commission. I read the entire series of transcripts by the NBAC and I was astounded at some of the false information they put out.
The citation you are concerned about strongly suggests that there is a contradiction of terms, and here is one of the concerns I had in reading the NBAC proceedings. Traditionally, the term "embryo" is applied as soon as there is fusion between the oocyte and the sperm. This designation continues until the end of the eighth week. At the beginning of the ninth week the new individual human life is referred to as the "fetus". By this time virtually all of the major organs and organ systems have been initiated. Also, the facial plates begin to develop much more rapidly, and differentiation of the reproductive system begins; that is, whether or not the phenotype will be shown to be male or female. Please note that the gender, under normal circumstances, has already been decided at fusion [fertilization].
Bear in mind that the terms "embryo" and "fetus" are taxonomic designations. These distinctions allow human embryologists to talk to one another, and to obstetricians and gynecologists. True, however, these terms have been abused, and the citation you write about may well be one of those instances.
One of your statements, which most likely come from the NBAC report, is: "Embryonic stem cells, found in early-stage embryos, retain the ability to develop into nearly any cell type." There is something fundamentally troubling about this statement. A "stem cell" is by definition a reparative or regenerative cell [see my article on the origin of stem cells which I sent to you some time ago]. This term has been commandeered by some to imply that cells of the early human embryo, say the 2, 4, or 8 cell age, and even the blastocyst age which may contain anywhere from 60 some to 160 some cells, may form any tissue of the body. This claim is made simply because the entire body continues to develop from those early ages.
Two things are important to know here: 1. In the continuing development of the entire body from these early ages the cells of those early ages go through countless generations; and, in doing so, many, many changes are occurring in those developing cells and tissues. The cells are essentially "talking" to one another, and passing information, signals, and directions back and forth, until they are fully differentiated. During this transformation process, true "stem cells" are being formed in virtually every tissue of the body, not all, but almost all. 2. At the present time, as far as I know, and I try very hard to read the current literature, the culturing process of those human embryonic "stem cells" [hesc] has not met with sucessful "tissue lines" and the cell lines formed are not responding well.
Is it any wonder? In the culturing process, the generations of cells are shortened or even bypassed. What might be missing in the cultured lines which ordinarily would be present during normal embryogenesis? This is a reasonable question to ask and an important one.
Keep in mind that as a scientist I do not necessarily preclude good and beneficial results from the efforts to attain useable and therapeutically useful definitive tissues from the efforts to use hesc. But, to date, the evidence does not seem to be there.
Secondly, you ask about the NBAC statement: "human stem cells can be derived from, among other sources, human fetal tissue following an elective abortion. . . ". Here is where it is likely that a contradiction of terms has occurred. The fetus, by definition begins at the start of the ninth week. If , as it is claimed, that "human stem cells" can be derived from a fetus, it would have to involve one or the other of two things: 1. those "stem cells" would actually be "adult" stem cells. They would already have been differentiated beyond the state for "stem cells" from early human embryos. Or 2. they could be talking about the "primary germ cells", often referred to as the "germ line". These are cells called Oogonia and Spermatogonia, which give rise to the egg and the sperm. They remain only partially differentiated in the fetus. But, if , in fact, that is what they are referring to it would be labor intensive and probably unredeeming to try to dissect them out of the young fetus.
The rest of the quote states: ". . .and human embryos that are created by in vitro fertilization that are no longer needed. . . .". Here they are talking about the "spare" embryos left over from IVF procedures. These are the ones kept frozen in liquid nitrogen.
Finally, my conclusion is that the statement you are concerned about is a conflation of terms, probably originated from their ignorance. Whether or not the "stem cells" come from the early human embryo, or the fetus, the new individual must be killed in order to obtain those cells. Whoever coined this sentence did not make it clear as to what they are talking about.
One other thing comes to mind about the invocation of "fetal tissue" and this might refer to cord blood. But, of course, they do not say this and likely this is not the case. Cord blood is rarely referred to as fetal tissue, and it would be a misnomer to do so.
This is how I see it.
If there is anything else please contact me.
In fact, you should either give this information to the Judge or read it to him.
I am sure he has seen conflations before.
C. Ward Kischer, Ph.D.
Emeritus professor of Anatomy
University of Arizona
College of Medicine
6249 Camino Miraval
Tucson, Arizona 85718
e mail: firstname.lastname@example.org