The Stem Cell Debate: Science vs. Deception
An Interview with Richard Doerflinger

John Mallon
Reproduced with Permission

Richard Doerflinger is the U.S. Bishops' bioethics expert who spoke last September at an important conference in Rome on stem-cell research. A shorter version of this interview appeared under the title "Stem Cell Debate" in the December 2006 issue of the Italian publication, Messenger of Saint Anthony. It is published here with their kind permission.

Richard M. Doerflinger, Interim Executive Director of the U.S. Bishops' Secretariat for Pro-Life Activities, took part in an international congress titled "Stem Cells: What Future for Therapy?" September 14-16 at the Augustinianum Institute, adjacent to St. Peter's Square in Rome. The congress, featuring researchers from around the world who have published advances in the use of non-embryonic stem cells, was co-sponsored by the Pontifical Academy for Life, and the International Federation of Catholic Medical Associations.

Speaking at the conference in Rome Doerflinger said that embryonic stem cell research continues to pose the ethical problem of destroying human embryos, but increasingly poses the ethical problem of deceiving the public as well.

Mr. Doerflinger has testified before the U.S. Congress, the National Bioethics Advisory Commission, and the National Institutes of Health on ethical issues involving human embryo research. He has also published widely on this and other medical-moral issues. He holds a B.A. degree and an M.A. in Divinity from the University of Chicago, and conducted doctoral studies in Theology at that institution and the Catholic University of America.

Mr. Doerflinger, could you tell us about this conference in Rome, which included an audience with the Holy Father? What were the goals and objectives of the conference?

This is one in a series of conferences that have been sponsored in recent years by The Pontifical Academy for Life, an advisory group to the Vatican and the International Federation of Catholic Medical Associations. A previous conference in 2004 dealt with the problem of patients in the so-called "vegetative state" and the moral obligation to provide food and fluids for them. This issue of stem-cell research is another neuralgic issue of medicine and ethics that the conference was designed to shed light on, especially the great promise of adult stem cells that do not require any harm of embryos or any moral problem.

I'll get right to the million-dollar question: if the use of embryonic stem cells has been both unsuccessful and unethical, and the use of stem cells from adults, umbilical cord blood, and so forth, has been successful and ethical, why the resistance to adult stem cells and the huge push for embryonic stem cells?

There are several reasons. First, the researchers do think that embryonic stem cells might be more flexible, more useful for certain kinds of basic research, not so much for direct cell therapies, (though they tend to get misrepresented as useful for those therapies), but for studying disease models and so on. Obviously, if they end up with the right to make embryos to order, by cloning, they would have much more control over studying early human development and perhaps even get to the point of making tailored children, in the future. There are a number of reasons why the researchers want the embryo to be established as an object of research, even beyond stem cells.

Also, I think there's an economic bias. Biotechnology companies want a product they can bottle and sell, and patent. And that's much less true of adult stem cells - you cannot patent the stem cells that are in a person's own body. You cannot patent a surgical procedure for using those cells to heal that person. But if they could derive treatments from embryonic stem cells, they would have a product to sell and of course they would not have to share the profits with the donor, who has been destroyed.

Lastly, I think there is a built-in tendency in the scientific community to stand for the principle that society cannot tell them what not to do. And they are especially resistant to any limits that seem based on moral and religious grounds.

Many scientists are a-religious; I would say that a number of leaders in the field are anti-religious and they do not want any precedent set that "moral limits coming from outside science" can tell them what avenues not to explore.

Just in researching it, some of the things you uncover begin to sound like a Gothic horror tale from La Belle Epoch. For example in front of me I have a story I just printed off the Internet entitled, "Scientist to Create ‘Frankenbunny' in Big Research Leap." This whole issue of chimeras - animal-human hybrids - comes up. How much of this and the other issue of cloning, overlap with this stem cell question?

Well, the Frankenbunny thing is a little misleading because their real goal there is to clone human embryos but to use rabbit eggs for the project so they cannot be accused of exploiting women for their eggs. So the Frankenbunny experiment is very much geared toward human cloning. They feel that because the egg in the process has its own nucleus taken out, virtually all the genetic material in the new clone would be from the human cell they put into that egg. There would be a little residual of what they call mitochondrial DNA from the cell mass of the egg, but it does not seem to have much effect on the actual traits of the being that results. So, this is a sort of dodge to avoid the ethical problem being raised of harming women for their eggs. But of course, the ultimate results of mixing human and animal material that way is unknown. There are also experiments in the hybrid field where scientists have injected human brain cells into mice to study the brain and to study brain diseases. Some have said that it would be very interesting to produce a mouse that has all human brain cells. I guess you would call it a Stuart Little experiment.

What are the ethics of that? I assume taking human brain cells doesn't harm the human...

Yes, on the one hand, there are times when you can do xeno-transplantation - use a pig's heart valve, for example, in a human being to repair the heart. But the problem with this experiment, putting what might be an entirely human brain, human brain cells, into a mouse, is that you have then created a being to which you can never figure out your moral obligations. Could this being actually produce any kind of human consciousness? If so, is this now a person that we would have to respect and not treat as a laboratory animal? If you don't know, and you cannot resolve that question, you'd be morally obliged not to make the attempt.

And of course no one knows the answers...

And then, you know, either you would have to treat that mouse as an incipient human, which people would be very hesitant to do, or you destroy it as a laboratory animal and then you risk violating a very serious moral norm. So, the, I think the project of making any being whose species membership we cannot quite figure out would be morally problematic.

Yes, speaking of morally problematic, I just read your remarks to the conference, and you raise the interesting issue about deception towards a perceived greater good. You mentioned several highly respected medical journals that published false reports. Did they do so knowingly or did they find out later?

In the case of Nature and Science and the [Dr. Woo-Suk] Hwang cloning report, I think they were taken in as much as anyone else. I mean, the project produced plausible-looking data, and they could not have known from looking at it, initially, that it was fabricated.

In the case of the new study by Robert Lanza, of Advanced Cell Technology (ACT), in Worcester, Massachusetts, saying he had derived stem cells without harming the embryo, the article in Nature I feel was very misleading - the data were correct - but the actual description of what was done was so misleading that it took a good deal of digging to figure out that they had in fact destroyed all these embryos and that the technique might actually need to do that in order to succeed. Nature did end up apologizing for its initial press release, which they said was misleading, but I don't think they've ever really apologized for the article itself, which I think was almost as misleading.

The New England Journal of Medicine, misrepresented two existing studies using stem cell lines eligible for federal funding as though they were from cloning in order to highlight the great progress of human therapeutic cloning. Certainly the author of the article must have known what he was doing; it doesn't take a scientist to read the article and see that they're saying these are from ordinary fertilized embryos. Did the editors know what they were doing? Either that or they were asleep at the switch. They didn't review this article's footnotes at all.

You have a devastating statement: "To overcome the moral objections many people have to destroying human embryos, researchers justify their work by promising 'cures'. As these exaggerated promises have failed to produce results, the researchers have felt obliged to exaggerate and deceive more and more to maintain public trust and financial investment in their efforts in the hope that they will ultimately solve the practical problems and produce the cures that will make everyone forget their past ethical lapses."

Now that's a very exact description of what was going on with Dr. Hwang in South Korea, but I think it is a broader problem.

It raises an issue, certainly a moral and ethical issue, which moves into Catholic philosophy. As you mention right after that, the matter of the end justifying the means and utilitarianism. Are we to expect the corruption and deception to stop at a certain point, once they've achieved their goals? I think Catholic philosophy would say the corruption without repentance becomes a continuum of its own.

I think that's true, and I think that we've seen this kind of exaggeration before. I mean I think the dry run for the current wave of hype and exaggeration took place in the late 1980s and early 1990s with the campaign for federal funding of fetal tissue transplants from abortion. The same kinds of promises about miracle cures were used to gain this federal funding. The ironic thing is that the funding was achieved - President Clinton freed-up funds for this research and Congress later followed him. And the research was a disaster. The federal government spent millions of dollars finding out that this tissue makes some Parkinson's patients worse and leads to uncontrollable shaking that there doesn't seem to be any remedy for. But people have short memories, and they did not learn then that these medical and scientific groups sometimes exaggerate what they know in order to win public approval.

It goes back to the Frankenstein business, "Well, we'll lie about this now but we'll be heroes in the end and everything will be fine." But the curious thing seems to be, that with all the successes produced by adult stem cells, and those from cord blood and placentas, and so on, there almost seems to be a mania - an obsession with - embryonic stem-cells. Would you say this part of the Culture of Death?

I do think it's part of the Culture of Death because it shows an actual preference for pursuing medical progress by lethal means, even when the evidence shows morally unproblematic ways to achieve the same goal - perhaps even to achieve it more easily.

I think there are parallels elsewhere in the pro-life movement where we see that. It is interesting in the Holy Father's remarks where he speaks of the frequently unjust accusations of insensitivity addressed to the Church. It seems to be an easy sound byte for the proponents of embryonic stem cells to repeat some old refrain that the Catholic Church is standing in the way of progress, is uncaring, and so forth.

I was at a debate on this issue in Michigan yesterday, Cooley Law School in Lansing, and my opponent, my debating partner, started by saying that 128 million Americans are in need of treatments that can be achieved only through embryonic stem cells. Those who stand in the way of this research will be responsible for the deaths of those 128 million people. And that is their central argument. It's preposterous! They don't know at this point whether embryonic stem cells will ever work for a human disease and they certainly don't know that it will be as good at treating disease as are other alternatives, such as adult stem cells. But they assume the truth of this and then they accuse us of being insensitive to suffering and dying patients. The irony is that the Catholic Church has been very active in these promising avenues using adult stem cells. We have a rendition of some of the ways the Church has taken a positive role on the website of the [U.S.] Bishops' Conference, but among other things we were very active - in fact, we were cited by the sponsor of the bill as the first group that was instrumental in passing a major bill last year to create a nationwide public bank for umbilical cord blood stem cells, which has been associated with successful treatment of dozens of diseases. The main problem with cord blood is simply lack of supply - most cord blood is still thrown away in this country, instead of being banked for public benefit.

An easily remedied situation.

Right. It's simply a matter of supply - simply providing the money and the infrastructure to create a sizable enough supply of cells. Now the Church is very active in that. The Church in Australia has actually been a funding source for some groundbreaking adult stem cell research. They actually, directly, provided a grant that led to some new discoveries in versatility of adult stem cells. Some of the groundbreaking work in the use of adult stem cells for heart repair was done at St. Elizabeth's Caritas Christi Hospital in Boston, a major Catholic medical center. And so on. So to say that we're standing back and ignoring the suffering of millions when we are actually the ones who are benefiting patients, and they are not, is especially galling.

It's almost like those who blame the Church for AIDS ... if people...

Yes, if people had actually listened to the Church on AIDS there would be no AIDS.

Right. So, tell us about some of the positive effects of the licit procedures with adult stem cells, actually promising the kind of cures the others can't deliver...

Well, I think it's important not to err ourselves on the side of promising cures for everything. There are some very successful treatments in common use now, mainly in blood conditions and leukemias, there are many more conditions that are shown in peer review journal articles to have benefited patients with dozens of diseases in early trials. They will have to be pursued further to see whether they will become accepted and established treatments for patients everywhere. But to give you just one illustration, the National Institutes of Health has a website documenting the clinical trials for new treatments that are ongoing in medical centers around the country, and there are over a thousand entries from clinical trials using adult stem cells. I think 500 of them are continuing to accept new patients for the trials. There is nothing using embryonic stem cells. It has been said there is peer-reviewed journal literature documenting benefits for patients with 72 conditions now. And those are documented on the website

So it is making quiet progress despite what you see in the media...

Quiet and underappreciated progress. This is beginning to show great benefit for patients with heart damage, lupus, multiple sclerosis, and corneal damage - people have had their sight restored, they can see. Some early and very intriguing results in spinal cord injury, though so far, not a cure. But people have regained sensation and some movements that they had lost for years following this adult stem cell surgery. So the future seems bright if these treatments continue to be developed and refined. They may well provide cures for many conditions. Certainly the evidence is stronger for adult stem cells than for embryonic.

So, in closing, what was the outcome of the Rome meeting?

Well, the Rome meeting brought together scientists from around the world who are pioneering new research and treatments using adult stem cells. These scientists were able to share their latest advances and talk about what they're about to do next in terms of moving toward treatments. And it also included discussion of some very intriguing experimental ways to create embryonic-like stem cells without destroying embryos. There were a number of studies presented on that theme. There is a lot of work being done now in the reprogramming of adult cells to act more like what are called pluripotent stem cells that have great versatility. So there was some cutting-edge research being presented on creating cells with the properties of embryonic stem cells without harming or creating embryos. So the scientists were saying, "Well, if it is true there might end up being some uses for embryonic stem cells that cannot be duplicated we may even be able to provide an answer to that, through further development of cell reprogramming and other new advances.

It's very exciting. How was the meeting with the Holy Father?

It was very inspiring. His speech actually was in Italian and we didn't get the English translation for a little while. It was a very resounding reaffirmation of the Church's moral stance against any suppression of human life in the name of progress. And he had very kind and encouraging words to say to all the scientists who are exploring morally acceptable ways to do stem cell research. The gathering itself was a love-in, I would say. We were also surprised that the Holy Father was so accessible - this was only three days after his lecture at Regensburg, which was taken by some Muslims as such a slap at Islam because of his quoting of a 14th-century emperor. We saw no added security or other precautions against the Holy Father being able to meet and discuss with us on these topics.