Jeff Kahn: Debate over ethics of stem cell research

Dr. Jeffrey Kahn is the Director of the Center for Bioethics at the University of Minnesota, and a professor in the University's School of Medicine, School of Public Health, and in their Department of Philosophy. He writes a bi-weekly column about ethics for CNN. He joined the CNN.com chat room from Minnesota.

CNN: Thank you for joining us today, Dr. Jeff Kahn, and welcome.

JEFF KAHN: Hi, thanks for having me.

CNN: Does this decision balance the ethical concerns of the people who support stem cell research as well as those who oppose it?

KAHN: I think it both satisfies and angers both ends of the spectrum. On one hand, stem cell research will go forward with public funding. And on the other, no new embryos will be harmed. But 60 cell lines won't be enough to satisfy all the research needs as we move forward in this area. And I think to say that only 60 embryos were destroyed and that decision was already made tends to overlook the moral concern over making good uses of bad actions.

What President Bush's decision means Bush will allow federal funding for research on 60 lines of embryonic stem cells. These lines of cells have the ability to regenerate themselves indefinitely but not all have been approved by the National Institutes of Health, which sets federal standards for research. Embryonic stem cells have the potential to turn into any other kind of cell in the body, and have been looked to as possible treatments for Alzheimer's disease and Type I diabetes. VIDEO Watch President Bush's speech on federal funding for stem cell research (Part 1) (August 9) Play video (QuickTime, Real or Windows Media) Bush's speech (Part 2) Play video (QuickTime, Real or Windows Media) More video     MORE STORIES Bush to allow limited stem cell funding   Adult stem cells or embryonic? Scientists differ   Reaction mixed to stem cell decision   More stories     EXTRA INFORMATION Reaction to Bush decision   In-depth: The stem cell debate     RESOURCES CNN Access: Bioethicist on implications of Bush's decision   Message board: Stem cells and cloning

CHAT PARTICIPANT: When do scientists consider an embryo a life ?

KAHN: It depends on the scientist, but you'd get views ranging from "at conception" to "at birth". Many people consider the stage of embryos we're talking about to be "pre-embryos" since they are so early in their development.

CHAT PARTICIPANT: New embryos can be researched, just not federally funded though, right?

KAHN: Yes, that's correct. But federal funding is important for a few reasons. First, the federal government is the biggest funder of biomedical research in the world, so federal funding means much more and much faster research. And second, with federal funding comes federal rules, so it's much easier to control and oversee research if there is federal funding than if it all occurs in the private sectors.

CHAT PARTICIPANT: Dr. Kahn, will researchers be able to have access to most of those 60 stem cell lines as they are located in other countries?

KAHN: The problem won't be in access them because of geography -- they can be frozen and shipped anywhere -- but they may be costly since the 60 cell lines are controlled by private companies.

CHAT PARTICIPANT: Jeff, can you tell us who might be on the receiving ends of these funds??

KAHN: There will be a "request for applications" from the NIH and other agencies, and researchers will write grant proposals outlining the kinds of research they'd like to have funded. Mostly, that will come from universities and other research institutions.

CNN: Is there really any way to say whether this is ethical or not, or is it all subjective?

Karen Hughes: Bush "absolutely" kept his promise.

KAHN: I'm not sure I'd call it subjective, but there is certainly a range of opinion about whether stem cell research is ethical, and if so, under what conditions. We have to remember that lots of issues are controversial in our society, and we decide by majority not consensus.

CHAT PARTICIPANT: I am disturbed that I have heard the word "abortion" mentioned entirely too much through this whole debate over stem cell research. As far as I'm concerned they should be separate issues.

KAHN: It's hard to separate them, since for many people the destruction of human embryos is equivalent to abortion. I agree that they are not the same thing, but I don't think its legitimate to say we should only talk about one without reference to the other.

CHAT PARTICIPANT: What are the pros and cons of creating a registry?

KAHN: It depends what you mean by a registry. If you mean a collection of stem cell lines that could be accessed by researchers, there are some important things to consider. First, it creates a shared common resource for stem cell research. Second, it's limited to a few cell lines, which may peter out over time, and that have a limited range of genetic characteristics. We'll need to see what the research shows and hopefully be able to revisit the policy.

CHAT PARTICIPANT: Do Bush's restrictions on stem cell research give other nations a leg up over the U.S. on development of possible medical breakthroughs?

Like many scientists, Dr. Curt Freed was grateful Bush's decision didn't go further in limiting stem cell research.

KAHN: That's a very good question. The United Kingdom will certainly go ahead of the U.S., since they have approved research on not only stem cells, but on therapeutic cloning. That is, embryos can be made there for research purposes. A few prominent U.S. scientists have announced they are going to research institutions in the U.K. because it is so much more permissive there.

CHAT PARTICIPANT: Mr. Kahn. is there a worry about genetic weakness in using over and over again the stem cells from only 60 original stem cells?

KAHN: It's not clear whether the cells will continue to have all their original capacities, whether they are truly immortal, and whether they have a sufficient range of characteristics to satisfy all the research needs. We'll have to wait and see what the research shows.

CNN: What kinds of things will Bush's advisory panel have to take into consideration when it looks at stem cell studies?

KAHN: We don't know yet what the charge to the president's council will be, so that's a good question. Presumably, it will have to determine whether the 60 cell lines were appropriately obtained, whether proposed research follows some set of guidelines, what those guidelines should be, and even future policy for further stem cell research.

CHAT PARTICIPANT: Jeff, President Bush last night referenced Aldous Huxley's "Brave New World" in connection with embryonic stem cell research. I remember similar sentiments used when Louise Brown, the world's first test tube baby was born and now in vitro fertilization is quite accepted. Isn't it likely that stem cell research will be also quickly accepted?

KAHN: That's a good point. I think there is a history of public concern and even revulsion when new medical breakthroughs are announced. Think about heart transplants, artificial hearts, and test tube babies. But we come to embrace them eventually. There may be a similar course for stem cells. We'll need to wait and see.

CHAT PARTICIPANT: The moral concern over stem cells is the potential of life. Can these stem cells currently available have the potential to become autonomous embryos again?

KAHN: That's a good question, but the answer is no. Stem cells can go on and become any other kind of cell in the body, but nobody yet has figured out how to get them to reorganize into a whole embryo.

CHAT PARTICIPANT: Should we who are for stem cell research be concerned that Dr. Kass who is heading up the council is vehemently opposed to all stem cell research?

KAHN: I'm not sure he is vehemently opposed to all stem cell research, but he's certainly on the conservative end of the spectrum. Much depends on who else is appointed to the panel.

CHAT PARTICIPANT: If the scientists in the U.K. do find ways to use stem cells to cure some of these terrible diseases will Bush allow those therapies to be used here in the U.S.? And if so, isn't that a bit hypocritical?

KAHN: That's a good question. I think if the therapies are created within the laws and rules of these other countries, then they can be imported to the U.S. unless laws are made to prevent that. It's a problem not only of being hypocritical, but it shifts the economic and intellectual capital overseas.

CNN: If a treatment for a disease is found from stem cell research, will that change the equation -- will it then be unethical to Not pursue the work?

KAHN: The realization of benefits will certainly put more pressure on policy makers to find ways to allow and even fund the research. So the practical equation will certainly shift. It may even alter the moral balance, depending on how much stock you put into utilitarian forms of ethics.

CHAT PARTICIPANT: Are there different types of stem cells that could be differentiated as to being a viable candidate for the study and those that are not?

KAHN: I'm not sure the research is far enough along to answer that question yet.

CNN: Is there a time frame for finding a cure to something? Medical research can often take many years to be successful.

KAHN: You're right, it can take many years for research to go from the laboratory bench to the bedside, and federal funding should help make that process faster and even more efficient.

CNN: Do you have any final thoughts to share with us?

KAHN: It will be interesting to watch both the Congress and the new oversight panel as this issues goes forward. Stay tuned.

CNN: Thank you for joining us today

KAHN: Thanks for having me, it's been fun as always.

Dr. Jeff Kahn joined the CNN.com chat room by telephone and CNN provided a typist. This is an edited transcript of the interview which took place on Friday, August 10, 2001.