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The Waiting Line for Stem Cell

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Message Edward McSweegan
The Waiting Line for Stem Cells

In June 1942 there was just enough penicillin available to treat ten patients. This first antibiotic was so valuable and so hard to produce it had to be recycled from patients' urine. A similar scarcity plagued insulin therapy when it was used to treated diabetes twenty years earlier. Then a dying Leonard Thompson had to wait two weeks between insulin injections for scientists to prepare more of a crude pancreatic extract containing insulin. Even today, about 500 heart patients die each year while waiting for a donor organ to become available. Cutting-edge medical therapies are always in short supply and there is always a waiting line for them.

That will also be true for whatever therapies eventually emerge from the study of stem cells. Fortunately, the waiting line won't be as long as it could be; many people apparently are opting out on religious and political grounds.

Stem cells are those wonderfully plastic cells that have the potential to mature into various specialized cells needed to make new bone, skin, organs and nerves. They are like college freshmen who have not yet declared a major and committed themselves to a single career track as accountants and teachers, or in this case, as red blood cells and neurons.

The problem is the best stem cells are harvested from surplus embryos (called blastocysts), which are microscopic clumps of 200-250 cells. Somehow these tiny aggregates got caught up in the violent politics of "pro-life" and abortion-even though they are collected from fertility clinics-and in 1995 Congress banned embryonic stem cell research from receiving federal funds. (The 1998 work that led to the first isolation of human embryonic stem cells was supported by private funds.)

Yet, the potential for new therapies based on the versatile stem cell remains high, and efforts are underway across the country to bypass a religiously correct congress and a fundamentalist president in order to fund new experiments and start treatment trials.

California led the way with a recent $3 billion commitment from voters. Not wanting to miss the economic benefits of new technologies and biotech businesses, other states (Massachusetts, Connecticut, Wisconsin, New Jersey, Maryland and Illinois, for example) also are working on stem cell legislation.

Yet, at least five other states specifically ban such research, and in the absence of federal guidance and traditional funding from the National Institutes of Health, a balkanized research effort is emerging across the country.

Eventually, this fragmentation will complicate patient recruitment for clinical trials of stem cell-based treatments. Doctors will not only have to screen patients for appropriate medical conditions, but also for state residency. Perhaps too they'll have to query patients about their political affiliations and religious beliefs. That's an ugly thought, but one necessitated by the organized opposition of biomedical Luddites determined to preserve other people's pain and suffering.

After putting up $3 billion, California taxpayers will expect to be the first to benefit from any stem cell therapies and products. They're not going to let Nevada residents cross the border and cut in line. They're certainly not going to let anti-abortion hypocrites from Bible Belt states take advantage of research fought and paid for by Californians.

Those who oppose funding stem cell research should have no expectation of taking immediate advantage of medical advances arising from that research. Hypocrites and naysayers, move to the back of the line.

A few stem cell opponents have shown enough integrity to stay out of the waiting line altogether. During a stem cell hearing in Maryland last year, a wheelchair-bound opponent suggested that "each embryo destroyed for research is a life not allowed to reach its full potential." As proof, he offered up his young daughter who once was a frozen embryo in a fertility clinic.

A compelling argument perhaps, yet he seemed to lack both an awareness of his own full potential lost to a paralyzing accident, and the imagination to see himself one day walking his daughter down the aisle after having his shattered spine repaired.

As with past medical advances, stem cells may prove to be something other than what today's hype and hysteria predict. More research will tell. In the meantime, a fundamentalist minority should not be allowed to prevent others from trying to reach their full physical and mental potential through advances in medical research.
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Edward McSweegan is a microbiologist and writes a column on infectious diseases for The Capital newspaper in Annapolis, Md.
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