Daniel Herbster reporting
Dr. David Prentice is one of the foremost experts on bioethics in the country. He has valuable science experience from his days as researcher and teacher, and he now works for groups like the Family Research Council and Do No Harm speaking out on some of the most important (though sometimes confusing) ethical issues facing our society today. I’ve had the opportunity to meet Dr. Prentice a number of times and have heard him speak often so it is a distinct pleasure to interview him today and share with you his scientific expertise.
DH: First off, tell our readers a little about yourself. What did you do before you came to FRC? What are your responsibilities at FRC and Do No Harm?
DP: Before FRC, I spent almost 20 years as Professor of Life Sciences at Indiana State University, at the same time as Adjunct Professor of Medical & Molecular Genetics for Indiana University School of Medicine.
During those years I taught and did lab research, and also spent a few years in administration.
My job description now is somewhat similar: I lecture, give briefings, and testify about science, especially the scientific facts regarding stem cells, cloning, and other biotechnologies.
DH: You often hear people say that we should “leave science to the scientists,” that we who have ethical concerns with particular research techniques have no right to an opinion if we are not scientists ourselves. Is this true? Do we as a society have a stake in deciding what research should or should not be allowed? Why is this notion so dangerous?
DP: Some scientists might like that, but the fact is that society sets the agenda, both in terms of what's allowed as well as what resources are provided to science. Everyone has a stake in this discussion, because everyone is affected. Leaving these decisions just to one group means we abdicate our responsibility to help form a strong society.
DH: Dr. Prentice, what are stem cells?
DP: A stem cell has 2 main characteristics: (1) It continues to grow and divide, making copies of itself, and (2) given the correct signal, a stem cell can form many different specialized cells of the body.
DH: What are the two general types of stem cells, and are there any ethical differences between them?
DP: In general there are embryonic stem cells and adult stem cells.
Embryonic stem cells come from the early stage of life, the embryo, about 5-7 days after conception. The usual method of isolating embryonic stem cells destroys the young embryo, which leads to the ethical problem with these cells--it requires destroying young human life.
There are also practical problems with embryonic stem cells. Despite the hype about potentially curing all known diseases, there are zero patients that have been treated with embryonic stem cells, because they're not safe. They have a nasty tendency to form tumors, or misplaced tissues, or not stay where they were put. Practically, they are not a very good way to treat diseases.
Adult stem cells come from virtually any tissue of the body after birth, and are also found in umbilical cord blood, the placenta, and amniotic fluid. Harvesting adult stem cells doesn't destroy or harm the donor, so adult stem cells are not ethically a problem.
But the most exciting news is that adult stem cells really work! They have already helped improve human patient health, as documented by peer-reviewed published scientific results for over 70 different diseases and injuries. Thousands of patients are better, and alive today, because of adult stem cells.
DH: Explain for us the recent discoveries involving induced pluripotent stem cells (iPSC), and how could these discoveries revolutionize the stem cell and cloning debates?
DP: The induced pluripotent stem cells (iPS cells) are actually embryonic-type stem cells, but they are obtained without the use of embryos, eggs, or cloning. Dr. Yamanaka in Japan pioneered this work, and others have now repeated his experiments. He started by taking an ordinary body cell such as a skin cell, and adding to that cell 3-4 genes. The added genes "reprogram" the skin cell, and it looks and acts just like an embryonic stem cell.
One exciting aspect of iPS cells is that there are no embryos, eggs, or cloning involved, so these "embryonic-type" stem cells can be made ethically. So, if scientists think they need embryonic stem cells, they can get them without ethical concern. They're also easier to make than typical embryonic stem cells--in just a few months, several labs created over 100 different samples (termed "lines") of iPS cells.
Another exciting aspect is that iPS cells can be made directly from a person, including patients with various diseases. This means the iPS cells "match" the patient, so that scientists can study the disease in the lab using these iPS cells, and perhaps even use them to transplant back into the patient without transplant rejection.
DH: What is somatic cell nuclear transfer (SCNT), and is it true that it is really a type of cloning?
DP: Somatic Cell Nuclear Transfer (or Transplantation) is the technical term for cloning of an organism. The term describes the process. A somatic cell (which is just a body cell) has its nucleus (chromosomes) transferred into an egg (the egg previously had its own chromosomes removed.) So the 2 components for cloning are a nucleus and an egg.
Once those are recombined, a new embryo has been formed.
It's sometimes termed "asexual reproduction," because there is no sperm involved. But the result is still an embryo, indistinguishable from an embryo made the "old fashioned" way by combining an egg and a sperm. It can still grow and develop if allowed. This is how Dolly the cloned sheep and all the other cloned animals were created.
Sometimes people try to separate what is subsequently done with the cloned embryo into different types of cloning. The terms used are "reproductive cloning," in which the embryo is implanted into a womb in hopes of a live born clone, and "therapeutic cloning," in which the embryo is destroyed after a few days for its embryonic stem cells. But it's the same embryo, created the same way by SCNT; the only difference is what is done with the cloned embryo. And of course "therapeutic cloning" is not therapeutic for the embryo--the embryo dies in the process. There are also no therapies from "therapeutic cloning."
DH: What is the issue going on in Missouri, and how could what happens there affect the rest of the country?
DP: In Missouri in 2006, a state constitutional amendment was passed (Amendment 2) that redefined cloning as only occurring when the cloned embryo is placed into a womb. Many people were deceived because those promoting Amendment 2 claimed that they were banning human cloning and protecting research on lifesaving cures. But what it really did was make Missouri the "Clone Me" state, allowing cloning of human embryos for research and destruction, and not actually changing anything regarding the legality of any stem cell research or human treatments.
The amendment barely passed in 2006, because many people learned of the deception, but some didn't hear until too late. So those who are against all human cloning, for whatever purpose, are trying to put through a new ballot initiative that will truly ban all human cloning.
There has been some delay in the courts, with a fight over how the ballot language would read, so it may be 2010 before a new ballot initiative is before the citizens of Missouri, but hopefully they will have a chance to vote on a real cloning ban.
DH: What are some specific pieces of legislation in Washington relating to bioethics issues that you think should be passed or should be opposed?
DP: Senator Brownback has two bills awaiting action--one bill would prohibit all human cloning by the SCNT process, the other bill would prohibit creation of animal-human hybrids (sometimes called "chimeras") by various methods. (In the House, Rep. Dave Weldon is sponsor of the bill to ban all human cloning, and Rep. Chris Smith is sponsor of the bill to ban creation of animal-human hybrids.) Both of these bills should be passed.
Another good bill that should be passed is the Patients First Act, co-sponsored by Rep. Randy Forbes and Rep. Dan Lipinski. This bill would prioritize funding of stem cell research so that federal funds first go to stem cell research that has the best chance to help patients in the near term, not decades from now.
Another good bill that should pass is the "Prenatally and Postnatally Diagnosed Conditions Awareness Act,” again sponsored by Sen. Brownback. The idea is to make parents and doctors better informed about the range of choices and support available for babies diagnosed, in the womb or soon after birth, with Down's syndrome or other genetic conditions, saving lives and helping parents.
There is some bad legislation. Senators Feinstein, Hatch, Kennedy, Harkin, & Specter have sponsored a bill that would allow cloning of human embryos, then require their destruction.
We've also seen two attempts to open season on embryos in frozen storage at IVF clinics. Though in both attempts the bills were vetoed by President Bush, we've already heard that Rep. DeGette will be pushing similar legislation again.
DH: How could our readers get more involved on these crucial bioethics issues, and how can they educate themselves more fully?
DP: First, your readers should educate themselves on the real facts of the debate. This doesn't mean they have to become scientists! But there is a great deal of misinformation and deception, with the terminology as well as the actual results seen with adult vs. embryonic stem cells. So your readers need to check the real facts.
Two good websites that can help are:
Do No Harm http://stemcellresearch.org/
Family Research Council http://frc.org/
Both websites have lots of basic information, and also stories about some of the patients who have already been helped by adult stem cells.
Second, your readers need to make their voices heard. They should call, write, e-mail, and/or visit their elected representatives, at the state and federal level. These debates are going on in the states, in Washington, D.C., and around the globe. Our elected representatives need to hear from us, on what direction we want society to take.
Write letters to the editor, call up talk radio, giving some of the real facts or rebutting some of the misinformation that often finds its way into the media.
And tell others. Sometimes the best way to spread the truth is in person.
DH: What are other bioethics issues you see on the horizon of which we should be aware?
DP: We've already mentioned one example in the legislation above--animal-human hybrids. Since cloning requires lots and lots of eggs, and human eggs are scarce and their harvest can risk women's health, some scientists have decided that cloning can be done with animal eggs (human DNA into animal eggs.) There are also some who want to combine different animal and human components. Unfortunately, the U.K. has just approved this research.
Other areas include genetic engineering and genetic discrimination.
One good bill that just passed Congress is the Genetic Information Nondiscrimination Act (GINA), which would help prevent discrimination based on information from genetic tests. But there will continue to be a push to use more and more genetic information, or even to engineer human embryos.
DH: On a personal note, what drew you to the field of science, and what prompted you to leave the classroom and the research lab to get involved in the public policy debate?
DP: I've always had a curiosity about how things work, and especially about biology and cells in particular. It's fascinating to see the complexity in just a single cell, to try to understand how it functions, and how cells work together.
As science and biotechnology became a bigger and bigger issue in policy debates, I kept getting asked to explain these issues to the public and to politicians, so they could make informed decisions based on facts and not hype. Once there was an opportunity to do this full time, I took it. But in a real sense, I haven't left the classroom. I'm still working as a professor and teaching, because these are issues in which people need to be educated, even if it's not the traditional classroom.
DH: Dr. Prentice, it’s great to get in touch with you again. Thanks so much for taking the time to share your thoughts and expertise with our readers. Keep up the great work!