joel's thoughts

The weather and computers and education are all well and good, but I haven’t said much about politics. I tend to be a peacemaker, sometimes to a fault, and I tend to prefer engaging, ongoing discussion rather than polarizing polemics. So in politically mixed company I generally hesitate to clearly state my positions or thoughts on a given issue for fear of being either pigeonholed and dismissed or attacked and forced to back down, as I don’t think very well on my feet (I’d make a terrible politician — I’d always be saying, “Let me get back to you on that…”). Even here in my blog I’ve hesitated to say what I think for fear of alienating someone, silly though that sounds.

Well, that’s enough of that. I have to say something today, because a guy named Arthur Caplan really got to me. He holds a Ph.D. in the history and philosophy of science and is director of the Center for Bioethics at the University of Pennsylvania, so in theory he knows a thing or two about biology and medicine and ethics. Apparently he’s also very skilled in missing the point. In his commentary he lambasts the Bush administration for its position on federally-funded stem-cell research as dishonest, morally obtuse, and full of “chutzpah”. Chutzpah I’ll grant, if only for having the guts to take a moral stand on a very morally and politically controversial issue. Morally obtuse I might grant as valid from the perspective of someone coming from a different ethical worldview, although Caplan’s support of this claim is itself rather politically obtuse if not blatantly deceptive.

Worthwhile research needs funding, and research that is hopeful and promising and might someday soon Make Things Better will shrivel up and die for lack of funds. Dr. Caplan, however, would have us believe that funding is federal funding, or the project is dead. To hear Caplan tell it, in turning off the spigot Bush essentially passed a law banning all embryonic stem-cell research and declaring researchers felons. He did no such thing, although it must be noted that Germany, Australia, Canada, Norway, and of all countries France have in fact made “therapeutic cloning”, the manufacturing and cloning embryos for the purpose of stem-cell research, a felony.

What Caplan doesn’t mention is that in the world of research funding, there is federal money and there is private money. Bush essentially said that we, the American Public, will not pay for destroying more embryos. If you want to do it, get someone else to pay for it. Caplan himself says that “embryonic stem-cell research and cloning research have drawn huge interest” from, among other groups, the biotechnology industry. He fails to explain, though, why that “huge interest” hasn’t translated into research dollars. Most businesses I’ve come across tend to be rather profit-motivated, and if those with deep pockets see an opportunity to make their pockets deeper, they’ll invest. So why don’t they?

I’ll tell you why they don’t. The fact of the matter is that embryonic stem-cell research is anything but hopeful and promising. It’s a pipe dream. Experiments using stem cells from animal embryos have been far from successful, as apparently embryonic stem cells are unstable and unpredictable. The private sector knows this, and has little interest in throwing money away on research unlikely to prove worthwhile anytime soon, much less research based on a highly controversial practice such as manufacturing and destroying embryos. That’s why California has Proposition 71 on the ballot, which would borrow several billion dollars to fund embryonic stem-cell research. Advocates are trying to put it on the public tab because private investors have no interest in funding pipe dreams.

Private industry is putting money into stem cell research, but it’s research on adult stem cells, not those from embryos. Before launching his tirade Caplan gives us a brief overview of adult vs. embryonic stem cells, without going in to the current usefulness of adult stem cells today (here’s a better overview, by the way). The fact is that adult stem-cell research has already led to medical advances for what had previously been incurable diseases, and that’s where the private money is.

On a side note, there are three other potential sources of stem cells. One is from fetal tissue, taken from aborted fetuses. Caplan wisely avoided recommending that one, though I’d be curious how he felt about it in private. The other two are from the umbilical cord blood and the placenta, currently discarded after a baby is born. Caplan gives these no mention. If he’s so hungry for stem cells, why doesn’t he start a donation drive encouraging mothers to donate these sizable (relative to an embryo) pieces of tissue to research? It’s not as efficient as manufacturing embryos, and might be more costly, but it certainly doesn’t carry the same controversial baggage.

But back to Bush’s action three years ago. Caplan says the lack of funding amounts to a ban, and pooh-poohs Bush supporters’ efforts to recast it as a “compromise”.

Fine, I’ll call it a ban, but it is not a ban on funding the research, it is a ban on funding the destruction of embryos. Caplan would call this splitting hairs, I’m sure; I do not. More on that later, but I must point out that Caplan himself seems a bit confused on this issue. At one point he claims that Bush’s action prohibits “the expenditure of federal funds on embryonic stem-cell research after August 2001”. Two paragraphs later, he claims that “the $25 million the president has allocated for embryonic stem-cell research is absurdly low.” Which is it, Art? Is Bush allowing money for embryonic stem-cell research or is he not?

And on that “absurdly low” $25 million, I’ll grant that it doesn’t exactly match the defense budget. And I’m sure the federal government gives out much more for various other research purposes. But I have a hard time buying Caplan’s position that it’s essentially worthless. That’s a whole lot more money than I’ve ever had to play with, Dr. Caplan, and I’m quite sure there are many homeless shelters, transitional housing projects, pregnancy care centers, and the like who could do an awful lot with just a piece of that cake. Do you want it or not?

Even if embryonic stem-cell research were more promising, and could cure Alzheimer’s next year if given the funding, there remains a serious ethical issue. I’m baffled that Caplan, veiwed both in academia and in the media as a leading expert on medical ethics, seems oblivious to the ethical conundrum in the research he advocates. He grants that it’s controversial, but only insofar as to portray those opposed as whining, blathering idiots who just don’t get it. He seems to equate ethics with utility, such that an action is ethically right which helps the most people, while ignoring the part about “first, do no harm”.

And he apparently has no use for people who value an embryo as a life. While I don’t expect him to agree with me or anyone else, I would at least expect him, as an expert in medical ethics, to acknowledge that reasonable people disagree on this issue. The fact that he doesn’t explains his claim that Bush’s distinction of allowing funding for pre-existing stem cell lines (from embryos that have already been destroyed) but not for new ones is an “arbitrary moral line”. It’s not arbitrary in the least — if you value the embryo as a life, then you don’t want to destroy it. But since some have already been destroyed, you might as well make use of what you have. Whether or not you agree with that personally, it’s a perfectly obvious distinction that Caplan is either incapable or unwilling to comprehend.

Caplan’s failure to see this distinction continues when he accuses the president’s moral reasoning as “at best obtuse.” First, he fails to see the difference between embryos destroyed before August 2001 (when Bush made his decision) and those destroyed after. Again, what’s done is done, Art. Then he asks why, if embryo destruction is wrong, Bush does nothing to save extra embryos in fertility clinics (they’re not federally funded, Art). He then suggests that an embryo in a petri dish is somehow on a lower moral priority ladder than a child with a spinal cord injury (ask the couple who needed the fertility treatment; by the way, it’s still not federally funded). And he finishes up this line of questioning asking why Bush does nothing about scientists who go overseas to do their research and return home to publish.

It’s all about the Benjamins, Art. Who’s footing the bill?

He also takes a few minutes to address Laura Bush’s concern that the promise of this research is over-hyped. He basically shrugs it off as par for the course, asks her why she doesn’t likewise condemn regular ad campaigns by drug companies (who’s paying for them, Art? It’s not the federal government), and chastises her for being party to her husband’s policy, which he holds is “the cruelest thing you can do to patients with incurable diseases.”

Wait a minute. You grant that there’s more hype than reality? You acknowledge that things might not be quite as rosy as you’ve been promoting? And yet you would knowingly allow the hype to continue, dangling false hope in front of countless patients with these incurable diseases in order to gain their support in helping you squeeze more money out of federal pockets for research that private investors know is a waste of time?!?

Talk about cruel. And this from an expert in medical ethics.

Dr. Caplan finishes up his diatribe by purporting to reveal the true motivation behind the administration’s position as the advancement of its anti-abortion agenda (ignoring the fact that there are far more groups opposed to this research than just those opposed to abortion). In the process, he clearly reveals where he stands on the issues of abortion and when life begins, suggesting that conception in a petri dish is somehow less valuable than conception elsewhere. And he charges the Bush administration with attempting to spin their position as favorably as possible.

Last time I checked, that was what election-year politics was all about — positive spin to attract the most voters. But Caplan’s claim that the Bush campaign is using stem-cell research as “a pawn in election politics” is simply maddening. Bush’s policy decision was three years ago, but who’s suddenly bringing it up in an election year? It’s the advocates of this research who are trying to make an issue of it again in an effort to influence the election in favor of John Kerry, who supports their cause. If that’s not making an election-year political pawn out of an incredibly delicate, controversial, emotional issue, I don’t know what is.