23/03/05

Hope — not hype — should lead stem cell debate

Human blastocyst, the early form of embryo from which researchers obtain stem cells Copyright: NIH / J. Conaghan

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On 2 March, the Brazilian Congress approved a new biosafety law. The vote ended a six-year tug-of-war between supporters and opponents of biotechnology, which had brought the issue of genetically modified organisms to the courts, and kept the biotechnology industry on hold for the whole of that period.

Surprisingly, the press didn’t pay much attention to the long overdue regulatory decision on whether to allow transgenic crops.

Instead, the media focused on the provision authorising research using human embryonic stem cells derived from surplus embryos from in-vitro fertilisation clinics.

On 3 March, for example, Folha de S.Paulo, the Brazilian newspaper with the largest circulation (350,000 copies daily), dedicated a six-column front-page headline to the legislative breakthrough: "Country allows the use of embryonic cells". The following day, its lead editorial proclaimed: "Reason’s victory".

The large margin of votes in support of the bill’s provision allowing stem cell research (366 in favour, 59 against, and 3 abstentions) was surprising. Brazil is a major Catholic country, and the Catholic church, in tandem with evangelical churches of various other denominations, had strongly campaigned against the bill. They claimed that destroying four-day old human embryos to obtain stem cells was virtually a form of abortion, as it involved the termination of human lives.

Another point made by opponents of the bill was that the contentious issue of stem cell research needed more public debate, and should not ride on the back of legislation dealing primarily with the unrelated issue of genetically modified organisms (see Brazil’s quandary on bioethics).

Nobody really expected that only 59 representatives would follow the advice coming from the pulpit. Political commentators and insiders usually estimate the church faction to command between 100 and 200 votes, out of a total of 513 in the House of Representatives (the lower chamber of Brazilian Congress where the final round of the biosafety bill’s passage into law took place).

There are many possible political explanations for the outcome. But in my view, it is due only to the intense emotional atmosphere that accompanied the vote.

Patients with genetic disorders such as muscular dystrophy, as well as scores of people in wheelchairs, were hauled to Congress to put pressure on legislators. Their presence implied that those who were against the bill would kill their hope for the new cures and treatments that stem cell researchers say could be possible.

When the final vote came, the decision was hailed from the galleries as if revolutionary therapies had already been attained.

Mara Cristina Gabrilli, who lost her mobility in a road accident and was recently appointed secretary for the disabled by the mayor of Sao Paulo, was among those celebrating.

"It’s a big day," she told reporter Gilse Guedes from the daily newspaper, O Estado de S. Paulo. "I believe that in three to five years we’ll be in the position of employing scientific breakthroughs so that people like me can regain their mobility."

Gabrilli was in Congress on her own, but most disabled people who witnessed the vote were led there by researchers who were very — maybe too — proactive.

They succeeded in polarising the issue, pitting those they deemed old-fashioned — religious people and the Catholic hierarchy — against those who supposedly struggle for the advancement of science and aim to cure devastating diseases such as muscular dystrophy, Parkinson’s disease, diabetes, and even spinal cord injuries.

 

Following the law’s approval, newspaper readers were drowned in a flood of interviews and articles by stem cell researchers, who rushed to clarify that cures were not to be expected for years, perhaps decades.

Too late, perhaps, now that the genie is out of the bottle. At some point down the road, the biomedical research community will be expected to deliver the promised wonders of stem cell research to those in desperate need of them.

If researchers fail to do so, they risk a withdrawal of public support for stem cell research in the coming years.

 

If that happens, researchers will be just going down a sad but well-travelled road.

Rhetorical excesses also seem to be the norm when it comes to other putative biotechnology wonders such as genomics, gene therapy and genetically modified organisms.

Now stem cell research: researchers have let wild expectations overtake the public imagination, maybe relying too confidently on their own ability to modify them later, when it comes to actual results.

This is not a very rational way to proceed, and might actually backfire and contribute to the continuing erosion of public confidence in scientific enterprise.

Enlightened scientists — as well as science journalists, for that matter — should not be accessories to public misinformation. Promising too much can fall into that category.