Chronicles: A Magazine of American Culture » June 2003

From the Archives: Stemming the Tide

Monica M. Richert and Scott P. Richert — Mon, 09 Mar 2009 15:14:31 +0000

On August 9, 2001, during a speech from his ranch in Crawford, Texas, President George W. Bush put an end to several months of debate surrounding government funding of research on stem cells derived from human embryos. After discussing his administration’s research into the matter and declaring his own “deeply held beliefs” in science and technology and that “human life is a sacred gift from our Creator,” President Bush announced his decision:

As a result of private research, more than 60 genetically diverse stem cell lines already exist. They were created from embryos that have already been destroyed, and they have the ability to regenerate themselves indefinitely, creating ongoing opportunities for research. I have concluded that we should allow federal funds to be used for research on these existing stem cell lines, where the life and death decision has already been made.

Leading scientists tell me research on these 60 lines has great promise that could lead to breakthrough therapies and cures. This allows us to explore the promise and potential of stem cell research without crossing a fundamental moral line, by providing taxpayer funding that would sanction or encourage further destruction of human embryos that have at least the potential for life.

The President’s speech was widely hailed as an acceptable compromise by both advocates of research and pro-life leaders, although there were some notable voices of dissent (the National Conference of Catholic Bishops and Judie Brown’s American Life League most prominent among them). Almost two years later, however, a number of questions remain unaddressed, not least of which is whether the President’s “compromise” has actually restricted the use of government funds to embryos destroyed before 9:00 P.M. EDT on August 9, 2001. Moreover, recent research is calling into question the basic assumption of the President’s speech itself: that embryonic-stem-cell research is likely to provide greater advances in the fight against disease than research using adult stem cells.

What Are Stem Cells?

Stem cells may be a source of therapies for a variety of diseases, including diabetes, Parkinson’s, Alzheimer’s, and heart disease. The National Institutes of Health’s primer on stem cells defines them as undifferentiated cells that can renew themselves and can mature into a variety of other cell types, depending on the stimuli to which the cells are exposed. Embryonic stem cells are derived from three-to-five-day-old embryos that have been “conceived” through in vitro fertilization. They are pluripotent, which means that they can become any type of cell in the body. Adult stem cells are found in a variety of tissues but are most often derived from bone marrow. These cells are multipotent, which means that they can develop into a limited number of cell types. Until recently, researchers believed that an adult stem cell derived from a specific tissue could only differentiate into cells of that same tissue; in other words, a neural stem cell could only make brain cells, while a liver stem cell could only make liver cells. New studies, however, have demonstrated that adult stem cells can mature into a wide variety of cell types.

Stem cells work by three known mechanisms. They can be introduced into tissue and grow into cells of that tissue type. Alternatively, they can be differentiated in cell culture and then introduced into the target tissue, where they function as a cell of that organ. Finally, researchers have recently discovered that stem cells can migrate to an injured organ and fuse with damaged cells there, regenerating the organ. All three mechanisms are potentially of clinical use.

The Practical Limitations of Embryonic Stem Cell Research

Beyond the moral issue of producing embryos and destroying them in order to harvest embryonic stem cells, there are practical limitations to the clinical use of these cells. Scientists have not yet demonstrated that they can control the differentiation of embryonic stem cells. Moreover, as in a heart or lung transplant, embryonic stem cells may be rejected by a patient, since the cells come from a different person. Finally, if all of the embryonic stem cells implanted into a patient do not mature, tumors may develop. Adult stem cells, on the other hand, do not cause rejection, but researchers have been less interested in them because they are found in very small quantities in most tissues, making them harder to isolate and purify. Also, adult stem cells have not been identified for every tissue. They do not multiply as readily, and, as NIH points out, they could have DNA abnormalities from the environment or genetic disease.

Embryonic stem cells were first isolated from mouse embryos in the early 1980’s. They were not isolated from human embryos or fetuses until 1998. To date, no clinical studies have been conducted with embryo-derived stem cells because researchers cannot control their development into various tissue types or prevent rejection.

Adult stem cells, on the other hand, have been used for almost 30 years in bone-marrow transplantation. As early as 1976, reports indicated that bone-marrow-derived cells could be differentiated into bone, cartilage, and fat cells and that these new cells were transplantable. Unfortunately, these observations never became the focus of research, and, by 1999, only a year after they were first isolated from human embryos, more was known about embryonic stem cells than adult stem cells. Recent research on adult stem cells, however, suggests that they may be of more clinical benefit than embryonic stem cells.

In fact, studies indicate adult bone marrow may contain a pluripotent stem-cell population that could potentially repair all of the tissues of the body. These stem cells, called side population cells, are also found within umbilical cords and in adult blood and other tissues. A relatively abundant source of stem cells is fat obtained through liposuction: Fatty tissue can yield up to 200,000 undifferentiated cells per gram.

The Promise of Adult Stem Cell Research

While researchers cannot control the development of embryonic stem cells into particular tissue types, they have recently demonstrated that adult stem cells derived from one tissue can differentiate into cells of another tissue. Cells derived from skin have been grown into neurons and glial cells, smooth muscle cells, or fat cells, depending on the conditions under which the cells are cultured. An abundant supply of these cells can be obtained through skin biopsies. Bone-marrow cells have been differentiated into cardiac, esophageal, stomach, small and large intestine, kidney, neural, bone, and lung cells in both humans and rodents. Neural stem cells can mature into liver, intestine, kidney, and bone-marrow cells, while pancreatic stem cells can become liver cells. These studies indicate that the ability of adult stem cells to repopulate a variety of tissues may be equal to, or even better than, that of embryonic stem cells.

Doctors at William Beaumont Hospital in Royal Oak, Michigan, isolated stem cells from the bone marrow of a 16-year-old boy and introduced them through his aorta into his heart muscle, which had been damaged when he was shot with a nail gun while working on his home. The boy’s heart regained a significant amount of function after treatment. Moreover, there was no potential for rejection, since the donor cells were his own. In a similar study at the Texas Heart Institute, heart function in patients suffering from congestive heart failure significantly improved after bone-marrow-derived stem cells were injected into their heart muscle.

A 1999 Nature Medicine article reported that stem cells derived from bone marrow were differentiated into bone cells and used to treat three children suffering from osteogenesis imperfecta, which causes short stature and brittle bones. The children’s condition improved dramatically, and they suffered fewer fractures. At the 2001 meeting of the American Association for the Advancement of Science, P. Sanberg reported that stem cells isolated from umbilical-cord blood can be developed in culture into healthy brain cells. When these cells are injected into the bloodstream of rats with brain injury, the cells migrate to the area of injury and repopulate it. In a study of rats who had suffered a stroke, 80 percent of those treated with these differentiated cells recovered, compared with 20 percent of untreated rats. If the procedure works as well in humans, one to two umbilical cords may be enough to treat one stroke victim. This approach may be used to treat stroke patients within two years.

While the usefulness of embryonic stem cells remains unproved, these studies demonstrate the potential of adult stem cells for treating disease. Since there has been less focus on adult-stem-cell research, much is still not known about how adult stem cells function, but, even at this early stage, it seems likely that adult stem cells will be more readily adaptable to cure disease.

Loopholes in President Bush’s “Compromise”

The remarkable advances in adult-stem-cell research over the past two years make the potential loopholes in President Bush’s “compromise” all the more disturbing. While government funding of embryonic-stem-cell research is supposed to be confined to cell lines derived from embryos destroyed before President Bush began his speech, NIH’s implementation of the President’s directive potentially broadens the scope. In a statement released on August 27, 2001, NIH announced that “Such research is now eligible for federal funding as long as the derivation process (which begins with the destruction of the embryo) was initiated prior to 9:00 p.m. EDT on August 9, 2001.” Knowing what was coming—as many labs undoubtedly did, since they were approached by NIH before the President’s speech to determine whether they had eligible lines—labs may well have decided to keep their options open by engaging in mass destruction of embryos before the President went on TV. Already, of the 11 embryonic-stem-cell lines listed in NIH’s Human Embryonic Stem Cell Registry (escr.nih.gov), five are held by ES Cell International, a research lab that had no stem-cell lines listed among the original 64 that NIH had said would be eligible for funding.

Moreover, NIH’s implementation relies entirely on the honesty of grant-seeking researchers. The only proof required to make a line eligible for federal funding is a signed affidavit stating that the destruction of the embryo began before the President’s speech did. No documentation (such as certified lab notes) is required to support the affidavit, nor is any penalty prescribed for submitting a false affidavit. In other words, the only conditions preventing an embryonic-stem-cell line derived from an embryo destroyed after the speech from becoming a publicly funded line are the integrity of the person signing the affidavit and NIH’s willingness to look beyond the affidavit to official research records, which NIH is not required to do.

Of course, these loopholes may be largely irrelevant anyway. By choosing to implement his “compromise” by executive order rather than through legislation, President Bush left the door wide open to its repeal by a future administration—or, for that matter, by his own, if research on the initial pool of embryonic stem cells does not bear the predicted fruit.

The Brave New World of Embryonic Stem Cell Research

As this article goes to press, researchers at the University of Pennsylvania have announced that embryonic stem cells from mice have spontaneously transformed into eggs, before developing into parthenogenic embryos. (Parthenogenesis is a process by which embryos develop from an unfertilized egg. Such embryos do not have a complete set of chromosomes and, therefore, are usually not viable.) Hans R. Scholer of Pennsylvania’s School of Veterinary Medicine declared to the Associated Press his desire “to use these oocytes as a basis for therapeutic cloning and hope that our results can be replicated with human embryonic stem cells.” Other news stories indicate that researchers may eventually use this form of human cloning to allow homosexual couples to “conceive” children—eggs made from the stem cells of one male would be combined with the sperm of the other. Welcome to the brave new world of embryonic-stem-cell research, funded by your tax dollars.

Monica M. Richert is a research scientist in cell and molecular biology at the University of Colorado Health Sciences center. Her brother, Scott P. Richert, is the executive editor of Chronicles.

This article first appeared in the June 2003 issue of Chronicles: A Magazine of American Culture.

Hating Babies, Hating God

Aaron D. Wolf — Sun, 01 Jun 2003 14:20:27 +0000

When I sat down to write this article, Google reminded me that, when it comes to the issue of contraception, the stakes are very high. To check the date of publication of Dr. Charles Provan’s important work The Bible and Birth Control, I typed “Charles, Provan, Bible, Birth Control” into the mother of all search engines. As fast as my dial-up connection could react, I was confronted with a paid advertisement, spawned by my search criteria, for Ortho Evra, also known as The Patch, the bastard offspring of The Pill. I followed the link and immediately recognized the happy contraceptor from the ubiquitous television ad, who lifts her baby-T to show, just above her pantyline, the flesh-colored patch, which stands up to the ravages of both shower and swimming pool as it pumps norogestromin and ethinyl estradiol into her erstwhile fertile (healthy) body. The Patch, claims the commercial, is for women who just do not have time to worry about taking a pill every day.

The first link on the Ortho Evra page is "For Prescribers" and offers a full description of this handy transdermal technology. After stating that The Patch contains the same active ingredients as The Pill, the makers of Ortho Evra disclose something on which Dr. James Dobson and his research group at Focus on the Family, "after two years of extended deliberation and prayer," could not reach a "consensus as to the likelihood, or even the possibility."

Combination oral contraceptives act by suppression of gonadotropins. Although the primary mechanism of this action is inhibition of ovulation, other alterations include changes in the cervical mucus (which increase the difficulty of sperm entry into the uterus) and the endometrium (which reduce the likelihood of implantation).

Take comfort, then, wearers of The Patch: If you do happen to conceive a child, the fragile embryo will simply be unable to rest in your womb and will disappear, even as The Patch remains intact in the shower or swimming pool.

The list that follows is too long to reproduce here, but, suffice it to say, just about every imaginable side effect is warned against, from breast cancer to hemorrhaging to depression to ectopic pregnancy. The one that demands its own box and boldface type, of course, is that which warns: "WOMEN WHO USE HORMONAL CONTRACEPTIVES, SUCH AS ORTHO EVRA, SHOULD BE STRONGLY ADVISED NOT TO SMOKE."

Despite the keen attention given by pro-life crusaders to matters concerning abortion, with far too much detail regularly offered regarding such monstrous practices as partial-birth abortion, very few are willing to consider the possibility that The Pill is an abortifacient. A new life torn asunder from a wicked mother’s womb is deemed horrible, but let’s roll the dice, when it comes to the chances of discreetly flushing one down the toilet, and hope that those fanatical Catholic anticontraception zealots are wrong.

Behind every pro-lifer who chooses to think, say, about baseball whenever he is told that The Pill kills children is the need to terminate the discussion about contraception in general. There is always the reactionary excuse to fall back on—while Catholics reject (or, at least, they are supposed to reject) contraception because their Pope tells them to, we Protestants listen only to the Bible. From 1517 to 1930, however, no Protestant denomination or group ever permitted the practice, and it was Protestant state legislatures across the country that made the trafficking of contraceptives illegal until the Supreme Court intruded in Griswold v. Connecticut, paving the way for Roe v. Wade.

Last year, a courageous young Protestant couple, Sam and Bethany Torode, urged fellow evangelicals to forsake birth control in favor of an Open Embrace within marriage. Their work reflects the deep commitment in pockets of resistance all over the United States to the official line that contraception is only a Catholic concern. In a well-researched and poignant book, the Torodes argue that Protestant attempts to separate the pleasures of the marital bed from the spiritual blessing of openness to childbearing is gnostic. "By pitting spirit against matter, and companionship against procreation, contraception can become a means of exploiting the body and using one’s spouse—in spite of our good intentions." They also argue that any attempt to separate the procreative, unitive, and sacramental aspects of marital union leads to all sorts of physical, emotional, and spiritual deformities. And, in a brilliant Foreword, Professor J. Budziszewski of the University of Texas at Austin notes that “Evangelicals in search of God’s teaching turn first to holy Scripture, and that is well and good. But Scripture teaches that God has also built wisdom into the design of his creation, and this is something that evangelicals tend to forget.”

To its credit, Christianity Today devoted considerable space in its November 12, 2001, edition to an adapted portion of Open Embrace. They could not, however, allow the Torodes to go unchallenged, even for one issue. "This essay," the editors note, "explains how one young couple answered these questions. An accompanying essay by Raymond C. Van Leeuwen reaches different conclusions."

Dr. Van Leeuwen’s essay underscores the attitude underlying so many Protestants’ open embrace of contraception. His argument is twofold: First, God is simply bigger than your desire to thwart Him (which, as a principle, is certainly true). If we really believe that God is sovereign, then no barrier can stand in His way:

If God can use even evil to accomplish good (Gen. 45:5-8), surely he can use human actions that seek to serve God with the freedom he has given us. God’s sovereignty works in and through human actions, and, if necessary, in spite of them.

To suggest that birth control is evil or perverse because it undermines God’s sovereignty is to underestimate God’s sovereignty and reject our responsibility to serve him wisely. Of course human choices ought to be made in the realm of freedom set within the limits of God’s law. But where there is no law, our choices are free (Gal. 5)—provided they are wise and serve God.

Here, then, is the sine qua non of the righteous use of contraception: Intend to serve God thereby. If God wants you to be fruitful and multiply, He will make it so, despite your best efforts. At issue, therefore, is man’s intent, not his action.

Professor Van Leeuwen’s second argument is even more curious: The famous “Creation mandate” is no mandate at all. “Be fruitful and multiply” (Genesis 1:28),

is not a commandment, but a blessing. It does not refer to what humans must do to please God, but to what God does for and through humankind. The text says, “God blessed them, and God said to them, ‘Be fruitful and multiply’” (RSV). Fertility is not a command but a blessing that God gives to his creatures, to animals as well as humans (Gen. 1:22).

Of course, one might respond that the proper answer to a merciful Creator and Redeemer Who offers you a blessing is not “I know better.”

Too many Protestant leaders are simply unwilling to let go of the right to choose—in this case, the right to choose to reject God’s blessing of children. The issue, therefore, is simply not discussed. That life begins at the moment of conception is, thanks to the efforts of courageous pro-lifers, all but universally accepted among Bible-believing Protestant evangelicals. But the notion that the observable order of nature demonstrates God’s gracious design and intention for His Creation is ignored when it comes to so-called birth control.

This stance is not a reflection of the heritage of Protestantism but of the extent to which Protestant theologians have become victims of their times—especially in the realm of biblical exegesis and natural law. We see this in Professor Van Leeuwen’s statement that, “where there is no law, our choices are free.” It is the Enlightenment, not Sola scriptura, that tells us that we cannot see the intention of the Creator in the basic operations of nature. Certainly, Lutheran theology does cast doubt upon the ability of “Dame Reason” to lead us to Christ. (In fact, she leads in the opposite direction.) Both traditional Lutheran and Reformed theology, however, underscore along with St. Paul in Romans 1, that “the invisible things of [God] from the creation of the world are clearly seen, being understood by the things that are made, even his eternal power and Godhead”—but only to the extent that they render fallen man “without excuse” in his disobedience to God.

Wherefore God also gave them up to uncleanness through the lusts of their own hearts, to dishonour their own bodies between themselves: Who changed the truth of God into a lie, and worshipped and served the creature more than the Creator, who is blessed for ever. Amen. For this cause God gave them up unto vile affections: for even their women did change the natural use into that which is against nature.

This is the biblical basis of natural law, which, for centuries, guided Protestants not only in their formulation of morality but in their interpretation of Scripture. (Luther even writes that the only aspects of the law of Moses that are binding on Christians are those supported by natural law.) There need be no proof text for Christians to suggest that homosexuality is a sin. Instead, the biblical witness testifies to that which is already obvious from natural revelation. In his First Epistle to the Corinthians, St. Paul points out that, beyond the validity of the custom of women wearing head coverings in the Divine Service, it is “nature itself ” that teaches that “it is a shame for a man to have long hair, but, for a woman, it is her glory.” And, therefore, such violations of nature in God’s house “offend the angels” who are present.

It was obvious to the Protestant Reformers that the natural purpose in marital union was procreative as well as unitive. This revelation of God in natural law was reflected in His dealing with Onan, who, in Genesis 38, was commanded by his father, Judah, to take his late brother Er’s wife as his own, in order that their offspring might be counted as Er’s, receiving his inheritance (a Levirate marriage). Onan took Er’s wife into his bed but “wasted his seed on the ground” and, thus, contracepted. Moses tells us that “the thing which he did displeased the LORD: wherefore he slew him . . . ”

Modern Protestant scholars insist that it was what Onan intended to do—thwart the purpose of the Levirate marriage—that displeased God. After all, you cannot thwart God’s providence, no matter how hard you try, and Onan was under no natural law and, thus, had freedom to contracept in any other situation. Historic Protestantism, on the other hand, unanimously saw the action of Onan as a violation of natural law. In his commentary on Genesis, Martin Luther called Onan’s act sodomy:

[T]he exceedingly foul deed of Onan, the basest of wretches . . . is a most disgraceful sin. It is far more atrocious than incest and adultery. We call it unchastity, yes, a sodomitic sin. For Onan goes in to her; that is, he lies with her and copulates, and when it comes to the point of insemination, spills the semen, lest the woman conceive. Surely at such a time the order of nature established by God in procreation should be followed. Accordingly, it was a most disgraceful crime . . . Consequently, he deserved to be killed by God. He committed an evil deed. Therefore, God punished him.

John Calvin agreed, calling Onan’s act “doubly monstrous” and tantamount to a “violent abortion” in which the “offspring of his brother” was “torn from the mother’s womb” and “cast on the ground.” Similar natural-law arguments were made by John Wesley, the great Baptist Charles Haddon Spurgeon, and Reformed commentator Matthew Henry, among countless others.

The Anglican Church became the first Protestant body to sanction the use of contraception, although it took great pains to emphasize that contraception should only be used by married couples. Still, the 1930 Lambeth Conference’s declaration rejected natural law in favor of the law of “good intentions”: Contraception was deemed permissible “where there is a clearly-felt moral obligation to limit or avoid parenthood.” It is precisely married couples, however, who are least likely to have a legitimate reason to avoid parenthood, for having children is what they are commanded (or “blessed”) to do. And we know this not only from Scripture (the Creation mandate) but from the birds and the bees, whom God also made.

Conservative Protestants were horrified by Lambeth. T.S. Eliot said that it was an un-Christian experiment to remake society, and Lutheran Hour speaker Walter A. Maier called it “one of the most repugnant of modern aberrations, representing a 20th-century renewal of pagan bankruptcy.” The Missouri Synod pointed to St. Augustine’s warning that “Contraception makes a prostitute out of the wife and an adulterer out of the husband” and noted that so-called “Companionate marriage has been termed ‘licensed prostitution.’”

Nonetheless, one by one, Protestant denominations began to ignore the wisdom of their forebears; by 1981, even the conservative Missouri Synod’s Commission on Theology and Church Relations sanctioned contraception (“Human Sexuality: A Theological Perspective”). While arguing that Christian marriage should be “generally fruitful” and that the Creation mandate is “both a command and a blessing,” the commission condemned any “stigma” that is attached to a couple that chooses to “remain childless” (including, presumably, the charge of sodomy) and postulated that,

in the absence of Scriptural prohibition, there need be no objection to contraception within a marital union which is, as a whole, fruitful. Moreover, once we grant the appropriateness of contraception, we will also recognize that sterilization may under some circumstances be an acceptable form of contraception.

Despite this radical reversal, however, pockets of resistance are gaining ground, thanks to the courageous efforts of such traditionalists as the Torodes, who are calling attention to the Protestant legacy of remembering Romans 1 and the natural law when interpreting Scripture and ordering life. The stakes are high, not only because The Pill and The Patch are, as their manufacturers admit, abortifacients, but, more significantly, because to hate the natural law is to hate God’s intention and, thus, to hate God. The Lutheran theologian Lukas Osiander warned, “Such an evil deed strives against nature, and those who do it will not possess the kingdom of God (1 Cor. 6:9-10). The holier marriage is, the less will those remain unpunished who live in it in a wicked unfitting way so that, in addition to it, they practice their private acts of villainy.” We may take cold comfort in the fact that, as contraceptors go the way of the Cathars, who deemed fruitful marriage a sin, their practice is not being passed down to their children, who either are turning against contraception or are simply not around to believe the lie.

Aaron D. Wolf is the associate editor of Chronicles.

This article first appeared in the June 2003 issue of Chronicles: A Magazine of American Culture.