The American Journal of Bioethics

President George W. Bush has decided to use federal funds to support research on a limited number of stem cell lines derived from embryos. Before he did so, several commentators and a national commission had recommended that a panel be appointed to grapple not only with questions of scientific validity, safety, and efficacy but also with the broader ethical and social questions raised by stem cell research (Cohen 2001; Zoloth 2002; and National Bioethics Advisory Commission 1999). The president has announced that he will appoint a new Council on Bioethics. Just what will be its purpose and goals? Will it address the range of ethical and social issues that emerge from the use of stem cell technology?

The National Bioethics Advisory Commission (NBAC) (1999) called for a standing federal oversight panel to review and monitor stem cell research protocols, keep track of the history and use of stem cells, produce reports on the current status of stem cell research, and provide guidance regarding the ethical and social issues that the research raised. Such a national body, NBAC maintained, was necessary to ensure public accountability for this novel scientific effort, as well as public understanding of what it involves. NBAC, however, has disappeared and its panel with it.

Will the new presidential bioethics council carry out the functions recommended by the NBAC? Or Bush have some other goals for the council? At this point in time there is no generally accepted sense of what this body's charge will be, other than, as Bush (2001) said, to "keep us apprised of new developments and give our nation a forum to continue to discuss and evaluate these important issues."

One specific task mentioned for the new council is to monitor stem cell research. Yet it is unclear just what it can do in this regard, since the National Institutes of Health (NIH) (2001) has already issued new guidelines for federally funded embryonic stem cell research. Whereas earlier NIH guidelines (1999) set out detailed standards for informed consent from embryo donors and established a Human Pluripotent Stem Cell Review Group to review this research, the new guidelines state only that "informed consent must have been obtained for the donation of the embryo and that donation must not have involved financial inducements." Either the NIH is not particularly worried [End Page 43] about the issue of valid and uncoerced consent at infertility clinics or it believes that procedures at the 10 clinics with eligible stem cell lines ensure that such consent has been obtained and that money was not used to induce donations. This seems likely in Sweden, where detailed regulations govern the in vitro fertilization (IVF) process. Presumably, the other institutions whose cell lines are now eligible for use in the United States will also sign statements indicating that they have met these simple requirements.

Yet are these two requirements enough? The more stringent earlier NIH requirements were directed toward ameliorating pressure, coercion, and conflicts of interest among investigators. Will the president's council be able to tighten these new guidelines so that they ensure that those donating embryos for this federally funded research do so knowingly, freely, and without pressure from competitive researchers?

Bush's decision to allow federal funding of just 64 stem cell lines leaves open a myriad of other ethical and social questions. Is an embryo a potential or full-fledged human being owed protection from destruction (Green 2002)? Is there an ethical difference between embryos that will be implanted and those that will not? Does it really keep the government's hands clean when it benefits from the destruction of embryos so long as others do the destroying? If the destruction of embryos is wrong, why not ban IVF, since it leads to massively greater harm to embryos? Are stem cells totipotent and, if so, are they not...