The Promise and the Hype
"The Promise and the Hype" provides a brief explanation of what stem cells are, what stem cell research hopes to achieve, why scientific experts think stem cell medicine could be the greatest scientific advance of our lifetimes, and why it might not live up to the hype. It also describes the differences between "embryonic" and "adult" stem cells and why most scientists think the promise of embryonic stem cells cannot be achieved using adult stem cells alone.
The Embryo Wars
President Bush has prohibited the use of government funds to support most embryonic stem cell research. "The Embryo Wars" describes the Bush policy, criticizes the logic of affording early-stage embryos the same protections afforded living persons, and identifies a range of logical fallacies and internal inconsistencies within the policy. Congressional Democrats do not escape unscathed either. The pro-stem cell legislation that they have supported, and that President Bush has vetoed, is carefully analyzed and criticized as well for its substantial shortcomings.
Cloning, Congress and the Constitution
Why is the subject of cloning intertwined with that of stem cell research? "Cloning, Congress, and the Constitution" describes the similarities and differences between cloning people (not related to stem cell research) and cloning cells (important for stem cell research) and explains what is at issue for the future of regenerative medicine in the cloning debate. The chapter then explores the policy and constitutional law issues raised by Congressional attempts – unsuccessful so far but still very much alive – to make both types of cloning illegal in the United States.
Stem Cell Patents
Could a single scientist patent all stem cells, making it illegal for any other scientist to conduct research using any stem cells at all without paying a fee? The United States Patent Office has said "yes," although it is now revisiting that decision. "Stem Cell Patents" explains the controversy, criticizes the policy implications of the patent office decision, and evaluates the legal arguments that could be used to argue for its reversal.
The Taxpayers' Stake in Stem Cell Profits
When public dollars used to fund biomedical research that leads to valuable inventions, who should decide whether to seek patents on those inventions and who should profit from such patents? In the United States, private firms, universities, and individual researchers who use your tax dollars to achieve scientific breakthroughs can patent their inventions and keep 100 percent of the profits. California's new stem cell agency requires successful recipients of public grants to share the profits with the state. This chapter carefully analyzes the reasons for these competing policies, and which makes for better public policy.
Autonomy and Informed Consent
Scientists need to obtain the "informed consent" of volunteers before conducting clinical research on them, but the rules are less clear when the volunteers are not objects of experimentations but instead are asked merely to provide human tissues -- such as stem cells or human eggs -- for stem cell research. "Autonomy and Informed Consent" considers whether informed consent requirements should apply in these situations, whether scientists should have to disclose their financial interest in their research to potential donors, and whether research on embryos should require the consent of both people -- the sperm and the egg donor -- whose gametes created the embryo.
Buying and Selling Human Tissues
Several pro-stem cell research states, including California and Massachusetts, and passed laws prohibiting scientists from paying people for donating critical tissues for stem cell research, and a national advisory panel endorses this type of ban. "Buying and Selling Human Tissues" analyzes the arguments in favor of these rules prohibiting compensation and explains why they are logically incoherent as well as potentially crippling for stem cell research efforts.
Default Rules for Tissue Donations
This chapter builds on issues raised in "Autonomy and Informed Consent" and "Buying and Selling Human Tissues" but focuses on a slightly different question: what rights to compensation or control should tissue donors be entitled when they provide tissues to doctors or researchers but the terms of donation are never made explicit.
Looking Forward: Stem Cell Treatments
When stem cell research in the laboratory setting gives rise to blockbuster stem cell treatments that manage or cure debilitating illnesses like diabetes, Alzheimer's disease, or cancer, a host of new issues will rise to prominence in policy debates. This chapter describes and analyzes several of these issues. Should the Food & Drug Administration (FDA) regulate stem cell treatments just like other pharmaceuticals, or do the unique features of stem cells require unique regulation? In order to spur development and production of new stem cell treatments, should the manufacturers of treatments approved by the FDA receive protection from private lawsuits not given to more conventional medical products? If successful treatment requires stem cells from a compatible donor to avoid immune system rejection, should parents be permitted to use new technologies to ensure that they give birth to a new child who is compatible with a sick child?
Conclusion
This final chapter briefly recaps the issues raised, conclusions reached, and policy recommendations proferred throughout the book.