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BY ABBY LIPPMAN with the Canadian Women’s Health Network
An end to chronic disease. Treatments individualized for your injured body parts. Lifespans extending beyond 120 years—or longer. Sounds like the claims of some 21st Century snake oil salesperson, doesn’t it? In fact, these are just some of the miracles being promised by scientists and politicians seeking to gain support for embryo stem cell cloning research. And in case medical marvels don’t convince us that this research “MUST” be done, we are also told how the products of this work will lead to untold economic growth of the economy.
Separating fact from fiction
All this hype and more was in evidence in recent months, with stem cell research becoming a headline grabbing topic during the recent American elections. It was propelled by Proposition 71, on the ballot in California as part of the November 2004 US presidential election. Proposition 71 sought and won voters’ support for a multi-billion dollar public expenditure to underwrite embryonic stem cell and embryo cloning work in both public and private research facilities. The bill opens the door for biotech companies to become enormously wealthy using public dollars, with no guarantees that any therapies that might be developed would be truly accessible to citizens. The proposition passed (about 60% for, 40% against) despite opposition from feminist and social justice groups and individuals, including the California Nurses Association, the Boston Women's Health Book Collective/Our Bodies Ourselves, the National Women’s Health Network, and an ad hoc coalition called Pro-Choice Alliance Against Proposition 71.
The topic didn’t escape attention in Canada. Many in this country, including the Canadian Women’s Health Network, joined with feminist, social justice and human rights critics in the US to try and defeat Proposition 71. The Globe and Mail, on the other hand, took up the cause for research cloning. It regularly ran unsigned editorials warning that Canada will either fall behind in research, lose our scientists to the lure of lucre south of the border, fail to provide “cures” to just about every ailment we may develop, or all of the above if we don’t get on with research cloning in this country.
So what’s going on here? Is embryo stem cell research really the most important health issue or medical technology facing North America these days? The golden ring we must be sure to grab? Why are feminists seeming to take a position most often associated with the religious right? And is embryo stem cell research an issue for women in Canada to address?
Legislating limits
Stem cells come from a variety of sources, but the ones that cause the most debate are those from embryos. More precisely, from embryos created via cloning techniques. At the present time, Canada has legislation (An Act Respecting Assisted Human Reproduction and Related Research (AHR Act), passed March 29, 2004) that prohibits the creation of embryos for research purposes. It also bans all cloning, for either research or reproductive purposes. This same legislation will eventually put into place a regulatory agency that will be empowered to oversee how embryos created in in-vitro fertilization programs, but not implanted, are managed. If the donors of the egg and sperm used to create these embryos give their informed consent, some of these embryos, and the stem cells derived directly from them, may be used for research purposes. This is an activity that the AHR Act allows—and that most feminists and social justice activists accept. Fundamental understandings of biology and of disease processes—perhaps someday, even cures—can come from research that uses cells from these embryos.
The AHR legislation now in place allows Canadian researchers to study umbilical cord cells, adult stem cells, and other material that may someday provide treatments and cures. This material offers more than enough challenges and potential rewards to keep scientists in Canada productively working without any need to emigrate to California, as the Globe and Mail implies may happen. The AHR Act is a well-founded piece of legislation concerned with protecting the health of women and children in Canada. Moreover, the research doors opened by the AHR Act attempt to take human rights and social justice for women seriously, thanks to the efforts of women and groups who repeatedly called attention to these concerns whenever the “new” reproductive technologies were discussed during the past two decades. It was the absence of any such attention to the health and safety of women in Proposition 71 that generated much of the feminist opposition to it. Those same concerns fuel feminist objections to research cloning here in Canada.
What are the risks to women?
Feminists and other critics of an open door to embryo stem cell research share a number of concerns regarding the impact of the research on women. Research cloning—what Californians will now be paying for and what Canada prohibits—currently requires treating thousands of young women hormonally with powerful drugs in order to obtain their eggs, eggs that are the necessary “ingredient” in all embryo stem cell cloning approaches. These drugs have both known and unknown harmful side-effects. In fact, the most commonly used drug, Lupron (used primarily for women with endometriosis and men with prostate cancer), has never been approved for the purpose of “harvesting” eggs, and has a questionable safety record.
For example, in the one published research study on cloned embryos to date, 176 human eggs produced just one embryo. Thus, if a researcher wants to study (as one said he did) cell death in Parkinson's disease, and if he would need (as he said he did) multiple embryos to do so, it could involve exposing many thousands of women to unknown risks to obtain the needed eggs.
If we then think about ALL of the researchers who want to study just this disease, and then about the many other diseases thought to be embryo-stem-cell responsive that others want to investigate, it becomes apparent why so many women's health activists oppose cloning.
Feminists and social justice advocates are concerned with the rights of these women: can they give truly informed consent for this research if the health risks from treatment to obtain eggs are unknown? As well, there exists a strong possibility of coercion (by offers of large amounts of money) and commercialization (creating a market in eggs). Even if a “safe(r)” way of obtaining eggs were developed than the methods currently used, serious concerns would still remain, since this could paradoxically lead to turning women who provide their eggs into “workers” in a booming industry.
In much of the discussion about research cloning to create embryo stem cells, this focus on women is lost. Rather, proponents are portrayed as caring saviors of the sick, while opponents are all squeezed together and labeled “pro-life,” leaving the impression that a clash of values about the moral status of the embryo is the root of all differences. (In California in November, the discussion was also often reduced to an anti- vs. pro-Bush split.) But this manipulation of what is a badly needed democratic debate hides some important ethical and health concerns about the responsible use of powerful new technologies and about the best use of public funds for health promotion and disease prevention. And perhaps for Canadians, at the top of this list of concerns is the need for explicit and thoughtful attention to women's roles.
Keeping the focus on women
Debates over embryo stem cell research and research cloning are likely to heat up over the next 2-3 years as Health Canada holds consultations across the country to help it develop the details about permissible practices laid out in the AHR Act. It will be important that this debate not be hijacked into one that focuses on the status of the embryo or into setting up artificial pro-research/anti-science divides. The focus must remain on women. And women need to become engaged in this discussion.
Today, women in Canada are fortunate to have the AHR Act between them and the many with financial interests in research cloning and the creation of embryos for research purposes. But to remain protected, women—individuals and groups—will have to mobilize. The passage of Proposition 71 in California, and the rapid introduction of similar legislation in many American states since then, suggest that the prohibitions in the AHR Act will be under increasing attack in Canada as researchers and others try to find places on the stem cell/cloning bandwagon. We need to remain active not only to ensure that the agency the government will be putting in place to oversee future developments in assisted reproductive technologies is transparent, accountable, and licenses only those activities that are of proven safety and effectiveness, but that when the Act is reviewed—as it must be in about three years—the protections for women and children remain firm.
Let’s avoid snake-oil promises, protect women’s health, and stick with exploring stem cells from adults and from embryos already in in-vitro fertilization clinics not used for reproduction.
Abby Lippman is the co-chair of the Canadian Women’s Health Network and Professor of Epidemiology, McGill University.
For more information on the Assisted Human Reproduction Act please visit www.cwhn.ca/resources/cwhn/billc6.html
What are embryo stem cells?
Embryo stem cells are unspecialized cells that can become any cell type in the body and generate new cells and tissues. The stem cells are harvested from blastocysts, the growing group of cells that develops several days after an egg is fertilized.
What is embryo cloning?
The usual procedure for cloning—whether for research or for reproduction—involves what is called somatic cell nuclear transfer (SCNT). This is the procedure that was used in creating Dolly the sheep. In SCNT, the nucleus, which contains most of a cell’s genetic information (DNA), is removed from an unfertilized egg cell. The nucleus from a body cell (any cell, from any person) is then introduced into this egg cell, which is then stimulated to start dividing. The resulting cells are the embryo stem cells that can be used for research, and they will contain the genetic material (DNA) from the donor of the body cell. If they come from a person with some disease, researchers then have a supply of material with which to study this condition.