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When exactly does life begin?

"What harm is caused if the embryos made by infertility clinics that will anyway be destroyed are used for research?" Drazen wondered.



"I want people who have disease to be cured. If embryonic stem cells can achieve this, so be it," — Dr. Drazen. Photo credit: M.Moorthy

THE BLIND can see, the bald can once again become hirsute, diabetics can bid goodbye to the disease. The list is limited only by one's imagination. No, it is not gripping science fiction that we are discussing; it is stem cells and their myriad applications in medicine.

"It's a strong enabling technology," said Jeffrey M. Drazen, Editor-in-Chief of the prestigious The New England Journal of Medicine and professor of Medicine at Harvard Medical School, referring to stem cells. "It will change medicine and the way we treat and study disease." Like any new technology that raised fear in people's mind and faced opposition, it is now the turn of stem cells. Dr. Drazen was in Chennai to attend PRACTIMED 2004 organised by Ramachandra Medical College and Research Institute, Chennai.

So what if it has the potential to treat many diseases and help study various diseases, it appears that this technology has to pass the discerning eyes of many critics. Bigger the promise (the technology holds), tougher will be its journey to become an accepted tool. And if the technology is in any way connected with biology, or to be more specific, has anything to do with human life, bigger will be the opposition to the technology. Unlike the opponents of embryonic stem cell technology, Dr. Drazen sees the issue differently.

"We should use this technology considering the potential power it wields. And since it can be misused, it has to be regulated," he said as a matter of fact. "Cloning for reproductive purposes is dangerous and should be avoided. But that is no reason for imposing a blanket ban on stem cell research." He goes one step further to make his point — "In medicine the war is against disease. So we want the best and most potent weapons to fight diseases."

His thinking as an Editor-in-Chief of a prestigious international journal is a reflection of the way scientists around the world and particularly in the U.S. look at this technology. And they have not missed any opportunity to air their views. The reason is simple. Researchers in the U.S. have their hands tied with the Bush administration allowing Federal funding only for research on embryonic stem cell lines created on or before August 9, 2001.

But this is not the only reason why people like him are perturbed. Religious views and `right-to-life' groups are dictating the rules for scientists to follow. "The religious view is that this kind of research should not be done in the first place," he explained. Their argument stems around the notion that life begins immediately after a sperm fertilizes an egg. "Many people disagree with this view. But our President is associated with people who think that embryonic stem cell research is a bad idea," he noted.

The reason why these pro-life groups are against embryonic stem cell research is because harvesting stem cells from embryos kills them. And killing an embryo is seen as destroying life.

But are the pro-life people not right? Culling stem cells from the embryo, as mentioned earlier, does kill it. But the issue is not that simple. "When life begins is a philosophical question — it could be immediately after the egg is fertilized, when the foetus gets a soul, when the foetus can live independently outside the mother, or when the mother delivers the baby," he noted.

An increasing number of couples with fertility problems and inability to have children are turning to in-vitro fertilization (IVF). Ideally, 50-odd embryos are made, though only four or five will be used to make children. And the fate of the remaining embryos — they are either destroyed or their fate just hangs in a limbo. "So what harm is caused if these embryos that will anyway be destroyed are used for research?" he questioned.

But in the first place why create so many embryos and kill them later? Is the pro-life group not against this? "Of course they are against it. They want only the required number of embryos to be made in the first place," he said. But pro-life sympathisers cannot dictate IVF protocols as the technique is constrained by many factors. So the number of embryos in the infertility clinics that will be destroyed or never be used will only keep increasing.

So the issue can be best tackled by taking one step at a time. "Science has to move forward and the first step will be to use the embryos that already exist in the infertility clinics for embryonic stem cell research," Dr. Drazen noted. This clearly seems to be the wise thing to do.

The latest findings by researchers from Harvard Medical School and Massachusetts General Hospital show that female mice are not born with a fixed number of eggs. Rather, these mice continuously produce eggs, courtesy stem cells. If this is true in humans as well, then the fear that women with limited egg supply will be exploited may be unfounded.

Harvard University is one of the centres in the U.S. that will carry out research on embryonic stem cells using State and private funding. They have already succeeded in growing 17 new embryonic stem cell lines and in a rare gesture will provide these cell lines free of charge to scientists in the U.S. who do not receive Federal funds.

Many other states are legally allowing and at times encouraging research in this contentious area. But all this will turn out to be illegal if the President signs the Bill and Senate passes the Bill to ban all forms of cloning. "I don't think the law will ever be passed," he said confidently. "And if it is ever passed then young scientists will go to countries that allow research in this area."

R. Prasad

in Chennai

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