President George W. Bush “felt pulled in both directions” in the early months of his presidency, as he struggled to decide whether to support US funding of human embryonic stem cell research, the ex-president writes in his new memoir, Decision Points.
“I had no interest in joining the Flat Earth Society. I believed in the promise of science and technology to alleviate suffering and disease…..At the same time, I felt that technology should respect moral boundaries. I worried that sanctioning the destruction of human embryos for research would be a step down the slippery slope from science fiction to medical reality,” Bush writes in a chapter that gives the blow-by-blow on how he arrived at his August, 2001 decision to fund human embryonic stem cell research only on stem cells lines that existed at that time.
(For an excellent history of US stem cell policy through 2004, see this Congressional Research Service report.)
Bush writes that he had input from all sides in the debate during the first half of 2001, as it became known that he was actively considering whether to extend the 1999 Clinton administration policy — which had not yet been implemented with the actual issuance of grants — of funding the research as long as the derivation of stem cells, with its attendant embryo destruction, was privately financed.
Bush learned that even staunch anti-abortion Republican senators Orrin Hatch and Strom Thurmond supported government funding for the research; after speaking at Yale, the president collared former National Institutes of Health (NIH) director Harold Varmus for his opinion; and that April, he received a written plea from former first lady Nancy Reagan asking him to support the “miracle possiblities” of the research. (Ronald Reagan died of Alzheimer’s disease in 2004.)
But he also got an earful from opponents of the research, including the National Right to Life Committee, which pointed to a program run by Nightlight Christian Adoptions, facilitating the implanting of left-over embryos from in-vitro fertiliziation in adoptive mothers. His adviser Jay Lefkowitz read aloud to him in the Oval Office from Aldous Huxley’s 1932 dystopian fantasy, Brave New World. And Bush bent the ear of a Parkinson’s-disease-stricken Pope John Paul II in his summer residence overlooking Lake Albano. “He was firm in his view that human life must be protected in all its forms,” Bush reports.
But the key decision point came during a July 10, 2001 conversation with Leon Kass, the University of Chicago physician and bioethicist. Bush writes that he himself proposed a compromise: funding research only on existing stem cell lines. Kass replied that such a policy would be ethical as long as the president made it clear that no US funding would be provided for further stem cell derivation. “If you fund research on lines that have already been developed,” Kass said, “you are not complicit in their destruction.”
Bush at first faced harsher criticism from the right than from the left for the new policy, he says. But, with time, he writes, “Democrats …concluded that stem cell research was a political winner. It allowed them to open a new front in the abortion debate while also claiming the mantle of compassion.”
He adds that the new policy placed then-NIH director Elias Zerhouni “in a tough position. He felt trapped between a president he had agreed to serve and the scientific community of which he was part.” But Zerhouni, Bush goes on, “was more interested in new cures than in politics. He funded the alternative stem cell sources aggressively, and a good deal of credit for the breakthroughs in the field belongs to Dr. Zerhouni and his team of professionals at the NIH.”
Bush does not dwell on what he means by “breakthroughs,” except to restate the oft-repeated claim that non embryonic sources “yielded new treatments for patients suffering from dozens of diseases— free of moral drawbacks.” He cites one example: the use of umbilical cord stem cells to treat patients with leukemia and sickle-cell anemia.
Bush goes on to trumpet his push for greater funding of non-embryonic human stem cell research, and to defend his vetoing, twice, of legislation passed by Congress that would have allowed US funding of research on lines newly derived, with private funding, from leftover embryos at fertility clinics. “I would not change my position,” he writes. “If I abandoned my principles on an issue like stem cell research, how could I maintain my credibility on anything else?”
The innocent reader might be forgiven for concluding, based on the chapter’s closing paragraphs, that the controversy is over. In late 2007, “I was thrilled by the news,” Bush writes, that induced pluripotent stem cells had been derived. He adds that the Cell paper by Shinya Yamanaka and colleagues showed that, “By adding just four genes to the adult [skin] cell, scientists were able to replicate the medical promise of embryonics stem cells without moral controversy.”
The ex-president then quotes the conservative columnist Charles Krauthammer: “The verdict is clear: Rarely has a president — so villified for a moral stance — been so thoroughly vindicated.”
Today, most researchers would argue that induced pluripotent cells have provided no such slam-dunk solution. Nevertheless, with a lawsuit challenging President Barack Obama’s liberalized funding policy for human embryonic stem cell research wending its way through the courts, one can imagine President Bush’s book tucked into a few briefcases and affecting the public’s perception of the case just as it approaches a crucial turning point.
(For full coverage of the ongoing litigation, see Nature‘s Stem Cell Injunction News Special.)