Just before this past Thanksgiving, I spent three days inside Vatican City at a very unusual conference. The topic was stem-cell research, a subject of fierce political and moral debate because some forms of stem-cell research involve human embryos or, potentially, cloned human embryos.
So what was I, a known proponent of embryonic stem-cell research, doing inside the Vatican walls? The Pontifical Academy for Culture had convened a meeting to examine “ethical” ways to do such research. And while I do not agree with the church about the immorality of embryonic stem-cell research, I do agree that pursuing other forms of stem-cell research is absolutely worthwhile. So, leaving behind a cell-phone number lest I should wind up in a dank medieval dungeon, off to Rome I went.
I need not have worried. I could not have been treated more kindly nor given a better forum to say whatever I wanted. But, just as I had presumed, the topic of embryonic stem-cell research was not going to get any attention other than condemnation. This was a meeting to extol adult stem-cell research.
Church leaders have made it clear time and again that they oppose the destruction of embryos as a way to get stem cells. It does not matter where the embryos come from; even if they are obtained from unwanted embryos at fertility clinics, as I suggested a decade ago, the church says they must not be used.
That stance leaves the Roman Catholic hierarchy in a tough ethical spot. The church wants to find cures for a long list of awful diseases, but prelates face the prospect of a possible cure coming from ongoing embryonic stem-cell research that is taking place in many nations and some states in the United States. That would force the church to take a position on the morality of the desperately ill using any such cure on themselves or of parents using it on their desperately ill children. That is a dilemma the Catholic Church is understandably eager to avoid.
A major point of the meeting this past November was to make it clear to the world that the Vatican recognizes the need to find cures. The meeting was called to illustrate a possible way forward via what the church has been convinced is the promising path of adult stem cells—which are found in various organs and tissues of the adult human body. These cells, the Vatican thinks, hold the moral and scientific answer to the challenge of finding possible cures without resorting to embryonic stem-cell research.
Efforts to transplant naturally occurring adult stem cells or to tweak them into more powerful states to fix what ails you are, in the view of the Vatican, worthy of enthusiastic support—so much so that at the meeting, high-ranking church leaders explicitly endorsed the efforts of a small company, Neostem, which has been in the adult stem-cell business for years.
Neostem is an international biopharmaceutical company with aggressively marketed adult stem-cell operations in the United States, a network of adult stem-cell therapeutic providers in China, and a 51 percent ownership interest in a Chinese generic pharmaceutical manufacturing company. The company has been criticized for its highly optimistic pitches exhorting people to bank, at significant cost, their own bone marrow or, for new moms, cord blood. The benefit of such banking is somewhat overstated in the company’s advertisements. And those connections to China, given a history of problems with the integrity of clinical trials and the safety of drugs made there, also are reasons for concern. Still, despite these warning flags, the church chose Neostem as something of a partner to push adult stem-cell research forward.
The Roman Catholic Church is trying to steer an emerging area of science—stem-cell medicine—in a particular direction using its opposition to embryo research as an ethical rudder. By throwing its ethical might and even its money into the debate about where to get stem cells and how best to study them—and praising the work of scientists and companies that follow the church’s position—the church is telling scientists and investors to focus only on stem-cell work that does not involve embryos.
Do men in red caps and clerical collars know best about how scientists should seek to find cures for terminal and disabling diseases? I don’t think so, and not simply because I am a proponent of embryonic stem-cell research. In my view, the Vatican’s earnest desire to offer hope without compromising a core moral stance about embryo destruction led it to show way too much enthusiasm about adult stem-cell research at this meeting. Time and again, speaker after speaker gave presentations on studies with very small samples of subjects or with no real long-term follow-up. To be blunt, some of the reports had nothing but the backing of a tiny handful of very optimistic scientists, some of whom had equity in the work being discussed.
The church, if this conference is any indication, is not very good yet at separating the wheat from the biomedical chaff when it comes to adult stem-cell claims. In its enthusiasm to remain a leading voice on how to help the hundreds and hundreds of millions of people worldwide suffering miserably from chronic and incurable diseases, the Vatican showed it can be dangerously susceptible to hyperbolic claims of cures involving non-embryonic stem cells. To give but one example, one Italian bishop talked about an alliance he had created with a scientist to procure fetal stem cells from the brains of spontaneously aborted fetuses born in Italy in order to pursue treatments for neurological diseases. No one challenged this idea. Yet the idea is horrendously bad, both because it is very hard to control the quality of such cells and because the chance of their being abnormal or infected with nasty microbes or necrotic material is significant.
Adult stem-cell research holds promise for treating many diseases. But the Vatican needs to realize that it has its own ethical pitfalls, including a lack of adequate international regulatory oversight, companies rushing to hype their work to attract investment, the outsourcing of trials to places where protection for human subjects interests is iffy, an absence of standardized registries to evaluate short- and long-term claims of cure, and more than a few outright shysters looking to make a quick buck off of the desperate.
It remains to be seen how this effort by the Vatican will play out. Many researchers, patient advocacy groups, and companies pursuing embryonic and cloned stem-cell research in the United States, Britain, Singapore, China, Korea, and elsewhere will pay no attention to the church’s message that adult stem-cell work is the most promising avenue to pursue. It may be that the Vatican finds itself on the wrong side of some overheated claims about the efficacy of adult stem-cell research in its zeal to nudge research along that path. When religious or ideological values are in play, extreme caution is in order about what is the best way for science to advance.
Arthur L. Caplan is the Sidney D. Caplan Professor of Bioethics and the director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.