August 20, 2006 to August 27, 2006
Stem-Cell Research
Policy toward Stem Cell Research-BECKER
I agree with Posner that President Bush should allow much greater freedom for federal financing of research on embryonic stem cells. However, I am not convinced that the restrictions he imposed will make that much difference either to world research in this area, or even to that by the United States.
In addition to federal financing of stem cell research, American funds are coming from state governments, foundations and wealthy individuals, and for-profit biotech companies. Since even the strongest supporters of stem cell research would agree that this field should take only a small fraction of the over $35 billion Federal budget for medical research, it should not be difficult to make up any federal shortfalls with monies from other sources.
Californian voters strongly supported a referendum in 2004 for the state to spend $3 billion on stem cell research. While that spending is temporarily held up by litigation, private donors in California have pledged hundreds of millions of dollars to help the state make the transition until the litigation is resolved. New Jersey, Connecticut, Illinois, and Maryland are also discussing state support for research on stem cells. A few private companies are venturing into the stem cell area, even though they concentrate on aspects of this research that could lead to patents and profits.
The aggregate of all spending on stem cell research by non-federal sources probably exceeds what the federal government would have spent in the absence of any restrictions. One useful comaprison is with Singapore, the nation considered to have perhaps the most liberal and generous policies toward research on embryonic stem cells. According to a New York Times article, Singapore has spent a total of $950 million on biotechnology since 2000, and has budgeted another $900 million to be spent over the next five years to finance development of new therapies and drugs. That this is a much larger fraction of Singapore's GDP than say is the ratio of California's approved $3 billion spending on stem cell research alone to U.S. GDP is not relevant. For it is the absolute spending level that determines the amount of research that can be done when comparing America to countries like Singapore with quite high standards of living.
A well-known result in economics is that up to a point increased federal government spending on various programs discourages private and local government spending on similar programs almost dollar for dollar. By that is meant that if other sources had been spending say $500 million on research on cancer, and if the federal government adds another $200 million to its own spending on cancer research, these other sources would reduce their spending by close to $200 million, perhaps to spend the money on other diseases. In that example, the greater federal spending had little net effect on total spending on cancer research. Only if the increase in federal sponsored cancer research greatly exceeded $500 would that make a large difference to the total amount spent on cancer research.
This analysis is directly applicable to the controversy over financing of stem cell research. The amounts budgeted by state governments, universities, and private philanthropies for research on stem cells is large relative to any additional amounts that would be spent by the federal government in this area, absent any restrictions on what the federal government can finance. So mainly what is happening is that private and more local public sources of finance are replacing the federal government, and federal monies are going instead to research on other aspects of health.
If that is the case, why it might be asked, have several prominent American stem cell researchers moved to Singapore to conduct their research? Part of the answer is that Singapore is lavishing very high salaries and generous research budgets on a small number of prominent stem cell researchers. In this way they have also attracted well-known British researchers, even though Britain has a much more liberal government policy toward stem cell research than the U.S. federal government has. This means that Singapore probably would have succeeded in attracting some prominent stem cell researchers from the U.S. even without the present federal restrictions.
Two qualifications should be made to my rather rosy view about the effects of the limited federal approach to financing stem cell work. One is that, as Posner suggests, some stem cell specialists may believe that the U.S. restrictions will grow tighter in the future than they are at present. I believe the opposite is more likely, that pressure will build to loosen them further, but that is far from certain. Another qualification is that present restrictions make it difficult for researchers supported by federal grants in other medical areas to combine that work with use of embryonic stem cells. I do not know how serious that restriction is, but scientists who call for more liberal policies on federal financing of embryonic stem cell research do not frequently raise this argument.
My final point is that it is not necessary or possible for the U.S. to take the lead in all areas of medical research. If Singapore, Great Britain, Finland, Canada, or other nations take the lead in stem cell research, the United States would be allocating more of its generous federal support of medical research toward other fields. This may well be close to an optimal allocation of monies spent on medical research among different fields and approaches, even considering U.S. interests alone.
The Economics of Stem-Cell Research--Posner
Stem cells are "general purpose" cells out of which the cells specialized to particular organs develop. Stem cells could, in principle, be used to "grow" human organs for transplant purposes. The thereapeutic potential of stem cells is considered enormous, but, for the most part, not imminent; stem-cell research is at the basic- rather than applied-science stage.
For research purposes, embryonic stem cells, found in fertilized ova of a few days old, are greatly superior to adult stem cells. The usual source of embryonic stem cells is embryos created for use in vitro fertilization. More are created than are used to produce a fetus, and the surplus embryos are stored for future use or destroyed. Stem cells can be extracted from these "excess" embryos, but, thus far, not without destroying the embryo.
In a thoughtful speech in August 2001, President Bush laid out the pros and cons of continued stem cell research. The principal pro is obvious: the therapeutic potential of stem cells. (Later I'll give some additional reasons why we shouldn't want to discourage such research.) The cons are ethical in nature. Many religious people believe that a fertilized human ovum is a human being and they therefore regard the extraction of stem cells from the embryo, when it causes the embryo's destruction, to be murder, just like therapeutic (as distinct from spontaneous) abortions. Miscarriages are the best-known form of spontaneous abortion, but about half of all pregnancies are terminated by spontaneous abortions, most occurring before the woman realizes she's pregnant.
Some people who do not consider an embryo a human being nevertheless oppose stem cells research believe that the use of stem cells for therapeutic purposes would be the equivalent of cloning a human being in order to create spare parts to replace a person's organs as those organs become incurably diseased or wear out. They imagine a time when, if permitted, parents will clone their child at birth and use the clone as a source of replacement organs for the child. Other people oppose embryonic stem cell research because they oppose in vitro fertilization as tampering with the natural order of things.
It is not easy to deal analytically with arguments that are based on religion or emotion rather than on pragmatic considerations. Given the number of spontaneous (not to mention deliberate) abortions and the fact that in vitro fertilization, which produces excess embryos, is lawful, it is a little mysterious what exactly is objectionable about using some of these excess embryos, which would otherwise either be destroyed or stored indefinitely with dim prospects of ever being used to produce more in vitro children, unless the objector opposes all nonspontaneous abortion. And that is an opposition founded on religious belief. Some secular people oppose abortion as encouraging promiscuity, but that concern is inapplicable to the use of embryos as a source of stem cells.
The idea of cloning a child in order to have a spare source of organs--the idea that the clone's organs would be harvested, as needed, for transplantation into the child--is fanciful. To create organs from stem cells would not require creating an entire person. Moreover, whether a person originates as a clone (which is, for example, what an identical twin is), as a product of caesarean section, or in any other nonstandard fashion, it is still a human person with all the rights that persons have, including the right not to be killed just because someone else would like his organs. (I am of course assuming that an embryo is not a person for legal purposes.)
Bush concluded his August 2001 speech by announcing that he would oppose lifting the existing ban on federal support of stem cell research except with regard to existing stem cell lines, of which there were then 60, in laboratories scattered around the globe. Many of these lines turned out to be unusable for research purposes; today only 22 are left, which are too few to satisfy research needs. In response to this deficit Congress passed, but the President has now vetoed, a statute that would have lifted the ban.
Many countries, such as the United Kingdom and Singapore, not only do not share our qualms about stem cell research but want to make such research a major focus of their thriving biotech industries. Singapore recently lured leading American stem cell researchers to its major biological research center.
There are several economic points that spring to mind about the U.S. ban. The first is its futility, and this for two reasons. Since the researchers are not tied to any particular country, the maximum effect of the U.S. ban would simply be to shift all stem cell research to other countries; it would not stop the research and save the embryos. In addition, however, U.S. law does not ban stem cell research, but only the use of federal funds for that research. The main therapeutic applications of stem cell research lie too far in the future and are too uncertain to attract much private investment, given the high discount rates that most businesses use to evaluate projects. But there is plenty of state and especially private charitable spending on medical research, and so the ban on federal funding of this one area of medical research should merely cause a reallocation of research funds. More state and private money will go to stem cell research and more federal money to areas of research that will be receiving less state and private money because more of that money will be used for stem cell research.
But if the federal ban is not affecting the amount of financial support for stem cell research, why are many of our researchers going abroad to conduct that research? Why do countries like the U.K. and Singapore think they can steal a march on us? The answer may be that the U.S. research community does not think that opposition to stem cell research will express itself only in a ban on federal support for such research. Although the Supreme Court has recognized a constitutional right to abortion, it is unlikely to recognize a constitutional right to conduct stem cell research, even if the objections to such research are the same as the objections to abortion. The fact that the objections are primarily a product of religious belief would not invalidate them, because banning stem cell research does not infringe anyone's free exercise of religion or constitute an establishment of religion. Many moral precepts embodied in laws that no one supposes unconstitutional are the product of sectarian beliefs that secular people (or indeed religious people belonging to sects that are less influential in this country) reject. However, most of the precepts themselves, such as the taboo against murder, are shared by people of different, and of no, religious faiths; you don't have to believe that Moses brought the Ten Commandments down from Mount Sinai (you don't have to believe there was a Moses) to condemn murder. In contrast, opposition to abortion and stem cell research is not widely shared by people who do not belong to a particular subset of religious sects.
The loss of leading-edge biological researchers to other countries could be costly to the United States, especially if there are complementarities between stem cell research and other areas of biological and medical research. We may wake up some day to find that foreign institutions have obtained patent protection for highly lucrative medical therapies that our population will demand the government subsidize. I predict, however, that generous state and private funding of stem cell research will stem the reverse brain drain. (And if researchers are easily lured abroad, they are easily lured back.) Moreover, as therapeutic applications of stem cell research become more imminent, the pressure to relax the ban on federal funding is bound to give way.
Response to Comments on Stem Cell Research--Posner
There were a number of interesting comments. I will reply to a few.
Several comments oppose federal support of medical or other research. That is a legitimate position, but it is not directly relevant to the stem cell issue. The reason is that banning federal support of stem cell research does not entail a reduction in the total federal funding of research, but merely a reallocation from stem cell research to other research.
In support of federal funding of basic research in general, as distinct from relying on state and private donations, David points out that "Almost every lab in a reputable academic institution in this country pursues multiple projects at once. Thus, scientists from those labs would have to create entirely new labs, devoid of federal funding, to perform even one experiment using stem cells."
Federal fundingof research is not ideal, because of political interference--the ban on stem cell research is only one example. More important is the overinvestment in research on AIDS, relative to the number of lives at risk, and the disproportionate investment in research on breast cancer, compared for example to research on prostate cancer. In general, though, the federal peer review process assures that NIH grants (for example) go to high-quality projects. I do not believe there is the same kind of politicized geographical dispersion that one finds in more politicized and less objective areas that federal largesse supports, such as grants by the National Endowment of the Humanities.
A number of the comments debate what seem to me purely metaphysical questions concerning when life begins, whether five-day embryos should be treated as full-fledged human beings, etc. By "metaphysical" I mean can't be resolved by reference to logic or evidence. They are matters of opinion and endless contestation, strongly influenced by religious views that cannot be verified or refuted (modern religions are careful to avoid proposing falsifiable hypotheses, such as that the world will end on September 1, 2006). I get no nourishment from such debates. I believe that upbringing, temperament, experience, emotion, and certain brute facts determine one's answers to such questions, not truth or falsity. If stem cell researh fulfills its promise, I believe that the moral objections will be swept aside, because even religious Americans are pragmatists.
I do not agree that if you think it's okay to harvest stem cells from a five-day old embryos, you've got no grounds for condemning the murder of children and adults or even the killing of a three-month old fetus. All societies draw lines in these matters; none I think considers a decision to be celibate the equivalent of murder because the decision results in extinguishing potential life. Where the lines are drawn depend ultimately, I have suggested, in our society at least, on practical considerations.