Tuesday, March 24, 2009

Obama Flubs on Stem Cells

He did just sign an executive order lifting the August 9, 2001 restrictions on Federal funding for research involving human embryonic stem cell (ESC) lines, but President Obama still doesn't seem to understand the science involved in the decision. Of the thirteen questions he fielded in tonight's press conference, the one he did the worst answering was the one from Washington Times journalist John Ward.

Watch the Q&A and then indulge me by reading my take on Obama's response.

Did you catch the sections where Obama displayed a strangely Bush-in-the-headlights look. I'll remind you as we read through it again together.

QUESTION: In your remarks on stem cell research earlier this month, you talked about a majority consensus in determining whether or not this is the right thing to do, to federally fund embryonic stem cell research.

I'm just wondering, though, how much you personally wrestled with the morality or ethics of federally funding this kind of research, especially given the fact that science so far has shown a lot of progress with adult stem cells, but not a lot with embryonic?

PRESIDENT OBAMA: Okay. No, I -- I think it’s a -- I think it’s a legitimate question.

Actually, no! The question is not entirely legitimate. The questioner added on the to the end of his question the words, "especially given the fact that science so far has shown a lot of progress with adult stem cells but not a lot with embryonic." This is horribly misleading. Adult stem cells have been "researched" for half a century. Human embryonic stem cells were first characterized in 1998. The speaker sets up a straw man that the two types of cells are on level ground. So the question isn't legitimate if it isn't true. By calling it legitimate Obama ceded ground because everybody has in their mind that last phrase. To clarify, embryonic stem cells have shown more promise in the past 10 years than adult stem cells did in their first 25.

OBAMA: I -- I wrestle with these issues every day. As I mentioned to -- I think in an interview a couple of days ago, by the time an issue reaches my desk, it’s a hard issue. If it was an easy issue, somebody else would have solved it and it wouldn’t have reached me.

Look, I believe that it is very important for us to have strong moral guidelines, ethical guidelines, when it comes to stem-cell research or anything that touches on,

AWKWARD FUMBLING-FOR-WORDS SILENCE... So this is why you use the teleprompter so much!!! By the way, it's not cool to conflate morals with ethics. Morals can influence ethics, but they are not the same. This confusion is a big reason so many scientists are upset with the religious right. Morals are personal standards. Ethics inform a social standard. By definition, defining ethics is a consensus-dependent activity. Players on both sides of this argument are still not ready to talk with each other.

you know, the issues of possible cloning or issues related to, you know, the human life sciences.

COME ON! "possible cloning or issues related to, you know, the human life sciences?" I would have liked to hear a reference to the main issue here: when do we think humanity begins?

I think those issues are all critical, and I’ve said so before. I wrestle with it on stem cell; I wrestle with it on issues like abortion.
Okay, there it is. Finally, there's a politician willing to call a spade a spade. The reason this debate is so lively is that the pro-life contingent already has a high-functioning political machine... Now we just need some effective communication about how stem cell research isn't the same as abortion.

I think that the guidelines that we provided meet that ethical test. What we have said is that for embryos that are typically about to be discarded, for us to be able to use those in order to find cures for Parkinson’s or for Alzheimer’s or for, you know, all sorts of other debilitating diseases, juvenile diabetes, that -- that it is the right thing to do. And that’s not just my opinion. That is the opinion of a number of people who are also against abortion.
Nooooooooooooooo! Not the C-word! What we scientists are after is understanding that leads to treatments. Politicians LOVE cures. The thing is, there aren't many cures in medicine. (And some ill-informed autism advocates want to take those away from us!) When there is no cure, the adoring crowd supporting research could turn to an angry mob. And another thing: When are the politicians' science advisors going to step in to help them understand which diseases stem cell research is likely to yield treatments for??? Stem cell research might have a chance at curing neurological diseases. There's a chance that Parkinson's could be treated because its a pretty well-defined region of the brain that's affected. Even then, I'm not sure we've figured out how to convince the ESCs to become substantia nigra (that's the region of the brain involved) cells, much less how to get them to integrate. But Alzheimer's Disease (AD)? We still know relatively little about how AD occurs. We know it hits different people differently and have really good tests to identify dementia or to diagnose the disease at autopsy, but even the expensive medicines so many people take hardly work at all. Nancy Reagan pleaded with GW Bush to lift his restrictions because of AD. Politicians who support ESC research use Alzheimer's because 1) a lot of people get it and 2) everyone is scared of it. Okay, so I don't like AD or Parkinson's. What are the diseases that could benefit from ESC research? Try spinal cord injury - the first FDA approved human trial for any ESC therapies is underway already. Diabetes is another good one, though my cynical side believes that disease was thrown in because the Juvenile Diabetes Research Foundation is one of the biggest science lobbying groups. The disease no one talks about is CANCER. What we are learning about reprogramming stem cells will likely inform future treatments for cancer.

Back to OBAMA: Now, I am glad to see progress is being made in adult stem cells. And if the science determines that we can completely avoid a set of ethical questions or political disputes, then that’s great. I have -- I have no investment in causing controversy. I’m happy to avoid it if that’s where the science leads us.

Fair enough. In an ideal world, we will be able to learn from ESCs in order to reprogram other stem cells to do the same thing. And that is exactly what a couple of scientists did recently with induced pluripotent cells (IPCs). Read about them at Wikipedia. A future Nobel Prize may be awarded for this work... But this work would not have been possible without ESC research.

OBAMA: But what I don’t want to do is predetermine this based on a very rigid ideological approach. And that’s what I think is reflected in the executive order that I signed.

Way to finish strong. Let science ask the questions, but have a more-or-less consensus ethical framework within to let them work.

QUESTION: I meant to ask as a follow-up, though, do you think that scientific consensus is enough to tell us what we can and cannot do?

PRESIDENT OBAMA: No. I think there’s always an ethical and a moral element that has to be -- be a part of this. And so, as I said, I don’t take decisions like this lightly. They’re ones that I take seriously. And -- and I respect people who have different opinions on this issue.

But I think that this was the right thing to do and the ethical thing to do. And as I said before, my hope is, is that we can find a mechanism ultimately to cure these diseases in a way that gains a hundred percent consensus. And we certainty haven’t achieved that yet. But I think on balance this was the right step to take.
The president wisely ended on the ethics part of the question, so finished strong, but I hope that Mr. Obama's science advisers help him understand this topic so that it's not the science question at his next news conference that he flubs.

And I'll be honest with you: in terms of the potential for the cells to become any tissue in the body, I didn't think that the IPCs would stand a chance against ESCs back when they were first derived. But the great thing about science is that opinions only matter until the data comes back. And if you don't accept the data that everyone else does, you can do the experiment yourself. Unlike politics, the central element of all science is honesty and integrity; when proven wrong, the best scientists dust themselves off and start asking new questions. The investigator who does not will soon be out of a job.

1 comment:

gecko said...

I had many of the same (though not nearly as complete) thoughts when I heard Obama's comments on stem cells. The comparison to adult stem cells! - so few people (especially not the media...) actually understand that not only is there a difference in the number of years of data available but also the therapies in which adult stem cells have been "successful" are completely different, for the most part, from the ones being considered for ESCs/iPSCs. Hematopoietic stem cells have done wonders in the world of leukemia, but aren't so hot at curing heart disease. And as for iPSCs - indeed, how would we know what they could do without having already characterized their truly embryonic counterparts?

Thanks for your comments on Obama's press conference. I too hope that he gets a better briefing on the actual science and not just the media sound bytes.