An Instance When John McCain Rightly Decides To Distance Himself From George Bush And His Wars

McCain may not be a Warmonger, and he is right to make this statement, but he has miles to go before I would agree with his position on the wars we're fighting. Check out other David Horsey cartoons. (Click on the image above to see a larger version.)

Floating An Idea

In between some pages for patients, I just finished watching snippets of Bush's SOTU and the Democratic response.

One of the calls was for a patient who developed severe tachycardia (his heart rate shot to 150-170) just as Bush began his speech. He assured me that it was not anxiety that caused the spike.

But I digress. If you are planning to vote for a Democrat in the fall, I need your advice. What do you think about the strategy of getting behind your candidate, but not so much that you are upset if she/he doesn't get the nomination? Or is this just a rationalization for me to justify not picking a horse in this race?

Middle Ground For Stem Cells?

You've probably already seen the headlines: "Top Scientists Generate Stem Cells From Cloned Skin." My local Seattle paper has a story. So does the NYTimes. Not surprisingly, the Times article is really good. They tend to get it when it comes to stem cell science and politics. The articles there represent the science well and give a good breakdown of the political context of the announcement. But for a better breakdown, read Matt Nisbet's post on his Framing Science blog. He points out that middle ground in the stem cell debate is murky, if it even exists. I think the potential for middle ground would be greater if we could get away from the polarizing environment that make a presidential "I told you so" possible. I'll get to that in a minute. First the science:

Tonight I passed on reading about chronic pain to get the dirt on the research in the Cell and Science articles. And what do I get? Well at first it was a bunch of freakin' press releases and 'digested for the lay public' news articles. I started to think that this was just a ruse to provide a reason for me to give thanks tomorrow when the currency of science - the paper - was released. But then I found the Sciencexpress paper (you need a subscription, of course).

What do I think? These stories look pretty good. Okay, really good. The teratomas look a lot better than the sorry examples provided by the Yamanaka group in July of '07. (The Yamanaka paper in Cell also looks much better this time around.) The pathologist in me wants more than the H&E tissue sections the Thomson group provided. I want to see definitive lineage markers by histology. But none the less, I am pretty impressed. They set out to create a stem cell line that could produce all three germ layers. It looks like they did. The next question is whether these pluripotent cells are as pluripotent and as controllable as the embryonic stem cells. The only way we will know is by doing the experiments. My former dissertation adviser, Chuck Murry, has already put an order in for these cells and should have some in Seattle by January 2008. Can they be coaxed into beating human embryonic stem cell derived heart cells?

(By the way, if you are looking for a more detailed take on the science, please refer to Pharyngula, The Scientific Activist or Dear Science.)

Moving on to the political situation, there is plenty of hot air out there to get indigestion about. Fortunately, there are some level heads to provide the TUMS needed for me to get a good night's sleep.

From the New York Times article.

Karl Zinsmeister, a domestic policy adviser to Mr. Bush who kept the president apprised of the work said, “I don’t think there’s any doubt that the president’s drawing of lines on cloning and embryo use was a positive factor in making this come to fruition.”

Mr. Bush’s critics say he should not be so quick to take credit. They note that the reprogramming method has some kinks to be worked out and say the research would never have proceeded without the initial embryo experiments. The critics say that far from encouraging research, Mr. Bush has stood in its way.

I got queasy reading the first paragraph (the aforementioned presidential "I told you so"). If you will allow me to continue with disease/treatment metaphors, its follower provided the anti-emetic I needed to keep my keyboard vomit-free.

Let's not overlook the quote from the only Republican senator I ever voted for:

“I really don’t think anybody ought to take credit in light of the six-year delay we’ve had,” said Senator Arlen Specter of Pennsylvania, the lead Republican sponsor of the bill that Mr. Bush vetoed in July 2006. “My own view is that science ought to be unfettered and that every possible alternative ought to be explored.”

Yeah! I think I would vote for him again!

[tirade]

What's not being brought to the table here is the notion that most of science is not about designing cures! It's about asking questions and answering them. Goal-oriented science and translational research is what pays the bills because it captures our imagination. But when it comes down to the bottom line in biomedical research, we need to understand mechanisms and systems before we go and use some new-fangled therapy in the clinic. Why is this important? I need only cite the unfortunate example of Jesse Gelsinger. Viral gene therapy was not ready for prime time, and a sick kid paid the price. Where do we begin to understand stem cell differentiation?

The thing is, embryonic stem cell researchers have always contended that the goal is to generate stem cell lines that don't need to come from blastocysts. After all, it's a good chance that ES cell-derived tissue replacements would need immune suppression to prevent rejection. If stem cells could be derived from other cells, that would obviate the side effect-prone rejection medicines. Embryonic stem cell research teaches us about cell reprogramming so that maybe there will be a clinical application in the future. Indeed, the same interventions that were used in these (what I think will amount to) monumental papers to generate these ES cell-like cells were studied in embryonic stem cells.

Science is and relies on progress. To say that the shortsighted policy made by George Bush and his puppet show of a Presidential Bioethics Committee is anything but a hindrance to science is not just disingenuous, it's an outright lie.

[/tirade]

And I wonder why we can't all just get along. Let me tell you (and myself): It's because crazies like me are tired of the political misuse and misrepresentation of science.

CDC and the White House

A good cartoon tells it the best sometimes. I am behind on this story, and a bunch of other folks have covered this really well. Such as Mr. Mooney, Pugwash, and Mr. Mad Biologist. So all I have to offer is this clever cartoon by David Horsey from my local newspaper. The incident referred to is just the latest in a string of censorship that our great leader has perpetrated against science.
I would like to think that this sort of thing will not continue after Jan 20, 2009. But something deep inside me feels like the threat of political interference in science will always be there...

Stem Cells Vetoed

No surprises today. George Bush put on his 'sanctity of life' mask as he vetoed the stem cell bill presented to him two weeks ago. Ellen Goodman from the Boston Globe wrote a pretty good editorial of the stem cell issue (syndicated here in my parents' home-town paper). Highlights from that piece include quotes that I hope hit home with the lay reader:

The reason researchers use embryos is not because they want to run a recycling program for in vitro fertilization clinics. Nor because they have a passion for wedge issues. It's because the embryo can do what scientists can't do yet.

and

In short, we'll need to use human embryos even to help us eventually stop using human embryos.

This is basically true. As I have advocated before, we need to support both embryonic and adult stem cell research, and not just with lip service. The counter-offer the administration is proposing is focuses on recent scientific advances that have the potential to sidestep ethical controversies involving embryonic stem cell work. The full text of the executive order is here.

Let me point out to you the important parts of this proclamation and also some of its nonsense:

Section 1 (a): The Secretary of Health and Human Services (Secretary) shall conduct and support research on the isolation, derivation, production, and testing of stem cells that are capable of producing all or almost all of the cell types of the developing body and may result in improved understanding of or treatments for diseases and other adverse health conditions, but are derived without creating a human embryo for research purposes or destroying, discarding, or subjecting to harm a human embryo or fetus.

• The leading techniques for doing this involve nuclear reprogramming or somatic cell nuclear transfer. You know what the lay press calls these techniques? Cloning! This is a good example of double-speak.
• "embryo or fetus" It sure is convenient that Bush's science consultants threw in an emotional term like fetus, even though it has no relevancy to the science.

Section 1 (b) iv: Within 90 days of this order, the Secretary renames the "Human Embryonic Stem Cell Registry" the"Human Pluripotent Stem Cell Registry."

• Hmmm... I am not sure if I like this or not. I've noted before that scientist failed to frame this properly by using the word embryonic, so I kindof like the idea of changing the terminology.
• It's the next point that pulls me in the other direction.

Section 1 (b) v: The Secretary must add to the registry new human pluripotent stem cell lines that clearly meet the standard set forth in subsection (a) of this section.

• Whoa!!! Let's just water down an already dilute stock of limited stem cell lines with some less potent, uncharacterized lines.
• The last time I checked, there aren't any human non embryonic pluripotent stem cell lines. Let me know in 5 years if there are any yet.

Section 1 (c) Not later than December 31 of each year, the Secretary shall report to the President on the activities carried out under this order during the past fiscal year, including a description of the research carried out or supported by the Department of Health and Human Services, including the National Institutes of Health, and other developments in the science of pluripotent stem cells not derived from human embryos.

• Over Christmas Cookies, Bush: "Hey Mikey, got any new-fangled stem cells that don't come from cute little babies?"
• Michael Leavitt: "No sir, but we're timing another mouse stem cell study to be released around the time those pesky congressmen give you another bill to veto."

Section 2 (b): It is critical to establish moral and ethical boundaries to allow the Nation to move forward vigorously with medical research, while also maintaining the highest ethical standards and respecting human life and human dignity.

• Exercise for the reader: try changing "medical research" to "international diplomacy."

Finally a note of practicality: the NYTimes points out that:

this effort appears largely symbolic — there is no money attached — and scientists were instantly skeptical.

Including the same scientists who published the recent skin stem cell work.

It is true that the August 9, 2001 Bush stem cell policy has caused an explosion of creative techniques to acquire non-embryonic pluripotent stem cells. But many commentators believe this work would have occurred anyway because of the desirability of personalized stem cells that are not rejected. What is too bad is that much of the US will be handicapped when these restrictions are lifted because, as Ellen Goodman writes, "the embryo can do what scientists can't do yet." The best way we will learn about what the embryo (and these potential new sources of pluripotent cells) can do is by, well, studying human embryonic stem cells.