The pursuit and production of knowledge through scientific research offer enormous intellectual rewards while also performing an important social function. Human stem cell research holds great promise of falling into this category, as reflected in the papers appearing in this special issue. But as several authors point out, certain types of stem cell research engender controversy. It seems sensible, therefore, to consider how best to balance the promise of such research with the genuine concerns about proceeding with it that are held by some sectors of society.
During the past year, policy proposals have been issued by three bodies in the United States: the National Bioethics Advisory Commission (bioethics.gov/stemcell.pdf), the National Institutes of Health (www.nih.gov/news/stemcell/draftguidelines.htm), and the American Association for the Advancement of Science (AAAS) (www.aaas.org/spp/dspp/sfrl/projects/stem/report.pdf). These constitute a basis for informed and broad-based public discourse and policy deliberations at the national level. Outside the United States, many countries are revisiting their policies on embryo research in light of the recent advances related to primordial human stem cells (see the Viewpoint by Lenoir, p. 1425).
We must accept the fact that public policy in a pluralistic society cannot resolve all differences that arise regarding sensitive social issues. Tension is inevitable between what we can do and what we should do. Nevertheless, to forego efforts to construct policy where important social values are at stake would be to abdicate a critical public responsibility. What criteria, then, should be used for assessing these various policy proposals regarding stem cells? Surely we want a policy that promises to advance knowledge that contributes to improved patient welfare. To achieve this will undoubtedly require a large and sustained infusion of public funds. Justifying such a public investment, however, calls for a policy that embodies broad social values, such as assurances that people in need will have access to the benefits derived from the research and that personal autonomy will be respected. Public policy should provide a basis for developing uniform ethical guidelines, a task as critically important as it is inevitably difficult, but one that can draw on the reservoir of values deeply rooted in religious and secular traditions. It should balance the promotion of scientific inquiry with public accountability, providing scientists with clear expectations and requirements for conducting stem cell research, while also establishing the transparency of the research for public review and oversight. Such oversight should be in proportion to the seriousness of the concerns raised and not create unwarranted barriers to realizing potential benefits. Public policy should also recognize an appropriate role for public-private partnerships, thereby acknowledging the crucial role that industry has and can continue to play in supporting stem cell research. Finally, but by no means least, policy should be informed by and continue to support civic discourse so that the values of all stakeholders can be carefully considered and weighed. As part of that national conversation, scientists should be prepared to communicate the results of their research in ways that are understandable to a diverse audience and to temper their enthusiasm about the promises of stem cell research with realistic appraisals of the hard work that remains to be done.
In our search for common ground on a subject that so stirs emotions, all parties must tone down the rhetoric if we are to craft a workable and acceptable policy for human stem cell research. We must not let this “policy moment” pass without action. Neither scientific inquiry nor all those challenged daily by serious diseases who might benefit from medical applications derived from stem cell research, whatever the source of the stem cells, should have to endure an extended period of uncertainty about what is permitted and what is not.