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Stem Cell Tales from the Crypt

The Vatican’s Enduring Effort to Steer Scientific Research Toward Its Moral Worldview

Well, OK, truth be told, I did not actually see a crypt during my visit to the Vatican last week. I did get to eat dinner in the Casina of Pope Pius IV, a wonderful home finished in 1562 that sits inside a gorgeous garden inside the Vatican that now houses the Pontifical Academy of Sciences. But that was as close to ancient sages and their remains as I got.

So what was I doing inside the Vatican walls? Attending a rather unusual conference sponsored by the Pontifical Academy for Culture.

The general theme of the conference was “can religion and science ever get along?” Specifically, can stem cell research proceed with the blessing of religion? The Roman Catholic Church thinks so. That is why the Vatican held this unprecedented three-day meeting of mainly Catholic theologians, a few ethicists, politicians, doctors, patients, and scientists from around the world that wrapped up this past Saturday with an audience with Pope Benedict XVI.

The Vatican will issue a statement in a week or two about the conference. But since I was given the chance to be one of the invited speakers, I can offer a peek into what they will likely say.

The leaders of the Roman Catholic Church have made it clear time and again that they oppose the destruction of embryos as a way to get stem cells. No news there. In fact, the scientific status of embryonic stem cell research never got a spot in the three-day event. The point of this meeting was partly to reemphasize Rome’s implacable moral opposition to any research involving embryo destruction.

The Vatican is throwing its ethical might and even its money into the debate about where to get stem cells and how best to study them.

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 the prelates face the prospect of a possible cure coming from embryonic stem cell research now ongoing in many nations and then having to take a position, likely to be negative, on the morality of the desperately ill using such a cure on themselves or their children.

A major point of the meeting was to address these dilemmas and make it clear to the world that the Vatican is aware of the need to find cures. The meeting was designed to illustrate a new possible way forward via what the church believes is promising research using stem cells found in your own body—so-called adult stem cells. They, the Vatican thinks, hold the moral and scientific answer to the challenge of not having to deal with the possible positive results of embryonic stem cell research.

Efforts to transplant naturally occurring adult stem cells or to tweak them and put them back in more powerful states to fix what ails you is, 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 new startup company, Neostem.

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, as well as a 51 percent ownership interest in a Chinese generic pharmaceutical manufacturing company. The company has had issues in the past with its highly optimistic recruitment of people to bank their own bone marrow or cord blood at significant cost with uncertain benefit. The connections to China, given a history of problems with the integrity of clinical trials there, also are reasons for concern. Still the church chose Neostem as something of a partner.

The Roman Catholic Church, by holding this meeting sponsored at the highest levels of the church, is trying to steer an emerging area of science—stem cell medicine—down a particular path using a particular moral position as a rudder.

By throwing its ethical might and even its money into the debate about where to get stem cells, 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 on adult stem cell work anywhere in the world. That message is what the Vatican will offer when a statement about the conference is issued in the coming weeks.

Do men in red caps and clerical collars know best about how scientists should seek to find cures for terminal and disabling diseases? Not yet and not just because of the battle over the value of researching cells obtained from embryos.

At this meeting, the Vatican’s earnest desire to offer hope without compromising a core moral stance led to way too much enthusiasm about the prospects for current research in adult stem cell research. While some top-tier science was presented at the conference, including research involving the use of adult stem cells to repair damaged heart muscle (out in The Lancet this past Monday), there was too much time given to claims of cures that had little to support them. Time and again patient testimonials, studies with very small samples of subjects with no real long-term follow-up, and, to be blunt, some adult stem cell science that has nothing but the backing of a handful of very optimistic scientists looking to attract a grant or an investor were mixed in with the real thing in terms of legitimate, truly promising adult stem cell work.

The church is not yet very good at picking the wheat out of the biomedical chaff. In its enthusiasm to remain a leading voice on how to help the hundreds of millions of people worldwide suffering from chronic and miserable incurable diseases, the Vatican is dangerously susceptible to hyperbolic claims of cures involving nonembryonic stem cells. To give but one such example, one Italian bishop talked about an alliance he had created with a scientist to procure fetal stem cells in Italy obtained from the brains of spontaneously aborted fetuses to pursue treatments for neurological diseases. This is a horrendously bad idea since it is very hard to control the quality of such cells and the chance of their being abnormal or infected with nasty microbes or necrotic material is significant.

Adult stem cell research holds promise for 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 protecting human subjects’ interests is iffy, an absence of standardized registries to evaluate short- and long-term claims of cure, and not a few outright shysters looking to make a quick buck off of the desperate. Pushing for adult stem cell research as the right course to take means pushing for it to be ethical in all regards, not just because embryo destruction is not involved.

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 about why adult stem cell work is the most promising avenue to pursue. Politicians in the United States and other nations with large groups of Catholic and evangelical Christian voters are likely to press harder for reorienting funding toward only adult stem cell work. Tommy Thompson, the former secretary of the Department of Health and Human Services and likely senatorial candidate from Wisconsin, did exactly that in his talk at the meeting. Catholic medical schools and universities will be encouraged to move forward with adult stem cell research.

As remarkable as this conference was in explicitly seeking to use an ethical view to shape the science and industry of stem cell research, it left much more to be done. When it comes to adult stem cell research, the Vatican still has a ways to go in distinguishing good science from hype and overpromising by scientists. In pushing for adult stem cell work, the Vatican must insist that both high-quality science and a reliable ethical infrastructure to support it constitute the foundation for what the church wishes to promote as good.

Art Caplan is the director of the Center for Bioethics at the University of Pennsylvania in Philadelphia.

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