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Stem Cell Debate Continues in Maryland

John Gearhart
C. Michael Armstrong Professor of Medicine at Johns Hopkins Medicine
Thursday, March 10, 2005; 2:00 PM

John Gearhart, C. Michael Armstrong Professor of Medicine at Johns Hopkins Medicine and pioneer in the field of embryonic stem cell research, examined the ongoing debate over stem cell research in the Maryland General Assembly.

Recent Post Coverage:
Stem Cell Debate Hits Assembly (John Wagner, March 3)
Stem Cell Showdown Looms in Annapolis (John Wagner, February 6)

John Gearhart was online Thursday at 2 p.m. ET to discuss the debate.

The transcript follows.

Sen. Andrew P. Harris (R-Baltimore County) was online Thursday, March 10 at 1 p.m. ET to discuss the ongoing debate over embryonic stem cell research in the Maryland General Assembly, where he has worked to enlist Republicans and antiabortion Democrats to engage in a filibuster, according to The Washington Post.

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washingtonpost.com: Dr. Gearhart, thank you for joining us today. Maryland lawmakers introduced legislation in February to spend state money on embryonic stem cell research that has been restricted by President Bush at the federal level. Can you explain your exact position on the bill introduced in the Maryland General Assembly?

John Gearhart: The Maryland Stem Cell Act of 2005 allows for the state funding of research utilizing stem cells from adult and embryonic origins, not just embryonic stem cells. It does allow for research to be funded that cannot currently be funded by the federal government. The bill as amended does not permit funding of embryos produced through nuclear transfer.

I support this bill for two reasons. One is that the state must remain competitive with respect to biotechnology and maintain its leadership position in this area. Secondly, the research involving stem cells will lead to new types of therapies for debilitating disease and injuries as well as new discoveries in human biology.


Southern Maryland: Where do the embryos come from that are used in stem cell research? I had read that they come from the "leftovers" (an ugly word in this context) from in vitro fertilization. If that's the case, why aren't opponents of stem cell research also campaigning to end in vitro?

Also, do stem cells from umbilical cord blood have the same potential for medicine as stem cells from embryos?

John Gearhart: Currently embryos from stem cell research come from stored embryos that have not been needed following in vitro fertilization. There are currently probably in excess of 500,000 such embryos in the U.S. alone. Patients donate these embryos through a consenting mechanism for stem cell research. The fate of the stored embryos is generally to be discarded.

Stem cells from umbilical cords, although demonstrating the potential for forming a variety of cell types in the laboratory, have been used mainly for blood cell restoration. They do not have the potential of producing all cell types (over 200) that are present in the human body.


Annapolis, Md.: Hi--

When does life begin?

Does life begin when two cells join to form a fertilized human egg?

Or does life begin, as Roe vs. Wade asserts, after the first trimester when, according to this Supreme Court ruling there is a sentient being in the womb?

What is the status of an unfertilized human egg? Is it life?

John Gearhart: When does 'life' begin I would contend is not a question that biology can answer. Rather, it deals with philosophy or theology. The egg and sperm are alive. Each of us must decide what we mean by 'life.' Some believe that we are persons at the moment of conception (which by the way is not a moment but occurs over hours), while others believe that as development proceeds, and various tissues and organs begin to development, as the central nervous system, we being to acquire those attributes that we associate with personhood, sentience, etc.

We live in a pluralistic, multi-cultural society, with many different views as to what these earliest stages of human development represent, particularly when the interpretation can impact enormously on those of us with illnesses and injuries that could be alleviated through the use of these embryos.


washingtonpost.com: A recent article in The Washington Post said that you have urged lawmakers to act along with "a stream of people with diabetes, spinal cord injuries and other conditions who might be aided by the research." Can you describe how you urged lawmakers?

John Gearhart: I do not know that this is a correct quote but I certainly urged the lawmakers to support the Maryland Stem Cell Act of 2005. As a research scientist I can only bring to our policy makers what the science has already demonstrated and where, in my objective judgment, it will take us. With our work to date on embryonic stem cells, our results with a variety of different types of cells, including cardiomyocytes and motor neurons, our experimental results are consistent with developing cell-based therapies in humans -- particularly for diseases and injuries for which no effective therapy is currently available.


Davis, Calif.: What is the impact of the recent discovery that current human embryonic stem cell lines are contaminated with Neu5Gc and what, in your view, should be done about this problem?

John Gearhart: There is no question that if we can easily avoid any contamination of human stem cells by animal products of any kind, be they viruses or cell surface components that are found on non-human cells, we should do it. In this case, we should use cell lines that have been cultured utilizing new approaches that have been developed since President Bush's policy decision on August 9, 2001 @ 9pm.
There are now a number of human embryonic stem cell lines that have been developed that do not pose the risk of these inter-species transfers of material. A number of U.S. senators and representatives are aware of this issue and have introduced legislation in an attempt to enable federal funding for these new lines.


Anonymous: If these embryos are not used for research, what would happen to them? Would we able to produce a human for each unused embryo?

John Gearhart: IVF patients must decide what to do with embryos that are stored and will no longer be used by them. Options can be (depending on the facility) that they are discarded, used by other couples, or used for specific research projects.

Your question is difficult to answer. Certainly some of these embryos could successfully produce a child. Not every embryo placed in the uterus results in a pregnancy or a newborn.


Washington, D.C.: Senator Harris implied that the consensus of the hearing that was held was that adult stem cells are just as good as embryonic stem cells for research. He said testimony concluded that adult stem cells are actually more likely to provide cures.
I do not believe this to be the scientific consensus and I am really confused. Please explain what the scientific consensus actually is and whether all sides were represented in the hearing.

Thank you.

John Gearhart: It is difficult in the short testimony permitted at the hearings on bills to address the issue that you raise. I emphasized in my testimony that in determination after determination by our scientific organizations, panels of our leading scientists of the National Academy of Sciences and our Nobel Laureates, the conclusion that is reached is that the adult sources, while demonstrating in specific cases some efficacy in cell-based therapies, they do not have the potential of the embryonic cell source for effecting therapies. This is fact. One of those providing testimony for the adult cell position, presented a document purporting to have hundreds of references showing that adult cells can do all that embryonic stem cells can do. This information was not peer reviewed and would not pass any peer review.

I would say that the answer to your question is that some people accept to willing claims that are false, perhaps accepting them because it fits with their own philosophy or theologic base. Policy makers, when acting in the best interest of all the people should be more objective. We are all welcome to our own opinions, but not to our own facts. Pat Monyhan said that.


Washington, D.C.: I support embryonic stem cell research 100 percent, but not the use of funds set aside from Md.'s portion of the multi-state tobacco settlement. Those funds are supposed to be for treatment, prevention, and research on tobacco-related illnesses. I see this effort to get state funding as a me-too bill relative to what has happened in Calif. Johns Hopkins would be the major beneficiary, seeing that it has already set up an institute to do stem cell work.

John Gearhart: I cannot address your concern over the use of the tobacco restitution money as the source of the funds in this bill. I would imagine that this work would be eligible through this mechanism for it would not have been proposed but I don't know this as fact.

I take issue with the use of the term 'beneficiary' to describe competitive grant research money coming to any institution. Our charge is to provide therapies that are safe and effective, that is where the money would go. All Marylanders (and others) will benefit. An institute is not necessary to perform many aspects of the research that are needed to bring this work to the clinic.


Washington, D.C.: DR. Gearhart, What do you think will be the next big scientific discovery in terms of stem cell research, embryonic and/or adult?

John Gearhart: It is difficult to predict the next discovery that will propel this work forward. It is the unexpected or unanticipated discovery that most times opens new avenues or removes obstacles to success. Still, there is something to be said for perseverancece.


Arlington, Va.: You mention competition with other biotech centers -- can you offer a better assessment of what is being done elsewhere in the country? Aside from California, who are you really vying to compete with?

John Gearhart: All research facilities, be they public or private, academic or industry, must have a supportive environment to achieve their goals as rapidly as possible. Of major concern within such laboratories is the ability to attract and maintain the best and brightest investigators. They too are looking for the best place in which to work to advance their careers. Already we have had significant numbers of our stem cell faculty contacted and recruited for jobs elsewhere.


Annapolis, Md.: Dr. Gearhart -- Some legislators are using their pro-life record as a crutch to not support this bill. Can you please explain to us how having an abortion to terminate a pregnancy relates to using excess IVF eggs for embryonic stem cell research? Can't pro-life Democrats and Republicans support this bill?

John Gearhart: I have difficulty with this issue as well and can only conclude that the same individuals view the earliest stages of human development as having the same moral value as an adult.


Frederick, Md.: My six-year-old daughter has had three open-heart surgeries to correct a problem with the right side of her heart. Her cardiologist says she will need a valve replacement in a few years - and we aren't out of the woods yet in terms of a heart transplant.

Based on what I've read about stem cell research, I'm excited about the possibilities that it could hold for my daughter over the long term. But I wonder if I am hoping for too much.

Will stem-cell research eventually get us to the point where we'll be able to actually grow new heart valves -- or new hearts? Or are the benefits likely to be much more modest? When I am thinking about my daughter's life 30 years from now, should I be optimistic about the direction this branch of science is taking us in?

John Gearhart: I would be optimistic. True, at this point in time there are remarkable results with stem cells for enhancing weak hearts in patients. Biomedical engineers are working on building sections of heart wall. Animal experiments are now demonstrating that pacemaker cells can be introduced into ailing hearts with recovery. The cardiac field is one of the most robust and aggressive in using stem cells to effect therapies.


washingtonpost.com: The Washington Post recently quoted Sen. Andrew P. Harris (R-Baltimore County) on the bill in a recent article:
"Harris, the minority whip and the chamber's only doctor, said the bill 'crosses the ethical divide' in his view. Moreover, Harris said, 'it makes no sense for Maryland to get in the business of funding this research. For states to delve into this is very much beyond the role of state government.'" How would you respond to the senator's remarks?

John Gearhart: First, I believe that this research does not cross an ethical divide. Political leaders must take into account all points of view including those in which they do not believe. A recent poll of Marylanders (Gonzales Research & Market Strategies) reveals that an overwhelming majority of our citizens support this research, not unlike many polls throughout the country.

Would Senator Harris oppose this state taking action to counter a negligent federal policy on welfare, headstart, education, environment, etc.? The arenas of biomedical research and biotechnology are only going to increase in importance for development and utilization of technologies to improve our lives. States must become competitive if they want to benefit economically in these areas. I believe that the senator is not acting in the best interest of the people of Maryland.


John Gearhart: Seldom does an area of scientific endeavor have such a great potential for improving the quality of our lives as well as for fundamental discovery in human biology. It is also an area of research that is confusing to many of us with its terminology and the difficulty of distinguishing between hope and hype. The ethical concerns raise questions about our human dignity and the weighing of risk benefit in dealing with the earliest stages of human development. I feel strongly that we are morally committed to helping those who suffer debilitation injuries and diseases.

As a scientist I believe that we must take advantage of every opportunity and every medium to answer questions about our research, for only through a dialogue can we hope to contribute to the development of public policy.


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