Stem Cell Research: Ethical Issues

^Pr^ep^ar^{ed f}^o^r^M^e^m^b^ers^an^d^Com^mⁱ^t^t^ees^of^C^ong^r^e^ss

The central question before Congress in the debate over human stem cell research is how to treat
human embryonic stem cell research (ESR), which may lead to lifesaving treatments, but which
requires the destruction of embryos. The current federal policy, established by the George W.
Bush Administration in 2001, allows federal money to be used to support ESR on cell lines
created: (1) with appropriate informed consent of the donors; (2) using embryos created for
reproductive purposes; and (3) before the date of the policy. The third element has generated the
most debate, and prompted some states to fund ESR themselves, and others to further restrict
ESR.
Congress faces a range of policy options, each one prompting a set of ethical dilemmas. First,
Congress could allow federal funding for ESR regardless of the date the stem cell lines were
established. Supporters of expanded federal funding assert that many frozen embryos created for
in vitro fertilization (IVF) will be destroyed, and could be used for research regulated by the
federal government. Critics seek to limit embryo destruction and federal funding for it. Second,
Congress could do nothing, allowing the current policy to endure. Supporters contend that current
policy balances research interests and opposition to embryo destruction. Critics for and against
ESR call the date delineation ethically irrelevant, either because it stifles research or provides a
monopoly to those who first destroyed embryos.
Third, Congress could fund additional research that may eventually generate embryonic stem
cells without destroying embryos. Supporters assert that this facilitates research without ethical
dilemmas. Critics characterize it as unnecessary, costly, and a diversion from developing
treatments. Finally, Congress could discourage ESR via tax measures, or limit it by restricting
funding or research, banning certain cloning or scientific techniques, or giving embryos the
Constitutional right to life, or by some other measure. Supporters claim their approaches respect
human dignity; critics claim they harm people already living.
This report, which will be updated, is one of several Congressional Research Service (CRS)
reports on stem cell research. It details the ethical arguments that surround ESR. The broadest is
the balance of embryo destruction and relief of human suffering. More subtle issues focus on the
relative importance of the viability of embryos, the purpose of embryo creation, new versus
existing cell lines, the consent of donors, the ethics of egg procurement, the effectiveness of
alternatives, the possibility of generating embryonic stem cells without destroying human
embryos, and the use of federal funding.

Introduc tion ..................................................................................................................................... 1
Proponents and Opponents........................................................................................................2
Legi slation ................................................................................................................................. 4
June 20, 2007, Executive Order (E.O. 6/20).............................................................................4
Discussion of Ethical Issues............................................................................................................6
Embryo Destruction and Relief of Human Suffering................................................................6
Viability of Embryos.................................................................................................................7
Purpose of Embryo Creation.....................................................................................................7
New and Existing Cell Lines.....................................................................................................8
Consent of Donors.....................................................................................................................9
Egg Procurement...............................................................................................................10
Effectiveness of Alternatives...................................................................................................12
Generating Embryonic Stem Cells Without Destroying Human Embryos.......................13
Use of Federal Funding...........................................................................................................15
Author Contact Information..........................................................................................................16

Human stem cell research is controversial not because of its goals, but rather because of the
means of obtaining some of the cells. Research involving most types of human stem cells, such as
those derived from adult tissues and umbilical cord blood, has been uncontroversial, except when
its effectiveness as an alternative to embryonic stem cells is debated. The crux of the debate
centers around embryonic stem cells, which enable research that may facilitate the development ¹
of medical treatments and cures, but which require the destruction of an embryo to derive. In
addition, because cloning is one method of producing embryos for research, the ethical issues
surrounding cloning are also relevant.
Two policies are currently in force governing human embryonic stem cell research (ESR). Since
FY1996, the Dickey amendment, a provision added to each year’s Labor-Health and Human
Services (HHS)-Education appropriations legislation, has prohibited the use of National Institutes
of Health (NIH) funds for the creation of human embryos for research purposes or research in
which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of
injury or death greater than that allowed for research on fetuses in utero under 45 CFR 46.204(b).
This policy effectively precludes the use of federal funding to derive stem cells from embryos,
which typically are produced via in vitro fertilization (IVF). However, the extracted embryonic
stem cells can be used to generate embryonic stem cell lines that may continue to divide for many
months to years. According to a legal opinion issued by the HHS General Council in 1999, by
contrast to funding restrictions that Dickey places on the derivation of stem cells from embryos,
federal funding for research performed with embryonic stem cells themselves (which does not
itself involve embryos or the extraction of stem cells from embryos) is not proscribed by the ²
Dickey amendment. It is funding for research with these embryonic stem cell lines that is the
subject of the second policy and of much of the current legislation before Congress.
In August 2001, President George W. Bush announced that federal funds could be used for
research on human embryonic stem cells, but only on the lines that had been established as of the
date of the policy, in which the embryos had been obtained with appropriate informed consent ³
from the donors, and in which the embryos had been created for reproductive purposes. As of
January 2009, 21 lines were available, though initially it had been projected that approximately ⁴
three times as many lines would meet the criteria. In 2008, questions were raised about whether
one quarter of the lines eligible for federal funding actually met policy’s the informed consent ⁵
requirements. Even before 2008, many supporters of ESR viewed the Bush policy—particularly

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its August 2001 date—as too restrictive, pointing out that the United States was lagging behind ⁶⁷
other countries in publishing ESR studies. In response, many states funded their own initiatives.
Many opponents of ESR caution that spending any federal money to support research that
involves or derives from the destruction of human embryos is unethical. Some also point to the
actions of South Korean scientist Dr. Hwang Woo Suk, whose laboratory fabricated results of
stem cells extracted from cloned embryos, as reflective of a research community “more than ⁸
willing to play fast and loose with the facts in order to get their way.” Many of those in favor of
ESR assert that regulation is desirable in order to ensure that the benefits of the research are
affordable by all, that they do not endanger the well-being of women who provide eggs for
research, and that they are not used for socially and ethically unacceptable purposes such as ⁹
eugenics.
In the embryonic stem cell debate, the Bush Administration, a group of Representatives, a group
of Senators, and a group of Nobel Laureates have each presented their respective positions on
ESR. In addition, various other organizations, individuals, and councils have issued opinions and ¹⁰¹¹
reports on the topic. Some groups, such as the Christian Legal Society, Focus on the Family, ¹²
and the Christian Coalition support the 2001 Bush policy. Others, such as the National ¹³¹⁴
Academies, the Coalition for the Advancement of Medical Research (CAMR), former First ¹⁵¹⁶
Lady Nancy Reagan, former Presidents Gerald Ford, Jimmy Carter, and Bill Clinton, and the

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Union of Orthodox Jewish Congregations of America (UOJCA),¹⁷ favor more ESR than the Bush ¹⁸
policy allows. Still others, such as the National Right to Life Committee and the United States ¹⁹
Conference of Catholic Bishops, oppose all ESR.
Two presidential bioethics advisory panels have considered the issues involved in ESR. The ²⁰
President’s Council on Bioethics (President’s Council) published one report directly on the ²¹
topic, Monitoring Stem Cell Research, in which it sought to characterize the issues. While the
Council made no recommendations there, in two other reports it has recommended that “Congress
should ... [p]rohibit the use of human embryos in research beyond a designated stage in their ²²
development (between 10 and 14 days after fertilization),” and unanimously recommended “a
ban on cloning-to-produce-children,” with a 10-member majority also favoring “a four-year
moratorium on cloning-for-biomedical-research,” and a seven-member minority favoring ²³
“regulation of the use of cloned embryos for biomedical research.” More recently, the
President’s Council published Alternative Sources of Human Pluripotent Stem Cells, a white
paper exploring the ethics of four proposals to attempt to generate human embryonic stem cells ²⁴
“without creating, destroying, or harming human embryos.” A predecessor to the President’s ²⁵
Council, the National Bioethics Advisory Commission (NBAC), recommended federal funding

^(...c^on^tin^ue^d)
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¹⁶^Ibid^.
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^t^h^ei^{r vo}^t^e^{s i}ⁿ^f^a^vo^{r o}^f^a^m^o^rat^o^ri^um^.^Bo^t^h^m^a^d^eⁱ^t^cl^{ear t}^h^at^t^h^ey^h^a^{ve n}^o^et^hⁱ^cal^p^r^ob^l^e^m^wⁱ^t^h^cl^oⁿⁱ^{ng f}^o^{r b}ⁱ^o^m^edⁱ^cal
^re^s^e^a^r^c^h^{, but f}^e^{lt tha}^t^a^m^o^ra^toriu^m^w^{ould pr}^ov^ide^tim^e^f^o^{r a}^dditio^na^{l dis}^c^us^sⁱ^on.^T^h^e^c^h^aⁿ^g^e^{d v}^o^te^took^m^aⁿ^y^Counc^il
^m^e^m^b^e^r^{s b}^y^surprise^{, a}ⁿ^d^som^e^{on the}^C^o^uⁿ^c^il^be^lie^v^e^tha^t^th^e^m^o^r^a^torⁱ^um^opti^oⁿ^,^a^s^o^p^p^o^s^e^{d to}^a^b^a^{n, w}^a^s^thr^o^wⁿⁱⁿ
^at^t^h^{e l}^a^st^mⁱⁿ^u^t^{e an}^{d d}ⁱ^dⁿ^o^t^recei^{ve ad}^eq^u^a^t^e^dⁱ^scu^ssi^on^.^Iⁿ^addⁱ^tⁱ^oⁿ^,^s^o^m^e^oⁿ^t^h^{e C}^o^un^ci^l^b^e^lⁱ^e^{ve t}^h^at^t^h^{e w}ⁱ^d^e^l^y
^rep^o^r^t^e^d^fⁱⁿ^a^l^vo^t^e^o^f¹⁰^t^o⁷ⁱⁿ^f^a^vo^{r o}^f^{a m}^o^rat^o^ri^u^m^d^o^e^{s n}^o^t^accu^rat^e^l^y^re^f^l^e^c^t^t^h^{e f}^act^“t^h^a^t^t^h^{e maj}^o^ri^t^y^o^f^t^h^e
^c^ounc^il^ha^sⁿ^o^p^r^o^b^le^m^w^{ith the}^e^t^hic^s^of^bi^om^e^d^ic^a^l^c^l^oning^.”⁽^T^r^a^ns^c^r^ipts^of^the^C^o^uⁿ^c^{il m}^e^e^ting^s^and^pa^pe^r^s
^de^v^e^lope^d^by^sta^f^f^f^o^{r disc}^ussion^duriⁿ^g^Couⁿ^c^{il m}^e^e^ting^s^c^aⁿ^be^foun^{d a}^t^htt^p^://w^ww^.bioe^t^hic^s^.g^ov^{; S. S}^.^Ha^ll,
^“^P^re^sideⁿ^t^{’s Bioe}^t^h^ic^{s Co}^unc^{il D}^e^liv^e^r^s,”^Sc^ie^nc^e^{, v}^o^{l. 29}^{7, J}^u^ly^{19, 2}⁰⁰²^,^pp^{. 3}^22-³²^4.)^“^W^is^e^W^o^r^d^s^f^r^om^A^c^r^o^s^s^the
^P^o^nd^?,^”^Bi^oNe^w^s^,ⁿ^o^.²⁵^2,^M^a^r^c^{h 2}⁹^,²⁰⁰⁴^.
²⁴^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^Alte^rⁿ^ativ^e^S^our^c^e^s^{of H}^u^m^{an P}^l^urⁱ^poteⁿ^{t Ste}^m^C^e^lls⁽^M^a^y²⁰⁰⁵⁾^,^a^t
^http:^//w^w^w^.bioe^t^hic^s^.g^ov^/^r^e^por^ts^/^w^hite^_pa^pe^r^/in^de^x^.^htm^l^{, v}ⁱ^s^ite^{d J}^u^ly^{14, 2}⁰⁰⁵^.
²⁵^In¹⁹^95,^P^r^e^s^ideⁿ^t^Clin^to^{n c}^r^e^a^t^e^d^the^Na^ti^ona^{l Bi}^oe^thic^s^A^d^vⁱ^s^o^r^y^C^o^m^m^issⁱ^{on by}^Ex^e^c^u^tiv^e^O^r^der^,^{to a}^d^vⁱ^s^e^him
^on^bioe^t^h^ic^a^l^is^s^u^e^s^{. T}^h^e^O^r^de^r^e^x^pir^e^{d in}²⁰⁰¹^{. “}^F^or^m^e^r^Bⁱ^oe^thic^s^C^o^m^m^is^sⁱ^ons^,”^Presid^en^{t’s Commissio}ⁿ^on
^Bioe^thic^s^w^e^bsite^{, a}^t^htt^p^://w^ww^.^b^ioe^t^hic^s^.g^ov^/re^ports/^p^a^s^t_c^o^m^mⁱ^ssions/ⁱ^nde^x^.^htm^l^,^vⁱ^site^{d June}³⁰^{, 20}⁰⁴^.

for stem cell research using “embryos remaining after infertility treatments,” but not for the ²⁶
“derivation or use of embryos ... made for research purposes.”
Since ESR emerged, bringing hope for medical cures and fears about ethical implications, a
number of bills have been introduced that touch upon the subject. Several would have allowed
federal support for research regardless of the date on which the stem cells were derived. One such ^th
bill came closer to enactment than any other on stem cell research: S. 5 in the 110 Congress. In
2007, Congress passed S. 5, but not by enough votes to override the presidential veto that
followed. When the White House vetoed the bill, it issued Executive Order: Expanding Approved
Stem Cell Lines in Ethically Responsible Ways (E.O. 6/20), the specifics of which are discussed in ²⁷
the next subsection.
Another set of introduced bills sought to create incentives for activities that avoided ESR. Some
of these would have required federal support or tax benefits for research or activities that avoided
damaging embryos. Others would have created additional oversight for the conduct of ESR. Still
others would have created a bank of non-embryonic stem cells from amniotic fluid and placentas.
A third set of bills sought to further restrict or prohibit ESR. Some would have accomplished this
through legislation that would have placed the language of the Dickey amendment in statute,
and/or expended it by prohibiting federal funding using stem cells derived in violation of the
other restrictions. Others would have allowed funding only in very specific circumstances, such
as when using techniques with non-living embryos that were created for reproductive purposes.
Still others would have amended other law (such as that governing the right to life, organ ²⁸
transplantation, cloning, or the creation of animal-human hybrids) to prohibit ESR or restrict
some aspect its conduct.
President George W. Bush’s E.O. 6/20 contains four sections: (1) Research on Alternative Sources
of Pluripotent Stem Cells, (2) Policy, (3) Interpretation of this Order, and (4) General Provisions.
The details of E.O. 6/20 are discussed below.
Section One directs the HHS Secretary to support research on pluripotent stem cells derived
without creating a human embryo for research purposes or destroying, discarding, or subjecting to
harm a human embryo or fetus. It also directs the Secretary to create an implementation plan that
(i) determines the extent to which specific techniques may require research to ensure that any
research involving human cells using these techniques is clearly consistent with the standards
established under this order and applicable law; (ii) prioritizes research with the greatest potential

²⁶^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^p^.
^70-^71.
²⁷^G^e^or^g^e^W^.^B^u^s^h^{, Ex}^e^c^u^tiv^e^O^r^de^r^:^Ex^pa^ndi^ng^A^ppr^ov^e^d^Ste^m^C^e^{ll L}ⁱ^ne^s^{in Et}^hic^a^lly^R^e^s^pons^ible^W^a^y^s^{, J}^une²⁰^,
²⁰⁰^{7, a}^t^htt^p^://w^w^w^.^w^hite^hous^e^.^g^o^v^/^ne^w^s^/^r^e^l^e^a^s^e^s^/²⁰⁰^7/^06/²⁰⁰⁷⁰⁶^20-^6.htm^l^.
²⁸
^For^f^u^r^t^he^rⁱⁿ^f^o^r^m^a^{tion a}^b^o^u^{t 4}²^U^.^S.C^.²⁷^4e^a^{nd v}^a^lua^b^le^c^onsⁱ^d^e^r^a^tion,^s^e^e^C^R^S^R^e^por^t^R^L³³⁹^02,^Livⁱⁿ^g^O^r^gaⁿ
^D^onat^io^{n a}ⁿ^d^Val^u^a^b^le^C^onsⁱ^d^e^r^atioⁿ^,^by^{Erin D. W}^illia^m^s^{, Be}^rnic^e^Re^y^e^s-^A^k^inbile^je^{, a}^{nd Ka}^th^le^eⁿ^S.^Sw^e^ndim^a^n.

for clinical benefit; (iii) takes into account techniques outlined by the President’s Council on
Bioethics, and any other appropriate techniques and research that clearly meet the standard set
forth in the order; (iv) renames the “Human Embryonic Stem Cell Registry” the “Human
Pluripotent Stem Cell Registry”; and (v) adds to the registry new human pluripotent stem cell
lines that clearly meet the standard set forth in the order. Finally, it directs the Secretary to deliver
an annual report to the President on progress made under the order.
Section Two sets forth principles with which the Secretary’s actions are to be consistent: (i) to
direct HHS, including NIH, to intensify peer reviewed research that may result in improved
understanding of treatments for diseases and other adverse health conditions, and to promote the
derivation of human pluripotent stem cell lines from a variety of alternative sources while clearly
meeting the standard set forth in the order; (ii) 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; (iii) the
destruction of nascent life for research violates the principle that no life should be used as a mere
means for achieving the medical benefit of another; (iv) human embryos and fetuses, as living
members of the human species, are not raw materials to be exploited or commodities to be bought
and sold; and (v) the Federal Government has a duty to exercise responsible stewardship of
taxpayer funds, both supporting important medical research and respecting ethical and moral
boundaries.
Section Three provides two definitions and one provision to be used when interpreting the order:
(i) “human embryo” means any organism, not protected as a human subject under 45 CFR 46 as
of the date of this order, that is derived by fertilization, parthenogenesis, cloning, or any other
means from one or more human gametes or human diploid cells; (ii) “subjecting to harm a human
embryo” means subjecting such an embryo to risk of injury or death greater than that allowed for
research on fetuses in utero under 45 CFR 46.204(b) and section 498(b) of the Public Health
Service Act (42 USC 289g(b)) as of the date of this order; and (iii) nothing in this order shall be
construed to affect any policy, guideline, or regulation regarding embryonic stem cell research,
human cloning by SCNT, or any other research not specifically authorized by this order, or to
forbid the use of existing stem cell lines deemed eligible for other federally funded research in
accordance with the presidential policy decision of August 9, 2001, for research specifically
authorized by this order.
Section Four specifies that the order shall be implemented consistent with applicable law and
subject to the availability of appropriations. It also specifies that it is not intended to, and does
not, create any right, benefit, or privilege, substantive or procedural, enforceable at law or in
equity, by any party against the United States, its departments, agencies, or entities, its officers,
employees, or agents, or any other person.
None of the sections contains measures contrary to the President Bush’s August 2001 policy.
While it has been argued that E.O. 6/20 sparked federal funding for alternative research methods,
some lawmakers have reportedly criticized the order as having no substance, adding no new ²⁹
money or research, and making no policy change.

²⁹^J^e^a^nnie^Ba^um^a^{nn, “}^B^us^h^V^e^t^o^e^s^Ste^m^Ce^{ll Bill, Is}^s^u^e^s^O^r^de^{r A}^u^thoriz^ing^St^udy^of^non-Em^bry^o^A^l^t^e^rna^tiv^e^s^,”
^He^{alth C}^a^re^Daily^{, v}^o^l^.¹²^,^no^{. 9}⁽^J^une²¹^,²⁰⁰⁷⁾^{, I}^SSN¹⁰^91-⁴⁰²¹^.

Detailed review of the assorted reports and statements reveals that while positions on ESR may
be broadly categorized as for or against, there is an array of finer distinctions present. These finer
distinctions, in turn, reveal the variation in ethical and moral as well as factual beliefs. The
following discussion breaks down the arguments about ESR according to these finer distinctions,
demonstrating both the complexity of the issues and the points of resonance among the groups.
Most positions on ESR rest at least in part on the relative moral weight accorded to embryos and
that accorded to the prospect of saving, prolonging, or improving others’ lives. For some, the
inquiry begins and ends with this question. For instance, one opponent of the research, the
American Life League, posits that “human life begins at conception/fertilization and that there is ³⁰
never an acceptable reason for intentionally taking an innocent human life.” Similarly, the
United States Conference of Catholic Bishops states that the research is immoral because it ³¹
“relies on the destruction of some defenseless human beings for the possible benefit to others.”
Some groups explore the moral standing of human embryos, and also consider the “duty to ³²
relieve the pain and suffering of others.” Others take the position that embryos do not have the
same moral status as persons. They acknowledge that embryos are genetically human, but hold
that they do not have the same moral relevance because they lack specific capacities, including ³³
consciousness, reasoning, and sentience. They also argue that viewing embryos as persons
would “rule out all fertility treatments that involve the creation and discarding of excess
embryos,” and further assert that we do not have the same “moral or religious” response to the ³⁴
natural loss of embryos (through miscarriage) that we do to the death of infants. Some have also
rooted their arguments in religious texts, which inform them that an “isolated fertilized egg does ³⁵
not enjoy the full status of person-hood and its attendant protections.” They conclude that
performing research to benefit persons justifies the destruction of embryos. Acceptance of the
notion that the destruction of embryos can be justified in some circumstances forms the basis of
pro-stem cell research opinions, and is usually modified with some combination of the
distinctions and limitations that follow.

³⁰^Ameri^can^Lⁱ^f^e^L^e^a^g^u^e^,^T^h^{e B}^u^s^h^S^t^{em Cel}^l^Deci^si^oⁿ^{, 2}⁰⁰¹^{, a}^t^htt^p^://w^w^w^.a^ll.org^/
^a^r^tic^le^.php?ⁱ^d⁼¹⁰⁷⁴⁶^&^s^e^a^r^c^h⁼²⁰^{01, v}ⁱ^s^ite^d^J^a^nua^r^y^18,²⁰^07.
³¹^O^f^fⁱ^c^e^o^f^C^o^m^m^unic^a^tions^{, U}ⁿ^it^e^d^Sta^t^e^s^C^o^nf^e^r^eⁿ^c^e^of^C^a^tholic^Bⁱ^s^hops^,^Cat^h^o^lic^Bish^{ops Crit}^ic^ize^{Bush P}^o^lic^y^oⁿ
^Embry^o^Re^se^arc^h^(A^ug^{ust 9,}²⁰⁰¹^{), a}^t^http^://w^ww^.usc^c^b^.org^/c^om^m^/^a^r^c^h^iv^e^s^/²⁰^01/^01-¹⁴^2.shtm^l.
³²^T^h^e^P^r^esi^d^eⁿ^t^’^{s C}^o^un^ci^l^on^Bi^o^e^t^hⁱ^c^s,^M^oni^torⁱ^ng^S^t^e^m^C^e^ll^Re^s^e^ar^c^h^,^J^a^nua^r^y²⁰⁰^4,^p^p^{. 5}⁸^{, 62}^.
³³^P^r^esen^tatio^{n b}^y^B.^S^t^einb^o^c^k,^Dep^a^rtm^eⁿ^t^o^f^P^hⁱ^l^o^s^op^h^y^,^S^UNY,^A^l^b^aⁿ^y^,^NY,^{NIH Hu}^man^Em^b^r^yo^Research^P^aⁿ^e^l
^Me^e^ting^,^Fe^br^ua^r^y^{3, 19}^94.
³⁴^Mⁱ^ch^ael^S^a^nd^el^,^“E^m^b^ry^o^E^t^hⁱ^cs—T^h^e^M^o^ral^L^o^gi^{c o}^f^S^t^e^m^-Cel^l^Research^,^”^N^e^w^Engla^{nd J}^ourⁿ^a^l^{of M}^e^dicⁱ^ne^{, v}^o^l^.
³⁵¹^{, n}^o^.^{3, J}^u^ly^15,²⁰^04,^p.²^08.
³⁵^UOJCA^le^tte^r.

Some proponents of ESR base their support on the question of whether an embryo is viable. The
relevance of the viability distinction rests on the premise that it is morally preferable for embryos
that will not grow or develop beyond a certain stage and/or those that would otherwise be
discarded to be used for the purpose of alleviating human suffering.
The 2001 Bush policy requires, among other things, use of stem cells derived from only excess
(non-viable) embryos for federally funded research. One report of the President’s Council
explores the moral significance of viability that is based upon “human choices” rather than an ³⁶
embryo’s “own intrinsic nature,” but draws no conclusions. A second report broaches the subject
of viability, recommending that Congress ban both the transfer of a human embryo to a woman’s
uterus for any purpose other than to produce a live-born child, and also research conducted on ³⁷
embryos more than 10 to 14 days after fertilization. The NBAC report touches on the moral ³⁸
status of embryos in utero and those in vitro, though NBAC does not specify whether viability ³⁹⁴⁰
was a key rationale for its recommendations. A group of Representatives, a group of Senators,
and CAMR imply but do not state a distinction based on viability by expressly calling for the use ⁴¹
of “excess” embryos developed for IVF, and making no mention of those in utero. UOJCA
makes a similar argument in its letter. By contrast, the National Academies and the group of
Nobel Laureates more broadly support research on embryos, making no mention of viability.
A separate distinction that often leads to the same conclusions as viability is the purpose for
which embryos are created. This distinction draws an ethical line based upon the intent of the
people creating embryos. In the view of some, it is permissible to create an embryo for
reproductive purposes (such as IVF), but impermissible to create one with the intention of
destroying it for research. Others worry that moral lines will erode quickly—from using only
“spare” embryos left over in fertility clinics to creating human embryos solely for research to ⁴²
creating (or trying to create) cloned embryos solely for research.
Most groups at least note the potential ethical significance of reproductive versus research
motives for creating embryos. The 2001 Bush policy draws a motive distinction by including a
requirement that federally funded research be conducted only on embryonic stem cell lines

³⁶^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^M^oni^torⁱⁿ^g^Ste^m^C^e^{ll Re}^s^e^a^r^c^h^{, J}^a^nua^r^y²⁰⁰⁴^{, p}^.⁸⁷^.
³⁷^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^Re^pro^duc^ti^on^a^nd^Re^spoⁿ^si^bility^,^M^a^r^c^h²⁰⁰⁴^.
³⁸^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^.
^50.
³⁹^L^e^tte^r^f^r^om^{206 Me}^m^b^e^r^s^of^the^H^ous^e^of^R^e^pr^e^s^eⁿ^ta^tiv^e^s^to^P^r^e^sⁱ^d^eⁿ^{t G}^e^or^g^e^W^.^B^u^s^h^{, A}^p^r^{il 2}⁸^,²⁰⁰⁴^{, a}^t
^http:^//w^w^w^.hous^e^.^g^o^v^/^de^g^e^tte^/ne^w^s^/^r^e^le^a^s^es^/040⁴²^8.p^d^f^.⁽^H^e^r^e^a^f^t^e^r^c^ite^{d a}^s^L^e^tte^r^f^r^om^{206 Me}^m^b^e^r^s^of^the^H^ous^e^of
^Rep^r^esen^t^a^tⁱ^v^es.⁾
⁴⁰^L^e^tte^r^f^r^om^{58 Se}^na^{tors t}^o^P^r^e^s^id^eⁿ^{t G}^e^org^e^W^.^{Bush, Ju}^ne⁷^,²⁰⁰⁴^{, a}^t^http^://f^eⁱ^nste^in.seⁿ^a^t^e^.^g^o^v^/⁰⁴^Re^le^a^s^e^s^/^r^-
^ste^m^c^e^ll-ltr.pdf^{. (He}^r^e^a^f^t^e^r^c^ite^{d a}^s^L^e^tte^r^f^r^o^m^{58 Se}^na^t^o^rs.)
⁴¹^In^t^e^rn^atⁱ^oⁿ^a^l^S^o^ci^et^y^f^o^{r S}^t^e^m^C^e^l^l^Research^,^“^A^l^t^e^rn^a^tiv^e^Me^tho^d^{s of}^P^r^o^duc^ing^Ste^m^Ce^{lls: No Substit}^ute^f^o^r
^E^m^b^r^y^oⁿⁱ^{c S}^t^em^Cel^l^Res^earch^,^”^Pre^{ss Re}^le^ase^{, (A}^ug^{ust 2, 20}⁰⁵⁾^,^a^t^http^://w^ww^.is^s^c^r^.org^/pre^ss_re^le^a^s^e^s^/
^c^a^m^r^_a^lte^rna^tiv^e^s^.ht^m^{, v}ⁱ^site^{d A}^p^{ril 1}⁰^,²⁰^07.
⁴²^Se^e^,^e^.^g^{., Er}^ic^C^o^he^{n a}^{nd R}^obe^r^t^G^e^or^ge^{, “}^S^tem^C^e^lls^W^{ithout M}^o^r^a^{l C}^o^r^r^u^ptio^{n: C}^ong^r^e^s^s^C^a^{n G}ⁱ^ve^R^e^s^e^a^r^c^h^a
^B^oos^{t W}^ith^out^Su^pp^or^ti^ng^the^Mⁱ^s^u^s^e^of^H^u^m^a^{n E}^m^br^y^o^s^,^”^W^a^s^h^ingt^{on Pos}^t^,^J^u^ly^{6, 2}⁰⁰⁶^,^{p. A}^21.

derived from embryos created solely for reproductive purposes. NBAC draws the same
distinction by recommending that federal funding be used for embryos remaining after infertility
treatment but not for research involving the derivation or use of stem cells from embryos made ⁴³
for research purposes or from cloned embryos produced by SCNT. UOJCA argue similarly that
they “believe it is entirely appropriate to utilize for this research existing embryos, such as those
created for IVF purposes that would otherwise be discarded but for this research. We think it
another matter to create embryos ab initio for the sole purpose of conducting this form of ⁴⁴
research.”
The President’s Council recommends that Congress ban attempts at conception by any means
other than the union of egg and sperm (essentially banning cloning via SCNT) but does not ⁴⁵
specify whether embryos might be created in vitro specifically for research purposes. Two
Council members expressed a dissenting opinion in a medical journal article, arguing that SCNT ⁴⁶
“resembles a tissue culture” and that the products of SCNT should be available for research. A
group of Representatives, a group of Senators, and CAMR imply but do not state that embryos
should not be created for research purposes. They overtly call for the use of “excess” embryos ⁴⁷
developed for IVF and make no mention of embryos created expressly for research. By contrast,
the National Academies supports the creation of embryos for research purposes, including via
cloning (SCNT), to “ensure that stem cell-based therapies can be broadly applied for many ⁴⁸
conditions and people [by] overcoming the problem of tissue rejection.” Mrs. Nancy Reagan,
her supporters, and the group of Nobel Laureates also take this position.
A further distinction has been drawn based upon the timing of the creation of embryonic stem cell
lines. Here, the premise is that it is unacceptable to induce the destruction of embryos for the
creation of new lines. However, in cases in which embryos have already been destroyed and the
lines already exist, it is morally preferable to use those lines for research to improve the human
condition.
This was one central distinction drawn in the 2001 Bush policy, which limited the use of federal
funding to research on lines derived on or before the date of the policy. Supporters of the Bush
policy on both sides of the issue favor this distinction as a compromise. It allows research on
some embryonic stem cell lines. It deters the future destruction of embryos for research. The
President’s Council writes that the Bush policy mixes “prudence” with “principle, in the hope that ⁴⁹
the two might reinforce (rather than undermine) each other.” The Council notes that the policy is

⁴³^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^p^.
⁷⁰^-⁷²^.^In^S^C^NT^t^h^{e n}^u^c^l^e^u^s^o^f^{an egg i}^s^re^m^o^ved^an^d^rep^l^aced^b^y^t^h^{e n}^u^c^l^e^u^s^f^r^o^m^a^mat^u^re^body^c^e^{ll, s}^u^c^h^a^s^a^s^kⁱⁿ
^c^e^{ll obta}ⁱ^ne^{d f}^r^om^a^pa^tie^{nt. I}ⁿ¹⁹^{96, s}^c^ieⁿ^tis^tsⁱⁿ^Sc^otla^nd^us^e^d^t^h^e^SC^N^T^pr^oc^e^dur^e^t^o^pr^o^duc^e^D^o^ll^y^the^s^h^e^e^p^{, the}
^fⁱ^{rst m}^a^m^m^a^liaⁿ^c^l^one^.
⁴⁴^UOJCA^le^tte^r.
⁴⁵^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^Re^pro^duc^ti^on^a^nd^Re^spoⁿ^si^bility^{, Ma}^rc^h²⁰⁰⁴^{, p.}^x^l^v^iii.
⁴⁶^P^a^{ul Mc}^H^u^g^h^,^“^Z^y^g^ote^a^{nd ‘}^C^lo^note^’^—^T^he^Ethⁱ^c^a^l^U^s^e^of^Em^br^y^onic^S^t^e^m^C^e^lls^,”^N^e^w^Englan^{d J}^ourⁿ^a^l^of
^M^e^dicⁱ^ne^{, v}^o^l.³⁵^1,^no.^3,^J^u^ly¹⁵^{, 20}⁰⁴^{, p}^.²¹⁰^.
⁴⁷^L^e^tte^r^f^r^om^{206 Me}^m^b^e^r^s^of^the^H^ous^e^of^R^e^pr^e^s^eⁿ^ta^tiv^e^s^{; L}^e^tte^r^f^r^o^m^{58 Se}^na^t^o^r^s^.
⁴⁸^N^a^tiona^{l R}^e^s^e^a^r^c^h^C^o^unc^il,^Iⁿ^s^tit^ute^of^Me^dicⁱ^ne^,^N^a^tiona^l^A^c^a^d^em^ies^,^Ste^m^C^e^lls^an^{d t}^h^e^Fu^tur^e^o^f^Re^ge^ne^r^a^tiv^e
^M^e^dicⁱ^ne⁽^W^a^s^hing^{ton: N}^a^ti^ona^l^A^c^a^d^em^ie^s^,²⁰⁰¹⁾^{, p}^.⁵⁸^.
⁴⁹^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^M^oni^torⁱⁿ^g^Ste^m^C^e^{ll Re}^s^e^a^r^c^h^{, J}^a^nua^r^y²⁰⁰⁴^{, p}^p^.^33-³⁴^.

supported by what it titles a moralist’s notion of when one may benefit from prior bad acts
(referring to embryo destruction): it prevents the government from complying in the commission ⁵⁰
of or encouraging the act in the future, and it reaffirms the principle that the act was wrong. The
same report also contains analyses of the Bush policy that characterize distinction between new ⁵¹
and existing cell lines as “arbitrary,” “unsustainable,” and “inconsistent.” The Council itself
takes no position in the report on this or any other issue.
Opponents of the Bush policy on both sides of the issue view the distinction between new and
existing stem cell lines with reproach. One side, which includes The National Right to Life
Committee and the United States Conference of Catholic Bishops, objects because the distinction
validates destruction of embryos, and rewards those who did so first with a monopoly. The other
side, which includes the National Academies, a group of Representatives, a group of Senators,
Nancy Reagan and her supporters, Gerald Ford, CAMR, and the group of Nobel Laureates,
objects because the distinction limits the number of embryonic stem cell lines available for ⁵²
research, particularly since the number of authorized lines are dwindling and are “contaminated ⁵³
with mouse feeder cells.” Likewise, though NBAC recognized the distinction between
destroying embryos and using ones previously destroyed (e.g., “derivation of [embryonic stem]
cells involves destroying the embryos, whereas abortion precedes the donation of fetal tissue and ⁵⁴
death precedes the donation of whole organs for transplantation”), it still recommended future
development of embryonic stem cell lines. UOJCA also recognizes a distinction between new and
existing lines: “research on embryonic stem cells must be conducted under careful guidelines ⁵⁵
[that] ... relate to where the embryonic stem cells to be researched upon are taken from.”
There is consensus throughout a wide array of viewpoints about ESR that embryos should only be
obtained for research with the consent of their biological donors. This consent requirement
necessitates that embryos be taken only with donors’ knowledge, understanding, and uncoerced
agreement, which may, in fact, be complicated by conflicting studies regarding the long-term ⁵⁶
health effects of egg donation. The donor consent requirement is consistent with the rules
governing human beings’ participation in research, and with individuals’ general legal authority to
make decisions regarding embryos they procreate. A potential drawback of the requirement is that
it may restrict the number of embryos available for research purposes.
The 2001 Bush policy contains a donor consent requirement. It limits approved stem cell lines to
those derived with the informed consent of the donors, and obtained without any financial
inducements to the donors. Despite the policy, a 2008 report indicated that there may have been

⁵⁰^Ibid^.
⁵¹^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^M^oni^torⁱⁿ^g^Ste^m^C^e^{ll Re}^s^e^a^r^c^h^{, J}^a^nua^r^y²⁰⁰⁴^{, p}^p^.^63-⁶⁷^.
⁵²^B^r^idg^e^{t M. K}^u^e^hⁿ^,^“^G^eⁿ^e^tic^Fla^w^s^Found^{in A}^g^ing^Ste^m^C^e^{ll L}ⁱⁿ^e^s^,^”^Jo^u^rⁿ^a^l^o^f^t^h^{e A}^m^eri^c^an^Medi^ca^l^A^sso^ci^atⁱ^oⁿ^,
^v^o^{l. 2}^94,ⁿ^o^.^{15 (}^O^c^t^obe^r²⁰⁰⁵⁾^,^{p. 1}⁸⁸³^.
⁵³^L^e^tte^r^f^r^om^{206 Me}^m^b^e^r^s^of^the^H^ous^e^of^R^e^pr^e^s^eⁿ^ta^tiv^e^s^{; L}^e^tte^r^f^r^o^m^{58 Se}^na^t^o^r^s^.
⁵⁴^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^.
^49.
⁵⁵^UOJCA^le^tte^r.
⁵⁶^Ka^thy^{Hudson, “}^I^nte^r^na^tio^na^{l S}^o^cⁱ^e^t^y^f^o^{r Ste}^m^Ce^{ll Re}^se^a^r^c^h^Dra^f^{t G}^u^ide^line^s^,”^Ge^ne^tic^s^&^Public^Polic^y^Ce^nte^r
^ENe^w^s,^Issue¹⁰^(July²⁰⁰^{6), a}^v^a^ila^ble^on^line^a^t^htt^p^://w^ww^.dna^pol^ic^y^.^org^/
^ne^w^s^.e^ne^w^s^.a^rtic^le^.noc^a^t^e^g^or^y^.^php?^a^c^tion=^de^ta^il&^ne^w^s^le^tte^r_id=¹^3&^a^r^tic^le^_id=³¹^.

ethical lapses in the way some of the Bush-approved cells were obtained from embryo donors.
The author found two categories of problems with the consent forms: (1) they omitted
information important for informed consent, and (2) they set restrictions that obstructed key areas ⁵⁷
of research. A subsequent article suggested that NIH staff were pressured to make these stem
cell lines eligible for federal funding:
^{NIH in}^sⁱ^ders^{, s}^p^eakⁱⁿ^g^on^condition^of^an^onym^it^y^,^s^a^{id th}^e^y^h^a^d^{little ch}^oⁱ^{ce at th}^{e ti}^m^e^{. T}^h^e
^admⁱⁿⁱ^s^t^ration^w^a^s^ada^m^aⁿ^{t t}^h^{at as}^m^a^ny^{cell li}ⁿ^e^s^as^pos^sⁱ^bl^{e th}^at^w^e^{re deriv}^e^{d bef}^o^{re t}^h^e
^A^u^g^u^s^t^{9, 2001 deadl}ⁱⁿ^{e be i}ⁿ^cl^u^d^{ed on}^t^h^{e approv}^{ed l}ⁱ^s^t^,^N^I^H^s^o^u^r^ces^s^aⁱ^d^{, i}ⁿ^t^h^e^h^{ope t}^h^at⁵⁸
^scien^t^ist^s^w^o^u^l^d^b^e^m^o^lli^fⁱ^ed^.
Like the 2001 Bush policy, the NBAC, the President’s Council, and the UOJCA also favor donor
consent requirements. The National Academies notes the importance of informed consent in its ⁵⁹
discussion of stem cell research oversight requirements. A group of Representatives and a group ⁶⁰
of Senators mention and imply their support for donor consent requirements. In addition,
consent is one NIH funding requirement.
Egg procurement from women has raised a number of issues, most notably, those of informed
consent and payment. The topic of informed consent in egg procurement came to the public’s
attention in November 2005 with allegations that some human eggs used in South Korean
scientist Dr. Hwang’s laboratory had been obtained under coercive conditions. Informed consent
can be undermined when a coercive situation prevents a free choice from being made, or when
insufficient information is provided to the person making a decision. The situation alleged in Dr.
Hwang’s laboratory raises the issue of coercion both because subordinate women in the
laboratory allegedly donated eggs, and because some women were allegedly paid for their eggs. A
2002 study conducted by a University of Pennsylvania student raised the issue of insufficient
information, finding that a number of programs seeking donor eggs for reproductive purposes ⁶¹
downplayed the risks involved in egg retrieval. The wide consensus regarding the need for
informed consent necessarily implies similar consensus on the need for an information-rich,
coercion-free method of obtaining eggs, however there is some disagreement on the specifics of
whether payment for eggs necessarily constitutes coercion.
Paying women for their eggs, which has been debated in the context of seeking donor eggs both
for reproductive purposes (for example, to enable women who do not produce their own eggs to
become pregnant), and for research purposes, is not unheard of in the United States. According to
a 2000 study by the American Society of Reproductive Medicine (ASRM), some IVF programs
reportedly offered as much as $5,000 for one egg retrieval cycle, though $2,500 appeared to be a

⁵⁷^R^obe^r^t^Str^e^if^f^e^r^,^“^I^nf^or^m^e^{d C}^ons^eⁿ^{t a}ⁿ^d^Fe^de^r^a^{l F}^uⁿ^d^ing^f^o^r^Ste^m^C^e^{ll R}^e^s^e^a^r^c^h^,”^H^a^s^tings^C^e^nte^r^Re^por^t^{, v}^o^l^.^38,
^{no. 3}⁽^M^a^y^-^J^une²⁰⁰⁸⁾^{, p. 40.}
⁵⁸^Ri^{ck W}^eⁱ^ss,^“E^t^hⁱ^cal^l^y^Ch^al^l^eⁿ^g^e^d^:^On^{e Qu}^art^e^r^o^f^S^t^e^m^Ce^ll^Lⁱ^ne^{s Elig}^ible^f^o^{r Fe}^de^ra^{l Fu}^nd^ing^F^a^{il Ethic}^s
^G^u^ide^line^s^,”^Sc^ie^nc^e^Pr^ogr^e^s^s⁽^J^uly^{25, 2}⁰⁰⁸⁾^,^a^t
^http:^//w^w^w^.s^cⁱ^eⁿ^c^e^p^r^o^g^r^e^s^s^.^or^g^/²⁰⁰⁸^/^07/^e^t^hic^a^lly^-^c^ha^lle^ng^e^d^/.
⁵⁹^N^a^tiona^{l R}^e^s^e^a^r^c^h^C^o^unc^il,^Iⁿ^s^tit^ute^of^Me^dicⁱ^ne^,^N^a^tiona^l^A^c^a^d^em^ies^,^Ste^m^C^e^lls^an^{d t}^h^e^Fu^tur^e^o^f^Re^ge^ne^r^a^tiv^e
^M^e^dicⁱ^ne⁽^W^a^s^hing^{ton: N}^a^ti^ona^l^A^c^a^d^em^ie^s^,²⁰⁰¹⁾^{, p}^.⁵³^.
⁶⁰^L^e^tte^r^f^r^om^{206 Me}^m^b^e^r^s^of^the^H^ous^e^of^R^e^pr^e^s^eⁿ^ta^tiv^e^s^{; L}^e^tte^r^f^r^o^m^{58 Se}^na^t^o^r^s^.
⁶¹^“^E^g^g^D^ona^tion^Ethic^s^Stu^d^y^Wⁱⁿ^s^A^w^a^r^d^,”^Re^s^e^ar^c^h^{at Pe}ⁿⁿ^,^(Ma^r^c^h^7,²⁰⁰⁵⁾^{, a}^t^http^://w^ww^.upe^nn.e^du/
^research^at^p^eⁿⁿ^/^artⁱ^c^l^e^.^p^hp^?1¹³^&so^c^,^vi^si^t^e^d^Decem^b^e^{r 5}^,²⁰⁰⁵^.

more common amount.⁶² Offers of much higher amounts ($50,000-$100,000) have been reported ⁶³
elsewhere. Dr. Huang’s laboratory reportedly made payments of $1,400 to each woman who ⁶⁴
donated eggs. Payments are not illegal in the Unites States, nor were they illegal in South Korea
at the time Dr. Huang’s laboratory allegedly made them. The questions are, is payment for egg
donation ever acceptable, and if so, what amount is appropriate?
Several arguments have been put forth in favor of payment for egg donation, many focused on ⁶⁵
donation for reproductive purposes. First, some have argued that payment creates incentives to
increase the number of egg donors, thus facilitating research and benefitting infertile couples.
Second, some reason that payment for eggs gives women parity with sperm donors, who may be
compensated for donating gametes at a lower rate given that they require a much less involved
procedure. In addition, some argue that participants should be offered an amount commensurate
with the time, inconvenience, discomfort, and risks of the procedure, as is the general practice in ⁶⁶
biomedical research. Third, some allege that fairness dictates that women who donate eggs
ought to be able to benefit from their action. Fourth, some claim that pressures created by
financial incentives may be no greater than those experienced by women asked to make altruistic
egg donations for relatives or friends, and may thus not rise to the level of coercion. These are the
types of arguments that led ASRM to recommend in 2000 that sums of up to $5,000 may be
appropriate for typical egg donation, while sums of up to $10,000 may possibly be justified if
there are particular difficulties a woman must endure to make her donation.
Several arguments have also been put forth against payment for egg donation. First, some voiced
fears that payment might lead to the exploitation of women, particularly poor women, and the ⁶⁷
commodification of reproductive tissues. Second, some have argued that payment for eggs for ⁶⁸
research purposes might undermine public confidence in endeavors such as human ESR.
Arguments such as these have prompted both the National Academies and the President’s Council
to recommend that women not be paid for donating their eggs for research purposes. It also led
the President’s Council to note that in theory, there is the possibility that eggs could be procured
from ovaries harvested from cadavers, which might at least alleviate concerns related to coercion.
It is worth noting that a woman may choose to undergo egg retrieval for her own reproductive
purposes, which would effectively take the process of egg procurement out of the research arena

⁶²^A^m^e^r^ic^aⁿ^Socⁱ^e^t^y^of^R^e^pr^oduc^ti^v^e^Me^dicⁱ^ne^{, “}^F^inaⁿ^cⁱ^a^l^Iⁿ^c^eⁿ^tiv^e^s^{in R}^e^c^r^uitm^eⁿ^{t of}^O^o^c^y^te^D^onor^s^,^”^Fe^rtility^an^d
^Ste^r^ility^{, v}^o^l.⁷⁴^,^no.^{2 (}^A^ug^us^{t 2}⁰⁰⁰⁾^,^p.²¹⁶^.
⁶³^S^{ee e.}^g.^,^“E^{gg Do}ⁿ^a^tⁱ^o^{n E}^t^hi^{cs S}^t^u^d^y^Wⁱⁿ^s^Award^,^”^Re^s^e^ar^c^h^at^Peⁿⁿ^{, (}^M^a^r^c^h⁷^,²⁰⁰⁵⁾^,^a^t^htt^p^://^w^w^w^.upe^nn.e^d^u^/
^research^at^p^eⁿⁿ^/^artⁱ^c^l^e^.^p^hp^?1¹³^&so^c^,^vi^si^t^e^d^Decem^b^e^{r 5}^,²⁰⁰⁵^.
⁶⁴^J^a^m^e^s^B^r^ook^e^,^“^K^or^e^aⁿ^L^e^av^e^s^C^l^oni^ng^C^e^nte^rⁱⁿ^Et^hic^s^Fur^o^r^,^”^P^r^of^e^s^sⁱ^ona^{l Ethic}^s^w^e^bs^ite⁽^N^ov^em^be^r^25,²⁰⁰⁵⁾^,
^a^t^http^://e^thic^s.ta^m^u^c^c^.^e^du/^a^r^tic^le^.pl?^sid=⁰⁵^/^11/^26/¹⁵²⁴²^06&^m^ode⁼^t^hre^a^d^vⁱ^site^{d De}^c^e^m^b^e^r^12,²⁰⁰⁵^.
⁶⁵^Un^l^e^{ss o}^t^h^e^rwⁱ^s^{e n}^o^t^ed,^t^h^{ese ar}^gu^men^t^{s can}^b^e^f^o^uⁿ^d^,^am^oⁿ^g^o^t^{her p}^l^aces,^at^Ameri^can^S^o^ci^et^y^o^f^Rep^r^o^d^u^c^tⁱ^v^e
^Me^dicⁱ^ne^{, “}^Fⁱⁿ^aⁿ^cⁱ^a^lⁱⁿ^c^eⁿ^tiv^e^s^{in r}^e^c^r^uitm^eⁿ^{t of}^ooc^y^t^e^donor^s^,^”^Fe^rtility^an^d^Ste^r^ility^{, v}^o^l^.⁷⁴^,^no^.^{2 (}^A^ug^us^{t 2}⁰⁰⁰⁾^,
^{p. 2}¹⁸^;^aⁿ^{d C}^l^a^u^dia^K^a^{lb, “}^E^thic^s^,^Eg^g^s^a^{nd Em}^br^y^o^s^,^”^MS^NB^C.^co^m,^{Newsweek web}^sⁱ^t^e^{, a}^t
^http:^//w^w^w^.^m^s^nbc^.m^sⁿ^.c^om^/ⁱ^d/⁸¹⁸⁵³³⁹^/^s^ite^/ne^w^sw^e^e^k^/^{, v}ⁱ^s^ite^{d D}^e^c^e^m^b^e^r^12,²⁰^05.
⁶⁶^Ka^thy^{Hudson, “}^I^nte^r^na^tio^na^{l S}^o^cⁱ^e^t^y^f^o^{r Ste}^m^Ce^{ll Re}^se^a^r^c^h^Dra^f^{t G}^u^ide^line^s^,”^Ge^ne^tic^s^&^Public^Polic^y^Ce^nte^r
^ENe^w^s,^Issue¹⁰^(July²⁰⁰^{6), a}^v^a^ila^ble^on^line^a^t^htt^p^://w^ww^.dna^pol^ic^y^.^org^/
^ne^w^s^.e^ne^w^s^.a^rtic^le^.noc^a^t^e^g^or^y^.^php?^a^c^tion=^de^ta^il&^ne^w^s^le^tte^r_id=¹^3&^a^r^tic^le^_id=³¹^.
⁶⁷^Se^e^e^.^g^.,^P^r^e^s^ideⁿ^{t’s C}^o^uⁿ^c^il^on^Bioe^thic^s,^W^hⁱ^t^e^Pa^pe^r^:^Alte^rⁿ^a^tⁱ^v^e^Sour^c^e^s^of^Plurⁱ^poteⁿ^{t S}^t^e^m^C^e^lls⁽^M^a^y²⁰⁰⁵⁾^,
^pp.⁴⁰^-⁴^{1 a}^t^h^ttp:^//w^w^w^.bioe^t^hic^s^.g^ov^/r^e^por^ts^/^w^hite^_pa^pe^r^/inde^x^.^h^t^m^l^{, v}ⁱ^s^ite^{d D}^e^c^e^m^b^e^r^12,²⁰^05.
⁶⁸^Na^tiona^{l A}^c^a^d^e^m^ie^s,^G^u^ide^line^s^for^H^u^m^a^{n Em}^br^y^onic^Ste^m^C^e^ll^Re^s^e^ar^c^h^{, (}^W^a^s^hing^{ton, D}^C^:^N^a^ti^ona^{l A}^c^a^d^em^ie^s
^P^r^e^s^s^,^p.^87,^a^t^ht^tp:/^/b^ook^s^.^na^p^.^e^du/^bo^ok^s^/⁰³⁰⁹⁰⁹⁶⁵^37/^htm^l/87.^ht^m^l^{, v}ⁱ^s^ite^{d, D}^e^c^e^m^b^e^r^{12, 20}⁰⁵^.

and avoids the question of payment entirely. (For example, this could be an option for a woman
seeking IVF because her fallopian tubes are blocked). While not making specific
recommendations about payment for research-related egg donation, several groups’
recommendations that only embryos left over from IVF procedures be used for stem cell research
(noted above in the Purpose of Embryo Creation section) effectively takes the process of egg
procurement from women out of the research arena. The Bush policy keeps the consent process
for egg retrieval separate from donation by funding research only on lines derived from embryos
originally created for fertility treatments.
One factual distinction that has been used to support competing ethical viewpoints is the efficacy
of alternatives to ESR. The promise of stem cell therapies derived from adult tissue and umbilical
cord blood have buttressed opposition to ESR. A report that stem cells similar to embryonic stem
cells can be found in amniotic fluid may do the same, although the lead scientist conducting
research on the amniotic cells and others have stated that amniotic cells will not make embryonic ⁶⁹
stem cells irrelevant. Perhaps more promising, scientists claim to have generated pluripotent
stem cells from adult cells, though technical and safety concerns regarding the cells’ therapeutic ⁷⁰
use remain unresolved. Alternatives such as those proposed for consideration by the President’s
Council are discussed in the next section. Some opponents of the current method of obtaining
embryonic stem cells argue that therapies and cures can be developed without the morally
undesirable destruction of embryos. E.O. 6/20 affirmatively directs the pursuit of alternative
methods of deriving embryonic stem cells, implying both a belief in the promise and necessity of
such actions.
Not all scientists agree that adult stem cells or pluripotent stem cells derived from adult tissue
hold as much potential as embryonic stem cells. Notably, during a congressional subcommittee
hearing, when the NIH Director, Dr. Elias Zerhouni, was asked if other avenues of research
should be pursued instead, he stated that “the presentations about adult stem cells holding as
much or more potential than embryonic stem cells, in my view, do not hold scientific water. I ⁷¹
think they are overstated.” Concerns have been raised that pluripotent stem cells derived from ⁷²
adult tissue may not be as versatile as embryonic stem cells, and may induce tumors. Most
supporters of ESR believe that it is the quickest and, perhaps in some cases, the only path that
will yield results. Supporters also stress that embryonic and other stem cell research should be
conducted collaboratively, so that they can inform one another. On a related note, some have
pointed out that benefits from one alternative to ESR, umbilical cord blood banking, may only be
available to families who can afford to pay private companies’ storage fees.

⁶⁹^Ric^k^W^e^{iss, “}^S^cⁱ^eⁿ^{tists Se}^e^P^o^te^ntia^{l In}^Am^niotic^Ste^m^Ce^lls,”^Was^hⁱⁿ^gt^{on Pos}^t^,^J^a^nua^r^y^{8, 20}⁰⁷^,^{p. A}¹^{, a}^t
^http:^//w^w^w^.^w^a^s^hing^tonp^os^t.c^o^m^/^w^p^-^d^yⁿ^/c^onteⁿ^t/^a^r^tic^le^/20^07/^01/⁰⁷^/^A^R²⁰⁰⁷⁰¹⁰⁷⁰⁰⁶⁷^4.^htm^l^{, v}ⁱ^s^ite^{d J}^a^nua^r^y^{8, 2}⁰⁰⁷^.
⁷⁰^J^uny^ing^Y^u^e^t^a^l^{., “}^Iⁿ^duc^e^d^P^l^urⁱ^poteⁿ^{t Ste}^m^C^e^{ll L}ⁱ^ne^s^D^e^rⁱ^v^e^d^f^r^om^H^u^m^a^{n Som}^a^tic^C^e^lls^,”^Sc^ie^nc^e^{, v}^o^{l. 3}^18,ⁿ^o^.
⁵⁸⁵^{8 (}²¹^D^e^c^e^m^b^e^r²⁰⁰^{7; o}^r^ig^ina^lly^publis^he^dⁱⁿ^Sc^ie^nc^e^Ex^pr^e^s^s^{on 20}^N^o^v^e^m^b^e^r²⁰⁰⁷⁾^.
⁷¹^D^r^{. Elia}^s^Ze^r^h^ou^ni’^s^aⁿ^s^w^e^r^{to a}^que^s^tioⁿ^durⁱⁿ^g^the^“^F^is^c^a^l²⁰⁰⁸^budg^e^t^f^o^r^t^h^e^N^a^tiona^l^Iⁿ^s^tit^ute^s^of^H^e^a^lth,”
^H^e^ar^ing^{of t}^h^e^U^.^S^.^Se^nate^A^ppr^o^p^rⁱ^ati^ons^Su^bc^om^m^itte^e^oⁿ^L^a^b^o^r^,^H^e^alth^a^{nd H}^u^m^a^{n Se}^r^v^ic^e^s^{, Ed}^uc^ati^on,^a^nd
^R^e^l^a^t^e^d^A^g^en^ci^es^(M^arch¹⁹^,²⁰⁰⁷^).
⁷²^“^T^he^Ne^w^s^{: Sc}^ie^{ntists f}^o^{r the}^fⁱ^rs^{t tim}^e^ha^v^e^ge^ne^r^a^te^{d hum}^aⁿ^s^t^e^m^ce^lls^f^r^o^m^a^{dult c}^e^lls^,”^Bioe^thⁱ^c^s^Re^s^ponde^r^fr^om
^the^H^a^s^tⁱ^ngs^C^e^nte^r^,⁽²^{0 N}^o^v^e^m^b^e^r²⁰⁰⁷⁾^.

Findings regarding the effectiveness of alternatives to ESR are mixed. The President’s Council
notes that there is a “debate about the relative merits of embryonic stem cells and adult stem ⁷³
cells.” Focus on the Family cites promising non-embryonic stem cell research: “adult stem cells
may be as ‘flexible’ as embryonic ones and equally capable of converting into various cell types ⁷⁴
for healing the body.” By contrast, the National Academies finds that the “best available
scientific and medical evidence indicates that research on both embryonic and adult human stem ⁷⁵
cells will be needed.” NBAC finds in its deliberations that “the claim that there are alternatives ⁷⁶
to using stem cells derived from embryos is not, at the present time, supported scientifically.”
CAMR supports both embryonic and adult stem cell research, and adds that “many scientists
believe and studies show that embryonic stem cells will likely be more effective in curing
diseases because they can grow and differentiate into any of the body’s cells and tissues and thus ⁷⁷
into different organs.” Mrs. Nancy Reagan and her supporters favor expedient approaches ⁷⁸
including ESR.
Several laws have supported the development of stem cells from sources other than embryos. For
each of fiscal years 2004 through 2006, Congress allocated money in the HHS appropriations for
the establishment and continuation of a National Cord Blood Stem Cell Bank within the Health
Resources and Services Administration. In 2005, Congress enacted P.L. 109-129 for the collection
and maintenance of human cord blood stem cells for the treatment of patients and for research.
One possible alternative to ESR as it has typically been conducted, the ability to generate
embryonic stem cells without destroying human embryos, was explored by the President’s ⁷⁹
Council in its 2005 white paper, described in the introductory section of this report. The white
paper discusses four potential methods of obtaining embryonic stem cells without having to
destroy embryos. Those methods, the scientific and practical merits of which remain far from
settled, are (1) extracting cells from organismically dead embryos; (2) non-harmful biopsy of ⁸⁰
living embryos; (3) bioengineering embryo-like artifacts; and (4) dedifferentiating somatic cells.
In the white paper, the President’s Council examined the ethical acceptability of each method.
The first two seek to avoid the destruction of embryos either by developing standards for
declaring an embryo “dead” when its cells have stopped dividing or by removing a cell from an

⁷³^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^M^oni^torⁱⁿ^g^Ste^m^C^e^{ll Re}^s^e^a^r^c^h^{, J}^a^nua^r^y²⁰⁰⁴^{, p}^.¹⁰^.
⁷⁴^C^a^r^rⁱ^e^G^o^r^{don Ea}^r^l^l^,^“^T^a^l^kⁱ^ng^P^o^ints^oⁿ^S^t^e^m^C^e^{ll R}^e^s^e^a^r^c^h^,”^Foc^u^{s o}ⁿ^the^Family^{, Se}^pte^m^be^r^{17, 200}³^a^t
^http:^//w^w^w^.f^am^il^y^.^or^g^/^c^f^or^um^/^f^o^s^i/bioe^t^hic^s^/f^a^q^s^/^a⁰⁰²⁷⁹⁸^0.c^f^m^.
⁷⁵^N^a^tiona^{l R}^e^s^e^a^r^c^h^C^o^unc^il,^Iⁿ^s^tit^ute^of^Me^dicⁱ^ne^,^N^a^tiona^l^A^c^a^d^em^ies^,^Ste^m^C^e^lls^an^{d t}^h^e^Fu^tur^e^o^f^Re^ge^ne^r^a^tiv^e
^M^e^dicⁱ^ne⁽^W^a^s^hing^{ton: N}^a^ti^ona^l^A^c^a^d^em^ie^s^,²⁰⁰¹⁾^{, p}^.⁵⁶^.
⁷⁶^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^.
^53.
⁷⁷^Coa^liti^{on f}^o^{r t}^h^e^A^d^v^a^nc^e^m^eⁿ^{t of}^Me^dic^a^l^Re^se^a^r^c^h^{, “}^T^he^P^r^om^is^e^of^Em^br^y^onic^Ste^m^C^e^lls,”^a^t
^http:^//w^w^w^.c^am^r^a^dv^oc^a^c^y^.^or^g^/^r^e^sour^c^e^s^/T^he^_^P^r^o^mⁱ^s^e^_of^_Em^b^r^y^oⁿ^ic^_Ste^m^_^C^e^lls^.htm^{, v}ⁱ^s^ite^{d J}^a^nu^a^r^y^{18, 2}⁰⁰⁷^.
⁷⁸^“Nan^c^y^Rea^g^an^p^l^{ea o}ⁿ^st^em^cel^l^s^,^”^{BBC News}^{, Ma}^y^{10, 2}⁰⁰⁴^{, a}^t^http:^//ne^w^s^.^bbc^.c^o.^uk^/2/^h^i/^am^e^r^ica^s^/370⁰⁰^15.s^t^m^,
^vⁱ^s^ite^{d J}^a^nua^r^y^{18, 2}⁰⁰⁷^{; L}^e^tte^r^f^r^om^N^a^ncy^R^e^a^g^aⁿ^{to Se}^na^tor^O^r^rⁱ^{n H}^a^tc^{h, Ma}^y^{1, 2}⁰⁰⁶^{, a}^t
^http:^//w^w^w^.c^am^r^a^dv^oc^a^c^y^.^or^g^/^r^e^sour^c^e^s^/N^aⁿ^c^y^_R^e^a^g^a^n.pdf^{, v}ⁱ^s^ite^{d J}^a^nua^r^y^18,²⁰^07.
⁷⁹^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^W^h^ite^P^ape^r^:^Alte^rⁿ^ativ^e^S^o^u^r^c^e^s^{of H}^u^m^a^{n Pl}^ur^ip^oteⁿ^t^Ste^m^C^e^lls^{, Ma}^y
²⁰⁰^{5, on}^line^a^t^htt^p^://w^ww^.bioe^t^hic^s^.g^ov^/re^ports/w^hite^_pa^pe^r/^inde^x^.^htm^l^.
⁸⁰^For^m^o^r^e^inf^o^r^m^a^{tion, s}^e^e^C^R^S^R^e^por^{t R}^L³³⁵⁴^0,^Ste^m^C^e^{ll Re}^s^e^ar^c^h^:^Fe^de^r^a^l^Re^s^e^ar^c^h^Fu^ndⁱⁿ^g^and^O^v^e^r^sⁱ^ght^{, by}
^Judit^h^A^.^Johⁿ^son^aⁿ^d^Erin^{D. W}^illia^m^s^.

embryo without destroying the embryo itself. The other two methods would avoid having to use
an embryo altogether, by attempting to obtain embryonic stem cells through the destruction of
something that is not an embryo.
The Council concluded that the use of organismically dead embryos raises a number of ethical
questions that have yet to be answered. They include whether it is possible to be certain that an
embryo is really dead, whether the proposal would put embryos at additional risk, and whether
IVF practitioners would be encouraged to create extra embryos. A September 2006 report that a
team based in Serbia and England had derived stem cells from “dead” embryos prompted
precisely these types of questions, as well some regarding whether the stem cells might carry ⁸¹
some defect that had made the embryos non-viable.
Regarding the use of non-harmful biopsy, the Council found that it would be ethically
unacceptable to test in humans because risks should not be imposed on living embryos destined to
become children for the sake of getting stem cells for research. This same response was prompted
by an August 2006 report in the journal Nature that a California company had used the non-⁸²
harmful biopsy method to derive stem cells. In addition, the technique was criticized on one side ⁸³
for effectively “creating a twin and then killing that twin,” and on the other for being an ⁸⁴
inefficient method for deriving stem cell lines. In November 2006, Nature issued an addendum
to the August article to clarify that, while the company’s lead scientist maintained that his method
could be used to derive stem cells without destroying embryos, in fact, he had destroyed all of the ⁸⁵
embryos during his own experiments.
The Council also concluded that bioengineering embryo-like artifacts raises many serious ethical
concerns, including whether the artifact would really be a very defective embryo, the ethics of
egg procurement, concerns about the use of genetic engineering itself, and the possibility of its
use creating a “slippery slope.” Finally, the Council found the proposal to dedifferentiate somatic
cells to be ethically acceptable if and when it became scientifically practical, provided that de
facto embryos were not created.
Although some Council members expressed their support for efforts to identify means of
obtaining human embryonic stem cells for biomedical research that do not involve killing or
harming human embryos, not all of the members agreed. Some expressed concern that all four
methods would “use financial resources that would be better devoted to proposals that are likely
to be more productive.” One member wrote that he did not support publishing the white paper
“with the implied endorsement that special efforts be made in the scientific areas described.
While some of the suggestions could be explored in a scientific setting, most are high-risk options
that only have an outside chance of success and raise their own complex set of ethical questions.”

⁸¹^S^ee,^e.^g.^,^Ri^{ck W}^eⁱ^{ss “Re}^s^earch^e^r^{s Rep}^o^r^t^G^r^o^wⁱⁿ^{g S}^t^em^Cel^l^s^F^r^o^m^Dead^E^m^b^r^y^o^s,^”^W^a^s^h^ingt^on^Pos^t^{, Se}^pte^m^be^r
^23,²⁰⁰⁶^{, p}^.^A^{03, a}^v^a^ila^ble^oⁿ^li^ne^a^t^htt^p^://w^ww^.^w^a^s^hing^ton^post.c^o^m^/^w^p^-d^yⁿ^/c^onteⁿ^t/^a^r^tic^le^/200^6/⁰⁹^/^22/
^A^R²⁰⁰⁶⁰⁹²²⁰¹³⁷⁷^.htm^l.
⁸²^Se^e^e^.^g^{., Nic}^hola^s^W^a^de^{, “}^S^te^m^Ce^{ll Ne}^{ws Could}^Inte^nsif^y^P^o^lit^ic^a^l^De^ba^te^,”^{New Yo}^{rk Times}^{, A}^u^g^u^s^t²⁴^,²⁰^06,
^a^v^a^ila^ble^online^a^t^htt^p^://w^ww^.n^y^tim^e^s^.c^om^/²⁰⁰^6/^08/^24/^sc^ie^nc^e^/
^24s^te^m^.^htm^l^?e^x⁼¹¹⁶⁴⁸⁶²⁸⁰^0&^eⁿ⁼^1d5^1e^f^92c^ddc^3e^82&^eⁱ⁼⁵⁰^70.
⁸³^Ibid^.
⁸⁴^Se^e^e^.^g^{., J}^o^s^e^phi^ne^Q^uⁱⁿ^ta^v^a^lle^{, “}^T^he^La^nz^a^P^r^ot^oc^ol:^D^a^mⁿ^e^d^With^Ve^r^y^Fa^int^P^r^aⁱ^s^e^,”^BioNe^w^s^,^v^o^{l. 3}^73,⁽^A^ug^us^t
^22-^28,²⁰⁰⁶⁾^,^a^v^a^ila^ble^oⁿ^line^a^t^http:^//w^w^w^.bione^w^s^.or^g^.uk^/^c^o^m^m^e^nta^r^y^.^la^s^s^o^?^s^tor^y^id=³¹⁵^7.
⁸⁵^Ro^b^e^rt^L^{aza et}^al^.^,^“Hu^m^an^E^m^b^r^y^oⁿⁱ^{c S}^t^e^m^Cel^l^Lⁱⁿ^e^{s Deri}^v^e^d^f^r^o^m^Sⁱⁿ^g^l^e^Bl^ast^o^m^e^r^e^s,^”^Na^tu^re^,^v^o^{l. 4}^44,^p.⁴⁸¹
^(N^ov^em^be^{r 23,}²⁰^06),^a^v^a^ila^ble^oⁿ^line^a^t^htt^p^://w^w^w^.na^t^ur^e^.^c^o^m^/^na^ture^/jour^na^l/^v^444/ⁿ⁷¹¹^8/^f^u^ll/na^t^ure⁰⁵³⁶⁶^.h^tm^l.

E.O. 6/20 specifies that the HHS Secretary should consider the techniques outlined by the
President’s Council, and fund attempts to generate sources of pluripotent stem cell therapies that
were not derived from human embryos.
Some division over the support for and opposition to ESR focuses on the question of whether the
use of federal funding is appropriate. Those who oppose federal funding argue that the ⁸⁶
government should not be associated with embryo destruction. They point out that embryo
destruction violates the “deeply held moral beliefs of some citizens,” and suggest that “funding ⁸⁷
alternative research is morally preferable.” Proponents of federal funding argue that it is
immoral to discourage life-saving research by withholding federal funding. They point out that
consensus support is not required for many federal spending policies, as it “does not violate ⁸⁸
democratic principles or infringe on the rights of dissent of those in the minority.” They argue
that the efforts of both federally supported and privately supported researchers are necessary to
keep the United States at the forefront of what they believe is a very important, cutting edge area
of science. Furthermore, supporters believe that the oversight that comes with federal dollars will
result in better and more ethically controlled research in the field. Requirements attached to
federal funding are one traditional mechanism that Congress has used to regulate scientific ⁸⁹
research that might otherwise be conducted without federal oversight.
Groups’ positions on federal funding tend to mirror their positions on stem cell research generally.
The Bush policy authorizes federal funding for some ESR. The President’s Council does not take
a position on the issue, but notes the pros and cons and stresses that there is a “difference between ⁹⁰
prohibiting embryo research and refraining from funding it.” Focus on the Family generally
supports President Bush and his policy, but is “disappointed by his decision to allow federal ⁹¹
funding of research on the existing stem cell lines.” NBAC finds the arguments in favor of ⁹²
federal funding more persuasive than those against it. The National Academies, a group of
Representatives, a group of Senators, Mrs. Nancy Reagan and her supporters, CAMR, the Nobel ⁹³
Laureates, and the UOJCA favor federal funding for ESR.
Several pieces of legislation would use federal funding to add ethical requirements to the conduct
of ESR. While the August 2001 Bush policy does contain some ethical requirements regarding
the creation of stem cell lines eligible for federal funding, those requirements would serve only to

⁸⁶^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^.
^57.
⁸⁷^Ibid^.
⁸⁸^Ibid^.
⁸⁹^For^f^u^r^t^he^r^inf^o^r^m^a^{tion a}^b^o^u^{t C}^o^ng^r^e^s^sⁱ^ona^{l r}^e^g^u^la^tio^{n of}^r^e^s^e^a^r^c^h^inv^o^lv^ing^h^u^m^a^{n s}^ubje^c^t^s^,^s^e^e^C^R^S^R^e^por^t
^R^L³²⁹⁰^9,^Fe^de^r^a^{l Pr}^o^t^e^c^tion^for^H^u^m^an^Re^s^e^ar^c^h^S^ubje^c^t^s^:^Aⁿ^Aⁿ^aly^s^is^{of t}^h^e^C^o^m^m^{on R}^u^le^an^{d I}^t^s^Iⁿ^te^r^a^c^tio^ns^wⁱ^t^h
^{FDA Re}^gul^ati^ons^an^d^t^h^e^HIPAA^Priv^ac^y^Rule^,^by^{Erin D. W}^illia^m^s^.
⁹⁰^T^h^e^P^r^e^s^ideⁿ^{t’s Co}^unc^il^oⁿ^Bioe^t^h^ic^s,^M^oni^torⁱⁿ^g^Ste^m^C^e^{ll Re}^s^e^a^r^c^h^{, J}^a^nua^r^y²⁰⁰⁴^{, p}^.³⁷^.
⁹¹^C^a^r^rⁱ^e^G^o^r^{don Ea}^r^l^l^,^“^T^a^l^kⁱ^ng^P^o^ints^oⁿ^S^t^e^m^C^e^{ll R}^e^s^e^a^r^c^h^,”^Foc^u^{s o}ⁿ^the^Family^{, Se}^pte^m^be^r^{17, 200}³^a^t
^http:^//w^w^w^.f^am^il^y^.^or^g^/^c^f^or^um^/^f^o^s^i/bioe^t^hic^s^/f^a^q^s^/^a⁰⁰²⁷⁹⁸^0.c^f^m^.
⁹²^Na^tiona^{l Bi}^oe^thic^{s A}^d^vⁱ^sory^Com^mⁱ^ssion,^Et^hic^a^{l I}^s^s^u^e^s^{in H}^u^m^an^Ste^m^C^e^{ll Re}^s^e^ar^c^h^{, v}^o^l^.^{1, Se}^pte^m^be^r¹⁹⁹⁹^{, p}^.
^70.
⁹³^Se^e^,^e^.^g^{., Na}^tio^na^{l Re}^se^a^r^c^h^Couⁿ^c^{il, I}ⁿ^stitute^of^Me^dicⁱ^ne^{, Na}^ti^on^a^l^A^c^a^d^e^m^ie^s,^Ste^m^Ce^{lls and}^the^Future^of
^Re^ge^ne^r^a^tiv^e^M^e^dicⁱ^ne⁽^W^a^s^hing^ton:^N^a^tiona^l^A^c^a^d^em^ies^,²⁰⁰¹⁾^,^{p. 4}⁹^.

evaluate researchers’ previous activities, not to influence their future ones. This is because
researchers who created stem cell lines before the policy took effect could not have been
influenced by its ethical constraints regarding the derivation of stem cells from embryos, as the
policy did not yet exist. Researchers who created stem cell lines after the policy took effect would
not be motivated to follow the Bush policy’s ethical guidelines regarding the creation of stem cell
lines, because the results of their work would be ineligible for federal funding regardless of their
methodology. By contrast, E.O. 6/20 may affect the future derivation of embryonic stem cells to
the extent that it encourages that such activities take place without creating embryos for research
or harming, endangering, or destroying them.
^Erⁱⁿ^{D. W}^illia^m^s ^Ju^di^t^h^A^.^Johⁿ^s^oⁿ
^Sp^{ecialist i}ⁿ^P^u^b^{lic Healt}^h^an^d^Bⁱ^o^e^th^ics^Specialis^{t i}ⁿ^Bⁱ^o^m^{edical P}^o^licy
^e^wⁱ^l^lⁱ^a^m^s^@^c^rs^.l^oc.g^ov^{, 7}^-⁴⁸⁹⁷^j^a^j^o^hnsoⁿ^@^c^r^s.^l^o^c^.^go^v^{, 7}^-⁷⁰⁷⁷