By Alan Malnak, MD, Naples Daily News (Florida)

Following the furor raised by President Barack Obama’s commencement address at the University of Notre Dame, perhaps it’s time to again examine the necessity for human embryonic stem cell research and review the reasons it must be continued and expanded rather than condemned.

Embryonic stem cells hold promise because of their ability to develop into any of the over 200 body cells as well as to replace cells and tissue destroyed by disease. This has incredible potential for aiding the understanding and treatment of innumerable diseases and even birth defects. Testing of new medications for safety could be performed in labs using lines of embryonic stem cells. Diabetes, heart disease and spinal-cord injuries are just a few of the conditions that potentially could be treated.

These cells could help us understand the complex events that occur during human development, such as identification of the factors involved in the cellular decision-making process that results in cell specialization.

Turning genes on and off is central to this process, but we do not know much about these “decision-making” genes or what turns them on or off. Some of our most serious medical conditions, such as cancer and birth defects, are due to abnormal cell specialization and cell division.

And finally, what some have labeled “low-hanging fruit,” because it will most likely be utilized first. It involves producing a disease base using “somatic-cell nuclear transfer” from a patient with say Parkinson’s disease. Now, in a petri dish you have growing a disease-based line. What a powerful tool to study and understand the disease process at the cellular and even molecular levels. Later one could try different chemicals in the dish to determine if they could affect the disease. Only the effective drugs would go on to animal and, finally, human testing.

Keep in mind the pre-embryo from which stem cells are extracted is not implanted and growing in a woman’s uterus, so it will never, ever become a fetus or a child. If it came from an in-vitro fertilization clinic, it will remain frozen or eventually be destroyed. It has no recognizable human features or form. It is, rather, a blastocyst, a frozen tiny cluster of cells in a petri dish, that can easily fit into President Franklin D. Roosevelt’s eye on the face of a dime. A four-day-old human embryo is a collection of 150 cells. There are, for the sake of comparison, more than 100,000 cells in the brain of a fly. The embryos that are destroyed in stem-cell research do not have brains, or even neurons. Consequently, there is no reason to believe they can suffer their destruction in any way.

It has been pointed out that incorrect terminology is often responsible for a lot of the controversy. Fertilization and conception are not synonymous and do not occur at the same time. Fertilization of an egg may occur naturally in the fallopian tube (in vivo) or in a piece of glass equipment by scientific means (in vitro). Conception occurs when a fertilized egg implants itself in a suitable uterine lining and begins to draw nourishment. A pregnancy does not actually begin until the process of conception is complete. Thus, we correctly use the term “in-vitro fertilization” but not “in-vitro conception.”

What about adult stem cells? Adult stem cells reprogrammed to accomplish the same goals as embryonic ones still have not been shown to fully have that ability. If/when that occurs, and it most likely will in another decade or less, embryonic research will no longer be needed. Until then, however, embryonic stem-cell studies remain essential.

Most organ transplants are made from patients who are brain dead, even though they still have beating hearts and a blood pressure is obtainable. They have suffered complete loss of all brain function, and this makes them clinically and legally dead. A blastocyst has yet to develop any organs of any type, let alone a heart or brain.

Next question: Is the potential to become a person the same as being a person? A human embryo certainly is human in the biological sense that it did not originate from a different animal species. If a fertilized human egg has the potential to become a person even though not implanted into a uterus, what about other cells that also have such a potential? Doesn’t every sperm and ovum have such a potential under the right circumstances? As shown with the cloning of Dolly, the sheep, even a human skin cell has the potential to develop into a person.

I well understand the present conflict over the moral status of the human embryo reflects deep differences in our basic convictions and is unlikely to be resolved through deliberation or debate. Could anyone be more pro-life than those dedicated to working to prevent and treat innumerable horrendous illnesses? I ask, whose future is more important, that of a cluster of frozen, destined to be destroyed cells or a sick or injured child or adult and that person’s family?

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Following his internship and residency, Malnak served as chief of internal medicine at U.S. Army Hospital, Fort Sill, Okla., and then was a clinical investigator in liver disease at Mount Sinai Hospital, Chicago. He was a board-certified internist in the Chicago area for more than 35 years. He was a clinical instructor at Chicago Medical School for eight years and an assistant clinical professor at the Stritch School of Medicine of Loyola University for 25 years. Malnak was medical director of a number of medical organizations, including Principle Health Care of Illinois and the emergency department of Chicago’s Mount Sinai Hospital. He is a frequent contributor of letters to the editor and guest commentaries to the Naples Daily News.