Emerging Stem Cell Strategies: Practices, Rhetorics & Policies
Report from the joint 4S & EASST Conference, August 2004
Over the last five years human stem cell research has emerged as a new and much discussed new bio-medical strategy. Many positive expectations are connected with stem cell research concerning the potential treatment of several serious diseases and health conditions. Stem cell research has also created a great deal of political controversy and put pressure on regulatory policy making. A double session on stem cell research was organized by Herbert Gottweis and Linda Hogle. The seven papers focused on the interrelationship between emerging research strategies, research support and regulatory policies in the field of stem cell research. The session was a great opportunity to meet other STS scholars studying stem cell research; a small but growing number.
The papers included case studies on Sweden, Israel, the USA, the United Kingdom and Germany. Sweden, Israel and the United Kingdom have developed liberal policies on stem cell research, whereas Germany has developed a more restrictive policy. The USA has a mixed position. Several papers provided clues on how to explain differences between countries.
Teresa Kulawik provided an insight in the Swedish policy which is, within Europe, closest to that of the United Kingdom. Quite surprisingly for a social-democratic regime, the Swedish political debate on biomedical research and practice faced not much criticism. Kulawik puts this down to the rather elitist policymaking structures that are still in tact within technological policies. The Israelian policy pursues one of the most permissive regulations of stem cell research. Barbara Prainsack has put the permissive policy of Israel in a cultural and religious perspective; an endangered society and a religious view on embryo’s as not fully human. This has shaped a specific bioethics climate in Israel. Endorsing a permissive approach towards technologies by finding new cures for the sick is offered as the only solution. Herbert Gottweis used discourse analysis to explain differences between the USA, the UK and Germany, especially differences in dealing with risks and uncertainty. The UK has adopted a regulatory approach towards stem cell research that allowed a broad range of experimental research in this field under government control. This policy has united a broad variety of socio-political groups. Gottweis characterized the UK strategy as a ‘democratic model’. My own analysis of the UK Stem Cell Bank, the world’s first, represented step two of this UK democratic model. I have analyzed two different roles for the public in the emerging network of the bank. The public in general was addressed to create broad support for stem cell research; specific publics were merely involved in some form of consultation setting, for example lay members in the Steering Committee of the SCB and focus group interviews with embryo donors.
The US stem cell research was examined from three different perspectives. Morten Christiansen used ANT concepts to reconstruct the network dynamics of human embryonic stem cells when they were introduced in the late nineties. Actors who agreed with this introduction attempted to construct embryonic stem cells as an obligatory point of passage, whereas the opposition focused on alternative points of passage such as adult stem cells. These notions help to understand why the US debate was powerfully structured around this controversy. Linda Hogle presented a paper on the strategy work going on in tissue engineering (grounding specific techniques, linking laboratories internationally) in the USA. She has done ethnographic research in practices of regenerative medicine. Hogle argued that attention should be shifted away from the political theatre to the practice of stem cell research, as the work done there will have a much bigger impact. Gottweiss identified a strong mobilization of emotional language within the political theatre of the USA, used both by supporters and critics of embryonic stem cell research.
Germany was the sole country included in the session with an explicit restrictive policy. In Germany it is prohibited to harvest embryonic stem cells; however it is allowed to import them. In contrast to the debate in the USA the German debate is not polarized. There is a broad socio-political alliance that constructs embryonic stem cell research as in conflict with the political identity of Germany. The National Ethics Council in Germany very recently announced that it would continue to oppose the cloning of human embryos for research despite calls for more research into its benefits, which confirms Gottweis’ analysis of the German policy.
The aim of the Paris 4S meeting was to explore new relations between science and democracy. The idea that the public should be consulted about scientific and technological developments has been widely accepted. But how can or should the public be involved to ensure new forms of governance? The use of rhetorics and discourses by experts has structured the debates quite strongly, leaving the public more or less aside. An interesting counterpoint was provided by Catherine Waldby in her paper on cord blood banking. Private cord blood banking has been largely condemned by bioethical and professional medical bodies because the likelihood of an individual actually needing his or her cord blood for a transplant is very low and public redistributive banking is a more efficient use of resources. Still there is a public interest. Waldby argued that a private cord blood account allows the donor to retain control over their tissues as a form of non-commodified, inalienable property if there are prospects of selling one’s cord blood. It also gives the account holder a stake in the future of biotechnological development. The lesson for governance of stem cell research might be to involve specific publics, like stakeholders and donors of embryos and cord blood.
Loes Kater is at the Centre for Studies of Science, Technology and Society and the School of Business, Public Administration and Technology of the University of Twente, P.O. Box 217, Enschede, The Netherlands