Stem Cells and the Reagan Legacy

Although it is not likely to be as significant as the war in Iraq or the economy for the November 2004 election, the issue of embryonic stem cell research seems to have political staying power. For now, the debate focuses largely on President Bush’s policy of providing federal funding for research on a limited number of embryonic stem cell lines, where the embryos in question have already been destroyed. But the stem cell debate, rightly understood, encompasses much more: Stem cell advocates see it as a referendum on scientific progress, often seeming to forget that the birth of bioethics in the twentieth century was in considerable measure a result of scientific research that seemed unwilling to recognize moral limits. Opponents of embryo research see the issue as just part of a larger question about moral limits to the drive for mastery of nature (and, even, human nature).

The stem cell debate took center stage at the Democratic National Convention in July, where Ron Reagan, son of President Ronald Reagan, delivered a keynote address describing, as he saw it, the future of regenerative medicine and calling for more federal funding for more stem cell lines. Because President Reagan had died of Alzheimer’s disease so recently, the moment had special poignancy, and one might think of it as an attempt to make aggressive support of embryonic stem cell research a Reagan legacy. But the speech, examined closely, is actually an example of the many confusions — moral and scientific, deliberate and inadvertent — that shape public debate over this crucial question. It may be useful, therefore, to place the speech into a larger moral framework, and perhaps in the process to set the record straight.

Moments after Ron Reagan had completed his “nonpartisan” speech recommending (though he did not say so) cloning for purposes of embryonic stem cell research, I was channel surfing on my minimal cable package in search of comment on the speech. For my sins I landed on MSNBC, where Campbell Brown was interviewing (on the convention floor) Rep. Diana DeGette, a Democrat from Colorado.

Rep. DeGette earnestly assured Campbell and the rest of us that what Ron Reagan had recommended was simply using “spare” embryos that had been produced — but, as it turned out, not needed — for in vitro fertilization procedures. These embryos, destined for destruction anyway, were what Ron Reagan had recommended be used to bring about the cures that Rep. DeGette was confident lay in the future if only we forged ahead with research.

Campbell Brown seemed satisfied; at any rate, she raised no questions about Rep. DeGette’s analysis of and response to the speech. I, however, was amazed, and uncertain which would be the more charitable reaction to Rep. DeGette: Should I assume that she was knowledgeable but duplicitous? Or should I assume that her comments were entirely straightforward, even though utterly mistaken? Probably it is more charitable — and closer to the truth — to conclude that Rep. DeGette simply didn’t know what she was talking about.

Rep. DeGette was probably not alone in failing to understand what Ron Reagan was actually recommending; for, he never used the words that embryonic stem cell research advocates now avoid like the plague. What words? “Cloning.” And “embryo.” Yet, the procedure he described (that would, he implied, within another ten years give each of us our “own personal biological repair kit”) was precisely cloning. One takes an ovum, removes its nucleus and replaces it with the nucleus of the person to be cloned. The resulting product is then stimulated in such a way that it begins the cell division that characterizes the earliest stages of embryonic development of a human being — and then, bingo, we get embryonic stem cells. But, of course, we get them because this procedure results in an embryo, which is destroyed in order to procure those cells.

Clearly, Ron Reagan had been getting some coaching. When stem cell research first became a controverted topic, proponents tended to speak of “therapeutic cloning” (as opposed to “reproductive cloning”), trusting that the positive overtones of “therapeutic” would outweigh public distaste for anything called cloning. When this turned out not to be the case, proponents turned instead to sanitized technical language — speaking of somatic cell nuclear transfer to produce stem cells, but not of cloning or of embryos. That Ron Reagan knows this is deceptive was clear from the rest of his speech. After all, were no embryos involved or destroyed in this process, there would have been no need for him to argue that these “cells” “are not, in and of themselves, human beings.” And were it not a cloning procedure that he was describing and recommending, he could not have stated that it would eliminate the risk of tissue rejection.

Opponents of embryonic stem cell research have regularly noted that its advocates slip back and forth between talking of research carried out with “spare” IVF embryos and research using cloned embryos created solely and explicitly for research. The reason is simple: What researchers really want is what Ron Reagan recommended — cloned embryos for research. But, sensing that the public may be more receptive for now to research using “spare” embryos (doomed to destruction in any case, as we are always told), proponents often prefer to start there, all the while deriding “slippery slope” arguments which suggest and predict that we will not in fact stop there. At any rate, it should be clear that anyone who wants to join the cause that Ron Reagan set forth — and who, unlike Rep. DeGette, understands what he was saying — is supporting research using cloned embryos.

Were we actually to take seriously what Ron Reagan said, we would, I think, be stunned by its hubris, its utter lack of any sense of human limits. (And this speech was delivered, we should recall, at a convention intent on arguing that — with respect to war in Iraq — President Bush lacked the wisdom to sense the limits of what could be done and, instead, placed his trust in technical might alone.) Speaking of “a wide range of fatal and debilitating illnesses: Parkinson’s disease, multiple sclerosis, diabetes, lymphoma, spinal cord injuries and much more,” Ron Reagan opined: “It may be within our power to put an end to this suffering. We only need to try.”

Our inability really to think through such promises was demonstrated almost immediately by a comment made by Andrea Mitchell, serving on a panel moderated — if that can possibly be the right word — by Chris Matthews (MSNBC again). What struck her — and impressed her — was that Ron Reagan had not mentioned Alzheimer’s, the disease that had so recently taken the life of President Reagan. For, she asserted, it was one of the few diseases where embryonic stem cell research had not been helpful (as if it had been helpful with many others). What she should have said, of course, is that researchers doubt that embryonic stem cells will be useful for treating Alzheimer’s and that they have more hope with respect to some (though not all) of the other conditions Ron Reagan had listed, even though research has yet to confirm such hopes. (Nor did she — or Ron Reagan — seem to realize the serious obstacles that stand in the way of using cloning to treat an autoimmune disease such as juvenile diabetes. The immune system that has produced diabetes by destroying the body’s insulin-producing cells is also likely to reject identical cells that have been cloned and reinserted.) But such technical issues do not yet get us to the hopes and fears — pathos mixed with hubris — that generate Ron Reagan’s call for research.

The deeper issue, which begs for analysis and critique, is the commitment to a kind of limitless war on disease. “We only need to try.” Why is it that those so certain that we cannot remake the world and rid it of political ills by applying American power and technical know-how are equally certain of our ability to wage successful war on one disease after another? Why is it that those so impressed with our need to accept moral limits when waging war, and so critical of American hubris, seem tone-deaf to the possibility that moral limits might rightly be placed upon the experiments by which we wage war against illness and suffering?

Evidently, if one knows oneself to be on the side of what is desirable and good, no moral limits need apply. Whence this confidence? “The tide of history is with us,” Ron Reagan said. This, of course, is an assertion in the name of which great evil can be done. Indeed, it boggles the mind that a son of President Reagan — who set himself so firmly against what seemed to be the tide of history — should suppose that our (quite dim and uncertain) sense of where history is going should be more important than our sense of what is right or wrong, that how long we live should be more important than how we live.

Along the way to that happy future in which each of us is equipped with his or her “own personal biological repair kit,” we are going to need a lot of ova from which to extract nuclei in order to insert our own DNA (in order to produce embryos that can be disaggregated to obtain stem cells). Ron Reagan said nothing at all about where these eggs are to come from, about the women who will have to “donate” them, or about the possibilities for exploitation and commodification this need for eggs will create. A surprising omission in a speech delivered at a convention packed with people whom one might expect to sniff out the slightest possibility for exploitation.

Ron Reagan also told us nothing about “the theology of a few” that is, he asserts, placing roadblocks in the way of “the health and well-being of the many.” Perhaps, of course, he simply knows very little of the actual arguments used by opponents of embryonic stem cell research (and, more particularly, opponents of cloning for stem cell research). The only argument he made is that we can and must distinguish between those human beings who, at the earliest stages of development, have not yet developed the characteristics that will distinguish them as human adults and those human beings who already have such characteristics (brain, spinal cord, thoughts, fears). He said nothing at all about the implications of this argument for those human beings who may lack many of these qualities or who may have lost the capacities they once had.

Moreover, he said nothing at all about how the cloning he recommends can be done for experimental purposes without opening the door to cloning more generally. After all, to spell out how he might propose to do this would inevitably open him to powerful counter-arguments. He said nothing at all about how the “theology” he rejects may teach us to value those whose capacities are relatively undeveloped, who are weak in relation to our strength. And how strange it is, once again, that those who are concerned that America use its strength only in ways that clearly serve the disadvantaged and vulnerable, should so rigidly exclude from the scope of their concern embryos in the first stages of human development.

No one can be against compassion, of course, and no one should be against it when it is properly understood. But the debased currency of compassion in our public discourse today is by no means the real virtue itself. The meaning of compassion has been isolated entirely from any larger moral framework which might give it direction and set limits to what can be done in its name. To see what such a moral framework looks like we might turn to a children’s story.

The Magician’s Nephew is one of the seven Chronicles of Narnia written by C.S. Lewis. First in the order of Narnian chronology but sixth in order of publication, it is, among other things, a story about forbidden knowledge and about the temptation to do evil in search of good. Young Digory Kirke, whose mother is dying back in England, is drawn by magic (along with Polly, who lives next door) into the world of Narnia, newly created by the great lion Aslan. It is a land of youth, bursting with life and energy. When Digory realizes this, he begins to hope for a chance to take back some of the fruit of Narnia to his dying mother. Aslan, however, has other plans.

Aslan sends Digory on a journey beyond the borders of Narnia, into the Western Wild, to a place where he will find “a green valley with a blue lake in it, walled round by mountains of ice. At the end of the lake there is a steep, green hill. On top of that hill there is a garden. In the centre of that garden is a tree.” From that tree Digory is to “pluck an apple” and bring it back to Aslan, who intends to use it to plant the Tree of Protection that will keep Narnia safe from the evil witch Jadis for many years.

Digory finds the garden and the tree, picks an apple, and puts it in his pocket. The sweet smell of the fruit is so ravishing that he is tempted to take it for himself. That temptation he resists, but a far more powerful temptation then faces him. Jadis has come to the garden ahead of Digory. Seeing her, he turns to flee, but she stops him. Why, she asks, take the apple of youth to the lion Aslan? Why not eat it himself and live forever? But then Jadis cuts more deeply still. Why not take the apple for his mother?

Use your Magic and go back to your own world. A minute later you can be at your Mother’s bedside, giving her the fruit. Five minutes later you will see the color coming back to her face. She will tell you the pain is gone. Soon she will tell you she feels stronger. Then she will fall asleep — think of that; hours of sweet natural sleep, without pain, without drugs. Next day everyone will be saying how wonderfully she has recovered. Soon she will be quite well again. All will be well again. Your home will be happy again.

Digory gasps, realizing that “the most terrible choice lay before him.” Aslan’s instructions had been clear: to take one apple from the tree and return with it. And Digory must choose what sort of person he will be, whether the meaning of “compassion” is governed by any other moral goods. He resists, returns with the apple, and hears Aslan’s “Well Done.”

Later, when the apple has been planted and the Tree of Protection grown into a towering tree, Aslan gives Digory an apple from it to take to his mother. Aslan explains that had Digory stolen an apple it would indeed have healed his mother, but it would not have brought joy. “The day would have come when both you and she would have looked back and said it would have been better to die in that illness.”

These are hard words for anyone to hear (as Digory’s choice is hard), but the vision of life they undergird is noble. Of course, we want to help those who suffer, but we should not suppose that such help is the only good in life — that a “compassion” which knows only that goal is true compassion. Unlimited war against illness can no more be recommended than unlimited war against military enemies. The point is not simply to win, to stay alive, but to live in ways that are worthy of continued existence. Son of President Reagan though Ron was, the apple seems to have fallen quite far from the tree. President Reagan was known for his optimism, for his belief in better days still to come. No doubt he would have brought that optimistic spirit also to the world of medicine, believing and hoping that continued advance would create a better future for many. But he also had a sense of limits, freedom from the hubris which supposes that how long we live is of greater moral significance than the shape of the life we live. He was able, therefore, in the moving letter he wrote to the American people after he had been diagnosed with Alzheimer’s, to accept the trajectory of his own life with its coming decline and mortality. He did not see his illness as desirable, as the future he would, given alternatives, have chosen for himself. But he also did not see it simply as something to be avoided. “I now begin the journey that will lead me into the sunset of my life,” he wrote. It was part of life’s trajectory, part of the shape of a life that begins in weakness and incapacity and often ends there.

None of us really wants to grow old. None of us wants gradually to lose the powers that characterized us at the height of our flourishing. Nor do we want this for those we love. Evidently we want to exercise our powers fully and completely up to the end — and then suddenly drop off the face of the earth. (But, then, why would we ever find an end acceptable?) It is desperation born of that image of the good life which skews the meaning of compassion and drives the engine of cloning embryos for research and destruction. Hence, it’s that image of the good life, not embryos, that we should be destroying. President Reagan’s letter might teach us this lesson, but we must be willing to learn.

For Ron Reagan, it seems, the only questions future generations raise for us involve our willingness to do whatever we can to relieve their suffering. They do not, evidently, provoke us to thought about the kind of moral world we bequeath to them. They seem to care only about what we accomplish — not about what we do, or the kind of people we become. In the name of an unrestricted pursuit of scientific research we are given a surprisingly narrow and constricted sense of what counts morally. Perhaps we would do better to see ourselves and others in need not as the “fellow angels” of whom Ron Reagan spoke but, rather, as “fellow human beings.” Sharing alike in the weakness of our embryonic origins, united in our desire to pursue what is good in ways that do not violate our common humanity, prepared to do right whatever the tide of history might seem to be, and able to honor moral limits even in the wars we wage against illness and suffering.