Time - Man of the Year/Time_Man_of_the_Year_Compact_Publishing_3YX-Disc-1_Compact_Publishing_1993.iso/moy/040692/0406620.000

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                                                                                ETHICS, Page 52

When Abortions Save Lives


Is the fetal-tissue implant a revolutionary therapy or an immoral
experiment based on murder? The debate rages from medical labs
to the White House.

By DICK THOMPSON/WASHINGTON


    A question of ethics stood between renowned cancer
researcher Elliott Osserman and his last remaining hope. For
nine years, Parkinson's disease had been stealing his abilities
-- to write, to walk and then to talk. Still, his mind continued
exploring an important advance in cancer therapy, and with help
from colleagues, he continued treating patients. Osserman's last
hope was an experimental therapy in which the cells
malfunctioning in his brain would be replaced by an injection
of vigorous developing cells -- cells from a fetus that a woman
had chosen to abort.

    But by the time Osserman was accepted for the procedure at
Yale, all federally supported research involving the transplant
of tissue from aborted fetuses into humans was halted while a
presidential panel weighed the therapy's ethical implications.
In December 1988, after waiting several months, Yale decided to
go ahead with Osserman's operation based on the panel's
recommendation that the moratorium be lifted. Nearly all of the
handful of transplants performed for Parkinson's have produced
dramatic results, but for Osserman it was too late: he died
within months. Says Yale team leader Eugene Redmond: "He may
have been the first victim of the moratorium."

    He may not be the last. Despite the presidential panel's
recommendation, Presidents Reagan and Bush, bowing to pressure
from antiabortion activists, de cided to keep the moratorium on
fetal-tissue research in place. This week the Senate is
scheduled to debate whether to defy the Administration by
overturning that ban. The House has already passed such
legislation, and a majority of Senators seem ready to go along.
But the proponents may not have enough votes to override an
expected veto from Bush, who so far shows no sign of relenting
on the transplant issue.

    Bush is supported by much of the vocal pro-life movement,
which argues that fetal-tissue research and transplants depend
on murderous abortions -- and could, the pro-lifers claim, even
encourage some pregnant women to have abortions they might
otherwise decide against. On the other side of the battle are
many medical researchers who think the experiments could lead
to therapies for many diseases. They have been joined by an
unusual coalition that includes victims of such diseases as
Parkinson's and even by quite a few converts from the pro-life
camp. Their tactic is to separate the issue of fetal-tissue
research from the debate over abortion. As they see it, fetal
cells are equivalent to vital organs that are available to save
lives but are now being thrown away.

    Fetal cells are unlike any other tissues. "There's
something magic about them," says California neurosurgeon Robert
Ia cono. In experiments with rats, mice and monkeys, scientists
have discovered that fetal cells are effective in treating a
wide range of stubborn conditions. Transplanted cells have
cured diabetes and restored some sight in animals. The cells
have repaired some spinal-cord injuries, allowing injured rats
to run at normal speed. Implants in the brain have improved
memory and learning. The work has led scientists to speculate
that the cells can be used to treat epilepsy, combat leukemia
and stop such degenerative diseases as Huntington's chorea and
Alzheimer's.

    More than 600 people have received fetal-cell transplants.
The cells have effectively treated DiGeorge syndrome, an
extremely rare and fatal genetic disease, and appear to have
helped people with Parkinson's. But in victims of the Chernobyl
catastrophe, fetal cells failed to regenerate bone-marrow
function lost to radiation exposure. People with diabetes have
been the largest group of transplant recipients, but while there
was limited improvement, no patient ever came off insulin. Says
Hans Sollinger, a diabetes researcher at the University of
Wisconsin: "In animals we were extremely successful, but in
humans there's been no success [with diabetes] up to this
point. We have to find out what the difference is."

    Now the ban on federal funding has pushed fetal-tissue
research beyond the guidance and control of American science.
Only two centers in the U.S. perform the surgery. One surgeon
flies his patients to China to perform the transplant. The
meager research that has continued with the help of private
funds has been done on a piecemeal basis, rather than as part
of a broad strategy. Moreover, results of operations often skip
science journals and appear -- unverified -- on the evening
news.

    Still, the stories are remarkable. Donald Nelson of Denver
became the first American to have fetal cells implanted to
battle Parkinson's -- on the day George Bush was elected
President. Nelson, who once trembled so violently that he was
forced to crawl on the floor, believes the procedure is the
reason he can now walk, sometimes without a cane. In Huntsville,
Ala., Fay Day, 65, claims a transplant relieved 80% of her
disability. Says she: "If everyone involved in the debate could
have Parkinson's for one month, they'd change their minds."

    Is the fetal tissue responsible for these improvements?
Parkinson's patients have lost cells that produce a crucial
chemical called dopamine. In theory, the transplanted fetal
cells manufacture the missing dopamine, but there are at least
three other explanations for the apparent benefits. First,
poking around in the brain during surgery may stimulate diseased
cells to start production of repair chemicals, including growth
factors that could trigger dopamine release. Second, perhaps the
developing fetal cells themselves make the growth factors but
not dopamine. Or third, the success stories may have nothing at
all to do with the transplants but are just part of the
mysterious remission-and-relapse cycle characteristic of
Parkinson's.

    Scientists do know that the best cells for transplants
come from elective abortions. Cells from spontaneous abortions
and ectopic pregnancies (in which the fetus never makes it to
the uterus) are often abnormal. Yet the reliance on elective
abortions could lead to questionable decisions: women becoming
pregnant to provide fetal cells for a relative or simply selling
the aborted fetus as if it were a pint of blood. In fact,
Osserman's two daughters volunteered to get pregnant to furnish
fetal cells for their father.

    Acknowledging the possibility of abuse, advocates of
fetal-cell transplants say a wall should be built between the
recipient and the donor. The legislation now in Congress would
prohibit the sale of fetal material. And the Yale research team
has developed a method of freezing the cells for weeks or months
to separate donor from recipient.

    The pro-life lobby maintains that social acceptance of
fetal transplants would result in increased funding for abortion
clinics and broader access to the procedure. "It would affect
the cultural attitude toward the unborn if society were to
become hooked on this tissue," says Douglas Johnson, legislative
director for the National Right to Life Committee. Explaining
the fetal-cell ban to Congress, Assistant Secretary for Health
James O. Mason said, "[The research] cannot help tilting some
already vulnerable women toward a decision to have an abortion."

    But some pro-lifers are breaking ranks on the issue of
fetal-cell transplants. One of the most persuasive supporters
is the Rev. Guy Walden, a Southern Baptist minister from Florida
who is also a committed antiabortionist. Walden's son Nathan
received fetal cells to fight a fatal genetic affliction,
Hurler's syndrome. Two Walden children had died of the disease,
but so far the transplant seems to be working for Nathan.
Walden's message: "We're not talking about whether a person has
a right to have an abortion. But right now this tissue is being
thrown in the trash cans. If we can save a life, shouldn't we?"

    Lobbying by Walden and others has won over many pro-life
legislators, including Republican Senator Strom Thurmond of
South Carolina, who is now fighting the fetal-cell ban.
Thurmond, whose daughter Julie is diabetic, believes this issue
"should not be lumped together with the debate about abortion."
Says he: "I believe that for the sake of Julie and other
individuals . . . we cannot afford to lose this opportunity to
develop a cure."

    The future of the research will soon be in Bush's hands
again -- a difficult predicament for a President seeking
re-election. Bush needs to mend fences with Pat Buchanan's wing
of the Republican Party, and may use a veto to revalidate his
conservative credentials. But if he refuses to lift the
fetal-cell funding ban, transplants will be left largely to
entrepreneurs offering a crude and expensive procedure to the
desperate.