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- ETHICS, Page 52When 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.
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