FYI: This was in the paper and I thought some might find it of interest.

newsday.com/news/opinion/ny-vpeggs0512938438jul03,0,7995370.story
Newsday.com
EDITORIAL:
With little discussion, NY crosses a stem cell threshold

7:33 PM EDT, July 3, 2009

Cloning and anything involving embryonic stem cells inhabit a frontier of modern science with an unparalleled capacity to make people queasy. The potential for medical breakthroughs is great, but the ethical issues involved are profound.

President George W. Bush imposed tight restrictions on federal funding for stem cell research to avoid making the government complicit in the destruction of embryos. And President Barack Obama is moving ever so carefully to crack that door a bit wider by allowing funding for research using stem cells taken from embryos lying frozen and unused in fertility clinics.

New York has now flung open another door, becoming the first state to allow women who donate eggs for stem cell research to be compensated for the expense, time, burden and discomfort associated with the long process. The state intends to begin compensating donors next year, a move that should give New York a leg up in attracting scientists and building its biotech industry.

But the decision was made quietly by a board whose members are not accountable to the public, and with little public input. And there's no explicit ban on using tax money to create and destroy fertilized, potentially viable embryos. That's no way to make policy fraught with ethical quandaries.

Paying for eggs with taxpayer dollars, while likely to generate controversy, is a reasonable step to promote important research that has been stalled for want of eggs. Women who donate eggs for in-vitro fertilization are routinely compensated, although with private money. With effective protections to prevent exploitation, there's no reason to treat women who donate for research differently.

Tougher than the question of compensation are the issues raised by what will become of those eggs once they're donated.

That's where New York needs to move more deliberately, and with wider public debate. Such policy decisions shouldn't be made and implemented quietly by experts. The public, via its elected representatives, should be heard. That's sure to make for a messier fight. But, in the end, what's decided will reflect the will, and the conscience, of the public.

The call in New York was made instead by the Empire State Stem Cell Board, which was established to oversee $600 million that the legislature set aside for stem cell research. The board spent more than a year weighing the issues before quietly voting June 11 to allow researchers funded by the state to pay egg donors.

The amount of compensation and procedures for screening donors are consistent with guidelines from the American Society for Reproductive Medicine, which are followed now when eggs are donated for infertile couples. Payments over $5,000 must be justified and those exceeding $10,000 are considered excessive. Also required are a medical exam, psychological counseling and detailed, informed consent, including full disclosure of the physical and psychological risks.

Officials should make sure that also includes a frank acknowledgment that the long-term effects on young, fertile egg donors are unknown. And a firm limit on the number of times a woman can donate should be imposed, to avoid the possibility that poor women will resort to repeatedly giving up their eggs to make a buck.

The rules will leave it to research review boards at individual institutions and embryonic stem cell research oversight committees to monitor payments and procedures, while the state stem cell board will decide what research is funded. That's important, but insufficient. State officials should have a larger role in ensuring compliance.



Then, how will the eggs be used?

But it's after eggs have been donated that things get really complicated.

Many will be used in a subset of stem cell research involving a procedure called somatic cell nuclear transfer. Known as therapeutic cloning, it's the process that was used in 1996 to create Dolly the sheep, the world's first successful animal clone. It involves removing the genetic material from an egg and replacing it with genetic material taken from an adult, for instance from a skin cell. Over a few days, stem cells will be created that can be harvested.

While in its infancy right now, this subset of stem cell research holds the potential for one day possibly growing organs like kidneys or livers for transplant that would have the recipient's genetic code - eliminating the problem of organ rejection. Or by inserting genetic material from a person with, say, diabetes into an egg, scientists in search of cures could gain the advantage of watching the disease develop on a cellular level.

With nuclear transfer, the egg is never actually fertilized. So no viable embryos are created or destroyed. And while anything that hints at cloning is controversial, it's illegal to clone humans and has never been done successfully.

Much more worrisome is the possibility that some donated eggs will be fertilized, making embryos to create stem cells. That's not prohibited by current state policy and it raises a difficult moral question: Should embryos ever be created for the sole purpose of being destroyed for research?

It also raises the fundamental issue that Bush grappled with when he restricted federal funding: Should taxpayer dollars be used in such a way that the public becomes complicit in the destruction of embryos?

The state's elected officials shouldn't have handed off those critical decisions to an unelected board, no matter how thoughtful, informed and deliberate its members are. Such decisions should be made by people that voters can hold accountable.

Copyright © 2009, Newsday Inc.