five framings one entity?...mankind’s techno-fix. the main topic is the intended crea-tion of and...

Five Framings – One Entity? The Political Ethics of Human Embryonic Stem Cells

Published in Science Studies 1/2005: 30-51

Torben Hviid Nielsen, Universitetet i Oslo

[email protected]

Department of Sociology and Human Geography

University of Oslo

P.O.Box 1096 Blindern

N-0317 OSLO Norway

Telephone: + 47 22855257

Fax: + 47 22855253

Internet: http://www.iss.uio.no

Science Studies 1/2005

Science Studies, Vol. 18(2005) No. 1, 30–51

Five Framings – One Entity?The Political Ethics of HumanEmbryonic Stem Cells

Torben Hviid Nielsen

Following their initial derivation in 1998, human embryonic stem cells have beenpresented in five dominant framings. The original framings as a breakthrough in ba-sic research and a medical hope were both intended and orchestrated to anticipateand overrule the old bioethical concerns. The third framing nonetheless questionedthe legitimacy of the bare laboratory research from day one. Two subsequent framingspresented adult stem cells as Nature’s own solution and cloning as Mankind’s techno-fix solution, i.e. as alternative points of passages to the ethical concerns, but they didnot succeed to regain the agenda and the public discourse. The five framing are thuselements of a still unclosed encounter over-determined by (bio)politics. Finally theframing of “facts” of nature, technological “artefacts” and social “construct” is discussedin the light of recent interpretations of stem cells as “state” rather than as “entity”, thusindicating that no single entity is to be found behind the five framings.

Key words: bioethics, biotechnology, stem cells

page, 2238-2239). In November 1999 acommittee under the American Associa-tion for the Advancement of Science con-cluded that stem cell research “raisesethical and political concerns, but theseare not unique to stem cell research”(AAAS, 1999: iv). Two years later a com-mittee under the National ResearchCouncil stated that “the stem cell debatehas led scientists and nonscientists aliketo contemplate profound issues, such aswho we are and what makes us humanbeings” (NRC, 2001: xi).

The 1998 Summer-issue of TechnologyReview disclosed the ongoing pioneerresearch on human embryonic stemcells under the front-page heading“Biotech Taboo”… “The troubled Huntfor the ultimate Cell,… that could beused to grow any type of human replace-ment tissue” (Regalado, 1998: front-page, 34). Barely a year and a half laterthe front-page of the 1999 Christmas-is-sue of Science promoted stem cells as the“Breakthrough of the Year,… capturingthe Promise of Youth” (Vogel, 1999: front-

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Human embryonic stem cells have –together with cloning – become the mostpromising, as well as the most contro-versial, amongst the many new andemerging biotechnologies. After they leftthe laboratories in 1998 to become partof public debate five framings havedominated their presentation and dis-cussion. The first public pronounce-ment was well orchestrated as progressin basic science, and the second framingas a medical hope was often presentedas just the other, applied, side of it. Thetwo original framings were partly in-tended to prevent the reoccurrence oftraditional ethical concerns, which nev-ertheless questioned the first two fromthe very beginning. Subsequently, thescientific community itself suggestedtwo “solutions” to the reoccurring ethi-cal concerns: in a fourth framing offer-ing the potentials of the adult stem cellsas Nature’s own solution and in a fifthframing offering therapeutic cloning asMankind’s techno-fix.

The main topic is the intended crea-tion of and the relation between the fiveframings, their interplay in the publicnarrative and discourse, as well as thepartly unforeseen and unintended con-sequences thereof. None of the fiveframings have succeeded to bring a clo-sure to the controversy. All remain partof the still vibrant scientific and publicdebate, but they are utilized in favour ofevaluations so varied and regulations soconflicting that compromises are diffi-cult to formulate and attain. They alsoappear diverse and partly apart, to theextent where geneticist and biologistsare now questioning whether one andthe same well defined biological entityis to be found behind all of them.

Pioneer STS-articles by Trevor Pinch

and Wiebe Bijker conceptualized and re-told the story of the high-wheel Ordinarybicycle and Bakelite as the framing, de-sign and eventually production of newtechnological artefacts or inventions.After decades of competition between avariety of designs for the bicycle andmethods for the production of pre-bakelite plastic, the high-wheel Ordinarybicycle and Baekeland’s patents of 1907finally brought success to a single fram-ing and design and thus eventually alsoclosure to the flexibility and controver-sies (Pinch and Bijker, 1989; Bijker, 1989).The term “framing” is throughout thisarticle used in relation to the public rep-resentation of an entity of nature, suchas in media-studies (Evans, 2002); to themobilization of collective actors and so-cial movements, such as in the socialsciences (Benford and Snow, 2002) – not,as in the case of Pinch and Bijker, to des-ignate the design and creation of tech-nological artefacts. The eventually suc-cessful high-wheel bicycle and Bakeliteboth had their possible alternativeframings and artefacts (as e.g. the Kan-garoo bicycle and Ivoride/Xylonite orCelluloid), whereas the five framings ofhuman embryonic stem cells, to be dis-cussed below, all assume or presume toaddress different aspects and evalua-tions of the very same biological entity.Instead of diverse framings leading todifferent technological artefact, thesame entity of nature is presented to thepublic in five different framings indicat-ing different horizons and valuations. Upuntil now, none of the five framings havebecome dominant and “successfully”,able to exclude the others and close theflexibility and controversy, in the sameway as the high-wheel bicycle andBakelite did.


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First framing. The Derivation of aScientific Discovery

During the years from 1995 to 1998 labsin Wisconsin and Baltimore were thesites of the initial derivation of humanembryonic stem cells, but their first pub-lic presentation took place via internetfrom the rented offices of their coordi-nator and financier, the entrepreneur Dr.Michael West at Geron Corporation, whohad licensed the cells worldwide, or-chestrated the framing of their first pub-lic announcement as a “scientific discov-ery” and “progress in basic research”very thoroughly. Two press releases fromthe company provided the key back-ground information for the printedpress’ front-page news that “ScientistFound Cells at Root of Human Life” onNovember 6, 1998 (The New York Times).The press releases referred back to twoprestigious scientific publications: Anarticle in Science by professor James A.Thomson and colleagues from Univer-sity of Wisconsin, who had isolated hu-man embryonic stem (hES) cells fromthe inner cell mass of human embryosat the blastocyst stage (Thomson et al.,1998), and another article in Proceedingsof the National Academy of Science byprofessor John D. Gearhart and col-leagues from John Hopkins University,Baltimore, who had isolated humanembryonic germ (hEG) cells from foetaltissues obtained from terminated preg-nancies (Shamblott et al., 1998).

The passage from the scientific peri-odicals via the press releases to the front-page news was, however, also an essen-tial translation and reframing. Stemcells, especially from bone marrow, hadbeen known and used in cancer treat-ment since the 1950s, and embryonic

stem cells had been derived from micein 1981 (Evans et al., 1981) and from pri-mates in 1995 (Gearhard et al., 1995).The “novelty” presented in the scientificpublications was thus neither the exist-ence of stem cells as such, nor of embry-onic stem cells or even of human embry-onic stem cells, but merely the success-ful “derivation” of human embryonicstem cells, which consequently was pre-sented as technical and practical know-how more than as scientific and system-atic knowledge.

The two articles do not have the auraof a new theoretical insight nor do theyproclaim any controversial break-through. The definition of the cell linesand the operational criteria for theirderivation are both conveyed un-changed from the preceding experi-ments with mice and primates. The es-sential content of the two articles is asummary and documentation of re-search-protocols with references to pre-ceding studies. Description and docu-mentation of practical procedure in thelaboratories take precedence over con-ceptual clarification and explanations.Large passages of the two articles thus re-semble a mix of cookbook and manual,conceptual trivialities and complicatedtechnicalities: those were the ingredi-ents and this is how we proceeded at thelab-bench. By way of a not untypical ex-ample:

Cells were grown in DMEM (GIBCO/BRL) supplemented with 15% fetal bo-vine serum (HyClone), 0,1 mM nones-sential amino acids (GIBCO/BRL),0,1mM 2-mercaptoethanol (Sigma), 2mM glutamine… Cultures were grownin 5% or 8% CO

2, 95% humidity and

were routinely passaged every 7 daysafter disaggregation with 0.05%

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trypsin/0.53 mM EDTA (GIBCO/BRL)or 0,25% trypsin at 37° C for 5-10 min…Cells prepared for cytogenetic analysiswere incubated in growth media with0.1. µg/ml of Colcemid for 3-4 hr,trypsinized, resuspended in 0.075 MKCl, and incubated for 20 min at 37° C,then fixed in 3:1 methanol/acctic acid(Shamblott et al., 1998:13727).

The articles do not claim to have foundor discovered any new or even unex-pected entity or substance, but rather tohave demonstrated that an expectedentity can be kept and maintained in acertain form: isolated, cultivated andexpressed. The two research-teams hadsuccessfully adapted and replicated orcopied in human cells, what had previ-ously been attained in cells from miceand primates. The articles thus consti-tuted human embryonic stem cells as anew object for science analogous to theway Gregory Mendel constituted genet-ics (and Crick & Watson later DNA) asobjects for science (Foucault, 1971), butneither theoretical implications norpractical applications were part of thepresentation.

The triangle of collaboration betweenthe private company Geron, the partlypublic universities and their partlyoutsourced research-teams was a re-sponse to the political reality, that theUSA had had a de facto ban on publicfunding of research since 1996 “in whicha human embryo or embryos are de-stroyed, discarded, or knowingly sub-jected to risk of injury or death greaterthan that allowed for research on fetusesin uteri.” Congress had taken the decisionad hoc as the Dickey-Wicker amendmentto Department of Health and HumanServices annual budget – and against therecommendations of the National Insti-tute of Health and the Clinton-adminis-

tration. As only the use of public fundingwas forbidden, a paradoxical conse-quence was, however, quoting Dr. RonaldGreen, a key advisor to the Clinton-ad-ministration.

…[that] although much of the previousanimal research on ES cells that had ledto Thomson’s achievements was feder-ally financed, the commercial benefitwould now be in private hands (Green,2001: 9).

Geron Corporation had been founded byDr. Michael West in 1990. Following thepublication of the derivation of embry-onic stem cells from primates in 1995,Geron had funded the research ofThomson and Gearhart, as well as Pro-fessor Roger Peterson, University of Cali-fornia, San Francisco – considered bymany the most promising candidate tosucceed (Regalado, 1998: 38). The invest-ments in funding for licenses turned outto be an immediate financial success.Two applications for patents were filedwell in advance of the scientific publi-cation and subsequently approved. Onthe very day of announcement, stocksrose from $ 6 to $ 23. One month later,convertible debentures worth $ 15 mil-lion were sold to venture capitalists.

Yet, a fourth type of text had precededthe triangle of publications behind thefirst public announcement. The articlesin the prestigious scientific journals bothrounded off with reservations character-istic of the genre, in the words ofThomson and colleagues: “Substantialadvances in basic developmental biol-ogy are required to direct Es cells effi-ciently to lineages of human clinical im-portance” (Thomson et al., 1998: 1147).Two patent-applications were, however,filed well in advance, and they presentedthe findings with a confidence and firm-


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ness fare from the modesty and reserva-tions in the scientific articles. Both ap-plications were “continuation-in-part”of earlier applications. They were moredetailed, fare longer than the articles andthe “Scientists” were completed in thestandard formula as “Inventors”. Gear-hart’s application (United States Patent,1998a) had the largest number of formal“Claims”, thirty-six, all concerning meth-ods of producing and/or maintaining“human pluripotent embryonic germcells”. The eleven claims in Thomsen’s ap-plication (United States Patent, 1998b)were presented in another “logic”. Thefirst eight claims cover different variantsof “a purified preparation of pluripotenthuman embryonic stem cells”, the twonext methods of isolating such cell lines,and last the cell line developed by themethod.

The rationale behind the comprehen-sive claims is the quest for a maximumof legal protection. And the criteria forpatentability may have determined eventhe choice of the key concept or techni-cal term “derivation”. The term “deriva-tion” was not used in the articles report-ing the previous use of identical proce-dures and techniques on mice and pri-mates; the key terms here were “isola-tion” and “establishment”, partly used assynonyms. But “derivation” was the keyterm also in the 1997-article announc-ing the cloning of a “viable offspring”, thesheep Dolly (Wilmut et al., 1997). Fol-lowing the new terminology or the newuse of old terms, human embryonicstem cells and cloned sheep were bothpresented as “derived”. The two promi-nent cases are only examples of a gen-eral trend in the prestigious scientificperiodicals during the 1990s (see Fig. I.).“Isolation” and “establishment” were the

most frequently used terms in the firsthalf of the decade, but during the sec-ond half “derivation” took over as themost frequent. The significant changetook place just around the years whenthe sheep Dolly and the human embry-onic stem cells both were termed as “de-rived”.

The new trend might be a momentaryconjuncture, but the relative increase inthe use of the term “derivation” at theexpense of “isolation” and “establish-ment” during the 1990s is both signifi-cant and meaningful. The term “deriva-tion” was increasingly used to describethe isolation, cultivation and expressionof embryonic stem cells, as well as thecloning of viable offspring, i.e. two verydifferent phenomena, but the two mostpromising and controversial of the manynew biotechnologies. The new tendencyis “real”, but we don’t know the degree towhich it reflects substantial changes inresearch priorities, mere changes in edi-torial criteria or even merely a change ofhabitual wording. Asked for the causesof the change, the typical answer from ahandful of prominent researchers in thefield was that they had not previouslybeen aware of any such change; that thechange nevertheless seemed plausible,but that it did not require any specialexplanation. “It is quite simply the con-cept we use.” The diverse and escalatinguse of the term “derivation” might ap-pear irrelevant or even trivial to theworking scientists, but the precedencefrom the terms prehistory in patentingof organic chemistry is well known andacknowledged among lawyers. The“derivation” of a substance was suffi-cient to satisfy one of the three general,but crucial, criteria for patentability. Al-though still a product of nature, since it

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would not have existed in the new formwithout the intervention of science, aderived entity was considered also aproduct of ingenuity and thus a patent-able invention.1

Second Framing. The Promise of aRegenerative Medicine

The second framing of the human em-bryonic stem cells as a medical hope, the

promises of regenerative medicine, wasoften presented as just the other side ofthe progress in basic knowledge, as thestep from “pure” to “applied” science.The principal agents were the same, butalongside the scientific community andventure capitalists the appeal was di-rected more towards the general publicand authorities as The National Instituteof Health. Both steps in this widespreadand still persuasive, but very traditional,

0 %

10 %

20 %

30 %

40 %

50 %

60 %

70 %

80 %

1990-91 1992-93 1994-95 1996-97 1998-99 2000-01

Isolation & Establishment Derivation

Figure I. From isolation towards derivation.

The relative occurrence of “isolation” and “establishment” versus “derivation” in Nature, Proc.

Nat. Acad. Sci. and Sciene, 1990-2001.

Source: Data-search in “Titles” in the three periodicals from 1990 to 2001.

Truncations used were “Isolat#”, “Establish#” and “Deriv#”.

N = 1137, with 266 in 1990-91, 214 in 1992-92, 209 in 1994-95, 161 in 1996-97, 162 in 1998-99

and 125 in 2000-2001.


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presentation of the novelty are, however,deceptive. Down to the choice of basicterminology desired ends were built andcalculated into the “discovery” from thefirst design of the laboratory studies. The“application” is also a redefinition ortranslation of health and illness, life anddeath, from existential and social terms.

The applied potential of embryonicstem cells was presented as the bio-technical mean to retain, modify or evenundo apoptosis, i.e. the programmed celldeath, which (beginning with LeonardHayflick and Paul Morehead’s proposalin 1961 that “cancerous” cell lines werethe only immortal cells, whereas “nor-mal” cells had a finite lifespan) had re-placed the immortality of cell lines as theparadigmatic understanding. Socialdeath and euthanasia had, according toHannah Landecker, become

“cellular, even to the extent that a cellcan commit altruistic suicide or die byinteraction with another cell in theKevorkian option”... Death was rede-fined as a mixed metaphor, marking a“radical shift in biological knowledge inthe late twentieth century, from anoppositional model of life and deathto one in which cell death is integralto the ongoing life of the organism.”(Landecker, 2003: 23-24).

All stem cells, also adult, do produce theenzyme telomerase, which was isolatedfor the first time in 1989 and maintainsthe non-coding bits of DNA attached tothe end of each chromosome (Dwayneet al., 1989). With a biochemical expla-nation for philosophers, telomerase “re-sets the cell’s chromosomal clock” and“prevents the timed death suffered bymost differentiated cells”. Stem cellshence have the capacity for “prolongedself-renewal”; they are able to produce“at least one type of highly differentiated

or specialized descendant.” (Green,2001: 35) Yet, the emerging new para-digm ascribes three additional capaci-ties to embryonic stem cells: they arepluripotent (able to differentiate to alltypes of tissues in the body); they aremalleable (can be manipulated withoutloosing the structure of the cell); andthey are immortal (able to continue dif-ferentiation apparently unlimited)(Weismann, 2000; Fuch and Segre, 2000;Chiu and Rao, 2003). The three uniquecapacities were the background for Sci-ence’s presentation of human embryonicstem cells as the 1999-breakthrough ofthe year.

“If it lives up to its early promise, it mayone day restore vigour to aged and dis-eased muscles, hearts, and brains – per-haps even allowing humans to com-bine the wisdom of the old age with thepotential of youth”... [They] “may oneday be used to treat human diseases inall sort of ways, from repairing dam-aged nerves to growing new hearts andlivers in the laboratory; enthusiasts en-vision a whole catalog of replacementparts” (Vogel, 1998: 2238).

The three potentials considered uniqueto embryonic stem cells add up to thescenario of “regenerative medicine”,which enlarges the scope of medicaltherapy “from simply halting the pro-gression of acute or chronic disease toinclude restoration of lost organ func-tions”. Bypassing surgery’s interventionsin the body, as well as the side effects ofpharmaceuticals, regenerative medicinewill - according to Dr. Thomas Okarma,who had succeeded West as CEO ofGeron - “be a totally new value paradigmfor clinical therapeutics.” Okarma wasthus able to revolve the moral concernand argument against the bioethiciststhemselves. “Not to develop the technol-

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ogy would do great harm to over 100million patients in the U.S. alone.”(Okarma, 2001: 3). The number origi-nates from an overview over the poten-tial US patient population for stem cell-based therapies, which is estimated 58million with cardiovascular diseases, 30million with autoimmune diseases, 16million with diabetes, 10 million withosteoporosis, and 8.2 million with can-cer (Perry, 2000). The twisted optic ac-quits the optimistic scientists in order tomake the sceptic bioethicists, willing todeprive one third of the population theircure, the real threat to real morality. Stemcells thus acknowledge or confirm thecellular level as the space or place ofdeath (Landauer, 2003), but besides theyoffer themselves as the biomedicalmeans able to postpone or ultimatelyundo cellular death.

Geron’s strategy has been character-ized as “a redefinition of the human andthe social in which social responsibilityfor health risks becomes biologized inorder to be industrialized” (Franklin,2003: 123), a characterization in accord-ance with Technology Review’s scenarioof “the human body shop” a decade fromnow:

...an elderly man gets the grim newsthat his heart is rapidly decaying andthat the left ventricle – the chamberthat squeezes blood out to the body –needs to be replaced. His physiciantakes a biopsy of the heart cells that arestill healthy and ships the tissue to a labthat is really an organ factory. There,workers use that patient’s own cells andspecial polymers to fashion and grow areplacement part – certified by the origi-nal manufacturer. In three months, thenew ventricle is frozen, packaged andsent to the hospital, where the patientundergoes a standard surgical proce-dure: the insertion of a living implant

created from his own tissue (Garr, 2001:73).

The aura is high-tech, but the medicaluse of embryonic stem cells is presentedas low intervention. The stem cells are“organic”, i.e. the body’s own internalhealing mechanisms, “personal”, i.e.one’s own, and “clean”, i.e. uncontami-nated. But the real “magic” is the prom-ise to break the arrow of time. “The im-mortal Cell” is a shortcut to “The eter-nal Life”. Destiny and fate are no longeruntouchable. Regenerative medicine ishigh-tech utilization of the individualsown embryonic stem cells as cure againstthe otherwise unavoidable apoptosis ofthe cells. Science and medicine promiseto accomplish here and now, what reli-gion in the past barely believed possiblein the next world. Life is about to becomereversible or restorable, the permanentbeginning or the continuous renewal.The hopes of “there and then” will be-come the reality of “here and now” (Al-exander, 2003; Hall, 2003).

Medical hopes and expectations arehigh and hype, but the “applied” realityis – at least up to now – a “proof of prin-ciples”. Experiments in vitro and withmodel-animals confirm the principle:new tissues can differentiate and oldones can be restored. The step from sci-entific principle to medical practice is,however, also a question of degree andtype of differentiation, density and in-tensity, compatibility, targeting, andpossible side-effects. The old blood-forming stem cells in bone marrow(HSC) are still “the only type of stem cellcommonly used for therapy” (NationalInstitute of Health, 2003).

The severe shadow and potentialbacklash hanging over the medical hopeis over-selling, promising too much too


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fast. Even the pioneering-scientists soonwarned of the backlash likely to come.As early as 2002, Prof. Thomson wasquoted for not “looking forward to thebacklash 3 years from now when peoplesay, ‘What happened to stem cells?’ …Weneed to educate the public that sciencetakes a long time” (Holden and Vogel,2002: 2119). But entrepreneurs, such asWest, were eager to insist on the non-scientific, and thus unnecessary, charac-ter of all obstacles. “We have the basicdiscoveries within our reach to put re-generative medicine into the hand ofphysicians. We are missing only twocomponents – an organized effort andtime” (West, 2003: 220).

Third Framing. Playing God? Old(Bio)ethical Concerns in New Voices

Emphasizing the progress in basic re-search and the hope for cure of illness,the two initial framings were also antici-pating strategies intended to trump andoverrule the expected moral concerns.The two framings succeeded to counter-balance, but they were unable to neu-tralize the critique, which questionedthe very legitimacy of the basic labora-tory research from day one. If sciencewas about to replace religion as the ex-planation of life, then Christian (orCreationist) religion was soon to returnaccusing the new technologies of “play-ing God”. The most prominent opponentwas the Vatican, but the recently inaugu-rated U.S. president, Republican GeorgeW. Bush, followed along the same line. OnAugust 9, he addressed the nation broad-cast primetime from Crawford Texas todiscuss the “complex and difficult issue,an issue that is one of the most profoundof our time” (Bush, 2001). His speech

hinted to and utilized the two argumentsmost frequently used by opponents andsceptics.

The first and foremost argument gainsits immanent strength by ascribing aspecial moral status to the embryo. TheChristian background is manifest in thePresident’s characterization of the em-bryo as “a sacred gift from our Creator”.Most believers in and users of the argu-ment consider the status of the embryoas emerging gradually (increasing fromsome time after fertilization to the fullborn baby), but a more radical versionconsider the status as absolute and be-ginning from fertilization. The Presi-dent’s wording of the argument alludesto the absolute version. “The beginningof Life” should also be “The end of Sci-ence.” But the President is politicianenough not to take an explicit stand inthe controversial dispute between thetwo versions splitting the supporting re-ligious communities.

The second moral argument alludedto by the President is a more philosophi-cal and formal maxim as regards the re-lation between means and ends. Themaxim is usually traced back or ascribedto Immanuel Kant’s practical imperative,but the President’s version is another.“Even the most noble ends do” in thewording of the President “not justify anymeans”. The Presidents open-ended ver-sion is an anticipation of its own appli-cation. The casuistic question is whetherthe “most noble ends” (as a healthier orprolonged life) can justify “any means”(as the destruction of embryos to harvestrequired stem cells)?

A strict interpretation and radical ap-plication of the two arguments pre-scribes a “No” or a “Ban” to all researchusing human embryonic stem cells. The

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status of the Cell is violated and themaxim of the Philosopher infringed.Endorsed with an absolute status the“embryo” resists its own use in science.The technologically unavoidable is con-sequently morally untouchable, the re-quired source morally problematic. Eth-ics stands versus science and scienceversus ethics. No compromise seemspossible. But instead of the absolute banindicated by his rhetoric and supposedby his arguments the president con-cluded

…that we should allow federal funds tobe used for research on these existingstem cell lines (more than 60 lines as aresult of private research), where thelife and death decision has alreadybeen made (Bush, 2001).

The unexpected conclusion was in-tended as a political balance offeringconcessions to the most influential in-terest-groups and their lobbyists: theproponents were offered (some) stemcell lines to work with, and the oppo-nents were assured that no new demandfor embryos would be created. Bothsides were, however, soon to designatetheir respective concessions as unsatis-factory. Scientists complained that theavailable stem cell lines were too few andnot pure enough. The religious commu-nities accused the use of already exist-ing lines of being a double moral stand-ard and even bioethicists, such as ArthurCaplan, denounced the decision as a“fuzzy logic” utilized by the administra-tion in “a political calculation to use op-position to stem-cell research and clon-ing as a low-risk stalking horse to ad-vance its anti-abortion agenda and se-cure support among its most avid anti-abortion constituents” (Caplan, 2004).

As decided upon, but unsettled and

postponed, human embryonic stemcells remained an issue also during thenext presidential campaign in 2004. TheDemocratic candidate John Kerry prom-ised to “overturn the ban on federalfunding of research on new stem celllines, … he will allow doctors and scien-tists to explore their full potential withthe appropriate ethical oversight. Pa-tients and their families should nolonger be denied the hope that this newresearch brings” (Kerry and Edwards,2004). Kerry utilized the first two of thefive framing discussed here, i.e. scienceas a necessary precondition for usefulmedicine. The five arguments in thepress release stating his position werethus able to circumvent the controver-sial ethical issues. The first argument waspolitical, an appeal to consensus: “Stemcell research has broad bipartisan sup-port.” The last argument concernedcompetitiveness: U.S.A. is “losing lead-ership in stem cell research”. The threeremaining arguments were all technicalcriticisms of Bush’s decision as not onlyinsufficient, but also unimplemented.Fewer cell lines than promised wereavailable; they were contaminated withmouse cells; and other cells were notavailable. Apart from a few empty inser-tions, ethical issues were unmentioned– apparently considered an argument ofthe opposition so profound that the besttactic was to steer clear of it.

After the re-election and revitalizationof the Bush-administration in the au-tumn of 2004, the disagreement as towhether the two first or the third fram-ing, the scientific and medical progressor the moral concern, should gain domi-nance was continued on state level. Thetwo leading states in stem cell research,the republican governed California and


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the democratic governed Massachu-setts, both passed state laws permittingand offering public funding for researchon human embryonic stem cell.

Forth Framing. Adult Stem Cells asNature’s Own Solution?

The first two framings were influential,but they did not succeed to avoid, neu-tralize or overtrump the old and antici-pated ethical considerations. The focalpublic debate became a partial revival ofold ethical concerns, a new version ofthe debate on embryonic research, butnovel and unique to human stem cellswas the way science itself suggested new“technical” solutions to the old ethicalconcerns. In two subsequent steps sci-

ence partly regained the framing and theagenda, first by the idea of adult stemcells as Nature’s own solution, then bytherapeutic cloning as Mankind’s techno-fix to the ethical challenges. Using thelanguage of Actor-Network-Theory bothwere framed or presented as alternativepoints of passage (Christiansen, quotedby Kater, 2004). The entrepreneurs, thescientists and their labs partly regainedthe scene and the agenda from publicpolicy and ethical concerns.

The very article in Science that pro-moted stem cells as the breakthrough ofthe year, also pointed to another “aston-ishing development that occurred in1999 (and that) may ease the ethical di-lemma”.

In defiance of decades of accepted

Figure 2. The Ontological Hierarchy of Stem Cells.

Source: The National Institute of Health, Primer, 2002.

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wisdom, researchers in 1999 found thatstem cells from adults retain the youth-ful ability to become several differentkinds of tissues: Brain cells can becomeblood cells, and cells from bone marrowcan become liver (Vogel, 1999: 2238).

If it could be demonstrated that adultstem cells had the same (or equivalent)potentials as the embryonic, they wouldallow to obtain the advantages of stemcells without the use of embryonic cells,and could thus be framed as “Naturesown solution” to the reoccurring ethicalconcerns. Even Thomson kept the theo-retical possibility open: “If it becomes

possible to derive an ES cell line from asource other than an embryo, ethicalcontroversies surrounding hES cellswould greatly diminish” (Thomson,2001). Partly funded and eagerly moni-tored by politicians sceptical to researchon embryonic stem cells, research-teams speeded up their work on adultstem cells. During 2001 examples ap-pearing to prove the principle were re-ported continuously (Clark et al., 2001;Colter et al., 2001; Scolding, 2001). OnJune 21, 2002 Science illustrated the plas-ticity “too good to be true”, … “that stemcells from a variety of tissues can produce

Figure 3. The Plasticity of Adult Stem Cells . “Too good to be true?”

Reprinted with permission from Holden & Vogel, SCIENCE 296: 2126-2129 (2002).

Illustration by C. Slayden. Copyright 2002 AAAS.


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progeny in different organs” (Holden andVogel, 2002: 2126).

Researchers and scientists did, how-ever, disagree no less and no less severelythan the bioethicists. The National Insti-tute of Health’s authoritative and widelyused Primer thus initially reproducedthe old “accepted wisdom” ranking stemcells in a one-way “ontological” hierar-chy, which prescribed a moral dilemmafor anyone ascribing a special moral sta-tus to the embryo. The closer to the bio-logical origin, the greater the medicalpotentials – and the more suspect themorality!

The N.I.H. has since changed theprimer also in order to reflect the possi-ble potentials of adult stem cells better.Figure III was omitted in an update of3.17.2002 and replaced by the additionthat “until recently, there was little evi-dence that stem cells from adults couldchange course and provide the flexibil-ity that researchers need in order to ad-dress all the medical diseases and disor-ders they would like to. New findings inanimals, however, suggest that even af-ter a stem cell has begun to specialize, itmay be more flexible than previouslythought”.

Theoretical arguments in favour ofthe hierarchical necessity were mostlyvoiced by developmental biologists andembryologists. Typical is Stephen JayGould’s argument for a “progressivespecification and differentiation.”

The very structure of material realityimposes a principle of trade-offs inboth nature and human affairs… Wehave, in short, traded regenerative ca-pacity for the undeniable evolutionaryadvantages of maximal complexity…Unfortunately, von Bauer’s law, andnature’s broader structural rules of

trade-off between complexity and flex-ibility, give us no alternative to embry-onic stem cells for now (Gould, 2001).

Highly esteemed scientists conceptual-ised and interpreted the potentiality ofadult stem cells as a closed “theoreticalimpossibility” visualised as an “irrevers-ible hierarchy”, as well as an open “em-pirical possibility” visualised as an “ema-nating star”. Different levels of abstrac-tion and conceptual traditions are atstake, but the two positions and hypoth-eses can not both be the whole truth. Thestill unsettled disagreement resemblesthe state of internal “anomie” often pre-ceding a new paradigm, more than theeveryday routines of an accepted “nor-mal-science” (Kuhn, 1962).

Fifth Framing. Therapeutic Cloningas Mankind’s Techno-fix?

Following the dubious and doubtfulpresentation of adult stem cells as Na-ture’s own solution, cloning and parthe-nogenesis were soon framed and pre-sented as Mankind’s own techno-fix so-lution and a second alternative point ofpassage to the relentless moral concerns.

On November 25, 2001, Advanced CellTechnology (A.C.T.), Worchester, Massa-chusetts announced to the public thatthey had succeeded in creating the firsthuman embryo using cloning tech-niques. Two techniques had been used,both combining a human egg with theperson’s own cells in order to providestem cells. A technique á la Dolly re-placed the genetic material of humaneggs with that of adult cells. Eleven at-tempts used adult skin cells, eight cumu-lus cells. None of the eggs with skin cellssurvived to divide, whereas three eggswith cumulus cells divided once or twice

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before they died. The second and mostsuccessful technique was, however, par-thenogenesis, i.e. a chemical stimulationof eggs to divide without fertilization.Twenty-two attempts were made, sixeggs lived and divided for up to five days,but all died before stem cells ready to beharvested were formed.

Key players had moved from Geron toA.C.T, now headed by the former CEO ofGeron Dr. West, and the modus andmoment of going public was no lessorchestrated than Geron’s initial an-nouncement of the derivation. The trin-ity of information, i.e. periodicals, pressreleases and mass media, was thus in-tended as a blue print of the initial suc-cess, but the prestigious Science and Pro-ceedings of the National Academy of Sci-ence were substituted by a prepublica-tion of the January 2002 issue of thepopular Scientific American (2002) anda “Rapid Communication” in the newweb-journal E-biomed: The Journal ofRegenerative Medicines (Cibelli et al.,2001). Lacking the scientific backing, themass media consequently reported thewhole event as scientifically premature.Professor I.L. Weismann, a nestor instem cell research, denounced the wholestory as a “non-event”. The venture capi-talists did not respond in any support-ive way and the intended revival of thefirst framing as scientific progress wasonce again overruled by moral concerns.The techniques were identical with thefirst steps in reproductive cloning - anissue highlighted around Christmas thesame year with a series of equally pre-mature pronouncements of the first hu-man clone already in uterus. The sug-gested techno-fix was thus consideredand denied as just another moral prob-lem: Hubris, playing - or taking the place

of - God. Mankind’s attempt of a techno-fix creation was dammed as just as of-fensive as his research on God’s owncreations. The alternative point of pas-sage was rejected as a new moral prob-lem, rather than a smart technical solu-tion to the old moral problems. The ex-perienced staff was, however, preparedto counter that. Dr. Ronald Green, thefounding director of Office of GenomeEthics under the Clinton Administration,was now Chair of A.C.T.’s own Ethical Ad-visory Board, and the Boards conclusionsand recommendations were printed sideby side with the reportage in ScientificAmerican:

…unlike an embryo, a cloned organismis not the result of fertilization of an eggby a sperm. It is a new type of biologi-cal entity never before seen in nature…we preferred the term “activated egg”,and we concluded that its characteris-tics did not preclude its use in work thatmight save the lives of children andadults (Scientific American, 2002).

A.C.T.’ s Ethical Advisory Board was thusable to expel or disqualify the moral con-cern as a question of (mis)understand-ing more than of substance, and as suchto be solved on the level of concepts,neither in the labs nor on the politicalscene. Preceded by the terms “deriva-tion” and “regenerative medicine” thisconceptual manoeuvre is a third majorexample of the “power of definition”(Wolpe and McGee, 2001). A.C.T.’ s Ethi-cal Board is just one among many exam-ples of how U.S. bioethicists, in additionto the few appointments to publiccommities (where they often expressconcern), are hired and employed as aprofession on the level of labs and uni-versities (where they often justify plannedor ongoing research) (Donalson, 2001;


44

Elliott, 2001). The supply of well-edu-cated bioethicists has by far surpassedthat of stem cell lines, and in the absenceof a comprehensive national law in theUS they often serve as “lawmakers” onthe level of the firm. The old maxims ofbioethics still dominating public dis-course and the new profession of bio-ethicists increasingly employed in pri-vate frontline labs are thus drawing anddrawn in each their direction, betweenconcern and justification.

The Political Ethics of HumanEmbryonic Stem Cells

The five framings of human embryonicstem cells, presented and discussedabove, did not originate and emanatefrom the science in the making in thelabs; nor were they orchestrated by a sin-gle network or a single set of homoge-neous agents; nor did they succeed eachother successfully rendering the formersuperfluous. The two initial framings, asprogress in basic science and hope ofmedical cure, were motivated and stirredby the entrepreneurs to avoid the expe-riences from the public debate follow-ing previous progress in biotechnology,but the public and political debate over-ruled the intention and strategy by thethird framing as a moral concern. Thetwo remaining framings representingadult stem cells and therapeutic cloningas alternative points of passage and so-lutions, redirected the debate to the levelof the labs and the entrepreneurs, butthey did not succeed to dominate andeven less to close the debate – at leastup until now.

The five framings do still coexist in anunsettled and unclosed tension, but theframings and their implications differ in

such a profound way, that the questionas to whether (and if so, how) they canreally all refer back to the very same“clonogenic cells” nearly poses itself. Isthe diversity of framings just a mere andfair reflection of the still un-describedpotentials inherent in the unique cells?Is the multitude of framings better inter-preted as an expression of the many ex-ternal interests involved in the politicaldecisions? Should the disparity betweenthe framings rather be seen as an echoof the plurality and relativism in post-modern optics? Might the many, stillcompeting, framings be a mere conse-quence of the fact that the unique cellsonly recently were constituted as objectfor science, a question of time soon tobe resolved? Or could it be that there isno one single and well-defined biologi-cal entity behind the five framings?

Professions and experts have oftenclaimed a normative priority or evenprecedents on behalf of “their” framing:for science as the necessary precondi-tion; for medicine as the ultimate goal;for ethics as the absolute limit to all theothers; for adult stem cells as the ulti-mate and for the techno-fix as the smart-est solution. None of the framings have,however, attained any such priority. Allhave been part of an encounter for atruthful understanding and a fair evalu-ation, but none of them have had thepower or influence to prescribe theirunderstanding as unequivocal. Theframings never posed a single agenda;nor did they determine a correspondingevaluation. Political interests and com-promises have consequently over-deter-mined, tinted and intermixed, the fiveframings from the very beginning. Thepresentation of the scientific break-through was co-determined by the re-

45


quirements for funding and patents. Themedical hope was embedded in generalchanges of life-style. Ethical recommen-dations were altered according to politi-cal appointments. Adult stem cells andcloning/parthenogenesis were instantlypresented to politics as possible solu-tions to the ethical concerns.

Sheila Jasanoff has mapped and em-phasized substantial national differencesin the American, British and Germanregulation of biotechnology (Jasanoff,1995). Unrelated shifts of governmentsin the three nations during the earlyyears of human embryonic stem cellshave, however, shaped noteworthy shiftswithin the national regulations. TheU.S.A. has turned towards a more restric-tive and Germany towards a more per-missive regulation whereas Great Britainrepresents a national continuity.

The British continuity is firmly rootedin the nation’s customary scientific self-understanding and institutionalizedthrough the Warnock-Committee, thesubsequent Human Fertilisation andEmbryology Act and its correspondingexecutive body The Human Fertilisation& Embryology Authority (Mulkay, 1997).Within this framework Tony Blair’s newLabour-government could turn to TheChief Medical Officer for a delimited andauthoritative examination. Neither gov-ernment nor the parliamentary major-ity had problems in following the pre-dictable recommendation that “researchusing embryos […] to increase under-standing about human disease and dis-orders and their cell-based treatmentshould be permitted subject to the con-trols of the Human Fertilisation andEmbryology Act”. The only additionalstep needed was the Human reproduc-tive Cloning Act of 2001 that prohibited

“the placing in a woman of a humanembryo which has been created other-wise than by fertilization” i.e. by repro-ductive cloning.

Following the President’s broadcastedaddress on August 9, 2001, the U.S.A. im-plemented a new advisory structure. AnExecutive Order of Nov. 28 establishedThe President’s Council on Bioethicsheaded by the well-known conservativebioethicist Professor Leon Kass (Kass,2001). Seventeen additional memberswere appointed on January 16, 2002. ThePresident addressed them the followingday (Bush, 2002) and the Council’s reportHuman Cloning and Human Dignity: AnEthical Inquiry was published in July thesame year. The Council was unanimousto refuse “cloning-to-produce-children”(reproductive cloning), but split regard-ing “cloning-for-biomedical-research”(therapeutic cloning). A majority of tenrecommended “a four-year morato-rium”, whereas a minority of seven rec-ommended “regulation on the use ofcloned embryos for biomedical re-search” (The President’s Council onBioethics, 2002). Accordance betweenthe President’s policy and (the majorityof) his ethical advisors was thus re-es-tablished. A recent reconstruction of thedecision making process and its proce-dure by Alta Charo, a member of Presi-dent Clinton’s National Bioethics Advi-sory Commission (1996-2001), concludesthat what distinguishes President Bush’snew Council from the former “is not thatit incorporates politics into its work, butthat it does so with a concerted effort topromote a particular political philosophy,and pursues this philosophy through itsmembership and its staffing”. Her finaldeep sigh that the most vibrant and en-during debates “are not at all about the


46

ethics of biology or medicine, but theethics of governance” (Charo, 2004: 308,312) is in full harmony with the abovefindings.

Following Helmut Kohl’s CDU-gov-ernment Gerhard Schroeder’s new SPD-government initiated the reverse shift to-wards a more permissive policy taken inGermany. The new Nationaler Ethikratwas appointed on April 25, 2001. Ad-dressed by the Chancellor at its firstmeeting on June 8 (Schroeder, 2001) andits report Stellungnahme zum Importmenschlicher embryonaler Stamzellenwas published the following summer.Fifteen members voted in favour of “aprovisional and temporary import ofhuman embryonic stem cells on hardconditions”, whereas ten members votedfor “a provisional refusal of import ofstem cells” (Nationaler Ethikrat, 2002).Accordance between the Chancellor’spolicy and (the majority of) his ethicaladvisors was thus re-established.

The unchanged British policy, the U.S.shift toward a more restrictive and theGerman toward a more permissivepolicy, are good illustrations of how ef-fected even the principles of bioethicshave been by national differences andpolitical conjunctures. Bioethics oftenargue in a strong rhetoric and with ab-solute arguments, but they have neverbeen unambiguous, nor a decisive oreven superseding argument in politicaldecisions. Shifting politicians have re-peatedly appointed their bioethical ad-visors in accordance with predeter-mined policies. Bioethics has always alsobeen political. The (Christian) argumentfrom status and the (Kantian) maxim ofmeans-ends have been powerful rhe-torical tools, but pragmatic and utilitar-ian ethics have had a greater impact on

political decisions. The considerations ofpolitical bioethics have gradually turnedfrom the status of the biological sub-stances and general maxims towards themore comprehensive questions of soci-ety’s justice and the individual’s identity.Possible consequences for society atlarge, i.e. the possibility of a more hier-archical and competitive post-humanworld, and the emergence of a new, lib-eral and unintended eugenics, havegained increased attention. Fukuyama,a U.S. neo-liberal and a member of theBush Council, argues that what ought tobe the real cause of worry are the “mon-sters we will soon be capable of creat-ing,” not the sources of stem cells. “Theposthuman world could be one that isfar more hierarchical and competitivethan the one that currently exists, and fullof social conflicts as a result” (Fukuyama,2002: 91, 218). Jürgen Habermas (2003),a German philosopher in the traditionof the Frankfurt School, questions theidentity of individuals whose geneticmakeup has been pre-selected or pre-manipulated as an issue of “Gattungs-ethik”.

Most policy decisions and regulationshave been open and pragmatic enoughto enable two apparently opposed, butcoexisting critiques: one aimed at theuse of dual or double “moral” standardsvoiced mainly by religious communities,and another aimed at the too restrictiveregulations and voiced mainly by thescientific communities and business.

The Presidential decision permittedthe use of old embryonic stem cell linesdating back before the speech of August9, 2001 “where the life and death deci-sion has already been made”. The newGerman Law permitted the use of im-ported stem cell lines. Already existing

47


and imported cell lines are both prag-matic loopholes, without which the criti-cism for too restrictive policies wouldhave been even more vociferous, butpolitical regulations have nonethelessincreasingly been used to excuse andexplain away disappointed or post-poned hopes and expectations. The ini-tial framings are thus twisted to the ar-gument that politicians giving too manyconcessions to the ethical concerns arethe prime cause of the still unfulfilledexpectations. The disappointment isthus presented as a matter of time, notof principle; a question of delay, not ofunsolvable problems. Had science onlyhad the freedom to follow its course,promises and expectations would al-ready have been fulfilled! A hypotheti-cal bogey is thus turned into a partialexcuse.

Entity or State?

Representing a radical version of the “ex-tended social constructivism”, presentedearlier by Pinch and Bijker, John Law hasdrawn the methodological implicationthat “… from the standpoint of the net-work those elements that are human orsocial do not necessarily differ in kindfrom those that are natural and techno-logical” […] “it makes sense to treatnatural and social adversaries in termsof the same analytical vocabulary” (Law,1989: 114). Yet, the difference betweenBijker and Pinch’s use of the term “fram-ing” to indicate different designs and in-ventions and the five framings of whatis expected to be the same biological en-tity, discussed here, suggests importantdifferences between the design of “tech-nological artefacts” (as the bicycle andBakelite) and the derivation of an “en-

tity of nature” (as embryonic stem cells).Both are open to interpretative “flexibil-ity”, but natural “facts” appear less opento design than technological “artefacts”and social “constructs”, and it appearsthat natural entities can be “stabilized”without a closure of the debate and con-troversy over them.

Culminating in the so called “sciencewar”, representatives of the hard sci-ences have repeatedly criticized radicalsocial constructivism as mere relativis-tic or even subjectivistic, as the prec-edence of sociology of knowledge overepistemology, and thus also of powerover truth. A recent review article by thegeneticist and system-biologist DovZipori suggests, however, “state” ratherthan “entity” as the real “nature” or trueinterpretation of embryonic stem cells.The transient stem cell state, termed the“stem state”, may be assumed by any celland the persistent search for specificgenes expressed by any stem cells, mightthus be futile, doomed to become un-successful. Following Zipori, stem cellsare just a “molecular configuration”without permanent characteristics,which should be identified or predictedby system-biology tools, i.e. overall ge-nomic and proteomic analysis coupledwith mathematical modeling (Zipori,2004: 873).

Zipori’s system-biological reinterpre-tation of embryonic stem cells, empha-sizing the state rather than the entity, thebiological environment rather than thegenetic make-up, represents an ironictwist and implicit concession to the radi-cal social constructivists and offers apossible explanation to the diversity offramings. Stem cells as just a state in-stead of a specific type of cells, makes theapparent “triviality” of their derivation


48

less mysterious. Stem cells as “stemness”dissolve the alleged differences in poten-tiality between embryonic and adultstem cells, and dissolute the alternativebetween embryonic stem cells as eitheran ontological hierarchy or pure plastic-ity dissolute. The moral discussion,which presupposes or ascribes a specific“ethical” nature or validity of embryonicas opposed to adult stem cells, appearseven more ungrounded and futile thanimplied above. Science’s editorial standback in 1999 that stem cells “forces sci-entists to reconsider fundamental ideasabout how cells grow up” (Vogel, 1999)might have more profound and far-reaching implications than fainted andglimpsed hitherto.

Acknowledgements

Research for this article was supportedby a grant from The Research Council ofNorway, Ethical, Legal and Social As-pects of Bio- and Gentechnology, ELSA-Norway (156232/510). Research, includ-ing site-visits and interviews at GeronCorporation and Advanced Cell Tech-nology, started up under the hospitalityof University of California, Berkeley,2001-2002. Experiences from the Norwe-gian Biotechnology Advisory Board2000-2004 are also reflected in the arti-cle. The author wants to thank Siv F. Berg,Ole Johan Borge, Troy Duster, VidarEnebak, Karen Lebacqz, Ole DidrikLærum, Esben A. Nilssen, Rune Nydal,Dorethy Olsen, Gisli Palsson, AntonioRegalada, Gunnar Skirbekk, HenrikTreimo, and Dov Zipori. A travel-grantwas given by Etikkprogrammet, Univer-sity of Oslo, Norway.

Notes

1 Further patents, licensing policies, thenew importance of patents after the U.S.Presidential decision of August 9, 2001,and Geron’s later patent strategy in coop-eration with The Roslin Institute are de-scribed in Franklin (2003) and Rohrbaugh(2003).

References

American Association for the Advancementof Science1999 Stem Cell Research and Applications.

Washington, D.C.: National AcademyPress.

Advanced Cell TechnologyInformationPacket. www.advancedcell.com. Various versions.

Alexander, B.2003 Rapture. How Biotech Became the New

Religion. New York: Basic Books.Benford, R.D & Snow, D.A.2000 “Framing Processes and Social Move-

ments: An Overview and Assessment”.Annual Review of Sociology 26: 611-39.

Bijker, W.E.1987 “The Social Construction of Bakelite:

Towards a Theory of Invention.” Pp.159-187 in W.E. Bijker, T.P. Hughes andT. Pinch (eds.), The Social Constructionof Technological Systems. Cambridge &London: The MIT Press.

Bush, G.W.2001 Remarks by the President on Stem Cell

Research. August 9. The White House.2002 Remarks by the President in Meeting

with Bioethics Committee. January 17.The White House.

Caplan A.L.2004 “Stem-cell Research a Pawn in Election

Politics”. Bioethics.net. The AmericanJournal of Bioethics. Posted 2004.10.05.

Charo, A.2004 “Passing on the Right: Conservative

Bioethics is Closer Than It Appears”.Journal of Law, Medicine & Ethics. 32:307-314.

49


Chui, A.Y. & Rao, M.S. (eds.)2003 Human Embryonic Stem Cells. New

Jersey: Humana Press.Cibelli J.B. et al.2001 “Somatic Cell Nuclear Transfer in Hu-

mans: Pronuclear and Early EmbryonicDevelopment.” E-biomed: The Journalof Regenerative Medicine. November26. www.livertpub.com/ebl

Clarke, D. et al.2001 “Generalized Potential of Adult Neural

Stem Cells.” Science 2888, June 2: 1660-1663.

Coghlan, A. & Young, E.2001 “Adult Skin Cells are Turned Into Heart

Cells Without Creating Embryos, ClaimScientists.” New Scientist. Feb. 23.

Colter, C.C. et al.2001 “Identification of a Subpopulation of

Rapidly Self-renewing and Multi-potential Adult Stem Cells in Coloniesof Human Marrow Stromal Cells.” Pro-ceedings of the National Academy ofSciiences, USA, June 26.

Dwayne A.B. & Fossel, M.1989 “Telomeres, Cancer and Aging. Altering

the Human Life Span.” Journal of theAmerican Medical Association, 278:1345-48.

Donaldson, T.2001 “The Business Ethics of Bioethics Con-

sulting.” Hastings Center Report 31(2):12-19.

Elliott, C.2001 “Throwing a Bone to the Watchdog.

Bioethics in Business.” Hastings CenterReport 31(2): 9-12.

Evans, J.H.2002 Playing God? Human Genetic Engi-

neering and the Rationalization of Pub-lic Bioethical Debate. Chicago: TheUniversity of Chicago Press.

Evans, M.J. & Kaufman, M.H.1981 “Establishment in Culture of Pluri-

potential Cells From Mouse Embryo.”Nature 292, July 9: 154-156.

Foucault, M.1971 L’ordre du Discours. Paris: Editiones

Gallimard.

Franklin, S.2003 Ethical Biocapital. Pp. 97-127 in S.

Franklin and M Lock (eds.), RemakingLife & Death. Towards an Anthropologyof the Biosciences. Santa Fe & Oxford:School of American Research Press &James Currey Ltd.

Fukuyama, F.2002 Our Posthuman Future. New York:

Farrar, Straus and Giroux.Fucks, E. & Segre, J.A.2000 “Stem Cells: A New Lease on Life”. Cell.

100: 143-155.Garr, D.2001 “The Human Body Shop”. Technology

Review, April: 73-79.Gould, S.J.2001 “What Only the Embryo Knows”. The

New York Times. Aug. 27.Green, R.M.2001 The Human Embryo Research Debates.

Bioethics in the Vortex of Controversy.Oxford: Oxford University Press.

Habermas, J.2003 The Future of Human Nature. Cam-

bridge: Polity.Hall, S.S.2003 Merchants of Immortality. Chasing the

Dream of Human Life Extension. Bos-ton: Houghton Mifflin Company.

Holden, C. & Vogel, G.2002 “Plasticity: Time for Reappraisal?” Sci-

ence. Vol. 296, June 21: 2126-2129.Jasanoff, S.1995 Product, Process, or Programme: Three

Cultures and the Regulation of Biotech-nology. Pp. 311-331 in M. Bauer (ed.),Resistance to new Technology. Cam-bridge: Cambridge University Press.

Kater, L.2004 “Emerging Stem Cell Strategies: Prac-

tices, Rhetorics & Policies”. Report fromthe joint 4S & EASST Conference, Au-gust 2004.

Kass, L.2001 “Why We Should Ban Cloning Now:

Preventing a Brave New World”. NewRepublic, May 21:30-39.


50

Kerry, J. & Edwards, J.2004 Supporting Stem Cell Research to Find

Cures For Millions Of Americans Suf-fering From Debilitating Diseases.Press Release. www.johnkerry.com/is-sues/health_care/stemcell.html

Kuhn, T.S.1962 The Structure of Scientific Revolutions.

Chicago: The University of ChicagoPress.

Landecker, H.2003 On Beginning and Ending with

Apoptosis. Cell Death and Biomedi-cine. Pp. 23-59 in S. Franklin and MLock (eds), Remaking Life & Death. To-wards an Anthropology of the Bio-sciences. Santa Fe & Oxford: School ofAmerican Research Press & JamesCurrey Ltd.

Law, J.1987 “Technology and Heterogeneous Engi-

neering: The Case of Portuguese Ex-pansion.” Pp.111-134 in W. E. Bijker, T.P. Hughes and T. Pinch (eds), The So-cial Construction of Technological Sys-tems. Cambridge & London: The MITPress.

Lebacqz, K. et al.1999 “Research with Human Embryonic

Stem Cells: Ethical Considerations.”Hasting Center Report. 29, 2:31-36.

Martin, G.R.1981 “Isolation of Pluripotent Cell Line From

Early Mouse Embryos Cultivated in Me-dium Conditioned by TeratocarciomaStem Cells.” Proceedings of the Na-tional Academy of Sciences 78(12):7634-7638.

Mulkay, M.1997 The Embryo Research Debate. Science

and the politics of Reproduction. Cam-bridge: Cambridge University Press.

National Institute of Health2000 Stem cells: A Primer. http://www.nih.

gov/news/stemcell/primer.htmNational Research Council2001 Stem Cells and the Future of Regenera-

tive Medicine. Washington D. C.: Na-tional Academy Press.

Nationaler Ethikrat2002 Stellungnahme zum Import mensch-

licher embryonaler Stamzellen. (Posi-tion on Import of Human EmbryonicStem Cells).

The New York Times1998 “Scientists Cultivate the Cells From

Which Human Life.” Nov 6: 1-2.Okarma, T.B.2001 “Human Embryonic Stem Cells: A

Primer on the Technology and its Medi-cal Applications”. Pp. 3-13 in S. Hol-lander, K. Lebacqz and L. Zoloth (eds.),The Human Embryonic Stem Cell De-bate. Cambridge & London: The MITPress.

Perry, D.2000 “Patient’s Voices: The Powerful Sound

in the Stem Cell Debate.” Science, 287:1423.

Pinch, T.J. & Bijker, W.E.1987 “The Social Construction of Facts and

Artifacts: Or How the Sociology of Sci-ence and the Sociology of TechnologyMight Benefit Each Other.” Pp. 18-50 inW. E. Bijker, T. P. Hughes and T. Pinch(eds), The Social Construction of Tech-nological Systems. Cambridge & Lon-don: The MIT Press.

The President’s Council on Bioethics2002 Human Cloning and Human Dignity:

En Ethical Enquiry. Washington, D. C.:Government Printing Office.

Regalado, A.1998 “The Troubled Hunt for the Ultimate

Cell.” Technology Review. July-August:4-41.

Rohrbaugh, M.L.2003 Intellectual Property of Human Pluri-

potent Stem Cells. Pp. 39-60 in A. Y. Chuiand M. S. Rao (eds.), Human EmbryonicStem Cells. New Jersey: Humana Press.

Scientific American2002 “The First Human Clone. The Clone

Makers Tell Their Story.” January:Frontpage & 43-51.

Schroeder, G.2001 “Rede des Bundeskanzler zur konsti-

tuierenden Sitzung“. (Address of theChancellor to Constitutive Meeting).Bulletin der Bundesregierung. Nr. 39-3. www.ethikrat.org/publikationen/reden/bundeskanzler

51


Scolding, N.2001 “New Cells From Old.” The Lancet, 357.

Feb. 3.Shamblott, M.J. et al.1998 “Derivation of Pluripotent Stem Cells

From Cultured Human PrimordialGerm Cells”. Proceedings of the Na-tional Academy of Sciences 95: 13726-13731.

Thomsen, J.A.2001 “Human Embryonic Stem Cells”. Pp.

15-26 in S. Hollander et al. (eds.), TheHuman Embryonic Stem Cell Debate.Cambridge & London: The MIT Press.

Thomson, J.A. et al.1995 “Isolation of a Primate Embryonic Stem

Cell Line.” Proceedings of the NationalAcademy of Sciences 92: 7844-7848.

1998 Embryonic Stem Cell Lines Derivedfrom Human Blastocysts. Science 282(6): 1145-1147.

United States Patent1998a Human embryonic germ cell line and

methods of use. Patent number6,245,566 filed March 31; approvedJune 21, 2001.

1998b Primate embryonic stem cells. Patentnumber 6,200,806 filed June 26; ap-proved March 13, 2001.

Vogel, G.1999 “Capturing the Promise of Youth.” Sci-

ence, 286: 2238-2239.Weismann, I.L.2000 “Stem Cells: Unit of Development, Unit

of Regeneration, and Unit in Evolu-tion.” Cell.100: 157-168.

West, M.D.2003 The Immortal Cell. One Scientist’s

Quest to Solve the Mystery of HumanAging. New York: Doubleday.

Wilmut, I. et al.1997 “Viable Offspring Derived From Fetal

and Adult Mammalian Cells.” Nature,385: 810-813.

Wolpe, P.R. & McGee, G.2001 “’Expert Bioethics’ as Professional

Discource: The Case of Stem Cells.” Pp.185-207 in S. Holland, K. Lebacqz andL. Zoloth (eds.), The Human EmbryonicStem Cell Debate. Cambridge & Lon-don: The MIT Press.

Zipori, D.2004 “The Nature of Stem Cells: State Rather

Than Entity.” Nature Reviews. Genetics.5: 873-878

2005 “The Stem State: Plasticity is Essential,While Self-renewal and Hierarchy areOptional.” Manuscript in preparation.Rehovot, Israel.

Torben Hviid NielsenCenter for Technology, Innovationand CultureUniversity of [email protected]

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