The Missouri Vote: Amendment 2

Here in Missouri, we are going to the polls on November 7, just like everyone else. However, here in Missouri, we have a constitutional amendment to consider and the emotions are running high on both sides.

Amendment 2, The Missouri Stem Cell Research and Cures Initiative, is the hot-button issue this year. On one side you find the Catholic Church and Missouri Right to Life. On the other side you have a whole host of medical research foundations and Jack Danforth.

In the breach, you have me. I will say up front that I am in the "Pro" camp. I will, however, attempt to explain why I take the stand I do. In plain English. And without going on for pages.

First lets clear up a huge misconception. Somatic Cell Nuclear Transfer (SCNT) is technically "cloning" - up to a point. In the sense that cloning means replication. But it stops there.

The amendment specifically outlaws human cloning. When the opposition says it legitimizes cloning, they are disingenuous at best, and more likely they are flat-out, intentionally, being dishonest.

In SCNT, eggs are extracted and the nucleus is removed from the egg with a very tiny glass pipette. The same procedure is used to remove the nucleus of a source cell, and the nucleus is injected into the vacated (enucleated) egg cell. If we say just the right magic words in the perfect pitch and cadence, this cell will begin to replicate. At five days, we have a blastocyst of stem cells, and we can harvest those undiferentiated cells. Remember that word. It is going to be revisited a bit down the page.

Passage of Amendment 2 will assure that Missourians have access to any and all stem cell therapies that might be developed in the future (embryonic stem-cell research is only about five years old) that would be available to other patients from other states. Passage of Amendment 2 will ensure that medical institutions in Missouri would be able to conduct research to help develop new cures to horrific diseases so long as those treatments are not prohibited by federal law. Many scientists, myself included, feel these cells provide the most promising treatments for traumatic brain and spinal cord injuries, organ failure, neuro-muscular diseases, Alzheimers, organic brain disorders, and a whole host of others...including, yes, Parkinsons.

If Amendment 2 is not passed, members of the Missouri legislature would be able to outlaw therapies that are developed that use embryonic stem cells. Those with private insurance or resources could gain treatment out of state, such as in Massachusettes or California. Those who are reliant on Missouri Medicaid (a high percentage of disabled and diabetic patients) will be out of luck. The state would not pay for the treatment. So the bottom line is the state legislature could pass laws that prohibited low income people from accessing cures available to those who are better off.

I don't believe that the opponents are intentionally discriminating against these future patients. I don’t think they have even thought about them, but they should. Especially since they are not only picking up the tab for long-term treatment, they are consciously denying them any hope for a cure, possibly without even realizing it. I have heard people say they don't oppose it across the board, they just don't want it here. I have changed a few minds when this has come up in conversation. I see what I have come to refer to as "the look" cross their faces, and they often say "Wow. I never thought of that." or "Why isn't that part of the debate?"

I don't know why it isn't part of the debate. I don't fancy myself the smartest person in Kansas City, let alone the entire state, but nobody else seems to be considering this facet of the argument.

The research is going forward, in this country, and cures will be found. Failure to pass this amendment will impact the economy of our state because research will move away under threat that the work could be criminalized. This will hurt the economy of Missouri while helping the economies of states on both coasts. If the amendment fails, and the legislature bans all embryonic stem cell research, this state will deny Missouri residents therapies that will be readily available to patients in other states.

Those who oppose the Amendment say something along the lines of "Embryonic stem-cell research hasn't produced a single cure, and besides we already have adult stem cell therapies available, and adult stem cells are readily available."

This is true - but we are also exploring a totally new science in embryonic stem cell research. (Edison's lightbulbs didn't work at first, you know.) Embryonic stem cell research is so promising precisely because we have had success with adult stem cells. Bone marrow transplantation is a form of adult stem cell therapy. Success with them is how we even got to where we are. Currently, adult stem cells are most often used in cancer treatment, and indeed many lives have been saved because of these therapies.

Embryonic stem cells are undifferentiated. In other words, they can become anything. Let's say that you or someone you love has diabetes and is facing a future of insulin dependence that will lose effectiveness and it will lead to amputation, organ failure and death. Embryonic stem cells can, in theory, be used to grow healthy cells for implantation into your pancreas. The idea is that healthy cells can be introduced and will replicate to replace the unhealthy ones. This is the only hope that currently exists for a cure for diabetes and many other diseases, as well as spinal cord injuries.

Or perhaps you will be in an auto accident and your spinal cord is severed. Or your child falls while roller skating and lands just right and is paralyzed. Embryonic stem cells are the only cells that have been coaxed into replicating as nerve cells. Animal studies have successfully restored movement after spinal cords were surgically severed. This is something we never thought possible even ten years ago. The factsheet from Missouri Coalition for Lifesaving Cures is here.

This is an area where I have a little more than an opinion. I am a working scientist, a science educator and a grad studednt in science. I am also a member in good standing of the American Society of Clinical Pathologists. I have been an associate researcher (read uncredited student lackey) on papers published in respected journals by my professors.

Yeah. I got some game here. Any questions you might have about this issue, pose them in comments and I will attempt to give an unbiased answer that provides information to allow you to make an informed and well-though-out decision as to where you stand on the issue.

UPDATE: Dornbecher Children's Hospital in Portland, OR, part of the Oregon Health Sciences University is launching a trial of stem cell therapy for Battens Disease, which is 100% fatal and for which no alternative treatments exist.