In his first term President George W. Bush posed an ethical question that remains unanswered today: Does stem cell research destroy or improve life?
"At its core, this issue forces us to confront fundamental questions about the beginnings of life and the ends of science," Bush said in August 2001.
"It lies at a difficult moral intersection, juxtaposing the need to protect life in all its phases with the prospect of saving and improving life in all its stages."
Facing a political dilemma that would test Solomon, the president decided to limit federal funding for embryonic stem cell research to existing cell lines, "where the life and death decision has already been made."
Yet by shutting the spigot to federal dollars, he effectively left the future of stem cell research to the states. Three — California, New Jersey and Wisconsin — have recently voted to back that research with their own financial resources, while others are proposing bans on embryonic study.
Illinois lawmakers, too, have begun to confront the moral questions that underlie any move to make this state a haven for the nascent science. In November, sponsors made a second unsuccessful move to get their legislative colleagues to approve state backing. Both attempts fell short, but narrowly, in the Senate.
The fall vote was a draining disappointment for the measure's bipartisan supporters, who thought they had secured the 30 votes needed for passage. But after an hour of impassioned debate, which included tales of ailing loved ones afflicted with diseases stem cell research might one day cure, the legislation fell two votes short, the same margin of defeat as last spring. Proponents promise to redouble their efforts in the next few months.
While Illinois already hosts some stem cell research, supporters believe a state endorsement would attract much more. This year, following California's $3 billion example, lawmakers are advancing a state bond issue to support the science. Under the measure, proposed by Illinois Comptroller Dan Hynes, the state would issue $1 billion in bonds to create an institute charged with overseeing and encouraging stem cell research.
The hope is that Illinois will become a center for the kind of research that could find answers to a range of diseases.
Since University of Wisconsin-Madison researchers isolated the first human embryonic stem cells in 1998, scientists have cited their potential for treating, and possibly curing, injuries and diseases, including diabetes, Alzheimer's, Parkinson's, leukemia and paralysis.
The unspecialized stem cells derived from embryos offer blank slates to researchers because they can be replicated for long periods while holding the potential to be developed into cell types with more specialized functions, such as brain cells, muscle cells or red blood cells. Adult stem cells, found in blood, bone marrow, tissues and organs, including the brain and liver, have lower regenerative qualities and generally are thought to be limited to the tissues they were taken from.
But while embryonic stem cells may be infinitely more versatile, they also are exponentially more controversial. They are extracted from embryos developed from eggs fertilized at in vitro fertilization clinics. Such embryos were taken from donors who no longer plan to use them.
President Bush has stood his ground, refusing to federally fund the creation of new stem cell lines, a stance he renewed during the State of the Union Address last month. He pledged to work with Congress to ensure that human embryos are not created for experimentation or grown for body parts.
Four years ago, he limited federal research funding to the 78 stem cell lines already in existence. The lines are populations of cells extracted from embryonic stem cells that can be replicated for long periods outside the body. Of the 78 lines eligible for federal dollars, the National Institutes of Health registry notes that only 22 have been deemed suitable for U.S. researchers. By limiting federal funding to these lines, the federal government created a vacuum for embryonic research that states are seeking to fill.
In November, California voters approved stem cell research in Proposition 71, a ballot initiative that authorized $3 billion in borrowing. It will fund a decade's worth of embryonic stem cell research grants. That move has spurred officials in other states, including the governors of New Jersey and Wisconsin, who announced their own initiatives to fund state research institutes.
"If other states don't take action, that ultimately means that California, in this country, will be dictating the pace and direction in a field that will revolutionize the way we practice medicine," says Dr. John Kessler, chairman of neurology at Northwestern University Medical School in Chicago.
Mary McAsey, director of the obstetrics and gynecology research department at Southern Illinois University Medical School in Springfield, says California's sizable investment in stem cell research will draw researchers and biotechnology companies to the West Coast. "Investigators have to go where the money is."
The question is whether Illinois can — or would be willing to — come up with the cash. Comptroller Hynes wants voters to help decide. His initiative would put a $1 billion state bond referendum on the November 2006 ballot.
"I think that an issue of this magnitude should be put to a vote by the people of Illinois and should be debated across Illinois, and a referendum is a perfect vehicle for doing that," Hynes says.
It also might lower the legislative hurdle. Authorizing state debt requires either approval by a three-fifths vote in the General Assembly or a majority of lawmakers and the voting public. "The latter course is the one we've chosen because I think it's more achievable and also because I think it's important to bring this issue to the people," Hynes says.
His plan would create the Illinois Regenerative Medicine Institute, a body similar to California's stem cell institute. Over 10 years, the Illinois institute would dole out $100 million annually under the plan, with private researchers required to put up $20 million a year in matching funds. It's unclear how much impact the measure could have on the state economy, but Hynes' staff points to California, where that state's stem cell initiative is expected to create anywhere from 5,000 to 22,000 jobs a year.
A new 6 percent levy on face lifts, Botox injections and other elective cosmetic surgeries would fund the $15 million startup cost for Hynes' proposed institute, and he estimates the new service tax would repay the bond debt over 25 years. The proposal would require the governor's signature as well, but for now Hynes is focused on winning legislative support.
"It's really a matter of getting the people who have a stake on this issue to speak out and to reach out to these key legislators to try to get us to the margin of victory that we need," he says.
That could be tricky. As the lead sponsor of legislation to simply endorse stem cell research, state Sen. Jeffrey Schoenberg pulled out all the stops last year. The Evanston Democrat enlisted the help of abortion opponent U.S. Sen. Orrin Hatch from Utah and Chicago Cub great Ron Santo, who wrote personal notes urging anti-abortion senators to support the bill. The measure was even renamed the"Ronald Reagan Biomedical Research Act" after the recently deceased former president who had Alzheimer's disease.
"I think adding President Reagan's name was a catchy way to say, 'Yes, Republicans are in favor of this,'" says Sen. Todd Sieben, the Geneseo Republican whose northwest Illinois district includes Dixon, Reagan's boyhood home. Sieben fumed last fall as the newly renamed bill was brought before committee. He suggested the legislation be renamed after Nancy Reagan, a stem cell proponent, and not her staunchly anti-abortion husband. The somewhat heated exchange was a prelude to the measure's failure in the full Senate.
"The narrow defeat in the veto session was initially heartbreaking," Sen. Schoenberg says. "But it also provided everyone with the chance to confront this critical issue and understand it better."
House Minority Leader Tom Cross watched in frustration as the Senate Executive Committee debated the stem cell measure last fall. The Oswego Republican's 11-year-old daughter, Reynolds, suffers from juvenile diabetes, a lifelong disease for which stem cells may hold the cure. Cross plans to sponsor the Hynes proposal in the House.
"I think this is an issue [that] the longer it's out there, the greater its chances of success," he says.
While last fall's defeat was difficult, stem cell supporters did win over one lawmaker. Sen. Kirk Dillard, a Hinsdale Republican, voted against the Schoenberg measure in May, but switched his vote after speaking with a local family practice physician and a neighbor whose 4-year-old son has juvenile diabetes. Another colleague, Sen. James Meeks, a Chicago Independent and pastor of Salem Baptist Church, helped Dillard make peace with his anti-abortion beliefs.
"He counseled me to remember that these embryos would be destroyed anyway, and perhaps it's better to put them to use to improve mankind," Dillard says. "My original reasoning would be that these embryos are, in fact, a human life, and I always vote to preserve human life.
Here, I don't have a way to preserve it, so I would rather use these embryos for the betterment of mankind."
Still, a Cook County judge last month gave unprecedented legal credence to the notion that an unimplanted embryo — such as those used in stem cell research — can be considered a human being. The decision came after a fertilization clinic accidently destroyed the frozen embryos of a Chicago couple, but the ruling could impact the debate over stem cell research.
Others point to a slippery slope leading to human cloning, though Schoenberg specifically included language to ban the practice in the measure he presented last fall. And opposition by some in the religious community will undoubtedly keep a few lawmakers from supporting stem cell legislation.
"I'll continue to be a 'no' on stem cell research because of my district," says Sen. James DeLeo, a Chicago Democrat, who, like many of his constituents, supports the position of the Catholic Church.
Sieben, who believes the focus should remain on adult stem cells, questions whether the state should inject its checkbook into the debate on embryonic research. "Part of the question here is the use of public dollars because a significant portion of people in this state do not support the destruction of human life," he says.
Of course, Hynes' proposal ultimately would require support from a majority of voters. But would a majority of legislators first sign off on embryonic research?
The scenario was much less tenuous in 2003, when Illinois lawmakers overwhelmingly supported legislation that requires hospitals to ask pregnant women to consider donating their umbilical cord blood. The adult stem cells collected from the cord blood are now banked and can be used in bone marrow transplants or for research.
Peoria Republican Rep. David Leitch says his colleagues were eager to make Illinois the first state to approve such a measure. Still, he says, it's too early for him to say whether he can support Hynes' embryonic stem cell proposal, underscoring the ethical dilemma it presents to each legislator.
Even the medical community does not present a unified front on this controversial subject. Dr. Gregory Brewer, professor of medical micro-biology, immunology, and cell biology and neurology at Southern Illinois University School of Medicine in Springfield, associates "almost unlimited" opportunities with adult stem cells, but questions the ethics of using embryonic stem cells.
At the same time, advocates say Illinois should take up the debate before it's too late. Kessler, the Northwestern cell biologist, says federal funding restrictions and California's head start could make it difficult for Illinois researchers to compete.
"I think we are well-positioned to be able to make contributions to this field if the playing field is a reasonably level playing field for our research," Kessler says. "Right now, it is not a level playing field."
Mary J.C. Hendrix, president and scientific director of the Children's Memorial Research Center in Chicago, also says the state should officially accept the science. "If Illinois could publicly embrace the performance of stem cell research, it would be easier to recruit and train researchers in this new field," Hendrix says. "The opportunities for economic investment are an important consideration as well."
But if Illinois waits, it could miss out on opportunities to recruit the best minds in the field, says Dr. Janet Rowley, a University of Chicago professor of medicine and of molecular genetics and cell biology.
"They [stem cell experiments] are very complicated. They require the most creative, innovative scientists we have," she says. "If we sit back and do nothing, and wait to decide five years from now [that] we're going to get into this, that's an extraordinarily short-sighted point of view."
As a member of the President's Council on Bioethics, Rowley already has seen the debate drag on. "It's really a civilized discussion between people of very differing opinions," she says, "but I don't know that anyone has changed their point of view about the fundamental ethical issues based onthe discussion."
At the national level, Bush has effectively closed that debate for four more years. So, in Illinois, lawmakers must wrestle with it before reaching for the state's checkbook.
Illinois Issues, March 2005