On August 23, 2010, US District Court Judge Royce C. Lamberth provided the latest course correction on the trajectory of stem cell research in the US when he blocked the federal government from funding research involving human embryonic stem cells. Sherley v. Sebelius, Civ. No. 1:09-cv-1575 (RCL) (D.D.C. Aug. 23, 2010) (hereinafter “Slip Opinion”).
The constant adjustments to federally supported stem cell research began in 1995, when congress passed and President Clinton signed the Dickey Amendment (Dicker-Wicker Amendment), which prohibited the use of federal funds for research in which a human embryo is destroyed. During President George W. Bush’s administration, it was determined that the Dickey Amendment did not apply to already-created stem cell lines, and on August 9, 2001, President Bush issued Executive Order 13435 allowing federal funding of research on existing lines of human embryonic stem cells. This decision did not end the debate over funding for stem cell research because the scientific community determined that the then existing 71 lines were insufficient to further needed research, and opponents of embryonic stem cell research urged a complete ban on federal funding for such research. The trajectory of stem cell research has been careening and oscillating ever since.
On July 19, 2006, President Bush exercised his veto power for the first time in his then six-year presidency to veto the Stem Cell Research Enhancement Act. This bill sought to repeal the Dickey Amendment and allow federal support for research on embryo-derived stem cells. Following the change in administrations, on March 9, 2009, President Obama issued Executive Order 13505, which allowed federal support of embryonic stem cell research on any cell, just not on the creation of such cells. Based on this Executive Order, the National Institutes of Health issued “Guidelines On Human Stem Cell Research” on July 7, 2009, which cleared federal funding for embryonic derived stem cells.
Shortly thereafter, a number of plaintiffs, including scientists Dr. James L. Shirley and Theresa Deisher, filed suit in the US District Court for the District of Columbia seeking declaratory and injunctive relief to prevent the Guidelines from taking effect. On October 27, 2009 , the federal court dismissed the case on grounds that the plaintiffs lacked standing to sue (Sherley v. Sebelius, 686 F. Supp. 2d 1, 5-7 (D.D.C. 2009)). However, on appeal, this holding was reversed by the Court of Appeals for the District of Columbia and remanded to the district court for consideration of the plaintiffs’ motion for a preliminary injunction (2010 WL 2540358, *5 (D.C. Cir. 2010)).
On August 23, 2010, Judge Lamberth of the District Court of the District Columbia, held that the Guidelines violated the Dickey Amendment and granted the motion for a preliminary injunction. The judge concluded that the language of the Dickey Amendment reflects the “unambiguous intent of Congress” and prohibits all “research in which a human embryo or embryos are destroyed,” not just the “piece of research” in which the embryo is destroyed (Sherley v. Sebelius, Slip Opinion, at 10-11). The federal government had attempted to distinguish between the destruction of embryos—for which research funding remains barred—and research using embryos that had already been destroyed. The judge determined that “the two cannot be separated” and thus concluded that embryonic stem cell research “necessarily depends on the destruction of a human embryo” (Slip Opinion at 12).
Based on the preliminary injunction, National Institutes of Health Director Francis Collins announced an immediate moratorium on $54 million in federal research grants scheduled to be distributed in September for stem cell research. New grants were also put on hold amounting to $15 million to $20 million in research money.
So where will the research trajectory go next? The district court opinion will be appealed, and indeed, on August 31, 2010, the Justice Department asked Judge Lamberth to stay the injunction pending the appeal. In support of the requested stay, the Department of Justice argued that the preliminary injunction, unless it is stayed, will cause irreparable harm to the science that has already been started, damaging not only the researchers’ interests but also the interests of taxpayers who have funded such research. On September 7, Judge Lamberth refused to stay his ruling, holding that Congress has mandated that the public interest is served by preventing taxpayer funding of research that entails the destruction of human embryos. The Department now has the option to ask a federal appeals court to stay Judge Lamberth’s ruling.
Looking beyond the immediate question of whether the preliminary injunction will be stayed, what is the likelihood Judge Lambert’s opinion will be reversed? While it is difficult to predict how appellate courts will rule, it must be recognized that the lower court’s “plain language” interpretation of the Dickey Amendment is premised upon a view that the term “research” in the Dickey Amendment involves a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalized knowledge. This makes the ability of the federal government’s alternative definition of research as a “piece of research” difficult to support. Also, the Dickey Amendment has been added to each Health and Human Services appropriations act from 1997–2009. The fiscal year 2009 version found in Section 509 of the Omnibus Appropriations Act, 2009, (enacted March 11, 2009) states:
None of the funds made available in this Act may be used for (1) the creation of a human embryo or embryos for research purposes; or (2) research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death [...] For purposes of this section, the term “human embryo or embryos” includes any organism, not protected as a human subject under 45 CFR 46 (the Human Subject Protection regulations) [...] that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes (sperm or egg) or human diploid cells (cells that have two sets of chromosomes, such as somatic cells). Public Law No. 111-8
In light of this statutory mandate, the district court determined that research involving the creation of the embryonic stem cell from a blastocyst that destroys the embryo cannot be separated from research on the cells themselves, including subsequent, downstream research (Slip Opinion at 11). The court stated:
ESC research is clearly research in which an embryo is destroyed. To conduct ESC research, ESCs must be derived from an embryo. The process of deriving ESCs from an embryo results in the destruction of the embryo. Thus, ESC research necessarily depends upon the destruction of a human embryo. (Slip Opinion at 12)
Thus, this opinion repudiates both President Obama’s position on the interpretation of federal law governing embryonic stem cell research, as well as former President Bush’s position.
The recent decision underscores that when science and law become intertwined, odd and unpredictable results may occur because the definitions of science do not always make their way into the arguments of law. A reading of Judge Lamberth’s opinion reveals that it consistently uses the term “ESC” for human embryonic stem cell, and it is this cell, and research surrounding it, which precipitates the ban (Slip Opinion at 2). The court then goes on to define ESCs as cells derived from a process discovered by James Thomson of the University of Wisconsin.
While this is certainly one opinion, it is not necessarily the consensus view of the scientific community, or for that matter, the Patent Office’s position. The Thomson process isolated cells from the inner cell mass cells of in vitro-fertilized embryos, typically between the 16 and 64 cell stage of development (US Patent Nos. 5,384,780 and 6,200, 806). There has been intense debate around the scope and meaning of these patents, as many scientists agree that the “specialness” of the so called “embryonic stem cell” is its properties of regeneration with differentiation and the ability to be pluripotent, ie become any cell in the body, not from where it was derived. Judge Lamberth’s opinion mentions other types of stem cells, such as induced pluripotent stem cells (IPSC) and adult stem cells (ASC) but does not identify other interesting cells, such as embryonic germ (EG) cells. EG cells are cells having the properties of the holy grail cell, regeneration without differentiation and pluripotency, but they can be obtained from the gonadal ridge of aborted fetal material (US Patent No. 5,453,357, for example) in addition to the inner cell mass. Judge Lamberth’s opinion does not appear to control such derived cells, as they are not derived from or destroy an embryo.
Moreover, federal law controlling federal research expenditures on embryonic-related research provides for research related to therapeutic transplantation and expressly states that such research may use “human fetal tissue [...] regardless of whether the tissue is obtained pursuant to a spontaneous or induced abortion or pursuant to a stillbirth” (42 USC § 289(g)(1)). Human fetal material is defined as “tissue or cells obtained from a dead human embryo or fetus after a spontaneous or induced abortion, or after a stillbirth” (USC § 289(g) (1)(g)). This research is allowed because of its importance to research, such as spinal cord and Parkinson’s therapies.
This means that pluripotent stem cells derived from an aborted fetus, such as those derived from the gonadal ridge, are considered to fall outside the Dickey Amendment and thus would fall outside the current injunction. In other words, it appears that Judge Lamberth’s opinion applies to blastocyst-derived cells only. Only time will tell if the science surrounding ESCs and the Obama administration will be able to pull out of the judicial and congressional trajectory flying the science into the ground.