Many first heard about fetal tissue research when the Center for Medical Progress released a series of videos about Planned Parenthood. But scientists have used fetal tissue since the middle of the 20th century. It has contributed to the development of many vaccines, including the vaccine for polio, and today some scientists say these cells – from aborted fetuses – are the key to more groundbreaking discoveries. Others are less optimistic, pointing to the advancement of new stem cell technologies and the complicated issue of abortion tied into research. We look at how the political fight over funding for Planned Parenthood is drawing attention to the medical uses of fetal tissue.

Guests

  • Julie Rovner senior correspondent, Kaiser Health News; author of "Health Care Policy and Politics A-Z"
  • Dr. David Prentice vice president and research director, Charlotte Lozier Institute
  • Dr. Akhilesh Pandey professor at the Institute of Genetic Medicine and the Departments of Biological Chemistry, Oncology and Pathology at Johns Hopkins University School of Medicine
  • Insoo Hyun associate professor in the Department of Bioethics and Director of the Case Western Reserve University Stem Cell Ethics Center.

Transcript

  • 10:06:53

    MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Yesterday, Planned Parenthood president, Cecile Richards, testified before Congress. The issue for Republican lawmakers is federal funding of that organization and whether Planned Parenthood is profiting from fetal tissue sales, a charge Richards calls categorically untrue.

  • 10:07:19

    MS. DIANE REHMHere to look at Planned Parenthood and fetal tissue research, Julie Rovner of Kaiser Health News, David Prentice of the Charlotte Lozier Institute. Joining us from the CBC studios in Vancouver, Dr. Akhilesh Pandey of Johns Hopkins. And joining us by phone from Cleveland, Ohio, Dr. Insoo Hyun of Case Western Reserve University.

  • 10:07:47

    MS. DIANE REHMThroughout the hour, I'm sure many of you will have questions, comments. Join us on 800-433-8850. Send us an email to drshow@wamu.org. You can follow us on Twitter or join us on Facebook. And welcome to all of you.

  • 10:08:07

    MS. JULIE ROVNERNice to be here.

  • 10:08:08

    DR. DAVID PRENTICEThank you.

  • 10:08:09

    DR. AKHILESH PANDEYThank you.

  • 10:08:10

    DR. ISOO HYUNThank you.

  • 10:08:11

    REHMGood to have you all with us. Julie Rovner, I gather you were at the hearing yesterday.

  • 10:08:18

    ROVNERI watched it.

  • 10:08:19

    REHMYou watched it. And give us a sense of Cecile Richards, how she presented herself in behalf of Planned Parenthood.

  • 10:08:33

    ROVNERWell, obviously, this was a hearing that was, you know, intended to allow opponents to score points and, in fact, she was interrupted more than she was allowed to answer questions that were posed, but I think she knew what she was walking into.

  • 10:08:47

    REHMAll right. We've got a short clip of her testimony. This is Cecile Richards. She is the president of Planned Parenthood.

  • 10:09:00

    MS. CECILE RICHARDSTo set the record straight, I want to be clear on four matters. First, using fetal tissue in life-saving medical research is legal, according to the 1993 law passed by the Senate, 93 to 4, and based on recommendations from a blue ribbon panel that was created under the Reagan administration. Second, currently, less than 1 percent of Planned Parenthood health centers are actually facilitating the donation of tissue for fetal tissue research.

  • 10:09:31

    MS. CECILE RICHARDSThird, in those health centers, donating fetal tissue is something that many of our patients want to do and regularly request. And finally, Planned Parenthood policies not only comply with, but indeed go beyond the requirements of the law.

  • 10:09:47

    REHMAnd once again, that was the voice of Cecile Richards testifying yesterday before Congress. She is the president of Planned Parenthood. Julie, give us a little political history. Cecile mentioned 1993, 93 to 4. So was there bipartisan consensus on fetal tissue?

  • 10:10:18

    ROVNERThere was and it was actually a debate that began -- it lingered through most of the 1980s. It really sort of hit the front pages in 1988 when a number of researchers asked the National Institutes of Health to do -- to work with fetal tissue. There had been this moratorium complication. The Bush administration, rather than the -- or actually the Reagan administration put another moratorium on. This lingered throughout the entire Bush administration.

  • 10:10:46

    ROVNERThere were committees that said yes, this is ethical. Here are the conditions under which we should do it. Congress, as Cecile pointed out, voted in 1993, but of course, Bill Clinton, when he came to office, had already basically eliminated the moratorium allowing fetal tissue when he took office in January of 1993. The key votes were actually in 1992 when this hadn't happened yet, when the Senate voted -- both the Senate and the House voted overwhelmingly to allow fetal tissue research.

  • 10:11:15

    ROVNERGeorge H.W. Bush vetoed the bill and the Senate, actually, overrode the veto. The House failed by 10 votes. But there was enormous bipartisan support for this, including strong conservatives like Strom Thurman to help lead the charge. Mitch McConnell now, the majority leader, voted for this at the time so it's not -- it was something that was considered relatively settled.

  • 10:11:35

    REHMDr. David Prentice of the Charlotte Lozier Institute, what's the current situation about and how do you connect the fetal tissue issue with abortion?

  • 10:11:55

    PRENTICERight. So historically, that statute is still in place that was put in back in 1993. There is continued NIH funding. It's not very much. In fact, there aren't very many projects currently going on. The current fiscal year, there are about 76 million NIH dollars going into federally-funded fetal tissue research. The science has advanced greatly, but frankly not, from our view, in terms of the fetal tissue aspects.

  • 10:12:27

    PRENTICEThere was some large clinical trials done in the late '90s, early 2000s. The results were appalling according even to some of the scientists, that the patients were made worse, for example, in terms of Parkinson's disease. Very few patients improved. The use of fetal tissue for vaccines has changed from the early years. Back in the '50s and '60s, it was used to grow polio virus for vaccine. It is not used for the current polio vaccine and most vaccines.

  • 10:12:59

    PRENTICEThose that do use fetal cell lines that were originated back in the 1970s primarily and even the '60s and in terms of the basic research, there are much better models now. Induced pluripotent stem cells, umbilical cord blood stem cells, bone marrow stem cells, lots of other opportunities. And so the connection, obviously, to abortion is that's the source of the tissue.

  • 10:13:29

    PRENTICEThe consent forms, I think there are some problems with that and we may get into that discussion. But I think the science has advanced until it's really outdated, at this point, to be using fresh fetal tissue.

  • 10:13:40

    REHMAll right. Let's go now to a researcher, Dr. Insoo Hyun, and he's a bioethicist and director of the Case Western Reserve Stem Cell Ethic Center. I gather this research has been going on for quite some time, particularly, Dr. Hyun, with vaccine development. Tell us about that.

  • 10:14:12

    HYUNYes, that's true. So traditionally, there has been a lot of fetal tissue used for the development of vaccines, but now the transition is towards making stem cell derived cells for transplant and for treating patients. And so as the previous speaker just mentioned, there is a new platform called induced pluripotent stem cells where you will take a normal cell from a healthy individual and you can transform that in the laboratory into an embryonic-like stem cell, which then you can turn into any other cell type you want.

  • 10:14:46

    HYUNThere is, I think, still some very fertile ground and some excitement around using fetal tissue to help inform IPS cell research, induces pluripotent stem cell research. Let me give you an example. So in the past, researchers have used fetal tissues mainly dopaminergic neurons from aborted fetuses to transplant into Parkinson's disease patients' brains to see if there could be a positive clinical impact.

  • 10:15:16

    HYUNThe trouble with doing that, however, is that the cells will come from many different sources. You have to cobble together several samples to transplant into one adult. So the problem with that is, they are genetically distinct. They may have slightly different developmental time points and so these differences may help explain why those trials were not as successful as researchers had hoped. Here's where induced pluripotent stem cells comes in and the connection to fetal cell research.

  • 10:15:46

    HYUNAnd that is, researchers are very excited about the prospect of making those types of neurons that you got from aborted fetuses in the lab by creating them from other samples, other cell samples.

  • 10:16:00

    REHMI see.

  • 10:16:01

    HYUNBut to make that type of stem cell product, you have to compare to the original. You have to compare to the fetal dopaminergic neuron so there is a great need to have fetal cells as a control to eventually transition over into what the previous speaker talked about, this other exciting area of lab-generated cells that you would then transplant.

  • 10:16:23

    REHMI'd like to now bring in Dr. Akhilesh Pandey. He's a molecular biologist and professor at the Johns Hopkins School of Medicine. Dr. Pandey, tell us briefly about your research and why you believe fetal tissue is so important to it.

  • 10:16:48

    PANDEYYes, I think we in the biomedical research field have all learned tremendously from experiments thus far with fetal tissues and I think that fetal cells have important lessons to provide us that we cannot learn from other cells. Some of the issues that are often not addressed in the context of what we have learned from fetal cells are what I will touch upon.

  • 10:17:12

    PANDEYAnd, for example, in the development of cancers, it is not widely known that cells start to behave somewhat like cells early in development and our lab studies proteins that are made by cancer cells and fetal cells, but not adult cells. And doctors use some of these proteins that are made by these cancer cells, otherwise not found in adults, for early detection of cancer. And these proteins can also be used to monitor when the cancer recurs.

  • 10:17:45

    PANDEYWe are also involved in understanding of the human genome and as you might know, all of the cells in our bodies have the same DNA and the same genes, but only some of these genes are used to make the real building blocks of cells, which are referred to as proteins.

  • 10:18:02

    REHMAll right. We'll have to stop you there, take a short break and when we come back, we'll talk further and hope to understand more clearly what fetal tissue research is all about.

  • 10:20:03

    REHMAnd welcome back as we talk about the uses of fetal tissue and why it has become such a major issue in the debate over Planned Parenthood. Here in the studio, Dr. David Prentice of the Charlotte Lozier Institute. And Dr. Prentice, would you explain what the Charlotte Lozier Institute actually does?

  • 10:20:33

    PRENTICEGlad to do. We're the education and research arm of the Susan B. Anthony List. We're essentially a think-tank. We're focused on life-related issues, whether it's early life, consent, ethical questions related to the life issues, so...

  • 10:20:51

    REHMAnd does the Charlotte Lozier Institute take a position on Planned Parenthood or abortion?

  • 10:21:03

    PRENTICEWe do take a position on abortion. We are a pro-life institute, and so we believe in the sanctity of human life from conception to natural death.

  • 10:21:13

    REHMAlso here in the studio is Julie Rovner of Kaiser Health News, author of "Health Care Policy and Politics A-Z." Julie Rovner, does Kaiser Health take a position on Planned Parenthood and/or abortion?

  • 10:21:35

    ROVNERNo, we are an independent news service.

  • 10:21:38

    REHMAll right, I just want to make sure of that. Dr. Pandey, what about the Johns Hopkins University School of Medicine, and you personally? Do you take a position on abortion?

  • 10:21:55

    PANDEYI feel science should not be a political issue. We are focusing on research, which is important, and on the science that has the potential to alleviate human suffering.

  • 10:22:06

    REHMAll right, and Dr. Hyun, what about you?

  • 10:22:10

    MS. INSOO HYUNI'm a bioethicist in the School of Medicine, and my specialties are research ethics and the ethics and policy around stem cell research. I primarily focus on ethical issues in the procurement of biomaterials for scientific research.

  • 10:22:25

    REHMAll right, Julie, here is our first email from Pat (PH) here in Washington, who says, I'm still confused on what Planned Parenthood did wrong. If making fetal tissue available at cost is legal, maybe some members of Congress should change the law.

  • 10:22:52

    ROVNERWell there is in fact discussion of changing the law. What's at issue in the videos is whether Planned Parenthood in sort of discussing some of the costs of these things was seeking a profit rather than just covering their costs, although we do know that the videos were edited to take out pieces where Planned Parenthood representatives said, you know, we're not trying to make a profit on this, it's just a question of covering costs.

  • 10:23:15

    ROVNERAnd as the law was written back in 1993, that is -- there is payment allowable to cover the additional costs of procuring the tissue but not to make a profit.

  • 10:23:27

    REHMSo what do hospitals do with fetal tissues and placental tissues? Do they sell? Do they throw away? What do they do?

  • 10:23:40

    ROVNERThey are subject to the same rules as Planned Parenthood. This is everyone who is procuring fetal tissue. Some hospitals do make it available to researchers, again I imagine recovering their costs. In some cases it is disposed of and not used, and this is sort of the ongoing question, is, you know, what is, what is the status of this tissue, you know, post-abortion, in some cases post-miscarriage, post-stillbirth, whether or not it can be used ethically. This has been studied for quite a long time.

  • 10:24:10

    ROVNEROne of the ethicists said to me, she said, you know, we take -- we do organ transplants from homicide victims. So you can separate the act of helping someone else from what even you consider an obviously abhorrent act that ended up in this product becoming available. So this is the continuing question that, you know, basically society has been wrestling with since the -- I think I first read about this in college in the 1970s.

  • 10:24:35

    REHMAnd Dr. Prentice, how do you separate these issues?

  • 10:24:40

    PRENTICEWell, I think there is significant difference between, say, the murder victim and accident victim in terms of this is a prospective type of donation. The woman has come into the abortion clinic and seeks to get an abortion, and it's then, before the abortion occurs and before the individual is dead, that the consent is sought.

  • 10:25:04

    ROVNERBut after the decision has been made to have an abortion. There are strict rules so that -- so as to not encourage women to perhaps get pregnant and have an abortion in order to provide fetal tissue.

  • 10:25:13

    PRENTICERight but in terms of just donating the tissue, even, we've obtained a copy of one of the consent forms that starts out that fetal tissue has been used to treat and cure HIV/AIDS, Parkinson's, Alzheimer's, diabetes and cancer. Now obviously that's misleading at the least. And so you've got to...

  • 10:25:34

    REHMCure Alzheimer's and diabetes?

  • 10:25:35

    PRENTICEThis is what the consent form said.

  • 10:25:39

    REHMOr does it say perhaps to help find a cure?

  • 10:25:44

    PRENTICENo, it says it has been used to treat or cure.

  • 10:25:46

    REHMI'd like to see a copy of that.

  • 10:25:48

    PRENTICEI'd be provide it.

  • 10:25:49

    REHMI wonder if Becca Kaufman, the producer on this program, might be able to find such a consent form. I'm truly interested. Have you, Julie, ever seen that consent form?

  • 10:26:07

    ROVNERI have not. I have seen some consent forms, but obviously they're all going to be somewhat different.

  • 10:26:14

    REHMBut wouldn't Planned Parenthood's consent form be absolutely consistent?

  • 10:26:20

    ROVNERIt might not be exactly the same because remember they're individual affiliates of Planned Parenthood. In fact one thing that we haven't mentioned that Cecile Richards mentioned at the top, the vast majority of Planned Parenthoods, even the ones that do abortion -- not all Planned Parenthoods do abortions -- not all Planned Parenthoods that do abortions have been arranging for fetal tissue. In fact, as far as we can tell, it's only happening in three or four states.

  • 10:26:45

    REHMAnd what about the question of exactly, Dr. Pandey, what fetal tissue has helped to do? Have there been breakthroughs because of fetal tissue? Can you help us understand what those might be?

  • 10:27:11

    PANDEYYes, I'll give you two examples. One of them is quite a common condition, where premature newborns are not able to breathe on their own and can die. And one major clue about how to prevent this came from studies in fetal cells, where a substance called surfactant was found to be made in very little quantities early in development. So one of the therapies for this disorder is to give surfactant to premature babies to help them breathe and therefore survive.

  • 10:27:42

    REHMNow Dr. Prentice, do you think that that is valuable?

  • 10:27:49

    PRENTICEThe research in terms of the goal is valuable, but that same goal can be achieved with other cell types and in fact has been.

  • 10:27:57

    REHMDr. Pandey, how might you have achieved the same goal with other cells?

  • 10:28:07

    PANDEYSo what I would say is this. We do not understand the intricacies of biology or development. And I think we are not in a position to say with absolute certainty what method will provide us the exact same insight that fetal tissues can. We are all trying, but until that happens, I think those tissues remain the gold standard because we are trying to replicate some of those processes in trying to come up with clinical cures.

  • 10:28:39

    REHMNow Dr. Prentice, I understand you've said that fetal tissue research might have been the gold standard back in the '50s and '60s. Now you say we're long past that.

  • 10:28:58

    PRENTICEI really think we are, Diane. I think we've got, as someone mentioned, the induced pluripotent stem cells, which Dr. Yamanaka won the Nobel Prize for just three years ago, umbilical cord blood stem cells, the solid part of the cord, various types of adult stem cells, which have already treated over 1.2 million people directly, not just in terms of basic research. There are many new models, and I think they have advanced, I would maintain, to the point that they can supplant the fetal tissue and in many cases already have.

  • 10:29:30

    REHMDr. Pandey, how do you respond?

  • 10:29:32

    PANDEYI feel the current state of science is saying that it is not true. We cannot be certain about this. And because of this research both at the basic science levels and in the form of clinical trials should continue.

  • 10:29:52

    REHMDr. Hyun, I wonder, do you believe that fetal tissue will be replaced by stem cell tissue?

  • 10:30:03

    HYUNI hope it will be, but it's going to take some time to make that transition. You have to study both types to know how best to replace one type with the other. I can tell you that researchers have a very difficult with the use of fetal tissue for research. I mean, nobody is very happy about that. But often that's the only source you can use to answer your research question.

  • 10:30:27

    REHMJulie, let's remind people, explain the difference, if you can for us, between fetal tissue and stem cell research because they do raise political issues.

  • 10:30:46

    ROVNERAnd they raise similar political issues. Basically, without going into too much of the science, fetal tissue is from aborted fetuses. Now, it can also be obtained from miscarriages and ectopic pregnancies, and that was considered, back when this debate was going on, you know, perhaps there would be a tissue bank for that. Doctors were worried that, you know, frequently miscarriages don't occur in, you know, sterile hospital surroundings, and ectopic pregnancies are quite rare, unlike abortions, which are not all that rare, or they're not as rare as ectopic pregnancies.

  • 10:31:16

    ROVNERStem cells, at least the procurement of stem cells that was authorized eventually by Congress, come from leftover embryos in in vitro fertilization. And so that's a similar ethical issue, but it's not an abortion, but it's again considered by some to be a potential life. It's an embryo. It's, you know, however many, you know, hundreds of cells. And that's been the main way to obtain embryonic stem cells.

  • 10:31:46

    ROVNERNow of course we're talking about, you know, stem cells that are actually created in the lab, which would obviate the need for either one of these things. But as the doctors have been saying, being able to actually do that, science is not quite there yet.

  • 10:32:02

    REHMNow Dr. Prentice, how do you feel about the in vitro embryos and their use in research?

  • 10:32:14

    PRENTICEWell, we would still be opposed to destroying those young lives, even though they're much younger. But that would be part of our consistent ethic. As Julie has mentioned, though, these induced pluripotent stem cells, and Dr. Hyun, where you can take basically a skin cell and transform them into an embryonic-like stem cells, these cells again get around any sort of ethical problem because you don't have to worry about ending a life no matter how young, and they can do virtually everything that these other types of stem cells can do.

  • 10:32:48

    PRENTICEAnd then we still have the cord blood and the adult stem cells, which, as I mentioned, are already treating people for dozens of different conditions. So I think we've got a set of cells for treatment, for vaccine production, for basic scientific studies and modeling. And in fact the induced pluripotent stem cells are probably a little better because you can take them from anyone, including a patient that has a disease, and study the disease right there in the dish.

  • 10:33:17

    REHMAnd you're listening to the Diane Rehm Show. Dr. Pandey, would you agree with Dr. Prentice that both methods are equally usable in finding disease, in using them for research, finding vaccines, curing diseases?

  • 10:33:44

    PANDEYI would say most biomedical researchers would say that long-term consequences of the induced pluripotent stem cells, they are still unknown, and we need to continue to study them. So they have a lot of potential. And as far as the point about the basic science and modeling, I have this one anecdote to share in terms of what we have learned from basic science.

  • 10:34:10

    PANDEYThere's an inherited genetic disorder called sickle-cell anemia, where the therapy used today is to use a drug that turns on the production of a form of hemoglobin that is made very early in developing the fetus. And this is turned off in adults. So in this disease, the defective hemoglobin is made by adult cells, and it is being induced by a drug, the fetal form of that is being induced by a drug.

  • 10:34:43

    PANDEYAnd unless we understood the basic biology, I don't think we'd be benefitting from coming up with a cure to this type of a disease.

  • 10:34:55

    REHMAll right, and now let's move on, if I may, to the whole question of profit. And Dr. Hyun, tell us about the guidelines surrounding profiting from fetal tissue.

  • 10:35:11

    HYUNYes, the prospect of profiting off the procurement is illegal. The guidelines for the procurement of fetal tissues for research by a research team explicitly state that there must be no payment beyond reimbursement for direct expenses and no other financial inducements to the woman to provide her aborted fetus for research purposes. So there's no financial incentive both for the people at the clinic who procure and send to the researchers aborted tissue, and there's no inducement or no financial incentive for the woman to undergo that, as well.

  • 10:35:50

    REHMAnd Julie, is that where this video comes in? Please talk about that.

  • 10:35:57

    ROVNERThat's exactly where this video comes in, and the question is, you know, there are these sort of middlemen companies, and it's not clear to anybody how sort of they are allowed to exist. They can't really be for-profit entities under the law. But they facilitate getting the, you know, the fetal tissue from the abortion clinic to the researchers.

  • 10:36:16

    ROVNERAnd of course what happened in these videos is that the undercover group created a fake middleman organization and went to Planned Parenthood to try and facilitate getting the tissue, saying that they would then get it to researchers, when in fact it was simply a way to get Planned Parenthood officials to talk about, you know, what they do and how they do this.

  • 10:36:41

    REHMAnd was there a request for payment?

  • 10:36:46

    ROVNERThere were discussion of potential costs, and as I mentioned, in the short videos, the edited videos that came out, they cut out -- we know because we've seen some of the longer ones, we do know that many of the Planned Parenthood officials all said, you know, we're not allowed to make profit on this, we're not doing this for profit, we just need to recover our costs. But there were different amounts that were thrown around in the videos.

  • 10:37:09

    REHMSo have you seen all those videos?

  • 10:37:14

    ROVNERWell, no one has seen all of them because there is actually a stay in a lawsuit in California from the National Abortion Federation because, among other things, they infiltrated a National Abortion Federation meeting. So we -- nobody has seen the entire thing. But there have been longer versions of just the ones that were sent out.

  • 10:37:33

    REHMI'm sure that Congress has.

  • 10:37:34

    ROVNERNo they haven't. That was the discussion yesterday.

  • 10:37:37

    REHMAll right, Julie Rovner of Kaiser Health News. Short break here. We'll be right back.

  • 10:40:04

    REHMAnd welcome back. I have two consent forms from Planned Parenthood in front of me, one which was put up by Planned Parenthood that U.S. News put up on the website. It is titled proprietary property of Planned Parenthood. The other from Planned Parenthood, Mar Monte, California, and it was put up by the Center for Medical Progress. Tell me about that center, Julie.

  • 10:40:43

    ROVNERThe Center for Medical Progress is the group that did these undercover videos.

  • 10:40:47

    REHMOkay.

  • 10:40:49

    ROVNERThey created -- in so doing, they created a fake entity, there is some question about whether that was illegal under California law, and, you know, misrepresented who they were in order to do these undercover videos.

  • 10:41:04

    REHMOkay, and in both, first sentence reads, research using, and this is from U.S. News, research using the blood from pregnant women and tissue that has been aborted has been used to treat and find a cure for such diseases as diabetes, Parkinson's disease, Alzheimer's disease, cancer and AIDS. The one release by the Center for Medical Progress reads, research using the blood from pregnant women and tissue that has been aborted has been used to treat and find a cure for such diseases as diabetes, Parkinson's disease, Alzheimer's disease, cancer and AIDS. Julie Rovner, is any of that inaccurate?

  • 10:42:11

    ROVNERIt may be a bit of a stretch. Certainly this is -- it's all being used in research that's aimed at those diseases. I'm not completely up to date on exactly where that research is.

  • 10:42:24

    REHMAll right, and second sentence reads, you can donate your blood and/or pregnancy tissue after an abortion. Before you give your consent, read each of the following statements. We will be happy to answer any questions we have. They are both identical. And Dr. Pandey, do you find anything that is erroneous in those statements? Is the tissue that has been aborted used to treat and find a cure for diabetes, Parkinson's, Alzheimer's, cancer or AIDS?

  • 10:43:21

    PRENTICEThat is not my area of expertise, but I agree with Julie in that there is ongoing and intense research activity into all of those areas.

  • 10:43:33

    REHMAnd Dr. Hyun, what do you say about that?

  • 10:43:37

    HYUNWell, informed consent forms like that have to be reviewed by an ethics board. We call them an IRB. And if I were to see that form, I would ask for a revision and to soften the language in the first paragraph. So yeah, I think there are some problems with that form.

  • 10:43:57

    REHMHow would you soften it?

  • 10:43:59

    HYUNTo say that it's aimed at research attempting to address those issues.

  • 10:44:04

    REHMAnd Dr. Pandey, what's your view?

  • 10:44:08

    PANDEYYes, I think I would agree.

  • 10:44:11

    REHMAnd Dr. Prentice?

  • 10:44:14

    PRENTICEIt definitely would be misleading for a woman in a vulnerable situation. So those statements should not have been made as is.

  • 10:44:23

    REHMAnd Julie?

  • 10:44:24

    ROVNERI don't take a position on it, but I bow to the expertise elsewhere.

  • 10:44:31

    REHMAll right, we have a number of callers. Let's go to the phones, first to Andrew in Fort Wayne, Indiana, you're on the air.

  • 10:44:41

    ANDREWHi Diane. How are you?

  • 10:44:43

    REHMFine, thanks.

  • 10:44:44

    ANDREWI was wondering if I may just pose a comment and a question. First off with my comment, I think, you know, a lot of times we're looking at the political -- this issue of fetal tissue and abortion as a political issue, and really it's an ethical issue. There are political ramifications that come from it, from whatever side you choose, whether you're pro-choice, pro-life, pro-fetal tissue, against fetal tissue. But in the end it's an ethical choice. So it's an ethical thing.

  • 10:45:14

    ANDREWSo, you know, we have -- we have to ask ourselves, I believe, whether or not what we're doing -- is it unethical, and is that okay to do something that's unethical to bring about a greater good? So the question I pose, as well, and this is just from me being -- not having that much knowledge with this, and I would love to hear what your panel has to say, is are there other ways to procure fetal tissue for scientific research besides abortion. Because I think -- I ask that because, you know, maybe it's not whether or not experimenting on fetal tissue is okay but how we procure the fetal tissue.

  • 10:45:56

    REHMAll right, Dr. Pandey, do you want to comment on other ways to obtain fetal tissue?

  • 10:46:06

    PANDEYI think there is new research that is being initiated in fetal DNA and fetal cells in the circulation of the mother's blood. I can think right off the cuff that as one example.

  • 10:46:21

    REHMWould you be more comfortable going about your research in that way?

  • 10:46:29

    PANDEYI would say that that is a very, very limited setting. It is being used to overcome some of the hurdles, but the large majority of the basic science research that we are doing I think we still do not have an alternative to using the cells or the tissue as the material from the fetus.

  • 10:46:52

    REHMAnd Dr. Hyun, how comfortable do you believe researchers can be or are using fetal tissue?

  • 10:47:04

    HYUNWell, you have to understand that last year, the NIH provided $76 million in fetal cell research to researchers around the country. Now, they wouldn't do that unless these proposals had strong scientific merit, and there was no other way to answer the research question that they wanted to pursue. Secondly, all these proposals had to go through strict institutional ethics review. So if they can both standards, the scientific bar and the ethical bar, I think wherever you get the tissues it's going to be justified.

  • 10:47:39

    REHMAll right, to Phyllis in Greenwich, Connecticut, you're on the air.

  • 10:47:43

    PHYLLISYes, I work for the Alliance for Cancer Gene Therapy here in Greenwich and Stamford, Connecticut. And we work with many scientists, who are looking for (unintelligible) gene therapy treatments. I am wondering why all of the scientists, such as your guest from Johns Hopkins University, who are benefitting in their research from the use of this fetal tissue are not speaking out to illuminate to the public at large that it is essential to their work. Thank you.

  • 10:48:13

    REHMDr. Pandey?

  • 10:48:16

    PRENTICEWell, I appreciate and admire the caller, and I think that is the purpose. We are passionate about science. We just worry about the science. And we want to point out that we have benefitted from research as a community and that we should definitely allow this type of research to continue under federal guidelines and after all the ethical procedures are followed.

  • 10:48:41

    REHMJulie?

  • 10:48:42

    ROVNERThis has been a question, you know, where are -- you know, where are the people using this tissue, the researchers, that's been asked ever since the first videos came out. When I was covering the original fetal tissue fight in the late 1980s and early 1990s and then the stem cell fight that happened about 10 years later, basically the researchers and the disease groups, you know, The Alzheimer's Association, Juvenile Diabetes Research Foundation, were everywhere. They were blanketing Capitol Hill. You couldn't turn around without, you know, bumping into one of them.

  • 10:49:09

    ROVNERAnd this time they've been remarkably silent.

  • 10:49:11

    REHMWhy?

  • 10:49:12

    ROVNERGood question. I mean, it may be that the politics of this are now so polarized and so obviously more polarized that they just don't want to get into it, but that's been a big question mark for I know a lot of reporters who have been covering this.

  • 10:49:28

    REHMAll right, to Eli in Utica, New York. You're on the air.

  • 10:49:33

    ELIHi Diane.

  • 10:49:34

    REHMHi.

  • 10:49:35

    ELISo the critical issue here is that the -- many members of the Republican Party are prepared to shut down the government over the fact, which they believe, that Planned Parenthood is illegally selling fetal tissue for a profit. This is -- this is their stance, that Planned Parenthood -- some are saying, are even pushing people to have abortions so that they can make money from the fetal tissue. But here are the facts, which prove their claim false.

  • 10:50:06

    ELIFirst of all, of the approximately Planned Parenthood clinics, only one percent are donating fetal tissue to research. So 99 percent aren't even attempting to make a cent. And of that one percent that are donating, half are charging zero. They're -- they're donating the tissue because they feel that it's a positive thing for medical research.

  • 10:50:41

    REHMAll right, Julie, is that one percent correct?

  • 10:50:44

    ROVNERThat's the one percent that Cecile Richards said. That's basically what we've been told. But it's interesting, a number of states have done their own investigations, including a couple of states where Planned Parenthood doesn't even do abortions. These are states where it's pretty clear that it's not involved in this at all, whether for profit or not for profit or donating, and, you know, so then the headlines come, you know, this state has cleared Planned Parenthood of any wrongdoing. It's, like, yeah, they don't do abortions there.

  • 10:51:08

    ROVNERBut yes, so there have been -- as the caller mentioned, as we've been told, I mean, I haven't been to every Planned Parenthood clinic and knocked on the door and asked, you know, are you doing this, but from what we can tell, it's really, you know, just a handful of states and not that many clinics, and a couple have stopped.

  • 10:51:28

    REHMWhat kinds of laws exist around the country?

  • 10:51:32

    ROVNERWell, there are a number of states that had previous restrictions or bans on fetal tissue research going all the way back to the first time this got debated that had been taken -- since this happened, though, there are a number of states that are looking at new bans on research. We went through this with stem cells also. And then you get, you know, the researchers versus the, you know, sort of the pro-life forces, you know, in arguments.

  • 10:51:57

    ROVNERI covered a stem cell referendum in Missouri that basically would have shut down one of the major stem cell research institutes in the country, and in the end, that went down, but that was I think 2006.

  • 10:52:09

    REHMDr. Hyun, you wanted to make a comment.

  • 10:52:15

    HYUNOh no, I just wanted to weigh in a little bit on this idea that you can replace embryonic stem cell research with these new forms of stem cells that are created. I mean, that comment's been made several times by Dr. Prentice. And in fact, you know, the science simply isn't there yet. So the attempt to replace one with the other, it's simply not true at this point.

  • 10:52:43

    REHMDr. Prentice?

  • 10:52:45

    PRENTICEWell, I would disagree, and I think there are a number of publications that document that the IPS cell science is there now, and in fact you've seen many labs switch, including Jamie Thomson's lab at University of Wisconsin, Madison. Jamie was the first to successfully grow human embryonic stem cells.

  • 10:53:02

    PRENTICEIn terms of your comment, though, I think there's still an open question whether it is only one percent. It's not just also a question, in fact, of the valuable consideration, but there's another part of the statute that talks about not changing the method or the timing of the abortion, and there are some open questions, shall we say, when some of the Planned Parenthood doctors were talking about crushing above or below or a less crunchy method of abortion to get intact organs.

  • 10:53:32

    REHMNow isn't that the part that's in question, Julie?

  • 10:53:35

    ROVNERThere -- yes, there's definitely debate about what the doctors were talking about, the extent to which you can actually, you know, alter the procedure that you're doing that would -- that would lead to a violation of the law.

  • 10:53:54

    REHMAnd you're listening to the Diane Rehm Show. Dr. Hyun, I know you wanted to jump in again.

  • 10:54:03

    HYUNWell, I think that we have to be very clear that the guidelines state you have to separate the treatment decision of the woman to have an abortion from the decision to provide (unintelligible) for research. What makes it tricky to propose we only use materials from stillborn or miscarriages is that these aren't expected events, and it's very difficult in that highly emotional time to then ask the woman at the bedside, would you mind donating this material for research. I think it's better once the woman has scheduled her appointment and has made that decision to terminate her pregnancy, then when she's got more time to think about her involvement, to come in and ask for her informed consent for the research donation.

  • 10:54:46

    REHMDr. Pandey, question for you. Is there fetal tissue research going on to further understand both Parkinson's disease and Alzheimer's disease?

  • 10:55:01

    PANDEYAgain, I'm not an expert on this, but I'm aware of clinical trials where scientists are evaluating these forms of therapies, and as scientists we like to test them under controlled conditions because we don't know for sure whether it will work or not, and we are driven by data. And for that reason, I believe that research into these methodologies that could transform our future should continue.

  • 10:55:28

    ROVNERYeah, you know, there were a lot of complaints both after the fetal tissue research was legalized and again after -- during the stem cell debate. You know, I think people were led to believe that the moment you made this research funding legal and available that there would be cures, and science doesn't work that way. And I do think there was probably some over-promising, and it's been slow.

  • 10:55:48

    ROVNERThese are -- the reasons that these are sort of the last remaining diseases that we can't treat is because they're very, very complicated, and, you know, there is a lot of work going on, but no has there been, you know, we can -- we're going to use stem cells to cure cancer, that hasn't happened yet.

  • 10:56:02

    REHMGiven all the testimony and Congress' look at what's going on with Planned Parenthood, what do you see as possible result?

  • 10:56:15

    ROVNERWell, you know, this is the, I think, what did they say, the 10th different attack on Planned Parenthood in the last 15 years. Last time there were undercover videos trying to suggest that Planned Parenthood was, you know, dealing with sex trafficking and various sort of -- that sort of thing. So this, you know, doing the fetal tissue procurement part of this is new, but trying to defund Planned Parenthood because Planned Parenthood does abortions and because there are people who don't believe in abortion, and therefore they shouldn't get any federal money, even though there is no federal money for abortion, except in very limited cases, you know, that continues.

  • 10:56:51

    ROVNERSo, I mean, if this one doesn't pan out, I'm sure they'll come up with some other way to try and defund Planned Parenthood.

  • 10:56:56

    REHMJulie Rover, Dr. David Prentice, Dr. Akhilesh Pandey and Dr. Insoo Hyun, I want to thank you all so much for being here and, pardon me, trying to help us understand the value or lack thereof of fetal tissue research. Thanks for listening, all. I'm Diane Rehm.

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