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February 01, 2005
Abortion and stem-cell research in the US- an overview
By Lene Johansen
Contrary to popular belief in Scandinavia, the U.S. abortion debate is not a big deal. Pro-choice advocates bring it up during judicial nominations, and Pro-life advocates bring it up during election times to rally their constituency. Most Americans feel strongly about the issue, but there is a general acceptance that it is not possible to resolve the issue politically.
The landmark decision of Roe vs. Wade defined a decision to terminate a pregnancy during the first trimester as the woman's own. The court achieved this by using a right to privacy, which was defined in previous judicial decisions. This is obviously a judicial creation, which cannot be found in any U.S. legislation. Roe vs. Wade overrode any state legislation on abortion.
When the Supreme Court passed Roe vs. Wade in 1973, 13 states had laws that in practice legalized abortion on demand. The rest either banned the procedure completely, or permitted it only in situations of rape and incest.
The political debate is as good as dead. It is not politically feasible to remove a right, which has already been granted. Because of this, the Pro-life movement has found greener pastures in debates on so called partial birth abortions and research on human embryonic stem-cell research.
Partial birth abortion, or dilation and extraction procedure (D&X) which is the medical term, is a procedure preformed late in the second trimester or in the trimester. Medical staff induces labor and the baby is delivered feet first. Before the head has emerged from the uterus, the medical staff punctures the brain and suck out the brain mass with vacuum suction. It is a very rare procedure, reasonable estimates but the number of procedures in the low thousands.
Congress passed a bill banning this procedure twice during the Clinton administration, but the President vetoed the bill twice because it did not contain exceptions to protect the mother's health. When congress tried to override the veto, the bill failed. Bush signed a similar bill with provisions to perform the procedure when the mother's health was at stake after he took office in 2000.
Pro-choice advocates like NOW and ACLU claimed that this was an infringement on a woman's right to choose, but the fact is that there is a wide consensus that this procedure is cruel and that is should only be performed when it is medically necessary. The most common use of the procedure is when a fetus become hydrocephalic, which means that fetal liquid is retained in the brain.
Hydrocephilia is very common, it happens in one of five pregnancies. In most cases, the medical staff is able to drain the liquid before it does any damage to the fetus' brain. On some extreme cases, the condition is too severe to be treated. In such cases, the baby's head can be more than four times the regular size. The damage to the brain because of pressure makes it impossible for the baby to survive after birth and giving birth will kill the mother.
The bill that President Bush signed has provisions to perform D&X in such cases. It is likely that the law will have little or no impact on the situations where the procedure is performed. It is a symbolic act, which is not an infringement on abortion rights.
Women's rights groups were screaming wolf, when no wolf was around, but the organizations in U.S. are running out of steam after they won the abortion fight and lost the equal right amendment battle. They cling to a scenario where abortion rights are in danger in order to retain its constituency. They need the Pro-life movement to have an enemy to fight.
The Pro-life movement on the other hand, has found new opponents in the debate on research on human embryonic stem-cells (hESC). Pro-life movements are not against abortion per se; they are opposing infanticide. Whether the fetus is a two-cell organism or a baby at full gestation is not relevant, it is murder of a human being in their eyes.
Since hESC research involve extracting stem-cells from the blastocyst at four to six days of gestation, when the fetus is a 200-cell organism, they are opposing the research on the grounds that it is infanticide.
The opposition they have met on the issue is a lobby consisting of research institutions, patient advocates and biotechnology industry. The Pro-life movement lost the battle when President Bush allowed federal funding of hESC research in August 2001.
Although many liberals will tell you that the President banned the research because he limited the funding to the lines that were registered with National Institutes of Health at the time, the truth is that he permitted it for the first time. President Clinton however, pre-empted a recommendation from NIH to allow research on human embryos in 1996 by passing an executive order that banned it.
The stem-cell lines that are available for research if the institution is receiving federal funding proved to be of varying quality, 80 percent of them proved not to be viable for research. The last 20 percent are viable for basic research, but cannot be used in clinical treatments on humans because the cells have been cultivated on mouse cells.
The federal guidelines will have to be revised once hESC-based clinical treatments become available. The treatments will not be usable unless the medical staff have access to lines that are generic enough to avoid rejection by the patients immune system, or lines that are an exact match of the patients tissue.
The current discussion on hESC legislation is efforts the Pro-life lobby has launched in state general assemblies to ban somatic cell nuclear transfer, often referred to as therapeutic cloning. Such bans are lumped together with bans prohibiting reproductive cloning. Nuclear transfer is considered one of the viable sources of hESC which produces stem-cells that match the patients tissue exactly and thus reduces the risk of rejection significantly.
Bans have been passed in six states, but efforts in the remaining states have been thwarted by the lobby that want to harvest the medical and economic benefits of the hESC research. They have received support from legislators who do not want to vote on the issue in order to prevent offending supporters with opposing views.
Although the Pro-life lobby primarily is consisted of Catholic Conference, Right to Life and various evangelical protestant organizations, polls have shown a wide support for the research across religious and political affiliations. As many as 73 percent of Americans support using embryos left over after in-vitro fertilization for stem-cell research. The lowest number of support is among born again Christians, were only 61 percent support such a measure.
The American Pro-life lobby is losing political battle after political battle, but they provide the American discourse with valuable thoughts on the value of human life. Their input provides an ethical depth, unseen in the Swedish discourse, to discussions on advancement of medical technology and the impact it has on society.
Posted by Waldemar at February 1, 2005 11:06 AM