Stepping Out of Line in Stem Cell Research

There’s no doubt that the emerging revolution in life sciences will profoundly transform society in the coming decades. The question Californians now need to ask themselves is whether they want to abdicate control of this transformation and hand it over entirely to scientists and the private sector. If they do, then Proposition 71, the California Stem Cell Research and Cures Act, is the way to go.

Biomedical scientists, patient advocacy groups and others have reason to be frustrated by the restrictions President Bush has placed on stem cell research. But Proposition 71 asks voters to cure these frustrations by undermining their own democratic safeguards and institutions.

Proposition 71 creates an unprecedented state constitutional “right to conduct stem cell research.” It sets aside $3 billion of public spending for stem cell research -- and then insulates that money from meaningful public or legislative accountability. It creates an oversight body -- the misnamed Independent Citizen’s Oversight Committee -- but then stacks that body with those who benefit directly and indirectly from the initiative. And it specifically precludes any amendments of the initiative for three years -- and even then allows them only with a 70% supermajority of the Legislature.

In other words, Proposition 71 would put stem cell research out of the reach of democracy -- in a move that would seriously undermine the unwritten social contract that exists between government and science in this country.

Under that social contract, the federal government increased its annual investment in basic scientific research from about $265 million in the early 1950s to close to $30 billion today (or a 2,000% increase after accounting for inflation), while affording scientists considerable protection from direct political interference in their work. In return, the world’s most productive research enterprise has delivered to Americans enormous benefits, such as childhood vaccines and the Internet.

But underpinning this contract is an understanding that scientists are accountable not just to themselves but to society, to democratic processes and, ultimately, to the public will. This core of public accountability has been good for science and for society in three important ways.

First, it maintains public trust in science through transparency of the legislative process. Scientists and bureaucrats who spend public funds on research must continually account for their activities to elected officials, and science must continually compete for funding with other legitimate public priorities, such as education, law enforcement and healthcare.

Second, it ensures that science responds to changing public interests and values. For example, political pressure from women’s groups has led to significant changes in both the priorities and practice of biomedical science, with federal funding for research on diseases such as breast cancer increasing much more rapidly than funding for health research as a whole. Such changes could not occur if a Proposition 71-like system were in place in the federal government.

Third, and perhaps most important, democratic accountability protects the public and the public interest from potential abuses. Most scientific research is conducted with high attention to ethical standards. But when abuses have occurred -- such as the infamous Tuskegee experiments, which used African American males as unwitting subjects in experiments on syphilis treatments for four decades, and as in the death of gene therapy patient Jesse Gelsinger in 1999, in which the doctor overseeing this research had a financial interest in a company that could have benefited from commercialization of the therapy -- mechanisms of democracy have been available to ensure open investigation, appropriate censure and the imposition of necessary new protections. Without this active oversight capability, such abuses would assuredly increase, and public trust in science would be eroded.

Although supporters of Proposition 71 claim that the initiative includes strict ethical controls, enforcement of these controls is left in the hands of the Independent Citizen’s Oversight Committee, which is made up of representatives of the academic stem cell research community, the biotechnology industry and advocacy groups. The resulting level of institutional conflict of interest -- all members of the committee stand to gain in some way from funding for stem cell research -- reveals an extraordinary hubris among the initiative’s authors.

And the hubris goes even deeper: Proposition 71 would actually give scientists a constitutional right to conduct stem cell research, as if this were a fundamental right equivalent to freedom of speech or religion. In doing so, Proposition 71 turns the privilege of conducting publicly funded research into an absolute legal protection for stem cell researchers, while offering no equivalent protection for the citizens who would be the voluntary subjects of that research.

The last 50 years of rapidly advancing American science shows us that democracy and science can fruitfully coexist, even if the relationship is sometimes contentious. If Californians want to fund stem cell research, they could do so through legislation that preserves the balance between scientific autonomy and democratic values by providing for annual appropriation of funds and accountability to elected officials rather than vested interests. Democracy is hard, but it deserves our protection more than anything else. Even more than science.