The President's Council on Bioethics
1801 Pennsylvania Avenue, N.W., Suite 700
Washington, D.C. 20006
January 14, 2004

The President
The White House
Washington, D.C.

Dear Mr. President:

I am pleased to present to you Monitoring Stem Cell Research, a report of the President's Council on Bioethics. Over the past two years, in keeping with your stated intention, the Council has been monitoring developments in stem cell research, as it proceeds under the implementation of the administration's policy. We have consulted widely, heard presentations, and commissioned review essays (included as appendices in this volume) on all aspects of the topic-scientific, ethical, and legal. Our desire has been both to understand what is going on in the laboratory and to consider for ourselves the various arguments made in the ongoing debates about the ethics of stem cell research and the wisdom of the current policy. Although both the policy and the research are still in their infancy, the Council is now ready to give you and the American people an update on this important area of research.

Because this field and the current policy are so young, this report can be no more than an "update." It summarizes some of the more interesting and significant developments since August 2001, both in the basic science and medical applications of stem cell research and in the related ethical, legal, and policy discussions. It does not attempt to be a definitive or comprehensive study of the whole topic. It contains no proposed guidelines and regulations, nor indeed any specific recommendations for public policy. Rather, it seeks to shed light on where we are now-ethically, legally, scientifically, and medically-in order that you, the Congress, and the nation may be better informed as we all consider where we should go in the future.

The report has four basic aims, three of them the subjects of independent chapters devoted to their themes.

First, we have sought to clarify and explain the current federal policy regarding stem cell research and to make clear the legal, ethical, and prudential foundations on which the policy rests: the desire to promote important biomedical research without endorsing, funding, or creating incentives for the future destruction of human embryos. We have also sought to describe how that policy is being implemented, especially by the National Institutes of Health. Many of these matters have not been well understood or accurately represented in public discussions since August 2001, and we hope that the clarifications introduced in this report will enable future discussions and debates to be better informed.

Second, we have tried to provide an overview of the ethical and policy debates surrounding stem cell research in the past two years. As you already know quite well, these are immensely difficult and challenging matters, with the obligations owed to nascent human life pitted against the obligations to seek knowledge that might someday alleviate much human suffering. Not surprisingly, arguments continue on all aspects of the moral and political debate. We have sought to present the arguments and counter-arguments, faithfully and accurately, so that all may learn what is at stake and where the debate now stands.

Third, we have monitored recent scientific developments in human stem cell research, embryonic and adult, basic and applied. Our goal in the report is to enable (especially non-scientific) readers to appreciate the reasons for the excitement over stem cell research, the complexities of working with stem cells, some early intriguing research and therapeutic findings, and the difficult road that must be traveled before we can reap therapeutic and other benefits from this potentially highly fertile field of research.

The other three specific goals have been informed by a fourth and overarching goal: to convey the moral and social importance of the issue at hand and to demonstrate how people of different backgrounds, ethical beliefs, and policy preferences can reason together about it. We want everyone to understand that biomedical research, being a human activity, must always be regarded as a moral endeavor, to be governed not only by the goals of gaining knowledge and relieving suffering, but also by the obligation to safeguard the inherent freedom and dignity of human life. Throughout the Council's deliberations and in this monitoring report, Council members have tried to acknowledge the strengths and importance of opinions and concerns held by people with whom they disagree. We have aspired to be careful and fair in our approach, precise in our use of language, accurate in presenting data and arguments, and thoughtful in our laying out of the various issues that remain before us. Above all, we want all parties to these debates to understand that their opponents, too, have something vital to defend, not only for themselves but for all of us.

The policy debates over stem cell research that led you to create this Council continue; they, and other debates on related topics, are unlikely to go away any time soon. Our hope is that our work will help to make those debates richer, fairer, and better informed.

Mr. President, allow me to join my Council colleagues and our fine staff in thanking you for this opportunity to offer you and the American people what we hope is a useful and constructive review of where things stand, both in the laboratory and in the public arena, with regard to this promising and ethically challenging area of research.

Sincerely,

Leon R. Kass, M.D.

Chairman