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FOIA Number: 2013-0365-F FOIA MARKER This is not a textual record. This is used as an administrative marker by the William J. Clinton Presidential Library Staff. Collection/Record Group: Clinton Presidential Records Subgroup/Office of Origin: Public Liaison Series/Staff Member: Barbara Woolley Subseries: OA/ID Number: 20953 FolderID: Folder Title: Stem Cell Issue [2] Stack: Row: Section: Shelf: Position: S 29 1 1 2 Withdrawal/Redaction Sheet Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001. email To Barbara Woolley; re: Appointment Request (partial) (1 page) 04/12/1999 b(7)(C), b(7)(E), b(6) 002. email To Barbara Woolley; re: Appointment Request (partial) (1 page) 04/12/1999 b(7)(C), b(7)(E), b(6) 003. email To Barbara Woolley; re: Appointment Request (partial) (1 page) 04/12/1999 b(7)(C), b(7)(E), b(6) COLLECTION: Clinton Presidential Records Public Liaison Barbara Woolley OA/Box Number: 20953 FOLDER TITLE: Stem Cell Issue [2] 2013-0365-F jp3302 RESTRICTION CODES Presidential Records Act - |44 U.S.C. 2204(a)] Freedom of Information Act - [5 U.S.C. 552(b)] P1 National Security Classified Information [(a)(1) of the PRA) b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRA] b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute [(a)(3) of the PRA| an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information |(a)(4) of the PRA] b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRA] b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRAJ b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells [(b)(9) of the FOIA] RR. Document will be reviewed upon request. EXECUTIVE OFFICE OF THE PRESIDENT OFFICE OF SCIENCE AND TECHNOLOGY POLICY WASHINGTON, D.C. 20502 July 28, 1999 MEMORANDUM FOR CHRIS JENNINGS BARBARA WOOLLEY FROM: RACHEL LEVINSON PEC SUBJECT: Information - 7/29 PATIENTS' CURe STEM CELL BRIEFING Patients' CURe has issued the attached media advisory, "Leading Congressional Conservatives to Speak in Favor of Stem Cell Research," in anticipation of other upcoming events regarding stem cell research. In addition, Science magazine ran the attached story on NBAC's recommendations and the WH reaction. Attachments cc: Arthur Bienenstock Jeff Smith FROM: OMNIFAX TO: 2024566027 AUG 11, 1989 9:22AM #211 P.02 Patients CONTACT: Joe Cerquone (202) 293-2856 CURe Patients' Condition for Urgent Research MEDIA ADVISORY Leading Congressional Conservatives to Speak In Favor of Stem Cell Research at Media Roundtable What: In anticipation of the release of the National Bloethics Advisory Commission's final report, the final NIH guidelines regarding federal funding stem cell research, and related activity on Capitol HIII, the Patients' Coalition for Urgent Research (Patients' CURe) will host a media roundtable briefing. Who: The Honorable Strom Thurmond (R-SC) U.S. Senate The Honorable Brian Bilbray (R-CA) U.S. House of Representatives Dan Perry, Chairman Patients Coalition for Urgent Research Dr. Robert Goldstein Juvenlle Diabetes Foundation Joseph Balley ALS (Lou Gehrig's Disease) Patient When: 10:00 a.m., Thursday, July 29, 1999 Where: U.S. Capitol Building, Room HC7 Refreshments will be served ### 2021 K Street NW, Suite 305 Washington, DC 20006 Tel: 202-293-2856 Fax: 202-785-8574 THIS WEEK PAGE 507 508 NEWS Korean science Watching reform draws the brain protests decipher smells bryo research and apply it explicitly to the BIOMEDICINE derivation or use of embryonic stem cells. Representative John Porter, chair of the House Ethicists Back Stem Cell Research, appropriations subcommittee for Labor and HHS, which drafts the NIH budget, has tenta- tively set a meeting on 21 July to begin work White House Treads Cautiously on next year's appropriation. Although Porter told Science that he personally supports NIH's Research on a scientifically promising type on these cells "is permissible under the cur- perspective, he said he didn't want this discus- of human cell received a vote of confidence rent congressional ban." sion to "overwhelm the funding process." last week. In a decision that Stanford Uni- With this, the Administration formally Porter said: "I told [NIH director Harold] Var- versity biologist Paul Berg calls "gutsy," the backed a policy adopted by NIH and the De- mus that we should fight the issue on the in- National Bioethics Advisory Commission partment of Health and tellectual basis of what will happen with or (NBAC) recommended on 14 Human Services (HHS) without this kind of research. But I don't July that the federal govern- in January. Their legal want to see NIH's funding wrapped up in an ment fund not only research experts ruled that gov- argument that to me is tangential." on human embryonic stem ernment funds may be Other members of Porter's subcommittee cells but also the production spent to study, but not -including Representative Jay Dickey of cell cultures-even if it to derive stem cells from, (R-AR), a sponsor of the embryo research means sacrificing embryos. embryos (Science, 22 Jan- ban-reject both NBAC's view and the Ad- In an official notice, NBAC, uary, p. 465). Under this ministration's compromise position. "We be- policy, only private labs lieve that science should serve humans, not may develop human stem that humans should serve science," says "I don't want cells from embryos, but Dickey. He does not think the current law NIH-funded and other permits federal research on embryonic stem to see NIH's U.S.-backed researchers cells, and says he will help take the fight to may use them. (The re- court, if necessary. He hasn't proposed any funding striction on development change in the embryo research ban. doesn't apply to fetal tis- But Berg, a spokesperson for the Ameri- wrapped up in sue.) Even this plan is con- can Society for Cell Biology, says NBAC troversial, however, because some right-to- has developed a position that he hopes will an argument that to life activists have declared that any destruc- make sense to scientists and the public. He tive use of an embryo is immoral. calls NBAC's recommendations for moni- me is tangential." Despite the legal clouds, many biomedi- toring the field "bureaucratic," but reason- cal researchers think this field has a bright able if they reassure the public that this re- -John Porter future. They say that stem cells derived search will be guided by ethical principles. from human embryos and fetal gonadal -ELIOT MARSHALL cells, which are capable of developing into a presidential panel of 17 scholars and ethi- a wide variety of specialized cells, may be a RESEARCH FUNDING cists, says it will deliver its final report (not valuable source of transplant tissue. For the past 9 months, NBAC has been deliberating Michigan Plans Massive yet finished) to the president "very soon." The president's staff, however, didn't over ethical guidelines that might enable Investment Biotech wait long to distance itself. On the same day more rapid development of this biomedical that NBAC reached its decision, the White technology by opening it to public funding. In what may be the House released a note saying that the Ad- NBAC concluded that the potential bene- largest windfall for ministration's policy will be spelled out in fits of stem cell research outweigh the research from a state guidelines being drawn up by the National disadvantages-provided the cells are tobacco settlement so Institutes of Health (NIH). It noted that the drawn from embryos that would otherwise far, Michigan Gover- president has ruled out funding the creation be discarded. NBAC recommended that nor John Engler this of human embryos for research. Congress only "spare" embryos from fertility clinics week signed a bill al- has gone further, for several years adding a be used, and only when both donors give locating a stunning general ban on funding embryo research to full consent. NBAC also said that the gov- $1 billion over the next the NIH appropriation; the current law runs ernment should establish a watchdog com- 20 years for a competitive through 30 September. The White House mittee to set ethical rules and enforce them. biotechnology research fund for his state's concluded: "No other legal actions are nec- NBAC's position could have an impact on scientists. The fund, to focus on aging and essary at this time because it appears that debates on biomedical funding in Congress health, may be spent on a range of pro- human embryonic stem cells will be avail- this summer and fall if right-to-life advocates grams, from research grants for diabetes to able from the private sector," and research seek to extend the congressional ban on em- building new bioinformatics databases. 502 23 JULY 1999 VOL 285 SCIENCE www.sciencemag.org THE WHITE HOUSE WASHINGTON July 26, 1999 MEMORANDUM FOR JOHN PODESTA CC: DOUG SOSNIK STEPHANIE STREETT LORETTA UCELLI LARRY STEIN CHRIS JENNINGS MARY BETH CAHILL DAVID BEIER DAN MENDELSON FROM: NEAL LANE Jhis for n L SUBJECT: Stem Cell Event: Healthcare Advances for the 21st Century Purpose The rationale for holding this event is to enable the President to associate his Administration with medical research that holds enormous promise for finding new treatments and cures for diseases that afflict approximately 128 million Americans, nearly half the population of the United States. "Such research," states Harold Varmus, head of the National Institutes of Health (NIH) "has the potential to revolutionize the practice of medicine." The ability of the NIH to fund research using human embryonic stem cells is being threatened by some in Congress who want to tighten the Congressional ban on human embryo research. A White House event that makes clear the President's position in support of human stem cell research within the context of current law will help conservative Members who support stem cell research hold the line against efforts to broaden the ban against such research. As has been widely reported, the White House, at this time, is endorsing a more moderate scope of research activities than NBAC has concluded should be eligible for federal funding. Nonetheless, by thanking NBAC for their report in a public ceremony, the White House can align itself with their core message, which is that stem cell research should proceed cautiously under appropriate ethical guidance. The President can use this event to take a strong stand that human stem cell research must be done according to the highest ethical standards, and direct that NIH put appropriate guidelines and oversight in place to ensure those standards are met. The President's efforts could be viewed as rolling up our sleeves and directing that fresh troops, namely, our nation's world-class Federally- funded medical research establishment, be fully dedicated to learning how to harness stem cells to treat people with diabetes, heart disease, Parkinson's disease, cancer, and spinal cord injuries. Seventy-four percent of Americans responded favorably to a public opinion poll on the use of Federal funds for research using human embryonic stem cells. A White House event that endorses that view, emphasizes the need to maintain high ethical standards, and directs NIH to move ahead with all deliberate speed, will resonate strongly with the majority of Americans who are desperately searching for cures and treatments for themselves and their loved ones. Background On the political landscape, the use of human embryos in research has been a hot button topic for the last several years. The House Pro-Life Caucus was successful in attaching a rider to DHHS's appropriations bill for the last four years that prohibits federal funding for any research in which human embryos are created or destroyed. An HHS legal interpretation of this ban permits Federal funding for research that uses human embryonic stem cells (because stem cells are not embryos), but Representatives Dickey (R-AR) and Bliley (R-VA) oppose this research as well and have stated their intention to broaden the ban to include stem cells. The patient advocacy groups have been active in lobbying Congress very strongly to commit public funds and resources to allow such research. Their efforts apparently are paying off in that neither Dickey nor Bliley have acted on their statements to date. The timing of this event is critical. Holding it before Congress leaves will help spur the advocacy efforts of these patients groups during the month of August in Congressional Districts across the nation. A nationwide coalition of over 110 patient groups and professional and academic organizations have drafted a letter in support of Federal funding of stem cell research (attached), and it could be released in conjunction with this event. Outline of event: The President meets briefly with the National Bioethics Advisory Commission, and then in the East Room, or the Rose Garden, accepts the Commission's report, briefly discusses the importance of stem cell research, and charges NIH to move ahead with all deliberate speed to put the necessary oversight process in place to ensure that Federally-funded stem cell research is conducted according to the highest ethical standards. Other speakers might include Secretary Shalala, Harold Varmus, or a parent with an ill child with a cell-failure disease. President's suggested remarks: The control of human stem cells may open the door to the greatest medical discoveries since antibiotics. Every parent whose child has diabetes or any cell-failure disease is going to be riveted to this research, because it is the answer. The President would thank NBAC and acknowledge their efforts, discuss the importance of stem cell research, paint a vision of the future in which certain dreaded diseases could be defeated. Additionally, he would charge NIH to develop and implement an oversight process for stem cell research that will ensure that our ethics are as good as our science; and that our newest technologies must always incorporate our oldest values. Would also acknowledge the critical role of voluntary patient groups in raising public awareness regarding stem cells and their potential medical benefits. Would acknowledge the past and current Federal investments in science and technology that made this breakthrough possible, and urge Congress to provide full FY2000 funding for his Twenty-first Century Research Fund budget request. Would acknowledge Members of Congress and thank them for their support of biomedical research, and for holding the line so that stem cell research can proceed. Attachments Americans Affected by Diseases Stem Cell Research May Help Stem cell research could help as many as 128 million Americans. Following are facts about the diseases that scientists say may be treated or cured with advancements in stem cell research. Diabetes kills one American every three minutes.¹ Condition Americans Affected Cardiovascular 58,000,000 Approximately 1.5 million Americans are afflicted with Parkinson's disease Diseases while roughly three million more have Autoimmune Diseases 30,000,000 at-risk, pre-symptomatic dopamine cell loss. 2 Diabetes 16,000,000 Five Boeing 747 jumbo jets crashing Osteoporosis 10,000,000 every day for a year equals the 563,100 Americans who die each year from cancer.³ Cancer 8,200,000 Cardiovascular diseases remain the number Alzheimer's 4,000,000 one cause of death among Americans. Parkinson's 1,500,000 They accounted for 41 percent of all deaths in 1996. 4 Burns (Severe) 300,000 In the U.S. today, 10 million individuals Spinal Cord Injuries 250,000 already have osteoporosis and more than 18 million additional people have low bone Birth Defects mass, placing them at increased risk for the 150,000/ per year disease. 5 Total Americans Every year in the United States two 128,400,000 million people are burned, 300,000 of which are severe burns. 6 There are more than 80 known autoimmune diseases such as lupus, multiple sclerosis, rheumatoid arthritis and Graves' disease. Autoimmune diseases occur when the immune system attacks its own tissue. 7 By developing therapies for those who have spinal cord injuries and preventing injuries, the U.S. could save as much as $400 billion on future direct and indirect lifetime spinal cord injury costs. 8 Birth defects are the leading cause of infant death and a major cause of disability in young people, affecting more than 150,000 babies each year. 9 About 2.7 million Americans care for people with Alzheimer's disease. 10 ¹Juvenile Diabetes Foundation ⁶Onhealth.com ²Parkinson's Action Network ⁷American Autoimmune Related Diseases Assn. National Coalition for Cancer Research ⁸American Paralysis Association ⁴American Heart Association ⁹March of Dimes ⁵National Osteoporosis Foundation 10-The Alzheimer's Association CARAVAN ® Stem Cell Research Polling Information Opinion Research Corporation International was commissioned by Patients' Coalition for Urgent Research (Patients' CURe) to conduct polling on the subject of stem cell research. Several questions were included in our CARAVAN® Survey, a weekly omnibus telephone survey. Between May 6-9 the survey of 1,005 adults was conducted. Chosen through a random-digit-sample, the adults included 503 men and 502 women 18 years of age or older, living in private households in the continental United States. Prior to asking a question specifically addressing federal funding for stem cell research, a definition of the research was given. Following is the definition that was used: As you may already know, a stem cell is the basic cell in the body from which all other cells arise. Medical researchers have been able to isolate stem cells from excess human embryos developed through in vitro fertilization and fetal tissue that has been donated to research. Medical researchers believe that human stem cells can be developed into replacement cells to cure diseases such as diabetes, Parkinson's, Alzheimer's, cancer, heart disease, arthritis, burns or spinal cord problems. After hearing the definition, 74 percent of respondents said they favored the funding of stem cell research by the National Institutes of Health. Men are more likely than women to be in favor of the research funding (79% VS. 71%). Americans who have had at least some college education are more likely to favor the funding of research than those without any college education (78% VS. 71%). Janet Ulrich 1-800-999-0213 phone 1-800-759-5786 fax * OPINION RESEARCH CORPORATION INTERNATIONAL Date: TBD The Honorable U.S. House of Representatives Washington, DC 20515 Dear Representative : This past February we wrote to you regarding our support for federal funding of research using human pluripotent stem cells. With the Appropriations process progressing we write now to reiterate that support and to urge you to allow this research to move forward. Human pluripotent stem cells have enormous potential for treatment of disease because they have the ability to form into any type of cell in the body. But only a fraction of the work that will be necessary to transform this potential into reality has yet begun, and only a fraction of the biomedical research community has been able to participate because the federal government has not yet funded any of this work. The National Institutes of Health are in the process of completing guidelines that will permit and govern the use of these cells by federally funded investigators. Only when these guidelines are in place will it be possible to unleash the full capability of the biomedical research workforce toward bringing the remarkable potential of human pluripotent stem cells to fruition. It is also clear that the American public supports federal funding of this research. A recent nationwide survey conducted by Opinion Research Corporation International has found that 74% of those polled favor funding of stem cell research by the NIH. Some have argued that "adult" stem cells will be sufficient in our pursuit of treatments or cures of various diseases. While we believe that research in the area of adult stem cells is vital to the research effort, we are concerned that to restrict work to that area alone will prove insufficient and would be a grave mistake. The prospect of cutting off an avenue of research as promising as that with embryonic stem cells at this very early stage of discovery deeply troubles those of us who conduct and promote health research. Such a prohibition could delay possible treatments for diseases like diabetes, cancer, Alzheimer's and Parkinson's by years. Past work on animals has shown us that it is the embryonic stem cells that hold the greatest potential in their ability to be manipulated for treatments of disease. We are also concerned by the argument that embryonic stem cell research can be left to the private sector. While it is clear that a few privately funded centers are working on pluripotent stem cell research, it is not generally the practice of private companies to conduct this kind of basic research into fundamental developmental processes. That is why it has been and remains the role of the federal government to make the lion's share of the investment in basic research, which has then been used by biotechnology and pharmaceutical companies to develop products used for treating diseases. And that is why we cannot rely on private industry to conduct the kind of basic research necessary to move the field of stem cell research from the laboratory bench to the clinic. Our intent is simply to ensure that research on stem cell lines is not unduly restricted. With appropriate ethical safeguards, such as those being developed by the National Institutes of Health, we believe that a balance can be achieved, which respects both the moral status of the embryo and the public's sensitivity to this issue while ensuring progress in critical medical research. As we have said before, the government can play an important role of oversight so that our nation's federally funded scientists can conduct this critical work. Federal support will also increase the financial resources directed to this area of research, which will speed the pace of scientific discovery. With the great hope pluripotent stem cell research provides to patients ailing or dying from devastating diseases we urge the Congress to allow this research to move forward with federal support. Sincerely, Academy of Clinical Laboratory Physicians and Scientists Alliance for Aging Research Alliance for Lung Cancer Advocacy, Support and Education American Academy of Allergy, Asthma and Immunology American Academy of Child and Adolescent Psychiatry American Academy of Ophthalmology American Association for Dental Research American Association of Anatomists American Association of Dental Schools American Association of Immunologists American Autoimmune Related Diseases Association American Burn Association American College of Clinical Pharmacology American College of Neuropsychopharmacology American College of Obstetricians and Gynecologists American College of Physicians - American Society of Internal Medicine American Gastroenterological Association American Medical Association American Neurological Association American Pediatric Society American Physiological Society American Society for Biochemistry and Molecular Biology American Society for Bone and Mineral Research American Society for Cell Biology American Society for Clinical Nutrition American Society for Investigative Pathology American Society for Microbiology American Society for Pharmacology and Experimental Therapeutics American Society for Reproductive Medicine American Society of Clinical Oncology American Society of Hematology American Society of Human Genetics American Thoracic Society American Veterinary Medical Association Americans for Medical Progress Association for Research in Vision and Ophthalmology Association of Academic Health Centers Association of American Cancer Institutes Association of American Medical Colleges Association of American Universities Association of Chairs of Departments of Physiology Association of Independent Research Institutes Association of Medical and Graduate Departments of Biochemistry Association of Medical School Pediatric Department Chairs Association of Medical School Psychologists Association of Professors of Medicine Association of Subspecialty Professors Association of Teachers of Preventive Medicine Association of University Radiologists Boston University School of Medicine Cancer Research Foundation of America Citizens for Public Action on High Blood Pressure and Cholesterol Coalition for American Trauma Care Columbia University Cure for Lymphoma Foundation Dartmouth Medical School Duke University East Carolina University School of Medicine Easter Seals The Endocrine Society Eye Bank of America Federation of American Societies for Experimental Biology Fred Hutchinson Cancer Research Center Genetics Society of America Glaucoma Research Foundation Harvard University Interstitial Cystitis Association of America, Inc. Johns Hopkins University Joint Council of Allergy, Asthma, and Immunology Juvenile Diabetes Foundation International Krasnow Institute for Advanced Study March of Dimes Massachusetts Institute of Technology Medical College of Wisconsin Myasthenia Gravis Foundation of America, Inc. Myositis Association of America, Inc. National Alliance for Eye and Vision Research National Alliance for the Mentally Ill National Association of State Universities and Land-Grant Colleges National Caucus of Basic Biomedical Science Chairs National Childhood Cancer Foundation National Coalition for Cancer Research National Health Council National Osteoporosis Foundation The National Pemphigus Foundation National Psoriasis Foundation National Spinal Cord Injury Association New York University School of Medicine Oncology Nursing Society Osteogenesis Imperfecta Foundation Paralyzed Veterans of America Parkinson's Action Network The Protein Society Research!America Resolve, the National Infertility Association Roswell Park Cancer Institute Scleroderma Foundation Sjogren's Syndrome Foundation Society for Investigative Dermatology Society for Pediatric Research Society for Reproductive Endocrinology and Infertility Society for the Advancement of Women's Health Research University of California University of California, San Diego, School of Medicine University of Florida University of Illinois at Chicago University of Michigan Medical School University of Pittsburgh University of Rochester Medical Center University of Utah Health Sciences Center University of Washington University of Wisconsin-Madison UPMC Health System Vanderbilt University Medical Center Yale University Stem Cell July 15, 1999 The Honorable U.S. House of Representatives Washington, DC 20515 Dear Representative : This past February we wrote to you regarding our support for federal funding of research using human pluripotent stem cells. With the Appropriations process progressing we write now to reiterate that support and to urge you to allow this research to move forward. Human pluripotent stem cells have enormous potential for treatment of disease because they have the ability to form into any type of cell in the body. But only a fraction of the work that will be necessary to transform this potential into reality has yet begun, and only a fraction of the biomedical research community has been able to participate because the federal government has not yet funded any of this work. The National Institutes of Health are in the process of completing guidelines that will permit and govern the use of these cells by federally funded investigators. Only when these guidelines are in place will it be possible to unleash the full capability of the biomedical research workforce toward bringing the remarkable potential of human pluripotent stem cells to fruition. It is also clear that the American public supports federal funding of this research. A recent nationwide survey conducted by Opinion Research Corporation International has found that 74% of those polled favor funding of stem cell research by the NIH. Some have argued that "adult" stem cells will be sufficient in our pursuit of treatments or cures of various discases. While we believe that research in the area of adult stem cells is vital to the research effort, we are concerned that to restrict work to that area alone will prove insufficient and would be a grave mistake. The prospect of cutting off an avenue of research as promising as that with embryonic stem cells at this very early stage of discovery deeply troubles those of us who conduct and promote health research. Such a prohibition could delay possible treatments for diseases like diabetes, cancer, Alzheimer's and Parkinson's by years. Past work on animals has shown us that it is the embryonic stem cells that hold the greatest potential in their ability to be manipulated for treatments of disease. We are also concerned by the argument that embryonic stem cell research can be left to the private sector. While it is clear that a few privately funded centers are working on pluripotent stem cell research, it is not generally the practice of private companies to conduct this kind of basic research into fundamental developmental processes. That is why it has been and remains the role of the federal government to make the lion's share of the investment in basic research, which has then been used by biotechnology and pharmaceutical companies to develop products used for treating diseases. And that is why we cannot rely on private industry to conduct the kind of basic research necessary to move the field of stem cell research from the laboratory bench to the clinic. Our intent is simply to ensure that research on stem cell lines is not unduly restricted. With appropriate ethical safeguards, such as those being developed by the National Institutes of Health, we believe that a balance can be achieved, which respects both the moral status of the embryo and the public's sensitivity to this issue while ensuring progress in critical medical research. As we have said before, the government can play an important role of oversight so that our nation's federally funded scientists can conduct this critical work. Federal support will also increase the financial resources directed to this arca of research, which will speed the pace of scientific discovery. With the great hope pluripotent stem cell research provides to patients ailing or dying from devastating diseases we urge the Congress to allow this research to move forward with federal support. Sincerely, American Academy of Allergy, Asthma and Immunology American Academy of Child and Adolescent Psychiatry American Academy of Ophthalmology American Association of Anatomists American Burn Association American College of Neuropsychopharmacology American Medical Association American Pediatric Society American Society for Cell Biology American Society for Clinical Nutrition American Society for Investigative Pathology American Society for Microbiology American Society for Reproductive Medicine American Society of Hematology American Society of Human Genctics American Thoracic Society American Veterinary Medical Association Americans for Medical Progress Association for Research in Vision and Ophthalmology Association of Academic Health Centers Association of American Cancer Institutes Association of American Medical Colleges Association of American Universities Association of Medical School Pediatric Department Chairs Association of Professors of Medicine Association of Subspecialty Professors Citizens for Public Action on High Blood Pressure and Cholesterol Coalition for American Trauma Care East Carolina University School of Medicine AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS The Endocrine Society Eye Bank of America Fred Hutchinson Cancer Research Center Genetics Society of America Joint Council of Allergy, Asthma, and Immunology Juvenile Diabetes Foundation International Krasnow Institute for Advanced Study Massachusetts Institute of Technology National Alliance for Eye and Vision Research National Caucus of Basic Biomedical Science Chairs National Childhood Cancer Foundation National Coalition for Cancer Research National Health Council National Spinal Cord Injury Association Oncology Nursing Society Osteogenesis Imperfecta Foundation Paralyzed Veterans of America Research!America Resolve, the National Infertility Association Roswell Park Cancer Institute Scleroderma Foundation Society for the Advancement of Women's Health Research Society for Pediatric Research University of Florida University of Washington Histemlet.doc THE WHITE HOUSE WASHINGTON July 6, 1999 MEMORANDUM FOR JOHN PODESTA FROM: NEAL LANE mal SUBJECT: Human Stem Cell Research Update Background: In November 1998, human embryonic stem cells were successfully isolated and cultured in two privately funded laboratories. Human embryonic stem cells are primitive cells, which themselves lack a specific function but have the capacity to develop into any specialized type of cell found in the human body (such as nerve, bone, blood, or muscle cells). While this announcement stirred great excitement in the biomedical research community, because of the tremendous potential that stem cells have for treating human disease, the source of these cells (human embryos and aborted fetuses) generated a great deal of controversy. The isolation of stem cells from human embryos (but not fetuses) currently cannot be done using public funds because of the Congressional ban on the use of Federal funds for human embryo research, which has been attached to the HHS appropriations bill for the last four years. On November 14, 1998, the President asked his National Bioethics Advisory Commission (NBAC) for a "thorough review of the issues associated with such human stem cell research, balancing all ethical and medical considerations." In January 1999, HHS General Counsel Harriet Rabb issued a decision that the human embryo research ban did not include human embryonic stem cells, because stem cells are not themselves embryos, and so research using these cells would be eligible for Federal funds. The House Pro-Life Caucus has objected strenuously to this decision. However, Senators Specter and Harkin of the Senate Appropriations Committee strongly support NIH funding of human stem cell research (they held three hearings on this issue in late 1998), as does Congressman Porter of the House Appropriations Committee. Present Status: NBAC is examining the ethics of research on stem cells derived from fetuses, embryos left over from fertility treatments, and embryos produced for research, either from fusing donated eggs and sperm or via cloning methods. They are also considering the ramifications of Federal funding of each of these activities. The Commissioners unanimously agree that the use of human embryonic stem cells for research is ethically defensible and should be eligible for Federal funding. However, there is still considerable debate over the ethics of deriving cells from the different sources, and the use of Federal funds for such research. Even though NBAC generally agrees that deriving cells from embryos left over from fertility treatments is ethically acceptable, some Commissioners may recommend against using public funds to support such a controversial activity. At this point, it appears that the Commission will not recommend Federal funding for research using stem cells derived from embryos produced for research purposes using either cloning or IVF technologies, which is consistent with the President's 1994 position opposing the creation of human embryos for research purposes. NBAC expects to finalize their report shortly after they meet next week (July 13-14) in Cambridge, MA. NIH has drafted a set of guidelines describing the steps investigators must complete to receive NIH funds for research involving the use of human stem cells, to be published in the Federal Register for a 60-day public comment period, once they have received departmental clearance. The guidelines will parallel existing regulations covering fetal tissue transplantation research. NIH will not fund research that would include the destruction of human embryos as this would violate the Congressional embryo research ban. Possible Administrative Action: The release of the NBAC report and/or the publication of the draft NIH guidelines are opportunities for an Administration statement. Two draft statements are attached, which express support for funding research using human embryonic stem cells, but emphasize the need for this research to be done using the highest ethical standards. Because valuable research can proceed using stem cells that are derived using private funds, there is no need at this time to push for a relaxation of the current Congressional ban on human embryo research. Attachments Tab A Draft Statement for Neal Lane and/or Joe Lockhart Tab B Draft Statement for POTUS cc: Bruce Reed Larry Stein Dan Mendelson Elena Kagan David Beier Chris Jennings Barbara Woolley Barry Toiv Joe Lockhart Draft 7/7/99 Draft Statement for Neal Lane or Joe Lockhart when NIH Guidelines are Published/NBAC Report is Nearing Completion Last November, the President asked his National Bioethics Advisory Commission to undertake a thorough review of all of the ethical and medical considerations associated with human stem cell research. In the ensuing months, a national dialogue took place highlighting the potential applications of stem cells for treating people with diabetes, heart disease, Parkinson's disease, cancer, and spinal cord injury. Ethical issues were also central to this debate, including a wide range of religious and philosophical views that are a part of the fabric of our democratic culture. NBAC has nearly completed its deliberations and appears ready to endorse the medical promise and ethical acceptability of certain types of human stem cell research. The Clinton Administration recognizes that human stem cell technology's potential medical benefits are compelling and worthy of pursuit, so long as the research is conducted according to the highest ethical standards. NIH is putting in place guidelines and an oversight system that will ensure that the cells are obtained in an ethically sound manner. The President's 1994 ban on the use of Federal funds for the creation of human embryos for research purposes will remain in effect. Because it appears that human stem cells will be available from the private sector, such research is permissible under the current Congressional ban on human embryo research and no other legal actions are necessary at this time. Revised Draft 7/7/99 (incorporating John Podesta's 7/6/99 edits) Draft Statement for POTUS when NIH Guidelines are Published/NBAC Report is Released Back in November, when I asked my National Bioethics Advisory Commission to look at the ethical and medical issues surrounding human stem cell research, I recognized the enormous medical potential of such research. The scientific results that have come out in just the past few months already strengthen my basis for hope that one day, stem cells will be used to replace cardiac muscle cells for people with heart disease, nerve cells for hundreds of thousands of Parkinson's patients, or insulin-producing cells for children who suffer from diabetes. But I also understand that stem cell research raises ethical concerns that need to be addressed, and the national dialogue has highlighted a range of opinions that must be respected. First, I want to restate the ban I issued in 1994 prohibiting the use of Federal funds for the creation of human embryos for research purposes. Second, I will continue to insist that any Federally-supported human stem cell research be held to the highest ethical standards. The NIH guidelines, with input from NBAC, will be the principal mechanism to ensure this outcome, while helping scientists turn the promise of stem cell technology into reality. THE WHITE HOUSE WASHINGTON July 6, 1999 MEMORANDUM FOR JOHN PODESTA FROM: NEAL LANE mal SUBJECT: Human Stem Cell Research Update Background: In November 1998, human embryonic stem cells were successfully isolated and cultured in two privately funded laboratories. Human embryonic stem cells are primitive cells, which themselves lack a specific function but have the capacity to develop into any specialized type of cell found in the human body (such as nerve, bone, blood, or muscle cells). While this announcement stirred great excitement in the biomedical research community, because of the tremendous potential that stem cells have for treating human disease, the source of these cells (human embryos and aborted fetuses) generated a great deal of controversy. The isolation of stem cells from human embryos (but not fetuses) currently cannot be done using public funds because of the Congressional ban on the use of Federal funds for human embryo research, which has been attached to the HHS appropriations bill for the last four years. On November 14, 1998, the President asked his National Bioethics Advisory Commission (NBAC) for a "thorough review of the issues associated with such human stem cell research, balancing all ethical and medical considerations." In January 1999, HHS General Counsel Harriet Rabb issued a decision that the human embryo research ban did not include human embryonic stem cells, because stem cells are not themselves embryos, and so research using these cells would be eligible for Federal funds. The House Pro-Life Caucus has objected strenuously to this decision. However, Senators Specter and Harkin of the Senate Appropriations Committee strongly support NIH funding of human stem cell research (they held three hearings on this issue in late 1998), as does Congressman Porter of the House Appropriations Committee. Present Status: NBAC is examining the ethics of research on stem cells derived from fetuses, embryos left over from fertility treatments, and embryos produced for research, either from fusing donated eggs and sperm or via cloning methods. They are also considering the ramifications of Federal funding of each of these activities. The Commissioners unanimously agree that the use of human embryonic stem cells for research is ethically defensible and should be eligible for Federal funding. However, there is still considerable debate over the ethics of deriving cells from the different sources, and the use of Federal funds for such research. Even though NBAC generally agrees that deriving cells from embryos left over from fertility treatments is ethically acceptable, some Commissioners may recommend against using public funds to support such a controversial activity. At this point, it appears that the Commission will not recommend Federal funding for research using stem cells derived from embryos produced for research purposes using either cloning or IVF technologies, which is consistent with the President's 1994 position opposing the creation of human embryos for research purposes. NBAC expects to finalize their report shortly after they meet next week (July 13-14) in Cambridge, MA. NIH has drafted a set of guidelines describing the steps investigators must complete to receive NIH funds for research involving the use of human stem cells, to be published in the Federal Register for a 60-day public comment period, once they have received departmental clearance. The guidelines will parallel existing regulations covering fetal tissue transplantation research. NIH will not fund research that would include the destruction of human embryos as this would violate the Congressional embryo research ban. Possible Administrative Action: The release of the NBAC report and/or the publication of the draft NIH guidelines are opportunities for an Administration statement. Two draft statements are attached, which express support for funding research using human embryonic stem cells, but emphasize the need for this research to be done using the highest ethical standards. Because valuable research can proceed using stem cells that are derived using private funds, there is no need at this time to push for a relaxation of the current Congressional ban on human embryo research. Attachments Tab A Draft Statement for Neal Lane and/or Joe Lockhart Tab B Draft Statement for POTUS cc: Bruce Reed Dan Mendelson Elena Kagan David Beier Chris Jennings Barbara Woolley Barry Toiv Joe Lockhart Draft 7/6/99 Draft Statement for Neal Lane or Joe Lockhart when NIH Guidelines are Published/NBAC Report is Nearing Completion Last November, the President asked his National Bioethics Advisory Commission to undertake a thorough review of all of the ethical and medical considerations associated with human stem cell research. In the ensuing months, a national dialogue took place highlighting the potential applications of stem cells for treating people with diabetes, heart disease, Parkinson's disease, cancer, and spinal cord injury. Ethical issues were also central to this debate, including a wide range of religious and philosophical views that are a part of the fabric of our democratic culture. NBAC has nearly completed its deliberations and appears ready to endorse the medical promise and ethical acceptability of certain types of human stem cell research. The Clinton Administration recognizes that human stem cell technology's potential medical benefits are compelling and worthy of pursuit, so long as the research is conducted according to the highest ethical standards. NIH is putting in place guidelines and an oversight system that will ensure that the cells are obtained in an ethically sound manner. The President's 1994 ban on the use of Federal funds for the creation of human embryos for research purposes will remain in effect. Because it appears that human stem cells will be available from the private sector, such research is permissible under the current Congressional ban on human embryo research and no other legal actions are necessary at this time. Draft 7/6/99 Draft Statement for POTUS when NIH Guidelines are Published/NBAC Report is Released Back in November, when I asked my National Bioethics Advisory Commission to look at the ethical and medical issues surrounding human stem cell research, I recognized the enormous medical potential of such research. The scientific results that have come out in just the past few months already strengthen my basis for hope that one day, stem cells will be used to replace cardiac muscle cells for people with heart disease, nerve cells for hundreds of thousands of Parkinson's patients, or insulin-producing cells for children who suffer from diabetes. (Juvenile Diabetes Foundation, Alliance for Aging Research, Paralyzed Vets or other members of the Patients' Coalition for Urgent Research may be invited.) But I also understand that stem cell research raises ethical concerns that need to be addressed, and the national dialogue has highlighted a range of opinions that must be respected. First, I want to restate the ban I issued in 1994 prohibiting the use of Federal funds for the creation of human embryos for research purposes. Second, I hereby direct that any Federally- supported human stem cell research be held to the highest ethical standards. The NIH guidelines, with input from NBAC, will be the principal mechanism to ensure this outcome, while helping scientists turn the promise of stem cell technology into reality. THE WHITE HOUSE WASHINGTON June 17, 1999 MEMORANDUM FOR JOHN PODESTA FROM: NEAL LANE real SUBJECT: Human Stem Cell Research Update I want to alert you to two upcoming events regarding oversight of human stem cell research and discuss actions that we might take regarding human stem cell research and cloning for the purpose of human reproduction. NIH Guidelines NIH expects to send a human stem cell research oversight plan and draft guidelines to DHHS next week. Once cleared, the guidelines will be published in the Federal Register for a 60-day public comment period. The guidelines are expected to describe the steps investigators must complete in order to receive NIH funds for research involving the use of human stem cells. The guidelines will parallel existing regulations covering fetal tissue transplantation research. NIH will not fund research that would include the destruction of human embryos as this would violate the Congressional embryo research ban. National Bioethics Advisory Commission Report NBAC will meet on June 28-29 to discuss human stem cell research. The Commission expects to complete its report shortly after their meeting on July 13-14, in Cambridge, MA. The report will respond to the President's Nov. 14, 1998 request for a "thorough review of the issues associated with such human stem cell research, balancing all ethical and medical considerations." NBAC is examining the ethics of conducting research on stem cells derived from fetuses, and embryos left over from fertility treatments, embryos produced from donated eggs and sperm or via cloning methods. They are also considering the ramifications of Federal funding of each of these activities. Although the Commission has not yet completed its deliberations, it appears that they will support Federal funding for research using stem cells derived from fetuses or excess embryos. A majority of Commissioners do not draw an ethical distinction between the use and the derivation of stem cells and are comfortable with the practice of deriving stem cells from excess embryos for research purposes. Despite news reports to the contrary, however, NBAC has not concluded that they will recommend that the Congressional ban be eased to allow Federally-funded research involving the destruction of human embryos to obtain stem cells. Even without an ethical basis, some Commissioners may recommend against using public funds to support such a controversial activity. At this point, it appears that the Commission will not recommend Federal funding for research using stem cells derived from embryos produced for research purposes using cloning or IVF technologies. Recent News Reports It was reported in the June 14 Washington Post that two separate companies, Geron Corporation and Advanced Cell Therapeutics, have launched programs to produce human embryos using cloning technology. In the June 15 New York Times, Geron denied that it was producing human embryos but was, instead, using somatic cell nuclear transfer to learn about factors produced in the egg that turn back the developmental clock in an adult nucleus. The company may, in fact, be producing human embryos. Advanced Cell Technology is resuming earlier somatic cell nuclear transfer experiments using a human adult cell and a cow egg. Both companies state that their purpose is the isolation of embryonic stem cells, and not human reproduction (i.e., therapeutic, not reproductive, cloning). In 1994, President Clinton banned the use of Federal funds to create embryos for research purposes (this ban was broadened by Congress in 1995 to include all research using human embryos), and in 1997 banned Federal funding for the use of cloning to reproduce a human being. None of these bans apply to the private sector, although some companies have said that they will comply with the President's voluntary moratorium. Hill Activity The Congressional ban on human embryo research will be debated in the HHS appropriations process. Patient advocacy groups have formed an active coalition (Patients' CURe) that has been very effective in making the case of the importance of stem cell research in developing treatments for diseases such as diabetes, heart disease, Parkinson's and cancer. Rachel Levinson, of my staff, Chris Jennings, David Beier, and Barbara Woolley, met with the coalition on April 13 to hear about their message development efforts. Chris reiterated the Administration's position as articulated in the President's and Harold Varmus' statements on the potential medical benefits of stem cell research. Senators Specter and Harkin have indicated strong support for NIH funding of human stem cell research. Senate markup of the Labor/HHS appropriations bill could come as early as July 1, but that is unlikely. Rep. Porter supports the Administration's position on stem cell research. House Labor/HHS appropriations staff have said that they don't envision a tightening of the embryo research ban in order to prohibit stem cell research. However, something along these lines can always slip in, especially if there is an Omnibus bill. Last month, Rep. Bliley announced that he would hold a hearing in response to press reports that NBAC would recommend easing the ban to allow public sector research deriving stem cells. No stem cell hearings have been scheduled. Possible Administrative Actions Publication of the NIH guidelines and/or release of the NBAC report are opportunities for an Administration statement, in the event one is called for. However, I do not see a compelling reason to make a new statement at this time. We are on record supporting human stem cell research as a promising avenue of biomedical research. We have already stated the need for stringent ethical oversight and publication of the NIH guidelines will reinforce this message. In the event that NBAC recommends in mid-July that the government fund research involving the destruction of human embryos in order to obtain stem cells, I would advise against working toward relaxation of the current Congressional ban. Harold Varmus says valuable research can proceed using stem cells that are derived using private funds and there is no need to go across this line for the time being. Although fertility research could be enhanced if the ban were lifted, the incremental approach appears to be more prudent at this juncture. Going further might lose the support of some of the patient groups (Paralyzed Vets, e.g.) because it would bring the debate closer to the abortion issue. We drafted a bill to prohibit reproductive cloning (June 97) while protecting biomedical research but it was never introduced. We could call on Congress once again to address this real area of concern-rather than restricting biomedical research. Additionally, we should work with FDA to clarify their regulatory authority to prevent private sector use of cloning technology to produce a child. We might also explore other administrative oversight options. Given that our current positions on stem cell research and reproductive cloning are clear and enjoy the support of patient groups and the biotechnology and pharmaceutical industries, we need not issue new statements until we see what develops in the appropriations process. cc: Bruce Reed Elena Kagan David Beier Chris Jennings Barbara Woolley stere CLONING HUMAN EMBRYOS June 14, 1999 Context: Today's Washington Post reports that two separate companies, Geron Corporation and Advanced Cell Therapeutics, have started programs to create cloned human embryos. Geron Corp. is funding an unnamed American researcher to create human embryos by using somatic cell nuclear transfer with a human adult cell and a human egg. Advanced Cell Therapeutics is resuming earlier somatic cell nuclear transfer experiments using a human adult cell and a cow's egg. Both companies state that their purpose in creating cloned human embryos is for the isolation of embryonic stem cells, and not for human reproduction (i.e., therapeutic, not reproductive, cloning). In 1994, President Clinton banned the use of Federal funds to create embryos for research purposes (this ban was broadened by Congress in 1995 to include all research using human embryos), and in 1997 banned Federal funding for the use of cloning to reproduce a human being. None of these bans apply to the private sector. This article follows on a piece in yesterday's Post, in the Outlook section, on the religious perspective of the ethics of embryo research, which highlighted the lack of any consensus among different religious leaders on the acceptability of using early-stage embryos to derive stem cells. That article incorrectly stated that the National Bioethics Advisory Commission is planning to recommend that Congress ease the embryo research ban to permit Federal funding for the derivation of stem cells from excess IVF (in vitro fertilization) embryos. The Commission is still actively involved in discussion of this and other issues, and has not come to final agreement. General Two companies are separately funding research programs to create cloned human embryos for the purpose of deriving human embryonic stem cells that could be used therapeutically. The Post article voiced concern that this research brings us closer to cloning human beings. In 1997, President Clinton banned the use of Federal funds to clone a human being, and asked for a voluntary moratorium in the private sector (see below for text). The Administration also sent draft legislation to the Hill to outlaw reproductive cloning, however Congress did not act on it. The FDA has said that they have the authority to regulate the use of cloning as a reproductive method in the private sector. Q. Are we closer to cloning a human being? A. No. Two companies have announced that they are funding American researchers to create cloned human embryos for the purpose of isolating embryonic stem cells, which could then be used to treat disease. Neither company has reported a success. The possibility of using this technology for reproductive purposes remains uncertain. Q. Are there any laws or regulations that would restrict the creation of cloned human embryos in the private sector? A. No Federal funds may be used to create human embryos, either through cloning or the more conventional IVF technologies. Two years ago, the President issued a directive specifically banning Federal funds for cloning a human being, and requested a voluntary moratorium in the private sector, stating that the cloning technique of somatic cell nuclear transfer shouldn't be used to create human beings. At the same time, the President sent draft legislation to Congress to prohibit reproductive cloning in the private sector, however Congress did not act on that legislation. The FDA has stated that they have the authority to regulate the use of cloning as a reproductive method, and would prohibit its use on the basis of safety concerns. Text of the President's March 4, 1997, Directive on Cloning: THE WHITE HOUSE Office of the Press Secretary For Immediate Release March 4, 1997 MEMORANDUM FOR THE HEADS OF EXECUTIVE DEPARTMENTS AND AGENCIES SUBJECT: Prohibition on Federal Funding for Cloning of Human Beings Recent accounts of advances in cloning technology, including the first successful cloning of an adult sheep, raise important questions. They potentially represent enormous scientific breakthroughs that could offer benefits in such areas as medicine and agriculture. But the new technology also raises profound ethical issues, particularly with respect to its possible use to clone humans. That is why last week I asked our National Bioethics Advisory Commission to thoroughly review the legal and ethical issues associated with the use of this technology and report back to me in 90 days. Federal funds should not be used for cloning of human beings. The current restrictions on the use of Federal funds for research involving human embryos do not fully assure this result. In December 1994, I directed the National Institutes of Health not to fund the creation of human embryos for research purposes. The Congress extended this prohibition in FY 1996 and FY 1997 appropriations bills, barring the Department of Health and Human Services from supporting certain human embryo research. However, these restrictions do not explicitly cover human embryos created for implantation and do not cover all Federal agencies. I want to make it absolutely clear that no Federal funds will be used for human cloning. Therefore, I hereby direct that no Federal funds shall be allocated for cloning of human beings. WILLIAM J. CLINTON ### 05/18/99 TUE 19:10 FAX 202 944 1964 H & K 1 1002 Patients' Draft not Public till Thus 10:00 AL CURe Patients' CURe Overview Patients' Coalition for Urgent Research The recent advances in stem cell research could lead to new treatments and even cures for diseases that affect millions of Americans. Doctors may one day be able to use stem cells to regenerate or replace damaged tissue in people who live with debilitating illnesses such as Parkinson's disease, cancer, heart disease, diabetes, Alzheimer's disease, spinal cord injuries, severe burns, osteoporosis and other diseases. Stem cell research will also allow scientists to study cell differentiation, which holds the key to a deeper understanding of birth defects and abnormal cell behavior, such as cancer. Mission The Patients' Coalition for Urgent Research (Patients' CURe) is a broad alliance of patients' groups dedicated to informing the public, media and policymakers about the extraordinary potential of this revolutionary research. In addition to educating, Patients' CURe is committed to ensuring stem cell research receives proper oversight and support through federal funding. Coalition Members Alliance for Aging Research The ALS Association Nat'l Coalition of Autoimmune Patient Groups National Health Council American Autoimmune Related Diseases Assn. National Marfan Foundation American Cancer Society National Osteoporosis Foundation American Parkinson Disease Association National Patient Advocate Foundation Cancer Leadership Council Christopher Reeve Paralysis Foundation National Spinal Cord Injury Association Paralyzed Veterans of America Citizens for Public Action on Blood Pressure & Cholcsterol Parkinson's Action Network Cure for Lymphoma Foundation Research!America Glaucoma Research Foundation Huntington's Disease Society of America Resolve, The National Infertility Association Society for the Advancement of Women's Juvenile Diabetes Foundation International Health Research Kidney Cancer Association Spina Bifida Assn. of America Foundation National Coalition for Cancer Research Tourette's Syndrome Association, Inc. Coalition Principles Gives Hope to Millions of Patients and their Families No research in recent history has offered as much hope to as many as 128 million Americans suffering from debilitating and often fatal diseases. By studying tissues that would otherwise be discarded, researchers can potentially develop treatments and cures for our most intractable diseases, thereby saving and improving the lives of patients and their families. Lives will be Saved Faster Early basic science is generally underfunded by the private sector because it does not produce marketable products quickly enough to make the investment worthwhile. Therefore, public funding is the only way to ensure stem cell research is thoroughly conducted. Government funding will allow many more scientists to study stem cells, which will hasten the discovery of effective therapies. Federal Funding Ensures Oversight and Public Accountability Scientists who receive federal grants will be required to adhere to strict guidelines developed by the NIH with advice from ethicists, theologians and the public. It is important for this medical research to occur in the public domain with careful oversight and opportunities for evaluation. 2021 K Street NW, Suite 305 Washington, DC 20006 Tel: 202-293-2856 Fox: 202-785-8574 1003 05/18/99 TUE 19:10 FAX 202 944 1964 H&K CARAVAN ® Stem Cell Research Polling Information Opinion Research Corporation International was commissioned by Patients' Coalition for Urgent Research (Patients' CURe) to conduct polling on the subject of stem cell research. Several questions were included in our CARAVAN Survey, a weekly omnibus telephone survey. Between May 6-9 the survey of 1,005 adults was conducted. Chosen through a random-digit-sample, the adults included 503 men and 502 women 18 years of age or older, living in private households in the continental United States. Prior to asking a question specifically addressing federal funding for stem cell research, a definition of the research was given. Following is the definition that was used: As you may already know, a stem cell is the basic cell in the body from which all other cells arise. Medical researchers have been able to isolate stem cells from excess human embryos developed through in vitro fertilization and fetal tissue that has been donated to research. Medical researchers believe that human stem cells can be developed into replacement cells to cure diseases such as diabetes, Parkinson's, Alzheimer's, cancer, heart disease, arthritis, burns or spinal cord problems. After hearing the definition, 74 percent of respondents said they favored the funding of stem cell research by the National Institutes of Health. Men are more likely than women to be in favor of the research funding (79% vs. 71%). Americans who have had at least some college education are more likely to favor the funding of research than those without any college education (78% vs. 71%). Janet Ultich . 1-800-999-0213 phone 1-800-759-5786 fax OPINION RESEARCH CORPORATION INTERNATIONAL Joanne S. Tornow 76% 05/18/99 01:27:45 PM Record Type: Record To: Christopher C. Jennings/OPD/EOP@EOP, Barbara D. Woolley/WHO/EOP@EOP CC: Subject: Patients' CURe meeting today FYI Forwarded by Joanne S. Tornow/OSTP/EOP on 05/18/99 01:27 PM Penny Catterall <[email protected]> 05/18/99 12:46:42 PM Record Type: Record To: Joanne S. Tornow/OSTP/EOP, Rachel E. Levinson/OSTP/EOP CC: "Perry, Dan" <[email protected]> Subject: Patients' CURe meeting today FYI - Dan Perry asked me to forward this notice which I sent out earlier today. This is a notice that the Patients' CURe will be having its final press conference planning meeting this afternoon at 2:00 pm at the offices of Hill and Knowlton at 600 New Hampshire Avenue, Watergate complex, 6th floor. If you wish to participate by conference call, please call Krista Donahue at H&K at (202) 944-5108 this morning and give her your phone number. Also, if your group is a patient member of the coalition and you wish to have a statement on the importance of stem cell research to your constituency included in the press packet that is mailed out to reporters tomorrow, please either bring it to the meeting or have it messengered to Hill and Knowlton before COB today. So far, we only have one statement from one group to include. If you cannot get a statement ready by today, please bring at least 50 copies on your letterhead to the press conference on Thursday morning and it will be put out on the press table at that time. If endorsing groups (i.e. non-patient based) wish to put out a statement, your main thrust should be the endorsement of Patients' CURe and the coalition's focus and efforts, with lesser emphasis on stem cell research itself. Please contact Krista at H&K at [email protected] if you have any questions about the content of a statement. Finally, for the information of those new groups signing on either as members or endorsers, the press conference to announce the coalition and strong national support for stem cell research will take place in the Capitol in room HC6 at 10:00 am on Thursday, May 20. We strongly urge ALL coalition groups to be represented at the press conference by at least one senior member of their organization. While you will not have to speak formally, your group may be asked questions by the media after the announcement, and we would like to have a very strong showing from all involved. Thanks, Penny Penelope B. Catterall Director, Corporate and Foundation Relations Alliance for Aging Research (202) 293-2856 Penelope B. Catterall Director, Corporate and Foundation Relations Alliance for Aging Research (202) 293-2856 Penelope B. Catterall Director, Corporate and Foundation Relations Alliance for Aging Research (202) 293-2856 Penelope B. Catterall Director, Corporate and Foundation Relations Alliance for Aging Research (202) 293-2856 Penelope B. Catterall Director, Corporate and Foundation Relations Alliance for Aging Research (202) 293-2856 Joanne S. Tornow 05/18/99 12:31:08 PM Record Type: Record To: Barbara D. Woolley/WHO/EOP@EOP CC: Subject: FWD: Patients' CURe FYI, status of March of Dimes. Forwarded by Joanne S. Tornow/OSTP/EOP on 05/18/99 12:30 PM Dan Perry <[email protected]> 05/18/99 11:25:23 AM Record Type: Record To: Joanne S. Tornow/OSTP/EOP CC: [email protected] Subject: FWD: Patients' CURe Note: Some recipients have been dropped due to syntax errors. Please refer to the "$AdditionalHeaders" item for the complete headers. Joanne, Here is the message I received from Jess Melanson who has been representing the March of Dimes at our weekly strategy meetings. This states where we stand with MOD and Marina Weiss' current position. Help from your folks could be decisive here. --Dan Original Message from "Melanson, Jess" <[email protected]> at 5/17/99 4:12 pm >Original Recipient(s): >To: TLESHAN <[email protected]> > dperry <[email protected]> > >| have some unfortunate news regarding our efforts to include the March of >Dimes as a member of Patients' CURe. Marina just informed me that her >meeting today with our President, Research Director, and Medical Director >was canceled, and we can take no action until they meet. > >| pushed the idea of the March of Dimes simply signing on as a member before >the press conference and defining our role at a later date, but she >maintains that the foundation will take no action until we have a clear >strategy that has been endorsed by key members of the organization. > >| will attend tomorrow's meeting, but any further questions on this matter >will have to be directed toward Marina as this is now out of my hands. I'll >keep you posted of any further developments. > > >Jess Melanson >Associate Director of State Affairs >March of Dimes >1901 L St., NW, Ste. 200 >Washington, DC 20036 >(202) 659-1800 Dan Perry Executive Director Alliance for Aging Research (202) 293-2856 (202) 785-8574 (fax) [email protected] summit yougher dperry @ AGINGRESEARCH.ORG 4/16/99 04:44:00 PM Record Type: Record To: Barbara D. Woolley Purpose: st. j to MGWT CC: Subject: stem cell coalition Rachel, I found your email address, at last, so I can pass on these thoughts on major patient groups where we need help in getting commitments to the stem (Deart I sheld cell coalition. We currently have 15 groups signed on, the latest being the Sprina Bifuda Association Foundation. I believe you have the others on a onwed list. The top targets still outstanding are: 1) American Heart Association; 2) American Cancer Society; 3) Alzheimer Association; Arthritis Foundation; and the Multiple Sclerosis Society. These are all high profile, important "alye patient groups for diseases that likely will be approached far more effectively because of what we will learn from stem cell research. Christopher Reeve Paralysis Foundation. I don't have to tell you how nothing conce forally Park It was also just announced this week that two groups have merged to form the valuable that name is. Two other groups I have not mentioned because I am sure they will agree to the coalition without further pressure are the March of Dimes Birth Defects Foundation and the Paralyzed Veterans of America. I would be happy to talk with anyone about the status of approaches to these 1000 groups. Calls from the right people in the Clinton Administration could be decisive in bringing these names to our coalition. privo Incidentally, I just learned that our message testing strategy will be in the field next Thursday with two focus groups in Lansing, MI, followed the next Wednesday by two groups in Nashville, TN. >won't charge differs. Let me know how I can support your good efforts. --Dan them shalala- / bten Cell -wed leadership fetal Pad issue-diag march Dine Marina Wass 659 1800 rd Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001. email To Barbara Woolley; re: Appointment Request (partial) (1 page) 04/12/1999 b(7)(C), b(7)(E), b(6) COLLECTION: Clinton Presidential Records Public Liaison Barbara Woolley OA/Box Number: 20953 FOLDER TITLE: Stem Cell Issue [2] 2013-0365-F jp3302 RESTRICTION CODES Presidential Records Act - [44 U.S.C. 2204(a)] Freedom of Information Act - 15 U.S.C. 552(b)| P1 National Security Classified Information ((a)(1) of the PRAJ b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office |(a)(2) of the PRA] b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute [(a)(3) of the PRA] an agency |(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information [(a)(4) of the PRA] b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRA] b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy |(b)(6) of the FOIA] personal privacy [(a)(6) of the PRA| b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. 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Appointment With: WOOLLEY, BARBARA Appointment Date: 4/13/99 Appointment Time: 2:30:00 PM (b)(6) Appointment Room: 100 Appointment Building: OEOB Appointment Requested by: WOOLLEY BARBARA Phone Number of Requestor: 62155 WAVES APPOINTMENT NUMBER: U70270 16 If you have any questions regarding this appointment, please call the WAVES Center at 456-6742 and have the appointment number listed above available to the Access Control Officer answering your call. TOTAL NUMBER OF NAMES SUBMITTED FOR ENTRY : 15 TOTAL NUMBER OF NAMES OF CLEARED FOR ENTRY: 14 CHOW, IDA DOUGHERTY, PAMELA GUARDUCCI, MARA HENDRICKS, KAREN Walley 60 KERR, ELEANOR [oa] LESHAN, TIMOTHY LIPNER, ROBYN LUDLAM, CHARLES (b)(6) MELANSON, JESS (b)(6) MILO, SARA MOORE, DAVE SOLER, LAWRENCE TIPTON, SEAN WEINBERG, NINA Vir (b)(6) Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 002. email To Barbara Woolley; re: Appointment Request (partial) (1 page) 04/12/1999 b(7)(C), b(7)(E), b(6) COLLECTION: Clinton Presidential Records Public Liaison Barbara Woolley OA/Box Number: 20953 FOLDER TITLE: Stem Cell Issue [2] 2013-0365-F jp3302 RESTRICTION CODES Presidential Records Act - [44 U.S.C. 2204(a)] Freedom of Information Act - [5 U.S.C. 552(b)] P1 National Security Classified Information |(a)(1) of the PRA b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRA| b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute [(a)(3) of the PRA] an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information |(a)(4) of the PRA] b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA| and his advisors, or between such advisors [a)(5) of the PRA| b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRA] b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions ((b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells ((b)(9) of the FOIA] RR. Document will be reviewed upon request. MAILMGT @ A1 04/12/99 06:28:00 PM Record Type: Record To: Barbara D. Woolley CC: Subject: CONFIRMATION: APPT. REQUEST FOR WOOLLEY FROM: WAVES OPERATIONS CENTER - (b)(6) (b)(7)c (b)(7)e [002] Date: 04-12-1999 Time: 18:25:18 This message serves as confirmation of an appointment for the visitors listed below. Appointment With: WOOLLEY Appointment Date: 4/13/99 Appointment Time: 2:30:00 PM Appointment Room: 100 Appointment Building: OEOB Appointment Requested by: WOOLLEY BARBARA Phone Number of Requestor: 62155 WAVES APPOINTMENT NUMBER: U70270 If you have any questions regarding this appointment, please call the WAVES Center at 456-6742 and have the appointment number listed above available to the Access Control Officer answering your call. TOTAL NUMBER OF NAMES SUBMITTED FOR ENTRY : 2 TOTAL NUMBER OF NAMES OF CLEARED FOR ENTRY: 2 TURNER, SAM WHITE, FRANCIS (b)(6) [002] Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 003. email To Barbara Woolley; re: Appointment Request (partial) (I page) 04/12/1999 b(7)(C), b(7)(E), b(6) COLLECTION: Clinton Presidential Records Public Liaison Barbara Woolley OA/Box Number: 20953 FOLDER TITLE: Stem Cell Issue [2] 2013-0365-F jp3302 RESTRICTION CODES Presidential Records Act - |44 U.S.C. 2204(a)] Freedom of Information Act - [5 U.S.C. 552(b)] PI National Security Classified Information |(a)(1) of the PRAJ b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRA] b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute |(a)(3) of the PRA] an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information |(a)(4) of the PRA| b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information |(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRA] b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRA} b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells [(b)(9) of the FOIA] RR. Document will be reviewed upon request. reserve to WAVES CONF @ PMDF.EOP.GOV seats 17 04/12/99 07:23:56 PM Record Type: Record To: Barbara D. Woolley/WHO/EOP CC: Subject: WAVES Confirmation ADDRESSEES: BARBARA D. WOOLLEY SUBJECT: CONFIRMATION: APPT. REQUEST FOR WOOLLEY, BARBARA FROM: WAVES OPERATIONS CENTER (b)(6) (b)(7) (b)(7)e [003] Date: 04-12-1999 Time: 18:16:41 This message serves as confirmation of an appointment for the visitors listed below. Appointment With: WOOLLEY, BARBARA Appointment Date: 4/13/99 Appointment Time: 2:30:00 PM Appointment Room: 100 Appointment Building: OEOB Appointment Requested by: WOOLLEY BARBARA Phone Number of Requestor: 62155 WAVES APPOINTMENT NUMBER: U70270 If you have any questions regarding this appointment, please call the WAVES Center at 456-6742 and have the appointment number listed above available to the 26 Access Control Officer answering your call. TOTAL NUMBER OF NAMES SUBMITTED FOR ENTRY : 15 TOTAL NUMBER OF NAMES OF CLEARED FOR ENTRY: 15 CHOW, IDA DOUGHERTY, PAMELA GUARDUCCI, MARA HENDRICKS, KAREN KERR, ELEANOR LESHAN, TIMOTHY anyous LIPNER, ROBYN (b)(6) MELANSON, JESS NIN [003] LUDLAM, CHARLES MILO, SARA MOORE, DAVE PERRY, DANIEL SOLER, LAWRENCE TIPTON, SEAN WEINBERG, NINA Rachel E. Levinson 04/13/99 12:47:49 PM Record Type: Record To: Barbara D. Woolley/WHO/EOP, Jennifer M. Luray/WHO/EOP, Devorah R. Adler/OPD/EOP CC: Subject: stem cell meeting at 3 today - updated agenda and list of attendees Human Stem Cell Research April 13, 1999, 3 p.m. OEOB, Room 100 Agenda 1. Introductions Attendees 2. Opening Remarks Chris Jennings Jennifer Luray Welcome. Describe point in Weekly Standard that GOP may be planning to raise human stem cell research and tightening of the Congressional ban on embryo research as part of anti-choice movement. We convened this meeting to convey this information, to touch base once again with groups who are following this issue and have been helpful to us in the past, and to hear what they have been working on to ensure that important biomedical research is not constrained unnecessarily. The President has already stated very clearly the "promising significant medical benefits" of human stem cell research (Nov. 14 letter to NBAC). We have been working very closely with Harold Varmus and others at HHS to ensure that such research would be carried out under appropriate oversight and in accordance with the highest ethical standards. 4. Brief Reports on Status of Relevant Activities National Bioethics Advisory Commission Rachel Levinson The Commission is preparing a report to the President in response to his Nov. 14 request and has reached a degree of consensus in support of the use of human stem cells derived from aborted fetuses and from embryos left over from infertility treatment. There is concern on the part of at least one commissioner regarding HHS' determination that the embryo research ban does not apply to use of stem cells. Alex Capron agrees with this conclusion but feels that use of the cells cannot be decoupled from derivation of the cells from embryos. The Commission hopes to have a report completed around June or July. NIH Ad Hoc Advisory Panel Lana Skirboll On April 8, Harold Varmus convened an ad hoc panel in a public forum to help NIH develop an oversight process and guidelines for the ethical use of human stem cells in federally-funded research. This meeting was a first step in a deliberative process. Once the panel finishes their draft guidelines, NIH plans to publish them for a 60-day public comment period. A final version must be approved by Dr. Varmus' advisory committee before he will consider moving ahead to fund human stem cell research. During a public comment session, a representative of the House Pro-Life Caucus reiterated earlier Congressional statements that Federal funding of human stem cell research violates the Congressional ban on human embryo research. 5. Report on Congressional Activity and Meetings Attendees Several groups have been active in meetings with Hill staff. Patient advocacy groups and scientific and professional societies met in February to discuss legislative strategy for forestalling a tightening of the ban on federally-funded human embryo research. While some advocate using stem cells as tool for attacking the ban altogether (AAMC and American Society for Reproductive Medicine), others are uncomfortable with this approach and fear that it might provoke a backlash in the form of a more restrictive ban via HHS approps. 6. List of Attendees Robyn Lipner, Bass and Howes Inc., Parkinson's Disease Charles Ludlam, BIO Jess Melanson, March of Dimes Mara Guarducci, Pharmaceutical Research and Manufacturers of America Victoria Blattner, Merck Ida Chow, Society for Developmental Biology Nina Weinberg, National Health Council Pamela Dougherty, American Cancer Society Sean Tipton, American Society for Reproductive Medicine Daniel Perry, Alliance for Aging Research Lawrence Soler, JDF International Sara Milo, NCCR Timothy Leshan, American Society for Cell Biology Dave Moore, Association of American Medical Colleges Karen Hendricks, American Academy of Pediatrics Harley Thomas, Paralyzed Vets Association Pat White, American Association of Immunologists Sam Turner, Geron THE WHITE HOUSE WASHINGTON November 14, 1998 Dr. Harold Shapiro Chair National Bioethics Advisory Commission Suite 3C01 6100 Executive Boulevard Bethesda, Maryland 20892-7508 Dear Dr. Shapiro: This week's report of the creation of an embryonic stem cell that is part human and part COW raises the most serious of ethical, medical, and legal concerns. I am deeply troubled by this news of experiments involving the mingling of human and non-human species. I am therefore requesting that the National Bioethics Advisory Commission consider the implications of such research at your meeting next week, and to report back to me as soon as possible. I recognize, however, that other kinds of stem cell research raise different ethical issues, while promising significant medical benefits. Four years ago, I issued a ban on the use of federal funds to create human embryos solely for research purposes; the ban was later broadened by Congress to prohibit any embryo research in the public sector. At that time, the benefits of human stem cell research were hypothetical, while the ethical concerns were immediate. Although the ethical issues have not diminished, it now appears that this research may have real potential for treating such devastating illnesses as cancer, heart disease, diabetes, and Parkinson's disease. With this in mind, I am also requesting that the Commission undertake a thorough review of the issues associated with such human stem cell research, balancing all ethical and medical considerations. I look forward to receiving your reports on these important issues. Sincerely, Bin Cunton National Institutes of Health Department of Health and Human Services March 30, 1999 FACT SHEET ON STEM CELL RESEARCH The Department of Health and Human Services (DHHS) has concluded that current law permits federal funds to be used for research utilizing human pluripotent stem cells. The National Institutes of Health (NIH) plans to move forward in a careful and deliberate fashion to develop rigorous guidelines that address the special ethical, legal, and social issues relevant to this research. The NIH will not fund research using human pluripotent stem cells until guidelines are developed and widely disseminated to the research community and an oversight process is in place. The Promise of Stem Cell Research Scientists have recently isolated and successfully cultured human pluripotent stem cells¹. These human pluripotent stem cells have an unlimited capacity to divide, and the ability to develop into most of the specialized cells or tissues in the body. This advance represents a major step forward in human biology and has generated much enthusiasm and interest among scientists and the public, particularly patients and their families. Because these cells can give rise to many different types of cells, such as muscle cells, nerve cells, heart cells, blood cells, and others, they are enormously important to science and hold great promise for advances in health care. For example, further research using pluripotent stem cells may help us: Generate cells and tissue that could be used for transplantation. Pluripotent stem cells may be stimulated to develop into many different specialized cells of the body, which may someday be used as replacement cells and tissue to treat many diseases and conditions including Parkinson's disease, spinal cord injury, stroke, burns, heart disease, diabetes, and arthritis. Improve our understanding of the complex events that occur during normal human development and also help us understand what goes wrong to cause diseases and conditions such as birth defects and cancer. Change the way we develop drugs and test them for safety and potential efficacy. New medications could be tested using human pluripotent stem cells, such as liver cells or skin cells; only the drugs which are both safe and appear to have a beneficial effect would graduate to human testing. Legal Issues These human pluripotent stem cells were isolated using two different methods. One group of ¹Michael Shamblott, et al, Derivation of pluripotent stem cells from cultured human primordial germ cells. PNAS, 95: 13726-13731, Nov. 1998. James Thomson, et al, Embryonic stem cell lines derived from human blastocysts. Science, 282: 1145-1147, Nov. 6, 1998. scientists derived the pluripotent stem cells from early-stage embryos donated by people who were undergoing fertility treatment in an in vitro fertilization (IVF) clinic. Another group of scientists isolated the pluripotent stem cells from non-living fetuses obtained from pregnancies that had been terminated. In both cases, all of the individuals gave full informed consent for the embryos or fetal tissue to be used in research. Neither research project utilized federal funds. Because of the regenerative capacity of pluripotent stem cells, a single culture of human pluripotent stem cells could supply numerous other researchers. Federal law currently prohibits the DHHS from funding human embryo research. In light of this legislative ban, the Director of the NIH sought a legal opinion from the DHHS Office of the General Counsel on whether DHHS funds may be used for research utilizing human pluripotent stem cells. After a thorough analysis of the law, DHHS concluded that the congressional prohibition on the use of DHHS funds for certain types of human embryo research does not apply to research utilizing human pluripotent stem cells because such cells are not embryos. The legal opinion also clarified that human pluripotent stem cells derived from non-living fetuses would fall within the legal definition of human fetal tissue and are, therefore, subject to certain Federal restrictions on the use of such tissue. Thus, research using pluripotent stem cells derived from human embryos can be funded by DHHS. Research that generates and uses pluripotent stem cells from non-living fetuses can also be supported by DHHS, subject to existing law and regulation. NIH Support In view of the scientific and medical benefits that may result from research using pluripotent stem cells, the NIH plans to fund research using these cells. It is essential that the Federal government play a role in funding and overseeing the conduct of this research, so that all scientists--both privately and federally funded--have the opportunity to pursue this important line of research. Federal funding will provide oversight and direction that would be lacking if this research were the sole province of industry and academe. The NIH understands and respects the compelling ethical, legal, and social issues relevant to pluripotent stem cell research and is sensitive to the need for stringent oversight of this research that goes beyond the traditional NIH scientific peer review process. In light of these issues, the NIH plans to move forward in a careful and deliberate way, prior to funding any research utilizing pluripotent stem cells. In an effort to ensure that any research utilizing human pluripotent stem cells is appropriately and carefully conducted, the NIH will convene a Working Group of the Advisory Committee to the Director (ACD), NIH to advise the ACD on guidelines and oversight for research involving human pluripotent stem cells, at the Bethesda Marriott, 5151 Pooks Hill Road, Bethesda, Maryland 20814, on April 8, 1999. The meeting will begin at approximately 9:00 a.m. and end at approximately 5:30 p.m. The goal of the Working Group is to provide advice to the ACD about the scientific, ethical, legal, and social issues relevant to guidelines for the conduct of research utilizing human pluripotent stem cells. The working group will meet in public session and will be composed of scientists, patients and/or their families, ethicists, clinicians and lawyers. They will be asked to consider advice from the National Bioethics Advisory Commission (NBAC), the public, and the Congress. Once developed, guidelines for research utilizing human pluripotent stem cells will be published in the Federal Register for public comment. Until both the guidelines and the oversight process are in place, interested investigators have been notified, via the NIH web site, NIH program staff, and the Deputy Director for Intramural Research that they cannot use DHHS funds to conduct research using human pluripotent stem cells. Congress of the United States Mashington, DC 20515 February 11, 1999 The Honorable Donna E. Shalala Secretary of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Madam Secretary: Last month the General Counsel at HHS, Harriet Rabb, issued a memorandum to Dr. Harold Varmus, Director of the National Institutes of Health (NIH), supporting the claim that taxpayer funds may be used for research on stem cells taken from living human embryos. Shortly thereafter, and using the Rabb memo as a basis, Dr. Varmus announced that NIH will reverse current federal policy and begin funding research which relies on the mutilation and destruction of human embryos. We wish to express to you, in the strongest possible terms, our objection to Ms. Rabb's memo and to Dr. Varmus's decision. Any NIH action to initiate funding of such research would violate both the letter and spirit of the federal law banning federal support for research in which human embryos are harmed or destroyed.¹ Rather than providing guidance on how best to implement the law that Congress passed and the President signed, the memorandum appears to be a carefully worded effort to justify transgressing that law. In her memorandum Ms. Rabb makes significant errors on the way to her conclusion that it would be permissible for NIH to fund research using stem cells harvested from human embryos. We call upon you to correct the General Counsel's interpretation and to reverse Dr. Varmus's decision. Since January 1996, Congress has included in the annual Labor, Health and Human Services, Education Appropriations Act a section prohibiting funding for this type of research. Section 511 of the most recently enacted research funding bill, Public Law 105-277, provides (in part) that-- (a) 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 greater than that allowed for research on fetuses in utero under CFR 46.208(a)(2) and section 498(b) of the Public Health Service Act (42 U.S.C. 289g(b)). PRINTED ON RECYCLED PAPER SENT BY The Honorable Donna E. Shalala February 11, 1999 At the start of her analysis, the General Counsel unilaterally narrows the meaning of "research in which a human embryo or embryos are destroyed" and states that it prohibits only direct federal funding of the specific act of destroying the embryo. In this way she limits the scope of the law passed by Congress. While the act of destroying or injuring an embryo would certainly be ineligible for Federal funding, the law has a broader application. It also bars the use of tax dollars to fund research which follows or depends upon the destruction of or injury to a human embryo. Congress could have structured paragraph (2) of subsection (a) of the law like paragraph (1) and simply prohibited the use of funds for the destruction or discarding of human embryos. We did not do that, and by established rules of statutory construction, IIHS may not construe the law's provision on "research in which" embryos are destroyed as narrowly as its provision on the creation of embryos.² Instead. we prohibited the funding of research projects in which the lothal dissection or harmful manipulation of living human embryos is a necessary prerequisite, including projects where the material used in the experiments is obtained by destruction of an embryo that would not otherwise be done (or not otherwise done in the same way). In congressional testimony, Dr. Varmus has confirmed that it is impossible to obtain stem cells from embryos for these experiments without destroying the embryos. The Rabb memo also ignores the policy reflected in current law on fetal tissue transplantation research using tissue from intentionally aborted children. While that law is itself open to criticism, it at least bans the use of fetal tissue in federally funded research If abortion was Induced for the purpose of providing the tissue. Under current law, federal funds may not be used for fetal tissue transplantation experiments following an abortion if the timing and method of the abortion were altered solely for the purpose of providing usable tissue for research. Yet, in the embryonic stem cell research which NIH proposes to fund, the timing, method and procedures for destroying the cmbryonic child would be determined solely by the federally funded researcher's need for usable stem cells. Finally, both-Ms. Rabb's memorandum and Dr. Varmus's testimony before a Scnate subcommittee present a new definition of "human embryo" that would undermine both the congressional rider on embryo research, and the President's own 1994 directive against using federal funds to create human embryos for research purposes. They now say that an entity is an "embryo"only if one can show that it is capable, if implanted in the womb, of becoming a born "human being." This narrow definition has no support whatsoever in federal law. When a law has two parallel clauses, one of which is deliberately written in broader terms than the other, it may not be interpreted to have the same meaning as the narrower clause. See Russello V. United States, 464 U.S. 16, 23 (1983), and cases cited therein. The Honorable Donna E. Shalala February 11, 1999 Nevertheless. researchers are already offering to use damaged human embryos in their destructive research. or even to engineer lethal defects in advance into the embryos they create for such research, in order to take advantage of this Administration cover and ignore the congressional and presidential directives altogether. For more than 20 years, Federal laws and regulations have protected the human embryo and fetys from harmful experimentation at the hands of the Federal government - regardless of whether the embryo is "perfect" or damaged, wanted or unwanted, intended for abortion or intended for live birth. This area of law has provided a bulwark against government's misuse and exploitation of human beings in the name of medical progress. It would be a travesty for this Administration to attempt to unravel this accepted ethical standard. We urge you to review this issue carefully, and to put a stop to a proceeding which so clearly does violence to the meaning and intent of Federal law. Sincerely, Spen JAY DICKEY. M.C. SPENCER BACHUS. M.C. Hanny Hyde HENRY J. HYDE, M.C. Ron Pasbard RON PACKARD, M.C. JOE BARTON, M.C. fe Barban Dan Burton DAN BURTON, M.C. Billy Jangin W.J. (BILLY) TAUZIN, M.C. DUNCAN HUNTER, M.C. 2 SENT BY The Honorable Donna E. Shalala February 11, 1999 JOSEPH R. PITTS, M.C. GARY G Says MILLER, M.C. nD Don Yenns Tood Tight RONLEWIS, M.C. TODD TIAHRT M.C. Robert. ROBERT B. ADERHOLT, Adertees M.C. CHIP PIC PING, M.C PETER Pitcking T. KING, M.C. JO N SHIMKUS, M yr ЛМ Jine RYUN, M.C. Laz STEPHEN E. BUYER, M.C. Ron Paul BOB SCHAFFER, M.C. RON PAUL, M.C. Pet Horbeta Pas RETE SESSIONS, M.C. Sussis PETER HOEKSTRA, M.C. The Honorable Donna E. Shalala February 11, 1999 JOHN John COOLITTLE, T. M.C. Dolittle JOHN Jon HOSTETTLER, Hostetler M.C. David Mclatool DAVID M. McINTOSH, M.C. RICK HILL Rick M.C. Hill HELEN CHENOWETH, M.C. JAMES J A BARCIA, Barcia M.C. Eluis SmiTh CHARLES Clinit. T. CANADY, Conada M.C. CHRISTOPHER H. SMITH, M.C. Six Rahall Steve Largent NICKT. RAHALL П, M.C. STEVE LARGENT. M.C. Did Anny Ravie Show RICHARD K. ARMEY, M.C. RONNIE SHOWS, M.C. Majority Leader Rom alohm / BALANT TOM A. COBURN, M.C. LINCOLN DIAZ-BALART, M.C. 3 The Honorable Donna E. Shalala February 11, 1999 CHRIS CROK JOHNMM.C. K KEVIN BRADY. M.S. Brany Aar ASA HUTCHINSON, M.C PHIL ENGLISH, M.C. Part Road Tom Tanus PAUL RYAN,M.C. TOM TANCREDO, M.C. ROBERT Bob W. NEY, ny M.C. JIM TALENT. M.C. Jack Metar Donald A. Manzyllo JACK METCALF, M.C. DONALD A. MANZULLO, M.C. DEMINT. Jim M.C. DeMint PaweWeller JIM DAVE Tom Lex WELDON, M.G. RAY LaHOOD, M.C. TOM LATHAM, M.C. The Honorable Donna E. Shalala February 11, 1999 Ray Blent Ave Myricl ROY BLUNT. M.C. SUE MYRICK, M.C. CHARLES Charles H. TAYLOR, H. Dolor M.C. Phil Crave PHILIP M. CRANE. M.C. Ed Whitfit Sym Charat ED WHITFIELD, M.C. STEVE CHABOT, M.C. mile Fabs make Souder MICHAEL P. FORBES. M.C. MARK E. SOUDER, M.C. JOHN John E. PETERSON. E M.C. Peterson TOM Majority Iom DoLAY, Whip M.C. Delay MA COB BARR, M.C RICHARD H. BAKER, M.C. Mahr Mr Intyn Vinge Broon MIKE McINTYRE. M.C. VIRGIL H. GOODE, Jr., M.C. " 4 The Honorable Donna E. Shalala February 11, 1999 Daird D. Pholps Ling Dan DAVID D. PHELPS, M.C. LINDSAY O. GRAHAM. M.C. Einust lotal IKE SKELTON, M.C. ERNEST J. ISTOOK, Jr., M.C. Saloman P. Orting SOLOMON P. ORTIZ. M.C. J.C. WATTS, Jr., M.C. Republican Conference Chairman THE SECRETARY OF HEALTH AND HUMAN SERVICES WASHINGTON. D.C. 20201 USA FEB 23 1999 The Honorable Jay Dickey U.S. House of Representatives 2453 Rayburn House Office Building Washington, DC 20515 Dear Mr. Dickey: Thank you for your letter dated February 11, 1999, concerning the recent announcement by the Director of the National Institutes of Health (NIH) regarding federal funding for research utilizing human pluripotent stem cells. As you know, this research has the potential to lead to great progress in our treatment of debilitating and deadly diseases, our understanding of human development and our ability to develop and test new drugs. Stem cell research is richly promising, yet raises important ethical issues. Therefore, Dr. Varmus and his colleagues at the National Institutes of Health (NIH) will proceed with great caution to ensure that the highest standards are set before moving forward in this area. In keeping with the important ethical concerns that must be considered, the NIH plans to proceed in a careful and deliberate fashion to develop rigorous guidelines. A working group of the Advisory Committee to the Director of NIH will develop guidelines for the conduct of research using pluripotent stem cells and will recommend an oversight mechanism for protocol review. The National Bioethics Advisory Commission is studying these issues and will provide us with advice that - together with counsel from outside experts, Congress and other interested parties -- will help ensure appropriate oversight. First and foremost, these guidelines will ensure that any research funded in this area is consistent with the prohibition on federal funding for human embryo research contained in section 511 of the HHS appropriations law. Since this prohibition was first enacted in 1996, the Department of Health and Human Services (HHS) has conscientiously adhered to its strictures. For example, we have included the restriction on the use of funds in the NIH Grants Policy Statement and have issued notices reminding NIH intramural staff and the extramural research community that they must observe the prohibition. When necessary, we have not and will not hesitate to take appropriate enforcement action. I am firmly committed to our continued adherence to the law. Your letter makes specific inquiries regarding a legal memorandum on this subject from the HHS General Counsel. You suggest that the legal analysis is problematic because it relies on a new definition of human embryo that would undermine the Congressional prohibition. In fact, the memorandum relies on the definition provided in the statute itself. The statute defines human embryo as "any organism ... that is derived from one or more human gametes or diploid cells." 168505 P.02 FEB-23-1999 10:04 2026907203 Page 2 - The Honorable Jay Dickey The legal memorandum, relying on the scientific definition of the word "organism", concludes that the stem cells at issue are not organisms and therefore cannot be considered human embryos under section 511 of the HHS appropriations law. The prohibition on federal funding for human embryo research bars the expenditure of federal funds for the creation of a human embryo for research purposes or for research in which a human embryo is destroyed, discarded or knowingly subject to greater than minimal risk. You suggest that this provision should be read to also bar federal funding for research which follows or depends upon the destruction of or injury to a human embryo. The plain language of the statute supports the opinion issued by the General Counsel. The law applies by its terms to research in which "a human embryo or embryos are destroyed, discarded" or subjected to more than minimal risk, and not to research preceding or following such research projects. Moreover, I have been advised that there is nothing in the legislative history to suggest that the provision was intended to prohibit funding for research in which embryos - organisms - are not involved. I have reviewed our Department's position and am reassured that proceeding cautiously with research on existing pluripotent stem cell lines is both legal and appropriate. Further, it will allow the NIH to foster world-class research on stem cells, assure appropriate oversight, and bring together the finest minds and facilities to further medical and scientific advances. Allow me to assure you that the NIH understands and respects the deep convictions of people in the research, academic and religious communities, and in Congress, and intends to seek the advice and comment of those communities as we move ahead. I look forward to working with you to ensure that the legal and ethical issues involved in this extremely promising area of research are addressed. Sincerely, Down E Shlol Donna E. Shalala P.03 FEB-23-1999 10:04 2026907203 D:2026907203 PAGE 3/4 FEB-17-99 14:12 FROM:DHHS os 105 EX SEC Hnited States Senate WASHINGTON, DC 20510 February 12, 1999 The Honorable Donna E. Shalala The Department of Health and Human Services 200 Independence Avenue, SW SPECIAL Washington, D.C. 20201 Dear Secretary Shalala: We are deeply concerned with what appears to be a unilateral attempt on your part to effectively undermine congressional intent, by circumventing the current federal funding ban on embryo research. Of particular concern to us is testimony Dr. Varmus gave on January 26, 1999, during a hearing before the Appropriations Subcommittee on Labor, Health and Human Services and Education. During Dr. Varmus' testimony he stated, "Dr. Thomson and his co-workers derived pluripotent stem cells from the blastocyst stage of an early embryo- the embryos used were donated by couples who were receiving infertility treatment; this derivation of stem cells from the embryo does fall under the ban on Federal funding." The contention being made is that once the stem cells are derived, federal funding of research which directly relies on such destruction is acceptable. We disagree. Also of concern to us is Dr. Varmus' response to a statement by some researchers that human pluripotent stem cells may come together in culture to begin developing as an embryo. If this does occur, then NIH would be directly violating the congressionally imposed ban by funding embryonic stem cell research. Dr. Varmus stated that he was unsure if it does occur, and that it would be "grossly unethical" to try to find out because that would involve implantation. If the director of the National Institutes of Health is unsure, then the proper course of action would be to take no action. Better to em on the side of preserving congressional intent than destroying it. Congress never intended for the National Institutes of Health to give incentives for the killing of human embryos for the purpose of stem cell research. We are very interested in any further insight you might provide on this issue and look forward to hearing from you soon. Sincerely, In Nickled 99FEB17 All 9:53 COSTED 168409 2026907203 99% P.03 FEB-17-1999 13:15 6 FEB-17-99 14:13 FROM:DHHS os 105 EX SEC ID 2026907203 PACE 4/4 Donkul Bob Smith JOH KyL Jesse Helms Midael Michael John amount SPECIAL 02-17-99-0011 2026907203 P.04 FEB-17-1999 13:15 THE SECRETARY OF HEALTH AND HUMAN SERVICES WASHINGTON, D.C. 20201 The Honorable Don Nickles MAR 2 1999 United States Senate 133 Hart Senate Office Building Washington, DC 20510 Dear Senator Nickles: Thank you for your letter dated February 11, 1999, concerning the recent announcement by the Director of the National Institutes of Health (NIH) regarding federal funding for research utilizing human pluripotent stem cells. As you know, this research has the potential to lead to great progress in our treatment of debilitating and deadly diseases, our understanding of human development and our ability to develop and test new drugs. Stem cell research is richly promising, yet raises important ethical issues. Therefore, Dr. Varmus and his colleagues at the National Institutes of Health (NIH) will proceed with great caution to ensure that the highest standards are set before moving forward in this area. In keeping with the significant ethical concerns that must be considered, the NIH plans to proceed in a careful and deliberate fashion to develop rigorous guidelines. A working group of the Advisory Committee to the Director of NIH will develop guidelines for the conduct of research using pluripotent stem cells and will recommend an oversight mechanism for protocol review. The National Bioethics Advisory Commission is studying these issues and will provide us with advice that - together with counsel from outside experts, Congress and the public - will help ensure appropriate oversight. First and foremost, these guidelines will ensure that any research funded in this area is consistent with the prohibition on federal funding for human embryo research contained in section 511 of the HHS appropriations law. Since this prohibition was first enacted in 1996, the Department of Health and Human Services (HHS) has conscientiously adhered to its strictures. For example, we have included the restriction on the use of funds in the NIH Grants Policy Statement and have issued notices reminding NIH intramural staff and the extramural research community that they must observe the prohibition. When necessary, we have not and will not hesitate to take appropriate enforcement action. I am firmly committed to our continued adherence to this law. You have asked whether pluripotent stem cells may come together in culture to begin developing as an embryo. The scientific knowledge base about pluripotent stem cells comes from years of experience in animal research. Mouse pluripotent stem cells grown in a petri dish can give rise to specialized cells and tissues which sometimes form an aggregated structure, similar to certain tumors of the ovary and testis, termed an "embryoid body." These mouse embryoid bodies, however, are not embryos. Similarly, in one report on the derivation of human pluripotent stem cells, researchers observed that the human pluripotent stem cells can form embryoid bodies that are similar in structure to mouse embryoid bodies, which, as noted above, are not embryos. 168409 MAR-02-1999 17:58 97% P.02 Page 2 - The Honorable Don Nickles I have reviewed our Department's position and am reassured that proceeding cautiously with research on existing pluripotent stem cell lines is both legal and appropriate. Further, it will allow the NIH to foster world-class research on stem cells, assure appropriate oversight of such research, and bring together the finest minds and facilities to further medical and scientific advances. I assure you that the NIH understands and respects the deep convictions of people in the academic, religious and bioethics communities, and in Congress, and intends to seek the advice and comment of those communities as we move ahead. I look forward to working with you to ensure that the legal and ethical issues involved in this extremely promising area of research are addressed. GS Donna E. Shalala Sincerely, MAR-02-1999 17:58 97% P.03 Congress of the United States Mashington, DC 20515 SPECIAL March 15, 1999 The Honorable Donna E. Shalala WIRDL CENTER Secretary of Health and Human Services 99 HAR 16 PH 4:32 200 Independence Avenue, S.W. Washington, D.C. 20201 Dear Madam Secretary: Thank you for responding so quickly to our February 11 letter concerning federal funding of research in which human embryos are destroyed. Unfortunately, your letter was not responsive to our concerns but only raises further questions. Consequently, we once again are compelled to point out that well-established rules of statutory construction have been ignored by the HHS General Counsel's memorandum reinterpreting current law on embryo research. The Supreme Court of the United States, as we noted in our earlier correspondence, has ruled that two parallel clauses of a law may not be interpreted in the same way if Congress expresses one provision narrowly and the other broadly. Had Congress intended only to ban the use of funds for the specific act of destroying or discarding embryos, Congress would have done that. Instead, Congress prohibited funding of "research in which" embryos are destroyed or discarded. For this reason, your contention that "the plain language of the statute supports the opinion issued by the General Counsel" remains unconvincing. In fact, your conclusion that the ban was not intended to cover "research preceding or following" such destruction contradicts NIH's own policy and practice ever since the funding ban was first enacted. In 1997, for example, researcher Mark Hughes was found to be in violation of this law and dismissed from NIH. His violation was that he had used NIH-funded equipment to analyze genetic material obtained from human embryos. NIH funds were used in research which followed the harvesting of a cell from an embryo; in cases where a genetic defect was found, the analysis may also have preceded the discarding of an embryo. There was never any indication that the NIH equipment was used to destroy embryos. Yet in testimony before the House Commerce Subcommittee on Oversight and Investigations on June 19, 1997, NIH Director Harold Varmus agreed that the ban had been violated and he assured Congress that NIH had taken "several steps to further diminish the risk of subsequent violations." Now HHS proposes that these types of violations become the norm. We would also point out that the context in which the funding ban was enacted supports NIH's enforcement of the law from its enactment in January 1996 until Dr. Varmus's announcement in January 1999. Congress passed the law in response to a 1994 report from the NIH Human Embryo Research Panel. The panel recommended taxpayer support of "research involving the development of embryonic stem cells" as part of its recommendations on funding of PRINTED ON RECYCLED PAPER 8 The Honorable Donna E. Shalala page two "various areas of research involving the ex utero preimplantation human embryo." The panel treated embryonic stem cell research as a form of embryo research because it knew that the cells would have to be obtained by destroying embryos. When Congress rejected the recommendations of the NIH panel by enacting the current funding ban, it did not make any exceptions. It rejected this form of experimentation as well. In this context, it is remarkable that your February 23 letter proposes the Advisory Committee to the Director of NIH as the body that will ensure respect for ethical and legal standards in this research. This committee unanimously endorsed the original recommendations of the Human Embryo Research Panel - including proposals for special creation of embryos for research purposes that were immediately rejected by President Clinton. This same committee openly planned a lobbying campaign to prevent Congress from enacting the ethical protections that remain in law today. Thus we are more concerned than ever that HHS's current course is less a good-faith interpretation of the law than an attempted end-run by those who have always opposed the law. With regard to the definition of human embryo', we are not troubled at all by HHS's use of a scientific definition of the word "organism." As the HHS General Counsel rightly states, an "organism" includes any "individual constituted to carry out all life functions," including a one- celled individual. Rather, we are troubled by the paragraph in which she completely ignores this definition and states that "a human embryo, as that term is virtually universally understood, has the potential to develop in the normal course of events into a living human being." Ms. Rabb declares on behalf the Department, with an appeal to no authority in science or law, that virtually no one considers a human embryo to actually be a living human being. This position simply contradicts the definitions which Ms. Rabb used a few lines before this in her memo to establish that a human embryo is an organism, and, as such, is an "individual constituted to carry out all life functions" of a human being. In other words, an embryo is a human being. Ms. Rabb's statement that certain cells "do not have the capacity to develop into a human being, even if transferred to a uterus" leaves a doubt in our mind as to the point in biological development when Ms. Rabb considers a "human being" to come into existence, or whether she considers any child before birth to be a "human being." This is not an insignificant point. If the potential or capability of something "to develop into a living human being" is the standard used to determine whether an organism is a human embryo, and HHS does not consider a "human being" to exist before live birth, then the entire law on embryo research, as well as President Clinton's directive against special creation of research embryos, is undermined. Scientists have already offered to conduct their destructive experiments on damaged embryos not expected to survive to live birth, or to engineer lethal defects into embryos in advance, so that the human embryos they create for purposes of destructive research will not legally be "embryos" at all. I Current law provides that, "For purposes of this section, the term 'human embryo or embryos' include any organism, not protected as a human subject under 45 CFR 46 as of the date of the enactment of this Act, that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes or human diploid cells." The Honorable Donna E. Shalala page three This new and arbitrary use of the term "human being" also contradicts the entire history of federal regulations on human experimentation which, since 1975, have treated the child in the womb at every stage of development as a "human subject" to be protected from harmful research. In commissioning studies of ethical issues in genetics, Congress has urged respect for "the essential equality of all human beings, born and unborn" (42 USC 300v-1). Clearly, in science and law, a human embryo has no need to "develop into" a human being because it already is a human being. The fact that a particular embryo may ultimately have a longer or shorter life span is irrelevant in this regard. It would be akin to HHS claiming that a seriously ill infant is not really an infant because he or she most likely will not "develop into" a live adult. Even if HHS's arbitrary definition were valid, the General Counsel's statement that pluripotent stem cells "do not have the capacity to develop into a human being, even if transferred to a uterus" is open to question. On January 26, Dr. Varmus testified that he does not know whether these stem cells may sometimes recongregate in culture to begin developing as a human embryo. He added that it would be "grossly unethical" to transfer these cells into a woman's uterus to try to answer this question. Would it not also be grossly unethical to simply ignore this question and pursue such embryonic stem cell research, particularly if NIH admits that it may violate the law? Finally, your letter makes no reference to the precedent established by current law on the use of fetal tissue from induced abortions. Under this law, which also specifically covers cells and tissue obtained from embryos, the harvesting procedure itself must not destroy prenatal life, and the timing and method for taking life must not be influenced solely by the needs of the federally funded research project. These principles are violated by the Administration's proposal for stem cell research. Madam Secretary, because these are complex and important issues, we urge you once again to address our very serious concerns. For three years the ban on taxpayer funding of harmful research involving human embryos was enforced clearly and appropriately. The change in policy proposed by Dr. Varmus, based on the faulty reasoning in your General Counsel's memo, would violate the funding ban and mark a tragic step backward in federal standards for research involving human subjects. Sincerely, Celuir Smith Dadich 9 page four Mil Rhall Dont Mathsh Bot-May Pete Rete sessions Steve Largest Jack Metcalf Barbara Culin John Hostetter John T.Daritte David D. Philse Dan Buton KimBanny Rick J Lill Brooy Vigil Doobe The Honorable Donna E. Shalala page five In Rey Heen Mark Souder Ron Paul Rondevis he Myinl Phil Craue John E Peterson Jim Rynn Tom Dehay Pite King Donald A. Mangullo Cly Rhy Tost Tiahet for U.Colum Jim DeMint page six make Forber Gay smille Phil English Clos T. Comely Orman Huns Hing Hyde Jue Barton Asnual rhun Tan Tancudo As Hulchn Shm charaí - MA Ray Blunt The Honorable Donna E. Shalala page seven Garl Ryan SPECIAL 03-16-99-0062 11 Congress of the United States Mashington, DC 20515 Statement of Members of the House of Representatives to the Working Group of the Advisory Committee to the Director of the National Institutes of Health APRIL 8, 1999 When Dr. Harold Varmus announced in January that he would reverse current policy and begin using taxpayer funds for research on stem cells taken from living human embryos, we -- together with many of our colleagues -- wrote to Health and Human Services Secretary Donna Shalala to protest. As the ban on such funding originated in Congress, and has been consistently opposed by this Administration, we believe we have something to contribute to today's proceedings, particularly with regard to the legality of Dr. Varmus's plan. Put simply, any NIH action to initiate funding of research which relies on the mutilation and destruction of human embryos would violate both the letter and spirit of the federal law banning federal support for research in which human embryos are harmed or destroyed. We believe the memorandum from HHS General Counsel Harriet Rabb to Dr. Varmus supporting the claim that taxpayer funds may be used for experiments on embryonic stem cells is wrong. Rather than providing guidance on how best to implement the law that Congress passed and the President signed, the memorandum appears to be a carefully worded effort to justify transgressing that law. The General Counsel unilaterally narrows the meaning of "research in which a human embryo or embryos are destroyed" and states that it prohibits only direct federal funding of the specific act of destroying the embryo. While the act of destroying or injuring an embryo would certainly be ineligible for federal funding, the law has a broader application. It also bars the use of tax dollars to fund research which follows or depends upon the destruction of or injury to a human embryo. Congress could have structured paragraph (2) of subsection (a) of the law like paragraph (1) and simply prohibited the use of funds for the destruction or discarding of human embryos. We did not do that, and by well-established rules of statutory construction, HHS may not construe the law's provision on "research in which" embryos are destroyed as narrowly as its provision on the creation of embryos. The Supreme Court of the United States has ruled that two parallel clauses of a law may not be interpreted in the same way if Congress expresses one provision narrowly and the other broadly. Had Congress intended only to ban the use of funds for the specific act of destroying or discarding embryos, Congress would have done that. Instead, Congress prohibited funding of "research in which" embryos are destroyed or discarded. 1 In fact, the Secretary's conclusion that the ban was not intended to cover "research preceding or following" such destruction contradicts NIH's own policy and practice ever since the funding ban was first enacted. In 1997, for example, researcher Mark Hughes was found to be in violation of this law and dismissed from NIH because he had used NIH-funded equipment to analyze genetic material obtained from human embryos. NIH funds were used in research which followed the harvesting of a cell from an embryo; in cases where a genetic defect was found, the analysis may also have preceded the discarding of an embryo. There was never any indication that the NIH equipment was used to destroy embryos. Yet in testimony before the House Commerce Subcommittee on Oversight and Investigations on June 19, 1997, NIH Director Varmus agreed that the ban had been violated, and he assured Congress that NIH had taken "several steps to further diminish the risk of subsequent violations." Now NIH proposes that these types of violations become the norm. We would also point out that the context in which the funding ban was enacted supports NIH's enforcement of the law from its first enactment in January 1996 until Dr. Varmus's announcement in January 1999. Congress passed the law in response to a 1994 report from the NIH Human Embryo Research Panel. The panel recommended taxpayer support of "research involving the development of embryonic stem cells" as part of its recommendations on funding of "various areas of research involving the ex utero preimplantation human embryo." The panel treated embryonic stem cell research as a form of embryo research because it knew that the cells would have to be obtained by destroying embryos. When Congress rejected the recommendations of the NIH panel by enacting the current funding ban, it did not make any exceptions. It rejected this form of experimentation as well. Even members of the National Bioethics Advisory Commission (NBAC) criticized Ms. Rabb's memo as "disingenuous" for attempting to draw a line between actually destroying embryos for research purposes and using the cells derived from that destruction. According to a news report, NBAC member Alex Capron, co-director of the Center for Health Policy and Ethics at University of Southern California, was quoted as saying, "I don't believe use and derivation can be separated." John Fletcher, a biomedical ethicist from the University of Virginia expressed the belief that HHS and NIH were relying on an excessively legalistic interpretation and said the legal argument "is not an ethical argument. It is an opinion that use can be separated from derivation, as if derivation is not relevant." He continued, "As a moral construct I think that is very weak and evasive." (Source: Washington FAX, March 4, 1999) Dr. Varmus's plan and the Rabb memorandum also ignore the policy reflected in current law on fetal tissue transplantation research using tissue from intentionally aborted children. While that law is itself open to criticism, it at least bans the use of fetal tissue in federally funded research if abortion was induced for the purpose of providing the tissue. Under current law, which also specifically covers cells and tissue obtained from embryos, federal funds may not be used for fetal tissue transplantation experiments following an abortion if the timing and method of the abortion were altered solely for the purpose of providing usable tissue for research. Yet, in the embryonic stem cell research which NIH proposes to fund, the timing, method and procedures for destroying the embryonic child would be determined solely by the federally funded researcher's need for usable stem cells. 2 Finally, both Ms. Rabb's memorandum and Dr. Varmus's testimony before a Senate subcommittee present a new definition of "human embryo" that would undermine both the congressional funding ban on embryo research, and the President's own 1994 directive against using federal funds to create human embryos for research purposes. Ms. Rabb states that "a human embryo, as that term is virtually universally understood, has the potential to develop in the normal course of events into a living human being." She declares on behalf the Department of Health and Human Services, with an appeal to no authority in science or law, that virtually no one considers a human embryo to actually be a living human being. This position simply contradicts the definitions which Ms. Rabb used a few lines before this in her memo to establish that a human embryo is an organism, and, as such, is an "individual constituted to carry out all life functions" of a human being. In other words, an embryo is a human being. The position that an entity is an "embryo" only if one can show that it is capable, if implanted in the womb, of becoming a born "human being" has no support whatsoever in federal law. Nevertheless, researchers are already offering to use damaged human embryos in their destructive research, or even to engineer lethal defects in advance into the embryos they create for such research, in order to take advantage of this Administration cover and ignore the congressional and presidential directives altogether. This new and arbitrary use of the term "human being" also contradicts the entire history of federal regulations on human experimentation which, since 1975, have treated the child in the womb at every stage of development as a "human subject" to be protected from harmful research. In commissioning studies of ethical issues in genetics, Congress has urged respect for "the essential equality of all human beings, born and unborn" (42 USC 300v-1). Clearly, in science and law, a human embryo has no need to "develop into" a human being because it already is a human being. The fact that a particular embryo may ultimately have a longer or shorter life span is irrelevant in this regard. It would be akin to HHS claiming that a seriously ill infant is not really an infant because he or she most likely will not "develop into" a live adult. Even if HHS's arbitrary definition were valid, the General Counsel's statement that pluripotent stem cells "do not have the capacity to develop into a human being, even if transferred to a uterus" is open to question. On January 26, Dr. Varmus testified that he does not know whether these stem cells may sometimes recongregate in culture to begin developing as a human embryo. He added that it would be "grossly unethical" to transfer these cells into a woman's uterus to try to answer this question. Would it not also be grossly unethical to simply ignore this question and pursue such embryonic stem cell research, particularly if NIH admits that it may violate the law? For more than 20 years, Federal laws and regulations have protected the human embryo and fetus from harmful experimentation at the hands of the Federal government -- regardless of whether the embryo is "perfect" or damaged, wanted or unwanted, intended for abortion or intended for live birth. This area of law has provided a bulwark against government's misuse and exploitation of human beings in the name of medical progress. It would be a travesty for this Administration to attempt to unravel this accepted ethical standard. 3 We urge you to recommend that the Director rescind his decision to begin funding research involving the manipulation and destruction of living human embryos and continue to enforce the embryo research funding ban as Congress intended. Respectfully, The Honorable Jay Dickey, M.C. The Honorable Christopher H. Smith, M.C. The Honorable Rick Hill, M.C. The Honorable Steve Largent, M.C. The Honorable Ron Lewis, M.C. The Honorable Kevin Brady, M.C. The Honorable Mark E. Souder, M.C. The Honorable Bob Ney, M.C. The Honorable Gary G. Miller, M.C. The Honorable Ron Paul, M.C. The Honorable Tom A. Coburn, M.C. The Honorable John T. Doolittle, M.C. The Honorable Richard H. Baker, M.C. The Honorable Bob Schaffer, M.C. The Honorable Jim Ryun, M.C. 4