Billions of dollars will be committed to hES cell research from public and private sources in the coming years. It is not yet clear exactly what specific therapeutic benefits will emerge from this investment, but there is reason for concern that they will not be equitably distributed in our current health-care system. Skeptics may argue that the social investment in science that still requires much research before any health benefits will be realized is not merited when so many basic, often technology-intensive, health services are not adequately provided.
The therapeutic possibilities inherent in hES cells can mean vastly improved lives for millions of disease sufferers, and the successful practice of regenerative medicine could yield substantial reductions in health-care expenditures. It is critical that hES cell research, especially as it approaches clinical application, serve the needs of all populations. There must be a concerted effort to ensure diversity not just in the genetic makeup of cell lines but in the approaches to clinical care. Our current health-care system is not well designed for the just distribution of the benefits of research. Besides the excellent scientific work that will surely be accomplished, institutions involved in hES cell research should concern themselves with ensuring genetic diversity in the development of cell lines and in devising health-care systems that can make the long-term benefits of this work widely available.
The hES cell research community should ensure that there is sufficient genetic diversity among cell lines to allow for potential translation into health-care services for all groups in our society.
The proposed local ESCRO committees and national forum should help to ensure that conventional and well founded research practices and protections apply to hES cell research. Among those practices is the use of in vitro and animal models before interventions that involve human subjects. Protections include minimizing the use of human gametes or embryos and ensuring that recruitment, disclosure, informed consent, and risk assessment procedures are in accord with the highest ethical standards. The consensus on prohibition of NT for reproductive purposes can also be reinforced with a rigorous system of oversight of hES cell research. With this system in place, the scientific community will signal its respect for the views of those who have ethical reservations about the research and provide an opportunity for those views to be expressed. As some have observed, when many people find a practice morally troubling—particularly one that is novel—that is an indication that further consideration is required. An initial reaction of moral alarm need not be