Stem Cell Century: Law and Policy for a Breakthrough Technology

The Preface to Stem Cell Century: Law and Policy for a Breakthrough Technology demonstrates the controversial, often adversarial subject the authors have undertaken. What began as a book coauthored by 2 UCLA law professors has devolved into a predominantly solo effort due to “differences in our substantive views and preferred style of presentation.” If 2 colleagues cannot reach agreement to complete a book on the topic of stem cell research and its societal ramifications, then the fractious stem cell debate presently simmering will certainly boil over as the issue comes to the forefront of the rhetoric associated with the presidential election of 2008. Coauthor Russell Korobkin—who takes sole responsibility for the entire book save the coauthored chapter 4—boldly asserts in the preface that of the many books recently published on the subject of stem cells, “[n]one of them is like this one.” Stem Cell Century delivers on this assertion, thoroughly and engagingly charting the history of the stem cell debate and predicting its future course while persuasively arguing for laws, protocols, and procedures that will maximize benefits and minimize moral conundrums regarding one of the most divisive challenges facing the nation.

Stem Cell Century begins with the basic background of stem cell research and a discussion of the Bush Administration's controversial decision not to provide federal funds for research using new stem cell lines, including a detailed analysis of the administration's view that “five-day-old blastocysts are the moral equivalent of persons.” Korobkin terms the debate over blastocysts “the embryo wars” and examines, both legally and scientifically, the opposing views before ultimately siding with those who believe blastocysts should not, in fact, be considered “human life.” Using a simple yet powerful simile—“a person who crushes an acorn is unlikely to be viewed as committing a harm equivalent to a person who chops down an enormous oak”—and analogizing the legal status of embryos resulting from in vitro fertilization, Korobkin illuminates the inconsistencies in the Bush Administration's policy and predicts Congress will pass the Stem Cell Research Enhancement Act in 2009.

In a chapter that perhaps only attorneys might truly grasp, Korobkin traces in detail the history of cloning legislation and the ensuing legal cases, wherein he concludes that a legislative ban on cloning would most likely be unconstitutional. The chapter coauthored with Stephen R. Munzer focuses on stem cell research patents and the problems associated with compensation for such patents, which ultimately might pit commercial and academic research facilities against governments—such as the state of California—that passed laws allowing for taxpayer funding of stem cell research with the expectation of generated revenue. Korobkin then discusses informed consent, the debate over compensation for human tissue donation, and the potential treatments emanating from successful stem cell research.

One of the most ethically challenging issues for physicians/researchers in the stem cell debate is that of informed consent and donation. Stem Cell Century details the problems associated with therapeutic treatments that evolve into commercially lucrative medical ventures and the challenges facing researchers who simultaneously desire a successful treatment while hoping the associated research leads to commercially viable technology. Korobkin argues convincingly for a thorough informed consent, even when a patient is not the research participant but is merely donating tissue; but in the case of a physician/researcher disclosing any financial interest to a donor, Korobkin draws a line between a therapeutic donor—who deserves full financial disclosure—and a nontherapeutic donor, for whom full disclosure might dissuade donating for research purposes. Stem Cell Century never shies from staking definitive positions and defending them legally and scientifically, positions that may well run contrary to the views of a wide swath of readers.

It is in some ways difficult to gauge the readership of Stem Cell Century beyond attorneys and perhaps policy makers, although substantial portions of the book certainly would be understood and appreciated by physicians and some laypersons. As an attorney who has written a book for physicians, I know the difficulties in explaining complex legal arguments and constitutional analysis to those whose profession is not the law (just as attorneys often find it difficult to comprehend detailed medical discussions). Physicians interested in this topic should certainly read this book because, beyond the legal and legislative discussions, the coauthors deftly map out the history and arguments surrounding the stem cell debate and provide a reasoned prognosis of the future of stem cell research and treatment.

Stem Cell Century certainly answers many of the questions swirling around the stem cell debate; however, at its core, the book poses just as many new and unique challenges facing this revolutionary technology, stimulating the debate. Korobkin and Munzer have achieved a noteworthy feat by clearly and succinctly synthesizing the most contentious issues surrounding stem cell science. At times, readers might benefit from some degree of legal experience or training to fully comprehend the analysis and arguments—but in general, Stem Cell Century is precisely what it purports to be, “a timely and provocative analysis of the broad range of policy issues raised by stem cell science and how lawmakers should address them.”