Stem Cells and the Future of Regenerative Medicine ... - NCBI - NIH

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of Regenerative Medicine. Committee on the Biological and Biomedical Applications of Stem Cell Research;. National Academy Press, ww.nap.edu; ISBN ...
Stem Cells and the Future of Regenerative Medicine Committee on the Biological and Biomedical Applications of Stem Cell Research; National Academy Press, ww.nap.edu; ISBN 0-309-07630-7; 94 pages This report by the National Research Council and the Institute of Medicine's Joint Committee on the Biological and Biomedical Applications of Stem Cell Research summarizes their research and deliberations on stem cells and the ethical issues raised by stem cells, especially embryonic stem cells. The report bases its recommendations on examinations of the scientific literature, presentations by scientists on their research projects and presentations by ethicists, theologians and lay individuals on the ethical and policy concerns surrounding this research. The first chapter overviews the committee's project and the possible impact of stem cells on medical practice. It also defines adult, fetal and embryonic stem cells as well as contrasts them with reproductive cloning. The second chapter addresses adult stem cells. It begins by discussing hematopoietic stem cells (HSCs), which are treated as a model for discussion of all adult stem cells. The chapter discusses the success of bone-marrow transplant and how HSCs are responsible for that success. While the chapter discusses the remarkable potential of HSCs as well as other adult stem cells to produce the multitude of cells that constitute the organs ofthe body, the majority of the chapter focuses on the limitations of adult stem cells as an avenue for regenerative medicine. The third chapter focuses on embryonic stem cells. Most of this chapter focuses on the proper-

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ties of these cells that make them ideal for regenerative medicine. Substantially less space is given to discussing their limitations than for adult stem cells. The fourth chapter summarizes the opportunities and barriers facing stem cell research. While the scientific issues are summarized here, the chapter focuses primarily on the ethical and policy issues surrounding stem cells. A multitude of ethical perspectives is presented, and public funding and oversight of the ethically controversial research is praised. The final chapter summarizes the committee's findings and its recommendations on stem cell research and regenerative medicine. The committee's recommendations range from more research on human rather than animal, stem cells, continued research on all types of stem cells despite ethical objections of some groups, and increased public oversight of stem cell research, which would be accomplished through the NIH. This report is a solid product of research and deliberation on scientific and ethical issues, yet it suffers from the weaknesses of all reports on cutting-edge science; it aims to hit a quickly moving target. While none of the scientific research discussed has been definitively disproved or discredited, recent reports have shed more light on the gene expression of embry-

JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION

onic stem cells and challenged the idea of adult stem cell plasticity. Despite this limitation, the book still provides a useful primer on stem cell research for those with minimal knowledge of the field, and the bibliography provides a useful starting point for those who want to read more about the broad range of research on stem cells. Also, much ofthe report's examination of policy occurred before President Bush's August 9, 2001 speech announcing his policy limiting embryonic stem cell research. The report makes mention of Bush's policy, but it does not address its impact on stem cell research or respond to the political debate that ensued after the policy was announced. Although it does not engage the current political debate about stem cell research, the report's discussion of and response to the ethical and policy dimensions of stem cell research provide a useful overview of the issues that medical practitioners, researchers and policy experts must address as we move toward a future of regenerative medicine.

Reviewed by John Lynch, MA Department ofSpeech Communication 110 Terrell Hall University of Georgia Athens, GA 30602 lynchjoa@uga. edu

Scientific and Medical Aspects of Human Reproductive Cloning National Academy of Sciences, National Academy of Engineering, Institute of Medicine, National Research Council, 2002; ISBN 0-30907637-4; 272 pages

The Scientific and Medical Aspects of Human Reproductive VOL. 97, NO. 7, JULY 2005 1041