Therapeutic Promise in the Discourse of Human Embryonic Stem Cell Research

Abstract

In the recent past, biomedical research has been repeatedly promoted on the grounds that it will lead to novel cures. Future remedies have been proposed and propagated by diverse actors such as scientists, the media and patient representatives. Proposals for novel therapies based on human embryonic stem cells (hESCs) have framed the initiation, reception, and implementation of novel research in multiple ways. The Foucauldian notion of a dispositif as well as the concept of the “therapeutic promise” serve to draw attention to the central role of medical proposals in the discourse on hESC research. In particular the quest for therapies has rendered the human embryo accessible first as an object of experimental manipulation, then of public debate, and finally as the subject of regulation. This therapeutic promise has enabled a reorientation of hESC research towards medical applications, has guided public debate and, in so doing, has itself been enrolled as a legal norm. This paper highlights the work done by the therapeutic promise in initiating an alliance between bioethics and science in an endeavour that both shaped and ensured the continuation of hESC research.

Acknowledgements

I would like to thank Professor Rainer Schweizer and PD Dr Hans-Peter Bernhard for the collaboration on the project which formed the basis of this publication. In this respect I would like to thank the cogito foundation and the University of St Gallen for the financial support, which enabled this work. In particular I would like to thank Sabine Maasen, Alison Kraft, Mario Kaiser, and the editorial team for critical reading and many important comments.

Notes

1. The countries of reference were selected because they possess sufficiently similar, but yet disparate political cultures (Jasanoff, 2005, pp. 21–31). This allows for indicating the role of the therapeutic promise, as a common motif in divergent paths of regulation. The author is well aware of the geographical limitations of this analysis and would like to refer the reader to other explorations for a global view on the reception and regulation of hESC research (Bender et al., 2005).

2. A monograph discussing the single phases in more detail is in preparation.

3. In the period between the publication in 1981, which introduced for the first time the concept of embryonic stem cells in mice (Evans & Kaufmann, 1981) and the publication in 1998 on the isolation of human embryonic stem cells (Thomson et al., 1998) a partially successful attempt at isolating embryonic stem cells from human embryos had been reported (Bongso et al., 1994).

4. The absence of organized three-dimensional structures in the culture dish, which resemble those within the organism, was considered a major drawback in using embryonic stem cells for studies in developmental biology. With the advent of hESC research the status of the field of mouse embryonic stem cell biology and of the scientists involved, has improved decisively. The knowledge generated in this field constitutes, for now, the most advanced source of therapeutically relevant know how.

5. Definitions and descriptions of regenerative medicine abound, but have a common theme, the treatment of degenerative processes: ‘Regenerative medicine is the process of creating living, functional tissues to repair or replace tissue or organ function lost due to age, disease, damage, or congenital defects. This field holds the promise of regenerating damaged tissues and organs in the body by stimulating previously irreparable organs to heal themselves. Regenerative medicine also empowers scientists to grow tissues and organs in the laboratory and safely implant them when the body cannot heal itself’ (National Institutes of Health, Fact Sheet, 2007).

6. The phrase ‘regenerative medicine’ has been used to search the PubMed data base (www.ncbi.nlm.nih.gov/entrez/query.fcgi). To account for the presence of the term in different contexts its occurrence in all fields of the publication record, including title, abstract, address, key words, and journal name has been recorded.