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C. Christopher Hook, director of ethics education for the Mayo Graduate School of Medicine, knows blood very well. As an experienced hematologist and a senior fellow at the Center for Bioethics and Human Dignity, he's done a lot of thinking about the debate over stem cells, which we glimpsed in an interview he gave to associate editor Agnieszka Tennant. Hook stressed that his comments are his own and do not necessarily represent the views of the Mayo Clinic.

Have you used adult stem cells in therapy?

I have used adult stem cells in bone marrow and peripheral stem-cell transplantation for the treatment of diseases that otherwise would be incurable. They include acute leukemias, Hodgkin's and non-Hodgkin's lymphomas, and other serious hematologic disorders.

Are adult stem cells as good a material for healing diseases as embryonic stem cells?

Because of the limited and often disappointing use of embryonic stem cells to date, one has to honestly respond that we don't know the answer to that question. However, is it really the right or most important question to ask?

The ostensible reason cited by many scientists, clinicians, and politicians for vigorously pursuing embryo destruction or cloning is the promise for creating treatments that will help, or in the best case, heal, millions of people suffering from a whole host of diseases. If that is the real goal, and you can achieve those same therapeutic benefits without having to destroy or clone embryonic human beings, then even if embryonic stem cells might prove easier to use—still a highly debatable hypothesis—it doesn't matter. You can achieve this goal without commodifying human beings in the process.

What do we know about the effectiveness of adult stem-cell therapies?

The advances in adult stem-cell therapy development have been nothing short of astounding. I don't see any reason to believe that we will not achieve the therapeutic goals we all desire using adult stem cells. The September issue of Nature Cell Biology reviews the ability of bone-marrow derived cells to be reprogrammed after incorporation in defective tissues, healing and regenerating the organ. My friend and colleague, Dr. David Prentice, presented an excellent overview of the derivation and therapeutic use of adult stem cells before the President's Council on Bioethics (see http://bioethicsprint. bioethics.gov/background/prentice_paper.html).

Why is there such vigorous disagreement among scientists over adult stem cells?

Scientists in general do not like to hear the word no. They believe that science is an unmitigated good, and thus should not be restricted. Science has indeed benefited humanity in many ways. The products of science and technology, however, have also produced significant problems for humanity and the environment, and thus these activities require careful oversight and regulation. Unfortunately, science has evolved more into techno-science and is big business for individual scientists, universities, and industry in general. There are patents, profits, professional posturing, and political power at stake in this debate, and I fear that this is really what is driving much of the demand for unrestricted research.

Why is there an even more passionate debate among politicians over this issue?

There is a lot of political currency that comes with being seen as pro-progress, pro-health, pro-hope, and pro-science. Consequently, it is often difficult for politicians to question or oppose something that is constantly hyped as the cure for everything, even if such claims are vastly overblown, devoid of evidence, and may have a huge ethical price tag. Hope sells.

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November 2004, Vol. 48, No. 11