by Russell Korobkin with Stephen R. Munzer. New Haven: Yale University Press, 2007. 336pp. Cloth $29.95. ISBN: 9780300122923.
Reviewed by Christopher A. Riddle, Department of Philosophy, Queen’s University, Canada. E-mail: 9car[at]queensu[dot]ca.
STEM CELL CENTURY, by Russell Korobkin, provides an engaging, accessible and by and large, thorough examination of the contemporary debates surrounding human embryonic stem cell research. Korobkin demystifies the science associated with the stem cell debate by providing a brief but effective overview of the methods and terminology required as foundational knowledge to allow for the refocusing of attention to the political, legal, and ethical implications of the employment of such research into practice. Korobkin clearly displays his tendencies within the debate at numerous instances throughout the book, but nevertheless, presents clear and convincing conversations representative of a variety of potential positions. Korobkin comes off as far from dogmatic in his treatment of the subject matter and, on all but the rarest occasions, supports his views thoroughly with an apt amount of consideration to opposing perspectives.
That said, STEM CELL CENTURY proceeds by providing interrelated but distinct issue specific chapters that identify three primary goals: (1) identify the most important issues raised by stem cell research; (2) describe the current state of the law for the particular issue raised; (3) offer a critical assessment of the law as well as provide proposals for the implementation of policy.
The first chapter, “The Promise and the Hype,” provides the previously mentioned synopsis of the science relevant to exploration of the contemporary debate surrounding stem cell research. Korobkin presents the reader with information concerning what stem cells are, the possibilities of stem cell research, the perceived importance of the future of stem cell medicine, as well as the potential difficulties encountered by research scientists in this pursuit. Korobkin also makes clear the distinction between “embryonic” and “adult” stem cells as this becomes particularly relevant when examining the next chapter largely concerned with the ethics of stem cell research.
The second chapter, “The Embryo Wars,” contextualizes the ethical and legal debates over embryonic stem cell research through the Bush administration policy, designed to limit public funding disseminated to stem cell scientists. Korobkin dissects the logic behind the Bush administration’s decision and is critical of affording early-stage embryos the same protections as living persons. Much attention is paid to the logic of the ethical argument put forth by Bush, but I fear there was not enough care devoted to providing a thorough analysis of the current debate. While I found this chapter the most interesting and perhaps the most skillfully presented, tracing complex ideas and dilemmas through [*217] contemporary examples accessible to most people, it is nevertheless, lacking the academic rigor necessary to offer a meaningful contribution to the debate. I find myself agreeing with the majority of concerns Korobkin puts forth in this chapter, but he nevertheless, omits many nuances associated with the debate and possible counter-remarks made by individuals who believe an early-stage embryo has the same rights as a living individual. Green (2001), Holm (2002), Devolder (2005) and Agar (2007) all offer substantial contributions to this debate and are far more thorough in their considerations than Korobkin. It is worthy of mention however, that Korobkin has succeeded in presenting these discussions to a wider audience than the aforementioned views precisely because of the overly-brief treatment he affords the debate.
The third chapter, “Cloning, Congress and the Constitution,” describes the similarities and differences between cloning human individuals and cloning cells (with only the later being of importance for stem cell research). This chapter also attempts to explain the future of regenerative medicine in light of stem cell research and cloning. Korobkin explores the constitutional law issues introduced by Congressional attempts to make both types of cloning illegal in the United States. Similar to the previous chapter, I fear the treatment of this matter is too brief to offer anything other than an introduction to the subject matter.
When discussing the Fifth Amendment rights of individuals to pursue medical treatment, Korobkin introduces an analogy between abortion rights for women and the right to pursue medical treatment for maladies vis-à-vis the possible discoveries made in the future by stem cell research. This appears to be a faulty analogy and under-supported. While it serves to contextualize Korobkin’s justification for allowing pursuit of medical treatment through stem cell research discoveries, he nevertheless fails to support the analogy. Korobkin does acknowledge how possible critics could find fault with such a comparison but fails to give such opposition just weight.
For example, Korobkin recognizes that a distinction may be made between abortion and stem cell research on the basis that abortion can be viewed as an accessible cure to alleviate negative health implications, whereas stem cell research only signifies the potentiality of a discovery of a cure. He dismisses this critique by stating that individuals should have a fundamental right not to have the government impede their search for a cure. He furthers his point by an appeal to the landmark case, ABIGAIL ALLIANCE FOR BETTER ACCESS TO DEVELOPMENT DRUGS v. VON ESCHENBACH (2006), that concerns access to pharmaceuticals.
However, this analogy falls apart on at least one front when examined in further depth. This concern involves the indirect nature of stem cell research as a cure for a malady. This can be displayed through the use of a counter-analogy. If an individual is hungry, the cure for her hunger is eating (view this as being analogous with abortion). Conversely, one cannot say of a farmer praying for rain for his crops, that he is praying for a cure for his hunger. Perhaps the flourishing of his crops can secure food for his consumption, but it is [*218] nevertheless, not a cure for his hunger (view this as being analogous with the indirect relation of stem cell research to curing a malady).
That said, the aforementioned criticisms are amongst the only I could find within the many nuanced discussions put forth by Korobkin.
Korobkin provides a thorough discussion of The United States Patent Office’s decision to allow patenting of cell stems, thus halting research by other scientists on particular cells, within the fourth chapter of STEM CELL CENTURY. Not altogether unrelated to this discussion, Chapter Five continues by examining the tax payer’s stake in the provision of public funding to stem cell scientists. It examines how private firms or researchers utilizing public funds to achieve scientific breakthroughs can patent their discoveries to keep 100 percent of the profits.
Chapter Six, “Autonomy and Informed Consent,” considers whether informed consent requirements should apply in situations when patients are not involved as the object of experimentation, but are instead asked to provide human tissues. Also, Korobkin provides an interesting discussion on whether research on embryos should require the consent of both donors who created the embryo.
Korobkin then argues against justifications in favour of prohibiting the buying and selling of critical tissues for stem cell research. Similarly, “Default Rules for Tissue Donations” discusses the rights associated with donors providing tissues for research.
Finally, STEM CELL CENTURY provides the reader with possible ethical, legal and political questions that will require addressing once stem cell research has become more prominent as a medicinal cure. These include but are not limited to: 1) Should the Food & Drug Administration regulate stem cell treatments similar to pharmaceuticals?; 2) Should the manufacturers of treatments approved by the FDA receive protection from private lawsuits not given to more conventional medical products?
STEM CELL CENTURY provides the reader with a wide breadth of knowledge surrounding debate on stem cell research. Korobkin has not only succeeded in offering a wide array of knowledge for those interested and otherwise unacquainted with the political, legal, and ethical implications of stem cell research, but has also presented this information in a fun and exciting manner, with appeal to a variety of disciplines. The shortcomings mentioned previously do not serve to diminish the impact STEM CELL CENTURY will have. It provides an excellent foundation from which the debate on stem cell research can be both understood as well as advanced. Theorists with a firm background in these debates will perhaps find Korobkin’s treatment redundant at times. However, readers with less experience in an interdisciplinary approach to the stem cell debate will find themselves engulfed in engaging contemporary examples to use as starting points for further scholarship. Not only can this title be recommended to academics otherwise unfamiliar with the field, but it is equally suitable and accessible for [*219] non-academics wishing to become familiarized with the debate.
Agar, Nicholas. 2007. “Embryonic Potential and Stem Cells.” 21 BIOETHICS 198-207.
Devolder, Katrien. 2005. “Human Embryonic Stem Cell Research: Why The Discarded-Created-Distinction Cannot Be Based on the Potentiality Argument.” 19 BIOETHICS 167-186.
Holm, Søren. 2002. “Going to the Roots of the Stem Cell Controversy.” 16 BIOETHICS 493-507.
Green, Ronald. 2001. THE HUMAN EMBRYO RESEARCH DEBATES: BIOETHICS IN THE VORTEX OF CONTROVERSY. Oxford: Oxford University Press.
ABIGAIL ALLIANCE FOR BETTER ACCESS TO DEVELOPMENT DRUGS v. VON ESCHENBACH, 495 F.3d 695, (D.C.Cir. 2006).
© Copyright 2008 by the author, Christopher A. Riddle.