Thursday, May 26, 2005

Federal Funding for ESCR

The congress has been having hearings and going round and round about the virtues and dangers of federal funding for Embryonic Stem Cell research. Just as I began to blog disagreeing with this post at PowerLine on the topic Michael Medved came on the radio and started his radio show with his take. I think Paul missed the issue all together, Michael Medved gets it partially right. Hugh Hewitt got it partially right on his show yesterday. Between the last two they have what I think is most of the right answer. Being lawyers they missed what I think is the last piece of the puzzle that I shall dazzle you with at the end of this post :-)

Michael's argument 1: First, this is a highly politically and religiously controversial issue. Therefore federal funding would be tantamount to taking my money and using it for something that I am morally opposed to. I think this argument falls apart, at least on it's own. Most of the things the federal government does is opposed by a significant portion of us.

Michael's argument 2: The private sector and/or individual states are perfectly capable of providing the kind of funding that is being proposed. Rather than tax all of us to fund research some of us don't want to happen, let the private sector fund it and reap the benefits of any success. The portion of medical research provided by the feds is very small and (he didn't say this next part today that I heard but I have heard him say it before and implied it in a round about way) should be focused on those things where the private sector is unlikely to put their money because the potential payback is too small (orphan diseases, if you don't know about the plight of these people go google it).

Michael's argument 3: The federal government should not be involved where they don't need to be. This ties to the last part of #2 above. The private sector cannot go to war and they cannot patrol the borders, etc. The private sector does have the ability to do this, ergo the federal government should keep its nose out. I agree with this philosophy and its applicability to this issue. I would guess most of the 48% of the people who voted for John "I have finally signed my standard form 180 and will turn it in to the navy after my people finish going over it, and did you know I served in Vietnam" Kerry do not agree with it. This is a very Libertarian view that is not shared by the majority of the population, even many people who regularly vote Republican.

Hugh's argument: Adult stem cell research has a proven track record. Many diseases/conditions now have treatments/cures that are viable and working using adult stem cells. For all the money that has been put into embryonic stem cell research there is not one single treatment that has worked for one individual. A bunch of test patients have gotten brain tumors they didn't have before treatment but nobody has been cured. I didn't hear him talk about umbilical cord stem cell research which also looks more promising than ESCR but the facts support that position also. If the federal government is going to put money into stem cell research it should go where it is most likely to provide benefits.

Hugh is the closest to my view. Let me lay out, in order of importance IMHO, the viable argument set that others have made recently why the feds shouldn't fund ESCR.

1. ESCR has received a lot of funding and a lot of research has been done and treatments tried with NO positive results.

2. ASCR has so far produced reproducible cures/treatments for a couple dozen diseases/conditions.

3. Umbilical stem cell research appears, at least in the short term, to be more promising than ESCR in providing cures to things that ASCR may not.

5. ASCR and USCR are not ethically or morally controversial while ESCR is. They also are much more scientifically viable. The feds shouldn't fund ESCR so long as these two conditions remain true. There are enough controversial things that the feds have to do, this is not one of them.

6. The federal government should reserve its medical funding for things that the private sector will not fund sufficiently. To be specific the private medical and scientific research community puts very little funding into diseases known as Orphan Diseases. These are diseases which affect a very small percentage of the population. This makes sense. The private sector is always going to put more money into developing products that are likely to be purchased by a larger percentage of the population than they are into products which are by definition NOT going to be used by the vast majority of the population. If you want the federal government to put federal dollars somewhere to show compassion for the ailing, this is where it belongs. It does not belong in breast cancer research or heart repair research. I have many friends and family that are affected by these conditions, so before you go saying that is callous let me clarify. I have MANY friends and family that are affected by these issues. I assume you do to. The private sector invests MASSIVELY into cures for these ailments as a result. And private industry will always be more efficient when not encumbered by the government. I don't know anyone with an Orphan Disease to my knowledge. I do have compassion for them and think federal funding might actually make a significant difference in their lives. Federal funding for Breast Cancer or Parkinsons or Heart Disease are just pork in the budget. It does not significantly increase the level of treatment of people with those problems.

And now, for number 4, that the observant noted was missing above :-). This is a key point chatted about by scientists and engineers that is missed by the lawyers (all deference to Hugh and Michael and the good men at Powerline).

4. Scientific research is not a line, it is a curve. And when progress begins to be made that curve is usually geometric or exponential. This means that the progress this year is much higher with the same amount of effort as it was last year. For the non-mathematical let me use an example which is not based on reality, I made up the numbers.

Many years of research produce no cures.
The first year that a cure is found with stem cells we call year 1.
A couple of years later we get another cure, year 3.
In year 4 we see 2 cures.
In year 5 we see 5 cures.
In year 6 we see 9 new cures.

This is because the research this year has the benefit of the knowledge of all the things that have been tried for last decade(s) and which things worked and which things didn't. Over time we get a much stronger understanding of what works and why it works, what doesn't work and why it doesn't. This allows the researcher today to have a much higher level of probability of success than that same researcher had only a couple of years ago.

In the field of computers and electronics this is obvious to all of us. All you have to do to know it is look at the ads in your paper every week. On average the amount of compute power that you can buy for $1 doubles every year over the last one. This is geometric progression. It doesn't improve by X/$/year. It doubles every year.

Medical research works this way also it just isn't as obvious to us because we don't see weekly ads for a treatment much better than the one we bought last year for less than we paid. But I bet you know somebody who recently was treated for something and the doctor said "this treatment wasn't available a couple of years ago" or "the odds of success with this treatment has gone up 50% in the last 3 years."

If ESCR ever provides any significant results I would argue that it will only come after our use of ASCR is common. We still don't know exactly why some ASCR treatments work while others do not. Eventually we may come up with a little drink that causes our own stem cells in our body to wake up and get really active and cure us of some diseases. We aren't there yet. Once we really know how and why ASCR works we are much more likely to be able to make ESCR work. I would argue that ASCR research is, in fact, the right place to put funding to learn how to make ESCR work, or to determine that it will likely never work.

I also think that once we get to the point that we can use ESCR to cure people, we likely won't need to. Between ASCR and USCR and the potential to influence, without surgery or external manipulation, our own stem cells to become more active we will likely cure all or most of the human disease that can be cured with stem cells.

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