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Stem cell policies in the United States and in Germany: between bioethics and regulation

Stem cell policies in the United States and in Germany: between bioethics and regulation.

by Herbert Gottweis

Introduction

In November 1998, two research teams, one headed by John Gearhart of Johns Hopkins University, the other led by James Thomson at the University of Wisconsin, reported on a number of breakthroughs in the culturing of human embryonic stem cells. Whereas Gearhart's team had isolated embryonic germ cells from aborted fetuses (Gearhart, 1998), Thomson and his collaborators had obtained embryonic stem cells from embryos created by in vitro fertilization (IVE) and had grown them each for about 5 days until they had developed into a blastocyst (Thomson et al., 1998). It did not take long until the mass media hailed the work of Gearhart and Thomson as a "medical revolution" and the two scientists became media stars. Their research was widely interpreted as a crucial step in the development of new strategies to grow human tissues and even organs (Cohen, 1998, November 14).

Embryonic stem cell research potentially seems to address one of the challenges in modern medicine: irreversible and terminal organ and tissue failure. The spectrum of such typically life-threatening deficiencies reaches from scenarios affecting whole organs, such as heart or kidney diseases, to nonwhole organ scenarios, such as diabetes and neurodegenerartive disorders, for example, Parkinson's disease. In the past decades, modern transplantation medicine using allotransplantation--the grafting of organs from human donors--has been successful in replacing irreversibly damaged organs. But in many countries, patients are still on long waiting lists for organ donations. In October 1999, more than 66,000 patients were registered in the United States alone (Bramstedt, 2000). There were not enough organs available to meet the existing demand. Recently, a number of experimental medical strategies have come into the spotlight that claim to offer an answer to what has been labeled by some representatives of the medi cal establishment as an "organ crisis." Among these strategies, the most important ones are tissue engineering; the creation of "bioartificial" organs composed of live cells and artificial materials; xeno-transplantation, the usage of nonhuman tissue and organs to treat organ and tissue failure; therapeutic cloning, the cloning of a person's cells for his or her own medical use; and human embryonic stem cell research, which focuses on the culturing of human embryonic stem cells with the hope they will lead to ways of growing tissue and organs.

However, these new experimental medical strategies did not only raise positive expectations with respect to the treatment of serious diseases and conditions. They also created a great deal of controversy and put pressure on policymaking. Whereas tissue engineering and bioartificial organs have remained relatively uncontested, xenotransplantation and, in particular, therapeutic cloning and embryonic stem cell research have given rise to heated debates in Europe and in the United States. What some interpreted as a "medical revolution," others saw as an attempt to create "superhumans," as a revival of Nazi eugenics in new clothes, or as a potential public health disaster.

In this article, I will compare policymaking in the field of human embryonic stem cell research in the United States and in Germany The two countries seem to offer completely opposed environments for the conduct of such research. The major breakthroughs in recent human embryonic stem cell research have taken place in the United States, where a growing number of research groups in the public and the private sector is involved with this line of work. Research is financed either by companies or more recently, in a limited sense, by the government. Things could not be more different in Germany Despite strong interest in the scientific community, hardly any research is going on in the field of human embryonic stem cells. Currently, embryonic stem cell research is limited to work with animal models. The legal situation prohibits most strategies of human embryonic stem cell research, and government support for this type of work is unavailable. How can we explain these striking differences in the regulation and supp ort for research between the United States and Germany? And what future developments in the regulation of human embryonic stem cells can we expect in these two countries? Will the United States government continue with its limited support for embryonic stem cell research and Germany with its restrictive approach?

I will argue that in order to explain the contrast between the United States and Germany in dealing with human embryonic stem cell research and to predict possible future developments, we need to look carefully at a number of important differences in the interpretations and discourses of embryonic stem cell research and their consequences for the strategies of institutions and actors in the political-regulatory realm. As I will show, among the practices and discourses that constituted the scientific-political field of human embryonic stem cell research, evocations of political identity played an especially important role.

Policymaking in the Scientific-Medical Field: A Discourse-Analytical Perspective

Scientific-political fields such as human embryonic stem cell research are located at the fuzzy intersection between science, society, and politics. Policymaking in such areas tends to operate under conditions of substantial uncertainty and ambiguity (Shapiro, 1999). For example, the meaning of phenomena such as "stem cells" and "embryo" is by no ways fixed or stable. Phenomena such as human embryonic stem cells are not simply "objective data" for regulatory decision making. Rather, for human embryonic stem cells to become relevant in the policy process, they need to be transformed from something that is "out there" into something that is socially and politically signified. Political and scientific discourses that vary from policy field to policy field, from country to country, play a critical role in this process. This situation neither facilitates communication among the actors involved in the policy process nor decision making. Policymaking in areas such as stem cell regulation helps to sharpen our unders tanding that policy analysis should not depart from a fixed, given, and stable world (of politics, of economics, of society, of the body) but must assume that social, political, or natural phenomena, and inseparably from them--their meanings--are constantly moving, changing, and shifting in various directions. This point of departure underscores the importance of the study of language and related phenomena, for example, texts, narratives, and discourses, as critical for policy analysis. In this view, social, economic, and political "reality" are constructions made possible through articulatory practices involving human materials (such as words) and nonhuman materials (such as ultrasound devices) (Cooper, 1989; Reed & Hughes, 1992; Hassard & Parker, 1993). These processes of construction that involve representations such as narratives but also technologies (such as ultrasound devices) do not create a single, stable order, but something more plural and incomplete. They can be seen as plural processes of social and political ordering (Law 1994). For example, in political debates about embryo and fetal research, the body of a fetus is not simply "there" but is the result of the intervention of an ultrasound scanner that produces signs called "baby." The representation of the body of the fetus, which at the same time constitutes a technological intervention, becomes "the body" Signifying a fetus is as much a product of language as of technology, and both connect the fetus to policymaking.

Thus, from a discourse-analytical perspective, one important aspect of policymaking is the fact that it is always a performative process that uses and mobilizes complex and often heterogeneous systems of representations to fix the meaning of transient events. For example, in genetic engineering regulation, the risks of genetic engineering are typically expressed in tables, categories, and host-vector systems and are related to theories of risk, which are the basis for decision making. The ordering activity of systems of representation is inseparable from decision making in this policy field, because it transforms the risks of genetic engineering into a body of knowledge and markers that create the basis and orientation for political intervention. Policymaking, then, must be studied as a material practice that does not simply react to its environment but inscribes itself into its texture and creates/rewrites order by drawing from a multitude of discursively available narratives, modes of representations, artif acts, and technologies, a process that entails intermediation and translation between different social and nonsocial worlds and realms of perception.

In this context, policy narratives play an especially important role. Policy narratives describe frames or plots used in the social construction of fields of action for policymaking. They describe a structure of relationships that endow the events contained in the account with meaning by integrating them into a narrative. These plots create and stabilize the meaning of a policy phenomenon, such as embryonic stem cell research; describe central actors in a policy field; and suggest a pathway for policymaking. Typically, policy narratives are crafted by agencies or actors in the political decision system. Successful policy narratives usually do not emerge from one single location but are the result of a loosely structured discursive exchange among a number of actors and institutions, which at a certain point in time take on a more or less coherent form (Gottweis, 1998, pp. 31-34).

Policymaking, then, is always based on the careful intermediation between particular policy narratives and the broader discursive context, the general system of forming and transforming statements existing at a given period within a particular society, its central myths, stories, and public philosophies. Any policy narrative, for example, about embryo research, not only has to develop a rationale for the conduct of this type of research but also needs to relate this explanation to broader social themes, such as the importance of research for social progress. This attempt to mobilize actors, interpretations, meanings, technologies, and artifacts and to stabilize a political space by means of a dominant narrative is usually only temporarily successful and open to contestation: Policymaking is a fundamentally unstable and conflict-ridden operation. The currently emerging policies governing stem cell research in the United States and in Germany are good examples of policymaking under constraints of uncertainty, c ontroversy, and social ambiguity. They show the importance of discourse in the shaping of policy and the highly complicated interplay among discourse, culture, technology, nature, actors, and institutions in the process of policymaking.

Cells, Life, and Politics

Embryonic stem cell research, cloning, and xenotransplantation are medical strategies that stir emotions, create camps of fervent supporters and dedicated opponents, and stimulate discussions about the meaning and direction of modern medicine. Currently, in most Western countries bioethicists, philosophers, lawyers, scientists, and other kinds of experts ponder about the acceptability, the limits, and the promises of these new research strategies, which focus on the recovery, manipulation, and utilization of cells from humans and animals for medical purposes. They discuss different methods, such as transplanting tissues or organs from genetically modified pigs to humans, removing embryonic stem cells from aborted fetuses in order to create and transplant neural precursor cells, and taking cells from a person and using them to clone a blastocyst (1) and thus obtaining stem cells. As different as these various methods are, they share a focus on cells as their object of study and manipulation. This interest in c ells is as new as it is old.

Cellular therapies build on a longer history of research and experimentation. The first experiments in both xenotransplantation and cell transplantation date back to the 1960s, and tissue engineering originated in the 1980s. However, a number of technical developments and scientific advances renewed the interest in cellular approaches. During the 1990s, the creation of bioartifical organs, tissue engineering, xenotransplantation, and stem cell research seemed to make promising progress in the actual growing and transplantation of cells, tissues, and organs for therapeutic purposes (Hunkeler et al., 1999; Clark, 1999; Persidis, 1999; Machluf & Atala, 1998). Although this optimism concerning recent cellular therapies was based on research with animal models or speculations based on a few successful experiments with humans, medical doctors, scientists, and the mass media soon began to interpret the new research as a series of unprecedented breakthroughs in medical research ("Finance stem cell research," 1999, Ja nuary 8; "Stem cell for treatment," 2000).

The price of this scientific progress plus rhetoric was that cell-based therapeutic strategies--gradually developing for decades already but widely ignored by the larger public--became a topic of broader social-political debate. At the beginning of this century, one of the most controversial new cell-based medical therapy approaches is based on embryonic stem cell research.

Human embryonic stem cells were first isolated from the inner cell masses of mouse blastocysts in the early 1980s. However, it was not until 1998 that a team of researchers at Johns Hopkins University managed the first successful isolation and culturing of human embryonic stem cells. A few months later, the new research on stem cells was named by Science to be among the top scientific advances of 1999 (Vogel, 1999). Much of the excitement about stem cells was caused by the fact that embryonic stem cells were seen as "pluripotent," which means they are capable of self-renewal and of differentiation into a wide variety of cell types. Hence, the ability to grow them in renewable tissue cultures could have broad applications in research and transplantations, in particular, by offering new access to tissue and organs (National Institutes of Health [NIH], 2000b).

However, before any of the exciting future applications of embryonic stem cells could ever materialize, a steady source of these cells needed to be secured. There are a number of experimental ways to obtain pluripotent cells of which two seemed to be most promising and moved into the center of attention. The University of Wisconsin research team led by Thomson derived stem cells from spare embryos created in IVE clinics for the use of reproduction and donated by couples who no longer needed them. The pioneering Johns Hopkins University researchers obtained stem cells from aborted fetuses (Annas, Caplan, & Elias, 1999).

Precisely these two strategies to obtain embryonic stem cells and their application in medical research and therapy turned immediately into a site of political controversy in Germany and in many other countries, as well as in the United States. There were many issues and topics raised in these debates, ranging from the rights of embryos to the questions of the potential risks for patients involved in these novel, experimental medical strategies and the implications for women due to the possible increase in demand for "spare embryos." According to some interpretations, a blastocyst was a formation of cells, but others saw a human being. While certam voices identified a clear boundary that separated human totipotent from pluripotent cells, others rejected such categorizations (Robertson, 1999).

Signifying Embryos: Creating Historical Policy Narratives

Spaces of policymaking usually have some sort of history. Narratives referring to the "prehistory" of a policy are typically contingent and should be seen as materials that under certain circumstances are mobilized by actors in order to structure a space of policymaking. In Germany and the United States, the creation of the scientific-political field of human embryonic stem cell research was strongly influenced by the mobilization of historical narratives derived from past struggles over fetal and embryo research. Central in these debates was the question of what constitutes an embryo and a fetus and thus-implicitly--at which point in reproductive development "life" comes into existence. Also important were the potential socio-cultural and moral implications of fetal and embryo research and the role of the law and the state in the "protection" of embryos and fetuses.

In the United States, ex utero fetal tissue has been a subject of research since the 1930s at least (Kinner, 2000b). The National Institutes of Health's (NIH) support for such research has been available since the 1950s. (2) However, in the late 1980s, widespread controversy erupted over the use of tissue from dead, electively aborted fetuses in the treatment of neurodegenerative diseases. This debate culminated in a de facto ban on government support for this type of research from 1988 to 1993. The central argument of the critics of fetal research in the Reagan and Bush administrations was that research needed to be terminated; otherwise, there could be a chance that women might feel encouraged to have abortions because they might see a chance that their abortions could be useful to tissue recipients. To be sure, this claim was widely put in question by the supporters of fetal research (Vawter, 1993, p. 81). Furthermore, a de facto moratorium existed for federal funding of research on IVF and other types of research involving embryos (Gross, 2000, pp. 14-15).

The partial ban on government funding for fetal and embryo research, however, was not synonymous with the general prohibition in conducting fetal and embryo research. Those areas of fetal research not involving aborted fetuses continued to receive government funding. At the same time, privately funded fetal and embryo research was relatively free to proceed with research (Kinner, 2000a, 2000b). Hence, since the late 1980s in the United States, the emerging space of embryo and fetal research policy has been characterized by the establishment of a clearly drawn boundary between public and private research. This structuring of regulatory space was to a considerable extent influenced by the strongly rights-focused discourse about the regulation and public funding of nontherapeutic abortions. The central argument in this context was that the absence of public consensus regarding the moral status of the "preembryo" excluded both the development of regulation constraining research and the use of public funds to supp ort such research. In either case, the liberty or resources of some individuals would inappropriately be constrained or coopted to pursue ends that they would explicitly eschew (Khushf, 1997, pp. 497-498). Although federal funds for many kinds of fetal and embryo research were not available, privately sponsored research continued, either, as in the case of embryo research, without the existence of any viable regulatory system, or, as in the case of fetal research, within a complex system of federal and state laws. Hence, the rights-focused political discourse had played a critical role in justifying and explaining the creation of a boundary between private and public in the field of fetal and embryo research. It articulated a specific form of biopolitics in which definitions and potential uses of life increasingly were not anymore the exclusive prerogative of the state and clearly spelled out by law but partially left to the forces of a "market" composed of entrepreneurs, scientists, clinics, and medical doctors.

The moratorium on federal funding for research involving fetal tissue gained from abortions in transplantations was lifted in 1993 by President Clinton in one of his first actions in office (Vawter, 1993, p. 83). Now the rights-focused discourse about fetal and embryo research was supplemented by an interventionist argument that justified government support, that is, NIH support, for federally funded fetal research. This step was justified with the central importance of this line of research for developing cures for serious diseases such as Parkinson's and Alzheimer's disease. Fetal research increasingly began to be linked to the health of the population.

In 1993, the NIH formed the Human Embryo Research Panel (HERP), which set forth guidelines delineating the appropriate and inappropriate areas of embryo research (Tauer, 1997). In one part of the report, the panel made the controversial decision that researchers should be allowed to create embryos for certain research purposes. This position was rejected by President Clinton, who stated that federal funds should not be used to create embryos for research purposes. Before any NIH funding of research with so-called surplus embryos created in the context of IVF could begin, Congress took the opportunity afforded by the Department of Health and Human Services (DHHS) appropriations process to stipulate that an activity involving the creation, destruction, or exposure to risk of injury or death to human embryos for research purposes may not be supported with federal funds (Kinner, 2000b, p. F-4). In a 1995 rider to the appropriations bill coauthored by Republican Congressman Jay Dickey (later called the Dickey Amen dment), any research posing a risk to an organism derived by fertilization was prohibited. Despite this de facto ban on federally funded embryo research, the private sector continued to be free to make up its own rules and to conduct research in this area. Thus, until the early 1990s, the basic U.S. approach to fetal and embryo research was not to impose regulatory restrictions on embryo research but also not to spend public money on it. In the early 1990s, public funding of government-supported fetal research began. At the same time, the definition of an embryo as a "product of fertilization" implicitly rejected any notion of a "preembryo" or zygote, both of which were often used to describe human development from fertilization until the beginning of the second week of development. (Eiseman, 2000, p. C-3). As a result of this semantic shift, federal funds were not allocated for embryo research, whereas privately supported research continued.

The German debate and controversy about fetal and embryo research must also be located within a highly complex discursive economy. Fetal research that was not targeted by the abortion opponents is relatively clearly separated from the discourse about embryo research. Although the former is not regulated by any special legislation, is governed by regulations of the Bundesaerztekammer (National Chamber of Doctors), and is federally and privately supported (Schneider, 1995), embryo research is forbidden by the 1990 Embryo Protection Act, part of penal law and probably the strictest law regulating embryo research worldwide. Thus, neither privately nor federally funded research is possible in this area. In the United States, the main issue in the controversy was the equally symbolic and material question of federal support for embryo research, and the rights of the researchers to conduct embryo research were not touched. In Germany, the central issue was the duty of the state to protect "unborn life." German legal discourse emphasized the social function of the state over considerations of the freedom of research (Iliadou, 1999).

The story of the 1990 Embryo Protection Act began with legal challenges to the abortion law, which had been reformed in 1973. In this context, the German Constitutional Court had ruled that German penal law did not regulate the first 14 days of human development from fertilization until implantation into the uterus (Betta, 1995, pp. 82-85; Iliadou, 1999, p. 36), nor could it be applied to embryos existing separated from the mother, as is the case in the process of IVF. From the early 1980s, a debate evolved that focused on the need to find a legal solution that would ensure the protection of "unborn life" and at the same time be consistent with the legality of abortion. Furthermore, by the mid-1980s evidence had accumulated that research with embryos prior to implantation was going on in Germany (Rosenbladt, 1988, p. 213). The lack of any regulatory instruments dealing with this type of research was widely seen as highly problematic. In this situation, the Bundesaerztekammer (National Chamber of Doctors) iss ued guidelines that regulated research with "early embryos." According to the new guidelines, these early embryos (defined as organisms from fertilization to implantation) were now "officially" available for research purposes. In addition, the guidelines made provisions to create embryos for research purposes under certain special conditions (Iliadou, 1999, pp. 41-42). The new Bundesaerztekammer guidelines soon came under fierce attack.

During the second half of the 1980s, a controversy over embryo research erupted, in which two strategies to regulate embryo research competed: the strategy based on self-regulation by the medical community and the strategy insisting on the importance to regulate public and private research with embryos by means of a formal law. The major research organizations such as the Max Planck Gesellschaft and the DFG (Deutsche Forschungsgemeinschaft) were in support of self-regulation. On the other side of the spectrum, a broad coalition cutting across political positions from radical Greens and feminists to conservative groups had come into existence and rallied behind the call for the state to protect embryos from abuse, instrumentalization, and destruction (Betta, 1995, pp. 81-125). The outcome of this long and highly emotional debate was the passing of the Embryo Protection Act, a strict law that essentially outlawed most types of embryo research in Germany and, by implication, any private or public funding of suc h work. At the core of the 1990 Embryo Protection Law, which is part of the penal law, were a number of restrictions. Prohibited is artificial fertilization that has any other goal than to result in a pregnancy, a measure precluding the creation of embryos for research purposes. Furthermore, the law prohibited any manipulation of embryos that served other purposes than their survival. The law defined an embryo as any fertilized egg cell beginning with nuclear fusion and, furthermore, any totipotent cell capable of division and development towards a human being (Iliadou, 1999). With these provisions and definitions, German embryo regulations were quite similar to those regulating federally funded research in the United States since the 1990s--with the important difference that the German regulations also encompassed privately funded embryo research and imposed a criminal penalty In the absence of any strong rights-focused discourse, a clearly drawn boundary separating private from public research had never mat erialized in Germany.

Political Identity and Human Embryonic Stem Cells

As soon as the advances in human embryonic stem cell research by Gearhart and Thomson were published, certain actors in the United States and in Germany began to discursively mobilize national histories of dealing with embryo research. Other actors pointed out the difference between embryo research and embryonic stem cell research.

With human embryonic stem cell research, a very complicated set of bioethical issues had materialized. Obviously, the question of when life begins and what it is continued to be important in the ensuing debates. At the same time, the therapeutic promise of embryonic stem cell research seemed to be overwhelming and experimental medical applications in humans only a matter of decision and funding. These various processes of semantic mobilization constituted the initial steps to defining the emerging space of public policymaking in the field of embryonic stem cells. Past struggles to define the space of embryo research policy created a first set of boundaries and regulatory structures, a policy legacy that guided the emerging practices of human embryonic stem cell research.

Stem Cells in America: Manufacturing Social Compromise

In the United States, with Congress being hesitant to fund research involving human embryos, much of embryo and IVF research had been driven into the hands of private corporations. By the end of 1999, all research on totipotent and pluripotent stem cells in the United States had been done in the private sector, with the key research groups at the University of Wisconsin and at Johns Hopkins University being supported by Geron Corporation. The research that aimed at creating human embryos with cloning technology was financed and carried out by Advanced Cell Technology, a biotechnology company based in Massachusetts. This development of embryo research mainly financed by private companies was criticized by some observers and gave rise to a controversy that focused on if and under which conditions embryonic stem cell research should be supported by the government (Annas, Caplan, & Elias, 1999; Frankel, 2000). At the same time, the main participants in the political debate did not clearly raise the issue that th ere was no federal regulatory system in place that dealt with embryo research and IVF. Likewise, the boundary that separated private and public research in this area was not questioned by the main actors in the controversy.

The privately supported research of Thomson and Gearhart became both a symbol for the substantial medical potential of embryonic stem cell research and a demonstration of what many in the medical-scientific community saw as the shortcomings of embryo research in the public realm. Whereas Gearhart's work also could have been supported by government money, Thomson's research implied the necessity to abstract cells from a blastocyst necessary to isolate stem cells and then destroy the embryo. Thus, it would have been excluded from federal support.

Only weeks after the announcement of the successes of Thomson and Gearhart, the stage was set for the forthcoming controversy Although Harold Varmus, the director of NIH, said that embryonic stem cell research "is of sufficient magnitude and importance that the federal government should be playing an active role in supporting it," Congressman Jay Dickey defended the ban on embryo research and asserted that "the ban serves a very good purpose in our society because it honors the sanctity of life" (Butler, 1998, p. 104). At NIH, increasingly the view prevailed that it was not a question of whether the government should support human embryonic stem cell research but how to justify and explain the necessity of it (Interview conducted at the NIH, Bethesda, MD, August 30, 2000).

In this constellation of conflict, the critical challenge for all of the central actors was to craft a policy narrative that would eventually offer the dominant interpretation of the nature and relevance of human embryonic stem cell research and mobilize a powerful coalition pressing for and justifying government support in this field. An important step in the creation of a policy narrative explaining the importance of embryonic stem cell research was President Clinton's move to contact the National Bioethics Advisory Commission (NBAC) to prepare a review of the medical and ethical issues associated with human stem cell research. In September 1999, the NBAC delivered its two-volume report to :President Clinton, in which the Commission offered a "political philosophy" of stem cell research (National Bioethics Advisory Commission, 2000). The Commission considered it as its task to produce a statement in which a majority of the Americans should see their concerns and considerations reflected (interview conducte d at the Hastings Center, Garrison, NY, May 1, 2000). After a thorough discussion of the ethical, scientific, legal, and social implications of stem cell research, the NBAC strongly endorsed the funding of human embryonic stem cell research.

Already, during the deliberations of the NBAC, the question arose of whether federal funds could be used for research on stem cells using "surplus" embryos from IVF treatments. The legal opinion of General Counsel Harriet Raab of DHHS on the acceptability under current federal law to support research with stem cells was another important step in the shaping of the evolving dominant policy narrative. Raab had concluded that pluripotent cells are not organisms and that they do not have the capacity to develop into an organism, on the contrary, that they have the potential to evolve into different types of cells, such as blood cells or insulin-producing cells. Furthermore, Raab introduced a distinction between the destructive removal of embryonic stem cells from embryos and research that occurred with those cells after their removal. In Raab's view, federal research support could be provided as long as this research did not involve the removal of embryonic stem cells (Robertson, 1999, p. 112). Hence, a key figu re of the legal-political system had made the decision that the kind of things Thomson and Gearhart were working with were not embryos or something related but, rather, "simple cells," which, therefore, had no "life qualities" (Raab, H. S., memorandum to Harold Varmus, January 15, 1999). Raab's semantic creation of two types of stem cell research and her political framing of the status of the embryo should soon become a central axiom in the gradually developing stem cell policy narrative.

The director of NIH, the president of the United States, the NBAC, and Congressman Dickey were hardly alone in the emerging discursive space of embryonic stem cell research. A growing number of actors began to influence the policy-problem definition process. The efforts to develop a government position on the federal support of embryonic stem cell research culminated in the NIH draft guidelines for research using human pluripotent stem cells in December 2, 1999, and received approximately 50,000 comments from members of Congress, patient advocacy groups, scientific societies, religious organizations, and private citizens (NIH, 1999b). The final guidelines were published on August 25, 2000 (NIH, 2000b).

At the core of the new guidelines was the decision to extend the scope of government support for embryonic stem cell research and to create a framework for regulatory oversight. Whereas in the past the law permitted the use of federal funds for the derivation of embryonic stem cells from aborted fetuses, the situation was less clear with respect to the crucial issue of spare embryos donated by couples undergoing IVF. The August 25, 2000, guidelines, most importantly, permitted the usage cells derived from IVF spare embryos for research purposes and constituted a forceful, unambiguous statement of support for embryonic stem cell research. As a NIH "Fact Sheet" published earlier stated: "Human pluripotent stem cells are a unique scientific and medical resource ... [and] human pluripotent stem cell lines represent a major step forward in the understanding of human biology" (NIH, 1999a, p. 1). The guidelines emphasized the importance to consider the many ethical issues and concerns involved in embryonic stem cel l research. However, taking into account the huge potential for medical benefits of this type of research, funding under oversight was seen as the appropriate strategy for the NIH to pursue. At the same time, the guidelines explicitly excluded a number of related research strategies from government support, such as the practice of creating embryos for research purposes and the creation of stem cells with the aid of cloning techniques.

The governments emerging policy narrative also featured a number of references to some more general themes of U.S. political discourse. It connected to important political metanarratives. Political metanarratives describe general concepts and values of the political order and offer a conceptual framework that provides a polity and its subjects with an imagined, collective political identity. Hence, for a policy narrative to be powerful, it needs to be framed as expressing deeper sets of values and social preferences (Gottweis, 1998, p. 33). With American health and American leadership, two core elements of contemporary U.S. political identity were mobilized and connected to embryonic stem cell policy Various statements in government reports and guidelines concerning stem cells left no doubt that the continuation of stem cell research in the United States would be critical to helping Americans fight dreadful diseases for which there is currently no cure available (NIH, 1999a; NBAC, 2000). In other words, the health and the lives of many Americans began to be connected to the practices of embryonic stem cell research. Furthermore, it was argued that federal funding for embryonic stem cell research would also help to sustain U.S. leadership in science and technology "Federal funding is probably required in order for the United States to sustain a leadership in this increasingly important area of research" (NBAC, 2000, p. 60). There was no question, so the policy narrative went, that embryonic stem cell research raises all sorts of ethical and moral questions. But one needs to consider that, according to the current consensus in the scientific community, embryonic stem cells are not embryos. Provided the adequate precautions were taken, research could continue in a manner that might lead to substantial benefits for U.S. society and sustain scientific leadership of the United States in the world. This incorporation of important themes of U.S. political identity into the emerging policy narrative was no doubt a powerf ul strategy to explain and justify the government's plan to begin with the financial support of a highly controversial line of research.

Despite its many words, the new policy narrative also had its silences. The most striking omission was the absence of any attempt to regulate private or guide research in the field of embryonic stem cells--except for a recommendation of NBAC to voluntarily follow the recommendations set out in the new guidelines (NBAC, 2000, p. 79). Apparently, the rights-focused policy discourse that had dominated the U.S. debates from abortion to embryo research since the 1970s continued to define considerably the logic of regulatory decision making.

Thus, NIH's policy narrative combined in a complicated and heterogeneous process of signification silences with detailed arguments, generated with the help of medical technologies, such as what constitutes an embryo and why embryonic stem cell research represents cutting edge science, with references to important themes of U.S. political metanarrative, such as the duty of the government to ensure future U.S. scientific leadership and to protect the life and health of as many Americans as possible. Using this interpretation, research with embryonic stem cells research became an extended promise concerning the future of medical research and of America, an expression and a reinforcement of a particular image of U.S. political identity Government support for embryonic stem cell was equated with reason and orientation towards progress and modernity, but also with careful deliberation. With these arguments, technological representations of the human body and interpretations of politics and economy, the space of pol icymaking began to be structured, policy actors came into the situation to position themselves in the policymaking process, alliances between institutions and actors became possible, and due to the power of hegemonic definitions, political and scientific realities gradually began to take shape.

The many positive reactions to the NIH draft guidelines were an expression of a powerful alliance of groups and actors coming into existence that rallied behind human embryonic stem cell research. It reflected the success of NIH's policy narrative to articulate a coalition of meaning among relevant government officials, medical doctors, scientists, patient groups, and politicians. At the same time, with the issuing of the draft guidelines, NIH had become a central location from where the new policy discourse about human embryonic stem cell research emanated.

One central point of agreement between organizations and actors interested in stem cell work concerned the scientific and medical promise of embryonic stem cell research. For example, the National Coalition of Cancer Organizations (NCCR), a coalition of 26 national organizations of cancer researchers, patients, and research advocates wrote:

The NCCR believes that the NIH should fund and fully support research on human plutipotent stem cells and strongly opposes any attempts to ban this very promising research.... The possibilities are astounding and could unlock the doors to understand, treat, and cure many diseases. Further research is required to unlock the doors, and the financial support of the NIH to fund stem cell research is the key to ensure progress. (Aldige, 2000, January 31)

At the same time, many important voices in the scientific-medical community declared the question of the "life qualities" of human embryonic stem cells to be settled. Not only should embryo research become permissible but it would also ensure the maintenance of high bioethical standards. The American Association of Medical Colleges (AAMC) wrote on behalf of the nation's 125 medical schools and 400 teaching hospitals about the NIH guideline proposal:

We recognize that these guidelines have been developed in an environment in which federal monies may not be legally used for the creation of embryos for research purposes.... The federal support should not only be viewed as permissible, but also as highly desirable....In the absence of this proposal, stem cell work would undoubtedly occur, but in a very limited private context without the benefit of public scrutiny and ethical oversight that this proposal affords. (Castro, 2000, January 19)

To be sure, the many opponents of embryonic stem cell research had attacked this line of research based on a counternarrative related to the abortion debate that attempted a different structuring of the space of human embryonic stem cell research. The focus of this counternarrative was on the representation of embryos as human beings (not a formation of cells), their rights, and the duty of law to protect them. Furthermore, adult stem cell research and other research strategies were portrayed as viable alternatives to human embryonic stem cell research. The decision of the U.S. government to go ahead with research in this area was criticized by many actors; there was even fundamental opposition demanding that the NIH withdrew its guidelines, a position in particular articulated by religious groups. The National Conference of Catholic Bishops wrote in one of its submissions: "The guidelines, for the first time on our national history, authorize the federal government to approve and regulate destruction of inno cent human life for research purposes. They instruct researchers in how to harvest versatile "stem cells" from living week-old human embryos, a procedure which kills embryos" (National Conference of Catholic Bishops/United States Catholic Conference, 2000, January 31). Or, as Orange County Right to Life stated: "You will be known as the cannibals of the 21st century if you use human pluripotent stem cells...for research and experimentation (2000, January 16).

In this "discourse of morality" (Tatalovich & Daynes, 1998), there was no space for compromise or utility considerations--only right and wrong. This particular discursive structuring of the space of human embryonic stem cell research had a crucial impact on the types of arguments and actors that entered the political struggle and its outcome. The critics of human embryonic stem cell research positioned themselves as the defenders of the right to life. In contrast, the supporters of research were represented as violating against the most basic values a society can have, such as the importance of the protection of the sanctity of life. Consistent with the dominant tradition in American legal discourse, the critics' counter-narrative emphasized the defense of individual rights. This construction helped to position those in the political struggle who objected to embryo research because they viewed it as a "destruction of life." However, it offered no discursive space for arguments beyond the rights of the unborn, such as for the articulation of concerns about human embryonic stem cell research because of its potentially negative impact on the health of the women involved in embryo donations. This tendency in the counternarrative's construction of the conflict about embryonic stem cell research was actively reinforced by the evolving dominant policy narrative, which tended to identify opposition to stem cell research with a (religious-moral) minority project.

It must be pointed out that a number of the concerns of the critics entered the new NIH guidelines, such as the prohibition of cloning to obtain human stem cells. In this context, it should be remembered that hegemony implies domination of a social field but not elimination of opposition. It is about the reabsorption of discourses of polarity into a system of "legitimate differences" and the definition of the sites where opposition can take place (Laclau & Mouffe, 1985). Thus, although the central arguments of the critics that focused on the "rights of the embryo" and the duty of the law to protect human life from further potential abuses in the wake of embryonic stem cell research were rejected by the new policy narrative, elements of the counternarrative of the opponents of stem cell research were respected and served to create pockets of "legitimate polarity" (such as in the cloning question).

As a result of this strategy and despite the many critical voices, NIH was in a position to go ahead with its interpretation of the world of human embryonic stem cell research. The "success" of the policy narrative articulated in the NIH guidelines was based on the hegemonic strategy to create what could be broadly perceived as a reasonable social compromise" in which all enlightened Americans should be able to recognize themselves. This increasingly dominant discursive structuring of the space of human embryonic stem cell research had a crucial impact on the meaning of the arguments and actors that interacted in the political struggle. The critics' discourse of morality was replaced by a discourse of "utility-driven policymaking" with the goal of finding a "common ground." In this construction, a boundary emerged that separated the spokespeople of science and medicine from the spokespeople of backwardness. Support of embryonic stem cell research was equated with reason, opposition with lack of reason. As the director of Yale University's medical school residency training program put it: "It is time all sensible people with an interest in humanity's future banded together to prevent misguided individuals from preventing right decisions" (Kapadia, 2000, January 24). The conflict about human embryonic stem cells seemed to reflect a tension between two poles: "the Americans," wedded to science, progress, and modernity, and their adversaries, the forces associated with religion, ignorance, and backwardness. The passing of the NIH guidelines for research using human pluripotent stem cells initiated federally supported embryo research in the United States-and indicated the agency's trust in the discursive power of its policy narrative to define the nature of a newly emerging scientific-political field.

After President Bush took office in 2001, there were immediately rumors that the new president would change the government's stem cell policy and adopt a more restrictive approach towards funding and regulation (Stem cell study decision by summer, 2001, March 1). In a much publicized nationally televised speech on August 9, 2001, President Bush outlined the government's new policy Although the roughly 60 colonies or "lines" of embryonic stem cells already existing worldwide could be further studied and explored with support of government money, no more taxpayer money should be used in the future to create embryos for research or to study cells from newly destroyed embryos. Some scientists criticized this decision as impeding medical progress; other observers pointed out that the evolving new regulatory regime actually imposed fewer restrictions on research than existed under the Clinton administration. (Wade, 2001, August 18). In fact, President Bush's August 9 decision was in many ways consistent with the pr evious policy towards stem cells established by the Clinton administration. The Clinton administration's approach towards embryo and fetal research combined support for experimental medical research with an attitude of caution and elements of restriction. President Bush's decision fit well into this pattern. No doubt, new rules were imposed on the conduct of embryonic stem cell work, but federally supported research was nevertheless allowed to continue (NIH, Office of the Director, 2001). In fact, the Bush decision was instrumental in broadening the endorsement for stem cell research and continued the earlier strategy of reabsorbing discourses of polarity into a system of "legitimate differences." In the logic of the Bush decision, the central conflict in stem cell policy was not between medical research and the rights of the unborn but between those who wanted to develop new cell lines and those who were satisfied to work with the already existing lines of embryonic stem cells. On a symbolic level, the new r egulations offered to simultaneously protect the rights of the unborn and the freedom of research and to foster medical progress in America. As a result of the new strategy, the initially well-defined boundary between the supporters and the critics of stem cell research began to blur. At the same time, the base of its social support was broadened. Whereas a number of the critics of embryo research, such as the Catholic Church, condemned President Bush's decision as insufficient to protect unborn life, many social conservatives from the National Right to Life Committee to Jerry Falwell voiced support or at least understanding for the new policy (Sack, 2001, September 4).

Needless to say, the president's decision only affected the federal government's financial support strategy for human embryonic stem cells. Embryonic stem cells research in the private sector continued to be largely untouched by any federal regulations.

Stem Cells in Germany: A Conflict Between Human Rights and Science

Whereas embryonic stem cell research originated in the United States seemed to prosper and began to receive government funding after the passing of the NIH guidelines in 2000, the situation was strikingly different in Germany By the end of 2001, 3 years after the initial 1998 breakthroughs in stem cell research, human embryonic stem cell research was not conducted anywhere in the country. The 1990 Embryo Protection Act ruled out a number of conceivable strategies for stem cell research but left open the window to obtain stem cells from aborted fetuses that did not fall under this law. Also, the import of human embryonic stem cell lines from abroad did not conflict with the Embryo Protection Act (Deutsche Forschungsgemeinschaft [DFG], 1999, March 19; Von Buelow, 2000). But the import of embryonic stem cells was widely seen as a move to bypass existing laws and thus was considered very problematic. A strong national consensus seemed to prevail that human embryonic stem cell research is a highly questionable lin e of research. In this political climate, even the classical advocates of scientific interests, such as the German Research Foundation (Deutsche Forschungsgemeinschaft) were more than cautious with their statements and funding policies involving embryonic stem cells (DEG, 1999). How can we explain the imposition of a de facto ban imposed on embryonic stem cells research in Germany?

Clearly, from late 1998 on, the medical breakthroughs in embryonic stem cell research were also broadly discussed and appreciated in the German biomedical research community. Much of the kind of research on embryonic stem cells that was going in the United States was prohibited by the strict German Embryo Protection Act. However, younger German scientists that had trained in the United States brought their experiences with embryonic stem cell work back to Germany and continued their work there with animal models. Among them, uneasiness increased when forced to watch their work on animal models being used in experimental research with humans abroad (interview conducted at Institut fuer Neuropathologie, Universitaet, Bonn, Germany, Februrary 24, 2000). As one of the younger German researchers in this field put it: "We are ready to go ahead [with research]" (Die Zeit, 2000, August 24). Furthermore, the DFG , the Max Planck Institutes, the Ministry of Research, and many individual researchers left no doubt that t hey considered embryonic stem cell research crucial for research, with respect to potential medical applications but also for the scientific and economic future of the country. Also in 2000, the DFG began to move ahead and invited the German research community to submit research proposals for human embryonic stem cell work (Bundesministerium fuer Bildung und Forschung, 2000, p. 112).

However, despite these similarities between the research community in Germany and in the United States, the DFG and other German representatives operated in a discursive environment vastly different from the one in the United States. Whereas in the United States, the definition of the space of human embryonic stem cell research was dominated by the NIH'S plea for "normal" policymaking based on utility considerations, in Germany, the emerging dominant policy narrative tended towards a conversion of the central issues of stem cell research into moral polarities. NIH had done all to avoid possibly the impression that the embryonic stem cell issue was to be defined by a moral discourse dividing along the lines of right and wrong. By contrast, in Germany it was the government itself that early on advocated an approach towards stem cell regulation that was characterized by a dichotomizing attitude leaving little space for compromise. The Ministry of Health under the (Green) minister Andrea Fischer emerged as the c entral agency to lead the crafting of the new policy narrative.

One important characteristic in the gradually developing German debate about embryonic stem cells was the semantic linking of German history, in particular of the experience of the Third Reich and of Nazi eugenics with current medical research on embryos. Central in this context was the argument that all had to be done to avoid the dreadful mistakes of the past, even if this may look exaggerated viewed from a perspective outside of Germany Germany has a special responsibility in this respect, so the narrative went, even if living up to this responsibility means to sacrifice certain scientific or economic goals (Catenhusen, 1998, July 17; Rau, 2001a, January 26; Die Zeit, 2001, February 22). By connecting embryonic stem cells with Nazi eugenics and "special German responsibility," a core element of contemporary German political identity--the determination "not to repeat history"--had been mobilized as a pivotal issue in the political struggle.

Equally important for the discursive construction of embryonic stem cell research in Germany was the mobilization of the metanarrative of human rights. Human rights instruments describe minimum conditions for humans to flourish and aspirational goals for a world in which all humans live in harmony Many European countries, including Germany, have explicitly appealed to human rights in addressing issues of health care and biotechnology and emphasized terms such as solidarity, human dignity, and the collective good. In contrast, the U.S. legal discourse focused on the importance of negative rights without fully embracing the concept of positive rights or obligations between government and people. In American discourse, law and culture "rights" generally refer to individual rights based on noninterference rather than on the more expansive rights articulated in the human rights framework (Knowles, 2000). In Germany, not only were references to a broadly understood notion of human rights compatible with the domina nt law discourse but, in addition, during the second half of the 1990s human rights had turned into a topic of broad social interest and concern. The passing of the "Bioethics Convention" of the Council of Europe in 1996 (Europarat, 1997, April 4) had caused an uproar in Germany, where a number of the proposed regulations were seen as undermining the high standards of the German human rights tradition. Eventually, a network of "anti-bioethics" activists came into existence, which involved tens of thousands of activists engaged in the question of human rights and bioethics. As one group active in this field, the Arbeitskreis Bioethik Braunschweig wrote with respect to those paragraphs of the bioethics convention, which in their view, seemed to introduce lower standards of human rights in Germany:

Developments in medicine and biology . . . question the dignity and the rights of many people.... What even a few years ago was seen as undemocratic, unsocial and inhuman, now is increasingly accepted. . . . Should we really be condemned to repeat history, only because we don't want to remember it?" (1999)

In this discursive context, under the leadership of the Ministry of Health, a variety of actors increasingly construed the 1990 Embryo Protection Act as some sort of last wall that protected German society against an unprecedented attack by a tragically misguided biomedical establishment. In this interpretation, pressures to make embryonic stem cell research possible in Germany was only part of a larger scheme. A critical element of this plan--so went the critics' fierce argument--was a reform and weakening of the Embryo Protection Act only to clear the way for launching a new type of eugenic politics and creating a completely dehumanized, technocratic society with the ultimate goal to engineer "perfect" human beings. Of course, this would also be a society without disabled people. But as the disabled people initiative stated: "We don't need incredibly expensive research to avoid "painful" life. We need social conditions, which allow for social participation of all. Not being disabled is the problem, but the daily difficulties and rejections which disabled people have to encounter" (ISL-Interessenvertretung Selbstbestimmt Leben--Deutschland, 2000).

In May 2000, the Ministry of Health organized a 3-day dialogue conference about "reproductive medicine," which brought together in particular the critics and supporters of preimplantation genetic diagnosis, IVF, and embryo and stem cell research. The central topic of the conference was the ethics of preimplantation genetic diagnosis, which in Germany is banned by the Embryo Protection Act. According to the Embryo Protection Act, an embryo is defined as any fertilized egg cell beginning with nuclear fusion but also any totipotent cell taken from the embryo and capable of division and development towards a human being. In February 2000, the German Chamber of Doctors had issued draft guidelines for preimplantation genetic diagnosis in which the argument was put forward that German doctors could go ahead with preimplantation diagnosis after cell division had formed eight cells. According to the Chamber of Doctors, after the eight cell stadium, embryonic cells were no longer totipotent anymore; thus, preimplantat ion diagnosis was compatible with German law (Bundesaerztekammer, Deutsche, 2000; TAZ, 2000, February 23). At the Ministry of Health dialogue conference, this position was contested by the critics who claimed that the initiative of the Chamber of Doctors was only a strategic move to launch a discussion about the reform of the Embryo Protection Act. Representatives of disabled people groups, feminist critics, members of the clergy, and present members of the German Parliament from Christlich Demokratische Union (CDU), Sozialdemokratische Partei Deutschlands (SPD), and the Greens cautioned that preimplantation genetic diagnosis might lead Germany into a highly problematic direction.

As soon as embryonic stem cells began to become a topic in Germany, not only were they linked to Nazi eugenics but also to the question of human rights, the collective good, and, in general, the question of the "political nature" of Germany. In the gradually dominant policy narrative, embryonic stem cells were interpreted as part of an important development, which, however, should not be overrated. German history and the resulting responsibility--so the narrative went--made it crucial for Germany to proceed with extreme caution concerning embryonic stem cells. In this increasingly hegemonic construction of the political space, opposing views that argued for the necessity of catching up with international scientific developments, such as of the DFG, were not simply negated. Instead, aspects of the stem cell research supporting groups' positions were integrated into the dominant narrative, in particular by referring to the promise of adult stem cell research and the possibility to conduct research with aborted embryos (TAZ, 2000, February 23; Catenhusen, 2000, p. 124.). As the German state secretary for research and education put it:

The hope to grow tissues and organs for therapeutic purposes which do not cause negative reactions of the immune system is certainly an ethically justifiable goal. There are very good reasons to engage in stem cell research. . . . At the same time it is critical to analyze the different paths and goals of stem cell research in a differentiated way and not to reduce stem cell research to embryonic stem cell research. (Catenhusen, 2000, pp. 2-5)

Hence, in Germany the field of human embryonic stem cell research was discursively constructed between the poles of medical research that connected to German health and modernity and, on the other side, the pole of a broadly conceived notion of human rights, associated with the collective good and "learning from history." In other words, in Germany the space of embryonic stem cell research was not construed as a conflict between research and backwardness that coded reason against lack of reason--as was the case in the United States--but as a tension between research and human rights. This approach found its most dramatic expression in a widely received speech by the German President Johannes Rau who cautioned that in the light of German history technical feasibility in medical research should never be an argument to relativize ethical concerns (Rau, 2001b, May 18). Whereas in the dominant U.S. discourse, criticism of embryonic stem cell research was framed as an expression of religious opposition and narrow- mindedness, in Germany's "discourse of morality," the rejection of embryonic stem cell research became synonymous with a large number of broadly shared social and moral goals and values, such as the integration of disabled people into society, the protection of the interests of children and women, and, on a more general level, the preservation of a "good" and ethical German society. There was a price to be paid for this Sonderweg, such as a disadvantage in medical progress--but it was worth it.

This framing of the critique of embryonic stem cell research opened up the possibility for a variety of different groups to rally behind the rejection of this type of research. As a result, opposition to human embryonic stem cells research was not confined to mostly religious groups and arguments (such as in the United States) but reached from the churches to the Socialist Party, the Conservative Party, the Greens, the German president, and many other positions and groups. While a "rights of the embryo" argument might have immediately split the opposition against stem cell research, the mobilization and combination of a plurality of themes connecting German history with human rights topics discursively created a broad alliance of groups and actors critical of embryonic stem cells. In this constellation, any plan to reform the Embryo Research Protection Act came across as a highly questionable political project. The dominant "discourse of morality" left little space for compromise, utility considerations, and "normal" policymaking--only for the "right decision": to reject any notion of reforming the Embryo Protection Act and to prohibit human embryonic stem cell research. Whereas a number of individual medical scientists advocated a pragmatic approach toward human embryonic stem cell research that would have opened up the opportunity to go ahead with research under special provisions, for almost 3 years none of the potential architects for a counternarrative about stem cells, such as the Ministry of Health, the DFG, or the National Chamber of Doctors risked to move forward with a new and supportive interpretation of stem cell research and a proposal for action. Only towards the end of 2001, first demands were put forward, such as those by the DFG to consider the import of human embryonic stem cell lines and thus to end the de facto ban on embryonic stem cell research in Germany. In 2001, the German Parliament convened a parliamentary inquiry commission on "Law and Ethics in Modern Medicine," which among other thi ngs was called to develop a position on the ethical and sociopolitical implications of embryonic stem cell research. Furthermore, the German chancellor created a "National Bioethics Committee"--with embryo research as its first important agenda. In May 2001, finally, the DFG began to lobby for the import of human embryonic stem cell lines from abroad as a "quick solution" for the needs of German medical research (TAZ, 2001, May 5). This lobbying effort culminated in a highly controversial and partially paradoxical decision of the German Parliament (Bundestag) on January 30, 2002. After a long and heated discussion, a narrow majority of the representatives voted in support of a provision that allowed the import of human embryonic stem cell lines created before January 30, 2002, for research purposes.

But the same parliamentary decision declared the import of embryonic stem cells as illegal. Only under certain special circumstances could exceptions be made for the import of embryonic stem cells. In such cases, a number of restrictions were imposed on the import of these cells. For example, those applying for the import of embryonic stem cells were requested to document that for the planned research, alternative strategies would not yield the same results to be expected from the usage of embryonic stem cells. Finally, the Embyo Protection Act remained untouched by the legislators. The parliamentary decision from January 30, 2002, was seen as filling a gap in the Embryo Protection Act created by the advancement of science, rather than reversing it (Frankfurter Allgemeine Zeitung, 2002, January 31). Apparently, even in early 2002, for the broad majority of policy actors the option to change the established regulatory regime that protected the embryo was out of question. A well-defined boundary continued to se parate the supporters of research from the advocates of human rights. In this constellation, the import of human embryonic stem cells from abroad constituted a "quick solution" for the needs of medical research, but the interpretation continued to dominate the political debate that there is fundamental conflict between the conduct of embryo research and the principles of human rights.

Conclusions

Since 1998, developments in human embryonic stem cell research created two very different modes of policy response in the United States and in Germany In the United States, privately sponsored research in this area was never put in question, and in August 2000, government support became available for human embryonic stem cell research. In contrast, in Germany major strategies for human embryonic stem cell research were banned by law, and in general, there was great reluctance to move ahead with this type of research. These contrasting policies took a tremendous impact on the research base in these two countries. Although dozens of research groups and companies are active in this new field of research in the United States, there is no comparable development in Germany.

Clearly the historical legacy of embryo research has played an important role for structuring thinking spaces in embryo research. However, history can explain the contrasts between the United States and Germany only to a certain extent. As I have shown, the United States is hardly a country where, historically embryo research has always been broadly accepted. Nor is Germany a place where embryo research was always rejected. From the mid-1970s on, embryo and fetal research went on in Germany without much public discussion. At the same time, there was a ban on federally supported embryo-related research in the United States until the passing of the August 2000 NIH guidelines. Although history can always be a rhetorical resource for policymaking, it is hardly anything like a "cause" for policy developments.

Furthermore, political-institutional factors certainly played an important role in the structuring of the space of human embryonic stem cell research. But the same President Clinton, who in 1994 withdrew his support to create embryos for research purposes, in 2000 supported NIH'S decision to fund human embryonic stem cell research with embryos created in the process of IVF. In Germany, the Green politician Minister of Health Andrea Fischer was certainly important in the cautious approach of her agency in the area of stem cell research. However, taking into account the current climate of debate in Germany, any Minister of Health, independent of his or her political affiliation, would have been forced to act in a very careful and hesitant manner.

Instead of focusing on policy legacy or historical-institutional arguments, I stressed the importance of the discursive construction of spaces of decision making in the scientific-political field of human embryonic stem cell research. The meaning of a part of the human body, such as a stem cell, or the relevance of embryonic stem cells for medical research is the outcome of a struggle between competing language games or discourses, which transform "what is out there" into something that is socially and politically relevant signified. Actors mobilize what I have called heterogeneous systems of representation, intermediations between the symbolic and the material, that give broadly accepted, hegemonic definitions of the political and scientific realities, rationalities, and types of actors and institutions involved in a policy field. In the United States and in Germany, people talked about the same types of cells gained from embryos or fetuses. But these cells, embyos, and fetuses took on different meanings com bined with different words and arguments. It was during such complicated discursive elaborations, that in the United States human embryonic stem cell research began broadly to be viewed as a reasonable and important project for the United States to pursue, whereas in Germany embryonic stem cell research increasingly took on the air of an assault on humanity.

Although such discursive constructions always are fragile and subject to change, they can nevertheless lead to the temporary establishment of patterns to deal with certain types of problems. A point in case are the developments in stem cell policies in the United States and in Germany from the second half of 2001. Just as President Bush's new policy on stem cell research laid out in his August 9, 2001, speech constituted a nuanced readjustment of the Clinton administration's approach, the debate in Germany about the import of stem cell lines reflected a cautious policy maneuver within the tight framework of the Embryo Protection Act. Whereas in the United States, a national consensus seemed to exist that stem cell research should proceed as a project of national interest, in Germany, the interpretation still prevails that this line of research potentially undermines core values of German society.

As this article has shown, scientific practices, such as pursuing research with embryonic stem cells, are not only closely tied to multilayered processes of interpretation that create meanings and images. They are also social and political practices and thus can be consistent or inconsistent with the imagined collective images and identities of a country. Political identities and dominant metanarratives are not given or fixed and are in a constant state of definition and redefinition. But once mobilized and referred to, they can become a critical resource for the shaping of policymaking.

Notes

Drafts of this article were delivered at the 96th Annual Meeting of the American Political Science Association, Washington, DC, August 31-September 3, 2000, and at the European Council for Political Research (ECPR) Joint Sessions of Workshops, Grenoble, April 6-11, 2001.

(1.) A blastocyst is an early embryo of 30-150 cells.

(2.) One of the few relatively uncontested assumptions in the debate about embryo and fetal research is that an organism is a fetus from about the ninth week of development until the time of birth.

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Herbert Gottweis is a professor of political science at the University of Vienna, Austria. He taught previously at Cornell University, Hong University of Science and Technology, and the University of Salzburg. Among his books is Governing Molecules: The Discursive Politics of Genetic Engineering in Europe and in the United States (MIT Press, 1998). Gottweis is currently working on a book on stem cell and cloning policies in Germany, the United Kingdom, the United States, and Israel.

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