Order Code RL31015
CRS Report for Congress
Received through the CRS Web
Stem Cell Research
Updated December 13, 2004
Judith A. Johnson
Specialist in Life Sciences
Domestic Social Policy Division
Erin Williams
Specialist in Bioethical Policy
Domestic Social Policy Division
Congressional Research Service ˜ The Library of Congress

Stem Cell Research
Summary
Embryonic stem cells have the ability to develop into virtually any cell in the
body, and may have the potential to treat medical conditions such as diabetes and
Parkinson’s disease. In August 2001, President Bush announced that for the first
time federal funds would be used to support research on human embryonic stem
cells, but funding would be limited to “existing stem cell lines.” The National
Institutes of Health (NIH) has established the Human Embryonic Stem Cell Registry,
which lists stem cell lines that are eligible for use in federally funded research.
Although 78 cell lines are listed, 22 embryonic stem cell lines are currently available.
Scientists are concerned about the quality, longevity, and availability of the eligible
stem cell lines. For a variety of reasons, many believe research advancement requires
new embryonic stem cell lines, and for certain applications, stem cells derived from
cloned embryos may offer the best hope for progress in understanding and treating
disease. A significant cohort of pro-life advocates support stem cell research; those
opposed are concerned that the isolation of stem cells requires the destruction of
embryos. Letters from Congress, one signed by 206 Members of the House and a
second signed by 58 Senators, have been sent urging President Bush to expand the
current federal policy concerning embryonic stem cell research.
Some have argued that stem cell research be limited to adult stem cells obtained
from tissues such as bone marrow. They argue that adult stem cells should be
pursued instead of embryonic stem cells because they believe the derivation of stem
cells from either embryos or aborted fetuses is ethically unacceptable. Other
scientists believe adult stem cells should not be the sole target of research because
of important scientific and technical limitations. Groups make ethical distinctions
in the debate on how to proceed with stem cell research based upon embryo
protection, relief of suffering, viability, the purpose and timing of embryo creation
and destruction, donor consent, scientific alternatives, federal funding, and cloning.
On February 27, 2003, the House passed H.R. 534 (Dave Weldon), which would
ban the process of human cloning and the importation of any product derived from
an embryo created via cloning. Cloning could not be used for reproductive purposes
or for research on therapeutic purposes, which has implications for stem cell
research. The House defeated a substitute amendment, H.Amdt. 5, that would have
banned only human reproductive cloning; the ban would have sunset after 10 years.
H.R. 801 (Greenwood) is similar to H.Amdt 5. S. 245 (Brownback) would ban
reproductive cloning and research on therapeutic cloning; S. 303 (Hatch) would ban
only reproductive cloning. Supporters of H.R. 534 argue that a partial ban on human
cloning, such as S. 303 and H.R. 801, would be impossible to enforce. Critics argue
that H.R. 534 would curtail medical research and prevent Americans from receiving
life-saving treatments created overseas. President Bush has stated his support for the
Weldon bill, but 40 Nobel Laureates, who are in favor of nuclear transplantation
technology for research and therapeutic purposes, are strongly opposed to the
legislation. H.R. 3960 (Millender-McDonald) and H.R. 4682 (Castle) would fund
research on embryonic stem cell lines derived after the August 9, 2001, policy
established by the Bush Administration. This report will be updated as needed.

Contents
Overview of Basic Research and Potential Applications . . . . . . . . . . . . . . . . 1
Stem Cells from Embryos or Fetal Tissue . . . . . . . . . . . . . . . . . . . . . . . 1
Stem Cells from Adult Tissue or Umbilical Cord Blood . . . . . . . . . . . . 2
Potential Applications of Stem Cell Research . . . . . . . . . . . . . . . . . . . . 3
Current Federal Regulatory Landscape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The Dickey Amendment and Clinton Administration Stem Cell
Policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Bush Administration Stem Cell Policy . . . . . . . . . . . . . . . . . . . . . . . . . 6
Agency Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Access to Stem Cell Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
State Legislation on Embryonic Stem Cell Research . . . . . . . . . . . . . . . . . 13
Congressional Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
International Actions on Embryonic Stem Cell Research . . . . . . . . . . . . . . 20
Ethical Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Embryo Destruction and Relief of Human Suffering . . . . . . . . . . . . . 26
Viability of Embryos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Generating Embryonic Stem Cells Without Destroying
Human Embryos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Purpose of Embryo Creation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
New and Existing Cell Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Consent of Donors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Effectiveness of Alternatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Use of Federal Funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
List of Tables
Table 1. National Institutes of Health Funding . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Table 2. NIH List of Human Embryonic Stem Cell Lines Eligible for Use
in Federal Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Stem Cell Research
Overview of Basic Research and Potential Applications
Most cells within an animal or human being are committed to fulfilling a single
function within the body. In contrast, stem cells are a unique and important set of
cells that are not specialized. Stem cells retain the ability to become some or all of
the more than 200 different cell types in the body and thereby play a critical role in
repairing organs and body tissues throughout life. Although the term stem cells is
often used in reference to these repair cells within an adult organism, a more
fundamental variety of stem cells is found in the early stage embryo. Embryonic
stem cells may have a greater ability to become different types of body cells than
adult stem cells.

Stem Cells from Embryos or Fetal Tissue. Embryonic stem cells were
first isolated from mouse embryos in 1981. Animal embryos were the only source
for research on embryonic stem cells until November 1998, when two groups of U.S.
scientists announced the successful isolation of human embryonic stem cells. One
group, at the University of Wisconsin, derived stem cells from five-day-old embryos
produced via in vitro fertilization (IVF).1 The work is controversial, in the opinion
of some individuals, because the stem cells are located within the embryo and the
process of removing them destroys the embryo. The second group, at Johns Hopkins
University, derived cells with very similar properties from five- to nine-week-old
embryos or fetuses obtained through elective abortion.2 Both groups reported the
human embryos or fetuses were donated for research following a process of informed
consent. The cells were then manipulated in the laboratory to create embryonic stem
cell lines that may continue to divide for many months to years.
Another potential source of embryonic stem cells is somatic cell nuclear transfer
(SCNT), also referred to as cloning.3 In SCNT the nucleus of an egg is removed and
replaced by the nucleus from a mature body cell, such as a skin cell. The cell created
1 The IVF embryos were originally created for the treatment of infertility. Excess embryos
are often frozen in liquid nitrogen for future use. A couple may elect to discard their excess
embryos, donate the embryos for research, or allow another couple to adopt an embryo.
According to a survey of over 430 infertility clinics performed by the Society for Assisted
Reproductive Technology and RAND, nearly 400,000 embryos are being stored in the
United States; 88% of the embryos are being held to help the couples have children at a later
date.
2 Scientists and physicians use the term embryo for the first eight weeks after fertilization,
and fetus for the ninth week through birth. In contrast, the Department of Health and
Human Services (HHS) regulations define fetus as “the product of conception from the time
of implantation.” (45 C.F.R. § 46.203)
3 A somatic cell is a body cell. In contrast, a germ cell is an egg or sperm cell.

CRS-2
via SCNT is allowed to develop for a week and then the stem cells are removed. In
1996, scientists in Scotland used the SCNT procedure to produce Dolly the sheep,
the first mammalian clone.4 In February 2004, Korean scientists announced that they
had created human embryos via the SCNT process and had succeeded in isolating
human stem cells from a cloned embryo. This development and the unsubstantiated
announcement by Clonaid in December 2002 of the birth of a cloned child have
contributed to the controversy over research on human embryos.5
Some scientists have begun to explore ways of obtaining human embryonic stem
cells that bypass the destruction of living human embryos. One possibility under
discussion is deriving human embryonic stem cells from dead embryos. For
example, 60% of IVF embryos produced by infertility clinics are judged to be
incapable of developing to live birth, due to abnormal appearance or failure to divide
appropriately, and are not used by the infertile couple. Although failure to divide is
often caused by genetic abnormalities and might seem to eliminate any prospect of
using these embryos even for research, several studies suggest that some normal
cells may be obtained from such organismically dead embryos and may be useful in
creating stem cell lines.
Another possibility involves using the techniques of genetic engineering and
SCNT to obtain human embryonic stem cells from embryo-like groups of cells which
are not, in the strict sense, human embryos. This newly proposed approach, called
altered nuclear transfer (ANT), might serve as a temporary bridge until other
technologies are developed, such as direct nuclear reprogramming of somatic cells.
Until then, with federal support ANT would allow embryonic stem cell research
collaboration on a national level without the ethical concerns involved in using
leftover IVF embryos. A remaining obstacle, acquiring human eggs, is the subject
of intense scientific research. Researchers are trying to develop methods of obtaining
eggs without resorting to superovulation of female patients, an expensive procedure
that some find morally questionable.
Stem Cells from Adult Tissue or Umbilical Cord Blood. Stem cells
obtained from adult organisms are also the focus of research. There have been a
number of recent publications on adult stem cells from a variety of different sources,
such as bone marrow and the umbilical cord following birth. In addition, a number
of private companies (such as MorphoGen, NeuralStem, Osiris Therapeutics,
StemSource, ViaCell) are working on therapeutic uses of adult stem cells.
Some advocate that adult instead of embryonic stem cell research should be
pursued because they believe the derivation of stem cells from either IVF embryos
or aborted fetuses is ethically unacceptable. Others believe that adult stem cells
4 Dolly was euthanized in Feb. 2003 after developing a lung infection. Some claim her
death at 6 years was related to being a clone, but her ailment may also have occurred
because she was raised indoors (for security reasons) rather than as a pastured sheep, which
often live to 12 years of age. G. Kolata, “First Mammal Clone Dies,” New York Times, Feb.
15, 2003, p. A4.
5 For further information, see CRS Report RL31358, Human Cloning, by Judith A. Johnson
and Erin Williams.

CRS-3
should not be the sole target of research because of important scientific and technical
limitations. Adult stem cells may not be as long lived or capable of as many cell
divisions as embryonic stem cells. Also, adult stem cells may not be as versatile in
developing into various types of tissue as embryonic stem cells, and the location and
rarity of the cells in the body might rule out safe and easy access. For these reasons,
many scientists argue that both adult and embryonic stem cells should be the subject
of research, allowing for a comparison of their various capabilities.
Possible Sources of Stem Cells
— embryos created via IVF (for infertility treatment or for research purposes)
— embryos or fetuses obtained through elective abortion
— embryos created via SCNT (somatic cell nuclear transfer, or cloning)
— adult tissues (bone marrow, umbilical cord blood)
Potential Applications of Stem Cell Research. Stem cells provide the
opportunity to study the growth and differentiation of individual cells into tissues.
Understanding these processes could provide insights into the causes of birth defects,
genetic abnormalities, and other disease states. If normal development were better
understood, it might be possible to prevent or correct some of these conditions. Stem
cells could be used to produce large amounts of one cell type to test new drugs for
effectiveness and chemicals for toxicity. Stem cells might be transplanted into the
body to treat disease (diabetes, Parkinson’s disease) or injury (e.g., spinal cord). The
damaging side effects of medical treatments might be repaired with stem cell
treatment. For example, cancer chemotherapy destroys immune cells in patients,
decreasing their ability to fight off a broad range of diseases; correcting this adverse
effect would be a major advance.
Before stem cells can be applied to human medical problems, substantial
advances in basic cell biology and clinical technique are required. In addition, very
challenging regulatory decisions will be required on the individually created tissue-
based therapies resulting from stem cell research. Such decisions would likely be
made by the Center for Biologics Evaluation and Research (CBER) of the Food and
Drug Administration (FDA). The potential benefits mentioned above would be likely
only after many more years of research. Technical hurdles include developing the
ability to control the differentiation of stem cells into a desired cell type (like a heart
or nerve cell) and to ensure that uncontrolled development, such as a cancerous
tumor, does not occur. If stem cells are to be used for transplantation, the problem
of immune rejection must also be overcome. Some scientists think that the creation
of many more embryonic stem cell lines will eventually account for all the various
immunological types needed for use in tissue transplantation therapy. Others
envision the eventual development of a “universal donor” type of stem cell tissue,
analogous to a universal blood donor.
However, if the SCNT technique (cloning) was employed using a cell nucleus
from the patient, stem cells created via this method would be genetically identical to
the patient, would presumably be recognized by the patient’s immune system, and
thus would avoid any tissue rejection problems that could occur in other stem cell

CRS-4
therapeutic approaches. Because of this, many scientists believe that the SCNT
technique may provide the best hope of eventually treating patients using stem cells
for tissue transplantation.
Current Federal Regulatory Landscape
The Dickey Amendment and Clinton Administration Stem Cell
Policy. Prior to an August 2001 Bush Administration decision (see below), no
federal funds had been used to support research on stem cells derived from either
human embryos or fetal tissue.6 The work at the University of Wisconsin and Johns
Hopkins University was supported by private funding from the Geron Corporation.
Private funding for experiments involving embryos was required because Congress
attached a rider to legislation that affected FY1996 National Institutes of Health
(NIH) funding. The rider, an amendment originally introduced by Representative Jay
Dickey, prohibited HHS from using appropriated funds for the creation of human
embryos for research purposes or for research in which human embryos are
destroyed. The Dickey amendment language has been added to each of the Labor,
HHS and Education appropriations acts for FY1997 through FY2005.7 For FY2005,
the provision is found in Section 509 of Division F, which is the Labor, HHS and
Education division of the FY2005 Consolidated Appropriations bill (H.R. 4818, H.
Rept 108-792). It prohibits HHS from using FY2005 appropriated funds for
(1) the creation of a human embryo or embryos for research purposes; or
(2) research in which a human embryo or embryos are destroyed, discarded, or
knowingly subjected to risk of injury or death greater than that allowed for
research on fetuses in utero under 45 CFR 46.208(a)(2) and Section 498(b) of the
Public Health Service Act (42 U.S.C. 289g(b)). For purposes of this section, the
term “human embryo or embryos” includes any organism, not protected as a
human subject under 45 CFR 46 [the Human Subject Protection regulations] ...
that is derived by fertilization, parthenogenesis, cloning, or any other means from
one or more human gametes [sperm or egg] or human diploid cells [cells that
have two sets of chromosomes, such as somatic cells].
There is no similar federal prohibition on fetal tissue research; however, other
restrictions do apply.
Following the November 1998 announcement on the derivation of human
embryonic stem cells, NIH requested a legal opinion from HHS on whether federal
funds could be used to support research on human stem cells derived from embryos.
The January 15, 1999, response from HHS General Counsel Harriet Rabb found that
6 However, federal funds have been provided for research on both human and animal adult
stem cells and animal embryonic stem cells.
7 The rider language has not changed significantly from year to year. The original rider can
be found in Section 128 of P.L. 104-99; it affected NIH funding for FY1996 contained in
P.L. 104-91. For subsequent fiscal years, the rider is found in Title V, General Provisions,
of the Labor, HHS and Education appropriations acts in the following public laws: FY1997,
P.L. 104-208; FY1998, P.L. 105-78; FY1999, P.L. 105-277; FY2000, P.L. 106-113;
FY2001, P.L. 106-554; FY2002, P.L. 107-116; FY2003, P.L. 108-7; and, FY2004, P.L. 108-
199.

CRS-5
the Dickey amendment would not apply to research using human stem cells “because
such cells are not a human embryo within the statutory definition.” The finding was
based, in part, on the determination by HHS that the statutory ban on human embryo
research defines an embryo as an organism that when implanted in the uterus is
capable of becoming a human being. Human stem cells are not and cannot develop
into an organism; they lack the capacity to become organisms even if they are
transferred to a uterus. As a result, HHS maintained that NIH could support research
that uses stem cells derived through private funds, but could not support research that
itself, with federal funds, derives stem cells from embryos because of the federal ban
in the Dickey amendment.
Shortly after the opinion by the HHS General Counsel was released, NIH
disclosed that the agency planned to fund research on stem cells derived from human
embryos once appropriate guidelines were developed and an oversight committee
established. NIH Director Harold Varmus appointed a working group that began
drafting guidelines in April 1999. Draft guidelines were published in the Federal
Register
on December 2, 1999. About 50,000 comments were received during the
public comment period, which ended February 22, 2000. On August 25, 2000, NIH
published in the Federal Register final guidelines on the support of human
embryonic stem cell research. The guidelines stated that studies utilizing “stem cells
derived from human embryos may be conducted using NIH funds only if the cells
were derived (without federal funds) from human embryos that were created for the
purposes of fertility treatment and were in excess of the clinical need of the
individuals seeking such treatment.” Under the guidelines, NIH would not fund
research directly involving the derivation of human stem cells from embryos; this
was prohibited by the Dickey amendment.
Other areas of research ineligible for NIH funding under the guidelines include
(1) research in which human stem cells are utilized to create or contribute to a human
embryo; (2) research in which human stem cells are combined with an animal
embryo; (3) research in which human stem cells are used for reproductive cloning of
a human; (4) research in which human stem cells are derived using somatic cell
nuclear transfer, i.e., the transfer of a human somatic cell nucleus into a human or
animal egg; (5) research utilizing human stem cells that were derived using somatic
cell nuclear transfer; and (6) research utilizing stem cells that were derived from
human embryos created for research purposes, rather than for infertility treatment.
NIH began accepting grant applications for research projects utilizing human
stem cells immediately following publication of the guidelines; the deadline for
submitting a grant application was March 15, 2001. All such applications were to be
reviewed by the NIH Human Pluripotent Stem Cell Review Group (HPSCRG),
which was established to ensure compliance with the guidelines. James Kushner,
director of the University of Utah General Clinical Research Center, served briefly
as chair of the HPSCRG. Applications would also have undergone the normal NIH
peer-review process.8 The first meeting of the HPSCRG was scheduled for April 25,
8 According to media sources, as of Apr. 2001 only three grant applications had been
submitted to NIH, and one was subsequently withdrawn. (Washington FAX, Apr. 19, 2001.)
(continued...)

CRS-6
2001. The HPSCRG was to conduct an ethical review of human pluripotent stem
cell lines to determine whether the research groups involved had followed the NIH
guidelines in deriving the cell lines. However, in mid April 2001, HHS postponed
the meeting until a review of the Clinton Administration’s policy decisions on stem
cell research was completed by the new Bush Administration.9 According to media
sources, the 12 HPSCRG members, whose names were not made public, represented
a wide range of scientific, ethical and theological expertise and opinion, as well as
at least one “mainstream Catholic.”10
The Bush Administration conducted a legal review of the policy decisions made
during the Clinton Administration regarding federal support of stem cell research, as
well as a scientific review, prepared by NIH, of the status of the research and its
applications. The scientific review was released on July 18, 2001, at a hearing on
stem cell research held by the Senate Appropriations Subcommittee on Labor, Health
and Human Services and Education.11 The NIH report did not make any
recommendations, but argued that both embryonic and adult stem cell research
should be pursued.
Bush Administration Stem Cell Policy. On August 9, 2001, President
Bush announced that for the first time federal funds would be used to support
research on human embryonic stem cells, but funding would be limited to “existing
stem cell lines where the life and death decision has already been made.”12 President
Bush stated that the decision “allows us to explore the promise and potential of stem
cell research without crossing a fundamental moral line, by providing taxpayer
funding that would sanction or encourage further destruction of human embryos that
have at least the potential for life.” The President also stated that the federal
government would continue to support research involving stem cells from other
sources, such as umbilical cord blood, placentas, and adult and animal tissues,
“which do not involve the same moral dilemma.”
8 (...continued)
Presumably, scientists were reluctant to invest the time and effort into preparing the
necessary paperwork for the NIH grant application process when the prospects of receiving
federal funding were uncertain under the new Bush Administration. (P. Recer, “Stem Cell
Studies Said Hurt by Doubt.” AP Online, May 2, 2001.) In a related development, one of
the leading U.S. researchers on stem cells, Roger Pederson of the University of California,
San Francisco, decided to move his laboratory to the United Kingdom for “the possibility
of carrying out my research with human embryonic stem cells with public support.” (Aaron
Zitner, “Uncertainty Is Thwarting Stem Cell Researchers.” Los Angeles Times, July 16,
2001, pp. A1, A8.) Human embryonic stem cell research was approved overwhelmingly by
the House of Commons in Dec. 2000 and the House of Lords in Jan. 2001.
9 Rick Weiss, “Bush Administration Order Halts Stem Cell Meeting; NIH Planned Session
to Review Fund Requests.” Washington Post, Apr. 21, 2001, p. A2.
10 Ibid.
11 National Institutes of Health, Department of Health and Human Services. Stem Cells:
Scientific Progress and Future Research Directions
, June 2001. The NIH scientific report
can be found at [http://stemcells.nih.gov/info/scireport/]
12 The Aug. 9, 2001, Remarks by the President on Stem Cell Research can be found at
[http://www.whitehouse.gov/news/releases/2001/08/20010809-2.html].

CRS-7
Under the Bush policy, federal funds may only be used for research on existing
stem cell lines that were derived (1) with the informed consent of the donors; (2)
from excess embryos created solely for reproductive purposes; and (3) without any
financial inducements to the donors.13 NIH was tasked with examining the derivation
of all existing stem cell lines and creating a registry of those lines that satisfy the
Bush Administration criteria. According to the White House, this will ensure that
federal funds are used to support only stem cell research that is scientifically sound,
legal, and ethical. Federal funds will not be used for (1) the derivation or use of stem
cell lines derived from newly destroyed embryos; (2) the creation of any human
embryos for research purposes; or (3) the cloning of human embryos for any purpose.
Agency Regulation. Many entities and individuals that conduct research on
humans (“human subjects” research) are both federally and institutionally regulated.
Ex vivo embryos (those not in a uterus) are not considered “human subjects” for
these purposes, though federally funded research on them is regulated by the Dickey
Amendment as described above. Stem cells and stem cell lines are not considered
“human subjects,” nor are they governed by the Dickey Amendment.
Two HHS agencies, FDA and NIH, regulate some aspects of stem cell research,
even if research on stem cell lines is not classified as “human subjects” research.
FDA, the agency that ensures the safety and efficacy of food, drugs, medical devices
and cosmetics, regulates stem cell research aimed at the development of any
“product” subject to its approval. NIH, the medical and behavioral research agency
within HHS, regulates stem cell research that it funds in compliance with President
Bush’s 2001 policy. In accordance, NIH has created a Human Embryonic Stem Cell
Registry that lists the human embryonic stem cell lines that meet the eligibility
criteria as outlined in the Bush Administration stem cell policy.
FDA Regulation. All of the human embryonic stem cell lines listed on the
NIH Human Embryonic Stem Cell Registry (see Table 2) have been grown on beds
of mouse “feeder” cells. The mouse cells secrete a substance that prevents the human
embryonic stem cells from differentiating into more mature cell types (nerve or
muscle cells). Infectious agents, such as viruses, within the mouse feeder cells could
transfer into the human cells. If the human cells were transplanted into a patient,
these infected human cells may cause disease in the patient which could be
transmitted to close contacts of the patient and eventually to the general population.
Public health officials and regulatory agencies such as the FDA are specifically
concerned about retroviruses, which may remain hidden in the DNA only to cause
disease many years later, as well as any unrecognized agents which may be present
in the mouse cells.
The FDA defines xenotransplantation as “any procedure that involves the
transplantation, implantation, or infusion into a human recipient of either (a) live
cells, tissues, or organs from a nonhuman source, or (b) human body fluids, cells,
tissues or organs that have had ex vivo contact with live nonhuman animal cells,
13 The White House, Fact Sheet on Embryonic Stem Cell Research, Aug. 9, 2001, found at
[http://www.whitehouse.gov/news/releases/2001/08/20010809-1.html].

CRS-8
tissues or organs.”14 So transplantation therapy involving Bush approved stem cell
lines, which all have been exposed to mouse feeder cells, would constitute
xenotransplantation. Xenotransplantation products are subject to regulation by the
FDA under Section 351 of the Public Health Service Act (42 USC 262) and the
Federal Food, Drug and Cosmetic Act (21 USC 321 et. seq.). FDA has developed
guidance documents and the U.S. Public Health Service has developed guidelines on
infectious disease issues associated with xenotransplantation.15
During a Senate hearing on stem cell research held by the Health, Education,
Labor and Pensions Committee on September 5, 2001, HHS Secretary Thompson
stated that the FDA is overseeing 17 investigational protocols involving
xenotransplantation in other areas of clinical research that involve patients.
Therefore, the xenotransplantation-related public health concerns over the human
embryonic stem cell lines may not necessarily preclude the development of
treatments for patients. While the problems presented by xenotransplantation for
clinical research are neither unique to stem cell research nor insurmountable, many
scientists believe it will be preferable to use sterile cell lines when attempting to treat
patients via stem cell transplantation, and scientists have been successful in
developing human embryonic stem cells that can be maintained without the use of
mouse feeder cells.16
NIH Research Funding and Stem Cell Registry. The Bush
Administration’s August 9, 2001, policy statement on stem cell research and the NIH
Stem Cell Registry effectively replaced the NIH stem cell guidelines that were
developed under the Clinton Administration and never fully implemented. Grant
proposals for embryonic stem cell research undergo only the normal peer-review
process without the added review of the HPSCRG as had been specified under the
Clinton NIH stem cell guidelines. In February 2002, NIH announced the approval
of the first expenditures for research on human embryonic stem cells. Funding for
stem cell research by NIH is shown in Table 1. The NIH website provides additional
information about current stem cell activities and funding opportunities.17
Table 1. National Institutes of Health Funding
($ in millions)
FY2001
FY2002
FY2003
FY2004
FY2005
Stem cell research
$306
$387
$517
N/A
N/A
Human embryonic stem cell research
(0)
(10.7)
(20)
(25)
N/A
Source: NIH Budget Office, November 29, 2004.
14 Xenotransplantation Action Plan: FDA approach to the regulation of xenotransplantation.
Available at [http://www.fda.gov/cber/xap/xap.htm].
15 These documents are available at [http://www.fda.gov/cber/xap/xap.htm].
16 National Institutes of Health, Department of Health and Human Services, Stem Cells:
Scientific Progress and Future Research Directions
, June 2001, pp. 95-96.
17 See [http://stemcells.nih.gov/research/funding/].

CRS-9
The NIH Human Embryonic Stem Cell Registry lists stem cell lines that are
eligible for use in federally funded research and currently available to be shipped to
scientists.18 As shown in Table 2, the NIH registry originally listed universities and
companies that had derived a total of 78 human embryonic stem cell lines which
were eligible for use in federally funded research under the August 2001 Bush
Administration policy. However, many of these stem cell lines were found to be
either unavailable or unsuitable for research. As of August 11, 2004, the NIH
registry listed a total of 22 stem cell lines available from seven sources as shown
below.
Table 2. NIH List of Human Embryonic Stem Cell Lines Eligible
for Use in Federal Research
Namea
Number of stem cell
lines
Eligible
Available
BresaGen, Inc., Athens, GA
4
3
Cell & Gene Therapy Institute (Pochon CHA University), Seoul,
2
Korea
Cellaritis AB, Goteborg, Sweden
3
2
CyThera, Inc., San Diego, CA
9
0
ES Cell International, Melbourne, Australia
6
6
Geron Corporation, Menlo Park, CA
7
Goteborg University, Goteborg, Sweden
16
Karolinska Institute, Stockholm, Sweden
6
0
Maria Biotech Co. Ltd. — Maria Infertility Hospital Medical
3
Institute, Seoul, Korea
MizMedi Hospital — Seoul National University, Seoul, Korea
1
1
National Center for Biological Sciences/Tata Institute of
3
Fundamental Research, Bangalore, India
Reliance Life Sciences, Mumbai, India
7
Technion University, Haifa, Israel
4
3
University of California, San Francisco, CA
2
2
Wisconsin Alumni Research Foundation, Madison, WI
5
5
Total
78
22
a. Entities in italics do not have stem cell lines available for shipment to U.S. researchers because of
a variety of scientific, regulatory and legal reasons. The zeros entered in the “Available”
column indicate that “the cells failed to expand into undifferentiated cell cultures.”
Access to Stem Cell Lines. Many scientists, disease advocates and others
remain concerned that federally supported research on human embryonic stem cells
is limited to the number of cell lines that meet the criteria of the August 9, 2001 Bush
policy. As stated above, currently 22 cell lines are available for research with federal
18 Information about the NIH Human Embryonic Stem Cell Registry is available at
[http://stemcells.nih.gov/research/registry/index.asp].

CRS-10
dollars, and an unpublished NIH report indicates that under a best case scenario, a
total of 23 human embryonic stem cell lines will ever be ready for use in research.19
Because the pre-August 9 cell lines were developed in the early days of human stem
cell research using older 1990s techniques, the cell lines not only have the problems
of xenotransplantion described above, but they are harder to work with, not well
characterized, and somewhat unstable.
In reaction to the limitations imposed by the Bush policy, some U.S. research
groups have decided to develop additional human embryonic stem cell lines using
private funding. In June 2004, a team of scientists at the Reproductive Genetics
Institute, a private fertility clinic in Chicago, announced that they had isolated 50 new
human embryonic stem cell lines from frozen embryos that were donated by patients
following fertility treatment.20 By using genetic diagnosis techniques, the Chicago
team was able to create stem cell lines that carry the gene for muscular dystrophy as
well as stem cell lines with the gene for six other diseases.21 The new stem cell lines
are to be used to understand the origins of disease-related symptoms and to develop
and test new treatments.
In March 2004, a Harvard University laboratory headed by Douglas Melton
announced that using private research dollars they had isolated 17 new human
embryonic stem cell lines.22 In order to perform this work it was necessary to build
a new laboratory so that the group’s federally funded research would be conducted
separately from research on the new stem cell lines. Likewise, although the 17 stem
cell lines are available for use by other laboratories, any research using the new stem
cell lines must be performed at a facility that does not receive federal support. The
Harvard group intends to raise $100 million in private funding to establish a stem cell
center in order to continue the work begun by Melton and his group of scientists. In
October 2004 media reports stated that two groups at the newly formed Harvard Stem
Cell Institute intend to produced cloned human embryos for research studies on
juvenile diabetes, Parkinson’s disease, and several other diseases.23 One of the
groups, headed by Melton, has applied for permission from the university’s ethics
review board to perform the research. The other group, which includes George Q.
Daley and Leonard Zon, has not yet applied for permission. It is unclear when the
university will reach a decision on allowing the experiments to proceed.
In December 2002, Stanford University announced that a gift of $12 million
from an anonymous donor would be used to establish an institute that will use
19 Farhad Manjoo, “Thou Shalt Not Make Scientific Progress,” Salon.com, Mar. 25, 2004,
[http://www.salon.com/tech/feature/2004/03/25/stem_cells/index_np.html].
20 Gareth Cook, “Clinic in U.S. Isolates 50 Lines of Stem Cells,” Boston Globe, June 9,
2004, p. A1.
21 The six diseases are beta thalassemia, neurofibromatosis type 1, Marfan’s syndrome,
myotonic dystrophy, fragile X syndrome, and Fanconi’s anemia.
22 Rick Weiss and Justin Gillis, “New Embryonic Stem Cells Made Available,” Washington
Post
, Mar. 4, 2004, p. A2.
23 Gareth Cook, “Harvard Team Wants OK to Clone; Human-Cell Work Would Be First in
Nation,” Boston Globe, October 13, 2004, p. A1.

CRS-11
expertise in stem cell biology and cancer biology to develop novel treatments for
cancer and other diseases.24 The new institute is headed by Dr. Irving Weissman, a
Professor in Cancer Biology at Stanford. Scientists at the Institute for Cancer/Stem
Cell Biology and Medicine are developing new stem cell lines, some through the
process of SCNT, to study the disease process of a wide range of disorders including
cancer, diabetes, cardiovascular disease, autoimmune disease, allergies, and
neurological disorders such as Parkinson’s and Lou Gehrig’s disease. Initial studies
are performed in mice; however, the work may be extended to human cells and eggs.
The new stem cell lines may allow investigators to better understand the biological
and genetic basis of a disorder and thereby develop new treatments.
In August 2002, the University of California at San Francisco established the
UCSF Developmental and Stem Cell Biology Program with a $5 million matching
grant from Andy Grove, the chairman of Intel Corporation. The program funds basic
studies (using both animal and human cells) in stem cell biology and their translation
into clinical practice with a goal of developing treatments for such diseases as
diabetes, cardiovascular disease, Parkinson’s disease, Alzheimer’s disease and spinal
cord injury. UCSF and the University of Wisconsin are the only two universities in
the United States that have derived human embryonic stem cell lines that qualified
for inclusion on the NIH Stem Cell Registry. This past winter, the new UCSF stem
cell program announced it had met the Grove “Stem Cell Challenge” and had raised
the total funding for the program to more than $11 million in gifts and matching
funds. The program recently awarded $50,000 grants to four scientists who are
studying various aspects of stem cell biology.25
A worldwide survey of laboratories conducted by the Boston Globe found that
as of May 23, 2004, 128 human embryonic stem cell lines had been created since
August 9, 2001; all would be ineligible for use in federally funded research under the
Bush policy on stem cell research.26 More lines are being created in laboratories
overseas than in the United States, according to the survey. The survey found that
94 were created in labs outside the United States and 34 were created in this country.
Of the 128 lines, 51 of the new stem cell lines are currently available for use, the
remaining cell lines are not available for a variety of technical or legal reasons. For
example, some cell lines have not yet been fully characterized to determine their
stability or suitability for research. However, eventually their status is to be
determined by using laboratory techniques. In Japan, stem cell lines are not allowed
to be shipped to laboratories in other countries. In the United Kingdom, stem cell
24 For further information, see the Stanford University Medical Center website at
[http://mednews.stanford.edu/stemcellQA.html].
25 UCSF News Office, UCSF Names First Director of its Stem Cell Biology Program, Apr.
26, 2004. See [http://pub.ucsf.edu/newsservices/releases/200404261/].
26 Gareth Cook, “94 New Cell Lines Created Abroad since Bush Decision,” Boston Globe,
May 23, 2004, p. A14.

CRS-12
lines cannot be shipped abroad until they have been processed by the new UK Stem
Cell Bank.27
In response to concerns over access to human embryonic stem cell lines, in April
2004, a group of over 200 Members of the House of Representatives sent a letter to
President Bush requesting that the Administration revise the current stem cell policy
and utilize the embryos that are created in excess of need during the treatment of
infertile couples.28 The letter points out that an estimated 400,000 frozen IVF
embryos29 “will likely be destroyed if not donated, with informed consent of the
couple, for research.” According to the letter,
scientists are reporting that it is increasingly difficult to attract new scientists to
this area of research because of concerns that funding restrictions will keep this
research from being successful. ... We have already seen researchers move to
countries like the United Kingdom, which have more supportive policies. In
addition, leadership in this area of research has shifted to the United Kingdom,
which sees this scientific area as the cornerstone of its biotech industry.
Under the direction of the White House, NIH Director Elias A. Zerhouni sent
a letter in response to the House Members which restates the Bush Administration
position against using federal funds for research involving the destruction of human
embryos.30 The letter from NIH Director Zerhouni did contain the following sentence
which some observers believe indicates a potential future policy shift: “And
although it is fair to say that from a purely scientific perspective more cell lines may
well speed some areas of human embryonic stem cell research, the president’s
position is still predicated on his belief that taxpayer funds should not ‘sanction or
encourage further destruction of human embryos that have at least the potential for
life.”31 Although White House spokesperson Claire Buchan stated that the sentence
does not indicate the president’s position has changed, supporters of stem cell
research point out that it concedes that science could benefit from additional stem
cell lines and that the president’s position now rests solely on ethical arguments.
27 For further information on the UK Stem Cell Bank, see [http://www.nibsc.ac.uk/divisions/
cbi/stemcell.html].
28 See [http://www.house.gov/degette/news/releases/040428.pdf].
29 A survey conducted in 2002 and published in 2003 by the Society for Assisted
Reproductive Technology and RAND determined that nearly 400,000 frozen embryos are
stored in the United States, but most are currently target for patient use. See David I.
Hoffman et al., “Cryopreserved Embryos in the United States and Their Availability for
Research,” Fertility and Sterility, v. 79, May 2003, p. 1063-1069.
30 Rick Weiss, “Bush’s Stem Cell Policy Reiterated, but Some See Shift,” The Washington
Post
, May 16, 2004, p. A18.
31 Letter from Elias A. Zerhouni, Director, National Institutes of Health, to The Honorable
Diana DeGette and The Honorable Michael Castle, May 14, 2004.

CRS-13
A letter signed by 58 Senators urging President Bush to expand the current
federal policy concerning embryonic stem cell research was sent on June 4, 2004.32
The letter states that “despite the fact that U.S. scientists were the first to derive
human embryonic stem cells, leadership in this area of research is shifting to other
countries such as the United Kingdom, Singapore, South Korea and Australia.”
On July 14, 2004, HHS Secretary Thompson announced in a letter to Speaker
of the House Dennis Hastert that NIH would establish Centers of Excellence in
Translational Stem Cell Research.33 The new centers will be funded by $18 millions
in grants over a four year period and will investigate how stem cells can be used to
treat a variety of diseases. NIH will also create a National Embryonic Stem Cell
Bank that will collect in one location many of the stem cell lines that are eligible for
federal research funding. In the letter to Speaker Hastert, Secretary Thompson stated
that “before anyone can successfully argue the stem cell policy should be broadened,
we must first exhaust the potential of the stem cell lines made available with the
policy.”34 In reaction to the announcement, the President of the Coalition for the
Advancement of Medical Research stated that “creating a bank to house stem cell
lines created before August 2001 does nothing to increase the wholly inadequate
supply of stem cell lines for research.”35 The co-sponsors of the Stem Cell Research
Enhancement Act (H.R. 4682), Representative Michael Castle and Representative
Diana DeGette are quoted as saying that the plan is “a positive step forward but stops
short of providing researchers the full support they need.”36
Because of the current lack of federal regulation, the National Academies
established in July 2004 the Committee on Guidelines for Human Embryonic Stem
Cell Research to develop voluntary guidelines for deriving, handling and using
human embryonic stem cells. The guidelines will take into account important
scientific, ethical, and policy issues in this new area of research, including the use
and derivation of new stem cell lines created by nuclear transplantation, from surplus
IVF embryos, and from embryos created with donated gametes. The stated position
of the National Academies is that there should be a global ban on human
reproductive cloning and therefore the guidelines will focus only on therapeutic and
research uses of human embryonic stem cells and somatic cell nuclear transfer. A
final report from the Committee is expected in January 2005.
State Legislation on Embryonic Stem Cell Research
The Dickey Amendment restricts federal funding for embryo research; however,
states are the principal sources of direct regulation of non-federally funded embryo
research. State laws vary widely in their application and content. Nebraska, New
32 See [http://feinstein.senate.gov/04Releases/r-stemcell-ltr.pdf].
33 Andrew J. Hawkins, “NIH Stem Cell Bank, Centers of Excellence Will Fast-Track
Translational Research, Says Thompson,” Washington FAX, July 15, 2004.
34 Ibid.
35 Ibid.
36 Ibid.

CRS-14
Jersey, California and New Hampshire have enacted legislation directly regarding
stem cell research. Nebraska prohibits the use of state funds for embryonic stem cell
research (Nebraska Health Care Funding Act §71-7606(3)). New Hampshire’s
Safety and Welfare statutes (Title VXII §168-B: 16 (I, II)) circumscribe the
boundaries of permissible embryo research.37 New Jersey and California encourage
embryonic stem cell research, and permit state funding for it. Kansas restricts its
bioscience funding to exclude research that would be “contrary to federal laws that
are in effect on the date of enactment of [the] act.”38 In addition, several states
introduced stem-cell related legislation in 2004.39
California’s law, enacted in September 2002, was the nation’s first to expressly
permit and encourage research involving the derivation of human embryonic stem
cells and cloned embryos (California Health and Safety Code § 123440, 24185,
12115-7, 125300-320). The law does not authorize practices that were previously
proscribed, but instead provides assurances to researchers and sponsors hesitant to
invest in embryonic stem cell research since the 2001 Bush policy took effect. The
law has reportedly enticed several prominent researchers to move there from other
states. In November 2004, with the endorsement of Governor Arnold
Schwarzenegger, Californians passed Proposition 71, amending the state Constitution
to facilitate embryonic stem cell research. Proposition 71 establishes a California
Institute for Regenerative Medicine, and generates $3 billion in state-bond funding
for embryonic stem cell research over the next 10 years, none of which may be used
to fund reproductive cloning.40
In response to the California initiative, Wisconsin Governor Jim Doyle
announced in November 2004 that the state was providing $750 million in new
funding for stem cell research, including $500 million for new facilities at the
University of Wisconsin. Other states, including Pennsylvania and Massachusetts,
are considering similar efforts in order to remain competitive and prevent the
relocation of scientists and biotechnology firms to California.
New Jersey’s law, enacted in January 2004, specifically permits embryonic stem
cell research, but bans human cloning for reproductive purposes (NJ Permanent
Statutes, Title 26:2Z-2). Like the California law, New Jersey’s stem cell statute
provides assurances to researchers and sponsors and does not contradict the 2001
Bush policy. In May 2004, Governor James McGreevey signed a bill to create the
37 New Hampshire Safety and Welfare statutes (Title VXII §168-B: 16 (I, II) prohibit
“noncryo-preserved” embryos from being maintained for more than 14 days
post-fertilization, and prohibit embryos “donated for use in research” from being
“transferred to a uterine cavity.”
38 HB 2647 (2004); 12-1770a (Supp) (2004). It is unclear whether the 2001 Bush stem cell
policy would be interpreted to be a “law” for purposes of Kansas’s HB 2647. If so,
Kansas’s funding of stem cell research would be limited to those lines approved for federal
funding under the Bush policy.
39 John T. Softcheck, “Massachusetts Measure Would Permit Use of State Funds for Stem
Cell Research,” Washington Fax, Dec. 11, 2002; “U.S. States Making Stem Cell Policies,”
Bionews, no. 258, May 5, 2004.
40 Proposition 71, at [http://www.voterguide.ss.ca.gov/propositions/prop71text.pdf].

CRS-15
first state-funded embryonic stem cell research center, a $25 million endeavor.41 The
legislature funded the measure on June 25, 2004, passing a state budget that allocates
$9.5 million to the newly chartered Stem Cell Institute of New Jersey.42 The state
money is supposed to attract private investment, which Dr. Ira Black, the Institute’s
founding Director, says has already happened.43
In an effort to discourage abortion, 15 states restrict research on fetuses and
embryos that have been aborted, which may preclude some forms of stem cell
research. Among the states with such restrictions are California, which encourages
stem cell research in other law, Pennsylvania, which is considering pro-stem cell
research legislation, and Nebraska, which prohibits the use of state funds for stem
cell research. The restrictions on aborted fetal and embryonic tissue research vary
in scope among the states. Arizona, Indiana, North Dakota, Ohio, Oklahoma, and
South Dakota prohibit research on living and nonliving fetuses or embryos.
Arkansas, California, Florida, Montana, and Nebraska prohibit research on aborted
live fetuses. Massachusetts and Pennsylvania prohibit research on embryos and live
fetuses. Illinois prohibits research on aborted living and nonliving fetuses. Missouri
prohibits research on live fetuses before abortion. The remaining 35 states do not
prohibit research using aborted fetal tissue.
Thirteen states have restrictions on research using fetal or embryonic tissue
derived from processes other than abortion (such as in vitro fertilization (IVF) or
cloning), which may also preclude some forms of stem cell research. Among them
are Louisiana, which is considering pro-stem cell legislation, and North Dakota,
South Dakota and Illinois, which also prohibit research on fetuses and embryos.
Illinois prohibits research on fetuses and embryos. Louisiana prohibits research on
fetuses and embryos in utero and in vitro. Maine, New Mexico, Rhode Island, and
Utah prohibit research on fetuses or embryos born or extracted alive. This restriction
does not apply to pre-implantation in vitro fertilized embryos. South Dakota
prohibits research on embryos outside of a woman’s body or on cells or tissues
derived from an embryo outside a woman’s body. Minnesota prohibits research on
fetuses and on some live embryos. Michigan and North Dakota prohibit research on
live embryos and fetuses, or cloned embryos. The law in Virginia may prohibit
research on cloned embryos or fetuses.44 Arkansas and Iowa prohibit research on
cloned embryos. Thirty-seven states have no such restrictions.
41 “U.S. States Making Stem Cell Policies,” Bionews, no. 258, May 5, 2004.
42 Barbara Mantel, “Analysis: New Jersey Is First State to Fund Research on Stem Cell,”
NPR: All Things Considered, June 25, 2004.
43 Ibid.
44 “Virginia law does not expressly prohibit research on cloned embryos, but it is forbidden
to possess the product of human cloning. Under the state human cloning statute human
cloning is defined as the creation of or attempt to create a human being by transferring the
nucleus from a human cell from whatever source into an oocyte from which the nucleus has
been removed. Human being is not defined as to whether it includes neonates, embryos or
fetuses only.” Alissa Johnson, “State Embryonic and Fetal Research Laws,” National
Council of State Legislatures
, Jan. 27, 2004, at [http://www.ncsl.org/programs/health/
genetics/embfet.htm#b].

CRS-16
Congressional Actions
A number of hearings have been held by both House and Senate committees on
the topic of stem cell research. With regard to legislation, Congress addressed the
issue of stem cell research in the Consolidated Appropriations Act of 2005 (P.L. 108-
447) by again including the Dickey Amendment which has banned, since FY1996,
almost all publically funded human embryo research. The act also bars the Patent
and Trademark Office from spending money “to issue patents on claims directed to
or encompassing a human organism.” This restriction, which was first included in
the Consolidated Appropriations Act of 2004 (P.L. 108-199), could potentially deter
human stem cell research because researchers might not be able to claim ownership
of their work.
In FY2004, the Consolidated Appropriations Act of 2004 (P.L. 108-199)
provided $10,000,000 to establish a National Cord Blood Stem Cell Bank within the
Health Resources and Services Administration (HRSA). HRSA was directed to use
$1,000,000 to contract with the Institute of Medicine to conduct a study that would
recommend the optimal structure for the cord blood program. The study is to be
completed by the end of March 2005. For FY2005, H.R. 4818 provides $9,941,000
for the National Cord Blood Stem Cell Bank Program in HRSA.
Two other bills, H.R. 2852 (Christopher Smith) and S. 1717 (Hatch), both titled
the Cord Blood Stem Cell Act of 2003, would amend the Public Health Service Act
to establish a National Cord Blood Stem Cell Bank Network to prepare, store, and
distribute human umbilical cord blood stem cells for the treatment of patients and to
support peer-reviewed research using this type of stem cell. H.R. 2852 was referred
to the Committee on Energy and Commerce. S. 1717 was referred to the Committee
on Health, Education, Labor and Pensions.
H.R. 3960 (Millender-McDonald), the Stem Cell Replenishment Act of 2004,
was introduced on March 11, 2004. H.R. 3960 authorizes the use of federal funds
for research on human embryonic stem cells irrespective of the date on which the
derivation process for the stem cells was initiated or completed. The bill directs the
Director of NIH to review the guidelines and notices published by NIH with respect
to human embryonic stem cell research and revise the guidelines and notices to
ensure the availability of not less than 60 stem cell lines that are able to be used for
scientific research. H.R. 3960 was referred to the House Committee on Energy and
Commerce on March 30, 2004.
H.R. 4531 (Ackerman), the Ronald Reagan Memorial Stem Cell Research Act
of 2004, was introduced on June 9, 2004. The bill requires HHS through the Director
of NIH to conduct and support research using human embryonic stem cells, and
authorizes an appropriation of $87 million for FY2005 and such sums as may be
necessary for subsequent fiscal years. H.R. 4812 (Deutsch), the Stem Cell Discovery
Through Diversity Act, was introduced on July 12, 2004. The bill requires the
Director of NIH to conduct and support research using human embryonic stem cells,
and to ensure that the research program includes embryos donated from a significant
number of individuals who are members of racial or ethnic minority groups.

CRS-17
H.R. 4682 (Castle), the Stem Cell Research Enhancement Act, was introduced
on June 24, 2004. H.R. 4682 amends the Public Health Service Act and directs the
Secretary of HHS, in consultation with the Director of NIH, to fund research on
embryonic stem cell lines derived after the August 9, 2001 policy established by the
Bush Administration. In accordance with the Dickey Amendment, no federal funds
shall be used to derive stem cells or destroy embryos. Stem cell lines derived after
enactment must meet ethical guidelines established by the NIH. Only embryos that
were originally created for fertility treatment purposes and in excess of clinical need
are eligible for stem cell derivation. Only embryos that the individuals seeking
fertility treatments have determined will not be implanted in a woman and will be
discarded are eligible for stem cell derivation. Written consent is required for
embryo donation. The Secretary in consultation with the Director of NIH shall
promulgate guidelines 60 days after enactment. These guidelines shall ensure that
federally funded researchers adhere to ethical considerations. No federal funds shall
be used to conduct research on unapproved stem cell lines. The Secretary shall
annually report to Congress about stem cell research. H.R. 4682 has been referred
to the House Committee on Energy and Commerce.
On February 27, 2003, the House passed H.R. 534 (Dave Weldon), the Human
Cloning Prohibition Act of 2003 by a vote of 241-155. H.R. 534 amends Title 18 of
the United States Code and would ban the process of human cloning as well as the
importation of any product derived from an embryo created via cloning. Under this
measure, cloning could not be used for reproductive purposes or for research on
therapeutic purposes, which would have implications for stem cell research. H.R.
534 includes a criminal penalty of imprisonment of not more than 10 years and a civil
penalty of not less than $1 million. H.R. 534 is essentially identical to the measure
which passed the House in the 107th Congress (H.R. 2505).
During floor debate on H.R. 534, an amendment, H.Amdt. 4 (Robert Scott), was
agreed to by voice vote. H.Amdt. 4 requires that the General Accounting Office
(GAO), in consultation with the National Academy of Sciences, conduct a study on
the impact of the cloning ban on medical technology and assess the need (if any) for
modification of the cloning ban contained in the bill. A report to Congress with
findings and recommendations would be required within two years of enactment. An
amendment in the nature of a substitute, H.Amdt. 5 (Greenwood), failed by a vote of
174 to 231. The amendment would have prohibited human SCNT technology when
used to initiate a pregnancy but allowed SCNT to be used in medical research.
H.Amdt 5 is similar to H.R. 801 (Greenwood) (see below).
H.R. 534 was introduced on February 5, 2003, and reported (19-12 vote) by the
House Judiciary Committee on February 12, 2003 (H.Rept. 108-18). During mark-
up, four amendments were defeated by 12-19 or by voice vote. The amendments
attempted to either limit the ban to three years, exempt the importation of medical
treatments, exempt the use of cloning in research, or in the creation of additional
stem cell lines. A fifth amendment that would add the GAO study was withdrawn
when Chairman Sensenbrenner assured his support if it was added to the bill during
floor debate.
A companion bill, S. 245 (Brownback), was introduced on January 29, 2003.
It is similar to H.R. 534, except that (1) it does not contain the ban on importation

CRS-18
of products derived from therapeutic cloning; and (2) it amends Title 4 of the Public
Health Service Act (42 U.S.C. §§ 289 et seq.) instead of Title 18 of the United States
Code.45 S. 245 includes a criminal penalty of imprisonment of not more than 10
years and a civil penalty of not less than $1 million. It requires the General
Accounting Office to conduct a study to assess the need (if any) for any changes of
the prohibition on cloning in light of new developments in medical technology, the
need for SCNT to produce medical advances, current public attitudes and prevailing
ethical views on the use of SCNT and potential legal implications of research in
SCNT. The study is to be completed within four years of enactment. S. 245 has
been referred to the Senate Health, Education, Labor, and Pensions Committee.
H.R. 801 (Greenwood), the Cloning Prohibition Act of 2003, was introduced on
February 13, 2003. H.R. 801 would prohibit human reproductive cloning while
allowing cloning for medical research purposes, including stem cell research. The
bill includes a civil penalty of up to $10 million and a criminal penalty of up to 10
years in prison for those convicted of using SCNT for human reproductive purposes,
or for importing the products of human cloning if the products would be used to
initiate a pregnancy. The bill amends the Food, Drug and Cosmetic Act (21 U.S.C.
301 et seq.) and requires that all researchers performing SCNT on human cells must
register their research activity with the HHS Secretary; such registration would most
likely be submitted to the FDA.
H.R. 801 stipulates that all research involving human SCNT be conducted in
accordance with Part 50 (Protection of Human Subjects) and Part 56 (Institutional
Review Boards) of Title 21 of the Code of Federal Regulations (C.F.R.). Under the
bill, individuals whose cells are used for such research (presumably the donor of the
unfertilized egg and the donor of the somatic cell) would be considered human
subjects for the purposes of Parts 50 and 56 of 21 C.F.R. In addition to the
requirements under Parts 50 and 56 of 21 C.F.R., the human cell donors must sign
an informed consent statement declaring that (1) the cells are donated for research
purposes; (2) the donor understands that federal law regulates SCNT and use of
SCNT to initiate a pregnancy is a criminal act; and, (3) the individual does not intend
for the donated cells to be used to initiate a pregnancy. A sunset provision states that
the prohibition would expire 10 years after enactment.
H.R. 801 requires the Secretary of HHS to request a study reviewing the current
state of knowledge on (1) the biological properties of stem cells obtained from
embryos, fetal tissue, and adult tissue; (2) any biological differences of such stem
cells and the consequences for research and medicine; and (3) the ability of stem cells
to generate different types of tissue and their potential clinical uses. The study must
be conducted by the Institute of Medicine or another appropriate public or nonprofit
private entity.
S. 303 (Hatch), the Human Cloning Ban and Stem Cell Research Protection Act
of 2003, was introduced on February 5, 2003. Although S. 303 and H.R. 801 amend
different titles of the United States Code (S. 303 amends Title 18 and H.R. 801
45 By seeking to amend Title 18 of the U.S. Code rather than the Public Health Service Act,
S. 245 would likely be subject to different committee jurisdiction.

CRS-19
amends Title 21), both bills would have the same effect: human reproductive cloning
would be banned, but cloning for medical research purposes would be allowed,
including stem cell research.46 S. 303 includes a criminal penalty of imprisonment
of not more than 10 years and a civil penalty of not less than $1 million.
S. 303 requires the Comptroller General to prepare a report within one year of
enactment that describes the actions taken by the Attorney General to enforce the
prohibition on human reproductive cloning, the personnel and resources used to
enforce the prohibition, and a list of any violations of the prohibition. The
Comptroller General must also prepare a report within one year of enactment on
similar state laws that prohibit human cloning and actions taken by the states’
attorney general to enforce the provisions of any similar state law along with a list
of violations. A report on the coordination of enforcement actions among the federal,
state and local governments must also be prepared by the Comptroller General within
one year of enactment, as well as a report on laws adopted by foreign countries
related to human cloning.
S. 303 also would amend the Public Health Service Act by requiring that human
SCNT be conducted in accordance with the ethical requirements (such as informed
consent, examination by an Institutional Review Board, and protections for safety
and privacy) contained in subpart A of 45 C.F.R. Part 46,47 or Parts 50 and 56 of
21 C.F.R.48 In contrast, H.R. 801 requires that all such research shall be conducted
in accordance with Part 50 and 56 of 21 C.F.R. and does not refer to subpart A of
45 C.F.R. Part 46.49
S. 303 contains a prohibition on conducting SCNT on fertilized human eggs
(oocytes), and states that “unfertilized blastocysts” shall not be maintained after more
than 14 days from its first cell division, aside from storage at temperatures less that
zero degrees centigrade. S. 303 stipulates that a human egg may not be used in
SCNT research unless the egg is donated voluntarily with the informed consent of the
woman donating the egg; H.R. 801 contains a similar egg donation and informed
consent provision. S. 303 also specifies that human eggs or unfertilized blastocysts
46 Ibid.
47 This provision specifies protections due to human beings who participate in research
conducted or supported by HHS and many other departments.
48 This provision specifies protections due to human beings who participate in research
involved in testing a drug or medical device for FDA approval.
49 Often referred to as the Common Rule, 45 C.F.R. Part 46, Subpart A, “applies to all
research involving human subjects conducted, supported or otherwise subject to regulation
by any federal department or agency which takes appropriate administrative action to make
this policy applicable to such research.” The Common Rule covers 18 federal agencies by
force of law or Executive Order. FDA has regulatory authority over research on the
products the agency regulates (food, drugs, medical devices) and applies its own set of
regulations on the protection of human subjects, 21 C.F.R. Parts 50 and 56, that are
generally but not entirely the same as subpart A of 45 C.F.R. Part 46. For further
information, see National Bioethics Advisory Commission, Ethical and Policy Issues in
Research Involving Human Participants
, Appendix C: The Current Oversight System:
History and Description, Aug. 2001.

CRS-20
may not be acquired, received or otherwise transferred for valuable consideration if
the transfer affects interstate commerce. Under S. 303, SCNT may not be conducted
in a laboratory in which human eggs are subject to assisted reproductive technology
treatments or procedures, such as in vitro fertilization for the treatment of infertility.
Violation of these provisions in S. 303 regarding ethical requirements would result
in a civil penalty of not more than $250,000. S. 303 has been referred to the Senate
Judiciary Committee.
Supporters of a total ban on human cloning, such as that contained in H.R. 534,
argue that a partial ban on human cloning, like the one in H.R. 801 or S. 303, would
be impossible to enforce. Critics of the total ban on human cloning argue that SCNT
creates a “clump of cells” rather than an embryo, and that the ban would curtail
medical research and prevent Americans from receiving life-saving treatments
created overseas.
The U.S. Supreme Court has recognized in past cases certain personal rights as
being fundamental and protected from government interference.50 Some legal
scholars believe a ban on human cloning may be struck down by the Supreme Court
because it would infringe upon the right to make reproductive decisions which is
“protected under the constitutional right to privacy and the constitutional right to
liberty.”51 Other scholars do not believe that noncoital, asexual reproduction, such
as cloning, would be considered a fundamental right by the Supreme Court. A ban
on human cloning research may raise other constitutional issues: scientists’ right to
personal liberty and free speech. In the opinion of some legal scholars, any
government limits on the use of cloning in scientific inquiry or human reproduction
would have to be “narrowly tailored to further a compelling state interest.”52
However, no case involving these issues is scheduled to come before the Supreme
Court this term.
International Actions on Embryonic Stem Cell Research
The international community has taken a variety of action regarding stem cell
research. In November 2004, the United Nations General Assembly (UNGA),53
“averted a divisive vote” on two international conventions against human cloning by
adopting Italy’s proposal “to take up the issue again as a declaration at a resumed
50 For further discussion of these issues and their relationship to human cloning, see CRS
Report RL31422, Substantive Due Process and a Right to Clone, by Jon O. Shimabukuro.
51 L.B. Andrews, “Is There a Right to Clone? Constitutional Challenges to Bans on Human
Cloning,” Harvard Journal of Law and Technology, summer 1998, pp. 643-680.
52 Ibid., p. 667.
53 The General Assembly is the main deliberative organ of the United Nations. It is
composed of representatives of all 191 member states, each of which has one vote.
Decisions on important questions, such as those on peace and security, admission of new
Members and budgetary matters, require a two-thirds majority. Decisions on other questions
are reached by a simple majority, at [http://www.un.org/ga/58/ga_background.html].

CRS-21
February session.”54 “A convention is a legally binding treaty, coming into force
upon ratification by a certain number of States. A declaration is not legally binding
but carries moral weight because it is adopted by the international community.”55
Two convention proposals had been under consideration. One, introduced by Costa
Rica and backed by the United States, aimed to proscribe all human embryonic
cloning. A second proposal, introduced by Belgium, sought to proscribe only
reproductive cloning. Both convention proposals were supplanted by the adoption
of the Italy’s proposal for a declaration.
The European Union (EU) clarified its stem cell rules in November 2003,
smoothing the path for EU funding and support for human embryonic stem cell
research.56 Under the terms of its sixth research framework program(FP6), the EU
may fund embryonic stem cell research regardless of the date that the stem cells were
procured from embryos. A cut-off date, which would have created a restriction
similar to the one in the 2001 Bush policy, was under consideration, but was
dropped.57 FP6 allows funding for research on tissue derived from “spontaneous or
therapeutic abortion,” but not for the creation of human embryos for the purpose of
stem cell procurement.58 FP6 implies but does not state that it will allow funding for
research on embryos that remain after IVF, in that it “no longer requir[es] parental
consent where embryos have to be destroyed in order to produce embryonic stem cell
lines.”59 According to Members of the European Parliament, FP6 funding decisions
should depend “both upon the contents of the scientific proposal and the legal
framework of the Member States involved.”60
EU member states have a range of legislation on the subject. According to the
European Commission, the following distinctions can be made as of July 2004:61
54 Press Release GA/L/3270 “Legal Committee Text Calls for Further Discussions on
Human Cloning aimed at ‘Declaration’,” United Nations, November 19, 2004, at
[http://www.un.org/News/Press/docs/2004/gal3270.doc.htm].
55 United Nations, “Human Rights at Your Fingertips,” 1997 at [http://www.un.org/
rights/50/game.htm#28].
56 Committee on Industry, External Trade, Research and Energy, “Integrating and
Strengthening the European Research Area” (2002-2006) (COM(2003) 390 —
C5-0349/2003 — 2003/0151(CNS)) European Parliament (A5-0369/2003), Nov. 4, 2003.
57 John T. Softcheck, “European Union Moves Close to Funding Stem Cell Research with
Two Parliament Votes,” Washington Fax, Nov. 10, 2003.
58 Ibid.
59 “Sixth Framework Programme,” Bulletin EU 11-2003, Research and technology (8/10),
Nov. 26, 2003, at [http://europa.eu.int/abc/doc/off/bull/en/200311/p103069.htm].
60 John T. Softcheck, “European Union Moves Close to Funding Stem Cell Research with
Two Parliament Votes,” Washington Fax, Nov. 10, 2003.
61 Matthiessen-Guyader, ed., “Survey on Opinions from National Ethics Committees or
Similar Bodies, Public Debate and National Legislation in Relation to Human Embryonic
Stem Cell Research and Use,” European Commission, Directorate General: Research, July
2004, at [http://www.europa.eu.int/comm/research/biosociety/pdf/mb_states_230804.pdf].

CRS-22
! Allowing for the procurement of human embryonic stem cells
from excess IVF embryos62 by law under certain conditions:
Belgium, Denmark, Finland, France, Greece, the Netherlands,
Spain,63 Sweden, Switzerland,64 and the United Kingdom.65
! Allowing some research activities on excess IVF embryos, but
having no specific reference to human embryonic stem cell
research:
Estonia, Hungary, Latvia and Slovenia.
! Prohibiting the procurement of human ES cells from excess IVF
embryos but allowing by law for the import and use of human
embryonic stem cell lines under certain conditions:
Germany.
The import and use of human ES cell lines is not explicitly
prohibited in, e.g., Austria and Italy.
! Prohibiting the procurement of human ES cells from excess IVF
embryos: Austria, Ireland Lithuania, Poland and Slovak Republic.
! No specific legislation regarding human embryo research or
human ES cell research: Czech Republic, Luxembourg, Malta,
Portugal and the republic of Cyprus.
! Allowing by law for the creation of human embryos for research
purposes: UK and Belgium are for the moment the only Member
States, which allow by law for the creation of human embryos either
by fertilization of an egg by a sperm, or by somatic cell nuclear
transfer (SCNT, also called therapeutic cloning) for stem cell
procurement. The Dutch Embryo Act of 2002 includes a five-year
moratorium for the creation of embryos for research purposes
including by SCNT.
62 The European Commission used the term “supernumerary” rather than “excess IVF”
throughout their description.
63 Spain “will initially have two ES cell research centers.” “Spain to Begin ES Cell
Research,” Bionews, no. 278, Sept. 27-Oct. 3, 2004, at [http://www.bionews.org.uk/
new.lasso?storyid=2292]. In October 2004, Spain’s new Socialist government “made it
easier for stem cell research to be undertaken” by providing a “framework for granting
authorization for embryo use as well as setting out requirements for corresponding embryo
studies.” Xavier Bosch, “Spain Eases Embryo Research,” The Scientist, Nov. 1, 2004, at
[http://www.biomedcentral.com/news/20041101/01].
64 In November 2004, Swiss voters “endorsed legislation on stem cell research that forbids
the cloning of human embryos but allows scientists to extract the cells from unwanted
embryos to use in research.” “Swiss Voters Back Stem Cell Research,” Los Angeles Times,
Nov. 29, 2004, A4.
65 The UK opened “the world’s first embryonic stem cell bank,” in May 2004, and two months
later “founded a new £16.5 million (USD $30 million) stem cell center in Cambridge ... with
a commitment to fundamental research on both human embryonic and adult stem cells as a
precursor to studying therapeutic applications.” Philip Hunter, “UK to Open Stem Cell
Center,” The Scientist, June 22, 2004, at [http://www.biomedcentral.com/news/20040622/04].
In August 2004, the UK’s Human Fertilisation and Embryology Authority granted the first
license to create embryonic stem cells using SCNT. “HFEA Grants the First Therapeutic
Cloning License for Research” HFEA, Aug. 11, 2004, at [http://www.hfea.gov.uk/
PressOffice/Archive/1092233888].

CRS-23
! Prohibiting the creation of human embryos for research
purposes and for the procurement of stem cells by law or by
ratification of the Convention of the Council of Europe on
Human rights and Biomedicine signed in Oviedo on April 4,
1997:
Austria, Cyprus, Czech Republic, Denmark, Estonia, Finland,
France, Germany, Greece, Hungary, Italy,66 Ireland, Netherlands,
Lithuania, Portugal, Slovak Republic, Slovenia and Spain.
Other countries’ activities designed to regulate and promote stem cell research
have come to the attention of Congress.67 For example, in March 2004, the Canadian
government enacted legislation allowing stem cell and other research to be conducted
on donated embryos created but no longer needed for reproductive purposes.68 Japan
allows the creation of embryos for stem cell and other research, so that its researchers
can “obtain intellectual property rights based on such research.”69 Australia permits
the use of spare IVF embryos for stem cell research,70 and its government has
reportedly allotted $57.9 million to its National Stem Cell Centre.71 Singapore,
which allows scientists to clone human embryos and keep them alive for up to 14
days to extract the stem cells, is reported to have “research-friendly policies and
generous government funding have already helped jump-start the tiny city-state’s
nascent stem cell sector. ... Singapore and the New York-based Juvenile Diabetes
Research Foundation International launched a $3 million funding program to support
stem cell research [in Singapore], ... [and in May 2004, Singapore unveiled] its
resort-like Biopolis, created to give biotech researchers and their families a place to
66 A 2003 Italian law prohibits experiments on human embryos, the production of embryos
for research purposes, and any destruction of human embryos. Guidelines for the Italian
law’s implementation, revealed in July 2004, have been criticized by some, and have
buttressed calls “for the resignation of Health Minister, Girolamo Sirchia,” a supporter of
the law. The new law compels couples using IVF to transfer all fertilized embryos to the
uterus (including those with genetic disorders), despite the fact that, once implanted, they
could legally aborted. Criticism has also arisen due to the law’s chilling effect on stem cell
research. Rosella Lorsnzi, “Italian Minister in Trouble,” The Scientist, Sept. 9, 2004, at
[https://www.biomedcentral.com/news/20040909/04/]; Rosella Lorsnzi, “Outrage Over
Italian Law,” The Scientist, Aug. 2, 2004, at [http://www.biomedcentral.com/news/
20040802/03/].
67 See, e.g., Letter from 58 Senators to President George W. Bush, June 4, 2004; Letter from
206 Members of the House of Representatives to President George W. Bush, Apr. 28, 2004.
68 Assisted Human Reproduction Act (Canadian Bill No. C-6, 2004), LS-466E.
69 “Embryo Stem Cell Research OK’d,” The Japan Times, Feb. 14, 2004, at
[http://202.221.217.59/print/news/nn02-2004/nn20040214b1.htm]; See also, “Japan Allows for
Creation of Embryos for Research,” BioNews no. 269, Jul. 26-Aug. 1, 2004, at
[http://www.bionews.org.uk/new.lasso?storyid=2209].
70 Research Involving Human Embryos Act, no. 145, 2002.
71 “The National Stem Cell Centre,” Commonwealth of Australia’s Department of
Education, Science and Training
, Jun. 2, 2004, at [http://backingaus.innovation.gov.au/
2004/commercial/stem_cell.htm].

CRS-24
live and work.”72 South Korea, the home of the doctor who announced in February
2004 that he had cloned human embryos and extracted stem cells from them,
subsequently enacted legislation to regulate and license reproductive cloning.73
Ethical Issues
Stem cell research is controversial not because of its goals, but rather because
of the means of obtaining some of the cells. Research involving most types of stem
cells, such as those derived from adult tissues and umbilical cord blood, is
uncontroversial, except when its effectiveness as an alternative to embryonic stem
cells is debated. The crux of the debate centers around embryonic stem cells, which
enable research that may facilitate the development of medical treatments and cures,
but which require the destruction of an embryo to derive. In addition, because
cloning is one method of producing embryos for research, the ethical issues
surrounding cloning are also relevant.
As previously mentioned, the Bush Administration, a group of Representatives,
a group of Senators, and a group of Nobel Laureates have each presented their
respective positions on embryonic stem cell research. In addition, various other
organizations, individuals, and councils have issued opinions and reports on the
topic. Some groups, such as the Christian Legal Society,74 Focus on the Family,75
and the Christian Coalition,76 support the 2001 Bush policy. Others, such as the
National Academies,77 the Coalition for the Advancement of Medical Research
72 “Singapore Hosts Stem Cell Meeting” MSNBC, May 19, 2004, at the MSNBC website
[http://msnbc.msn.com/id/3341644/].
73 “Stem Cells Extracted from Human Clone,” MSNBC, Feb. 12, 2004, at [http://www.
msnbc.msn.com/id/4244988/], visited July 12, 2004; Dr. Hwuang, the South Korean
scientist referenced herein, stated on July 13, 2004 that he is still awaiting his license from
the South Korean Government to continue his cloning and stem cell research. Dr. Wu-Suk
Hwuang, Press Conference on Stem Cell Research, Gijon, Spain, July 13, 2004, 10:30 AM.
74 The Christian Legal Society is a “national grassroots network of lawyers and law students,
committed to ... advocating biblical conflict reconciliation, public justice, religious freedom
and the sanctity of human life.” [http://www.clsnet.org/clsPages/vision.php].
75 Focus on the Family was founded in 1977 by Dr. James Dobson to promote teachings of
Jesus Christ. [http://www.family.org].
76 The Christian Coalition is “the largest and most active conservative grassroots political
organization in America,” [http://www.cc.org].
77 The National Academies brings together “committees of experts in all areas of scientific
and technological endeavor” as “advisors to the Nation.” For statements on embryonic stem
cell research and cloning, see National Research Council, Institute of Medicine, National
Academies, Stem Cells and the Future of Regenerative Medicine (Washington: National
Academies, 2001); Committee on Science, Engineering and Public Policy and Global
Affairs Division et al., Scientific and Medical Aspects of Human Reproductive Cloning,
(Washington National Academy Press, 2002) at [http://www.nationalacademies.org/
about/#org].

CRS-25
(CAMR),78 former First Lady Nancy Reagan,79 and former Presidents Gerald Ford,
Jimmy Carter, Bill Clinton80 favor more embryonic stem cell research than the Bush
policy allows. Still others, such as the National Right to Life Committee81 and the
United States Conference of Catholic Bishops,82 oppose all embryonic stem cell
research.
Two presidential bioethics advisory panels have considered the issues involved
in embryonic stem cell research. The President’s Council on Bioethics (President’s
Council)83 published one report directly on the topic, Monitoring Stem Cell
Research
,84 in which it sought to characterize the issues. While the Council made no
recommendations there, in two other reports it has recommended that “Congress
should ... [p]rohibit the use of human embryos in research beyond a designated stage
in their development (between 10 and 14 days after fertilization),”85 and unanimously
recommended “a ban on cloning-to-produce-children,” with a 10-member majority
also favoring “a four-year moratorium on cloning-for-biomedical-research,” and a
seven-member minority favoring “regulation of the use of cloned embryos for
biomedical research.”86 A predecessor to the President’s Council, the National
78 CAMR is a nonprofit organization comprised of patient organizations, universities,
scientific societies, foundations, and individuals with life-threatening illnesses and
disorders, [http://www.camradvocacy.org/fastaction/]. For a statement on embryonic stem
cell research, see Coalition for the Advancement of Medical Research, “Embryonic Stem
Cell Research,” talking points [http://www.camradvocacy.org/fastaction/news.asp?id=167],
visited May 14, 2004.
79 “Nancy Reagan Urges Stem Cell Research,” MSNBC, May 9, 2004, at [http://www.msnbc.
msn.com/id/4937850/], visited May 14, 2004.
80 Ibid.
81 The National Right to Life Committee was founded in 1973 to “restore legal protection
to innocent human life,” at [http://www.nrlc.org/Missionstatement.htm].
82 The United States Conference of Catholic Bishops is “is an assembly of the hierarchy of
the United States and the U.S. Virgin Islands who jointly exercise certain pastoral functions
on behalf of the Christian faithful of the United States,” at [http://www.nccbuscc.org/
whoweare.htm].
83 The President’s Council was created by President Bush in Nov. 2001 to “advise the
President on bioethical issues that may emerge as a consequence of advances in biomedical
science and technology.” George W. Bush, “Creation of The President’s Council on
Bioethics,” Executive Order 13237, Nov. 28, 2001, at [http://www.bioethics.gov/reports/
executive.html].
84 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004.
85 The President’s Council on Bioethics, Reproduction and Responsibility, Mar. 2004,
p. xlviii.
86 President’s Council on Bioethics, Human Cloning and Human Dignity, July 2002, pp.
xxxv- xxxviii). Note: At the June 20, 2002, meeting, nine of 17 Council members voted to
support cloning for medical research purposes, without a moratorium, provided a regulatory
mechanism was established. Because one member of the Council had not attended the
meetings and was not voting, the vote seemed to be nine to eight in favor of research
cloning. However, draft versions of the Council report sent to Council members on June 28,
(continued...)

CRS-26
Bioethics Advisory Committee (NBAC),87 recommended federal funding for stem
cell research using “embryos remaining after infertility treatments,” but not for the
“derivation or use of embryos ... made for research purposes.”88
Detailed review of the assorted reports and statements reveals that, while
positions on embryonic stem cell research may be broadly categorized as for or
against, there is an array of finer distinctions present. These finer distinctions in turn
reveal the variation in ethical and moral as well as factual beliefs. The following
discussion breaks down the arguments about embryonic stem cell research according
to these finer distinctions, demonstrating both the complexity of the issues and the
points of resonance among the groups.
Embryo Destruction and Relief of Human Suffering. Most positions
on embryonic stem cell research rest at least in part on the relative moral weight
accorded to embryos and that accorded to the prospect of saving, prolonging, or
improving others’ lives. For some, the inquiry begins and ends with this question.
For instance, one opponent of the research, the American Life League, posits that
“human life begins at conception / fertilization and that there is never an acceptable
reason for intentionally taking an innocent human life.”89 Similarly, the United States
Conference of Catholic Bishops states that the research is immoral because it “relies
on the destruction of some defenseless human beings for the possible benefit to
others.”90
86 (...continued)
2002, indicated that two of the group of nine members had changed their votes in favor of
a moratorium. Both made it clear that they have no ethical problem with cloning for
biomedical research, but felt that a moratorium would provide time for additional
discussion. The changed vote took many Council members by surprise, and some on the
Council believe that the moratorium option, as opposed to a ban, was thrown in at the last
minute and did not receive adequate discussion. In addition, some on the Council believe
that the widely reported final vote of 10 to 7 in favor of a moratorium does not accurately
reflect the fact “that the majority of the council has no problem with the ethics of biomedical
cloning.” (Transcripts of the Council meetings and papers developed by staff for discussion
during Council meetings can be found at [http://www.bioethics.gov]; S. S. Hall, “President’s
Bioethics Council Delivers,” Science, vol. 297, July 19, 2002, pp. 322-324.) “Wise Words
from Across the Pond?,” BioNews, no. 252, Mar. 29, 2004.
87 In 1995, President Clinton created the National Bioethics Advisory Commission by
Executive Order, to advise him on bioethical issues. The Order expired in 2001. “Former
Bioethics Commissions,” President’s Commission on Bioethics website, at [http://www.
bioethics.gov/reports/past_commissions/index.html], visited Jun. 30, 2004.
88 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, pp. 70-71.
89 American Life League, Analysis of George W. Bush’s Stem Cell Decision, 2001, at
[http://www.all.org/issues/scanalyz.htm] visited May 11, 2004.
90 Office of Communications, United States Conference of Catholic Bishops, Catholic
Bishops Criticize Bush Policy on Embryo Research
(Aug. 9, 2001), at [http://www.usccb.
org/comm/archives/2001/01-142.htm].

CRS-27
Some groups explore the moral standing of human embryos, and also consider
the “duty to relieve the pain and suffering of others.”91 Others take the position that
embryos do not have the same moral status as persons. They acknowledge that
embryos are genetically human, but hold that they do not have the same moral
relevance because they lack specific capacities, including consciousness, reasoning
and sentience.92 They also argue that viewing embryos as persons would “rule out
all fertility treatments that involve the creation and discarding of excess embryos,”
and further assert that we do not have the same “moral or religious” response to the
natural loss of embryos (through miscarriage) that we do to the death of infants.93
They conclude that performing research to benefit persons justifies the destruction
of embryos. Acceptance of the notion that the destruction of embryos can be justified
in some circumstances forms the basis of pro-stem cell research opinions, and is
usually modified with some combination of the distinctions and limitations that
follow.
Viability of Embryos. Some proponents of embryonic stem cell research
base their support on the question of whether an embryo is viable. The relevance of
the viability distinction rests on the premise that it is morally preferable for embryos
that will not grow or develop beyond a certain stage and/or those that would
otherwise be discarded to be used for the purpose of alleviating human suffering.
The 2001 Bush policy requires, among other things, use of only excess (non-
viable) embryos for federally funded research. One report of the President’s Council
explores the moral significance of viability that is based upon “human choices” rather
than an embryo’s “own intrinsic nature,” but draws no conclusions.94 A second
report broaches the subject of viability, recommending that Congress ban both the
transfer of a human embryo to a woman’s uterus for any purpose other than to
produce a live-born child, and also research conducted on embryos more than 10 to
14 days after fertilization.95 The NBAC report touches on the moral status of
embryos in utero and those in vitro,96 though NBAC does not specify whether
viability was a key rationale for its recommendations. A group of Representatives,
a group of Senators,97 and CAMR imply but do not state a distinction based on
viability by expressly calling for the use of “excess” embryos developed for IVF, and
91 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004, pp. 58, 62.
92 Presentation by B. Steinbock, Dept. Of Philosophy, SUNY, Albany, NY, NIH Human
Embryo Research Panel Meeting, Feb. 3, 1994.
93 Michael Sandel, “Embryo Ethics — The Moral Logic of Stem-Cell Research,” New
England Journal of Medicine
, vol. 351, no. 3, July 15, 2004, p. 208.
94 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004, p. 87.
95 The President’s Council on Bioethics, Reproduction and Responsibility, Mar. 2004.
96 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, p. 50.
97 Letter from 58 Senators to President George W. Bush, June 4, 2004. (Hereafter cited as
Letter from 58 Senators.)

CRS-28
making no mention of those in utero.98 By contrast, the National Academies and the
group of Nobel Laureates more broadly support research on embryos, making no
mention of viability.
Generating Embryonic Stem Cells Without Destroying Human
Embryos. In December 2004, the President’s Council heard two different proposals
aimed at avoiding ethical dilemmas by creating embryonic stem cells without
destroying embryos. The first of these focuses on the “destruction” aspect,
recommending standards for declaring an embryo “dead” when its cells stopped
dividing. The declaration of death distinction is based on an analogy to organ
donation: “If it is ethically acceptable to allow organ donation from patients who
have been declared brain dead ... it should be acceptable to remove stem cells from
an embryo that has been declared dead.”99
The second proposal focuses on generating cells without an “embryo.” It rests
on the premise that is it possible to create something other than an embryo that is
capable of generating embryonic stem cells. If no embryo exists, none can be
destroyed. Dr. Paul Hurlbut, a Council member known for his opposition to the
destruction of human embryos and his vote for the moratorium, proposed the use of
genetic engineering techniques, in addition to SCNT, to create “cells equivalent to
human embryonic stem cells [without generating] an actual embryo.”100 Previously,
one Council member had suggested that the use of SCNT itself creates something
other than an embryo. Dr. Paul McHugh, who objects to the destruction of human
embryos and who had voted with the Council majority for a moratorium on cloning-
for-biomedical research, wrote in July 2004 that SCNT “resembles a tissue culture,”
and that the products of SCNT should be available for research once regulations are
in place to ensure that SCNT is conducted ethically.101
Both proposals received some criticism and some support. Critics included
Council member Dr. Michael Gazzaniga, who had voted with the Council minority
to allow cloning-for-biomedical research. Dr. Gazzaniga said that he saw no need
to declare the brain death of a “14-day old blastocyst, that has no brain,” and that,
because he had no “deep moral dilemma with using a 14-day old blastocyst to harvest
stem cells,” he found Dr. Hurlbut’s proposed “bio-engineering project”
98 Letter from 206 Members of the House of Representatives to President George W. Bush,
Apr. 28, 2004. (Hereafter cited as Letter from 206 Members of the House of Representatives.)
99 Gareth Cook, “Stem Cell Alternatives Gain Key Support,” The Boston Globe, December
4, 2004, A1, referring to a proposal by Columbia University professors Dr. Donald W.
Landry and Dr. Howard A. Zucker.
100 Gareth Cook, “Stem Cell Alternatives Gain Key Support,” The Boston Globe, December
4, 2004, A1, referring to a proposal by Dr. William Hurlbut, a Stanford University professor
and member of the PCBE.
101 Paul McHugh, “Zygote and ‘Clonote’ — The Ethical Use of Embryonic Stem Cells,” New
England Journal of Medicine,
vol. 351, no. 3 (July 15, 2004) p. 210, at [http://content.nejm.org/
cgi/content/full/351/3/209].

CRS-29
unnecessary.102 Others outside the Council criticized Dr. Hurlbut’s proposal to create
something that is not an embryo, yet generates embryonic stem cells, as one focused
on a “semantic issue, not a scientific one.”103 Both proposals received support from
other Council members, including Dr. Leon Kass, the Chair of the Council and a well
known opponent of embryo destruction. Dr. Kass said the proposals raise the
possibility that “the partisans of scientific progress and the defenders of nascent
human life can go forward in partnership without anyone having to violate things
they hold dear.”104 Also of note, Dr. Foster, who had voted with the Council minority
to allow stem cell research to continue immediately, expressed enthusiasm for the
proposals, which might facilitate the science and sidestep the ethical issues.
Purpose of Embryo Creation. A separate distinction that often leads to the
same conclusions as viability is the purpose for which embryos are created. This
distinction draws an ethical line based upon the intent of the people creating
embryos. In the view of some, it is permissible to create an embryo for reproductive
purposes (such as IVF), but impermissible to create one with the intention of
destroying it for research.
Most groups at least note the potential ethical significance of reproductive
versus research motives for creating embryos. The 2001 Bush policy draws a motive
distinction by including a requirement that federally funded research be conducted
only on embryonic stem cell lines derived from embryos created solely for
reproductive purposes. NBAC draws the same distinction by recommending that
federal funding be used for embryos remaining after infertility treatment but not for
research involving the derivation or use of stem cells from embryos made for
research purposes or from embryos made using cloning (SCNT).105 The President’s
Council recommends that Congress ban attempts at conception by any means other
than the union of egg and sperm (essentially banning cloning via SCNT), but does
not specify whether embryos might be created in vitro specifically for research
purposes.106 Two Council members expressed a dissenting opinion in a medical
journal article, arguing that SCNT “resembles a tissue culture,” and that the products
of SCNT should be available for research.107 A group of Representatives, a group of
Senators, and CAMR imply but do not state that embryos should not be created for
research purposes. They overtly call for the use of “excess” embryos developed for
102 Statement of Dr. Gazzaniga in “Transcript of the President’s Council on Bioethics ,19th
Meeting, held Dec. 3, 2004,” President’s Council on Bioethics website, at
[http://www.bioethics.gov/transcripts/dec04/session6.html].
103 Kirsty Horsey, “When Is an Embryo not an Embryo?” BioNews, no. 287, Dec. 6, 2004,
at [http://www.bionews.org.uk/commentary.lasso?storyid=2372].
104 David Brown, “Two Stem Cell Options Presented; Human Embryos Wouldn’t be Killed,”
Washington Post, Dec. 4, 2004, A1.
105 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, pp. 70-72.
106 The President’s Council on Bioethics, Reproduction and Responsibility, Mar. 2004, p. xlviii.
107 Paul McHugh, “Zygote and “Clonote” — The Ethical Use of Embryonic Stem Cells,”
New England Journal of Medicine, vol. 351, no. 3, July 15, 2004, p. 210.

CRS-30
IVF, and make no mention of embryos created expressly for research.108 By contrast,
the National Academies supports the creation of embryos for research purposes,
including via cloning (SCNT), to “ensure that stem cell-based therapies can be
broadly applied for many conditions and people [by] overcoming the problem of
tissue rejection.”109 Mrs. Nancy Reagan, her supporters, and the group of Nobel
Laureates also take this position.
New and Existing Cell Lines. A further distinction has been drawn based
upon the timing of the creation of embryonic stem cell lines. Here, the premise is
that it is unacceptable to induce the destruction of embryos for the creation of new
lines. However, in cases in which embryos have already been destroyed and the lines
already exist, it is morally preferable to use those lines for research to improve the
human condition.
This was one central distinction drawn in the 2001 Bush policy, which limited
the use of federal funding to research on lines derived on or before the date of the
policy. Supporters of the Bush policy on both sides of the issue favor this distinction
as a compromise. It allows research on some embryonic stem cell lines. It deters the
future destruction of embryos for research. The President’s Council writes that the
Bush policy mixes “prudence” with “principle, in the hope that the two might
reinforce (rather than undermine) each other.”110 The Council notes that the policy
is supported by what it titles a moralist’s notion of when one may benefit from prior
bad acts (referring to embryo destruction): it prevents the government from
complying in the commission of or encouraging the act in the future, and it reaffirms
the principle that the act was wrong.111 The same report also contains analyses of the
Bush policy that characterize distinction between new and existing cell lines as
“arbitrary,” “unsustainable,” and “inconsistent.”112 The Council itself takes no
position in the report on this or any other issue.
Opponents of the Bush policy on both sides of the issue view the distinction
between new and existing stem cell lines with reproach. One side, which includes
The National Right to Life Committee and the United States Conference of Catholic
Bishops, objects because the distinction validates destruction of embryos, and in fact
rewards those who did so first with a monopoly. The other side, which includes the
National Academies, a group of Representatives, a group of Senators, Nancy Reagan
and her supporters, Gerald Ford, CAMR, and the group of Nobel Laureates, objects
because the distinction limits the number of embryonic stem cell lines available for
research, particularly since the number of authorized lines are dwindling and are
108 Letter from 206 Members of the House of Representatives; Letter from 58 Senators.
109 National Research Council, Institute of Medicine, National Academies, Stem Cells and
the Future of Regenerative Medicine
(Washington: National Academies, 2001), p. 58.
110 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004, pp. 33-34.
111 Ibid.
112 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004, pp. 63-67.

CRS-31
“contaminated with mouse feeder cells.”113 Likewise, though NBAC recognized the
distinction between destroying embryos and using ones previously destroyed (e.g.,
“derivation of [embryonic stem] cells involves destroying the embryos, whereas
abortion precedes the donation of fetal tissue and death precedes the donation of
whole organs for transplantation”),114 it still recommended future development of
embryonic stem cell lines.
Consent of Donors. There is consensus throughout a wide array of
viewpoints about embryonic stem cell research that embryos should only be obtained
for research with the consent of their biological donors. This consent requirement
necessitates that embryos be taken only with donors’ knowledge, understanding, and
uncoerced agreement. The donor consent requirement is consistent with the rules
governing human beings’ participation in research, and with individuals’ general
legal authority to make decisions regarding embryos they procreate. A drawback of
the requirement is that it may restrict the number of embryos available for research
purposes.
The 2001 Bush policy contains a donor consent requirement. It limits approved
stem cell lines to those derived with the informed consent of the donors, and obtained
without any financial inducements to the donors. The NBAC and the President’s
Council also favor donor consent requirements. The National Academies notes the
importance of informed consent in its discussion of stem cell research oversight
requirements.115 A group of Representatives and a group of Senators mention and
imply their support for donor consent requirements.116
Effectiveness of Alternatives. One factual distinction that has been used
to support competing ethical viewpoints is the efficacy of alternatives to embryonic
stem cell research. The promise of stem cell therapies derived from adult tissue and
umbilical cord blood have buttressed opposition to embryonic stem cell research.
These opponents argue that therapies and cures can be developed without the morally
undesirable destruction of embryos. However, not all scientists agree that adult stem
cells hold as much potential as embryonic stem cells. Most supporters of embryonic
stem cell research believe that it is the quickest and, perhaps in some cases, the only
path that will yield results. Supporters also stress that embryonic and other stem cell
research should be conducted collaboratively, so that they can inform one another.
On a related note, some have pointed out that benefits from one alternative to
embryonic stem cell research, umbilical cord blood banking, may only be available
to families who can afford to pay private companies’ storage fees.
Findings regarding the effectiveness of alternatives to embryonic stem cell
research are mixed. The President’s Council notes that there is a “debate about the
113 Letter from 206 Members of the House of Representatives; Letter from 58 Senators.
114 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, p. 49.
115 National Research Council, Institute of Medicine, National Academies, Stem Cells and
the Future of Regenerative Medicine
(Washington: National Academies, 2001), p. 53.
116 Letter from 206 Members of the House of Representatives; Letter from 58 Senators.

CRS-32
relative merits of embryonic stem cells and adult stem cells.”117 Focus on the Family
cites promising non-embryonic stem cell research: “adult stem cells may be as
“flexible” as embryonic ones and equally capable of converting into various cell
types for healing the body.”118 By contrast, the National Academies finds that the
“best available scientific and medical evidence indicates that research on both
embryonic and adult human stem cells will be needed.”119 NBAC finds in its
deliberations that “the claim that there are alternatives to using stem cells derived
from embryos is not, at the present time, supported scientifically.”120 CAMR
supports both embryonic and adult stem cell research, and adds that “many scientists
believe and studies show that embryonic stem cells will likely be more effective in
curing diseases because they can grow and differentiate into any of the body’s cells
and tissues and thus into different organs.”121 Mrs. Nancy Reagan and her supporters
favor expedient approaches including embryonic stem cell research.122
Use of Federal Funding. Some division over the support for and opposition
to embryonic stem cell research focuses on the question of whether the use of federal
funding is appropriate. Those who oppose federal funding argue that the government
should not be associated with embryo destruction.123 They point out that embryo
destruction violates the “deeply held moral beliefs of some citizens,” and suggest that
“funding alternative research is morally preferable.”124 Proponents of federal funding
argue that it is immoral to discourage life-saving research by withholding federal
funding. They point out that consensus support is not required for many federal
spending policies, as it “does not violate democratic principles or infringe on the
rights of dissent of those in the minority.”125 They argue that the efforts of both
federally supported and privately supported researchers are necessary to keep the
United States at the forefront of what they believe is a very important, cutting edge
area of science. Furthermore, supporters believe that the oversight that comes with
federal dollars will result in better and more ethically controlled research in the field.
117 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004, p. 10.
118 Carrie Gordon Earll, “Talking Points on Stem Cell Research,” Focus on the Family, Sept.
17, 2003 at [http://www.family.org/cforum/fosi/bioethics/faqs/a0027980.cfm].
119 National Research Council, Institute of Medicine, National Academies, Stem Cells and
the Future of Regenerative Medicine
(Washington: National Academies, 2001), p. 56.
120 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, p. 53.
121 Coalition for the Advancement of Medical Research, “Embryonic Stem Cell Research,”
talking points [http://www.camradvocacy.org/fastaction/news.asp?id=167].
122 “Nancy Reagan Urges Stem Cell Research,” MSNBC, May 9, 2004, at
[http://www.msnbc.msn.com/id/4937850/].
123 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, p. 57.
124 Ibid.
125 Ibid.

CRS-33
Groups’ positions on federal funding tend to mirror their positions on stem cell
research generally. The Bush policy authorizes federal funding for some embryonic
stem cell research. The President’s Council does not take a position on the issue, but
notes the pros and cons and stresses that there is a “difference between prohibiting
embryo research and refraining from funding it.”126 Focus on the Family generally
supports the President Bush and his policy, but is “disappointed by his decision to
allow federal funding of research on the existing stem cell lines.”127 NBAC finds the
arguments in favor of federal funding more persuasive than those against it.128 The
National Academies, a group of Representatives, a group of Senators, Mrs. Nancy
Reagan and her supporters, CAMR, and the Nobel Laureates favor federal funding
for embryonic stem cell research.
126 The President’s Council on Bioethics, Monitoring Stem Cell Research, Jan. 2004, p. 37.
127 Carrie Gordon Earll, “Talking Points on Stem Cell Research,” Focus on the Family, Sept.
17, 2003 at [http://www.family.org/cforum/fosi/bioethics/faqs/a0027980.cfm].
128 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, Sept. 1999, p. 70.