Order Code RL33554
CRS Report for Congress
Received through the CRS Web
Stem Cell Research: Ethical Issues
July 28, 2006
Erin D. Williams
Specialist in Bioethical Policy
Domestic Social Policy Division
Judith A. Johnson
Specialist in Life Sciences
Domestic Social Policy Division
Congressional Research Service ˜ The Library of Congress

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Stem Cell Research: Ethical Issues
Summary
The central question before Congress in the debate over stem cell research is
how to treat embryonic stem cell research (ESR), which may lead to lifesaving
treatments, but which requires the destruction of embryos. The current federal
policy, established by the Bush Administration in 2001, allows federal money to be
used to support ESR on cell lines created: (1) with appropriate informed consent of
the donors; (2) using embryos created for reproductive purposes; and (3) before the
date of the policy. The third element has generated the most debate, and prompted
some states to fund ESR themselves, and others to further restrict ESR.
A range of policy options have come before the 109th Congress, each prompting
a set of ethical dilemmas. First, Congress could have allowed federal funding for
ESR regardless of the date the stem cell lines were established, as was proposed in
H.R. 810 (Castle). The House passed H.R. 810 on May 24, 2005, and the Senate
passed the measure on July 18, 2006. President Bush vetoed it, and an attempt in the
House to override the veto was unsuccessful. Supporters asserted that many frozen
embryos created for in vitro fertilization (IVF) would be destroyed, and could have
been used for research regulated by the federal government. Critics sought to limit
embryo destruction and federal funding for it. Second, Congress could have done
nothing, allowing the current policy to endure. (This was the effect of the failure to
override the veto of H.R. 810.) Supporters contended that the current policy
balanced research interests and opposition to embryo destruction. Critics for and
against ESR called the date delineation ethically irrelevant, either because it stifled
research or provided a monopoly to those who first destroyed embryos.
Third, Congress could fund research that may eventually generate embryonic
stem cells without destroying embryos. This was proposed in S. 2754, which the
Senate passed on July 18, 2006, but the House failed to pass with the required 2/3
vote (273-154). Supporters assert this facilitates research without ethical dilemmas.
Critics characterize it as unnecessary, costly, and a diversion from developing
treatments. Finally, Congress could restrict ESR by banning acts such as certain
cloning techniques. While ESR would not be restricted by some proposed cloning
bans (S. 876, H.R. 1822, and S. 1520), those proposed in H.R. 1357 (Weldon) and
S. 658 (Brownback) would curtail some forms of ESR, and would ban the
importation of any product derived by banned methods. In the 107th and 108th
Congresses, a similar bill passed the House and stalled in the Senate. Supporters
claim this approach is respectful of human dignity. Critics claim it is detrimental to
many people already living.
This report, which will be updated, is one of several Congressional Research
Service (CRS) reports on stem cell research, and details the ethical arguments that
surround ESR. The broadest is the balance of embryo destruction and relief of
human suffering. More subtle issues focus on the relative importance of the viability
of embryos, the purpose of embryo creation, new versus existing cell lines, the
consent of donors, the ethics of egg procurement, the effectiveness of alternatives,
the possibility of generating embryonic stem cells without destroying human
embryos, and the use of federal funding.

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Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Discussion of Ethical Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Embryo Destruction and Relief of Human Suffering . . . . . . . . . . . . . . . . . . 5
Viability of Embryos . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Purpose of Embryo Creation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
New and Existing Cell Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Consent of Donors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Egg Procurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Effectiveness of Alternatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Generating Embryonic Stem Cells
Without Destroying Human Embryos . . . . . . . . . . . . . . . . . . . . . 13
Use of Federal Funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

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Stem Cell Research: Ethical Issues
Introduction
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.1 In addition, because
cloning is one method of producing embryos for research, the ethical issues
surrounding cloning are also relevant.
Two policies are currently in force governing embryonic stem cell research
(ESR). Since FY1996, the Dickey amendment, a provision added to each year’s
Labor-Health and Human Services (HHS)-Education appropriations legislation, has
prohibited the use of National Institutes of Health funds for the creation of human
embryos for research purposes or for research in which human embryos are
destroyed. This policy effectively precludes the use of federal funding to derive stem
cells from embryos, which typically are produced via in vitro fertilization (IVF). The
extracted stem cells are used to generate embryonic stem cell lines that may continue
to divide for many months to years. In August 2001, President Bush announced that
federal funds could be used for research on human embryonic stem cells, but only on
22 existing stem cell lines.2 Many supporters of ESR view these policies as too
restrictive, pointing out that the United States is lagging behind other countries in
publishing ESR studies.3 In response, many states are moving forward with their
own initiatives to encourage or provide funding for stem cell research (in some
cases, therapeutic cloning as well) in order to remain competitive and prevent the
relocation of scientists and biotechnology firms to other states or overseas.4
Instead of focusing on the policy’s restrictions, many opponents of ESR caution
that spending any federal money to support the research is unethical. Some point to
1 For an overview of various religious perspectives on embryonic stem cell research, see
LeRoy Walters, “Human Embryonic Stem Cell Research: An Intercultural Perspective,”
Kennedy Institute of Ethics Journal, vol. 14, no. 1, March 2004, p. 3.
2 For further information, see CRS Report RL33540, Stem Cell Research: Federal Research
Funding and Oversight, by Judith A. Johnson and Erin Williams.
3 Tracy Hampton, “US Stem Cell Research Lagging,” Journal of the American Medical
Association, vol. 295, no. 19, May 17, 2006, p. 2233.
4 For further information, see CRS Report RL33524, Stem Cell Research: State Initiatives,
by Judith A. Johnson and Erin Williams.

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the actions of South Korean scientist Dr. Hwang Woo Suk, whose laboratory
fabricated results of stem cells extracted from cloned embryos, as reflective of a
research community “more than willing to play fast and loose with the facts in order
to get their way.”5 Many of those in favor of ESR assert that regulation is desirable
in order to ensure that the benefits of the research are affordable by all, that they do
not endanger the well-being of women who provide eggs for research, and that they
are not used for socially and ethically unacceptable purposes such as eugenics.6
In the embryonic stem cell debate, the Bush Administration, a group of
Representatives, a group of Senators, and a group of Nobel Laureates have each
presented their respective positions on ESR. In addition, various other organizations,
individuals, and councils have issued opinions and reports on the topic. Some
groups, such as the Christian Legal Society,7 Focus on the Family,8 and the Christian
Coalition9 support the 2001 Bush policy. Others, such as the National Academies,10
the Coalition for the Advancement of Medical Research (CAMR),11 former First
Lady Nancy Reagan,12 former Presidents Gerald Ford, Jimmy Carter, and Bill
5 Wesley J. Smith, “Another Cloning Breakthrough,” at [http://www.cbc-network.org/
redesigned/research_display.php?id=269], visited June 2, 2006.
6 See, e.g., Tom Paine and Richard Hayes, “Stem Cell Caution,” Center for Genetics and
Society website, May 24, 2000, at [http://www.genetics-and-society.org/resources/cgs/
20060524_tompaine_hayes.html], visited July 7, 2005.
7 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.” At [http://www.clsnet.org/clsPages/vision.php], visited July
15, 2005.
8 Focus on the Family was founded in 1977 by Dr. James Dobson to promote the teachings
of Jesus Christ. See [http://www.family.org].
9 The Christian Coalition is “the largest and most active conservative grassroots political
organization in America,” at [http://www.cc.org].
10 The National Academies brings together “committees of experts in all areas of scientific
and technological endeavor” as “advisors to the Nation.” For statements on ESR and
cloning, see National Research Council, Institute of Medicine, National Academies, Stem
Cells and the Future of Regenerative Medicine (Washington: National Academies, 2001);
and 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].
11 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 ESR, 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.
12 “Nancy Reagan Urges Stem Cell Research,” MSNBC, May 9, 2004, at [http://www.msnbc.
msn.com/id/4937850/], visited May 14, 2004.

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Clinton,13 and the Union of Orthodox Jewish Congregations of America (UOJCA),14
favor more ESR than the Bush policy allows. Still others, such as the National Right
to Life Committee15 and the United States Conference of Catholic Bishops,16 oppose
all ESR.
Two presidential bioethics advisory panels have considered the issues involved
in ESR. The President’s Council on Bioethics (President’s Council)17 published one
report directly on the topic, Monitoring Stem Cell Research,18 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),”19 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.”20 More
13 Ibid.
14 Letter from Harvey Blitz, President, UOJCA, et al., to President George W. Bush, July 26,
2001, at [http://www.ou.org/public/statements/2001/nate34.htm], visited July 14, 2005.
(Hereafter cited as UOJCA letter.)
15 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].
16 The United States Conference of Catholic Bishops “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].
17 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.
18 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004.
19 The President’s Council on Bioethics, Reproduction and Responsibility, March 2004,
p. xlviii.
20 The President’s Council on Bioethics, Human Cloning and Human Dignity, July 2002, pp.
xxxv-xxxviii). Note: At the June 20, 2002, meeting, 9 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 9 to 8 in favor of research cloning.
However, draft versions of the Council report sent to Council members on June 28, 2002,
indicated that 2 of the group of 9 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
(continued...)

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recently, the President’s Council published Alternative Sources of Human Pluripotent
Stem Cells, a white paper exploring the ethics of four proposals to attempt to generate
human embryonic stem cells “without creating, destroying, or harming human
embryos.”21 A predecessor to the President’s Council, the National Bioethics
Advisory Committee (NBAC),22 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.”23
A number of bills have been proposed in Congress.24 On May 24, 2005, the
House passed H.R. 810 (Castle), which would allow federal support of research that
utilizes human embryonic stem cells regardless of the date on which the stem cells
were derived from a human embryo, thus negating the August 2001 Bush stem cell
policy limitation. In July 2005, Senate Majority Leader Bill Frist announced his
support for H.R. 810 and S. 471 (Specter), and on July 18, 2006, the Senate passed
H.R. 810 on a 63-37 vote. On July 19, 2006, President Bush signed S. 3504 and
vetoed H.R. 810, the first veto of his six years in office. An attempt in the House on
July 19 to override the veto of H.R. 810 did not receive the required 2/3 vote
(235-193).
Bills focused on alternative sources of stem cells (H.R. 3144, S. 1557, S. 2754
and H.R. 5526) and on the separate issue of fetal tissue (S. 3504) have also been
introduced. On July 18, 2006, the Senate passed S. 2754 (100-0) and S. 3504 (100-
0). On the same day, the House passed S. 3504 (100-0) but failed to pass S. 2754
with the required 2/3 vote (273-154). On July 19, 2006, President Bush signed S.
3504, which became P.L. 109-242 (the Fetus Farming Prohibition Act of 2006).
The Weldon bill, which passed the House in the 107th and 108th and stalled in
the Senate, was reintroduced in the 109th Congress as H.R. 1357 and S. 658
(Brownback). The bill bans the process of cloning as well as the importation of any
product derived from an embryo created via cloning. It bans not only reproductive
applications, but also research on therapeutic uses, which has implications for stem
20 (...continued)
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.
21 The President’s Council on Bioethics, Alternative Sources of Human Pluripotent Stem
Cells (May 2005), at [http://www.bioethics.gov/reports/white_paper/index.html], visited
July 14, 2005.
22 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.
23 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, pp. 70-71.
24 For a more detailed description of the various bills proposed in the 109th Congress, see
CRS Report RL33540, Stem Cell Research: Federal Research Funding and Oversight, by
Judith A. Johnson and Erin D. Williams.

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cell research. Advocates of the legislative ban say that allowing any form of human
cloning research to proceed raises serious ethical issues, and will inevitably lead to
the birth of a baby that is a human clone. Critics argue that the measure would curtail
medical research and prevent Americans from receiving lifesaving treatments created
overseas. S. 876, H.R. 1822, and S. 1520 ban only human reproductive cloning. In
December 2005, the President signed H.R. 2520 (P.L. 109-129), which provides for
the collection and maintenance of human cord blood stem cells for the treatment of
patients and for research.
Detailed review of the assorted reports and statements reveals that while
positions on ESR 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 ESR according to these finer distinctions, demonstrating both
the complexity of the issues and the points of resonance among the groups.
Discussion of Ethical Issues
Embryo Destruction and Relief of Human Suffering
Most positions on ESR 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.”25 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.”26 None of the bills currently proposed would completely prohibit funding
for ESR or make the practice illegal. Two companion bills (H.R. 1357 and S. 658)
could curtail some ESR by banning human cloning techniques, including those used
solely for research purposes. The Dickey amendment, a provision added to each
year’s Labor-HHS-Education appropriations legislation since FY1996, has prohibited
the use of National Institutes of Health funds for research on embryos. Like the
Dickey amendment, H.R. 3144, H.R. 2574, and S. 1557 would prohibit research on
embryos.
Some groups explore the moral standing of human embryos, and also consider
the “duty to relieve the pain and suffering of others.”27 Others take the position that
25 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.
26 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.shtml].
27 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004, pp. 58,
(continued...)

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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.28 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.29
Some have also rooted their arguments in religious texts, which inform them that an
“isolated fertilized egg does not enjoy the full status of person-hood and its attendant
protections.”30 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. None of the proposed bills would end the Dickey
Amendment’s ban on the use of federal funds for research involving the destruction
of human embryos. H.R. 810 and S. 471 would have expanded the group of stem cell
lines eligible for federal funding by removing the date restriction imposed by
President Bush.
Viability of Embryos
Some proponents of ESR 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 stem cells derived
from 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.31 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.32 The NBAC report touches on
27 (...continued)
62.
28 Presentation by B. Steinbock, Department of Philosophy, SUNY, Albany, NY, NIH
Human Embryo Research Panel Meeting, Feb. 3, 1994.
29 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.
30 UOJCA letter.
31 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004, p.
87.
32 The President’s Council on Bioethics, Reproduction and Responsibility, March 2004.

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the moral status of embryos in utero and those in vitro,33 though NBAC does not
specify whether viability was a key rationale for its recommendations. A group of
Representatives, a group of Senators,34 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 making no mention of those in utero.35 UOJCA makes a
similar argument in its letter. By contrast, the National Academies and the group of
Nobel Laureates more broadly support research on embryos, making no mention of
viability. H.R. 810 and S. 471 implied a distinction based on viability, proposing that
federal funding be available only for ESR on lines derived from excess embryos. S.
876, H.R. 1822, and S. 1520 also imply such a distinction by proposing a prohibition
on implanting the product of nuclear transplantation into a uterus or the functional
equivalent of a uterus, thereby ensuring that it remains non-viable.
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. Others worry that moral
lines will erode quickly — from using only “spare” embryos left over in fertility
clinics to creating human embryos solely for research to creating (or trying to create)
cloned embryos solely for research.36
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 cloned embryos produced by somatic cell nuclear transfer
(SCNT).37 UOJCA argue similarly that they “believe it is entirely appropriate to
33 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, p. 50.
34 Letter from 58 Senators to President George W. Bush, June 7, 2004, at
[http://feinstein.senate.gov/04Releases/r-stemcell-ltr.pdf]. (Hereafter cited as Letter from
58 Senators.)
35 Letter from 206 Members of the House of Representatives to President George W. Bush,
Apr. 28, 2004, at [http://www.house.gov/degette/news/releases/040428.pdf]. (Hereafter
cited as Letter from 206 Members of the House of Representatives.)
36 See, e.g., Eric Cohen and Robert George, “Stem Cells Without Moral Corruption:
Congress Can Give Research a Boost Without Supporting the Misuse of Human Embryos,”
Washington Post, July 6, 2006, p. A 21.
37 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, pp. 70-72. In SCNT the nucleus of an egg is removed and replaced
(continued...)

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utilize for this research existing embryos, such as those created for IVF purposes that
would otherwise be discarded but for this research. We think it another matter to
create embryos ab initio for the sole purpose of conducting this form of research.”38
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.39 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.40 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 IVF and make no mention of embryos created expressly for research.41
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.”42 Mrs. Nancy Reagan, her supporters, and the group of Nobel
Laureates also take this position. H.R. 810 and S. 471 drew a distinction based on
the purpose of embryo creation by proposing that federal funding be available only
for ESR on lines derived from embryos created for individuals seeking fertility
treatments. S. 876, H.R. 1822, and S. 1520 also imply a distinction based upon
purpose by proposing a prohibition on the creation of embryos via cloning for
reproductive purposes but not for therapeutic ones. H.R. 1357 and S. 658 would
prohibit all human cloning, including embryos created for research purposes.
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.
37 (...continued)
by the nucleus from a mature body cell, such as a skin cell obtained from a patient. In 1996,
scientists in Scotland used the SCNT procedure to produce Dolly the sheep, the first
mammalian clone.
38 UOJCA letter.
39 The President’s Council on Bioethics, Reproduction and Responsibility, March 2004,
p. xlviii.
40 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.
41 Letter from 206 Members of the House of Representatives; Letter from 58 Senators.
42 National Research Council, Institute of Medicine, National Academies, Stem Cells and
the Future of Regenerative Medicine (Washington: National Academies, 2001), p. 58.

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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.”43 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.44 The same report also contains analyses of the
Bush policy that characterize distinction between new and existing cell lines as
“arbitrary,” “unsustainable,” and “inconsistent.”45 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
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 dwindling46 and are
“contaminated with mouse feeder cells.”47 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”),48 it still recommended future development of
embryonic stem cell lines. UOJCA also recognizes a distinction between new and
existing lines: “research on embryonic stem cells must be conducted under careful
guidelines [that] ... relate to where the embryonic stem cells to be researched upon
are taken from.”49 H.R. 3144, H.R. 2574, and S. 1557 make a distinction based on
timing by proposing a prohibition on funding for research involving stem cells “not
43 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004, pp.
33-34.
44 Ibid.
45 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004, pp.
63-67.
46 Bridget M. Kuehn, “Genetic Flaws Found in Aging Stem Cell Lines,” Journal of the
American Medical Association, vol. 294, no. 15 (October 2005), p. 1883.
47 Letter from 206 Members of the House of Representatives; Letter from 58 Senators.
48 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, p. 49.
49 UOJCA letter.

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otherwise eligible for funding by NIH,” which are those created after the August
2001 Bush Administration deadline.
Consent of Donors
There is consensus throughout a wide array of viewpoints about ESR 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 potential 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, the President’s
Council, and the UOJCA also favor donor consent requirements. The National
Academies notes the importance of informed consent in its discussion of stem cell
research oversight requirements.50 A group of Representatives and a group of
Senators mention and imply their support for donor consent requirements.51 H.R.
810, S. 471, S. 876, H.R. 1822, and S. 1520 would all require the consent of donors.
H.R. 3144, H.R. 2574, and S. 1557 also contain an implicit consent requirement by
prohibiting research on stem cell lines not otherwise eligible for NIH funding.
Consent is one NIH funding requirement.
Egg Procurement. The topic of informed consent in egg procurement came
to the public’s attention in November 2005 with allegations that some human eggs
used in South Korean scientist Dr. Hwang’s laboratory had been obtained under
coercive conditions. Informed consent can be undermined when a coercive situation
prevents a free choice from being made, or when insufficient information is provided
to the person making a decision. The situation alleged in Dr. Hwang’s laboratory
raises the issue of coercion both because subordinate women in the laboratory
allegedly donated eggs, and because some women were allegedly paid for their eggs.
A 2002 study conducted by a University of Pennsylvania student raised the issue of
insufficient information, finding that a number of programs seeking donor eggs for
reproductive purposes downplayed the risks involved in egg retrieval.52 The wide
consensus regarding the need for informed consent necessarily implies similar
consensus on the need for an information-rich, coercion-free method of obtaining
eggs, however there is some disagreement on the specifics of whether payment for
eggs necessarily constitutes coercion.
50 National Research Council, Institute of Medicine, National Academies, Stem Cells and
the Future of Regenerative Medicine (Washington: National Academies, 2001), p. 53.
51 Letter from 206 Members of the House of Representatives; Letter from 58 Senators.
52 “Egg Donation Ethics Study Wins Award,” Research at Penn, (Mar. 7, 2005), at
[http://www.upenn.edu/researchatpenn/article.php?113&soc], visited Dec. 5, 2005.

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Paying women for their eggs, which has been debated in the context of seeking
donor eggs both for reproductive purposes (for example, to enable women who do
not produce their own eggs to become pregnant), and for research purposes, is not
unheard of in the United States. According to a 2000 study by the American Society
of Reproductive Medicine (ASRM), some IVF programs reportedly offered as much
as $5,000 for one egg retrieval cycle, though $2,500 appeared to be a more common
amount.53 Offers of much higher amounts ($50,000 - $100,000) have been reported
elsewhere.54 Dr. Huang’s laboratory reportedly made payments of $1,400 to each
woman who donated eggs.55 Payments are not illegal in the Unites States, nor were
they illegal in South Korea at the time Dr. Huang’s laboratory allegedly made them.
The questions are, is payment for egg donation ever acceptable, and if so, what
amount is appropriate?
Several arguments have been put forth in favor of payment for egg donation,
many focused on donation for reproductive purposes.56 First, some have argued that
payment creates incentives to increase the number of egg donors, thus facilitating
research and benefitting infertile couples. Second, some reason that payment for
eggs gives women parity with sperm donors, who may be compensated for donating
gametes at a lower rate given that they require a much less involved procedure.
Third, some allege that fairness dictates that women who donate eggs ought to be
able to benefit from their action. Fourth, some claim that pressures created by
financial incentives may be no greater than those experienced by women asked to
make altruistic egg donations for relatives or friends, and may thus not rise to the
level of coercion. These are the types of arguments that led ASRM to recommend
in 2000 that sums of up to $5,000 may be appropriate for typical egg donation, while
sums of up to $10,000 may possibly be justified if there are particular difficulties a
woman must endure to make her donation.
Several arguments have also been put forth against payment for egg donation.
First, some voiced fears that payment might lead to the exploitation of women,
particularly poor women, and the commodification of reproductive tissues.57 Second,
some have argued that payment for eggs for research purposes might undermine
53 American Society of Reproductive Medicine, “Financial incentives in recruitment of
oocyte donors,” Fertility and Sterility, vol. 74, no. 2 (August 2000), p. 216.
54 See e.g., “Egg Donation Ethics Study Wins Award,” Research at Penn, (Mar. 7, 2005),
at [http://www.upenn.edu/researchatpenn/article.php?113&soc], visited Dec. 5, 2005.
55 James Brooke, “Korean Leaves Cloning Center in Ethics Furor,” Professional Ethics
website (Nov. 25, 2005), at [http://ethics.tamucc.edu/article.pl?sid=05/11/26/
1524206&mode=thread] visited Dec. 12, 2005.
56 Unless otherwise noted, these arguments can be found, among other places, at American
Society of Reproductive Medicine, “Financial incentives in recruitment of oocyte donors,”
Fertility and Sterility, vol. 74, no. 2 (August 2000), p. 218; and Claudia Kalb, “Ethics, Eggs
and Embryos,” MSNBC.com, Newsweek website, at [http://www.msnbc.msn.com/
id/8185339/site/newsweek/], visited Dec. 12, 2005.
57 See e.g., President’s Council on Bioethics, White Paper: Alternative Sources of
Pluripotent Stem Cells (May 2005), pp. 40-41 at [http://www.bioethics.gov/
reports/white_paper/index.html], visited Dec. 12, 2005.

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public confidence in endeavors such as human ESR.58 Arguments such as these have
prompted both the National Academies and the President’s Council to recommend
that women not be paid for donating their eggs for research purposes. It also led the
President’s Council to note that in theory, there is the possibility that eggs could be
procured from ovaries harvested from cadavers, which might at least alleviate
concerns related to coercion.
It is worth noting that a woman may choose to undergo egg retrieval for her own
reproductive purposes, which would effectively take the process of egg procurement
out of the research arena and avoids the question of payment entirely. (For example,
this could be an option for a woman seeking IVF because her fallopian tubes are
blocked). While not making specific recommendations about payment for research-
related egg donation, several groups’ recommendations that only embryos left over
from IVF procedures be used for stem cell research (noted above in the Purpose of
Embryo Creation section) effectively takes the process of egg procurement from
women out of the research arena. The Bush policy keeps the consent process for egg
retrieval separate from donation by funding research only on lines derived from
embryos originally created for fertility treatments. H.R. 810, S. 471, H.R. 3144, H.R.
2574, and S. 1557 contain proposals to do the same. S. 876, H.R. 1822, and S. 1520
would allow women who donate eggs for research to receive compensation for their
time and inconvenience, but would not allow them to be paid any further “valuable
consideration” for their donation.
Effectiveness of Alternatives
One factual distinction that has been used to support competing ethical
viewpoints is the efficacy of alternatives to ESR. The promise of stem cell therapies
derived from adult tissue and umbilical cord blood have buttressed opposition to
ESR. Alternatives such as those proposed for consideration by the President’s
Council are discussed in the next section. Some opponents of the current method of
obtaining embryonic stem cells 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 ESR 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 ESR,
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 ESR are mixed. The
President’s Council notes that there is a “debate about the relative merits of
embryonic stem cells and adult stem cells.”59 Focus on the Family cites promising
58 National Academies, Guidelines for Human Embryonic Stem Cell Research, (Washington,
DC: National Academies Press, p. 87, at [http://books.nap.edu/books/0309096537/
html/87.html], visited, Dec. 12, 2005.
59 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004, p.
(continued...)

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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.”60 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.”61 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.”62 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.”63 Mrs. Nancy Reagan and her supporters favor expedient
approaches including ESR.64
Several pieces of legislation support the development of stem cells from sources
other than embryos. For each of fiscal years 2004 through 2006, Congress has
allocated money in the Consolidated Appropriations Act for the establishment and
continuation of a National Cord Blood Stem Cell Bank within the Health Resources
and Services Administration. In 2005, Congress passed H.R. 2520 (P.L. 109-129)
for the collection and maintenance of human cord blood stem cells for the treatment
of patients and for research. S. 2754 authorizes funding for research to attempt to
generate pluripotent stem cells without involving human embryos. H.R. 3144, H.R.
2574, and S. 1557 would do the same.
Generating Embryonic Stem Cells Without Destroying Human
Embryos. One possible alternative to ESR as it has typically been conducted, the
ability to generate embryonic stem cells without destroying human embryos, was
explored by the President’s Council in their 2005 white paper,65 described in the
introductory section of the report. The white paper discusses four potential methods
of obtaining embryonic stem cells without having to destroy embryos. Those
methods, the scientific and practical merits of which remain far from settled, are (1)
extracting cells from organismically dead embryos; (2) non-harmful biopsy of living
59 (...continued)
10.
60 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].
61 National Research Council, Institute of Medicine, National Academies, Stem Cells and
the Future of Regenerative Medicine (Washington: National Academies, 2001), p. 56.
62 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, p. 53.
63 Coalition for the Advancement of Medical Research, “Embryonic Stem Cell Research,”
talking points [http://www.camradvocacy.org/fastaction/news.asp?id=167].
64 “Nancy Reagan Urges Stem Cell Research,” MSNBC, May 9, 2004, available online at
[http://www.msnbc.msn.com/id/4937850/].
65 The President’s Council on Bioethics, White Paper: Alternative Sources of Human
Pluripotent Stem Cells, May 2005, online at [http://www.bioethics.gov/reports/white_paper/
index.html].

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embryos; (3) bioengineering embryo-like artifacts; and (4) dedifferentiating somatic
cells.66
In the white paper, the President’s Council examined the ethical acceptability
of each method. The first two seek to avoid the destruction of embryos either by
developing standards for declaring an embryo “dead” when its cells have stopped
dividing or by removing a cell from an embryo without destroying the embryo itself.
The other two methods would avoid having to use an embryo altogether, by
attempting to obtain embryonic stem cells through the destruction of something that
is not an embryo.
The Council concluded that the use of organismically dead embryos raises a
number of ethical questions that have yet to be answered. They include whether it
is possible to be certain that an embryo is really dead, whether the proposal would put
embryos at additional risk, and whether IVF practitioners would be encouraged to
create extra embryos. Regarding the use of non-harmful biopsy, the Council found
that it would be ethically unacceptable to test in humans because risks should not be
imposed on living embryos destined to become children for the sake of getting stem
cells for research.
The Council also concluded that bioengineering embryo-like artifacts raises
many serious ethical concerns, including whether the artifact would really be a very
defective embryo, the ethics of egg procurement, concerns about the use of genetic
engineering itself, and the possibility of its use creating a “slippery slope.” Finally,
the Council found the proposal to dedifferentiate somatic cells to be ethically
acceptable if and when it became scientifically practical, provided that de facto
embryos were not created.
Although some Council members expressed their support for efforts to identify
means of obtaining human embryonic stem cells for biomedical research that do not
involve killing or harming human embryos, not all of the members agreed. Some
expressed concern that all four methods would “use financial resources that would
be better devoted to proposals that are likely to be more productive.” One member
wrote that he did not support publishing the white paper “with the implied
endorsement that special efforts be made in the scientific areas described. While
some of the suggestions could be explored in a scientific setting, most are high-risk
options that only have an outside chance of success and raise their own complex set
of ethical questions.”
S. 2754 specifies that the Secretary of the Department of Health and Human
Services should take the techniques outlined by the President’s Council into account,
and fund attempts to generate sources of pluripotent stem therapies that are not
derived from human embryos. H.R. 5526 would do the same.
66 For more information, see CRS Report RL33540, Stem Cell Research: Federal Research
Funding and Oversight, by Judith A. Johnson and Erin D. Williams.

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Use of Federal Funding
Some division over the support for and opposition to ESR 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.67 They point out that embryo destruction violates the “deeply held moral
beliefs of some citizens,” and suggest that “funding alternative research is morally
preferable.”68 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.”69
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.
Groups’ positions on federal funding tend to mirror their positions on stem cell
research generally. The Bush policy authorizes federal funding for some ESR. 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.”70 Focus on the Family generally supports President Bush
and his policy, but is “disappointed by his decision to allow federal funding of
research on the existing stem cell lines.”71 NBAC finds the arguments in favor of
federal funding more persuasive than those against it.72 The National Academies, a
group of Representatives, a group of Senators, Mrs. Nancy Reagan and her
supporters, CAMR, the Nobel Laureates, and the UOJCA favor federal funding for
ESR.73
Several pieces of legislation would use federal funding to add ethical
requirements to the conduct of ESR. While the Bush policy did contain some ethical
requirements for research on the lines to be funded, it only provided funding for ESR
with existing lines. Research conducted before the policy could not have been
67 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, p. 57.
68 Ibid.
69 Ibid.
70 The President’s Council on Bioethics, Monitoring Stem Cell Research, January 2004, p.
37.
71 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].
72 National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research,
vol. 1, September 1999, p. 70.
73 See, e.g., National Research Council, Institute of Medicine, National Academies, Stem
Cells and the Future of Regenerative Medicine (Washington: National Academies, 2001),
p. 49.

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influenced by its ethical constraints; and research conducted afterwards was not
eligible for funding, and was thus not bound by the constraints. The same is true for
H.R. 3144, H.R. 2574, and S. 1557 in that they would prohibit funding for ESR not
otherwise eligible for funding at NIH, which has been set by the Bush policy. H.R.
810 and S. 471 would have required ESR to be conducted with informed consent,
and only on excess embryos generated from fertility treatments. S. 876, H.R. 1822,
and S. 1520 would fund ESR and require that it be conducted with informed consent,
after examination by an Institutional Review Board, and with certain privacy and
security provisions, and that embryos not be maintained for more than 14 days from
initial cell division, to prevent reproductive human cloning.

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