The dilemma on the t­ip of a needle

Stem cell research may hold the key to future wonder cures. It is predicted that the market for stem

In a biotech laboratory close to the National Hospital for Neurology and Neurosurgery in Bloomsbury, London, Professor Geoffrey Raisman, is researching a treatment for spinal cord injury using adult stem cells. This week, with no brief for Republicans or Democrats, he has been pondering the presidential inauguration celebrations with serious misgivings. He believes that the new president’s pledge to fund human embryonic stem cell ­research could have a detrimental effect on the future of his work.

Ten years ago in a tiny, underequipped laboratory in the University of Wisconsin, Madison, Professor James "Jamie" Thomson, an embryologist, extracted the first human embryonic stem cells from an embryo. Thomson was part of a community of scientists who had been pursuing the "philosopher's stone" of embryonic stem cells with slender resources and huge determination for a decade. Last year, at a conference in New York City calling itself the World Stem Cell Summit, it was projected that the market for stem cell clinical products could reach $8.5bn within a decade.

Stem cells have potential to be coaxed into different tissue, blood and cell types, in the body. In the human embryo they are "totipotent", that is, in a state of greatest potential to become any blood or cell type. But stem cells, albeit with more restricted potential, also exist in adults: in the gut, high in the nose, in blood, in the ­umbilical cord, and in bone marrow. While stem cell research has been hailed for its prospects for future wonder cures, scientists are divided over the merits of the two basic cell strategies: adult and embryonic. Some, such as Raisman, believe that adult cells are yielding the fastest and safest ­clinical results; others insist that embryonic cells ­offer the best prospects. Thus the question arises: where do governments and investors put their money?

Professor Raisman charges that the media hype over embryonic research as a coming miracle cure has put his adult stem cell research programme in the shade

Scientists on the Raisman wing believe that human embryonic research holds back medical progress by attracting funds that might otherwise go to adult stem cell work. Raisman, who is not against embryonic stem cell research on ­ethical grounds, has been funded by the Medical Research Council, and by private donations, but in common with many similar research programmes he is underfunded. If President Barack Obama makes good his promise to support funding for human embryonic research, Raisman predicts that there will be a rush to "invest" in embryonic strategy.

Information on the actual sums invested by private industry and governments into the many hundreds of stem cell research programmes worldwide are impossible to calculate because of secrecy. In the meantime, however, adult stem cell therapies have been achieving notable successes. The Stem Cell Summit in New York cited the use of a breast cancer patient's own stem cells in breast reconstruction, and a heart patient whose bone marrow stem cells mended a severe lesion. In Bristol, last November, the first tissue-engineered trachea (windpipe), using the pat­ient's own stem cells, were transplanted into a young woman with a failing airway, saving her life. No such tangible successes can yet be produced based on human embryonic stem cells.

Under George W Bush, federal funding of ­human embryonic stem cell work was banned in the United States for religious reasons. Bush's scruples were prompted by the stock objections of the American religious right, which regards human embryos as persons with full human rights. The Catholic Church also bans research that threatens the life of the human embryo for, according to papal teaching reiterated frequently by the late John Paul II, human individuality, or ensoulment, commences from the moment of conception. Research involving embryos has, for two decades, riven churches and religious groups within and outside America, as well as national governmental policies and research communities throughout the west. During his election campaign Obama repeatedly claimed, however, that he would overturn George W Bush's policy on the issue in the interests of its future benefits for a wide range of illnesses.

Under Tony Blair, Britain adopted a go-ahead policy on human embryonic stem cell research during a period (ending three years back) when the European Union declined to fund such programmes. Last year Britain went beyond the ­ethical limits of most countries in the west by sanctioning the creation of hybrid animal/ ­human embryos. After a heated nationwide ­debate, the Human Fertilisation and Embryology Authority (HFEA) licensed three British research laboratories, in Newcastle, London and Warwick, to create embryos in which the ovum comes from an animal (typically a cow or rabbit) and the nuclear DNA from a human being.

The scientific and political arguments in Brit­ain in favour of hybrid embryos focused on the scarcity of donated human embryos available for research, and the claim that such research transgressed moral norms was rejected by parliament. Professor Raisman argues, however, that the ethical debate over both human and hybrid stem cells ignores the issue of intellectual property rights and patenting: in other words, the profit motive. "Adult stem cells are much more promising therapeutically; they are already in use for such things as skin grafting, but they attract less funding and much less interest because they can't be patented." As the adult cells come from the patient's own body, the cells are not amenable to the imposition of intellectual property rights. On the other hand, exploitation of embryonic stem cells for therapy requires many complex laboratory processes from the out­set, and is consequently more amenable to patenting. Both governments and industry the pharmaceutical industry) are loath to invest or fund unless they can see the prospect of intellectual property rights - in other words, ownership.

Germany has been reluctant to allow stem cell research in the light of its Nazi history

In Britain, consciousness of the urgent requirement to pay heed to patents in medical science gathered impetus when Margaret Thatcher came to power in 1979. She argued that Britain had lost billions of pounds in revenue through a single failure in the mid-1970s to patent an important discovery. The episode, ­notorious in the annals of British science, involved the development in Cambridge of monoclonal antibodies (crucial to diagnostic testing) by César Millstein’s molecular biology team. The discovery was not patented, but a member of the team patented a further development of the process in America, thus earning billions of dollars for biotech research in the United States. During the Thatcher years, the promotion and protection of intellectual property rights in British research became an absolute priority.

Individual European countries have pursued their own national funding policies on embryonic stem cell research, reflecting traditional ethical attitudes, in some cases to the detriment of commercial advantages. While Italy has banned funding because of the influence of the Catholic Church, Germany has been equally reluctant as a consequence of its sensitivity to human ­ex­experiments in the light of its Nazi history. Japan has adopted similar policies, for the same reasons. Both Germany and Japan invoke the "slippery slope" argument. In other words, they are less preoccupied with doctrinal issues due to their caution based on national historical experience. Britain's more liberal ethical attitudes are largely based on classic utilitarian principles. The ideas of John Stuart Mill and Jeremy Bentham - the greatest good for the greatest number - hold more sway than arguments about ensouled embryos. When I served on an HFEA ­inquiry panel two years ago, exploring public attitudes towards ­hybrid embryos, it was noticeable that the majority of the participants, which included an ­ordained Church of England ethicist, emphasised the consequentialist clinical benefits - finding cures for Alzheimer's disease, multiple sclerosis, and cancer.

In the United States, the administration's views on stem cell research have been largely shaped by a combination of Evangelical and Catholic attitudes. While Catholics traditionally voted for the Democrats during and after the John F Kennedy era, the Republicans under George W Bush's leadership won over a sizeable proportion of the massive Catholic vote. Rights to life, abortion, and embryonic stem cell issues loomed large. A mailshot of four million letters was despatched to Catholics in advance of the 2000 election, claiming that the Republican Party endorsed John Paul II's views on family and life issues. Meanwhile John Kerry, the Democratic candidate, and a Catholic, appeared at odds with his own church on abortion.

During the 2008 election campaign, the Republicans were no less energetic in seeking the Catholic vote, and the Catholic bishops were ­vociferous in condemning Obama's human ­embryonic stem cell policies. In 2000 and 2004, half of America's Catholics voted for Bush. In 2008, however, there was a noticeable swing towards Obama of one crucial segment of the Catholic vote. Catholics, numbering 65 million, form the largest single denomination in the US, making up 27 per cent of the entire electorate. Some 52 per cent of white Catholic regular church-goers voted for McCain, and 47 per cent for Obama. But non-church-going Catholics voted 61 per cent for Obama and 37 per cent for McCain. The swing is probably a reflection of the increase in Hispanic voters, who opted for Obama on account of the economic downturn. The total Catholic vote was 54 per cent for Obama and 45 per cent for McCain, a five-point swing for the Democratic candidate on 2004.

Professor Raisman is typical of scientists who are agnostic on questions over the status of the human embryo; his jaundiced view of embryonic stem cell research is scientific, he insists. Using rat models, he has been grafting adult stem cells (known as olfactory ensheathing cells) from the upper region of a rat's nose to create pathways across spinal cord lesions. The strategy has been amazingly successful in rats. Animals that had been paralysed in a front limb have completely regained movement. In the near future, Raisman hopes to apply the treatment to human beings, starting with victims of accidents (typically motorbike riders) who have lost the use of an arm as a result of trauma at a site of the spinal cord known as the brachial plexus (where the shoulder meets the spinal cord). The olfactory human cells will be taken from the patient's own nose, thus reducing the possibility of immunity problems. This is just a prelude to tackling major spinal cord injury.

Raisman complains, however, that he has had scant fund­ing over the years because he cannot promise patents that will make profits. He charges moreover that the media hype for embryonic research as a coming miracle cure, including for spinal cord injury, has put his kind of research programme in the shade. A new surge in gov­ernment-funded human embryonic research in the United States, he believes, is likely to make things worse, as grant bodies in Britain and ­elsewhere will seek to compete. "The scramble to fund human embryonic stem cell experiments looks like the scientific equivalent of sub-prime mortgages," says Raisman. "One wonders how long the large sums of money and hype can go on chasing such a distant goal before the bubble bursts."

Many clinicians agree with Raisman that actual therapies using embryonic stem cells are far off. Professor Keith Peters, until recently president of the Academy of Medical Sciences, puts it as distant as two, even three decades. Yet by no means all supporters of embryonic research base their enthusiasm on early delivery of therapies, or on the prospect of financial returns. There are many potential problems with all stem cell therapies, including adult stem cells, as scientists such as Raisman agree. Scientists still do not know how to make embryonic stem cells proliferate reliably, or indeed switch off once they do proliferate; hence there is anxiety that cancers could develop in treated patients.

All the more reason, according to one constit­uency of the research lobby, for studying human stem cells from their very earliest stage: the embryo. Most persuasive on this score is Professor James Pedersen of Cambridge University (who came to Britain from San Francisco to escape Bush's ban on federal funding in 2004). He ­argues that ­reliable stem cell therapies must go hand in hand with fundamental research on the process of ­development from conception to birth to understand in depth how stem cells work, and hence how to avoid mistakes in therapies. Pedersen's largely academic, non-clinical developmental work, however, does not involve the scramble for patenting rights described by Professor ­Raisman.

While the scientific row over funding and patenting heats up against the background of the new American president's science policies, the ethical arguments are likely to be revived in a population where 57 per cent believe in creationism: the literal belief in the Genesis creation story. But as the economic downturn bites, there will be greater scrutiny of the returns on embryonic research funding - whether in terms of profits to be made on intellectual property rights, or actual delivery of successful therapies to the clinic. A 20- to 30-year delay for dividends in the current economic climate is a long time to wait. In the meantime, Professor Raisman makes an interesting link between regulation in medical science and regulation in banking and the economy: "The creditworthiness of scientific claims," he says, "has no better system of regulation than other derivatives and instruments beloved of financiers, attracting huge bonuses by moving other people's money about."

It is a salutary reminder that the widespread adoption of entrepreneurial and monetarist models from the 1980s onwards for the conduct of medical research is as much due for scrutiny as other failing economic institutions.

John Cornwell is director of the Science and Human Dimension Project at Jesus College,

Hybrid embryos: a short history

The controversy over stem cell research revolves around the use of human embryonic cells, since extracting the cells destroys the embryo they are taken from. In December 2000, the UK parliament voted to permit the research under guidelines that, by European standards, were liberal. The Human Fertilisation and Embryology Authority (HFEA) was charged with granting licences for research on embryos discarded as part of the IVF process. Opposition from anti-abortion groups and senior Catholics was intense. Tory MP Edward Leigh described the research as “the killing of the innocents”, comparing its supporters to Nazis.

“Therapeutic cloning”, or the creation of human embryos for the purpose of growing stem cells, raised controversy on a second front. The lab-created embryos typically only exist for a few days, and are little more than a ball of cells; nevertheless, opponents such as Peter Garrett, research director for the pro-choice group Life, warned, also in 2000: “We are only a couple of years away from cloning human beings.'' In 2004, the UK became the second country in the world to permit the procedure.

By 2006, British scientists were seeking permission to create hybrid embryos by injecting human nuclei into the shells of rabbit eggs. The resulting embryos would contain just 0.1 per cent animal DNA – but this was enough to raise the question as to whether the embryos were human. In late 2006, faced with furious opposition, the government proposed legislation banning the creation of hybrid embryos; but in September 2007, the HFEA decided that there was no fundamental reason to prevent cytoplasmic hybrid research.

A revised Human Fertilisation and Embryology Bill was drafted.

In January last year, the first licences were granted to carry out projects involving hybrids; but within days, 16 MPs had rebelled, calling for a free vote. The Catholic Church also vocally opposed the proposed bill – among them Cardinal Keith O’Brien, who claimed that the bill endorsed “experiments of Frankenstein proportion". Nevertheless, in April, the first human-animal embryos were created in the UK, and in October, despite a further attempt by Edward Leigh to have the technique banned, the Human Fertilisation and Embryology Bill was passed in October 2008, on its third reading.

Alyssa McDonald

This article first appeared in the 26 January 2009 issue of the New Statesman, Nixon went to China... Will Obama go to Iran?

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The age of loneliness

Profound changes in technology, work and community are transforming our ultrasocial species into a population of loners.

Our dominant ideology is based on a lie. A series of lies, in fact, but I’ll focus on just one. This is the claim that we are, above all else, self-interested – that we seek to enhance our own wealth and power with little regard for the impact on others.

Some economists use a term to describe this presumed state of being – Homo economicus, or self-maximising man. The concept was formulated, by J S Mill and others, as a thought experiment. Soon it became a modelling tool. Then it became an ideal. Then it evolved into a description of who we really are.

It could not be further from the truth. To study human behaviour is to become aware of how weird we are. Many species will go to great lengths to help and protect their close kin. One or two will show occasional altruism towards unrelated members of their kind. But no species possesses a capacity for general altruism that is anywhere close to our own.

With the possible exception of naked mole-rats, we have the most social minds of all mammals. These minds evolved as an essential means of survival. Slow, weak, armed with rounded teeth and flimsy nails in a world of fangs and claws and horns and tusks, we survived through co-operation, reciprocity and mutual defence, all of which developed to a remarkable degree.

A review paper in the journal Frontiers in Psychology observes that Homo economicus  might be a reasonable description of chimpanzees. “Outsiders . . . would not expect to receive offers of food or solicitude; rather, they would be fiercely attacked . . . food is shared only under harassment; even mothers will not voluntarily offer novel foods to their own infants unless the infants beg for them.” But it is an unreasonable description of human beings.

How many of your friends, colleagues and neighbours behave like chimpanzees? A few, perhaps. If so, are they respected or reviled? Some people do appear to act as if they have no interests but their own – Philip Green and Mike Ashley strike me as possible examples – but their behaviour ­attracts general revulsion. The news is filled with spectacular instances of human viciousness: although psychopaths are rare, their deeds fill the papers. Daily acts of kindness are seldom reported, because they are everywhere.

Every day, I see people helping others with luggage, offering to cede their place in a queue, giving money to the homeless, setting aside time for others, volunteering for causes that offer no material reward. Alongside these quotidian instances are extreme and stunning cases. I think of my Dutch mother-in-law, whose family took in a six-year-old Jewish boy – a stranger – and hid him in their house for two years during the German occupation of the Netherlands. Had he been discovered, they would all have been sent to a concentration camp.

Studies suggest that altruistic tendencies are innate: from the age of 14 months, children try to help each other, attempting to hand over objects another child can’t reach. At the age of two, they start to share valued possessions. By the time they are three, they begin to protest against other people’s violation of moral norms.

Perhaps because we are told by the media, think tanks and politicians that competition and self-interest are the defining norms of human life, we disastrously mischaracterise the way in which other people behave. A survey commissioned by the Common Cause Foundation reported that 78 per cent of respondents believe others to be more selfish than they really are.

I do not wish to suggest that this mythology of selfishness is the sole or even principal cause of the epidemic of loneliness now sweeping the world. But it is likely to contribute to the plague by breeding suspicion and a sense of threat. It also appears to provide a doctrine of justification for those afflicted by isolation, a doctrine that sees individualism as a higher state of existence than community. Perhaps it is hardly surprising that Britain, the European nation in which neoliberalism is most advanced, is, according to government figures, the loneliness capital of Europe.

There are several possible reasons for the atomisation now suffered by the supremely social mammal. Work, which used to bring us together, now disperses us: many people have neither fixed workplaces nor regular colleagues and regular hours. Our leisure time has undergone a similar transformation: cinema replaced by television, sport by computer games, time with friends by time on Facebook.

Social media seems to cut both ways: it brings us together and sets us apart. It helps us to stay in touch, but also cultivates a tendency that surely enhances other people’s sense of isolation: a determination to persuade your followers that you’re having a great time. FOMO – fear of missing out – seems, at least in my mind, to be closely ­associated with loneliness.

Children’s lives in particular have been transformed: since the 1970s, their unaccompanied home range (in other words, the area they roam without adult supervision) has declined in Britain by almost 90 per cent. Not only does this remove them from contact with the natural world, but it limits their contact with other children. When kids played out on the street or in the woods, they quickly formed their own tribes, learning the social skills that would see them through life.

An ageing population, family and community breakdown, the decline of institutions such as churches and trade unions, the switch from public transport to private, inequality, an alienating ethic of consumerism, the loss of common purpose: all these are likely to contribute to one of the most dangerous epidemics of our time.

Yes, I do mean dangerous. The stress response triggered by loneliness raises blood pressure and impairs the immune system. Loneliness enhances the risk of depression, paranoia, addiction, cognitive decline, dem­entia, heart disease, stroke, viral infection, accidents and suicide. It is as potent a cause of early death as smoking 15 cigarettes a day, and can be twice as deadly as obesity.

Perhaps because we are in thrall to the ideology that helps to cause the problem, we turn to the market to try to solve it. Over the past few weeks, the discovery of a new American profession, the people-walker (taking human beings for walks), has caused a small sensation in the media. In Japan there is a fully fledged market for friendship: you can hire friends by the hour with whom to chat and eat and watch TV; or, more disturbingly, to pose for pictures that you can post on social media. They are rented as mourners at funerals and guests at weddings. A recent article describes how a fake friend was used to replace a sister with whom the bride had fallen out. What would the bride’s mother make of it? No problem: she had been rented, too. In September we learned that similar customs have been followed in Britain for some time: an early foray into business for the Home Secretary, Amber Rudd, involved offering to lease her posh friends to underpopulated weddings.



My own experience fits the current pattern: the high incidence of loneliness suffered by people between the ages of 18 and 34. I have sometimes been lonely before and after that period, but it was during those years that I was most afflicted. The worst episode struck when I returned to Britain after six years working in West Papua, Brazil and East Africa. In those parts I sometimes felt like a ghost, drifting through societies to which I did not belong. I was often socially isolated, but I seldom felt lonely, perhaps because the issues I was investigating were so absorbing and the work so frightening that I was swept along by adrenalin and a sense of purpose.

When I came home, however, I fell into a mineshaft. My university friends, with their proper jobs, expensive mortgages and settled, prematurely aged lives, had become incomprehensible to me, and the life I had been leading seemed incomprehensible to everyone. Though feeling like a ghost abroad was in some ways liberating – a psychic decluttering that permitted an intense process of discovery – feeling like a ghost at home was terrifying. I existed, people acknowledged me, greeted me cordially, but I just could not connect. Wherever I went, I heard my own voice bouncing back at me.

Eventually I made new friends. But I still feel scarred by that time, and fearful that such desolation may recur, particularly in old age. These days, my loneliest moments come immediately after I’ve given a talk, when I’m surrounded by people congratulating me or asking questions. I often experience a falling sensation: their voices seem to recede above my head. I think it arises from the nature of the contact: because I can’t speak to anyone for more than a few seconds, it feels like social media brought to life.

The word “sullen” evolved from the Old French solain, which means “lonely”. Loneliness is associated with an enhanced perception of social threat, so one of its paradoxical consequences is a tendency to shut yourself off from strangers. When I was lonely, I felt like lashing out at the society from which I perceived myself excluded, as if the problem lay with other people. To read any comment thread is, I feel, to witness this tendency: you find people who are plainly making efforts to connect, but who do so by insulting and abusing, alienating the rest of the thread with their evident misanthropy. Perhaps some people really are rugged individualists. But others – especially online – appear to use that persona as a rationale for involuntary isolation.

Whatever the reasons might be, it is as if a spell had been cast on us, transforming this ultrasocial species into a population of loners. Like a parasite enhancing the conditions for its own survival, loneliness impedes its own cure by breeding shame and shyness. The work of groups such as Age UK, Mind, Positive Ageing and the Campaign to End Loneliness is life-saving.

When I first wrote about this subject, and the article went viral, several publishers urged me to write a book on the theme. Three years sitting at my desk, studying isolation: what’s the second prize? But I found another way of working on the issue, a way that engages me with others, rather than removing me. With the brilliant musician Ewan McLennan, I have written a concept album (I wrote the first draft of the lyrics; he refined them and wrote the music). Our aim is to use it to help break the spell, with performances of both music and the spoken word designed to bring people together –which, we hope, will end with a party at the nearest pub.

By itself, our work can make only a tiny contribution to addressing the epidemic. But I hope that, both by helping people to acknowledge it and by using the power of music to create common sentiment, we can at least begin to identify the barriers that separate us from others, and to remember that we are not the selfish, ruthless beings we are told we are.

“Breaking the Spell of Loneliness” by Ewan McLennan and George Monbiot is out now. For a full list of forthcoming gigs visit:

This article first appeared in the 20 October 2016 issue of the New Statesman, Brothers in blood