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The Limiting of Science Is Cutting Off Hope

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    The Limiting of Science Is Cutting Off Hope

    The Limiting of Science Is Cutting Off Hope

    Oliver Strewe/Stone

    few months ago I visited an AIDS organization called the Freedom Foundation outside Bangalore in South India. The whitewashed buildings, once part of a chicken farm, had been converted into a haven for people with H.I.V. infection. By scrambling and cajoling, the volunteer staff managed to get antiretroviral drugs for every infected child. But for the adults wasting away from unchecked H.I.V. infection, the future did not look bright. Had they been able to afford the medications, or for that matter, been residents of the United States, patients in my county hospital in El Paso, Tex., I felt they soon would have had flesh on their bones, the strength to sit up and the prospect of a future.

    Patients and caregivers at the Freedom Foundation could only look to the horizon and hope that someday, in some research lab, a scientific breakthrough would result in a novel means of attacking H.I.V., something both effective and affordable. If this should happen -- whether vaccine or drug -- the odds are great that it will come from an American research lab. The United States has not only been at the forefront of AIDS research, it has also become the de facto biomedical research wing of our planet. All over the world parents of children with AIDS, with spinal-cord injuries and with so many other diseases dream of miracles that might change their children's future, and it is to the U.S. that they look. The quaint image of a researcher with a pith helmet and microscope working in a jungle is an illusion; the tough questions of basic science require sophisticated institutions and expensive tools of molecular biology -- and money.

    How surprising and embarrassing then that we might be slamming the door on cloning human embryonic cells. As for the stem-cell research that uses the cells derived from leftover embryos in fertility clinics, President Bush has restricted federal financing to studies with the 60 cell lines supposedly already in existence. This means that research with the potential to reverse the course of Parkinson's disease or diabetes will be hamstrung, at least in America. The House vote against all human cloning, in its abruptness and its finality and in the magnitude of its penalties for those who dare oppose it, made me think of the Taliban and their draconian edicts: very little sorting out of details, few distinctions, meaningful debate drowned out by fundamentalist rhetoric and then an a priori proclamation of what society needs, followed by the order -- destroy the Buddhas.

    Let me make clear, I am a clinician, not a researcher. The moral and ethical concerns about human cloning or embryonic stem-cell research do not escape me. Far from it, I know how easy it is to slide down the slippery slope of abusing technology: amniocentesis and ultrasound technology in some parts of India are used largely to find and abort female babies. Still, on the continuum between benefits and risks, was there not a place where we could have allowed narrowly targeted research by our best scientists to proceed? No human versions of Dolly the sheep, thank you very much, but why not a limited exploration of the potential of stem cells from cloned embryos to reverse debilitating diseases? America, the beautiful, the brave -- where is our courage? The world with good reason expects better of us.

    This is the paradox that I find most curious: we are at once a sophisticated nation benefiting from scientific and technological advances, and yet we can display a surprising backwardness. My patients often know more about their diseases from the Internet than I do. Television routinely takes us into operating rooms, courtrooms and outer space. We live in the era of the new, new thing, we have the moxie to build an unproved missile defense system, but when it comes to stem cells and cloning, our puritanical fears get the better of our sophistication, and we backpedal to a dubious moral high ground.

    In my H.I.V. clinic in Texas a few weeks ago, I saw a young woman -- a physician -- who was failing her treatment regimen; the virus she harbored had evolved to resist the drugs I had her on. But I had in my hands the results of a genotype test in which her particular viral strain had been probed for the gene patterns that predict resistance to new drugs I plan to use. ''Wow,'' my intern said as he examined the viral gene printout that looked like a felon's rap sheet, ''I didn't know we could do this.'' Yes, son, fortunately we can. The ethical debate when it came to cloning genes and to recombinant DNA did not shut down the science.

    Stem-cell and cloning research may not live up to scientists' expectations. But the possibility of bringing relief to those who are suffering is simply too precious to pass by. To turn our backs on such research robs patients with incurable disease of the one thing they cling to -- hope. William Osler, the great man of American medicine, said, ''It is not for you to don the black cap and assuming the judicial function, take hope away from any patient . . . hope that comes to us all.'' This statement, cherished by generations of medical students, could well serve as advice for our society as we ponder the future of science.

    Abraham Verghese is the Grover E. Murray Distinguished Professor of Medicine at Texas Tech. His latest book is ''The Tennis Partner

    Great article Max!


      Hope is not lost.

      I agree that people often resist that which they fear or just don't understand. I believe that the decision (if you want to call it that) was all that we could expect from such a conservative president. But I see it as a begining! The announcement was seen by millions, and millions were talking about it. It started a conversation that we must continue. Hope can be very contagous. Without hope, we can do nothing. With it we can do the impossible!