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“You are our only hope”: Trading metaphorical “magic bullets” for stem cell “superheroes”

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Abstract

In the wake of two recent developments in stem cell research, it is a fitting time to reassess the claim that stem cells will radically transform the concept and function of medicine. The first is the U.S. Food and Drug Administration’s decision in January 2009 to approve Geron Corporation’s Phase I clinical trial using human embryonic stem cells for patients with spinal cord injuries. The second is the National Institutes of Health’s decision to permit federal funding of research using donated IVF human embryos in their July 2009 Guidelines on Human Stem Cell Research. We are now poised to see whether stem cell research can deliver on what it promises. However, what exactly does it promise and how? Moreover, who is doing the promising? Turning to the use of metaphor can help us to answer these questions and enable us to develop a better appreciation of the unique features of promised stem cell therapies. Indeed, metaphors have exerted profound influence in medicine, and it is fitting that we seek new metaphors for new therapies where appropriate. In this case, other metaphors such as magic bullets or the Holy Grail cannot capture what is unique about stem cells. Accordingly, I propose a new metaphor: the stem cell superhero. Stem cell superheroes are characterized by the following traits: they are seemingly capable of fighting the evil of virtually all disease (unlike “magic bullets”) and they seem to be our only hope of doing so, although to summon them we must make difficult moral choices. In the course of assessing the merits of three recent yet covert references to the superhero metaphor, I conclude that this powerful new paradigm employs a problematic logic (i.e., we cannot know that something is “our only hope”), but that the aspiration as such is a good one.

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Notes

  1. I am very grateful to an anonymous reviewer for this comparison to the shaman.

  2. In July 2009, he challenged the new NIH Guidelines for assuming without adequate evidence that a moral consensus has formed around prohibiting the creation of embryos for research [25].

  3. The 2002 Stem Cell Act and its 2008 amendment permits the importation of human embryonic stem cell lines if they were created from surplus embryos prior to May 2007. Some critics have considered the German compromise to be disingenuous because German researchers still profit from the destruction of embryos, irrespective of where or when they were destroyed [37].

  4. The Genetic Interest Group, a strong advocate for the research, is emphatic on this point: “True hybrids and chimeras are what people understand to be human-animal hybrids. Cytoplasmic hybrids are not human-animal hybrids nor are they ‘half animal half human.’ Cytoplasmic hybrids are considered to be legally ‘human’ in U.K. law and are therefore under the jurisdiction of the Human Fertilisation and Embryology Authority (HFEA)” [43].

  5. A more realistic alternative to the “only hope” claim was offered in a commentary by two notable U.K. scientists (Justin St. John and Robin Lovell-Badge) who said, “The long-term aims of studying genetic disease or ultimately for deriving therapies are so laudable, one must ask why would anyone choose to prevent any form of research that harms no one and might allow such breakthroughs to take place?” [47].

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Acknowledgements

The research for this paper was supported by a Grant-in-Aid from Associated Medical Services (2006-07) and the research assistance of Caroline McInnes and Chris Kaposy.

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    Lawrence Burns

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Burns, L. “You are our only hope”: Trading metaphorical “magic bullets” for stem cell “superheroes”. Theor Med Bioeth 30, 427–442 (2009). https://doi.org/10.1007/s11017-009-9126-0

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