Transcript Stem Cells, Women, and Dangerous Things

Stem Cells, Women, and
Dangerous Things
Charis Thompson
Associate Professor, Gender and Women’s Studies and Rhetoric
Director, Science, Technology, and Society Center
Project Director, Stem Cells and Society
Director, Designated Emphasis in Women, Gender, and Sexuality
Member, Academic Senate Committee on the Status of Women and
Ethnic Minorities
UC Berkeley
Overview: From Babies, Barriers,
and Bias to Pioneers, Priorities,
and Procurement
• Women in Stem Cell Science
• The Stem Cell Science of Gender
• The Gender(ing) of Stem Cell Science
(Those who write about stem cells, unlike those who
write about assisted reproductive technologies, are
not feminist or even post-feminist)
1. Women in Stem Cell Science
• Distribution by gender among stem cell
scientists
• Academy-industry alliances and IP new gap
in which to get left behind
• Workplace culture, especially “family
balancing”
• Values of women researchers and clinicians,
e.g. disease research priorities
Distribution by gender among
stem cell scientists
• Charismatic megafauna almost all men in field,
private and public, corporate and academy
• Mixed: e.g. at UC Berkeley, <20% of senior
faculty are women, BUT ~ 40% of junior faculty
in the biological sciences are women, from a UCB
applicant pool of ~ 30% women;
underrepresented minority women pipeline still
not functioning; close to parity in US PhD pool
among top quartile research institutions
• Women clinicians involved in IVF / HESC
interface; also fairly well represented in ethics,
law, tech transfer, bio-banking, regulation
Academy-industry alliances; IP
• Recent work suggesting that women life
science faculty lag behind men in start-up
and IP activity
• This compounds the gender earnings gap;
reduces the likelihood of discoveries
making it to market - and thus to therapies and makes it less likely that credit (pay,
rank, prizes) will accrue to scientists from
downstream visible pay-off
Family Balancing…
• Workplace culture critical, especially balance of
family/other obligations with work place
excellence
• “Family balancing”: expression used to garner
support for sex selection: presents gender-planned
family as efficient, and even feminist, allowing
women to go to work; rationalize labor of
production side as well as labor of reproduction
(my own suggestion would be to move women up
faster, rather than slowing down tenure clock, so
that they have to spend less time in the lab…)
Priorities for Publicly Funded Research?
• 1. Scientific prospects: diseases most amenable to stem cell
treatment
• 2. Severity: diseases with fastest ticking clock and worst
symptoms
• 3. Economic: diseases where the expenditure/cure ratio is
best
• 4. Single path: diseases lacking other treatments, regardless
of severity
• 5. Incidence: diseases that afflict the most people
• 6. Public health: diseases that disproportionately effect
sectors of population that are least likely to be able to afford
products of private sector R&D and health care costs
• 7. Organic: building from existing interest in particular
research questions and researcher expertise without regard
to above criteria
• 8. Activist driven: diseases with the best organized activist
community
The Stem Cell Science of Gender
As has been argued, science reflects, re-imagines,
and reinscribes theories and contradictions of
gender and sexuality
• In vitro fertilization “leftover” and “supernumary”
embryos
• Moral status of the asexual embryo of somatic cell
nuclear transfer
• Sexing the embryo
Where do Human Embryonic Stem Cells
come from, Mommy?
“Sect. 4. Article XXXV is added to the California
Constitution, to read: . . . There is hereby established a
right to conduct stem cell research which includes research
involving adult stem cells, cord blood stem cells,
pluripotent stem cells, and / or progenitor cells.
Pluripotent stem cells are cells that are capable of selfrenewal, and have broad potential to differentiate into
multiple adult cell types. Pluripotent stem cells may be
derived from somatic cell nuclear transfer or from surplus
products of in vitro fertilization treatments when such
products are donated under appropriate informed consent
procedures.” (Prop 71’s Missing Women, my emphasis).
The Problem of Asex, or, the Heteronormativity of
the Moral Status of the Embryo Debate
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SCNT: Embryo Creation or Destruction? NO:
There is no involvement of germ cell nuclei, and NO SPERM!
There is no meiosis
There is no fertilization
There is no procreational intent (the principle that has become
critical to US law in disambiguating underdetermined
parentage, e.g. Calvert v. Johnson)
• SCNT: Embryo Creation or Destruction? YES:
• A blastocyst is by definition an embryo
• SCNT blastocysts can, in some tiny proportion of cases, lead to
the birth of offspring, if implanted (Dolly the Sheep)
• Removing the inner cell mass prevents the blastocyst from
developing
Sexing the embryo…
Pre-implantation genetic diagnosis, where in-vitro
embryos are examined for genetic disease; crucial
for Lanzer idea (non-destruction of embryo in
HESC), as well as for “disease in a dish”
rationales for human embryonic stem line
derivation and bioassay and drug toxicity testing,
and matched sibling cord blood hematopoietic
stem cell transplants
Reinscribes a chromosomal biologization of
sex/gender
• NIH registry sexes the approved lines…
The Gender(ing) of Stem Cell
Science
The Gendering of Regenerative Medicine:
The rise of egg donation as THE women’s issue, and
the role of markets, academy and publics in
“procurial” life science
Women’s issues pushed off-stage: health care
priorities and disparities, health carers, health
activists
Egg Donation: THE Woman’s Issue?
• Why did procuring women’s eggs for human
embryonic stem cell research suddenly become
THE women’s issue?
• Concerns about medical and psychological risks
associated with donating eggs, e.g. OHSS / impact
on future fertility/potential increased risk of
reproductive tract cancers
• Worries that low-income women would be coerced
into donating eggs if paid (but not paying egg
donors may increase the risks of donation by
reducing pool of donors to patients themselves,
who have higher co-morbidity)
• Taint of Hwang Woo Suk scandal
• NAS and many others ruled out payment already
Egg Donation
• Not self-evident that egg donor protection would
have become, or ought to be, a paramount
women’s issue
• NOT a “women’s issue” in IVF; indeed,
widespread parody of donors and their suitors,
despite: much greater financial inducements;
potential for eugenics; elevated risks due to poor
regulation of field, youth and nulliparity of modal
donors, emphasis on high egg yield, incest;
potential for charge of baby-selling
• How come only donors don’t get paid (unilateral
altruism)? Some of us argued FOR payment
• Other tissues and organs: some gifted, anonymous
or known, and some paid for; no general rule
Regenerative Medicine as
“Procurial” Life Science
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Biosecure: closed capital
Billanthropic: excess capital
Big pharma: market capital
Procurial: promissory capital (“hope-hype”)
– Regenerative medicine suffers from various market
failures, including: political opposition owing to moral
status of embryo; difficulties in scale-up and
inapplicability of IND and clinical trials procedures for
cell-based therapies, especially if aiming for
histocompatibility; lack of proof of principle in key
areas; gene therapy specter overhanging trials
– VC doesn’t like it; 5-year exit not likely
– Need way to get research funded as either pure science
(no-go in the US currently) or get public and private
monies for start-up costs
Hello Dolly, Buy-Bayh-Dole
• Regenerative biology and medicine has to get
support from and withstand scrutiny of the public,
to get public money, and start bench to bedside
ideal of the post-Bayh-Dole era:
– Pro-cures, tried and true way to get government subsidy
for open science, where appropriations need to go
through the public; heightened for regenerative
medicine because of federal policy. Patient desperation
– Procurement, need to get “stakeholder”
permission, also old concern, but crucial in postBelmont age of the protection of human subjects, and
has only grown with AIDS activism, genome
bioprospecting, and recruitment for global clinical trials;
eggs goes one step further in being a research substrate.
Donor protections
Missing Issues:
• Health care disparities, especially by race, class, and
disability, e.g. Greenlining
• Health care priorities: is this what we want to spend
public money on?
• Accountability/transparency/conflicts of interest
• Integrating and taking account of women’s special
kinship and labor roles as health care guardians and
care-givers, as well as their roles as patient
advocates
• Public opposition spokeswomen: CGS, HOOO,
Disability Rights activists, Pro-Choice Alliance
• Transnational egg trade: off-shored incentives