1. "Stem Cells, Moral Status, & California Proposition 71" "Stem Cells, Moral Status, & California Proposition 71" Ethics@Noon October 13, 2004

2. © 20042 What are stem cells? Self-renewing, unspecialized cells that can give rise to multiple types of specialized cells in the body through differentiation. Self-renewing, unspecialized cells that can give rise to multiple types of specialized cells in the body through differentiation. Sources: embryonic (hES), fetal (hGS), and adult tissue (hAS) Sources: embryonic (hES), fetal (hGS), and adult tissue (hAS)

3. © 20043 Why the interest? Medical promise Medical promise Tissue transplants Tissue transplants Deliver gene therapies Deliver gene therapies Screen drugs/toxins Screen drugs/toxins Better understanding of human development Better understanding of human development

4. © 20044 Adult stem cells Have been found in: Have been found in: Brain Brain Bone marrow Bone marrow Blood vessels Blood vessels Digestive tract Digestive tract Skeletal muscle Skeletal muscle Skin Skin Liver Liver Umbilical cord Umbilical cord Are multipotent, e.g., hematopoietic stem cells form blood components Are multipotent, e.g., hematopoietic stem cells form blood components

5. © 20045 Embryonic stem cells Derived from embryos that develop from eggs that have been fertilized in vitro and then donated for research purposes with informed consent of the donors Derived from embryos that develop from eggs that have been fertilized in vitro and then donated for research purposes with informed consent of the donors Not derived from eggs fertilized in a woman's body Not derived from eggs fertilized in a woman's body Are pluripotent, i.e., can differentiate into any body cell type Are pluripotent, i.e., can differentiate into any body cell type

7. © 20047 The Funding Debate Federal funding of hES research Federal funding of hES research $180 million in 2002 for hAS and hES research $180 million in 2002 for hAS and hES research Funds for hES restricted to 64 pre-existing lines Funds for hES restricted to 64 pre-existing lines Only 15 lines currently available Only 15 lines currently available None are safe None are safe Private funding Private funding Can create new lines Can create new lines Can create embryos for purpose of deriving hES Can create embryos for purpose of deriving hES State funding via Prop. 71? State funding via Prop. 71?

8. © 20048 Prop. 71 is not... a referendum on stem cell research per se a referendum on stem cell research per se one could support stem cell research in general and be opposed to this initiative one could support stem cell research in general and be opposed to this initiative California law currently allows research on stem cells and will continue to do so California law currently allows research on stem cells and will continue to do so

9. © 20049 Prop. 71 Constitutional amendment Constitutional amendment $3 billion for stem cell research and research facilities over 10 years $3 billion for stem cell research and research facilities over 10 years < $350 million per year in state general obligation bonds (state guarantees payment) < $350 million per year in state general obligation bonds (state guarantees payment) Proceeds from bond sales put in new California Stem Cell Research and Cures Fund Proceeds from bond sales put in new California Stem Cell Research and Cures Fund

10. © 200410 Stem Cell Initiative Forms California Institute for Regenerative Medicine responsible for oversight Forms California Institute for Regenerative Medicine responsible for oversight Award grants and loans for research and facilities Award grants and loans for research and facilities Establishes regulatory standards for research within the state Establishes regulatory standards for research within the state Staff of up to 50 employees exempt from civil service requirements Staff of up to 50 employees exempt from civil service requirements Governed by 29-member Independent Citizen’s Oversight Committee (ICOC) Governed by 29-member Independent Citizen’s Oversight Committee (ICOC)

11. © 200411 Stem Cell Initiative Funding priority given to stem cell research “that has greatest potential for therapies or cures,” i.e., “pluripotent stem cells” Funding priority given to stem cell research “that has greatest potential for therapies or cures,” i.e., “pluripotent stem cells” Funding priority given to research unlikely to receive federal dollars, i.e., hES cells Funding priority given to research unlikely to receive federal dollars, i.e., hES cells Includes “somatic cell nuclear transfer” Includes “somatic cell nuclear transfer”

12. © 200412 Note Bene I Grants and loans subject to agreements that would allow state to benefit financially from patents, royalties, licenses Grants and loans subject to agreements that would allow state to benefit financially from patents, royalties, licenses Up to 10% of funds during the first 5 years could be used to develop research facilities for nonprofits Up to 10% of funds during the first 5 years could be used to develop research facilities for nonprofits States that conducting stem cell research is a “right” within California States that conducting stem cell research is a “right” within California

13. © 200413 Note Bene II Costs to state depend on interest rates when bonds are sold. Costs to state depend on interest rates when bonds are sold. If paid over 30 years at 5.25% interest, the cost to the General Fund would be ~ $6 billion to pay off both principal and interest If paid over 30 years at 5.25% interest, the cost to the General Fund would be ~ $6 billion to pay off both principal and interest Potential profit to state if there are positive economic effects of research, e.g., patents, job growth, decrease in health care costs—likelihood unknown Potential profit to state if there are positive economic effects of research, e.g., patents, job growth, decrease in health care costs—likelihood unknown