Background, positions, controversies

In this book, we will discuss two contested technologies, xenotransplantation and stem cell technologies, paying particular attention to human embryonic stem cell technologies. Both technologies are deeply embedded in the molecular medicine of our time. We will use this first chapter to provide a general background on molecular methods and to position ourselves in the interdisciplinary field of science studies.

1.1 The rise of molecular medicine

The book of life

In February 2001, two prestigious scientific journals, Nature and Science, devoted thick special editions to the revelation of the gene sequences of the human genome (International Human Genome Sequencing Consortium, 2001, Venter et al., 2001). Apart from highlighting a scientific breakthrough, the two publications illustrated that it was a negotiated publication. The two competing consortia, one private and one public, had agreed on the forms and time of publication. The race ended with two winners who could both claim priority.

The publication of the human genome was also a significant media event at the highest political level. The American president at the time, Bill Clinton, appeared at a media event to celebrate the publication, and proclaimed that the sequencing of the human genome was like looking into the 'book of life'. It supposedly overshadowed all previous human discoveries, including the wheel, the steam engine, electricity, and the atomic bomb. It was as though humanity was able to gain true knowledge of itself for the first time.

Such awe of the human genome, and the hyperbole it inspired in the likes of Clinton, is by no means a new phenomenon. It is deeply embedded in popular culture. In a study of how genes and modern genetics are viewed in American popular culture, the sociologists Dorothy Nelkin and M. Susan Lindee claim in their book, The DNA Mystique: The Gene as a Cultural Icon, that the concept of the gene has become essential in defining human (individual) identity, and is seen as an almost a magical entity that may replace the religious concept of the soul (Nelkin & Lindee, 1995). They also demonstrate how interpretations of the gene have influenced both our definitions of social problems and practices to treat these problems.

The papers in Nature and Science not only marked a historical breakthrough in biology. They also represented the merging of biological knowledge and technology with another powerful technology of our time, information technology. Each copy of the journals included a CD-ROM with the full inscription of the human genome.

However, there were also important differences between the public and the private actors in the field of human genome research. While the public consortium opened up all its databases to the scientific community, the private consortium, Celera, did not, which led to a protracted debate around this exception to the publication rules of Science (Duncan, 2001). According to Celera, their intention was to be able to make money from selling access to their superior databases. Economic logic eventually won out over profit, since no one is interested in paying for something they can get for free. Celera is no longer in business in the genomic area.

This type of interplay between public and private spheres is something we will meet many times in the history of the development of xenotransplantation and human embryonic stem cells. In particular, it is one of the most divisive issues in the fierce debate over the commercialisation of these technologies. Much of the development dealt with in this book was dependent to some extent on private firms and private money, especially in the case of xenotransplantation.

The DNA code and recombinant DNA

The developments leading up to the joint publication of the human genome had begun nearly fifty years earlier. In 1953, Francis Crick and James Watson published their discovery of the structure of the DNA molecule (Watson & Crick, 1953). In the decades following, more details of the so-called genetic code were revealed. It was learnt that there are specific combinations of three nucleic acids (of which there are four in the DNA molecule: adenine, cytosine, guanine, and thymine), coding for specific amino acids (of which there are twenty), and that these combinations of nucleic acid triplets make up genes and can, through the mediation of RNA, combine amino acids to make proteins, the basic building blocks of all living terrestrial organisms. The molecular basis for many hereditary diseases was also discovered.

In 1973, an American research group led by Stanley Cohen and Herbert Boyer published an article on a technology, which proved to be highly important for the application of the new molecular knowledge (Cohen et al., 1973). They had developed a technique to isolate and amplify individual genes and insert them into other cells, a technique that later became known as recombinant DNA technology. Cohen, Boyer, and their co-workers used so-called restriction enzymes that had been discovered a couple of years earlier to cut DNA sequences and splice them into bacterial plasmids. These plasmids are extrachromosomal DNA that can be found in certain bacteria. The plasmids are then used to carry the desired gene into other bacteria, where the gene will be able to express itself by making the same protein it was coded for, producing it in the other organism. By culturing such transgenic bacteria in bioreactors, it is possible to produce huge amounts of recombinant proteins that otherwise would be difficult and expensive to produce. The most common bacteria used for this purpose is E-Coli (Escherichia coli). The recombinant products can be used for various medical purposes. Production of human growth hormone is one example of a recombinant product that has been used in clinical treatment for a long time now. It used to be very expensive to produce large amounts of human growth hormone. It had to be derived from the brains of deceased humans, while collection was a dangerous procedure as the brain substance and the eventual medical product could be infected with various diseases. Today, not only are bacteria used in this kind of manufacture, but transgenic animals such as cows can be used to produce medicines in their milk.

The technologies resulting from the ability to splice genes and put them into new places, where they (with luck) fulfil the same function, are a cornerstone of biotechnology. The number of genetically modified plants used in agriculture for food production and for industrial purposes is expanding. The use of transgenic mice, which can carry a gene (or lack a specific gene) that produces a human disease, is very important in medical research and crucial to the early phases of testing new drugs against human diseases.

It can be argued that biotechnology carries great promise...