There have been advancements in the medical field to cure and repair human tissues and organs. Such advancements have resulted in extensive research that has seen scientists develop different methods that can be a remedy for certain diseases and conditions that in past have proved difficult to treat. Accordingly, researchers have come up with Stem Cell therapy that has shown promising results in the curing and repairing of body tissues. In the U.S, policies have been implemented about the study of embryonic stem cells. It is therefore important to explore the U.S. Embryonic Stem Cell Policy in a rational model. Furthermore, there is also the need to examine the alternatives to embryonic stem cells.
The rational model
In policy analysis, several models can be used to evaluate and analyze policies that need to be formulated and/or implemented to offer a solution to a given problem. The rational model involves a series of analytical steps which form the basis for rational analysis (Sullivan, 2009, p. 386). The steps involved include the definition and analysis of the problem, alternatives of the policy, construction of criteria for evaluation, and drawing of the conclusions (Sullivan, 2009, p.386; Kraft & Furlong, 2010, p.101).
On definition and analysis of the problem, we look at the unsatisfactory set of conditions that exists and we try to look for the remedy of the same either from the perspective of the government or the private sources. Data is therefore for purposes of factual presentation. In addition, the magnitude of this data will also be examined. The data will serve the purpose of explaining the nature of the problem, the sector of the or area where it exists, the victims who are affected by the problem, how it developed, its causes, and how policy action can affect the causes of the problem at hand. For our analysis, we are to look at the problem of embryonic stem cells in the U.S. On the alternatives of the policy, we look at the options that might be considered for dealing with this problem identified earlier.
Criteria evaluation tries to look at the best or most suitable decisive factor for the problem or the alternative(s). It also looks into the costs of taking action as compared to not taking any action. The effectiveness of the policy relating to the political, social, and equity feasibility is also a consideration in this step. The third step, assessment of the alternatives, entails looking into the best alternative and how best it is compared to others. Here there is an analysis to help in distinguishing the best and the worst alternatives. The availability of the evidence is also considered so that ways can be devised on how to produce it.
Lastly, in concluding, we look at the most desirable policy option regarding the available circumstances and the criteria for evaluation (Kraft & Furlong, 2010, p.101; Sullivan, 2009, p.386; Bellinger, 2007, p.7).
The policy in the Context of pubic policy
Public policies are affected by the interplay of several contexts in society. These contexts are; social, economic, political, governing, and cultural contexts. In this case, we will look at this problem from a governing perspective in the sense of the problems of divided authority in putting the policy into practice.
An embryonic stem cell is a term used about the derivatives of a pre-implantation embryo (often aged only five days). Such cells have the potential to divide upon exposure to a suitable growth medium, with no differentiation involved (System cell information, 2010). The embryo(s) used are fertilized in the laboratory and the cells extracted from them are also grown in the laboratory. The stem cell policy is believed at developing new technology on ways of understanding better and treating many diseases and conditions that are disabling. Some of these diseases are diabetes, cancer, heart diseases, Alzheimer’s disease, and Parkinson’s disease (Trizio and Christopher, 2004, p.3).
The policy has been developed over the years but has lacked funding from the federal government. The funding was limited by the presidential actions. However, with the change of government in Washington in November 2008, the current US president (Barrack Obama) appears to have somewhat mellowed on the whole issue of providing funds into embryonic stem cell research.
The human embryonic stem cells are harvested from cryopreserved blastocysts created during ‘in vitro’ fertilization. These embryos are donated for research by the people whose genetic materials were used for the creation of these embryos, which after extraction of these stem cells the embryo loses its ability to develop into a human being (Trizio and Christopher, 2004, p.5), therefore the embryo is discarded.
The context of governance comes in as the actions by the president were the major impediment for the policy to come to full implementation for the benefit of human health in substantial margins. The fact that the president and his party control the White House, and the other parties had a bigger control on the house of congress, presenting a situation of non-compromise. The president’s decision or action prevailed due to the powers vested in him by the constitution (Kraft and Furlong, 2010, p.13).
The changing political views, however, and the need for change within the American population which brought the current president to power played a major role in the uniting of the majority of the political parties, and for this reason, compromised and the consensus was possible. This was vital as public policies of big impact as this one requires unity in the passing of new policies so that the country can move from outdated policies and make new and better policies, and implement them (Kraft & Furlong, 2010, p.13).
The issue of divided authority, where the federal government can provide funds but the state government may not work well with the government (Kraft & Furlong, 2010, p.14), may be contributed by the fact that the different states have different political affiliations and as a result, there may be differences in views and willingness to work together. This is because the respective states will be required to fund the project (policy) as units but the federal government will only be making political decisions regarding the policy implementation. This may be paradoxical in that the states may be facing budgetary deficits making it difficult to implement the policy as required by the federal government, hence conflict.
Even if the president and the majority of his party members have agreed on the implementation of the policy, there are other states where the members are not of the same view and might have been opposing the policy. This may bring about conflict in the policy implementation. Contrary to this the U. S. government, through the president (Bush), had banned the use of stem cell research from embryos, and even if the states wanted to commence on the implementation of such a policy, it would be difficult. However, the lifting of the barrier that limited the federal government from funding this policy is a positive step as the federal government does not only share on political responsibility(s) but also financial responsibility in financing the policy implementation.
An instrument for the model
This is a sensitive policy and it should be provided similarly. Several instruments are used by governments to implement public policies. The instrument used depends on the sensitivity and the complication of the matter. The government needs to look into issues of whether the policy is aimed at curbing a certain trend of behavior in the society or if the policy is to promote the welfare of the community, with equity being looked into.
For our case, we are going to use the instrument of ‘Government management’. According to Kraft and Furlong (2010, p.89), the government uses this instrument when it wants to provide a certain service(s) directly to its citizens, and because these services require to be provided in a specific way. A policy like this one where health provision using such sophisticated technology, like a stem cell, can be exploited by the private sector as it is very profitable.
Again the private sector may take the matter too far if they are not well checked and regulated by the government. Because of this, it would be better for the government to take charge in the management of such a policy and the provision of such services. The government can also contract private companies to provide these services and pay for them, but they have to be provided by the stipulation of the government. The reason for the involvement of the government, though having contracted private companies to provide these services, is for the sole purpose of checking accountability, effectiveness, and cost to the public and avoid exploitation by the private companies (Kraft and Furlong, 2010, p.89).
This can also be through privatization but the government should still be the one controlling the implementation of these policies and service provisions (Kraft and Furlong, 2010, p.89). Before the government can contract a private company it has to rely on the market system in the sense that the best company that is cost-effective and offers the highest quality of services, is the one that is contracted. Private management is usually linked with efficiency and, therefore, the government would utilize them more often than not especially these days.
There are three major categories of typologies that are used by governments to classify their functions, which are: distributive, redistributive, and regulatory (Lowi, 1964 in Kraft and Furlong, 2010, p.91). Each typology fits a certain line of functions that the government wants to achieve in the provision of services. In our case, we will be discussing the relevant typology only. The typology used is the Distributive one.
Here the government provides funds for such a service regardless of limited resources (Kraft and Furlong, p.91). Health is a basic need for all people and where citizens of a country have access to better health, like in our case, then the public is to benefit. There will be the provision of the service regardless of any financial constraints like deficits in the budget. This typology views the functions as being delivered to benefit the constituencies of the selected representatives and for our case, the government will have to look into the issue of equality so that there can be a fair distribution of this service.
Different states are represented and the works of any state as regards the provision of the health service would be of direct effect (benefit) to them as the involved lot. Other states would not question any other state’s way of providing the service as they too have their own and have the freedom to provide it to their constituents the best way they see it (Kraft and Furlong, 2010, p.91). Although in distributive typology we look at it in terms of those who gain and those who lose, for our case it looks like a win-win situation, although the funds to finance this program may be derived from taxation.
The effect would be that the high-income earners would have to contribute more than the low-class, therefore deeming the latter as the winning group and the former, losing group. In many countries, the embryonic stem cell is prohibited and also cloning. In the United States, however, due to the support by the government regulation of this practice is not the way to go but rather the government should use distributive typology to the functioning of this policy and with strict supervision so that it will be the one to provide this service.
Further research in embryonic stem cells promises a lot of potentials as far as disease treatment is concerned. However, it is surrounded by criticisms and controversies as it is viewed as a way that involves destroying human embryos. There is a need for the scientists in the medical research program to think of possible alternatives to embryonic stem cells that will not have the kinds of criticisms and/or controversies. There are alternatives to this policy that can be adopted. The reason behind this may result from the criticism based on religious, ethical, and moral considerations of the policy (Trizio and Christopher, 2004, p.5).
We will, however, discuss three alternatives that can be developed rather than the embryonic cell stem. These alternatives are going to address the different alternative sources where stem cells can be harvested. They are Adult stem cells, multipotent adult progenitor cells, and Parthenotes (Morley, 2003, p.1).
Adult stem cells (ASCs) are unspecialized cells that are found in the body of an adult human being. They can be found in places like the bone marrow and the brain. They are self renewable and they have the potential to develop into cell types that are specialized (Morley, 2003, p.1). Adult stem cells will provide solutions to medicine that will avoid the legal and ethical problems associated with cloning and embryonic stem cell approaches (Turksen, 2004, p.1).
Studies have shown that adult stem cells are plastic. This means that they can differentiate into their source tissue and cells of unrelated tissues too (Turksen, 2004, p.1). The plasticity in adult stem cells might allow the use of bone marrow stem cells to replace myocardial cells that might be damaged following ischemic damage; curing of insulin-dependent diabetes by pancreatic islet cells; and the Parkinson’s disease being cured by cells from substantia nigra (Turksen, 2004, p.2).
Multipotent adult progenitor cells (MAPCs) are isolated from the bone marrow. The mesenchymal cells that are found in the bone marrow are the ones that are responsible for this. The MAPCs are autologous just like the ASCs cells and can renew themselves indefinitely (Bock, Jaime and Novartis foundation, 2005, p.55). They are also capable of differentiating themselves into cells that make up a variety of tissues. Tissues like the brain, skin, and liver are some of the tissues that these cells can be able to form (Morley, 2003, p.1). MAPCs cells’ ability to engraft in many tissues has been demonstrated repeatedly.
The studies that have been conducted show that the concept of multipotent stem cells can engraft in distinct organ sites and they undergo specific changes related to that organ in differentiation and potentially providing multipotent cells that contribute to organogenesis. These cells can be able to provide precursor cells to repair organs that have suffered from disease or injury (Lanza, Hogan and John, 2004, p.387).
Lastly, we look at Parthenotes. These are embryos that are created using the process called parthenogenesis, which involves taking an immature egg cell from a female donor. It is treated with chemicals stimulating it and it starts to divide just like a fertilized egg (Beval, 2006, p.22). It continues to divide and forms a blastocyst. The inner cell mass is the one that is harvested to create a stem cell line and it is genetically identical to the original egg donor. The blastocyst can also be implanted in a woman and this is better because the child that will be born will have the same genome as the egg donor and would therefore be her clone (Morley 2003, p.1).
Parthenotes cannot go into the fetal stage as it lacks the paternal DNA. The paternal DNA is vital for the promotion of the growth of the umbilical cord. The fact that it, parthenote, is not an embryo it can be used for harvesting of stem cells and this would not be considered as controversial (Kelly, 2007, p.133).
Public policies can be evaluated by several criteria. Kraft and Furlong (2010) have developed about eight criteria that can be used to assess public policies but for our case, we will concentrate on three criteria to evaluate a public policy in the rational model. These criteria are social acceptability, political feasibility, and technical feasibility.
First, social acceptability is used in the evaluation of policies that are seen as controversial. It entails evaluating the extent to which the public will support the given policy. The attractiveness of a public policy will depend on its acceptability socially. This is because the policies which are considered to be socially unacceptable generate views that are paradoxical and do not go well with the majority of the society members.
Policies such as control of crime and issues to do with rights for abortion are some of the policies that can be assessed or evaluated using social criteria. If the public is in agreement with a public policy the policy is likely to get support from the public. However, the level of awareness and saliency by the public matters a lot. This is because of the difficulty there is in the determination of such an evaluation criterion even if the public support is measurable. Policies that are considered by the society as having ethical and moral issues which are not in line with the point of view of the community are normally not supported by the public which in this case forms the society or a particular group. Social evaluation is considered a normative issue and it is very important for the policymakers to put it into consideration (Kraft and Furlong, 2010, p.161).
Any process that may ignore the social values in its decision-making is a failure (Kraft and Furlong, 2010, p.161). There is a need to look at the possible effects of the future generations and how these problems, if any, can be best handled by the authorities, say, for example, the government (Kraft and Furlong, 2010, p.161). This evaluative criterion shows how important public opinion and involvement in the decision-making process are required (Kraft and Furlong, 2010, p.161).
Secondly, political feasibility is essential in the evaluation of public policies. Some political analysts see it as improper for the analysts to include ethics and dimensions that are considered normative in their work. Politics, though normative, play an important role in the evaluation of the policies to be adopted. Some experts will argue that the political process is there to address and resolve ethical and value disputes (Kraft and Furlong, 2010, p.160).
Political feasibility can be looked into as the role of government authority which is very vital in decisions regarding the formulation of public policies (Kraft and Furlong, 2010, p.161). The primary functioning and implementation of the public policies lie with the willingness of the political hand in any country. If the government has not been adequately considered in the formulation of a policy or the decision-making process then the whole applicability of the policy may fail. Politics are also about the legality of a policy or decision to be formulated or arrived at. Matters that are considered to be contentious are better evaluated politically (Kraft and Furlong, 2010, p.161).
Lastly, is technical feasibility which looks at the availability and reliability of technology that is needed for the implementation of the policy. The criterion will, therefore, address the question of whether the needed technology for a policy to be implemented and maintained is available or can be accessed. Again it will have to look if the technology available can be relied upon for the smooth running of the policy if it were to be implemented. It is, however, often difficult to anticipate the changes in the technology that would alter the feasibility of technology at a future date. This evaluation criterion is applied in policies that are related to science and technology, and those policies that affect environmental sustainability and other social services that are offered for the benefit of the public like in defense (Kraft and Furlong, 2010, p.154).
Policies that are affected by technology and the ways that technology may change thus affecting their feasibility are evaluated so that the best ways in which they can be implemented and maintained for a considerable period can be forecasted or determined for the sake of future advancements and generations.
The alternatives to embryonic stem cells that we have discussed, that is, adult stem cells, multipotent adult progenitor cells, and parthenotes, apart from being economically viable just as embryonic stem cells, are going to be assessed with these three evaluation criteria discussed earlier, one at a time.
To start with, adult stem cells, is first, widely accepted or preferred to embryonic stem policy by society and it is not seen as controversial, as it does not involve the termination of human life. The public is more comfortable with the use of adult stem cells as the cells are harvested from the bone marrow and the brain, of an adult human being, and it does not involve the termination of the donor or person as it does not in any way inhibit the normal growth of the person.
The religious and the ethical professionals are, therefore, more confident and comfortable with its use and it can be widely adopted in many other countries without obstruction, as it will be considered to be ethically and morally okay. The kind of information that the public has concerning its operation is satisfactory enough and so the decisions and support of its implementation instead of the embryonic one are more readily accepted.
Second, the political feasibility of the adult cell is more acceptable to embryonic stem cells. This is because the government or the political authority feels the obligation to protect life as a primary role. This brings about the protection of the right to life, as stipulated in the constitution in most countries. Again the political aspect, as has been argued before, is seen as a way to solve the ethical and moral dispute. Since the embryonic stem cell is considered unethical by the public, the political institution will come in and address this issue/ dispute. It will try to balance and put into consideration the more acceptable policies in the public as well as economically.
Third, the technical evaluation criterion will auger well with the adult stem cell policy. This is because the needed technology for its implementation and maintenance is available, as it was being proposed to substitute embryonic stem cells. The technology has been advancing in the last couple of years and so the question of its availability and sustainability should not be there as there is enough evidence to support its existence and applicability.
The second alternative, which is multipotent adult progenitor cells, can also be evaluated using these criteria. Socially, which is very much similar to the adult stem cell has also the same acceptance just like the former. This is due to the ethical and moral acceptance that many people find with it. It is accepted, therefore, by society, or the public as it is not controversial in its operation. Its implementation as regards public opinion is taken well by a diversity of individuals of different beliefs as it is in line with the social ethics and moral standards that are acceptable to many.
Secondly, it is also politically sound and the ultimate responsibility to protect life is also taken into consideration. It is an option for the government to implement and carry on as its results are similar to those of the embryonic stem cell, just that it is not as successful as the embryonic stem cell.
Technically, it is feasible as its source of stem cells is more available and it has been developed for a considerable number of years. Just as the adult stem cell it is possible for its implementation, maintenance and continuation.
Lastly, the parthenotes’ stem cell is also considered to be embryonic one. Though it is very similar to the embryonic, and it is usually termed cloning, it uses eggs that are treated chemically and they form blastocysts which not embryos, just that they are similar to embryos. This makes it more acceptable as it does not terminate life, as the blastocyst cannot develop into an embryo as it lacks the paternal component. This reduces criticisms though to a limited amount. Different people have different views and it is not well received as it is termed as cloning and some people argue that these clones could just live like human beings if implanted to a woman who donated the egg. This makes them less desirable just as the embryonic stem cell.
Politically, it has been viewed as embryonic and so it has also not received a warm reception by many governments. In their opinion, political institution, ‘life’ is to be safeguarded at all costs and this has seen the use of pathogens receive as much critique just as embryonic stem cells. This was the reason that saw it being banned along with the embryonic stem cell, though some would consider it to be an embryonic stem cell. The government has to step in and solve the social ethical and moral contradiction and/ or controversy.
Lastly, it is very much technically feasible just like all the other alternatives that have been discussed. Relevant technology has been developed and is available for its implementation and maintenance. Scientists have developed it to try to harvest better stem cells than those found in adult and adult multipotent stem cells.
Justification of an alternative
From the above analysis of the evaluation with different criteria, the best alternative is either the adult stem cells or the multipotent adult progenitor cells. However, we must look at one justification based on the evaluation of the four, embryonic, adult, parthenotes, and multipotent adult stem cells. For this purpose, we base the justification on the assessment criteria that we have just discussed. This will lead to our decision being the adult stem cell.
This is because it is socially acceptable as it will bring about the advantages of using the stem cell without breaking the moral and ethical responsibility in its research, implementation, and maintenance. Again the results are as attractive as the one for embryonic stem cells, though not quite with similar potential. The fact that it is ethically and socially acceptable and it has the support of the political institution makes it desirable and applicable to be adopted in many countries, not just the U.S.
Keeping all the evaluation and assessment criteria in mind it is also cost-effective and economically feasible, efficient, administrative feasible, technically feasible, and socially and politically acceptable.
Policy analysis method
Policymakers use a variety of policy analysis methods before they can enact and implement a given policy. The different analysis methods are technical, economic, political, and ethical analyses. The viability of any of the analysis methods will depend on the economical benefits, compared to related costs that are going to be derived from the policy implementation. However, despite the economic benefits, there is a need for the ethical professionals to be consulted first so that if any policy may prove problematic in its implementation as regards to ethics and morals of the society, proper guidance can be offered before the commencement of such policies (Kraft and Furlong, 2010, p.177). Failure of the professionals to guide on ethical matters may lead to some policies being implemented with less regard to the ethical implication of such policies.
The use of stem cells, especially, from embryos for the cure and repair of different diseases and conditions which can be disabling, is surrounded by the intense controversy of moral concern ethically. The problem is the source of the cells that are used for the therapy and not the research itself. This is because the embryonic stem cells are harvested from embryos of about five to seven days old in the blastocyst stage. These embryos are then discarded. The possible alternatives that have been discussed earlier are believed not to have the full potential to differentiate into all cell types thus limiting their usefulness in therapy (Pompe, Michael, and Christof, 2005, para.3).
Despite the economic gains and the number of lives that might be saved, and conditions rectified as the therapy promises, the ethical controversy makes the enactment of the policy to support embryonic stem cells wrong. The embryos are human beings and life needs to be protected. A critique from the religious point of view sees the policy as morally wrong as it uses human life as a specimen for the research and then terminating it as after the stem cells have been harvested the embryo cannot develop into a human being. This makes the policy unethical.
For this reason, such a policy should be analyzed in terms of ethical analysis. Enactment and implementation of such a policy prove paradoxical as regards the ethics of morality. There will indeed be an impediment to valuable medical research but the moral responsibility to safeguard life is far more crucial. Besides, there are alternatives to embryonic stem cell procedure, though not as effective but they will contribute positively to the curing of diseases and repairing of body tissue in considerable terms without necessarily having to terminate the life of a human being (embryo).
In the U. S., the government had banned the use of embryos to harvest stem cells based on moral and ethical responsibility. The ban was recently lifted by the current president (Obama), authorizing full federal support in embryonic stem cell research (Kraft and Furlong, 2010, p.179). This can be attributed to differences in views in the overall benefit to the community and the need to advance technology which in the future could lead to the development of cures and therapies for diseases and conditions that prove to be too taxing to treat currently.
From the moral approach, we can look at other ways of stem-cell therapy, which have been discussed in the alternatives for this policy. Though not completely as effective as the embryonic stem cell, they have similar results, and therefore, they can be used instead of using embryos in the harvesting of the stem cell. This way the research and the policy would be economically, politically, and ethically viable to an extent of being implemented in other countries without any opposition as the benefits from it would be enormous.
The stem cell policy in U. S. was banned by former George W. Bush on grounds of moral and ethical violation of human life. Despite the many economic benefits that could be derived from embryonic stem cell research, the government had banned its operation and did not fund research into it. This ban, however, has been lifted by the current president of the United States; Barrack Obama.
The president also fully supports research into embryonic stem cells in terms of funding. Despite the moral and ethical violation resulting from this policy, the American government and health fields see it as an opportunity to advance in scientific discoveries that will lead to solutions on the curing of diseases and in repairing tissues resulting from damage and diseases. In the discussion we have analyzed the policy in a rational approach where we have looked into the problem leading to the policy, the alternatives of the policy for solving the problem posed, and a method for its analysis. However, the adult stem cell is the alternative that is more justifiable as it is morally, ethically, and professionally responsible and it is acceptable to embryonic stem cells and use of parthenotes or clones.
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