“Ethics and Policy in Embryonic Stem Cell Research” (1999), by John Ancona Robertson

In 1999, John Ancona Robertson, a researcher who studied bioethics and law, published “Ethics and Policy in Embryonic Stem Cell Research,” hereafter “Ethics and Policy,” in the Kennedy Institute of Ethics Journal. In the article, Robertson analyzes the ethical debates around research that uses human embryonic stem cells, or ESCs, and categorizes the different kinds of concerns within those debates. Researchers obtain human ESCs from human embryos. ESCs are pluripotent, which means they have the capability to transform into various cell types, such as skin cells or muscle cells. Robertson explains that ESCs have great medical potential, but since obtaining them requires destroying embryos, some people oppose the use of ESCs in research. After reviewing the main concerns present in debates over ESC research, he concludes that ESC research is still morally permissible. With “Ethics and Policy,” Robertson argued that ESC research should go forward and be federally funded in the US at a time when many politicians, bioethicists, and scientists opposed such research.

1. Background and Context
2. Article Roadmap
3. Impacts

Background and Context

At the time he published “Ethics and Policy,” Robertson was a professor at the University of Texas School of Law in Austin, Texas, and had been writing about bioethics for many years. Throughout his career, Robertson authored over 200 works, including articles, book chapters, and book reviews. Additionally, Robertson authored books on prevalent bioethical dilemmas during the late twentieth century. For example, in 1983, he published The Rights of the Critically Ill, which explores ethical and legal aspects of medical treatment decisions for critically ill individuals, covering topics like treatment choices, end-of-life decisions, and ethical and legal considerations surrounding organ transplants. In 1994, Robertson published Children of Choice: Freedom and the New Reproductive Technologies, which examines the ethical, legal, and social implications of reproductive technologies, such as cloning, genetic screening, and in vitro fertilization, or IVF. IVF is a procedure that people with fertility issues may pursue. It entails retrieving an egg cell, or ovum, and then having it fertilized outside of the body with sperm cells. Outside of his written work, the National Public Radio in Texas, legislative and regulatory bodies, and national newspapers often reached out to him to speak on certain topics. He had been a part of, or a consultant to, many national bioethics advisory bodies and was chair of the ethics committee of the American Society for Reproductive Medicine.

“Ethics and Policy” contributed to the debate around the use of ESCs in certain kinds of medical research, such as tissue repair and disease modeling. The ability of ESCs to turn into most cells makes them potentially useful for medical purposes like regenerative medicine, disease modeling, and drug testing. Regenerative medicine is a field focused on repairing and restoring the body. One method includes using ESCs to replace or repair damaged tissues and organs. For example, researchers have been looking into using ESCs to treat spinal cord injuries. Another use of ESCs includes disease modeling, which involves creating cellular or tissue models of specific diseases in a dish, providing insights into the cause and underlying mechanisms of various diseases. Drug testing utilizes those cellular and tissue models to assess the efficacy and safety of potential pharmaceuticals.

Article Roadmap

“Ethics and Policy” is divided into eight sections. In the untitled introduction section, Robertson explains the potential applications of ESCs, focusing on their roles in research, and also addresses the main ethical and legal challenges associated with their use. In the next section, “Are Human Embryonic Stem Cells Embryos?” the author discusses the distinction between ESCs and embryos and the debate over federal funding for ESC research. In “Two Kinds of Complicity,” Robertson explores the argument that research using ESCs cannot be morally or legally separated from the process of their derivation. In “Ethics and Policy in Retrieval of ESCs from Aborted Fetuses,” the author traces the history of US policy toward funding the retrieval of ESCs from aborted fetuses for research under strict conditions. In “Ethics and Policy in the Retrieval of ES Cells from Human Preimplantation Embryos,” Robertson explores the ethical concerns surrounding the potential use of human preimplantation embryos, or embryos at the earliest stage of development, as a major source of ESCs for research. The section “Use of Donated Spare Embryos in Research” addresses questions of whether ESC research should involve spare embryos from assisted reproduction procedures and the moral status of embryos based on varying views on abortion. In “Creation of Human Embryos for Research or Therapy,” Robertson discusses the perspectives of those who find research that involves destroying spare embryos morally acceptable but disagree with the creation of embryos solely for research purposes. In the final section, “Public Research Policy at the Beginning of Life,” Robertson advocates for the reassessment of federal policies that restrict funding for embryonic stem cell research, emphasizing the potential benefits of that research and calling for ethical guidelines to permit carefully reviewed and regulated research.

In the untitled introduction, Robertson discusses the origin and potential applications of ESCs in medical research and the ethical concerns that prevent funding for ESC research. He traces the history of how scientists isolated ESCs from mouse embryos in the 1980s, and then soon after, obtaining ESCs from humans in 1998. Robertson argues that the versatility of ESCs, which are capable of self-renewal and differentiation into various cell types, holds promise for diverse applications in research and transplantation. Those applications include improving understanding of human development and potential clinical therapies for conditions, such as diabetes. Robertson also highlights the ethical and legal concerns surrounding ESC research. Since scientists must obtain human ESCs from aborted fetuses or from spare preimplantation embryos from IVF, Robertson explains that research using ESCs raises concerns about respect for human life at its earliest stages. A preimplantation embryo is an embryo that exists in the very early stages of development, typically after fertilization but before it has implanted into the uterus. He concludes by describing the existing federal prohibition on funding research that involves the creation or destruction of human embryos and suggesting the need for a reassessment of the ethical limits on using aborted fetuses or preimplantation embryos for ESC research and therapy.

In the second section, “Are Human Embryonic Stem Cells Embryos?” Robertson considers the differences between ESCs and embryos. ESCs, while pluripotent, are not capable of developing into an individual, unlike embryos. Robertson starts off by referring to a legal opinion written by General Counsel Harriet Raab of the US Department of Health and Human Services, which is a federal organization that protects the health of US citizens and provides human services to the people of the US. He explains that Raab’s 1999 opinion affirmed that ESCs, not meeting the statutory definition of embryos, were exempt from the federal ban on embryo research. That legal nuance could allow for federal funding for ESC research, provided that the destructive removal of cells from embryos was not federally funded. However, Robertson goes on to explain that Raab’s stance faced criticism. Some members of Congress who considered themselves pro-life argued that it went against federal law. Some members of the National Bioethics Advisory Commission, or NBAC, an organization that provided recommendations to the government concerning the protection of the rights and well-being of human subjects involved in research, found the distinction to be, in their words, disingenuous and legalistic. The NBAC was replaced by the President’s Council on Bioethics in 2001 and continues to be updated. Despite the controversy, Robertson explains, others saw the distinction as a practical means to allow federal funding for ESC research without altering existing laws.

In the third section, “Two Kinds of Complicity,” Robertson argues that the point of contention in the discourse on ESC research revolves around the moral and legal separation between the derivation of those cells and their subsequent use. He explains that critics argue that the moral acceptability of later research uses cannot be divorced from the initial derivation process. Some contend that if the original derivation of ESCs is deemed immoral, any later use of those cells remains morally questionable, as it is complicit in the original derivation. The chain of complicity, in that view, persists even through multiple generations or passages of the original cells. Robertson then explains that if the intent behind the initial derivation of ESCs was to enable later research on them, then those involved in subsequent research might be seen as complicit in the original act. However, Robertson points out that if the original derivation had occurred irrespective of the activities of later researchers and is available anyway, the later researchers are not complicit in the initial immoral derivation. That is only if those later researchers had no bearing on the occurrence of the immoral act. Robertson points out that others may see that as the researchers benefiting from someone else’s wrongdoing. However, he states that if we viewed things from that angle, then organ transplants coming from someone who had been murdered would be impossible.

In the fourth section, “Ethics and Policy in Retrieval of ES Cells from Aborted Fetuses,” Robertson discusses the ethics of deriving stem cells from fetal tissue obtained during abortions. The crux of the matter, according to Robertson, lies in determining whether those involved in deriving and using ESCs from aborted fetuses are morally complicit in the act of abortion. Then, Robertson explains the policy evolution on the use of aborted fetal tissue in research from 1988 to 1993. Initially, in 1998, the Assistant Secretary of Health placed a moratorium, or temporary prohibition, on such research. The National Institutes of Health, or NIH, made recommendations emphasizing the importance of maintaining a clear separation between abortion decisions and tissue donation. Debate continued on lifting the moratorium, but it was not until 1993 that then-President of the United States Bill Clinton lifted the moratorium. Robertson writes that, at the time “Ethics and Policy” was published, federal law permitted ESC retrieval from spontaneous or induced abortions under strict conditions, such as acquiring informed consent and no promises of transplantation to specific individuals. The NBAC recommends continued federal funding under those conditions because retrieving the ESCs did not cause the abortion itself.

In the fifth section, “Ethics and Policy in the Retrieval of ES Cells from Human Preimplantation Embryos,” Robertson explains that using human preimplantation embryos, rather than aborted fetuses, as a primary source of ESCs for research introduces ethical dilemmas surrounding the destruction of those embryos. Preimplantation embryos are embryos that have yet to implant in the uterine wall. Those embryos may come from fertility clinics. Couples at those clinics may not use all the preimplantation embryos that they produced during IVF and may choose to donate them to scientific research. While ESCs derived from embryos are distinct from embryos themselves, isolating those cells from live embryos raises concerns of complicity in the destruction of the embryos. If preimplantation embryos are donated by couples undergoing IVF, typically, those embryos may be discarded or stored indefinitely. He clarifies that in some cases, embryos may be created expressly to obtain ESCs for research. Regardless, the live nature of the embryos at the time of ESC extraction, unlike aborted fetuses, raises ethical considerations about the direct destructiveness of preimplantation embryo research.

The sixth section of the article, “Use of Donated Spare Embryos in Research,” is divided into two sections, and the first part, titled “Normative Concerns,” explains that the central debate in embryo research revolves around whether research using embryos should even be acceptable. Robertson notes that once researchers have determined whether the use of spare embryos as a result of IVF is acceptable, researchers have to ascertain the acceptability of the destruction of those embryos for research. The core issue revolves around determining the moral status of preimplantation human embryos and whether their use in research is ethically justifiable. Robertson explains that scientists agree that preimplantation embryos do not have differentiated organs and tissues. However, opponents of embryo research argue that embryos have full moral status from conception due to the potential of becoming a human being, making any nontherapeutic research ethically unacceptable. Conversely, supporters argue that the lack of development and absence of a nervous system or sentience in embryos means their moral status evolves over time, making it ethically permissible to use spare, donated embryos for life-saving ESC research. They point out that the alternatives for those embryos are either destruction or indefinite storage. Robertson states that that perspective leads to the argument that while embryos may not have inherent rights or interests, they deserve a degree of respect due to their potential to develop into a fetus. Thus, the ethical framework for conducting ESC research with spare IVF embryos usually requires a balance between the pursuit of scientific knowledge and ethical standards. Ethical review processes at local and national levels ensure that such research has legitimate goals, aiming to improve medical knowledge and treatment capabilities while navigating the complex ethics of embryo research.

In the second part of the sixth section titled “National Advisory Commissions and the Use of Spare Embryos for Research,” Robertson explains that national advisory commissions in some countries, such as the United Kingdom, Canada, and the US, have endorsed the ethical acceptability of embryo research. He explains that in the UK, the 1984 Warnock Report laid the groundwork for the Human Fertilization and Embryology Act of 1990, establishing the Human Fertilization and Embryology Authority, or HFEA, to regulate fertility clinics and embryo research. However, as Robertson explains, the act mandates that embryo research is authorized only if deemed, in their words, necessary or desirable. That may include using embryo research for infertility treatments or acquiring knowledge about congenital diseases.

In 1979, the Secretary of Health, Education, and Welfare arranged for an Ethics Advisory Board, which is a group that offers guidance in navigating ethical challenges, to advise on ESC research. The Board recognized the profound respect owed to the pre-embryo but did not give it full legal and moral rights. Subsequently, the Clinton administration supported the removal of EAB review requirements in 1993. Soon after, the NIH put together A Human Embryo Research Panel, or HERP, which is a federal panel that determines which projects using human embryos should be funded. They created a 125-page report, which centered on different forms of human embryo research that may be acceptable for funding. Nevertheless, congressional reluctance has prevented funding for such research.

To close the sixth section, Robertson argues that the resurgence of interest in federally funded embryo research, particularly involving ESCs, prompted the NBAC to address the issue. In 1999, the NBAC recommended that research involving the use of ESCs derived from embryos remaining after infertility treatments be eligible for federal funding. However, that research would only occur with proper regulation and monitoring of the research process. As Robertson discusses, NBAC acknowledged the deep-seated disagreements between opponents and supporters of embryo research, opting for policies that respect diverse viewpoints. It recognized a potential consensus on permitting federally funded research involving ESC derived from embryos in cases where it is deemed crucial to develop cures for certain health conditions or diseases. NBAC asserted that a ban on federal funding could be considered unjust as it would interfere with creating treatments with the potential to cure diseases. Robertson explains that the NBAC proposed the formation of a regulatory panel called the National Review and Oversight Panel, aimed at ensuring strict adherence to guidelines, transparency, and public assurance in ESC research.

In the seventh section, “Creation of Human Embryos for Research or Therapy,” Robertson argues that the future trajectory of ESC research introduces a complex ethical dimension related to the potential creation of embryos for specific research purposes. While much ESC research currently involves cells donated after IVF treatment, certain applications, like developing tissue compatible with patients’ immune systems, may necessitate the creation of embryos. Robertson explains that examining whether the creation of embryos for ESC research would be feasible could then allow researchers to foresee the feasibility of vital research endeavors with them. Within the subset of individuals who support research with spare embryos due to the belief that embryos lack inherent interests, disagreements arise about the acceptability of creating embryos solely for research purposes. He clarifies that the opposition to creating embryos for research within that subset is not grounded in concerns over harms to, or the rights of, embryos, but is driven rather by worries about the impact of such research on others, and the potential of such research to degrade the symbolic value of human life.

Additionally, in the seventh section, Robertson breaks down those arguments about the potential negative societal consequences of creating embryos for research, such as the commercialization of procreation, the risk of creating a market for buying and selling embryos, and the potential impact on women who donate eggs for research purposes. Robertson argues that it is unlikely that creating embryos for well-justified research could quickly lead to trivial uses, such as toxicology screening of drugs or cosmetics, and the emergence of an embryo market. He mentions that those uses are even more unlikely in federally funded research institutions with strict restrictions on embryo use. Robertson also deems concerns about demeaning human reproduction and parenting by commercializing procreation as improbable, especially if specific restrictions on embryo research are in place. He also writes that it is improbable that creating embryos for research would undermine respect for other research subjects or weaken the existing system of ethical research review and informed consent, given the well-established safeguards in place. Lastly, Robertson discusses that the argument that the creation of embryos might adversely affect women who donate eggs for research overlooks the potential personal benefits those women might derive from contributing to scientific advancements. The key, he writes, is to ensure the careful protection of the rights and welfare of women donating eggs, with informed consent and thorough consideration of risks and benefits.

In the following subsection, “Deontologic and Symbolic/Constitutive Concerns in Creating Research Embryos,” Robertson points out that much of the opposition to creating embryos for research stems not from seeing embryos as inherently moral entities but from what he terms deontological and symbolic concerns. Deontology is an ethical perspective that views actions as good or bad depending on a specific set of rules or duties. Critics with those concerns argue that creating embryos solely for research instrumentalizes potential human life, showing inherent disrespect. That argument assumes that even preimplantation embryos deserve consideration similar to human beings, not to be used merely as a means to an end. Alternatively, Robertson discusses that a more useful argument against creating embryos for research is by viewing them from a symbolic standpoint. He notes that the symbolic dimension is subjective and influenced by individual beliefs and policy preferences. According to Robertson, the ethical stance on creating research embryos hinges on weighing those symbolic objections against the research’s potential benefits. As Robertson explains, some may argue that the symbolic harm outweighs uncertain benefits, while others may find the symbolic harm minimal and justifiable for significant research.

Robertson’s final subsection for the seventh section, “National Advisory Commissions on Creating Embryos for Research,” contrasts the regulatory perspectives between the UK and the US on embryo research. In the UK, following a nine-to-seven vote by the Warnock Committee in 1984, research on embryos is permissible based on the research’s purpose, not the embryos’ origin. In 1990, the Parliament passed legislation allowing for the use of embryos in fertility research. The regulations on such ESC research in the UK come from the state health authorities. In contrast, the US faced a more contentious debate. The 1994 Human Embryo Research Panel recommended allowing federal funding for research requiring the creation of embryos, especially in studies of exceptional scientific and therapeutic merit. The Panel also opened the door for discussions on embryo creation for ESC research, hinting at the possibility of revisiting funding policies as scientific advancements unfold. Despite those recommendations, Clinton opposed federal funding for research using embryos, leading to a congressional ban on federal funding for all embryo research, irrespective of purpose or source, enacted annually since 1996. Furthermore, the NBAC, in its 1999 report on ESC research, did not support federal funding for creating embryos for research, given the lack of pressing scientific justification at the time. However, the NBAC’s position could potentially permit approval of creating embryos for ESC research if the scientific need became significant, aligning with the HERP’s approach in analogous situations.

In the final section, “Public Research Policy at the Beginning of Life,” Robertson argues for a reassessment of federal policy against funding any destructive embryo research, particularly regarding ESCs. He explains the distinction made by Raab between federal funding and the use of ESCs, which would allow for certain federally funded ESC research without changing existing laws. However, a ban that prevents the derivation and the use of ESCs would hinder the progression of ESC research. Robertson explains that the objections to using aborted fetuses or spare embryos for ESC research come mainly from those who view fertilized eggs, early embryos, and fetuses as persons or subjects with intrinsic rights. The author contends that view is not universally accepted and should not dictate federal research policy. His approach allows research with embryos or aborted fetuses when good reasons exist and subjects it to institutional or national review.

Impacts

Following the publication of “Ethics and Policy,” debates around the use and funding of research ESCs continued into the early 2000s. In 2001, President George W. Bush approved funding for research on existing embryonic stem cell lines but still banned the creation of new ESC lines. According to Varnee Murugan, a researcher who studied public health, only twenty-one of the existing cell lines were useful for research. By 2009, then-President of the United States Barack Obama revoked the order placed by President Bush, which allowed researchers to use hundreds of available ESC lines. However, by that point, researchers had begun experimenting with generating induced pluripotent stem cells, or iPSCs. Those are adult stem cells that researchers can reprogram to be pluripotent, as ESCs are. After the development of iPSCs, funding sources shifted towards advancing iPSC technology rather than funding ESC research since iPSCs raise fewer ethical objections as they do not come from embryos. 

Robertson’s “Ethics and Policy” helped shape subsequent discussions on embryo research ethics, especially during a time when most researchers and government institutions disagreed on embryo research. According to Google Scholar, researchers have cited “Ethics and Policy” 138 times as of 2025. Researcher Inigo De Miguel-Beriain, who studies bioethics, law, and legal philosophy at the University of the Basque Country in Northern Spain, points to Robertson’s analysis to argue that the stance that embryos created for another reason is acceptable, but to use them for research is immoral, does not make sense. Similarly, Robert Sparrow, who is a researcher who studies philosophy in Australia, draws on Robertson’s work to explore the contentious ethics surrounding the creation and use of embryos, especially those designated as surplus embryos in the context of IVF. Bertha Alvarez Manninen, a researcher who studies philosophy in Glendale, Arizona, uses Robertson’s in arguing a detailed analysis of abortion rights and arguments related to personhood and the Roe v. Wade (1973) decision.

Sources

1. de Miguel-Beriain, Iñigo. “The Ethics of Stem Cells Revisited.” Advanced Drug Delivery Reviews 82–3 (2015): 176–80.
2. Manninen, Bertha Alvarez. “Rethinking Roe v. Wade: Defending the Abortion Right in the Face of Contemporary Opposition.” American Journal of Bioethics 10 (2010): 33–46.
3. Mao, Angelo S., and David J. Mooney. “Regenerative Medicine: Current Therapies and Future Directions.” Proceedings of the National Academy of Sciences 112 (2015): 14452–9. https://pmc.ncbi.nlm.nih.gov/articles/PMC4664309/ (Accessed July 15, 2025). 
4. Murugan, Varnee. “Embryonic Stem Cell Research: A Decade of Debate from Bush to Obama.” Yale Journal of Biology and Medicine 82 (2009): 101–3. https://pmc.ncbi.nlm.nih.gov/articles/PMC2744932/ (Accessed July 15, 2025). 
5. Omale, Adekunle Ebenezer, and Adegbenro Omotuyi John Fakoya. “Ten Years of Progress and Promise of Induced Pluripotent Stem Cells: Historical Origins, Characteristics, Mechanisms Limitations, and Potential Applications.” PeerJ 6 (2018): e4370. https://pmc.ncbi.nlm.nih.gov/articles/PMC5951134/ (Accessed July 15, 2025). 
6. Roberts, Christopher. “In Memoriam: Professor John A. Robertson.” The University of Texas at Austin School of Law. https://law.utexas.edu/news/2017/07/07/in-memoriam-prof-john-a-robertson/ (Accessed July 15, 2025). 
7. Robertson, John Ancona. The Rights of the Critically Ill : The Basic ACLU Guide to the Rights of Critically Ill and Dying Patients. Cambridge: Ballinger Publishing Company, 1983.
8. Robertson, John Ancona. Children of Choice: Freedom and the New Reproductive Technologies. Princeton: Princeton University Press, 1994.
9. Robertson, John Ancona. “Ethics and Policy in Embryonic Stem Cell Research.” Kennedy Institute of Ethics Journal 9 (1999): 109–36.
10. Sparrow, Robert. “In Vitro Eugenics.” Journal of Medical Ethics 40 (2014): 725–31. https://researchmgt.monash.edu/ws/portalfiles/portal/252673958/2317796_oa.pdf (Accessed July 15, 2025). 
11. Takahashi, Kazutoshi, Koji Tanabe, Mari Ohnuki, Megumi Narita, Tomoko Ichisaka, Kiichiro Tomoda, and Shinya Yamanaka. “Induction of Pluripotent Stem Cells from Adult Human Fibroblasts by Defined Factors.” Cell 131 (2007): 861–72. https://www.cell.com/cell/fulltext/S0092-8674(07)01471-7?_returnURL=http://linkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867407014717%3Fshowall%3Dtrue (Accessed July 15, 2025). 
12. Takahashi, Kazutoshi, and Shinya Yamanaka. “Induction of Pluripotent Stem Cells from Mouse Embryonic and Adult Fibroblast Cultures by Defined Factors.” Cell 126 (2006): 663–76. https://www.cell.com/cell/fulltext/S0092-8674(06)00976-7 (Accessed July 15, 2025). 
13.