Decision Points Part 7

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Congress's answer seemed clear. Every year since 1995, the House and Senate had pa.s.sed legislation banning the use of federal funds for research in which human embryos were destroyed. The law was known as the d.i.c.key Amendment after its sponsor, Congressman Jay d.i.c.key Jay d.i.c.key of Arkansas. of Arkansas.

In 1998, a researcher at the University of Wisconsin isolated an individual embryonic stem cell for the first time. As the cell divided, it created a mult.i.tude of other cells-called a line-that could be used for research. Soon after, the Clinton administration adopted a novel interpretation of the d.i.c.key Amendment. Lawyers argued that taxpayer dollars could be used to support stem cell research on lines derived from destroyed embryos so long as the destruction itself was funded by private sources. The National Inst.i.tutes of Health prepared to award grants under those terms, but President Clinton's term ended before any funds were distributed. The immediate decision facing me was whether to allow those grants to proceed.

It was clear this would be more than a funding dispute. The moral questions were profound: Is a frozen embryo a human life? If so, what responsibilities do we have to protect it?

I told Margaret and Deputy Chief of Staff Josh Bolten Josh Bolten that I considered this a far-reaching decision. I laid out a process for making it. I would clarify my guiding principles, listen to experts on all sides of the debate, reach a tentative conclusion, and run it past knowledgeable people. After finalizing a decision, I would explain it to the American people. Finally, I would set up a process to ensure that my policy was implemented. that I considered this a far-reaching decision. I laid out a process for making it. I would clarify my guiding principles, listen to experts on all sides of the debate, reach a tentative conclusion, and run it past knowledgeable people. After finalizing a decision, I would explain it to the American people. Finally, I would set up a process to ensure that my policy was implemented.

To run the process, Josh tapped Jay Lefkowitz Jay Lefkowitz, the general counsel of the Office of Management and Budget, the agency that would oversee my funding policy. Jay was a thoughtful and lively lawyer from New York with a serious commitment to his Jewish faith and a dry sense of humor. I liked him immediately. That was good, because we were going to spend a lot of time together.



With Margaret Spellings and Jay Lefkowitz. White House/Eric Draper White House/Eric Draper Jay loaded me up with background reading. He included articles from medical journals, writings on moral philosophy, and legal a.n.a.lyses. The reading he sent spanned the spectrum of viewpoints. In Science Science magazine, bioethicist Dr. magazine, bioethicist Dr. Louis Guenin Louis Guenin argued, "If we spurn [embryonic stem cell research], not one more baby is likely to be born. If we conduct research, we may relieve suffering." argued, "If we spurn [embryonic stem cell research], not one more baby is likely to be born. If we conduct research, we may relieve suffering."

Those on the other side of the debate argued that government support for the destruction of human life would cross a moral line. "Embryonic stem cell research takes us onto a path that would transform our perception of human life into a malleable, marketable natural resource-akin to a cattle herd or copper mine-to be exploited for the benefit of the born and breathing," bioethics expert Wesley J. Smith Wesley J. Smith wrote in wrote in National Review National Review.

At its core, the stem cell question harked back to the philosophical clash between science and morality. I felt pulled in both directions. I had no interest in joining the Flat Earth Society. I empathized with the hopes for new medical cures. I had lost a sister to childhood leukemia. I had served on the board of the Kent Waldrep National Paralysis Foundation, an advocacy group led by a former Texas Christian University football player who had suffered a spinal cord injury. I believed in the promise of science and technology to alleviate suffering and disease. During my presidential campaign, I had pledged to follow through on the commitment Congress made in the late 1990s to double funding for the National Inst.i.tutes of Health.

At the same time, I felt that technology should respect moral boundaries. I worried that sanctioning the destruction of human embryos for research would be a step down the slippery slope from science fiction to medical reality. I envisioned researchers cloning fetuses to grow spare body parts in a laboratory. I could foresee the temptation of designer babies that enabled parents to engineer their very own blond-haired basketball player. Not far beyond that lies the nightmare of full-scale human cloning. I knew these possibilities would sound fanciful to some people. But once science started heading down that path, it would be very hard to turn back.

The stem cell question overlapped with the abortion debate. It seems hard to believe now, but abortion was not a major political issue when I was young. I don't remember it coming up much during Dad's early campaigns or in conversations at Andover or Yale. That changed in 1973 when the Supreme Court, in a decision Justice Byron White Byron White called "an exercise in raw judicial power," deemed abortion a right protected by the Const.i.tution. called "an exercise in raw judicial power," deemed abortion a right protected by the Const.i.tution.

The abortion issue abortion issue is difficult, sensitive, and personal. My faith and conscience led me to conclude that human life is sacred. G.o.d created man in His image and therefore every person has value in His eyes. It seemed to me that an unborn child, while dependent on its mother, is a separate and independent being worthy of protection in its own right. When I saw Barbara and Jenna on the sonogram for the first time, there was no doubt in my mind they were distinct and alive. The fact that they could not speak for themselves only enhanced society's duty to defend them. is difficult, sensitive, and personal. My faith and conscience led me to conclude that human life is sacred. G.o.d created man in His image and therefore every person has value in His eyes. It seemed to me that an unborn child, while dependent on its mother, is a separate and independent being worthy of protection in its own right. When I saw Barbara and Jenna on the sonogram for the first time, there was no doubt in my mind they were distinct and alive. The fact that they could not speak for themselves only enhanced society's duty to defend them.

Many decent and thoughtful people disagreed, including members of my family. I understood their reasons and respected their views. As president, I had no desire to condemn millions as sinners or dump new fuel on raging cultural fires. I did feel a responsibility to voice my pro-life convictions and lead the country toward what Pope John Paul II Pope John Paul II called a culture of life. I was convinced that most Americans agreed we would be better off with fewer abortions. One of my first acts in the White House was to reinstate the so-called Mexico City Policy, which prevented federal funding for groups that promote abortion overseas. I supported state laws requiring parental notification for minors seeking abortions. And I supported, signed, and defended a bill banning the grisly practice of partial-birth abortion. called a culture of life. I was convinced that most Americans agreed we would be better off with fewer abortions. One of my first acts in the White House was to reinstate the so-called Mexico City Policy, which prevented federal funding for groups that promote abortion overseas. I supported state laws requiring parental notification for minors seeking abortions. And I supported, signed, and defended a bill banning the grisly practice of partial-birth abortion.

Laura and I were also strong supporters of adoption adoption. After having difficulty conceiving children, it was hard for us to imagine anyone rejecting what we considered a precious gift. Yet as the father of daughters, I could envision the dilemma facing a scared teenager with an unplanned pregnancy. Adoption was such a positive alternative to abortion, a way to save one life and brighten two more: those of the adoptive parents. I was pleased to sign legislation increasing funding for crisis pregnancy counseling centers, as well as to expand tax credits to offset the costs of adoption.

In the long run, I hoped a change in hearts would lead to a change in law, as new technologies like 3-D ultrasounds help more Americans recognize the humanity of unborn babies. I also hoped political leaders would continue to speak out for a culture that values all innocent human life. Bob Casey Bob Casey, the late Democratic governor of Pennsylvania, said it well: "When we look to the unborn child, the real issue is not when life begins, but when love begins."

Beginning in the spring of 2001, Margaret, Jay, and Karl Rove-who was in close touch with advocacy groups on both sides of the issue-invited a series of distinguished scientists, ethicists, religious thinkers, and advocates to discuss embryonic stem cell research. The conversations fascinated me. The more I learned, the more questions I had. When I delivered the commencement address at Notre Dame, I brought up embryonic stem cell research with Father Ed "Monk" Malloy, the president of the university. When I spoke at Yale the next day, I raised the topic with Dr. Harold Varmus Harold Varmus of the Memorial Sloan-Kettering Cancer Center. At a birthday party for a doctor in the White House Medical Unit, I asked all the physicians there what they thought. As word got out that I was seeking opinions, I was bombarded with input from Cabinet secretaries, staffers, outside advisers, and friends. of the Memorial Sloan-Kettering Cancer Center. At a birthday party for a doctor in the White House Medical Unit, I asked all the physicians there what they thought. As word got out that I was seeking opinions, I was bombarded with input from Cabinet secretaries, staffers, outside advisers, and friends.

Of course, I asked Laura for her advice. Her father had died of Alz-heimer's, her mother had suffered from breast cancer, and she held out great hope for the possibility of new cures. But she worried that advocacy groups would overpromise what embryonic stem cell research could achieve, leaving desperate families with dashed hopes.

Members of the scientific community presented two main arguments in favor of funding embryonic stem cell research. First was the medical potential. Researchers told me there were millions of Americans suffering from diseases that might be alleviated through treatments derived from embryonic stem cells. Experts believed that only a few stem cell lines would be needed to explore the science and determine its value. "If we had ten to fifteen lines, no one would complain," Irv Weissman Irv Weissman, a prominent researcher from Stanford, told the New York Times New York Times.

A research team from the National Inst.i.tutes of Health told me that several dozen stem cell lines were already under development. They also reported some preliminary research into alternative ways of deriving stem cells without destroying embryos. Their unanimous opinion was that denying federal support for embryonic stem cell research would result in a missed opportunity. Taxpayer dollars were important not only as a source of financing, they explained, but also as a seal of approval for scientific innovation.

The scientists' second point was a practical one: Most of the embryos used to derive the stem cells would likely be discarded anyway. The primary source of these embryos was In Vitro Fertilization (IVF) clinics. When a couple signed up for IVF, doctors usually fertilized more eggs than they implanted in the prospective mother. As a result, some embryos would be left after the treatment was complete. They were usually frozen and stored by the fertility clinic. Since these so-called spare embryos were not going to be used to conceive children, scientists argued, didn't it make sense to use them for research that could potentially save lives?

One of the groups most actively supporting embryonic stem cell research was the Juvenile Diabetes Research Foundation Juvenile Diabetes Research Foundation. In July 2001, I invited representatives from the organization to the Oval Office. Among the delegation were two friends of mine, Woody Johnson Woody Johnson and and Mike Overlock Mike Overlock. Both men were political backers, and both had children suffering from diabetes. They were pa.s.sionate, compelling advocates with an unmistakable devotion to their children. But their certainty about a rapid embryonic stem cell breakthrough surprised me. When I pointed out that the science was unproven and that there could be alternatives to embryo destruction, it was obvious that the advocacy group had left no room for doubt in their minds. The meeting was a window into the pa.s.sions the issue could generate.

That same day, I also met representatives of National Right to Life National Right to Life. They opposed any research that destroyed embryos. They pointed out that each tiny stem cell cl.u.s.ter had the potential to grow into a person. In fact, all of us had started our lives in this early state. As evidence, they pointed to a new program run by Nightlight Christian Adoptions Adoptions. The agency secured permission from IVF partic.i.p.ants to place their unused frozen embryos up for adoption. Loving mothers had the embryos implanted in them and carried the babies-known as snowflakes-to term. The message was unmistakable: Within every frozen embryo were the beginnings of a child.

Many of the bioethicists I met took the same position. They acknowledged that most embryos frozen in IVF clinics would not become children. Yet they argued that there was a moral difference between allowing embryos to die naturally and proactively ending their lives. Sanctioning the destruction of life to save life, they argued, crossed into dangerous moral territory. As one put it, "The fact that a being is going to die does not ent.i.tle us to use it as a natural resource for exploitation."

I heard some opinions that surprised me. Dr. Dan Callahan Dan Callahan, a thoughtful ethicist, told me he was pro-choice on abortion but against embryonic stem cell research. He believed there was a moral distinction between aborting a baby for the direct benefit of its mother and destroying an embryo for the vague and indirect purpose of scientific research. Dr. Benjamin Carson Benjamin Carson, one of the world's most respected surgeons, told me that stem cell research could be valuable, but that scientists should focus on alternatives to embryo destruction, such as collecting stem cells from the blood of umbilical cords. On the other hand, Orrin Hatch Orrin Hatch and and Strom Thurmond Strom Thurmond, two of the most staunchly pro-life members of the Senate, supported federal funding for embryonic stem cell research because they thought the benefit of saving lives outweighed the cost of destroying embryos.

In July 2001, I visited Pope John Paul II Pope John Paul II at his beautiful summer residence, Castel Gandolfo. Swiss Guards in full regalia escorted us through a series of rooms and into the reception area. Pope John Paul II was one of the great figures in modern history. A survivor of n.a.z.i and communist rule in his native Poland, he had become the first non-Italian pope in 455 years. With his call "Be Not Afraid," he rallied the conscience of Central and Eastern Europe to bring down the Iron Curtain. As the distinguished Cold War historian at his beautiful summer residence, Castel Gandolfo. Swiss Guards in full regalia escorted us through a series of rooms and into the reception area. Pope John Paul II was one of the great figures in modern history. A survivor of n.a.z.i and communist rule in his native Poland, he had become the first non-Italian pope in 455 years. With his call "Be Not Afraid," he rallied the conscience of Central and Eastern Europe to bring down the Iron Curtain. As the distinguished Cold War historian John Lewis Gaddis John Lewis Gaddis later wrote, "When John Paul II kissed the ground at the Warsaw airport on June 2, 1979, he began the process by which communism in Poland-and ultimately everywhere else in Europe-would come to an end." later wrote, "When John Paul II kissed the ground at the Warsaw airport on June 2, 1979, he began the process by which communism in Poland-and ultimately everywhere else in Europe-would come to an end."

Visiting Pope John Paul II at Castel Gandolfo in 2001. The Holy Father urged me to defend life in all its forms. White House/Eric Draper White House/Eric Draper By 2001, the Holy Father's vigor and energy had given way to frailty. His movements were deliberate, his speech soft and slow. Yet his eyes sparkled. He was filled with an unmistakable spirit. He gingerly walked Laura, our daughter Barbara, and me to a balcony, where we marveled at gorgeous Lake Albano below. He and I then retired to a simple meeting room, where we discussed a variety of issues, including stem cell research. He understood the promise of science-the Holy Father himself was stricken with Parkinson's. Yet he was firm in his view that human life must be protected in all its forms. I thanked him for his example of principled leaders.h.i.+p. I explained that the Catholic Church Catholic Church's steadfast support of life provided a firm moral foundation on which pro-life politicians like me could take a stand. I told him I hoped the Church would always be a rock in the defense of human dignity.

When the Holy Father pa.s.sed away in 2005, Laura, Dad, Bill Clinton Bill Clinton, and I flew together to his funeral in Rome. It was the first time an American president had attended the funeral of a pope, let alone brought two of his predecessors. Shortly after we arrived, we went to pay our respects to the Holy Father while he was lying in state. As we knelt at the communion rail to pray over his body, Laura turned to me and said, "Now is the time to pray for miracles." An unexpected impulse came over me. I prayed for Peter Jennings Peter Jennings, the ABC News anchor who was dying of cancer.

The funeral ma.s.s was incredibly moving. The crowd in St. Peter's Square cheered, sang, and carried banners celebrating the Holy Father's life. After a homily by Cardinal Joseph Ratzinger-who eleven days later emerged from the conclave as Pope Benedict XVI Pope Benedict XVI-a group of Church officials carried the Holy Father's casket up the stairs toward St. Peter's Basilica. Just before entering the doors, they turned to face the crowd and lifted the coffin for a last time. As they did, the clouds parted and the sun s.h.i.+ned through onto the simple wooden box.

After several months of listening and reflecting, I was close to a decision on stem cell research. A defining moment came in a conversation with Leon Ka.s.s Leon Ka.s.s on July 10. Leon was a highly respected physician and philosophy professor at the University of Chicago. He had written and taught in fields as diverse as evolutionary biology, literature, and the Bible. He struck me as a thoughtful and wise man. on July 10. Leon was a highly respected physician and philosophy professor at the University of Chicago. He had written and taught in fields as diverse as evolutionary biology, literature, and the Bible. He struck me as a thoughtful and wise man.

I told Leon I had been wrestling with the decision. Embryonic stem cell research seemed to offer so much hope. Yet it raised troubling moral concerns. I wondered if it was possible to find a principled policy that advanced science while respecting the dignity of life.

Leon's logical mind went to work. He argued that embryos-even those long frozen-had the potential for life and thus deserved some form of respect. "One goes with a heavy heart if we use these things," he said. "We at least owe them the respect not to manipulate them for our own purposes. We are dealing with the seeds of the next generation."

I shared an idea: What if I authorized federal funding for embryonic stem cell research-but solely for existing stem cell lines? The embryos used to create those lines had been destroyed. There was no way to get them back. It seemed logical to let scientists use them to pursue treatments that might save other lives. But that raised another question: If I allowed federal funding for research that relied on destroyed embryos, would I be tacitly encouraging further destruction?

Leon said he believed that funding research on already destroyed embryos would be ethical, with two conditions. I must reaffirm the moral principle that had been violated-in this case, the dignity of human life. And I must make clear that federal funds would not be used in the further destruction of embryos. So long as I did both, he said, the policy would pa.s.s the ethical test. "If you fund research on lines that have already been developed," he said, "you are not complicit in their destruction."

The conversation with Leon crystallized my thinking. I decided that the government would fund research on stem cell lines derived from embryos that had already been destroyed. At the same time, I would ask Congress to increase federal funding for alternative sources of stem cells that brought no ethical controversy. And I would draw a firm moral line: Federal tax dollars would not be used to support the destruction of life for medical gain. I also created a new presidential bioethics council, composed of experts from all backgrounds and chaired by Leon Ka.s.s.

The next step was to announce the decision to the American people. Karen suggested a rare primetime speech to the nation. When the president addresses the nation in primetime, he usually speaks as commander in chief. In this case, I would be speaking as educator in chief. I liked the idea. Stem cell research was a serious issue for the nation, but an obscure one for most citizens-as it had been for me in January. Explaining my decision would be almost as important as making it.

On August 9, 2001, I addressed a nationwide network TV audience from Crawford, Texas-definitely a first in presidential history. The night before the speech, Laura and I had dinner with Jay, Karen and her son Robert, and a family friend, Fort Worth interior designer Ken Blasingame Ken Blasingame. I asked Jay to say a prayer before we began the meal. He delivered some thoughtful words. As he finished, we all kept our heads bowed, waiting for the amen. After a few seconds of hanging, Jay told us that Jewish prayers don't always end with amen. It was a fitting conclusion to a process filled with learning.

"Good evening," I began my address, "I appreciate you giving me a few minutes of your time tonight so I can discuss with you a complex and difficult issue, an issue that is one of the most profound of our time." I outlined the dilemma: "While we must devote enormous energy to conquering disease," I said, "it is equally important that we pay attention to the moral concerns raised by the new frontier of human embryo stem cell research. Even the most n.o.ble ends do not justify any means."

Near the end, I pivoted to my decision: Embryonic stem cell research offers both great promise and great peril. So I have decided we must proceed with great care....I have concluded that we should allow federal funds to be used for research on these [existing] stem cell lines, where the life-and-death decision has already been made. Leading scientists tell me research on these sixty lines has great promise that could lead to breakthrough therapies and cures. This allows us to explore the promise and potential of stem cell research without crossing a fundamental moral line, by providing taxpayer funding that would sanction or encourage further destruction of human embryos that have at least the potential for life....I have made this decision with great care, and I pray it is the right one.

For weeks before the speech, I had felt a sense of anxiety. I had constantly questioned my a.s.sumptions and weighed the options again and again. With the decision made, I felt a sense of calm. I didn't know what the reaction would be. We hadn't commissioned a focus group or taken a poll. Just as we had waited for the amen at the end of Jay's prayer, we settled in to await the response.

Reaction to my stem cell decision poured in quickly. Many politicians and activists on both sides praised the policy as reasonable and balanced. While some scientists and advocacy groups responded with disappointment, many welcomed the unprecedented federal funding as a vote of confidence in their work. The head of the Juvenile Diabetes Research Foundation Juvenile Diabetes Research Foundation issued a statement saying, "We applaud the president for supporting embryonic stem cell research." My friend issued a statement saying, "We applaud the president for supporting embryonic stem cell research." My friend Kent Waldrep Kent Waldrep, the paralyzed TCU football player on whose advocacy board I used to sit, told a reporter, "It does everything the scientific community needs and I think a little bit more."

To the degree that I faced criticism, it came from the right. One conservative activist compared my decision to n.a.z.i conduct during the Holocaust. Another said, "I am ashamed of our president, who compromises and gives my generation the...mentality that human life can be picked apart, abused, and destroyed." The spokesman for the U.S. Conference of Catholic Bishops said, "I seem to be the only man in America who is against the president's policy."

His loneliness did not last long. The tone of the debate quickly became heated and harsh. Looking back, it is clear that a toxic pair of factors had converged: money and politics.

Many of the first to turn against the policy were scientists. By providing some federal funding, I had whetted their appet.i.te for more. In the spring of 2002, I addressed a major complaint by allowing privately funded embryonic stem cell research to be conducted at facilities that received federal dollars. It was an important step, but it did not satisfy the scientists, who constantly demanded more.

Advocacy groups quickly followed. Their high hopes for new cures had led them to make unrealistic promises. They seemed to feel that limiting the number of stem cells available for research would delay breakthroughs. They recruited well-meaning Hollywood stars to tug at heartstrings. They also discovered that the issue could help them raise large amounts of money. Some who had initially supported my decision transformed into vocal critics.

Politicians recognized that they, too, could capitalize on the issue. By 2004, Democrats had concluded that stem cell research was a political winner. It allowed them to open a new front in the abortion debate while also claiming the mantle of compa.s.sion. Candidates across the country ran TV ads that highlighted the benefits of embryonic stem cell research without mentioning that the science was unproven, the morality was in doubt, and ethical alternatives existed.

The Democratic presidential nominee, Senator John Kerry, campaigned hard on the issue. Kerry frequently criticized what he called a "ban" on embryonic stem cell research. I pointed out that there was no such ban. To the contrary, I was the first president in history to fund embryonic stem cell research. Plus, there were no restrictions on funding from the private sector.

Nonetheless, Kerry's campaign used stem cell research as the foundation for a broader attack, labeling my positions "anti-science." The charge was false. I had supported science by funding alternative stem cell research, promoting clean energy development, increasing federal spending on technology research, and launching a global AIDS initiative. Yet the demagoguery continued all the way up to the election. The low point came in October, when Kerry's running mate, Senator John Edwards John Edwards, told a political rally in Iowa that if Kerry became president, "people like Christopher Reeve Christopher Reeve* will get up out of that wheelchair and walk again." will get up out of that wheelchair and walk again."

The stem cell debate was an introduction to a phenomenon I witnessed throughout my presidency: highly personal criticism. Partisan opponents and commentators questioned my legitimacy, my intelligence, and my sincerity. They mocked my appearance, my accent, and my religious beliefs. I was labeled a n.a.z.i, a war criminal, and Satan himself. That last one came from a foreign leader, Venezuelan President Hugo Chavez Hugo Chavez. One lawmaker called me both a loser and a liar. He became majority leader of the U.S. Senate.

In some ways, I wasn't surprised. I had endured plenty of rough politics in Texas. I had seen Dad and Bill Clinton Bill Clinton derided by their opponents and the media. derided by their opponents and the media. Abraham Lincoln Abraham Lincoln was compared to a baboon. Even was compared to a baboon. Even George Was.h.i.+ngton George Was.h.i.+ngton became so unpopular that political cartoons showed the hero of the American Revolution being marched to a guillotine. became so unpopular that political cartoons showed the hero of the American Revolution being marched to a guillotine.

Yet the death spiral of decency during my time in office, exacerbated by the advent of twenty-four-hour cable news and hyper-partisan political blogs, was deeply disappointing. The toxic atmosphere in American politics discourages good people from running for office.

Over time, the petty insults and name-calling hardened into conventional wisdom. Some have said I should have pushed back harder against the caricatures. But I felt it would debase the presidency to stoop to the critics' level. I had run on a promise to change the tone in Was.h.i.+ngton. I took that vow seriously and tried to do my part, but I rarely succeeded.

The shrill debate never affected my decisions. I read a lot of history, and I was struck by how many presidents had endured harsh criticism. The measure of their character, and often their success, was how they responded. Those who based decisions on principle, not some snapshot of public opinion, were often vindicated over time.

George Was.h.i.+ngton once wrote that leading by conviction gave him "a consolation within that no earthly efforts can deprive me of." He continued: "The arrows of malevolence, however barbed and well pointed, never can reach the most vulnerable part of me."

I read those words in Presidential Courage Presidential Courage, written by historian Michael Beschloss Michael Beschloss in 2007. As I told Laura, if they're still a.s.sessing George Was.h.i.+ngton's legacy more than two centuries after he left office, this George W. doesn't have to worry about today's headlines. in 2007. As I told Laura, if they're still a.s.sessing George Was.h.i.+ngton's legacy more than two centuries after he left office, this George W. doesn't have to worry about today's headlines.

Far from the yelling on the TV sets and the campaign trail, my stem cell policy quietly moved forward in the labs. For the first time in history, scientists received federal grants to support embryonic stem cell research.

Scientists also used new federal funding for alternative stem cell research to explore the potential of adult bone marrow, placentas, amniotic fluid, and other non-embryonic sources. Their research yielded new treatments for patients suffering from dozens of diseases-free of moral drawbacks. For example, doctors discovered a way to collect stem cells harmlessly from the blood of umbilical cords to treat patients suffering from leukemia and sickle-cell anemia.

Much of this research was overseen by Dr. Elias Zerhouni Elias Zerhouni, the talented Algerian American I appointed to lead the NIH. I had put Elias in a tough position. He felt trapped between a president he had agreed to serve and the scientific community of which he was part. He did not agree with my embryonic stem cell policy. Yet he was more interested in new cures than in politics. He funded the alternative stem cell sources aggressively, and a good deal of credit for the breakthroughs in the field belongs to Dr. Zerhouni and his team of professionals at the NIH.

Unfortunately, most members of Congress paid more attention to politics than to the scientific discoveries. As the 2006 elections approached, Democrats made clear they would again use the issue as a political weapon. A U.S. Senate candidate in Missouri persuaded Michael J. Fox Michael J. Fox, who suffers from Parkinson's, to attack her opponent in statewide TV ads. Some Republicans who had initially supported the policy feared for their seats and changed their minds. In July 2006, the House and Senate considered a bill that would overturn my stem cell policy by permitting federal funding for research that destroyed human life.

Five and a half years into the presidency, I had yet to veto a piece of legislation. I had worked closely with our congressional majorities to pa.s.s bills I could accept. But as the stem cell bill was working its way through Congress, I had made clear I would veto it. When it reached my desk, I did.

I was. .h.i.t with all sorts of labels, "stubborn" being one of the most polite. But I would not change my position. If I abandoned my principles on an issue like stem cell research, how could I maintain my credibility on anything else?

I thought a lot about how to send the right signal about the veto. I wanted a vivid way to show that my position was grounded in my reverence for life, not any aversion to science. When Karl Zinsmeister Karl Zinsmeister, my domestic policy adviser, suggested inviting a group of snowflake babies snowflake babies to the White House, I thought the idea was perfect. Each had come from a frozen embryo that, rather than being destroyed for research, was implanted in an adoptive mother. to the White House, I thought the idea was perfect. Each had come from a frozen embryo that, rather than being destroyed for research, was implanted in an adoptive mother.

I gave my veto speech in the East Room with twenty-four excited children and their parents onstage. One of the little wigglers was fourteen-month-old Trey Jones. He started life as an embryo fertilized by Dave and Heather Wright Dave and Heather Wright of Macomb, Michigan. The couple had undergone IVF treatment, which helped them bring three beautiful children into the world. They gave permission for their remaining frozen embryos to be adopted, instead of being destroyed for research. of Macomb, Michigan. The couple had undergone IVF treatment, which helped them bring three beautiful children into the world. They gave permission for their remaining frozen embryos to be adopted, instead of being destroyed for research.

Holding Trey Jones. White House/Kimberlee Hewitt White House/Kimberlee Hewitt In Cypress, Texas, J.J. and Tracy Jones were praying for a child. Through Nightlight Christian Adoptions Adoptions, they were paired with the Wright family embryos. The result was the smiling, blond-haired boy named Trey whom I held in my arms at the White House. Thanks to the miracle of science and the compa.s.sion of two families, Trey had a loving home and a hopeful life ahead of him.

A few weeks after the event, I received a touching letter from J.J. Jones. He described the "pain of infertility" and how blessed he and Tracy felt to have their "precious Trey who some describe as a leftover destined to be either destroyed or used for research." He also informed me that Trey would soon have a sibling, the product of another frozen embryo he and Tracy had adopted.

Congress's response to my veto was not so warm. The Democratic sponsor of the bill erupted with a statement claiming that my veto was based on "cynical political gain." It was hard to see how, since most polls showed my stem cell stance was not popular. As punishment for my veto, Democrats refused to pa.s.s legislation supporting research into alternative sources of stem cells. The message was that if they couldn't fund stem cell research that destroyed embryos, they would prefer to fund none at all. So much for their pa.s.sionate desire to see new cures.

When Democrats won control of the House and Senate, they decided to make another run at overturning my policy. Speaker Nancy Pelosi Nancy Pelosi announced that it was one of her top priorities. They sent me another bill in June 2007; I sent it back again with my veto. Thanks to the courage of many Republicans on Capitol Hill, the veto held. announced that it was one of her top priorities. They sent me another bill in June 2007; I sent it back again with my veto. Thanks to the courage of many Republicans on Capitol Hill, the veto held.

Five months later, Americans awoke to an unexpected headline on the front page of the New York Times New York Times: "Scientists Bypa.s.s Need for Embryo to Get Stem Cells." The article described how two teams of researchers, one in Wisconsin and one in j.a.pan, had reprogrammed an adult skin cell to behave like an embryonic stem cell. By adding just four genes to the adult cell, scientists were able to replicate the medical promise of embryonic stem cells without moral controversy.

The discovery reverberated throughout the scientific community. Fervent advocates of embryonic stem cell research hailed the breakthrough as "a spectacular advance" and "ethically uncomplicated." Ian Wilmut Ian Wilmut, the Scottish scientist who cloned Dolly the sheep, announced that he would no longer pursue the cloning of human embryos, but would instead use this new technique.

I was thrilled by the news. This was the scientific breakthrough that I had hoped for when I made my announcement in 2001. Charles Krauthammer Charles Krauthammer, one of the most insightful columnists in America and a respectful critic of my stem cell decision in 2001, wrote, "The verdict is clear: Rarely has a president-so vilified for a moral stance-been so thoroughly vindicated."

In the years to come, our nation will face more dilemmas about bioethics, from cloning to genetic engineering. History will judge the character of our country in large part by the way we answer these challenges to human dignity. I have faith, as I did when I announced my stem cell decision in 2001, that science and ethics can coexist. With thoughtful policy, we can usher in the new cures that Nancy Reagan hoped for, without moving toward the world foreseen by Aldous Huxley.

After my address to the nation on stem cell research in August 2001, several commentators called it the most important decision of my presidency. That was true at the time, but not for long.

*The famous actor who played Superman, Reeve was confined to a wheelchair after a horse-riding accident. Sadly, he died in October 2004, one day before Edwards's statement.

n Tuesday, September 11, 2001, I awoke before dawn in my suite at the Colony Beach and Tennis Resort near Sarasota, Florida. I started the morning by reading the Bible and then went downstairs for a run. It was pitch-black as I began my jog around the golf course. The Secret Service agents had grown accustomed to my exercise routine; the locals must have found this run in the dark a little bizarre.

Back at the hotel, I took a quick shower, ate a light breakfast, and skimmed the morning papers. The biggest story was that Michael Jordan was coming out of retirement to rejoin the NBA. Other headlines focused on the New York mayoral primary and a suspected case of mad cow disease in j.a.pan.

Around 8:00 a.m., I received the Presidential Daily Briefing. The PDB, which combined highly cla.s.sified intelligence with in-depth a.n.a.lysis of geopolitics, was one of the most fascinating parts of my day. The September 11 briefing, delivered by a bright CIA a.n.a.lyst named Mike Morell Mike Morell, covered Russia, China, and the Palestinian uprising in the West Bank and Gaza Strip.

Shortly after the PDB, we left for a visit to Emma E. Booker Elementary School to highlight education reform.

On the short walk from the motorcade to the cla.s.sroom, Karl Rove mentioned that an airplane had crashed into the World Trade Center. That sounded strange. I envisioned a little propeller plane horribly lost. Then Condi called. I spoke to her from a secure phone in a cla.s.sroom that had been converted into a communications center for the traveling White House staff. She told me the plane that had just struck the Trade Center tower was not a light aircraft. It was a commercial jetliner.

I was stunned. That plane must have had the worst pilot in the world. How could he possibly have flown into a skysc.r.a.per on a clear day? Maybe he'd had a heart attack. I told Condi to stay on top of the situation and asked my communications director, Dan Bartlett Dan Bartlett, to work on a statement promising the full support of federal emergency management services.

I greeted Booker's princ.i.p.al, a friendly woman named Gwen Rigell Gwen Rigell. She introduced me to the teacher, Sandra Kay Daniels Sandra Kay Daniels, and her roomful of second-graders. Mrs. Daniels led the cla.s.s through a reading drill. After a few minutes, she told the students to pick up their lesson books. I sensed a presence behind me. Andy Card Andy Card pressed his head next to mine and whispered in my ear. pressed his head next to mine and whispered in my ear.

"A second plane hit the second tower," he said, p.r.o.nouncing each word deliberately in his Ma.s.sachusetts accent. "America is under attack."

Andy Card delivering the terrible news. a.s.sociated Press/Doug Mills a.s.sociated Press/Doug Mills

My first reaction was outrage. Someone had dared attack America. They were going to pay. Then I looked at the faces of the children in front of me. I thought about the contrast between the brutality of the attackers and the innocence of those children. Millions like them would soon be counting on me to protect them. I was determined not to let them down.

I saw reporters at the back of the room, learning the news on their cell phones and pagers. Instinct kicked in. I knew my reaction would be recorded and beamed throughout the world. The nation would be in shock; the president could not be. If I stormed out hastily, it would scare the children and send ripples of panic throughout the country.

The reading lesson continued, but my mind raced far from the cla.s.sroom. Who could have done this? How bad was the damage? What did the government need to do?

Decision Points Part 7

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