California Proposition 71 was placed on the ballot in 2004 for voters to consider. It is also known as the California Stem Cell Research and Cures Act. The goal of this effort was to let residents of the state decide if they were in support of using stem cell research in the state for medical purposes. The initiate process eventually led to its approval on November 2, and it amended the Health and Safety Code and the Constitution of the state.
Prop 71 makes conducting stem cell research a constitutional right in California. It authorized the sale of general obligation bonds to allocate $3 billion in funding over a ten-year period to research facilities performing this work. The priority was given to human embryonic stem cell research, but it could be used to finance any other kind of work in this area as well.
As part of the pros and cons of California Prop 71, the creation of the California Institution for Regenerative Medicine occurred as well. This institution became responsible for making grants and loans in this field while establishing appropriate regulatory standards, it would also create an independent citizen’s oversight committee to oversee the work of the institution.
List of the Pros of California’s Prop 71
1. It was the first proposition of its type to use general obligation bonds.
Most general obligation bonds are used to create tangible items for the public good, like buildings, roads, or bridges. This initiative was the first time that this form of debt was used to provide funding for scientific research. It provided an annual limit of $350 million per year, with a complete total of $3 billion over ten years, to create more opportunities for researchers to find cures for various diseases. The goal of this project was to find new cures for diabetes, cancer, and heart disease.
2. This proposition prohibited cloning technologies.
As one of the safeguards of Prop 71, California could not authorize cell cloning projects when looking at embryonic stem cells for research purposes. That meant scientists could not use the technologies at the time to create “designer” babies based on specific DNA sequences or genetic profiles. This advantage meant that the state would take on more of a role that was traditionally left to the federal government while still maintaining some moral safeguards to stop the exploitation of a future generation.
3. It looked to create new avenues for disease treatment.
Stem cells provide a lot of potential for finding cures and treatments for a wide variety of medical concerns. Several different diseases, including cancer, Parkinson’s disease, Alzheimer’s disease, and more can be treated when the stem cells replace diseased tissues or damaged cells. This process can even include neurons that might impact certain neurological diseases. One day, it may be possible to replace entire organs because of the research efforts that came about through the world of California’s Proposition 71.
Studying embryonic stem cells could also lead to a better understanding of how embryos develop over time. It might even lead to treatments that could address potential problems that would normally be untouchable based on the stages of pregnancy that are present.
4. Researchers can obtain embryonic stem cells in ethical ways.
Proponents of embryonic stem cell research and California’s Prop 71 would point out that not every method of collection is one that is morally unethical to the average person. Even if someone is opposed to the idea of destroying a blastocyst, the collection of these important cells can still occur from cord blood. Parents can decide to bank this resource for medical treatments that other people may need or designate it for research purposes. That makes it possible to continue looking for a cure for many diseases without needing to enter a philosophical debate about the morality of collecting cells.
5. Materials collected under Prop 71 would occur at an early stage of development.
Critics would point out that even if someone doesn’t believe that life begins at conception, the destruction of a blastocyst does eliminate the potentiality of life at that moment. There may not be any pain receptors developed at the time of cell collection, but some people would still point to the loss of potential as a critical negative.
What we must look at is the total number of frozen blastocysts and embryos that are kept in storage because of in-vitro fertilization techniques and other practices common to reproductive health. There are hundreds of thousands of stored cells that also have human life potential. Instead of allowing them to go through a disposal process, the embryonic stem cells allow for research potential.
6. Doctors only harvest embryonic stem cells with permission.
Some people get the idea that the concept of Prop 71 was to start taking embryonic stem cells involuntarily from people. That just wasn’t the case. The funding promised by this voter initiative allowed researchers to continue looking for cures to various severe diseases that impact the quality of life of people. No one is going to take a frozen embryo or an extra blastocyst without the permission of the parents or donors. Each person must give their explicit permission before medical researchers can begin working with those materials, so there are legal consequences to face if that work is not accurately performed.
7. It helped to develop the field of embryonic stem cell research.
When California’s Prop 71 passed in 2004, the goal was to push the field of embryonic stem cell research beyond its earliest stages. It’s been more than two decades since scientists started postulating that we could manipulate stem cells to become part of a new field of regenerative medicine. Even though there were no significant advances in the search for a cure with this effort, the state did their part in advancing the science behind this work so that ongoing research efforts wouldn’t duplicate their work.
8. There is potential already documented with stem cell treatments.
Blood cord stem cells are useful in the treatment of several conditions, including cancers like non-Hodgkin’s lymphoma. We have evidence that there is potential in this line of research because cures are possible with direct treatments. Our current approach is to destroy problematic cells, and then replace them with healthy ones from a donor. This approach works so effectively that some people continue to have DNA from their donors in their bodies in addition to their own genetic profile.
There are over 60 different diseases that medical researchers have successfully treated using cord blood therapies. California might not have seen a lot of success with this investment, but that definition is based on a financial return.
9. CIRM has so far funded 56 clinical trials since its creation.
The agency that Prop 71 created in California has provided research funds for 56 clinical trials since 2004. Blood and blood cancers are the most common areas of disease targeting with these funds, responsible for 38% of the total investments. Solid cancers receive 14% of the funding, while neurological issues represent 12% of the dollars spent on promising stem cell treatments for challenging disease indications.
List of the Cons of California’s Prop 71
1. The cost of interest on the general obligation bond was massive.
When Californians adopted Prop 71 in 2014, they were authorizing a $3 billion bond that would initiate more debt for the state to pay back over time. The overall cost of this obligation was just as much over 30 years as it would be to finance the projects in the first place. The fiscal impact of this decision from the legislative analyst in the state meant that the total expense would be about $6 billion, with 50% of that cost going to the interest on the bonds. The state would need to average about $200 million in payments to stay current with its obligation.
2. The money did not produce the intended results.
After five years of funding from California’s Prop 71, there were no imminent medical cures that arose from the work being performed. The goal of the supporters was more to counter the policy of the Bush administration at the time to stop federal funding on embryonic stem cell research. Despite the best efforts of everyone involved, nothing came out of the massive amount of cash that was allocated, causing the backers of this legislation to admit failure in 2009.
3. Much of the opposition to Proposition 71 is theological or philosophical.
Stem cell research presents several problems, but that is also something that could be said of any other form of this work. The issue that drove people to vote against this measure was the fact that a blastocyst must be destroyed to gather the stem cell lines for studying. If someone believes that life begins at conception, then destroying a blastocyst is immoral and unacceptable – sometimes even viewed under the lens of murder.
There are also issues to consider with the idea of creating living tissue in a laboratory setting. Some critics of this measure and embryonic stem cell research in general see this activity as a representation of trying to take on the role of God. It is here where there were several concerns about the development of human cloning techniques.
4. The results of stem cell research continue to be less-than-successful.
Supporters of Prop 71 would point out that there are several positive impacts that cord blood treatments can make on a person’s health. That’s a different approach than what a pure embryonic stem cell procedure creates. The people who receive this option often experience unstable gene expressions during their therapy. Tumors are also more likely to form when trying to cure a condition using these young cells. One of the most significant challenges that scientists face is the inability to activate the cells to fulfill their specific purpose. Until these issues find some level of resolution, no amount of money will help to advance the field of medicine more readily.
5. A blastocyst or embryo meets the definition of life.
Life beginning at conception isn’t necessarily a belief. The various definitions of what constitutes life belong to the blastocysts that get destroyed to create embryonic stem cells in the first place. They have the capacity to grow, have functional activities if allowed enough time to develop, provide reproduction through cell division, and have changes that occur to the cells before they die. Those are the features that have researchers excited about the idea of regenerative medicine in the first place.
6. No one has seen much success from embryonic stem cell research.
The creators of California’s Prop 71 thought that the state could generate more revenues because it would apply more money to this research area than anyone else in the world at that time. Since the practice began in the United States, taxpayers have fronted the industry with $500 million to encourage cure developments. California decided that they would offer six times that figure in direct funding, and then pay an additional $3 billion in bond payments. Although there have been a few successes in mice, those efforts have not yet transitioned over into human medicine.
7. It takes a significant amount of time for embryonic stem cells to be ready.
Once researchers gather the embryonic stem cells to look for a cure to a specific disease, they must work to grow the cells so that they can be capable of regeneration. These cultures and this time can take several months of work to create the desired results. When you add in the cost of obtaining eggs from women and sperm from men that are genetically viable for the creation of a useful blastocyst, there are tens of thousands of dollars already spent before any new research efforts become possible. This disadvantage is the reason why donations are highly encouraged, and cord blood tends to be the priority.
Why Was California Prop 71 Not Successful?
Success is defined by the eye of the beholder. Although there were no magical cures that came from this work, CIRM continues to fund clinical trials even though the initial bond period is over.
Natalie Regoli is a child of God, devoted wife, and mother of two boys. She has a Master's Degree in Law from The University of Texas. Natalie has been published in several national journals and has been practicing law for 18 years.