Admiring portrayals of George W. Bush always expose, inadvertently, what's wrong with him. "Steady leadership," the theme of his 2004 re-election ads, was a case in point. Bush has always been too certain to admit error, too steady to turn the wheel when the road bent, and too preoccupied with principle to understand that principle wasn't enough. That was his downfall in Iraq. It's also why he pushed through his 2001 tax cuts even after the circumstances that originally justified them vanished.
Now the former White House aide who coordinated the formulation of Bush's stem-cell policy has published an account of how the president reached his decision. The reporting is new, but the story is familiar. Once again, the case for Bush is the case against him.
The account, published in Commentary, comes from Jay Lefkowitz, who served as a senior domestic-policy adviser to Bush until 2003. Lefkowitz calls Bush's 2001 deliberations "a model of how to deal with the complicated scientific and ethical dilemmas that will continue to confront political leaders in the age of biotechnology." He describes Bush swatting away a National Right to Life polling memo. The president "came to a moderate, balanced decision that drew a prudent and principled line," based not on polls but on "lengthy study and consultation with people of widely divergent viewpoints," Lefkowitz writes. That's Bush: serious, principled, indifferent to pressure.
But bioethics isn't some timeless philosophical puzzle. Its principles connect to evolving facts. Tweak one gene, and suddenly the thing you're growing for its stem cells isn't quite an embryo. One day, you're for adult stem-cell research and against embryonic stem-cell research; the next, you learn that a virus can turn an adult cell into an embryonic stem cell. Every discovery overturns previous moral calculations.
Bush decided to fund research on stem-cell lines made from embryos that were destroyed before Aug. 9, 2001—the day he announced his policy—but not afterward. He pegged this compromise to factual calculations. He claimed there were "more than 60 genetically diverse stem cell lines," enough "to explore the promise and potential of stem cell research." Three days after his speech, in a New York Times op-ed, he wrote, "According to the National Institutes of Health, these lines are genetically diverse and sufficient in number for the research ahead."
Lefkowitz portrays these factors as crucial to Bush's decision. In a meeting with NIH researchers, "The President pointedly asked how many embryonic stem-cell lines were already in existence," Lefkowitz recalls. He cites another conversation in which Bush suggested a cautious but flexible approach. "Perhaps we should only take one step at a time," the president proposed. Underscoring the fact-based and flexible nature of the deliberations, Lefkowitz writes, "Our discussions were focused throughout on reaching a coherent and consistent position where the President could stand with honor for as long as the facts on the ground remained as they were."
The facts began to change right away. New information and analysis challenged Bush's assumptions about the existing cell lines' numerical sufficiency, genetic diversity, and stability. People who worked with Bush argue that these problems never became consequential enough to change the policy. But Bush's comments show no sign that he was willing even to consider this possibility. A day after his op-ed ran, Bush cut off reporters' questions about the policy. "I spent a lot of time on the subject," he reminded them. "I laid out the policy I think is right for America. And I'm not going to change my mind. I'm the kind of person that when I make up my mind, I'm not going to change it."
A week later, a reporter told Bush, "You've said that the 60 stem cell lines can be experimented on. It now turns out they've been mixed in the laboratory with mice cells. Under FDA guidelines, they could have no practical effect. Did you know that when you made this decision that these possibly couldn't be used?" Bush replied, "I haven't changed my opinion in the least." He invoked the same test he had used two months earlier to explain his trust in Vladimir Putin: "The NIH came into the Oval Office and they looked me right in the eye and they said, we think there is ample stem cell lines to determine whether or not this embryonic stem cell research will work or not."
Three days after that invocation of its authority, NIH issued an update on the policy. It warned, "As with any new technology, the characteristics and utility of the existing stem cell derivations will only fully emerge with considerable future research." As the research progressed, some basic questions were answered, and further questions arose, suggesting further lines of research. In May 2004, NIH Director Elias Zerhouni told Congress that "more cell lines may well speed some areas of human embryonic stem cell research." Despite this, the White House repeated that Bush, for moral reasons, wouldn't budge. In an exchange with reporters, press secretary Scott McClellan repeatedly insisted that Bush's policy was "well thought out" and that Bush was "committed" to it. Three days later, Vice President Cheney told pro-lifers, "The President has got a policy on stem cell research that he devoted an enormous amount of time to. This is a subject he really grappled with. … So I don't think there should be any doubt in anybody's mind about where he's headed with respect to those kinds of issues. He's been rock solid on it."
A year later, Bush's point man in the Senate, Majority Leader Bill Frist, declared the policy obsolete. "Senator Frist said today that there were supposed to be 78 stem cell lines after the August 9th decision, and there's only 22 available today, and some of those have degraded to the point that they're not useful," a reporter told McClellan. Another asked whether Frist was correct that Bush was "stuck in a 2001 decision when the science is passing him by." McClellan brushed the questions aside. "The President came to a policy position back in 2001, after a lot of deliberation," he reminded them. "It was a very thoughtful process; he listened to people with different views."
It's very clear from the point of view of science and what I have overseen that these cell lines will not be sufficient to do all the research we need to do for the reasons that you mentioned, but the most important one is that these cell lines have exhibited instability from the genetic standpoint, and it's not possible for me to see how we can continue the momentum of science in stem cell research with the cell lines that we have currently at NIH that can be funded. So from my standpoint, it is clear today that American science would be better served and the nation would be better served if we let our scientists have access to more cell lines, so that they can study with the different methods that have emerged since 2001, the different strategies that we now understand.
What did Bush have to say about this defection by the agency on whose authority he had based his policy? When reporters asked whether the president "had any second thoughts in light of what his own NIH Director said," Bush's spokeswoman replied, "The President weighed this issue very carefully back in 2001, and has thought about it since. And he believes that that clear moral line that he established back in August of 2001 is a good place for the country to be."
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