Hopes that embryonic stem cell research will one day lead to breakthrough treatments that could rebuild spinal cords or reverse blindness tend to dominate discussion in the UK of the controversial field.
However, in continental Europe - as in the US - the debate over the morality of such research is far from over.
After years of successful compromise by European politicians on the issue, a group of members of the European Parliament debating plans for the European Commission's forthcoming research funding programme Horizon 2020 last week reignited calls for funding of such research to be cut.
The move prompted a coalition of patient groups and biomedical research funders - among them the Wellcome Trust and the Medical Research Council - to issue a joint statement to MEPs calling on the European Parliament to continue to support the field.
Funding of embryonic stem cell research by the Commission is significant - it stands at €107 million (?86 million) over the seven years of its Framework Programme 7.
But more important is the message that cutting investment would send, said David Lynn, director of strategic policy and planning at the Wellcome Trust. "If Europe were no longer to fund [embryonic stem cell research] through Horizon 2020, it would risk giving the impression that Europe is no longer open for business in this area."
Research in the field is just starting to gather momentum, with the world's first two clinical trials now under way.
According to Outi Hovatta, a fertility researcher and professor of obstetrics and gynaecology at Sweden's Karolinska Institute, European funding is also crucial because it enables collaborations.
"We can't do it alone in small countries like Sweden and Finland. We need consortia, and UK scientists need us," she said.
Around 20 of the EU's member states allow stem cell research. However, not all allow researchers to derive new stem cell lines (see box below), which involves taking cells from donated embryos a few days old that have been discarded during IVF treatment.
In Germany, researchers must import stem cell lines, and then only ones created before 2007.
Debate about ethics
Under current rules, EU funds can be used for stem cell research in countries that allow it, but the funds cannot be used for research that actively destroys embryos, such as creating new stem cell lines. Some MEPs - often those who also oppose abortion - have seen Horizon 2020 as a chance to reopen the issue.
According to Dr Lynn, the latest moves are the culmination of a debate around the ethics of embryonic research that has been heating up over the past nine months.
In November, the US biotech firm Geron announced it was cancelling its stem cell research programme.
Seeing that as a sign that heralded the end of work on embryonic stem cells, Peter Liese, a German Christian Democrat MEP and a spokesman on health issues for the biggest pan-national group in the European Parliament, the centre-right European People's Party, said: "I demand that we focus on the alternatives now, such as adult stem cell research, IPS cells [induced pluripotent stem cells] and stem cells from cord blood.
"In contrast to embryonic stem cell research, there are true successes in these areas."
IPS cells are less controversial because they are made from adult stem cells genetically reprogrammed to an embryo-like state. But Professor Hovatta said that such technologies, which were made possible only through work on embryonic stem cells, have not yet been proven to be as safe.
More worrying for researchers was the decision by the European Court of Justice in October last year that technologies that have at any stage involved the destruction of a human embryo - which at present encompasses all embryonic stem cells - cannot be patented.
Last month, on the back of this ruling, the European Parliament passed a resolution that included an amendment calling on the European Commission to "draw the appropriate consequences from these decisions also in other relevant policy areas".
This prompted Miroslav Mikol¨¢?ik, a Slovak MEP, to ask: "If one of the main EU competitiveness incentives is research leading to patents, how can we fund research that will never be patentable?"
Although the ruling is unlikely to have a big impact on commercialisation or funding because such work can still be patented in the US and elsewhere, researchers worry that the message - that any research that destroys human embryos, whether viable or not, is "immoral" - could be a wider threat.
On this issue, it seems that Europe is truly divided. A survey by the European Commission in October 2010 found that overall 63 per cent of respondents said they approved of embryonic stem cell research if strict laws regulate it.
However, national responses varied wildly. Approval was as low as 39 per cent in Austria and 50 per cent in Germany, but as high as 78 per cent in Spain and 80 per cent in the UK.
And the dials are not all moving in the same direction. Between 2005 and 2010, support fell by 8 percentage points or more in Austria, Cyprus, the Czech Republic, Germany, Hungary, Italy, Poland and Slovakia.
Information, please
Public opinion in this area is shaped by religion, in particular the Catholic Church, and by cultural and historical legacies, said Austin Smith, director of the Wellcome Trust Centre for Stem Cell Research in Cambridge.
Germany's conservatism, for example, is attributed to the Nazi legacy of genetic experiments carried out on concentration camp inmates.
Professor Smith said the public needs more information. The "odd alliance" of Greenpeace and the Vatican in opposing embryonic stem cell research has two things in common, he added. "In all this, they ignore the patient, and they ignore the scientific evidence."
His personal view is that using embryos in research is akin to organ donation from a brain-dead trauma victim. "For both, they have no possibility of development. You can say that there is life there, but it's not viable. With informed consent, the tissue can be donated for the research to save other lives.
"People can understand that, but they're not told that. They're told that we're destroying little babies."
Participants at a meeting called by the Wellcome Trust in December decided that a pan-European initiative was required to educate the public and policymakers about the value of embryonic stem cell research.
The European Parliament's Industry, Research and Energy Committee will vote on final proposals for Horizon 2020 this autumn.
Professor Smith said he hopes that the compromise of previous EU funding would be allowed to continue so that the promise of embryonic stem cells could be explored fully.
"In the end the EU is a pluralist, democratic system - or it should be. People shouldn't be allowed to impose fundamentalist views on the rest of the community," he said.
elizabeth.gibney@tsleducation.com
