California Proposition 71 (2004)

Last updated March 17, 2019

Proposition 71 of 2004 (or the California Stem Cell Research and Cures Act) is a law enacted by California voters to support stem cell research in the state. It was proposed by means of the initiative process and approved in the 2004 state elections on November 2. The Act amended both the Constitution of California and the Health and Safety Code.

In political science, an initiative is a means by which a petition signed by a certain minimum number of registered voters can force a public vote in parliament called an indirect initiative or via a direct initiative, the latter then being dubbed a Popular initiated Referendum.

The Constitution of California is the primary organizing law for the U.S. state of California, describing the duties, powers, structures and functions of the government of California. Following cession of the area from Mexico to the United States in the Treaty of Guadalupe Hidalgo that ended the Mexican–American War, California's original constitution was drafted in both English and Spanish by delegates elected on August 1, 1849, to represent all communities home to non-indigenous citizens. The delegates wrote and adopted the constitution at the 1849 Constitutional Convention, held beginning on September 3 in Monterey, and voters approved the new constitution on November 13, 1849. Adoption of the "state" constitution actually preceded California's Admission to the Union on September 9, 1850 by almost ten months.

The Act makes conducting stem cell research a state constitutional right. It authorizes the sale of general obligation bonds to allocate three billion dollars over a period of ten years to stem cell research and research facilities. Although the funds could be used to finance all kinds of stem cell research, it gives priority to human embryonic stem cell research.

Stem cells are cells that can differentiate into other types of cells, and can also divide in self-renewal to produce more of the same type of stem cells.

A constitutional right can be a prerogative or a duty, a power or a restraint of power, recognized and established by a sovereign state or union of states. All constitutional rights are expressly stipulated and written in a consolidated national constitution, which is the supreme law of the land, meaning that any other laws which are in contradiction with it are considered unconstitutional and thus regarded as invalid. Usually any constitution defines the structure, functions, powers, and limits of the national government and the individual freedoms, rights, and obligations which will be protected and enforced when needed by the national authorities.

In finance, a bond is an instrument of indebtedness of the bond issuer to the holders. The most common types of bonds include municipal bonds and corporate bonds.

Proposition 71 created the California Institute for Regenerative Medicine (CIRM), which is in charge of making "grants and loans for stem cell research, for research facilities, and for other vital research opportunities to realize therapies" as well as establishing "the appropriate regulatory standards of oversight bodies for research and facilities development".^[1] The Act also establishes a governing body called the Independent Citizen’s Oversight Committee (ICOC) to oversee CIRM.

The California Institute for Regenerative Medicine (CIRM) was created in 2004 after 59% of California voters approved California Proposition 71, which allocated $3 billion to fund stem cell research in California.

Proposition 71 is unique in at least three ways. Firstly, it uses general obligation bonds, which are usually used to finance brick-and-mortar projects such as bridges or hospitals, to fund scientific research. Secondly, by funding scientific research on such a large scale, California is taking on a role that is typically fulfilled by the U.S. federal government. Thirdly, Proposition 71 establishes the state constitutional right to conduct stem cell research. The initiative also represents a unique instance where the public directly decided to fund scientific research.

A general obligation bond is a common type of municipal bond in the United States that is secured by a state or local government's pledge to use legally available resources, including tax revenues, to repay bond holders.

The Federal Government of the United States is the national government of the United States, a federal republic in North America, composed of 50 states, a federal district, five major self-governing territories, and several island possessions. The federal government is composed of three distinct branches: legislative, executive, and judicial, whose powers are vested by the U.S. Constitution in the Congress, the President, and the federal courts, respectively. The powers and duties of these branches are further defined by acts of congress, including the creation of executive departments and courts inferior to the Supreme Court.

Provisions

Proposition 71 states that "This measure shall be known as the California Stem Cell Research and Cures Act”. That is therefore the official citation. However the measure is also headed as the California Stem Cell Research and Cures Initiative.^[2] The Act is long and complex. It amends the state constitution by adding "Article 35 – Medical Research". This article establishes the CIRM and guarantees a right to conduct stem cell research. Proposition 71 also amends the Health and Safety Code, by introducing a provision in Part 5 of Division 106 called "Chapter 3 – California Stem Cell Research and Cures Bond Act". This chapter, among other provisions, establishes the ICOC.

The new institute

ICOC membership

(5 members) the chancellors of University of California at San Francisco, Davis, San Diego, Los Angeles, and Irvine.
(12 members) the Governor, the Lieutenant Governor, the Treasurer, and the Controller each appoints a member from each of the following three categories:
- A California university, excluding the ones mentioned above.
- A California nonprofit academic and research institution that is not part of the University of California.
- A California life science commercial entity that is not actively engaged in researching or developing therapies with pluripotent or progenitor stem cells.
(2 members) the Governor appoints two members, each from the following disease advocacy groups: Alzheimer's and spinal cord injury.
(2 members) the Lieutenant Governor appoints two members, each from the following disease advocacy groups: type II diabetes and multiple sclerosis, or amyotrophic lateral sclerosis.
(2 members) the Treasurer appoints two members, each from the following disease advocacy groups: type I diabetes and heart disease.
(2 members) the Controller appoints two members, each from the following disease advocacy groups: cancer and Parkinson’s disease.
(1 member) the Speaker of the Assembly appoints a member from a mental health disease advocacy group.
(1 member) the President pro Tempore of the Senate appoints a member from an HIV/AIDS disease advocacy group.
(2 members) A chairperson and vice chairperson who shall be elected by the ICOC members.

CIRM membership

CIRM may have up to 50 employees, who are exempt from civil service. CIRM is divided in three working groups.

Scientific and Medical Research Funding Working Group; has 23 members:
- Seven ICOC patient advocates who must be from California.
- Fifteen stem-cell experts who cannot be from California.
- The ICOC chair.
Scientific and Medical Accountability Standards Working Group; has 19 members:
- Five ICOC patient advocates who must be from California.
- Nine stem-cell experts.
- Four ethicists.
- The ICOC chair.
Scientific and Medical Research Facilities Working Group; has 11 members:
- Six members from the Research Funding Work Group.
- Four real estate specialists who must be from California.
- The ICOC chair

Background

Human embryonic stem cell research became a public issue in 1998 when two teams of scientists developed "methods for culturing cell lines derived, respectively, from: (1) cells taken from the inner cell mass of early embryos, and (2) the gonadal ridges of aborted fetuses".^[3] Since then, this type of research has sparked intense controversy in the United States.

The United States of America (USA), commonly known as the United States or America, is a country composed of 50 states, a federal district, five major self-governing territories, and various possessions. At 3.8 million square miles, the United States is the world's third or fourth largest country by total area and is slightly smaller than the entire continent of Europe's 3.9 million square miles. With a population of over 327 million people, the U.S. is the third most populous country. The capital is Washington, D.C., and the largest city by population is New York City. Forty-eight states and the capital's federal district are contiguous in North America between Canada and Mexico. The State of Alaska is in the northwest corner of North America, bordered by Canada to the east and across the Bering Strait from Russia to the west. The State of Hawaii is an archipelago in the mid-Pacific Ocean. The U.S. territories are scattered about the Pacific Ocean and the Caribbean Sea, stretching across nine official time zones. The extremely diverse geography, climate, and wildlife of the United States make it one of the world's 17 megadiverse countries.

Ever since 1996, Congress has attached to the Health and Human Services appropriations bill (which regulates the funding for the National Institutes of Health) a provision known as the "Dickey–Wicker Amendment". This amendment, named after the former representative Jay Dickey, Republican from Arkansas, prohibits the use of federal monies to fund "research that destroys or seriously endangers human embryos, or creates them for research purposes".^[4]

In 1999, however, the General Counsel of the Department of Health and Human Services issued a legal opinion arguing, "that the wording of the law might permit an interpretation under which human embryonic stem cell research could be funded".^[4] This interpretation stipulated that the government could fund this research so long as the embryos used had been destroyed by researchers privately paid. Although the Clinton administration adopted this interpretation and wrote the corresponding guidelines, it did not have the time to enforce them. The issue would pass on to the next administration.

On August 9, 2001, President George W. Bush announced his administration's policy regarding human embryonic stem cell research. The President opted to fund only research on the existing 60 cell lines. The small number of cell lines quoted by the President surprised many scientists. Furthermore, they were concerned about the availability and quality of these lines. Scientists also worried about the impact the president’s policy could have on the American research community. The United States, they argued, lags behind other countries where governments support stem cell research. This, in turn, could cause American scientists to move to these countries.

Proposition 71 represents a response to the federal policy. The idea for this proposition came about after the California legislature blocked a billion-dollar measure to fund stem cell research. Robert N. Klein II, a real-estate developer from Palo Alto, whose son suffers from diabetes and whose mother has Alzheimer's, became the leader of the campaign effort to pass Proposition 71, and spent three million dollars of his own money in the campaign.

Campaign

Proponents

The Coalition for Stem Cell Research and Cures comprised a broad group of people and organizations that included: 22 Nobel laureates; celebrities such as Christopher Reeve, Sharyn Rossi, Monica Siegenthaler, Brad Pitt, Saba Motakef, and Michael J. Fox; a number of elected officials such as State Treasurer Phil Angelides, and State Controller Steve Westly, and State Senator Deborah Ortiz; more than fifty patient and disease advocacy groups (e.g., Juvenile Diabetes Research Foundation, Alzheimer's Association California Council, Sickle Cell Disease Foundation of California), medical groups and hospitals (e.g., California Medical Association, Children's Hospital-Los Angeles), groups representing Latinos and African Americans (e.g. National Coalition of Hispanic Organization, California NAACP), women's advocacy groups (e.g., Planned Parenthood, California NOW) and faith-based organizations (e.g. Catholics for a Free Choice).

The Republican Party opposed this initiative, but two key Republican figures endorsed it. They were George P. Shultz, the U.S. Secretary of State in the Reagan Administration and California Governor Arnold Schwarzenegger. Although Schwarzenegger did not endorse it until October 18, 2004, his support may have helped to solidify the proposition's lead in the polls.

This campaign raised approximately $25 million. The contributors included such prominent figures as Bill Gates, who donated $400,000; Pierre M. and Pamela Omidyar, the founders of eBay who together gave $1 million; Gordon Gund, the owner of the Cleveland Cavaliers basketball team, who contributed $1 million; Herbert M. Sandler, chairman of the board of World Savings Bank, who gave $500,000; John Doerr, a Silicon Valley venture capitalist, who donated $2 million; and William Bowes Jr., a founder of Amgen (a biotech company), who gave $600,000.

Opposition

Those who opposed Proposition 71 included the Roman Catholic Church, Orange County Republicans, and the California Pro-Life Council, an affiliate of the National Right to Life Committee. Among the politicians in this group were State Senator Tom McClintock (R-Thousand Oaks) and Orange County Treasurer-Tax Collector John Moorlach. The Hollywood actor Mel Gibson also joined the efforts to defeat this initiative. Conservative groups, however, were not the only ones opposing Prop. 71; organizations such as the California Nurses Association (CNA), the Green Party, the Center for Genetics and Society, Our Bodies Ourselves, among others, were also against the initiative.

Two prominent groups campaigning to defeat the initiative were the Pro-Choice Alliance Against Proposition 71 and Doctors, Patients, and Taxpayers for Fiscal Responsibility. These two groups lacked the wide range of endorsements that the proponents had (however, the Pro-Choice Alliance Against Proposition 71 was endorsed by seven organizations and a number of university professors). On the Doctors, Patients, and Taxpayers for Fiscal Responsibility website (which no longer exists) there were only fourteen members listed. Among these members were Dr. Vincent Fortanasce, a physician; Diane Beeson, a medical sociologists; Carol Hogan, a spokesperson for the California Catholic Bishops; and Dr. H Rex Greene, an oncologist and hospital administrator.

The four organizations campaigning against the initiative raised almost $400,000. The main contributors were the United States Conference of Catholic Bishops, which donated $50,000 and Howard Ahmanson Jr., founder and president of Fieldstead & Company, who gave $95,000.

Analysis

Initial analysis and discussion of need for analysis was done in 2007^[5]

Sociologist Ruha Benjamin offers the first in-depth analysis of Proposition 71 in People's Science: Bodies and Rights on the Stem Cell Frontier (Stanford University Press 2013). Too frequently the debate over stem cell research devolves in to simple judgments—good or bad, life-saving medicine or bioethical nightmare, symbol of human ingenuity or our fall from grace—ignoring the people affected. Benjamin moves the terms of debate to focus on the shifting relationship between science and society, on the people who benefit—or don't—from Proposition 71 and what this says about democratic commitments to an equitable society. Benjamin discusses issues of race, disability, gender, and socio-economic class that serve to define certain groups as more or less deserving in their political aims and biomedical hopes.

Results of vote

Proposition 71
Choice	Votes	%
Yes	7,018,059	59.05
No	4,867,090	40.95
Valid votes	11,885,149	94.40
Invalid or blank votes	704,534	5.60
Total votes	12,589,683	100.00
Registered voters and turnout	16,557,273	76.04

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References

↑ Title and Summary by the Attorney General's office of Proposition 71 Archived 2013-05-22 at the Wayback Machine .
↑ Full text of Proposition 71 Archived 2013-05-22 at the Wayback Machine .
↑ "Archived copy". Archived from the original on 2005-11-23. Retrieved 2005-12-03.
1 2 "Archived copy". Archived from the original on 2005-12-28. Retrieved 2005-12-03.
↑ Longaker, Michael T; Baker, Laurence C; Greely, Henry T (2007). "Proposition 71 and CIRM—assessing the return on investment". Nature Biotechnology. 25 (5): 513. doi:10.1038/nbt0507-513. PMID 17483831.

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[1] Title and Summary by the Attorney General's office of Proposition 71 Archived 2013-05-22 at the Wayback Machine .

[2] Full text of Proposition 71 Archived 2013-05-22 at the Wayback Machine .

[3] "Archived copy". Archived from the original on 2005-11-23. Retrieved 2005-12-03.

[bioethics.gov-4] 1 2 "Archived copy". Archived from the original on 2005-12-28. Retrieved 2005-12-03.

[5] Longaker, Michael T; Baker, Laurence C; Greely, Henry T (2007). "Proposition 71 and CIRM—assessing the return on investment". Nature Biotechnology. 25 (5): 513. doi:10.1038/nbt0507-513. PMID 17483831.