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JAMA Forum Archive, 2012-2019: Health policy commentary from leaders in the field
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Selective Regrets: The “Dickey Amendments” 20 Years Later

The 104th US Congress marked an important period in the legislative legacy of then-Rep Jay Woodson Dickey, Jr, (R, Ariz). Only 2 years into his 8-year congressional tenure, Rep Dickey spearheaded the 1996 enactment of 2 far-reaching amendments. In so doing, Rep Dickey assured the prohibition of public funding of gun violence research and human embryo research by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), respectively.

The lasting impact of the 2 amendments can hardly be overstated. Both remain in effect. Now, in an interview 20 years later with the Huffington Post, the retired 75-year-old congressman expressed his regrets over the curbing of gun violence research. Similar sentiments have been expressed earlier in a 2012 op-ed with the Washington Post. No such qualms have been publicly articulated relevant to the generation-long funding freeze of human embryo research.

Effects on Gun Violence Research

Buoyed by the results of the 1994 midterm Republican Revolution, the National Rifle Association and its congressional allies set out to constrain gun violence research conducted by the National Center for Injury Prevention and Control (NCIPC) of the CDC, which they perceived as advocating for gun control. They initially targeted the NCIPC for elimination, or failing that, curtailing its funding. It was in this context that Rep Dickey offered an amendment to theOmnibus Consolidated Appropriations Act of 1997 (H.R. 3610). The bill specified that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control” and that $2.6 million—the amount spent on firearm-related research in 1995—were to be removed from the CDC budget. These provisions were included in the version of the bill signed into law by President Clinton on September 30, 1996.

In the ensuing 2 decades, gun violence research at the NCIPC has been at a standstill. In the Huffington Post interview Rep Dickey expressed his remorse, “I wish we had started the proper research and kept it going all this time. I have regrets.” In the same interview, he added, “If we had somehow gotten the research going, we could have somehow found a solution to the gun violence without there being any restrictions on the Second Amendment.”

The second “Dickey Amendment,” cosponsored with then-freshman Rep Roger Wicker (R, Miss), was likely presaged by 2 key developments. The first was the National Institutes of Health Revitalization Act of 1993, which eliminated a regulation that prevented the US Department of Health and Human Services from funding research proposals involving human in vitro fertilization (IVF). The second was the release of the report of the Human Embryo Research Panel on September 27, 1994, which included the recommendation that the NIH fund human embryo research using “oocytes fertilized expressly for research” under select circumstances. The “Dickey-Wicker” amendment, which sought to curtail federal funding of research involving human embryos, was approved by the House Committee on Appropriations on July 27, 1995, and signed into law on January 26, 1996, as a rider attached to an appropriations bill, the Balanced Budget Downpayment Act, I.

The relevant language prohibits any federal funds from being used for “the creation of a human embryo or embryos for research purposes” or “research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death....” As such, this rider has been attached annually to the appropriation bills of the Departments of Health and Human Services, Labor, and Education since its enactment.

On July 11, 1996, Rep Nita Lowey (D, NY) and Rep Nancy Johnson (D, Conn) offered an amendment to strike the Dickey-Wicker rider off the 1997 appropriation bill. During the subsequent House floor debate, Reps Dickey and Wicker offered harsh criticism of this. Rep Dickey said that “we cannot allow Federal funds to be used to terminate lives, for the creation or the experimentation which is a lethal experimentation because it is eliminating lives [and] is not acceptable.” Rep Wicker said that the federal government had never funded such research and that amendment posed “a very slippery slope. … Let us leave it to the private sector, and let us respond to the 76 percent of Americans who say do not use tax dollars to fund embryo research.”

Effects on Human Embryo Research

In precluding the NIH from funding human embryo research, the Dickey-Wicker amendment has relegated the underwriting of this effort to the private sector for the better part of the last 20 years. In so doing, human embryo research has been deprived not only of a critical source of funding but also of the expertise of NIH study sections, councils, and staff. Studies of nonhuman primates have likely been curtailed as well. Only the study of human embryonic stem cell lines (but not the derivation of them) has been exempted from these funding restrictions.

Human embryo research remains as important as ever. Changing platforms of preimplantation genetic screening in IVF are in need of ongoing evaluation. Prevention of pregnancy loss cannot be advanced absent improved understanding of early development. And expanding options for the prevention of mitochondrial diseases are crying out for preclinical validation.

Going forward, the prospect of an altered status quo is entirely contingent on the outcome of the upcoming national elections. Even so, given their staying power, the Dickey Amendments do not appear to be going anywhere anytime soon, irrespective of which party ends up in power to assume control of Congress.

About the authors:
Eli Y. Adashi, MD, MS, is a professor of Medical Science and the former dean of Medicine and Biological Sciences at the Warren Alpert Medical School of Brown University in Providence, Rhode Island.
I. Glenn Cohen, JD, is a professor of Law and director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Cambridge, Massachusetts.
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