Ethics Stopping Stem Cell Research - Literature review Example

Ethics Stopping Stem Cell Research Loye Russell Ethics, PHI 2600 Dr. William D. Trudgen September 10, 2008 Ethics Stopping Stem Cell Research Researches on “Stem Cells” have gained acceleration during the last decade. The researches on stem cells provided us with increasing hope for possible treatment for several severe diseases which human beings suffer throughout their lives. Stem cells are the basic cells of our body formed during conception. These cells are then transformed into different specialized cells of our body like muscle, nerve, blood, bone, etc. The unique property of the cells is that they can renew themselves indefinitely into different types of cells (Jimenez & Grischenko, 3). That is why they are called “Plastic”. Our body preserves stem cells and uses them for any kind of repair and replacement when required. But the major problem is that the reserve of stem cells in our body is limited and as we end up using the whole reserve we fall prey to different diseases. Stem cell therapy helps us to replenish the reserve of stem cells in the body to fight different diseases. There are a number of diseases and disorders caused by insufficient repair of damaged body tissues. Blood cancer, heart failure, stroke, osteoarthritis, diabetes (both type 1 and 2), Parkinson’s disease, spinal cord injury and even aging are some of the examples of such diseases and disorders. Stem cell therapy using the huge potential of stem cells to regenerate looks promising for the treatment of such diseases through repair and renewal of damaged tissues. There are three major types of stem cells: embryonic, fetal and adult with different sources. Zygote formed after the fertilization is known to have the highest degree of plasticity as they can develop into any kinds of cells. They are known as “totipotent” stem cells. Embryonic stem cells, derived from the inner cell mass of mammalian blastocysts, are able to grow indefinitely while maintaining pluripotency (Yamanaka, 40). As embryo develops into fetus it starts accumulating fetal stem cells which are more tissue specific. They are termed as “multipotent”. They have the potential to turn into pluripotent when subjected to appropriate condition. These are the richest sources of primitive progenitor cells. Adult stem cells are derived from bone marrow, bloodstream and cord blood. They can also turn into pluripotent at right situations. Embryonic and fetal stem cells are best suited for the stem cell therapy as because they do not have the Class II HLA protein which can produce rejection when transplanted to another individual. Ordinary cells and adult stem cells carry this protein leading to rejection and the matching of donor and recipient becomes essential. Embryonic and fetal stem cells are also hypoallergenic and thus give rise to side effect very rarely (Jimenez & Grischenko, 3). Thus the embryonic stem cells show the most utility in the research about stem cell therapy. But the research on stem cells has drawn significant amount of ethical controversies due to its relation with creation, usage and destruction of human embryo, the beginning of human life. The conservatives find it morally unacceptable and think it to reduce the value of human life whereas the liberals argue that it is more important to consider the ailments of already active human life suffering from terminal diseases than to value just a ‘clump of cells’. The issue of abortion is also a very important concern for the stem cell research in the United States. Some people of conservative religious belief considered the embryo as a human life and termed any destruction to the embryo as a similar offence as murder. On the other hand the more liberal ones, such as philosopher John Harris from the University of Manchester, believed the embryo to be a cluster of cells without any soul in it. So any research on it is not accused of murdering human life and putting excess value on the future existence of life at the cost of already existing human life can not be acceptable (Wertz, 677). The main problem related to the stem cell research is its requirement to destroy human embryo. The activists believe it to be the early aged human life and stem cell research to instrumentalize the violation of the sanctity of life. They believe human life to start from the phase of fertilization. But the medical benefit of the stem cell research sounds to be more influencing than the life status of human embryo. In certain research the embryos need to be stored for long period of time exceeding their viable storage life. Moreover, if the cells derived from the embryo are transplanted into any recipient then the cells are getting permanency rather than complete destruction with the embryo. This fact has encouraged some opponents of abortion to support these researches (de Wert and Mummery, 675). But the objections to stem cell research takes into account the religious doctrines which believe in beginning of life at conception. With the advancement of science the possibility of fertilization and following complete development of the embryo outside womb can not be ruled out and thus the beginning of life at conception is surely possible. As a result the stem cell research destroying a life or potential life can not be accepted. Some opponents also cite scientific flaws in the research with stem cells. They state that autologous embryonic stem cells generated for therapeutic cloning may still face rejection by immune system and thus effective transplantation becomes impossible. They also cite the potentiality of the embryonic stem cells to produce tumor. They find alternatives to embryonic stems cells in the adult stem cells which they claim to be successfully reintegrated into an autogenic animal. They even find the adult stem cells to be more promising if funded properly than the embryonic stem cells (de Wert and Mummery, 675). The huge expectations from the stem cells research have not been fulfilled yet and researchers and opponents feel that with the lack of realization of expected promises the public backlash on the entire system is inevitable. The proponents of embryonic stem cell research argue that before the primitive streak is formed, i.e., before the attachment of embryo to the uterus, an individual human life does not exist as the same embryo can go on to create two separate individuals. Thus the blastocyst destroyed to get the embryonic stem cells is not a form of human life and thus can be used for research purpose. The embryonic stem cells are stated to be more efficient than any other alternatives by them. Embryonic stem cells are easier to be isolated compared to adult ones and are able to divide more rapidly. Embryonic stem cells have more plasticity than the adult stem cells making them suitable for the treatment of wider range of diseases including genetic disorder where adult stem cells are not a feasible option. Moreover the DNA abnormalities found in the adult stem cells as a result of toxins and sunlight may reduce their effectiveness as a treatment for several diseases. On the other hand, in vitro fertilization gives rise to a huge number of unused embryos which are slated to be destroyed ultimately. In this case it should be more ethical to use them for scientific research for social benefit rather than just waste them. This will not require any new embryo to be destroyed but only the utilization of those which are going to be destroyed anyway (de Wert and Mummery, 675). The ethical consideration using the utilitarianism theory also finds the benefits to be achieved from the embryonic stem cells research to outweigh the costs of destroying embryos. The embryonic stem cells can grow indefinitely in the laboratory to form almost every type of body tissues and thus can be used for cellular therapies in a wide range of diseases. The value of embryos can by no means be equal to the value of existing human lives as they are incapable to exist outside womb. It is also can not be denied that about 18% zygotes do not implant after conception. Thus the natural loss of embryos is much more than the proposed requirement for the research purpose. Before development into any organ tissue or life activities the blastocyst can be treated as any other human body tissue and not a separate life. During this turmoil phase and extreme debate related to the stem cell research the issue which was equally disturbing as the issue of the beginning of life in any permanent decision making about the legality of the research was the issue of abortion. The researches on stem cells in the United States of America are intertwined with the issue of abortion since its beginning. Most of the legal and political decisions gained pace due to the combination of the issue of abortion with the issue of life status of the embryos. In 1973 the US Supreme Court legalized abortion in the country prompting the government of the country to introduce a legal ban on the use of federal funds in the research on stem cells involving human embryo, fetuses and the embryonic and fetal tissues (Wertz, 674). With the legalization of abortion the government has become more concerned with the stem cell research using human embryo fearing that the researches may encourage women to undergo abortion which is treated as a form of destroying human life. The Congress has also become concerned with the unfair research exploitation of the aborted embryos. But the ban imposed by the US government did not stop the private sector from conducting research in this field and a number of private organizations took over research on stem cells. The political debate in this regard continued for a long time in the country with the release of different moratoriums and enactments in this field. The medical and research organizations requested to lift the ban citing the usefulness of the stem cells and the alternatives available. Attempts have been made to lift moratoriums banning the researches but presidential veto by President George Bush stopped this attempt. Following the suit by Disease Advocacy Organization against Department of Health and Human Services, President Clinton lifted the ban on the research. But due to the public opposition the researches could not be funded and finally in 1995 the Congress again banned the federal funding for stem cell research which is even continued till date. During 2000-2001 the government proposed funding stem cell research with the cells already available to the scientists but did not permit any new attempt to derive stem cells from embryos. The issue of bioethics regarding the stem cell research had been given the top most priority at that time. But in spite of the partial permission, the scientists expressed dissatisfaction owing to the inadequacy of the stem cells available to them. The also cited that many existing cell lines were derived on mouse media and could be harmful for human trial. The religious and ethical organizations also expressed unhappiness as they did not want any kind of research on human embryo. Some organizations like the National Right to Life Committee and other patient organizations supported the decision but decided to wait until a final settlement had been achieved. But strangely enough during this entire debate on the stem cell research using human embryo the government did not ban the research conducted by the private organizations. They were permitted to run the research during this time and were even permitted to derive stem cells from newly created embryos cloned from adult cells though the Congress was requested to ban both reproductive and therapeutic cloning in the United States (Wertz, 675). In 2005 the “HR 810, The Stem Cell Research Enhancement Act” was passed by the Republican led house and in 2006 the senate passed the “Stem Cell Enhancement Act of 2005”. But President Bush vetoed against the act to become US law. Thus the progress in this field of research faced halt once again. The “Stem Cell Research Enhancement Act of 2007” was also designed to provide federal funding to the embryonic stem cell research which was again vetoed by President George W. Bush in June, 2007 (White, n.p.). Under these controversial circumstances the hugely potential stem cell researches lost pace in the United States. The permitted funding for the researches using existing stem cells also could not progress much due to the doubt among the scientists regarding public and political reaction to the researches. Though the basic researches using human embryonic cells continued throughout the entire phase using federal funds, still the results were unable to be used for direct treatment purposes and thus were not thought to be harmful. The government did not object on the researches for genetic or environmental purposes and even for medical purposes when the results were not intended to be used for treatment purpose. The restrictions were made on therapeutic researches such as infertility, in vitro fertilization, genetic therapy, HIV, genetic therapy, etc. (Wertz, 676). Private organizations though were permitted for such researches but without government approval and encouragement they also could not progress as expected. It is more evident when the situations are compared with other nations like Australia, UK, India, etc. which have shown significant progress in these researches armed with permissive policies and strong government backing. But at the verge of increased global effort regarding the improved stem cell research, the US slow down is affecting not only the progress in the country but also that of the entire world. President Bush was seriously condemned by the scientists for his decision against the embryonic stem cells research which has even gathered huge public support for its potential to cure several life threatening diseases. His strange position which stops federal funding for the researches while permitting private organizations is also found to be damaging not only the science but also the image of the country (“Bush ‘out of touch’…”, n.p.; ). Many of the scientists are of the opinion that the policy by Bush restricted the US to become the world leader in the field of stem cell research (Lanza and Green, n.p.). But all pictures in the country are not so gloomy. The US showed considerable progress in the field of adult stem cell research. The traditional thought that, the adult stem cells are limited in their capacity to produce new and different types of cells, has changed with the progress in the research. It has been shown that the bone marrow stem cells could not only generate the cells of bone marrow and blood but also that of liver, lungs, digestive tract, skin, heart and muscles. The stem cells from bone marrow, peripheral blood, umbilical cord blood, inner ear, nasal mucosa, amniotic fluid, placental amniotic membrane, etc. have shown pluripotency. The treatments on animal models have been found to be successful with the adult stem cell therapies. Diseases like Parkinson’s diseases, diabetes, etc. showed promising results with adult stem cells therapy. Not only the transplant but also the stimulation of endogenous adult stem cells for regeneration also showed promise (Prentice, 35). Thus the adult stem cells showed potentiality as an alternative to embryonic stem cells but wide spread clinical application or complete acceptance as an alternative for embryonic stem cells can not be assured at present. Discarding the embryonic stem cell research with these results may also not be viable at this stage. As the adult stem cell research is also at a very initial stage, it is not the time to compare the potentiality of both types of researches, especially when the embryonic stem cell research has been brought to a halt practically. Another very important fact is that with the federal level back off in research on embryonic stem cells in the country like the US, the progress made in the private sector may not be able to reach the people at broader level and thus many needy people both inside the country and worldwide would miss out the benefits they would have received otherwise. In this context the recommendations made by Chapman, Frankel and Garfinkel (pp. iv-xi) of American Association for the Advancement of Science and Institute for Civil Society in 1999 still find relevance in the progress of the embryonic stem cells research. The recommendations indicated the huge potentiality of the human stem cells research and encouraged the studies at the therapeutic context. The ethical concerns were treated not at unique level but were thought to be common for any innovative research. In this regard the recommendations emphasized on the public information and education schemes to spread awareness about its potentiality. The recommendations stated the then federal policies combined with public opinion to be enough to protect public interest in this regard. The authors stressed the need of federal funding in order to promote investment and sound public policy in this regard. The recommendations encouraged stem cell research from all sources including embryo, fetus and adult in order to understand the potential of the human stem cells from various sources for the treatment of diseases. They recommended analysis of the situation and public opinion before indulging in any type of funding for embryonic stem cell research keeping in mind the ongoing debate but they did not recommend to stop funding the embryonic stem cell research as a whole neither the already established ones. The recommendations emphasized on the embryos produced during in vitro fertilization and later discarded as the source of embryonic stem cells and suggested to achieve informed consent before using them for research purpose. The protection of rights and assurance of voluntary nature of donation must be achieved before using the embryos. There should not be any extra effort to generate more embryo, the donors must not be paid and must give full consent for the research. The formation of appropriate guidelines to address public and professional concerns, determination of the source of embryo before research, proper formation of intellectual property guidelines, formation of ethics advisory board for each private company undergoing research, etc. were some of the important recommendations framed by the authors. Finally, the issue of equitable access to the benefits of stem cells research had been given special emphasis in the recommendations. Thus as a whole it can be stated that though the time and research have progressed much from the time of 1999 recommendations, still the debate is on in the country and without immediate attention in this sector the strange and conservative public policies are bound to harm the entire scientific progress of the research, thereby the potential for the human society to reap the benefits of the researches at long term basis. Works Cited 1) “Bush ‘out of touch’ on stem cells”. BBC News. 20 July 2006. Available at: http://news.bbc.co.uk/2/hi/science/nature/5197926.stm (accessed on 10 September 2008). 2) Chapman, Audrey R., Mark S. Frankel and Michele S. Garfinkel. “Stem cell research and applications: Monitoring the frontiers of biomedical research”. American Association for the Advancement of Science and Institute for Civil Society. November 1999. Available at: http://www.aaas.org/spp/sfrl/projects/stem/report.pdf (accessed on 10 September 2008). 3) de Wert, Guido and Christine Mummery. “Human embryonic stem cells: Research, ethics and policy”. Human Reproduction 18.4 (2003): 672-682. 4) Jimenez, A. and V.I. Grischenko. “Understanding the Basics of Stem Cell Therapy”. The Institute for Life Science (2008): 1-39. 5) Lanza, Robert and Ronald M. Green. “Bush’s policy stopped US gaining stem-cell lead”. Nature 438.422 (2005). 6) Prentice, David A. “Current science of regenerative medicine with stem cells”. Journal of Investigative Medicine 54.1 (2006): 33-37. 7) Wertz, D.C. “Embryo and stem cell research in the United States: history and politics”. Gene Therapy 9.11 (2002): 674-678. 8) White, Deborah. “Pros & cons of embryonic stem cell research”. About.com. 2008. Available at: http://usliberals.about.com/od/stemcellresearch/i/StemCell1.htm (accessed on 10 September 2008). 9) Yamanaka, S. “Strategies and new developments in the generation of patient-specific pluripotent stem cells”. Cell Stem Cell, 1 (2007): 39–49. Read More