This document summarizes ethical issues related to human embryonic stem cell research. It discusses the potential benefits of hES cell research for developing new medical treatments but also outlines arguments against it. Specifically, it examines debates around the moral status of embryos, whether hES cell derivation and research violates their right to life, and if researchers are complicit in embryo destruction. The document also explores options for bypassing these ethical concerns, such as using stem cells from parthenogenesis or fatal research.
This document summarizes ethical issues related to human embryonic stem cell research. It discusses the potential benefits of hES cell research for developing new medical treatments but also outlines arguments against it. Specifically, it examines debates around the moral status of embryos, whether hES cell derivation and research violates their right to life, and if researchers are complicit in embryo destruction. The document also explores options for bypassing these ethical concerns, such as using stem cells from parthenogenesis or fatal research.
This document summarizes ethical issues related to human embryonic stem cell research. It discusses the potential benefits of hES cell research for developing new medical treatments but also outlines arguments against it. Specifically, it examines debates around the moral status of embryos, whether hES cell derivation and research violates their right to life, and if researchers are complicit in embryo destruction. The document also explores options for bypassing these ethical concerns, such as using stem cells from parthenogenesis or fatal research.
Department of Philosophy Department of Medical History and Bioethics Department of Medical Sciences, School of Veterinary Medicine University of Wisconsin, Madison
[email protected] http://philosophy.wisc.edu/streiffer/ Outline 1. Introduction to hES cells and their potential uses 2. The Benefit Argument for hES cell research 3. The Pro-Life Argument against hES cell research 4. The question of the fetuss moral status 5. Bypassing the abortion debate: other options 6. Bypassing the abortion debate: research on those who are already going to die 7. Bypassing the abortion debate: issues of complicity 8. Bypassing the abortion debate: religion and politics 9. Exploitation and Commodification Concerns What Are Stem Cells? Stem cells (embryonic, fetal, or adult) are self-renewing cells that are also capable of differentiating into more specialized cells. Source: NIH Stem Cells: Scientific Progress and Future Research Directions In late 1998, James Thompson at UW- Madison discovered how to isolate and culture hES cells. What Are Human Embryonic Stem Cells (hES cells)? A human embryonic stem cell (hES cell) is a stem cell that is derived from the inner cell mass of the blastocyst stage of a human embryo. Properties of hES Cells hES cells are immortal.
hES cells are pluripotent. That is, they can differentiate into any kind of tissue in the human body.
Unlike an embryo, they are not totipotent. That is, they are not (at the present time) capable of being implanted in a uterus and giving rise to a human being. Bioluminescent Mice These nice had a gene from a jellyfish which expresses green fluorescent protein. This technique is widely used to tag a cell in such a way that all of its offspring are also easily identifiable. This can be used to prove that a cell is a pluripotent stem cell. How to Demonstrate Pluripotency Source: Catherine Varfaillie hES Cell Colony (Source: University of Wisconsin-Madison.) Microscopic 20x view of a colony of undifferentiated human embryonic stems cells. The embryonic stem cell colonies are the rounded, dense masses of cells. The flat, elongated cells in between the embryonic stem cell colonies are fibroblasts that are used as a "feeder layer" on which the embryonic stem cells are grown. Source: Stem Cells: A Primer Drug Development and Testing http://www.news.wisc.edu/9064.html hES Cell-derived cardiac cells spontaneously organize themselves and begin to beat. 90% of what we know about early human development is inferred by studies on mouse embryos.
hES cells provide a window into early human development that researchers have never before had. Developmental Research Stage 6 Human Embryo Day 7.5 Mouse Embryo Trophoblast Trophoblast Extraembryonic Endoderm Extraembryonic Endoderm Extraembryonic Mesoderm Extraembryonic Mesoderm Ectoderm Ectoderm Human vs. Mouse Embryology Tissue/Cells for Therapy Multiple Sclerosis results from a degradation of myelin, resulting in the interruption of electrical signals traveling down nerve fibers. Shiverer mice have an MS-like condition, and so are used as a model to study potential MS treatments. Researchers injected stem cells from a healthy mouse into the brains of shiverer mice. The stem cells multiplied, migrated throughout the brain, and became myelin-producing cells. Injected mice stopped shivering. If injected young enough, shiverer mice never start shivering. The Benefit Argument for hES Cell Research We believe that not to develop the technology would do great harm to over 100 million patients in the United States alone who are affected by diseases potentially treatable by the many medical applications of hES cells. Thomas B. Okarma Geron President and Chief Executive Officer Human Embryonic Stem Cells: A Primer on the Technology and Its Medical Applications A More Rigorous Reconstruction 1. hES cell research is reasonably expected to provide substantial benefits.
2. If an activity is reasonably expected to provide substantial benefits, then society is morally required to support it. (Implicitly presupposed moral premise)
3. Hence, society is morally required to support hES cell research. Two Problems The Benefit Argument begs the question of whether or not the opportunity costs of funding hES cell research are excessive in comparison to its benefits. If they are, then society is not morally required to fund it.
The Benefit Argument begs the question of whether or not hES cell research violates anyones rights. If it does, then society is not morally required to fund it (even if the opportunity costs of doing so are not excessive).
The Opportunity Costs Objection Even if HES cell therapy is beneficial, there are other more cost-effective uses to which the money could be put. We Spend Too Much U. S. health care costs are about 15% of our GNP, whereas other first world countries costs are around 7% of their GNP U. S. health care costs are expected to exceed 30% by the year 2030 The use of new technology and the overuse of existing technology is estimated to account for up to 50% of the rise in health care costs. And Receive Too Little 44.3 million Americans are chronically underinsured (about 16% of the U. S. population) The U. S. ranks 16 th in terms of male life expectancy 13 th in terms of female life expectancy 6 th among industrialized countries in terms of the infant mortality rate The Pro-Life Argument against hES Cell Research First Stage: It is unethical to derive hES cells because doing so involves the destruction of a human being with a right to life.
Second Stage: It is unethical to perform any downstream research on hES cell lines or to use products developed with hES cell lines because anyone doing so is complicit in the wrongful death of the embryo from which the cell line was derived.
Third Stage: The government is morally required to prohibit those unethical activities because activities that are wrong in the way those are, are legitimate objects of government action. Can We Bypass the Moral Status Question? Perhaps there are other sources of human pluripotent stem cells.
Perhaps some kinds of fatal research on people are permissible.
Perhaps researchers who do downstream research on cell lines are not complicit in the allegedly wrongful death of the embryos.
Perhaps views about the moral status of the fetus are really religious views, and are therefore inappropriate as a basis for public policy. The First Stage First Stage: It is unethical to derive hES cells because doing so involves the destruction of a human being with a right to life. Other Options: Parthenogenesis A team led by fertility specialist David Wininger at biotech firm Stemron of Maryland has grown parthenogenetic human embryos to the blastocyst stage, at which stem cells can be obtained. Cells taken from one of the embryos survived for a few days ( Stem Cells , vol 21, p 152).
To the right are primate parthenogenetic embryos.
Mouse Parthenogenesis Reported in Nature, April 21, 2004. Researchers led by Tomohiro Kono of the Tokyo University of Agriculture in Japan managed to bring two parthenogenetic mice to term (a, b) with one (a) surviving into adult and capable of reproduction, out of 457 attempts.
Other Options 1. Removal without destruction 2. Adult stem cells 3. Chimeras 4. Genetically engineered embryos
Research on Those Who Are Already Going to Die 1. Even granting that embryos have a right to life, if they were going to be destroyed anyway, then it is permissible to destroy them in the process of deriving hES cells.
2. Given current IVF practices, surplus embryos are inevitable. (Currently, there about 400,000 frozen human embryos in the U.S.) Couples have four options:
A. Implant B. Donate C. Freeze D. Discard Overly Simple The mere fact that a person is going to die does not permit research which is certain to cause that persons death. 1. IVF is permissible.
2. IVF routinely results in the destruction of excess embryos (600,000 in the past 10 years).
3. Hence, it is also permissible to destruction excess embryos.
4. And if that is permissible, then surely it is permissible to destroy them in the name of research that has the kind of potential benefit that hES cell research has. A Better Argument? The Second Stage Second Stage: It is unethical to perform any downstream research on hES cell lines or to use products developed with hES cell lines because anyone so doing is complicit in the wrongful death of the embryo from which the cell line was derived.
This is clearly problematic: not all who benefit from or do research on someone who was wrongly killed are complicit in that persons death.
Bushs Proposal Bushs August 9 th proposal:
As a result of private research, more than 60 genetically diverse stem cell lines already exist. They were created from embryos that have already been destroyed, and they have the ability to regenerate themselves indefinitely, creating ongoing opportunities for research. I have concluded that we should allow federal funds to be used for research on these existing stem cell lines, where the life and death decision has already been made. Leading scientists tell me research on these 60 lines has great promise that could lead to breakthrough therapies and cures. This allows us to explore the promise and potential of stem cell research without crossing a fundamental moral line, by providing taxpayer funding that would sanction or encourage further destruction of human embryos that have at least the potential for life. The Third Stage Third Stage: The government is morally required to prohibit those unethical activities because activities that are wrong in the way those are, are legitimate objects of government action. Are Views about Early Human Life Religious? Some claim that views about whether or not early forms of human life have moral status or intrinsic value are controversial religious views, which do not provide a legitimate basis for state action. Ronald Dworkin, Lifes Dominion The connection between [religious peoples] faith and their opinions about abortion is not contingent but constitutivethe latter are shadows of religious beliefs about why human life itself is important. We may describe most peoples beliefs about the inherent value of human lifebeliefs deployed in their opinions about abortionas essentially religious beliefs.
States have no power to impose on their citizens a particular view of how and why life is sacred. Research vs. Surplus Embryos 1. Many who are in favor of deriving HES cells from surplus IVF embryos are against the creation of embryos solely for the purpose of using them as a source of HES cells.
2. Separates fertilization from reproductive intent Concerns about Exploitation of Egg Donors 1. Some believe that the increasing medicalization of reproduction gives men even more power over womens lives and will lead to increasing exploitation of womens reproductive capacities by men. Concerns about Commodification 1. For-profit companies involvement in egg donation and HES cell research will result in or itself typically constitutes a problematic commodification of persons.
2. Many committees have agreed that eggs and fetal tissue, like solid organs, should not be bought and sold. The Fetal Tissue Debate vs. the hES Cell Debate 1. Issues of the moral status of the fetus weigh heavily in each, but on some views, the ex utero/in utero distinction is relevant to the status of the fetus 2. Issues of complicity are more prominent in the hES cell debate; but they are also prominent in the debate about the use of fetal tissue from elective abortions. It is important to note, though, that the death of the embryo is directly brought about by the harvesting of the hES cells. 3. HES cell research is motivated by a goal which all agree is important, human health; abortion is viewed by some as being motivated by an impermissible desire to abdicate ones parental responsibilities. 4. The strongest argument for a right to abort is a right to bodily integrity, which does not apply in the case of ex utero embryos. Avenues for Resolution 1. Alternate source of equally useful stem cells
2. Removal of stem cells without destroying the embryo
3. Effective separation of later research from original derivation
4. Consensus on the moral status of the embryo
5. Willful complacency of opponents in the face of successful therapies
6. Failure of hES cell research to fulfill its potential