Bioethics and Stem Cell Research Controversy

The media has had a major role in shaping the controversy surrounding embryonic stem cell research, giving a great deal attention to the potential of ESCR while ignoring the great successes already being achieved with adult stem cells and umbilical cord blood stem cells.
  • ESCs have caused tumours and other problems in animal research and could very likely lead to tissue rejection by the recipient.
  • Dozens of diseases are already giving way in experiments to treatment with adult stem cells.
  • Those involved in stem cell research, believe that aborted foetal tissue has exciting potential and point out that some good can come out of a sad situation with the foetal tissue bringing healing to a living human being.
  • The real issue is the billions of dollars up for grabs in research grants, with very little going to ASCR.
Most people can't understand why there should be any controversy over stem cell research. After all, there are the potential benefits to the millions who suffer from spinal-cord injuries, cardiovascular disease, autoimmune disease, diabetes, osteoporosis, cancer, Alzheimer's disease, Parkinson's disease and other disorders.

Unlike the issue of abortion, there is no real emotional outcry against harvesting the embryonic stem cells (ESCs) of an embryo that is already destined for destruction either as a result of abortion, or from unwanted embryos obtained from IVF (fertility) clinics.

In order to better understand the problem we need first to understand what cells and stem cells are.

Cells:
Cells are the basic building blocks of living things. All living things grow by increasing the number of their cells. When cells grow to their full size they divide, most importantly the nucleus and every chromosome are duplicated. Each cell contains all the chemicals and structures it needs to play its part in the living thing to which it belongs.

The cell protoplasm [the complex, semi-fluid, translucent (jelly-like) substance that constitutes the living matter of plant and animal cells and manifests the essential life functions of a cell] consists of the nucleus and the cytoplasm [the protoplasm which is outside the nucleus of a cell].

The nucleus is the central controller of the cell, containing such chemicals as DNA (deoxyribonucleic acid) and RNA (ribonucleic acid). The nucleus uses these chemicals to send out a stream of chemical instructions that lie in the cytoplasm.

Stem Cells
Stem cells are primitive, or unprogrammed, cells in the human body that have the ability to change into other types of cells.

According to the National Institutes of Health, Stem Cell Basics, Stem Cells are viewed with excitement by scientific researchers because they are seen as having the potential to develop into many different cell types in the body. This new field of science, called "regenerative medicine," means that Stem Cells could serve as a sort of 'repair system' for diseased and malfunctioning parts of the body. Theoretically, they could divide without limit to replenish other cells for as long as the person is still alive.

Dr. Marc Hedrick of the UCLA School of Medicine says:

"Stem cells are like little kids who, when they grow up, can enter a variety of professions. A child might become a fireman, a doctor or a plumber, depending on the influences in their life -- or environment. In the same way, these stem cells can become many tissues by making certain changes in their environment."
Stem cells can be roughly divided into the following four categories:
  • Adult stem cells (ASCs) are undifferentiated cells that reproduce daily to provide certain specialised cells, i.e., blood cells, liver cells, heart cells etc...In the past it was thought that each of these cells could produce just one particular type of cell-this is called differentiation.

    An editorial in the British medical journal, The Lancet, in June 4th 2005 "Stem cell research: hope and hype," mentioned that dozens of diseases are already giving way in experiments to treatment with adult stem cells. "Several forms of cancer are already routinely treated using the patient's own stem cells derived from his blood or bone marrow." 1 See Successful use of Stem Cells
  • Cord blood stem cells are a source of adult stem cells found in blood from the placenta and umbilical cord that are left over after birth. Cord blood stem cells have been used to treat Gunther's disease, Hunter syndrome, Hurler syndrome, Acute lymphocytic leukemia and many more problems occurring mostly in children. This has led to the establishment of 'cord blood banks' where parents may either donate their baby's cord blood cells, or deposit them against a future need of their child.
  • Embryonic stem cells (ESCs) are stem cells derived from the undifferentiated (primitive) inner mass cells of a blastocyst [an early stage embryo - approximately 1 week old in humans] consisting of 50-150 cells. They are usually obtained from unused embryos left over from In Vitro Fertilisation (IVF) procedures, and are seen to have the greater possibilities by many researchers and bio-ethicists.

    A group called the Coalition for the Advancement of Medical Research Australia (CAMRA) called upon Australian politicians not to be swayed by "irrational hype or irrelevant distractions". Despite the opposition to proposed legislation by several prominent Australian scientists, CAMRA claimed that world scientists "unanimously" agreed on the need for both embryonic and adult stem cell research.

    One in particular, Australian Professor Michael Good, an immunologist and director of the Queensland Institute of Medical Research said, "To me, the science in favour of embryonic stem cell research does not stack up." 2

    The problems with human ESCR, other than religious and ethical positions, are because i) they have caused tumors in animal studies, and ii) using ESCs as a 'regenerative treatment', by using 'foreign' tissues, could very likely lead to tissue rejection by the recipient. Therapeutic cloning is seen as a way to get around this problem.
  • Foetal stem cells are stem cells that have been taken from aborted foetal tissue. An embryo is termed a foetus after the end of the 8th week of pregnancy.

Media spin
Part of the problem has to do with the way the issue is treated by the media. Wesley J. Smith, attorney and author of books on issues such as cloning, stem cells, assisted suicide, euthanasia, and bioethics wrote:

"When a research advance occurs with embryonic stem cells, the media usually give the story the brass-band treatment. However, when researchers announce even greater success using adult stem cells, the media reportage is generally about as intense and excited as a stifled yawn.

As a consequence, many people in this country continue to believe that embryonic stem cells offer the greatest promise for developing new medical treatments using the body's cells - known as regenerative medicine - while in actuality, adult and alternative sources of stem cells have demonstrated much brighter prospects. This misperception has societal consequences, distorting the political debate over human cloning and embryonic stem cell research (ESCR) and perhaps even affecting levels of public and private research funding of embryonic and adult stem-cell therapies."3
Smith recounts stories of patients treated successfully with their own adult stem cells and concludes:
"The media continue to imply that embryos hold the key to the future. But increasingly, it looks as if our own body cells offer the quickest and best hope for regenerative medicine. The time has come for the public to insist that the media stop acting as if adult stem cells are the "wrong" kind of stem cells, and report to the American people fully and fairly the remarkable advances continually being made in adult regenerative medicine."4
Human person v Natural Resource
In the United States and Western and Eastern Europe, where later abortion is more common, disposal of the aborted foetus is increasingly seen as wasteful when body parts could be harvested for medical research.

Doctors and clinical staff involved in stem cell research, believe that aborted foetal tissue has exciting potential. The ethical rationale is that the foetus is already dead, through the woman exercising her legal right to a termination. It was unwanted, but some good can come out of a sad situation - the foetal tissue may bring healing to a living human being.

Opponents of using aborted foetuses for Stem Cell Research and other medical experiments claim that it is unethical and a throwback to Nazi medical experimentation.

Such opponents point to the Nuremberg War Criminal Trials in 1946, where Dr Julius Hallervorden defended his medical experiments on Jews and other concentration camp inmates. "I heard that they were going to do that, so I went up to them and said: 'Look here now boys, if you are going to kill all these people, at least take the brains out so that the material can be utilized.'"

The U.S. National Institutes for Health used similar language in their October 1988 Draft Report of the Human Fetal Tissue Transplant Panel: "Inasmuch as it is cadaver tissue (from abortions) we are concerned with, and inasmuch as it would ordinarily be disposed of, and inasmuch as research on this tissue holds the promise of saving countless lives and alleviating the suffering of countless others, we find the use of such tissues acceptable."

Bioethicist and author Leon R. Kass who was appointed to head President Bush's Council on Bioethics, said in an interview with Wesley J. Smith:
"It is rare to see a scientist who thinks that nascent human life has any dignity worth respecting whatsoever. One sees here something of the dehumanizing effect of experimenting on something you become so familiar with you no longer stand in any awe. If you want to see what is going to happen to the rest of us if we go down this road, you should look at what has happened to scientists themselves. 

They no longer look upon early embryonic human life as something before which we should stand in awe because of what it can develop into; they really treat it as chopped liver. To that extent, they find it unbelievable that anybody would want to protect nascent human life and they simply attribute it to religious superstitions. But you don't have to be religious or believe that the embryo is a full human person to recoil from wanting to see it turned into a natural resource."5
Flawed philosophy
It is an objective scientific fact that human life begins at conception (fertilisation). The problem lies with the question of when a human being qualifies as a person which is a matter of philosophy. The  idea of 'delayed personhood'  or a mind/body split is regarded by many philosophers as, historically, the consequence of wrong-headed thinking about reality. It has been regarded as totally indefensible since the time of Plato with the exception of Descartes, and now some comtemporary bioethicists.

Descartes' philosophy, including the mind/body split idea, was abandoned hundreds of years ago because of its many theoretical problems.

Some opponents of ESCR are concerned that, since scientific, philosophical, ethical or bioethical "experts" who are in favour of the "delayed personhood" idea are being used as advisors to help determine health care and medical research issues in public policy, they should present their "personhood" arguments publically and openly before a body of philosophical scholars.

Dianne N. Irving, a former career-appointed bench research biochemist/biologist (NIH, NCI, Bethesda, MD), an M.A. and Ph.D. philosopher (Georgetown University, Washington, D.C.), and Professor of the History of Philosophy, and of Medical Ethics, says
"It would seem that they should at least be held to the same standards of professional activity as are other "professionals" who have as significant an impact on the public welfare."6
The real issue at stake
Given the fact that there have been no successes and many problems with ESCR in contrast to the great success in treating human patients with ASCs, the real issue would seem to be what is hitting the media headlines - the issue of money. 

Billions of dollars are involved. 

Researchers have reported that grant applications have been turned down because they are studying ASCs. In the U.S., the National Institutes of Health have has funded only 30 projects involving stem cells from umbilical cords.  In contrast, it has funded 634 projects involving embryonic stem cells.7

Critics of ESCR are worried that the trend of ignoring scientifically proven ASCR, in favour of the potential benefits of ESCR at some unknown time in the future, is likely to cost lives that may otherwise have been saved by the use of adult stem cell therapy. 

Referrences:
  1. The Lancet, June 4th 2005 "Stem cell research: hope and hype"
  2. Australasian Bioethics Information, "EMBRYO RESEARCH / Debate intensifies before Parliament resumes" Weekly Newsletter, Friday, 16 August 2002
  3. Wesley J. Smith, Spinning Stem Cells
  4. Ibid
  5. Wesley J. Smith, Religion, Research and Stem Cells San Francisco Chronicle, October 20, 2002
  6. Dianne N. Irving, M.A., Ph.D. Scientific and Philosophical Expertise: an evaluation of the arguments on "Personhood"
  7. Miracle Cells World Magazine February 8, 2005