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Academic affiliation: Oklahoma State University
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The ethics of stem cell research is a controversial and extensively debated topic. Stem cell research shows a great potential for producing a cure to life threatening diseases; but, left unregulated, it could potentially lead to more controversial and unethical advancements in areas such as cloning and gene therapy. The purpose of this essay is to examine different debates and perspective concerning the ethicalness of stem cell research and the impact it leaves on the evolving medical world.
In today's world of medicine there are many problems, and many solutions. Stem cell research seems to be one of those solutions, but there are problems within this solution as well. The primary source of controversy in the utilization of stem cell research is the concern of ethics in the use of human embryonic stem cells. The opposition to stem cell research views the harvested human embryonic stem cells to be an early form of human life, as discussed in Daryl Sas's essay, which states that despite the benefits of stem cell research "the embryos destroyed in the process are human beings who should not be exploited for the supposed 'good' of others" (82). He argues that "technology's promises are exaggerated" (Sas 84). He also claims that instead of technology getting to the cause of a problem, it "only masks the symptoms" (Sas 85). A rebuttal to this argument is made by Nikolaus Knoepffler stating that "One has to draw the line at a certain arbitrary point as one does with every moral decision" (62). A way to combat the problems that may arise from a researcher taking stem cells too far would be the implication of ethical guidelines and policy options to regulate the research and harvesting of the stem cells. An example of such guidelines has already been put in place in Shanghai, China, by the Ethics Committee of the Chinese National Human Genome Center, titled "Ethical Guidelines for Human Embryonic Stem Cell Research." These guidelines address the issues of beneficence and life saving, respect and autonomy, harmlessness and benefit, being informed and consent, and prudence and confidentiality. It also defines procedures to be in the different types of stem cell harvests. These policies dictate the necessary precautions to be taken by stem cell researchers.
Along a similar line is Knoepffler's article "Stem Cell Research: An Ethical Evaluation of Policy Options." This piece provides examples of different ways of harvesting embryonic stem cells, and also discusses policy options based on the different harvesting methods. Knoepffler does not specifically argue for stem cell research, but there is an underlying tone of support for the issue. He seems to argue most strongly for policy option number three, which calls for research to be allowed "with stem cells harvested from surplus embryos" (Knoepffler 64). He does not view option one (not allowing stem cell research at all) and option two (allowing stem cell only to be harvested from existing stem cell lines) as being permissive enough, but feels as though options four through eight push the understood ethical guidelines too far. He argues that the "line of defense" for option 3 against options one and two "is not to accept the claim that an early embryo is ontologically and morally the same as an already born human being" (Knoepffler 64). To pacify the opposition, he also explains that "option 3 exercises caution with regard to the early embryo, but does not take into account that this caution also leads to the result that important chances for therapies may be missed. This brings into question who should be the one to determine what is right and wrong in stem cell research. There is always going to be a differing of opinions and who is right cannot always be based on the Christian perspective, as argued by Sas.
Another scholar, Thomas A. Shannon, agrees with Knoepffler's view that stem cell research should be permissible. Shannon describes the debate on human embryonic stem cell research as being "conducted with the use of inflated rhetoric" (813). In further support of his claim, he begins his article by informing his readers that a critical problem with the current debate is that this type of research is still in it beginning stages, asserting that it is wrong to criticize something before you have given it a chance. He points out that embryonic stem cell researchers "have yet to achieve…the ability to consistently isolate embryonic stem cells and then tease them into the desired type of tissue" (Shannon 812). Although Shannon points out a few flaws of stem cell research, one such being that "no one is sure whether this research will work or even if stem cells can consistently be teased into becoming specified tissues" (814), he still supports the fact that the research process should continue. He "argues that very thorough, well designed, carefully monitored, federally funded studies of stem cells derived from a variety of sources, including human embryos, could be morally justified" (Shannon 814).
The American Medical Association also addresses the issue of stem cell research. They "support the use of somatic stem cell nuclear transfer technology in biomedical research (therapeutic cloning), but oppose the use of somatic cell nuclear transfer technology for the specific purpose of producing a human child (reproductive cloning)" (AMA). This medical website gives a bit of background on the subject of stem cell research, stating that "stem cells were postulated to exist more than 40 years" (AMA). They hold the claim that regardless of their source, stem cells will benefit humankind greatly. They will provide treatment for diseases, "as well as answer some basic biological questions regarding development" (AMA). They cite different types of stem cells such as, embryonic stem cells, adult stem cells, and cord stem cells. Their research shows that embryonic stem cells are found to be the most "capable of forming a variety of somatic germ-line tissues, a capacity referred to as pluripotency" (AMA). The AMA is still not sure whether adult stem cells have the same regenerative potential as embryonic stem cells. Until this issue has an answer for certain "most researchers agree that work must continue on both embryonic and adult stem cells" (AMA).
Like the AMA, Thomas B. Okarma, focuses on the potential benefits of stem cell research. He refers to stem cells as a "self-renewing cell line that gives rise to all cells in the body" (Okarma 5). He asserts that there is a great potential for stem cells to be able to permanently repair failing organs by "injecting healthy functional cells developed from them" into the tissues, calling this "an approach to regenerative medicine" (Okarma 5). Okarma supports stem cell research by claiming that it will further our comprehension of "the molecular mechanisms of normal development" which will allow us a basis for understanding "fetal developmental abnormalities" (6). He identifies ways that embryonic stem cell research can identify potential pathogens. He states that "embryonic stem cell screens can be used to identify and study environmental toxins and pharmaceuticals that could cause abnormalities in the differentiation of these cells" (Okarma 7). They would be useful in drug development programs by aiding in early identification of agents that possess potential pathogen properties. As for the area of regenerative medicine, he claims that "human embryonic stem cells should promote regenerative medicine in the near future not only because of their biologic properties, but also because they can be produced in large quantities in the laboratory under standard conditions" (Okarma 7).
Another author, Cynthia B. Cohen, discussed stem cell policies in her article "Stem Cell Research in the U.S After the President's Speech of August 2001." She discusses alternate sources of stem cells, such as germ cells, adult stem cells, and the different derivations embryonic stem cells; and the ethical issues they raise. She praises researchers for being able to tease germ cells and adult stem cells into a variety of different uses, but can be quoted as writing that "stem cell investigators…have maintained before Congress and the President's Council on Bioethics that embryonic stem cells hold greater promise of being able to differentiate into a wide range of different types of cells and tissue" (Cohen 102).
Another argument outlined by Cohen concerning the creation of embryos for stem cell research has to do with the respect shown for the embryos. It is a concern of those in Congress that it shows a lack of respect to create the embryos only to destroy them (as pertaining to policy option 1 in Knoepffler's article). A counterargument to this is that "until an embryo is transferred to the uterus, it is not a potential human being and it is therefore not wrong to create embryos for this research" (Cohen 102). Another protest to this method is that "the practice would require the use of large numbers of eggs from many women, thereby subjecting them to the unknown health risks of providing eggs" (Cohen 103). She concludes her article by stating, "The question of whether early embryos are owed the same protections that we accord to fully-developed living human beings still overshadows other questions in discussions of stem cell research inside and outside the Beltway. There is hint that new ways of thinking about this question are developing, but it is difficult to state at this point whether these will provide a way to resolve the deadlock that has developed on the hill about the ethics of pursuing embryonic stem cell research" (Cohen 111).
A different aspect of stem cell research is discussed by Dorothy C. Wertz. She analyzes the views of stem cell research from an American citizen's point of view. She begins her article by criticizing the US for being more concerned "about the fate of the embryo, which must be destroyed to derive the stem cells, than the use of cloning techniques" (Wertz 200). She explains that since adult stem cells cannot be derived for every use, we must utilized embryonic stem cells. She contrast the United States with the UK, by reporting that "the UK has permitted and funded embryo research up to 14 days, and has allowed creation of embryos specifically for research since 1990" (Wertz 201). She writes that there are three major cultural differences between the United States and the UK. The first reason being that the US is a religious nation, and deems the destruction of anything created by God (for the purpose of good or evil) to be a moral sin. Secondly, the US "has an active anti-abortion movement. Stem cell research is linked with the abortion debate" (Wertz 201). The third reason has to do with free enterprise, which makes it "difficult to forbid private companies from pursuing their own strategies, unless there is a clear and present danger to the public" (Wertz 202).
Hilary Bok relates to the cultural side of this issue by discussing "Justice, Ethnicity, and Stem-Cell Banks." In her article she identifies the problem with stem cells as that presents "limited biological access to stem-cell therapies" (Bok 118). She explains two different strategies to solve this problem, the coverage-maximizing strategy and the ancestral/ethnic representation strategy. "The advantage of the coverage-maximizing strategy is that it provides for the largest number of potential beneficiaries of HLA-matched stem-cell based treatments" (Bok 118-119). Although this strategy sounds as though it holds more potential, it, however, does not. This strategy would not provide many viable matches for the Asian American or African Americans. It would provide "matches for about 40% of white Americans, but only 7.8% of African-Americans and 3.6% of Asian-Americans" (Bok 119). She argues that the ancestral/ethnic representation strategy would be a more optimal choice because it would provide "coverage for the same proportion of people from each ancestral/ethnic group…" (Bok 119), and would also "prevent the expressive harm that would result from unequal representation" (Bok 120).
Bok, Hilary. "Justice, Ethnicity, and Stem-Cell Banks." The Lancet 364.9429 (2004): 118-122.
Cohen, Cynthia B. "Stem Cell Research in the U.S. after the President's Speech of August 2001." Kennedy Institute of Ethics Journal 14.1 (2004): 97-114.
Knoepffler, Nikolaus. "Stem Cell Research: An Ethical Evaluation of Policy Options." Kennedy Institute of Ethics Journal 14.1 (2004): 55-74.
Okarma, Thomas B. "Human Embryonic Stem Cells: A Primer on the Technology and Its Medical Applications." The Human Embryonic Stem Cell Debate: Science, Ethics, and Public Policy. Eds. Suzanne Holland, Karen Lebacqz, and Laurie Zoroth. Cambridge: The MIT P, 2001. 6-13.
"Report 5 of the Council on Scientific Affairs (A-03) Full Text: Cloning and Stem Cell Research." American Medical Association. 9 June 2003. 10 Oct 2004.
Sas, Daryl. "Reliance on Technology: Stem Cell Research and Beyond." Cutting Edge Bioethics: A Christian Exploration of Technologies and Trends. Ed. Kilner, John F., C. Christopher Hook, and Diann B. Uustal. Grand Rapids: Wm. B. Eerdmans Publishing Co., 2002. 82-89.
Shannon, Thomas A. "Human Embryonic Stem Cell Therapy." Theological Studies 62.4 (2001): 811-24.
Wertz, Dorothy C. "Embryo and Stem Cell Research: Views form the USA." Journal of Commercial Biotechnology 8.3 (2002): 200-08.
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