Volume 3, Issue 07 - September 2000

Ethical Dilemmas in Human Embryonic Stem Cell Research

Stem cells offer vast potential for therapeutic advancement. Yet, as with any new technology, there is good reason to pause and consider the ethical justification of this means of achieving desired ends. This article aims to report on this technology and to identify and comment on ethical issues raised by it.

Research Developments

In November of 1998, two independent teams of U.S. scientists - one at the University of Wisconsin-Madison and the other at Johns Hopkins University in Baltimore, Maryland - reported that they had successfully isolated and cultured human stem cells. Such a feat had eluded researchers for almost two decades. The Wisconsin team of researchers obtained the stem cells from surplus embryos donated by couples who had undergone in vitro fertilization (IVF) and the Johns Hopkins team obtained the stem cells from aborted fetal tissue. In the process of isolating the stem cells, the surplus embryos were destroyed.¹ 

Thus, with the advent of the microscopic manipulation of embryonic human life, comes additional macroscopic discussions regarding when human life begins with all its inalienable rights and whether a utilitarian ethic, where the good of the many outweighs the good of the few, will and should rule the day.

Stem Cells

Stem cells are tiny bits of pluripotent protoplasm capable of developing into all 210 types of tissue found in the human body. Unlike most other cells which are naturally programmed for a specific purpose (e.g., red blood cells that carry oxygen to other cells), stem cells are not yet specialized or differentiated.

There are many different types of stem cells in the human body. For example, in March 1999, researchers in Pasadena, California isolated stem cells from nerve tissue for the first time ever. These cells, unlike human embryonic stem cells (hES), are differentiated and can usually only develop into new nerve cells. However, recent research seems to indicate that these more differentiated neural stem cells can, indeed, assume the function of other types stem cells, such as those which produce blood.

hES, on the other hand, are the precursors to all adult stem cells, forming the inner cell mass of the blastocyst, an early stage of the human embryo. The reason that stem cells are of particular interest to researchers is because they are "immortal" (i.e., sustainable in culture and reproducing themselves indefinitely).

Thus, embryonic stem cells create the potential for significant advances not only in Alzheimer's or Parkinson's diseases or spinal cord injury, but also in organ and tissue transplantation, pharmaceutical testing, embryology, cancer, stroke, diabetes, cardiovascular failure, and hip/joint degeneration research. In addition, stem cells could be used for introducing genes to correct inherited disorders.

The Moral Issues

Notwithstanding these tremendous benefits, there are reasons to worry about the nature of this research and the development of approaches that result in the destruction of human embryos.

Religious and cultural values traditionally maintain a high profile in complex ethical discussions - and this case is no exception. For example, Catholics and Protestants maintain that a new life begins at the moment of fertilization. Thus, the human embryo is seen as a human being - with the entire blueprint necessary to build a human being, capable, with the appropriate set of life-nurturing circumstances, of doing further embryological research of its own one day!

Supported by Scriptural passages, the belief is that the unborn are human beings who are created, known, and uniquely valued by God. All creation exists for God's own pleasure and purpose, not ours (Col.1:16). Though we are co-creators with God, we are not owners of God's creation. We are seen as stewards of God's creation. Thus, there is a cost to the benefits of using techniques that result in the loss of human embryos that many would argue is too high to pay.

Government Policy

So how are these issues being handled in pluralistic societies where governments, among others, are left to try and grapple with the various competing values?

In January 2000, the U.S. Department of Health and Human Services (DHHS) determined that an existing Congressional ban on using federal funds to support the creation or destruction of human embryos, in place since 1994, did not apply to research on human embryonic stem cells because the stem cells themselves are not the equivalent of embryos.² In response to the DHHS, Dr. Harold Varmus, the Director of the National Institutes of Health (NIH), proscribed all federally-funded researchers from doing hES research until the opinions of Congress and the public had been taken into account.

A U.S. Senate committee proceeded to hear scientific and ethical arguments for and against government funding of hES research. Among those who testified were Christopher Reeve, a famous actor who was paralyzed following a horse-riding accident in May 1995, and other individuals who could benefit from hES research. Some researchers giving testimony distinguished between using adult stem cells and hES. They argued that use of the adult stem cells was a more ethically acceptable alternative to hES. However other scientists sided with Reeve by arguing that all research avenues should remain open if positive therapeutic advancement is to be achieved.

In mid-August, the U.K.'s Blair administration agreed in principle to accept a recommendation that the cloning of early human embryo cells should be allowed for research purposes only. "As a matter of conscience" however, the government will conduct a free vote this fall in parliament.³ If the legislation is passed, Britain would be at the forefront of a global discussion on the moral implications of creating human embryos and then destroying them when experimentation is completed.

On August 23, 2000, following the Blair administration's lead, U.S. President Bill Clinton announced new federal guidelines and the availability of funding through the NIH for scientists to conduct research on stem cells taken from frozen human embryos in fertility clinics. Accordingly, privately funded researchers will harvest the hES, destroying the embryos in the process, and pass them along to federally supported scientists for their research. Federal funds cannot be used to destroy the embryos.⁴

Clinton noted that this new research initiative offers "potentially staggering benefits" for advances in health care worldwide. Many in the U.S. would agree with Clinton; however, many more (particularly anti-abortion advocates) question the necessity of such measures and are not satisfied that other alternatives have not been adequately explored to date. In addition, setting such a research precedent seems rather disingenuous. As long as a private lab will destroy the embryos to harvest the hES, the federally-funded researchers will ostensibly not be morally culpable for using them. Such hES developments in the U.K. and the U.S. carry significant weight in influencing Canada's therapeutic research and reproductive policies' development.

Conclusion

Many proponents of hES maintain that it is morally wrong to protect the lives of a few unborn human beings when so much potential healing benefit is at stake for so many more people who suffer from fatal or debilitating diseases. However, from a Christian and Kantian point of view, we are not free to justify good ends with unethical means (Deut.27:25). We are reminded of the medical experiments in Nazi Germany where doing evil in the name of science became morally acceptable. We ought never to sacrifice one class of human beings, the vulnerable or weak among us for the benefit of others (those who suffer from serious illness).

The U.S. National Bioethics Advisory Commission (NBAC) has identified various alternatives to hES research. Stem cells can be extracted from adult tissues, bone marrow, or umbilical cord blood. Even if hES promises faster medical advances, federal funds ought to be designated for alternative research methods which do not involve the destruction of the human embryo.⁵ 

Canada is poised for challenging debates regarding hES research within her own borders. The exploration of micro forms of life within macro forms of pluralistic norms has already begun.

References:

1. http://www.bioethix.org

2. "UK Decision Due on Human Cloning" BBC News Online

4. http://stemcells.nih.gov/policy/2009guidelines.htm

In Memory

On September 9, 2000, a friend of the Network, Sandra (Sandy) McKinnon of Edmonton, passed away peacefully at the age of 45 after a courageous battle with cancer. She will be lovingly remembered by her family and her many dear friends and colleagues in the palliative and health care communities. Sandy was the manager of the Grey Nuns Palliative Care Unit and spent her nursing career in the oncology and palliative care fields. She touched and inspired many lives with her kind and generous spirit and will be missed.

Bioethics Distance Education

PHEN is pleased to announce a distance education course in Introductory Bioethics to run from February 5 to May 18, 2001.

This course will be taken remotely and cover 12 modules over a 14 week period. Instruction will be delivered by several prominent North American bioethicists and the course will be administered by the Network staff. To conclude the course, participants will have the opportunity to attend an in-person session/graduation where two final topics will be presented. This session will coincide with the PHEN annual conference and general meeting. The course is to be accredited through Grant MacEwan College.

Registration will be limited to 25 people at a fee of $500. A brochure with further information, including detailed course curriculum and registration procedures, will be sent out in early October.

Announcements

• The next deadline for applications to PHEN's User Fund to support members of the Network in their pursuit of educational opportunities is November 15, 2000. Applications can be found on the PHEN website and from the Northern Alberta office.

PHEN Staff Notes:

• Melissa Trono, who has served in the capacity of Programme Officer with PHEN's Southern Alberta office, has completed her contract and will be moving on to other endeavours. Melissa was involved with various projects including the Values Framework research program. PHEN thanks Melissa for her contribution to the Network and wishes her well with her future life projects.

Views offered in this article are those of the author and do not necessarily reflect the position of the Provincial Health Ethics Network.