Ethics of stem cell research

Ethics Behind Stem Cell Research

Research into new means of curing diseases heretofore untreatable, and research into preventing conditions that damage and destroy life are all dependent upon the discovery that embryonic stem cells promise to hold the answer to many of these problems. Embryonic stem cells were isolated from inner cell masses of mouse blastocysts in the early 1980s. They are present in mammalian organs and tissue holding pluripotent embryonic stem (ES) cells present at the embryo development stage of the blastocysts. In 1998, researchers at the University of Wisconsin and a Johns Hopkins University team announced the first successful isolation and culturing of human ES cells. While donors of healthy oocytes do not donate any part of themselves or their tissues, their tissues are used to create research material. This is distinct from past ethical problems where parts of human bodies are donated. Yet donors are exposed to certain risks and derive no direct benefit from the studies. An informed consent does not minimize risks of oocyte procurement, nor does it claim existing therapy stem cell transplantation research is going to be successful (Magnus 1747).

Oocytes originally obtained specifically for human embryonic stem cell research and not for reproductive or medical purposes create an object of ethics research, as every side explores the moral issues involved for those who both perform such studies and for the donors. The National Research Council-Institute of Medicine in the United States has set guidelines that are exemplary. Even though not required, because of the special ethical situations raised by the research study, there is agreement that these guidelines should be followed.

Stem cells have the potential to save many lives through future research. But the tissues must come from aborted fetuses or live embryos. Tissue from aborted fetuses may be utilized without involving moral complicity in the abortion, but embryo-derived stem cells necessarily kill the embryo, and therefore difficult questions are raised about using human embryonic tissue to save human lives. Some say stem cell research done with spare embryos from infertility treatments, or embryos created specifically for research or therapeutic purposes are ethically acceptable and therefore federal funding should be received when these are used. "Because ES cells are capable of self-renewal and differentiation into a wide variety of cell types, the ability to grow them in renewable tissue cultures could have broad applications in research and transplantation" (Robertson 109).

Stem cell research dependant upon somatic cell nuclear transfer (SCNT) presents risks for donors and so the women donor's welfare is a concern, but in actuality, the risks faced by these healthy women are equal to the risks other clinical research subjects face. If other research were to be scrutinized as much as these are and are to be found acceptable, then stem cell research donors should be able to fulfill the same scrutiny and find equal footing. The concerns of inducing service and recruiting where women are vulnerable, as well as reimbursing donors sufficiently should be considered, controlled, and informed consent be guaranteed. (Mertes 629).

In one study where the maximal number of live births per donor was determined by cultural and social perspective, the researchers proposed three criteria to evaluate impact on consanguinity and disease incidence from artificial insemination by donor (AID), results indicated that a "strong degree of assortative mating, small population size and insufficient supply in gamete donors will lead to greater risk of consanguinity" (Wang, 1093). This risk is ever prevalent and should be considered in ethical context.

In 2005, a South Korean team conducting stem-cell research, led by Woo Suk Hwang, admitted that they obtained oocytes from junior scientists in the laboratory as well as from paid donors and that the circumstances under which the oocytes had been obtained was not truthfully recorded. The questions about fraud created a scandal. The group's stunning 2005 report about obtaining embryonic stem cells from human blastocysts created by somatic-cell nuclear transfer was retracted, as was the Science magazine report about the derivation of a stem-cell line from a cloned blastocyst. Moreover, it appears that dozens more donors and eggs were used than were reported. A committee found that Hwang had used 2061 eggs from 129 women. With the research suspended, the donated eggs were wasted, which is a betrayal of trust between scientist and subject (Hwang 1777).

The Korean scandal focused attention on the oocyte issue, creating an ethical dilemma for those concerned. Donating eggs is time consuming, uncomfortable and risky, but willing donors are the only source. When the source is doubtful of their ethical status and not fully informed about their role, there will be fewer donors. Some consider it wrong to pay donors; others think it the only fair thing to do. Donors are routinely paid $4,000 to $5,000 per cycle and in some case considerably more (Ethics S240).

Oocytes are usually developed and donated not for research, but for reproductive purposes. According to the Centers for Disease Control and Prevention, donor eggs were used in 13,183 (11.4%) of the 115,392 procedures involving assisted reproductive technology in the United States in 2002. Women in other nations receive compensation, but in other countries, such as Canada and the United Kingdom, they receive nothing, as such payments are banned and only expenses can be reimbursed. Hormone injections over a period of 7 to 10 days stimulate development of multiple ovarian follicles. Then oocytes are retrieved through the insertion of a needle through the vagina in a brief surgical procedure requiring anesthesia (Practice 1309).

The American Society for Reproductive Medicine estimates that egg donors spend "56 hours in the medical setting, undergoing interviews, counseling, and medical procedures related to the process" (Steinbrook 324). Injections are uncomfortable and have side effects. The retrieval of oocytes carries risks, such as those of anesthesia and bleeding as well as ovarian hyperstimulation syndrome (an unpredictable response to ovulation-induction therapy that may require hospitalization and produces complications such as ascites, pleural and pericardial effusions) and venous thromboembolism (Practice 1309). Some fear that women who undergo multiple cycles of hormonal stimulation may develop ovarian cancer later in life, based on data from research on animals, but not on humans. Still, research subjects in many areas of medicine knowingly accept risks to benefit others (Magnus 1748).

It is generally accepted that laboratory workers should not be egg donors, as their participation may not be considered fully voluntary. Nor is oocyte sharing, in which a woman, who is undergoing ovarian stimulation for her own reproductive purposes, donates some of her eggs to another woman or for use in research, accepted. Not only does this mix treatment with research, but few oocytes are produced this way.

While, in the United States, compensation for egg donation is frowned upon, men are systematically compensated for sperm donations, and, of course, research subjects are usually compensated when they undergo invasive procedures. It is inconsistent to compensate certain invasive procedures but not others or to allow compensation for egg donation for reproductive purposes but not for research. and, while the commercial potential of stem-cell research profits is huge, the subjects of the research have no rights, financial or otherwise, to share the benefits.

Bioethicists argue that egg donors should be compensated, and payment for donations for research is ethically acceptable (Ethics S240). "Fairness may require that they be adequately compensated. At the same time, there's a general consensus that it would be improper to offer enormous sums of money to egg donors" (Steinbock 255).

Payment for research donations was prohibited in 2005 in Massachusetts and in 2004 in California. Payments have also been banned in South Korea since Hwang's research, in which donors were paid. The National Academies recommended in its 2005 "Guidelines for Human Embryonic Stem Cell Research" that no payments be made for donating eggs, sperm, or blastocysts for research. This has been criticized by many, including John Robertson of the University of Texas School of Law at Austin, an expert on stem-cell research (Steinbock 255).