Ethical inconsistencies in embryonic stem cell research regulation

Limitations of Stem Cell Research

The primary objection to stem cell research in the United States is based on the belief that commonly held social, moral, and ethical boundaries will be breached in the effort to ensure adequate supplies of embryonic stem cells (Hoffman, et al., 2004; Reeves, 2001) Because of the potential medical and economic implications of stem cell research, executive level governmental decisions have been made regarding acceptable limits for stem cell research (Hoffman, et al., 2004; Reeves, 2001) These limits have changed as the national executive leadership has changed (Hoffman, et al., 2004; Reeves, 2001) Presidents have issued Executive Orders regarding stem cell research that reflect their personal beliefs and the beliefs expressed by voices dominating the American press at any given time (Hoffman, et al., 2004; Reeves, 2001) Representation of stem cell researchers and those who potentially would benefit from stem cell research have been less well reflected in the national debate about how to provide oversight and how to legislate the issue of stem cell research (Hoffman, et al., 2004; Reeves, 2001) What is most often disregarded in the debate is that embryonic stem cells can be harvested from embryos produced in assisted reproductive technology (ART) laboratories to provide viable embryos for women experiencing fertility problems (Robinson, 2007) The debate about whether embryos should be permitted to be developed in laboratories for eventual implantation in infertile women does not attract the attention of the media or particular interest groups to the same degree that stem cell research, taken as a singular issue, does -- but perhaps it should (Robinson, 2007) Given the inconsistencies in the arguments presented by different stakeholder groups with regard to regulation of stem cell research, it is reasonable to expect any limitations placed on stem cell research reflect the actual praxis and not the imagination or rhetoric of its opponents (Robinson, 2007) Embryonic stem cell research that uses stem cells derived from undifferentiated mass of cells called blastocysts -- pre-embryos less than 14 days old -- for in-vitro fertilization shall be considered a viable source of stem cells for medical research to prevent or cure human diseases and disorders (Robinson, 2007)

Part Two -- Argument

The public treats stem cell research as a special ethical and moral case while largely ignoring parallel ethical and moral issues related to the treatment and use of embryos in the practice of artificial human reproduction (Robinson, 2007) Ethical and legal implications exist for extracting new stem cells from embryos, from research performed on descendents of stem cells, from the problem of surplus embryos in ART clinics, and for developing methods of obtaining embryonic stem cells with fewer moral and ethical concerns (Robinson, 2007) The current emphasis on restricting embryonic stem cell research creates a disjoint between press coverage and protests related to other ethically challenging practices that is unduly constraining promising science (Robinson, 2007)

The approximate number of in-vetro embryos that died, were killed, and were eventually discarded by fertility clinics each year runs in the hundreds of thousands (Robinson, 2007) Despite that fact that members of the pro-life movement consider embryos to be human beings, pro-life groups seem focused on the few dozen or so embryos that have been killed through stem cell extraction while inexplicably ignoring the masses of embryos destroyed by ART clinics (Robinson, 2007) Controversy over stem cell research is in part a function of the many different ways that human life can be defined at the cellular level (Robinson, 2007)

Stem cells are a distinct form of human life that contains human DNA, and can exist for a time outside of the human body under very particular and customized conditions (Hoffman, et al., 2004; Reeves, 2001) Three types of stem cells exist: Embryonic, adult, and pluripotent (Hoffman, et al., 2004; Reeves, 2001) Embryonic stem cells can be coaxed into further development that results in the formation of some or all of the human body's 220 distinct cell types (Hoffman, et al., 2004; Reeves, 2001) Adult stem cells are not as useful from a research perspective since they have begun to specialize to the degree that they can only develop into a very few cell types (Hoffman, et al., 2004; Reeves, 2001) Specially treated cells called pluripotent stem cells have the potential to behave in ways that are similar to embryonic stem cells (Hoffman, et al., 2004; Reeves, 2001)

Religious groups and social conservatives who hold pro-life beliefs are the main opponents to stem cell research (Hoffman, et al., 2004; Reeves, 2001) Their opposition is based primarily on a belief that the pre-embryonic cells from which embryonic stem cells are harvested is at that point already a human being -- an individual person (Hoffman, et al., 2004; Reeves, 2001) Their logic dictates that when cells are extracted from the pre-embryo, that human being -- that person -- is murdered (Hoffman, et al., 2004; Reeves, 2001) This argument represents one of several from the range of positions that people may assume when considering stem cell research (Hoffman, et al., 2004; Reeves, 2001)

The embryonic stem cell debate tends to fall into several camps: (1) Those who object to any research or practice that alters the natural occurrence of human fertility; (2) those who accept practices and research that address problems with human fertility, but exclude abortion; (3) those who accept practices and research that address problems with human fertility and stem cell research to address human diseases and disorders, but exclude abortion as a source of stem cells; and (4) those who accept practices and research that address problems with human fertility and stem cell research to address human diseases and disorders, but hold that abortion is a separate issue and should be considered separately (Hoffman, et al., 2004; Reeves, 2001) Many stem cells used in research derive from discarded or excess embryos stored at ART clinics, but stem cells are also removed from aborted fetuses from patients who previously and independently decided to terminate pregnancy (Hoffman, et al., 2004; Reeves, 2001)

Those individuals who would theoretically be placed in the first category -- those who object to any research or practice that alters the natural occurrence of human fertility -- present the most complex configuration of beliefs because of the apparent omissions in their logic or their inattention to contradiction (Hoffman, et al., 2004; Reeves, 2001) Few people in this group give evidence of objecting to practices and research that involves artificial fertilization to solve fertility issues for couples (Hoffman, et al., 2004; Reeves, 2001) With most of the opposition to stem cell research coming from pro-lifers, objections seem to be misplaced since practically no protests occur at ART clinics where masses of embryos are destroyed or left to die when they are not used for fertilization (Hoffman, et al., 2004; Reeves, 2001)

Part Four -- Response to Counter-Thesis

Arguments for or against stem cell research largely ignore parallel ethical and moral issues in the field of artificial reproductive technology where in-vitro fertilization techniques are used ("Stem Cell Breakthrough," 2009). If decisions about imposing limitations on stem cell research are going to be based on the treatment and outcomes of pre-embryos, then similar limitations should apply to in-vitro fertilization and the decisions used in ART clinics should mirror those used in stem cell research ("Stem Cell Breakthrough," 2009).

The provision of embryonic stem cells for use in stem cell research does depend on a viable supply -- a need that can be addressed by harvesting stem cells from embryos that are and will continue to be produced in laboratories by those who provide fertility services to women and couples, and by the provision of cells through parthenogenesis ("Stem Cell Breakthrough," 2009. As a result, it can be argued that stem cell research, in and of itself, does not result in an increased rate of abortions or deliberate embryo deaths in the United States -- or are in any way different from what occurs at ART clinics ("Stem Cell Breakthrough," 2009). Both of these points indicate that the limitations of embryonic and parthenogenetic stem cell research must be more particular and less general ("Stem Cell Breakthrough," 2009).

The dialogue around the issue of ethics in stem cell research must expand to address the many new sources and techniques for utilizing this promising line of research ("Stem Cell Breakthrough," 2009). Stem cell research issue is clouded by fears about embryonic cloning and the production of embryos for fertility, which many people object to, if not in principle, then in fact (Holden, 2009; "NIH Final Guidelines," 2000; Vogel, 2008). Further, the general public -- and pro-life leaders and pro-choice leaders -- must continue to educate themselves with the changes in the field so that they can fairly and accurately represent the issues (Holden, 2009; "NIH Final Guidelines," 2000; Vogel, 2008).

In 2006, the state of Missouri passed an amendment to the constitution known as the Missouri Stem Cell Research and Cures Initiative ("2006 Ballot Measure," 2005). Essentially, Missouri's legislation prohibits reproductive cloning and permits therapeutic cloning -- the latter enabling human embryonic stem cell research ("2006 Ballot Measure," 2005). The forms of "early stem cell research" permitted by the constitutional amendment are those extracted from pre-embryos by Somatic Cell Nuclear Transfer (SCNT) or from surplus embryos that remain after in-vitro fertilization procedures have been completed for patients at fertility clinics ("2006 Ballot Measure," 2005). To date, this amendment has presented the clearest legislation with language differentiating both the purposes of stem cell research and the sources of the stem cells for research ("2006 Ballot Measure," 2005). The limitations imposed by the state of Missouri on stem cell research include restricting the stem cell research to surplus embryos from ART clinics ("2006 Ballot Measure," 2005). Further, of those cells so obtained, only blastocysts less than 14 days old to preclude using embryos in which cell differentiation has begun and the development of a neural tube (which will become the brain and spinal cord) is apparent ("2006 Ballot Measure," 2005). The constructs resulting in this legislative language bring the issue of the treatment of pre-embryos in ART clinics together with the issue of stem cell sourcing ("2006 Ballot Measure," 2005). In doing so, the pertinent language and limitations on the two practices are aligned and consistent (Holden, 2009; "NIH Final Guidelines," 2000; Vogel, 2008).