Human embryonic stem cell research

Embryonic Stem Cell Research

The use of human embryonic stem cells in scientific research has held great promise for some but this research has also produced powerful objections from others. Indeed, there is a profound if sometimes vehemently expressed moral argument that emerges from embryonic stem cell research. The principal objections to the use of these stem cells has come from evangelicals, conservative Christians and others who equate using embryonic stem cells with killing a potential human. Those who acknowledge the potential benefits that may be derived from research using embryonic stem cells tend to people who are politically progressive, college educated individuals, and those in the field of science and those searching for treatments and/or cures for Alzheimer's, cancer, Parkinson's disease, spinal cord injuries, among other serious health issues. This paper will examine both sides of the issue, all relevant arguments, and will attempt an unbiased review of what the current research into embryonic stem cell research has produced or promises to produce based on existing data and reports.

What are Embryonic Stem Cells?

"Among stem cells, human embryonic stem (hE's) cells are considered to have the greatest potential for biomedical and clinical research," writes professor Joanna Hanley in the British Journal of Haematology. The reason hE's cells have so much potentiality, Hanley and colleagues explain, is that they are capable of "unlimited self-renewal" and they have the capacity to "differentiate into all somatic cell types" in the human body (Hanley, 2010, p. 16). Hence, when doctors and scientists are searching for appropriate treatments for "debilitating injuries" and diseases -- or "age related degenerative disorders" -- hE's cells can serve as a source of tissues and cells that are unlimited in their flexibility (Hanley, 16).

An article in the Journal of Experimental Therapeutics and Oncology explains that embryonic stem cells can serve as a "variety of repair system for the body" due to the fact that they can (at least theoretically) divide in unlimited fashion. Hence they can be utilized to generate "specific cells types" to treat, say, a muscle cell in one instance, a red blood cell or a brain cell in other instances (Saxena, 2010, p. 224).

The American Presidency Project explains that embryonic stem cells are retrieved from the "inner cell mass of a human embryo" and those cells have the potential to "develop into all or nearly all of the tissues in the body… [and this is called] pluripotentiality" (Woolley, et al., 2011). And in order to create an embryonic stem cell for research, a "stem cell line" has to be created from the "inner mass of a week-old embryo… [and as a rule] embryonic stem cells are derived from excess embryos created in the course of infertility treatment" (Woolley, p. 2). It is a fact that many excess embryos are produced when participants using in vitro fertility treatment do not use all the embryos that are created. Hence, "many individuals" donate those unused embryos to science for continuing research (Woolley, p. 2).

Opposition to the use of Embryonic Stem Cells for Research

The original policy collision of ideas and theories vis-a-vis embryonic stem cell research reached a zenith in the first year of the presidency of George W. Bush. It should be noted that the conservative Christian community, including in particular those observing the evangelical faith, were among the strongest constituencies to support Bush's narrow and controversial win over Al Gore in the 2000 presidential election. This constituency is generally known as "pro life" (against abortions), and this voting bloc has expressed serious moral qualms about using human embryonic stem cells in research, notwithstanding the potential health benefits therein.

Bush campaigned against legal abortions and he took positions critical of embryonic stem cell research, as well, which assured him votes from the conservative faith community. He did not disappoint that constituency once he was in office.

Indeed, it was no surprise that in August 2001, in Bush's first year in office, he indicated (though a presidential executive order) that the only stem cells that could be funded by the federal government for research during his administration were those that had already been harvested. According to The American Presidency Project (Woolley, 2011) at the time of the Bush announcement on the restriction of research there were "60 existing stem cell lines that have already been derived." But the acquisition of additional human embryos would not be allowed under the president's executive order.

Bush's statement embraced the idea that to fund additional research -- beyond the 60 genetically diverse stem cell lines that already were available -- would entail "…crossing a fundamental moral line by providing taxpayer funding that would sanction or encourage further destruction of human embryos that have at least the potential for life" (Woolley, p. 1). So basically on August 9, 2001, Bush was saying that stem cells that were "derived from an embryo that was created for reproductive purposes and was no longer needed" were okay to be used where federal funding was in place (NIH, 2012, p. 1).

While Bush had the support of the conservative Christian movement -- a small segment of the American population -- a majority of Americans were in favor of continuing research into the use of embryonic stem cells. Even some high-profile conservative Republicans like then Senate Majority Leader Bill Frist (a heart surgeon) were in favor of federal funding for the continued research; also former first lady Nancy Reagan (whose husband Ronald Reagan suffered from Alzheimer's) lobbied for addition embryonic stem cell research to be allowed.

And so, in 2006 the U.S. Congress authored and passed a bill that would in effect discard Bush's executive order; but the president vetoed the legislation, saying that he would not "…support the taking of innocent human life in the hope of finding medical benefits for others" (Babington, 2006). Bush held a White House ceremony in order to receive the maximum attention for his veto, and he brought children into the White House that had been "adopted" from frozen embryos. Every child on the stage, Bush explained, "…began his or her life as a frozen embryo that was created for in vitro fertilization but remained unused after the fertility treatments were complete… These boys and girls are not spare parts," he asserted (Babington, p. 1).

An attempt to override Bush's veto fell short. U.S. Senator Arlen Specter noted that there were an estimated 400,000 frozen embryos available for stem cell research, many of those would never be used. Bush's argument was that if the veto had been successful, and the bill had become law, then "…American taxpayers would for the first time in our history be compelled to fund the deliberate destruction of human embryos" (Babington, p. 2).

Meanwhile Dr. Stephen Napier of the National Catholics Bioethics Center in Philadelphia contends that "battle lines" in the ongoing debate about using embryonic stem cells in research have been drawn around "metaphysical questions" like, "What is an embryo?" And "Am I the same thing as my embryo?" (Napier, 2009, p. 496). While these questions do have value within the embryonic stem cell milieu, Napier explains that there are regulatory issues linked to the embryonic stem cell research that are being overlooked. He points to the National Research Act (NRA) (passed in 1974) that gave the authority for a commission to be established that would clearly lay out the ethical considerations that should guide the conduct of "biomedical and behavioral research with human subjects" (Napier, 497).

The genesis for the NRA was the disastrously unethical "Tuskegee Syphilis experiment" that was carried out on African-American men (1932-1972). The commission produced the Belmont Report (published in the Federal Resister in 1979) that offered three main ethical principles: a) the principle of "respect for persons"; b) the principle of "beneficence"; and c) the principle of "justice" (Napier, 497). Moreover, the Belmont Report asserted that in order to respect people there are two "ethical convictions": a) individuals should be treated as "autonomous agents"; and b) people who have "diminished autonomy are entitled to protection" (Napier, 497).

Napier's point comes to fruition when he notes that human subjects with "diminished autonomy" -- subjects that are quite vulnerable -- include human embryos (499). In order to justify his assertion that human embryos should qualify under the tenets of the NRA, Napier believes that his "pre-theoretical intuitions suggest that the human embryo is simply a young human being" and hence, should be protected from intrusions that are part of stem cell research (500). Napier goes on to hypothesize that given the National Research Act's statutes, then: a) if a subject is a member of a vulnerable population, "he/she should be protected from research harms"; and b) "therefore, the human embryo should be protected from ESCR" (embryonic stem cell research) (501).

Professor Insoo Hyun boils the main arguments against the use of embryonic stem cell down to two positions. One, he posits that since the beginning of embryonic stem cell research (ESCr), the movement has "…tapped into underlying dystopian fears about human cloning, the commodification of human biological material, the missing of human and animal species, and the hubristic quest for regenerative immortality" (Hyun, 2010, p. 71). And while the concerns citizens have about science and its "implications" are not new, the hE's cell research -- and all its implications -- has provided the chance for these above-mentioned concerns to "coalesce around a new, scientific field (Hyun, 71).

Number two on Hyun's synthesis of the main objections to embryonic stem cell research: those in opposition to the research believe "…for religious or other personal reasons that all preimplantation embryos have a moral standing equal to all living persons" regardless of whether those embryos are in a woman's body or in a dish in a fertility clinic (71). Given this point-of-view, people who object to the research also believe that destroying preimplantational embryos is "akin to murder and therefore never acceptable, no matter how noble the aims of the research may be" (Hyun, 71).

Supportive Positions Vis-a-vis Use of Embryonic Stem Cells for Research

"…Treating a patient who suffers from type I diabetes by replacing his destroyed insulin-producing cells with normal insulin-producing cells could be better than the blood-sugar monitoring and the insulin injections that are essential parts of the lives of diabetics… [and] perhaps liver cells produced from stem cells can be injected into patients with severely diseased livers so that satisfactory liver function can be restored. Because there are good reasons for trying to cure diseases and because human embryonic stem cell research promises markedly better treatments of disease than are currently available, the case for pursuing human embryonic stem cell research seems overwhelming…." (Marquis, 2007, p. 191).

Meanwhile, Jeff McMahan writes in the journal Metaphilosophy that the main objection to the use of human embryos is because they are viewed as "…essentially beings of the same sort that you and I are" and hence, using embryonic stem cells for research is "killing" humans (McMahan, 2007, p. 170). McMahan, a philosophy professor at Rutgers University, points out that those who object to the use of embryonic stem cell research believe it is "seriously morally objectionable" to kill them or to allow them to die -- "or to create them solely for certain instrumental purposes" (170).

But when the announcement was made in August, 2006, that researchers had found a way to "…harvest embryonic stem cells from embryos created for reproductive purposes" without destroying them -- a unique way in which the embryo would remain alive and could even be implanted into a woman -- McMahan figured this revelation would quiet the opponents. He believed that those who were morally opposed could now see that the medical benefits of the research would far outweigh concerns about the use of human embryos.

However, McMahan's hopes were dashed when it became apparent that the reaction from opponents of embryonic stem cell research simply restated their earlier opposition. McMahan writes that this response was "baffling" but on the other hand the author understands that the real therapeutic promise of the research entails the "deliberate destruction of embryos" (170). A great deal of the hope for health solutions that could be derived from this research lies in the prospect of "our being able to clone an embryo from a particular individual, derive stem cells from it, and use those stem cells to grow tissue" -- or even grow an organ that would match genetically to that organ that needs replacement (McMahan, 171).

The author dips into some cryptic narrative when he explains that notwithstanding the possibility that a "…surviving embryo from which stem cells had been obtained would not have to be killed…it could instead be indefinitely frozen," those who believe it is morally wrong would not support the above-mentioned process. Among those that would not support this policy -- those that believe "…embryos are innocent human beings" and even using them solely as a way to help others is wrong -- is former president George W. Bush. Bush claimed to believe this, McMahan explains, "…perhaps after conferring with the same Higher Power whom he claimed to have consulted about invading Iraq and who advised him to go ahead" (171).

McMahan wonders sarcastically if in fact that "Higher Power" is really "…a group of voters known as the 'religious right'" (171). That having been said, McMahan returns to a more serious aspect of the issue, pointing out two "false" assumptions: a) the embryo is the "earliest stage in the existence of someone like you or me"; and b) we have the "same moral status at all times at which we exist… [and] we mattered just as much when we were embryos as we do now" (171). McMahan correctly points out that the American society has long since accepted the notion of assisted conception "even though it involves the creation of more embryos than will be implanted" (172). Moreover, it has been socially acceptable to create several embryos in vitro, and either kill them, let them die, or "more commonly," freeze them "indefinitely" so while they exist, they are neither alive nor dead.

The author's argument based on the paragraph above is that if it is morally wrong to "kill it for its stem cells" than it should also be morally wrong to "deliberately create embryos" knowing full well that "many of them will never be implanted" (172). Moving on to other points of objection that opponents employ in their arguments, McMahan believes it is truly splitting moral hairs to argue that freezing an embryo (which will likely never be used) is morally more appropriate than letting it die. "…The vast majority of embryos that are frozen cannot, though for contingent reasons, be enabled to develop into adult persons and thus will have to be allowed to die at some point" (174).

Freezing embryos just postpones their deaths "…without extending their lives," the author argues (174), and in the process freezing them simply shifts the responsibility for allowing them to die to other folks at a later date. At this point in his narrative, the philosophy professor then brings Bush into the discussion again. It is within the aforementioned point about postponing the ultimate death of myriad frozen embryos that McMahan views the Bush veto announcement as "…deceptive and manipulative posturing" (174). When Bush surrounded himself with babies he claims were developed from "…supernumerary embryos" it was basically a political stunt, McMahan argues, because even with the most "aggressive harvesting of embryonic stem cells that scientists could possibly desire," those embryos left over and frozen "would still greatly exceed any possible level of demand" (175).

There was no sarcasm or cryptic attacks on former president Bush noted in the decisions of eight states to go ahead with their own embryonic stem cell research. According to the National Conference of State Legislatures (NCSL) (January, 2008) California, New Jersey, Connecticut, Illinois, Iowa, Maryland, Massachusetts, and New York, all established their own research facilities and regulations prior to President Barack Obama's executive order in 2009 that overturned the Bush policy and opened the door for this research using federal resources (NCSL).

In California, the NCSL reports, voters passed Proposition 71 that funded adult and embryonic stem cell research; the proposition provided $3 billion in bonds to be used beginning in 2005 (but never more than $350 per year). When a lawsuit was launched to block the voter-backed proposition, which slowed the process of setting up laboratories and hiring staff for the California institute of Regenerative Medicine, then governor Arnold Schwarzenegger "loaned the institute $150 million in August, 2006," thus California began its own research.

Also in 2006, the Maryland legislature created the Maryland Stem Cell Research Fund, providing grants for embryonic stem cell research; $15 million was awarded to the fund, the NCSL explained. In New York State, legislators set aside $100 million for The Empire State Stem Cell Trust in order to create an active research facility for the purpose of researching the applications of embryonic stem cell research (NCSL).

Less than three months after taking office, President Obama issued an executive order that removed the restrictions that had been placed on the use of federal funds for embryonic stem cell research. "The purpose of this order," Obama wrote, "is to remove…limitations on scientific inquiry, to expand NIH support for the exploration of human stem cell research, and in so doing to enhance the contribution of America's scientists to important new discoveries and new therapies for the benefit of human kind."

Shortly after Obama's executive order, a Federal District Court placed a preliminary injunction on federal funding for Embryonic Stem Cells, citing the Dickey-Wicker legislation passed by the U.S. Congress, which prevented the destruction of a human embryo during any research project (Harvard Law Review, 2011). After several months when no federal funds were allowed to be spent on embryonic stem cell research, the D.C. Circuit Court "vacated the preliminary injunction," basing the overturn of the injunction on the fact that the Dickey-Wicker's definition of research is "flexible" and open to "more than one possible reading" vis-a-vis the concept of research (Harvard Law Review).

Seeing the Embryonic Stem Cell Research From Both Sides of the Issue

In the Stanford Encyclopedia of Philosophy (SEP), the writer explains that the "potential therapeutic benefits" of human embryo stem cell (HESC) research "provide strong grounds in favor of the research." From a "strictly consequentialist perspective," it is "almost certainly the case that the potential health benefits…outweigh the loss of embryos involved" (SEP). It is also clear, the SEP continues, that the benefits of this research can outweigh "…whatever suffering results from that loss [of embryonic stem cells] for persons who want to protect embryos." (Consequentialism is related to utilitarianism in that an act is judged to be moral based on the consequences of that act.)