Stem Cell Research -- Ethical

Stem Cell Research -- Ethical Issues

The positive, progressive view of stem cell research raises the promise of one day helping to heal individuals with diseases like Parkinson's, Alzheimer's, spinal injuries, cancer, among other health issues and serious medical disorders. One of the controversial aspects of stem cell research relates to whether or not human embryos should be destroyed in order to conduct deep research into the potentiality of embryonic stem cells. This moral issue, along with other ethical questions, and updates on recent stem cell advances, will be addressed in this paper.

What are Embryonic Stem Cells?

Basically, according to the National Institutes of Health, stem cells are: a) "capable of diving and renewing themselves for long periods"; b) they are not specialized; and c) they are capable of giving rise to "specialized cell types" (NIH.gov). The wonder of stem cells that that they can proliferate and from a very few in the laboratory they can produce "millions of cells," the NIH explains. Moreover, scientists know that embryonic stem cells -- derived for the most part from embryos that develop from eggs that have been fertilized in vitro, but not derived from eggs fertilized in a woman's body -- will proliferate for a year or more. The stunningly adaptive power of embryonic stem cells is that they can "differentiate spontaneously to form "muscle cells, nerve cells, and many other cell types" (NIH, p. 2).

In order to expand the utility of embryonic stem cells, scientists are learning how undifferentiated stem cells can become the differentiated cells that will form tissues and organs. Induced pluripotent stem cells (iPSCs) are adult cells that have been "genetically reprogrammed to an embryonic stem cell-like state by being forced to express genes and factors important for maintaining the defining properties of embryonic stem cells" (NIH, p. 3). There is much more research to be conducted prior to science fully understanding iPSCs, but already, the NIH information pages reveal, iPSCs are useful tools "for drug development and modeling of diseases" along with possible application in transplantation medicine" (NIH, p. 3).

With additional research, scientists hope to use pluripotent stem cells to actually reprogram cells to repair tissues in the human body that have been damaged -- including heart tissues. In fact, when cardiovascular disease deprives the heart tissues of oxygen -- killing cardiac muscle cells -- this can trigger a "cascade of detrimental events…leading to heart failure and eventual death" (NIH, p. 4). However, the use of embryonic stem cells to repair the cardiac condition mentioned in the sentence above is an ongoing aspect of stem cell research. Some small studies have already been carried out in which stem cells are "injected into the circulation or directly into the injured heart tissue," and in several cases there appears to have been improved cardiac functionality, albeit much more research needs to be conducted before this procedure is considered workable (NIH, p. 3).

Moreover, stem cells offer the possibility of a "renewable source of replacement cells and tissues that could treat Alzheimer's diseases, stroke, burns, diabetes, spinal cord injury, osteoarthritis and rheumatoid arthritis (NIH, p. 3).

The Moral Issues -- the Controversies

Richard Doerflinger writes in the Journal of Law, Medicine & Ethics that a human embryo is in fact a human being albeit that human is only in its first week of development. The embryo is one part of what Doerflinger calls "the continuum of human development that stretches from that first formation of a unique organism…" to the end of a person's life (Doerflinger, 2010, p. 212). It should be noted that Doerflinger is heavily involved in the "pro-life" activities as an associate director in the U.S. Conference of Catholic Bishops; hence his view of an embryo is from the pro-life anti-abortion milieu.

Doerflinger insists that while many researchers and scholars are "…dazzled by the alleged potential of research that requires destroying embryos" there is a dramatic irony associated with embryonic stem cell research. Just at the time when science has reached a point of sophistication to be able to demonstrate the "…wonderful complexity and organization of the embryo," Doerflinger writes (213), and the "incredible continuity of the human being through all developmental landmarks," society is being "driven" by a desire for better healthcare and workable strategies for curing previous incurable diseases -- to "insist that membership in the species is simply not enough to warrant our respect." Clearly the pro-life Doerflinger believes that using embryos in stem cell research suggests that society ignores the human potentiality of embryos and hence embryos count "…for little nothing, and they become non-persons" (216).

In his conclusion (218) Doerflinger uses the analogy of an addicted gambler to make his point against the use of embryonic stem cells. He asserts that the passion scientists and policy makers exhibit to "justify stem cell research by demonstrating its benefits" is equally as obsessive as "…the conviction of the gambling addict that if he makes just one more all-or-nothing bet," he can "recoup all of his losses and come out the winner" (218). In Doerflinger's view, the current stem cell research is not "the Holy Grain" for regenerative medicine (218).

On the other side of the issue is professor Insoo Hyun of the Department of Bioethics at Case Western Reserve University in Cleveland Ohio. Hyun insists, "…it is simply false to claim that all early-stage embryos have the potential for complete human life" (Hyun, 2010, p. 71). It is false because many fertility clinic embryos are "…of poor quality and therefore not capable of producing a pregnancy" albeit they may yield usable stem cells (Hyun, 71).

The author backs up his assertion by pointing to the math vis-a-vis the number of embryos created through intercourse -- 75% to 80% of those embryos -- that "fail to implant and are naturally lost" due in many cases to certain genetic abnormalities (71). Hyun believes the ethical controversies surrounding embryonic stem cell research goes back to public "unease" regarding the "potential negative impacts of science on society" (71). The author refers to the "dystopian fears" relating to human cloning, the "commodification of human biological material, the mixing of human and animal species," and the "hubristic quest for regenerative immortality" (71).

In other words, existing worries vis-a-vis science trumping morality had the perfect foil in stem cell research -- the ideal research to "coalesce around…" for the pro-life community (Hyun, 71). In fact the main "driving force" behind ethical questions regarding stem cell research has been the pro-life ideology, Hyun continues. The pro-life opposition to embryonic stem cell research believe "for religious reasons…that all preimplantation embryos have a moral standing equal to all living persons," Hyun asserts (71). And conservative Christians and other pro-life individuals believe that regardless of whether stem cells are in a "fertility clinic dish or in a woman's body," they have a moral standing the same as a perfectly healthy child or a 40-year-old minister or any human being, for that matter. Hence, destroying preimplantation embryos during research -- in the view of those opposed to this research -- is "akin to murder" (Hyun, 71).

Meanwhile two recent developments have helped to cool down much of the heated debate over human embryonic stem cells, Hyun explains. One development is the "advent of human induced pluripotent stem cells (iPS)," genetically engineered dermal fibroblasts that behave just like human embryonic stem cells (hE's)" (72). The second development was the election of Barack Obama -- a "far friendlier" administration when it comes to stem cell research than the George W. Bush Administration was (72).

The Politics that Stalled Stem Cell Research

On the subject of Bush and his policies -- he gave an executive order on August 9, 2011, that federal funds could be used only for those embryonic stem cells that existed on that date, putting a huge damper on progress into this vital research -- the former president was clearly courting the conservative Christian vote when he ran for office in 2000, and his election was paying dividends to that constituency (Hurlbut, 2006, p. 819). The New York Times editorialized in 2005 that Bush's actions are based on "…strong religious beliefs on the part of some conservative Christians, and presumably the president himself" (Hurlbut, 820). By using the word "presumably," the Times subtly raised the point that no one really knew what Bush's personal religious values were, but it was obvious that he was making a powerful appeal to the evangelicals and other conservative Christians to vote for him because he was against abortion and against stem cell research. (it should be noted that Bush's executive order did not prevent private research money from continuing to explore medical / scientific research with stem cells.)

The Times' editorial (quoted by Hurlbut went on to admit that "Some convictions deserve respect, but it is wrong to impose them on this pluralistic nation" (Hurlbut, 820). Hurlbut quotes then New York Governor Mario Cuomo, who described the situation Bush had created as a "religious morass," and went on to say that perhaps "millions of Americans" share Bush's view that human life "begins with fertilization" -- including many Christians and evangelicals" (Hurlbut, 822). but, Cuomo continued, Bush's position "…remains a minority view" (Hurlbut, 822).

Christine Todd Whitman, who served Bush as administrator of the Environmental Protection Agency in Bush's first term (she served from January 2001 to May 2003), and was the first female governor of New Jersey, supported embryonic stem cell research. Whitman noted in her book that right after Bush was re-elected in 2004, Christian conservative organizer Phil Burress was heard to say, "The president rode our coattails" (Whitman, 2006).

Whitman believes the support of the Christian conservatives (i.e., evangelicals and others) for Bush was exaggerated; to wit, just twenty million of the fifty-nine million who voted for Bush indicated "moral values as their most important issues" -- which is just a third of the Bush victory vote.

Author Gary Scott Smith examines the great lengths the Bush campaign went to in 2004 to identify Bush as anti-abortion and anti-stem cell research. The campaign built a website to attack Democrat candidate John Kerry (www.kerrywrongforevangelicals.com) and distributed 300,000 copies of a documentary called "George W. Bush: Faith in the white House" directly to churches (Smith, 2006, p. 377). Moreover, the Bush reelection campaign attempted to get its hands on the membership directories of 1,600 churches in "the swing state of Pennsylvania"; this provoked a controversy because it "violated campaign finance and tax laws" that require congregations to remain non-partisan if they truly expect to retain their tax-exempt status.

It became clear by 2004-2005 that a majority of American supported embryonic stem cell research; according to a poll in 2005 "…two-thirds of Americans approved of the research" (Burgin, 2009, p. 4). Hence, a bill to basically overturn Bush's executive order (H.R. 810) began working its way through the House of Representatives with the proviso that the embryos had to have been donated by fertility clinics, that they were created specifically for fertility treatment, and that otherwise the embryos would be discarded if not used. These provisions were built into the bill so it would remove serious potential ethical issues.

The House took a full year of negotiations to come up with a final vote, but on May 24, 2005, the legislation passed the House, 238-194. The breakdown was 187 democrats and 50 Republicans (plus one independent) voting for, 180 Republicans and 14 Democrats voting against. By the time the U.S. Senate began debate on the legislation, a Gallup poll reflected that 61% of respondents believed embryonic stem cell research was "morally acceptable" (Burgin, 4). On July 18, 2006, the Senate approved H.R. 810 by a vote of 63 to 37 (43 Democrats, 19 Republicans voted yes). Very quickly, on July 19, Bush, remembering his important constituency of conservative Christians and evangelicals, vetoed the legislation. There were not enough votes to override the veto, and so important tools for conducting research were not to be made available during the Bush eight-year presence in the White House.

Additional Ethical Approaches to Stem Cell Research

To Philosophy professor Phillip Montague's (Western Washington University), the proposition that individuals who are now full-grown adults "…once existed as embryos from which stem cells could have been removed" is a flawed argument (Montague, 2011, p. 308). That argument implies that in the developmental history "…of every adult human being" there was, at the beginning, "an embryo to which the adult is numerically identical," Montague writes. But "…there is no such numerical identity" and in fact no adult human being "ever existed as an embryo (or any part of an embryo) from which stem cells could have been obtained" (Montague, 308).

Montague finds it interesting that opponents of stem cell research claim that "all human beings once existed as zygotes"; he goes through an esoteric explanation that is difficult for the layperson to understand, but basically he points out that albeit adult human beings can be traced backwards, to childhood and infancy "and well into the prenatal period" (Montague, 318). But to go deeper into the genesis of humans would require investigating the embryonic discs, which comes into existence "early in the third week following fertilization," he explains (318). The embryonic disc is created as a result of the "differentiation on the part of cells from the inner cell mass"; and though the embryonic disc may well form a fetus, and in time an adult human, the same can't be attributed to the inner cell mass, which is nothing but a "cluster of cells" (318).