Ethics of Stem Cell Research and Oocyte Donation

Introduction to Embryonic Stem Cell Research

Research into new means of curing previously untreatable diseases, and research into preventing conditions that damage and destroy life, are both dependent upon the discovery that embryonic stem cells may hold the answer to many of these problems. Embryonic stem cells were first isolated from the inner cell masses of mouse blastocysts in the early 1980s. They are present in mammalian organs and tissue, holding pluripotent embryonic stem (ES) cells at the blastocyst stage of embryo development. In 1998, research teams at two universities announced the first successful isolation and culturing of human ES cells.

While donors of healthy oocytes do not donate any part of their own formed tissues, their biological material is used to create research specimens. This distinguishes the practice from past ethical problems involving donations of human body parts. Nevertheless, donors are exposed to certain risks and derive no direct benefit from the studies. Informed consent does not minimize the risks of oocyte procurement, nor does it claim that existing stem cell transplantation research will be successful (Magnus 1747).

Oocytes obtained specifically for human embryonic stem cell research — rather than for reproductive or medical purposes — create a distinct object of ethical inquiry, as every stakeholder explores the moral issues involved for both researchers and donors. The National Research Council–Institute of Medicine in the United States has established guidelines that are considered exemplary. Although not legally required, there is broad agreement that, given the special ethical situations raised by this research, these guidelines should be followed.

Ethical Framework and Donor Welfare

Stem cells have the potential to save many lives through future research. However, the tissues must come from aborted fetuses or live embryos. Tissue from aborted fetuses may be used without implying moral complicity in the abortion itself, but embryo-derived stem cells necessarily destroy the embryo, raising difficult questions about using human embryonic tissue to save human lives. Some argue that stem cell research conducted with spare embryos from infertility treatments, or with embryos created specifically for research or therapeutic purposes, is ethically acceptable and therefore deserving of federal funding. As Robertson notes, "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" (109).

Stem cell research dependent upon somatic cell nuclear transfer (SCNT) presents risks for donors, making the welfare of women volunteers a central concern. In practice, however, the risks faced by these healthy women are comparable to those faced by subjects in other areas of clinical research. If other research subjects are scrutinized under the same standards and found acceptable, then stem cell research donors should be able to meet those same standards and receive equal treatment. Concerns about inducement, recruiting vulnerable women, and the adequacy of reimbursement must all be addressed, controlled, and accompanied by a guarantee of informed consent (Mertes 629).

One study examining the maximum number of live births per donor — determined by cultural and social perspective — proposed three criteria to evaluate the 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 of gamete donors will lead to greater risk of consanguinity" (Wang 1093). This risk is ever-present and must be considered in ethical deliberations.

The Hwang Scandal and Its Fallout

In 2005, a South Korean stem cell research team led by Woo Suk Hwang admitted that they had obtained oocytes from junior scientists in their own laboratory as well as from paid donors, and that the circumstances under which those oocytes had been obtained were not accurately recorded. The resulting questions about fraud created a major scientific scandal. The team's landmark 2005 report on obtaining embryonic stem cells from human blastocysts created by somatic cell nuclear transfer was retracted, as was a Science magazine report on the derivation of a stem cell line from a cloned blastocyst. Furthermore, it emerged that far more donors and eggs had been used than had been reported. An independent committee found that Hwang had used 2,061 eggs from 129 women. With the research suspended, all donated eggs were wasted — a profound betrayal of trust between scientist and research subject (Hwang 1777).

The Korean scandal focused international attention on the oocyte issue, creating an ethical dilemma for all those concerned. Donating eggs is time-consuming, physically uncomfortable, and medically risky, yet willing donors remain the only source of research material. When donors are uncertain of their ethical standing or are not fully informed about their role, the pool of available donors will inevitably shrink. Some consider it wrong to pay donors; others regard payment as the only fair course of action. Donors are routinely paid $4,000 to $5,000 per cycle, and in some cases considerably more (Ethics S240).

Conclusion

So, while stem cell research is an exciting new field that holds much promise, ethical problems arise to delay research, the discovery of benefits or dangers, and involve many people who have no knowledge of the complexities of the field. Though controversies usually accompany new discoveries in science, this biotechnological process involves manipulating the very basis of life itself in embryonic stem cells. The field is, however, rapidly changing. What is true today may be outmoded tomorrow. A neutral substitute for stem cells may yet be discovered that will provide answers to these ethical questions.