With well-publicized declarations that embryonic stem cells may be the panacea for every disease and affliction that defies current medical treatments based on surgical procedures and drug-based therapies, vocal support for stem cell research continues to grow louder. Proponents emphatically state that such research could regenerate failing organs since they have the potential to “become nerve cells, muscle cells, heart cells and all of the other cells in the body”[1] and cure diseases and other afflictions such as Alzheimer’s disease, diabetes, macular degeneration and even blindness, multiple sclerosis, Parkinson’s disease and spinal cord injuries. In the rush to justify and promote this research ethical questions such as “Do embryonic stem cells represent a life, should ‘extra’ frozen embryos created through in vitro fertilization be used to establish stem cell lines, and does the end (potential for and even cures of debilitating diseases and afflictions) justify the means (human embryonic stem cell research even if the embryo is destroyed in the process)?”[2] are pushed aside. Worse yet, research has even been distorted, exaggerated and/or fabricated to promote embryonic stem cell research.
When focusing on the ethical dilemmas involved, a conservative approach is required. Thus when the first question is posed, one must view each stem cell from the perspective that life begins at the moment of conception rendering the embryo a living human being despite differing opinions. While Jewish leaders take a neutral view since the Hebrew word “golem” or “unformed substance” is vague regarding the beginnings of life, Christianity based on the incarnation of Christ, in which the Word became flesh from the moment of conception takes a stronger stance as illustrated by the sample statements below: “Before I formed you in the womb I knew you, and before you were born I consecrated you,” [Jer 1:5; cf. Job 10:8-12; Ps 22:10-11], “Each soul is created by God along with body and grows together with the body from the moment of its creation [Gregory of Nyassa (c. 335-394)] and “from the outset, (fertilization) a person is created as a whole, complete both in a body and with a soul” [John Breck, a prominent theologian at St. Sergius Orthodox Theological Institute in Paris, France].
Nevertheless, since sincere differences exist even among Christians regarding when life begins, it is imperative that John Paul II’s (1920-2005) words in Evangelium Vitae “What is at stake is so important that, from the standpoint of moral obligation the mere probability that a human person is involved would suffice to justify an absolutely clear prohibition of any intervention aimed at killing a human embryo” and in Catechism of the Catholic Church” “Life must be protected with the utmost care from the moment of conception…” and the Church of Scotland’s statement, “…if God brings a new human being into existence through the process of fertilization, and if there is no other point at which anyone can be as certain in its affirmation that an individual life has begun… there is a moral imperative to resolve any doubts on the side of protecting life,”[3] be heeded.
This then brings a narrower focus on stem cells themselves. “Do they represent a life?” Presently there is no evidence that a single stem cell, once replication has begun has “the intrinsic capacity to generate a complete organism in any mammalian species” when extracted during the blastomere stage (when the fetus is two-days old and consists of eight cells), Dr. Robert Lanza, a scientist at Advanced Cell Technology stated.[4] Yet critics argue that the potential does exist presenting an ethical dilemma that can only be resolved through scientific research. Accordingly it is imperative that scientists who already extract a single cell from a human blastomere for PGD (preimplantation genetic diagnosis) during in vitro fertilization to test for genetic disorders, replicate this cell prior to testing and conduct research to determine if it indeed can create an embryo and thus a life, on its own. However, unless proven otherwise, it is doubtful that a single cell extracted during the blastomere stage constitutes nor can create a life any more than during any stage following fertilization and replication from the initial single cell. Otherwise much if not all medical research and procedures (e.g. blood testing, organ transplants, etc.) would be morally unethical since they would involve the destruction of life or potential life.
Based on the above arguments, it is clear that “‘extra’ frozen embryos created through in vitro fertilization” should not be used to establish stem cell lines especially since they are in the blastocyst stage (consisting 150 or more cells) and any such extraction will destroy the fetus and ultimately a human life. Even arguments that stem cells should be extracted since couples responsible for the said embryos have ordered their destruction remain inconsistent and indefensible. Such originating instructions by and of themselves are unethical and morally reprehensible. As a matter of fact, each frozen embryo should be made available for implantation so that a human life is permitted to develop to its full potential in lieu of perpetual stasis or destruction.
Consistent with the above premise, the Church of Scotland explicitly states “human dignity inheres in the very existence of the embryo… it has the full genetic complement of a human being, which neither egg nor sperm possessed separately,”[5] reinforced by the Catechism of the Catholic Church, “Human life must be respected and protected absolutely from the moment of conception. From the moment of existence, a human being must be recognized as having the rights of a person – among which is the inviolable right of every innocent being to life.”[6]
The third question poses additional ethical challenges since it also attempts to discern the value of a life itself. When focusing on embryonic stem cell research that may destroy one life to save another – the end justifying the means, the value of two lives is compared, a proposition that has been the subject of philosophical, theological, and scientific discussion for centuries. “Is one life more valuable than another and is one life worth saving at the expense of another?”
When these arguments are viewed, the end (saving of one life) can never justify the means when it involves the taking of another life (destruction of a blastocyst fetus to extract embryonic stem cells) when the life taken has not posed an imminent threat to the life saved, the basis of self-defense. When the debate about when life begins is put aside, Judeo-Christian tradition considers each and every life to be equally sacred and inviolable since “from its beginning it involves the creative action of God and remains for ever in a special relationship with the Creator.”[7] This position is further affirmed by the philosopher Josef Popper-Lynkeus who asserts in Das Individuum und die Bewertung menschlicher Existenzen that “the existence of a stupid peasant-boy is just as infinitely valuable as the existence of a Shakespeare or a Newton.”[8]
In short, “all life is worth living under any condition because of its inherent value… since it is intrinsically good, no life is more valuable than another, [and] that lives not fully developed (embryonic and fetal stages) and lives with no great potential (the terminally ill [and] the severely handicapped) are still sacred” whose termination cannot be justified.[9]
Accordingly, embryonic stem cell research is neither incompatible nor unethical. Only such research that destroys an embryo, puts it at unnecessary or material risk, and/or creates clones or embryos even if they are genetically manipulated to terminate at a given time in their developmental state before birth, poses serious ethical problems.
However not all embryonic stem cell research presents moral hurdles. Today technology is evolving that permits the creation of embryonic stem cells without embryonic destruction. A project by Advanced Cell Technology, a Massachusetts biotech company successfully created embryonic stem cells from a single cell that had been removed from an 8-cell blastomere mouse embryo.
When it comes to humans, laboratories already extract a single cell from an 8-cell blastomere to test for chromosomal abnormalities prior to implantation. Therefore because of this PGD test, such a cell could be extracted and then cultivated overnight into additional embryonic stem cells prior to testing, posing a negligible risk to the fetus. As this test is already conducted and to date has resulted in no adverse affects, it is ethically acceptable and even obligatory to expand upon the PGD test to create embryonic stem cells that can be used for scientific research and ultimately to treat debilitating diseases and afflictions.
Next in a second study, Japanese scientists at the University of Kyoto, Shinya Yamanaka and Kazutoshi Takahashi created “all kinds of tissue types without the use of embryos” by exposing mouse skin cells to Oct3/4, Sox2, c-Myc and Klf4, “four messenger chemicals found in embryonic cells.”[10]
Third, though not tested or proven, a member of the President’s Council on Bioethics has offered another alternative to avoid embryonic destruction. He proposed “a technique, called ‘altered nuclear transfer,” that would genetically engineer an egg (which it has been established does not constitute a life) so that it is incapable of becoming an embryo, but can still produce embryonic stem cells.”[11]
Therefore as scientific research progresses and new technology evolves, embryonic stem cell research can be harnessed to its full potential overcoming ethical barriers, namely the destruction of one human life to save another. However, it must be noted that despite optimistic promises, embryonic stem cell research is still in its infancy with a lot to be done. Even once embryonic stem cells can be produced in quantity overcoming the inefficiency of today’s methods and potential problems (e.g. efficacy of viruses in implanted cells, use of c-Myc that is known to play a role in the progression of cancer), further research will be needed to determine and provide the correct instructions for an embryonic stem cell to grow into its desired pathway (e.g. neurons, rods and cones, a liver, myocardial muscle, etc.). Only then will replacement tissue be generated, overcoming organ shortages and possible immuno-rejection that will give individuals a new lease on life. As a result, “many scientists have begun to back off from the field’s extravagant promises” and consider it a long-term project whose “horizon is as many as 15 to 20 years away” leading to Gordon Keller’s (appointed Director of the McEwen Centre for Regenerative Medicine in Toronto, Canada, whose term commences in 2007) cautionary words, “We need to be careful that we’re not overselling the immediate potential” of embryonic stem cells.[12] However, once ethical concerns are overcome through research and new technology, the time frame from promise to treatment may accelerate as many major pharmaceutical and biotechnology firms that have stayed away, enter the field leading to increased life spans and enhanced quality of life.
_____
[1] Robert Lanza and Nadia Rosenthal. The Stem Cell Challenge. Scientific American. (June 2004, Vol. 290 Issue 6).
[2] The Ethics of Stem Cell Research. Odyssey. (October 2004, Vol. 13 Issue 7).
[3] Embryo Research, Human Stem Cells and Cloned Embryos. Church of Scotland. (2006) 30.
[4] Gareth Cook. Stem-Cell Method Preserves Embryo; Mass. Lab Hopes Top End Standoff. The Boston Globe (August 24, 2006) A1.
[5] Embryo Research, Human Stem Cells and Cloned Embryos. Church of Scotland. (2006) 29.
[6] Catechism of the Catholic Church. Libreria Editrice Vaticana. (Pauline – St. Paul Books & Media: Vatican City, 1994) 547: 2270.
[7] Catechism of the Catholic Church. Libreria Editrice Vaticana. (Pauline – St. Paul Books & Media: Vatican City, 1994) 544: 2258.
[8] Paul Edwards, ed. The Encyclopedia of Philosophy. (Macmillan: New York. 1967) 403.
[9] The value of life: who decides and how? 115. 11 November 2006.
http://www.fleshandbones.com/readingroom/pdf/399.pdf
[10] Bruce Goldman and Andy Coghlan. Organs on demand, no embryo needed. New Scientist. (October 7, 2006: Vol. 191 Issue 2572).
[11] Gareth Cook. Stem-Cell Method Preserves Embryo; Mass. Lab Hopes Top End Standoff. The Boston Globe (August 24, 2006).
[12] Sally Lehrman. Hope, Unfulfilled Promises on Stem Cell Work. The Boston Globe. (October 1, 2006) D9.
_____
Additional Sources:
Ann McLaren. Ethical and social considerations of stem cell research. Nature. (November 2001).
David P. Hamilton. Study Indicates Embryos Survive Cell Extraction. The Wall Street Journal. August 24, 2006. B1.
Stem Cells Without Embryo Loss. [Editorial] The New York Times. August 26, 2006. A14.
