stem cell controversy
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The stem cell controversy is the consideration of the
ethics Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concerns m ...
of research involving the development and use of human
embryos An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male spe ...
. Most commonly, this controversy focuses on
embryonic stem cell Embryonic stem cells (ESCs) are pluripotent stem cells derived from the inner cell mass of a blastocyst, an early-stage pre- implantation embryo. Human embryos reach the blastocyst stage 4–5 days post fertilization, at which time they consist ...
s. Not all
stem cell In multicellular organisms, stem cells are undifferentiated or partially differentiated cells that can differentiate into various types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type o ...
research involves human embryos. For example,
adult stem cells Adult stem cells are undifferentiated cells, found throughout the body after development, that multiply by cell division to replenish dying cells and regenerate damaged tissues. Also known as somatic stem cells (from Greek σωματικóς, ...
,
amniotic stem cells Amniotic stem cells are the mixture of stem cells that can be obtained from the amniotic fluid as well as the amniotic membrane. They can develop into various tissue types including skin, cartilage, cardiac tissue, nerves, muscle, and bone. The cell ...
, and
induced pluripotent stem cell Induced pluripotent stem cells (also known as iPS cells or iPSCs) are a type of pluripotent stem cell that can be generated directly from a somatic cell. The iPSC technology was pioneered by Shinya Yamanaka's lab in Kyoto, Japan, who showed in ...
s do not involve creating, using, or destroying human embryos, and thus are minimally, if at all, controversial. Many less controversial sources of acquiring stem cells include using cells from the umbilical cord, breast milk, and bone marrow, which are not
pluripotent Pluripotency: These are the cells that can generate into any of the three Germ layers which imply Endodermal, Mesodermal, and Ectodermal cells except tissues like the placenta. According to Latin terms, Pluripotentia means the ability for many thin ...
.


Background

For many decades, stem cells have played an important role in medical research, beginning in 1868 when
Ernst Haeckel Ernst Heinrich Philipp August Haeckel (; 16 February 1834 – 9 August 1919) was a German zoologist, naturalist, eugenicist, philosopher, physician, professor, marine biologist and artist. He discovered, described and named thousands of new sp ...
first used the phrase to describe the fertilized egg which eventually gestates into an organism. The term was later used in 1886 by William Sedgwick to describe the parts of a plant that grow and regenerate. Further work by
Alexander Maximow Alexander Alexandrowitsch Maximow (russian: Александр Александрович Максимов; – December 4, 1928) was a Russian-American scientist in the fields of Histology and Embryology whose team developed the hypothesis about ...
and Leroy Stevens introduced the concept that stem cells are
pluripotent Pluripotency: These are the cells that can generate into any of the three Germ layers which imply Endodermal, Mesodermal, and Ectodermal cells except tissues like the placenta. According to Latin terms, Pluripotentia means the ability for many thin ...
. This significant discovery led to the first human bone marrow transplant by E. Donnall Thomas in 1956, which although successful in saving lives, has generated much controversy since. This has included the many complications inherent in stem cell transplantation (almost 200 allogeneic marrow transplants were performed in humans, with no long-term successes before the first successful treatment was made), through to more modern problems, such as how many cells are sufficient for engraftment of various types of hematopoietic stem cell transplants, whether older patients should undergo transplant therapy, and the role of irradiation-based therapies in preparation for transplantation. The discovery of adult stem cells led scientists to develop an interest in the role of embryonic stem cells, and in separate studies in 1981 Gail Martin and
Martin Evans Sir Martin John Evans (born 1 January 1941) is an English biologist who, with Matthew Kaufman, was the first to culture mice embryonic stem cells and cultivate them in a laboratory in 1981. He is also known, along with Mario Capecchi and Olive ...
derived pluripotent stem cells from the embryos of mice for the first time. This paved the way for
Mario Capecchi Mario Ramberg Capecchi (born 6 October 1937) is an Italian-born molecular geneticist and a co-awardee of the 2007 Nobel Prize in Physiology or Medicine for discovering a method to create mice in which a specific gene is turned off, known as knock ...
,
Martin Evans Sir Martin John Evans (born 1 January 1941) is an English biologist who, with Matthew Kaufman, was the first to culture mice embryonic stem cells and cultivate them in a laboratory in 1981. He is also known, along with Mario Capecchi and Olive ...
, and
Oliver Smithies Oliver Smithies (23 June 1925 – 10 January 2017) was a British-American geneticist and physical biochemist. He is known for introducing starch as a medium for gel electrophoresis in 1955, and for the discovery, simultaneously with Mario Cape ...
to create the first
knockout mouse A knockout mouse, or knock-out mouse, is a genetically modified mouse (''Mus musculus'') in which researchers have inactivated, or "knocked out", an existing gene by replacing it or disrupting it with an artificial piece of DNA. They are importan ...
, ushering in a whole new era of research on human disease. In 1995 adult stem cell research with human use was patented (US PTO with effect from 1995). In fact, human use was published in World J Surg 1991 & 1999 (B G Matapurkar). Salhan, Sudha (August 2011). In 1998, James Thomson and
Jeffrey Jones Jeffrey Duncan Jones (born September 28, 1946) is an American character actor, best known for his roles as Emperor Joseph II in '' Amadeus'' (1984), Edward R. Rooney in ''Ferris Bueller's Day Off'' (1986), Charles Deetz in ''Beetlejuice'' (1988 ...
derived the first human embryonic stem cells, with even greater potential for drug discovery and therapeutic transplantation. However, the use of the technique on human embryos led to more widespread controversy as criticism of the technique now began from the wider public who debated the moral ethics of questions concerning research involving human embryonic cells.


Potential use in therapy

Since pluripotent stem cells have the ability to differentiate into any type of cell, they are used in the development of medical treatments for a wide range of conditions. Treatments that have been proposed include treatment for physical trauma, degenerative conditions, and genetic diseases (in combination with
gene therapy Gene therapy is a medical field which focuses on the genetic modification of cells to produce a therapeutic effect or the treatment of disease by repairing or reconstructing defective genetic material. The first attempt at modifying human DN ...
). Yet further treatments using stem cells could potentially be developed due to their ability to repair extensive tissue damage. Great levels of success and potential have been realized from research using adult stem cells. In early 2009, the FDA approved the first human clinical trials using embryonic stem cells. Only cells from an embryo at the
morula A morula (Latin, ''morus'': mulberry) is an early-stage embryo consisting of a solid ball of cells called blastomeres, contained in mammals, and other animals within the zona pellucida shell. The blastomeres are the daughter cells of the zygot ...
stage or earlier are truly
totipotent Pluripotency: These are the cells that can generate into any of the three Germ layers which imply Endodermal, Mesodermal, and Ectodermal cells except tissues like the placenta. According to Latin terms, Pluripotentia means the ability for many thin ...
, meaning that they are able to form all cell types including placental cells. Adult stem cells are generally limited to differentiating into different cell types of their tissue of origin. However, some evidence suggests that adult stem cell plasticity may exist, increasing the number of cell types a given adult stem cell can become.


Points of controversy

Destruction of a human embryo is required in order to research new embryonic cell lines. Much of the debate surrounding human embryonic stem cells, therefore, concern ethical and legal quandaries around the destruction of an embryo. Ethical and legal questions such as "At what point does one consider life to begin?" and "Is it just to destroy a human embryo if it has the potential to cure countless numbers of patients and further our understanding of disease?" are central to the controversy. Political leaders debate how to regulate and fund research studies that involve the techniques used to remove the embryo cells. No clear consensus has emerged. Much of the criticism has been a result of religious beliefs and, in the most high-profile case,
US President The president of the United States (POTUS) is the head of state and head of government of the United States of America. The president directs the executive branch of the federal government and is the commander-in-chief of the United Stat ...
George W Bush George may refer to: People * George (given name) * George (surname) * George (singer), American-Canadian singer George Nozuka, known by the mononym George * George Washington, First President of the United States * George W. Bush, 43rd Presid ...
signed an executive order banning the use of federal funding for any stem cell lines other than those already in existence, stating at the time, "My position on these issues is shaped by deeply held beliefs," and "I also believe human life is a sacred gift from our creator." This ban was in part revoked by his successor
Barack Obama Barack Hussein Obama II ( ; born August 4, 1961) is an American politician who served as the 44th president of the United States from 2009 to 2017. A member of the Democratic Party, Obama was the first African-American president of the U ...
, who stated: "As a person of faith, I believe we are called to care for each other and work to ease human suffering. I believe we have been given the capacity and will to pursue this research and the humanity and conscience to do so responsibly."


Alternatives to embryonic stem cells

Some stem cell researchers are working to develop techniques of isolating stem cells with similar potency as embryonic stem cells, but do not require the destruction of a human embryo.


Induced pluripotent stem cells (iPSCs)

Foremost among these was the discovery in August 2006 that human adult somatic cells can be cultured in vitro with the four “Yamanaka factors” (
Oct-4 Oct-4 (octamer-binding transcription factor 4), also known as POU5F1 ( POU domain, class 5, transcription factor 1), is a protein that in humans is encoded by the ''POU5F1'' gene. Oct-4 is a homeodomain transcription factor of the POU family. ...
, SOX2,
c-Myc ''Myc'' is a family of regulator genes and proto-oncogenes that code for transcription factors. The ''Myc'' family consists of three related human genes: ''c-myc'' ( MYC), ''l-myc'' ( MYCL), and ''n-myc'' ( MYCN). ''c-myc'' (also sometimes re ...
, KLF4) which effectively returns a cell to the
pluripotent Pluripotency: These are the cells that can generate into any of the three Germ layers which imply Endodermal, Mesodermal, and Ectodermal cells except tissues like the placenta. According to Latin terms, Pluripotentia means the ability for many thin ...
state similar to that observed in
embryonic stem cell Embryonic stem cells (ESCs) are pluripotent stem cells derived from the inner cell mass of a blastocyst, an early-stage pre- implantation embryo. Human embryos reach the blastocyst stage 4–5 days post fertilization, at which time they consist ...
s. This major breakthrough won a
Nobel Prize The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel's will of 1895, are awarded to "those who, during the preceding year, have conferred the greatest benefit to humankind." Alfr ...
for the discoverers,
Shinya Yamanaka is a Japanese stem cell researcher and a Nobel Prize laureate. He serves as the director of Center for iPS Cell (induced Pluripotent Stem Cell) Research and Application and a professor at the Institute for Frontier Medical Sciences at Kyo ...
and
John Gurdon Sir John Bertrand Gurdon (born 2 October 1933) is a British developmental biologist. He is best known for his pioneering research in nuclear transplantation and cloning. He was awarded the Lasker Award in 2009. In 2012, he and Shinya Yamanaka ...
. Induced pluripotent stem cells are those derived from adult
somatic cells A somatic cell (from Ancient Greek σῶμα ''sôma'', meaning "body"), or vegetal cell, is any biological cell forming the body of a multicellular organism other than a gamete, germ cell, gametocyte or undifferentiated stem cell. Such cells compo ...
and have the potential to provide an alternative for stem cell research that does not require the destruction of human
embryos An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male spe ...
. Some debate remains about the similarities of these cells to embryonic stem cells as research has shown that the induced pluripotent cells may have a different epigenetic memory or modifications to the genome than embryonic stem cells depending on the tissue of origin and donor the iPSCs come from. While this may be the case, epigenetic manipulation of the cells is possible using small molecules and more importantly, iPSCs from multiple tissues of origin have been shown to give rise to a viable organism similar to the way ESCs can. This allows iPSCs to serve as a powerful tool for tissue generation, drug screening, disease modeling, and personalized medicine that has far fewer ethical considerations than embryonic stem cells that would otherwise serve the same purpose.


Somatic cell nuclear transfer (SCNT)

In an alternative technique, researchers at
Harvard University Harvard University is a private Ivy League research university in Cambridge, Massachusetts. Founded in 1636 as Harvard College and named for its first benefactor, the Puritan clergyman John Harvard, it is the oldest institution of higher le ...
, led by Kevin Eggan and Savitri Marajh, have transferred the
nucleus Nucleus ( : nuclei) is a Latin word for the seed inside a fruit. It most often refers to: *Atomic nucleus, the very dense central region of an atom * Cell nucleus, a central organelle of a eukaryotic cell, containing most of the cell's DNA Nucl ...
of a somatic cell into an existing embryonic stem cell, thus creating a new stem cell line. This technique known as somatic cell nuclear transfer (SCNT) creates pluripotent cells that are genetically identical to the donor. While the creation of stem cells via SCNT does not destroy an embryo, it requires an
oocyte An oocyte (, ), oöcyte, or ovocyte is a female gametocyte or germ cell involved in reproduction. In other words, it is an immature ovum, or egg cell. An oocyte is produced in a female fetus in the ovary during female gametogenesis. The female ...
from a donor which opens the door to a whole new set of ethical considerations such as the debate as to whether or not it is appropriate to offer financial incentives to female donors.


Single-Cell blastomere biopsy

Researchers at Advanced Cell Technology, led by
Robert Lanza Robert Lanza (born 11 February 1956 in Boston, Massachusetts) is an American medical doctor and scientist, currently Head of Astellas Global Regenerative Medicine, and Chief Scientific Officer of the Astellas Institute for Regenerative Medici ...
and Travis Wahl, reported the successful derivation of a stem cell line using a process similar to
preimplantation genetic diagnosis Preimplantation genetic diagnosis (PGD or PIGD) is the genetic profiling of embryos prior to implantation (as a form of embryo profiling), and sometimes even of oocytes prior to fertilization. PGD is considered in a similar fashion to prenatal ...
, in which a single
blastomere In biology, a blastomere is a type of cell produced by cell division (cleavage) of the zygote after fertilization; blastomeres are an essential part of blastula formation, and blastocyst formation in mammals. Human blastomere characteristics In ...
is extracted from a blastocyst. At the 2007 meeting of the International Society for Stem Cell Research (ISSCR), Lanza announced that his team had succeeded in producing three new stem cell lines without destroying the parent embryos."These are the first human embryonic cell lines in existence that didn't result from the destruction of an embryo." Lanza is currently in discussions with the National Institutes of Health to determine whether the new technique sidesteps U.S. restrictions on federal funding for ES cell research.


Amniotic fluid stem cells (AFSCs)

Anthony Atala of
Wake Forest University Wake Forest University is a private research university in Winston-Salem, North Carolina. Founded in 1834, the university received its name from its original location in Wake Forest, north of Raleigh, North Carolina. The Reynolda Campus, the un ...
says that the fluid surrounding the
fetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal deve ...
has been found to contain
stem cells In multicellular organisms, stem cells are undifferentiated or partially differentiated cells that can differentiate into various types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type of ...
that, when used correctly, "can be differentiated towards cell types such as fat, bone, muscle, blood vessel, nerve and liver cells." The extraction of this fluid is not thought to harm the fetus in any way. He hopes "that these cells will provide a valuable resource for tissue repair and for engineered organs, as well." AFSCs have been found to express both embryonic and adult stem cell markers as well as having the ability to be maintained over 250 population doublings.


Umbilical cord blood (UCB)

Similarly, pro-life supporters claim that the use of adult stem cells from sources such as the
cord blood Cord blood (umbilical cord blood) is blood that remains in the placenta and in the attached umbilical cord after childbirth. Cord blood is collected because it contains stem cells, which can be used to treat hematopoietic and genetic disorders s ...
has consistently produced more promising results than the use of embryonic stem cells.Prentice, David. (October 17, 2005
"Live Patients & Dead Mice".
''Christianity Today''. Retrieved on August 24, 2006.
Research has shown that umbilical cord blood (UCB) is in fact a viable source for stem cells and their progenitors which occur in high frequencies within the fluid. Furthermore, these cells may hold an advantage over induced PSC as they can create large quantities of homogenous cells. IPSCs and other embryonic stem cell alternatives must still be collected and maintained with the informed consent of the donor as a donor's genetic information is still within the cells and by the definition of pluripotency, each alternative cell type has the potential to give rise to viable organisms. Generation of viable offspring using iPSCs has been shown in mouse models through tetraploid complementation. This potential for the generation of viable organisms and the fact that iPSC cells contain the DNA of donors require that they be handled along the ethical guidelines laid out by the food and drug administration (FDA), European Medicines Agency (EMA), and International Society for Stem Cell Research (ISSCR).


Viewpoints

Stem cell debates have motivated and reinvigorated the anti-abortion movement, whose members are concerned with the rights and status of the human embryo as an early-aged human life. They believe that embryonic stem cell research profits from and violates the
sanctity of life In religion and ethics, the inviolability of life, or sanctity of life, is a principle of implied protection regarding aspects of sentient life that are said to be holy, sacred, or otherwise of such value that they are not to be violated. This ca ...
and is tantamount to
murder Murder is the unlawful killing of another human without justification (jurisprudence), justification or valid excuse (legal), excuse, especially the unlawful killing of another human with malice aforethought. ("The killing of another person wit ...
."The stated reason for President Bush's objection to embryonic stem cell research is that 'murder is wrong'
(BBC)
/ref> The fundamental assertion of those who oppose embryonic stem cell research is the belief that human life is
inviolable In religion and ethics, the inviolability of life, or sanctity of life, is a principle of implied protection regarding aspects of sentient life that are said to be holy, sacred, or otherwise of such value that they are not to be violated. This can ...
, combined with the belief that human life begins when a sperm cell fertilizes an egg cell to form a single cell. The view of those in favor is that these embryos would otherwise be discarded, and if used as stem cells, they can survive as a part of a living human person. A portion of stem cell researchers use embryos that were created but not used in ''in vitro'' fertility treatments to derive new stem cell lines. Most of these embryos are to be destroyed, or stored for long periods of time, long past their viable storage life. In the United States alone, an estimated at least 400,000 such embryos exist.Weiss, Rick. (May 8, 2003
"400,000 Human Embryos Frozen in U.S.,"
''Washington Post''. Retrieved August 24, 2006.
This has led some opponents of abortion, such as Senator
Orrin Hatch Orrin Grant Hatch (March 22, 1934 – April 23, 2022) was an American attorney and politician who served as a United States senator from Utah from 1977 to 2019. Hatch's 42-year Senate tenure made him the longest-serving Republican U.S. senato ...
, to support human embryonic stem cell research.Connolly, Ceci. (July 30, 2005
"Frist Breaks With Bush On Stem Cell Research"
''The Washington Post''. Retrieved August 24, 2006.
See also
embryo donation Embryo donation is one disposition option for users of in vitro fertilisation with remaining fresh or frozen embryos. It is defined as the giving—generally without compensation—of embryos remaining after in vitro fertilization procedures to r ...
. Medical researchers widely report that stem cell research has the potential to dramatically alter approaches to understanding and treating diseases, and to alleviate suffering. In the future, most medical researchers anticipate being able to use technologies derived from stem cell research to treat a variety of diseases and impairments. Spinal cord injuries and Parkinson's disease are two examples that have been championed by high-profile media personalities (for instance,
Christopher Reeve Christopher D'Olier Reeve (September 25, 1952 – October 10, 2004) was an American actor, best known for playing the title character in the film '' Superman'' (1978) and three sequels. Born in New York City and raised in Princeton, New Jersey ...
and
Michael J. Fox Michael Andrew Fox (born June 9, 1961), known professionally as Michael J. Fox, is a Canadian-American retired actor. Beginning his career in the 1970s, he rose to prominence portraying Alex P. Keaton on the NBC sitcom ''Family Ties'' (1 ...
, who have lived with these conditions, respectively). The anticipated medical benefits of stem cell research add urgency to the debates, which has been appealed to by proponents of embryonic stem cell research. In August 2000, The U.S. National Institutes of Health's Guidelines stated:
... research involving human pluripotent stem cells ... promises new treatments and possible cures for many debilitating diseases and injuries, including Parkinson's disease, diabetes, heart disease, multiple sclerosis, burns and spinal cord injuries. The NIH believes the potential medical benefits of human pluripotent stem cell technology are compelling and worthy of pursuit in accordance with appropriate ethical standards.
In 2006, researchers at Advanced Cell Technology of Worcester, Massachusetts, succeeded in obtaining stem cells from mouse embryos without destroying the embryos. If this technique and its reliability are improved, it would alleviate some of the ethical concerns related to embryonic stem cell research. Another technique announced in 2007 may also defuse the longstanding debate and controversy. Research teams in the United States and Japan have developed a simple and cost-effective method of reprogramming human skin cells to function much like embryonic stem cells by introducing artificial viruses. While extracting and cloning stem cells is complex and extremely expensive, the newly discovered method of reprogramming cells is much cheaper. However, the technique may disrupt the DNA in the new stem cells, resulting in damaged and cancerous tissue. More research will be required before noncancerous stem cells can be created. Update of article to include 2009/2010 current stem cell usages in clinical trials: The planned treatment trials will focus on the effects of oral lithium on neurological function in people with chronic spinal cord injury and those who have received umbilical cord blood mononuclear cell transplants to the spinal cord. The interest in these two treatments derives from recent reports indicating that umbilical cord blood stem cells may be beneficial for spinal cord injury and that lithium may promote regeneration and recovery of function after spinal cord injury. Both lithium and umbilical cord blood are widely available therapies that have long been used to treat diseases in humans.


Endorsement

* Embryonic stem cells have the potential to grow indefinitely in a laboratory environment and can differentiate into almost all types of bodily tissue. This makes embryonic stem cells a prospect for cellular therapies to treat a wide range of diseases.


Human potential and humanity

This argument often goes hand-in-hand with the utilitarian argument, and can be presented in several forms: * Embryos are not equivalent to human life while they are still incapable of surviving outside the womb (i.e. they only have the potential for life). * More than a third of
zygotes A zygote (, ) is a eukaryotic cell formed by a fertilization event between two gametes. The zygote's genome is a combination of the DNA in each gamete, and contains all of the genetic information of a new individual organism. In multicellula ...
do not implant after conception. Thus, far more embryos are lost due to chance than are proposed to be used for embryonic stem cell research or treatments. * Blastocysts are a cluster of human cells that have not differentiated into distinct organ tissue, making cells of the inner cell mass no more "human" than a skin cell. * Some parties contend that embryos are not human persons, believing that the life of ''
Homo sapiens Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...
'' only begins when the heartbeat develops, which is during the fifth week of pregnancy, or when the brain begins developing activity, which has been detected at 54 days after conception.Singer, Peter.
Rethinking life & death: the collapse of our traditional ethics
', p. 104 (St. Martins Press 1996). Retrieved 2007-03-04.


Efficiency

* ''In vitro'' fertilization (IVF) generates large numbers of unused embryos (e.g. 70,000 in Australia alone). Many of these thousands of IVF embryos are slated for destruction. Using them for scientific research uses a resource that would otherwise be wasted. * While the destruction of human embryos is required to establish a stem cell line, no new embryos have to be destroyed to work with existing stem cell lines. It would be wasteful not to continue to make use of these cell lines as a resource.


Superiority

This is usually presented as a counter-argument to using adult stem cells, as an alternative that does not involve embryonic destruction. * Embryonic stem cells make up a significant proportion of a developing embryo, while adult stem cells exist as minor populations within a mature individual (e.g. in every 1,000 cells of the bone marrow, only one will be a usable stem cell). Thus, embryonic stem cells are likely to be easier to isolate and grow ''
ex vivo ''Ex vivo'' (Latin: "out of the living") literally means that which takes place outside an organism. In science, ''ex vivo'' refers to experimentation or measurements done in or on tissue from an organism in an external environment with minimal ...
'' than adult stem cells. * Embryonic stem cells divide more rapidly than adult stem cells, potentially making it easier to generate large numbers of cells for therapeutic means. In contrast, adult stem cell might not divide fast enough to offer immediate treatment. * Embryonic stem cells have greater plasticity, potentially allowing them to treat a wider range of diseases. * Adult stem cells from the patient's own body might not be effective in treatment of genetic disorders.
Allogeneic Allotransplant (''allo-'' meaning "other" in Greek) is the transplantation of cells, tissues, or organs to a recipient from a genetically non-identical donor of the same species. The transplant is called an allograft, allogeneic transplant, o ...
embryonic stem cell transplantation (i.e. from a healthy donor) may be more practical in these cases than
gene therapy Gene therapy is a medical field which focuses on the genetic modification of cells to produce a therapeutic effect or the treatment of disease by repairing or reconstructing defective genetic material. The first attempt at modifying human DN ...
of a patient's own cell. * DNA abnormalities found in adult stem cells that are caused by toxins and sunlight may make them poorly suited for treatment. * Embryonic stem cells have been shown to be effective in treating heart damage in mice. * Embryonic stem cells have the potential to cure chronic and degenerative diseases which current medicine has been unable to effectively treat.


Individuality

* Before the primitive streak is formed when the embryo attaches to the uterus around 14 days after fertilization, two fertilized eggs can combine by fusing together and develop into one person (a tetragametic chimera). Since a fertilized egg has the potential to be two individuals or half of one, some believe it can only be considered a 'potential' person, not an actual one. Those who subscribe to this belief then hold that destroying a blastocyst for embryonic stem cells is ethical.West, Michael D. (2005). ''The Ethics of Genetic Engineering'' (At Issue Series). pp. 100–107. Thomson Gale


Viability

* Viability is another standard under which embryos and fetuses have been regarded as human lives. In the United States, the 1973 Supreme Court case of ''
Roe v. Wade ''Roe v. Wade'', 410 U.S. 113 (1973),. was a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution of the United States conferred the right to have an abortion. The decision struck down many federal and s ...
'' concluded that viability determined the permissibility of
abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
s performed for reasons other than the protection of the woman's health, defining viability as the point at which a fetus is "potentially able to live outside the mother's womb, albeit with artificial aid."''Roe v. Wade''
410 U.S. 113
(1973). Findlaw.com. Retrieved 2007-05-15
The point of viability was 24 to 28 weeks when the case was decided and has since moved to about 22 weeks due to advancement in medical technology. Embryos used in medical research for stem cells are well below development that would enable viability.


Further Uses for Stem Cells

Adult stem cells have provided many different therapies for illnesses such as Parkinson's disease, leukemia, multiple sclerosis, lupus, sickle-cell anemia, and heart damage (to date, embryonic stem cells have also been used in treatment), Moreover, there have been many advances in adult stem cell research, including a recent study where pluripotent adult stem cells were manufactured from differentiated fibroblast by the addition of specific transcription factors. Newly created stem cells were developed into an embryo and were integrated into newborn mouse tissues, analogous to the properties of embryonic stem cells.


Stated views of groups


Government policy stances


Europe

Austria, Denmark, France, Germany, Portugal and Ireland do not allow the production of embryonic stem cell lines, but the creation of embryonic stem cell lines is permitted in Finland, Greece, the Netherlands, Sweden, and the United Kingdom.


United States


=Origins

= In 1973,'' Roe v. Wade'' legalized abortion in the United States. Five years later, the first successful human ''in vitro'' fertilization resulted in the birth of
Louise Brown Louise Joy Brown (born 25 July 1978) is an English woman who was the first human to have been born after conception by ''in vitro'' fertilisation experiment (IVF). Her birth, following a procedure pioneered in Britain, has been lauded among "t ...
in England. These developments prompted the federal government to create regulations barring the use of federal funds for research that experimented on human embryos. In 1995, the NIH Human Embryo Research Panel advised the administration of President
Bill Clinton William Jefferson Clinton ( né Blythe III; born August 19, 1946) is an American politician who served as the 42nd president of the United States from 1993 to 2001. He previously served as governor of Arkansas from 1979 to 1981 and agai ...
to permit federal funding for research on embryos left over from ''in vitro'' fertility treatments and also recommended federal funding of research on embryos specifically created for experimentation. In response to the panel's recommendations, the Clinton administration, citing moral and ethical concerns, declined to fund research on embryos created solely for research purposes, but did agree to fund research on leftover embryos created by ''in vitro'' fertility treatments. At this point, the Congress intervened and passed the 1995 Dickey–Wicker Amendment (the final bill, which included the Dickey-Wicker Amendment, was signed into law by Bill Clinton) which prohibited any federal funding for the Department of Health and Human Services be used for research that resulted in the destruction of an embryo regardless of the source of that embryo. In 1998, privately funded research led to the breakthrough discovery of human embryonic stem cells (hESC). This prompted the Clinton administration to re-examine guidelines for federal funding of embryonic research. In 1999, the president's National Bioethics Advisory Commission recommended that hESC harvested from embryos discarded after ''in vitro'' fertility treatments, but not from embryos created expressly for experimentation, be eligible for federal funding. Though embryo destruction had been inevitable in the process of harvesting hESC in the past (this is no longer the case), the Clinton administration had decided that it would be permissible under the Dickey-Wicker Amendment to fund hESC research as long as such research did not itself directly cause the destruction of an embryo. Therefore, HHS issued its proposed regulation concerning hESC funding in 2001. Enactment of the new guidelines was delayed by the incoming
George W. Bush George Walker Bush (born July 6, 1946) is an American politician who served as the 43rd president of the United States from 2001 to 2009. A member of the Republican Party, Bush family, and son of the 41st president George H. W. Bush, he ...
administration which decided to reconsider the issue. President Bush announced, on August 9, 2001, that federal funds, for the first time, would be made available for hESC research on currently existing embryonic stem cell lines. President Bush authorized research on existing human embryonic stem cell lines, not on human embryos under a specific, unrealistic timeline in which the stem cell lines must have been developed. However, the Bush Administration chose not to permit taxpayer funding for research on hESC cell lines not currently in existence, thus limiting federal funding to research in which "the life-and-death decision has already been made." The Bush Administration's guidelines differ from the Clinton Administration guidelines which did not distinguish between currently existing and not-yet-existing hESC. Both the Bush and Clinton guidelines agree that the federal government should not fund hESC research that directly destroys embryos. Neither Congress nor any administration has ever prohibited private funding of embryonic research. Public and private funding of research on adult and cord blood stem cells is unrestricted.


=U.S. Congressional response

= In April 2004, 206 members of
Congress A congress is a formal meeting of the representatives of different countries, constituent states, organizations, trade unions, political parties, or other groups. The term originated in Late Middle English to denote an encounter (meeting of ...
signed a letter urging President Bush to expand federal funding of embryonic stem cell research beyond what Bush had already supported. In May 2005, the House of Representatives voted 238–194 to loosen the limitations on federally funded embryonic stem-cell research – by allowing government-funded research on surplus frozen embryos from
in vitro fertilization In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) f ...
clinics to be used for stem cell research with the permission of donors – despite Bush's promise to veto the bill if passed. On July 29, 2005,
Senate Majority Leader The positions of majority leader and minority leader are held by two United States senators and members of the party leadership of the United States Senate. They serve as the chief spokespersons for their respective political parties holding t ...
William H. Frist (R- TN) announced that he too favored loosening restrictions on federal funding of embryonic stem cell research. On July 18, 2006, the Senate passed three different bills concerning stem cell research. The Senate passed the first bill (the
Stem Cell Research Enhancement Act Stem Cell Research Enhancement Act was the name of two similar bills that both passed through the United States House of Representatives and Senate, but were both vetoed by President George W. Bush and were not enacted into law. Stem Cell Resea ...
) 63–37, which would have made it legal for the federal government to spend federal money on embryonic stem cell research that uses embryos left over from ''in vitro'' fertilization procedures. On July 19, 2006, President Bush vetoed this bill. The second bill makes it illegal to create, grow, and abort fetuses for research purposes. The third bill would encourage research that would isolate pluripotent, i.e., embryonic-like, stem cells without the destruction of human embryos. In 2005 and 2007, Congressman Ron Paul introduced the Cures Can Be Found Act, with 10 cosponsors. With an
income tax An income tax is a tax imposed on individuals or entities (taxpayers) in respect of the income or profits earned by them (commonly called taxable income). Income tax generally is computed as the product of a tax rate times the taxable income. Tax ...
credit, the bill favors
research Research is "creativity, creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization and analysis of evidence to increase understanding of a topic, characterized by a particular att ...
upon non-embryonic stem cells obtained from
placenta The placenta is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas and waste exchange between the physically separate mater ...
s,
umbilical cord In placental mammals, the umbilical cord (also called the navel string, birth cord or ''funiculus umbilicalis'') is a conduit between the developing embryo or fetus and the placenta. During prenatal development, the umbilical cord is physiologi ...
blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...
,
amniotic fluid The amniotic fluid is the protective liquid contained by the amniotic sac of a gravid amniote. This fluid serves as a cushion for the growing fetus, but also serves to facilitate the exchange of nutrients, water, and biochemical products betwee ...
, humans after birth, or unborn human offspring who died of natural causes; the bill was referred to committee. Paul argued that hESC research is outside of federal jurisdiction either to ban or to subsidize. Bush vetoed another bill, the
Stem Cell Research Enhancement Act of 2007 Stem Cell Research Enhancement Act was the name of two similar bills that both passed through the United States House of Representatives and Senate, but were both vetoed by President George W. Bush and were not enacted into law. Stem Cell Researc ...
, which would have amended the Public Health Service Act to provide for human embryonic stem cell research. The bill passed the Senate on April 11 by a vote of 63–34, then passed the House on June 7 by a vote of 247–176. President Bush vetoed the bill on July 19, 2007. On March 9, 2009, President Obama removed the restriction on federal funding for newer stem cell lines. Two days after Obama removed the restriction, the president then signed the
Omnibus Appropriations Act of 2009 The Omnibus Appropriations Act, 2009 (, ) is an Act for the United States government that combines bills funding the operations of each of the Cabinet departments, except Defense, Homeland Security, and Veteran Affairs into a single appropriat ...
, which still contained the long-standing Dickey–Wicker Amendment which bans federal funding of "research in which a human embryo or embryos are destroyed, discarded, or knowingly subjected to risk of injury or death;" the Congressional provision effectively prevents federal funding being used to create new stem cell lines by many of the known methods. So, while scientists might not be free to create new lines with federal funding, President Obama's policy allows the potential of applying for such funding into research involving the hundreds of existing stem cell lines as well as any further
lines Line most often refers to: * Line (geometry), object with zero thickness and curvature that stretches to infinity * Telephone line, a single-user circuit on a telephone communication system Line, lines, The Line, or LINE may also refer to: Arts ...
created using private funds or state-level funding. The ability to apply for federal funding for stem cell lines created in the private sector is a significant expansion of options over the limits imposed by President Bush, who restricted funding to the 21 viable stem cell lines that were created before he announced his decision in 2001. The ethical concerns raised during Clinton's time in office continue to restrict hESC research and dozens of stem cell lines have been excluded from funding, now by judgment of an administrative office rather than presidential or legislative discretion.


=Funding

= In 2005, the NIH funded $607 million worth of stem cell research, of which $39 million was specifically used for hESC.
Sigrid Fry-Revere Sigrid Fry-Revere is a medical ethicist and lawyer who has worked on many issues in patient care ethics, but most recently has been working on the rights of living organ donors. Background Fry-Revere worked as an attorney, practicing bioet ...
has argued that private organizations, not the federal government, should provide funding for stem-cell research, so that shifts in public opinion and government policy would not bring valuable scientific research to a grinding halt. In 2005, the State of California took out $3 billion in bond loans to fund embryonic stem cell research in that state.


Asia

China has one of the most permissive human embryonic stem cell policies in the world. In the absence of a public controversy, human embryo stem cell research is supported by policies that allow the use of human embryos and therapeutic cloning.


Religious views

Generally speaking, no group advocates for unrestricted stem cell research, especially in the context of embryonic stem cell research.


Jewish view

According to Rabbi Levi Yitzchak Halperin of the Institute for Science and Jewish Law in Jerusalem, embryonic stem cell research is permitted so long as it has not been implanted in the womb. Not only is it permitted, but research is encouraged, rather than wasting it. Similarly, the sole Jewish majority state,
Israel Israel (; he, יִשְׂרָאֵל, ; ar, إِسْرَائِيل, ), officially the State of Israel ( he, מְדִינַת יִשְׂרָאֵל, label=none, translit=Medīnat Yīsrāʾēl; ), is a country in Western Asia. It is situated ...
, permits research on embryonic stem cells.


Catholicism

The
Catholic Church The Catholic Church, also known as the Roman Catholic Church, is the largest Christian church, with 1.3 billion baptized Catholics worldwide . It is among the world's oldest and largest international institutions, and has played a ...
opposes human embryonic stem cell research calling it "an absolutely unacceptable act." The Church supports research that involves stem cells from adult tissues and the umbilical cord, as it "involves no harm to human beings at any state of development." This support has been expressed both politically and financially, with different Catholic groups either raising money indirectly, offering grants, or seeking to pass federal legislation, according to the
United States Conference of Catholic Bishops The United States Conference of Catholic Bishops (USCCB) is the episcopal conference of the Catholic Church in the United States. Founded in 1966 as the joint National Conference of Catholic Bishops (NCCB) and United States Catholic Conference (US ...
. Specific examples include a grant from the Catholic Archiocese of Sydney which funded research demonstrating the capabilities of adult stem cells, and the U.S. Conference of Catholic Bishops working to pass federal legislation creating a nationwide public bank for umbilical cord blood stem cells.


Baptists

The
Southern Baptist Convention The Southern Baptist Convention (SBC) is a Christian denomination based in the United States. It is the world's largest Baptist denomination, and the largest Protestant and second-largest Christian denomination in the United States. The wor ...
opposes human embryonic stem cell research on the grounds that the "Bible teaches that human beings are made in the image and likeness of God (Gen. 1:27; 9:6) and protectable human life begins at fertilization." However, it supports adult stem cell research as it does "not require the destruction of embryos."


Methodism

The
United Methodist Church The United Methodist Church (UMC) is a worldwide mainline Protestant denomination based in the United States, and a major part of Methodism. In the 19th century, its main predecessor, the Methodist Episcopal Church, was a leader in evangelic ...
opposes human embryonic stem cell research, saying, "a human
embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male spe ...
, even at its earliest stages, commands our reverence." However, it supports adult stem cell research, stating that there are "few moral questions" raised by this issue.


Pentecostalism

The
Assemblies of God The Assemblies of God (AG), officially the World Assemblies of God Fellowship, is a group of over 144 autonomous self-governing national groupings of churches that together form the world's largest Pentecostal denomination."Assemblies of God". ...
opposes human embryonic stem cell research, saying, it "perpetuates the evil of
abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
and should be prohibited."


Islam

Islamic scholars generally favor the stance that scientific research and development of stem cells is allowed as long as it benefits society while causing the least amount of harm to the subjects. "Stem cell research is one of the most controversial topics of our time period and has raised many religious and ethical questions regarding the research being done. With there being no true guidelines set forth in the Qur'an against the study of biomedical testing, Muslims have adopted any new studies as long as the studies do not contradict another teaching in the Qur'an. One of the teachings of the Qur'an states that 'Whosoever saves the life of one, it shall be if he saves the life of humankind' (5:32), it is this teaching that makes stem cell research acceptable in the Muslim faith because of its promise of potential medical breakthrough." This statement does not, however, make a distinction between adult, embryonic, or stem-cells. In specific instances, different sources have issued fatwas, or nonbinding but authoritative legal opinions according to Islamic faith, ruling on conduct in stem cell research. The ''Fatwa'' of the Islamic Jurisprudence Council of the Islamic World League (December 2003) addressed permissible stem cell sources, as did the ''Fatwa'' Khomenei (2002) in Iran. Several different governments in predominantly Muslim countries have also supported stem cell research, notably Saudi Arabia and Iran.


The Church of Jesus Christ of Latter-day Saints

The First Presidency of
the Church of Jesus Christ of Latter-day Saints The Church of Jesus Christ of Latter-day Saints, informally known as the LDS Church or Mormon Church, is a Nontrinitarianism, nontrinitarian Christianity, Christian church that considers itself to be the Restorationism, restoration of the ...
"has not taken a position regarding the use of embryonic stem cells for research purposes. The absence of a position should not be interpreted as support for or opposition to any other statement made by Church members, whether they are for or against embryonic stem cell research.”


See also

* Stem cell laws * Dickey–Wicker Amendment *
Medical ethics Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. T ...
*
Stem Cell Research Enhancement Act Stem Cell Research Enhancement Act was the name of two similar bills that both passed through the United States House of Representatives and Senate, but were both vetoed by President George W. Bush and were not enacted into law. Stem Cell Resea ...
* Stem cell research policy *
Fetal tissue implant Fetal tissue implant or fetal cell therapy is an experimental medical therapy where researchers implant tissue from a fetus into a person as treatment of a disease. In the case of Parkinson's disease, it is hoped that the fetal tissue would produ ...


References


External links


Video: The Stem Cell Controversy
January 18, 2006,
Woodrow Wilson Center The Woodrow Wilson International Center for Scholars (or Wilson Center) is a quasi-government entity and think tank which conducts research to inform public policy. Located in the Ronald Reagan Building and International Trade Center in Was ...
event featuring
Robin Cook (novelist) Robert Brian "Robin" Cook (born May 4, 1940)Stookey, Lorena Laura (1996). ''Robin Cook: A Critical Companion'', Westport, Connecticut, London: Greenwood Press. is an American physician and novelist who writes about medicine and topics affecti ...
,
William B. Hurlbut William B. Hurlbutt is a Consulting Professor in the Department of Neurobiology at Stanford University Medical Center. Born in 1945 in St. Helena, California, St. Helena, California, he grew up in Bronxville, New York, Bronxville, New York (state ...
, and
Michael D. West Michael D. West (born in Niles, Michigan on 28 April 1953) is an American biogerontologist, and a pioneer in stem cells, cellular aging and telomerase. He is the founder and CEO of AgeX Therapeutics, a startup focused on the field of experime ...

The Hinxton Group: An International Consortium on Stem Cells, Ethics & Law

A Scientific-Industrial Complex? By Sigrid Fry-Revere




{{DEFAULTSORT:Stem Cell Controversy Stem cells Ethically disputed medical practices