Saturday, March 07, 2009

Should Embryonic Stem Cells be Used for Medical Research?


On Monday 9 March 2009 President Obama signed an executive order reversing the Bush administration's ban on the use of Federal funding for embryonic stem cells for medical research (and presumably for any medical treatments that might eventually be developed as the result of that research). This policy change has raised a storm of controversy among right-to-life- advocates, and also among "intelligent design" supporters. This controversy has centered on the ethics of science, and whether scientists should be allowed to pursue their research wherever it leads.

Currently, most embryonic stem cells are derived from human egg cells that have been fertilized in vitro (that is, outside of the body of the egg-donor mother) as part of the process of in vitro fertilization (IVF) whereby childless couples can conceive of a baby using their own genetic material.

IVF clinics generally fertilize multiple donor eggs and then let them
divide by mitosis
until the blastula stage is reached. During this process the inner cell mass is formed inside the blastula, from which embryonic stem cells are derived. The point to this process is not to produce the embryonic stem cells in the inner cell mass, but rather to produce viable blastulas, which can then be implanted in the uterus of the egg donor (or, in rare cases, a surrogate).

The way this process is carried out necessarily produces multiple unused blastula-stage embryos for every one that is implanted. These unused blastula-stage embryos are usually frozen in liquid nitrogen, in case the egg donor requires a repeat implantation.

Currently, there are almost half a million such blastula-stage embryos frozen in liquid nitrogen in IVF clinics in the United States, which leads to the first ethical question:
What becomes of the unused frozen embryos, and who decides?

Here is what generally happens:
Any embryos that you do not use in your first IVF attempt can be frozen for later use. This will save you money if you undergo IVF a second or third time. If you do not want your leftover embryos, you may donate them to another infertile couple, or you and your partner can ask the clinic to destroy the embryos. Both you and your partner must agree before the clinic will destroy or donate your embryos. [source]

So, should the "parents" (i.e. the egg and sperm donors) have the right to decide that their unused blastula-stage embryos be destroyed? Despite some political efforts to deny them this right, there is no legal jurisdiction in the U.S. in which this right has been abrogated (yet).

One way to solve this particular ethic dilemma is to "adopt" the frozen embryos by having them implanted in an "adoptive" mother. There is an organization that advocates this, Nightlight Christian Adoptions, and has arranged for some of these frozen embryos (which the organization calls "snowflakes") to be "adopted" by implantation in "adoptive" mothers who are medically infertile (and married).

According to data at that website, the current number of successful "snowflake adoptions" is approximately 202 since the program was started in 1997. That works out to around 17 per year, or 0.0034% of the current half-million "snowflake backlog". At that rate, all of the frozen embryos currently in cryogenic suspended animation will be "adopted" by the year 31421.

However, this grossly underestimates how long this backlog will persist, as it assumes that no new "snowflakes" are generated by new IVF procedures. Currently, the rate of production of new frozen blastula-stage embryos at IVF clinics in the US is approximately 18,000 per year. The current rate of "snowflake adoption" is approximately 20 per year, so unless IVF is permanently stopped, it is mathematically impossible for the current "snowflake backlog" to eventually be "adopted".

One way to avoid the use of embryonic stem cells taken from frozen blastula-stage human embryos is to use adult stem cells instead. There are many different tissues in adult humans that qualify as pluripotent stem cells (that is, cells that can continue to divide by mitosis). Recent research has made it possible to "regress" adult stem cells almost to the embryonic stem cell stage, which raises the possibility of using adult stem cells instead of embryonic stem cells.

Personally, I strongly hope that adult stem cells can be used for all of the scientific and technical uses that most scientists originally thought only embryonic stem cells could be used for. However, this will then lead to two new, unforseen ethical dilemmas:
What will be done with the "snowflakes" that are currently frozen at IVF clinics, if they are not used for stem cell research and medical treatment?

and
What will be done with the adult stem cells that have been regressed to the embryonic stem cell stage, since these would then qualify genetically and developmentally as "snowflakes" themselves?

Clearly, one irony of the development of adult stem cell regression will be that the "snowflakes" now frozen in liquid nitrogen in all of those IVF labs will now almost certainly be disposed of (I suppose they defrost and incinerate them), rather than contributing to the advance of medical technology and human welfare.

The other irony, of course, is that by regressing adult stem cells to the embryonic stem cell stage, there would be many more "snowflakes", rather than fewer, thereby necessitating the destruction of many more "potential human beings" than is currently the case.

There are two other solutions, both of which avoid the ethical dilemmas outlined above. One alternative would be:
To consider that neither embryonic stem cells nor adult stem cells are "human beings" until they are implanted into a mother and are born as human babies.

This, of course, would require defining "human life" as beginning at birth, rather than "conception" (regardless of where that "conception" took place).

Another alternative would be:
To consider that all stem cells are "human beings", which would require that all stem cell research and treatment and all forms of in vitro fertilization be declared unethical, and presumably outlawed.
But this would also require that we outlaw all developmental research, because somewhere along the line some researcher somewhere might find out how to regress any human cell to the embryonic stem cell stage, and then simply scratching your head or drinking a cup of too-hot coffee would be equivalent to murder.

As always, comments, criticisms, and suggestions are warmly welcomed!

--Allen

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13 Comments:

At 3/08/2009 03:41:00 AM, Anonymous Sassan said...

Hi,

Well, it depends! if we get more than what we spend, yeah it should be used, I mean, eating a hamburger is somehow equal to killing an animal and eating it! and that's horrible! but hamburger is not :) so, yeah we should use them, and we've to use them, 'if' we could do something astonishing, something like curing cancers, AIDS, blindness, and such.

 
At 3/08/2009 04:15:00 AM, Anonymous Anonymous said...

stem cell research is only a cover for torture. the c.i.a. refers to torture as conducting research and makes big money doing it. how ever the victims im sure would rather abolish this type of research. any way, all of the mentioned benifits of stem cell research could easily and economically be cured simply by abolishing the uses of pesticide on crops, and educating the nation on the positive benifits of proper nutrition. how ever then the a.m.a. wouldnt have the leverage to extort americas taxes because then the entire nation would be healthy. the a.m.a. them selves are the causes for cancer and other health related problems because thats what brings in the mula to the practitioners.

 
At 3/08/2009 09:15:00 AM, Blogger bw said...

Using other people (or potential people) for one's own benefit seems very similar to slavery. In the case of slavery the owner takes the profit derived from the slave's work.In embryonic stem cell research we take the step toward using others for profitable scientific research. Would you really want to kill someone to cure your own disease or maybe own a few slaves to do your work? For moral reasons, no matter what my personal gain would be, I would not decide to do either.

 
At 3/08/2009 10:23:00 AM, Blogger Allen MacNeill said...

This is precisely the point: embryonic blastulas are not people, nor are they any more "potential" people than frozen unfertilized egg cells or frozen sperm in a sperm bank. All of these are "potential people", but none of them are "actual people" until they have successfully undergone fetal development and been born as viable infants.

Ergo, the decision to use (or not to use) embryonic stem cells for research and/or therapeutic purposes is most appropriately based on what is known in ethical philosophy as "competing harms" (or, if you prefer, "cost/benefit analysis"). Does the benefit that might come from stem cell technology outweigh the harm that might accrue to frozen blastulas (which would either be destroyed or remain frozen anyway)? Most people agree (including many political conservatives), and want this technology to go forward.

And yes, ethical decisions not only do, but should include exactly the kind of community-level negotiation that has resulted in President Obama's change in policy. Otherwise a potentially huge public benefit can be held hostage to the essentially irrational whims of a religious minority. And yes, the ethical positions of individuals are indeed respected by the new policy, because the "parents" of the frozen blastulas are still given complete authority over whether they are to be destroyed, preserved, or used for embryonic stem cell research.

As to equating embryonic stem cell technology to slavery, this is manifestly absurd. Slavery involves the threat or outright use of force to make people do something against their will. Blastula-stage embryos have no "will", nor can they ever (unless they are eventually implanted in a mother and brought to term). Ergo, this argument is entirely nugatory.

 
At 3/08/2009 11:13:00 AM, Blogger Allen MacNeill said...

Every sperm is sacred:

http://www.youtube.com/watch?v=r-L3JMk7C1A

Warning: Monty Python is an equal opportunity satirist.

 
At 3/08/2009 02:04:00 PM, Anonymous Anonymous said...

I do not doubt that the research on embryonic stem cells will be fruitful, however nobody consider how the potential treatment will look like. Let suppose that researchers find a way to force embryonic stem cells to produce, for example, insulin. To treat a person with diabetes type-I, it will be required first to take from this person sperm/ovum and use for in vitro fertilization in order to create an embryo which will be next used to create cells producing insulin. Such cells will be introduced into this person. There is still chance that the cells producing insulin will be rejected by the patient because they have 50% of genetic information from this person. I suppose that the next generation of studies in our future would be to create cells which will be accepted by patient. To achieve this it will be better to create embryos from sperm/ovum of patient and his/her mother/father, that means incest embryos, since only such cells will have much grater chance to be accepted by patient’s body.

Would you like to treat your illness in such way? Would you agree to create embryos with your wife/husband’s ovums/sperm by in vitro fertilization, which would be your unborn daughter or son, in order to treat your illness? I think that it is good that people have an ideas but not all ideas are "proper ". We need all to let people understand where it will go, how this treatment will look like. I do not believe that this is the only way to treat the illness. It may be the shortest way but not the only.

Researcher

 
At 3/09/2009 11:19:00 AM, Blogger Hannah said...

Embryonic stem cells can be encouraged in medical research, as it would lead us to a better tomorrow. Do you feel that this move would help the doctors to find cure for so many diseases that are not curable as of now? . Would this lead to a better or a bitter tomorrow? Share your views with us at
www.allvoices.com/journalism
.

 
At 3/10/2009 10:22:00 PM, Anonymous chunkdz said...

Allen said: "To consider that neither embryonic stem cells nor adult stem cells are "human beings" until they are implanted into a mother and are born as human babies."


Nobody thinks that embryonic stem cells or adult stem cells are human beings, Allen. It's a strawman, along with your silly "Every sperm is sacred" reference.

The real issue is that a human life must be killed to harvest embryonic stem cells. This extinguishing of life to harvest cells is also unnecessary since safe adult stem cell pluripotency was recently achieved a couple of weeks ago.

Obama should be ashamed of himself for ignoring this science. You should be ashamed for misrepresenting the opposing arguments. Bad form.

 
At 3/14/2009 10:58:00 AM, Anonymous John Wendt said...

"Any embryos that you do not use in your first IVF attempt can be frozen for later use."

Can a frozen embryo be considered alive? One of the characteristics of life is a continual flow of energy; cut off the energy, by cutting off either glucose (the energy source) or oxygen (the destination of the energetic electrons -- no destination, no flow) and the organism dies. Without energy flow, the embryo is just an organized array of chemicals.

"require defining 'human life' as beginning at birth, rather than 'conception' "

Many states define death as "brain death", the cessation of electrical activity in the brain. How about defining (human) life as the beginning of electrical activity? This takes place in humans around the eighth month of gestation.

 
At 3/18/2009 05:28:00 PM, Blogger Chip said...

Both sides of this argument seem to always forget (or just not know) that a method exists for harvesting embryonic stem cells without any harm to the embryo. Look up Dr. Robert Lanza and Advanced Cell Technologies (ACTC). This method has been around for at least a year but all we ever hear in the news is the old "killing babies" saw.

 
At 4/05/2009 07:05:00 AM, Anonymous Egy Azziera said...

There is no ban on embryonic stem cell research for President Obama to lift. When Bush provided federal funding for embryonic stem cell research, which no President had done before him, he restricted what research that funding could be used for. He did not ban embryonic stem cell research.

 
At 4/13/2009 05:56:00 PM, Anonymous Anonymous said...

hey you should post what are each type of stem cells used fore. that would be very helpful. there are no websites that have that info!

 
At 9/12/2009 09:52:00 PM, Anonymous Anonymous said...

"regression" is another way to say somatic cell nuclear transfer which is cloning - there would be no viable human from a regressed embryonic stem cell, so no ethics should be involved and I believe this is the way we should proceed in the future. I'm 15 and just did an abstract in biology on this subject and got a 100%! yay
http://www.aamc.org/advocacy/library/research/res0003.htm

 

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