Student Writers: Jonathan H, Denae M, Christopher N, Neil P
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The cell is the most basic form of life. Every living organism, from trees to animals, is composed of billions of cells. Although human cells are extremely microscopic, they are entirely responsible for the health of our human bodies. Since their initial discovery, stem cells in particular have shown major promise in the field of medicine. These cells have commonly been referred to as a possible miracle cure for ailments affecting the human body, including Alzheimer’s disease, heart disease, diabetes, arthritis, and much more (Stem Cell Basics). Despite the recognized benefit of research in this field, stem cell research has an unclear future due to an ongoing debate about the legality and ethicality of stem cell research. Our group contends that the arguments against stem-cell research ignore key information about the processes and unjustly handicap ongoing research into potentially life-saving treatments.
History of Stem Cell Research:
With the recent advances in medical research, scientists are experimenting with stem cells and their potential for curing a wide range of diseases and disabilities. The diagnosis of paralysis once meant a life confined to a wheelchair, but with the aid of stem cells, something once thought incurable finally can be cured.
The Science Behind Stem Cells:
Stem cells were initially discovered in the mid 1800s. It was observed that these stem cells could give rise to other cells, making a stem cell a “progenitor” to other human cells. Stem cell research involves both human and animal stem cells. The controversy surrounding embryonic stem cell research involves the destruction of living human embryos. The human embryos used in the production of embryonic stem cells are donated with the donors consent. These embryos are derived from in-vitro fertilized eggs. During fetal development, stems cells are directed to differentiate into a variety of cells, such as brain and liver cells. The inner cells lining the cavity of blastocyte, a 3-5 day old embryo, give way to multiple cells and organs of the entire body (Stem Cell Information). A stem cell is essentially an unspecialized cell. It is simply a cell with no direction or function, until it is called upon to differentiate into a multitude of different human cells. It is this differentiation that turns an unspecialized stem cell into a specialized one. This characteristic of stem cells allows them to have the programming capability to cure a wide range of diseases (Stem Cell Information).
Researcher James Thompson successfully isolated the first line of viable embryonic stem cells in 1998. The successful completion of this milestone stirred great interest among the medical and scientific community. Thompson is credited with discovering how to stimulate differentiation in a laboratory setting. Thompson achieved this by taking the inner cell mass of a blastocyte and spreading it over a nutrient covered Petri dish. This nutrient agar supplied the undifferentiated embryonic stem cells with an ideal environment to grow and divide. Cells present in the Petri dish clumped together and created what is known as embryoid bodies (Stem Cell Information). It is these embryoid bodies that begin to differentiate under the right conditions to produce functional human cells. The addition of certain precursors causes the complete differentiation of viable stem cells. The attempted induction of undifferentiated stem cells is known as directed differentiation. Scientists are able to direct differentiation by varying a multitude of factors such as the changing the surface of the Petri dish, changing the chemical composition of nutrient agar, and by modifying the cells by the insertion of specific genes specific to that cell (Stem Cell Information). For example, if a researcher wanted to differentiate stem cells into brain cells, the addition of neuronal precursors would create dopamine/serotonin-secreting neurons (Stem Cell Information). These stems cells can replace damaged or carcinogenic cells.
Breakthroughs in Medical Research:
The biggest breakthrough in stem cell research took place in September of 2005. Scientists in California successfully injected human neural stem cells in a partially paralyzed mouse. This injection repaired the spinal cord, allowing the once paralyzed mouse to walk again. This was the first time a set of human transplantable cells was used to fix the nervous system and cure spinal cord paralysis. On August 23rd, 2006, researchers at the Advanced Cell Technology Company reported it was possible to remove cells from an embryo without destroying it. The cells extracted from the embryo are then cultured on a dish to produce viable embryonic stem cells (Stem Cell Information). This discovery is a solution to the constant controversy surrounding stem cell research. Shortly after on January 11th 2007, researchers at Harvard and Wake Forest University reported that stem cells extracted from donated amniotic fluid shares many of the same characteristics as embryonic stem cells. In November 2007, two independent research teams found another method for making viable embryonic stem cell without the destruction of human embryos. The method involved a mixture of four genetic factors to human skin cells. The addition of these genetic factors allowed for the isolation of cells that are identical to embryonic stem cells (Stem Cell Information).
Recent news highlights the exciting breakthroughs made in the field of stem cell research. Researchers at the Stanford-Burnham Medical Research Institute recently discovered the molecular messengers that are responsible for translating inflammatory signals into genetic changes that stimulate stem cells to differentiate. Patients suffering from muscular dystrophy lack stem cells that are capable of regenerating new muscle fibers (Inoue 2560). Another recent study highlights the potential healing therapies degenerative brain diseases. The presence of defective microglia leads to the release of inflammatory molecules, leading to degenerative diseases such as Alzheimer’s and Dementia (Inoue 2560). The discovery that microglia develop for only a short period after conception allows researchers to manipulate stem cells to produce viable microglia, in the hopes of replacing damaged microglia present in the brain (Inoue 2561).
Contemporary stem cell research is now exploring methods of extracting stem cells from sources such as umbilical cord blood. Through the years, research performed on umbilical cord blood shows that this fetal blood is a viable source of stem cells (Feng 271). This method is becoming increasingly popular because the extraction of these stem cells destroys no human embryos in the process. Although this umbilical cord blood contains a source of stem cells, scientific evidence suggests that the cells extracted from embryos remain the best source (Hudson).
It is impossible to discuss human embryonic stem cell (HECS) research without also discussing the debate about the ethicality of the research. Many different individual arguments comprise a single, larger debate: Is it ethical to destroy human embryos to alleviate the pain and suffering of existing human lives? The debate polarizes the issue of stem-cell research as a whole, although it applies only to embryonic stem-cell research. Stem-cell research using cells from umbilical cords or adult “somatic” stem-cells, which are not as useful for research, are not subject to the same controversy. The effects of this debate are readily evident; because of the controversial nature, many religious organizations refuse to acknowledge the benefits of research using embryonic stem-cells, politicians refuse to support research efforts, and federal funding is in a constant state of limbo. But while the argument against embryonic stem-cell research seems at first glance strongly founded, further investigation uncovers serious flaws and instances of false logic.
Michael Sandel, in his article entitled “Embryo Ethics – The Moral Logic of Stem-Cell Research” outlines the two main arguments of opponents of HESC research: "Some hold that despite its worthy ends, stem-cell research is wrong because it involves the destruction of human embryos; others worry that even if research on embryos is not wrong in itself, it will open the way to a slippery slope of dehumanizing practices, such as embryo farms, cloned babies, the use of fetuses for spare parts, and the commodification of human life" (207). The first argument is based on an appropriate concern that, as Sandel explains, “biomedical ethics is not only about ends but also about means; even research that achieves great good is unjustified if it comes at the price of violating fundamental human rights” (207). To the opponents who follow this train of logic, who are represented by most religious groups but also many secular or scientific groups, life begins at conception, which means that all fertilized human eggs represent human life. Therefore, to these opponents, using HESC for research is tantamount to murdering another person to harvest their organs.
The problem with this argument is not the intentions of the argument, but with the basic logic that supports it. For one, a blastocyst, a laboratory-fertilized human egg, is no more a human than an acorn is an oak tree. Both are fertilized, but one does not immediately equal the other. Many factors must perfectly align before development can continue for an embryo (or an acorn). More than half of all embryos fail to implant “or are otherwise lost” during the natural pregnancy process (Sandel 207), and therefore never continue development. Like an acorn that will likely never develop into an oak tree, a blastocyst (embryo) will likely never develop past the embryonic stage due to natural, uncontrollable forces. This is a hotly debated topic that may have more religious and philosophical beliefs driving it, however. Most importantly, though, the overall argument of the HESC research opponents ignores key facts about the origins of the blastocysts used in HESC research.
Couples who use in-vitro fertilization (IVF) typically have unused fertilized eggs (blastocysts) after the procedure is finished. Some couples choose to donate the leftover embryos for research; these are the embryos that are used for HESC (McLaren 130). What opponents of HESC research don’t address in their argument is that nearly all leftover embryos from IVF are prevented from continuing development (Robinson, religioustolerance.org). After IVF, many couples (about 20%) choose to freeze their leftover embryos indefinitely, never to be implanted and allowed to continue development (Bell, CNN Health). Most of the remaining 80% of couples choose to donate the embryos to another couple or discard the embryos. A small percentage of these couples (roughly 2.8%) donate to medical research. Donating to another couple often involves difficult legal procedures, and so many of the leftover embryos ultimately are destroyed – either by purposely implanting during a time when pregnancy is unlikely, letting the embryos thaw without implantation, or simply discarding them. Despite the relatively small percentage of people who choose to donate the embryos for research compared with the overwhelming percentage of people who choose indefinite freezing or willful destruction of the embryos, HESC opponents are singularly focused on the anti-HESC argument, and wholly ignore the fact that scores of embryos are purposefully destroyed in the IVF process on a regular basis. The ultimate question, therefore, becomes: Is it not unethical to allow multitudes of excess embryos to be discarded rather than utilizing them for research into life-saving treatments? Ultimately, what should be noted are the countless lives that can be saved by HESC research, rather than focusing all efforts on demonizing the research process itself.
There are many differing views and opinions on the research of embryonic stem cell research. To understand the legal arguments, one must first understand where the two sides originate from. The lawyers and medical ethicist in favor of embryo stem cell research argue that stem cells are incapable of growing into a complete person; they will never become a living person (Robinson). Geneticists and biologists have turned to stem cell research because of the ability to become special functions cells, which can be stimulated to become different cells of the body (Reis, 319). Those in favor of research state that there are spare embryos in fertility clinics which can have their stem cells extracted if they are to not be used. The group against embryonic stem cell research believes that an embryo is a human being with a soul; removing their stem cells is certain death, which would be murder (Robinson). The spare embryos are to be contained in storage for "adoption" rather than discarding them (Robinson). We can call these groups the pro-choice for those that favor research and the ones that oppose it are pro-life (Robinson).
These two groups are the major players in the spectrum of displaying public opinion and have the most power in government/court rulings.
The history of legal affairs concerning embryonic stem cell research in court rooms is an arduous one, causing delay in what could be a monumental breakthrough in medicine and science. The pro-life and the pro-choice, in their collective sense, keep the fight going (Robinson). Both sides have their reasons, the pro-life fighting for their beliefs while the pro-choice believe in the choice of the person sacrificing few for the sake of many. The following is a brief overview of how stem cells in the legal proceedings have fared since the beginning of the dispute.
In 1996, a federal law was placed that prohibited federal funds from supporting research on embryonic stem cells (Duffy). Research previously funded by the National Institute of Health (NIH), a government agency, halted due to the 1996 ban on funding (Duffy).
In 1998 scientists at the University of Wisconsin were able to isolate human embryonic stem cells and influence the cells to grow into specialized cells (Duffy). The discovery of the newfound isolation of stem cells caused an agglomeration of legality cases for and against further research. The result of many court cases over the next couple of years was permission to federally fund research using existing stem cells that had been previously extracted using private funds. This was a step in the right direction, but the legal battle continued. The new president at the time, George W. Bush, limited stem cell research funding on August 9, 2001 because of his pro-life political base (Robinson). It was then decided that no stem cells other than the ones already obtained could be procured or extracted. Until recent months, many court cases and federal bills were brought up to continue the research and overturn the decision by President Bush (Robinson). However, all bills that did pass legislation and senate approval were vetoed by President Bush (Robinson).
It was not until March 09, 2009 that the next president, President Barack Obama, overturned Bush’s policy on stem cell research. At this point in time, a group of plaintiffs filed a suit against the Secretary of Health and Human Services on the basis that the new research was illegal (Robinson). The existing guidelines for federal funding require that stem cells are to be extracted from pre-embryos using private funds, that the embryos that were acquired are surplus and are no longer needed for reproductive purposes, that the donors must consent to the embryo used in research, and finally that the donors are not paid for donating (Robinson). In October 2009, the case by the plaintiffs was dismissed on the basis that it had no standing under the law. On June 25th, 2010 a case involving two of the plaintiffs was overruled by a three-judge appeal who decided the plaintiffs did have standing. The case was sent back to the judge who had decided they did not have standing originally in October (Robinson). On August 23rd, 2010 through a judicial ruling of an injunction, all federal funding on embryonic stem cell research was suspended. The most recent court case, as of the posted date of this article, was September 9th, 2010, during which an appeals court temporarily lifted the injunction which suspended funding for research until both sides prepare their arguments (Robinson 40).
It is difficult to predict the direction the court cases will take. There are many arguments between both pro-choice and pro-life groups, and neither is willing to back down. Even though both sides have their differences, there are times when the two seem single-minded on their hopes about the future of the research. A recent survey of adults showed that 73% believe that scientists should be allowed to use embryonic stem cells that are left over in fertilization clinics to find potential cures or treatments for diseases (Gardner). A small group (12%) opposes using stem cells at all for biomedical research (Gardner). The poll was taken recently (September 28-30, 2010) and polled 2,113 participants (Gardner). The new guidelines set in place by President Obama after overturning former President Bush’s 2001 ruling are so agreeable that many citizens have already accepted them (Gardner). A large two-thirds majority of the populous agree with the statement that: “If most scientists believe that stem cell research will greatly increase our ability to prevent or treat serious diseases we should trust them and let them do it”. Why, then, must this debate rage on in court rooms (Gardner)? The possibility to finding cures and saving lives is being debated away in courtrooms. Political views and beliefs should be cast aside for the greater good.
The Future of Stem Cell Research:
The future of human embryonic stem cell (HESC) research is one that stands to unlock a plethora of new medical treatments as well as new areas of study yet to be discovered. The direct application to medical treatments is nothing short of miraculous. The concept of tissue generation is now becoming a practice that can be applied to patients like never before. In tandem, researchers are pushing the very limits of our understanding of the human body and the role that these stem cells could play in treating and curing disease. Human embryonic stem cells serve as a tool for them as they are the epitome of a scientific control that can be quantified and compared against precisely manipulated experimental data through gene therapy. This cyclical exchange between experimentalists and patient caretakers, by their application of cutting edge research, is what is advancing the future of stem cell research.
The direct application of HESCs to medical treatment is just one of the ways that our future will be intertwined with stem cells. One of the burgeoning areas in this field is the incorporation of HESCs to create new tissue from the “instructions” of our own genetic code.
Currently there are significant developments in the creation of skin grafts that are created from the donor’s own DNA. This would be unlike the skin grafts that we currently have for burn victims, because they are actually the patient’s own skin. The only difference is that these have been grown in a lab and at a faster rate than what our own bodies can generate. The scaring would be considerably less, because they have circumvented the body’s own response to healing the wound. This however is just one step forward to a more complex problem of tissue generation. Ultimately, the direction is towards the transplantation of artificially created human organs.
Organ transplantation is when donated organs are removed from donors and physically transplanted into people that need them. The surgery is then followed by a lifetime of anti-rejection medications to ensure that the organ isn’t rejected and consequently disposed of by the body’s immune system. The goal of advanced tissue generation is “to avoid the problem of immune rejection” and “generate tissues that will not be rejected” (Stem Cell Basics). The long term plan for stem cell research is aimed at solving these issues by allowing us to grow our own replacement organs.
“Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues to treat diseases including Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.” (Stem Cell Basics)
This would enable your doctor to “order” a replacement heart, kidney, or liver for you if you needed one for a transplant. The chance of organ rejection would be a thing of the past due to the organ actually being grown from your own genetic blueprint.
The list of potential cures and treatments that could come about from using stem cells is varied from diseases such as Alzheimer's, diabetes, and cancer (Zaneka). Stem cells will allow researchers to essentially create microscopic test labs where the actual components of our bodies that lead to the development of disease could be observed and experimented with. Zaneka focuses and expands this idea by stating that “human embryonic stem cells are easily accessible for controlled and specific genetic manipulation. When this facility is combined with their rapid growth, remarkable stability, and ability to mature in vitro into multiple cell types of the body, human embryonic stem cells are attractive potential tools for gene therapy” (Zaneka). This would take the emphasis of clinical trials for new drugs out of the realm of direct human experimentation, because the components of the cells that need to be observed can be done so without a human body. This would greatly reduce the time needed for testing new drugs and change the time frame from a decade to several years for the introduction of new treatments (Lovell-Badge 91).
By opening up these cells as a tool to researchers we stand to learn more about how our body actually develops and matures. This is the cutting edge of medical science and the wonders that we can discover are hidden right within the cells of our own bodies. By allowing the use of human embryonic stem cells we are investing in a future for ourselves and for our children. By understanding the history of this issue we gain insight into our shared future together and it gives us a point of reference for the moral and legal arguments that can and do erupt. We believe that by opening up research in human embryonic stem cells we could help bring about a future free of the diseases and death that has plagued mankind for centuries.
To learn more about stem cell research:
Beil, Laura. “What Happens to Extra Embryos After IVF?”. CNN Health. 19 Sept. 2009. Web. 19 Oct. 2010.
"Culture Club." Cox & Forkum. Web. 20 Nov 2010. <http://www.coxandforkum.com/archives/000593.html>.
Duffy, Diane. "Background and Legal Issues Related to Stem Cell Research." Policy Almanac. Almanac of Policy Issues, 02 Jun 2002. Web. 20 Oct 2010. <http://www.policyalmanac.org/>.
Feng, Jian. "Embryonic Stem Cells: Don’t Let Litigation Put Research Off Limits." 467. (2010): 271. Web. 10 Nov 2010.
Gardner, Amanda. "Most Americans Back Embryonic Stem Cell Research: Poll." U.S. News. U.S.News & World Report, 07 Oct 2010. Web. 13 Nov 2010. <http://health.usnews.com/>.
Hudson, Kathy, Joan, Scott, and Ruth Faden. "Values in Conflict: Public Attitude on Embryonic Stem Cell Research." DNA Policy. Genetics and Public Policy Center, October 2005. Web. 13 Nov 2010.<http://www.dnapolicy.org/images/reportpdfs/2005ValuesInConflict.pdf>.
Inoue, Haruhisa. "Neurodegenerative disease-specific induced pluripotent stem cell research." 316.16 (2010): 2560-2564. Web. 10 Nov 2010.
Kalb, Claudia. “All That Remains”. Newsweek 20 Jan. 2010. Web. 19 Oct 2010.
Lovell-Badge, Robin. “The future for stem cell research”. Nature. Nov 2001: 88-91.
McLaren, Ann. “Ethical and Social Considerations of Stem Cell Research”. Nature 414 (2001): 129-131. Web. 19 Oct 2010.
Reis, Raul. "How Brazilian and North American Newspapers Frame the Stem Cell Research Debate." Science Communication 29.3 (2008): 316-334. Web. 15 Nov 2010.
Robinson, B.A. “Are Pro-life Leaders Ignoring the Real Problems?”. Religious Tolerance. Religious Tolerance: Ontario Consultants on Religious Tolerance, 28 Nov. 2008. Web. 19 Oct. 2010. <http://www.religioustolerance.org/>.
Robinson, B.A. "Stem cell research: All viewpoints." Religious Tolerance. Ontario Consultants on Religious Tolerance, 28 Sep 2010. Web. 20 Oct 2010. <http://www.religioustolerance.org/>.
Sandel, Michael. “Embryo Ethics – The Moral Logic of Stem-Cell Research”. New England Journal of Medicine 351.3 (2004): 207-209. Web. 19 Oct 2010.
“Stem Cell Basics: What are the potential uses of human stem cells and the obstacles that must be overcome before these potential uses will be realized?”. Web. National Institutes of Health, U.S. Department of Health and Human
Services, 2009. 05 Nov. 2010. <http://stemcells.nih.gov/info/basics/basics6>.
“Stem Cell Information”. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services, 2010. Web. 13 Nov. 2010. <http://stemcells.nih.gov/index>.
Zawaka, Thomas. “Use Of Genetically Modified Stem Cells In Experimental Gene Therapies”. Regenerative Medicine 2006. Web. 05 Nov. 2010. <http://stemcells.nih.gov/staticresources/info/scireport/PDFs/Regenerative_Medicine_2006.pdf>.