Lea Wenger
AN INTRODUCTION TO THE STEM CELL DEBATE
The field of stem cell research is barred by controversy due to the origin of stem cell development. Stem cells originate from human embryos. Due to this, the stem cell debate involves opposing sides. Research scientists, religious institutions, government officials, and anti-abortion activists fight for their beliefs regarding the use of stem cells in future research.
As a bioengineering graduate student from the University of Pittsburgh, the stem cell debate is vital to my future and the entire future of bioengineering. I am specifically researching regenerative organs and how they are used to regrow human limbs. Stem cells are vital to my research as they are the biological scaffolding material used in the regeneration of limbs. The biological scaffolds are used to stimulate growth and regeneration of lost or damaged tissue. This regrowth is a small stepping stone in the future of regenerative medicine. The regeneration of small limbs is bringing research scientists one step closer to vital organ regeneration. Regenerative medicine is my passion, and I am thankful to have the opportunity to do research in Dr. Badylak’s laboratory at the McGowan Institute of Regenerative Medicine.
MY RESEARCH AND WHY STEM CELLS ARE RELEVANT
Stem cells: Defined
Stem cells receive a lot of attention in the media, but few people understand what stem cells are. Stem cells are unspecialized meaning they have the ability to reproduce copies of themselves and then differentiate into specialized cells, such as blood and muscle cells [1]. Specialized cells like blood and muscle cells do not have the ability to self-replicate. Therefore, the unique ability for stem cells to differentiate into more specialized cells is pertinent to life. Stem cells are within every human being at this moment regenerating the blood cells necessary to live.
Alternatives to stem cells: Embryonic vs. Adult
Embryonic stem cells are cultivated from embryos that are 5-6 days old [2]. At this point in its development, the embryo is referred to as a blastocyst – which is the size of a grain of sand. Embryonic stem cells are also called pluripotent stem cells. Pluripotent stem cells can differentiate into over 200 different types of cells [2].
Adult stem cells are often referred to as somatic stem cells. As the term “somatic” suggests they are found and cultivated within a grown body [1]. Typically, adult stem cells are cultivated from bone marrow. Isolating and cultivating adult stem cells is often more challenging than isolating and cultivating embryonic stem cells. It is much easier to reproduce and grow the high amount of stem cells needed for replacement therapy with embryonic stem cells rather than adult stem cells. However, adult stem cells are less likely to be rejected by the human body after transplantation.
Scientists have recently engineered induced pluripotent stem cells, also known as iPS cells. Induced pluripotent cells are somatic stem cells reprogrammed back into a pluripotent stem cell. Induced pluripotent cells can be made from the patient they will be reintroduced to, which further decreases rejection by the body of the reintroduced iPS cells [2].
ETHICS
My Ethical Dilemma
The research I am conducting in Dr. Badylak’s laboratory at the McGowan Institute of Regenerative Medicine requires the use of stem cells. While my superior, Dr. Badylak, insists that embryonic stem cells are more useful due to their ability to differentiate into any specialized cell, I believe the use of adult stem cells or iPS cells would suffice despite their lesser functional capabilities. I must decide whether to insist on the use of alternatives to embryonic stem cells or risk implications from the use of embryonic stem cells in my research. If I choose to use adult stem cells or iPS cells, I must explain to Dr. Badylak why their use is more practical. While contradicting my superior is intimidating and could cause conflict, I must make an ethically sound decision. The controversial use of embryonic stem cells could bring negative attention to our laboratory and the research could be compromised as a result.
Ethics: Engineering Codes
The field of engineering is often thought of to be strictly scientifically driven. Few realize the ethical implications engineers have on society until they are in a position to make an ethical decision. For this reason, The National Society of Professional Engineers and the Biomedical Engineering Society created a code of ethics.
The National Society of Professional Engineers and the Biomedical Engineering Society both have a code of ethics I, as a bioengineer, must agree to and fulfill. An engineer should be capable of handling any ethical situation that could arise as a result of their work. The Biomedical Engineering Society Code of Ethics states, “Biomedical engineers involved in research shall: Comply fully with legal, ethical, institutional, governmental, and other applicable research guidelines, respecting the rights of and exercising the responsibilities to colleagues, human and animal subjects, and the scientific and general public” [3]. It is my duty as a biomedical engineer to respect the rights of humans. This suggests I should protect the rights of the unborn embryo and avoid its use in my scientific research. Alternatively, The National Society of Professional Engineers’ Code of Ethics states, “Engineers shall not be influenced in their professional duties by conflicting interests” [4].While this is further elaborated on to specify that engineers should not accept bribes from other parties that would compromise professional work, my personal opinions and beliefs should not play a major role in my work as an engineer. However, my conflicting interest is a question of ethics not a personal problem.
CASE STUDIES
In order to help me in my decision, I decided to review some case studies which I felt would be relevant to my situation. Learning from and building upon previous research and experiences is how progress is made.
Case 1: Car Accident
In this case, a young college student returning home for fall break late at night crashed his car into a tree. The boy damaged his spinal cord at the T7 vertebrae “and the resulting inflammation damaged precious nerve cells in that area” [5]. These nerve cells are vital in sending electrical signals to his legs. As a result, the boy would be paralyzed from the waist down. However, he was a candidate for an experimental treatment using the injection of human embryonic stem cells into the site of the damaged nerve cells [5]. The young man and his parents decided to try the experimental treatment and found great success. This is merely one of plentiful examples of stem cells benefits to medicine. If the family had decided against the use, the man would be paralyzed forever at such a young age. His life had merely begun, but what about the embryos potential life? It did not even have a chance to begin life outside the womb.
Case 2: A family debate
A mother of two children conceived with the help of in vitro fertilization treatments over 10 years ago. She had watched a documentary on embryonic stem cells and their vast amount of medical benefits to society. She consulted her husband about donating their frozen embryos from IVF. The couple was not intending to have any more children she said, “Why not put those cells to good use?” [6].Many people could benefit from the embryos she and her husband might not put to use. Her husband, however, felt it was wrong to use the embryos which are potential human beings for science. He reminded her that they were pro-life. The wife stood firm in her belief that if the couple was not to use the embryos for future pregnancies then the embryonic cells should be put to use to benefit others’ lives. The couple donated their frozen embryonic stem cells to science. The cells may have been used to help Parkinson’s patients, diabetics, victims of car accidents, or even just for regenerative research. All that is known is that their donation supported the use and future of stem cell research.
Case 3: Corneal Implants
At a young age, a female was blinded due to a grilling accident. She continued through life adjusted to her loss and compensated through her other senses. Her corneas were badly damaged and after three transplantations failed she had begun to give up faith of ever seeing again. One day, the woman’s doctor suggested a clinical study that used corneal stem cell implants [7]. The woman’s husband was concerned with the procedure due to her lack of success in the past, and the unethical use of embryonic stem cells. Fortunately, the stem cells used in this clinical study were adult stem cells donated by a relative. The doctor explained, “The full potential, diversity, and problems associated with their use are only at the beginning stages of research, but early studies indicate great promise in this area”[7]. The mother decided to go through with the treatment, and after the three month process was able to see her child for the first time. The article did not specify any later problems resulting from the transplantation. This case shows how adult stem cells can be just as useful as embryonic stem cells.
MY PERSONAL VIEW: ADDITIONAL SOURCES
I was raised in a Roman Catholic family and attended Catholic school for nine years of my life. My faith is against the use of embryonic stem cells. “The Roman Catholic…believe the embryo has the status of a human from conception and no embryo research should be permitted” [8]. My faith has been an integral part of my life since a young age, and to ignore what I was brought up on could be difficult.
In as early as fifth grade, I recall learning about abortion. We spent religion class learning about our faith and the history of it. But something I will never forget learning is how a human embryo develops. Reflecting back, I did not quite understand the significance of what I was learning. We began early in the school year learning about what abortion was and why it was wrong. Every few weeks we would return to the topic of human development in the womb. We would learn how large the child had grown at a certain point and what physical features began to develop. At certain weeks when significant embryonic development occurred we would receive small gifts to remind us of the child developing. The two gifts I remember impacting me the most, were a feet pin and a small fetus doll. We received the feet pin at 10 weeks after we began learning about the development of a child, the time in which the embryo would have developed feet and hands in reference to when we started learning. The pin was the same size as the feet would have been at the time. Everyone put their pins on their shirts or back packs or even pencil cases. We received the fetus doll at about five months. Five months is typically the latest women have abortions. This was an exciting day for the entire grade. We all got our fetuses and played with them at recess. The dolls had developed arms, legs, fingers, toes, eyes, and a nose. In each fifth grade classroom you could find one of the dolls laying on a student’s desk. As impressionable fifth graders, we never challenged what we were learning, but simply accepted it and agreed.
As a lover of science and proponent of medical research to better the future in medicine, I acknowledge the need and vast benefits of the use of stem cells. Stem cells are currently being used in regenerative organ research. Continued research in this field could lead to the regrowth of a human heart and other vital organs, minimizing the need for organ donors. Stem cells can also be used to treat diseases such as Parkinson’s disease by replacing damaged nerve cells that cannot regenerate on their own. As the granddaughter of a man with Parkinson’s, I believe the use of stem cells could have extended and improved his short life. Furthermore, stem cells can be used to treat several other diseases including diabetes and regenerate human limbs. “If this research leads to possible treatments… the demand for many thousands of cell lines with different genetic profiles will be difficult to resist” [9] This exemplifies why the benefits of stem cells far outweigh the ethical costs and are difficult to ignore.
My background and my passion conflict on the use of embryonic stem cells in the field of medicine. I consulted two people who have influenced my life. My grandmother has been an integral figure in my life and faith. I asked my grandmother her view on my use of stem cells in my research. Mygrandmother encouraged me to avoid the use of embryonic stem cells in my current research “at all costs” [10]. Despite informing her that this stem cell research could have extended her husband’s life, my grandmother continued to advise me to refrain from the use of embryonic stem cells. She said, “Lea, Bob lived a good amount of his life and those children did not even begin to start theirs” [10].
I also consulted a close family friend and the man who introduced me into the field of regenerative medicine, Dr. Richard Schaub. Dr. Schaub had encouraged me to pursue the field of bioengineering as a young teenager and was my engineering analysis professor during my first year as an undergraduate student at the University of Pittsburgh. Dr. Schaub encouraged me to continue my research with stem cells because “the future benefits of stem cell research have the potential to forever change the medical field” [11]. I further inquired whether he thought embryonic stem cell use was necessary or if alternatives would be equally effective. He encouraged me to use adult stem cells or iPS cells to avoid the ethical conflict that arises with the use of embryonic stem cells. He said, “They [embryonic stem cells] may be more versatile, but I don’t believe they are worth the backlash your work may receive from the public and outside organizations” [11].
CONCLUSION: THE FINAL DECISION
After a lot of thought, considering codes of ethics, reviewing case studies, reflecting on my catholic school education, and consulting my grandmother, I have come to a final decision. This decision has not been an easy one to come to. I have weighed all of my options, and determined the best option. I came into the field of biomedical engineering to better human life. For that reasoning, I have decided to make use of adult stem cells or induced pluripotent stem cells to avoid the controversy of embryonic stem cells. Although embryonic stem cells are more simplistic to cultivate and have higher differentiability capabilities, the adult stem cells and iPS cells are sufficient in my research. The benefits of embryonic stem cells do not outweigh the ethical and moral dilemma brought about by their use. I know that my personal views should not influence my work, however, mitigating any ethical controversy in my research will encourage the public of all different backgrounds and beliefs to more willingly accept the research I am doing. I know Dr. Badylak will not be delighted with my decision, but I am prepared to present my argument and accept the struggles that may be ahead with my use of adult stem cells and iPS cells instead of embryonic stem cells. I am a bioengineer. I am devoted to my field and research, but I am also a human being with rooted beliefs. I know that my decision may make my research more difficult, but I believe I should refuse to use embryonic stem cells and respect human life.
REFERNECES
[1] “Stem Cell Basics.” National Institutes of Health. (Website).
[2] “About Stem Cells and Regenerative Medicine.” EuroStemCell. (Website).
[3] (July 2007). “Code of Ethics for Engineers.” National Society of Professional Engineers. (Online article).
[4] (February 2004). “Biomedical Engineering Society Code of Ethics.” Biomedical Engineering Society. (Online article).
[5] M. Segura-Totten “A case on Stem Cell-Based Therapy.” National Center for Case Study Teaching in Science. (Online article).
[6] L. Yaich “Stem Cells: Promises to Keep?” National Center for Case Study Teaching in Science. (Online article).
[7] K. Mergenhagen “Stem Cell research and Corneal Implants.” National Center for Case Study Teaching in Science. (Online article).
[8] “Embryonic stem cell research: an ethical dilemma” EuroStemCell. (Website).
[9] A. Siegel (January 2013). “Ethics of Stem Cell Research” Stanford Encyclopedia. (Online article).
[10] R. Stanley (27 October 2015). Interview.
[11] R. Schaub (27 October 2015). Interview
ACKNOWLEDGEMENTS
In the writing of this paper, I would like to thank the writing instructors and librarians who came into my engineering analysis class to ensure I understood all the requirements of this paper. I would like to thank my family and friends for supporting me as I continue my studies as a bioengineering student.
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