Schaub 4:00
L-13
Ethics Involved in Stem Cell Research
Ben Roadarmel ()
University of Pittsburgh, Swanson School of Engineering
2014/09/30
Ben Roadarmel
Benefits of Tissue Engineering
Scientist have the amazing ability to use emerging technology and techniques to create actual human organs. For example, if you are the victim of terrible burn and a large percentage of the skin on your body has been burnt beyond repair, how would you feel if a doctor told you he could simply grow you new skin to replace your burnt skin? Tissue engineering offers a whole new way to treat ailments. Instead of treating failing organs and tissues with drugs or trying to replace them with donor organs from cadavers or live donors, you can simply replace them with brand new organs made entirely in a laboratory. This takes away the ethical issue of live donors which has been around for many years now, and gives a way for modern medicine to provide treatment to more people than live donors and cadaver transplants would never provide enough for. It would also provide a way to treat diseases and conditions that have always been terminal in the past. However, something so good cannot come without a heavy price to pay. How would you feel if you knew that your new organ that saved your life, was only possible due to the death of human embryos? Many of the salient, justifying arguments for the use of tissue engineering hinge on the telos, or goal, of the treatment: If the goal is to cure or treat human disease, then the benefits will outweigh the burdens of the work- controversy, cost, and difficulty [1]. So is it merely a matter of “the ends justify the means?” How ethical is it to end the development of a human embryo in order to advance an admittedly promising scientific field?
Ethical Scenario
To understand how useful this new field may be and also look into the possible ethical situations, looking at case studies will prove useful. In a possible scenario, your son who has finished his first semester in college has suffered a car accident of the trip home. His spinal cord has been damaged in such a way that inflammation has damaged nerves cells essential for leg movement. It may be possible to inject embryonic stem cells into the vertebrae in order to return use of his legs, and if fact these stem cells come from left over egg cell that were place in storage years ago and never used. So, no fetuses have to be aborted in order to get the stem cell necessary for treatment [1]. I wound not consider the eggs used in this case to be human life, and in addition, these leftover eggs are scheduled for incineration anyway so they at least get to serve a purpose. As long as this treatment actually has a chance of working, it must be worth a shot to end the life of several eggs in order to try. It is more ethical to use theseeggs for potential good than it is to simply destroy them. In another case study we can see some actual results showing the usefulness of stem cell research. Deafness is a major public health issue worldwide, with more than three million people in the UK alone enduring a moderate to profound hearing loss [2]. New developments is stem cells show led by Dr. Marcelo Riviolta show hope in creating treatment for auditory neuropathy. His team was able to convert stem cells into cells similar to spiral ganglion neurons and injected them into the inner ears of deaf gerbils. There results showed that, on average, the gerbils recovered 46% of their hearing. This is the first time that transplanted cells have successfully restored hearting in animals [2]. This advancement is an important step in this field. It would not be ethical to abandon an endeavor that may one day provide significant advancements in modern medicine, and now that we have solid evidence that suggests this research can provide new medicines, it cannot be abandoned simply because some people do not think it is morally right. Whether or not you see the harvesting of stem cells at killing an innocent human or not, you have to see the potential benefits of stem cells research and see all the lives that it could save in the future. Another interesting case study I looked at involved comparing survival rates in patients treated with and allogeneic bone marrow transplantation and patients treated with autologous stem cell transplantation. The study noted that the survival rate in patients who received the autologous stem cell transplant was significantly higher, perhaps noting another viable use for stem cells [3]. Using these case studies, I can imagine an ethical scenario I could possibly encounter while working as a biomedical engineer. Perhaps I have discovered a new possible use for stem cells that could heal blindness. I need to do more research on the subject and will need a substantial amount of cells in order to conduct my tests. While it seems likely to me that my research will result in a cure for blindness, it is not guaranteed. Would it be ethical for me to use stems cells harvested for embryos provided by mothers wanting an abortion?
Code of Ethics
The first Fundamental Canon listed in the National Society of Professional Engineers (NSPE) Code of Ethics states that, “Engineers, in the fulfillment of their professional duties, shall: 1. Hold paramount the safety, health, and welfare of the public” [4]. Tissue engineering in general is seeking new technology for the very purpose of protecting the safety, health, and welfare of the public.However, if it has to harm the public in order to accomplish its goals then it may be hypocritical. In the Biomedical Engineering Society Code of Ethics it states that, “Biomedical engineers involved in health care activities shall: 2. Consider the larger consequences of their work in regard to cost, availability, and delivery of health care” [5]. So as a biomedical engineer you have to see the possible dangers of what you are doing. Looking at the code of ethics for engineers in general and specifically biomedical engineers only give these vague descriptions of guidelines we should follow. This normally encompasses every situation that an engineer may encounter, but one such as the ethical dilemma of using stem cells is trickier to really understand. Someone may argue that the embryos that the stem cells are harvested from are not truly humans yet. In fact human embryonic stem cells (HESCs) are derived in vitro around the fifth day of the embryo’s development. A typical day-5 human embryo consists of 200-250 cells, most of which compose the trophoblast, which is the outermost layer of the blastocyst. HESCs are harvested from the inner cell mass of the blastocyst, which consists of 30-34 cells. The derivation of HESC cultures requires the removal of the trophoblast. This process of disaggregating the blastocyst’s cells eliminates its potential for further development [6]. Whether or not this clump of about two hundred cells should be considered a human or not is an impossible argument to end. Because of this problem, the code of ethics will not be very useful in determining the right choice of action for this situation, so other outside sources may be useful and finding a course of action.
Other Sources
One of the general principles of the WMA Declaration of Helsinki states that, “The primary purpose of medical research involving human subjects is to understand the causes, development and effects of diseases and improve preventive, diagnostic and therapeuticinterventions (methods, procedures and treatments). Even the best proven interventions must be evaluated continually through research for their safety, effectiveness, efficiency, accessibility and quality” [7]. The purpose of my research is just according to this. However, this does not say whether the harm of even willing human test subjects if permissible. Later in the declaration is says that it is the duty of physicians involved in medical research to protect the life and health of persons involved in research [7]. If you consider five day old embryos to be human life, then this research is not allowed. Another interesting source I found was an essay written to explain that most stem cell research was morally wrong. It says that even if we give embryos and fetuses full moral rights as human beings then abortion is still permissible. However, the cloning of embryos for the purpose of destroying them for stem cells is wrong [8]. This argument is interesting because it means that it would be ethical for me to obtain my stem cells for research if I harvest them from embryos aborted from willing mothers, but not if I clone embryos using existing cells.
My views
My view on the situation is that stem cells could possibly provide treatments for countless ailments and should be regarded as an important field. The answer to the ethical situation I presented would be to do the research. I think that the destruction of a five day old embryo is permissible in order to help the rest of the world. In addition, another interesting new technique that scientists are using involves the creation of cells that appear to have all the properties of stem cells from adult human skin cells. These induced pluripotent stem cells (iPSCs) may one day end this ethical debate, but until a day comes that stem cells are not needed, it will still be a heated argument.
REFERENCES
[1] M. Sequra-Totten. (February 2 2012). “Jim and the Forgotten Embryos: A Case on Stem Cell-Based Therapy.”
[2] “Discovering a stem cell cure for deafness.”
[3] B. Bjorkstrand. (December 1, 1996). “Allogeneic bone marrow transplantation versus autologous stem cell transplantation in multiple myeloma: a retrospective case-matched study from the European Group for Blood and Marrow Transplantation”.
[4] “NSPE Code of Ethics for Engineers”.
[5] “Biomedical Engineering Society Code of Ethics”.
[6] (April 25, 2008). “Ethics of Stem Cell Research”.
[7] “WMA Declaratin of Helsinki – Ethical Principles for Medical Research Involving Human Subjects”.
[8] E. Harman. (2007). “HOW IS THE ETHICS OF STEM CELL RESEARCH DIFFERENT FROM THE ETHICS OF ABORTION?”
ACKNOWLEDGMENTS
I would like to thank my friend Oliver for his amazing support throughout this lengthy writing process. He stuck with me through thick and thin and I hope that I was able to help him with his paper as much as he did with mine.
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