Society of Bioethics and Medicine
The Crossroads of Embryonic Stem Cell Research
Written by Martyna Kulecv
Edited by Jacquelyn Tang
Human embryonic stem cell (hESC) research has been one of the most ethically and politically controversial subjects of the past four decades. Human embryonic stem cells are cells derived in vitro “from the inner cell mass of an embryo at the blastula stage” or at approximately the fifth day of the embryo’s development (Panigrahy). At this stage, the human embryo consists of 200-250 cells, most of which comprise the trophoblast or the outermost layer of the blastocyst. Within the blastocyst which consists of 30-34 cells, hESC’s are harvested. Though the merits of stem cell applications cannot be overstated, the ethical and moral dilemma they present have instigated debate within political and religious spheres.The embryonic stem cells are pluripotent, signifying that they can be differentiated into a diverse plethora of specialized cell types that make up the human body, including nerve cells, muscle cells, and blood cells. The potential prescribed to these stem cells is also validated by their “ability to self-renew while maintaining their pluripotency”, indicating that as these cells differentiate into any cell type, they are indefinitely providing a stable foundation for the development and maintenance of tissues (Avery).
The ethical controversy regarding embryonic stem cells is not necessarily concentrated on the curative elements of these cells, but on the means of obtaining the stem cells. “The derivation of hESC cultures requires the removal of the trophoblast”, or the external layer of the blastocyst (Stanford). This disaggregation of the blastocyst’s cell eliminates any potential for further development and ultimately destroys the human embryo, which some people believe to be synonymous with the murder of innocent human beings. As a result, a divisive line is drawn between those who believe embryonic stem cell research is a violation of life that begins at conception and those who believe that embryonic stem cells are the potential for life but not life itself and therefore could be utilized to further developments in medicine and disease treatment.
Many supporters of embryonic stem cell-based therapy argue that hESCs are the future of regenerative medicine and are predicted to surpass the present use of conventional drug-based therapies. Stem cells offer a unique solution to the targeting of pathogenic mechanisms because they are able to differentiate into the specialized cell types that are critical to the “repair of diseased tissues'' and the maintenance of healthy cells (Aly). Through tissue and organ transplantation, hESC’s have the potential to translate into unlimited therapeutic approaches to a diverse array of diseases and conditions. Proponents of hESC treatments argue that “embryonic stem cell research holds great promise for understanding and curing diabetes, Parkinson’s disease, spinal cord injury, and other debilitating conditions' ' (Harvard Stem Cell Institute). The potential to not only prevent disease progression and aggression, but to successfully treat patients and enrich their hope in a permanent recovery, is a miracle and a possibility that is sought by millions of individuals and families who are suffering from cancer, neurological diseases, and the burden of unforgiving illness. Most significantly, hESC-based therapy is at the leading forefront of potential treatments for neurodegenerative diseases, which are the least understood and least curable ailments. Current drug therapies are insufficient against neuropathology because “drugs struggle to get into the brain as the brain’s blood supply is largely separate to the rest of the body” (Götz). hESCs, however, have the potential to differentiate into specialized neuronal cells and potentially target and repair the progression of irrecoverable neurodegenerative diseases such as Parkinson’s, Alzheimer’s, and ALS.
However, before human embryonic stem cells can be actively pursued as a largely accessible avenue for disease treatment, the ethics and moral disquiet needs to be addressed. The United States, in particular, has always been divided regarding the question of when human life begins because of its correlation to abortion and a woman’s right to choose. In the context of hESCs, there is no question that the embryos “have the potential to become human beings”, given that if an embryo were to be implanted into a woman’s uterus at the appropriate phase of a hormonal cycle, it would develop into a fetus and become a live-born child and a human being with its own rights.
In adherence to moral conviction or religious faith, some people believe that life begins at conception and as a result, an embryo is a person with the same moral status as an adult or a living child. Human embryos, therefore, have rights that need to be protected as well as respected, and the destruction of said embryos to harvest stem cells is tantamount to murder. One such advocate claims “Every human being-each one of us-began life as an embryo. Unless we can point to a definitive moment in the passage from conception to birth that marks the emergence of the human person, we must regard embryos as possessing the same inviolability as fully developed human beings” (Harvard Stem Cell Institute). Others believe that while life does not necessarily begin at conception, an embryo has the potential to become a person at a later stage of development and must therefore be protected and weighed in a moral sense. And then there are others who believe the early embryo is a mere clump of cells that ought to be sacrificed for the sake of research and the progression of modern science. In this case, advocates claim that an embryo is “not implanted and growing in a woman’s uterus…it is not a fetus, it has no recognizable human features or form…it is, rather, a blastocyst, a cluster of 180 to 200 cells, growing in a petri dish, barely visible to the naked eye” (Harvard Stem Cell Institute).
Most Americans fit squarely on a middle ground, claiming that though the early embryo “deserves special respect as a potential future human being”, it should be acceptable to use it for research that has significant scientific justification and medical significance (Lo & Parham). The embryos currently used to harvest stem cells are derived from eggs that were “fertilized at in vitro fertilization clinics but never implanted in women’s uteruses…the stem cells are donated with informed consent from donors” (Mayo Clinic). Women or couples who undergo a complete infertility treatment and have remaining embryos can choose to donate their embryos to other couples for reproductive purposes, destroy the embryos, or donate them to stem cell research. It is largely regarded that the remaining frozen embryos ought to be designated towards stem cell research, which is a morally viable alternative to their destruction. Senator Hatch, the former president pro tempore of the United States Senate claimed “I believe that human life begins in the womb, not a Petri dish or refrigerator…the morality of the situation dictates that these embryos, which are routinely discarded, be used to improve, and save lives. The tragedy would be in not using these embryos to save lives when the alternative is that they would be discarded” (Hatch). The debate for the use of hESCs continues to rage with the development of iPSCs or induced pluripotent stem cells which are cells derived from adult human skin cells that have been reprogrammed to serve the same function as hESCs and can therefore readily substitute the use of embryonically derived stem cells. With each new scientific and medical development, the controversial nature of hESC use only swells. Each individual must therefore be accountable for their own moral compass and decide whether it is morally acceptable to condemn a potential human life to death or sacrifice embryos in pursuit of medical treatments that could alleviate the suffering and prevent the death of many people.
- Panigrahy, Simran, et al. “Bioethical Issues in Stem Cell Research - Globalbioethicsenquiry.com.” Bioethical Issues in Stem Cell Research, 2019, https://globalbioethicsenquiry.com/wp-content/uploads/2021/02/Bioethical-Issues-in-Stem-Cell-Research-.pdf.
- Lo, Bernard, and Lindsay Parham. “Ethical Issues in Stem Cell Research.” Endocrine Reviews, U.S. National Library of Medicine, 30 May 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726839/. Siegel, Andrew. “Ethics of Stem Cell Research.” Stanford Encyclopedia of Philosophy, Stanford University, 19 Dec. 2018, https://plato.stanford.edu/entries/stem-cells/.
- “Examining the Ethics of Embryonic Stem Cell Research.” Harvard Stem Cell Institute (HSCI), https://hsci.harvard.edu/examining-ethics-embryonic-stem-cell-research.
H;, Avery S;Inniss K;Moore. “The Regulation of Self-Renewal in Human Embryonic Stem Cells.” Stem Cells and Development, U.S. National Library of Medicine, 15 Oct. 2006, https://pubmed.ncbi.nlm.nih.gov/17105408/.
- Aly, Riham Mohamed. “Current State of Stem Cell-Based Therapies: An Overview.” Stem Cell Investigation, U.S. National Library of Medicine, 15 May 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367472/.
- Götz, Jürgen, and The Conversation. “Why It's so Hard to Treat Dementia.” CNN, Cable News Network, 18 Jan. 2018, https://www.cnn.com/2018/01/18/health/dementia-alzheimers-drug-treatment-partner. “Answers to Your Questions about Stem Cell Research.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 Mar. 2022, https://www.mayoclinic.org/tests-procedures/bone-marrow-transplant/in-depth/stem-cells/art-20048117.
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