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The Controversy of Embryonic Stem Cell Research THE 210/04 December 2, 2012
There is a debate over the ethics of stem cell research and many people on opposing sides of the issue are not aware of all aspects. In order to intelligently debate the legal and ethical issues regarding stem cell research, one must understand what stem cells are, the applications currently available, and the impact of the research. It is also important to understand the distinction between adult and embryonic stem cells before exploring their uses and impacts. Stem cells possess unique properties that make them different from all other cells in the body. Most cells do not have the ability to replicate where stem cells have the potential to multiply indefinitely. Before they have a specific function in the body, stem cells are essentially blank slates. There are two basic types of stem cells, which have different empirical properties and ethical implications. Researchers successfully attained embryonic stem cells from the embryos of mice in 1981, which led to the discovery of this process in human beings in 1998 (National Institutes of Health, 2001). Embryonic stem cells are derived from an in vitro embryo between five days and seven weeks. Regenerative medicine can benefit greatly from the characteristics of embryonic stem cells. This process enables damaged organs and tissues to heal themselves with the help of implanted stem cells matching the organ (Hunziker, 2010, p. 1). There are two traits that make embryonic stem cells especially suited for this task: the ability to reproduce at a markedly rapid

2 rate and the ability to do this without differentiating for an extended period. Embryonic stem cells are unspecialized, which allows them to interact with and adopt the functions of a specialized cell. This has proven to be an important part of regenerative medicine and a controversial topic among the debate of science and ethics (National Institutes of Health, 2001). There are also adult stem cells. These differ from embryonic stem cells because they are undifferentiated, which are rare by comparison. Adult stem cells can be found throughout the body in certain organs and tissues, unlike embryonic stem cells. Although adult stem cells lack the ability to differentiate and multiply as embryonic cells, adult stem cells have the ability to repair the damaged cells of tissue in which they are located. Research on adult stem cells has been ongoing for over half a century, and there has been a vast amount of information gained in the quest for knowledge that has resulted in immeasurable benefits to the medical science community. A better understanding of adult stem cells has led to research on controlling these cells and manipulating them in order to develop more advanced treatments for serious injuries and illnesses (National Institutes of Health, 2001). Although adult and embryonic stem cells share some characteristics, the science and ethics communities are at odds with the application of research and treatment because of the differences between the cells. The majority accepts adult stem cell research because the stem cells can be obtained with no harm to the donor. There are several arguments regarding the advantages and disadvantages of both types of cells. Embryonic stem cells are advantageous because they are easily obtained, have the potential for unlimited cell production, and are not limited to what they can become (Pecorino,

3 2001). Despite these characteristics, there are some drawbacks to using these cells. Manipulation of the stem cells would be difficult because the diseases that embryonic stem cells could benefit are not entirely understood. There is also the risk of rejection by the recipients immune system, which is a common risk factor with tissue transplants. The most prolific disadvantage is the ethical dilemma and the corresponding viewpoints (Pecorino, 2001). As with any controversial topic, there is a corresponding argument for the benefits and limitations in harvesting adult stem cells for regenerative therapy. There is less risk involved to the patient since they are receiving their own cells, and they may be easier to activate because adult stem cells are already specialized. Research has discovered adult stem cells may be able to give rise to cells from different tissues. The ease of attaining these cells is a mixed bag; while it is safe to harvest most types, it is extremely dangerous to extract stem cells from the brain. Few adult stem cells can be found in each tissue type, making it difficult to extract in large quantities. The stem cells that are cultivated in a laboratory do not produce as much or for as long as embryonic stem cells. The cells may be damaged by carrying mutations or from experimentation (Pecorino, 2001). On August 9, 2001, former President George W. Bush restricted funds given to research using human embryonic stem cells. The constrained funding and extensive criteria had a severe impact on the number of stem cell lines that were able to continue research. According to the I am Pro Stem Cell organization (2012), the US Congress tried to expand the number of stem cell lines eligible for federal funding between the years of 2005 and 2006, but was vetoed by President Bush. President Obama changed the way the National Institutes of Health (NIH) can administrate stem cell research during his first term as president. The NIH can receive funding to

4 review existing stem cell research lines and create new guidelines (National Institutes of Health, 2001). The purpose of stem cell research is to find cures for diseases that we know little about. The implementation of stem cell research allows for the treatment of Parkinsons disease, Alzheimers disease, heart disease, stroke victims, people with diabetes, birth defect victims, spinal cord injuries, and the repair and replacement of organs (Lilienthal, 2010). Stem cells are also thought to be able to aid us in the quest for a cure to cancer. These diseases are quite prevalent today and need to be addressed. Stem cell research is the best way to find cures or at least treatments for people who are succumbed to these terrible diseases. There are two kinds of stem cell research: adult, which is more widely accepted, and embryonic. Adult stem cell research is generally more accepted because it does not raise the question of when life begins as is the case with embryonic stem cell research. Adult stem cells are regenerative, meaning that they can renew themselves (Lilienthal, 2010). This makes them useful in the fight against diseases. Embryonic stem cells are thought to be much better for experimentation because they work much faster and can be used to treat many more diseases than adult stem cell. Most of the controversy surrounding stem cell research is centered on the idea of embryonic stem cell research. One of the major arguments for the implementation of embryonic stem cell research is the view point that claims embryos are not actual humans, although they do have the potential for human life. This is a viable assumption, because without a womans womb to carry the embryo full term, the embryo is only an embryo and not a human being. Stem cell research on that embryo cannot be determined to be murderous because it is only experimentation on an embryo that through appropriate measures could eventually become a human life. In no way is

5 life taken away from any organism; it is the potential to become life that is taken away from the embryo. This is not ethically wrong because it is not the killing of the innocent. Another way to support this claim is the fact that more than one-third of zygotes or embryos that are conceived in a laboratory are never implanted into a woman (Lilienthal, 2010). In other words, more embryos are lost due to chance rather than through the use of stem cell research. Many people will agree with the fact that they would rather see the embryo be used to advance the human species than be lost and never used for anything. In Australia alone, 70,000 embryos were destroyed because they were not used in the in vitro fertilization process (Lilienthal, 2010). These embryos were destroyed. It makes sense that embryos should be recycled because we recycle things we do not use. Embryos that are never implanted should be used for stem cell research in order to find cures to diseases that we desperately need to them. Parties who support the idea of abortion contend that human life does not start until a heartbeat can be heard or seen through ultrasound. This happens in the fifth week of pregnancy (Lilienthal, 2010). This means that an embryo that is essentially stopped in time right after the sperm has met the egg should not be regarded as a life by anyone who believes in pro-choice. The embryo will not develop a heartbeat for another five weeks. Abortion is legal in many countries and various states. Abortion is the killing of innocent human beings because the woman actually chooses to destroy her child. It allows for the killing even after a heartbeat can be found. If abortion is allowed to take place and actually ends lives, then the experimentation in embryos should be condoned. As stated earlier, embryos do not possess a heartbeat and are not considered to be a human life, at least not by a majority of the human population. When an abortion occurs before a heartbeat can be distinguished, it should be legal to use that embryo in stem cell research. Many abortion materials including fetuses and embryos are tossed in a waste receptacle. It would be more beneficial to actually use that

6 embryo for research. Through this research, we could actually find a cure for some of the diseases that ravish our population in the United States and beyond! Embryonic stem cell research is regarded as superior to adult stem cell because embryonic stem cells make up a large portion of an embryo. Adult stem cells only exist in small population. This makes for a situation where it is far easier to acquire and use embryonic stem cells for research than it is to obtain an adult stem cell for the same purpose. Another argument for the implementation of embryonic stem cell research over adult stem cell research is the fact that embryonic cells divide at a much more accelerated rate than those that come from an adult cell (Singer, 1994, p. 104). This allows for more cells to be used in therapy which leads to better results. Adult cells, because they divide much slower, take a much longer time to cause an effect in a patient. Embryonic stem cells also possess more plasticity, meaning that they can be easily molded to treat a greater variety of disease ((Singer, 1994, p. 104). It seems obvious to choose embryonic cells if they are proven to treat a wider variety of diseases than the cells that come from adults. With these evident advantages, it seems like the implementation of embryonic stem cell research is a good choice. There are a few studies and experiments that have demonstrated the promise of embryonic stem cell research. On July 12, 2001, scientists at UCLAs Jules Stein Eye Institute injected retinal cells derived from embryonic stem cells into the eyes of two patients who suffered from progressive blindness (Park, 2012). One of the patients was a seventy-eight year old Sue Freeman who lives in Laguna Beach, California. Freeman was diagnosed with agerelated macular degeneration (AMD), the leading cause of blindness in adults over age fifty. The disease is located in the retinal pigment cells, which help the eyes photoreceptors process light into sight. Freeman, who was diagnosed in 1998, has slowly been going blind. The second

7 patient, fifty-one year old Rosemary from Los Angeles was diagnosed with Stargardts macular dystrophy over twenty years ago. Stargardts macular dystrophy is a type of macular degeneration that is often inherited through genetics (Park, 2012). Before the surgery, Rosemary stated she was unable to see out of the center of her eye. Rosemary would have to turn her head on an angle to see an object directly in front of her. The surgery took 50,000 stem cells and injected them into each eye of both patients. According to Park (2012), the two patients recovered very well after the surgery, showing no signs of adverse effects from the treatment and even reporting small improvements in their vision. It was expected that 24 more patients were to receive that same treatment at that time. This surgery showed how crucial embryonic stem cells could benefit healthcare. In a recent poll, about 27% of Americans disputed against embryonic stem cell research (Research America, 2012). A pattern has emerged; those groups or individuals who do not agree with topics such as abortion and euthanasia also tend to disagree with the concept of embryonic stem cell research. Individuals or groups opposing the idea of embryonic stem cell research vary from considering themselves religious or secular, meaning all opponents to this research are not strictly part of a religious gathering (although many of them are). Pro-life groups dissent this topic simply because they believe researchers are killing a valuable human life, just like the concept of abortion. Religious groups disagree with embryonic stem cell research because they believe it is going against Gods will. Others who do not consider themselves to be involved with either of those camps argue it is immoral and unethical on similar grounds. These people contend that embryos have the same right to life that living, breathing humans do, even if they are not fully developed. These people do not agree that their tax dollars should go to this type of research because they do not support it.

8 Religion is a strong source of views for the majority of the world; it shapes the way many Americans think. Embryonic stem cell research is a hot topic in political, religious, and social debates, and has been a center of discussion for many years. Most religious groups are specifically opposed to embryonic stem cell research because they believe scientists and researchers are going against the will of God (Nisbet, 2005, p. 92). Religions focus is on Gods creations, which include the gift of life. Those who practice Catholicism believe that embryos represent a human life worthy of full moral protection from the moment of conception (Nisbet, 2005, p. 92). Embryonic stem cell research does not involve using every embryo; it may mean only a few embryos are used in the research while the rest are simply destroyed. Religious groups believe that this is an act against God because He is the only power that has the ability to give and take life away. When embryos that are not being used are destroyed, challengers believe researchers are violating and devaluing human life, as well as killing something that has the potential to become a human being (Fox News, 2001). In 2008, an interview was conducted with Yuval Levin, the former director of the Presidents Council on Bioethics. He discussed that the real issue concerning embryonic stem cell research lies in the concept of human equality. Levin stated that the Declaration of Independence, the birth certificate of the United States, describes each man as being created equal (Masci & Levin, 2008). He further states: Human equality doesnt mean that every person is the same or that every person can be valued in the same way on every scale. What it means is that our common humanity is something that we all share. And what that means, in turn, is that we cant treat a human being in certain ways that we might non-human beings (Masci & Levin, 2008).

9 Levin and other supporters agree upon the fact that grieving an elderly mans death should have the same magnitude as grieving the death of an embryo. The right to life is implied and stated in the Declaration of Independence, and this type of research contradicts our so called birth certificate. Still there are several other arguments against embryonic stem cell research. Opponents agree that this type of exploration is inhumane because there has been no real evidence of a successful cure that is legitimate enough to destroy human life (Health Articles 101, 2010). Mark Souder, a representative for Indiana in 2001, agreed with this statement. He stated that all clinically successful applications of stem cell research involved the use of adult stem cells, not embryonic stem cells (Brownback, Souder, Hook, & Doerflinger, 2001, p. 241). Souder also believed that without any evidence of success, embryonic stem cell research is solely derived from the killing of embryos and that finding cures for diseases should not be based upon research that cannot be clearly proven. Many of the arguments stem from the fact that this concept is not fully developed; the process of using embryonic stem cells is not completely known, and it can lead to the body rejecting them, cancers, or other diseases that cannot be cured or treated. For example, in 2007 the United States and Japan lead experiments involving embryonic stem cells in mice. Although a few positives were found from this research, many of the mice developed tumors from the altered cells (ABC News, 2007). With this topic still being somewhat novice and providing unfamiliar outcomes, embryonic stem cell research is taking away funding from other experiments that have been proved to be beneficial for humans, like finding cures for cancers and other terminal illnesses. Opponents also argue that the estimated cost of this type of treatment is

10 too high, and the unknown factors are too risky in order for it to be applied in humans (Health Articles 101, 2010). Sam Brownback, a Kansas senator in 2001, argued against embryonic stem cell research. He contested that this type of research seems simple and ethical at this time, but it could lead to performing even more unethical procedures, such using DNA from fully developed humans like himself, which could have disastrous outcomes that we are not completely aware of at this time. Brownback later states that it has never been, and it will never be, acceptable to kill one person for the benefit of another, despite any positive results that may come from it (Brownback, Souder, Hook, & Doerflinger, 2001, p. 235). In his interview, he concludes that funding embryonic stem cell research is going against the history of our Nation: the government is destroying and exploiting human life for our own or someone elses purpose (Brownback, Souder, Hook, & Doerflinger, 2001, p. 241). At the end of his interview, Brownback expressed his professional opinion that there are other possibilities for researching cures and treatments that are more humane and ethical. Embryo destruction in stem cell research is one of the biggest arguments. Finding a solution to this dilemma is not an easy process. There are two different alternatives that avoid destruction of an embryo yet both alternatives require further research. The alternatives avoid destruction of the embryo by deriving embryonic stem cells without damaging the fetus or obtaining embryonic stem cells without actually creating a fetus. Standard nuclear transfer is also known as cloning but the scientific name is somatic cell nuclear transfer or SCNT. The nucleus containing DNA is removed from an adult body (somatic)

11 cell and implanted into an egg cell that first has its own nucleus removed. The nucleus is removed from an adult body cell and implanted into an egg cell that first has its own nucleus removed (Hurlbut, 2005, p. 215). After it is electrically stimulated, the egg then has a full set of DNA and starts to divide like a naturally fertilized egg and forms an embryo (Hurlbut, 2005, p. 215). Altered Nuclear Transfer (ANT) uses the technology of standard nuclear transfer but with a modification that assures that no embryo is created. The somatic cell nucleus or the enucleated egg contents are first altered before the somatic cell nucleus is transferred into the egg (Hurlbut, 2005, p. 211). The alterations cause the somatic cell DNA to function in such a way that no embryo is generated; instead pluripotent stem cells are produced. Blastomere extraction is also a technique used in ANT. This procedure is performed on a two-day old embryo. Once the fertilized egg is divided into eight blastomeres or cells, the extraction occurs. The techniques which have been previously used for harvesting involve the derivation of embryonic stem cells at a later developmental stage, when the embryo is made up of approximately 150 cells (Murnaghan, 2012). The embryo was destroyed once these cells were harvested. Embryonic stem cells can be extracted from the blastomere which prevents the embryo destruction and allows use of stem cells for research and therapeutic treatment of disease. Another alternative is to use adult stem cells because they are extracted from adult tissues. The issue with only using these adult stem cells is that they cannot differentiate into as many different types of cells as embryonic stem cells.

12 It is evident that using cells such as adult stem cells, amniotic stem cells, and induced pluripotent stem cells can avoid the dilemmas on the creation, use, and destruction of human embryos. Although we may not arrive at a definite or perfect solution to the stem cell controversy, the government will continue to fund research. Stem cell research is without a doubt a pivotal turning point in technology in regards to curing many diseases. In conclusion, it is apparent that there is a separation in opinions to embryonic stem cell research. However, the facts about the functions and composition of stem cells are clear. These cells have the ability to become different types of cells and create cells such as blood cells or brain cells. These cells can be used to repair damaged cells to treat the injury or disorder that the body has surrendered to. There are arguments that embryonic stem cells are the most resourceful because they are not tissue specific and have the most potential to cure a patient. According to I Am Pro Stem Cell (2012), a frequent misapprehension on the theory of stem cell research is that stem cells are used from aborted fetuses, which is why many groups are opposed to this type of research. Others who believe that life starts at conception are also against to this theory because stem cell research experiments on human life. Despite the arguments against embryonic stem cell research, doctors and researchers have used stem cells to treat and cure an assortment of conditions within the last forty years: diseases of the blood, leukemia, lymphoma, Parkinson's and Alzheimer's diseases, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis (Lilienthal, 2010). Research and experimentation have also led to regeneration of new tissues and new stem cells. One of the pioneers in this field, George Q. Daley, MD, PhD, Director of Stem Cell Transplantation Program at Children's Hospital Boston, stated that his team is going to make

13 stem cells from patients with a genetic disease, repair those gene defects, coax their cells to become the tissue or the organ affected by the disease and give them back healthy tissues (Daley, 2008). With the proper resources, stem cells have the potential to drastically influence various areas of health and medical research and cure diseases what were never thought to be possible.

References ABC News. (2007, June 20). Reality check: Embryonic stem cell alternatives. Retrieved from http://abcnews.go.com/Health/story?id=3298286&page=1 Brownback, S., Souder, M., Hook, C., Doerflinger, R. (2001). Government stem cell research? Congressional Digest, 80(10), 235-243. Retrieved from http://0-web.ebscohost.com.alvin.iii.com/ehost/pdfviewer/pdfviewer?sid=961836a299a5-43bc-99a7-c0f3624dc1c4%40sessionmgr115&vid=4&hid=108 Daley, George. (2008). Boston Childrens Hospital: Treating patients. Retrieved from http://stemcell.childrenshospital.org/treating-patients/ Fox News. (2001, August 9). The cases for and against stem cell research. Retrieved from http://www.foxnews.com/story/0,2933,31748,00.html Health Articles 101. (2010). Top 10 arguments against stem cell research. Retrieved from http://www.healtharticles101.com/top-10-arguments-against-stem-cell-research/ Hunziker, R. (2010). Regenerative medicine. National Institutes of Health, 1-2. Retrieved from http://report.nih.gov/NIHfactsheets/Pdfs/RegenerativeMedicine(NIBIB).pdf

14 Hurlbut, W. (2005). Altered nuclear transfer as a morally acceptable means for the procurement of human embryonic stem cells. Perspectives in Biology and Medicine, 48(2), 211-228. Retrieved from http://muse.jhu.edu/login?auth=0&type=summary&url=/journals/perspectives_in_biolog y_and_medicine/v048/48.2hurlbut.html I Am Pro Stem Cell (2012). Educate yourself. Retrieved from http://www.iamprostemcell.org/iamprostemcell_educate.html Lilienthal, G. (2010, June 26). Pros and cons of stem cell research Ethical issues. Retrieved from http://suite101.com/article/pros-and-cons-of-stem-cell-research--ethical-issuesa254568 Masci, D. (Interviewer) & Levin, Y. (Interviewee). (2008). The case against embryonic stem cell research: An interview with Yuval Levin [interview transcript]. Retrieved from the Pew Forum on Religion & Public Life website: http://www.pewforum.org/Science-andBioethics/The-Case-Against-Embryonic-Stem-Cell-Research-An-Interview-with-YuvalLevin.aspx Murnaghan, I. (2012, August 27). Stem cell controversy. Retrieved from http://www.explorestemcells.co.uk/stemcellcontroversy.html National Institutes of Health. (2001). Federal policy in stem cell information. Retrieved from <http://stemcells.nih.gov/policy>. Nisbet, M. (2005). The competition for worldviews: Values, information, and public support for stem cell research. International Journal of Public Opinion Research, 17(1), 92-94. Retrieved from http://ijpor.oxfordjournals.org/content/17/1/90

15 Park, Alice. (2012). Early success in a human embryonic stem cell trial to treat blindness, Time Magazine. Retrieved from http://healthland.time.com/2012/01/24/early-success-ina-human-embryonic-stem-cell-trial-to-treat-blindness/>. Pecorino, L. (2001). Stem cells for cell-based therapies. Retrieved from http://www.actionbioscience.org/biotechnology/pecorino2.html?print Research America. (2012). Voters Favor Expanding Funding for ESC Research. Retrieved from http://www.researchamerica.org/stemcell_issue Singer, P. (1994). Rethinking life & death: The collapse of our traditional ethics. Oxford: Oxford University Press