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Issues surrounding embryonic stem cells: The Genuine Never Ending Story? (Is there an alternative?) By Dr. Anthony G. Payne One of the arguments advanced against utilizing embryonic stem cells in
research and ultimately therapy for various diseases and maladies is a moral
or ethical one: Many people view viable human life as beginning with the
union of sperm and egg. By this definition, a scientist who employs an embryo
- even at the earliest stages of development (blastocyst) - is essentially engaged in
harvesting and exploiting viable human life (The stem cells are extracted and
the blastocyst or such is oftentimes dispensed with). There is compelling scientific as well as ethical arguments to the
contrary. But for people whose faith tradition or religious perspective views
the fusion of sperm and egg as marking the advent of a human life, these do
not satisfy them nor disabuse them of the belief that even a zygote (egg +
sperm) is viable human life. Beliefs predicated on faith that are not testable lie outside the purview
of science. For example, the religious concept that every human has a soul or
spirit imputed by the Almighty at conception or thereafter is not something
that can be tested and verified or refuted using the tools of science. There
is no laboratory assay that will disclose or measure something that is held
to have no material substance as we know it and which is not physically
manifest in cells or tissues or such. For religionists who hold that ensoulment (i.e., spirit is imputed)
occurs at conception, and (who) refuse to consider even slightly modifying
this perspective in light of contrary biological evidence or ethical
reasoning, there exists an impasse that cannot be readily breeched (If at
all). And when enough people embrace such a spin on what constitutes viable
human life, their collective influence on the direction federally funded
research takes in a democracy will be very manifest (Some would argue
disproportionately so). This is clearly the case here in the Many scientists regard the convictions of those who hold that viable
human life begins at conception or during the very early stages of
development as both presumptuous and naive. Many religionists and theologians
agree. Among those who happen to hold fast to a belief that a fertilized egg
is entitled to full status as a viable human, the use of blastocytes or very
early stage embryos constitutes a species of murder. Some even go so far as
to decry those who take exception to their faith-based beliefs as being
immoral or amoral. Does the truth lie somewhere between the strictly secular and the sacred?
Most of us probably harbor a feeling that somewhere in all this - lurking in
the facts of biology and the world of polemics and logic, ethics and religion
- there is an answer that will win the day. If this is the case, it is quite
obviously going to take time for such a truth to fully emerge. Many have asked me, “What is your spin on what constitutes viable human
life?” Being as I have a foot in both worlds - which is to say religious
belief and science - it seems logical to suppose that I would be able to
offer up a “faith and science-friendly” definition of when viable human life
begins. Well, yes, I do have something to offer up for consideration. And
here it is - informed by biology, of course. The heart begins beating at three weeks of gestation and the first neural
reflex is manifest at eight weeks (and consists of hand withdrawal in
response to stimulation of the fetal lip region). During weeks 9-13 the first
brain waves appear and are discernible using special medical instrumentation. Given that death is defined (in part) as a cessation
of both heart and brain wave activity, one could argue conversely that to be
alive in any meaningful sense beyond mere biological existence (Potential
life begins when both heart and brain are operational - (Week 9 onwards). Interestingly, in my own faith tradition (Geir toshav in the
Netzarim branch of Orthodox Judaism http://www.netzarim.co.il/)
the fetus generally becomes a viable human life after day 40 of gestation. In
the ancient Jewish context, the fetus is deemed to be little more than water
until “quickening” occurs, about 40 days after insemination. “What
Do Orthodox Jews Think About Abortion and Why? By
Judith Shulevitz - http://slate.msn.com/id/1005956/
If we take week 9 as our bench mark -- the heart and brain being recognizably
functional - then the fetus would be deemed viable from about day 63 onward. Applying this definition of when human life becomes viable, it follows
that embryos from conception to week 9 or so are “pre-viable” or
“proto-viable.” Now is this to say that embryos prior to week 9 are “fair game”? Say,
that we can create embryos strictly for the purposes of harvesting their stem
cells? These embryos aren’t viable, so why not? Well this brings us full
circle to religious and ethical concerns. Rather than belabor that in this
op-ed piece, I would direct readers to an excellent treatment of this subject
in this posted article: http://www.jewishvirtuallibrary.org/jsource/Judaism/abortion.html OK, so we don’t create embryos to harvest, how about using intentionally aborted fetuses as a
source of embryonic stem cells? As one fellow actually said to me, “Hey, Doc,
they are going to die anyway, so why not get some good out of them for sick
and ailing people”. To my mind, this comes uncomfortably close to the
arguments advanced by physicians and scientists who performed hideous
experiments on human subjects in Nazi concentration camps. This very line of
reasoning was, in fact, used as a defense by some of the physicians being
tried for war crimes in the 1946 “Doctor’s Trail” in Germany). Granted, there
is a world of difference between an abortion by consent and the intentional
dispatch of life at the hands of doctors (such as the late Nazi “Angel of
Death” Dr. Josef Mengele and his ilk) who abandoned universally acknowledged
medical ethics in the service of the state. But even so, harvesting aborted
fetuses from any source does strike many folks in Moving on, what about extracting stem cells from fetuses that are
spontaneously aborted? This is probably a more acceptable alternative to that
of taking stem cells from intentionally aborted fetuses to many folks,
provided one can show that the stem cells coming from such a fetus are not
defective (Genetic abnormalities cause many spontaneous abortions.) This is
not yet easy to do, which would lend most of us to take a “better safe than
sorry tactic” -- use these cells only when they can be declared free of
genetic defect with great confidence. Clearly, resolving the question of exactly when viable human life begins
will not make doing embryonic stem cell research here in So while we as a society continue to grapple with the moral and ethical
concerns, and scientists try to work out matter of safety and efficacy, many
folks who might be helped by stem cell therapy must wait. Unfortunately, for
many suffering Americans their window of opportunity to stabilize and even
reverse or cure their health challenges will pass them by. This has resulted
in scores of ailing people leaving US shores and undergoing experimental
treatments with stem cell-rich embryonic or fetal material or stem cells in
clinics abroad (In countries where stem cell therapy is legal, such as Costa
Rica, Mexico, and such). I can and do fully sympathize with people who have intractable conditions
or incurable illnesses or such who elect to take their changes on getting
some manner of improvement from embryonic stem cell therapy in foreign lands.
My concern lies in the realm of safety issues. Will today’s palliative,
curative or even restorative embryonic stem cell treatment result in
something more insidious cropping up a few years down the line? Is relief
from the anguishing symptoms of advanced progressive MS or some other
neurological disease over the short-term really worth it if one (say) winds
up with an embryonic stem cell therapy-spawned tumor in a vital organ in a
year or two or so? At what level is the risk acceptable? Is a 1 in 20 chance
of developing complications or worse in time an acceptable risk level? Is a 1
in 10 risk acceptable? How about 1 in 5? Is there an alternative to embryonic? There are, after all, two other
kinds of stem cell available: Adult and umbilical cord. Adult stems
cells been employed to successfully treat many diseases and conditions.
However, there appear to be many limitations associated with using adult stem
cells. For one thing, they are often present in only minute quantities and
are often difficult to isolate and purify. But stem cell-rich
umbilical cord blood provides a ready source of stem cells that can be
readily isolated and expanded. Human umbilical cord stem cells (hUCSC) also
boast an impressive clinical pedigree: Stem cell-rich cord blood has been
successfully employed to combat many intractable and even terminal illnesses
for more than 20 years now. And by-and-large, very few folks so treated went
on to develop a secondary illness or such due to the umbilical cord blood
treatment. This track record suggests that the safety margin is substantial. Cord blood is currently being used experimentally to treat ALS, MS and
many other conditions and diseases (Outside the US by-and-large). And by
employing modern laboratory technology, scientists have isolated the stem
cell cells in cord blood, harvested and then expanded their numbers, and thus
have pure (CD34+ and the high neural marker-rich CD133, CD34-/45+, etc.) stem
cells on-hand that they use in animal and human experiments. So why is the
medical, scientific and political establishment not investing more energy and
resources into exploring the promise and utility of umbilical cord stem cell
therapy? Well, there is funding and research going on, but it is
disappointingly small compared to that being channeled into embryonic stem
cell work. This is due (in part) to that fact that many scientists argue that
umbilical cord stem cells are not as capable as embryonic stem cells of being
transformed into target tissues (They are not as “plastic” as embryonic). But
recently published studies are increasingly challenging this position: http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/07-19-2004/0002212680&EDATE Clearly many
suffering people need a shot at improvement or clinical benefit that only
stem cell therapy can conceivably provide. Ethical, safety and technical
challenges are immense when it comes to embryonic stem cells and thus takes
them out of the picture -- for now. Adult stem cells do not carry the ethical
baggage true of embryonic, but appear saddled with various limitations. This
leaves umbilical cord stem cells. There are few if any ethical concerns connected
with their use, the safety margin appears significant and solid, and they can
be coaxed into become neurons, bone cell and other cells needed by many
diseased or disabled people. Until and if such time as “We the people” reach a consensus on the question
of when viable human life begins and reach an accord on assorted other
ethical issues connected with the use of embryonic material, this plus the
unanswered safety and technical challenges will no doubt keep embryonic stem
cell therapy a distant hope for quite some time to come (At least here in the
states). Thankfully, we have an apparently safe, less controversial and
technically daunting alternative in umbilical cord stem cells. ________________________________________________________ Readers interested in learning more about the safety issues that surround
the use of embryonic stem cells should visit http://www.stemcellresearch.org/
, specifically http://www.stemcellresearch.org/facts/quotes3.htm. Stem cell basics from the National Institutes of Health: http://stemcells.nih.gov/info/basics/
For information on umbilical cord stem cells: http://www.stemcelltherapies.org/
Dr. Anthony G. Payne can be readily reached by
e-mail at biotheoretician@gmail.com.
Original version © 2004. This revised version
© 2006 by Dr. Anthony
G. Payne. All rights reserved. |
