I'm Pro-Life And Oppose Embryonic Stem Cell Research By Will
Im Pro Life And Oppose Embryonic Stem Cell Researchjc Willke Mdmu
Im Pro Life And Oppose Embryonic Stem Cell Researchjc Willke Mdmu
I'm Pro-Life and Oppose Embryonic Stem Cell Research J.C. Willke, M.D Much has been said and written about 'stem cell' research. Unfortunately, a number of biologic inaccuracies continue to be promulgated and, as a result, have colored decision making for many people. The first thing to distinguish is the fact that ethically we can experiment on human tissue, but we should not experiment on human beings. Accordingly, it is perfectly ethical to proceed with any and all type of stem cell research as long as this is human tissue, but it is completely unethical to do embryonic stem cell research, which of its very nature necessitates the killing of a living human embryo to obtain that stem cell.
To understand this we must first review early developmental biology. Human life begins at the union of sperm and ovum. During that first day, this is properly termed a 'fertilized egg.' However, this single-celled human body divides, divides, and divides again, so that nearing the end of the first week this embryo, now called a 'blastocyst,' numbers several hundred cells. To obtain an embryonic stem cell, the researcher must cut open this embryo, thereby killing him or her and extracting stem cells. After the first day, a number of names apply to various developmental stages of the same living human, fertilized egg or zygote (a single cell), a blastocyst (many cells), embryo, fetus, infant, child, adolescent, etc.
During the first week, this tiny new human floats freely down his or her mother's tube, dividing and sub-dividing as the journey is made. At about one week of life, he or she plants within the nutrient lining of the woman's uterus. In about three more days, having sent roots into the wall of the uterus, this new human sends a chemical hormonal message into the mother's blood stream and this stops her menstrual period. Four days later, the embryonic heart begins to beat and three weeks after that, brain waves are measurable. The biologic fact is that from day one, inside and then outside of the uterus, this is one continuous, uninterrupted period of growth and development.
It is impossible to draw a line in time and to say that before this time, this was not a living human, and after this, it is. This is, in fact, a living human at the first cell stage and remains so until the old man dies. Accordingly, killing this living human embryo at day four or five, at week four or five or at year four or five is, in fact, killing a living human. At the first cell stage, you were everything you are today. You were already male or female.
You were alive, not dead. You were certainly human as you had 46 human chromosomes (you were not a carrot or a rabbit); and most importantly, you were complete. For nothing has been added to the single cell whom you once were, from then until today, nothing except food and oxygen. You were all there then, and to terminate your life at any stage of that can be called nothing other than killing. Note that Senator Mack in his Wall Street Journal column repeats the biologic error seen almost everywhere.
He speaks constantly of stem cells from 'fertilized eggs.' That stage lasts only one day. You cannot take a stem cell from a fertilized egg which itself is only one cell. Rather what he is advocating is killing a human embryo and extracting stem cells from the inside of that new living human. He attempts to distinguish between 'a frozen fertilized egg' and a fetus. Actually the only difference is location, size, age and degree of development as the one is just a bit younger than the other.
I can understand why a pro-abortion Senator Jeffords or Chafee would favor destructive embryonic stem cell research, for they are strongly pro-abortion and have demonstrated many times their support for killing babies in the womb. What I don't understand is pro-life Senator Orin Hatch, who 'insisted' that a frozen embryo was not the equivalent of an embryo or a fetus in the womb. I've known Senator Hatch well for 20 years. He's pro-life, but on this he has his facts dead wrong, and it's a tragedy that he would lend his undoubted prestige to destructive stem cell research by repeating an obvious biologic falsehood. To say that these tiny humans will be 'discarded' and not used and therefore should be 'used' is a fallacious argument.
Why then don't we use the tissues of a criminal who has been legally executed? Why did we universally condemn the Nazi doctors who used Jewish subjects because they were going to be killed anyway? Why is it that we cannot cannibalize a person's body who was killed in an accident? It's because we have respected the human body, an absolute necessity in a civilized nation. But are there other options?
Certainly, there are. There have been marvelous and well-publicized advances in the last year. We now have scientific data showing that stem cells can be obtained from fat. They can be obtained from cord blood. They can be obtained from neural tissue, from bone marrow, muscle, placental, and skin cells.
We have reports of bone marrow stem cells being changed into liver cells. We have a report of skin cells being changed into heart cells. We have a report of cord blood promising to possibly create neural cells. Almost every month we receive reports of new advances in this field. One of the latest is from Congressman Ron Lewis (R-KY), in a letter to HHS Secretary Tommy Thompson.
He urges him to consider a 'tobacco based adult stem cell alternative to embryonic stem cell research.' He notes the leadership of plant protein assisted stem cell research, which has identified the genes in proteins that cause self-renewal of adult stem cells. He points to the fact that certain plant proteins found in tobacco can stimulate such changes. And much more. This is yet the latest revelation. Rest assured there is much more to come.
There is a possibility, perhaps a probability that adult stem cells may function more efficiently and more safely than embryonic stem cells. Adult stem cells are increasingly being shown to have a similar and perhaps an identical capacity to become cells of other types. They can be taken from the patient himself, then re-injected, thus eliminating the problem of immune rejection, which is a real problem in using tissues from another human, even from an embryonic human. There is no question but that there is probably an immense potential of use for stem cells. But this increasingly is being shown to not be exclusive for embryonic stem cells.
In fact, adult stem cells may prove to be superior because they don't suffer the problem of rejection. As for public opinion polls, as usual the wording of the question leads the answer. When the poll speaks of 'fertilized eggs' and doesn't mention the destruction of human embryos, you get one kind of an answer. In comparison, a recent poll by International Communications Research of over 1,000 adults was worded more objectively. Its question was as follows: 'Stem cells are the basic cells from which all of a person's tissues and organs develop. Congress is considering whether to provide federal funding for experiments using stem cells from human embryos. The live embryos would be destroyed in their first week of development to obtain these cells. Do you support or oppose using your federal tax dollars for such experiments?' The results were: Support - 24%, Opposed - 70%, Don't Know and Refused - 6%. Further, only 18% supported 'all stem cell research' while 67% supported 'only adult stem cell research.' Finally, can embryonic stem cells be said positively to be able to cure diseases that stem cells from other ethical sources would be unable to? No one can make that statement.
Let us by all means pursue aggressive research with stem cells but there are some bridges that we, in a civilized society, should not cross. We should not deliberately kill one living human to possibly benefit another. Use stem cells? Yes, but don't kill to get them. Paying Patients for Their Tissue: The Legacy of Henrietta Lacks 1.
Robert D. Truog 1 , * , 2. Aaron S. Kesselheim 2 , 3. Steven Joffe 3 In The Immortal Life of Henrietta Lacks , Rebecca Skloot tells the moving story of the woman who was the source of the first immortal cell line (HeLa) ( 1 ).
The cells were obtained at Johns Hopkins University in 1951 from biopsies performed during her treatment for cervical cancer. Her physicians did not seek her consent before using her tissue for research, nor did they receive any personal financial gain from the cell line. The cell line did become extremely lucrative, however. Although it is difficult to precisely quantify the total revenue generated from the HeLa line, it is not unreasonable to assume that the line has contributed to hundreds of millions of dollars in downstream revenue. Hundreds of patents contain the word “hela” in their claims, and genetically modified versions of the line currently sell for as much as $10,000.
For many, it seems an injustice that the Lacks family never received any financial benefits from the HeLa line, especially given that they lived in poverty, unable to pay even for their own medical care. Christoph Lengauer, a cancer drug developer and former Hopkins faculty member, articulated this sense of inequity when he reportedly told Lacks's daughter that he thought Hopkins had “screwed up” by not sharing some of the proceeds from the HeLa cell line with the Lacks family ( 1 ). Although this sentiment resonates with a sense of fairness for many people, it requires critical examination before becoming accepted as precedent regarding payments to patients. We recently had an opportunity to consider issues surrounding sharing revenues with patients who provide tissue for research when a young man (we will call him DF) was treated at Dana-Farber Cancer Institute for a rare metastatic malignancy.
Shortly before he died, he was admitted to the hospital with increasing shortness of breath, requiring placement of a pleural drainage catheter. With his knowledge and permission, the physician-investigators obtained discarded fluid from the catheter to obtain and isolate tumor cells. The cells were processed into a cell line that holds promise for basic science research and the development of therapeutics. The line may result in a revenue stream for the medical center, as well as personal income for the physician-investigators. After the patient died, the physician-investigators who cared for him were motivated to see that his family received some financial benefit from his contribution.
They sought advice from the Research Ethics Consultation Service at the Harvard Clinical and Translational Science Center, on which we serve. Property rights in human tissue If patients own their tissues, even after removal from their bodies, then it follows that they have the right to demand payment when a profitable discovery derives from them. One of the earliest cases addressing this question was Moore v. Regents of the University of California ( 2 ). John Moore had his spleen removed as part of his treatment for hairy cell leukemia. Several years later, he initiated a lawsuit after learning that his physician at the University of California, Los Angeles, had developed a lucrative cell line (MO) from this tissue; at the time Moore predicted a market value of around $3 billion. In 1990, the California Supreme Court decided that Moore did not have a property interest in his removed cells, worrying that giving property rights to patients would “hinder research by restricting access to the necessary raw materials” and might “destroy the economic incentive to conduct important medical research.” Most other legal precedent supports the view that patients do not maintain a property interest in discarded tissue ( 3 ). Even if patients lack such property rights, there are many examples of individuals receiving financial compensation for donating tissue.
A striking case was that of Ted Slavin, a man with hemophilia who developed extremely high antibody titers after contracting hepatitis B ( 4 ). When his physician informed him that his blood might be valuable to medical researchers, he was able to sell his serum for as much as $10,000 per liter, providing himself with a source of income for the rest of his life. Are the Moore or Slavin cases relevant to those of Lacks or DF? What are the salient features that determine whether patients should be paid for their tissue? Investigators' obligations to individuals from whom they seek tissue for research There are three distinct obligations that an investigator who seeks access to tissue might have toward an individual whose tissues, upon removal from the body, might hold value for biomedical research (see the table).
In addressing each of these obligations, it is necessary to distinguish between situations in which the tissue constitutes excess material that remains after an indicated clinical procedure and those in which obtaining the tissue imposes incremental inconvenience, burden, or risk. Consent: Residual clinical tissues, such as those at issue in the case of DF, are obtained as a by-product of necessary care, involve no increased potential for harm or discomfort to the patient, and entail no extra effort or inconvenience beyond that inherent in the patient's medical treatment. Although consent is not always required for the use of residual clinical tissue (as with de-identified tissues obtained from pathology department archives), current U.S. regulatory standards require investigators to obtain the individual's consent whenever they prospectively intend to use residual clinical tissue for research.
Of course, investigators must also obtain informed consent before undertaking additional procedures, beyond necessary clinical care, to procure tissues for research. · Download high-res image · Open in new tab · Download Powerpoint Compensation for effort and burden: By definition, the use of residual clinical tissue for biomedical research imposes no additional effort, burden, or risk on the patient. As a result, no compensation for such effort is owed. By contrast, when the procurement of the tissue imposes burdens over and above those required for indicated clinical care, it may be necessary to offer individuals, whether patients or healthy volunteers, compensation. Ample precedent exists for offering payment when individuals are asked to cooperate with physicians or investigators for the benefit of others.
For example, in research contexts beyond that of tissue acquisition, subjects are commonly compensated for the time, effort, and cooperation that participation requires ( 5 ). Similarly, payments are often made when renewable tissues are procured from volunteers, not for their medical benefit, but solely for the benefit of others. This is reflected in the markets that exist for blood and blood derivatives, oocytes, sperm, and breast milk. Although many individuals do not demand payment for these tissues (as reflected in the largely volunteer supply of banked blood), it is widely acknowledged that, as in the case of Ted Slavin, individuals may seek payment for these renewable tissues. In light of the Moore decision and other legal precedents holding that individuals do not retain property ownership over removed tissues, we suggest that a plausible rationale for justifying such payments is that they are made in exchange for the performance of a service, rather than for the transfer of property.
Rights to revenue streams: Cases such as Lacks and DF pose the question of whether investigators and institutions owe individuals payment for the potential value of the tissue, and in particular whether contributors should have rights to a portion of any revenue stream that derives from their tissue. As discussed, neither legal norms nor contemporary practice treat tissues that have been separated from the body as the ongoing property of the individual such that it would generate a revenue stream. Nevertheless, beyond legal duties, do ethics require that individuals whose tissues ultimately provide revenue for institutions and investigators be offered a share of the proceeds? Several considerations mitigate against the claim that patients such as Lacks or DF should be offered financial compensation for use of their residual clinical tissue.
First, although it is true that the patients have contributed “raw materials” necessary for development of the cell line, it is the investigators, not the patients, whose intellectual contributions lead to the creation of value. Second, paying such individuals raises questions of fairness. Investigators may preferentially reward patients and families with whom they have become emotionally bonded, but not those who were equally generous but with whom personal relationships were absent. Third, the implications of reconceptualizing tissue acquisition as an economic exchange rather than as a gift relationship must be carefully considered. Payment might paradoxically have a negative effect on patients' willingness to give their tissues for research.
Providing upfront payments to all patients who donate tissue—independent of and without prior knowledge regarding the actual financial value of their contributions—suggests that the payments themselves would likely be quite modest. The enormous number of tissue samples collected, as compared with the relatively small number that acquire significant value, suggests that the prior estimated value of any given tissue sample is low. Such small payments might not merely fail to incentivize patients, but might actually be scorned as an unfair or token reward. In addition, there is a risk that invoking the extrinsic motivation of money would crowd out intrinsic motivations, such as the desire to contribute altruistically to improved knowledge and treatment ( 6 , 7 ).
Finally, and perhaps most important, few individuals will contribute tissues that generate financial blockbusters. As a result, compensating such persons in effect rewards them for “winning the lottery,” whereas the vast majority, despite their ex ante identical contributions, receive nothing. If financial rewards for the development of useful cell lines should be tied to material contributions rather than to luck, then compensating patients such as Lacks or DF, ostensibly in the service of justice, may lead to an outcome that is manifestly unjust. Conclusion Although Skloot's book is moving and compelling, we use caution in using the Lacks example as a model for thinking about compensating patients who provide tissue for research.
Although one can point to the many injustices Lacks endured as a poor woman without access to needed medical care, the use of her residual clinical tissue, involving no additional risk or burden to her, does not demand any form of compensation. Furthermore, compensating such patients may have unintended consequences that could work to decrease the availability of tissue for research, and may paradoxically become a source of injustice. In the case of DF, we therefore advised the investigators not to offer his family any payments for use of the residual clinical tissue they obtained.
Paper For Above instruction
Embryonic stem cell research has been at the center of heated ethical debates due to its fundamental reliance on the destruction of early-stage human embryos. Advocates argue that embryonic stem cells hold exceptional promise for regenerative medicine, disease treatment, and understanding human development. However, opponents, particularly those with pro-life perspectives, contend that the research fundamentally involves the deliberate destruction of human life from its earliest stages, raising significant ethical concerns.
Understanding the biological basis of this debate is crucial. Human life begins at fertilization, when sperm and ovum unite to form a zygote. This single cell contains a