June 1, 2020

The Niche

Knoepfler lab stem cell blog

Stem Cell Ethics: from cells to the Vatican

What does “ethical” stem cell research mean?

What is “unethical” stem cell research?

Who decides the answers to these questions? A church? Governments? Individual people?

The reality is that we all have our own opinions about what is ethical or unethical not only when it comes to stem cells, but for pretty much everything.

For some things, societies have reached a consensus about right and wrong.

For many other things, such as stem cells, there is no one consensus in most countries or across the globe for that matter.

Sometimes when there is no consensus on an issue, people turn to authority figures to provide guidance. These authorities can be religious figures, doctors, scientists, or political leaders. They can be parents or grandparents. It is very important to realize that for a non-consensus issue such as stem cell research there is no one right or wrong answer even from an authority figure. For example, if any scientist tells you that we have proof of when human life begins, then they are stating their own opinion, not a scientific fact.

We can hope that mature people can disagree about these “gray zone” issues without becoming enemies, but history would argue that often times they do become enemies.

Data versus belief. When it comes to stem cell research, while I hold to my beliefs for example that embryonic stem cell research is ethical, I respect that fact that a lot of people disagree with me. What bugs me, however, is when folks opposed to embryonic stem cell research state their opinions as facts. Scientists like facts. We like data. We have a duty to take information and form opinions about it too or otherwise our research is useless. However, we are very particular about distinguishing between data and our opinions about that data. When it comes to the issue of when human life begins, there is no data to prove that and there never will be in my opinion.

Scientists need to think about ethics too. An important element of science is ethics in the sense that scientists need to conduct and report their research in an ethical way, for example without plagiarism.

However, there is another level of ethics in science, the big picture level. Scientists have to be concerned about the impact of their work on society. I also believe that scientists have to consider the sources of the materials, such as ES cell lines, that they use.

If you fill out the paper work and pay a fee, most scientists can obtain a vial of human embryonic stem cells from a repository. They can study them. I think if they do so, they should give some thought to the fact that a human blastocyst was used to make the ES cells and how they feel about that. To me, this is an ethically important step to be conscious of what you are working with. Part of this means educating yourself about ES cells, early human development, and even IVF, which is where human ES cells come from. I’m not sure all scientists working on human ES cells do this. For me personally, I took this extra step before my lab even ordered our first vial of human ES cells. In my way of thinking the use of human ES cells by my lab was the right decision.

It is also important to point out that scientists really should be thinking about the source of all materials, particularly from biological sources (human or otherwise) that they are using in their lab. This becomes especially important if the materials you are thinking of using are of a certain type such as human eggs, human ES cells, etc, but for other human materials as well. For example, if you obtain a human cancer cell line from a repository, I think it is wise to pause for a moment and consider the fact that this came from a real, live human patient who was struck with cancer. That means something and gives context to your experiments.

My opinion is that it is ethical to make use of frozen IVF embryos, rather than throw them away, to make ES cell lines that might help people. While I don’t believe that science can prove when the life of a human being begins, I do believe that scientists can have unique perspectives on this issue that are informative. For example, I have been growing cells in a lab, studying tissues, etc for almost half my life. From my experience, I do not believe that living cells are the same thing as living people. I don’t see a microscopic ball of a few dozen cells a few days post-fertilization in a dish as a human being.  This is just my opinion, not a fact, but that’s how I see it. At some point that microscopic ball can become a human being if many essential things happen, but to me personally it is not yet a human being at that early stage. It is still very much like a seed until implantation occurs and the embryo develops organs, etc. A seed can become a tree, but it is not the same thing as a tree.

What it boils down to for me is whether an unused frozen human blastocyst produced entirely in a lab for fertility treatments should be thrown away as medical waste or be used to make ES cells that could help a lot of sick people. To me, the ES cell route seems most ethical and logical. It’s a relatively new technology and because of that not yet proven, but it nonetheless provides hope for millions of living breathing thinking scared people who deserve hope.

I understand that you might disagree with me, but if you do, then you should think about the realities of that blastocyst. It was made in a dish in a lab and never was in a womb. It did not come from a pregnancy. If it meets its end, that is not abortion because there was no pregnancy. It came from in vitro fertilization (IVF) so if you are opposed to using it for making ES cells, then you should start by opposing IVF, but think about the impact of not having IVF. Millions of couples wanting to be parents would have no hope without IVF. IVF is not going away, but some have argued it should be more strictly regulated to produce fewer unused embryos. Getting back to our blastocyst in question, it has only a few dozen cells and is only a few days post-fertilization. There is no debate that this is a special little ball of cells, but it is far removed from a human being.

I hope that at the upcoming Vatican meeting on adult stem cells that the living, breathing, thinking people of the world who happen to have the misfortune of being sick or injured in such a way that current medicine cannot help them are not entirely ignored. I also hope that the myth of adult stem cells as panacea is not presented as fact. I hope that embryonic stem cell research is not a punching bag at that meeting. While I’m not naive enough to believe that all these hopes will be realities, I can still wish that that meeting ends up being a thoughtful, mature, productive dialogue. Let’s see how it goes.