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Saudi Journal of Kidney Diseases and Transplantation
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STUDENTS PUBLICATION SECTION Table of Contents   
Year : 2005  |  Volume : 16  |  Issue : 4  |  Page : 606-611
Ethical Aspects of Stem Cells Research


Gulf Medical College Ajman, U.A.E, 5th year 2005-06, P.O. Box 645, Sharjah, United Arab Emirates

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How to cite this article:
Al-Sayyari RA. Ethical Aspects of Stem Cells Research. Saudi J Kidney Dis Transpl 2005;16:606-11

How to cite this URL:
Al-Sayyari RA. Ethical Aspects of Stem Cells Research. Saudi J Kidney Dis Transpl [serial online] 2005 [cited 2021 Oct 23];16:606-11. Available from: https://www.sjkdt.org/text.asp?2005/16/4/606/32852
As research is going on and revealing a lot of interesting facts about stem cells and whether these researches should be funded by the governments or not, a lot of questions are floating up to the surface waiting for answers. Question like whether blastocytes should be protected under the same laws that control other researches done on the human subjects? Or when exactly life begins? [1] The later questions seem to be the most important to some people who believe that life starts at the moment of conception. For those who hold such a belief, research on stem cells and the destruction of human blastocysts are simply unacceptable. [2]


   The Debate Top


The production of new cell lines involves destruction of pre-implantation embryo at the "100-200 cells blastocytes" stage. These embryos are stored frozen for the purposes of in vitro fertilization (IVF) created by somatic cell nuclear transfer. [2],[3]

Those who support the continuation of the stem cells research believe that an embryo is just a collection of cells and that destroying a few of them will do no harm and will benefit the millions of patients who are suffering, craving and desperate for a cure. Additionally, they believe that the progress in stem cell research would reveal a lot of unknown facts about the embryonic development

In contrast, those who are opponents believe that embryonic stem cells researches are nothing but killing an embryo, which to them is exactly similar to killing an adult human being or child since the embryo is a potential life, starting from the moment of conception. [2] Therefore, they believe that consideration should be regarded on a higher scale. Some go further as to say that researchers are trying to satisfy their pleasure and obsessions with disregard to the benefit of both the embryo and adults.

Between those two extremes lies the middle group of people that thinks that embryo should not be regarded and respected to the same extent an adult human being is respected and protected by strict laws related to researches and clinical trials; on the other hand, they are certain that embryos possess a different potential than the unfused sperm and egg.

Some congressmen in the USA have said that embryos created in the laboratory do not qualify as a human life until they are implanted in the uterus. They conclude that frozen embryos and those being grown in  Petri dish More Detailses are therefore acceptable for research. Others agree with Pope John Paul II, maintaining that if an embryo has the potential to develop into a human, it should be protected. [4] Yet another view is that because an embryo can still split into two or more separate individuals up until 14 days in the womb, it cannot have a soul during that time. [5] If aborted fetuses are made available to researchers, does this imply that life begins at birth? Drawing the stem cell from cloned human embryos seems like an obvious solution, but opens another door as to whether to allow human cloning for this purpose, which is already controversial. [6]

The debate started in 1998 when it was published in Science magazine [7] that Thomson et al at the University of Wisconsin developed embryonic stem cells taken from embryos donated from IVF clinics. This was followed by scientists from the Johns Hopkins who announced a method of obtaining similar cells from the primordial tissue of aborted fetuses.

On January 8, 1999 the stem cell lines were reported to be free of cancerous traits [8] the plague of most immortal cell lines.

Following that on January 19, of the same year, The National Institutes of Health announced that US law does not bar federal support for the use of embryonic stem cells. This meant, that federal funds may be used for the extraction of stem cells as the federal law was believed to indicate that once the cells are obtained, they are no longer organisms or even precursors to organisms. As such, embryonic stem cells cannot develop into an embryo even if implanted in the uterus; that is why NIH director Harold Varmus hoped to begin funding such projects by March, 1999, after hearing from the National Bioethics Advisory Commission.

The Center for Bioethics and Human Dignity in February, 1999 published the following statements including: "The fact that all embryos from which stem cells are obtained must be destroyed should cause us all to consider the implications of furthering medical science at such a great cost." "We must not sacrifice one class of human beings (the embryonic) to benefit another (those suffering from serious illness)." [9] On April 2, 1999, a report in Science "Mulitlineage Potential of Adult Human Mesenchymal Stem Cells" [10] tell of a newly isolated multipotent cell derived from adult humans that can differentiate into specialized cells. The opponents of embryonic stem cell research, who said that adult stem cells would be enough for research and, embryonic cells are thus not needed, used this fact. At the same time, seventy congressmen called for the law to be re-written to exclude the use and extraction of embryonic stem cells. [11]

The National Bioethics Advisory Committee again released on may 27 1999, an initial draft of a report that recommends the government should pay for both the use of and the extra­ction of embryonic stem cells. That allowed the scientist to use frozen embryos from IVF clinics. It was clear that the report was rejecting the use of human embryos that gets destroyed later. The committee also recommended allow­ing continued extraction of embryonic germ cells from aborted fetuses. Meanwhile, polls showed that 74% of American public favored federal funding of embryonic stem cell research. [12]

Over 100 anti-abortionists released a state­ment arguing that "research on human embryonic stem cells is scientifically unnecessary and urging Congress to fund alternatives." That was in July 1999. [13] On the other side, there were a number of people who believed that any delays in research funding would harm patients who could eventually be treated by therapies based on embryonic stem cells.

The White House released a statement saying that the administration "recognizes that human stem-cell technology's potential medical benefits are compelling and worthy of pursuit, so long as the research is conducted according to the highest ethical standards". [14] The report did oppose the federal funding of extraction of embryonic stem cells.

The question is being debated on whether federal funds should be used to support stem cell research. The National Institute of Health's (NIH) guidelines in the United States speci­fically forbid the creation of embryos for research purposes, while the British Government has announced a policy permitting the practice. [15]

Those that oppose the research on the embryo are worried about what they think could be a slippery slope. Their contention was that if we agree to destroy an organism that has the potential to develop into a human being, it may be easy to move on to other destructive acts. [16] Another fear is that the legislation of stem cell research may encourage the couples either to donate or charge for the fertilized ova, i.e. fertilization will take place just for the sake of stem cells. Therefore, the Ethics Advisory Board strongly recommends that the donating women or couples provide fully informed consent that they will not use their fertilized ova for profit or commercial gain. [17] It is believed that this may reduce the fear of using or regarding the fertilized egg as a property that the couple has the right to sell. On the other hand, there were worries that increasing need will create a commercial market for fertilized eggs. However, this was not evident in that for the past four to five years, few fetuses, less than 100, have actually been used; experiments at the University of San Francisco and University of Wisconsin use less than two dozen IVF embryos per year [1] This is because one embryo could provide enough embryonic stem cells for many researchers.

The excuse of those who support the research is that fertility clinics routinely destroy thousands of embryos and have not been similarly pro­tested against, and question the motivation of opponents of research. [18] Proponents also point out that embryos used for stem cell research would normally be discarded or kept frozen indefinitely if not used in research. [19]

Many Jewish groups are supportive of embryonic research, as they do not view an early stage embryo as a human being. Many Humanists Unitarian Universalists, and many Muslim clerics have also come out in favor of embryonic stem cell research. [19] The oppo­nents respond that adult stem cells could be an alternative since they have proved their successes in contrast to the embronic stem cells and that the funds should be focused on the adult stem cells. Another weapon the opponents are using is that one of the ways embryonic stem cells can be derived from, is from a cloned embryo and that is regarded as unethical. [19]


   Stem Cells and Politics Top


President Bush and the Democratic candidate John Kerry addressed their nation during their debate at the Washington University in St. Louis. One of the issues that came up was stem cells.

One member of the audience asked Kerry: "Thousands of people have already been cured or treated by the use of adult stem cells or umbilical-cord stem cells. However, usage of embryonic stem cells has not cured any one. Wouldn't it be wise to use stem cells obtained without the destruction of an embryo?" "I really respect your feeling that is in your question," Kerry answered. "I understand it.

I know the morality that's prompting that question, and I respect it enormously." But Kerry said that people like former first lady Nancy Reagan, whose husband suffered from Alzheimer's, and actor Michael J. Fox, who suffers from Parkinson's disease, and actor Christopher Reeve, who suffered from paralysis (died of cardiac arrest two days after the debate at the age of 52), cause him to support embryonic stem cell research.

President Bush, in his response to the same question, noted that embryonic stem cell research requires the destruction of life to create a stem cell. "I think we've got to be very careful in balancing ethics and science," Bush said. "Science is important, but so is ethics. So is balancing life. To destroy life to save life is one of the real ethical dilemmas that we face". The President said he helped double the National Institutes of Health budget to $28 billion a year to find cures using adult stem cell research, "to balance science and the concerns for life". [4]

In 1995, the US congress prohibited the federal funding to any sort of research related to the use of human embryo. That explains why the breakthroughs that took place in the 1998 were funded privately

On august 11 2001, president George W Bush announced for the first time that there will be federal funds available so that the embryonic stem cells research can go on but that is restricted to the already existing embryonic stem cell lines and the admini­stration did encourage research preformed on the adult stem cells and animal stem cells.

The Bush administration's decision does not prohibit private embryonic stem cell research. As a result of the federal funding restrictions, embryonic stem cell research in the US is commonly acknowledged to have been hampered in comparison with other countries, such as South Korea which successfully cloned human embryos in early 2004. [19]


   An Islamic Perspective on Stem Cells Research Top


As stem cell research and the controversy embracing Lit took the whole world by storm, Islam had it's own perspective on the stem cell ethical debate.

It seems that there is no major controversy in the Islamic opinion. Muslim jurists have made a clear distinction between the early stages of pregnancy (first 40 days) and its later stages. [20],[21]

Majority of American Muslims agree with embryonic stem cell research according to a poll that took place in the Islamic institute based in Washington. The poll involved 629 individuals and the results came as the following. [22]

  • 62% (394) stated their support to stem cell research overall [22]
  • 73% (457) stated their support to the use of embryos that are already donated for IVF. [22]
  • 62% (383) supported the use of embryos to be donated in the future. [22]
  • 49% (312) feel it is acceptable to produce embryo specifically for stem cell research purpose. [2]
  • 69% (433) believe that the research should be funded by the federal government. [22]
  • 44% (275) stated that they follow the stem cell research news often. [22]
  • 53% (335) stated that they follow the news about stem cell research occasionally. [22]


Muslims have rejected human cloning experi­mentation, and as described by the mufti of Egypt, it "contradicts Islamic legislation and is prohibited in all its forms because it contradicts with Islam". [23]

On the other hand, IVF is regarded as a compassionate and scientific procedure that helps infertile couples to have children as long the sperm and egg is from the lawful husband and wife respectively during their married life [20],[22] and as long as the uterus is the wife's (from whom the egg is obtained) and not some other woman's uterus (surrogate mother).

The use of aborted fetuses to extract stem cells would be allowed only if the fetus was less than 42 days old (in accordance with the Hadith narrated by ibn Mas'ud). Imam Muslim narrates from Ibn Mas'ud that he heard the Messenger of Allah (saw) saying, "When 42 nights have passed on the nutfah (mixing of male and female discharge of semen), Allah sends an angel to form it. He creates its hearing, vision, skin, flesh, and bones. Then the angel says, O Allah! Male or female?" In another narration "40 nights" was mentioned instead of 42. [21]

As to questions like whether it is acceptable to destroy an embryo for the sake of research, even if this research can potentially cure many otherwise fatal diseases, the answer given by Islamic jurists is that as long as it not placed in the womb, it will not survive and it will not become a human being and therefore, no harm is done. Moreover, it is well known that it is inevitable that in IVF procedure, the doctors produce several embryos (spare embryos) to give the women more than one chance to become pregnant. Therefore, the Islamic institute sees that under Islamic Shariah, it is permissible to carry on with embryonic stem cell research for the purpose of greater good that would come out of it rather than to discard thousands of spare embryos 20,22 especially if this research has a potential to cure diseases. [20]

In addition, the experts in the panel (consisting of doctors, scientists and Islamic scholars) that was formed by the institute to come out with an Islamic perspective towards stem cells research believe that there should be guide­lines to ensure that there is no kind of any abuse. One of the guidelines suggested was that there should be a full informed consent by the parents. [22]

Finally, the quarrel between the ethicists and scientists will go on until some answers are found. Some believe that a reasonable answer cannot be found unless research is permitted to proceed forward simply because we will know the answers only when we do the research.

Arguments that are made that stem cells have not cured a single disease yet, should not be taken as evidence against stem research because research has been hampered by current regulations. It seems to be the case with all scientific advances that it takes time and a great deal of money, effort, persistence and determination to prove and translate the un­believable to be part of reality. [2]

 
   References Top

1.http://www.meta-library.net/stemtp/quest1­frame.html  Back to cited text no. 1    
2.Gerald D Fischbach, Ruth L Fischbach. Stem cells: science, policy, and ethics. J Clin Invest 2004;114:1364-70.  Back to cited text no. 2    
3.http://www.stemcellnetwork.ca/research/pro jects/project04.php  Back to cited text no. 3    
4.Yang Carter M. Bush under pressure over stem cells. ABCNews.com, dailynews. http://abcnews.go.com/sections/politics/Dail yNews/Stem_Cells_Influences010724.html, July 24, 2001.  Back to cited text no. 4    
5.Zitner, Aaron. Bible guides senate on stem cell studies. The Los Angeles Times, July 19, 2001.  Back to cited text no. 5    
6.By Erin Curry Oct 11, 2004. Bush, Kerry discuss stem cells, abortion in 2nd debate.  Back to cited text no. 6    
7.Thomson JA, Itskovitz-Eldor J, Shapiro SS et al. Embryonic stem cell lines derived from human blastocysts. Science 1998;282: 1145.  Back to cited text no. 7    
8.Ferber D. Immortalized cells seem cancer­free so far. Science 1999;283:154-5.  Back to cited text no. 8    
9.Marshal E. A Versatile Cell Line Raises Scientific Hopes, Legal Questions. Science 1999;282:465.   Back to cited text no. 9    
10.Pittenger M. Multilineage potential of adult human mesenchymal stem cells. Science 1999;284:143-6.   Back to cited text no. 10    
11.Couzin, J. The promise and peril of stem cell research. U.S. News & World Report. May 31, 1999.  Back to cited text no. 11    
12.Wadman, M. Ethicists urge funding for extract­ion of embryo cells. Nature 1999;399:292. http://www.goshen.edu/bio/Biol410/BSSpapers99/bensmucker.html  Back to cited text no. 12    
13.Wadman M. Protestors seek US ban on embryo stem-cell work as wiscousin researchers awaits go ahead. Nature 1999;400:96.  Back to cited text no. 13    
14.Wadman M. White House cool on obtaining human embryonic stem cells. Nature 1999; 400:301.  Back to cited text no. 14    
15.Bailey, Ronald 2000. "Getting On With It," Reason Online (08/24/2000) http://www.islam-online.net  Back to cited text no. 15    
16.President's Council on Bioethics 2003. Beyond therapy: biotechnology and the pursuit ofbappiness. A report of the President's Council on Bioethics. 1st edition. ReganBooks. New York, USA. 328 pp.  Back to cited text no. 16    
17.Karen Lebacqz, Michael M. Mendiola, Ted Peters, Ernle W.D. Young, and Laurie Zoloth-Dorfman, "Research with Human Embryonic Stem Cells: Ethical Consi­derations," Hastings Center Report, 29:2 (March-April 1999) 31-36.  Back to cited text no. 17    
18.(http://www.time.com/time/magazine/article/0,9171,1101040531-641157,00.html  Back to cited text no. 18    
19.http://en.wikipedia.org/wiki/Stem_cell  Back to cited text no. 19    
20.http://www.islam101.com/science/stemCells.htm  Back to cited text no. 20    
21.Source: http://risala.org/index.php?option= com_content&task=view&id=37&Itemid=7 2 The Islamic Verdict on Stem Cell Research Dr Saqib Latif. www.khilafah.com  Back to cited text no. 21    
22.http://www.islamicinstitute.org/i3­stemcell.pdf a Muslim perspective on embryonic stem cell research volume 11,no.3 published by the Islamic institute on august 29,2001.  Back to cited text no. 22    
23.http://ngin.tripod.com/211.htm Dr Hamid K Ahmed "ISLAMIC VIEWS ON GE " 6 December 2000.  Back to cited text no. 23    

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Correspondence Address:
Rehab A Al-Sayyari
Gulf Medical College, Ajman, U.A.E. 5th year 2005-06, P.O. Box 645, Sharjah
United Arab Emirates
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