Going to the roots of the stem cell controversy

Bioethics

Volumn 16, Issue 6, 2002, Pages 493-507

  Holm, Søren ^a  

^a UNIVERSITY OF MANCHESTER   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

CLONING; EMBRYO CELL; HUMAN; LAW; MEDICAL ETHICS; MEDICAL RESEARCH; NONHUMAN; OOCYTE; POLICY; REPRODUCTION; REVIEW; SCIENCE; SPECIES; STEM CELL; STEM CELL TRANSPLANTATION;

EID: 0036837610     PISSN: 02699702     EISSN: None     Source Type: Journal    
DOI: 10.1111/1467-8519.00307     Document Type: Review

References (46)

1. One major topic has been left out of this paper because of space constraints. That is the question of intellectual and actual property rights in human stem cell lines and the techniques by which they are produced. This is a huge topic on its own, actualising all the issues of ownership of the human body, body parts and human genetic material.
2. J.A. Thomson, J. Itskovitz-Eldor, S.S. Shapiro, M.A. Waknitz, J.J. Swiergiel, V.S. Marshall, J.M. Jones. Embryonic stem cell lines derived from human blastocysts. Science 1998; 282: 1145-1147.
3. I. Wilmut, A.E. Schnieke, J. McWhir, A.J. Kind, K.H. Campbell. Viable offspring derived from foetal and adult mammalian cells. Nature 1997; 385: 810-813.
4. The mitochondria in this cell come from the ovum, and contain their own genetic material. It is thus only if both nucleus and ovum come from the same woman that 100% genetic identity is achieved.
5. C.B. Johanson, S. Momma, D.L. Clarke, M. Risling, U. Lendahl, J. Friesen. Identification of a neural stem cell in the adult mammalian central nervous system. Cell 1999; 96: 25-34.
6. In this paper 'adult stem cell' will be used for any stem cell derived from a human being after birth.
7. D.L. Clarke, C.B. Johansson, J. Wilbertz, B. Veress, E. Nilsson, H. Karlstrom, U. Lendahl, J. Friesen. Generalized potential of adult neural stem cells. Science 2000; 288: 1559-1561; P.A. Zuk, M. Zhu, H. Mizono, J. Huang, J.W. Futrell, A.J. Katz, P. Benhaim, H.P. Lorenz, M.H. Hedrick. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Engineering 2001; 7: 211-228.
8. D.L. Clarke, C.B. Johansson, J. Wilbertz, B. Veress, E. Nilsson, H. Karlstrom, U. Lendahl, J. Friesen. Generalized potential of adult neural stem cells. Science 2000; 288: 1559-1561; P.A. Zuk, M. Zhu, H. Mizono, J. Huang, J.W. Futrell, A.J. Katz, P. Benhaim, H.P. Lorenz, M.H. Hedrick. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Engineering 2001; 7: 211-228.
9. Two recent papers cast some doubt on these possibilites for transdifferentiation, but their validity and relevance is contested. N. Terada, T. Hamazaki, M. Oka, M. Hoki, D.M. Mastalerz, Y. Nakano, E.M. Meyer, L. Morel, B.E. Petersen, E.W. Scott. Bone marrow cells adopt the phenotype of other cells by spontaneous cell fusion. Nature 2002; 416: 542-545; Q-L. Ling, J. Nichols, E.P. Evans, A.G. Smith. Changing potency by spontaneous fusion. Nature 2002; 416: 545-548. N. Dewitt, J. Knight. Biologists question adult stem-cell versatility. Nature 2002; 416: 354.
10. Two recent papers cast some doubt on these possibilites for transdifferentiation, but their validity and relevance is contested. N. Terada, T. Hamazaki, M. Oka, M. Hoki, D.M. Mastalerz, Y. Nakano, E.M. Meyer, L. Morel, B.E. Petersen, E.W. Scott. Bone marrow cells adopt the phenotype of other cells by spontaneous cell fusion. Nature 2002; 416: 542-545; Q-L. Ling, J. Nichols, E.P. Evans, A.G. Smith. Changing potency by spontaneous fusion. Nature 2002; 416: 545-548. N. Dewitt, J. Knight. Biologists question adult stem-cell versatility. Nature 2002; 416: 354.
11. Two recent papers cast some doubt on these possibilites for transdifferentiation, but their validity and relevance is contested. N. Terada, T. Hamazaki, M. Oka, M. Hoki, D.M. Mastalerz, Y. Nakano, E.M. Meyer, L. Morel, B.E. Petersen, E.W. Scott. Bone marrow cells adopt the phenotype of other cells by spontaneous cell fusion. Nature 2002; 416: 542-545; Q-L. Ling, J. Nichols, E.P. Evans, A.G. Smith. Changing potency by spontaneous fusion. Nature 2002; 416: 545-548. N. Dewitt, J. Knight. Biologists question adult stem-cell versatility. Nature 2002; 416: 354.
12. The term 'research programme' is here used in the sense given to it by Lakatos, i.e. a group of concrete research endeavours kept together by a common core of relatively stable assumptions about the goals of research, the proper research methodologies and the most fruitful research topics. What distinguishes the three stem cell research programmes from each other is primarily different beliefs about what kind of stem cell is going to be the basis for the most progressive (i.e. productive in terms of scientific and commercial results) research. I. Lakatos. 1974. Falsification and the methodology of scientific research programmes. In Criticism and the Growth of Knowledge. I. Lakatos and A. Musgrave, eds. Cambridge. Cambridge University Press: 91-196.
13. R.P. Lanza, J.P. Cibelli, M.D. West. Prospects for the use of nuclear transfer in human transplantation. Nature Biotechnology 1999; 17: 1171-1174; E. Fuchs, J.A. Segre. Stem Cells: A New Lease of Life. Cell 2000; 100: 143-155.
14. R.P. Lanza, J.P. Cibelli, M.D. West. Prospects for the use of nuclear transfer in human transplantation. Nature Biotechnology 1999; 17: 1171-1174; E. Fuchs, J.A. Segre. Stem Cells: A New Lease of Life. Cell 2000; 100: 143-155.
15. R.M. Doerflinger. The ethics of funding embryonic stem cell research: a Catholic viewpoint. Kennedy Institute of Ethics Journal 1999; 9: 137-150.
16. L.H. Harris. Ethics and politics of embryo and stem cell research: Reinscribing the abortion debate. Women's Health Issues 2000; 10: 146-151; D.C. Wertz. Embryo and stem cell research in the USA: a political history. TRENDS in Molecular Medicine 2002; 8: 143-146.
17. L.H. Harris. Ethics and politics of embryo and stem cell research: Reinscribing the abortion debate. Women's Health Issues 2000; 10: 146-151; D.C. Wertz. Embryo and stem cell research in the USA: a political history. TRENDS in Molecular Medicine 2002; 8: 143-146.
18. G. McGee, A. Caplan. The ethics and politics of small sacrifices in stem cell research. Kennedy Institute of Ethics Journal 1999; 9: 151-158.
19. PPL Therapeutics PLC. 2001. Interim Report 2001. Edinburgh. PPL Therapeutics PLC.
20. See for instance the report from the American National Bioethics Advisory Commission. National Bioethics Advisory Commission. 1999. Ethical Issues in Human Stem Cell Research. Rockville. NBAC. A number of jurisdictions have legislation concerning assisted reproductive technologies that allow research on spare embryos, but prohibit the creation of embryos for research purposes.
21. On the cogency of the distinction see S. Holm. The spare embryo - A red herring in the embryo experimentation debate. Health Care Analysis 1993; 1: 63-66.
22. Unless it is possible to use ova obtained from aborted foetuses, dead women, or ovaries removed as part of surgical interventions. The first two of these alternative sources of ova may in themselves raise ethical issues but these are beyond the scope of this paper.
23. L.S. Cahill. Genetics, Commodification, and Social Justice in the Globalization Era. Kennedy Institute of Ethics Journal 2001; 11: 221-238; S. Holland. Contested Commodities at Both Ends of Life: Buying and Selling Gametes, Embryos, and Body Tissues. Kennedy Institute of Ethics Journal 2001; 11: 263-284; L. Andrews, D. Nelkin. 2001. Body Bazaar: The Market for Human Tissue in the Biotechnology Age. New York. Crown Publishers; M.J. Radin. 1996. Contested Commodities. Cambridge, MA. Harvard University Press; R. Macklin. 1996. What is Wrong with Commodification? In New Ways of Making Babies: The Case of Egg Donation. C.B. Cohen, ed. Bloomington. Indiana University Press: 106-121.
24. L.S. Cahill. Genetics, Commodification, and Social Justice in the Globalization Era. Kennedy Institute of Ethics Journal 2001; 11: 221-238; S. Holland. Contested Commodities at Both Ends of Life: Buying and Selling Gametes, Embryos, and Body Tissues. Kennedy Institute of Ethics Journal 2001; 11: 263-284; L. Andrews, D. Nelkin. 2001. Body Bazaar: The Market for Human Tissue in the Biotechnology Age. New York. Crown Publishers; M.J. Radin. 1996. Contested Commodities. Cambridge, MA. Harvard University Press; R. Macklin. 1996. What is Wrong with Commodification? In New Ways of Making Babies: The Case of Egg Donation. C.B. Cohen, ed. Bloomington. Indiana University Press: 106-121.
25. L.S. Cahill. Genetics, Commodification, and Social Justice in the Globalization Era. Kennedy Institute of Ethics Journal 2001; 11: 221-238; S. Holland. Contested Commodities at Both Ends of Life: Buying and Selling Gametes, Embryos, and Body Tissues. Kennedy Institute of Ethics Journal 2001; 11: 263-284; L. Andrews, D. Nelkin. 2001. Body Bazaar: The Market for Human Tissue in the Biotechnology Age. New York. Crown Publishers; M.J. Radin. 1996. Contested Commodities. Cambridge, MA. Harvard University Press; R. Macklin. 1996. What is Wrong with Commodification? In New Ways of Making Babies: The Case of Egg Donation. C.B. Cohen, ed. Bloomington. Indiana University Press: 106-121.
26. L.S. Cahill. Genetics, Commodification, and Social Justice in the Globalization Era. Kennedy Institute of Ethics Journal 2001; 11: 221-238; S. Holland. Contested Commodities at Both Ends of Life: Buying and Selling Gametes, Embryos, and Body Tissues. Kennedy Institute of Ethics Journal 2001; 11: 263-284; L. Andrews, D. Nelkin. 2001. Body Bazaar: The Market for Human Tissue in the Biotechnology Age. New York. Crown Publishers; M.J. Radin. 1996. Contested Commodities. Cambridge, MA. Harvard University Press; R. Macklin. 1996. What is Wrong with Commodification? In New Ways of Making Babies: The Case of Egg Donation. C.B. Cohen, ed. Bloomington. Indiana University Press: 106-121.
27. L.S. Cahill. Genetics, Commodification, and Social Justice in the Globalization Era. Kennedy Institute of Ethics Journal 2001; 11: 221-238; S. Holland. Contested Commodities at Both Ends of Life: Buying and Selling Gametes, Embryos, and Body Tissues. Kennedy Institute of Ethics Journal 2001; 11: 263-284; L. Andrews, D. Nelkin. 2001. Body Bazaar: The Market for Human Tissue in the Biotechnology Age. New York. Crown Publishers; M.J. Radin. 1996. Contested Commodities. Cambridge, MA. Harvard University Press; R. Macklin. 1996. What is Wrong with Commodification? In New Ways of Making Babies: The Case of Egg Donation. C.B. Cohen, ed. Bloomington. Indiana University Press: 106-121.
28. Advanced Cell Technology. Advanced Cell Technology Announces Use of Nuclear Replacement Technology for Successful Generation of Human Embryonic Stem Cells. Press Release November 12, 1998. Available at http://www.advancedcell.com/ pr_11-12-1998.html E. Marshall. Claim of human-cow embryo greeted with scepticism. Science 1998; 282: 1390-1391.
29. There are two lines of argument seeing major ethical problems in the use of non-human ova. The first sees the technique in itself as a transgression of an important boundary line between human and animal. The second points to a possible slippery slope from the use of this technique for the production of stem cells, to a use for reproductive purposes.
30. The literature on the ethics of reproductive cloning is extensive. A range of views can be found in a thematic issue of the Journal of Medical Ethics 1999; 25(2), and in a thematic issue of the Cambridge Quarterly of Health Care Ethics 1998; 7(2).
31. The literature on the ethics of reproductive cloning is extensive. A range of views can be found in a thematic issue of the Journal of Medical Ethics 1999; 25(2), and in a thematic issue of the Cambridge Quarterly of Health Care Ethics 1998; 7(2).
32. E. Check. Call for cloning ban splits UN. Nature 2002; 416: 3.
33. This is the approach chosen by the governments of the UK, Denmark and the Netherlands among others. For an overview of European policies in this area see: L. Matthiessen. 2001. Survey on opinions from National Ethics Committees or similar bodies, public debate and national legislation in relation to human embryonic stem cell research and use. Bruxelles. European Commission Research Directorate-General.
34. P.G. Wood. To what extent can the law control human cloning? Medicine, Science & the Law, 1999; 39: 5-10.
35. Anon. Taking stock of spin science. Nature Biotechnology 1998; 16: 1291.
36. Given the time needed for basic research, clinical research and regulatory approval it is unlikely that any therapy using biological materials, and based on a truly novel therapeutic approach could move from initial discovery to clinical use in 5-10 years. See also R. Lovell-Badge. The future for stem cell research. Nature 2001; 14: 88-91.
37. B. Albert. Presentation to the All-Party Disablement Group - July 25th 2000. Unpublished manuscript.
38. N. Axelsen. 2001. Commercial interests in stem cells. In Nordic Committee on Bioethics. The Ethical Issues in Stem Cell Research. Copenhagen. Nordic Council of Ministers: 79-80.
39. J.R. Meyer. Human embryonic stem cells and respect for life. Journal of Medical Ethics 2000; 26: 166-170;
40. V. Branick, M.T. Lysaught. Stem cell research: licit or complicit? Is a medical breakthrough based on embryonic and foetal tissue compatible with Catholic teaching? Health Progress 1999; 80: 37-42. This kind of reasoning also seems to underlie the National Bioethics Advisory Committee report op. cit. note 15, although it draws the line of contentiousness between the spare embryo and the embryo produced for research.
41. Most of this debate has centred on the therapeutic uses of stem cells. With regard to the 'pure' scientific production of knowledge about cell biology it seems clear that each of the research programmes will produce at least some unique bits of knowledge, and that each of them must therefore be pursued if complete scientific knowledge is the goal.
42. A difference in speed of development between two research programmes is important, even if they will both eventually lead to the same goal, since any delay in implementation of stem cell therapies entail costs in term of human suffering.
43. National Bioethics Advisory Commission, op. cit, note 15, pp. 71-72.
44. Chief Medical Officer's Expert Group. 2001. Stem Cell Research: Medical Progress with Responsibility - A Report from the Chief Medical Officer's Expert Group Reviewing the Potential of Developments in Stem Cell Research and Cell Nuclear Replacement to Benefit Human Health. London. Department of Health. p. 40.
45. S. Holm. 2001. European and American ethical debates about stem cells - common underlying themes and some significant differences. In Nordic Committee on Bioethics. The Ethical Issues in Stem Cell Research. Copenhagen. Nordic Council of Ministers: 35-45.
46. This might be the proper policy response even if it would lead to some delay in the development of treatments.