stem cell research ethics and policy

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Scientists have shown a high degree of creativity and commitment to changing lives through stem cell studies over the last few decades.
However, there are ethical and political concerns over the use of human embryonic stem cells in science.
And if the scientists’ efforts are only in their early stages, there are hopes that the findings would aid in the treatment and discovery of treatments for a variety of severe diseases.
In the United States, stem cell science has inextricably linked with the political controversy over abortion. It has been ascertained that the ‘naked,’ isolated inner cell mass (ICM) (where the hES cell lines are derived) no longer has the ability to develop
a. Thus, isolated ICM cannot further form a fetus and a child
b. This helps in justifying the use of ICM in research.
4. Criticism of stem cell research
a. Critiques of the stem cell research hold the argument that hES cells are equivalent to embryos.
b. In addition, creating embryos with the aim of using them for purposes of research and later destroying them is a process of utmost violation of respect for the nascent life of a human.
5. Proponents of the research:
a. argues that research on cell therapy is actually more defensible as compared to that on reproduction.
b. Besides, the use of surplus IVF embryos to derive hES cells offers a significant justification for stem cell research.
6. Therefore, it is quite difficult to have a consensus on such an issue with extreme arguments, all of which are valid and justifiable.  
Introduction
Any scientific research that has the potential to produce cells that will prove useful in the field of contemporary medicine is likely to be considered acceptable. Stem cells refer to the undifferentiated cells (or ‘blank’ cell in other terms); hence they have the potential to develop into cells that will later serve different roles in different body parts. For the past few decades, scientists have shown a high level of ingenuity and dedication improving lives by use of stem cell research. There is the need to note that even though the effort of the scientists is still young, there are promises that the research will help the world in treatment of as well as find cures for various serious diseases such as Amyotrophic Lateral Sclerosis (ALS), diabetes, leukemia, heart disease, Parkinson’s, etc. (Wert and Mummery 673). In that light, stem cell research has turned out to be one of the most significant new areas in the field of human biology. With their unique regenerative abilities, stem cells provide promising and potentials for treating diseases that have for a long time been considered detrimental to human health. However, much work is yet to be done in the laboratory and the clinic in efforts to understand how scientists, as well as physicians, will best use these cells for cell-based therapies (reparative medicine) in treating diseases. The more work that remains to be done in the clinics and laboratory raises the issue of effectiveness as well as possible side effects of the technology. Critics of the research cite ethical aspects of using embryonic stem cells in such endeavors. This research paper assesses whether the stem cell research is unethical, particularly due to the political controversies created on the derivation of pluripotent stem cell lines from embryos and oocytes and their relationship with the issue of abortion.

Background: The Science of Stem Cell and Stem Cell Research
In the United States, the research on stem cell has been inevitably connected with the political controversy of abortion. Since the year 1973, following the decision of the Supreme Court v Wade to legalize abortion, the United States government has declined to fund any research pertaining to embryos, with the inclusion of IVF (In Vitro Fertilization), as the Congress feared that it would encourage women to procure abortions (Wertz 674). However, Bush’s decision to allow federal funding for stem cells research that was derived prior to August 9, 2001, was the first use of federal funds, but the overall ban on such embryo research is still in place. There have been more than four decades when the federal government has refrained from funding stem cell research, with the support of religious beliefs, political controversies as well as ethical issues surrounding creating blastocysts to gain stem cells as well as therapeutic cloning. Stem cells have had an interesting history and background, even though it has been tainted with debate and numerous controversies. Before assessing the ethical and policy issues regarding the concept of stem cells research, a full understanding of the scientific concepts is essential.
Stem cells are pluripotent cell types that are capable of differentiating into multiple cell types. Differentiation refers to the process by which an unspecialized cell gains specialized characteristics, for instance, the features of such organs as liver, heart, or even muscle cells. Embryonic stem cells are considered to be pluripotent since they can become all body cell types. Even though there are various kinds of stem cells in the human body, some are more differentiated to a specific function as compared to others. In that light, the term stem cell is commonly applied to refer to the cells that are found in the adult organism that is capable of renewing tissues.
The embryonic stem cell is a recent addition to the previously existing stem cell types as it was initially separated by researchers at the Johns Hopkins Medical Institutions in the year 1997. The embryonic stem cells are significantly different from any adult stem cell as the former are naturally derived in the early stages of embryonic development, and are referred to as totipotent, or they can form any type of either adult cell and or adult cell precursor (Lo and Parham). The embryonic germ cell is another type of stem cell, and it has features that are similar to those of the embryonic stem cell. The embryonic germ cells are derived from the aboriginal or primordial reproductive cells of the fetus that is in its stages of development. The study of embryonic stem cells enables researchers to have a full understanding of the mechanisms through which an organism develops from a single cell. Besides, the study provides information about how healthy cells can potentially replace those cells that are damaged in adult organisms. With such, there is potential for cell-based therapies aimed at treating diseases (regenerative medicine).
Two types of stem cells can be broadly distinguished; namely the embryonic stem (ES) cells and adult stem cells. The ES cells can be broadly derived from pre-implantation embryos, and as stated earlier, they have the ability to form cells of all tissues as found in the adult organism (thus called ‘pluripotent’). The human embryonic stem cells (hES cells) come from the ‘inner cell mass’ of the blastocyst stage embryos that in culture, develop within five days of fertilization of the oocytes (Wert and Mummery 672). In light of the controversy in using the hES cells in research and also its potential application in therapeutic medicine, it is essential to note that even though the stem cells can differentiate to form all somatic (body) tissues, they are incapable of forming all of the ‘extraembryonic’ tissue pertinent for complete embryonic development. Wert and Mummery further explain that embryonic stem cells cannot form such tissues as membranes and placenta, and thus it would be impossible to form a new complete individual out of the hES cells (p. 672). In addition, the hES cells different from the ‘totipotent’ fertilized blastomere and oocytes cells arising from the first cleavage division. Another significant feature of the hES cells is that they are immortal and tend to express high amounts (levels) of the telomerase gene, which is the protein responsible for retaining the telomere ends of the chromosomes at each cell division, and also ensuring that the cells do not go through senescence (Wert and Mummery 672). Other cells with similar pluripotency of the ES cells are the embryonic germ (EG) cells that are derived from ‘primordial germ cells’ that have the potential to form the gametes in the case the fetus was not aborted. In addition, the hEG cells have many biological features in common with hES cells.
In the adult organisms, different tissues have been established to contain stem cell populations. Such tissues include the skeletal muscle, bone marrow, the brain, and umbilical cord blood. The heart on the other side has been proven to have no stem cells after birth (Wert and Mummery 673). As further described by Wert and Mummery, research has been conducted to show that these adult stem cells have the capacity to form only the stem cell types of the specific organ where they are found, even though recent research has shown that the cells could portray an unexpected difference in expression of characteristics. Therefore, there arise issues pertaining to such adult stem cell types i.e. those from the intestine, brain, and skin, as their fate may remain unclear for the immediate future (Wert and Mummery 673).
Ethical Exploration of Stem Cell Research
Through research, hES cells has been shown to be capable of generating cardiac, neural, pancreas and liver cells, as well as skeletal muscle in teratocarcinoma in vivo in tissue culture and also immunodeficient mice. However, it has been considered an illusion to think that cell therapies will gain widespread application within a couple of years to come (Wert and Mummery 673). The perception has mostly been perpetuated by the sensational treatment of the issue by the media. The information relayed to the public by the media is mostly misleading, as it has implied the derivation of whole organs from hES cells, and thus a negative impression towards the new research. In that light, some patient groups already view the research as already disappointing. However, some countries allow the isolation as well as the application of existing hES cells, thus proper scientific assessment of the potential benefits that would emanate from its therapeutic uses. Even with such approval by different governments, there arise the ethical questions of whether it is justified to derive new hES cell lines, particularly with the understanding that eventual therapeutic medicine (using hES or adult stem cells) will be beneficial in the long-term (Wert and Mummery 673).
In efforts to justify (or otherwise) the ethical stand of the stem cell research, it is essential first to consider the ontological status of the hES cell, which will lay a suitable foundation on whether they should be viewed as similar to embryos or not. The ethical consideration of the research pertains the question of whether it is acceptable for stem cell researchers to use pre-implantation embryos to derive ES cells for research n cell transplantation therapy. In addition, it is still controversial if embryo use should be or should not be used so as to spare embryos, or if the research may include the development of embryos through nuclear transfer, or what is otherwise known as therapeutic cloning (Wert and Mummery 674).
The argument considers the status of the ‘naked,’ isolated inner cell mass (ICM) which is where the hES cell lines are derived. The ICM has for a long time being understood as the ‘essence’ of the pre-implantation embryo, or in other words, the precursor of the ‘embryo proper’ (Wert and Mummery 674). However, with the development in research and powerful technology, it has been ascertained that ICM no longer has the ability to develop and further from a fetus and a child. The ICM lacks trophoblast cells that are pertinent to the process of implantation and further nourishment of the embryo. In addition, there is the absence of extra-embryonic endoderm in ICM. In that light, it is essential to note that it does not necessarily imply that the isolated ICM ceases to be an embryo, but researchers suggest that the entire isolated ICM could best be termed as disabled, and non-viable embryo (even though it could be, but in theory, be ‘rescued’ by covering it with adequate trophoblast cells) (Wert and Mummery 674).
Therefore, it is scientifically considered that the status of the individual cells from the isolated ICM as well as the embryonic stem cell lines from ICM is non-viable. Wert and Mummery put forth the argument that when the cells of the ICM start to spread and further spread in culture, there is disintegration and perishing of the non-viable embryos (p. 174).
At this point, the existing controversy is that some individual researchers could argue that hES cells are, by themselves, embryos, as even though hES cells lack the potential to develop into a human being, they might if only they were ‘built into’ a cellular background that would otherwise have the ability to produce extra-embryonic tissues which are useful during implantation and feeding of the embryo (Wert and Mummery 674). Such ability can, at present, be conferred through ‘embryonic reconstruction,’ a process in which the isolated ICM of an existing embryo is substituted by embryonic stem cells (Wert and Mummery 674).
Critiques of the stem cell research hold the argument that hES cells are equivalent to embryos. Therefore, the critiques hold the stand that any cell from which a human being could arise or be created, even if it requires micromanipulation by use of high technology, should be considered as an embryo, hence it must be protected at all costs. However, Wert and Mummery explains that the downside of the critiques’ argument is that their inclusive definition of an embryo encompasses even somatic cells as they have a somatic nucleus that has the potential to become an embryo after nuclear transplantation in an oocyte that is enucleated (p. 674). In that light, it turns out to be unreasonable to consider hES cells as embryos, thus the justification for their use in research, particularly considering the potential therapeutic benefits.
A significant justification of stem cell research is the use of surplus IVF embryos to derive hES cells. Besides, there is a consensus that research that entails embryos should be driven by an important goal or ‘an important health interest’ (Wert and Mummery 675). In various countries, there is permission to conduct research on pre-implantation embryos as long as it is related to human reproduction, even though internationally, such a limitation is considered as too restrictive (Wertz). For instance, the British Nuffield Council on Bioethics discredited any reason for making a distinction between any research that evaluates methods of diagnosis or reproduction and that involving potential cell therapies (Wert and Mummery). If there is permission to use embryos for research into the infertility causes or treatment, then it would be uncalled-for to reject any research aimed at possible treatment of severe diseases on the basis that it lacks sufficient essence (Wert and Mummery).
Proponents of stem cell research argue that research on cell therapy is actually more defensible as compared to that on reproduction. In instances when embryos are scheduled to be discarded after IVF, they may earn another chance of permanence through stem cell research (Wert and Mummery 675). Each year, fertility clinics create many blastulae that is later destroyed since they are produced in surplus. The supporters of hES cell research hold the feeling that it is much better to use the cells from the surplus blastula for research and further develop therapeutic medicine as it will help improve and also save lives. The supporters of stem cell research hold the opinion that a blastula is not exactly a child just yet, with the argument that unless a blastula is embedded in the wall of the uterus, there are no chances that it will develop into a baby. However, some people feel that destroying a blastula for its cell is similar to destroying an unborn child. In addition, there are numerous concerns about oocyte donation, and as explained by Lo and Parham, members of the public, as well as some legislators, are much concerned that infertility clinics downplay the risks associated with oocyte donation in California (p. 208-9). The ethical issue of oocyte donation is built on feminist perspectives as it attempts to understand the interest of women who donate the oocyte (Wert and Mummery 677).
There are objections to producing embryos specifically for stem cell research. People who object to Somatic Cell Nuclear Transfer (SCNT) hold the belief that creating embryos with the aim of using them for purposes of research and later destroying them is a process of utmost violation of respect for the nascent life of a human (Lo and Parham 209). There is the need to note that even the supporters of acquiring stem cell lines from embryos that have already been frozen that would otherwise be destroyed usually reject the idea of intentionally creating embryos for research. However, on contrary opinion, some individuals and also policy makers claim that pluripotent potential as a result of SCNT is biologically and ethically different from embryos, hence the justification for their use. As further argued by Wertz, critiques of the research on stem cell feel that permitting it would be putting a good face on abortion, which is also a controversial issue. Such criticism is based on religious beliefs, and as such, the US President George W. Bush restricted federal funding for any research about cell lines, other than the ones that were already in existence (Wertz 674).
Conclusion
Stem cell research offers potential benefits in regard to serious health conditions such as cardiovascular diseases, diabetes, leukemia, Parkinson’s, and others. The debate involving embryonic stem cell research is significantly new buy a heated controversy. As elaborated in the paper, an informed look at such a topic calls for a full understanding of stem cells, the background of the debate over the use of stem cell lines, as well as the current policy pertaining to the research. Various ethical issues are surrounding the use of stem cells in research, and they include the religious view of respecting human life which is sacred, the immorality of creating embryos specifically for research, and also giving abortion a new face. However, the supporters of the research argue that if it is permissible to use embryos for research into causes and treatment of infertility (in reproduction), then it is needless to reject any research aimed at possible treatment of severe diseases on the basis that it lacks sufficient essence. Besides, since most fertility clinics create many blastulas that are later destroyed since they are created in surplus, hence it is defensible to use them in research rather than to discard them. Therefore, it is quite difficult to have a consensus on such an issue with extreme arguments, all of which are valid and justifiable.

Works Cited
Lo, Bernard and Lindsay Parham. “Ethical Issues in Stem Cell Research.” Endocrine Reviews 30.3 (2009): 204-213.
Wert, Guido de and Christine Mummery. “Human embryonic stem cells: research, ethics and policy.” Human Reproduction 18.4 (2003): 672-682.
Wertz, D C. “Embryo and stem cell research in the United States: History and politics.” Gene Therapy 9 (2002): 674-678.

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