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Falling behind in the stem cell race?
An expert panel appointed by the British government recently recommended that the country lift its ban on the cloning of human beings. What they envision is not the creation of a population of identical citizens, but "therapeutic cloning" to create human embryos for the specialized cells that can be derived from them. Embryonic stem cells have the potential to become any kind of cell in the human body, and promise new breakthrough approaches to treating everything from diabetes and spinal cord injury to organ transplant.
We all begin as the union of one egg and one sperm, and somehow the cells in the resulting embryo are correctly triggered to become skin, muscle, nerve or any of the varied cells that make up the human body. Once we understand the process by which cells develop into one type versus another-called differentiation-the next step will be to control it, and turn embryonic stem cells into specific target cells.
The most promising source of embryonic stem cells is human embryos, and extraction of the stem cells means destruction of the embryos from which they come. For many, human embryos have special status, so their destruction raises ethical concerns. The British panel proposes that human embryos be cloned for their stem cells, which raises the moral ante.
The main source for embryonic stem cells in research will be so-called 'spare' embryos, those that remain frozen and unused after in-vitro fertilization (IVF). These embryos face four possible fates: remaining frozen indefinitely, being discarded, donation to other couples, or donation for research. Few, if any, are used by other couples--so many people believe that the use of spare embryos in research is no worse than either their remaining frozen or ending up washed down the drain. But even with the thousands of spare embryos that remain frozen in fertility clinics all over the world, scientists will likely still need stem cells of a specific genetic makeup which can only be obtained by creating embryos.
The creation of embryos for the purpose of using them in research raises its own ethical issues. In the case of spare embryos, their creation was intended for reproduction. But embryos created for stem cell research-whether clones or genetically unique-are made for the purpose of collecting the stem cells that develop from them, effectively treating them as means to an end. For many groups and individuals, this difference in intention is morally significant.
Principles, politics, or pragmatism?
At the moment, U.S. policy bars the use of federal funds for research on human embryos, a ban that has been in place since the early 1980s. But that doesn't mean that embryo research is illegal in the United States -it's only illegal to use federal dollars. So embryo research can proceed, albeit at an excruciatingly slow pace compared to the level of funds available through the government research enterprise. While the British consider allowing government support of "therapeutic cloning," the National Institutes of Health (NIH) has proposed its own policy solution.
The NIH wants to fund research on the embryonic stem cells that are collected from human embryos by privately funded efforts. The embryo research ban would be respected, but the major research engine of government funding could promote stem cell research. This has set up a classic test of how much we care about principles in the face of promising medical breakthroughs.
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.
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