Stem cells: don’t dodge the debate
Even if scientists didn't have to destroy embryos, that wouldn't end the ethics war.
‘Stem cell creators find answer to ethical doubts’ proclaimed one headline on 17 October (1). In work published by the science journal Nature this week, two teams report the successful use in mice of two different techniques for deriving embryonic stem cells without requiring the destruction of viable embryos (2).
It’s interesting stuff, certainly – even to a scientific illiterate like myself. In the brief period that it has been around, stem cell research appears to offer some of the most exciting, and tangible, outcomes of genetic science – although as many scientists and medics point out, developments are still at the early stages, and there is a tendency to hype the level of progress that has been made to date.
Stem cells are generally taken from embryos, meaning that they are still at an early stage of development and retain the potential to turn into many different types of cell, including a cell with a more specialised function. A useful Q&A feature on BBC News explains the potential in simple terms:
‘Scientists believe it should be possible to harness this ability to turn stem cells into a super “repair kit” for the body. Theoretically, it should be possible to use stem cells to generate healthy tissue to replace that either damaged by trauma, or compromised by disease. Among the conditions which scientists believe may eventually be treated by stem cell therapy are Parkinson’s disease, Alzheimer’s disease, heart disease, stroke, arthritis, diabetes, burns and spinal cord damage.’ (3)
Thanks to scientific progress, once again humanity had the potential to find cures for previously debilitating conditions. And once again scientific progress is accompanied by fears about the ‘ethical’ character of this new technology. While few deny the positive potential of stem cell research, there is significant consternation about the fact that this work involves the deliberate destruction of embryos in order to create the cell lines.
This is why the USA has effectively outlawed new stem cell research – federal funds for embryonic stem (ES) cell work is only available for a small number of cell lines derived before August 2001 – and Germany has outlawed the use of ES cell lines created since January 2002, making such use punishable by up to three years in jail. It is why every discussion about the progress of stem cell research, even in countries such as Britain that have a more positive approach, is dogged by controversy. And it is why this latest possibility of carrying out ES research without destroying embryos has been greeted in rather gushing terms – as the ‘answer to ethical doubts’, or even as a direct ‘challenge’ to US president George W Bush (4).
The new research into possible alternatives to destroying embryos may yield some positive scientific results. But to rush to embrace these alternatives, in the premature fashion that much of the UK press has done, is both naive and wrong. One of the alternatives discussed in Nature is ‘switching off’ a gene in a cell so that it lacks the ability to develop into a baby (described by William Hurlbut, a consulting professor at Stanford University, as ‘the embryonic equivalent of brain death’) (5). The other is using a technique similar to preimplantation genetic diagnosis (PGD), a technique currently occasionally used in IVF treatment to test for genetic disorders. The idea is that scientists would remove a single cell from the embryo to derive new ES cell lines, while the embryo would go on to develop normally.
No doubt these developments are worthwhile. But they have been leapt upon, not because they seem to provide a solution to a scientific problem, but because they appear to offer a way out of having a moral argument. The idea seems to be that, if only we can get rid of the yuk factor element of killing embryos, stem cell research can pursue a smooth, unfettered path to unequivocally positive medical benefits. Life, however, does not work like that.
It is understandable that many scientists feel frustrated by the way that ethical objections get in the way of important new research. Many non-scientists, such as myself, are far more excited by the life-improving potential of stem cell research than they are worried about the destruction of embryos. And in an age where abortion – the destruction of a fetus for sake of a woman’s choice – is widely accepted across the Western world (at least, in the first trimester), the heightened concern about the destruction of embryos for the greater good of medical research seems rather contradictory.
But these are arguments that we need to have out in public, not attempt to circumvent with a search for less ethically challenging alternatives. Ethical objections towards new scientific developments may be wrong-headed – even, sometimes, verging on the lunatic. They may come from a vociferous minority, and work against the interests of the majority. The extent to which regulatory authorities tend to bend over backwards to accommodate minority ethical concerns about such issues as stem cell research and fertility treatment, to name but two, deserves criticism, on the grounds that it is the role of the authorities to make decisions and take a lead in scientific progress, not facilitate an ongoing, inconclusive dialogue.
All this being said, ethical discussions are not simply an inconvenience that, in an ideal world, would simply not need to take place. The fact that members of a society disagree on such fundamental questions as ‘When does life begin?’ or ‘What price scientific progress?’ is part of what makes us human, and our societies democratic. In this sense, the debates that have accompanied the development of stem cell research are just as important as the scientific developments themselves. It is our capacity to debate questions of principle that makes us capable of making big decisions about life.
The attempt to circumvent these debates by desperately seeking non-controversial alternatives mimics the moral trepidation of other medical, ethical minefields, such as abortion and animal research. In recent years, much of the abortion lobby, and its pragmatic supporters in government, have pushed the importance of early abortion (in the first 12 weeks of pregnancy), while tacitly accepting that late abortion is a problem. In this debate, the issues of principle – to do with women’s autonomy and the meaning of life – are swept under the carpet, replaced with a pragmatic desire to reduce teenage pregnancy and sentimentalism about a fetus that looks like a baby.
Similarly, debates about animal experimentation have elevated sentiment and pragmatism over principle. Scientists preach the need to find alternatives to experimenting on animals where possible, and to worry about questions of animal welfare. This represents a refusal to have the moral argument about the relative value of human v animal life, and a refusal to face an obvious contradiction – that all animal experimentation is detrimental to animals’ welfare. Few argue that we should experiment on primates, despite the obvious benefits of such research for humans, simply because apes look a bit like us. What has happened to issues of principle and conscience, to make them so intellectually void?
Finally, it is worth noting that attempts to skirt controversy by pragmatically seeking alternatives or going for ‘less bad’ options do not work. The animal rights lobby has become more, not less, vociferous in the face of scientific apology. The direction that the abortion debate has taken may make it harder, not easier, for some women to have an abortion when they need it.
And opponents of stem cell research do not seem to think that the new alternatives to destroying embryos are much of an improvement. For example, the UK pressure group Comment on Reproductive Ethics (CORE) has press released its view that ‘New ways to create embryonic stem cells are not ethical’ (6). The organisation’s head, veteran anti-abortion campaigner Josephine Quintavalle, objects that the new research either involves deliberately creating ‘abnormal’ embryos or sacrificing ‘normal’ ones. I don’t agree with her objections – but they are consistent with Quintavalle’s position on these matters. After all, somebody who believes that life begins at fertilisation and has deep worries about scientists ‘playing God’ is hardly likely to be won over by the notion of artificially creating ‘brain dead’ embryos.
The upshot of all this moral trepidation is that by attempting to accommodate to ethical considerations, nobody is happy – and science suffers from the lack of robust support. We need less hyperbole about the immediate benefits of stem cell research, and more confident backing for the steps that are necessary to turn scientific potential into reality.
(1) Stem cell creators find answer to ethical doubts, Nic Fleming, Daily Telegraph, 17 October 2005
(2) ‘Ethical’ routes to stem cells highlight political divide, Nature, 16 October 2005
(3) Stem cells, BBC News, 19 May 2005
(4) Challenge to Bush in new stem cell breakthrough, Ian Sample, Guardian, 17 October 2005
(5) ‘Ethical’ routes to stem cells highlight political divide, Nature, 16 October 2005
(6) New ways to create embryonic stem cells are not ethical, Comment on Reproductive Ethics
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