Original Article: http://dartreview.com/archives/2006/04/07/the_stem_cell_debate_at_dartmouth.php
Friday, April 7, 2006
Our physical health is engaged in a tug-of-war with our civil well-being; a mechanistic cold war waged by science and technology over and against the spirit of cultural and religious traditions. As technology races ahead of human understanding, culture and philosophy, the preservation of human values—humanism—is stressed and often fractured in the breach.
In this dynamic era, people are compelled to consider the biotechnological possibilities—and, as some argue, civic limitations—of stem cell research. Specifically, embryonic stem cell research, tied up with therapeutic-biomedical cloning, presents ethical hurdles that must be considered deliberately and reasonably.
Though bio-medically Dartmouth has not taken steps toward human embryonic stem cell research, Dartmouth is host to several professors whose bioethical positions on stem cell research are quite renowned. Among them: former Dartmouth Professor and current member of the Executive Bioethics council, Professor Michael Gazzaniga, and Department of Religion’s Professor Ronald Green. The perspective of several Dartmouth professors is useful in explaining the scientific backdrop of embryonic stem cell research and the accompanying ethical debate that this burgeoning technology has quickened.
Materially, humans first exist as a single cell of 46 chromosomes—the union of a 23 chromosome sperm with a 23 chromosome egg. After conception, this cell begins to divide exponentially; one cell to two cells, two to four, four to eight…&c. This process occurs until several hundred cells create a structure called a blastocyst; once the blastocyst is established, the organism’s genome dictates that certain cells differentiate into specified tissues with unique functions. Thus, prior to differentiation, the nature of somatic cell division guarantees that these cells are undifferentiated and identical. With luck, such divisions will be free of errors, though the possibility of error certainly exists.
When the blastocyst is removed from its initial environment and broken open, there exists a mass of embryonic stem cells. Astoundingly, if these cells are placed in a test tube with the nutrients proper to them, they can reproduce undifferentiated, ad infinitum. These stem cells are referred to as plurypotential. As yet undifferentiated they nonetheless have the potential to become a plurality of cell types. One important and perhaps daunting question for stem-cell researchers today is how to coax these embryonic stem cells into becoming a specific cell, and then tissue, of interest.
After all, every disease is a disease of the cell, originating, literally, from one lone cell. The cell’s malfunction is caused by an array of possible internal or external factors. The fundamental aim of stem-cell research is to replace these deviant cells with healthy cells produced in the laboratory. For instance, if one is afflicted with a spinal cord injury, stem-cell researchers would ideally replace the impaired neurons with healthy neurons. Going back to a previous point, these neurons would have been created by inducing undifferentiated embryonic stem cells to become cells of the central nervous system.
Yet implementing this methodology begs several key questions: 1) how to create the specific cells, 2) how to place the cells into the patient, and 3) how to ensure that once the cells are incorporated into the patient’s body they are not tagged as foreign non-self cells by the patient’s immune system which would otherwise destroy them.
The first two questions are objects of intense and systematic scientific research, while the third question has a ready solution. Based on current technology, embryonic stem cell researchers can therapeutically clone these cells. With this technology the patient can be treated with his own stem cells. Therefore, the immune system will recognize these cells as self-cells and auto-immune self-destruction is avoided.
For therapeutic cloning, the mother of a potentially sick child, perhaps diabetic, donates her egg to the doctor and/or researcher. The researcher removes the egg’s nucleus from the cytoplasm, leaving behind a serum rich in nutrients and growth factors—the necessary ingredients for cell proliferation. Then, a cell from the child’s body is removed, and its nucleus is inserted into the cytoplasm of the mother’s egg cell. After several rounds of replication, the blastocyst is broken open and the aggregate of cells within it are removed to create an embryonic stem cell line. These stem cells are “immunologically compatible” with the child.
It should be noted that therapeutic biomedical cloning and reproductive cloning are two distinct phenomena that should not be conflated with one another. To clone an embryonic stem cell entails cloning one cell. To clone a human being requires placing that cloned embryo into the mother’s womb to create an individual with distinct thoughts, emotions and will. There is no serious ethical debate within the scientific community regarding reproductive cloning; the consensus is that such activity should be prohibited because of, in the words of once director of the Center for Cognitive Neuroscience at Dartmouth, Professor Gazzaniga, the “biomedical risk, religious concerns…and flat out weirdness of the idea.” Biomedical cloning is ethically more permissible than reproductive cloning, yet it also has its opponents. Notably, the Executive Bioethics council has advised against reproductive cloning, without condemning biomedical cloning.
Thus, as outlined so far, the two foundational moves in the stem cell research protocol involve destroying a human embryo in order to then clone it. Renowned bio-ethicist, Ronald Green, phrases the ethical dilemma in the following way, “can we intentionally kill a developing human being at this stage to expand scientific knowledge and potentially provide medical benefit to others?”
Typically, the debate is divided between two vocal camps: the scientific community and the religious-right. As in the abortion debate, in the stem cell research debate most people believe that the concept of “choice” is a good thing, while value the sanctity of life. The issue in both cases then, is when human life begins and how we define it?
Opponents of embryonic stem cell research tend to believe in a culture of life in which life begins at the moment of conception. Biologically and concretely, the debate can be summarized in the following way: there are two absolute existential points that a human being undergoes—life and death, existence and nonexistence. Existence occurs when the sperm and egg unite to create a distinct member of the human species with 46 chromosomes.
Death occurs when that distinct unit of the species no longer exists. Every change between the two absolutes is a relative one, and therefore does not explain the moment life begins, because life begins at an absolute point. Consequently, a human embryo is a life, and to knowingly destroy said life is morally wrong, therefore to destroy a human embryo is wrong. The argument against cloning follows a similar pattern because the embryo is cloned to be destroyed for purposes of research.
Gilbert Meilaender and Robert George, also members of the President’s bioethics council, write that “as a people we Americans are committed to the equal worth and dignity of every human being—and, hence, every member of our community. When we ask whose good counts in the common good, we seek to answer that question in a way which includes the weak, the incapacitated, and the vulnerable.” Thus, they fear that dismissing the rights of an embryo will lead to neglecting the rights of the mentally retarded, babies, Alzheimer’s patients &c… By applying the term human beings universally to blastocysts, feti and grown individuals, as Professor George does, begs the question: the issue of when life begins is precisely the lynch-pin around which the embryonic stem cell debate revolves.
Advocates of embryonic stem cell research do not often believe that an embryo is the moral equivalent of a human being, whether that human being is healthy, sick, mentally disabled or vulnerable in any other way. Many in the scientific community repudiate the claim that life begins at conception by contrasting the qualities of an embryo with an actual human being. By holding a developmental or gradualistic view of human life, the scientific community asserts that the embryo lacks individuality and the ability to feel and think. In a very Cartesian sense, the embryo is all body, but no mind. Further, the scientific community reduces the validity of the argument through potentiality by holding that the embryo, as a blastocyst, has a high mortality rate and two separate embryos can fuse into one distinct embryo that will develop separately and uniquely from the way that either of its constituents would have developed.
Most in the scientific community do not believe in such a culture of life, holding instead that there is no equivalence, “between a bunch of molecules in a lab and a beautifully nurtured and loved human who has been shaped by a lifetime of experiences and discoveries.” Following this argument, to believe that the developed human being is the same thing as its embryo once was is to reduce humans to their DNA. Thus to account for every nuance in human character, every curiosity, and every thought and choice as a product of genetic codes, is to dismiss free will, which is ethically egregious. After all, ethics could not even exist without free will, since moral choice presupposes the ability to autonomously choose.
Further, scientists tend to speak of a cost-benefit ratio when discussing issues mired in ethical dilemmas. In the case of stem cell research, scientists believe that the cost of destroying embryos is overshadowed by the benefit of healing the chronically sick. Since the cost of destroying an embryo has already been analyzed, some actual benefits of stem cell research shall be briefly outlined.
Scientist at the Technicon-Israel Institute of technology have been collaborating with the American Technico Society, producing groundbreaking and medical advances with the use of stem cells. According to PR materials from the society, “technicon researchers have turned embryonic stem cells into insulin-producing cells for treating diabetes, and into muscle and blood vessel cells for the future replacement of parts.” Further, embryonic stem cells are being grown into beating heart cells that are being tested against new drugs for chronic heart disease. Moreover, said scientists have overcome a major obstacle in stem cell research by successfully integrating stem cells into a damaged heart to create a “biological pacemaker.”
As most people know, there has been a ban on the federal funding of embryonic stem cell research. Though an entire article may be dedicated to explaining the implications of such a ban, briefly, the ban amounts to slowing the entire process down. Professor of Biology Lee Witters offered this when I spoke to him about stem cell research, “if I told you that today, you could walk over to my laboratory and I could give you some cells that you could give to your sister who has just developed type-one diabetes, and that these cells would cure her and save her from death, do you think that the government could justify themselves in banning this type of research?”
Throughout modern-times technology has worked to support human physical existence, even at times redeeming human civic and social existence, while at others jeopardizing the ephemera of life itself; inoculations and eugenics come to mind, as antipodes. When it comes to embryonic stem cell research because we are dealing in the defined black and white of death and life, and the subtleties of quality of life; both our physical and psychic existences are affected and often determined by it. In the arena of bio-ethics, there is no room for ideology and superstition as it is imperative that scientists, bio-ethicists, and national leaders thoughtfully weigh both views, consider each in their multiplicity and rationality, and finally decide on a final course of action.