The use of adult stem cells, particularly those obtained from the patient themselves (autologous), pose few ethical issues. Bone marrow transplants, both autologous and allogeneic (cells or tissue obtained from a donor), have been used for decades. More recently referred to as haematopoietic stem cell therapies, they are routinely used to treat various types of cancers, mainly leukaemias, as well as other diseases such sickle cell diseases. Mesenchymal stem cell therapies have also been used clinically without ethical concerns being raised.
However, the proposed use of embryonic stem cells for research and subsequent clinical therapies has proved controversial. The main ethical and moral dilemma centres around whether it is better to use embryonic stem cells to prevent or alleviate suffering, or to respect the right to life of the embryo. This raises the question of when does the embryo have moral status as a person i.e. the right to life.
When does an embryo have the right to life?
This is a complex issue and people have very different opinions. The two extreme views are that:
- The embryo has the right to life from the moment of conception.
- The embryo has no moral status at all and that right to life begins at birth.
However, many people take more moderate views and think that the moral status of an embryo increases as it becomes more human-like.
What is your opinion on this question? Is it right to destroy an embryo to try and cure diseases, or should the embryo have the right to life?
If you take the moderate view and think the moral status of the embryo increases as it develops, at what point should it have the right to life? While the development process is continuous, you have to draw a line somewhere, so where should that point be?
Ask your friends and family and see whether their views differ from your own. While there is no right or wrong answer, people have very strong views.
These questions are important as they help define the laws on this subject.
Stem cell ethics and the law
There are arguments for and against each of the views stated above and it is a fiercely debated subject. However, the ethical debates around use of embryonic stem cells and the moral status of the embryo are important as they help to shape the laws which regulate what scientists and clinicians are allowed to do. As a result of these debates different countries have set out their own rules on what is and is not allowed and, where embryos are allowed to be destroyed for research purposes, at what point this is allowed to happen.
Regulation of stem cell research in the UK
The embryos used for research are ‘spare’ or ‘surplus’ embryos donated by patients undergoing in vitro fertilisation treatment. In this process, many more embryos are generated than are ever implanted and as a result they will be discarded. Thus the view in the UK is that these ‘spare’ embryos can be used for research if donated with the full consent of the patients.
This research can only take place on embryos up to 14 days, although in practice embryonic stem cells are obtained much earlier, around days 5-6 post-conception. This ‘14-day rule’ has been decided for a number of reasons:
- Shortly after this the ‘primitive streak’ begins to appear, which will make the three germ layers including the cells that will become the central nervous system, which in turn will lead to consciousness and sensory feeling.
- After this, twinning is no longer normally possible, so we know that it is indeed one particular individual.
- Implantation in the womb is normally complete by then.
The UK has a comprehensive and well-established regulatory framework detailing exactly what is and is not allowed to happen in stem cell research. All research is conducted under licence from the regulatory authority, which is called the Human Fertilisation and Embryology Authority (HFEA). There are also other regulatory authorities, such as the Human Tissue Authority (HTA) and Medicines and Healthcare products Regulatory Agency (MHRA), who work with the HFEA to ensure stem cell research and the developments of products based on this research meet the strict guidelines.
The rules in the UK allow scientist the freedom and opportunity to develop novel stem cell-based regenerative therapies and to use stem cells to develop better drugs and improve therapies to alleviate suffering and cure disease.
Religious views on embryonic stem cell research
Some religions, mainly Roman Catholic, Orthodox and Protestant churches, believe in the right to life from conception and are therefore against any kind of embryonic stem cell research. Other religions, for example Judaism and Islam, believe in saving lives and as a result take the view that embryonic stem cell research should be allowed as it could save lives. These religious views have also impacted on policy and there are countries around the world that have banned embryonic stem cell research on the basis of religious belief.