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Stem Cell Research:

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Dresser: 'Stem cells are not human embryos, but they must be derived from embryos. ... And 'at the point that stem cells are derived, which is about five days after ... – PowerPoint PPT presentation

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Title: Stem Cell Research:


1
Stem Cell Research The Bigger Picture Rebec
ca Dresser
2
PRELIMINARY POINTS I
  • Cells used in embryonic stem cell research can
    come from fetal tissue from miscarriages or
    abortions, or from embryos that are created by
    fertility clinics for people who no longer
    require them. They could also be created
    specifically to be used in research.
  • B,W,K,M Each source raises important moral
    questions.
  • People who are opposed to abortion on moral
    grounds object to stem cell research on fetal
    tissue obtained in abortion.
  • Those who are not morally opposed to abortion do
    not take issue with stem cell research on fetal
    tissue obtained in abortion.

3
PRELIMINARY POINTS II
  • B,W,K,M As a matter of public policy, so long
    as abortions are carried out in ways that are
    consistent with law and policy, the use of fetal
    tissue is acceptable.
  • As indicated, embryos can be created in fertility
    clinics but then no longer be needed, or they can
    be created for research.
  • Does what they are created for make a moral
    difference to their possible use in stem cell
    research?
  • Do embryos deserve special respect because of
    what they are and the potential that they
    represent?
  • What about the potential they may have to cure
    disease for existing and future persons?

4
STEM CELL RESEARCH AND ABORTION
  • The morality of stem cell research is not
    necessarily the same as the morality of
    abortion.
  • B,W,K,M note important differences between human
    stem cell research and abortion
  • 1) abortion is a procedure that takes place
    substantially later in development, well after
    the 10-14 day window for embryo research
  • 2) abortion terminates a pregnancy, necessarily
    within a womans body, while human embryonic stem
    cell (hESC) research relies on embryos created in
    the laboratory and never implanted into a womans
    body.

5
SOME FACTS AND QUESTIONS
  • B,W,K,M Embryos created in vitro (outside the
    body, as in the laboratory) can only survive
    about fourteen days after fertilization, before
    they must be either frozen for some later use or
    implanted into a womans body.
  • If it is acceptable to discard an embryo created
    in vitro, why would it not be acceptable to use
    it in research?
  • Should someone who objects to human embryonic
    stem cell research also object to in vitro
    creation of embryos?
  • Or should it be maintained that an embryo only be
    created in vitro if it is intended to be
    implanted in a womans body?

6
PRELIMINARY POINTS III
  • Dresser Stem cells are not human embryos, but
    they must be derived from embryos.
  • Dresser To derive stem cells, scientists must
    destroy a human embryo.
  • B,W,K,M Somehow, as the embryo divides, cells
    are programmed to become heart, liver, skin,
    hair, eyes, and the multitude of other body parts
    it takes to become a fully formed human.
  • B,W,K,M Embryonic stem cells have the
    potential to become any of these so-called
    differentiated cells, a quality known as
    pleuripotency.

7
PRELIMINARY POINTS IV
  • B,W,K,M Because of this quality of
    pleuripotency they embryonic stem cells are
    extremely valuable in understanding what makes
    cells of one type instead of another, and also
    for the therapeutic potential that could come
    with understanding that process.
  • B,W,K,M Once cell control is harnessed,
    researchers may be able to grow colonies of
    particular cell types to treat organ failure, and
    treat diseases in wholly new ways.

8
THE MORAL STATUS OF EMBRYOS I
  • On the view that human life begins at conception,
    embryos have the moral status of persons.
  • Dresser says that, for people who believe that,
    possible knowledge gains cannot justify stem
    cell or any other research that requires embryo
    destruction.
  • Others disagree, and maintain that embryos lack
    many characteristics that make persons morally
    significant, such as the ability to think and
    feel pain and pleasure.

9
THE MORAL STATUS OF EMBRYOS II
  • Dresser In early embryos, the beginning of the
    nervous system hasnt yet formed.
  • And at the point that stem cells are derived,
    which is about five days after conception,
    embryos are not even clear individuals since
    twining can occur after that point.
  • Dresser says that where an embryo is located
    inside or outside of a womb may make a moral
    difference to some they are only morally
    protected in a womb.

10
THE MORAL STATUS OF EMBRYOS III
  • As Dresser notes, the location of embryos
    separates the stem cell controversy from the
    abortion debate.
  • The key moral issue of stem cell research comes
    from pitting the value of the embryonic life?
    against the social value of advancing
    knowledge.
  • Dresser says that people who argue that embryos
    arent morally equivalent to persons usually
    adopt a developmental approach to moral status,
    in which prenatal life gains increased moral
    status over time.

11
THE MORAL STATUS OF EMBRYOS IV
  • Even if embryos are not considered to be persons
    we can still ask if they have moral value.
  • If they arent persons are they just objects or
    property?
  • Can anything be done with them?
  • Some think that, because they have the potential
    to become persons, embryos deserve special
    respect.

12
THE MORAL STATUS OF EMBRYOS V
  • Dresser says though that simply saying that
    embryos should be treated with special respect
    fails to resolve the stem cell research
    question.
  • Anyone holding this view must decide what
    special respect means in the research context.
  • Is it possible to show special respect to an
    organism while at the same time allowing it to be
    used in destructive research to advance the
    interests of others?

13
TWO KINDS OF EMBRYO
  • As seen, an embryo created in the laboratory
    through in vitro fertilization (an IVF embryo) is
    different from one that is created specifically
    for research purposes.
  • Some think that surplus IVF embryos can be used
    in stem cell research, but that embryos should
    not be created specifically for stem cell
    research.
  • People who support the use of IVF embryos in
    research think that it is better to use them in
    research that might benefit others than to
    discard them.
  • Those who object to creating embryos for research
    see treating such embryos as products to be
    manufactured for utilitarian reasons.

14
CREATING RESEARCH EMBRYOS
  • Is it acceptable to create embryos purely for
    medical research if humanity would benefit, and
    perhaps immeasurably, from such research?
  • Or is the production of human embryos for
    research unacceptable because it treats an entity
    deserving of respect as an object?
  • Would therapeutic cloning creating an embryo by
    cloning a living persons cell for biomedical
    research purposes be morally acceptable if it
    could cure some diseases that might otherwise not
    be cured?
  • Would this threaten to lessen respect for other
    forms of human life?

15
THE USE OF WOMEN I
  • Dresser points out that there are risks to women
    in providing the eggs necessary to create
    research embryos.
  • This is because they must take high doses of
    hormones and undergo numerous tests and
    procedures . . . that may carry a small risk of
    serious injury and, rarely, death.
  • There may also be a risk of health and fertility
    problems later in life.

16
Amedeo Modigliani 1884-1920
17
THE USE OF WOMEN II
  • Using women in the manufacturing of research
    tools providing eggs to be used to create
    embryos seems to regard their bodies as means
    of production.
  • Women would probably have to be paid to donate
    eggs to ensure an adequate supply of eggs for
    research. That both makes it look as if embryos
    are created as research property, and that this
    may be undue inducement of students and
    low-income women to provide eggs for research.
  • Dresser recognizes that many of these same
    problems apply when women supply eggs to help
    infertile people have children.

18
Study for Woman I
Woman I 1950-1952
Willem de Kooning 1904-1997
19
MORAL INTERMEDIATES
  • Something that is morally intermediate is between
    a thing with no moral value or rights such as a
    stone and a thing with full moral value or
    rights such as a normal adult human being.
  • Some medical research might involve entities that
    are moral intermediates.
  • Dresser This is research that involves the
    destructive study of organisms generally viewed
    as having appreciable moral significance, but not
    the moral worth of a fully developed human
    being.
  • This might include human embryos and fetuses and
    non-human animals.

20
SPECIAL RESPECT AND RESEARCH
  • Some argue that human embryos should be treated
    with special respect that precludes their
    creation to be used purely for research.
  • Karen Lebacqz thinks that, at the same time that
    embryos can be viewed with awe and reverence
    and having special value, they can be used and
    killed in limited circumstances, when necessity
    is established.
  • As Native Americans respected animals that they
    killed of necessity for food, we might respect
    embryos that we kill of necessity for research.

21
JUSTIFICATION OF RESEARCH I
  • For Dresser, justification of embryonic stem cell
    research depends on assessing the value of a
    studys proposed objectives, which requires us to
    rank the good of various research ends.
  • One has to look at the human interests that might
    be advanced by stem cell research and determine
    which, if any, is important enough to warrant
    creation and destruction of human embryos, and
    other potential harms, such as injury to women
    providing eggs, that could accompany research.

22
JUSTIFICATION OF RESEARCH II
  • For embryonic stem cell research to be justified,
    it must also be shown that the goals of the
    research depend on the use of embryos, and cannot
    be reached without their use.
  • Dresser what is the likelihood that a proposed
    embryo study will advance important human
    interests?
  • To what extent could the human interests at
    stake be satisfied by an alternative approach?

23
JUSTIFICATION OF RESEARCH III
  • Although Dresser thinks that the moral and
    scientific justification of stem cell research
    will inevitably be an imperfect process, she
    says that human embryos may be viewed as
    organisms of extraordinary moral value, to be
    reserved for the most promising and worthwhile
    projects that could contribute to benefits
    unavailable through other means.

24
JUSTIFICATION OF RESEARCH IV
  • Proposals for stem cell research should be
    reviewed by groups that include philosophers,
    theologians, and other nonscientists in addition
    to scientists.
  • Reviewers should also have different views on
    the moral issues raised by creating and
    destroying human embryos for research.
  • Thus we need a lively and serious exchange of
    ideas to get at the moral value of this kind of
    research rather than a consensus on one side or
    the other that does not reflect that sort of
    exchange.

25
WHERE DO WE DRAW THE LINE? I
  • If we allow the creation and destruction of human
    embryos for medical research to benefit persons,
    how far can we allow embryos to develop before
    killing them in the process of research?
  • Some say we can go up to 14 days, and some permit
    embryo destruction beyond that point. How far
    can we go before destruction is impermissible?
  • Dresser At what point would we say that no
    benefit to others could justify the instrumental
    creation and destruction of developing human
    life?

26
WHERE DO WE DRAW THE LINE? II
  • Dresser Because there is likely to be pressure
    to allow destructive research on developing
    humans past the point at which stem cells can be
    retrieved, we need to establish a strong moral
    and policy basis for drawing the line at a
    particular point, a line that will prevent a
    slide down the slippery slope and enable us to
    stand firm against the allure of achievements
    that could come from permitting research that
    destroys human life at later stages of
    development.

27
PROBLEMS WITH THE PUBLIC DEBATE I
  • Dresser says that the public debate over the
    moral status of human embryonic stem cell
    research has several problems.
  • The first is responses to the question of where
    we are to draw the line.
  • Some opponents exaggerate the threat of the
    slippery slope, while some proponents minimize
    the slippery slope threat.
  • In a world where vulnerable humans have often
    been seen as resources for experimentation to
    benefit the powerful, it would be dangerous to
    dismiss the line-drawing challenges implicit in
    policy making about research that destroys
    developing human life.

28
PROBLEMS WITH THE PUBLIC DEBATE II
  • A second problem with the public debate is
    exaggeration about potential cures and therapies
    from stem cell research.
  • Embryonic stem cells are a new tool for
    research, not a sure cure for serious illness.
  • Dresser says that the goal of biomedical research
    is to advance knowledge, while the goal of
    medicine is to heal and prevent disease. These
    should not be confused, as they sometimes are in
    the public debate.
  • Portraying any kind of stem cell research as
    therapeutic is highly misleading.

29
PROBLEMS WITH THE PUBLIC DEBATE III
  • Dresser A third problem with the public debate
    is a failure on all sides to consider the
    distributive justice implications of stem cell
    research. Distributive justice is concerned
    with who ought to get what goods. Here it
    specifically pertains to who should get the goods
    or the benefits of stem cell research.
  • Should the ability to extend the average U.S.
    life span be a priority in biomedical research,
    over research that may be of greater world
    benefit in targeting diseases, such as malaria,
    that are responsible for high rates of premature
    death worldwide?

30
PROBLEMS WITH THE PUBLIC DEBATE IV
  • Is it more important to promote stem cell
    research or obtain universal health care?
  • Dresser millions of people in this country lack
    access to high quality health care. Many, many
    patients cannot obtain existing therapies that
    could extend and improve lives.
  • We should not allow the stem cell issue to
    divert our elected leaders from this nations
    deepening health care crisis.

31
PROBLEMS WITH THE PUBLIC DEBATE V
  • Dresser Public and policy discussions should
    also acknowledge the challenge of supplying
    patients with any stem cell treatments that might
    emerge, which are likely to be expensive.
  • Would stem cell therapies be available solely to
    the wealthy?
  • Because helping patients is the ultimate ethical
    justification for conducting stem cell research,
    access to potential therapies should be part of
    the national discussion.

32
PROBLEMS WITH THE PUBLIC DEBATE VI
  • Dresser says that the final problem with the
    public debate over stem cell research is that it
    sometimes lacks civility.
  • Partisans in the debate too often dismiss the
    concerns of those who disagree, and they dismiss
    as well the idea that deliberation,
    accommodation, and compromise might be warranted.

33
DELIBERATIVE DEMOCRACY
  • Dresser thinks that those involved in the stem
    cell debate who are vituperative and
    disrespectful of opposing views should recognize
    the importance of deliberative democracy to this
    key moral issue.
  • Dennis Thompson and Amy Gutman say that
    deliberative democracy is based on the idea that
    citizens and officials must justify any demands
    for collective action by giving reasons that can
    be accepted by those who are bound by the action.
    When citizens morally disagree with one another,
    they should deliberate with one another, seeking
    moral agreement when they can and maintaining
    mutual respect when they cannot.
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