Human Embryonic Stem Cell Research: An Intercultural Perspective

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Human Embryonic Stem Cell Research An
Intercultural Perspective

• LeRoy Walters
• Kennedy Institute of Ethics
• Georgetown University

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Overview

• A visit to the White House
• Biological background
• Three policy options
• Regional maps and policy trends
• The U.N. debate about cloning
• ISSCR initiatives
• International data
• Ethical arguments
• Religious perspectives
• Conclusions and recommendations

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The Visit to the White HouseAugust 2, 2001
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Biological Background
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Three Policy Options

• The Restrictive Option Prohibits human embryo
  research does not explicitly permit research
  with existing human embryonic stem cell lines
  (shown in red)

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Three Policy Options

• The Permissive Option Accepts the production of
  human embryos for research purposes through in
  vitro fertilization and/or nuclear transfer
  (cloning) (shown in green)

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Three Policy Options

• The Moderate Option Permits the derivation of
  new human embryonic stem cell lines but only
  through the use of remaining embryos from
  infertility clinics (shown in blue)

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A Fourth Policy Option?

• The Compromise Option Permits research with
  existing human embryonic stem cell lines but not
  the derivation of new stem cell lines through the
  destruction of human embryos (shown in yellow)

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Seven World Regions An Overview

• Europe
• The Middle East and the Persian Gulf
• Africa
• Asia
• Oceania Australia and New Zealand
• South America
• North America (outside the U.S.)

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The European Union

• The rules for funding hESC research under the
  6th Research Programme

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Liberalizing Countries2002-Present

• Australia
• Belgium
• Brazil
• Czech Republic
• Denmark
• France
• Germany
• Greece
• Japan

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Liberalizing Countries2002-Present

• The Netherlands
• New Zealand
• Portugal
• Singapore
• South Korea
• Spain
• Sweden
• Switzerland
• The United Kingdom

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U.S. Government Funding Policy

• Option 2, with a time limit of August 9, 2001,
  for the creation of the stem cell lines

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Public Opinion in the U.S.
The Gallup Organization, Societys Moral
Boundaries, May 16, 2005
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The U.N. Debate about Cloning

• Major stages in the debate
• August 2001
• February 2002
• Fall 2003
• December 2004
• March 2005

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The United Nations General Assembly Vote in March
2005

• The key text in the compromise Italian
  declaration (L.26)
• (b) Member states are called upon to prohibit all
  forms of human cloning inasmuch as they are
  incompatible with human dignity and the
  protection of human life

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The General Assembly Vote

• Nations voting in favor of the resolution (84)
• Australia
• Austria
• Germany
• Hungary
• Ireland
• Italy
• Mexico
• Poland
• Portugal
• Switzerland
• The United States

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The General Assembly Vote

• Nations voting against the resolution (34)
• Belgium
• Brazil
• Canada
• China
• Denmark
• Finland
• France
• India
• Japan

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The General Assembly Vote

• Nations voting against the resolution (cont.)
• Netherlands
• New Zealand
• Norway
• Republic of Korea
• Singapore
• Spain
• Sweden
• United Kingdom

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The General Assembly Vote

• Nations abstaining (37)
• Egypt
• Iran
• Israel
• South Africa

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ISSCR Inititatives

• June 2006
• November 2006 (projected)

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Source of Data

• Figure 1 from Jason Owen-Smith and Jennifer
  McCormick, An International Gap in Human ES Cell
  Research, Nature Biotechnology 24(4) April
  2006, 391-392. Date range Papers published
  between November 1998 and December 31, 2004.

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Ethical Arguments
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Arguments in Favor of the Restrictive Option

• Human embryos have a high moral status. They
  deserve to be protected from avoidable harm.

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Arguments in Favor of the Restrictive Option

• When human embryos are developing in vitro,
  their continuing development does not conflict
  with any rights of the men or women who were the
  progenitors of the embryos. Thus, the issues of
  embryo research and embryo discard can be
  distinguished from the abortion issue.

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Implication of This Policy for Assisted
Reproduction

• Only the number of early human embryos should be
  produced that will be transferred in the attempt
  to start a pregnancy. That is, there should be
  no remaining embryos, either fresh or frozen.

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Arguments in Favor of the Moderate Option

• Human embryos have an important moral status
  only after their biological individuality has
  been established and only after the completion of
  implantation.

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Arguments in Favor of the Moderate Option

• No additional harm is done to remaining early
  human embryos if they are used in research rather
  than discarded.

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Arguments in Favor of the Moderate Option

• The development of additional HESC research
  lines offers great promise for basic science in
  the short term and may help to provide new
  approaches to therapy in the long term.

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Implication of This Policy for Assisted
Reproduction

• The current practice of fertilizing multiple
  eggs per ovulatory cycle is morally justified
  because it reduces the number of egg retrievals
  each woman must undergo. The practice of
  freezing human embryos is permitted because of
  the embryos modest moral status.

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Arguments in Favor ofthe Permissive Option

• Certain kinds of hESC research can be conducted
  only with human embryos that have particular
  genetic characteristics for example, genotypes
  associated with serious diseases like cystic
  fibrosis or amyotropic lateral sclerosis (ALS).

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Arguments in Favor ofthe Permissive Option

• The circumstances of a human embryos creation
  do not affect its moral status while it is in
  vitro.

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Arguments in Favor ofthe Permissive Option

• This kind of HESC research offers great promise
  for basic science in the short term and may help
  to provide new approaches to therapy in the long
  term.

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Arguments in Favor ofthe Compromise Option

• Embryos that have been destroyed in the past to
  create the existing hESC lines cannot be brought
  back to life. Therefore, it seems reasonable to
  use the lines in research. However, no
  additional stem cell lines should be produced if
  that process would destroy presently existing or
  future embryos.

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Religious Perspectives
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Human Embryo Research and Religious Traditions

• Thesis At least some representatives of most
  major religious traditions judge human embryo
  research (including human embryonic stem cell
  research), to be ethically acceptable, within
  limits.

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Major Religious Traditionsand Standard hESC
Research

• In the West
• Judaism (an almost universal view)
• Christianity
• Roman Catholicism (several theologians)
• Eastern Orthodoxy
• Protestantism (multiple viewpoints)
• Islam
• The Sunni tradition (multiple viewpoints)
• The Shii tradition (multiple viewpoints)

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Major Religious Traditionsand Standard hESC
Research

• In the East
• Hinduism
• Buddhism
• Taoism
• This evidence is derived primarily from
  submissions to the Singapore Bioethics Advisory
  Committee.

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A Text from the Hebrew BibleExodus 21 22-24

• When men strive together, and hurt a woman with
  child, so that there is a miscarriage, and yet no
  harm follows, the one who hurt her shall be
  fined, according as the womans husband shall lay
  upon him and he shall pay as the judges
  determine.

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Exodus 21 22-24 (continued)

• If any harm follows, then you shall give life
  for life, eye for eye, tooth for tooth, hand for
  hand, foot for foot, burn for burn, wound for
  wound, stripe for stripe.
• Revised Standard Version (1952)

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Conclusions and Recommendations

• Early human embryos in vitro have a relatively
  modest moral status.
• The Moderate and Permissive Options can be
  morally justified in principle.
• It is too early to know the extent to which hESC
  research will contribute either to basic science
  or to new therapies.

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Conclusions and Recommendations

• Research in this field should be transparent to
  public view.
• HESC research should be reviewed locally and
  monitored nationally for scientific merit and to
  ensure respectful treatment of sperm, egg, and
  cell donors.

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Acknowledgments

• The following people provided general
  information for this presentation Cynthia Cohen
  (Georgetown University), Thomas Eich
  (Ruhr-University Bochum), Julia Finkel (Johns
  Hopkins University) Gail Javitt (Johns Hopkins
  University), Lori Knowles (University of
  Alberta), Alexandre Mauron (University of
  Geneva), and Erik Parens (the Hastings Center).
  The following people provided information for
  specific parts of the presentation Ahmed
  Muhammed Al-Tayyeb (Islam) Robert Araujo (U.N.,
  Observer Mission of the Holy See) D.
  Balasubramanian (India)

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Acknowledgments

• Zelina Ben-Gershon (Israel) Ole Johan Borge
  (Norway) Jan Carlstedt-Duke (Sweden) Robin Alta
  Charo (multiple nations)Ole Döring (China)
  Mostafa Dolatyar (U.N., Mission of the Islamic
  Republic of Iran) Carlos Fernando Diaz (U.N.,
  Mission of Costa Rica) B. M. Gandhi (India)
  Ahmad Hajihosseini (U.N., Observer Mission of the
  Organization of the Islamic Conference) William
  Hoffman (multiple nations) Alissa Johnson (state
  legislation, U.S.) Gareth Jones (New Zealand)
  Phillan Joung (South Korea) Young-Mo Koo (South
  Korea)

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Acknowledgments

• Line Matthiessen-Guyader (European Commission,
  Directorate General Research) Jonathan Moreno
  (NAS guidelines) Michel Revel (Israel) Adam
  Thiam (Islamic Fiqh Academy, Saudi Arabia)
  Carolyn Willson (U.N., Mission of the United
  States) and Laurie Zoloth (Judaism, South
  Korea).
• Postdoctoral fellows at the Boston Childrens
  Hospital