Ethical questions of stem cell research. Jozsef Kovacs MD. PhD Semmelweis University-Budapest Institute of Behavioral Sciences Department of Bioethics. Historical remarks. 1978—The first infant (Louise Brown) was born following in vitro fertilization (IVF)
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Jozsef Kovacs MD. PhD
Institute of Behavioral Sciences
Department of Bioethics
1978—The first infant (Louise Brown) was born following in vitro fertilization (IVF)
1997—First successful Somatic Cell Nuclear Transfer (SCNT) (cloning) in a mammal
1998—Isolation and culturing of the first human pluripotent embryonic stem cell lines
To drive stem cells to differentiate into a desired cell type is still not a solved problem
Human Embryonic Stem Cells (hESC) (pluripotent)
Pluripotent stem cells: they cannot form a whole organism, but they can specialize into almost all forms of adult cell types
Umbilical cord stem cells (multipotent)
Adult-derived stem cells (multipotent)
Multipotent stem cells: can give rise only to some specialized cells
1. They can be isolated from the inner cell mass of human embryos (blastocyst)—these embryos can be found in IVF (in vitro fertilization) clinics
2.Primordial germ cells retrieved from first-trimester aborted fetuses
3. To use somatic cell nuclear transfer (SCNT)=cloning to produce embryos, and then the same as 1. (therapeutic cloning)
4. To transform multipotent adult stem cells?
To cure diseases like
Spinal cord injury
Replace cells injured by trauma
Regenerative medicine will transform our conception of
Extracting the stem cells kills the embryo (which is in the blastocyst stage of development)
Is destroying the embryo killing a human person?
If a 4-5 days old embryo is a person, then healing a person with stem cells is performed by killing an other one
The basic question
At what stage of embryonic development does the life of the embryo deserve the same respect and protection due a newborn infant?
The main answers
Conservative: at conception
Liberal: at birth
Moderate: at some stage during embryonic development
All human beings have the same value
Human life begins at conception
Killing an embryo is just as bad as killing adults
It uses the term „human life” in two different meanings: (human life at a cellular level and human life as the life of an organism)
„But the zygote is a potential human being”—then it only potentially has a right to life
The potentiality argument leads too far—it would prohibit contraception as well
It takes into account women’s right to self-determination over their bodies, which is relevant in case of abortion
It is, however, irrelevant, when the status of the embryo, outside the woman’s body is considered
Common in them: development is relevant to attain full moral status
The gradualist position: human life is valuable at all stages of its development, but it becomes more and more valuable during development until it reaches full moral status
At what point is personhood reached?
Conclusion: this in practice favors some form of the moderate positions
We could use organs for transplantation purposes, even if they resulted from a homicide
Similarly, if IVF technology involves discarding the surplus (spare) embryos, using their cells before discarding them could be acceptable, if the user did not contribute to the creation of the embryo?
IVF programs necessarily entail discarding spare embryos
Deriving ES cells from spare embryos before discarding them will lend permanence to the embryo (McGee—Caplan, 1999)
Conclusion: destructive embryo research destroys the embryo less, than discarding it
If IVF programs are permitted, it is inconsistent to prohibit derivation of ES cells from spare embryos
Is destructive embryo research on donated spare embryos of IVF programs ethically acceptable?
Is the creation of embryos for research purposes ethically acceptable?
Controversial research that can be carried out there:
The difference between opponents and proponents of destructive embryo research proved to be intractable
Imputing full moral status to the embryo is mostly based on religious premises
Can the health needs of persons submitted to the religious views of others?
The constitutional principle of separation of church and state should be followed