The ethics of embryonic stem cell research

In this article I rebut conservative objections to five phases of embryonic stem cell research. I argue that researchers using existing embryonic stem cell lines are not complicit in the past destruction of embryos because beneficiaries of immoral acts are not necessary morally tainted. Second, such researchers do not encourage the destruction of additional embryos because fertility clinics presently destroy more spare embryos than researchers need. Third, actually harvesting stem cells from slated-to-be-discarded embryos is not wrong. The embryos are not sacrificed for the good of others because they would have been destroyed anyway. Fourth, harvesting stem cells from embryos that are not doomed is morally acceptable, because preserving frozen embryos is futile therapy. Finally, creating embryos solely for the sake of harvesting stem cells from them is morally acceptable because the assumption that embryos have the right to life has very counterintuitive implications.     

Nanotechnology for regenerative medicine: nanomaterials for stem cell imaging

Although stem cells hold great potential for the treatment of many injuries and degenerative diseases, several obstacles must be overcome before their therapeutic application can be realized. These include the development of advanced techniques to understand and control functions of microenvironmental signals and novel methods to track and guide transplanted stem cells. The application of nanotechnology to stem cell biology would be able to address those challenges. This review details the current challenges in regenerative medicine, the current applications of nanoparticles in stem cell biology and further potential of nanotechnology approaches towards regenerative medicine, focusing mainly on magnetic nanoparticle- and quantum dot-based applications in stem cell research.     

Informed consent and federal funding for stem cell research

A review of the consent forms signed by those who donated embryos for the NIH-approved embryonic stem cell lines reveals several problems, providing ethical as well as scientific reasons to overturn the Bush administration's restrictions on federal funding for stem cell research.     

How traditions of ethical reasoning and institutional processes shape stem cell research in Britain

This article aims to show how the traditions of ethical reasoning and policy-making shape stem cell research in Britain. To do so I give a detailed account of the earlier developments of regulations on embryo research and the specific scientific advances made in Britain. The subsequent regulation of stem cell research was largely predetermined by those structures and the different and partly opposing orientations of a utilitarian approach to policies on biomedicine. The setting up of the first stem cell bank and the directing of public funding into not only bioethical but also sociological guidance of the development of the new science field are aspects of the particular British way of supporting stem cell research. However, there is also an ongoing philosophical and juridical debate on the possible erosion of fundamental values caused by incremental regulatory weakening. Although I am highly sympathetic to the critical position that there is a need for a metaphysical anchor to secure individual human rights, one has to admit that the British mode of handling the inevitable ethical problems we face with biomedical progress is rather successful in terms of securing some of the basic needs and values of a modern democratic society.     

The point of a ban. Or, how to think about stem cell research

We might be convinced that the goal of relieving suffering offers a straightforward justification of sacrificing embryos in research. Or we might hold that although embryos merit our respect, the greater the good to be achieved by destroying them, the more respect must give way to research. Or, if we take the notion of respect seriously, we might find that relieving suffering is a real but not supreme imperative.     

Consenting futures: professional views on social, clinical and ethical aspects of information feedback to embryo donors in human embryonic stem cell research

This paper reports from an ongoing multidisciplinary, ethnographic study that is exploring the views, values and practices (the ethical frameworks) drawn on by professional staff in assisted conception units and stem cell laboratories in relation to embryo donation for research purposes, particularly human embryonic stem cell (hESC) research, in the UK. We focus here on the connection between possible incidental findings and the circumstances in which embryos are donated for hESC research, and report some of the uncertainties and dilemmas of our staff participants. We explore the views of our study participants in relation to two themes: (1) rights to information and anticipating how donors might be informed about future research findings and (2) occupational work goals and trust.     

Conception to obtain hematopoietic stem cells

A couple may have a child to provide stem cells for another child. They may also use preimplantation testing--even, troubling though it is, prenatal testing and selective abortion--to ensure a close tissue match.     

On the German debate on human embryonic stem cell research

Germany since 1990 has one of the strictest human embryo protection laws, yet according to the Stem Cell Act of 2002 allows, under strict conditions, the import and use of human embryonic stem cells (hESC) for high priority research goals. The author tries to show how this is taken to be coherent by the parliamentary majority (though not necessarily by the general public) in Germany. In doing so, he firstly looks into the chronicle of the debate in Germany showing its different stages since 1999, then dwells upon the relation between the law and the role of ethics in this issue, and thirdly presents the two fundamentally different positions of the German debate, that is, that the human embryo created for IVF purposes is a human being and stands from its very beginnings under the constitutional principles of respect for, and protection of, human life versus the position that before being implanted the human embryo may become a human being and therefore belongs to the human species only potentially, so that its right to life protection may be assessable over against other high priority goals, such as research aiming at possible help for patients with life-endangering diseases. In spite of the Stem Cell Act of 2002, the debate of the German general public goes on, especially due to the recent EU 6th Research Framework Program which plans to also fund hESC research.     

Access to Health‐Related Goods

There are many good reasons for a merger between bioethics and human rights. First, though, significant philosophical groundwork must be done to clarify what a human right to health would be and—if we accept that it exists—exactly how it might influence the practical decisions we face about who gets what in very different contexts.     

The Ethics of ALTRUISM in Clinical Research

If people sometimes participate in research because of altruism—because they want to help in the search for treatments—should we revise our views about what kinds of experiments are ethical? If participants act out of altruism, we might let them accept greater risks than we would if they are motivated only by a desire for personal gain. But how can we know when participants are genuinely altruistic?     

The meanings of consent to the donation of cord blood stem cells: perspectives from an interview-based study of a public cord blood bank in England

This paper explores the perspectives of women who have agreed that their umbilical cord blood may be collected for a public 'cord blood bank', for use in transplant medicine or research. Drawing on interview data from 27 mothers who agreed to the collection and use of their umbilical cord blood, these choices and the informed consent process are explored. It is shown that the needs of sick children requiring transplants are prominent in narrative accounts of cord blood banking, together with high expectations for future applications of stem cells. Given this dynamic, a concern arises that the complex and multiple uses of tissues and related data might be oversimplified in the consent process. In conclusion, the positive finding of a commitment to mutuality in cord blood banking among these women is underlined, and its implications for the wider debate on cord blood banking are discussed.     

Policy as Product: Morality and Metaphor in Health Policy Discourse

Where we once spoke in military terms, we now often wield the language of the market: health care is a “product” and we are its “providers” and “consumers.” The market metaphor constrains in various ways our vision of the goals we pursue in making health policy, of the options available to us in pursuing them, indeed—because policy implies a certain view of moral agency—of the way we relate to each other.     

Passion, activity, and "the care of the self"

To ask whether we should use Prozac or other technologies as “enhancement” is perhaps to ask the wrong question, one that belongs to a life of what Heidegger discerned as technological ordering (die Technik). We might better ask a question belonging to a life of receptivity (Gelassenheit): Can or should we—some of us—live differently than we do?     

To restore faith and trust: justice and biological access to cellular therapies

Stem cell therapies should be available to people of all ethnicities. However, most cells used in the clinic will probably come from lines of cells stored in stem cell banks, which may end up benefiting the majority group most. The solution is to seek additional funding, earmarked for lines that will benefit minorities and offered as a public expression of apology for past discrimination.     

The role of nanofibrous structure in osteogenic differentiation of human mesenchymal stem cells with serial passage

Using scaffolds with autologous stem cells is a golden strategy for the treatment of bone defects. In this strategy, human mesenchymal stem cells (hMSCs) have often been isolated and expanded in vitro on a plastic surface to obtain a sufficient cell number before seeding on a suitable scaffold. MATERIALS & METHODS: Investigating the influence of serial passages (from passage two to passage eight) on the abilities of proliferation and osteogenic differentiation of hMSCs on 24-well tissue culture polystyrene plates and poly L-lactic acid electrospun nanofibrous scaffolds was performed to determine how prolonged culture affected these cellular abilities and how the nanofibrous scaffolds supported the osteogenic differentiation potential of hMSCs. RESULTS & CONCLUSION: Serial passage caused adverse changes in hMSCs characteristics, which were indicated by the decline in both proliferation and osteogenic differentiation abilities. Interestingly, the poly L-lactic acid nanofibrous scaffolds showed a significant support in recovering the osteogenic abilities of hMSCs, which had been severely affected by prolonged culture.     

Discriminatory Demands by Patients

Most of us working in health care are concerned—perhaps even appalled—when patients make demands for doctors or nurses or other caregivers that accord with their bigoted sentiments. Even though there may be some reasons to believe that matching certain characteristics of doctors with those of their patients (whether the latter ask for them or not) may produce both more patient satisfaction and even some health benefits, how does one tease apart or distinguish requests that are potentially beneficial from those we find abhorrent? What facts might make it acceptable for an African American patient to request an African American doctor or a Chinese Mandarin‐speaking patient to request a physician who is fluent in Mandarin and is also of Chinese ethnicity? At the same time, why do we recoil or find it objectionable that the father of the baby under Tonya Battle's care in Michigan might want a nurse caring for his child with whom he identifies ethnically, or racially or religiously, or based on any other superficial trait(s) that we use to characterize people?     

The embryo in relationships: a French debate on stem cell research

While many European countries are entering unknown legal terrain where the embryo in vitro is concerned, France can already look back on a long tradition of public discussion and legal codification of ways of dealing with in vitro embryos. In its comprehensive law of 1994, France had still rejected embryo research; however, due to the promising perspectives of stem cell research, the new law now pending implies a clear liberalization of the 1994 provisions. Both the French lawmakers and the National Ethics Commission have repeatedly argued that possible utilization of embryos for research purposes may seem legitimate from the moment that there is no more "parental project." De facto, this concept implies that an embryo can be transformed into an object from the moment that the parents cease to desire it and that the value of protection is solely dependent on the will of third persons. At the same time, France is still speaking of guaranteeing respect for the "dignity of the embryo," which would mean that an embryo must not be reduced to a thing and treated for purposes which are not his own. Therefore, the French solution is not a consistent and honest solution, and in its new legal provisions, France has involved herself in manifold contradictions. France has rejected the conception of pre-embryo, but is de facto following Britain's model without making it explicit.     

The Heart of the Matter

A heart transplantation team at a major urban teaching hospital invariably has more candidates than hearts available to transplant. The program is known to benefit both low risk and high risk patients. Nevertheless, 30 percent of the candidates die before a heart becomes available. Members of the transplant team, who are both medical practitioners and scientific researchers, consider alternative sources of organs and decide upon the hearts of chimpanzees. The researchers realize that they are entering upon relatively uncharted waters, despite the close evolutionary link between human beings and chimpanzees. However, they have previously performed a series of preparatory experiments transplanting hearts between cynomologous monkeys and baboons. Though all the hearts were ultimately rejected due to the incompatibility of the two species' tissue types, there was temporary survival—an average of eleven weeks— sufficient to “buy time” for potential transplant recipients. If the analogy between monkey/ baboon and chimpanzee/human being holds, the chimpanzee heart could serve as a temporary “bridge” to a human heart, if and when it becomes available. For various reasons, medical and otherwise, the transplant team considers the chimpanzee heart preferable, as a bridge, to an artificial, mechanical heart. Moreover, it is possible that the chimpanzee heart could become a permanent replacement, if problems of immunological rejection could be overcome. Still further, this experiment might lead to scientific knowledge allowing the use of other types of animal hearts, for example, those of pigs or cows. This would solve—practically, if not ethically—the chronic problem of the insufficient supply of transplantable hearts. Confounding this possible human benefit and heady medical technology are certain inexorable facts. Chimpanzees are an endangered species. There are about 100,000 chimpanzees left in the world and about 2,500 in captivity in the United States. International trade in chimpanzees is banned, breeding in captivity is difficult, and capture of wild chimpanzees is “inefficient” in terms of preserving individual lives. For every wild chimpanzee captured and delivered to its destination, as many as 10 other chimpanzees die. Moreover, captive chimpanzees are much in demand for other forms of scientific and medical research. Finally, the scientific merits of using chimpanzees in research and particularly in this medical therapy carry a correlative ethical albatross. Can we, for such a purpose, ethically justify the use of such a complex and elaborate form of animal life, in several behavioral activities so close to our human selves? Should the transplantation team go ahead with its experiment? Should the project be approved by the institution's Institutional Review Board and Animal Care and Use Committee?     

Dr. Douchebag: a tale of the emergency department

“I'm not afraid of dying,” he says, despite his plea on arrival. “Listen up, douchebag. Are you calling my cousin or what?” The emergency department might be the only sphere of human exchange where one party—patients (and sometimes family)—are permitted to insult, threaten, and even spit at the very people on whom they depend for help, while the offended parties—physicians, nurses, and other health care providers—must not only tolerate the abuse, but treat their tormentors. Does the ED's collective duty to greater numbers of patients demand a revised ethos of tough love for extreme cases of misbehavior? Can we ask these patients to leave without legal recourse after extending genuine, compassionate efforts to participate in their care—barring evidence of a medical explanation for their toxic comportment or a mental illness that puts them at risk of harming themselves or others?     

Embryonic stem cells and property rights

This article contributes to the current debate on human embryonic stem cell researchers' possible complicity in the destruction of human embryos and the relevance of such complicity for the issue of commodification of human embryos. I will discuss if, and to what extent, researchers who destroy human embryos, and researchers who merely use human embryos destroyed by others, have moral use rights, and/or moral property rights, in these embryos. I argue that the moral status of the human embryo, however justified, places few restrictions on the latter researchers' use of it, and property rights in it, once it is destroyed. I argue that the former researchers have no property rights in the destroyed embryo but use rights in it to the extent allowed by the legitimate owners of the destroyed embryo. I discuss the implications of this account for previous and current US federal law regulating human embryonic stem cell research.