Stem Cell Trial for Stroke: Is It Cannabilizing Human Beings?
By Julian Savulescu
Reneuron has today announced the first transfer of stem cells in the UK to treat stroke. This follows quickly from Geron’s recent trial in spinal cord injury.
This is a historic moment which may be viewed in the same way as the first attempts to use antibiotics. Stem cells offer the door to entirely new form of medical treatment called regenerative medicine. When cells (the building blocks) or tissues of the body are damaged, they are generally not replaced. The dead tissue is replaced by scar that holds the rest of the organ together. So when a person has a stroke (or heart attack) a blood vessel to an area of brain is typically blocked and that area of the brain dies, being replaced by a scar that is functionless. Stem cell therapy offers the hope of replacing that dead or damaged tissue and cells with functioning new cells, in this case nerve cells. This trial is the very first stage to see if the transfer can be done safely.
Regenerative medicine is one of the most exciting areas of medical research and many scientists will be looking expectantly to the Geron and Reneuron trials. There will be one major hurdle, though, even if these trials are safe and show the treatment to be effective. Stem cells can come from a variety of sources but one of the major sources are from embryos. The derivation of embryonic stem cells from embryos results in their destruction.
It is not clear from the press release or Reneuron’s website (http://www.reneuron.com/news__events/news/document_260_237.php) whether or not their stem cells have been derived from embryos. Their press release states, “The ReN001 cells that are being used in the initial clinical trial are taken from the existing manufactured cell banks that will form the basis of the eventual marketed product.”
Whether or not the stem cells used in Reneuron’s research were or were not derived from human embryos, there is an interesting question which arises now or will arise in the future for the field of regenerative medicine: if stem cell therapies were originally derived from the destruction of embryos, should they be used? Such research has previously been described by its opponents as cannabalizing human beings.
How should we view stem therapies which are based on the destruction of human embryos? Is it wrong to destroy human embryos to derive life saving medical treatments?
The Moral Status of the Human Embryo: Solving the Stem Cell Puzzle
In March 2006, a 21 year old Cleveland man, Christopher Challancin, was driving home from a party with his 17 year old girlfriend, Jessica Karos. She was 4 months pregnant. They began to argue about her ability to care for their child. Challancin, who had been drinking, became angry. He began to weave high speed through traffic and crashed. Karos was left paralysed. The baby died. Challancin was unhurt. Because he killed the baby, he was charged with homicide.
In 2005, Alison Miller and Todd Parrish sued their fertility clinic in Chicago. They had been having IVF treatment back in 2002 and stored 9 embryos. One of these was “mistakenly” discarded. The clinic apologised and offered the couple a free cycle of IVF. They sued for the “wrongful death” of their embryo.
Every year, about 100 000 fetuses are aborted in the UK. No one is charged over these deaths. Thousands of embryos are also destroyed. The law on UK requires their destruction after 10 years. How can killing a fetus at once be homicide and yet no crime at all?
How can the destruction of embryos be required by law and widely practised but also, in some places, the crime of wrongful death? How can one act – killing early human life – be both right and wrong? This is the puzzle of social practice involving early human life.
One solution has been proposed by the Christian Right, the Catholic Church, “pro-life” movements and conservative politicians. That solution is to give the embryo, from the moment of creation, a full right to life.
That strategy certainly resolves the conflict. Killing embryos is always wrong. But it leaves us with no abortion (even after rape or when the woman’s life is at stake), no effective contraception (the commonest effective methods – IUD and pill – destroy embryos), no IVF and no effective control over our own reproduction. Many conservative religious and political leaders joyfully embrace these consequences, and seek to impose their values on society, because they are convinced they are right. This is the sort of disrespect of liberty and intolerance of which we so righteously accuse countries like Iran.
The kinds of Christian values which claim that the embryo has a full right to life account poorly for ordinary English life and conflict with accepted practices, regardless of whether a few good men disagree. Good men can be wrong.
There are other values which can account for our polar opposite moral norms, attitudes, practices and laws. This is a value to controlling our reproduction, in deciding how many children we will have and when to have them. “Go forth and multiply” – but there is a limit. Early human life has value when it is a part of plan to have a child. The reason why Challancin was wrong to kill his girlfriend’s baby was because she wanted to have that baby. Challancin is more like a drunk driver who recklessly kills an innocent child than a doctor who performs an abortion. Destruction of embryos is a moral crime when parents wanted them. It should have been Miller and Parrish who decided the fate of their embryos, not the Chicago clinic.
Here is the solution to the puzzle of our conflicting attitudes: embryos have special moral value when they are part of a plan to have a child, or at least desired by the people who made them. Embryos do not have special moral value when they are not desired by the people who formed them.
Creating embryos for research or medical treatment, either by cloning or by IVF, does not destroy any embryo that is a part of anyone’s plan to have a family. It does not deny the world of a child that would otherwise have existed. It is morally equivalent to engaging in sex using contraception. Both create and destroy embryos, the difference being research is to save lives, but sex is just for fun.
Opposing embryo research represents a backdoor assault on hard won reproductive liberty. It holds embryos as sacred and commits us to a world of vast overpopulation and unbearable family size. Women should not be compelled to bear 10 children or be abstinent.
The two missing pieces in the puzzle of early human life are the value of reproductive liberty and the conditional moral status of early life. Once we solve the puzzle, rational opposition to creating embryos for research melts away.
(Adapted from an opinion piece written for The Age several years ago.)
Professor Julian Savulescu University of Oxford