Moral and Scientific Issues in the utilization of Human Stem Cells

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Moral and Scientific Issues in the utilization of Human Stem Cells Allen R. Dyer, M.D., Ph.D. dyer@etsu.edu http://faculty.etsu.edu/dyer

Scientific Ethical Legal Religious

Scientific Ethical Religious Legal

Principles of Bioethics Beneficence (or Paternalism) Physician-focused choices Non-perniciousness First Do No Harm Autonomy Patient's entitlement to self-assurance Justice Fairness Ethical

Evolution of Ethical Priorities Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology 144,168-172 (1997)

Human Genetic Intervention Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology 144,168-172 (1997)

Ethical Issues for Gene Therapy and Genetic Engineering Safety (nonmaleficence) Efficacy (usefulness) Informed assent (independence) Allocation of assets (equity) Allen R. Dyer: Ethics of Human Genetic Intervention Experimental Neurology 144,168-172 (1997)

Ethical issues in helped proliferation "Morals, Advertising and Assisted Reproduction: The Goals and Methods of Advertising" Concern for "commodification" of life and life items Concern for accessibility, portion, and evaluating of the innovation Allen R. Dyer: Women's Health Issues 7:3, pp. 143-148. May/June 1997

Human Embryo Blastocyst organize Immunosurgery Embryonic immature microorganisms Scientific

STEM CELL (DEFINITION) A cell that can persistently separate and separate (create) into different kind(s) of cells/tissues

History of Human Stem Cell Research In 1968, the principal bone marrow transplant was effectively utilized as a part of treatment of SCID Since the 1970's, bone marrow transplants have been utilized for treatment of immunodeficiencies and leukemias

Bone Marrow Stem Cells

History of Human Embryonic Stem Cell Research 1954 – John Enders got a Nobel prize in Medicine for developing polio infection in human embryonic kidney cells

History of Human Embryonic Stem Cell Research In 1998, James Thomson (University of Wisconsin-Madison) detached cells from the inward cell mass of the early fetus, and built up the main human embryonic undeveloped cell lines. In 1998, John Gearhart (Johns Hopkins University) determined human embryonic germ cells from cells in fetal gonadal tissue (primordial germ cells). Pluripotent immature microorganism "lines" were created from both sources

History of Somatic Cell Nuclear Transfer (Cloning) 1952 – Briggs and King cloned tadpoles 1996 – The main warm blooded creature cloned from grown-up cells was Dolly, the sheep. 1998 – Mice cloned 1998 – Cows cloned 2000 - Pigs cloned 2001 - Cat cloned (CC = Carbon duplicate) 2002 - Rabbits cloned 2004 - Human Embryos cloned and embryonic undeveloped cells extricated 2004 - Bull serially cloned

Possible Uses of Stem Cell Technology Replaceable tissues/organs Repair of imperfect cell sorts Delivery of hereditary treatments Delivery of chemotherapeutic specialists

Diseases conceivably treatable with undifferentiated cells Cancer Diabetes Parkinson's Alzheimer's Spinal Cord harm Heart Disease Infertility Basic information of cell advancement

Who are partners? Individuals with ailments Parents of youngsters with diseases Physicians and researchers Research Institutes: NIH, Universities, Corporations and shareholders (the individuals who may benefit) Government (s) USA, California, UK, Australia, Czech Republic, South Korea Taxpayers Churches and pastorate The cells themselves

Misconceptions hamper understanding Sources of immature microorganisms: Adult undeveloped cells: bone marrow, blood, muscle, fat, nerves , and so on. Umbilical line undifferentiated organisms: Umbilical rope blood and placenta Embryonic immature microorganisms: From TABs or (supernumerary) IVFs Embryos made exclusively for research purposes Embryos made utilizing substantial cell atomic exchange (SCNT) DNA

Possible purposes of conflict Source of cells Source of subsidizing Autonomy or flexibility Respect forever Definition of "life"

Legal Considerations: Embryonic Stem Cell Research 1973 – ban on government financing for human developing life look into 1988 – NIH Panel voted 19-2 for government subsidizing 1989 – DHHS Secretary Sullivan amplified the ban Legal

Legal Issues: Embryonic Stem Cell Research 1990 – Congress voted to supersede the ban, vetoed by President George H.W. Bramble 1993 – President Clinton lifted the boycott 1994 – the Human Embryo Research Panel favored research, yet Clinton superseded the board 1995 – Congress banned elected financing

Legal Consideration: Embryonic Stem Cell Research August 25, 2000, President Clinton permitted subsidizing of research in light of cells from (prematurely ended) human fetal lines, however not embryonic cells On August 9, 2001, President Bush reported his choice to permit Federal assets to be utilized just for research on existing human embryonic immature microorganism lines made before his declaration

Laws Banning Reproductive Cloning

Laws Banning Research Cloning

Embryonic Research Cloning Laws Worldwide

Legislation on Reproductive/Therapeutic Cloning, Embryo Research, and Stem Cell Research 2003 Source: Encyclopedia of Bioethics

Allow for the obtainment of human embryonic cells from supernumerary fetuses by law Finland Greece The Netherlands Sweden United Kingdom Prohibit acquirement yet permit by law the import and utilization of human embryonic foundational microorganism lines Germany

IVF cells just to be utilized for restorative helped generation Austria Denmark France Iceland Spain Allowing for formation of human incipient organisms for undifferentiated organism acquisition by law United Kingdom

The Case for Federal Funding "The main conceivable hotspot for sufficient support of our medicinal schools and restorative research is the saddling force of the Federal Government. Such a program must guarantee finish opportunity for the foundations and the individual researchers in creating and leading their exploration work." 1932 1945 1995 2004

The Case for Federal Funding "The main conceivable hotspot for satisfactory support of our restorative schools and therapeutic research is the exhausting force of the Federal Government. Such a program must guarantee finish flexibility for the organizations and the individual researchers in creating and directing their exploration work." b) 1945 US Surgeon General Thomas Parran contending for the foundation of the National Institutes of Health (NIH)

California Stem Cell Research and Cures Initiative November, 2004, vote activity passed Run by an Independent Citizen's Oversight Committee made out of government officials, promotion gatherings, and official officers of colleges Provides $3 billion for embryonic immature microorganism investigate Grants up to $6 million Includes development costs

Contributions from Religious customs (No predictable positions) Catholic (shifts after some time) has a tendency to distinguish purpose of life at origination Protestant: changes by division, area, assembly, and parishioner Jewish tends to support look into, early mediation, pre-birth determination, and treatment Muslim inclines toward practicality specifically setting, e.g. objectives of marriage, reproduction Buddhist numerous contemplations and translations. Religious

Early Judaism Genesis 1:28 "Be productive and increment in number." Exodus 21: "When men endeavor together, and hurt a lady with tyke, so that there is a premature delivery, the person who hurt her should be fined. In the event that mischief takes after, then you should give life forever. Creating life not give legitimate status of a man. Fetus removal not approved in early Judaism.

Early Christianity New Testament takes no position on fetus removal or the status of embryonic or fetal life. Negative references to pharmakeia may allude to abortifacient medications and not solution by and large. In making an interpretation of Exodus from Hebrew to Greek, "hurt" get to be "shape".

Catholicism The spirit not joined to the body until arrangement. Just when fetal improvement advances to a phase that looks like human shape is it feasible for the human soul to be available. 40 days after origination for guys/90 for females. Until 1869 Catholic Church perceived a refinement between the ensouled and unensouled baby.

Another qualification Possible people - substances that could form into people if certain moves were made as for them (e.g. implantation) Potential people - substances that will form into people in the typical course of occasions unless that advancement is intruded on Development of "primitive streak" at 14 days a conceivable "good marker" Development of gastrulation, organ arrangement, at 17 days Development of neural tube at 21 days

Protestant Many structures Luther and Calvin dismisses the philosophical religious philosophy of Thomas Aquinas Protestantism sees fetus removal (and other regenerative choices) as an issue of individual inner voice (no ecclesiastical power) now more tolerant of premature birth as an issue of decision or individual obligation (no state religion). Disheartened for not exactly dire reasons

Contemporary Judaism Tolerant of contemporary open arrangement of "decision" Teaches premature birth ought to be picked just to compel reasons. Incipient organism's status for the initial forty days (as indicated by Talmud) "as though it were just water". Henceforth Judaism strong of IVF and Pre-implantation Genetic Diagnosis (PGD).

Islam Koran 23:12-16 Human creation starts with a modest drop from which the bigger hatchling is formed by God the creat