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Stem Cells and Cloning - Medical Potential and Ethical Dilemmas
Dr Donald Bruce, Society Religion and Technology Project, Church of Scotland
, 121 George Street, Edinburgh EH2 4YN, +44 131 240 2250, srtp@srtp.org.uk http://www.srtp.org.uk
The SRT Project was set up by Scotland’s national church in 1970 to engage with ethical and social issues in technology. It has been in the forefront of ethical assessment of cloning and related issues since 1996.
Human stem cells open up exciting medical possibilities to treat hitherto untreatable degenerative diseases by producing suitable replacement cells. At this early stage in the science, embryonic stem (ES) cells seem to be the most likely source of the widest range of cell types and thus of treatments, but they raise major ethical problems over the inherent ethical status of the embryo. For some, the early embryo is just a ball of cells with no formed human characteristics, justifying research for medical benefit. For others, all research on the embryo is unacceptable on principle because the embryo is as fully human in status as a baby.
In 1996 the Church of Scotland took an intermediate position which affirms the special status as created by God, but it recognised the potential benefits of embryo research under limited circumstances, in the present UK Act. To use an embryo as a source of body cells, however, is different scientifically and ethically from research towards problems of fertility. Instead of treating the embryo as a reproductive entity, removing stem cells treats the embryo merely as a resource from which to take parts and no longer as a whole. It is hard to see how the embryo would retain the "special status" inherent in the present UK Act if becomes a routine resource for replacement cells; it pushes the ethical balance over to the "ball of cells" side. We note that a 1998 Ministry of Agriculture report into animal cloning cautioned against seeing animals "merely as means to an end". We should beware treating human embryos with less respect than animals.
While there are thus serious problems about creating embryos to generate stem cells, some Christians consider that it justifiable, as the lesser of two evils, to use existing "spare" embryos in potential treatments for serious diseases, if they would otherwise be destroyed. The 2001 General Assembly said that embryos ought not be diverted from reproductive purposes to those of cell production, but this remains a point of controversy. A stronger ethical case would exist if all the relevant cells could be derived from adult or cord blood stem cells. Despite many encouraging recent discoveries, however, claims that a similar range of desired cell types could be produced in sufficient numbers and quality are so far premature. They express a hope of a much desired outcome, but not a scientific certainty. These are early days. We advise against putting undue emphasis on early or unrepeated results on any source of stem cells, simply because they would support a route preferred on ethical, political or commercial grounds. All stem cell research must be subject to normal scientific and medical peer review and rigour. Adult cells could also pose serious ethical problems if hopes for them are not realised. To limit developments to what could be achieved with the adult/cord blood cells might restrict the range of fatal diseases which could be treated, compared with what was possible with ES cells. If this proved to be the case, it would pose an acute dilemma of conflicting of ethical principles. The possible use of nuclear transfer cloning to produce embryos of the same genetic type as the patient, to minimise the risk of cell rejection, raises additional issues. We have argued since 1996 that it would be inherently wrong to clone people. Humans are far more than their genes, but a human being should not be given a genotype which has been pre-determined to be that of an existing person. No third party should be granted power to pre-determine anyone else’s genotype. It would also criminally irresponsible to attempt human cloning because of the high physical risk of harm, based on the welfare problems experienced in animal cloning. Because of the uncertainties involved across species it is unlikely ever to be safe enough to attempt human cloning. There are also psychological, social and relational risks. The unfortunate publicity given to some who wish to attempt human reproductive cloning underlines the urgent need for an international treaty to ban it globally.
There is a risk that to create a cloned embryo for cell replacement would make such attempts more likely, but would not seem to make a crucial difference. It seems unlikely, however, that enough human eggs would be available for general use of therapeutic cloning. Hybrid animal-human nuclear transfer would be ethically unacceptable. We support that technically ambitious but ethically desirable goal of reprogramming human somatic cells directly without the need to creation an intermediate embryo. This may justify some short term research on cloned embryos if there were a prospect of avoiding all embryos use in future. We would, however, caution against "hyping" cell replacement as a medical panacea which justifies almost any research. It may only work for some cases, and in any event we cannot go on replacing cells without limit. Neither stem cells nor cloning will deliver human immortality.
Stem Cells and Embryonic Cloning
A more complete discussion paper on stem cell issues from the Conference of European Churches working group on Bioethics.
SRT Project Stem Cell and Cloning Pages
This page was created on 27 November 2001
