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Home > People > Bishop Fisher > Addresses > Article

Printable Version

Ethical issues related to stem-cell research

Cross-discipline Therapeutics: Advances in Stem-cell Therapy
Grand Rounds, St Vincent's Hospital Sydney, 31 August 2004

By Most Rev. Anthony Fisher OP
Auxiliary Bishop of Sydney

1 September 2004

Adobe Reader version (PDF)
1. Primum non nocere: ES cell derivation is lethal & therefore unethical; adult stem-cell derivation is harmless
Whereas adult stem-cells are taken from donors of all ages, from cord blood & even from patients themselves, without harming anyone, embryonic stem-cells ['ES cells'] are taken from human embryos, killing the embryonic 'donors' in the process. These embryos are still very small, 120 cells or so. They are still very young, only a week old in some petri dish or a few years old in some freezer. Certainly they have not had a long life: for all the promises at the time they were made in the IVF clinic, they have never been given that chance. But like us, they are human & they are alive-at least until we remove vital parts. However much we try to dress it up, the derivation of ES cells is not life-saving & it is not therapy: for those from whom these cells are taken, it is death-dealing.
 
2. Deinde non mentiri: It is immoral to create false expectations through promoting the ES cell panacea
Despite the enthusiasm of some researchers, corporations & governments for ES cell research, few realize that
- ES cells have still not demonstrated any therapeutic benefit to anyone
- there are no current clinical treatments using ES cells
- there have been few if any successes even in animal models
- it is very difficult to obtain pure petri cultures of ES cells & to establish & maintain ES cell lines
- unless we create designer embryos (cloned twins of each patient), ES cell products will probably suffer immune-rejection
- ES cell products are inclined to tumour formation &/or tissue destruction
The embryonic stem-cell panacea is wishful thinking for some (patients, doctors), deliberate exaggeration for others (some researchers, corporations & governments) & plain confusion for others (the media & the general public).
+ Dr Peter Rathjen (Head of Molecular Biosciences, Univ Adelaide): "It's bloody nonsense that stem-cells might be able to cure Alzheimer's. We don't even know what causes it."
+ Dr Colin Masters (Neuroscience, Univ Melbourne): "Stem-cell people might have an argument for replacing [dead cells] in traumas like strokes or spinal injuries, but in diseases like Alzheimer's or Parkinson's, it is beyond our imagination."
 
3. Adult stem-cells are more promising
There is ample evidence that adult stem-cells have pluripotent capacity
- bone marrow, neural & other stem-cells have been directed to form a wide variety of tissue types including heart muscle, neurones & other body tissues
- adult stem-cells have been shown to be effective in tissue repair after stroke, spinal cord injury, diabetes, heart damage, Parkinson's disease, & numerous other conditions
- current clinical uses of adult stem-cells include uses for cancers (of the breast, ovary, testicle, blood, kidney & brain, & multiple myeloma), autoimmune diseases (such as multiple sclerosis, systemic lupus, rheumatoid arthritis, scleroderma, scleromyxedema & Crohn's disease), anemias, bone, skin & cornea damage
 
4. Why the push for ES cells?
Problem
- embryo industry has saturated its market
- women are reluctant to donate their eggs
- excessive embryo-production & embryo-banking Ò public unease about the 'frozen generation'
Response
+ encourage people to think of human embryos not as human lives but as human left-overs for research / therapies
+ if people can be sold on killing just a few excess embryos, it will be much easier to sell them down the track on manufacturing new, better designer embryos & clones for various uses
+ really big markets for embryos will be not in therapies but in drug testing & toxicology, new abortifacients, lab training
 
But aren't embryos too young / tiny / powerless to be human beings?
- Embryology: each individual human life is conceived by the fertilization of a human egg by a human sperm
- Philosophy: these are beings continuous with foetuses, babies, children, adults, senior citizens; the opening pages of someone's biography
- Unlike any other kind of embryo, human embryos have the inherent nature / organisation / 'soul' to grow up as human beings do
- Newness or smallness is no more morally relevant than colour, nationality, sex
 
But aren't they going to die soon anyway? Shouldn't we use them for something?
- Short life-expectancy or being declared unwanted or marked for disposal is also irrelevant to the moral status of an embryo
- Why hold back from killing or using frail elderly people, or prisoners 'on death row' or unconscious patients or others who are 'going to die soon anyway'?
Because human dignity deserves better; minimally it requires that we treat every instance of our human nature with care & respect
+ History is littered with stories of people declared 'unworthy of respect', 'lacking the requisite capacities', 'unwanted', 'spare', to be used up & disposed of
+ Sometimes doctors must let people die (there is a limit to what we can & should do to save life); but that is very different from actively killing
+ founding principle of medicine: primum non nocere, first do no harm.
 
What's driving the push for cloning & ES cells?
- results are all that count mentality
- fear that scientists or projects will move to other places
- difficulty of getting a regulatory system that works
- technological imperative
- logic of the market
- embryos as commodities attitude
 
What kind of a society?
We are being asked to consent to the designation of a laboratory underclass
- the wanted embryos, who will be protected for what they already are & respected for what they will become -v-
- the second class embryos, useable & disposable, whether leftovers or deliberately fertilized or cloned for the purpose
Killing anyone harms not only the victim, but the perpetrator & the society complicit in it
+ Church insists that no hoped for therapeutic good is sufficient to justify the immorality of killing our very young
+ We need a pause long enough, at least, to ensure that ordinary people & their leaders understand the language, the science, the issues, the promises & the costs
+ What kinds of science do we want our brightest & best to engage in?
+ What kinds of projects do we want our limited resources invested in?
+ What kinds of manipulation of human life do we want to be complicit in?
 
Some other complex ethical questions
- Should we cooperate with other teams or systems that do not share our ethical concerns & readily engage in or profit from embryo destruction?
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