Our People

“Seeing the world as it should be: contemporary bioethical dilemmas and Catholic social teaching,” Dialogue with Young Adults on Human Dignity

conducted by the Archdiocesan offices for Justice and Peace, Marriage and Family, and Life
St Mary’s Cathedral College Sydney

By Most Rev. Anthony Fisher OP
Auxiliary Bishop of Sydney
3/6/2006

Today’s forum conducted by the Archdiocese of Sydney’s offices for Justice and Peace, Marriage and Family, and Life, demonstrates that the concerns of each of these offices are in fact one unitary set of concerns. They are this: how are we to live well in our world today, so as to fulfil our vocation as the Christian people, to reverence the dignity of every human person, and to serve their needs and God’s plan for them. For Catholics passion for justice, peace, life and love can only be complementaries: for there is only one God we serve, one humanity to whom we all belong, one truth about how we are best to belong and serve. Today I thought I might illustrate this by reflecting upon a government report issued late last year and the bioethical challenges it presents.

The report known as ‘the Lockhart Report’ was issued just before Christmas by the chairman of the committee Mr Justice John Lockhart AO QC. His committee had been appointed to review the legislation on human cloning and embryo experimentation passed by the Commonwealth and State parliaments in 2002. Dr Vout and I appeared before the Review Committee on behalf of the Catholic Archdiocese of Sydney. We were received courteously. At the time I expressed my misgivings about the Committee excluding from its consideration specifically ethical concerns surrounding human cloning and destructive experimentation on human embryos. My concern was exacerbated by the absence that day from the hearings of the only member of the Committee with ethical expertise. I think my unease was vindicated by the final Report which is ethically very ‘thin’ and which recommends lifting most ethical or legislative constraints in this area.

At the time of the appointment of the Committee it was suggested in the media that its conclusions were foregone because all its members were pro-cloning and opposed to parts of the 2002 legislation. Those commentators no doubt felt vindicated when, despite the fact that the Australian Parliament had voted in 2002 unanimously in favour of a ban on all human cloning, despite the fact that the UN had passed a similar resolution as recently as March 2005, and despite the fact that the Australian Government had supported that UN resolution, the Committee reported in favour of legalising cloning.

The Lockhart Report turned out to be much worse than the pessimists predicted at the time of the Committee’s constitution or hearings. It recommended the legalisation of:

• human cloning (as long as the cloned embryos are destroyed within two weeks of their creation)
• the production of animal-human crosses (as long as the hybrid embryos are destroyed within a day or so of its creation)
• the production of human embryos with multiple human parents or only one (for destructive experimentation) and
• the IVF manufacture of new human embryos for the specific purpose of destructive experimentation.

Very few of those who made submissions to the Committee even addressed these matters, as few would have imagined that the Committee would be making proposals so completely at odds with Australian community attitudes and more universal ethical principles.

There are other, very worrying elements in the Report. There is a great deal of ‘Orwellian newspeak’ suggesting, for instance, that Parliament redefine the embryo so as to exclude very early embryos from the very definition of an embryo and thus from any legal protection, allowing a free-for-all in such early experimentation. At one point the Report chillingly describes human embryos as mere “cellular extensions” of adults rather than nascent human beings in their own right. Such commodification of human life would have been the realm of science fiction and nightmare until very recently. It brings to mind the umpteen cases throughout history of governments and experts conniving with commercial interests and ideologies to allow the exploitation or termination of some human beings and the devaluation of their human dignity.

There are many other aspects of the Report which might be criticized but today I will mention just one more to you: that there was not a single dissent expressed by the Committee members. Given that almost the entire Australian community would be opposed to the Committee’s more extreme proposals, and that a significant proportion would oppose some of its other proposals, it is extraordinary that there was no dissent expressed. This certainly confirms the view of commentators at the time of the appointment of the committee that it was rigged. We are yet to hear how the Commonwealth and State governments propose to respond.

Stem-cells, OK: but whose stem-cells?

So what is all the hullabaloo about stem-cells and cloning and the rest? Isn’t it just like organ transplantation and so many other medical advances that people were afraid of at first but are now mainstream medicine? Well, let’s reflect for a moment upon organ transplantation. Did any of the doctors such as Christiaan Barnard willingly kill some patients in order to perfect their transplant technique? They might have; but I doubt it. It seems very clear that Barnard wanted to save life, not lose it, and he tried his best for every patient. Nowadays transplantation is so successful it has created new dilemmas: there are not enough organs to go around.

What are we to do about that? Ethicist John Harris suggested an organ lottery: just like jury duty and military conscription, people would be picked out and required to donate a kidney or lung to someone who needs one; after all, we only really need one each. [1] Yes, responded one commentator: that’s a great idea. But why stop at one kidney? Why not take two, and two lungs, and the heart, and the liver and all? You could help half a dozen recipients. Sure, someone would die in the process. But the greatest good would be served for the greatest number! [2]

Harris is not alone in supporting a more ‘pro-active’ transplant programme. Some want to take vital organs from those who are not yet dead but are going to die soon; others have suggested taking them from those who have died even if they have said No to organ donation. Isn’t it best to make the most of a situation like this, they say? Isn’t it unethical not to use the dying and the dead in this way? We are wasting such a valuable resource…

What’s this got to do with stem-cells? Well, the tiniest organs so far proposed for harvesting and transplant are stem-cells, and many of the same ethical issues are at issue here as in the larger tissue and organ transplant debate. There are two main sources for stem-cells, from which the cells take their names: non-embryonic stem-cells – sometimes wrongly called adult stem-cells – and embryonic stem-cells. I suggest ‘non-embryonic’ is a better name for the first kind because they can in fact be taken from donors of all ages, not merely adults. Umbilical cord blood, the placenta and even the amniotic fluid have in fact been found to be rich in stem-cells.[3] Stem-cells have also been found in almost every body tissue such as the brain, [4] pancreas,[5] liver,[6] skin,[7] fat,[8] muscle,[9] blood, [10] bone marrow,[11] lungs,[12] nose[13] and tooth pulp.[14] The US President’s Council on Bioethics recently published a whole white paper on Alternate Sources of Human Pluripotent Stem Cells.[15] Sometimes these cells could be taken from the recipient patients themselves, avoiding any immune-rejection difficulties. At other times they are taken from donors. There are even proposals to create new non-embryonic organisms which can produce human stem-cells.[16] What all these non-embryonic stem-cells have in common is that they are derived from people without harming anyone.

But there is a second, more ethically-troublesome kind of stem-cells: embryonic stem-cells [‘ESCs’] which are taken from human embryos. Despite some speculation about a future non-lethal process for deriving ESCs, the present method of deriving these cells always involves killing the embryos in the process.[17] These embryos are still very small, having only developed to the stage of 120 cells or so since their creation by IVF or, more recently, by cloning.[18] They are still very young—approximately 5 to 6 days old—and grown in a culture in some petri dish; they might even be a few years old, having been stored in some freezer soon after their manufacture.[19] Certainly they have not had a long life: for all the promises at the time they were made in the IVF laboratory, they have never been given that chance. But like us, they are human and they are alive—at least until we remove vital parts. However much we try to dress it up, the derivation of ESCs is not life-saving and it is not therapy: for those from whom these cells are taken, it is death-dealing.

Yet embryonic stem-cell research is all the rage. Given the enthusiasm of some labs, corporations and governments for ESC research, people might be surprised to learn:

• that ESCs have still not demonstrated any therapeutic benefit to anyone;
• that there are no current clinical treatments using such cells;
• that there have been few if any successes in animal models;
• that it is very difficult to obtain pure petri cultures of ESCs; or
• that it is also very difficult to establish and maintain ESC lines.

Likewise very few people understand

• that, unless we go down the path of creating designer embryos for each patient—live cloned twins of the patient—any ESCs taken from human embryos or tissues grown from them will probably suffer immune-rejection
• that a large proportion of cloned embryos are genetic disasters; or
• that those ESC products which are not immunological or genetic calamities may very well cause tumour formation and/or tissue destruction.[20]

And of course ESCs can only be obtained in ways that are lethal to those from whom they are taken! The embryonic stem-cell panacea is wishful thinking for some (patients, doctors), deliberate exaggeration for others (some researchers, corporations and governments) and plain confusion for others (the media and the general public). So far, at least, it is the merest science fiction as well as an ethical minefield.

On the other hand there is ample evidence that non-embryonic stem-cells which normally help repair the tissue types in which they appear also have some pluripotent capacity. Umbilical cord blood stem-cells have already been shown to differentiate into bone, cartilage, nerve, fat and blood tissue types. [21] Bone marrow stem-cells can transdifferentiate into brain neurones, [22] heart muscle,[23] pancreatic[24] and other body tissues. In groundbreaking Australian research—part-funded, I am proud to say, by the Catholic Archdiocese of Sydney—nasal stem-cells have likewise been directed to grow into cardiac, liver, kidney, nerve and muscle tissue types.[25] Hæmatopoetic,[26] neural,[27] aural[28] and pancreatic[29] stem-cells have also demonstrated the ability to transdifferentiate into other tissue-types. Some argue that non-embryonic stem cells are “almost like embryonic stem-cells” only “better behaved”, with “a developmental repertoire close to that of embryonic stem cells” but less inclination to chaotic development as tumours.[30]

Cord blood stem-cells already have direct clinical applications in human patients,[31] and current research in animal models is very promising.[32] Non-embryonic stem-cells have already been shown to be effective in tissue repair after stroke, [33] spinal cord injury,[34] diabetes,[35] heart damage,[36] Parkinson’s disease,[37] cancers (of the brain, breast, ovary, testicle, blood, kidney, skin and multiple myeloma),[38] autoimmune diseases and many other conditions.[39] Recently the Journal of Clinical Oncology reported that more than 45,000 people now receive non-embryonic stem-cell transplants across the world each year; a follow-up study of blood cancer patients who were recipients of adult stem-cells found that ten years later they are virtually as healthy as their peers.[40]

A few brave researchers are now wondering publicly why we continue to pump so much of the limited medical research budget into ESCs.[41] In my own country Dr Peter Rathjen, head of Molecular Biosciences at the University of Adelaide, said: “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, a neuroscientist at the University of Melbourne, agreed: “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.[42] ” Johns Hopkins Alzheimer's Disease expert Peter Rabins likewise told to US Senate “do not expect embryonic stem cells to play a rôle in Alzheimer's treatment”[43]. But others remain enthusiastic and keep up the pressure with their promises of miracle cures. The story is yet to be written on why so many researchers, funders, reporters and politicians were so smitten with the embryo industry and how non-embryonic stem-cell researchers were so effectively silenced while their projects were cash-starved and the glamour bucks went to the embryo people…

Even with fabulous grants the embryo industry has its problems. For one thing it has saturated its market. There are dozens of ‘providers’, often drawing upon the public purse. They are already giving some infertile couples dozens of IVF cycles, as well as some fertile ones whom no-one has bothered properly to investigate. Extending ARTs to surrogates, singles, lesbians, widows, the ‘psychologically’ or ‘socially’ infertile’, people who want babies designed for matched tissue or deafness or some other preference… none of this will raise demand nearly enough to satisfy the industry.

Another problem is that women are reluctant to donate their eggs for ART programmes—after all it is a considerable burden and a not inconsiderable risk for them.[44] Couples are often disinclined to hand over their embryos too. If that situation is to change we need to create a social expectation, indeed invent a new social duty, to give up your eggs and your embryos for others.

A third problem for the embryo industry has been its practice of excessive egg-collection, zygote-production and embryo-banking. There is more now considerable unease about this in many countries. What are we to do with the ‘frozen generation’ left in freezers and denied their parents? If it is to keep the embryo market expanding, the industry needs to find new rationales for the creation, exploitation and destruction of embryos, and find them fast.

So the current ploy is to encourage people to think of human embryos not as human lives but as human left-overs. ‘Turn them into therapies,’ the industry whispers seductively, ‘then you needn’t feel so bad about the frozen generation.’ Not that these embryos are going to be much use for therapies: for the reasons I have already suggested, ESCs are unlikely candidates for transfer to anyone.

Well if the excess IVF embryos aren’t really going to be used for stem-cell therapies, what’s the hidden agenda? In the first place I think it is this: if people are 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 to use for cells, tissues, parts and many other uses. Cloning, in particular, though repudiated by the United Nations, is favoured by scientists and scientific bodies such as our National Academy of Science which in 2003 joined other academies in recommending ‘nice’ therapeutic cloning but not ‘nasty’ reproductive cloning.[45] But as the religious leaders of Australia noted in 2001:

The supposed distinction between ‘therapeutic’ and ‘reproductive’ cloning must be exposed for the furphy it is: to produce an embryo is always ‘reproductive’; to destroy an embryo is never ‘therapeutic’. [46]

The really big markets for embryos will be not in therapies but in drug testing and toxicology, in the creation of new abortifacients, and in training lab technicians by trial and error. All this will yield the embryo industry the bigger profits it craves. But the general public is still queasy, and so it will continue to hear promises of cures for people like Ronald Reagan, Christopher Reeve and Michael J Fox, which no scientist really believes, and more and more countries will be encouraged to join the race.

But why not embryonic stem-cells?

Were embryonic stem-cells the panacea some people say they are, would there still be a problem? I’ve already suggested that there would be, because the only way of getting these cells, at least till now, has been by killing embryos. But, some people will say, these embryos are too young or too tiny or too powerless to be human beings. No honest embryologist says that of course: every embryology text book agrees that each individual human life is conceived by the fertilization of a human egg by a human sperm (or, now, by cloning).[47]

Philosophy and commonsense agree: these are beings continuous with foetuses, babies, children, adults, senior citizens. They are the opening pages of someone’s biography. Unlike any other kind of embryo, human embryos have the inherent nature, organisation, ‘soul’ as some call it, which means they grow up as human beings do, indeed as embryologists do, and never as kangaroos do or roses do.[48] And if they are human beings then the fact that they are tiny is no more morally relevant than that they are black or white, Aussie or foreign, boy or girl, at the beginning of life or soon to die. Thus the International Convention on the Rights of the Child provides that “the child, by reason of his or her physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth”. [49]

The only thing that is different about these human beings is that they have been created in unusual circumstances and then later declared ‘excess’ and marked for disposal. Shouldn’t we use them for something? people ask. To which I would respond: many frail elderly people, prisoners on death row, people with terminally illnesses and unconscious patients are ‘going to die soon anyway’. We hold back from killing and using them because we are convinced human dignity deserves better. History is already sufficiently littered with stories of people declared ‘unworthy of respect’, ‘lacking the requisite capacities’, ‘useless eaters’; it is full of ‘unwanted’, ‘spare’, ‘left-over’ people whom others thought could be used up and disposed of. We must resist the notion of people with a ‘use-by date’.

Sometimes, of course, doctors must let people die. There is a limit to what we can and should do to save life. But that is very different from actively killing. We only dare entrust ourselves to doctors when we are at our most vulnerable because we trust them not to kill. Not all doctors fulfil that trust, as the shocking British case of Harold Shipman (who killed hundreds of his patients) reminded us. As Pope John Paul speaking for the Christian but also the Hippocratic tradition repeatedly insisted and Pope Benedict has echoed: medicine must recover its founding principle: primum non nocere, first do no harm.

The deliberate decision to deprive an innocent human being of his life is always morally evil and can never be licit either as an end in itself or as a means to a good end. It is in fact a grave act of disobedience to the moral law, and indeed to God himself, the author and guarantor of that law; it contradicts the fundamental virtues of justice and charity. Nothing and no one can in any way authorise the killing of an innocent human being… even an embryo… Nor can any authority legitimately recommend or permit such an action.[50]

What kind of society?

What’s driving the ESC push? A results are all that count mentality? Political fears about the fall-out from scientists or projects moving to other places? Legal worries about the difficulty of getting a regulatory system that works? A technological imperative by which the technology dictates the terms to humanity rather than vice versa? The logic of the market with its seductive promises of a ‘stem-cell led recovery’ not just for patients but for the economy? An embryos as commodities attitude which treats some human beings as refrigerator ‘left-overs’ or, as one scientist-entrepreneur put it, ‘the ultimate biological resource’? The recent scandal over the South Korean programme demonstrates how powerful these drivers are today.[51]

Yet we are being asked to consent to the designation of a laboratory underclass: there are now the wanted embryos, who will be protected for what they already are and respected for what they will become; and then there are the second class embryos, useable and disposable, whether leftovers passed their ‘use-by date’ or human lives deliberately manufactured for the purpose.[52] Should we go there? In 1997 the Pontifical Academy for Life suggested we should not:

The human cloning project represents the terrible aberration to which value-free science is driven and is a sign of the profound malaise of our civilization, which looks to science, technology and the ‘quality of life’ as surrogates for the meaning of life and its salvation. The proclamation of the ‘death of God’, in the vain hope of a ‘superman’, produces an unmistakable result: the ‘death of man’. It cannot be forgotten that the denial of man's creaturely status, far from exalting human freedom, in fact creates new forms of slavery, discrimination and profound suffering. Cloning risks being the tragic parody of God’s omnipotence.[53]

Killing anyone harms not only the victim, but the perpetrator, the profession and the society complicit in it. Admittedly we have been desensitised to this in recent years. Though it is untrue to say that we couldn’t care less, it is true to say that we care less than we should. Once parliaments, medibusiness or individual labs take us down the slippery slope of killing some for the benefit of others, we are well down a path towards other developments tomorrow which public opinion today would never tolerate.[54] What is not clear is how we will be able to resist such incremental pressure in the future having so hastily agreed to allow embryo destruction for research these past few years.

What makes it even worse is that in the future we may well judge that much of the talk of an embryonic stem-cell panacea was just so much hype, as was a lot of the talk of gene therapy and fœtal tissue transplants in the early ’90s. By the end of this decade we may well look and wonder how we could have so cruelly created false hopes for sufferers of various conditions, how we could have wasted millions of our precious research resources on an ESC dream, how we could have done so at such a huge ethical and social cost. We may look back realizing, too, that by going down that particular blind alley we neglected to pursue as energetically as we could have done those ethical alternatives which were staring us in the face way back in 2006.

Today’s symposium invited us to reflect upon the subject of human dignity and the many challenges to it in today’s world, and to dream of the world as it should be. Part of my dream for the world where we no longer ride roughshod over human dignity and our brother and sisters who are the bearers of that dignity. In March 2005, the United Nations endorsed a universal Declaration on Human Cloning which calls on all member states to “prohibit all forms of human cloning inasmuch as they are incompatible with human dignity and the protection of human life”. The General Assembly made this declaration:

• Guided by the purposes and principles of the Charter of the United Nations,
• Recalling the Universal Declaration on the Human Genome and Human Rights…
• Aware of the ethical concerns that certain applications of rapidly developing life sciences may raise with regard to human dignity, human rights and the fundamental freedoms of individuals,
• Reaffirming that the application of life sciences should seek to offer relief from suffering and improve the health of individuals and humankind as a whole,
• Emphasizing that the promotion of scientific and technical progress in life sciences should be sought in a manner that safeguards respect for human rights and the benefit of all,
• Mindful of the serious medical, physical, psychological and social dangers that human cloning may imply for the individuals involved, and also conscious of the need to prevent the exploitation of women, [and]
• Convinced of the urgency of preventing the potential dangers of human cloning to human dignity.[55]

Catholics in the Australia, committed with others to justice and peace, life and love, hope and work for new developments in biotechnology and medicine that will improve the health and wellbeing of all, especially the poor. We believe there are ways of achieving such results without compromising research ethics or further polarising our communities; ways which protect and promote the health and wellbeing of every member of the human family. But if such ways are to be found I think we need to pause for thought before jumping headlong into a brave new world of cloning, embryo farming and harvesting for stem-cells and other parts. We need a pause long enough, at least, to ensure that ordinary people and their leaders understand the language, the science, the issues, the promises and the costs. We should give ourselves enough time to ask: what kinds of science do we want our brightest and 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?

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2. Michael Green, “Harris’s modest proposal,” Philosophy 54 (1979): 400-406.
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5. S Bonner-Weir et al, “In vitro cultivation of human islets from expanded ductal tissue,” Proc Natl Acad Sci USA 97 (2000), 7999-8004.
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8. PA Zuk et al, “Multilineage cells from human adipose tissue: Implications for cell-based therapies,” Tissue Engineering 7 (2001): 211-228.
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11. M Reyes et al, “Purification and ex vivo expansion of postnatal human marrow mesodermal progenitor cells,” Blood 98 (2001): 2615-2625.
12. M Emura, “Stem cells of the respiratory epithelium and their in vitro cultivation,” In Vitro Cell Dev Biol Anim 33 (1997).
13. W Murrell et al, “Multipotent stem cells from adult olfactory mucosa,” Developmental Dynamics 233 (2005): 496-515.
14. Gronthos et al, “Postnatal human dental pulp stem cells (DPSCs) in vitro and in vivo,” Proc Natl Acad Sci USA 97 (2000): 13625-13630.
15. President’s Council on Bioethics, White Paper on Alternate Sources of Human Pluripotent Stem Cells (Washington DC, May 2005), www.bioethics.gov
16. Subgroup of the President’s Council on Bioethics, “The moral retrieval of ES cells,” Ethics and Medics 30(7) July 2005. In view of these proposals it is important to engage in careful metaphysical and linguistic reflection on the very definition of the human embryo. I would here suggest that embryo means a uni- or multicellular biological entity, however formed, which has a human genome or an altered human genome and has the intrinsic orientation to develop in an integrated way towards forming a foetus, given a suitable environment.
17. Of course even if a non-lethal means of deriving these cells could be devised and applied, all the ethical issues of IVF or cloning (by which such embryos were derived) would still apply.
18. Regarding ESCs derived from cloned human embryos: WS Hwang et al, “Evidence of a pluripotent human embryonic stem cell line derived from a cloned blastocyst,” Science 303 (2004): 1669-74; WS Hwang WS et al, “Patient-specific embryonic stem cells derived from human SCNT blastocysts,” Science 308 (2005): 1777-83; WS Hwang WS et al, “Human embryonic stem cells and therapeutic cloning,” J Vet Sci 6 (2005): 87-96; R Highfield, “Scientists take a giant step forward in human cloning,” UK Telegraph, 10 May 2005. Advanced Cell Technology in the USA recently announced production of a parthenogenetically derived human embryo by manipulation of a human egg to develop as an embryo without fertilisation or cloning. See JB Cibelli et al, “Somatic cell nuclear transfer in human: Pronuclear and early embryonic development,” J Regen Med 26 (2001): 25-31. Researchers at Advance Cell Technology in the USA fused a human cell with an enucleated cow’s egg to produce an embryo that developed to the 32-cell stage. Stem Cell Sciences in Victoria, Australia conducted a similar experiment using a pig’s egg to produce a 32-cell embryo that was destroyed before further development could take place. A form of ESC has also been isolated from the gonads of aborted fœtuses: MJ Shamblott et al, “Derivation of pluripotent stem cells from cultured human primordial germ cells,” Proc Natl Acad Sci USA 95 (1998): 13726-31.
19. JA Thompson et al, “Embryonic stem cell lines derived from human blastocysts,” Science 282 (1998): 1145-1147.
20. N Scolding, a proponent of embryonic stem-cell research, nonetheless recently noted that “Techniques for culturing human embryonic cells have advanced…but an increasing appreciation of the hazards of embryonic stem cells has rightly prevented the emergence or immediate prospect of any clinical therapies based on such cells. The natural propensity of embryonic stem cells to form teratomas, their exhibition of chromosomal abnormalities, and abnormalities in cloned mammals all present difficulties.” Stem-cell therapy: hope and hype, The Lancet 365 (2005): 9477.
21. G Kögler et al, “A new human somatic stem cell from placental cord blood with intrinsic pluripotent differentiation potential,” J Exp Med 200 (2004): 123-135; J Sanchez-Ramos et al, “Molecular and cellular evidence for neural progenitors in human umbilical cord blood,” Neurology 56 (1001, Supp 3): S03.001.
22. E Mezey et al, “Transplanted bone marrow generates new neurons in human brains,” Proc Natl Acad Sci USA 100 (2003): 1364-69; BJ Crain et al, “Transplanted human bone marrow cells generate new brain cells. J Neurol Sci 233(1-2) (2005): 121-123.
23. C Stamm et al, “Autologous bone-marrow stem-cell transplantation for myocardial regeneration,” Lancet 361 (4 Jan 2003): 45-46; Y-S Yoon et al, “Clonally expanded novel multipotent stem cells from human bone marrow regenerate myocardium after myocardial infarction,” J Clin Invest 115 (2005): 326-338.
24. C Morisco et al, “Human bone marrow mesenchymal stem cells can express insulin and key transcription factors of the endocrine pancreas developmental pathway upon genetic and/or microenvironmental manipulation in vitro,” Stem Cells 23 (2005): 594-604.
25. Professor Mackay-Sim’s team at Griffith University in Queensland: W Murrell et al, “Multipotent stem cells from adult olfactory mucosa,” Developmental Dynamics 233 (2005): 496-515. cf. J Lu et al, “Olfactory ensheathing cells promote locomotor recovery after delayed transplantation into transected spinal cord,” Brain 125 (2002): 14-21.
26. Y Zhao et al, “A human peripheral blood monocyte-derived subset acts as pluripotent stem cells,” Proc Natl Acad Sci USA 100 (2003): 2426-2431; MA Eglitis & Mezey E, “Hematopoietic cells differentiate into both microglia and macroglia in the brain of adult mice,” Proc Natl Acad Sci USA 94 (1997): 4080-4085; OE Sigurjonsson et al, “Adult human hematopoietic stem cells produce neurons efficiently in the regenerating chicken embryo spinal cord,” Proc Natl Acad Sci USA 102 (2005): 5227-5232.
27. DL Clarke et al, “Generalized potential of adult neural stem cells,” Science 288 (2000): 1660-1663; CR Bjorson et al, “Turning brain into blood: a hematopoietic fate adopted by adult neural stem cells in vivo,” Science 283 (1999): 534-537.
28. H Li et al, “Pluripotent stem cells from the adult mouse inner ear,” Nature Med 9 (2003): 1293-1299.
29. C Kruse et al, “Pluripotency of adult stem cells derived from human and rat pancreas,” Applied Physics 79 (2004): 1617-1624.
30. Sylvia Pagan, “Ultimate stem cell discovered. New Scientist Jan 2002 and http: //www.newscientist.com/news/news.jsp?id =ns99991826; DL Clarke et al, “Generalized potential of adult neural stem cells,” Science 288 (2000): 1660-1663; Y Jiang et al, “Pluripotency of mesenchymal stem-cells derived from adult marrow,” Nature 418 (4 July 2002): 41-49; MK Körbling et al, “Hepatocytes and epithelial cells of donor origin in recipients of peripheral-blood stem-cells,” NEJM 346 (2002): 738-746; DS Krause et al, “Multi-organ, multi-lineage engraftment by a single bone marrow-derived stem-cell,” Cell 105 (2001): 369-377; G D’Ippolito et al, “Marrow-isolated adult multilineage inducible (MIAMI) cells, a unique population of postnatal young and old human cells with extensive expansion and differentiation potential,” J Cell Sci 117 (2004): 2971-2981; Gretchen Vogel, “Can old cells learn new tricks?” Science 287 (2000): 1418-1419; JC Howell et al, “Pluripotent stem cells identified in multiple murine tissues,” Ann New York Acad Sci 996 (2003): 158-173.
31. MJ Laughlin et al, “Hematopoietic engraftment and survival in adult recipients of umbilical-cord blood from unrelated donors,” New Engl J Med 344 (14 June 2001): 1815-1822; UH Ziegner et al, “Unrelated umbilical cord stem cell transplantation for X- linked immunodeficiencies,” J Pediatr 138(4) (April 2001): 570-573; L Gore et al, “Successful cord blood transplantation for sickle cell anemia from a sibling who is human leukocyte antigen-identical: implications for comprehensive care,” J Pediatr Hematol Oncol 22(5) (Sept-Oct 2000): 437-440; L Gore et al, “Successful cord blood transplantation for sickle cell anemia from a sibling who is human leukocyte antigen-identical: implications for comprehensive care,” J Pediatr Hematol Oncol 22(5) (Sept-Oct 2000): 437-440. For examples of clinical applications to leukemia and lymphoma see http: //www.biocellaustralia.com; to spinal cord injury see http: //times.hankooki.com/lpage/200411/kt2004112617575710440.htm; and to muscular dystrophy and Krabbve’s disease see C Zhang et al, “Therapy of Duchenne muscular dystrophy with umbilical cord blood stem cell transplantation,” Zhonghua Yi Xue Yi Chuan Xue Za Zhi 22(4) (Aug 2005): 399-405; ML Escolar et al, “Transplantation of umbilical cord blood in babies with infantile Krabbe’s Disease,” New Engl J Med 352(20) (2005): 2069-2081. The numerous clinical trials underway to assess the ability of cord blood to treat a wide range of conditions are detailed at http: //www.clinicaltrials.gov
32. For example, in a study using rats, researchers have used umbilical cord blood to treat spinal cord injury. The rats showed improvements even when treated days after the injury: S Saporta S et al, “Human umbilical cord blood stem cells infusion in spinal cord injury: engraftment and beneficial influence on behavior,” J Hematotherapy Stem Cell Res 12 (2003): 271-278; J Chen et al, “Intravenous administration of human umbilical cord blood reduces behavioral deficits after stroke in rats,” Stroke 32 (Nov 2001): 2682-2688.
33. A Arvidsson et al, “Neuronal replacement from endogenous precursors in the adult brain after stroke,” Nature Medicine online 5 August 2002; J Chen et al, “Intravenous administration of human umbilical cord blood reduces behavioral deficits after stroke in rats,” Stroke 32 (November 2001): 2682-88; Y Li et al, “Human marrow stromal cell therapy for stroke in rat,” Neurology 59 (August 2002): 514-523; P Riess et al, “Transplanted neural stem-cells survive, differentiate, and improve neurological motor function after experimental traumatic brain injury,” Neurosurgery 51 (2002): 1043-1052; W-C Shyu et al, “Functional recovery of stroke rats induced by granulocyte colony-stimulating factor-stimulated stem cells,” Circulation 110 (2004): 1847-1854; AE Willing et al, “Mobilized peripheral blood stem cells administered intravenously produce functional recovery in stroke,” Cell Transplantation 12 (2003): 449-454.
34. DP Ankeny et al, “Bone marrow transplants provide tissue protection and directional guidance for axons after contusive spinal cord injury in rats,” Exp Neurol 190 (2004): 17-31; SS Han & I Fischer, “Neural stem cells and gene therapy: prospects for repairing the injured spinal cord,” J Am Med Assoc 283(17) (2000): 2300-2301; CP Hofstetter et al, “Marrow stromal cells form guiding strands in the injured spinal cord and promote recovery,” Proc Natl Acad Sci USA 99 (2002): 2199-2204; T-G Kim, “Korean scientists succeed in stem cell therapy,” Korea Times 26/11/04 http://times.hankooki.com/lpage/200411/ kt2004112617575710440.htm; C Lima reported in R Highfield, “New hope for paralysed woman,” UK Telegraph 12 June 2004 http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2004/12/06/ncell06. xml&sSheet=/news/ 2004/12/06/ixnewstop.html (Congressional testimony of Lima’s collaborator, Dr Jean Peduzzi at http://www. stemcellresearch.org/testimony/peduzzi-nelson.htm); J Lu et al, “Olfactory ensheathing cells promote locomotor recovery after delayed transplantation into transected spinal cord,” Brain 125 (2002): 14-21; M Ohta et al, “Bone marrow stromal cells infused into the cerebrospinal fluid promote functional recovery of the injured rat spinal cord with reduced cavity formation,” Exp Neurol 187 (2004): 266-278; A Ramón-Cueto et al, “Functional recovery of paraplegic rats and motor axon regeneration in their spinal cords by olfactory ensheathing glia,” Neuron 25 (2000): 425-435; M Sasaki et al, “Transplantation of an acutely isolated bone marrow fraction repairs demyelinated adult rat spinal cord axons,” Glia 35 (2001): 26-34. See also US congressional testimony by Prof. Jean D. Peduzzi-Nelson, Science, Technology, and Space Hearing: Adult Stem Cell Research, 14/07/04: http: //commerce.senate.gov/hearings/testimony.cfm?id= 1268&wit_id=3671
35. EJ Abraham et al, “Insulinotropic hormone glucagon-like peptide-1 differentiation of human pancreatic islet-derived progenitor cells into insulin-producing cells,” Endocrinology 143 (August 2002), 3152-61; D Hess et al, “Bone marrow-derived stem cells initiate pancreatic regeneration,” Nat Biotech 21 (2003): 763-770; ME Horb et al, “Experimental conversion of liver to pancreas,” Current Biology, 13 (2003): 105–115; A Ianus et al, “In vivo derivation of glucose competent pancreatic endocrine cells from bone marrow without evidence of cell fusion,” J Clin Invest 111 (2003): 843-850; S Kodama et al, “Islet regeneration during the reversal of autoimmune diabetes in NOD mice,” Science 302(5648) (2003): 1223-1227; S Matsumota et al, “Insulin independence after living-donor distal pancreatectomy and islet allotransplantation,” The Lancet 365 (2005): 1642-1644; C Moriscot et al, “Human bone marrow mesenchymal stem cells can express insulin and key transcription factors of the endocrine pancreas developmental pathway upon genetic and/or microenvironmental manipulation in vitro,” Stem Cells 23 (2005): 594-604; SH Oh et al, “Adult bone marrow-derived cells trans-differentiating into insulin-producing cells for the treatment of type I diabetes,” Lab Invest 84(5) (2004): 607-617; VK Ramiya et al, “Reversal of insulin-dependent diabetes using islets generated in vitro from pancreatic stem-cells,” Nat Med 6 (2000): 278-82; A Ryan et al, “Glycemic outcome post islet transplantation,” Annual Meeting of the American Diabetes Association, 22/06/01; S Ryu et al; “Reversal of established autoimmune diabetes by restoration of endogenous B cell function,” J Clin Invest 108 (2001): 63–72; T Sapir et al, “Cell-replacement therapy for diabetes: generating functional insulin-producing tissue from adult human liver cells,” Proc Nat Acad Sciences US 102 (2005): 7964-7969; L Yang et al; “In vitro trans-differentiation of adult hepatic stem-cells into pancreatic endocrine hormone-producing cells,” Proc Nat Acad Sciences US, 99 (2002): 8078-8083.
36. MB Britten et al, “Infarct remodeling after intracoronary progenitor cell treatment in patients with acute myocardial infarction,” Circulation 108 (2003): 2212-2218; E Check, “Cardiologists take heart from stem-cell treatment success,” Nature 428 (2004): 880; B Dawn et al, “Cardiac stem cells delivered intravascularly traverse the vessel barrier, regenerate infarcted myocardium, and improve cardiac function,” Proc Natl Acad Sci USA 102 (2005): 3766-3771; AA Hagege et al, “Regeneration of the myocardium: a new role in the treatment of ischemic heart disease?” Hypertension 38(6) (2001): 1413-1415; P Menasché et al, “Autologous skeletal myoblast transplantation for severe postinfarction left ventricular dysfunction,” J Am Coll Cardiol. 41(7) (2003): 1078-1083; P Menasché et al, “Myoblast transplantation for heart failure,” Lancet 357 (2001): 279-280; D Orlic et al, “Mobilized bone marrow cells repair the infarcted heart, improving function and survival,” Proceedings of the National Academy of Sciences USA 98 (2001): 10344-49; D Orlic et al, “Bone marrow cells regenerate infarcted myocardium,” Nature 410 (2001): 701-705; EC Perin et al, “Transendocardial, autologous bone marrow cell transplantation for severe, chronic ischemic heart failure,” Circulation 107(18) (2003): 2294-302; EC Perin et al, “Improved exercise capacity and ischemia 6 and 12 months after transendocardial injection of autologous bone marrow mononuclear cells for ischemic cardiomyopathy,” Circulation 110(11 Suppl 1) (2004): 1213-1218; C Stamm et al, “Autologous bone-marrow stem-cell transplantation for myocardial regeneration,” Lancet 361 (2003): 45-46; BE Strauer et al, “Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans,” Circulation 106 (2002): 1913-1918; BE Strauer et al, “Myocardial regeneration after intracoronary transplantation of human autologous stem cells following acute myocardial infarction,” Dtsch Med Wochenschr 126 (2001): 932-938; H-F Tse et al, “Angiogenesis in ischaemic myocardium by intramyocardial autologous bone marrow mononuclear cell implantation,” Lancet 361 (2003): 47-49; BE Strauer et al, “Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans,” Circulation 106 (2002): 1913-1918; P Menasché et al. “Myoblast transplantation for heart failure,” Lancet 357 (2001): 279-280; C Toma et al, “Human mesenchymal stem-cells differentiate to a cardiomyocyte phenotype in the adult murine heart,” Circulation 105 (2002): 93-98; KC Wollert et al, “Intracoronary autologous bone marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial,” Lancet 364 (2004): 141-148; Y-S Yoon et al, “Clonally expanded novel multipotent stem cells from human bone marrow regenerate myocardium after myocardial infarction,” J Clin Invest 115 (2005): 326-338.
37. P Åkerud et al, “Persephin-overexpressing neural stem-cells regulate the function of nigral dopaminergic neurons and prevent their degeneration in a model of Parkinson’s disease,” Molecular and Cellular Neuroscience 21 (2002): 205-222; M Dezawa et al, “Specific induction of neuronal cells from bone marrow stromal cells and application for autologous transplantation,” J Clin Invest 113 (2004): 1701-1710; J Fallon et al, “In vivo induction of massive proliferation, directed migration, and differentiation of neural cells in the adult mammalian brain,” Proc Natl Acad Sci USA 97 (2000): 14686-14691; S Love et al, “Glial cell line-derived neurotrophic factor induces neuronal sprouting in human brain,” Nature Med 11 (2005): 703-704; J Ourednik et al, “Neural stem-cells display an inherent mechanism for rescuing dysfunctional neurons,” Nature Biotechnology 20 (2002), 1103-10; L Studer et al, “Transplantation of expanded mesencephalic precursors leads to recovery in Parkinsonian rats,” Nature Neurosci 1 (1998): 290-295.
    Using the patient’s own adult neural stem-cells, a group at Los Angeles Cedars-Sinai Medical Center reported a reversal of symptoms in the first Parkinson’s patient treated: M Lévesque & T Neuman, “Autologous transplantation of adult human neural stem cells and differentiated dopaminergic neurons for Parkinson disease: 1-year postoperative clinical and functional metabolic result,” Am Assoc Neurol Surg Ann Meeting Abstract #702, 8 April 2002; see the testimony of Professor Levesque and of the patient himself (Dennis Turner) to the US Senate Committee on Science, Technology, and Space Hearing: Adult Stem Cell Research, 14/07/04.
38. LE Abrey et al, “High dose chemotherapy with autologous stem cell rescue in adults with malignant primary brain tumors,” J Neurooncol 44 (1999): 147-153; RK Burt et al, “Autologous hematopoietic stem cell transplantation in refractory rheumatoid arthritis: sustained response in two of four patients,” Arthritis & Rheumatology 42 (1999): 2281-2285; LE Damon et al, “High-dose chemotherapy and hematopoietic stem cell rescue for breast cancer: experience in California,” Biol Blood Marrow Transplant 6 (2000): 496-505; IJ Dunkel IJ & JL Finlay, “High-dose chemotherapy with autologous stem cell rescue for brain tumors,” Crit Rev Oncol Hematol. 41(2) (2002): 197-204; H Hertzberg et al, “Recurrent disseminated retinoblastoma in a 7-year-old girl treated successfully by high-dose chemotherapy and CD34-selected autologous peripheral blood stem cell transplantation,” Bone Marrow Transplant 27(6) (2001): 653-655; GL Mancardi et al, “Autologous hematopoietic stem cell transplantation suppresses Gd-enhanced MRI activity in MS,” Neurology 57 (2001): 62-68; V Waldmann et al, “Transient complete remission of metastasized merkel cell carcinoma by high-dose polychemotherapy and autologous peripheral blood stem cell transplantation,” Br J Dermatol 143: 837-839, October 2000; NM Wulffraat et al, “Prolonged remission without treatment after autologous stem cell transplantation for refractory childhood systemic lupus erythematosus,” Arthritis Rheum 44(3) (2001): 728-731.
39. DL Clarke et al, “Generalized potential of adult neural stem-cells,” Science 288 (2000): 1660-1663. For detailed citations for all these uses of ADULT stem-cells, see http: //stemcellresearch.org/ I record my indebtedness to David Prentice and this website for many of my citations. See also the excellent collection of material in Southern Cross Bioethics Institute, Briefing Note on Stem Cells (Adelaide: SCBI, 2005).
40. Study by K Syrjala in the Journal of Clinical Oncology reported in “Stem cell patients ‘are healthy’,” BBC News 16/09/05 http: //news.bbc.co.uk/2/hi/health/4251972.stm
41. E.g. New Scientist 23/01/02 which reported that the “ultimate stem-cell” had been discovered in adult bone marrow, leading several commentators to wonder why the hype and energy was going into embryonic stem-cells. At a workshop on “Stem-cells and the Future of Regenerative Medicine” sponsored by the National Academy of Sciences’ Institute of Medicine in Washington DC (22/06/01) Marcus Grompe, M.D., Ph.D., from the Department of Molecular and Medical Genetics, Oregon Health Sciences University, and an expert in cell transplantation to repair damaged livers, said “There is no evidence of therapeutic benefit from embryonic stem-cells.” At the same conference Bert Vogelstein, Professor of Oncology and Pathology at Johns Hopkins University and Chairman of the Institute of Medicine’s committee studying stem-cell research, said “There is no experience with embryonic stem-cells in humans, and very little in mice.” He described all claims of therapeutic benefit from embryonic stem-cells as “conjectural.”
42. Weekend Australian 29-30 June 2002.
43. US Senate testimony, 11/05/04.
44. Editorial, “Proceed with caution,” Nature Biotechnology 23(7) July 2005 observed that “Of course it will be many more years before cloned ESCs can be turned into routine clinical treatments for patients. From a practical standpoint, although Hwang’s tenfold more efficient derivation of cloned ESCs is impressive, the shortage of fresh human eggs to reprogram somatic cell nuclei and derive ESCs remains a considerable drawback.” Likewise F Shenfield observed that “in practice the specific issues of the source of oocytes used for any embryos created for the purpose of research is a major problem, in view of the well documented imbalance between needs and supply in egg donation. If there is a limited number of oocytes available should they preferentially be allocated to reproduction? Potential abuse of vulnerable women who might be enticed to sell their oocytes for research is a grave concern as it has been for several years in gamete donation.” (Semantics and ethics of human embryonic stem-cell research, The Lancet 365 (2005), 9477.
45. InterAcademy Panel on International Issues, Statement on Human Cloning, September 22, 2003 http: //www4.national academies.org/news.nsf/isbn/s09222003b?OpenDocument
46. Open Letter of Australia’s religious leaders and other distinguished persons on Cloning and Embryo Experimentation and Destruction, 2001.
47. “Individual life begins with conception by the union of gametes or sex cells… Growth and development continue thereafter…” (Brookes & Zietman, Clinical Embryology 1998); “The beginning of the development of a new individual is the fusion of… sperm and ovum… The result of this fusion is the formation of the first cell of the new individual, the zygote.” (Hamilton & Mossman, Human Embryology); “Conception: 1. The beginning of pregnancy, usually taken to be the instant that a spermatozoon enters an ovum and forms a viable zygote. 2. the act or process of fertilization.” (Anderson et al, Mosby’s Medical, Nursing & Allied Health Dictionary 2002); “The formation, maturation and meeting of a male and female sex cell are all preliminary to their actual union into a combined cell, or zygote, which definitely marks the beginning of a new individual.” (Arey, Developmental Anatomy); “The precise moment of conception is that at which the male element, or spermatozoon, and the female element, or ovum, fuse together.” (Thomson, Black’s Medical Dictionary); “An egg is programmed to form a new individual organism when activated by a sperm...” (Alberts, Molecular Biology of the Cell); “Almost all higher animals start their lives from a single cell, the fertilized ovum… The time of fertilization represents the starting point in the life history, or ontogeny, of the individual.” (Carlson, Patten’s Foundations of Embryology 1996). Likewise: Moore & Persaud’s Clinically Oriented Embryology; Sadler & Langman’s Medical Embryology; O’Rahilly & Müller’s Human Embryology and Teratology; Moore’s Essentials of Human Embryology; Sweeney’s Basic Concepts in Embryology: all suggest that a new, individual member of the human species is conceived at fertilization.
48. John Paul II, Evangelium Vitæ: Encyclical on the value and inviolability of human life (1995) §60: “From the time that the ovum is fertilized, a life is begun which is neither that of the father nor the mother; it is rather the life of a new human being with his own growth. It would never be made human if it were not human already. This has always been clear, and modern genetic science offers clear confirmation. It has demonstrated that from the first instant there is established the programme of what this living being will be: a person, this individual person with his characteristic aspects already well determined. Right from fertilization the adventure of a human life begins, and each of its capacities requires time—a rather lengthy time—to find its place and to be in a position to act.”
49. International Convention on the Rights of the Child, United Nations General Assembly resolution 20/11/89.
50. John Paul II, Evangelium Vitæ §57. The World Medical Association’s modern version of the Hippocratic Oath likewise declares: “I will maintain the utmost respect for human life from the moment of conception.” This theme was repeated innumerable times throughout John Paul’s pontificate. Likewise Pope Benedict has already spoken to this matter in: Address to the Italian Bishops’ Conference 30.05.05; Allocution to the Diocese of Rome’s Conference on the Family, Basilica of St John Lateran, 06/06/05. As Cardinal Ratzinger he observed: “For modern man, the idea of placing limits on research sounds like blasphemy. However, an intrinsic limit exists, and this is human dignity. Progress obtained at the price of the violation of human dignity is unacceptable. If research attacks man, it is a deviation of science. Even if we protest that this or that research will open possibilities for the future, we must say no when man is at stake. The comparison is a bit strong, but I would like to recall that already once before someone has carried out medical experiments on persons who were held to be inferior. Where will the logic that consists in treating a fetus or an embryo as a thing lead?” Interview with Le Figaro magazine, Dec 2001. cf. the World Medical Association’s Declarations of Nuremburg (1948) and Helsinki (2000): the latter provides that “in medical research on human subjects, considerations related to the well-being of the human subject should take precedence over the interest of science and society.” (World Medical Assocation, Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects, 52nd WMA General Assembly, Edinburgh, Scotland, Oct 2000 A.5).
51. Bryan Walsh, “A cloning cover-up,” Time Magazine, 05/12/05, 7. After the Manila Congress there were several more revealations of unethical use of donors, the publication of fraudulent research findings and other examples of bad science and ethics in the South Korean cloning and ESC programme.
52. John Paul II, Evangelium Vitæ §14; “These so-called ‘spare embryos’ are used for research which, under the pretext of scientific or medical progress, in fact reduces human life to the level of simple ‘biological material’ to be freely disposed of.
53. Pontifical Academy for Life, Reflections on Cloning (1997).
54. On the question of ‘opening the floodgates’ or ‘slippery slopes’, the leader of the Australian stem-cell industry, Alan Trounson, told Deborah Hope “I don’t care if it’s a floodgate. If it opens an opportunity to treat really serious diseases and disabilities its alright with me.” Hope, “Pushing the boundary of cell research,” The Australian 01/04/02, 42.
55. Article 18 of the European Convention on Human Rights and Biomedicine (1997) also specifically forbids the creation of embryos for use in research.