Transcript Slide 1

Human Embryonic Stem Cell Research:
An Intercultural Perspective
LeRoy Walters
Kennedy Institute of Ethics
Georgetown University
Overview
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A visit to the White House
Biological background
Three policy options
Regional maps and policy trends
The U.N. debate about cloning
ISSCR initiatives
International data
Ethical arguments
Religious perspectives
Conclusions and recommendations
The Visit to the White House:
August 2, 2001
Biological Background
Three Policy Options
• The Restrictive Option: Prohibits human
embryo research; does not explicitly
permit research with existing human
embryonic stem cell lines (shown in red)
Three Policy Options
• The Permissive Option: Accepts the
production of human embryos for research
purposes through in vitro fertilization
and/or nuclear transfer (cloning) (shown in
green)
Three Policy Options
• The Moderate Option: Permits the
derivation of new human embryonic stem
cell lines but only through the use of
remaining embryos from infertility clinics
(shown in blue)
A Fourth Policy Option?
• The Compromise Option: Permits
research with existing human embryonic
stem cell lines but not the derivation of
new stem cell lines through the destruction
of human embryos (shown in yellow)
Seven World Regions: An Overview
• Europe
• The Middle East and the Persian Gulf
• Africa
• Asia
• Oceania: Australia and New Zealand
• South America
• North America (outside the U.S.)
The European Union
The rules for funding hESC research
under the 6th Research Programme
Liberalizing Countries
2002-Present
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Australia
Belgium
Brazil
Czech Republic
Denmark
France
Germany
Greece
Japan
Liberalizing Countries
2002-Present
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The Netherlands
New Zealand
Portugal
Singapore
South Korea
Spain
Sweden
Switzerland
The United Kingdom
U.S. Government Funding Policy
Option 2, with a time limit of August 9,
2001, for the creation of the stem cell lines
Public Opinion in the U.S.
The Gallup Organization, “Society’s Moral Boundaries,” May 16, 2005
The U.N. Debate about Cloning
Major stages in the debate
• August 2001
• February 2002
• Fall 2003
• December 2004
• March 2005
The United Nations General Assembly
Vote in March 2005
• The key text in the compromise Italian
declaration (L.26):
– (b) Member states are called upon to prohibit
all forms of human cloning inasmuch as they
are incompatible with human dignity and the
protection of human life;
The General Assembly Vote
• Nations voting in favor of the resolution (84)
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Australia
Austria
Germany
Hungary
Ireland
Italy
Mexico
Poland
Portugal
Switzerland
The United States
The General Assembly Vote
• Nations voting against the resolution (34)
– Belgium
– Brazil
– Canada
– China
– Denmark
– Finland
– France
– India
– Japan
The General Assembly Vote
• Nations voting against the resolution
(cont.)
– Netherlands
– New Zealand
– Norway
– Republic of Korea
– Singapore
– Spain
– Sweden
– United Kingdom
The General Assembly Vote
• Nations abstaining (37)
– Egypt
– Iran
– Israel
– South Africa
ISSCR Inititatives
• June 2006
• November 2006 (projected)
Source of Data
Figure 1 from Jason Owen-Smith and
Jennifer McCormick, “An International Gap
in Human ES Cell Research,” Nature
Biotechnology 24(4): April 2006, 391-392.
Date range: Papers published between
November 1998 and December 31, 2004.
Ethical Arguments
Arguments in Favor of the
Restrictive Option
Human embryos have a high moral status.
They deserve to be protected from
avoidable harm.
Arguments in Favor of the
Restrictive Option
When human embryos are developing in
vitro, their continuing development does
not conflict with any rights of the men or
women who were the progenitors of the
embryos. Thus, the issues of embryo
research and embryo discard can be
distinguished from the abortion issue.
Implication of This Policy for
Assisted Reproduction
Only the number of early human embryos
should be produced that will be transferred
in the attempt to start a pregnancy. That
is, there should be no remaining embryos,
either fresh or frozen.
Arguments in Favor of the
Moderate Option
Human embryos have an important moral
status only after their biological individuality
has been established and only after the
completion of implantation.
Arguments in Favor of the
Moderate Option
No additional harm is done to remaining
early human embryos if they are used in
research rather than discarded.
Arguments in Favor of the
Moderate Option
The development of additional HESC
research lines offers great promise for
basic science in the short term and may
help to provide new approaches to therapy
in the long term.
Implication of This Policy for
Assisted Reproduction
The current practice of fertilizing multiple
eggs per ovulatory cycle is morally justified
because it reduces the number of egg
retrievals each woman must undergo. The
practice of freezing human embryos is
permitted because of the embryos’ modest
moral status.
Arguments in Favor of
the Permissive Option
Certain kinds of hESC research can be
conducted only with human embryos that
have particular genetic characteristics –
for example, genotypes associated with
serious diseases like cystic fibrosis or
amyotropic lateral sclerosis (ALS).
Arguments in Favor of
the Permissive Option
The circumstances of a human embryo’s
creation do not affect its moral status while
it is in vitro.
Arguments in Favor of
the Permissive Option
This kind of HESC research offers great
promise for basic science in the short term
and may help to provide new approaches
to therapy in the long term.
Arguments in Favor of
the Compromise Option
Embryos that have been destroyed in the
past to create the existing hESC lines
cannot be brought back to life. Therefore,
it seems reasonable to use the lines in
research. However, no additional stem
cell lines should be produced if that
process would destroy presently existing
or future embryos.
Religious Perspectives
Human Embryo Research and
Religious Traditions
Thesis: At least some representatives of
most major religious traditions judge
human embryo research (including human
embryonic stem cell research), to be
ethically acceptable, within limits.
Major Religious Traditions
and Standard hESC Research
• In the West
– Judaism (an almost universal view)
– Christianity
• Roman Catholicism (several theologians)
• Eastern Orthodoxy
• Protestantism (multiple viewpoints)
– Islam
• The Sunni tradition (multiple viewpoints)
• The Shi’i tradition (multiple viewpoints)
Major Religious Traditions
and Standard hESC Research
• In the East
– Hinduism
– Buddhism
– Taoism
This evidence is derived primarily from submissions
to the Singapore Bioethics Advisory Committee.
A Text from the Hebrew Bible:
Exodus 21: 22-24
When men strive together, and hurt a
woman with child, so that there is a
miscarriage, and yet no harm follows, the
one who hurt her shall be fined, according
as the woman’s husband shall lay upon
him; and he shall pay as the judges
determine.
Exodus 21: 22-24 (continued)
If any harm follows, then you shall give
life for life, eye for eye, tooth for tooth,
hand for hand, foot for foot, burn for
burn, wound for wound, stripe for
stripe.
Revised Standard Version (1952)
Conclusions and
Recommendations
• Early human embryos in vitro have a
relatively modest moral status.
• The Moderate and Permissive Options can
be morally justified in principle.
• It is too early to know the extent to which
hESC research will contribute either to
basic science or to new therapies.
Conclusions and
Recommendations
• Research in this field should be
transparent to public view.
• HESC research should be reviewed locally
and monitored nationally for scientific merit
and to ensure respectful treatment of
sperm, egg, and cell donors.
Acknowledgments
The following people provided general information
for this presentation: Cynthia Cohen (Georgetown
University), Thomas Eich (Ruhr-University Bochum),
Julia Finkel (Johns Hopkins University); Gail Javitt
(Johns Hopkins University), Lori Knowles (University
of Alberta), Alexandre Mauron (University of
Geneva), and Erik Parens (the Hastings Center).
The following people provided information for
specific parts of the presentation: Ahmed
Muhammed Al-Tayyeb (Islam); Robert Araujo (U.N.,
Observer Mission of the Holy See); D.
Balasubramanian (India);
Acknowledgments
Zelina Ben-Gershon (Israel); Ole Johan Borge
(Norway); Jan Carlstedt-Duke (Sweden); Robin
Alta Charo (multiple nations);Ole Döring (China);
Mostafa Dolatyar (U.N., Mission of the Islamic
Republic of Iran); Carlos Fernando Diaz (U.N.,
Mission of Costa Rica); B. M. Gandhi (India);
Ahmad Hajihosseini (U.N., Observer Mission of the
Organization of the Islamic Conference); William
Hoffman (multiple nations); Alissa Johnson (state
legislation, U.S.); Gareth Jones (New Zealand);
Phillan Joung (South Korea); Young-Mo Koo
(South Korea);
Acknowledgments
Line Matthiessen-Guyader (European
Commission, Directorate General: Research);
Jonathan Moreno (NAS guidelines); Michel Revel
(Israel); Adam Thiam (Islamic Fiqh Academy,
Saudi Arabia); Carolyn Willson (U.N., Mission of
the United States); and Laurie Zoloth (Judaism,
South Korea).
Postdoctoral fellows at the Boston Children’s
Hospital