Stem cell Research: Facts, Ethos and Ethics
The human body is an extraordinary biological machine, the perpetuation of whose being is supported and maintained by inter-dependent systems and organs of enormous breadths and complexities.
By OpenStax College - Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, Link
Understanding among others, its anatomy and physiology, all its levels of structural organization has been, and still is, the pursuit of many a scientific endeavor.
From since its birth in the 17th Century, it was not until the 20th Century that for me, modern Science generated its deepest and most revolutionary insights.
Buoyed by the introduction of novel research methods and augmented by technological progress, the 20th Century saw medicinal research find cures to several previously incurable diseases, but most conspicuously, the beginning of organ transplants so to speak in regard to breakthroughs in biological research.
But perhaps even more conspicuously was the fact that with the discovery of DNA, coupled with the development of genetics, scientists for the first time peeped into the fundamental processes of life and started to intervene in the gene pool of certain organisms. All of these laid the groundwork for the ambitious contemporary investigations of the human body,
Fast forward to the year 2017/2018, and scientific research has since achieved tremendous breakthroughs, cutting from human cell regeneration for growing organs to eliminating genetic diseases through novel gene-editing techniques.
That today we are able to alter a 20th Century discovered DNA, is a giant step closer to finally treating gene linked diseases.
DNA discovered in 20th Century (License: Public Domain):
Creative Commons Way back in the 20th Century between 1951 and 1953, in a milestone achievement that birthed modern molecular biology, and overall, yielded ground breaking insights into the genetic code and protein synthesis.
That said, and considering the progress of recent years of regenerative medicine studies, it is not too far-fetched to suggest that more than ever before, we are closest to mastering the capacity for repairing nerve damage, and to indeed growing entire body limbs and organs.
Even more, with the progress in gene editing technique, following one of the year 2017’s biggest scientific breakthroughs, gene related diseases could equally be history in due time.
The Breakthrough:
Last Year (2017) US researchers for the first time successfully used CRISPR in the human body to delete from a human embryo, a gene linked to heart conditions.
Throughout all these leaps and bounds of modern science since its birth in the 17th Century, it has to be acknowledged that Scientific investigations, having moved from the laboratory into animal studies, then from animal to human subjects, so to bring us on the brink of human cloning, have arrived to the point where, currently moving through different phases within humans, the human body is now both the object and the subject of its own study!
This is why and how we have arrived to the present level of human cell research. It is a perpetuation of the poignant insights into the basic mechanisms of human development and differentiation arrived at largely by investigating the cell; how it differentiates into complex tissues and organs of the human body.
Stem Cells
But it is not just any type of cells that i am talking about. It is stem cells! What are stem cells? To answer this question, let me illustrate with an example: Inside the womb, during that time when the human embryo is really still minute, a tube shoots out from the rapidly evolving realm of its primal lungs. That tube will grow and form two ridges along its length from inside.
TracheaAnatomy (License: Public Domain):
Creative Commons 
Eventually, these ridges fuse, resulting into two tubes, one in front, namely the windpipe (trachea), through which the child will breathe, and one behind, namely, the gullet (esophagus), through which the child will swallow food.
The mature windpipe begins from below the voice box, and runs down three or four inches, before finally branching to the lungs to mind the life-long respiration of that child.
That is how it started and became of all of us. But did you know that the fetal windpipe can in deed fail to form? It is an anomaly referred to as tracheal agenesis. The 2013 and 2016 stories of US born Thomas Richards, and Korean born Hannah Warren, are classic examples of babies born without a windpipe.
How do you resolve such anomalies and the like? Well, scientists have found a way, or at least a possible way: It is what you too would have imagined, except otherwise thought impossible. And that is to artificially grow body organs, in this case, a wind pipe on petri dishes in the lab, from scratch using a few specialized cells from the subject, so to replicate under lab control, the natural development process of humans and create a trachea for the subject, despite his/her body never having made one for them naturally.
This way an organ is created and grown using the subject's own cells. The cells used are called stem cells, special type of cells that self-renew (i.e., makes copies of themselves) and at the same time differentiate (i.e., develop into more specialized cells, a process overall essential for the development, the growth, reproduction and the longevity of all multi-cellular organisms.)
Types of stem cells
From this cell differentiation, more than just the wind pipe, but the entire human body with its complex systems and organs is naturally formed. Understanding how that comes about –which is simply put, how the multi-cellular you, comes about - is an important foundation, before we can talk about the types of stem cells.
For starters, Life begins as a single cell that gets fertilized. That much is now obvious, whoever has ever entered a biology class knows it is among the first things you learn under reproduction. This fertilized egg undergoes several divisions to finally bring about the multi-cellular human being that you are, with all those tissues and organs and systems.
This brings us to the fundamental question of human development: How does a single cell lead to trillions of different cells that make up the human body? The answer to this complex question – no easy one by the way – starts from what happens to the human egg after it gets fertilized by sperm.
It will divide and eventually grow to form the blastocyst, one of the earliest stages of human life that, formed 3 to 5 days after an egg cell is fertilized by sperm, is composed of the trophoblast, an outer layer of cells and - the inner cell mass, a mass of internal cells. This (blastocyst) can only survive for a while before it must be implanted in the womb to become an embryo and finally a baby to be born.
That said, we can now briefly discuss the types of human stem cells. Broadly put, there are 2 types, namely, adult stem cells and embryonic (pluripotent) stem cells
Adult stem cells: Otherwise known as tissue stem cells, these originate from different parts of the adult body. The thing about them is that they are specific to a particular tissue/organ in the human body. Liver stem cells for example, can only regenerate liver tissue; muscle stem cells can only regenerate muscle fibres.
Adult stem cells are therefore limited to only just becoming more of their specialized tissue/organ. Simply put, liver stem cells can’t make new muscle fibres, neither can muscle stem cells make new liver tissues.
Blood-forming (hematopoietic) stem cells found in bone marrow can only give rise to red blood cells, to white cells and to platelets, but they cannot regenerate lung, liver or brain cells neither can stem cells in other tissues and organs generate platelets, red, or white blood cells
Induced Pluripotent stem cells (IPS): These are cells that are engineered in the laboratory by converting tissue-specific cells such as skin cells into cells that come to behave like embryonic stem cells. They are especially used by scientists in studies to understand normal human body development, disease onset and progression, including for testing new drugs and/or therapies
Embryonic/pluripotent Stem Cells: Our bodies are made up of thousands of cell types. All these come from one single ‘master builder’ cell known as the pluripotent stem cell. Think of them as ‘blank slates’ capable of building - with the exception of the placenta and umbilical cord - any other type of cell in the human body –brain cells, skins cells, muscle cells, etc.
As opposed to adult/somatic/tissue stem cells, embryonic/pluripotent stem cells, obtained from the inner cell mass of the blastocyst, a mainly hollow ball of cells that is about the size of the dot above this “i,” are not limited to becoming specific tissues or organs.
Human embryonic stem cell (hES) research as opposed to the rest, is currently one of the most ambitious scientific pursuits in all of Science history. In it has been vested the hope for alleviating the bulk of human suffering brought about by the ravages of diseases and injury.
As it is, human embryonic stem cell research is premised on identifying mechanisms that govern cell differentiation. The idea is to be able to turn Human embryonic Stem Cells into specific cell types capable of being used for treating incapacitating and life-threatening injuries and diseases, especially those caused by loss or low function of only one, or a limited number of cell types, such as stroke, Parkinson’s disease, diabetes, spinal cord lesions among others.
Potential applications of Human embryonic Stem (hES) cells
Stem cell uses: (License: Public Domain):
Creative Commons 
In theory, overall, Human embryonic stem cells can be used for many different purposes (Keller and Snodgrass, 1999).
Examples in regard to fundamental research on early development of humans, include among others, cause of early pregnancy, failure of older women to become pregnant (where genetic defects in the Oocyte after fertilization, appear important.
A second category is toxicology, specifically, research on the possible toxic effects of new drugs in regard to early embryonic cells which, compared to adult cells, are more sensitive (drug screening)
The third and arguably most important potential use of human embryonic stem cells is clinically in transplantation medicine, where they could potentially be used to develop cell replacement therapies for diseases, some of which already named.
Overall, the major goal of Human Embryonic Stem cell research is to identify mechanisms that fundamentally govern cell differentiation with the aim of turning human embryonic stem cells into into specific cell types capable of being used for treating debilitating as well as life-threatening injuries and diseases Andrew Siegel, (2013).
At any rate, a moral dilemma is constructed, the kind that has antagonistic sides battling out in governmental offices, in legislative parliaments, in beer pubs as well as on the street corridors.
On which side do you belong?eurostemcell.org
The choice is between two moral principles, one: the duty to prevent and or alleviate human suffering from disease and injury, in which case human embryonic stem cell research should be promoted, and two:
The duty to respect and value human life, which would mean no such thing as human embryonic stem cell research, seen as doing the opposite
Human embryonic stem cell research without question has a tremendous therapeutic promise, and many a scientist is pursuing it. That notwithstanding, it is a subject of some of the hottest quarrels to-date cutting across ethicist, intellectual, academic, governmental and social life.
The quarrel has to do with the fact that human embryonic stem cell (hES) cells are derived from human pre-implantation embryos which get destroyed in the process.
According to Thomson et al. (1988), hES cells are derived in vitro around the 5th day of the embryo's development. Typically, this human embryo consists of 200–250 cells, the majority of which comprise the trophoblast, the blastocyst’s outermost layer. It is from the inner cell mass of the blastocysts (consisting of 30-34 cells) that human embryonic stem cells are derived.
The problem is, to derive these human embryo stem cells, the trophoblast (outermost layer) has to be removed, effectively eliminating the embryos potential for further development. This constructs a moral dilemma at the heart of the human embryonic stem cell debate:
From one side is hurled the charge: You are deliberately destroying nascent human life! And from the other side, the retort: the potential therapeutic benefits of human embryonic stem cell research more than justify it!
Indeed, considered from a strictly consequentialist perspective, the case for potential health benefits, proponents of hES cell research maintain, far outweighs the loss of embryos that is involved and whatever grief of loss conferred on those who want to protect them
On which side do you belong? In its basic form, the fundamental argument in support of the claim that destroying human embryos is unethical, observes that it is morally not permitted to deliberately kill innocent human life, and embryos are innocent human beings. To deliberately kill them, is therefore impermissible.
This raises an obvious question: Are embryos human beings? But most importantly, when does a human being begin to exist?
An Ethical Exploration
For a start, it is a biological fact that the embryos have a potential to become human beings. Provided they are implanted into a woman’s uterus at the correct hormonal phase, an embryo, all factors considered, implants, develops into a fetus and consequently grows into a live born child.
To detractors of embryonic stem cell research however, it is more than just potential but being. The pre-implanted embryo, they maintain, is a person and not a thing, and must therefore be accorded the same moral status as an adult or live-born child.
From a religious perspective, they maintain that “human life begins at conception” when, according to them, the soul enters the body. An embryo therefore has interests and rights requisite to be respected and protected. Taking out a blastocyst and removing the inner cell mass so to derive an embryonic stem cell line since it leads to its destruction, is equivalent to murder.
Others who take a less religious view maintain that, personhood starts at conception, from the time the one-cell zygote emerges, immediately after fertilization. At this stage, according to George & Gomez-Lobo (2002), a human embryo is a ‘whole living member (s) of the species homo sapiens…It has at this point, they argue, the epigenetic primordia necessary for self-directed growth into adulthood.
That makes the embryo inviolable. Overall, membership into Homo sapiens species confers on the embryo that right not to be sacrificed, even if for purposes of achieving good ends, such as to save human life. The assumption is that human beings all have the same moral status at all their life stages (particularly in regard to the right not to be killed.)
The radical
The view that personhood starts at conception, from the time the one-cell zygote emerges, immediately after fertilization such as promulgated by George & Gomez-Lobo (2002), is however rejected by some who, basing on the fact that monozygotic twinning remains possible until around 14–15 days of an embryo's development (Smith & Brogaard 2003), contend that any such individual who is an identical twin, is accordingly not numerically identical to the one-cell zygote. The reasoning is that both twins bear a similar relationship to the zygote, and yet numerical identity is requisite to satisfying transitivity.
Numerical identity satisfying transitivity means that if for example a Zygote X divides into two genetically identical cell groups so to result into identical twins Y and Z, Y and Z cannot be the same individual as X since they are not numerically identical with each other. Thus not all persons can affirm that they began life as the one-cell zygote
In a similar vein, some reject the notion that the early human embryo is a human being. One view asserts that the early embryo or blastocyst is but a clump of homogenous cells existing in the same membrane but do not necessarily form a human organism; reason being that these cells do not function in a coordinated way such as is requisite to regulating and preserving a single life (Smith & Brogaard 2003).
These cells, although they are each alive, only come to be part of the human organism upon undergoing substantial cell differentiation, and then coordination which only occurs around the 16th day after fertilization. Taking this into account disqualifies the ‘human being’ murder charge detractors levy on disaggregating the cells of the 5 day embryo to derive human embryonic stem cells.
As plausible as this account is, it is disputable on empirical grounds. The fact that the early embryo’s development requires some cells to become part of the inner cell mass while others become part of the trophoblast (necessary for implantation and nourishment of the embryo, and extra‐embryonic endoderm) means that there is indeed some inter-cellular coordination in the zygote. Otherwise, if there was no such coordination between the cells, there would be, according to Damschen, Gomez-Lobo and Schonecker (2006), nothing to prevent all the cells from differentiating in the same direction.
Even then, a question remains: is this degree of cellular interaction sufficient to render the early embryo (blastocyst) a human being? How much intercellular coordination is required for a group of cells to constitute a human organism? According to Macmahan (2007a), this is an open metaphysical question, the kind unresolvable by scientific facts.
Furthermore, and alluding to the assertion that the human embryo belongs to homo sapiens species, some people despite admitting that the human embryo is a human being, argue that it still doesn't have that moral status that ascribes it a right to life. This raises another very important question: is species membership the one property that determines the moral status of a being?
Others meanwhile assert the ascription to all humans, the right to life, with the view that higher order mental capacities indeed ground this right by distinguishing between two particular ‘mental capacity senses’, namely, “immediately exercisable” and “basic natural” capacities (George and Gomez-Lobo 2002, 260). On account of these view, the actualization of the ‘natural capacities’ for higher mental function that give rise to an individual’s immediately exercisable capacity for higher mental functions, are the ones that exist at the embryonic stage of life. Human embryos have that ‘rational nature’; except it is not fully realized until any given individual is able to finally exercise their reasoning capacity.
The difference between these capacities, namely the ‘immediately exercisable’ and ‘basic natural’ - according to adherents of this view - is the difference between degrees of development along the continuum. That said, between the mental capacities of an embryo, a fetus, an infant, a child, and an adult (including among infants, and children and adults) is merely a quantitative difference, the kind, the argument concludes, which cannot justify according some of these individuals moral respect and yet denying the same to others (embryo in this case).
However, because the human embryo can’t reason at all, to claim that it (embryo), has a rational natures strikes some as equivalent to asserting that it (embryo) has the potential to finally become an individual capable of engaging in reasoning (Sagan & Singer, 2007). But of course an entity by simply possessing this potential doesn’t logically ascribe it the same status as beings that have already realized all, or even some of their potential (Feinberg 1986). The likelihood is indeed, further complicated by the fact that the advent of cloning technologies and its continuum of entities that can be identified as being potential persons, and only creates more problems for those who put great moral weight on the potential of the embryo.
Take for example a single somatic cell or a human embryonic stem cell; though not yet in practice, these can in principle develop into mature human beings under appropriate condition, that is, where their nucleus is for example transferred to an enucleated egg, electrically stimulated to make an embryo, which is then transferred to a woman’s uterus to reach term.
So if the basis for protecting embryos for example, is that they have the potential of consequently becoming beings that reason, then the same (high moral status) has to be said as true for even the trillions of cells that indeed share this potential, in which case Sagan & Singer (2007) contend, we would have to assist as many of them as we possibly can, to realize their potential. If, as is expected, this is a position very few would agree to, the argument of those who oppose human embryonic stem cell research grounded just in the human embryo’s potential, is further deflated.
The moderates
Throughout the strong opinions of either side of this human embryonic stem cell research quarrel, some have taken a somewhat moderate position, granting that whereas human embryos lack the properties that are essential to being ascribed the right to life, they nonetheless possess an intrinsic value that, they opine, calls for a measure of respect so to warrant at least some moral constraints on their use Andrew Siegel, (2013).
With this in account, some human embryonic stem cell research detractors hold that treating human embryos as mere tools for research does not accord them proper respect. Others who assume a less absolutist position find embryo use less valuable compared to mature human beings but contend that the benefits of research on human embryonic stem cells are way too speculative, they do not warrant destroying embryos, especially given that the same benefits could indeed be achieved using non-controversial sources of stem cells such as adult stem cells (Holm, 2003).
Even then, those who support using human embryos for human embryonic stem cell research would, likely agree with opponents of the research that there are maybe some circumstances where using human embryos would otherwise display lack of proper respect for human life, such as were they destroyed for using cosmetic Andrew Siegel, (2013).
However proponents of the research are adamant that human embryo’s value is not as such that great enough to constrain the pursuits of science research that may indeed yield revolutionary therapeutic benefits.
If anything, detractors of human embryonic stem cell research don’t seem consistent in regard to their ascription of high value to the embryos, demonstrated in the fact that they seem not to attach as much concern to the many embryos created for fertility treatments but the excess of which are frequently discarded. In the US for example, fertility clinics yearly create many blastula (early human embryos) and then destroy because they are made in surplus
Conclusion
The good news about the human embryonic stem cell research quarrel, is that either side of this quarrel, the strong opinions notwithstanding, is interested in helping and protecting human life. Understanding this is requisite for respecting each other's opinions. It is the lowest common multiple following from which the quarrel on Human Embryonic Stem cell research should continue until that such time when common ground is found.
References
- Damschen, G., Gomez-Lobo, A., and Schonecker, D., (2006), “Sixteen Days? A reply to B. Smith and B. Brogaard on the Beginning of Human Individuals,” Journal of Medicine and Philosophy 31: 165–175
- Feinberg, J., (1986), “Abortion,” in Matters of Life and Death, ed. T. Regan, New York: Random House.
- McMahan, J., (2007a), “Killing Embryos for Stem Cell Research,” Metaphilosophy, 38(2–3): 170–189.
- Sagan, A., and Singer, P., (2007), “The Moral Status of Stem Cells,” Metaphilosophy 38(2–3): 264–284
- Smith, B., and Brogaard, B., (2003), “Sixteen Days,” Journal of Medicine and Philosophy, 28: 45–78.
- George, R.P., and Gomez-Lobo, A., (2002), “Statement of Professor George (Joined by Dr. Gomez-Lobo),” in Human Cloning and Human Dignity: An Ethical Inquiry, report by the President's Council on Bioethics: 258–266
- Keller, G. and Snodgrass, H.R. (1999) Human embryonic stem cells: The future is now. Nat. Med., 5, 151–152.Google Scholar
- Reubinoff, B.E., Itsykson, P., Turetsky, T., Pera, M.F., Reinhartz, E., Itzik, A. and Ben‐Hur, T. (2001) Neural progenitors from human embryonic stem cells. Nature Biotechnol.,19, 1134 –1140
- https://plato.stanford.edu/entries/stem-cells/
- https://www.jsonline.com/story/news/local/wisconsin/2017/10/16/surgery-enabled-first-american-survive-birth-without-trachea-breathe-now-he-can-eat/755543001/
- https://abcnews.go.com/Health/toddler-born-windpipe-artificial-trachea/story?id=19073070
- https://futurism.com/a-new-gene-editing-breakthrough-could-forever-change-life-on-earth/
- https://futurism.com/breakthrough-drug-discovery-could-let-scientists-repair-nerve-damage/
- https://futurism.com/new-algorithm-may-someday-enable-scientists-to-regrow-limbs-and-replace-damaged-organs/
- https://futurism.com/a-new-gene-editing-breakthrough-could-forever-change-life-on-earth/
- https://futurism.com/?post_type=glossary&p=53167?post_type=glossary&p=53167
- Monitoring stem cell research, (2004). Washington, D.C.: The President’s Council on Bioethics
Спасибо за столь интересную научную информацию!
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Very well-written and complete article, it's a topic I find very interesting. Personally I'm fully supportive of stem cell research and use, I believe that the benefits far outweighs the drawbacks, and that the loss of few potential lives in exchange for millions of lives are worth it. Something that I think could be done, would be to only use legally aborted embryos, that might help with the ethical problems.
So far the embryos i use are those from fertility clinics, the excess that is.
Great, no ethical problems that way, at least in my opinion, only benefits.
True. Thanks for reading
Blessings, excellent articles of stem cells. Enriching knowledge and interesting to share with students. God will continue giving you more wisdom, intelligence and knowledge.
Thanks for reading @mamidalia