The human embryonic stem cell research raises various issues, including political, ethical, legal, social and scientific issues. The research is an increasingly controversial issue for ethicists, politicians, scientists, and the public at large (Weed, 2004). The issues permeate the entire spectrum of society and have generated interests and heated debates all across the society. The debates on human embryonic stem cell research are numerous and they take different forms and shapes.
In the United States, after President George W. Bush’s August 9, 2001 television speech on federal funding for human embryonic stem cell research, the debate on stem cell research intensified. In his speech, President Bush announced his decision to allow the federal government to provide funding for research on limited human embryonic stem cells (The White House, 2001). The President’s decision and speech received mixed reactions from proponents and opponents of human embryonic stem cell research hailing or denouncing the guidelines and the speech generated enormous debates (Novak, 2001). Commentators, scientists, ethicists, religious leaders, and policy makers weighed in on various sides of the debate regarding President Bush’s August 9th speech (Shannon, n.d.)
Furthermore, during the 2004 United States presidential election campaign, the issue of human embryonic stem cell research was a major issue in the campaign. The two major presidential candidates, President Bush and United States Senator John F. Kerry, made human embryonic stem cell research very prominent in their respective campaigns. President Bush emphasized that if re-elected he would continue the limited federal funding of human embryonic stem cell research as he proposed in the August 9th speech. While Senator Kerry proposed expanding federal funding for human embryonic stem cell research if he is elected the president of the United States (Hart, 2004).
The debate still rages on. The promises and the developing technology of stem cell research fuel the debate. Stem cell research promises to provide answers to medical questions pertaining to lethal and incurable diseases. The technological advances in this field have been amazing. These new techniques are fueling the debate by promising new ways of approaching medical practices. Stem cells could be used for various purposes in basic science as well as for clinical applications, primarily for creating new therapies by stem cell culture and the control of differentiation (Devolder, 2005). Many believe that stem cell research could yield therapeutic results that may enhance the human condition (Cohen, 2004). From this perspective, many believe that the goal of stem cell research is an honorable one.
However, despite its promises, stem cell research is burdened with controversies. The sources of the stem cells underscore the controversies (Annas, Caplan & Elias, 1999). Generally, research on stem cells derived from adult tissues is not controversial (Juengst & Fossel, 2000; Knoepffler, 2004). Unlike the adult stem cell research, research on embryonic stem cells, that is, human embryonic stem cell, human embryonic germ cells and stem cells from cloned embryos are controversial.
The ethical controversy regarding the research on each of the embryonic stem cells differs. The ethical controversy surrounding human embryonic stem cell research pertains to the unavoidable destruction of the early embryos via extraction of the stem cells. The ethical controversy surrounding human embryonic germ cell research pertains to the extraction of the stem cells from aborted fetal tissues. The ethical controversy regarding stem cells from cloned embryos deals with the issue of human cloning.
The ethical issues surrounding human embryonic stem cell research, human embryonic germ cell research and research on stem cells from cloned embryos are vast and extensive. Because of this and the fact that the human embryonic germ cells’ possible clinical usefulness has barely been exploited (Vatts, 2005), this chapter will focus on the debate regarding early embryonic cells, that is, human embryonic stem cells and stem cells from cloned embryos.
The debate on early embryonic stem cell research revolves around the unavoidable destruction of the embryos via the extraction of the stem cells and/or the creation of human embryos via cloning for research. Those who support embryonic stem cell research, relying on the principle of beneficence, argue that it is justifiable to modify or destroy certain human embryos in the pursuit of treatments for millions of people suffering from various diseases who will benefit from the potential medical therapies.
Proponents, relying on consequentialist/utilitarian considerations, also argue that human embryonic stem cell research is justified because the research will yield medical therapies for most in the society. In contrast, opponents of the research, relying on deontological theory, argue against the instrumentalization of the human embryos by using them as a means to find cures for others suffering from various diseases. Opponents, relying on natural law principles, also argue that the medical benefits that may accrue from the research do not outweigh the destruction of early embryos via extraction of the stem cells.
As to the debate on the use of cloned embryos for research, both proponents and opponents rely on similar arguments of the respective parties as noted above. In addition, proponents of the research use pragmatic arguments to support their position. For instance, they argue that stem cells from cloned embryos are advantageous in stem cell transplantation because the cells would be genetically and immunologically compatible with the transplant recipients. In contrast, opponents challenge the creation of human embryos through cloning and the subsequent destruction of cloned embryos via extraction of the stem cells.
The debate on human embryonic stem cell research focuses on the source of the stem cells, that is, the blastocysts (early embryos) (Hawes, 2005). The human embryonic stem cell research involves the use of stem cells isolated from the blastocysts. The extraction of stem cells from the blastocysts results in their destruction. As will be presented in detail below, proponents of human embryonic cell research argue that it is justifiable to modify or destroy certain discarded early embryos in the pursuit of cures to relieve humanity of dreaded and lethal diseases. In contrast, opponents of human embryonic stem cell research object to the use of these cells because of their beliefs that the early embryo is a human being and that there is no justification to engage in research that destroys human life.
Generally, proponents’ arguments in support of human embryonic stem cell research focus on the medical therapies. One aspect of the argument is that the medical therapies will benefit millions of people suffering from various diseases. This line of argument is based on some form of beneficence. Another aspect of the argument focuses on the goal or consequences of stem cell research, that is, the medical therapies, which proponents maintain is the best outcome for the majority of people. This line of argument is based on consequential/utilitarian consideration.
Proponents of human embryonic stem cell research usually focus on the potential benefits of the research. They argue that the research will yield therapies that will ease the suffering of millions inflicted with debilitating diseases such as Alzheimer’s, Parkinson’s, heart failure, liver failure, cancer, and diabetes.
They point out that for instance over 100 million Americans (cardiovascular diseases [58 million], autoimmune diseases [30 million], Diabetes [16 million], Osteoporosis [10 million], Cancers [8.2 million], Alzheimer’s disease [4.5 million], Parkinson’s disease [1.5 million], Severe Burns [0.3 million], Spinal-card injuries [0.25 million] and Annual Birth defects [0.15 million]) (Ulick, 2004) suffer from illnesses that might be alleviated by cell transplantation technologies that use human embryonic stem cells. For them, the research is justified because millions of people suffering from various diseases will benefit from the potential medical therapies (Perry, 2000).
Proponents frame the issue as one of beneficence. They claim that their argument in support of embryonic stem cell research is grounded under the principle of beneficence, a bioethical variant of Christian understanding of agape love (a selfless love of one’s neighbor that inspires struggle against suffering and death). For them, the question under beneficence is whether human embryonic stem cell research further or hinder the betterment and well being of humanity.
They note that the research is supported by beneficence because this form of scientific research promises enormous leaps in the quality of health care (Peters & Bennett, 2001). Proponents note that beneficial research should be carried out by weighing risks against benefits as it is beneficence to do good (Kian & Leng, 2005). They argue that human embryonic stem cell research could provide knowledge and therapies that would benefit millions of people (Devolder, 2005).
Nonetheless, the benefits considered here are not those of the early embryos that are destroyed via the extraction of the stem cells. Rather, proponents focus on the benefits to those individuals that might benefit from human embryonic stem cell research. It is worth pointing out that this usage of the principle of beneficence by proponents to justify their position exemplifies the ambiguity inherent in the role of the principle of beneficence in ethical decision-making.
As the Belmont Report notes the role of the principle of beneficence is not always so unambiguous. For instance, the principle when invoked in research involving children, which presents more than minimal risk without immediate prospect of direct benefit to the children involved, raises a serious ethical dilemma.
The research, while it benefits children by providing effective ways of treating childhood diseases and fostering healthy development, poses a difficult ethical problem as to the research subjects who are exposed to major risks without direct benefit to them. The Belmont Report recognized that some have used the principle of beneficence to support this type of research while others have used the principle to argue against such research (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1979; Edwards & McNamee, 2005).
Proponents of human embryonic stem cell research use the principle of beneficence to justify human embryonic stem cell research, even when the research does not benefit the early embryos. Some proponents point out that it is commonly held that no human being should be allowed to lie unaided in preventable pain and suffering. They note that in contemporary medicine, diseases must be attended to and treated because they bring pain and suffering to their victims, families and communities. For them, the moral imperative of compassion compels for research involving stem cells because the research is a pursuit of known and important moral goods.
As some proponents note: “[w]e believe that the obligation to relieve human suffering binds us all and justifies the instrumental use of early embryonic life.”( Faden & Gearhart, 2004) Proponents explain that the need for human embryonic stem cell research is extraordinary because we are on the doorstep of a new type of restorative therapy that goes beyond treating disease symptoms. They caution that we must weigh the obligations of the moral imperative to help suffering individuals against the inherent value of the early embryos (Fischbach & Fischbach, 2004). Thus, they argue that it is justifiable to modify or destroy some early embryos in order to provide cures and treatments for individuals suffering from lethal and dreaded diseases (McGee & Caplan, 1999).
Some proponents of human embryonic stem cell research focus on the goal or results of the research. For them, the results, that is, the medical therapies from human embryonic stem cell research, are primary. They trumpet the potential benefits of the medical therapies and maintain that the medical therapies resulting from human embryonic stem cell research justify the means used to produce them. In this sense, it appears that those who make the above argument rely on a form of a consequential theory, which emphasizes that the moral status of an action is determined solely by the results that those actions produce (McConnell, 1997).
Consequential theory is the view that normative properties depend only on consequences. Whatever that maximizes good consequences is preferred irrespective of the means used to accomplish the task. Under this theory, the inherent nature of an action is not morally relevant. What counts in the moral assessment of an action is the value of that action’s consequences.32 Because consequential theory places emphasis on the goal (telos) or end result, some consider consequential theory as a form of teleological theory (McConnell, 1997).
Proponents maintain that the extraction of the stem cells from some early embryos, which leads to their destruction, is not morally relevant. The human embryonic stem cell research is the morally required action because it results in medical therapies that benefit humanity. What counts in the moral assessment of human embryonic stem cell research is the value of the medical therapies that will ease the suffering of millions inflicted with debilitating diseases such as Alzheimer’s, Parkinson’s, heart failure, liver failure, cancer, and diabetes.
They believe the failure to act via embryonic stem cell research will only prolong the agony of those suffering from numerous diseases who could benefit from the research. Thus, proponents argue that it is justifiable to modify or destroy some early embryos in the pursuit of cures for dreaded and lethal diseases. For proponents, human embryonic stem cell research is justified because it results in medical therapies that benefit millions of people (Brown, 1999; Perry, 2000).
On the other hand, as will be discussed below, opponents of human embryonic stem cell research oppose the destruction of early embryos via the extraction of stem cells and they challenge the above arguments of the proponents of human embryonic stem cell research. The arguments against human embryonic stem cell research are primarily based on deontological and/or natural law theories. Opponents’ arguments from either of the above theories emphasize that the early embryo is an entity whose right to existence needs to be respected and preserved. Those arguing from the deontological perspective argue against the instrumentalization of the early embryos.
They emphasize that the early embryo should be treated as an end and not as a means. In other words, using the early embryos as a means to find cures for others suffering from dreaded and incurable diseases is prohibited. Those arguing from natural law emphasize the dignity and worth of the early embryo and its right to pursue human goods for its human flourishing.
Opponents of the human embryonic stem cell research generally object not to the goal of the research but to the means used to accomplish the goal. For some of the opponents, the moral status of an action is determined not by the goals or consequences that the action produces but also by means used to accomplish the goal. Opponents frame the issue from a deontological perspective in that they question both the means and goals of human embryonic stem cell research. For them, any research that entails the destruction of the early embryos, irrespective of the medical benefits, is unacceptable. Deontology emphasizes duty as the basis of moral value.
An act or rule is right so long as it satisfies the main principle of a moral duty. Deontology views acts as determined by fundamental principles that do not derive from consequences. It emphasizes that the moral status of an action is not determined solely by the value of the consequences that the act produces. For deontologists the inherent nature of an action, as well as the consequences it produces, can make a moral difference (McConnell, 1997). Deontology places limits on the relevance of consequential/utilitarian considerations (Mappes & DeGrazia, 2001). It emphasizes that some features of actions other than or in addition to consequences make actions right or wrong.
Opponents of human embryonic stem cell research point out that respect for persons has been of paramount importance in the conduct of human medical research since the Holocaust and Nuremberg Tribunals. For them, it is this axiom that supplies the moral foundation for modern codes of research ethics (Center for Biblical Bioethics, 1999). Opponents maintain that it is objectionable to destroy human embryos via the extraction of stem cells for research because the early embryos are valuable and worthy of moral respect. It is unacceptable to use the early embryos as a means to find cures for diseases for others.
Opponents acknowledge that much good may come from the stem cell research, however, they point out that the means used to reach that good end must also be moral. Opponents maintain that the end does not justify the means and that the medical therapies that may result in the cure of thousands of persons, do not justify the destruction of others, even though they are still in the embryonic state of development.” (McCloskey, n.d.)
The medical benefits, which might accrue for some patients from human embryonic stem cell research, do not outweigh the grave consequences for the early embryo, which is destroyed in order to procure stem cells for medical therapy (Meyer, 2000). The human embryo should not be a resource to be used for the general public good of the progress of medical science (Jones, 2005).
Opponents believe the human early embryo is intrinsically valuable, whose life needs to be respected and the human early embryo should never be used as a means toward attaining other goals (Usala, n.d.). For them, the action that produces the potential therapeutic benefits is not separable from the end result or goal of human embryonic stem cell research. Opponents note that the underlying action, which results in the death of the embryo, may not be justified by the potential medical therapies.
They contend that the consequential/utilitarian considerations are inadequate for the justification of human embryonic stem cell research because there is no justification to engage in research that instrumentalizes human life. Thus, opponents contend we must not use one human life in an attempt to benefit another because that will amount to treating human beings as a means rather than as an end (Bevilacqua, 2000).
The Catholic Church is among those who oppose human embryonic stem cell research. The Catholic Church via its Magisterium teaches that the result of human procreation, from the first moment of its existence, must be guaranteed that unconditional respect which is morally due to the human being in his or her totality and unity in body and spirit. The Catholic Church further teaches that the human being is to be respected and treated as a person from the moment of conception and therefore, from that same moment his or her rights as a person must be recognized, among which in the first place is the inviolable right of every human being to life (Pontifical Academy for Life, 2000).
The above statements are grounded in both the Imago Dei theological doctrine and the philosophical doctrine of natural law. Under the theological doctrine, the human person is seen as made in the image and likeness of God (Genesis 1:26-27), and as such endowed with a transcendental dignity, whose dignity needs to be respected. As made in the image and likeness of God, humans possess intrinsic worth and dignity. The theological designation of this dignity is the Imago Dei (Hehir, 1992).
Some opponents using the Imago Dei doctrine argue against human embryonic stem cell research. They argue that the early embryos as human beings bear the image of God and thus, should be treated with the proper dignity and respect owed them. Thus, opponents contend that the resulting death of these early embryos via extraction of the stem cells is a violation of the early embryo’s intrinsic dignity and worth. Therefore, they maintain that it is morally wrong to destroy the early embryos for the purpose of stem cell research because the destruction is a violation of the early embryo’s dignity (Endara, 2005).
Furthermore, some opponents who want to engage the public using non-theological arguments in support of their position resort to a teleological approach. This teleological or goal-directed approach finds itself committed, from natural law reasoning, to an understanding of morality that is not imposed from the outside, but arises from the intrinsic demands of human nature seeking its own fulfillment (Quinn, 2000).
Opponents of human embryonic stem cell research, relying on the teleological theory of natural law argue against the research because of the source of the immortalized cell lines. The cell lines are created from stem cells extracted from the early embryos. The extraction of the stem cells results in the death of the early embryos. Opponents believe that the early human embryo at this stage of its development is a human being. They argue that an early embryo is a human being because it contains a complete human genome and all that is needed to develop into an adult human being (Kavanaugh, 2005).
These opponents believe that the early human embryo is a human subject with a well defined identity, which from the moment of the union of gametes begins its own coordinated, continuous and gradual development, such that at no later stage can it be considered as a simple mass of cells (Walters, 2004). Thus, opponents contend that the act of the extraction of the stem cells from the early embryos, which results in their death, is prohibited because the act entails the killing of an innocent human being (Usala, n.d.).
In addition to the above arguments, opponents of embryonic stem cell research generally contend that utilitarian arguments cannot justify unethical act and transform it into an ethical act and beneficence does not justify malfeasance. They note that a utilitarian approach to human embryonic stem cell research may benefit some at the expense of the early embryos. However, the approach ultimately undermines its own commitment to improving humankind by demoralizing life to a negotiable variable and accordingly devalues it (Chu, 2003).
Annas, G.W. Caplan, A. & Elias, S. (1999). Stem cell politics, ethics and medical progress. Nature Medicine, 5(12), 1339-1341.
Bevilacqua, A. (2000). Ways needed to treat diseases that do not devalue fife. Origins, 30, 195-203.
Brown, P. (1999). Scientist React to Government indecision. Nature Medicine, 5, 855-856.
Center for Biblical Bioethics. (1999). A pro-life assessment of stem cell research. Biblical Bioethics Advisor, 3(1), 1-4.
Chu, G. (2003). Embryonic stem-cell research and the moral status of embryos. Internal Medicine Journal, 33, 530-531.
Cohen, C.B. (2004). Stem cell research in the U.S. after the President’s speech of August 2001, Kennedy Institute of Ethics Journal, 14(1), 97-114.
Contee, R.L. (2004). Against embryonic stem cell research. Web.
Devolder, K. (2005). Creating and sacrificing embryos for stem cells. Journal of Medical Ethics, 31, 366-370.
Devolder, K. (2005). Human embryonic stem cell research: why the discarded-created-distinction cannot be based on the potentiality argument, Bioethics 19(2), 167-186.
Doerflinger, R. (1999). The ethics of funding embryonic stem cell research: Catholic viewpoints. Kennedy Institute of Ethics Journal, 9, 137-150.
Edwards, S.D. & McNamee, M.J. (2005). Ethical concerns regarding guidelines for the conduct of clinical research on children, Journal of Medical Ethics, 31, 351-354.
Endara, M. (2002). The law written on their hearts: Natural law reasoning as common moral ground. Christian Research Journal, 25(2), 1-6.
Faden, R.R. & Gearhart, J.D. (2004). Facts on stem cells, The Washington Post, A15.
Fischbach, G.D. & Fischbach, R.L. (2004). Stem Cells: Science, Policy, and Ethics. Journal of Clinical Investigation, 114 , 1364-1370
Hart, D.M. (2005). Bush-Kerry: More of the change? key policies will affect science’s development and role, The Scientist. Web.
Hawes, S. (2005). Debate around current restrictions on the derivation of new human embryonic stem cell lines, International Society for Stem Cell Research. Web.
Hehir, J.B. (1992). Policy arguments in a public church: Catholic social ethics and bioethics. Journal of Medicine & Philosophy, 17, 347-364.
Jones, D.A. (2005). The appeal to the Christian tradition in the debate about embryonic stem cell research. Islam and Christian -Muslim Relations 16(3), 265-283.
Juengst, E. & Fossel, M. (2000). The ethics of embryonic stem cells – now and forever, cells without end. Journal of American Medical Association 284(24), 3180-3184.
Kavanaugh, J. (2005). Leftover embryos: This is not junk science. America, 192(21), 8.
Kian, C.T. & Leng, T.S. (2005). The Singapore approach to human stem cell research, therapeutic and reproductive cloning, Bioethics. 19(3), 290-303.
Knoepffler, N. (2004). Stem cell research: an ethical evaluation of policy options. Kennedy Institute of Ethics Journal, 14(1), 55-74.
Mappes, T.A. & DeGrazia, D. (2001). Biomedical Ethics (5th ed.). Boston: McGraw Hill.
McCloskey, P. (n.d.). Is stem-cell research moral? Web.
McConnell, T. (1997). Moral Issues in Health Care: an Introduction to Medical Ethics. Belmont, CA: Wadsworth Publishing Company.
McGee, G. & Caplan, A. (1999). The ethics and politics of small sacrifices in stem cell research. Kennedy Institute of Ethics Journal, 9(2), 151-158.
Meyer, John, R. (2000). Human embryonic stem cells and respect for life. Journal of Medical Ethics, 26, 166-170.
Novak, M. (2001). The principle’s the thing: on george bush and embryonic stem-cell research. National Review Online. Web.
Perry, D. (2000). Patients’ voices: the powerful sound in the stem cell debate, Science . 287, 1423.
Peters, T. & Bennett, G. (2001). Theological support of stem cell research. The Scientist, 15(17)
Pontifical Academy for Life. (2000). Declaration on the production and the scientific and therapeutic use of human embryonic stem cells. Web.
Quinn, K.P. (2000). Method in Catholic bioethics. Kennedy Institute of Ethics Journal, 10(4), 353-363.
Shannon, T.A. (n.d.) Stem-Cell Research: How Catholic Ethics Guide Us. Catholic Update. Web.
The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. Web.
The White House (2001). Remarks by the President on stem cell research. Web.
Tsai, D. (2005). Human embryonic stem cell research debates: a Confucian argument. Journal of Medical Ethics, 31, 635-640.
Ulick, J. (2004). How to make a stem cell. Newsweek, 46-47.
Usala, A-L. (n.d.). The case against funding human embryonic stem cell research. Web.
Vatts, et. al. (2005). Stem Cells. Lancet, 366 (9485), 592-602.
Walters, L. (2004). Human embryonic stem cell research: an intercultural perspective. Kennedy Institute of Ethics Journal, 14(1), 3-38.
Weed, M. (2004). Ethics, regulation, and biomedical research. Kennedy Institute of Ethics Journal, 14 (4), 361-368.