Stem cell basics
Life starts from a single cell that is programmed to develop into a super-specialized life form. With stem cell research, scientists aim to understand and manipulate cell specialization. They are trying to find ways to replace diseased tissue/cell in the human body with stem cells. Medical breakthroughs can result from stem cell research.
There are two types of stem cells: embryonic stem (ES) cells and adult stem cells. ES cells are extracted from 3-4 day old embryos. These cells have the potential ability to develop into any specialized cell/tissue. Adult stem cells are extracted from adult tissue. These cells have limited differentiation potential. The debates and controversies (political, moral, religious or financial) are largely over embryonic stem cells.
Scientists use frozen or “leftover” embryos at fertility clinics to extract embryonic stem cell lines for research. In the process, the embryos lose their potential for life. This leads to a very profound moral dilemma - do ES cells represent human life? Just because science can do something, should it? How far should such science and technology be allowed to go? Who has the right to decide?
Opponents of ES cell research
· Certain religious groups and communities of people that claim to be pro-life, oppose stem cell research on moral grounds. The argument is that taking away life to create new life is unethical. “Snow-flake babies (abandoned embryos brought to full term by adopting couples) get a lot of media coverage and illustrate what is at stake when embryos are destroyed.
· Opponents believe that stem cell technology can eventually lead to reproductive cloning. This would fundamentally devalue human life.
· Anti-abortionists consider the destruction of human embryos as equivalent to homicide. They believe that the embryo in the petri dish is biologically capable of growing into a fully formed human being and should be assigned the right to live.
· Pro-life people argue that medical experiments, in the name of science, were carried out on the prisoners in Nazi death camps during World War II. These scientific experiments were termed as atrocities. Science should not be allowed to take away life.
Proponents of ES cell research
· This research could provide cures and treatments to patients suffering from chronic and debilitating diseases (multiple sclerosis, Parkinson’s, Alzheimer’s, cancer, diabetes, genetic and immune system disorders) giving them a chance to live a dignified life.
· The number of embryos destroyed during experiments cannot match in numbers the millions of abortions that take place worldwide.
· The embryos used are leftover embryos that would eventually be disposed or destroyed anyway. Some of the embryos are donated willingly by people for research purposes.
Politics and Policies
· ES cell research because of its profound moral quandary often becomes a matter of political debate. Countries have policies ranging from permissive to restrictive on ES cell research. Political leaders formulate the policies.
· The Bush Administration opposed "destruction of the potential for life for the benefit of life"; he limited federal funding for ES cell research to studies conducted using 21 established embryonic stem cell lines (world-wide) as of August 2001; two of these 21 lines are from Indian research institutes - Tata Institute of Fundamental Research (Bangalore) and Reliance Life Sciences (Mumbai)
· The Obama Administration is opposed to basing research on "ideology versus scientific basis"; a new directive was issued on March 10, 2009 to expand federal funding to more stem cell lines, directive does not address creation of new lines though, only expansion of the 21 eligible existing lines. Obama’s decision was cheered on by scientists. The Vatican disapproved completely. The issue is likely to be raised in the G8 summit in July when the Pope meets with Obama in Italy.
· Political debates over stem cell research heat up when backed by celebrities like Michael J. Fox, Nancy Reagan and Christopher Reeves.
· Germany has a very restrictive policy on ES cell research. Creation of ES cells is illegal. France prohibits reproductive cloning or creation of embryos for research. It does legalize ES cell research on imported embryos. In 2006 France legalized the creation of ES cells but only from surplus embryos in IV clinics. Singapore is dubbed as Asia’s stem cell centre and Saudi Arabia is touting biotechnology as their new oil. Think about how import/export of embryos would change the political equations between countries.
Research is still in very nascent stages – the scientific community welcomes more federally funded lines and therefore political support matters.
India and ES cell research
· Indian Council on Medical Research (ICMR) and Department of Biotechnology (DBT) formed guidelines for stem cell research in India in 2007- guidelines addresses ethical concerns and restrict practices of abortion for financial gain.
· While the guidelines have recently been formulated, India does not have a ban on the use of ES cells for research. Ramadoss, the union health minister admits that mere guidelines are not enough without proper legislation.
· Research in India - AIIMS is a global pioneer in using stem cell therapy for paediatric surgery
· PM Manmohan Singh recently gave a thumbs-up to the establishment of Stem Cell Science and Regenerative Medicine (SCSRM) in Bangalore in 2008
· Center for Stem Research in Vellore recently announced a breakthrough technology that makes adult stem cells from mice that mimic embryonic stem cell function. This could hold a lot of potential as no embryonic destruction is involved.
· Stem cell research has opened up a booming industry in India. There is a race against time for finding the cures and treatments that could forever remove the words “incurable” and “untreatable” from the medical dictionary.
· Stem cell research market in India is estimated to be about $540 million by 2010. Global businesses are willing to collaborate and invest in India as a research hub. India has a huge population with a varied genetic pool. There is a huge disease burden and need for organs, cheaper diagnostics and treatment. Clinical trials could easily be conducted in India where strong legislations are absent. Besides this India has a talented workforce. Setting up a research centre in India would be cost effective.
· U.S. estimates a $10 billion market in stem cell research over the next 10 years.
Tinkering with genes and cells will undoubtedly create chills and raise the question of ethics:
· Dangers of private companies and doctors advertising miracle cures available from stem cells
· Unethical and short-cut methods to gain quick results
· Unregulated practices to grow and harvest ES cells
· Donors of embryos could be from poor/uneducated backgrounds who may not know the risks involved
· Careful records need to be maintained and any breakthrough with a donor embryo must involve profit sharing with the donor – chances of misuse are high
· Unregulated growth of IVF clinics can have its dangers – potential racket for stem cell banking
· Imagine a situation where “embryo” becomes an import/export commodity
· Even if the lab experiments are successful, they cannot be used to treat patients immediately India does not maintain a follow-up record of patients. Stem cell therapy, if offered, would require close monitoring.
Some potential applications of stem cell research
· Can provide insights into the developmental processes of an embryo
· Organ development from a bank of embryonic stem cells for donation - no need of organ donors
· Regeneration of brain tissue using embryonic stem cells for treatment of Parkinson’s, Alzheimer's etc.
· Replacement of bone marrow tissue using stem cells from placenta- cells extracted during birth and stored
Research still has far to go. Clinical applications will still take years. ES cell research is caught between morality, politics, business and ethics. The point being missed is that it is the extraction of ES cells and not the research that is the matter of debate. If scientists can come up with alternative ways where embryos are not destroyed, science can make ethical, groundbreaking progress.
Like James Thomson of the University of Wisconsin and the Father of Stem-Cell Research has said, “If human embryonic stem cell research does not make you at least a little bit uncomfortable, you have not thought about it enough.”
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