Stem Cell Update

by hilzoy

Just a quick post on this story:

"In an innovative move, a biotech company has found a new way of making stem cells without destroying embryos, touting it as a way to defuse one of the country's fiercest political and ethical debates.

Some opponents of the research said the method still doesn't satisfy their objections and many stem cell scientists and their supporters called it inefficient and politically wrong-headed. (...)

he new method works by taking an embryo at a very early stage of development and removing a single cell, which can be coaxed into spawning an embryonic stem cell line. With only one cell removed, the rest of the embryo retains its full potential for development."

To my mind, the issues involved with this new method aren't made clear enough in the news accounts I've read, so I wanted to try to explain them here.

Any time a new development like this comes along, it's important to recognize that adopting it in place of existing methods would set embryonic stem cell research back for a year or two. That's because people are now pretty good at growing embryonic stem cell lines by the existing methods; they have figured out a lot of techniques that they would have to develop over again for this new method. To someone who believes that embryos are full persons from the moment of conception, this cost would, of course, be worth it. All I mean this point to show is: that there is a real cost to research involved in adopting a new method of deriving stem cells.

That cost makes it important to think hard about whether this technique, or any other substitute that is suggested, really does represent a moral advance over the existing method, which involves the destruction of an embryo. If it does, then it might be worth paying that price. If it doesn't, then it is obviously not worth it.

The main moral problem with this method is this: it might or might not be possible for the cell they remove from the embryo, and which they then grow into embryonic stem cells, to be implanted and develop into a normal infant. If this is not possible, no problem. But if it is possible, then presumably we should treat this cell as an embryo, which is being destroyed to create a stem cell line -- which is, of course, the very same problem the existing method has. This wouldn't be a more moral method of making stem cells at all; it would be exactly like making an embryo divide into identical twins, killing one of them, and saying: look! one of the twins is still alive! so everything is OK!

No one who is opposed to killing a blastocyst should think that this would be in any way an improvement over killing the original blastocyst.

The crucial question, then, is: can this cell develop into an infant? As I said, we don't know. In some species a cell like this can develop into an infant; in others, it can't. We don't know which group humans are in. Moreover, we aren't likely to find out, since to do so we'd have to do some plainly unethical experiments. (Consider: we also don't know whether an infant that did develop in this way would be normal. How would we find out? Trial and error? That would be plainly wrong, and no ethics review board would allow it.)

There are other questions we would need to answer in order to say that this method is morally OK. (For instance, does taking one cell at this stage harm the embryo from which it was taken? We take such cells now for various sorts of genetic tests, but as far as I know no one has studied the resulting kids to see whether or not they are more likely to have, for instance, birth defects.) But if I were opposed to abortion, this one would be a deal-breaker for me.

It would be one thing to delay research if a means of creating stem cells that did not involve destroying embryos were found. In that case, there would be something to debate. But to delay research in order to substitute one technique for another, when the new technique does not solve the problems of the old one, is just silly.

Comments

[Katherine's Dad]

What surprises me is that the opponents of stem cell research have never, to my knowledge, advocated closing down fertility clinics, one possible source of embryonic stem cells.

[liberal japonicus]

I have to observe two things. The first is that the position that we shouldn't do something new because it might cause a setback to current progress is precisely the same argument that was made concerning the current health set up in the US and its potential impact, which I (for one) took exception to when it was made there.

However, as Katherine's Dad notes, since there is no anti-fertility clinic movement, this suggests that the objections to this problem are not real objections, so taking up something new to deal with objections that are not made in good faith seems like a real waste of time.

[Tom Maguire]

For instance, does taking one cell at this stage harm the embryo from which it was taken? We take such cells now for various sorts of genetic tests, but as far as I know no one has studied the resulting kids to see whether or not they are more likely to have, for instance, birth defects.

Fpr completeness, there is the risk that the test process itself (extraction of one blastomere) actually "kills" the remaining embryo. Focusing on the fact that children from surviving embryos seem to be normal slides past the "death in testing" issue.

One clinic advertises that 99.1 percent of embryos survive the extraction process; in the context of testing for genetic abnormalities, and given a fertility rate of about 25% with implanted embryos, I assume people are fine with that.

However, if the extraction is done simply to gain a blastomere, then there is a 1% chance of killing the embryo for no obvious benefit to the embryo.

since there is no anti-fertility clinic movement...

Not sure what this means - the Catholic Church, for example, is opposed to IVF, and presumably, fertility clinics.

Are you saying that only if they bomb one will you take their view seriously?

We are talking about a ban on *Federal funding* of certain types of stem cell research, not a ban on the research itself. has the other side made the mistake of being so tolerant that they should be ignored?

[Jesurgislac]

Tom: Not sure what this means - the Catholic Church, for example, is opposed to IVF, and presumably, fertility clinics.

But Catholic priests don't urge their congregations not to vote except for politicians who are campaigning to ban IVF: and I've never heard of a "pro-life" demostration or picketing (Catholic or Protestant) outside a fertility clinic, though protesters there could just as rationally argue that they want to stop doctors from "killing babies". But then, it's fairly clear that the issue for "pro-lifers" is not saving fetal lives: it's controlling/punishing women. Plan B, freely available (and free to anyone on a low income) would prevent abortions: if "pro-lifers" were all about preventing abortions, they'd have been Plan B's biggest backers. That, as a political movement, "pro-lifers" were virulently in opposition to Plan B being freely available (and have succeeded in ensuring that teenage girls will still have to have abortions in most states, rather than take emergency contraception) is further proof that the "pro-life" movement is all about punishing women for having sex, not about preventing women from having to have abortions.

[john miller]

Hilzoy, I think you are overlooking a couple of things.

First is that packaging is all important. I think there are many people who have difficulty from a moral perspective with the current system, but believe in the promise of stem cell research. They want to believe there is a way to do such without compromising their moral systems. Packaged correctly this fulfills that need.

As such, it potentially opens the way for more funding of research. And a wait of a year may be worth it in order to get the funding. And I think anybody who goes out of there way to point out to those that embrace this system as morally superior that it may not be are shooting themselves in the foot.

And as Tom points out above, there are many people who are either against IVF or against the destruction of the surplus embryos.

[Jesurgislac]

Apologies - I have been having arguments/discussions elsewhere about Plan B/"pro-lifer" resistence to it, but I shouldn't have brought it up here as a distraction from the discussion about stem cell research. Please consider it unsaid. :-(

[rilkefan]

I imagine that with sufficient sophistication in DNA manipulation, one might be able to convince an adult cell to revert to embryonic form. Does the "if it is possible" argument disallow drawing blood? wearing clothes? surgery?

[hilzoy]

rilkefan: I don't think so. The thing is, it might be possible for us to do it now, knowing what we know. This very cell, if implanted, might grow into an infant. We don't know, and can't know without doing experiments that are plainly unethical.

Tom Maguire: In general, the fact that some people have serious moral objections to something does not show that we shouldn't federally fund it. Thus, the existence of Quakers (who are US citizens) does not show that it's wrong for the US government to fund wars. It does, I think, show that we shouldn't do whatever it is that people have serious moral objections to frivolously, for no good reason, but stem cell research is not being done for no good reason.

[mr.ed]

Good idea if it prevents development of a right wing.

[Anarch]

Good idea if it prevents development of a right wing.

You'd have a dang silly-looking chicken then.

[Anders Widebrant]

John Miller touches on a theme where this new method fits well. Federally funded stem cell research already rests on moral self-deceit: that it is right to use the existing stem cell lines. If destroying an embryo is equal to killing a human being, it cannot be right to continue to use the produce from that death. We do not allow experimentation on dead bodies unless the owner has given his consent.

It's a convenient argument, that the current policy causes no new "deaths". But it leads to absurdities like this, where only the basic viability of the embryo matters. That we're experimenting on a supposedly human being without its consent isn't judged to be relevant as long as the potential for life is preserved.

[JakeB]

Anarch--
not as much, if it prevents the formation of a left wing as well. You'd have "Centrist Chicken"!

Anders--
Without meaning the slightest offense, let me suggest that your use of 'produce' in your comment is infelicitous. To me, at least, it looks in this case like the word we use for fruits and vegetables, and hence sounds a little macabre.

Your comment and John's sound to me like there's an implication in them--on the assumption that use of embryonic stem cells may lead to significant medical advances (as most respectable and knowledgeable people seem to think), that research will be considered too important to halt when a certain number of positive results can be pointed to. People become accustomed to things; the more people who owe their health in one way or another to stem cells, the more they will support the research and possibly its expansion.

[heet]

This new technique is worthless in a practical sense. The following ignores the very good point that a totipotent cell is essentially a twin. Especially if you remove it from the cell mass in order to take advantage of its totipotency.

Also, I agree with those above that see a greater good here. Maybe a way to nudge the reluctant.

Here's the problem, as others have eluded to - you can't be sure reimplantation is 100% safe, either for the mother or (especially) the blastomere. And this goes especially for future risk for the embryo as a grown human. You'll never be able to satisfactorily prove it is without consequence in such a way as to prevent future liability. Nobody will touch this procedure when used on a blastomere destined for immediate reimplantation.

So, where can you use this procedure to get cells? Well, you could use the totipotent cells IVF joints use to test after fertilization. Except those tests generally destroy the cell. For example, to check for Down's you have to get at the DNA of the cell which kills it. So, if you could come up with a way to test without destruction, the remaining cell could be used. That is the only scenario where this technique is useful.

[hilzoy]

OT: No internet access at all for the next few days. Have fun.

I've just been to my aunt's 70th birthday party, the occasion for the trip. Seeing all the relatives was great, but one unexpected bit of wonderfulness was meeting the woman who, as a very young child, was one of the Jews spirited from Denmark to Sweden by night in 1943, who had stayed for a year with my grandparents. I had heard of her,since everyone remembered that such a child had existed, and stories about her, but no one seemed to know how to find her afterwards. However,about five years ago she came to (I think) the Swedish consulate, looking for my mom and my aunt, and they were able to reconnect. So now she came over for the party.

It was really moving, and made me think: who saves one life saves the world entire.

[Tom Maguire]

Tom Maguire: In general, the fact that some people have serious moral objections to something does not show that we shouldn't federally fund it. Thus, the existence of Quakers (who are US citizens) does not show that it's wrong for the US government to fund wars.

My problem with the specific "war" example is that I have a hard time imagining, in our Federal system, either California, New Jersey, or Merck deciding, legally and independently, to go to war. However, they are surely free to engage in stem cell research.

As an example, NEA funding for objectionable-to-some art might be better, except you would need to work pretty hard to convince me that the NEA represents a fundamental mission of a Federal government.

Another tack (which probably would convince me) is to whittle the moral oponenents down to a tiny (albeit disgruntled and embittered) minority - how many Quakers are we talking about, anyway? Or, on a different point, hom many Mormons are irked by our ban on bigamy?

Personally, as long as society has made a serious effort to respect the ethical issues, I am resigned to not everyone being happy with whatever answer we come up with.

[Fred in Vermont]

In the first place there are would-be parents and fertility doctors who perform these tests and so far they have lost only about one percent more implants than lost in ordinary fertility treatment, and seem to have produced no obvious congenital defects.

But of course they do this without the blessing of the Catholic Church (and others) who disapprove of all such methods and also of the use of selective abortion to accomplish the same end.

But looking at this from the point of view of a blob of 8 cells (which we all were once) of course there is no "advantage" to having one cell extracted and tested since not only is there a small risk in the procedure but there is a death sentence waiting if you fail the test and show some genetic problem.

But looking at it another way we might say that if the parents are only willing to implant cells that have been certified free from some suspected problem, then of course the test is a benefit to the cells since it represents their only chance of growing into a baby.

It seems to me that under these conditions if we could appoint a guardian ad litem for the blob they might argue that they had a right to consent to the risk on the grounds it was to the benefit of the his client as representing its only chance to stay out of the biohazard bin and the local clinic.

What the researchers have done is to use the same procedure on 8 cell masses (with no intention of implanting the seven remaining) and then rather than testing the extracted cell they have attempted to use it to start a line of cells. It has been done with mice in the past and now they say they have done it with human cells.

One pundit said today that since all the 7 cell remainders from these tests were disposed of at the end of the experiment, therefore these new lines were not produced without killing the source and so are just as objectionable as existing and new ordinary stem cell lines.

But what the researchers are saying is that if as part of existing testing the one cell was first cultured as a cell line and then one of those cells tested you could have a new cell line produced as a byproduct of the test. If the cells failed the test you would still have a new cell line -- perhaps suitable for special research on the defect that it had -- and the fact that the remaining 7 cells would then be doomed would be on the parents' Karma and not that of the researcher or the new (defective) cell line. They would be free of sin and properly used for federally funded research.

And of course if it passed the test and was successfully implanted then, as well as starting new cell line, you would have a child who would have something very unique and perhaps life-saving for him or her in the future -- a viable line of exactly matching stem cells. In another 40 years if this child got sick these cells might make it possible to treat medical conditions that would be otherwise untreatable because of rejection problems.

So one could argue that while there are some risks involved on balance the procedure it to the benefit of all the cells involved -- the seven who may get a chance to become a baby that would not otherwise be granted, and also perhaps there is some advantage to the remaining cell, since it becomes almost immortal, and who knows, someday one of its offspring might be turned into a twin of the born on unborn child that fathered it.

See how simple it is? I can't see why people think there is anything ethically complicated about this stuff.

[Nick]

But if I were opposed to abortion, this one would be a deal-breaker for me.

I think it's important to keep in mind that abortion, in the sense of ending a pregnancy, is not necessarily the same as destroying an embryo. A number of people who oppose the former have no particular problem with the latter, if the embryo is lab-created. Opposition to abortion and opposition to stem-cell research do not have a 1:1 correlation, as evidenced by the fact that embryonic stem cell research has a much larger majority of support than does the pro-choice movement.

To be clear, I think that opposition to either is unethical, but conflating the two is exactly what's allowing some to justify the research ban. Embryonic stem-call research is not abortion and, as a rule, has nothing in particular to do with it, given the massive oversupply of unused embryos from fertility clinics.