Sunday, October 25, 2009

BIOETHICS OF STEM CELL RESEARCH AND CLONING

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BIOETHICS OF STEM CELL RESEARCH AND CLONING



ANKUR BARUA, ROMILA SYANGDEN


Sikkim-Manipal University of Health, Medical and Technological Sciences
Gangtok, Sikkim, India 2009

Background: Dr. Ankur Barua had graduated with distinction from the University of Hong Kong (MBuddStud, 2009). He had also completed two other Master Degrees, one from Sikkim Manipal University (MBAIT, 2007) while the other from Manipal University (MBBS-2000, MD in Community Medicine - 2003) and presently working in professional field.
Ms. Romila Syangden is a Hospital Administration professional who has also a keen passion for conducting research on public health, religion and science.


First Publication on 26th October 2009
Sikkim Manipal University of Health, Medical and Technological Sciences, Sikkim, India


Copyright © Ankur Barua and Romila Syangden


Communication Address of Corresponding Author:
Dr. ANKUR BARUA
Block – EE, No.-80, Flat No.-2A,
Salt Lake City, Sector-2,
Kolkata - 700091, West Bengal, INDIA.
Email: ankurbarua26@yahoo.com
Mobile: +91-9434485543 (India), +852-96195078 (Hong Kong)

BIOETHICS OF STEM CELL RESEARCH AND CLONING

SYNOPSIS


Introduction
Stem cells are blank cells that have the potential to develop into any type of cell in the body. Scientists are trying to harvest the cells before they have differentiated, then coax them into becoming certain types. These cell lines are colonies of embryonic stem cells of different types. There is a rapid and astonishing progress in the field of cloning since the making of “Dolly” – the first cloned sheep, a few years ago.


Advantages of Stem Cell Research and Cloning Technology
The Stem Cell Research may lead to cloning a whole human being. In that case, if we can accept surrogate motherhood as an ethically acceptable process, cloning is more or less the same. Cloned individuals need not be necessarily being identified with the donor. Even identical twins are different from each other, influenced by environment and other psycho-social factors. During cloning of various organs and bone marrow transplants, these organs would be an exact genetic match of the recipient and so there will be no rejection.


Disadvantages of Stem Cell Research and Cloning Technology
Every form of reproductive technology raises the question of human values, dignity, worth, jurisdictional rights. A person should not be used as a mere mechanical instrument. Human being is an unrepeatable entity. Cloned embryo may undergo mutation and can lead to the creation of a monster instead of a human being. Natural birth is a product of human love. In cloning, the values of love and human procreation are missing. It violates the principle of equality among human beings and principle of non-discrimination through selective eugenic dimension used for specific cloning.


Conclusions
The clone’s sense of self-worth or individuality or dignity would be difficult to sustain. From the religious perspectives Judaism and Islam support most forms of Stem Cell Research and Cloning. The Vatican has expressed sadness and dismay at the proposal for this human cloning venture by stating that this process of cloning violates the right of a human being to be conceived in human way. Buddhist Bioethics also discourages cloning technology due to the fact that there is no limit to human ambitions and no strict judicious control over Stem Cell Research and Cloning in many countries of the world.

Key words: Stem Cell, Cloning, Bioethics, Research, Theological, Religious

BIOETHICS OF STEM CELL RESEARCH AND CLONING

INTRODUCTION
Stem cells are blank cells that have the potential to develop into any type of cell in the body. Scientists are trying to harvest the cells before they have differentiated, then coax them into becoming certain types. These cell lines are colonies of embryonic stem cells of different types. Stem cells are one of the human body's master cells, with the ability to grow into any one of the body's more than 200 cell types.

All stem cells are unspecialized (undifferentiated) cells that are characteristically of the same family type (lineage). They retain the ability to divide throughout life and give rise to cells that can become highly specialized and take the place of cells that die or are lost.

Stem cells contribute to the body's ability to renew and repair its tissues. Unlike mature cells, which are permanently committed to their fate, stem cells can both renew themselves as well as create new cells of whatever tissue they belong to (and other tissues).
Bone marrow stem cells, for example, are the most primitive cells in the marrow. From them all the various types of blood cells are descended. Bone marrow stem-cell transfusions (or transplants) were originally given to replace various types of blood cells.

The concept of this kind of research was believed to be in the minds of the Indians since long back. The Adi-Parva of Mahabharata gives clear indication that the kauravas were born from the stem cells. Human cloning means the asexual replication of a human individual by taking of cells with genetic materials and cultivation of these cells through egg, embryo and finally into human being.
There is a rapid and astonishing progress in the field of cloning since the making of “Dolly” – the first cloned sheep, a few years ago. “George” and “Charlie”, the two identical, genetically engineered calves that could make medicines in their milk were also successfully created. While “dolly” was cloned from a cell taken from an adult mammal, “Charlie” and “George” were cloned from cells taken from fetuses which are an easier process.


OBJECTIVES

(1) To study the various ethical issues related to Stem Cell Research and Cloning.
(2) To study the theological aspects of Stem Cell Research and Cloning.



REVIEW OF LITERATURE

About Stem Cells
Broadly speaking, a stem cell is one that–in the course of cell division and increase in the numbers of cells–is able to reproduce itself and also mature into various specialized types of cells. The stem cell with the greatest potential (totipotential) is the fertilized egg cell, which is capable of developing into a complete organism.

According to the usual–but actually very doubtful–explanation, the fertilized egg cell has totipotential up to the stage of division into eight cells, and in later stages the cells retain only "pluripotential." That is, they can form many different types of tissues, but not the complete organism. Embryonic stem cells–that is, those 50 cells within a blastocyst, which then continue to develop into the embryo proper–have this pluripotential. In the course of further specialization, stem cells of individual tissues are formed, such as that of the bone marrow, from which all the other kinds of blood cells develop.

Behind this description lies the conception that a linear process of differentiation is played out, in the development of the individual, toward increasingly "mature," specialized cells in the individual tissues, from totipotentiality to tissue specificity. This process is supposed to run only forward, but never backward. That is, as soon as a cell has reached a certain degree of "maturity," the way back to earlier stages of development is closed off. So it is evident that a stem cell’s capacity to perform is increasingly limited to specific functions, and it loses, correspondingly, the manifold capabilities still present in earlier developmental stages.

According to latest reports, however, this dogma of developmental biology does not hold. Evidently, tissue-specific stem cells have the ability–as has been impressively demonstrated in experiments with animals–to "transdifferentiate" themselves when in a different environment–that is, to take on the cell functions of the new tissue. Thus, neuronal stem cells of mice have transformed themselves into blood stem cells and produced blood cells. Indeed, there are indications of another capability of adult stem cells: Apparently they have the potential to be "reprogrammed." Not only can they adjust to the specific conditions of a new tissue environment, but they can even assume more generalized, earlier levels of development, so that it even appears possible that they become totipotent again.



Concept of Stem Cell Research and Cloning
Stem cells can divide for an infinite period of time when being grown outside of the body, and which can differentiate into various types of specialized cells. When fertilization of an egg with sperm occurs, the resulting fertilized cell has the capability to form an entire organism. The cell is described as being totipotent (having total potential). After some time, as rounds of cell division occur, specialization of cells occurs. But, early in fetal development, before the developing mass of cells attaches itself to the wall of the uterus, some cells still retain the ability to form virtually every type of cell in the body. These cells are pluripotent (capable of differentiating into many types of cells but not all types required for fetal development). With continued fetal development, further specialization of pluripotent stem cells results in multipotent stem cells--cells that give rise to cells having a particular function, such as blood cells and various types of skin cells. Stem Cell Research is concerned primarily with the pluripotent cells. The field is relatively new. James Thomson reported in Science in late 1998 his success in maintaining undifferentiated embryonic stem cells in their undifferentiated state in lab culture.

Stem cells can be obtained from human embryos at the so-called blastocyst stage (a stage very early in fetal development, only a few division cycles after fertilization). As well, cells can be obtained from fetal tissue from terminated pregnancies. The latter procedure has precipitated much discourse. In August 2001, United States president George W. Bush announced that he would support very limited federal funding of research using stem cells from human embryos. It was a compromise that did not completely satisfy parties on either side of the controversial issue.

Another potential means of obtaining pluripotent stem cells may be a technique called somatic cell nuclear transfer. In the technique involves the physical removal of its nucleus from an egg cell. The nucleus is the specialized area of the cell that contains the organized pieces of genetic material called the chromosomes. The material left behind in the egg cell contains nutrients and other energy-producing materials necessary for development of the embryo. Then, a somatic cell--any cell other than an egg or a sperm cell--is placed next to the denucleated egg cell, and the two cells are chemically fused together. After a requisite number of cell divisions, pluripotent stem cells can be recovered and used.
Pluripotent stem cells are important to science and to advances in health care. At the most fundamental level, study of these cells could advance the understanding of the processes of cellular development, such as the orchestrated mechanisms by which genes are turned on and off during development and growth. Some of the most serious medical conditions, such as cancer and birth defects, are due to abnormal cell specialization and cell division. Pluripotent stem cells could also be used to screen new drugs, eliminating the need to use living subjects for the early phases of drug discovery.

The most far-reaching potential application of the stem cells is the generation of cells and tissue that could be used for so-called cell therapies. Potentially stem cells may function as a kind of universal human donor cell, which could serve as raw material for whatever diseased cell requires replacing. Such donor cells would have to be genetically engineered so as not to form the cell surface molecules that would alert the recipient's immune system. The cells could be used for replacement of defective or diseased cells without the danger of transplantation rejection that occurs presently. Potential applications include the replacement of defective heart tissue and replacement of malfunctioning insulin producing cells in Type I diabetes.

In the last several years, several lines of research have produced concrete results showing the potential of stem cells in cell therapy. Genetic engineering of stem cells may be promising as a cancer eradication strategy. In rats, neural stem cells genetically engineered to convert a compound into a cancer-killing agent have been found to selectively target and destroy cancerous cells in the brain. Elsewhere, neural stem cells have also been shown capable of integration into the diseased retina of rats and of taking on some of the characteristics of retinal cells. This holds the promise that stem cell therapy may aid in repairing retinal damage. Other researchers have demonstrated, again in rats, that stem cells in the brain were able to repair damaged areas and restore function when stimulated by a growth-inducing protein. If replicated in humans, then stem cell treatments for stroke, nervous system and spinal cord injury and diseases such as Parkinson's and Alzheimer's that are marked by degeneration of nerve cells.
Another application of stem cells has been to form a chimera—an animal that grows from an embryo in which stem cells from another animal have been inserted. Some of the chimera's cells have one set of parents, and some cells have another set of parents. "Knockout" mice, research animals lacking specific genes, are chimeras. While theoretically conceivable, human chimeras are not contemplated.

Researchers have claimed success at reprogramming multipotent cells for a function other than that they were programmed for. Specifically, adult skin cells from cattle were reverted to stem cells and then transformed into heart cells. Other studies involved neural stem cells from mice and bone marrow cells from rats have also indicated that functional reprogramming of adult cells may be feasible. These breakthrough studies hold forth the potential of using cells from adults to treat diseases, rather than extracting embryonic cells.

There are several barriers to the use of adult stem cells at present. First of all, more knowledge of the locations of adult stem cells is still required since these cells might not be present in all tissues of the body. Secondly, adult stem cells are present in minute quantities, are difficult to isolate and their number decreases with age. The time necessary to locate, harvest, and grow the cells to usable numbers may be too long for practical purposes. Finally, adult stem cells may contain DNA abnormalities, which have accumulated as a result of a lifetime of exposure to DNA-altering agents such as sunlight and toxic chemicals. Further research may overcome these limitations, allowing stem cells obtained from adults to be used in cell therapy.

Stem cells from bone marrow can also, quite remarkably, give rise to non-marrow cells. In a 1999 report in the journal Nature, scientists from Boston led by Dr. Louis M. Kunkel reported that they gave bone marrow transplants from normal mice to dystrophic mice. Some 12 weeks later about 10% of the muscle fibers in the diseased animals were making the correct form of dystrophin, the protein that is defective in Duchenne muscular dystrophy. This work suggests that bone marrow stem cells may offer new ways of treating muscular dystrophy (and other non-blood diseases).






CONCLUSION FROM THE THEOLOGICAL ASPECT OF STEM CELL RESEARCH AND CLONING

From the religious perspectives, it is interesting to note that, the religions that have strong traditions of legal and religious law, namely Judaism and, Islam support most forms of Stem Cell Research. These two religions also support their beliefs on when life begins and Stem Cell Research by interpreting specific religious texts. While the Catholic Church has put the issue of Stem Cell Research on the forefront of its agenda, Pope John Paul II does not point to any specific biblical text that supports the Catholic Church’s concept of when life begins.

However, since religion can exert influence over the public and politicians, specifically, when it comes to moral arguments; religions such as Judaism and Islam need to be more vocal in their support of Stem Cell Research to balance out Catholicism’s almost blanket prohibition of the medical advance.

While science may never answer the question of when life begins, Catholicism, Judaism and Islam have answered the question in some ways that support and in other ways that prohibit the use of stem cells, even for therapeutic means. Since, there are no limits to human ambitions and no strict judicious control over Stem Cell Research; cloning technology for any purpose is never encouraged according to the Buddhist Bioethics.

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