Public Opinion About Stem Cell Research and Human Cloning

5 ISSN 1746-0751 10.2217/RME.09.84 © 2010 Future Medicine Ltd Regen. Med. (2010) 5(1), 5–6 “To further the advancement of responsible stem cell research, the Canadian Stem Cell Foundation ... released the Stem Cell Charter in September 2009 ... The promulgation and promotion of this Charter aims to prospectively frame stem cell research and to serve as a benchmark for the guidance of international and national initiatives in both scientific research and policymaking.” Bartha Maria Knoppers Author for correspondence: Director, Centre of Genomics & Policy, Faculty of Medicine, Department of Human Genetics, McGill University, 740 Dr. Penfield Avenue, Suite 5214, Montreal, Quebec, H3A 1A4 Canada Tel.: +1 514 398 8866; Fax: +1 514 398 8954; bartha.knoppers@mcgill.ca

Heiner ROETZ: Introduction Masahiro MORIOKA: The Ethics of Human Cloning and the Sprouts of Human Life Robert HORRES, Hans Dieter OLSCHLEGER, Christian STEINECK: Cloning in Japan: Public Opinion, Expert Counselling, and Bioethical Reasoning Qiu RENZONG: Cloning Issues in China Ole DORING: Culture and Bioethics in the Debate on the Ethics of Human Cloning in China Gerhold BECKER: Chinese Ethics and Human Cloning: A View from Hong Kong Chin KYO-HUN: Current Debates on 'Human Cloning' in Korea Marion EGGERT, Phillan JOUNG: The Cloning Debate in South Korea Jens SCHLIETER: Some Observations on Buddhist Thoughts on Human Cloning Pinit RATANAKUL: Human Cloning: Thai Buddhist Perspectives Siti Nurani MOHD NOR: The Ethics of Human Cloning. With Reference to the Malaysian Bioethical Discourse Heinz Werner WESSLER: The Charm of Biotechnology: Human Cloning and Hindu Bioethics in Perspective Abdulaziz SACHEDINA: Cultural and Religious in Islamic Biomedicine: The Case of Human Cloning Thomas EICH: The Debate about Human Cloning Among Muslim Religious Scholars since 1997 Y. Michael BARILAN: The Debate on Human Cloning: Some Contributions from the Jewish Tradition Christofer FREY: Bioethics in the Perspective of Universalization Nigel M. de S. CAMERON: The American Debate on Human Cloning Thomas Soren HOFFMANN: Primordial Ownership versus Dispossession of the Body. A Contribution to the Problem of Cloning from the Perspective of Classical European Philosophy of Law Ilhan ILKILIC: Human Cloning as a Challenge to Traditional Health Care Cultures Hans-Martin SASS: Let Probands and Patients Decide About Moral Risk in Stem Cell Research and Medical Treatment Florian BRAUNE, Nikola BILLER-ANDORNO, Claudia WIESEMANN: Human Reproductive Cloning: A Test Case for Individual Rights? Nikola BILLER-ANDORNO: Epilogue: Cross-Cultural Discourse in Bioethics: It's a Small World After All Notes on Contributors

Controversy regarding Human embryonic Stem Cell (hESC) research is evident in the medical and scientific community, legislative, judicial, and executive branches of the government, private companies, religious affiliations, special interest groups, and among the general American public. Stem cells are derived from adult stem cell resources, which are termed non-embryonic or from the cells of immature blastocysts termed embryonic stem cells. Non-embryonic cells do not have the ability to differentiate into other specialized tissues, whereas embryonic cells are capable of differentiating into almost any type of tissue. hESC research, which is the focus of this paper, includes the direct creation and therapeutic cloning of human embryos, known as somatic cell nuclear transfer (SCNT) during the blastocyst-stage of development, the use of surplus embryos from in vitro fertilization, and from tissue derived from extracted embryos through abortion. The purpose of hESC research is threefold: (1) to advance science and medicine, (2) prevent disease, and (3) cure certain diseases. hESC research is an ethical dilemma facing the United States of America. Opponents of hESC often cite the rights of the embryo and define the embryo at conception. Supporters of hESC research include the scientific and medical community, and private hESC research companies. The unique political system of the United States has allowed for a dichotomous policy to arise, where federal funding of hESC is prohibited, but private companies and individual states are able to legally forge a path in hESC research. The prohibition of federal funds has created an abyss between states who choose to fund hESC research and those who prohibit it. It has also set the stage for yet another private corporation to advance in hESC and place profit above the American public. The embryo is the only silent member of this debate.

Public policy debates such as we find in the Untied Nations, the Singapore Bioethics Advisory Committee, and the US President's Council on Bioethics reflect behind-the-scenes theological debates. Although religious spokespersons agree nearly universally that human reproductive cloning should be banned; moral ambivalence rises when confronting human embryonic stem cell research. Rather than focus on beneficence (medical benefits), religious bioethicists focus on nonmalificence (embryo protection). The Vatican claim that stem cell research should be banned because it destroys embryos appears at first to rely upon ensoulment at conception; but a closer analysis shows that the Vatican position relies upon genetic uniqueness. Appeal to genetic uniqueness is inadequate for Christian anthropology; what needs to be added is a relational and proleptic understanding of human dignity.

Human embryonic stem (hES) cell research, a burgeoning area of medical inquiry, has been lauded by scientists, patient advocates, and members of the general public for its potential to cure many of today’s most dreaded diseases. Cynthia Fox’s Cell of cells: the global race to capture and control the stem cell presents the travails of stem cell researchers the world round and the vicissitudes of the patients who depend on them. It is a travelogue that provides the background of the work, people, and places involved in what is an exciting race to be first to realize the promise of stem cell research. It is a well-written book with material for the casual reader wanting to know more about the subject as well as for those with a greater familiarity with the topic who prefer more scientific detail. The book provides an overview of the science and politics surrounding this topic. Since hES cell research requires the destruction of human embryos, it has divided the religious conservative and scientific communities. Scientists see the potential to treat many life-threatening diseases while conservatives argue that these cells are still the foundations of human life and therefore have a right to life. Right-to-life supporters have been able to politicize this issue and hence place restrictions on stem cell research in America that will likely result in America falling behind in this scientific area. The key attribute of hES cells that makes them critical weapons in the fight against debilitating diseases is their ability to regenerate any and all of the body’s myriad cells and tissues. From alleviating common ailments such as rheumatoid arthritis to treating feared killers, including cancer, stroke, and heart disease, stem cells have the potential to restore wellness. The reader travels around the world as Fox reports on the international race to use stem cells successfully — illustrating mundane problems such as sand in Petri dishes in the Sahara and describing an Israeli lab that narrowly escaped a terrorist bomb. Fox also demonstrates the often cooperative nature of this area of research, even when the scientists involved hold different and opposing religious and political beliefs. In her writing, Fox adds a human dimension to the topic of stem cells. While she covers the scientific aspects of stem cell research, she also depicts the people involved, their lives and hopes and struggles. They live in different societies, in different environments. One of the most eye-opening sections of the book, titled “Biopolis,” describes research in Singapore, where some of the world’s most talented scientists have been recruited to work in state-of-the-art laboratories. Singapore has reportedly spent $1.5 billion on national stem cell research initiatives. It is easy to feel the passion that this scientific race engenders. Fox also makes the subject of stem cell research exciting through her descriptions of the efforts to condition a patient so that a donor organ will be accepted rather than rejected. She reviews the status of cloning and how its useful applications are expanding. The author also addresses the rise and fall of Woo-Suk Hwang, the South Korean researcher who claimed astonishing advances in stem cell research with his publications in major scientific journals. His career came to an abrupt end when it was made public that he had fabricated many of his results and had breached ethical guidelines when he paid women to donate their eggs for research. Fox proves to be a good storyteller. The book is filled with narratives that serve to increase the reader’s interest in science. Fox keeps the scientific facts and jargon to a minimum yet still gives the reader relevant information. Her pictorial descriptions of foreign settings are wonderful. Fox paints extremely vivid (at times a bit too graphic) images of places and people, and the stories are often suspenseful. She attempts to provide a plethora of lab findings; however, peer-reviewed scientific research is reported alongside limited commentaries and rhetoric that have not yet been critiqued via traditional channels by the conventional scientific community. Unfortunately, Cell of cells does not add much that is new. However, it makes one think about the immense possibility science holds for society. It tells a great story, one that unfortunately has not yet ended with success. But the struggle is important; it makes scientific research exciting. Aspiring students of science would benefit from this book, both as stimulation and as an example of the kinds of approaches undertaken in this particular scientific endeavor. The restrictions placed on hES cell research by religious groups will only delay success (assuming that there will be success at the end of this road). Fox’s book is an excellent introduction to the field of stem cell research and makes for interesting and entertaining reading.

Analysis of an epigenetic argument against human reproductive cloning

Click to increase image sizeClick to decrease image size Notes 1 Bioethics Advisory Committee of Singapore, Ethical, Legal and Social Issues in Human Stem Cell Research, Reproductive and Therapeutic Cloning, report submitted to the Ministerial Committee for Life Sciences, June 2002. 2 Even Ian Wilmut, who cloned Dolly the sheep, has taken a consistent stand against reproductive human cloning. “The Roslin Institute and PPL Therapeutics have made it clear that they regard the idea as ethically unacceptable.” Ian Wilmut and Donald Bruce, “Dolly Mixture,” in Engineering Genesis, eds. Donald Bruce and Ann Bruce (London: Earthscan Publications, 1998), 75. The original scientific study that initiated the cloning controversy is by Ian Wilmut, et al., “Viable Offspring Derived from Fetal and Adult Mammalian Cells, ” Nature, 385 (1997): 810 – 813. 3 Edison Liu, “Rise of a Biomedical Dragon,” The Straits Times (Saturday, 4 November 2006), S9.

In 2003 it became legal to carry out human embryonic stem (hES) cell research in Denmark using embryos that are considered `spare' in connection with fertility treatment. The public debate preceding the change of the Fertility Act presented the `spare' embryo as a biological fact and discussed whether it was possible and morally acceptable to connect a given stock of `spare' embryos to the stem cell lab. This paper tells a different story. Based on ethnographic fieldwork in a fertility clinic in Copenhagen and among stem cell researchers, we argue that `spare' embryos are not straightforward biological facts. Rather, complex decision-making processes constitute embryos as `spare' and thus as possible objects of exchange between couples in fertility treatment, stem cell researchers and future citizens in need of regenerative medicine. The ongoing fact-making of the `spare' embryo in the fertility clinic reveals the network of relationships and conflicting responsibilities in which clinicians are positioned. Using the spatial metaphor of a moral landscape we explore how clinicians try out new moral pathways when seeking alternative ways to obtain and classify embryos as `spare'. We argue that changing moral landscapes and `spare' embryos are being co-produced in the development of hES cell research.

S oon the Bush administration will decide the fate of human embryonic stem cell (ESC) research at U.S. government-funded institutions, and the outcome of that decision will greatly influence the role of ESC science in human developmental biology around the world. But although the forces that science brings to this field are powerful, the future of ESC research will largely be determined by other interests: politics, organized religion, commerce, the legal community, and patient advocacy groups. The decision-making process needs to develop a policy that is fact-based and serves the best interests of society as well as science. Broadly, stem cells are rare cells that renew themselves and, in addition, give rise to differentiated cells. Some, from adult tissues, have multiple but usually restricted developmental potency: Hematopoietic stem cells (HSCs), for example, normally make only blood cells; multipotent brain stem cells make only brain cells. ESCs, in contrast, are derived from cells isolated from the inner cavity of the blastocyst: an early embryo that cannot develop further unless it successfully implants in the uterus. These cells are pluripotent: Given an encouraging environment, they can develop into any cell type; although so far in culture they have been unable to form whole organs, much less bodies. It would be convenient if pluripotent cells persisted into adulthood. Unfortunately, most (but not all) published accounts suggesting adult stem cell pluripotency have not successfully established that one type can produce a cell of another tissue type. Indeed, although HSCs capable of regenerating the blood can be isolated from adults or fetuses, so far brain stem cells capable of robust growth and transplantability have come only from fetal or ESC sources. This is likely to be true for a number of tissues; fetal stem cells are much more active than postneonatal cells. A moratorium on research and/or transplantation of fetal stem cells could thus be devastating. As for the search for pluripotent adult stem cells, it is always possible, perhaps even likely, that further research might reveal a source. But that is simply a hope, and it would be foolish to abandon the surer path for the unproven one. The greatest mysteries of human development lie in the time interval between the early blastocyst embryo and the much later point at which organs are formed. What is needed is a thorough understanding of the cellular and genetic events that make the organs and tissues from these pluripotent cells. That can come only from a broad-scale attack on the problem from all kinds of researchers, whether in academic, nonprofit, or commercial organizations. The outcome will surely have profound effects on medicine, science, and translational research. Yet these advances that could be gained from human ESC research are currently restricted in the United States to the single commercial entity that holds the patents for the ESCs developed using its own funding. That is a disturbing anomaly, but it can be remedied by a decision to approve ESC research by government-funded entities. Decisions to approve ESC research have been recently undertaken in several other countries, notably Germany and the United Kingdom, where government sought advice from a broad range of concerned interests. Not only does that provide a constructive example to our administration, it underscores another consequence of the wrong decisions here. Failure to make this research opportunity available in the United States will make those countries centers of the scientific, medical, and commercial advances in which we ought to be a contributing partner. Plainly, scientists alone should not make the decisions about the ethical conduct of their work or about its social applications. It is appropriate that governments, with appropriate public input, define the societal interest in particular lines of research. But in making those policies, the state should minimize purely political considerations and be mindful of the separation of church and state. The wrong action here could close the door to an important avenue of scientific and clinical discovery. The state should not be the barrier to the translation of these potentially revolutionary therapeutic opportunities into real medical advances.

This chapter reviews the regulatory situation for clinical stem cell research in the People’s Republic of China since the early 2000s. The paper is structured in four parts. Part I examines the regulatory conditions for the donation of human gametes and embryos and their use in basic and preclinical research. This involves an overview of China’s regulatory rules for assisted reproductive technologies (ART) and its approach to the governance of human embryonic stem cell (hESC) research. Part II offers a summary of the regulatory and legal instruments that govern clinical trials and other forms of human subjects research in China. These instruments, most of which have been launched in the 1990s and early 2000s, do not specifically address stem cell research, but they influence clinical stem cell research as horizontal regulatory rules. Part III focuses more specifically to the regulation of clinical stem cell research and applications, including the regulation of experimental (for-profit) interventions with stem cells that do not classify as clinical trials or systematic forms of clinical research. This part documents the formation of a regulatory approach for clinical stem cell applications since the mid-2000s, which was still ongoing at the time of writing. The conclusions discuss open questions and the repercussions of China’s regulatory approach for stem cell research for domestic researchers, clinicians, and corporations in China, as well as for international clinical and corporate collaborations.

This paper appraised the issues involved in human reproductive cloning and creationism from the standpoints of Raelian religion and African traditional belief. The methods adopted are descriptive and evaluative. The findings include the fact that human cloning is one of the religious tenets of Raelianism; and that African tradition and culture totally reject reproductive cloning on the ground of its unnaturalness. Finally, the paper from the African traditional paradigm concluded that human reproductive cloning is totally condemnable and should not be practiced on human beings on the ground of unnaturalness, distortion, negation, imperfection, and aberration.

Of the countless interviews I have conducted with scientists over the years, only once has a question prompted something of a striptease. In December of 1999, I found myself in the elegant parlor of the Union Club in New York City, chatting with a biologist named Leonard Hayflick. Although hardly a household name to the general public, Hayflick is that rare scientist whose name is permanently attached to a biological phenomenon. It is known as the “Hayflick limit,” and it derives from experiments he did in the late 19505 and early 19605 showing that human cells grown in Petri dishes will predictably replicate for a certain number of cell divisions, but then hit a wall and stop dividing. This has obvious implications for cell biology, aging, and immortality (of the in vitro sort), and indeed the Hayflick limit has been the seed around which a spirited biological debate about the biology of aging has swirled, without definitive resolution, for about four decades now. Because of this history, Hayflick has closely followed the recent work on the biology of aging and regenerative medicine, which in turn has made him a front-row spectator in the more recent controversies involving human embryonic stem cell research and “therapeutic cloning.” At the time of my conversation with Hayflick, his longtime friend Michael West was attempting to obtain human embryonic stem cells through cloning—in a particularly controversial way, by putting human cells into egg cells from ... cows. Almost as an aside, I asked Hayflick what he thought about West's experiments. Hayflick replied by rolling up his pants leg. He bared enough skin to be able to point out a tiny dimple on his right knee. “The human cells he's using for the cow work came from here,” he said. I had to stand up and lean over to see it, but there was undeniably a tiny divot in Hayflick's skin. The implications were stunning: Leonard Hayflick, the father of cellular senescence and one of the elder statesmen of gerontology, was allowing himself, in a manner of speaking, to be cloned. In addition to making the obvious point that even the most innocuous question can elicit a startling answer, Hayflick's reply offered another lesson, too: that colorful characters can provide a narrative thread for bringing a controversy to life.

This paper examines the influences that congressional staff people viewed as important in shaping legislators' voting decisions on the human embryonic stem (ES) cell research bill in the 109th Congress, the first legislation vetoed by President George W. Bush. The analysis illuminates factors that impact congressional decision making on a salient issue with a strong moral component. Constituent concerns, ideology, and a desire to make good public policy all centrally affected members' choices; however, moral overtones permeated considerations relevant to the human ES cell research question. In addition, at least three influences that directly reflect or relate to members' moral claims - religious convictions, personal connections to potential beneficiaries of human ES cell research, and moral pressure from outside interests - were important also. The analysis draws on data gathered from interviews with congressional aides.

Federally funded human embryonic stem cell research can move ahead unimpeded because of a Supreme Court decision announced last week. The Court declined to hear a case, which has dragged on for more than three years, challenging the legality of such stem cell research funding. The original lawsuit against the National Institutes of Health was filed in 2009 by two scientists who work with adult stem cells. They claimed that the agency’s policy for funding human embryonic stem cell research violates the Dickey-Wicker Amendment, an obscure law that prohibits federal funding of any research that destroys human embryos. Human embryos are destroyed in order to derive such stem cells. In 2010, the case temporarily halted government-funded research on human embryonic stem cells. A federal appeals court lifted the injunction, however, and subsequently ruled that conducting research on these cells is not the same as deriving them. The plaintiffs appealed to ...

State regulation of oocyte donation in the context of human embryonic stem cell (hESC) research has increased since California’s landmark passage of Proposition 71 and the establishment of the first state-funded stem cell agency, the California Institute for Regenerative Medicine (CIRM). Scholarship has largely focused on California’s regulation of stem cell research as a patchwork of private sector and state regulations, reflecting major debates about the social contract for science. Given California’s political exceptionalism, how does examining alternative state histories, political structures, and institutions at the state level illuminate the ways that bio-innovation is being regulated in a federal regulatory vacuum? Examining state management of oocyte donation in the context of hESC research, this article considers New York and California as comparative sites of stem cell science regulation, which enriches our understanding of how regulation of stem cell science arises out of an engagement with representative politics and the private sector in the United States. Employing a process tracing of policy development in New York and California, this article highlights alternative democratic pathways to the management of oocyte donation in research contexts: given differences in direct democratic action, legislative representation, executive leadership, and publicly funded state stem cell research institutions, distinct regulatory outcomes occur with important bioethical implications for publics and participants in stem cell science at the state level.