Stem Cells…The Moral Divide
Photo by NIH
Stem Cells are hope! They are medical marvel which may one day unlock the prison of Paralysis and many other terrible diseases and afflictions forever. What makes them unique is that they can potentially develop into any cell type in the body. They have the theoretic capability to act as the body's 'repair system.' Scientists think they can divide without limit and replace other damaged cells. When a stem cell divides, it can either remain a stem cell or turn into another type of cell such as a brain cell, muscle cell or red blood cell. What this means is that stem cells could potentially repair damaged heart tissue, Spinal Cord damage, stop and/or reverse the effects of Parkinson's, ALS, Stroke, Alzheimer's, repair a damaged kidney and multitudes of other horrible afflictions associated with human suffering. Sounds great, doesn't it? There is a catch...there is always a catch; that is the human experience. Moral dilemmas often stand in the way of progress.
But before we get to that, how do stem cells work?
Somatic Cell Nuclear Transfer (SCNT)
SCNT (Somatic Cell Nuclear Transfer) involves removing the nucleus of an unfertilized egg cell, replacing it with the material from the nucleus of a "somatic cell" (a skin, heart, or nerve cell, for example), and stimulating this cell to begin dividing. Once the cell begins dividing, stem cells can be extracted 5-6 days later and used for research. Source: CAMR (Coalition for the Advancement of Medical Research)
How is SCNT different from Reproductive Cloning?
The aim of reproductive cloning is to create human beings by cloning human embryos. Source: (Coalition for the Advancement of Medical Research)
The brightest minds on the planet have unearthed the theoretical potential of stem cells. Dr. Harold Varmus, former Director of the National Institutes of Health, testified before the US Congress on December 2, 1998 on the promise of Embryonic Stem Cell research. Embryonic stem cells are different than those found in all young and adult beings or "Adult Stem Cells." Embryonic stem cells are 'pluripotent,' meaning they can turn into virtually any cell type in the body. Adult stem cells, as far as they know so far, are not 'pluripotent.' Adult stem cells can and will be pursued vigorously to unleash their potential. Embryonic stem cells, currently at the forefront of scientific discussion and controversy, contain an enormous potential that many scientists and researchers alike agree have a greater potential than the adult stem cells. There is a possibility they could, in a much shorter period of time, relieve the suffering of hundreds of millions of people worldwide. The catch? Morality and ethics. Living as a C-5/6 quadriplegic for fifteen gruelling years, I found myself wrestling with these two words. I have intensely researched the subject and found a couple of paragraphs from the International Society for Stem Cell Research that I thought would help clarify 'the catch.' They are as follows:
"Ethics is not a specialized body of knowledge. Ethics is a conversation about questions. In that conversation, everyone has a place. We all have moral intuitions. Concerning Embryonic Stem Cell research, the question that we face takes a familiar form: does the end justify the means? In some moral situations, one or more of us may answer that question in the affirmative. For example, someone might conclude that the end of teaching life long lessons to a child justifies imposing discipline as a means. In other situations, it may seem that the end does not justify the means. Most of us would not approve of robbing a bank as a means to the end of helping the poor."
"In the case of Embryonic Stem Cell research, the end that scientists hope to achieve is the relief of human suffering. That this is a humanitarian and worthy end is not in dispute. The controversy is about the means, namely, the consumption of donated embryos. More particularily, embryonic stem cell research and therapy would use donated embryos that, by virtue of donor instruction, will never enter a uterus. Is it permissible to use those means to that end? Ancient religious texts provide little guidance. The ancients did not understand embryology, did not imagine that scientists might create and nurture what we now understand as embryos in the laboratory. Nor can we get an answer from laboratory experiments. There is no test for whether an embryo is a person. Instead, we are left to our own devices, to our own moral reasoning."
So, in short, this means that we all have to make up our own minds. My opinion? (I knew you would ask), is this. I do not know where human life begins. There are multitudes of opinions out there, each having their own merits depending on what you believe. I believe science has proven that once fertilized, an egg cell becomes an embyro, and contains all the genetic information needed to form a human being. The question then would be....is this the beginning of life? Some faith-based opinions would say yes, this is the beginning of life. Others might argue that life begins with consciousness. To quote Rene Descartes,"I think, therfore I am." There is a trend out there where people are speaking out negatively on Stem Cell Research without collecting a single fact. I urge you to educate yourself on this topic before you form an opinion one way or another. On this topic, we cannot just follow like sheep; the 'quality' of millions of human lives are at stake. One quote that blew me away came from Maura McCarthy-Stanford, a Catholic mother of a diabetic child. It aired May 25, 2005 on Nova Science Now. She was describing her feelings on embryonic stem cells. She said, "To me, that ball of cells is the miracle of possibility. It's the possibility of becoming a human being if it ends up implanted into a woman, it's the possibility of becoming cells to be put into my daughter because she needs to be cured of Diabetes, it's the possibility of becoming nerve endings for Spinal Cords so that somebody can walk again. It hasn't made its mind up yet of what it wants to be and therefore it is the possibility of all different kinds of life, whether it is new lives or saved ones."
The fact is that no one on either side of the argument really knows for certain where life begins. My opinion, and maybe a controversial one to some, is this. Does the end justify the means? I believe it does in the case of 'Therapeutic Cloning' or 'SCNT' and discarded embryonic stem cells. There is a major source of excess embryonic stem cells from in vitro fertilization clinics for the purpose of fertility treatments that, if not used for research, would otherwise be destroyed. Some people argue that it is against their faith to destroy one life to save another. Some people suffering miserably from one of these afflictions might want to know why should other people's faith affect the outcome of my life? I can't and won't even try to change their opinion. My Christian faith is also very strong. On the other hand, how do we know God didn't create those discarded embryonic stem cells in a bid to advance science and end multitudes of human suffering? Maybe he has heard our cries and our prayers and thinks we have suffered enough. If you do not have, live with or work closely with someone who is affected by one of these afflictions, you cannot know the anguish. But know this! In a split second, it could be you, your spouse, your son, your daughter or a close loved one needing treatment that does not yet exist! I believe that if the excess cells are being discarded anyway, therefore eliminating the 'potential' for a human life, then it would be irresponsible for us as compassionate human beings to discard a 'highly potential' opportunity to advance science in the hope of ending horrendous human suffering. The 'life', through the process of extremely important and potentially lifesaving research, will have served a lifetime of purpose.
How do we go about this? First of all we ban reproductive human cloning right away. There is virtual unanimity supporting a legally enforceable ban on all forms of this type of cloning. We support 'Therapeutic Cloning' or SCNT. We need sustained Government support to aid in this 'forward moving' and highly potential research. The Canadian Government, through the CIHR (Canadian Institutes of Health Research), has set up strict bioethical guidelines for all Government funded stem cell research. A Stem Cell Oversight Committee has been set up to monitor all Government funded research to ensure strict ehtical guidelines are followed. Read more at: http://www.cihr-irsc.gc.ca/e/15298.html Certainly it is inevitable that some rogue scientist will clone a human. We probably won't be able to stop that. However, the science is here, we nee to embrace it, and police it. Because a crook uses a knife in a robbery, does that mean we all have to lose our ability to spread butter? Again, common sense has got to lead the way. The United States' watchdog is the NIH (National Institutes of Health), who have also set up strict bioethical guidelines for all US Government funded research projects. Read more at: http://stemcells.nih.gov/info/basics/ .
Some states, such as California, believe that Government is handcuffing researchers and are branching out on their own with overwhelming public support for embryonic stem cell research. The state of California is doling out 3 billion dollars over the next ten years, dwarfing the federal Government's entire output in the same area of research. I hope Canadian politicians will put a higher priority on curing all forms of Paralysis as they begin to understand the urgency of our situations. The Canadian Government currently authorizes about 5 million annually for stem cell research according to a report by Global National on May 24, 2005. This is great, but could they do more? Yes, they could! I have friends with SCI who are suffering imminent kidney failure. Time is running out for them and has already run out for many. Case in point, Christopher Reeve. Because of my faith, I am not afraid to die. To lose this body/coffin that I am in would actually be a blessing. But, I don't want to die yet. I want to walk my daughter, who is nineteen now, down the aisle someday, dance with my wife again, go boating with my son who is seventeen, be able to feel my dogs' fur when I pet them. I want to go to the washroom without a nurse and a homecare aide in attendance, get up without the use of a machine to plunk me in my wheelchair, feel the wind and warmth of the sun again and have the excruciating, endless pain go away. I will never get used to looking at my body and not be able to feel it. Fifteen years in a chair, the phyisical changes to my body are horrific and humiliating. It is so hard to ask someone over and over again for the simplest things, like a glass of water for instance. Sometimes you can't help thinking you are inconveniencing them and that you are a burden. I'm only 43 years old. I want that 'normality' that I used to have, and envy in the majority of you, back again. More importantly, I do not want anyone else to have to experience even one hour of confinement, pain and humiliation due to Paralysis. What keeps me going? Hope! Hope is the work they are allowing to happen in Great Britain with embryonic stem cells, the Rick Hansen Foundation, the University of Manitoba Spinal Cord Research Center, research at the University of Alberta, CRPF, ICHORD Vancouver, the China SCI Network, the Miami Project to Cure Paralysis, Dr. Wise Young, Dr. Stephen Davies and multitudes of other organizations, foundations and everyday people striving toward the common goal, 'The Cure.' If I had to sum Paralysis up in one word, that word would be 'Horrifying.'
In my 15 years in a wheelchair, there has never been so much excitement in Spinal Cord Research. It certainly appears as if help is on the way. I really hope that Canada keeps up its fine committment to curing Paralysis as evidenced by the Conservative Governments pledge of 30 million dollars to the cause as well as the Provinces multi-million dollar pledges which are getting us closer everyday to advanced stages of research leading to 'human clinical trials.' I realize the importance of approaching cautiously, but I also understand all too well the urgency and desperation of hundreds of thousands of Canadians living a nightmare and staring down death everyday. Can the Canadian Government look us in the eyes and say we are doing everything we can? Everyday? Not yet, but were getting there. Canada's first stem cell legislation came into effect with the passing of Bill C-6, the Assisted Human Reproduction Act, which passed in March 2004, but already needs major revision to uncuff scientists. The bill permits the use, under strict licensed guidelines, of 'surplus' human embryos from invitro fertilization treatments to be used for very limited research, but still bans 'Therapeutic Cloning' or 'Somatic Cell Nuclear Transfer.' In fact, 'criminalizes' Therapeutic Cloning with a $500,000 fine and up to 10 years in prison. Still handcuffing researchers! What kind of message does this 'In Reverse' attitude send to our most brilliant scientists and researchers. Endless debate while other countries forge ahead. Don't try and tell me that if any of our law makers had a child or loved one with a severe Spinal Cord Injury and Great Britain had the cure that they would not jump through hoops to get their loved ones the treatment they need. If you think not, you are probably living in 'Never Never' land with Peter Pan. We need sustained Government support with an ethical 'move forward' approach to keep Canada in step with the world and the science resulting from this amazing research. When people become independent again, the Government will be paid back ten fold in tax dollars by putting people once on disability, hence relying on the public purse, back to work again. Not to mention being heralded along with the scientists, researchers and countless others as the alleviators of chronic human suffering! Sometimes I can't help but wonder if the negative attitude towards research for the better quality of human life, isn't being fuelled by companies or people who stand to lose monetarily from the end of many types of human suffering??? Think about it!
We have been down this road before in a sense. We have sent our young sons and daughters off to numerous wars to fight for freedom, not knowing exactly what we were getting into or what the outcome would be. But we went anyways. We knowingly sacrificed their lives in a bid to end human suffering and ensure a bright future for generations to come. We have another opportunity in front of us right now. What can you do to protect yourself or a close loved one from a possible life with Paralysis? Support the scientists and researchers who are feverisly working towards the cure. Donate to research and ask your Member of Parliament on an ongoing basis to make curing Paralysis a 'Priority.' My question is....are we ready? My answer? Yes, we are!
Doug Barker
Perhaps the most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. Today, donated organs and tissues are often used to replace ailing or destroyed tissue, but the need for transplantable tissues and organs far outweighs the available supply. Stem cells, directed to differentiate into specific cell types, offer the possibility of a renewable source of replacement cells and tissues.
My mission is to continue to offer 'Real Hope' to people suffering everyday from Paralysis due to Spinal Cord Injury or related illnesses.
Dr. Wise Young Sums It Up:
1. Spinal Cord Injury. Spinal cord injury disconnects the body from the brain. The brain communicates with the body through long nerve fibers in the spinal cord, called axons. Axons carry sensory information to the brain and motor information to the spinal cord. Spinal cord injury does not necessarily kill the neurons above and below the injury, only the connection between them.
2. Restoring Function. To restore function, one has to get the axons to grow back to where they once connected. This growth is slow (probably no faster than the rate of hair growth) and may take many months or years. Another way of restoring function is to have surviving axons sprout new connections. Finally, some surviving axons don't function properly because they have lost the insulation called myelin. Thus, some therapies may be able restore function by stimulating sprouting or improving conduction of demyelinated axons.
3. Regenerating the spinal cord. Regeneration has long been thought to be impossible. However, much data collected over the past decade indicate that the spinal cord can regenerate. Almost all neuroscientists around the world agree that the spinal cord can regenerate if we provide a path for the axons to grow, sustained growth factor support, and blockade of axon growth inhibitors that are present in the spinal cord. Many therapies have now been shown to regenerate animal spinal cords and some of these are just beginning to go into clinical trial, mostly in Canada and Europe.
4. Promising therapies. Several cell transplants have been reported to regenerate the spinal cord. At least three classes of axon growth inhibitors have been identified: Nogo, chondroitin-6-sulfate proteoglycan, and ephrins. Blockade of these inhibitors have been shown to result in functional regeneration in animals. Strategies for blocking these axon growth inhibitors include covering the inhibitor (i.e. antibodies against Nogo), blocking the receptor (i.e. Nogo receptor blocker), enzymes to break down the inhibitor (i.e. chondroitinase), and receptor agonists and antagonists. These therapies have been reported to cause functional regeneration in animals and several of these are now beginning clinical trial in Europe and overseas.
5. Combination therapies have been shown to be more effective than individual therapies. Several laboratories have reported that combining two or more of the therapies together have more effect than any of the individual therapies. For example, combining a cell transplants (to bridge the injury site and to remyelinated axons) with drugs that increase cAMP (which tells an axon to ignore growth inhibitorsP) have been reported to produce substantial regeneration. Likewise, combining cell transplants with multiple neurotrophins is more effective than the cell transplants and neurotrophins alone.
Many of these therapies are ready to go to clinical trial. We need more funding for research that would optimize these therapies for human use, to take these therapies to clinical trial, and to asess whether or not they individually and in combination will restore function to people with spinal cord injury.
Wise.
There are thousands of people working hard everyday from many countires around the world, all contributing to the final 'Quest,' a cure for Paralysis.
Here are some Links:
http://www.rickhansen.com/ Rick Hansen ' Man in Motion Foundation '
http://www.icord.org/ ICORD Vancouver B.C. Canada. A must see!
http://www.christopherreeve.org/site/c.geIMLPOpGjF/b.899265/ Christopher Reeve Paralysis Foundation
http://www.cureparalysisnow.org/ Awesome & Informative.
A great book to check out is 'Stem Cell Wars' by Author Eve Herold! Explains a lot!
