May 9, 2024 science

Murder or holy grail? The controversies in stem cell medicine

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January 12, 2022. A human induced pluripotent stem cell colony. Researchers at NIH's National Eye Institute (NEI) developed the first patient-derived stem cell model for studying eye conditions related to oculocutaneous albinism (OCA).

Picture by: National Eye Institute / NIH | Flickr

If one life could save millions of people, would you say it was a worthy sacrifice?

Well, the debate around stem cell usage dives into this exact issue. The process of generating organs from special cells called stem cells, an example of regenerative medicine, is viewed as the holy grail for people struggling with incurable illnesses.

For so long, medicine has been seen as a field drowning in blacks and whites. Science is definite, right? Not anymore.

With the vast progress being made on various frontiers, medicine has been thrust into a gray area, in which researchers struggle daily against ethical dilemmas, especially in the field of regenerative medicine.

Stem cells are a special type of cell with the potential to differentiate, or develop, into different types of cells, such as brain, heart muscle or bone cells. Stem cells from embryos are the most versatile because they can develop into all kinds of cells.

They are useful for a variety of reasons: increasing understanding of how diseases occur; testing new drugs for safety and effectiveness; researching causes of genetic defects; and generating new and healthy cells.

In contrast, highly specialized cells in the heart and brain do not replicate and repair themselves like other body cells, so once the cells lose function, organ damage is irreversible.

Stem cells have the potential to treat a myriad of conditions including Parkinson’s, arthritis and Alzheimer’s disease. In this rapidly developing field, scientists hold the power to alleviate pain and anguish, and ultimately prevent millions of deaths.

Researchers can take stem cells from embryos and culture them to grow into organ parts that can then be used for transplants. In fact, researchers have been able to make new heart muscle and blood in a petri dish, developments that past generations only dreamt of.

While the use of embryonic stem cells raises ethical questions about destroying the embryo, ultimately, regulated stem cell usage does not violate the principles of bioethics.

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Dr. Shahla Siddiqui, an Anesthesiologist and Intensivist at Beth Israel Deaconess Medical Center.

Picture supplied by: Shahla Siddiqui

Dr. Shahla Siddiqui1, an anesthesiologist and critical care physician in Boston, detailed the rigorous process necessary for approval of research. This includes meticulous approval by an institutional review board (IRB), a measure which ensures that research is ethical.

Every trial using stem cells has undergone this process, pointing to its regulated, ethical nature. Unregulated use of stem cells, such as creating “superior” genetics and horrific black-market sales, actually undermine both bioethics and the viability of stem cells themselves.

The IRB makes sure that the pillar of autonomy in medical ethics is held to a high standard: consent, equal access to information, and equal access to participation.

Stem cells are being investigated for treating type-1 diabetes, heart failure and osteoarthritis. In Dr Siddiqui’s words, “if used properly, stem cells have so much potential”.

Kimberly Ryan, a biology teacher at Acton-Boxborough Regional High School in Massachusetts, explained that stem cells are typically sourced from an excess of embryos produced by in vitro fertilization (IVF)

If IVF users chose to donate the plethora of extra embryos to regenerative medicine, scientists could see astonishing progress including the ability to ‘mend broken hearts’.

However, embryonic stem cells aren’t the only variety that scientists use – adult, fetal, and placental tissue and umbilical cord blood stem cells are also used for many purposes.

Many of these stem cell varieties, in particular adult stem cells, are less effective because they aren’t as versatile or durable as embryonic stem cells. In addition, researchers cannot manipulate them to retain all the properties of embryonic stem cells because they are difficult to isolate and purify, meaning scientists cannot utilize them as efficiently.

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In 2001, President Bush banned the federal funding of embryonic stem cell research and scientists were forced to look towards other alternatives.

And earlier this year, Alabama’s supreme court declared that an embryo created by IVF was a person, creating an atmosphere wholly opposed to stem cell usage.

The controversial nature of the subject has led many to block the use of embryonic stem cells, citing moral reasons.

Instead of backing down, scientists found other methods, including induced pluripotent stem cells (iPS cells). They are cells that have been manufactured from adult stem cells to retain all of the qualities of embryonic stem cells.

These cells have been shown to have promising potential but the yield is very low which isn’t cost-effective. Scientists are expanding their knowledge about iPS cells, and with the constant developments on the research front, increased use is looking closer to becoming a reality.

Ethics and morals are a fast-evolving field, with new developments that skew people’s opinions and divide our already polarized society.

However, the line between right and wrong is deeply personal and constantly changing with new scientific developments emerging.

When looking towards stem cells as a key to the future, we must outweigh the cons with the pros. In the words of Mrs. Ryan, “Is it worth one life if you can save thousands, or millions?”

Written by:

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Swara Kulkarni

Contributor

Massachusetts, United States

Born in the United States in 2006, Swara currently studies in Acton, Massachusetts. She is interested in the human body, particularly neuroscience, a subject she plans to pursue.

In her free time, Swara enjoys art, reading and writing – from short stories to longer pieces.

Swara joined Harbingers’ Magazine in 2023, having won the 2nd prize in the Essay on Science category of the Harbinger Prize 2023.

She speaks English, Marathi, and is currently learning Spanish.

Edited by:

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Ananya Prasanna

Science editor

Reading, United Kingdom

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Footnotes

1.

Anything spoken by Dr. Siddiqui reflects her own ideas, these are not representative of Beth Israel Deaconess Medical Center (BIDMC)

1

Anything spoken by Dr. Siddiqui reflects her own ideas, these are not representative of Beth Israel Deaconess Medical Center (BIDMC)