Human Embryonic Stem Cell Research: An Intercultural Perspective

1. Human Embryonic Stem Cell Research: An Intercultural Perspective LeRoy Walters Kennedy Institute of Ethics Georgetown University

2. Overview • A visit to the White House • Biological background • Three policy options • Regional maps and policy trends • The U.N. debate about cloning • ISSCR initiatives • International data • Ethical arguments • Religious perspectives • Conclusions and recommendations

3. The Visit to the White House:August 2, 2001

4. Biological Background

5. Three Policy Options • The Restrictive Option: Prohibits human embryo research; does not explicitly permit research with existing human embryonic stem cell lines (shown in red)

6. Three Policy Options • The Permissive Option: Accepts the production of human embryos for research purposes through in vitro fertilization and/or nuclear transfer (cloning) (shown in green)

7. Three Policy Options • The Moderate Option: Permits the derivation of new human embryonic stem cell lines but only through the use of remaining embryos from infertility clinics (shown in blue)

8. A Fourth Policy Option? • The Compromise Option: Permits research with existing human embryonic stem cell lines but not the derivation of new stem cell lines through the destruction of human embryos (shown in yellow)

9. Seven World Regions: An Overview • Europe • The Middle East and the Persian Gulf • Africa • Asia • Oceania: Australia and New Zealand • South America • North America (outside the U.S.)

11. The European Union The rules for funding hESC research under the 6th Research Programme

19. Liberalizing Countries2002-Present • Australia • Belgium • Brazil • Czech Republic • Denmark • France • Germany • Greece • Japan

20. Liberalizing Countries2002-Present • The Netherlands • New Zealand • Portugal • Singapore • South Korea • Spain • Sweden • Switzerland • The United Kingdom

22. U.S. Government Funding Policy Option 2, with a time limit of August 9, 2001, for the creation of the stem cell lines

23. Public Opinion in the U.S. The Gallup Organization, “Society’s Moral Boundaries,” May 16, 2005

24. The U.N. Debate about Cloning Major stages in the debate • August 2001 • February 2002 • Fall 2003 • December 2004 • March 2005

25. The United Nations General Assembly Vote in March 2005 • The key text in the compromise Italian declaration (L.26): • (b) Member states are called upon to prohibit all forms of human cloning inasmuch as they are incompatible with human dignity and the protection of human life;

26. The General Assembly Vote • Nations voting in favor of the resolution (84) • Australia • Austria • Germany • Hungary • Ireland • Italy • Mexico • Poland • Portugal • Switzerland • The United States

27. The General Assembly Vote • Nations voting against the resolution (34) • Belgium • Brazil • Canada • China • Denmark • Finland • France • India • Japan

28. The General Assembly Vote • Nations voting against the resolution (cont.) • Netherlands • New Zealand • Norway • Republic of Korea • Singapore • Spain • Sweden • United Kingdom

29. The General Assembly Vote • Nations abstaining (37) • Egypt • Iran • Israel • South Africa

30. ISSCR Inititatives • June 2006 • November 2006 (projected)

32. Source of Data Figure 1 from Jason Owen-Smith and Jennifer McCormick, “An International Gap in Human ES Cell Research,” Nature Biotechnology 24(4): April 2006, 391-392. Date range: Papers published between November 1998 and December 31, 2004.

33. Ethical Arguments

34. Arguments in Favor of the Restrictive Option Human embryos have a high moral status. They deserve to be protected from avoidable harm.

35. Arguments in Favor of the Restrictive Option When human embryos are developing in vitro, their continuing development does not conflict with any rights of the men or women who were the progenitors of the embryos. Thus, the issues of embryo research and embryo discard can be distinguished from the abortion issue.

36. Implication of This Policy for Assisted Reproduction Only the number of early human embryos should be produced that will be transferred in the attempt to start a pregnancy. That is, there should be no remaining embryos, either fresh or frozen.

37. Arguments in Favor of the Moderate Option Human embryos have an important moral status only after their biological individuality has been established and only after the completion of implantation.

38. Arguments in Favor of the Moderate Option No additional harm is done to remaining early human embryos if they are used in research rather than discarded.

39. Arguments in Favor of the Moderate Option The development of additional HESC research lines offers great promise for basic science in the short term and may help to provide new approaches to therapy in the long term.

40. Implication of This Policy for Assisted Reproduction The current practice of fertilizing multiple eggs per ovulatory cycle is morally justified because it reduces the number of egg retrievals each woman must undergo. The practice of freezing human embryos is permitted because of the embryos’ modest moral status.

41. Arguments in Favor ofthe Permissive Option Certain kinds of hESC research can be conducted only with human embryos that have particular genetic characteristics – for example, genotypes associated with serious diseases like cystic fibrosis or amyotropic lateral sclerosis (ALS).

42. Arguments in Favor ofthe Permissive Option The circumstances of a human embryo’s creation do not affect its moral status while it is in vitro.

43. Arguments in Favor ofthe Permissive Option This kind of HESC research offers great promise for basic science in the short term and may help to provide new approaches to therapy in the long term.

44. Arguments in Favor ofthe Compromise Option Embryos that have been destroyed in the past to create the existing hESC lines cannot be brought back to life. Therefore, it seems reasonable to use the lines in research. However, no additional stem cell lines should be produced if that process would destroy presently existing or future embryos.

45. Religious Perspectives

46. Human Embryo Research and Religious Traditions Thesis: At least some representatives of most major religious traditions judge human embryo research (including human embryonic stem cell research), to be ethically acceptable, within limits.

47. Major Religious Traditionsand Standard hESC Research • In the West • Judaism (an almost universal view) • Christianity • Roman Catholicism (several theologians) • Eastern Orthodoxy • Protestantism (multiple viewpoints) • Islam • The Sunni tradition (multiple viewpoints) • The Shi’i tradition (multiple viewpoints)

48. Major Religious Traditionsand Standard hESC Research • In the East • Hinduism • Buddhism • Taoism This evidence is derived primarily from submissions to the Singapore Bioethics Advisory Committee.

49. A Text from the Hebrew Bible:Exodus 21: 22-24 When men strive together, and hurt a woman with child, so that there is a miscarriage, and yet no harm follows, the one who hurt her shall be fined, according as the woman’s husband shall lay upon him; and he shall pay as the judges determine.

50. Exodus 21: 22-24 (continued) If any harm follows, then you shall give life for life, eye for eye, tooth for tooth, hand for hand, foot for foot, burn for burn, wound for wound, stripe for stripe. Revised Standard Version (1952)