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Little Cells, Big Issues: The Ethics of Stem Cell Research

Little Cells, Big Issues: The Ethics of Stem Cell Research. Jeffrey Kahn, PhD, MPH Director and Maas Family Endowed Chair in Bioethics Center for Bioethics University of Minnesota. Speaker Disclosure. The speaker has no relevant financial relationships to disclose. Background.

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Little Cells, Big Issues: The Ethics of Stem Cell Research

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  1. Little Cells, Big Issues: The Ethics of Stem Cell Research Jeffrey Kahn, PhD, MPH Director and Maas Family Endowed Chair in Bioethics Center for Bioethics University of Minnesota

  2. Speaker Disclosure • The speaker has no relevant financial relationships to disclose.

  3. Background • Stem cell research • Why are we interested? • “master cells” • Promise for understanding and treating a wide range of diseases • Where do they come from? • Human embryos—left over or created (UW) • Discarded fetal tissue—abortions (Hopkins) • Adult stem cells (U of MN, others) • Implicates human embryo research • Implicates human cloning research • No real oversight system or process • US approach to regulation: funding brings rules

  4. How we Got Here • 1998-2000—Clinton Administration response to ES cell isolation • Longstanding ban on embryo research • NIH funding decision • August 9, 2001--Pres. Bush announces new federal ES cell policy • State activity • NJ, CA, MA • Congress • vote in 2006 on loosening restrictions?

  5. Sources and Policies • Existing cell lines (J. Thomson and others) • Bush Administration; August 9, 2001 • Discarded fetal tissue (abortions) • Clinton Administration; 1993 • Spare embryos (IVF clinics) • HERP, NBAC, HFEA (UK), CA, Harvard lines • Created human embryos • US private sector (ACT, Norfolk IVF), HFEA, CA • Clones--somatic cell nuclear transfer • US private sector (ACT, others?), S. Korea, California, NJ, HFEA (therapeutic only) • Created hybrid embryos • US private sector (precursor to ACT)

  6. Policy and Ethics • Public vs. private funding • Limit is on use of federal funds • Sense that we can limit government endorsement by limiting public funds • Executive branch vs. Congress • Secy. Thompson: “No limitation on private investment for embryo research” (Aug. 10, 2001; PBS NewsHour) • Is legality of embryo research morally meaningful?

  7. Moral Status of Human Embryos • Continuum from mere tissue to respect as persons • Potential vs. actual persons • Left over (“spare”) vs. created (including cloned)—the importance of intention • New techniques • PGD to remove a single cell • What if cloned embryos couldn’t develop past very early stage?

  8. Stem Cells and the Policy Gap • Embryo research ban • no federal dollars (byproduct of abortion debate in Reagan I) • private funding OK, but no required oversight • Very limited third-party payment for reproductive medicine • no assessment of appropriateness • Very little self-regulation of ART • Limited liability in ART since modest expectations • BUT, Federal funding will bring federal rules and raise the bar for all

  9. What’s at Stake? • Respect for embryos (however understood) vs. value of research • Influence of disease-based advocacy • Role of politics, religion, and ethics in science • How do we move forward as a matter of public policy? . . .

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