       Human embryonic stem cell research: an ethical controversy that has persisted over time and into the values and beliefs of people around the world today. Human embryonic stem cell (HESC) research offers great hope in alleviating human suffering brought on by devastating diseases and injuries. HESCs are characterized by their capacity for self-renewal and their ability to differentiate into all types of cells of the body. The main goal of HESC research is identifying mechanisms that can differentiate human embryonic stem cells and to turn them into specific cell types which can be used in treating debilitating and life-threatening diseases and injuries we see throughout the world (Siegel). According to Oxford Academic, stem cells hold the capacity to divide and give rise to identical stem cells, or specialize by forming specific cells of tissues in the body. There are two types of stem cells that can be distinguished: embryonic stem cells, which are only derived from pre-implantation embryos and can form cells of all tissues of the adult organism (termed ‘pluripotent’), and adult stem cells which are found in many tissues and under normal conditions, more specialized (‘multipotent’) with an important function in tissue replacement and repair (Wert and Mummery). The National Institutes of Health defines embryonic stem cells as cells, “derived from embryos that develop from eggs that have been fertilized in vitro—in an in vitro fertilization clinic—and then donated for research purposes with informed consent of the donors. They are not derived from eggs fertilized in a woman's body” (“Stem Cell Information.”). 

One might ask what exactly are the potential uses for human stem cells? According to the NIH (National Institutes of Health), human embryonic stem cells have the ability to produce information of the complex events that occur during human development. The primary goal of this research is to identify how undifferentiated stem cells become differentiated cells that form our tissues and organs. Some of the most serious medical conditions, including birth defects and cancer, are a result of abnormal cell division and differentiation. A better understanding of these processes could yield information about how these diseases begin and treatments for them. Currently, human stem cells are being used to test new drugs and medications for safety on differentiated cells generated from human pluripotent cell lines. The most important potential application of human stem cells is the generation of cells and tissues that could be used for cell-based therapies. In medicine today, organs and tissues are donated to replace ill or destroyed tissues. However, the need for transplantable organs and tissues far outweigh the available supply. Stem cells are a renewable source of replacement cells and tissues to treat many devastating diseases (“Stem Cell Information”). 

With this research raises ethical concerns over whether it is morally ethical to subject human embryos to research. Most of the debate revolves around whether people should support this research that essentially involves the fundamental disagreement about how we should treat early embryos. Today, the isolation of human embryonic stem cells involves the dismantling of an early embryo, which it does not survive. Many place value on the human embryo and believe that they cannot be used for our research interests. On the other hand, human embryonic stem cell research carries promise for developing theories for incurable diseases, along with important biomedical research and drug toxicity testing. Essentially, some believe that an early human embryo is merely a collection of cells that has little value and its moral status provides no valid reason to abstain from research. On the contrary, others believe that the embryo has the same moral status as a typical human being, thus, isolating the embryo is murder and clearly unjustified (Quigley et al. 138). In other words, the ethical controversy entails two sides, “Proponents argue that embryonic stem cell research holds great promise for understanding and curing diabetes, Parkinson’s disease, spinal cord injury, and other debilitating conditions. Opponents argue that the research is unethical, because deriving the stem cells destroys the blastocyst, an unimplanted human embryo at the sixth to eighth day of development” (“Examining the ethics of embryonic stem cell research”). If restricted and regulated, human embryonic stem cell research is ethical, as utilizing a mass of cells not yet considered a fetus for the benefit of curing degenerative diseases and cancers does not entail the killing of a human being. 

       As already mentioned, the controversy over HESC research has persisted over time and throughout history into today’s medical field. In 1981, scientists Martin Evans of the University of Cambridge and Gail Martin of the University of California, San Francisco, conducted separate studies that derived pluripotent stem cells, capable of giving rise to several different cell types, from the embryos of mice. These cells were the first embryonic stem cells to ever be isolated in a lab. Then, in 1997, Dominique Bonnet and John Dick of Canada discovered that leukemia originates from the same stem cells that create our blood cells. This was one of the first major studies to state that cancer grows out of stem cells, supporting the concept of “cancer stem cells.” The first batch of human embryonic stem cells derived by embryos was created by a team at the University of Wisconsin, Madison in 1998, led by James Thomson and Jeffrey Jones. After finding that they were pluripotent, the team saw the potential these cells have for drug discovery and transplantation medicine. Just three years after the isolation of human embryos, then President Bush limited federal funding of the research (“History of Stem Cell Research – A Timeline”). An article published by TIME in 2012 talks specifically about the restrictions. In 2001, former President George W. Bush restricted federal funding for research on stem cells extracted from human embryos because the technology required the destruction of human life. Bush stated, “At its core, this issue forces us to confront fundamental questions about the beginnings of life and the ends of science,’ Bush said. ‘My position on these issues is shaped by deeply held beliefs,” he said. “I also believe human life is a sacred gift from our creator.” This ban limited the funding for research on stem cells that have the potential of curing diseases such as diabetes, heart disease and Parkinson’s – to already existing stem cell lines. Federal money could no longer be spent starting new cell lines or conducting any new research. Bush cited concerns that HESC research devalued human life because embryos are destroyed in the process (Park). Then, in 2009, President Barack Obama lifted the restrictions Bush had set in place eight years earlier. An article published on The New York Times, just after his announcement was documented. At the ceremony, before an audience which included lawmakers, scientists and patients, several of which were in wheelchairs, Mr. Obama announced that he was issuing an executive order intended to advance the research. He acknowledged that studying stem cells from human embryos is deeply divisive. Former President Obama stated, 

“Many thoughtful and decent people are conflicted about, or strongly oppose, this research,” the president said. “I understand their concerns, and we must respect their point of view.” But Mr. Obama went on to say that the majority of Americans “have come to a consensus that we should pursue this research; that the potential it offers is great, and with proper guidelines and strict oversight the perils can be avoided” (Stolberg). 

Following Obama’s lifting of restrictions on HESC research, In July of 2009, the NIH issued the revised guidelines on federal funding for stem cell research. This included strict provisions for informed donor consent and the ethical gain of leftover embryos from in vitro fertilization (“History of Stem Cell Research – A Timeline”). These provisions were set in place to respect the moral value of the embryos, as they acknowledged that a human life is just as important as the research itself. Since the 1980s, HESC research has clearly become a large topic of discussion. After hearing what President Obama had to say about the matter, many openly felt the same way about his decision on lifting the restrictions. While the history of HESC research is important in understanding where the world stands with the controversy, the ethical concerns still clearly persist, minus the fact that President Obama feels it is extremely essential. 

So, what exactly is the argument surrounding the ethics of HESC research? Why is it ethical and vital to today’s society? Human embryonic stem cell research does too much good to be evil, says Janet Rowley. Rowley was a professor of medicine at the University of Chicago and a member of the President's Council on Bioethics. Members on the Council were responsible for advising President George W. Bush on bioethical issues in the advancement of medical research. In her article, Rowley states,

“The decision to end many restrictions on embryonic stem cell research has removed a key barrier to research and discovery… A responsible expansion of embryonic stem cell research can advance a vital goal—the search for new medical treatments—while respecting the dignity of human life. At present, there are about 400,000 human embryos in the freezers of in vitro fertilization clinics. Many are destined to be thawed and discarded and thus die. It is a true moral dilemma, but science offers a way to bring something good from a flawed situation (Rowley). 

By using these embryos, which were not created solely for research, but created without the intentions to destroy human life, scientists can conduct promising research without ethical concerns. While people like Janet Rowley find that this research is more helpful than not conducting it at all, some believe that HESC is strongly unethical for valid reasons. Dr. Jim Eckman, a medical professional who holds a position on the advisory board of The Nebraska Coalition for Ethical Research (NCER), argues on Issues in Perspective that human embryonic stem cell research is unethical. The NCER opposes derivation and use of stem cells from human embryos, but supports their use when obtained from umbilical cord blood or other sources that do not involve destruction of human life. Eckman believes that human embryonic stem cell research is immoral and must be banned because it violates the life, dignity, and rights of human beings. He brings up four main points in his argument: every human has a right to life, every human has a right to be protected from discrimination, every human being is an end to be loved, not a means to be used for another’s end, and lastly every human is of equal value to every other human being (Eckman). He concludes his article with stating, “Failure to protect embryonic and fetal human life, the most vulnerable of human beings, erodes the moral fiber of our society” (Eckman). One may wonder how embryonic and fetal human life can be the most vulnerable of human beings, if they are not yet scientifically considered a fetus. While the right to human life exists for everyone, by enacting restrictions and finding common ground within this research, the moral value can be preserved. 

       One of the more popular responses to the dilemma has been to adopt some type of intermediate position. One such position that has been widely defended and also serves as a basis for stem cell policy in many western countries, including the United States under the Obama Administration, is the ‘discarded-created distinction’. In ‘Stem Cells: New Frontiers in Science and Ethics’, the authors state,   

“…a moral line between two types of hESCs based on their origin: embryos discarded following in vitro fertilisation (IVF) and embryos created solely for the purpose of stem cell research. Discarded–created distinction: It is ethically permissible to derive and use hESCs from discarded IVF embryos. It is ethically impermissible to create embryos solely for the purpose of stem cell derivation, and to derive or use hESCs from such embryos” (Quigley et al. 139).

This position gives both sides of the argument stable explanations as to what is ethically sound when completing the research, and what is not. This intermediate position is clear common ground to the ethical controversy that this paper has exclusively detailed.

In Anne McLaren’s, “Ethical and social considerations of stem cell research”, the moral value of donated embryos is again considered. Couples who undergo IVP treatment usually have embryos that they no longer need. These couples then have the option of letting the embryos die, donating them to another couple, or donating them to research. Many feel that moral value of a human embryo develops gradually. McLaren argues that both the stage of development and the object of the research must be considered when judging whether or not embryo research is ethically acceptable. Countries that have laws which allow HESC research set a time limit (McLaren). By identifying the circumstances for when embryos can and cannot be used for research, and limiting the duration that the embryo can be utilized, this research can be deemed ethical.

In Andrew Siegel’s Stanford Encyclopedia of Philosophy, he states, “…there is nothing objectionable about transplant surgeons and patients benefiting from the organs of murder and drunken driving victims” (Siegel). So, why are there objections when human embryos are used to conduct life-saving research that could potentially cure millions of people around the world? To answer this, one might look into the benefits of human embryonic stem cell research. According to the National Institutes of Health, approximately 1.1 million Americans suffer a heart attack each year. Per the CDC, cardiovascular diseases and cancers are the top two causes of death, killing over half a million Americans each year. Stem cell research holds the promise of ways to repair cardiovascular damage and improved cancer treatment. This research also stands to positively impact stroke, respiratory disease, diabetes (respectively 3, 4 and 7 on the CDC list of causes of death), neurological disorders, spinal cord injuries, and some birth defects. The benefits are widespread and vary from development and testing of new drugs to cell-based therapies where stem cells are used to replace ailing or destroyed tissues or cells (“What are the potential benefits of stem cell research?”). These benefits and statistics clearly explain how important stem cell research is to the US population. Some of the incurable diseases and cancers that are the leading causes of death could be cured with the advancement of HESC research.

       Susan Solomon, a health care advocate, supports human stem cell research aiming to cure major diseases and empower more personalized medicine. Her son’s Type 1 diabetes and mother’s fatal cancer are what inspired her to accelerate medical research with real-world results as a social entrepreneur. Solomon begins her speech with how incredible stem cells are. She states, “They are our body's own repair kits, and they're pluripotent, which means they can morph into all of the cells in our bodies. Soon, we actually will be able to use stem cells to replace cells that are damaged or diseased” (Solomon). She also talks about how scientists can now create avatars with human stem cells. Whether it’s the live motor neurons, beating cardiac cells or liver cells, scientists can test for drugs or promising compounds on the actual cells that they are trying to affect. She says that with the advancements of this research, we are not going to have to wait thirteen years until scientists have brought a drug to the market, only to find that the drug does not even work, or worse, harms humans. She ends her Ted Talk with some concluding thoughts about this idea of personalized medicine. Solomon states,

“It's here now, and in our family, my son has type 1 diabetes, which is still an incurable disease, and I lost my parents to heart disease and cancer, but I think that my story probably sounds familiar to you, because probably a version of it is your story. At some point in our lives, all of us, or people we care about, become patients, and that's why I think that stem cell research is incredibly important for all of us. Thank you” (Solomon).

Her personal experiences and story shed light on the argument as to why HESC research is so important for human life, present and future.
