Stem Cells, Human Embryos and Ethics (eBook)

Foreword 5
Introduction 7
Contents 10
Contributors 12
The Moral Status of Human Embryos with Special Regard to Stem Cell Research and Therapy 16
1.1 Introduction 16
1.2 The Topic 17
1.3 Embryo Development and the Stem Cell Field 18
1.4 Philosophical and Theological Traditions 21
1.4.1 Personhood 21
1.4.2 Potentiality 22
1.4.3 Biological Continuity 23
1.4.4. Graduality 23
1.4.5 Individuality 24
1.4.6 God’s Creation 24
1.5 Normativity and Terminology 25
1.5.1 Human Life 25
1.5.2 Human Being 25
1.5.3 Dignity 26
1.5.4 Value of Human Life 26
1.5.5 Respect 27
1.5.6 Knowledge as Ethical Value 27
1.5.7 Health 28
1.5.8 Quality of Life 28
1.6 Medical Progress and Respect for Embryos 28
1.7 Conclusion 32
Part I 34
Stem Cells: Sources and Clinical Applications 35
2.1 Introduction 35
2.2 Stem Cell Definition and Potency 36
2.3 Somatic Stem Cells 36
2.3.1 Stem Cells in Blood and Bone Marrow 37
2.3.2 Stem Cells in Skin and Intestine 37
2.3.3 Stem Cells in the Brain 38
2.3.4 Stem Cells in the Heart 38
2.3.5 Stem Cells in the Pancreas 38
2.3.6 Stem Cells in the Eye 39
2.3.7 Stem Cells in the Lung 39
2.3.8 Stem Cells in the Ear 39
2.3.9 Stem Cells in the Liver 39
2.3.10 Stem Cells in the Skeletal Muscle 40
2.4 Embryonic Stem Cells 40
2.4.1 hES Cells 40
2.4.2 ES Stem Cell Research 41
2.4.3 Somatic Cell Nuclear Transfer (SCNT) 42
2.4.4 Induced Pluripotency (iPS) 42
2.5 Prospects and Controversies in the Stem Cell Field 43
References 44
Alternative Means to Obtain Pluripotent Stem Cells 45
3.1 Supernumerary Embryos 46
3.2 ‘Dead’ Embryos 47
3.3 Genetically Defect Embryos 47
3.4 Single Blastomers 47
3.5 Somatic Cell Nuclear Transfer (SCNT) 48
3.6 Parthenogenesis 49
3.7 De-Differentiation of Specialized Cells from Adults 49
3.8 Pluripotent Stem Cells in Newborns and Adults 50
3.9 The Alternative Sources and the Future Development 50
References 51
Neurogenesis and Potential Use of Stem Cells from Adult Human Brain 54
4.1 Introduction 54
4.2 The Complexity of the Human Brain 55
4.2.1 Brain Diseases and Injuries 56
4.3 Tissue Regeneration 56
4.3.1 Regeneration and Neurogenesis in the Brain 57
4.3.2 Regeneration in the Adult Human Brain 59
4.4 Strategies for Neuronal Replacement 60
4.4.1 Endogenous Repair in the Adult Brain 61
4.4.2 Transplantation to the Adult Brain 62
4.5 Conclusion 63
References 64
Can We Use Human Embryonic Stem Cells to Treat Brain and Spinal Cord Injury and Disease? 67
5.1 Introduction 67
5.2 Spinal Cord Injury 69
5.2.1 What is the Spinal Cord Made of? 70
5.2.2 What Happens? 73
5.2.3 Other Types of Spinal Injury and Disease Relevant for Stem Cell- Based Treatment Strategies 74
5.2.4 Current Status of Efforts to Treat Spinal Cord Injury and Disease with Embryonic Stem Cells 74
5.3 Parkinson’s Disease 77
5.4 Alternatives to Cell Replacement 79
5.5 Summary 80
References 81
Stem Cells, Embryos and Ethics: Is There a Way Forward?* 83
6.1 Introduction 84
6.2 White Paper 85
6.2.1 Culture of Pluripotent Cells from Embryos that are Considered Organismically Dead 86
6.2.2 Culture of Pluripotent Cells from Single Blastomere Extraction from Living Embryos ( Embryo Biopsy) 86
6.2.3 Culture of Pluripotent Cells Through the Direct Production of Specifically Engineered Constructs Lacking the Character of Living Embryos – Altered Nuclear Transfer 87
6.2.4 Production of Pluripotent Cells by the Direct Reprogramming of Somatic Cells ( Dedifferentiation) 88
6.3 Practical Implications of the Proposals 89
6.4 Moral Meaning of Emerging Life 90
6.5 Altered Nuclear Transfer 91
6.6 Failures of Fertilization 92
6.7 Systems Biology 94
6.8 Cdx2 94
6.9 Advantages of ANT 97
6.10 Conclusion 98
References 99
Part II 100
An Intercultural Perspective on Human Embryonic Stem Cell Research1 101
7.1 Seven World Regions: An Overview Europe 102
7.2 The United Nations Debate about Human Cloning 106
7.3 HESC Research Policies in the United States 110
7.4 Philosophical and Ethical Issues Surrounding hESC Research 111
7.5 Religious Perspectives on hESC Research, Including Research Cloning 114
7.6 The Quest for the Best Analogy to Our Issue 115
7.7 Summary 117
References 118
Human Embryo Research: The European Perspective 120
8.1 Introduction 120
8.2 Sketching the Situation in the EU 121
8.3 EGE, CDBI, CEC, and EC Research Policy 123
8.4 An Alternative Perspective? 126
References 129
Stem Cells, Pluralism and Moral Empathy 130
9.1 Introduction 130
9.2 Long Live Pluralism? 131
9.3 Two Levels of Pluralism 133
9.3.1 ‘Pluralism without Relativism’ 133
9.3.2 ‘Relativism without Subjectivism’ 133
9.4 Value Pluralism and Systemic Pluralism 134
9.4.1 Value Pluralism 135
9.4.2 Systemic Pluralism 136
9.5 Moral Empathy versus Moralism 137
9.6 Moralism as Forgetfulness 139
9.7 Embryos: Which Values are at Stake? 140
9.8 Final Remarks 142
References 143
Part III 144
The Potentiality Argument and Stem Cell Research 145
10.1 Introduction 145
10.2 Arguments in Ethics 146
10.3 Status of the Embryo 146
10.4 The Potentiality Argument 148
10.5 Potentiality and Other Factors 150
10.6 Potentiality and Rights 151
10.7 Priorities, Social Justice 152
10.8 Alternatives 153
References 154
Can the Distinction between the Moral and the Descriptive Support a Full Moral Standing of an Embryo?* 156
11.1 Introduction 156
11.2 A Traditional View of the Normative and the Descriptive 157
11.3 Critical Comments on the Traditional View on the Normative and Descriptive 158
11.4 A Problem with the Metaphysical Argument: Created in the Image of God 159
11.5 Which Type of Potentiality? 160
11.6 Morton White on the Normative and the Descriptive 162
11.7 Thick Concepts 164
11.8 Thick Concepts and the Method of Reflective Equilibrium 166
11.9 Can Thick Concepts Be Avoided? 167
11.10 Prima Facie or Everything-Considered General Principles? 168
11.11 Prima Facie Principles and Natural Properties12 169
11.12 Graduality of Ethical Considerations 170
11.13 The Application of this to the Moral Status of a Human Embryo 170
11.14 Graduality and/or Created in the Image of God? 172
References 173
The Beginning of Individual Human Life 174
References 181
Embryonic Stem Cell Research – Arguments of the Ethical Debate in Germany 183
13.1 Introduction 183
13.2 Aims and Means of Research with ES Cell Lines 184
13.3 The Restrictive and the Gradualist Position 185
13.4 Ethical Assessment of the Different Ways of Generating Embryos Used for the Isolation of ES Cells 187
13.5 The ‘Protection-Worthiness’ of the Embryo – Further Considerations 188
13.6 Outlook 190
References 190
The Question of Human Cloning in the Context of the Stem Cell Debate 192
14.1 Introduction 192
14.2 Three Argumentational Fallacies 193
14.3 Reproductive Cloning? 195
14.4 Excursus: Gift, Not Property 199
14.5 ‘Therapeutic’ or ‘Research’ Cloning? 199
References 206
Part IV 208
Stem Cells from Human Embryos for Research? The Theological Discussion Within Christianity 209
15.1 Introduction 209
15.2 The Orthodox Churches 210
15.3 The Roman Catholic Church 213
15.4 The Protestant Churches 215
15.5 The Theological-Ethical Argumentation 220
15.6 Conclusion 223
References 223
Theological Arguments in the Human Stem Cell Debate: A Critical Evaluation 225
16.1 Introduction 225
16.2 The Role of Theological Arguments in Debates on Bioethical Issues 226
16.3 Different Argumentative Strategies in Theological Contributions to Bioethics 229
16.4 Theological Arguments in the Stem Cell Debate: Differences and Uniting Perspectives 231
16.4.1 A Conservative Roman Catholic Voice: Richard M. Doerflinger 231
16.4.2 A Moderate Roman Catholic Voice: Lisa Sowle Cahill 233
16.4.3 A Conservative Protestant Voice: Gilbert Meilaender 235
16.4.4 A Liberal Protestant Voice: Ted Peters 236
16.5 Conclusion 237
References 238
Human Embryos and Embryonic Stem Cells – Ethical Aspects 240
17.1 Autonomous Morality Within the Context of Christian Faith: Remarks About the Relationship of Philosophical Ethics and Theology 240
17.2 Ethical Questions Raised by Research Using Human Embryos and Embryonic Stem Cells 242
17.2.1 Ethical Problems Pertaining to the Extraction and/or Creation of Embryonic Stem Cells 242
17.2.2 Impossibility of Separating the Reproduction and Research Dimension of the Cloning Procedure 244
17.2.3 The Researcher’s Burden of Proof Concerning the Moral Status of Human Embryos and Embryonic Stem Cells 246
17.2.4 Explication, High Priority and Reachability of Therapeutic Research Goals 248
17.2.5 Prospects for Success and Lack of Alternatives in Research Using Embryos and Embryonic Stem Cells 250
17.2.6 Ethical Assessment and Procedural Limitations 252
References 252
Index 254