On Aug. 23, after months of debate, President Clinton announced the new federal guidelines for research involving fetal cells derived from fertilized human eggs. The president stated that "We cannot walk away from the potential to save lives and improve lives to help people literally get up and walk."
This new National Institute of Health (NIH) policy now permits federal grant support for human fetal cell research but avoids NIH financing to obtain the fetal tissue that will be used. It encourages the use of human early embryos for the development of stem cells that can eventually replace or repair damaged heart, liver, brain, spinal cord and insulin-producing cells needed in diabetes.
Sen. Sam Brownback (R-Kansas) denounced this decision as "Immoral and unnecessary - and contrary to the wishes of Congress that forbids the destruction of human embryos." This position was reaffirmed recently by the Vatican.
The problem in the past has been how to obtain stem cells in an ethical manner. The increase of infertile couples seeking assisted reproduction has now provided us with the opportunity to obtain embryonic tissue free of the ethical or religious stigma associated with abortion. Stem cells obtained from test-tube (in vitro) fertilization never resided in the womb and they have no brain, heart, face, limbs or fingerprints.
Parental contributions which pool early fertilized eggs, consisting of one to four cells in tissue culture, can eliminate our concern for the ethics of the sacrifice of one individual for another. These pooled early embryonic cells, no longer destined for pregnancy, provide a parable for the recognition that human needs are universal. We are all the same when merged in the common environment of a tissue culture.
With the new federal guidelines, we avoid the sacrifice of the fetus for the medical needs of the living which could threaten our reverence for life. And the NIH has firmly avoided making embryonic stem cell replacement dependent on commercial profit-making. No one is planning to use the culture of fertilized eggs as a source of profit.
Since 1978 medical technology has provided infertile couples with the rewards of pregnancy. The technology of assisted reproduction benefits 50,000 infertile couples in the U.S. each year. This involves in vitro fertilization, or the direct injection of sperm into the egg. To accomplish in vitro fertilization mature eggs are obtained by direct aspiration from the ovaries after hormonal stimulation. Following in vitro fertilization, these eggs destined for pregnancy are placed inside the uterus, while those that are unused are frozen for the possibility of future attempts at pregnancy. This has led to thousands of unused early embryos, consisting of from one to four cells or more, now residing in the purgatory of a freezer.
Very few of those stored frozen early embryos get the opportunity be born. What keeps most of the early embryos in suspended animation are the medical legal concerns as to whether we can discard them.
If these surplus embryonic cells are no longer predestined for existence as children, what is to be done? Under the best of natural circumstances not all fertilized eggs make it to birth whether conceived in the womb or in a test tube.
Many of us in the scientific community cannot understand the religious contrast made between the sanctioned contribution of mature organ transplants vs. the same application of early embryonic stem cells. Along with the NIH we feel that parental responsibility for an attempt at in vitro fertility should permit, where possible, parental donation of the early life they have created for research purposes and for the clinical benefit of those in need.
If we have no concern for the soul residing in a donated organ why should we hesitate if parents donate human tissue, no longer destined for pregnancy, that has never even existed in the womb? In stem cell research, we use cells derived form 2- to 5-day old fertilized eggs.
The value of stem cells would be for those awaiting heart or liver transplantation, or those suffering from stroke, Parkinson's Disease or diabetes. It is tragic to see the dying victims of congestive heart failure gasping for breath while awaiting the "lucky" death of a healthy heart donor. Data is now available from work at VCU showing the myocardial stem cells suspended in a plastic matrix, can create a living "plywood" that could patch the damaged heart instead of requiring a whole heart transplant.
Similar value may be seen in stem cell replacement providing neural tissue in cord or brain injury, or the application to bone marrow transplantation. Stem cells might help in wound healing, diabetes, vascularization and might eventually provide us with options for liver or kidney repair or replacement.
These early embryonic cells have no nervous system, no brain, heart or lungs, but their cells can be induced to provide us with nerves, muscle, skin, bowel, connective tissue, glands, etc when they are provided with the correct stimuli that we are learning to identify.
Our hope is that the pooling of early embryos, removed from the deep freeze, will answer some of the objections of those concerned with the sacrifice of a soul from an individual egg. A pooled collective tissue culture system provides an environment for immortality, certainly more appropriate than antifreeze. In a pooled tissue culture no single individual will be sacrificed to aid the living.
Stem cells, like children, can provide a parent with a legacy that helps others. We feel that religious blessings should go to those parents who contribute their stem cells to those in need. This act of kindness is no different from the generous act of organ donation.
William Regelson and Dale Stovall are physicians who work at Virginia Commonwealth University's College of Medicine.
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