Is Fetal Tissue Research Justified?

As the human population increases and man learns more, his desire to deal with the afflictions that bother him increase. However, dealing with some of these afflictions has proven to be difficult as numerous cell types of the human body naturally lack an ability to divide. Almost two decades ago, the discovery that the human body has multi-potential stem cells, which scientists can harness and manipulate to differentiate into a desired cell type, increased the hope of dealing with afflictions of human tissues whose cells lacked an intrinsic ability to replicate (Vakili et al., 2015). The discovery that fetal tissues have pluripotent stem cells –those with the ability to differentiate into any adult human cells – further increased the hope (Levine et al., 2013). It is for this reason that humans became increasingly interested in fetal stem cell research. Apart from their ability to divide into numerous adult cell-lines, fetal stem cells also produce growth factors that enhance cell division and limit immune reactions. This research promised to deliver the cure to many degenerative illnesses, traumatic injuries, and chronic inflammatory conditions (Vakili et al., 2015). Stem cell research offers an opportunity to provide treatment and management of diseases such as spinal cord injuries, heart failure, Parkinson’s disease, and juvenile diabetes. Numerous challenges have, however, hampered the progress of this research. Earlier studies revealed that despite their perceived benefits, fetal stem cells posed various risks to their recipients (Vakili et al., 2015). This discovery tended to encourage further research in the area rather than derail it. One key challenge that has curtailed the development of this area is the ever-continuing ethical debate. However, most Americans feel that this research is ethical and provides a treatment and disease management solution to most diseases associated with stem cell research. Further, this debate also has legal implications depending on the law of various countries. The fact that one has to harvest a fetus for them to acquire fetal cells for research, which is in itself abortion, is the key driver of these ethical and legal debates. Some people argue that abortion, especially when it is premeditated and done deliberately, is unethical and in some cases unlawful (Vakili et al., 2015). Scientists can use federally approved stem cell lines in their research. However, the potential benefits of fetal stem cells research including the management of neurodegenerative diseases and orthopedic cases, and the fact that many people are in full support of the research as it promises to save humanity from some of the most troublesome diseases fully justify the utilization of this technology. This view is in line with Rawls theory of justice which justifies a deed whose benefits massively outweigh the costs to humanity.

The Science of Fetal Stem Cell Research

Stem cells are cells that can divide and replace other cells of particular tissues. Most human tissues, for example, the liver and the retina have their stem cells which usually divide to replace aged and lost cells of these organs and tissues (Jones et al., 2012). These stem cells are unipotent; they can divide into cells of only one cell line. However, stem cells in the human fetus have a greater potency; this means that they are able to divide into a greater range of cells (Jones et al., 2012). Most fetal stem cells are multipotent – they can divide into various related cells. Some adult stem cells are multipotent too. This unique feature of fetal stem cells that makes them theoretically advantageous over adult stem cells is their pluripotency – their ability to divide into numerous cells lines that form whole tissues or even organs. Such cells offer the advantage of having an ability to replace cells of tissues that lack stem cells and lack an intrinsic inability to divide (Jones et al., 2012). The potency of fetal stem cells is highest during the earlier stages of pregnancy. In fact, at the blastocyst stage, fetal cells are totipotent; totipotency means that these cells can divide and form entire organisms with the placenta.

The placenta itself is an important source of multipotent stem cells. Clinicians have applied placental stem cells of humans and other mammals in the management of traumatic injuries and other surgical problems in orthopedics (Jones et al., 2012). Placental stem, however, have one limitation – they have a limited ability to divide hence they are majorly used in the management of musculoskeletal system disorders or disorders that affect human tissues that are derivatives of the mesenchymal germ cell layer.

The higher potency of earlier fetal stem cells explains the preference of earlier and more primitive fetuses for fetal stem cell research. Moreover, scientists always attempt to use the safest stem cells for transplant into humans (Piroth et al. 2014). As such, fetal cells derived from elective abortions are the safest source of fetal stem cells for research. Some people have proposed that it would be more ethical to utilize fetal stem cells from fetuses expelled spontaneously. However, fetuses from spontaneous abortions are likely to have higher concentrations of microbial organisms hence posing a greater risk of infectious complications in the recipient of the stem cells. Additionally, spontaneous abortions have various causes including infections and chromosomal abnormalities (Piroth et al. 2014). Transplantation of cells with chromosomal abnormalities is likely to cause more complications than help to the recipient. Therefore, fetal cells derived from elective abortions are, by far, the safest.

The source of the fetal stem cells for research is, thus, among the most controversial aspects of these research. Fetal stem cell research seems to encourage abortion which is unethical and unacceptable according to some religions. Further, the effectiveness of the technology is limited and can cause fatal adverse effects like infections. However, despite the imperfections, medical research is a moral duty to humanity since it will be important in the management of the afflictions of man in future. In the same way, despite being one of the areas of medical research with the greatest future potential; fetal stem cell research is also highly controversial. Since its potential is greater than its imperfections, fetal stem cell research is justified.

Application of Fetal Stem Cells in Management of Neurodegenerative Diseases

Neurons are the basic cells and the most important cells of the nervous system. Neurons lack an intrinsic ability to divide (Clarkson, 2001). This feature of neurons poses a major challenge in the management of neurodegenerative diseases including Parkinson’s disease and Huntington disease. Degeneration of dopaminergic neurons in the pars compacta part of the substantia nigra is what causes Parkinson’s disease (Clarkson, 2001). The destruction of these neurons, which are a major source of dopamine, decreases the availability of dopamine in the central nervous system. Dopamine is an inhibitory neurotransmitter in the basal ganglia, which control motor activities. The neurotransmitter is, however, excitatory in other areas of the central nervous system (CNS) including the limbic system. The deficiency of an inhibitory neurotransmitter in the basal ganglia makes it difficult for the brain to control unnecessary motor signals (Clarkson, 2001). These signals are thus transmitted through various nerves to the motor end plates of muscles hence causing muscle contraction. These uncoordinated and largely unnecessary muscle contraction causes the clinical features of Parkinsonism including dyskinesia, rigidity, drooling, and incoordination (Clarkson, 2001).

Throughout history, clinicians have used various strategies to manage Parkinson’s disease. The most important of these strategies include the inhibition of muscle contraction that causes the major clinical features of the disease. However, this strategy only offers symptomatic relief; Parkinsonism continues to progress as more dopaminergic neurons are lost and the amount of dopamine keeps decreasing (Clarkson, 2001). In later years, scientists discovered the use of dopamine precursors which can cross the blood-brain-barrier and access the CNS. In the CNS, these dopamine precursors, including levodopa, are converted to dopamine. Levodopa is combined with carbidopa to prevent its conversion to dopamine peripherally; dopamine cannot cross the blood-brain-barrier (Clarkson, 2001). However, this strategy also does not alter the progression of the disease and the drugs used have various side effects.

The use of fetal dopamine stem cells, which scientists derive from the CNS areas of primitive fetuses and transplant into a recipient’s CNS with the hope that this can differentiate into dopamine cells promises to be curative for Parkinsonism. Clarkson (2001) reports that between 1988 and 2001, 300 American patients had received fetal stem cell transplants. The author also reveals that most of these patients showed improvements in their motor skills and coordination. Moreover, these patients were using lesser amounts of levodopa and their dependency on levodopa decreased. Moreover, the study revealed that the most significant effects of the transplantation occur in the first six months post-transplant (Clarkson, 2001). Further, the number of years of since disease onset do not predict the outcome of transplantation.

However, the transplantation of fetal stem cells poses various risks to the recipient. Piroth et al. (2014) posit that the most important of these risk is the possibility of bacterial and fungal infections. Fetuses and their stem cells are often contaminated; in the study, prospective testing revealed that 47.7% of all fetuses revealed bacterial growth. The practice of immunosuppression in transplant recipients further increases the risk of debilitating bacterial and fungal infections. However, Piroth et al. (2014) propose an elaborate strategy for stringent decontamination of the fetuses hence reducing or even completely dealing with the risk of infectious complications. As such, fetal stem cell research is relatively safe and promises to be curative for Parkinsonism.

Currently, fetal stem cell research is also focusing on the management of other neurological diseases like Huntington disease and multiple sclerosis. Huntington’s disease is a poorly understood neurodegenerative disease with a genetic basis (Piroth et al., 2014). For this reason, fetal stem cell research is highly justified as it looks to solve the problems of humanity and not to destroy fetuses. Therefore, the future of clinical neurology is greatly dependent on advancements in fetal stem cell research. The increasing prevalence of neurodegenerative diseases, especially Alzheimer’s disease as health services and life expectancy increase proves the necessity of fetal stem cell research. Considering the number of humans and families that the technology would potentially help against the number of fetuses that will be lost, the technology is more important to humanity than the fetuses and is, thus, justified in accordance to Rawls theory of justice.

Application of Fetal Stem Cell Research in Orthopedics

Apart from their potential to divide rapidly into cells of various cell lines, fetal stem cells also produce numerous growth factors and cytokines (Hanselman et al., 2015). These growth factors induce the growth and regeneration of other tissues wherever the fetal cells are transplanted. Moreover, the cytokines that the fetal stem cells produce mainly limit rather than encourage inflammation. The inhibition of inflammation prevents scarring thus enhance better tissue function after healing.

The ability of fetal stem cells to produce growth factors and various cytokines confer their usefulness in various fields of surgery, especially trauma and orthopedic surgery. Most connective and muscle tissues including bones, tendons, and ligaments lack an intrinsic ability to divide and lack stem cells (Hanselman et al., 2015). Consequently, in orthopedics, surgeons can apply fetal stem cells to heal difficult tendon and ligament tears, and non-healing fractures. Moreover, the cytokines produced by the fetal stem cells inhibit chronic inflammation and healing by fibrosis and hence enhance the function of the healed connective tissues. These attributes of fetal stem cells explain their application in foot and ankle surgery, especially in athletes where both the patients and their physicians desire quick and complete recovery of the affected tissues without derangement of function.

The growth factors produced by fetal stem cells confer their application in the management of diabetic and other chronic ulcers. After debridement of the ulcers, the application of fetal stem cells causes the surrounding cells to regenerate and tends to suppress extreme inflammation which can interfere with tissue regeneration. This practice enhances the healing of diabetic ulcers. Diabetic ulcers have been an important clinical problem in the past (Hanselman et al., 2015). Thus fetal stem cell research is highly justified as it promises to offer curative measures to surgical conditions that have troubled man in the past.

The prevalence of lifestyle diseases like diabetes mellitus has kept increasing over the years. Further, the need for advanced trauma management techniques has increased; this is especially important in athletics. Fetal stem cell research has a great role in this areas. Advancement of this technology has the potential to positively influence the lives of many people and families when compared to the number that will be devastated by safe medical abortions; thus, the technology is highly justified basing on Rawls theory of justice.

Fetal Stem Cell Research is Ethically Justified

Since fetal stem cell research promises to have great benefits to humanity, many people are in full support of it. Despite the various controversies on selling fetal tissue for profit, there are more humans in the developed world who feel that fetal stem cell research is justified. Allum et al. (2017) found that majority of people in Europe, the USA, and Canada are in full support of fetal stem cell research. In Europe, the perceived benefits of fetal stem cell research are key drivers of its high popularity. By the rules of democracy, the higher acceptability of stem cell research, despite its various controversies, justifies it.

Allum et al. (2017) accept that in America, religious convictions are at the heart of either acceptability or unacceptability of fetal stem cell research. However, the study also found that unlike common expectations, most religious people in both Europe and North America are in full support of fetal stem cell research. Burgins (2009) further found that the members of the congress who opposed fetal stem cell research mainly did so because of inaccurate ideologies rather than factual realities; some were biased against abortion without consideration of possible benefits while others saw the potential adverse effects of the technology as enough reason to stop the advancement of the technology. Some of these members were initially negative towards abortion and simply allowed this negativity to influence their vote. However, even for those who supported fetal stem cell research, their link or close relationship to potential beneficiaries of the technology such as patients with Parkinson’s disease tended to encourage the legislator’s support. Religious convictions were the most important reason cited by those who were against the technology; subscribers of Abrahamic religions like Christianity, Islam, and Judaism view abortion as close to murder and thus unacceptable. The fact that fetal stem cells pose greater risks to recipients compared to any other stem cells fuel traditional Christians’ opposition to fetal stem cell research. However, post-traditional Christianity, which targets to incorporate contemporary principles into the basics of religion, does not oppose the destruction of human embryos to research purposes in that aim at bettering man’s life in future (Thomas, 2013). Burgins (2009) tends to suggest that the moral debate over the legitimacy of fetal stem cell research tend to undermine a good thing rather than add value to it. In other words, there are more individuals who accept fetal stem cell research than those who are against it.

In accordance with Rawls theory of justice, public acceptability is a key dimension of justice. Thus, the high public acceptability is, on itself, a proof that fetal stem cell research is just and should be accepted (Shaw, 2011).  Public acceptability is, in itself, evidence that the advantages of the technology outweigh its risks. It is possible to prevent and to mitigate the primary adverse effects of the technology such as infection and tissue rejection. Further, Rawls theory of justice justifies abortion if the intention for terminating a pregnancy is to save lives and to improve human lives. With current evidence suggesting that the technology is effective, abortion for purpose of deriving fetal stem cells for research is justified.

In his attempt to address this ethical dilemma, Green (2002) exposes the wrongfulness of abortion versus the potential benefits of the technology. The author exposes the beneficiaries of fetal stem cell research as accomplices in the unethical practice of abortion. This aspect is particularly true where the elective abortion is conducted specifically to provide stem cells for managing the condition of the potential beneficiary. Moreover, the author questions the possibility of the unethical practice of abortion increasing on the basis that it is potentially beneficial to the human race. However, the author dehumanizes the process of fetal cell division to form the pluripotential stem cells to conclude that it is ethical for opponents of abortion to benefit from fetal stem cell transplant since it is just one of the therapeutic options available to them. As such, since the application of the technology even in its opponents is ethical, the whole practice is ethical and justified.

Further, in view of Kantian ethics, an embryo does not merit to be a Kantian person. The fetus cannot plan for the end and do not have an idea of what the end is; it is, therefore, not ethically beneficial to treat embryos as autonomous human beings who have rights and a life to live (Manninen, 2008). Thus, abortion is a just procedure when it is done with the right intentions. Furthermore, the woman who procures an abortion is a Kantian person; therefore, the woman has the right to do what she thinks is good for her future, including procuring an abortion. Thus, since abortion is not injustice to a fetus, using a fetus to extract stem cells for research should not spark any controversies. Further, Kantian ethics are based on the view that the end justifies the means; if fetal stem cells can cure Parkinson’s disease, the means of acquiring them should not be a subject of controversy (Manninen, 2008).

Gimbel (2017) also addresses this issue with a mirror of mutual benefit. The author asserts that most feminists, who fully support the birth by choice rhetoric, support abortion. Thus, fetal stem cell research is something that, in itself, justifies abortion. In other words, fetal stem cells not only benefit the practitioners and the patient benefactors but also the mothers to the embryos used as they are able to procure an abortion to a good cause. Even though it is unethical to pay the mothers for their embryos, provision of safe medical abortion to mothers who give their fetuses to this course massively benefits. However, Gimbel (2017) concluded that the fetal stem cell research is exploitative of poor young women from minority groups; a conclusion that is, in itself, biased. The poor young women who are afraid of raising children due to financial constraints are likely to give in easily when someone promises them a few material benefits to offer them a safe medical abortion.

Therefore, a critical look at the issue of fetal stem cell research reveals that it is highly justified and a self-propagating thing. As Vakili et al. (2015) found that even in the absence of funding from the federal government, sheer necessity and developments in other countries kept driving fetal stem cell research. Additionally, a critical look at fetal stem cell research justifies its wide acceptability; it is ethical. Many countries including the USA have laws that govern the use of human tissues and cells for research and therapeutic purposes (Vakili et al., 2016). Strict adherence to these laws and regulations renders the practice legal. According to Rawls theory of justice, it is important to consider the risks or shortcomings of something against its benefits (Shaw, 2011). In the same way, considering the benefits and the potential risks of fetal stem cell research, the research is justified. In the same way, Immanuel Kant separated virtue from justice (Shapshay & Pimple, 2007). As such, even though abortion may not be virtuous, it is just since its potential benefits outweigh its risks or costs in this case.

Conclusion

Fetal stem research has kept developing as it promises to enable man to achieve effective therapeutic measures for various afflictions. The technology promises to control diseases that man has struggled to control such as Parkinsonism, Huntington’s disease, and diabetic ulcers. Moreover, a critical view at the technology reveals that it is ethical and lawful. The technology is popular among many people including strict subscribers to Abrahamic religions. Moreover, since the technology promises more benefits than risks, it is ethical basing on contemporary ethics. Fetal stem cell research is highly beneficial to the recipients of the cells and the women who offer their embryos as they get a chance to have a safe and lawful medical abortion. Moreover, since the practitioners of the technology base their activities on the laws of the land, it is lawful. Thus, there is not ethical dilemma on fetal stem cell research. The ethical rhetoric that curtails the development of the technology is unnecessary. Fetal stem cell research is highly justified and is an area of science that governments should fully support.

 

References

Allum, N. A. (2017). Religion and the public ethics of stem-cell research: Attitudes in Europe, Canada and the United States. Plos One, 12(4), p1 – 14.

Burgin, E. (2009, March). Deciding on human embryonic stem cell research. Politics & the Life Sciences., 28(1), 3-16.

Clarkson, E. D. (2001). Fetal Tissue Transplantation for Patients with Parkinson Disease: A Database of Published Clinical Results. Drugs & Aging., 18(10), 773-785.

Fetal Tissue Research. Laws Governing the Use of Fetal Tissue in Medicine. (2015, October). Congressional Digest., pp. 5-32. Retrieved from http://www.congressionaldigest.com.mcneese.idm.oclc.org

Gimbel, V. N. (2017). Fetal tissue research 7 abortion: Conscription, commodification, and the future of choice. Harvard Jounal of Law & Gender., 40(1), 229-299.

Green, R. M. (2002, Nov). Benefiting from “Evil”: An Incipient Moral Problem in Human StemCell Research. Bioethics, 16(6), 544-556.

Hanselman, A. (2015). Topical Review: Use of Fetal Tissue in Foot and Ankle Surgery. Foot & Ankle Specialists, 297-304.

Jones, G. N.-I.-M. (2012). Ontological Differences inFirst Compared to Third Trimester Human Fetal Placental Chorionic Stem Cells. Plos One., 7(9), 1-15.

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Manninen, B. A. (2008). Are human embryos Kantian persons?: Kantian considerations in favor of embryonic stem cell research. Philosophy, Ethics, and Humanities in Medicine, 3(1), 4. https://doi.org/10.1186/1747-5341-3-4

 

Piroth, T. P. (2014). Transplantation of Human Fetal Tissue for Neurodegenerative Diseases: Validation of a New Prorocol for Microbiological Analysis and Bacterial Decontamination. Cell Tranplantation, 995-1007.

Shapshay, S., & Pimple, K. D. (2007). Participation in biomedical research is an imperfect moral duty: a response to John Harris. Journal of Medical Ethics, 33(7), 414-417. doi:  10.1136/jme.2006.017384

Shaw, D. M. (2011). Justice and the fetus: rawls, children, and abortion. Cambridge Quarterly of Healthcare Ethics, 20(1), 93-101. https://doi.org/10.1017/S0963180110000654

Thomas (Joseph), B. (2013). Human Embryonic Stem Cell Research: Its Importance in the Culture Wars. 19(1), 60-71.

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