One of the most difficult things about the topic of stem cell research is that many people really do not understand the issue and what is at stake.
What are stem cells?
Stem cells are basically like the “master template” of all the body’s cells. They can become any of the human body’s particular kinds of cells, such as organ, tissue, skin, hair, bone, etc. The envisioned, but unproven, potential of these cells in treatment cases is significant.
There are basically two types of stem cells – those that can become almost any kind of particular cell (these are called “pluripotent”) and those that are limited in the kinds of cells that they can become (these are called “multipotent”).
Here’s where the difficulty enters. Obviously, the pluripotent cells are highly sought after due to their great flexibility. Unfortunately, until very recently, the only source we had for pluripotent stem cells were human embryos – hence the name “Embryonic Stem Cell Research”. Removing stem cells from the human embryo necessarily resulted in its destruction.
The fundamental position of the Church on embryonic stem cell research is, thus, the same as her position on abortion. The human being has inestimable dignity and an inviolable right to life from the moment of conception. She cannot be destroyed in the name of medical research.
Now, multipotent stem cells, though less flexible, can be obtained quite easily and ethically from skin, bone marrow or umbilical cord blood and are often called “Adult (or Somatic) Stem Cells.” These cells have proven more stable and successful in actual treatment cases. The Church supports and encourages adult stem cell research.
An incredible breakthrough using Adult Stem Cells
In November 2007, independent teams of Japanese and American researchers were able to create the equivalent of embryonic stem cells from skin cells. This major development changes everything about the stem cell discussion. These researchers were able to use human skin cells to produce stem cells with the same flexible qualities as embryonic stem cells. These are called “Induced Pluripotent Stem Cells (iPSC).” This breakthrough effectively overcomes the need for human embryos as a source of pluripotent stem cells. Unfortunately, embryonic stem cell advocates continue to press for further research on human embryos.
Church Documents and Teaching
Declaration on the Production and the Scientific and Therapeutic use of Human Embryonic Stem Cells, Pontifical Academy for Life, August 25, 2000
Catechism of the Catholic Church
2275 “One must hold as licit procedures carried out on the human embryo which respect the life and integrity of the embryo and do not involve disproportionate risks for it, but are directed toward its healing the improvement of its condition of health, or its individual survival.”83
“It is immoral to produce human embryos intended for exploitation as disposable biological material.”84 …
Scientific and Therapeutic Use of Embryonic Stem Cells
The first ethical problem, which is fundamental, can be formulated thus: Is it morally licit to produce and/or use living human embryos for the preparation of ES cells?
The answer is negative, for the following reasons:
- On the basis of a complete biological analysis, the living human embryo is – from the moment of the union of the gametes – a human subject with a well defined identity, which from that point begins its own coordinated, continuous and gradual development, such that at no later stage can it be considered as a simple mass of cells.[xiv]
- From this it follows that as a “human individual” it has the right to its own life; and therefore every intervention which is not in favour of the embryo is an act which violates that right. Moral theology has always taught that in the case of “jus certum tertii” the system of probabilism does not apply.[xv]
- Therefore, the ablation of the inner cell mass (ICM) of the blastocyst, which critically and irremediably damages the human embryo, curtailing its development, is a gravely immoral act and consequently is gravely illicit.
- No end believed to be good, such as the use of stem cells for the preparation of other differentiated cells to be used in what look to be promising therapeutic procedures, can justify an intervention of this kind. A good end does not make right an action which in itself is wrong.
- For Catholics, this position is explicitly confirmed by the Magisterium of the Church which, in the Encyclical Evangelium Vitae, with reference to the Instruction Donum Vitae of the Congregation for the Doctrine of the Faith, affirms: “The Church has always taught and continues to teach that the result of human procreation, from the first moment of its existence, must be guaranteed that unconditional respect which is morally due to the human being in his or her totality and unity in body and spirit: ‘The human being is to be respected and treated as a person from the moment of conception; and therefore from that same moment his rights as a person must be recognized, among which in the first place is the inviolable right of every innocent human being to life’”(No. 60).[xvi]
The second ethical problem can be formulated thus: Is it morally licit to engage in so-called “therapeutic cloning” by producing cloned human embryos and then destroying them in order to produce ES cells?
The answer is negative, for the following reason: Every type of therapeutic cloning, which implies producing human embryos and then destroying them in order to obtain stem cells, is illicit; for there is present the ethical problem examined above, which can only be answered in the negative.[xvii]
The third ethical problem can be formulated thus: Is it morally licit to use ES cells, and the differentiated cells obtained from them, which are supplied by other researchers or are commercially obtainable?
The answer is negative, since: prescinding from the participation – formal or otherwise – in the morally illicit intention of the principal agent, the case in question entails a proximate material cooperation in the production and manipulation of human embryos on the part of those producing or supplying them.
In conclusion, it is not hard to see the seriousness and gravity of the ethical problem posed by the desire to extend to the field of human research the production and/or use of human embryos, even from an humanitarian perspective.
The possibility, now confirmed, of using adult stem cells to attain the same goals as would be sought with embryonic stem cells – even if many further steps in both areas are necessary before clear and conclusive results are obtained – indicates that adult stem cells represent a more reasonable and human method for making correct and sound progress in this new field of research and in the therapeutic applications which it promises. These applications are undoubtedly a source of great hope for a significant number of suffering people.
Dignitas Personae: On Certain Bioethical Questions(http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20081208_dignitas-personae_en.html)
28. …Therapeutic cloning, on the other hand, has been proposed as a way of producing embryonic stem cells with a predetermined genetic patrimony in order to overcome the problem of immune system rejection; this is therefore linked to the issue of the use of stem cells. … Human cloning is intrinsically illicit in that, by taking the ethical negativity of techniques of artificial fertilization to their extreme
The therapeutic use of stem cells
31. Stem cells are undifferentiated cells with two basic characteristics: a) the prolonged capability of multiplying themselves while maintaining the undifferentiated state; b) the capability of producing transitory progenitor cells from which fully differentiated cells descend, for example, nerve cells, muscle cells and blood cells.
Once it was experimentally verified that when stem cells are transplanted into damaged tissue they tend to promote cell growth and the regeneration of the tissue, new prospects opened for regenerative medicine, which have been the subject of great interest among researchers throughout the world.
Among the sources for human stem cells which have been identified thus far are: the embryo in the first stages of its existence, the fetus, blood from the umbilical cord and various tissues from adult humans (bone marrow, umbilical cord, brain, mesenchyme from various organs, etc.) and amniotic fluid. At the outset, studies focused on embryonic stem cells, because it was believed that only these had significant capabilities of multiplication and differentiation. Numerous studies, however, show that adult stem cells also have a certain versatility. Even if these cells do not seem to have the same capacity for renewal or the same plasticity as stem cells taken from embryos, advanced scientific studies and experimentation indicate that these cells give more positive results than embryonic stem cells. Therapeutic protocols in force today provide for the use of adult stem cells and many lines of research have been launched, opening new and promising possibilities.
32. With regard to the ethical evaluation, it is necessary to consider the methods of obtaining stem cells as well as the risks connected with their clinical and experimental use.
In these methods, the origin of the stem cells must be taken into consideration. Methods which do not cause serious harm to the subject from whom the stem cells are taken are to be considered licit. This is generally the case when tissues are taken from: a) an adult organism; b) the blood of the umbilical cord at the time of birth; c) fetuses who have died of natural causes. The obtaining of stem cells from a living human embryo, on the other hand, invariably causes the death of the embryo and is consequently gravely illicit: “research, in such cases, irrespective of efficacious therapeutic results, is not truly at the service of humanity. In fact, this research advances through the suppression of human lives that are equal in dignity to the lives of other human individuals and to the lives of the researchers themselves. History itself has condemned such a science in the past and will condemn it in the future, not only because it lacks the light of God but also because it lacks humanity”.
The use of embryonic stem cells or differentiated cells derived from them – even when these are provided by other researchers through the destruction of embryos or when such cells are commercially available – presents serious problems from the standpoint of cooperation in evil and scandal.
There are no moral objections to the clinical use of stem cells that have been obtained licitly; however, the common criteria of medical ethics need to be respected. Such use should be characterized by scientific rigor and prudence, by reducing to the bare minimum any risks to the patient and by facilitating the interchange of information among clinicians and full disclosure to the public at large.
Research initiatives involving the use of adult stem cells, since they do not present ethical problems, should be encouraged and supported.
Attempts at hybridization
33. Recently animal oocytes have been used for reprogramming the nuclei of human somatic cells – this is generally called hybrid cloning – in order to extract embryonic stem cells from the resulting embryos without having to use human oocytes.
From the ethical standpoint, such procedures represent an offense against the dignity of human beings on account of the admixture of human and animal genetic elements capable of disrupting the specific identity of man. The possible use of the stem cells, taken from these embryos, may also involve additional health risks, as yet unknown, due to the presence of animal genetic material in their cytoplasm. To consciously expose a human being to such risks is morally and ethically unacceptable.
The use of human “biological material” of illicit origin
34. For scientific research and for the production of vaccines or other products, cell lines are at times used which are the result of an illicit intervention against the life or physical integrity of a human being. The connection to the unjust act may be either mediate or immediate, since it is generally a question of cells which reproduce easily and abundantly. This “material” is sometimes made available commercially or distributed freely to research centers by governmental agencies having this function under the law. All of this gives rise to various ethical problems with regard to cooperation in evil and with regard to scandal. It is fitting therefore to formulate general principles on the basis of which people of good conscience can evaluate and resolve situations in which they may possibly be involved on account of their professional activity.
It needs to be remembered above all that the category of abortion “is to be applied also to the recent forms of intervention on human embryos which, although carried out for purposes legitimate in themselves, inevitably involve the killing of those embryos. This is the case with experimentation on embryos, which is becoming increasingly widespread in the field of biomedical research and is legally permitted in some countries… [T]he use of human embryos or fetuses as an object of experimentation constitutes a crime against their dignity as human beings who have a right to the same respect owed to a child once born, just as to every person”. These forms of experimentation always constitute a grave moral disorder.
35. A different situation is created when researchers use “biological material” of illicit origin which has been produced apart from their research center or which has been obtained commercially. The Instruction Donum vitae formulated the general principle which must be observed in these cases: “The corpses of human embryos and fetuses, whether they have been deliberately aborted or not, must be respected just as the remains of other human beings. In particular, they cannot be subjected to mutilation or to autopsies if their death has not yet been verified and without the consent of the parents or of the mother. Furthermore, the moral requirements must be safeguarded that there be no complicity in deliberate abortion and that the risk of scandal be avoided”.
In this regard, the criterion of independence as it has been formulated by some ethics committees is not sufficient. According to this criterion, the use of “biological material” of illicit origin would be ethically permissible provided there is a clear separation between those who, on the one hand, produce, freeze and cause the death of embryos and, on the other, the researchers involved in scientific experimentation. The criterion of independence is not sufficient to avoid a contradiction in the attitude of the person who says that he does not approve of the injustice perpetrated by others, but at the same time accepts for his own work the “biological material” which the others have obtained by means of that injustice. When the illicit action is endorsed by the laws which regulate healthcare and scientific research, it is necessary to distance oneself from the evil aspects of that system in order not to give the impression of a certain toleration or tacit acceptance of actions which are gravely unjust. Any appearance of acceptance would in fact contribute to the growing indifference to, if not the approval of, such actions in certain medical and political circles.
Of course, within this general picture there exist differing degrees of responsibility. Grave reasons may be morally proportionate to justify the use of such “biological material”. Thus, for example, danger to the health of children could permit parents to use a vaccine which was developed using cell lines of illicit origin, while keeping in mind that everyone has the duty to make known their disagreement and to ask that their healthcare system make other types of vaccines available. Moreover, in organizations where cell lines of illicit origin are being utilized, the responsibility of those who make the decision to use them is not the same as that of those who have no voice in such a decision.
In the context of the urgent need to mobilize consciences in favour of life, people in the field of healthcare need to be reminded that “their responsibility today is greatly increased. Its deepest inspiration and strongest support lie in the intrinsic and undeniable ethical dimension of the health-care profession, something already recognized by the ancient and still relevant Hippocratic Oath, which requires every doctor to commit himself to absolute respect for human life and its sacredness”.