September 2001

Debate Over Stem Cell Research Raises Ethical Issues

In the midst of the highly publicized debate over federal funding for stem cell research using embryos, bioethicists at UAMS were featured on the subject in the Arkansas media. The following is the edited transcript of an interview Roby Brock, the host of “Talk Business,” conducted with Chris Hackler, Ph.D., director of the Division of Medical Humanities. The program aired on Little Rock TV station KLRT August 12.

Brock: Is it true stem cells can actually be transformed into several different types of cells, which is why they are so important to medical research? 

Hackler: That certainly is the hope, but no one knows for sure. That is why it is so important to do the research, so that we can find out what the potential really is. It appears as though we might be able to grow heart tissue that can replace tissue that has been damaged during a heart attack, for example, or brain and other nervous system tissues that can help with Parkinson’s and other kinds of neurological diseases. So, the promise is extremely hopeful, but the research must be done to find out.

Brock: How does the current debate over stem cell research compare to other great medical and ethical debates of the past — for instance, the debate over organ donations several decades ago.

Hackler: With new developments in medical technology, sometimes we have to rethink some basic assumptions, and heart transplantation is a good example. When surgeons developed the ability to take a heart out of one body and put it in another, we had to rethink the very notion of what it means to be dead. Ordinarily, or at least in the past, we considered a person dead only when the heart had irreversibly stopped beating. But to do a heart transplant, one must remove the heart before it has quit beating. Now, does that mean that one would be tearing the heart out of a living person?  Obviously, we are not going to allow that to happen, so we had to rethink what it means to be dead. The result was a new concept of brain death, which is part of the legal definition of death now in every state. The change was made, in part, so we could do heart transplantations.

Brock: Let’s talk about what some of the ethical issues are in this stem cell research debate. Tell me what questions should people be asking themselves regardless of which side of the debate they are on?

Hackler: It is such a difficult issue because the basic question is: ‘When does a human person begin? When does personhood begin?’ Obviously, it would be wrong of me to put you on an operating table and take out a part of your body to put in mine to help me get well. Clearly, that is wrong. One can’t just use a person’s body in that way to help another person.

Now, many people think that the embryo even from the very first moments of fertilization is a human person, and so if we destroy that embryo, no matter how early the stage of development, and use part of that embryo even for great benefit for other people, we’re doing the same thing ethically as ripping your heart out to put in my body.

On the other hand, if we don’t think about the embryo in the very early stage of its development as a human person, then we will think we need to balance the loss of the embryo with the great benefits that could be achieved from its use. But for those who believe an embryo is a person, it doesn’t matter what the benefits are; we shouldn’t sacrifice one person to benefit another or even a great number of people. So the basic issue that divides our society down the middle is, when does human personhood actually begin?

Brock: Let’s talk about the debate on adult stem cells versus embryonic stem cells. Is there a distinction on that?

Hackler: There was hope, and there still is some hope, that we could use stem cells from adults. It is possible to harvest stem cells from adults, but it appears as though these cells are not as versatile, that they don’t have as much potential for becoming various other kinds of organ tissues. More research must be done to decide this matter. Scientists think that the embryonic stem cells will be much more plastic, much more versatile than adult stem cells. But clearly, if adult stem cells could be used to achieve the same purpose, we would do an end run around that central ethical issue that I mentioned, because there would be no sacrifice of one person’s interests for another’s. We would just be taking a few stem cells from the bone marrow for example, and as long as the person agrees to it, so there is no ethical issue. The question is: Can we really achieve the same benefits? We won’t know that until scientists have done some more experiments with both embryonic and adult stem cells.

Brock: Now the President has staked out a position on this. What do you think of his position?

Hackler: I think it is a reasonable compromise in a society that is so clearly and so evenly divided in a way that is so deeply felt. Personally I would rather have seen fewer restrictions on the sources of embryonic stem cells. But, understanding that many people feel very deeply about any use of this kind of material, I think the president’s decision was a reasonable, acceptable compromise within a society so deeply divided.

Brock: Dr. Hackler, twenty or thirty years from now, do you think we will look back on these weeks of debate as a potential turning point in some of the major medical breakthroughs of the day?

Hackler: It depends upon what the research shows. I am not a biomedical scientist so it’s hard for me to say — I have no biomedical crystal ball by any means — but my hunch is, yes — this is one of those big turning points in medicine. If the technology could be developed to grow replacement tissues, perhaps even whole organs, it would be a marvelous advance in biomedical science.

Brock: Dr. Chris Hackler from UAMS, thank you for being with us.