Thursday, October 23, 2008

Life is for the Living

I'm putting the tangent at the beginning this time because the post following this is quite long. So there appear to be an exponential increase in blogs of late, haha. I haven't gotten around to all of them (or even the older ones that I've had bookmarked for some time now). But I did get to the two following:

a story of a boy and the universe
I Gotta Story To Tell

So if you get a chance, go over and say hi. :D

There is a proposal of great concern in my state right now. I know this issue isn't one in many other states, but mine has one of the strictest limitations. And that is Proposal 2, which if passed, would make embryonic stem cell research legal in my state.

Proposal 2 would allow embryos that would otherwise be discarded from fertility clinics - because they're either diseased, inviable, or were created in excess of fertility treatment - to be allowed to be donated to labs to conduct embryonic stem cell research on. Again, these embryos would have been discarded because they're either no longer useful or could never be useful in IVF; and now they can be used for embryonic stem cell research instead of being wasted.

I keep seeing in the student-run newspaper letters to the editor against embryonic stem cell research. And it infuriates me because it exposes the obvious misunderstanding and lack of knowledge on this subject. It's even likely that these opponents of embryonic stem cell research won't even look further into the issue, or that's at least how they sound. I will attempt to debunk several myths/misconceptions used by opponents.

Before I begin, let me very quickly elaborate what embryonic stem cells are. When the embryo is only a few days old, it becomes 2 kinds of cells - the trophoblast and the inner cell mass. These two cells form a hollow ball with the inner cell mass inside the trophoblast (the embryo at this state is also called a "blastocyst"). The inner cell mass has the ability to become any kind of tissue in the human body, whereas the trophoblast cells become all the kinds of non-body cells (i.e. the placenta, amniotic sac, etc). Adult stem cells are partially differentiated, meaning that they can only become a handful of different cells. For example, bone marrow is more or less blood stem cells, so it can become any kind of blood cell in the body. There are skin stem cells that just become skin. So on and so forth. Now to the issues.

The first is that embryonic stem cell research would take away funding from adult stem cell research, which has been proven effective in over 70 different treatments. This is egregiously wrong on many levels. First, embryonic stem cell research would not take away funding from adult stem cell research. Both kinds of stem cells are very important and need to be researched. It stands that adult stem cells just aren't as powerful, or potent, as embryonic stem cells. Also, all of those 70+ or so treatments using adult stem cells are not yet approved and can't be used by the public. They're still in the infancy of clinical testing, or stage 1 (maybe stage 2 if lucky). The most promising thus far is cord blood from the umbilical cord, where the adult stem cells there can be used to create any kind of blood cell in the body to replenish the body's ability to make blood cells after blood cancers like leukemia. But that's all they can do.

The second is why do we still want to use embryonic stem cells when there have been successes in "re-programming" adult stem cells to behave like embryonic stem cells? Well, it's certainly true that by fiddling around with 4 genes that researchers can "revert" adult stem cells back into embryonic stem cells. The problem here is that to do this the researchers have to use a virus to introduce the necessary genes. That's hard and will never pass clinical trials. The second problem is that these 4 genes also control cancer. So in a lot of samples, rather than becoming embryonic stem cells, these re-programmed cells become cancer. And there hasn't yet been a lot of success in bypassing that and making the "reversion" more efficient. So this is more costly and dangerous than just using embryonic stem cells in the first place, though it's an avenue of research that should (and will) continue to be pursued.

This last one is the one I personally hold the most frustration against. And it's the idea that to get embryonic stem cells that embryos are destroyed. Let's be clear on the word "destroyed." Destroyed, as I understand it in this context, means death or the cessation of life. So when embryos are discarded from fertility clinics, they are verily destroyed. Killed, what have you. Embryonic stem cells on the the other hand are very much alive, in fact, they're immortalized. A researcher takes the inner cell mass and grows them on a plate indefinitely, so they're technically still alive. Yes, the embryo as a functional unit is destroyed. But as far as the properties of living go, these cells are very much still alive.

An extension of this is that life is being destroyed when the embryo as a functional unit is destroyed. Let me reiterate, many of the embryos in fertility clinics can't survive anyway. Again, there is no way these embryos can ever develop into a person because they have a defect in their genomes. It's estimated that 2/3 of all pregnancies end in miscarriage and most of the time the woman doesn't even realize she's miscarried. Even the diseased or defective embryos are of use to science because with them we can understand the genetic background underlying development and genetic diseases. If we know that a particular embryo will develop a particular kind of genetic disease, then drugs can be tested on those cells rather than on animals or people.

I'm not going to trample on anyone's definition where "new individualistic life" begins, but know that most of the time, these embryos just won't survive anyway. And the extras will just be thrown away. Discarded. Destroyed. Dead. Why not put all of these - both the ones that can't survive on their own and the extras - and give them a purpose? If one truly believes that life begins at conception, then every single embryo in a fertility clinic - regardless if it can survive or not, if they're extra or not - should be implanted into a woman somewhere and given a "fair" chance at developing into a person. And this just won't happen. It can't.

I watched a documentary a couple days ago called "Life is for the Living." And you see in there all these people with these horrible dieases and accidents such as Parkinson's, type I diabetes, spinal cord injuries, etc. And right now there are no cures for these. Embryonic stem cells do offer real hope and real potential. If research happens, there could be a cure for these problems one day. I could feel my tears well up several times throughout the film and it's hard to believe that people would deny these people, with all the suffering they've had to put up with and people that are fully realized as human beings, a hope or a chance at a treatment or cure.

So here's the issue: there are about 100 million Americans suffering from diseases and disabilities every day and embryonic stem cell research offers the hope for treatment and cures. That's about a third of the US population we're talking about here. And the question is this: are you willing to let these people suffer because you don't want to "take life" by allowing embryonic stem cell research using embryos that will never have a chance of developing into a person anyway? Would you rather save the thousands of embryos in a clinic to be discarded over the millions suffering today, every day?

If after this and you're still against embryonic stem cell research, fine. That's your decision. No one can stop you from opposing it. But please don't deny the millions of people the hope they need. If you don't approve of embryonic stem cell research then don't use any therapeutic treatments or cures that arise from the research. And heaven forbid, if in the future you should break your spine, or get Parkinson's, or get Alzheimer's, just know that you said "no" and that you are happy and proud to refuse any treatment and/or cures that arose from embryonic stem cell research that could improve or even save your life.


Anonymous said...

If might, I'd like to give you two useful insights to complete your picture of how the other side sees this issue.

1) For those who have thought it through, it's not the using of embryonic stem cells, discarded our otherwise, that offends the sensibilities. It's the very sanction of the production of the embryos in the first place that's grounds for moral objection (since, as you point out, a great many of them will be slated for destruction). And, while miscarriage may be seen as a natural form of death, it's the willing choice of creation and destruction of the embryos that bothers people.

2) Saying that some of the embryos don't die because their cells live on in others is morally equivalent to saying that one is able to survive because he feeds off the flesh of another. Is it true? yes. Is it right? ehhhh....

Another insight, these people will categorically refuse treatment, even if it means living a substandard life due to future accidents or conditions. They see such creation and use of embryos as a very real threat on how the nation values life, and as something that ultimately ends in "bad."

So, hopefully that can help you understand some of the opponents to stem cell research, whether or not you accept the arguments is something else. I'm not sure it'll help you understand your fellow students...they still sound woefully ignorant.

naturgesetz said...

James makes a very good point about it being problematic to create embryos that never will be given the chance to survive.

As for the ones that either cannot survive or will in fact be discarded — there is a difference between seeing someone dying of a disease and putting a bullet through their heart. The same distinction applies, IMO, to letting the embryos die on their own versus taking direct action that kills them as individual organisms.

The condition of the people whose diseases you mention is something no decent person wishes on anyone. Certainly cures are desirable. But they are not guaranteed from embryonic stem cells, any more than they are from adult stem cells. So what opponents of embryonic stem cell research see is the actual destruction of human organisms for only a possibility of a benefit. And even if the benefit is achieved, it is also possible that it could be achieved without killing the embryos.

IMO this is one of those cases where "the end does not justify the means."

Doug said...

Thank you for this ultra-informative post. I really am trying to gain more knowledge on what's going on with our country and its politics and everything and this really has enlightened me on the issue. Also thanks to James and naturgesetz for further explanations.
I want to be the informed voter this year. Thank you for helping with that.

Shane said...

Very informative.
I like the last paragraph.

Aek said...

James: You touch on a key issue in your first point, and that is whether or not fertility treatment is moral. That issue should be at the root, but it's often forgotten because it's been accepted in the US for decades now (except by the very "hardcore").

I'm not sure I fully agree with your second point. I'd liken it more to donating organs - so in a sense a dead person's organs persist in another living person's body, and so a part of the deceased lives on. Neither of our analogies are perfect, but whatever.

I hope you're right about those people. But I've learned that people can be amazingly hypocritical.

naturgesetz: You make an interesting point, however, I'd like to clarify a bit as I'm not sure your analogy's quite accurate.

Most embryos have no shot at life because their genetically inviable. So there is zero chance of them becoming a person. Period. It's kind of like forcing a woman to give birth to a child with anencephaly (a condition where the child is born without a brain and dies within a few hours after birth, if the child is born alive at all) rather than letting the mother abort. And in this case, aren't these embryos just cells?

In the second case, with embryos being discarded, I see the "discarding" as your "bullet through the heart." These embryos are being killed, not having "nature take its course." On the other hand, using them for research gives their very creation (which you and James point out is in contention to some people) some purpose.

There are never guarantees from scientific research, and research is slow. I know, I've worked in several labs. But we have to give it a shot because if we don't, then we'll never know. And as I stated, all 3 avenues of research will (and should) continue - embryonic, adult, and "reverted" adult. In this way, if any one of them shows promise beyond the others, research can be more focused in that direction. My position is still that embryos aren't killed because technically the cells are alive and not only alive, immortalized.

Doug: I'm glad you found this informative. It's an issue that's pretty high on my priority list (as it should be, seeing as I'm a biology major going into the medical field).

Shane: Thanks! I'm glad you like the last paragraph. :P

Anonymous said...

Well, I'm just telling you how it's viewed, that's all. At any rate, it isn't seen merely as a group of cells.

Well, at least I can say for myself that I would deny myself treatment from research directly associated with embryonic research. Then again, we all know I do not value my maybe I'm not your typical bloke.

Of course, it might be difficult to know everything...we can only be so informed it's true. I wouldn't be willing to call someone a hypocrite that didn't honestly know that some treatment they were receiving made possible from stem cell research.

(And yes, for me the moral issue is with the research in the first place.)

naturgesetz said...

Without arguing the meaning of the word "person" I'll just say that the embryo is an individual organism of the species homo sapiens in part of the continuum of development which we all go through.

IMO, discarding an embryo and removing its stem cells are both a "bullet through the heart" of the embryo.

I do not agree that the embryo lives because some cells have been kept alive. The extracted cells are alive, but the organism as an organism no longer lives. It's like organ donors. The organs are only allowed to be harvested when the donor has died. When the organ is transplanted, you don't have two organisms. There is still only one organism: the same one as was there before the transplant. When John Doe receives Richard Roe's heart, he is still John Doe, and Richard Roe is dead.

naturgesetz said...

To explicate —
When I say that the embryo is an individual organism of the species homo sapiens, that is equivalent, IMOP to saying that it is a being that is human. IOW a human being. And as a human being, it should no more be treated as an object than we should.

E said...

First, I must give a shout out to AEK for mentioning my humble little blog. It's really new, so it's not as nearly prolific or controversial as others ;). It was a jolt to see it at the top of the tangent section; and as I find myself going into my own tangent I will post and be quiet. Thank you again.

I am conflicted on both fronts as I am a bio major and a man of faith. The implications of finding a viable means to fight degenerate disease are too great for the scientific/medical community to ignore. When a blastocysts forms there are no distinguishing features. The average person can no more tell the difference in the troph and blastocyst of a dolphin and a human. AND like AEK said, the cells are taken from unusable embryos, so nothing is really dying in the traditional sense.

The organ donor is a good example in respect to explaining how the embryos cellular material help the donee (I believe that is the correct term), but not in terms of death. The organ donor is a sentient being that lived and through regrettable circumstance expired within the walls of, or close to a medical facility. The embryo has no chance if implantation doesn't take place, and to quote AEK, "these embryos just won't survive anyway. And the extras will just be thrown away. Discarded. Destroyed. Dead. Why not put all of these - both the ones that can't survive on their own and the extras - and give them a purpose? If one truly believes that life begins at conception, then every single embryo in a fertility clinic - regardless if it can survive or not, if they're extra or not - should be implanted into a woman somewhere and given a "fair" chance at developing into a person. And this just won't happen."

So, if you wear condoms or use birth control, then TECHNICALLY you're already deciding that you don't want to procreate because you're altering copulation by killing sperm, or regulating your cycle to prevent conception. If you support IVF then you support the harvesting of embryos.

I can understand if you are against it, I really can, I have spiritual beliefs and ethics. But would you deny your child the right to live? Would you deny someone else's child their right to repair a birth defect or injury and be active and enjoy his/her childhood. I dare ANYONE with an opposing vote to walk through the halls of the NICU and pediatric wing of a hospital and tell the kids with leukemia and spinabifita "no".

I know this sounds preachy and I don't mean to be, but there are real live humans here on earth that are being trafficked and sold. To me it seems as if human life is SO valuable, then there would be more attention to stuff like that and ppl would put some of this passion behind those topics.

naturgesetz said...

@e — It would take too much space to respnd to everything you said. Here's a couple of points. The fact that human beings are being procreated with the intention of letting them die is certainly one of the reasons I consider IVF immoral and unethical.

My problem with your next to last paragraph is it seems to say that the validity of a moral principle depends on the willingness of its' adherents to undertake an uncomfortable discussion with people who are affected by that principle. To me this seems to reduce ethics and morality to sentimentality. If you feel compassionate toward people who suffer from some condition, then you you cannot hold any moral objection to anything which might relieve that condition. All principle must yield to feeling happy with the effects of the principle.

But if ethics and morality can never tell us that we can't have what we would like, then they are pointless: we don't need them; we just do as we please.

And to the final paragraph, certainly there are other evils in the world beyond the destruction of embryos and fetuses. But if more attention should be paid to at least some of those evils, that in no way invalidates the opposition to embryonic stem cell research, which stands or falls on its own merits.

Aek said...

Wow . . . I don't think I've ever had so many comments on a single post before. :P

E: I don't post many controversial things! Lol. You're very welcome. I didn't know you were a bio major, yay!! Btw, I don't think you're being particularly preachy, just expressing your views on this touchy issue.

naturgesetz: You clearly have an immovable opinion, and I can respect that. But we're getting a bit divergent here. None of us here are ethicists, much less bioethicists, so who are we to truly define what ethics and morality are? We only know them as far as we ourselves view them and have been taught throughout life.

Just for the record, medical research is governed by an intense hierarchy of rules and restriction. The IRB - which consists of scientists, clinicians, clergy members/ethicists, and community members - decides whether or not any research is ethical, and then decides to allow or deny the research. Above that is the federal HIPAA laws which embryonic stem cell research very easily falls under.

At several levels, any research done on embryonic stem cells is governed by a body of people who collectively determine whether or not that research is legal, moral, and ethical.

We are all of differing views and opinions. And that's why a consensus must be reached when proceeding forward with research. Many proponents for embryonic stem cell research are concerned for attaining the most good for the greatest number of people while minimizing harm. Discarding embryos does not help anyone, and people continue to suffer without hope.

Btw, if you only knew where some skin grafts (and some face creams) originally come from, you should be as equally outraged.

E said...
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E said...
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E said...

Just previewed my post and saw ur comment AEK. I like ur posts...I've LONG ago stopped trying to talk "Doctor-speak" with my close friends. LOL....

In response to naturgesetz:

Please allow me to clarify the contents of my second to last paragraph. It simply means that one should not deny someone something because you have problems with the means through which they resolve their personal [medical matters]. If it does not infringe on your personal being or on that of others, then why cause problems? A good example is Gay marriage. There is a faction of ppl who want to ban it. For what? What would be the logic behind banning gay marriage? Does a man and a man, or woman and woman deciding that they want to enter into a monogamous union before the sight of their creator affect someone else's life in ANY way. The short answer is no. I believe that the same holds true for this research.

Yes, I do believe the experience of coming face to face with someone affected by the types of disabilities that this research would treat could definitely. How can one effectively identify with an issue that they have not experienced? Children don't have a finite understanding of poverty. But let them volunteer to work with kids they're own age who have socio-economic hardships and/or incurable disease and that child will come out with a better understanding of how blessed he or she is.

There is a stark contrast between feeling badly, which I define as sentimentality, and morality which is conformity to the rules of acceptable conduct based on socio-cultural standards. Morality is why ppl are against gay marriage. It's why being homosexual is taboo in the first place, and its probably why most of us are still closeted and can't find a confidant among even our closest of friends. Three cheers for morality.

Lots of ppl feel bad for those who are affected, but does their morality cause them to stand up and make a decision that would change the circumstances under which that person lives? Let's say someone "feels badly for them", ok then what? Feeling badly doesn't dissolve their condition, nor does it mitigate the circumstances under which they live.

I am not saying that one evil invalidates another. My point is that there are tangible beings, that not only have a shot at life, but that are here and are living and being ignored. In vitro is going to continue to go on, that simply fact. My concern is that the there is an effort to concentrate on the lives that we can affect that aren't hypothetical, or debatable. I'm talking about the ones that are currently being lived every minute of the day.

E said...

*A correction* I meant to say:

Yes, I do believe the experience of coming face to face with someone affected by the types of disabilities that this research would affect whether one would consider the means "moral". Because morality is an personal principle.

Aek said...

E: I doctor-speak? Hmm, wasn't really supposed to start doing that until next year, lol. Maybe that's my default, though I prefer to think of it as "bio-speak" until then. :P You should re-join me!!

I'm glad you like my posts! I have a feeling many/most of them are unbearably long, haha (which is why I have few comments?).

If you haven't already, you might find my past post on values, ethics, and morality interesting. The post is titled "A Theological Discussion."

E said...

Really didn't intend on getting into a moral/ethics discussion. Just wanted to post my thoughts. Wasn't tryna rub anyone the wrong way.

Yeah, ur posts are pretty long, but u're probably like me in the aspect of when u get rolling its hard to stop.

Keep postin' and we'll keep reading.