Week 3 assignment_Human Engineering

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Oct 30, 2023

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1 Ethical issues in stem cell research Introduction Embryonic stem cell research offers great platform and path forward to understanding basic mechanism of human development and differentiation, as well as the hope to develop treatments for diseases. This raises sharp ethical and political controversies and has faced major push back that have generated an enormous number of political battles leaving the society in a major dilemma. A stem cell is a cell with the unique ability to continuously divide and differentiate into specialized cells or tissue types in the body. They can broadly be thought of in terms of whether they are derived from the embryo or foetus or from the adult, for example, bone marrow mesenchymal stem cells (Barker et al, 2013). Stem cells derived from the developing embryo or foetus have greater capacity for expansion and differentiation, but they have brought a lot of ethical problems related to the destruction of the embryos/foetus. Arguments put forth against and in support of embryonic stem cell research Until recently, all human embryonic stem cells came from embryos created in excess by in vitro fertility clinics. Women and couples who undergo infertility treatment often have frozen embryos remaining after they complete their infertility treatment. Some choose to donate these remaining embryos to research rather than giving them to another couple for reproductive purposes or destroying them (Lo et al, 2009). Several ethical concerns come into play when frozen embryos are donated, including informed consent from the woman or couple donating the embryo, consent from gamete donors involved in the creation of the embryo, and the confidentiality of donor information, even though they are eventually destroyed or thrown in the trash if they are not donated for biomedical research (Lindsay, 2008). The major debate and controversy associated with stem cell research is the concerns about moral implication of harvesting and using embryos in the stem cell research, which then leaves the embryos dead and research that promises treatment of several diseases which then improves the quality of life for suffering patients. The question then is, which is more valuable – the life of a human suffering from an illness or injury, or the life of human at one week of development? Is the potential to cure millions of a wide range of chronic debilitating diseases overshadowed by the possibility that this groundbreaking research, to some, violates the sanctity of life (Qwerty, 2013)? This is a legitimate concern for the pro- lifers who believe that harvesting embryos is the same as abortion and violation of human rights but at what point does humanness or personhood start in the developing human embryo or foetus? Some people believe that an early embryo is not an individual (Lindsay, 2008) whereas others believe that there is a clear threshold beyond which the cells become a person with human rights but that before this, it does not (Barker et al, 2013). The ability of these cells to generate large numbers of cells from a limited source have made them attractive to modern research in medicine with the hope to use these stem cells to replenish cells and repair dysfunctional systems for study as well as treat diseases. Stems

2 cells can also be used for drug screening to identify agents that may be therapeutically useful especially for chronic neurodegenerative diseases such as Parkinson’s, Alzheimer’s, and several other diseases. Could the ethical debate be put to rest with the use of adult stem cells instead of embryonic stem cells? Do we know enough yet about the potential of either embryonic or adult stem cells? For many years, doctors have been performing bone marrow and blood forming stem cells transplants and have treated over 70 diseases using adult stem cell therapy (Mitchell, 2009). Currently, there are few private clinics that are offering treatments or interventions using adult stem cells but at a hefty price that is not covered by the insurance. One of the challenges of using adult stem cells is that they do not have the same potential to proliferate under research conditions as the embryonic stem cells and must undergo a complicated process of de-differentiation prior to application (Lindsay, 2008). Although the potentials of adult stem cells are still ongoing, it is unclear whether these cells can develop into many different types of tissue as opposed to developing into different types of cells of similar tissue. Research have also shown that adult stem cells lack a key protein that maintains the pluripotency of embryonic stem cells, which suggests that they are not pluripotent (Barker, 2013). One major advantage of using adult stem cells is that replacement tissue could be developed from a person’s own adult stem cells without the issue of immune reaction or rejection as it would with embryonic stem cells (Lindsay, 2008). This approach avoids the ethical issues intrinsic to human embryonic stem research but does bring with it concerns that the disease being treated may also develop in the grafted tissue given it is derived from the patient themselves (Barker et al, 2013). Lack of evidence to support the efficacy and safety of the treatment interventions using adult stem cell, suggests that they are experimental in nature (Lysaght et al, 2013). How ethical consideration have changed after new advancements in genome editing Gene editing is a powerful technique that involves modifying specific parts of the genome by adding, removing, or changing genes of that living organism. In germline modification, gene editing changes the DNA of embryos, eggs, or sperm and because germline DNA is passed down to all future generations, any changes whether beneficial or harmful would have effects on all offsprings. The risks of such biologically extreme experimentation would be huge, from the early stages of embryonic development through the life span of an individual (Gaj, 2013). The ability to manipulate and study model organisms has dramatically expanded even though for safety, ethical, and social reasons, heritable genome editing is widely considered unacceptable and is prohibited in 70 countries by a binding international treaty (Biopolitical times, 2015). Some scientists have argued that germline editing could be used to prevent inherited diseases, but this would carry unacceptably serious safety, ethical, and social risks (Gaj, 2013). New technologies give rise to ethical questions about their unknown risks and benefits. These questions become especially tricky and essential especially when considering something like human germline editing, which affects future generations who obviously can’t consent to the changes being made to their DNA. What kind of risks are women being exposed to when carrying pregnancies of these gene edited babies? How could potential parents make informed decisions when there would be unknown health risks that might emerge during pregnancy for the woman and the fetus, epigenetic effects, and health issues that might not develop until adulthood or old age or that might affect future generations (Khan, 2019). Even though genes can be added or deleted in an organism, it would take a lot of time and experiments to predict what those added or deleted genes might do in the cell or the organism. This

3 would be extremely difficult, if not impossible, to ethically conduct the kind of follow-up studies that would be necessary to say that human genome editing is safe enough to use in reproduction. Scientist often present human germline modification as a way to prevent the transmission of inherited diseases but this can also be achieved through embryo screening and without manipulating any genes. Gene manipulation would eventually make it possible to eliminate undesirable traits such as race or gender, height and so many other issues. The social and commercial dynamics in which human germline modification would necessarily develop could easily exacerbate global disparities and take structural inequality to a whole new (molecular) level hence favoring those that are economically or socially privileged (Biopolitical times, 2015). UNESCO’s universal declaration on the human genome and human rights, unanimously passed by 77 national delegations, declares that the human genome underlies the fundamental unity of all members of the human family, as well as the recognition of their inherent dignity and diversity (Biopolitical times, 2015). I think we should be against the creation of genetically modified humans due to the dangers of irreversible traits we never know how that will affect us in the future or the ones we love.

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4 References Barker, R.A., & Beaufort, I. (2013, May 7). Scientific and ethical issues related to stem cell research and interventions in neurodegenerative disorders of the brain. Progress in Neurobiology, 110 (2013), 63-73. http://dx.doi.org/10.1016/j.pneurobio.2013.04.003 Linsay, R. A. (2008) Future bioethics. Overcoming taboos, myths, and dogmas. pp243-259.pdf Lo, B., & Parham, L. (2009, May 1). Ethical issues in stem cell research. Endocrine Reviews, 30 (3), 204– 213, https://doi.org/10.1210/er.2008-0031 Mitchell, T. (2009, March 11). The debate over stem cells. https://answersingenesis.org/sanctity-of- life/stem-cells/the-debate-over-stem-cells/ Khan, S. H. (2019, June). Genome-editing technologies: Concept, pros, and cons of various genome- editing techniques and bioethical concerns for clinical application. Molecular Therapy: Nucleic Acids, 16, 326-334. https://doi.org/10.1016/j.omtn.2019.02.027 Biopolitical times. (2015, May 7). Genetically modified humans? Seven reasons to say “No”. Center for genetics and society. https://www.geneticsandsociety.org/internal-content/what-human-gene-editing American society for reproductive medicine. (2013, October) Donating embryos for human embryonic stem cell (hESC) research: a committee opinion Fertility and Sterility. American Society for Reproductive Medicine, 100 (4), 935-939. http://dx.doi.org/10.1016/j.fertnstert.2013.08.038 Lysaght, T. & Campbell, A. V. (2013). Broadening the scope of debates around stem cell research. Bioethics, 27 (5), 251–256 https://doi.org/10.1111/j.1467-8519.2012.01963.x Gaj, T., Gersbach, C. & Barbas, C. (2013). ZFN, TALEN, and CRISPR/Cas-based methods for genome engineering. Trends in Biotechnology, 31(7), pp.397-405.