Should the State legislate for embryonic stem cell research?
YES
The current legal vacuum has led to a dangerous paralysis and must be filled by the carefully regulated use of IVF embryos, wrties Dolores Dooley.
SOCIETAL ATTITUDES to the question of fertility practice and embryonic research vary greatly. Some people are fundamentally opposed to any research involving pre-implanted human life, while others take the view that research on human embryos offers a legitimate opportunity to garner new scientific and medical knowledge and provide therapeutic remedies for diseases that cause immense human suffering. The Irish Council for Bioethics is of the view that the moral value of IVF embryos not used for reproductive purposes needs to be balanced against the welfare of patients. Thus, the council supports the carefully regulated use of IVF embryos that are otherwise destined to be destroyed, for the purposes of embryonic stem cell research aimed at alleviating human suffering.
In a recently published report, the Irish Council for Bioethics called for the provision of a comprehensive and cohesive regulatory system and, in particular, the establishment of a State-funded regulatory authority to govern stem cell research and its applications. This echoes the 2005 report published by the Commission on Assisted Human Reproduction, which by a majority recommended that couples be allowed to donate embryos, produced but not used during IVF (known as supernumerary IVF embryos) for research purposes and that a regulatory body should be established to oversee IVF and embryo research in Ireland.
Ireland does not have a legislative basis for the practise of IVF and, therefore, has no legislation pertaining to the use of embryos (supernumerary or otherwise) for research. Following a referendum in 1983, the Constitution was amended and Article 40.3.3 acknowledged the right to life of the unborn. However, no legislation followed this amendment either to define "unborn" or, with the expansion of fertility services, to clarify whether "unborn" included supernumerary embryos from the IVF process.
In 2006, clarification came in the form of a High Court judgment that three frozen IVF embryos were not "unborn", as defined under the Constitution. This case has been appealed to the Supreme Court. Justice McGovern, in his High Court ruling, remarked that rather than being a matter for the judiciary, the decision on whether the word "unborn" should include IVF embryos should be made by the Oireachtas or by the people in a referendum.
Due to a continuing lack of any regulatory authority governing stem cell research, Ireland is in a legal vacuum concerning the disposition of those embryos from IVF not used for a couple's reproductive ends. This legal vacuum has significant consequences for fertility clinics in Ireland, for couples using IVF and for citizens of the State who assume that all IVF practice and embryonic research is regulated and carefully monitored.
Grave uncertainty continues in relation to what is appropriate use of non-implanted embryos in fertility clinics and what options for consent or refusal are available to couples when it comes to the disposition of their supernumerary embryos. Hence, we live with a paralysis in regulated decision-making in relation to the fate of supernumerary embryos. Without a properly constituted regulatory authority, all is permitted.
Furthermore, there is currently no legal impediment on the importation or use of embryonic stem cell lines by scientists. Embryonic stem cell lines derive from pre-implanted embryos and in that process, the embryos are destroyed. If Ireland, on the one hand, prohibits stem cell research or refuses to regulate for it, then should the State benefit from the use of embryonic stem cell lines or future therapies derived from such research in other jurisdictions? Ireland may, once again, have to confront the dilemma of whether use of any future therapies derived from embryonic stem cell research constitutes a moral "free ride" on behalf of its citizens.
In response to the current legal quagmire, the Irish Council for Bioethics is calling for the Oireachtas to establish an independent regulatory authority. This authority could be tasked with clarifying ambiguities in the meaning of the term "unborn" and legislating for the registration, licensing and inspection of persons and premises working with human embryos. Such an authority could ensure clear processes of consent by couples and quality standards based on international best practice.
Failure by successive governments to provide a regulatory authority for fertility practice and research does not ensure that good practice will prevail; on the contrary, to do nothing allows for preventable harm to befall individuals using fertility services.
Whether or not Irish society accepts the council's conclusion that the embryo has significant moral value rather than full moral status, it is imperative that an end be brought to the legal vacuum. A failure to do so not only undermines the moral value of the human embryo but undermines people working in the field of infertility treatment, and the thousands of couples availing of IVF.
Dr Dolores Dooley is a philosopher and chairwoman of the Irish Council for Bioethics
NO
Embryonic stem cell research is both scientifically unnecessary and morally untenable, writes Ruth Cullen.
STEM CELL science is a good news story. Since scientists began discovering more and more about how cells develop and grow, and how they can be used to cure different illnesses, more than 70 new medical advances have been made across a range of diseases, including different cancers, heart diseases, Parkinson's disease, liver conditions, stroke, spinal cord damage etc.
However, the cures derived in this manner were developed using umbilical cord blood, and adult, rather than embryonic, stem cells. The controversy surrounding stem cell research has centred on the latter, since it involves the killing of human embryos.
Those clamouring for embryonic research, including the Irish Council for Bioethics (ICB), say that research on human embryos is needed because adult stem cells are not pluripotent. For this reason, it is claimed, they don't have anything like the research potential that embryonic stem cells have.
There are a number of scientific rejoinders to this point. But, more importantly, there is a vital moral objection: human embryos, however generated, are human beings. This is not merely a philosophical contention. It is, as Dr William Reville recently pointed out in this newspaper, a scientific fact. In other words, rather than simply being a random collection of cells, the human embryo is one of us.
Indeed, the ICB seems to go some way towards acknowledging this. In its recent report recommending that embryos be killed for research purposes, it says the human embryo is possessed of significant moral worth. This acknowledgment of the moral significance of the human embryo is welcome. It is just a pity that the council didn't see fit to follow the logic of this assessment - by recognising the right to life of the embryo.
Instead, the council decided that, although a member of the human family, the human embryo was an expendable member. This is a dangerous path for scientists to tread. Delegating the power of life and death to any sector of society is a step too far, a lesson we should have learned the hard way in the last century.
If designating an entire class of human beings as disposable is the price for scientific and medical progress, then it is a price not worth paying. But, as it happens, that isn't a trade we need to make in this case. Last year, researchers in Japan and the US discovered that they could generate pluripotent stem cells without the need to destroy human embryos.
These stem cells, known as reprogrammed cells, can be generated from adult skin cells. A range of scientists believe that this breakthrough will mark a huge sea change in stem cell science.
Dr James Thomson, who led the US team behind the reprogramming breakthrough, says this new discovery will make the debate about the ethics of embryonic research "a funny historical footnote". Dr Robert Lanza, another expert in the field, said it marked "a new era for stem cells" and was "the biological equivalent of the Wright brothers' first airplane". Quite apart from the ethical advance achieved by this cutting edge science, reprogrammed cells or induced pluripotent stem cells (iPSCs) have a number of scientific and practical advantages over embryonic stem cells. iPSCs allow scientists to create patient-specific stem cell lines for research on human diseases.
Many scientists say that, practically speaking, iPSCs will be easier to generate than stem cells from human embryos. Also, using iPSCs does not involve human embryos or human eggs and so obtaining them doesn't require the consent of a third party.
To date, we have only conducted a shadow debate on this issue. The Government-appointed Commission on Assisted Human Reproduction (CAHR) and the IBC conducted public consultations, which demonstrated the depth of public unease on the subject. In 2007, the Pro-Life Campaign commissioned Millward Brown IMS to conduct polling research on the issue. Seventy-four per cent of those who expressed an opinion agreed the Dáil should legislate to protect the human embryo.
For too long, the Government has allowed bodies such as CAHR and ICB to make the policy running on this issue. The composition of CAHR, which also recommended legalising embryonic research, showed how predetermined the outcome was. The commission voted in favour of such research by 24 to one, indicating total disregard for the profound misgivings felt by large numbers of Irish citizens on the issue.
Instead of legislating to make destructive embryo research legal in Ireland, the Government must intervene to redress the glaring imbalance to date in the consultation process. It is long past time for an open, honest and fair debate on these crucial and sensitive matters. Ireland can be a leader in world class, cutting edge and ethically sound stem cell research. We can strive for a win-win solution provided we abide by one simple principle: do no harm to other human beings.
Dr Ruth Cullen is a spokeswoman for the Pro-Life Campaign