Stem cells Flashcards
ethics and stem cell 4 domains considered
- the over-sell and its implications…….
The long term effect of the “ethical shadow”..
The use of embryonic stem calls will always be
tough for many people….
Ethical challenges of stem cell derived
gametes….
stem cells so far
Major breakthroughs in stem cell research have not yet enjoyed clinical success—all stem
cell therapies, bar hematopoietic stem cell transplantations remain experimental.
Despite great strides in understanding stem
cell biology, very few stem cell–based
therapeutics are as yet used in standard
clinical application.
Market forces/costs
There is often a belief in medicine that medical
improvements transcend market forces because they improve people’s lives,
Yet access to health care is the biggest ethical question in the world today.
Of major ethical concern is the production of patient-
specific therapies and personalized medicine, is its
cost.
A misconception that underlies the direct-to- consumer marketing of unproven uses of stem cells is that stem cells can be used as a cellular
panacea.
Furthermore, once off-label use of approved
stem cell applications becomes an option, there may be a new flood of untested therapeutic claims with which to contend.
The effect of marketing unproven therapies
Unproven stem cell therapies increase the risk
of therapeutic misestimation (where patients
incorrectly estimate the probability of benefit or
risk,
jeopardises the reputation of legitimate therapies
Deepens misconceptions regarding the current state of scientific and clinical developments.
the market for unproven therapies appears to
be expanding.
invasive procedures being done without evidence based practices
Often intrathecal injection or Intravenous infusion being preformed ; significant risk…
Highly driven by marketing, not evidence…
Occurring in hundreds of countries; taking
advantage of regulatory loopholes or non
existent regulations….
clinical progress and stem cell genomics
Concern that some of these technologies are generating research but not much in terms of clinical interventions.
Oversold?
Hype?
research or treatment?
With many interventions there is a complete blurring of lines between research and
treatment..
In many cases not research at all.
No available evidence beyond of testimonials…
the moral status of an embryo
Not a scientific question?
Long standing ethical question that will not go
away…
very closely tied to the abortion debate
Broad social consensus very unlikely
stem cells and reproductive technology
Stem cells are undifferentiated, due to their unlimited source, stem cells are considered as potentially new therapeutic agents for the treatment of infertility.
Stem cells could potentially be stimulated in vitro to develop various specialized cells
including male and female gametes
Furthermore, stem cell-based strategies for ovarian regeneration and oocyte production have been proposed as future clinical therapies
for treating infertility in women.
potential use
If a viable source of oocyte production were to remain in women with a reduced ovarian follicle pool, the potential exists to restore fertility in
these women.
This could be used for women that have has aggressive chemotherapy or ,are of advanced age.
multiple biological patents
A single child might be brought into existence through a rapid succession of genetic generations.
First, two in vitro embryos would be derived from two different couples either by IVF using their own gametes or by creating stem cell-derived gametes.
Subsequently, embryonic stem cell lines would be derived from each of these embryos and
differentiated into gametes out of which a singlenew embryo would be created and gestated. In this—still hypothetical—case, four people would together create a child. (Palacios-Gonzales et al,
2014).
same sex couple having genetically related children
The reproductive use of SCD-gametes for same-sex
couples is also grounded in an equality argument.
Alternatively non-therapeutic use of mitochondrial
replacement technology would allow lesbian couples to
have a child who is genetically related to both parents:
one mother providing the nuclear DNA, the other
providing the mitochondrial DNA.
SCD-gamete technology, however, promises a more
substantial genetic relatedness, both for lesbian and
gay couples.
solo reproduction
The possibility to combine a ‘natural’ gamete and
a derived gamete from the same individual does
exist.
Parent would in turn be mother and father in one.
Yet many argue, concepts of motherhood and
fatherhood are not fixed and evolve as societies
change.
One argument supporting this method is it may
create a stronger bond with the single genetic
parent.
cons of solo reproduction
Risks of disease and disability associated with
consanguinity(being genetically related) are real.
health risks to the offspring in turn is a major
ethical red flag.
solo reproduction limits the offspring’s possibility to
identity by not having knowledge of two branches
of genetic relatives, although there are possible
advantage.
ethical questions to consider
First, basic and preclinical research to generate gametes in vitro will involve the creation, use, and destruction of oocytes and embryos. For some this will be problematic.
Second, any initial clinical use of stem cell- derived gametes will be replete with risk and
uncertain outcome.
In turn extensive pre-clinical research on human embryos is required to understand process and improve safety and efficacy.
A key principle, and challenge, is that human biomaterials used to derive new stem cell lines must be obtained with explicit ,voluntary and full consent by the donor, and that consent is consistent with the full range of research use of the donated biomaterial.
Fourth, creating stem cell-derived gametes raises the possibility of making oocytes
exclusively for research purposes
