IVF Treatment, Therapeutic Cloning and Possible Future Medical Innovations
With emerging new innovations in technology, medical professionals keep pushing the boundaries of medical research. While medical innovations often aim to offer alternative treatment options to groups of patients who cannot currently fully benefit from existing choices, sometimes these medical innovations are scrutinized for stepping in territories they do not belong. One such controversial debate involves therapeutic cloning of human embryos. Even though the level of medical knowledge and technology used in embryo cloning are to be treasured, the act of cloning human embryos itself needs to be evaluated in terms of its implications in the code of ethics.
Since the cloning of “Dolly” in 1997 using a somatic cell nuclear transfer method, there has been a heated discussion as to whether or not this technology should be extended for use in human embryos. At this point, a distinction needs to be made between therapeutic cloning and reproductive cloning of human embryos where the former refers to using the somatic cell nuclear transfer (SCNT) method in order to obtain patient-specific stem cells for medical purposes1 and the latter refers to producing clones of a person. In 2005, the United Nations declaration on human cloning called the member states upon to prohibit all forms of human cloning on the basis that they are not compatible with human dignity and the protection of human life and that they can potentially lead to exploitation of women2.
While reproductive cloning of human embryos is viewed as highly unethical morally wrong, there are differing views on doing so for therapeutic purposes. Proponents of therapeutic cloning mostly believe that by creating immunologically compatible embryonic stem cells, it can potentially address serious medical conditions that arise from cell degeneration or cell death. Following a number of reported successful attempts at cloning, in 2004, the Human Fertilization and Embryology Authority (HFEA) granted the first license for cloning human embryos in the UK3. The purpose of this license was not to create human clones for reproductive purposes, but rather to investigate into the possible treatment of certain medical conditions. Therapeutic cloning of human embryos holds a promise in research and clinical applications including the use of stem cells as a vector for gene delivery and cell replacement in regenerative medicine4. In the field of regenerative medicine, embryonic stem cells can be used as a source of replacement cells and tissues to treat conditions such as macular degeneration, Immunological diseases, Nervous system diseases, spinal cord injury, stroke, burns, heart disease, diabetes, certain cancers, digestive disorders, lung diseases, arthritis and many more5,6.
While there exist many potential benefits to therapeutic cloning for stem cell research, opponents of this technology point to the ethical issues associated with creation and destruction of embryos for medical treatment or research purposes. One of the main arguments against cloning of human embryos is the argument of potential. This argument rests on two premises: An embryo has the potential to grow into a person, and it is morally wrong to kill a person7. A second line of argument, uses a similar reasoning by accepting embryo as a potential person and suggests that when an embryo is created for medical or research purposes, there is no intention of letting that embryo grow past the blastocyst stage, which essentially means denying a potential person right to life7,8. Another strong opposing argument advocates that the distinction between cloning of human embryos for therapeutic purposes and reproductive purposes is not a clear one and this research is a slippery slope where the line between medical and reproductive cloning may eventually get blurred and the scientists can possibly open the Pandora’s box9. A final concern over cloning of human embryos, as stated by the UN declaration, has to do with possible implications on female exploitation. Given that cloning of embryos requires the use of human oocytes, this project requires participation of a large number of women before any outcome can be reported after a series of trial and error procedures.
Just as there are many benefits to stem cell research using human cloning, there exist several grounded concerns. However, with the numerous possible benefits of therapeutic cloning, abandoning this research on the grounds of fear that things may get out of hand and the technology may get misused does not seem to be the appropriate action. It is very possible to create a legal framework where the anticipated benefits can be realized by minimizing public fear and other associated risks. In order to do so, certain components such as transparency, independent oversight via ethics committees, and a successful demonstration of benefit of this technology will need to be established. With a well-structured legal and ethical framework, allowing cloning of human embryos for therapeutic purposes and not for reproductive purposes can very well be justified.
REFERENCES
1. Yang, X., Smith, L.S., Tian, C.X., Lewin, A.H., Renard, P.J., Wakayama, T. (2007). Nuclear reprogramming of cloned embryos and its implications for therapeutic cloning. Nat Genet, 39(3), 295-302.
2. United Nations General Assembly. Resolution Adopted by the General Assembly: United Nations Declaration on Human Cloning. Fifty-ninth session, Distr.: General 23 March 2005.
3. Stojkovic, M., Stojkovic, P., Leary, C., Hall, V.J., Armstrong, L., Herbert, M. et al. (2005). Derivation of a human blastocyst after heterologous nuclear transfer to donated oocytes. Reproductive BioMedicine Online, 11.
4. Kfoury, J. (2007). Therapeutic cloning: promises and issues. McGill Journal of Medicine, 10(2), 112-120
5. NIH Stem Cell Information Home Page. In Stem Cell Information. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services, 2013. Available at: http://stemcells.nih.gov/info/scireport/pages/chapter3.aspx [cited December 6, 2014]
6. Bajada, S. et al., (2008). Updates on stem cells and their applications in regenerative medicine. J Tissue Eng Regen Med, 2, p169.
7. Staudacher, K. and Vossenkuhl, W. (2009). Ethical Problems of Therapeutic Cloning: An Argument from the Embryonic Potential; B.I.F. Futura, 24, 91.
8. Singer, P and Dawson, K., (1990). IVF technology and the argument from potential, in: Singer, P. et al., Embryo Experimentation (Cambridge), 87.
9. Kolata G, Grady D. Human embryos cloned in S. Korea. Star-Telegram; 12 Feb 2004. Available at: http://www.dfw.com/mld/dfw/7936289.htm?1c. [cited December 6, 2014]