The Dilemma of Embryonic Stem Cells

Victoria Smith

THE DILEMMA OF EMBRYONIC STEM CELLS

Victoria Smith ()

Victoria Smith

WHERE WILL IT COME FROM?

In 2022 I will have my bioengineering degree from the University of Pittsburgh, and I will be working in a lab to grow new organs using various types of stem cells. It is my job to ensure that each patient gets the exact type of stem cell grown organ that they need. One day my boss comes to me with a new assignment: A ten year old patient is in dire need of a new liver, but his parents refuse to accept an organ that was grown using embryonic stem cells. The problem is that he needs this new organ within a day or he is likely to die, but I lack the necessary resources to build his new organ from non-embryonic stem cells in that time frame. The patient’s doctor speaks to me personally and asks if I am willing to lie about the type of stem cell used to grow the liver. He wants me to say that it was grown using non-embryonic stem cells. This will save the patient’s life; however, I will be lying to the parents about the type of stem cell the organ was grown from. Lying about something I know is false is ethically wrong, but the child’s parents are risking their son’s life because they do not believe in using embryonic stem cells. By lying to the parents the son’s life will be saved, but I will be opposing the ethical system set up for engineers.

If the parents learn that embryonic stem cells were used, they could sue me and the company on the basis of being deceitful and going against their wishes. If this happens it would cost myself and my company a large sum of money, and it would also give the company a bad reputation. No one wants to work with a company that is publically known for disregarding the wishes of its customers. The company I work for could very well dismiss me with reasonable cause. This would make it difficult to find another source of employment since it would be on my permanent record that I lied to a consumer. However, the young child would be alive and his family would be together, which begs the question, should I save his life? Or should I follow his parent’s wishes?

ETHICAL CODES

The National Society of Professional Engineers (NSPE) has a code of ethics that all engineers must abide by. The first fundamental canon in the code clearly states, “Engineers… shall hold paramount the safety, health, and welfare of the public” [1]. These are among the first words in the code. This suggests that they are of the utmost importance. The health and safety of the public comes before all other concerns. This indicates that the life of the patient is more important than the opinions of his parents. This is useful in the decision on whether to follow through on the request of the doctor or not. I would rather save his life and deal with the repercussions later, than know I could have done something to help him even if it may have been unethical. Also stated in the NSPE code is that if an engineer makes a decision that is overruled by someone else, which then endangers life or property, the engineer should alert the appropriate authority [1]. As an engineer in that situation I would make an embryonic stem cell since it would save the child’s life. The parents are overruling my decision and therefore endangering their son. I would be obligated to tell those who could then take action on this issue. Those authority figures may include the police, more doctors, and my boss. Hopefully a combination of these specialists would be able to convince the parents, or give me permission to give the child the liver even without their consent. These two sections of the NSPE code of ethics are particularly helpful in the ethical problem. Both sections are leaning towards the idea that the life of the patient is more important than the ideals that his parents are trying to uphold. Engineers are working to protect lives, and it seems counterintuitive to have the ability to save a life, and not be allowed to do so.

One part of the NSPE that was not helpful in the decision was the canon, “Engineers shall perform series only in the areas of their competence”[1]. The feat which I am attempting to accomplish is clearly within the limits of my job, since it is exactly what I am paid to do. I am trying to grow a new organ in a laboratory for a specific patient utilizing a specific set of materials. This canon is not useful whatsoever and does not help advance the decision on my issue any further.

The Biomedical Engineering Society (BMES) Code of Ethics contains much of the same information as is in the NSPE code. The primary canon in the NSPE code is the same in the BMES code. The BMES code explains that engineers shall, “Use their knowledge, skills, and abilities to enhance the safety, health, and welfare of the public” [2]. Similarly to the NSPE code this leads me to believe that the safety of the patient is paramount to all else. The welfare of the public is more important than arbitrary choices of others.

EMBRYONIC STEM CELLS

The following information contains the majority of my research on embryonic stem cells. It encompasses information on the donation of stem cells and what medical professionals think is appropriate in terms of the use of these cells.

Donation

There are many situations where biological materials can be donated, such as the donation of blood or bone marrow. There is no ethical question as to whether or not these materials should be used because they were donated. The same thought process should be used for stem cells. According to Bioethical Inquiry, when embryos are created for reproductive assistance, there is sometimes a surplus that are not used for the intended purposes. They are then discarded, and if the country’s laws allow, they can be donated. Some countries allow the use of the embryos for stem cell research, and it is in fact their greatest source of stem cells, while other countries strictly forbid any use of these embryos [3]. If embryos are donated according to the nation’s laws, then there is no reason that they should not be used to their fullest extent. The embryos and stem cells would otherwise be wasted. Instead they should be used to save other’s lives. Especially if the fate of the stem cells was to be destroyed. In either case the stem cells would go to waste when they could be helping to extend the lives of others. The article also claimed, “The commonest rationale for opting to donate was a willingness to contribute to potentially curative medical research” [3]. If the donors are in complete agreement for the use of their donated embryos then there should be no restrictions on what the cells can be used for.

In this scenario the company I work for only uses embryonic stem cells that have been donated. Therefore, it is completely within the legal and ethical bounds for my company to use those stem cells. The parents of the patient should be able to recognize that the stem cells were donated for a situation similar to their son’s. They may be morally objected to the use of stem cells, but these stem cells have been willingly donated for the sole purpose of helping others recover and live better lives. This article is helpful to my scenario because it proves that not all embryonic stem cell use is immoral. If they are donated with the intent to aid others, it would be wasteful to not utilize them to their full extent.

Embryonic Stem Cell Replacements

Embryonic stem cells have no replacement that is known of yet, but scientists are working to find an alternative method that works just as well. The most recent advancement seems promising. The new method that Mark Brown, a professor at the University of Wisconsin, discusses is called induced pluripotent stem cell research. These stem cells can do the same things that embryonic stem cells do, without raising a moral impediment. It has become possible to create these cells without using embryonic stem cells, which erases the moral question of whether or not embryos are living and should be looked at using the same laws as all living humans [4]. In the words of the journal, the “technology seems to render this ethical debate quite moot” [4]. If this is the case then situations such as mine will no longer be a possible future. This article was not helpfulin coming to a decision about my scenario. This new method may render my scenario to be completely obsolete. There would no longer be any embryonic stem cells in the future. It does not address the moral question of embryonic stem cells. It only discusses the lack of a moral side of the new method. It is not helpful in my decision on whether or not to use the available embryonic stem cells to save the boy’s life.

Other Opinions

The debate on stem cells has been going on since approximately 1998, when the first human embryonic stem cells were harvested [5]. Since this first derivation of embryonic stem cells, research has continued with a growing fervor. The uses of these stem cells seem endless. According toScientific Engineering Ethics, one of the largest debates against these stem cells is that, “The process of isolation of ESC from a pre-implantation embryo called the blastocyst, results in the death of the embryo” [6]. The reason most dissenters are morally against the use of stem cells in because the embryo dies. The idea of killing another human is against many peoples’ values. However, the debate on whether or not embryos are actual, living humans is another topic. In my situation, this article was quite helpful. It was a study on medical students and doctors. The study consisted of approximately half male and half female volunteers. Of those who responded to the survey question, 85% of the males were in favor of stem cell research, while 86% of the females held the same opinion [6]. It represents that a large majority of the medical professionals believe that stem cell research is morally sound and that its benefits outweigh its downfalls. Dr. Cheryl Lee, an emergency room doctor in Cincinnati, Ohio, has the opinion that it is “totally justifiable” to use stem cells to save a patient’s life. Using fetal tissue that would otherwise not be used is completely warranted [7]. If the majority of medical professionals agree that stem cell research is justifiable, then the fact that the non-medically trained parents dissent has little to no sway on my opinion. The doctor of the patient and many medical professionals all agree that the use of stem cells to save a patient’s life is completely legitimate.

THE DECISION

In the end, it is of my opinion that the life of the boy is more important than his parent’s decision to not use embryonic stem cells. It is clear that the majority of medical professionals agree that it is worthwhile to use the embryonic stem cells, that may or may not grow to have a full life, to save the life of a patient who is guaranteed a complete life if the stem cells are used. Embryonic stem cells that are willingly donated should be unrestricted in their use. The donors understand what they are sacrificing, and they are in complete agreement that it is worth it to donate in order to save another human’s life. The ethical codes clearly state that an engineer’s first duty is to the safety of the public [1, 2]. In this case, the boy is the public, and his life is in danger from his parents. The decision to use the embryonic stem cells to save the boy’s life is an easy decision. In other similar circumstances I would make the same choice to save patient’s lives. The only way I would change this decision is if I knew that the stem cells would in some way cause him to come to future harm.

ADVICE FOR ENGINEERS

To any engineer in a similar dilemma, I advise looking at case studies with comparable circumstances. It was difficult to find a situation that was applicable to my topic due to the futuristic notion of my topic. If there had been similar situations I would have thoroughly researched them to understand what actions had been taken, and what the outcome was. I would then have decided whether or not those outcomes were favorable for the public. If they had been beneficial to the public, I would have taken similar measures. If they had not been beneficial, I would attempt to understand what those situations failed to do. By looking at the downfalls and successes of others, we can see what does the most good for the greatest number of people. I also advise to engineers in similar predicaments to do what they believe is right. Generally those who are practicing in the field have a higher knowledge than those who are emotionally involved in the situation. The engineer knows that the stem cells were donated to help the public in any way they can. It would be unwise to not utilize the stem cells to save a life. Typically the engineer will know best. When an engineer is confronted by another professional and that professional asks them to do a task to save a life, it seems logical to follow that professional’s advice. When the options are to save a life and lie, or to tell the truth knowing you are responsible for someone’s death, the decision is not difficult. I would make the same decision to save their life every time, knowing what the possible repercussions are.

REFERENCES

[1] (2007). “Code of Ethics for Engineers”. National Society of Professional Engineers. (Online article).

[2] (2004). “Biomedical Engineering Society Code of Ethics”. Biomedical Engineering Society. (Online Article).

[3] J. L. Scully, E. Haimes, A. Mitzkat, R. Porz, C. Rehmann-Sutter. (2012). “Donating Embryos to Stem Cell Research”. Bioethical Inquiry. (Online article).

[4] M. Brown. (2013). “No Ethical Bypass of Moral Status in Stem Cell Research”. Bioethics. (Online Article). pp. 12-13

[5](2015). “Stem Cell Basics”. National Institute of Health. (Online article).

[6] N. Manzar, B. Manzar, N. Hussain, M. F. A. Hussain, S. Raza. (2013). “The Ethical Dilemma of Embryonic Stem Cell Research”. Scientific Engineering Ethics. (Online article). p. 97-98, 102

[7] C. Lee. (2015, November 1). Interview

ADDITIONAL SOURCES

“Air Bags, Safety, and Social Experiments”. Online Ethics Center. (Online Article).

“Prioritizing Needs”. Stanford Biodesign. (Online Article).

“The Leaning Tower: A Timely Dilemma”. Texas Tech University. (Online Article).

ACKNOWLEDGMENTS

I would like to thank the librarians for their extremely useful website. It provided almost all of the information we needed. I would also like to thank Matthew McCutchen f

or keeping me on task when I was getting distracted from this paper. I would also like to thank my mom for letting me interview her, and for being a medical professional whose opinion on medical topics has a legitimate standing in the professional world.