Embryonic stem (ES) cells are believed to be able to differentiate into all tissues found within the human body. Potentially, these cells could be manipulated in the laboratory to induce the formation of specialised cells and new tissues which could be used to treat diseases such as multiple sclerosis, Alzheimer's disease, Parkinson's disease, heart disease, and kidney failure. The isolation of these cells involves the destruction of a five day old human embryo and is therefore ethically controversial. The aim of this review is to examine the ethical and legal issues raised by ES cell research. Embryonic development and the source of ES cells are described briefly. The ethical implications of ES cell research are presented, with reference to the ongoing debate on the moral status of the embryo. The statutory framework for regulation of embryo research in the UK is described in relation to the Human Fertilisation and Embryology Act, 1990. Finally, the recent amendments to the Human Fertilisation and Embryology Act, 1990 are discussed in light of reports by the Human Genetics Advisory Commission/Human Fertilisation and Embryology Authority, the Nuffield Council on Bioethics, and the Chief Medical Officer's Expert Advisory Group.
Get full access to this article
View all access options for this article.
References
1.
WattF. M. and HoganB. L. M.: ‘Out of Eden: stem cells and their niches’, Science, 2000, 287, 1427–1430.
2.
WinkelG. K. and PedersonR. A.: ‘Fate of the inner cell mass in mouse embryos as studied by microinjection of lineage tracers’, Developmental Biology, 1988, 127, 143–156.
3.
BivenM.: ‘Administrative development: NIH backs federal funding for stem cell research’, Journal of Law, Medicine and Ethics, 1999, 27, 95–99.
4.
ShamblottM. J. et al.: ‘Derivation of pluripotent stem cells from cultured human primordial germ cells’, Proceedings of the National Academy of Sciences of the USA, 1998, 95, 13726–13731.
5.
GearhartJ.: ‘New potential for human embryonic stem cells’, Science, 1998, 282, 10–11.
6.
PittengerM. F., et al.: ‘Multilineage potential of adult human mesenchymal stem cells’, Science, 1999, 248, 143–147.
7.
National bioethics advisory commission: ‘Executive summary’, in ‘Ethical issues in human stem cell research’, i–xi; 1999, Rockville, MD, Government Printing Office.
8.
Human Genetics Advisory Commission and Human Fertilisation And Embryology Authority. ‘Cloning issues in reproductive science and medicine’; 1998, London, Department of Trade and Industry.
9.
ThomsonJ. A. et al.: ‘Embryonic stem cell lines derived from human blastocysts’, Science, 1998, 282, 1145–1147.
10.
WadeN.: ‘Researchers claim embryonic cell mix of human and cow’, New York Times, 12 November1998, A1.
11.
FishelS.: ‘Assisted conception in the human – the embryological view’, in ‘Conceiving the embryo’, (ed. EvansD.), 13–26; 1996, The Hague, Kluwer Law International.
12.
National Bioethics Advisory Commission: ‘Human stem cell research and the potential for clinical application’, in ‘Ethical issues in human stem cell research’, 7–27; 1999, Rockville, MD, Government Printing Office.
13.
MorganD. and LeeR. G.: ‘Embryo research’, in ‘Blackstone's guide to the HFEA, 1990’, 63–88; 1991, London, Blackstone Press.
14.
WarnockM.: ‘Report of the committee of inquiry into human fertilisation and embryology’; 1984, London, Her Majesty's Stationary Office.
15.
MclarenA.: ‘Prelude to embryogenesis’, in ‘Human embryo research: yes or no?’; 1986, London, Tavistock Publications.
KimberS.: ‘IVF and manipulating the human embryo’, in ‘Ethics and biotechnology’, (ed. DysonA. and HarrisJ.), 93–120; 1984, London, Routledge.
18.
ThomsonJ. A. et al.: ‘Isolation of a primate embryonic stem cell line’, Proceedings of the National Academy of Sciences of the USA, 1995, 92, 7844–7848.
19.
EvansM. J. and KaufmanM. H.: ‘Establishment in culture of pluripotent cells from mouse embryos’, Nature, 1990, 292, 154–156.
20.
GravesK. H. and MoreadithR. W.: ‘Derivation and characterization of putative pluripotential embryonic stem cells from preimplantation rabbit embryos’, Molecular Reproduction and Development, 1993, 36, 424–433.
21.
PedersonR. A.: ‘Studies of in vitro differentiation with embryonic stem cells’, Reproduction, Fertility and Development, 1994, 6, 543–552.
22.
WilmutI. et al.: ‘Viable offspring derived from fetal and adult mammalian cells’, Nature, 1997, 385, 810–813.
23.
KuhseH. and SingerP.: ‘Introduction: the nature of ethical argument’, in ‘Embryo experimentation’, (ed. SingerP., et al.), 37–41; 1990, Cambridge, Cambridge University Press.
24.
DworkinR.: ‘What is sacred’, in ‘Life's dominion: an argument about abortion, euthanasia and individual freedom’, 68–101; 1994, New York, NY, Vintage.
25.
EvansD.: ‘Pro-attitudes to pre-embryos’, in ‘Conceiving the embryo’, (ed. EvansD.), 27–46; 1996, The Hague, Kluwer Law International.
26.
TooleyM.: ‘Abortion and infanticide’, in ‘Applied ethics’, (ed. SingerP.), 57–85; 1986, Oxford, Oxford University Press.
27.
Congregation for the doctrine of the faith: ‘Instruction on respect for human life and its origin and on the dignity of procreation (Donum vitae)’; 1987, London, Catholic Truth Society.
28.
DysonA.: ‘At Heaven's command? The churches, theology, and experiments on embryos’, in ‘Experiments on embryos’, (ed. DysonA. and HarrisJ.), 82–105; 1990, London, Routledge.
29.
DoerflingerR. M.: ‘The ethics of funding stem cell research: a Catholic viewpoint’, Kennedy Institute of Ethics Journal, 1999, 9, 137–150.
30.
DoerflingerR. M.: ‘Destructive stem-cell research on human embryos’, Origins, 1999, 28, 769–773.
31.
CoughlanM. J.: ‘The argument of the instruction’, in ‘The Vatican, the law and the human embryo’, 58–77; 1990, London, Macmillan.
32.
DawsonK.: ‘Fertilization and moral status: a scientific perspective’, in ‘Embryo experimentation’, (ed. SingerP., et al.), 42–52; 1990, Cambridge, Cambridge University Press.
33.
KuhseH. and SingerP.: ‘Individuals, humans and persons: the issues of moral status’, in ‘Embryo experimentation’, (ed. SingerP., et al.), 65–75; 1990, Cambridge, Cambridge University Press.
34.
EvansM.: ‘Human individuation and moral justification’, in ‘Conceiving the embryo’, (ed. EvansD.), 75–85; 1996, The Hague, Kluwer Law International.
35.
WerpehowskiW.: ‘Persons, practices and the conception argument’, Journal of Medicine and Philosophy, 1997, 22, 479–494.
MoriM.: ‘On the concept of the pre-embryo: the basis for a new ‘‘Copernican revolution’’ in the current view about human reproduction’, in ‘The future of human reporoduction: ethics, choice, and regulation’, (ed. HarrisJ. and HolmS.), 38–54; 1998, Oxford, Clarendon Press.
39.
PorterJ.: ‘Individuality, personal identity, and the moral status of the preembryo. A response to Mark Johnson’, Theological Studies, 1995, 56, 763–770.
40.
ShannonT. A.: ‘Fetal status: sources and implications’, Journal of Medicine and Philosophy, 1997, 22, 415–422.
41.
DawsonK.: ‘Segmentation and moral status: a scientific perspective’, in ‘Embryo experimentation’, (ed. SingerP., et al.), 53–64; 1990, Cambridge, Cambridge University Press.
42.
WarrenM. A.: ‘On the moral and legal status of abortion’, The Monist, 1973, 57, 43–61.
43.
LockwoodM.: ‘When does life begin?’, in ‘Moral dilemmas in modern medicine’, 9–31; 1985.
44.
‘Report of the Human Embryo Research Panel’; 1994, Bethesda, MD, National Institutes of Health.
45.
GloverJ.: ‘Abortion: the traditional approach’, in ‘Causing death and saving lives’, 119–128; 1990, London, Penguin Books.
46.
StrongC.: ‘The moral status of preembryos, embryos, fetuses and infants’, Journal of Medicine and Philosophy, 1997, 22, 457–478.
47.
TauerC. A.: ‘Embryo research and public policy’, Journal of Medicine and Philosophy, 1997, 22, 423–439.
48.
SingerP. and DawsonK.: ‘IVF technology and the argument from potential’, in ‘Embryo experimentation’, (ed. SingerP., et al.), 76–89; 1990, Cambridge, Cambridge University Press.
49.
IglesiasT.: ‘In vitro fertilisation: the major issues’, Journal of Medical Ethics, 1984, 10, 36–46.
50.
HolmS.: ‘The moral status of the pre-personal human being’, in‘Conceiving the embryo’, (ed. EvansD.), 193–220; 1996, The Hague, Kluwer Law International.
51.
HarrisJ.: ‘Embryos and hedgehogs: on the moral status of the embryo’, in ‘Experiments on embryos’, (ed. DysonA. and HarrisJ.), 65–81; 1990, London, Routledge.
52.
ChapmanA. R., FrankelM. S., and GarfinkelM. S.: ‘Stem cell research and applications: monitoring the frontiers of biomedical research’; 1999, American Association for the Advancement of Science/Institute for Civil Society.
53.
NoonanJ. T.: ‘An almost absolute value in history’, in ‘The morality of abortion’, (ed. NoonanJ. T.), 56–57; 1970, Cambridge, MA, Harvard University Press.
54.
CharoR. A.: ‘The hunting of the snark: the moral status of embryos, right-to-lifers and third world women’, Stanford Law and Policy Review, 1995, 6, 11–37.
55.
DworkinR.: ‘Life's dominion: an argument about abortion, euthanasia and individual freedom’; 1994, New York, NY, Vintage.
56.
HigginsonR.: ‘The ethics of experimentation’, in ‘Embryos and ethics: the Warnock report in debate’, (ed. CameronN. M. S.), 28–42; 1987, Edinburgh, Rutherford House Books.
57.
RobertsonJ. A.: ‘Symbolic issues in embryo research’, Hastings Center Report, 1995, 25, 37–38.
58.
RobertsonJ. A.: ‘Ethics and policy in embryonic stem cell research’, Kennedy Institute of Healthcare Ethics Journal, 1999, 9, 109–136.
59.
AnnasG., CaplanA., and EliasS.: ‘The politics of human embryo research – avoiding ethical gridlock’, New England Journal of Medicine, 1996, 334, 1329–1332.
60.
HarrisJ.: ‘The beginnings of life’, in ‘The value of life: an introduction to medical ethics’, 111–135; 1985, London, Routledge.
61.
SeachristL.: ‘Embryo stem-cell research debated in Senate sub-panel’, Bioworld Today, 1998, 9, 3.
62.
EdwardsR.: ‘Ethics and embryology: the case for experimentation’, in ‘Experiments on embryos’, (ed. DysonA. and HarrisJ.), 42–54; 1990, London, Routledge.
63.
GerrardN.: ‘Creating embryos for research’, Journal of Applied Philosophy, 1993, 10, 175–187.
64.
BrazierM.: ‘The challenge for Parliament: a critique of the White Paper on Human Fertilisation and Embryology’, in ‘Experiments on embryos’, (ed. DysonA. and HarrisJ.), 127–141; 1990, London, Routledge.
65.
McgeeG.: ‘The human cloning debate’; 1990, Berkeley, CA, Berkeley Hills Books.
66.
HolmS.: ‘A life in the shadows: one reason why we should not clone humans’, Cambridge Quarterly of Healthcare Ethics, 1998, 7, 160–162.
67.
HarrisJ.. ‘Cloning and human dignity’, Cambridge Quarterly of Healthcare Ethics, 1998, 7, 163–167.
68.
RabbH.: ‘Memorandum to Harold Varmus, M.D., Director, NIH. Federal funding for research involving human pluripotent stem cells’, 1999, 2–3.
69.
KhushfG.: ‘Embryo research: the ethical geography of the debate’, Journal of Medicine and Philosophy, 1997, 22, 495–519.
70.
MorganD. and LeeR. G.: ‘Introduction: law, morals and assisted conception’, in ‘Blackstone's guide to the HFEA, 1990’, 1–32; 1991, London, Blackstone Press.
71.
Ontario law reform commission: ‘Human artificial reproduction and related matters (1985)’, in ‘Medical law: text with material’, (ed. KennedyI. and GrubbA.), quoted at pp. 762–768; 1994, London, Butterworths.
72.
GunningJ. and EnglishV.: ‘Birth of a new ethical issue’, in ‘Human in vitro fertilisation: a case study in the regulation of medical innovation’, 15–32; 1993, Aldershot, Dartmouth Publishing.
73.
Lord houghton: House of Lords Official Report, 20 March 1990, col. 244.
74.
MasonJ. K. and Mccall smithR. A.: ‘Law and medical ethics’, 187–188; 1999, London, Butterworths.
75.
‘Annual report of the Human Fertilisation and Embryology Authority’, chapter 6; 1999.
76.
JaggerD.: personal communication, 11 August2000.
77.
Chief medical officer's expert advisory group: ‘Stem cell research: medical progress with responsibility’; 2000, London, Department of Health.
78.
Fifth report of session of the Science and Technology Committee, (HC373–1), 1996–7.
79.
House of Commons Official Report, 26 June 1997, col. 615.
80.
‘Therapeutic cloning: a submission by the Royal Society to the Chief Medical Officer's Expert Group’; 2000, London, The Royal Society.
81.
‘Stem cell therapy: the ethical issues. A discussion paper’; 2000, London, Nuffield Councilon Bioethics.
82.
JowellT. and SainsburyD.: ‘The Government response to the issues raised in the joint report of the Human Fertilisation and Embryology Authority and Human Genetics Advisory Commission’, June1999(available atwww.doh.gov.uk/cloning.htm).
83.
‘Government response to the recommendations made in the Chief Medical Officer's Expert Group report, “Stem cell research: medical progress with responsibility”’; 2000, London, TheStationery Office.
84.
KennedyI.: ‘Treat me right: essays in medical law and ethics’, 119; 1988, Oxford, Oxford University Press.
