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Johnston J, Hyun I, Neuhaus CP, Maschke KJ, Marshall P, Craig KP, Matthews MM, Drolet K, Greely HT, Hill LR, Hinterberger A, Hurley EA, Kesterson R, Kimmelman J, King NMP, Lopes MJ, O’Rourke PP, Parent B, Peckman S, Piotrowska M, Schwarz M, Sebo J, Stodgell C, Streiffer R, Wilkerson A. Clarifying the Ethics and Oversight of Chimeric Research. Hastings Cent Rep 2022; 52 Suppl 2:S2-S23. [PMID: 36484509 PMCID: PMC9911087 DOI: 10.1002/hast.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human-nonhuman chimeric research. Led by bioethics researchers working closely with an interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human-nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics' previous focus on human-centered questions about the ethics of "humanization" and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less-siloed governance and oversight and more-comprehensive public communication.
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Raposo VL. The new Japanese regulation on human/non-human chimeras: should we worry? JBRA Assist Reprod 2021; 25:155-161. [PMID: 33118717 PMCID: PMC7863089 DOI: 10.5935/1518-0557.20200045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/20/2020] [Indexed: 11/20/2022] Open
Abstract
In March 2019 Japan modified its norms regarding research with human/non-human chimeras. The amended rules allow the creation of chimeras with human brain cells, and the subsequent transfer of the resulting creature to an uterus, where it can develop for more than 14 days, eventually until term. At this moment, the real consequences of this new regulation in actual research are still uncertain. However, many concerning issues have already been identified. This paper will start by addressing traditional topics involving this practice: the use of non-human animals in research, the use of human stem cells in scientific experimentation and the creation of human/non-human chimeras. Subsequently, it will analyze the new concerning issues brought on by the 2019 amendment: the use of human brain cells, the transfer of the chimera to an uterus and its development for more than 14 days, and the possibility of using animals which present close similarities with humans. In the end, the paper will conclude that in spite of the legal and ethical hazards that this new regulation might carry, it should be allowed under strict scrutiny.
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Affiliation(s)
- Vera Lúcia Raposo
- Faculty of Law of Macao University, Macao, China
- Faculty of Law of Coimbra University, Coimbra, Portugal
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Al-Tabba' A, Dajani R, Al-Hussaini M. Stem Cell Statute in Jordan: Leading the Way. Front Genet 2020; 11:657. [PMID: 32765577 PMCID: PMC7379862 DOI: 10.3389/fgene.2020.00657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/29/2020] [Indexed: 12/03/2022] Open
Abstract
The use of stem cells in research has caused much controversy and ethical dilemma. The primary source of stem cells is human embryos, a source which has been confronted with objections based on ethical, moral, and religious positions. Jordan has passed the first of its-kind Statute in the region, aiming at regulating the use of stem cells both for therapeutic and research purposes. The Statute adopted a regulatory approach between the restrictive and intermediate. The Statute, however, pays more attention to stem cell banking in many of its articles. Many critical aspects in regulating stem cell research activities are overlooked. This is including but not limited to the process of informed consent, protecting privacy, maintaining confidentiality, the need for a national entity responsible for regulating embryonic stem cell (ESC) research, and requirements of monitoring activity. The authors recommend further review of the current Statute in light of the deficiencies discussed so as to develop a more comprehensive and coherent Statute.
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Affiliation(s)
- Amal Al-Tabba'
- Office of Human Research Protection Program, King Hussein Cancer Center, Amman, Jordan
| | - Rana Dajani
- Department of Biology and Biotechnology, Hashemite University, Zarqa, Jordan.,Jepson School of Leadership, University of Richmond, Richmond, VA, United States
| | - Maysa Al-Hussaini
- Office of Human Research Protection Program, King Hussein Cancer Center, Amman, Jordan.,Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan
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Abstract
Nurses and midwives are part of health care in all the stages of our lives from preconception to death. Recent scientific advances have introduced new techniques of screening and diagnosis linked to stem cell isolation and therapies. These could affect us at any age and therefore nurses will be involved as carers and patients advocates for these techniques. In this article stem cell techniques and therapies are outlined, as well as some of the ethical challenges faced by various nursing groups, whether in adult, learning difficulties, mental health, paediatric, primary care, public health or health visiting areas. Nurses have to understand the ethical issues and the rights of all parties (donor, recipient and families), which may conflict with each other, to be able to weigh up the benefits and costs to each group involved. Answers have to be found on a case-by-case basis within local moral frameworks and law. Nurses represent all parties in these therapies and act as advocates for every patient group. They need to act in an interprofessional environment to promote the best interests of all their clients, both clinically and ethically.
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Affiliation(s)
- S H Cedar
- Faculty of Health and Social Care, London South Bank University, 103 Borough Road, London SE1 0AA, UK.
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Donating embryos for human embryonic stem cell (hESC) research: a committee opinion. Fertil Steril 2014; 100:935-9. [PMID: 24074538 DOI: 10.1016/j.fertnstert.2013.08.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 12/21/2022]
Abstract
hESC research is an ethically acceptable use of human embryos that are in excess of those needed to meet the fertility goals of patients. The ethical basis for this view and issues to be considered during the informed consent process for the donation of embryos are developed in this document. This report replaces the Committee's 2009 report, "Donating spare embryos for stem cell research" (Fertil Steril 2009;91:667-70).
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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Abstract
BACKGROUND Cell-based therapies may soon be used to treat disorders in the perinatal period. Our aim was to assess pregnant women's knowledge, attitudes, and acceptance of different types of stem cell therapies. METHODS Pregnant women attending an Australian tertiary center were asked to complete a questionnaire to seek their views on the potential therapeutic use of stem cells in the future. Outcome measures were women's acceptability of different types of stem cell therapies for themselves and their baby, ethical concerns, knowledge, and willingness to use stem cells for different indications. RESULTS A total of 150 women completed the questionnaire. More women were happy to use any stem cell type (82%) than placental stem cells only (12.5%), adult stem cells only (2%), embryonic stem cells only (0), and 3.5 percent would not use. With respect to use for their baby, more women were happy to use any stem cell type (83%) than placental stem cells only (13%), embryonic stem cells only (2%), adult stem cells only (0), and 2 percent would not use. Ethical concerns were highest with embryonic stem cells (25%), than adult stem cells (11%), and placental stem cells (10%). Twelve percent of women were very confident and 66 percent reasonably confident with their knowledge, whereas 17 percent understood little and 5 percent reported no understanding. Acceptance of using any stem cell therapy was 75 percent for severe medical disorders, 57 percent for moderate disorders, and 25 percent for mild medical disorders. CONCLUSIONS Pregnant women are confident with their knowledge of stem cells and overwhelmingly support their use to treat both themselves and their baby. The level of this support, however, is proportionate to the severity of the medical disorder. (BIRTH 39:2 June 2012).
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Affiliation(s)
- Ryan J Hodges
- Department of Obstetrics & Gynaecology, Monash University, Monash Medical Centre, Southern Health, Clayton, Victoria, Australia
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Provoost V, Pennings G, De Sutter P, Gerris J, Van de Velde A, Dhont M. Reflections by patients who undergo IVF on the use of their supernumerary embryos for science. Reprod Biomed Online 2010; 20:880-91. [DOI: 10.1016/j.rbmo.2010.03.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 08/26/2009] [Accepted: 01/19/2010] [Indexed: 10/19/2022]
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Abstract
Science often progresses faster than regulation, and retroactive ethically linked rules have been a persistent issue in stem cell research. Proposed NIH funding rules are retroactive. Legal history and ethical analysis show why there should be a strong presumption that such new rules should be only prospective, in any area of scientific research.
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Affiliation(s)
- Patrick L Taylor
- Children's Hospital Boston, Office of General Counsel, 300 Longwood Avenue, Boston, MA 02115, USA.
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Brett S, Livie M, Thomas G, McConnell A, Rajkhowa M. Report on the donation of supernumerary embryos from fresh IVF and ICSI treatment cycles for human stem cell research. HUM FERTIL 2009; 12:34-9. [PMID: 19330611 DOI: 10.1080/14647270802438803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Research involving human embryos promises exciting therapeutic advances but raises ethical and moral dilemmas for scientists and potential donors. The aim of this study is to report the proportion of couples donating supernumerary fresh embryos for development of stem cell lines from a single centre and the characteristics of those who donate. METHODS Couples undergoing assisted conception treatment in a teaching hospital received research information between January 2005 and July 2006. Counselling and consenting was performed by a dedicated research nurse. Demographic data was collected for couples who enrolled in the study. MAIN OUTCOME MEASURES To determine the proportion of couples willing to donate surplus embryos for stem cell derivation and to examine the characteristics of those who consent to donate. RESULTS Of 508 couples, 353 (69%) expressed an interest in research on their treatment consent forms. Sixty-six percent of those interested in research and 87% of counselled couples consented to donation. The demographic characteristics of those who agreed to donate were similar to those of all couples attending the unit. CONCLUSIONS Approximately half of couples consented to donate under the described system in our centre. Detailed information provision helps the majority of those counselled to proceed to donation.
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Affiliation(s)
- S Brett
- Assisted Conception Unit, Ninewells Hospital and Medical School, Scotland, UK
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Ethical and Policy Issues Surrounding the Donation of Cryopreserved and Fresh Embryos for Human Embryonic Stem Cell Research. Stem Cell Rev Rep 2009; 5:116-22. [DOI: 10.1007/s12015-009-9060-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Accepted: 02/18/2009] [Indexed: 01/16/2023]
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Donating spare embryos for stem cell research. Fertil Steril 2009; 91:667-70. [DOI: 10.1016/j.fertnstert.2008.12.066] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 12/17/2008] [Indexed: 10/21/2022]
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Grunwell J, Illes J, Karkazis K. Advancing Neuroregenerative Medicine: a Call for Expanded Collaboration Between Scientists and Ethicists. NEUROETHICS-NETH 2008. [DOI: 10.1007/s12152-008-9025-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nelson E, Mykitiuk R, Nisker J, Nisker J, Christilaw J, Corey JA, Heaman M, Lippman A, Mykitiuk R, Nelson E, Rodgers S, Shapiro J, Sherwin S. Informed Consent to Donate Embryos for Research Purposes. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2008; 30:824-829. [DOI: 10.1016/s1701-2163(16)32947-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nelson E, Mykitiuk R, Nisker J, Nisker J, Christilaw J, Corey JA, Heaman M, Lippman A, Mykitiuk R, Nelson E, Rodgers S, Shapiro J, Sherwin S. Archivée: Consentement éclairé quant au don d’embryons à des fins de recherche. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2008. [DOI: 10.1016/s1701-2163(16)32948-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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An Investigation of Embryo Donation, Informed Consent, and Research Oversight in Canadian Human Embryonic Stem Cell Research. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2007; 29:997-1002. [DOI: 10.1016/s1701-2163(16)32692-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Caulfield T, Ogbogu U, Nelson E, Einsiedel E, Knoppers B, McDonald M, Brunger F, Downey R, Fernando K, Galipeau J, Geransar R, Griener G, Grenier G, Hyun I, Isasi R, Kardel M, Knowles L, Kucic T, Lotjonen S, Lyall D, Magnus D, Mathews DJH, Nisbet M, Nisker J, Pare G, Pattinson S, Pullman D, Rudnicki M, Williams-Jones B, Zimmerman S. Stem Cell Research Ethics: Consensus Statement on Emerging Issues. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2007; 29:843-8. [PMID: 17915069 DOI: 10.1016/s1701-2163(16)32632-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This article is a consensus statement by an international interdisciplinary group of academic experts and Canadian policy-makers on emerging ethical, legal and social issues in human embryonic stem cells (hESC) research in Canada. The process of researching consensus included consultations with key stakeholders in hESC research (regulations, stem cell researchers, and research ethics experts), preparation and distribution of background papers, and an international workshop held in Montreal in February 2007 to discuss the papers and debate recommendations. The recommendations provided in the consensus statement focus on issues of immediate relevance to Canadian policy-makers, including informed consent to hESC research, the use of fresh embryos in research, management of conflicts of interest, and the relevance of public opinion research to policy-making.
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Affiliation(s)
- Timothy Caulfield
- Health Law Institute, Faculty of Law, School of Public Health, University of Alberta, Edmonton AB
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Caulfield T, Ogbogu U, Isasi RM. Informed consent in embryonic stem cell research: are we following basic principles? CMAJ 2007; 176:1722-5. [PMID: 17548387 PMCID: PMC1877848 DOI: 10.1503/cmaj.061675] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Timothy Caulfield
- Faculty of Law and the School of Public Health, University of Alberta, Edmonton, Alta
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Zettler P, Wolf LE, Lo B. Establishing procedures for institutional oversight of stem cell research. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2007; 82:6-10. [PMID: 17198282 DOI: 10.1097/01.acm.0000250025.17863.bf] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Academic health centers (AHCs), which are at the forefront of stem cell research, need to establish institutional stem cell research oversight committees (SCROs) to comply with 2005 National Academy of Sciences (NAS) recommendations and to establish public trust in this sensitive research. Institutional review boards (IRBs) typically lack the expertise and time to adequately review the specific ethical issues raised by stem cell research. To assure careful, timely, and coordinated review of the science and ethics of stem cell protocols, AHCs need to address many practical procedural issues, such as SCRO membership, quorum, conflicts of interest, and procedures for protocol review. The SCRO committee at the University of California San Francisco (UCSF), established in 2003, has developed detailed policies and procedures on these issues. The UCSF SCRO has broad scientific expertise and uses ad hoc reviewers to strengthen the review process. Studies receiving full SCRO review have three lead reviewers: a scientist, a reviewer with ethics expertise, and a public representative. Studies introducing human stem cells into nonhuman blastocysts receive full review, even if the stem cells are anonymized. Some protocols are eligible for expedited review. The SCRO neither replaces nor duplicates review by the IRB and institutional animal care and use committees. Other AHCs can draw on the UCSF experience when developing their own policies and procedures for stem cell research oversight.
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Choudhary M, Nesbitt M, Leary C, Murdoch AP. Donation of fresh oocytes for nuclear transfer research--a new approach. Reprod Biomed Online 2006; 13:301-2. [PMID: 16895650 DOI: 10.1016/s1472-6483(10)60630-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lyerly AD, Steinhauser K, Namey E, Tulsky JA, Cook-Deegan R, Sugarman J, Walmer D, Faden R, Wallach E. Factors that affect infertility patients’ decisions about disposition of frozen embryos. Fertil Steril 2006; 85:1623-30. [PMID: 16678178 DOI: 10.1016/j.fertnstert.2005.11.056] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Revised: 11/16/2005] [Accepted: 11/16/2005] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe factors that affect infertility patients' decision making regarding their cryopreserved embryos. DESIGN Forty-six semistructured in-depth interviews of individuals and couples participating in IVF programs. SETTING Two major southeastern academic medical centers. PATIENT(S) Fifty-three individuals, including 31 women, 8 men, and 7 couples. MAIN OUTCOME MEASURE(S) Qualitative analysis of interview transcripts. INTERVENTION (S): None. RESULT(S) Seven broad themes informed participants' decisions about embryo disposition: family and personal issues, trust, definition of the embryo, prospective responsibility to the embryo, responsibility to society, adequacy of information, and lack of acceptable disposition options. Many wished for alternative options, such as a ceremony at the time of disposal or placement of embryos in the woman's body when pregnancy was unlikely. CONCLUSION(S) Recent debates regarding embryo disposition do not reflect the range of values that infertility patients consider when deciding about frozen embryos. In addition to questions about the embryo's moral status, decision making about embryos is informed by a range of factors in the lives of individuals who created them. These perspectives may have important implications for the content and timing of informed consent, facilitating embryo disposition, and advancing policy debates about the ethics of frozen embryo use.
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Affiliation(s)
- Anne Drapkin Lyerly
- Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina, USA.
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Abstract
Greely discusses unanswered ethical and legal issues, such as those surrounding the creation of embryos, derivation of cell lines, uses of cell lines, and questions of intellectual property.
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Taylor PL. The gap between law and ethics in human embryonic stem cell research: overcoming the effect of U.S. federal policy on research advances and public benefit. SCIENCE AND ENGINEERING ETHICS 2005; 11:589-616. [PMID: 16279757 DOI: 10.1007/s11948-005-0028-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Key ethical issues arise in association with the conduct of stem cell research by research institutions in the United States. These ethical issues, summarized in detail, receive no adequate translation into federal laws or regulations, also described in this article. U.S. Federal policy takes a passive approach to these ethical issues, translating them simply into limitations on taxpayer funding, and foregoes scientific and ethical leadership while protecting intellectual property interests through a laissez faire approach to stem cell patents and licenses. Those patents and licenses, far from being scientifically and ethically neutral in effect, virtually prohibit commercially sponsored research that could otherwise be a realistic alternative to the federal funding gap. The lack of federal funding and related data-sharing principles, combined with the effect of U.S. patent policy, the lack of key agency guidance, and the proliferation of divergent state laws arising from the lack of Federal leadership, significantly impede ethical stem cell research in the United States, without coherently supporting any consensus ethical vision. Research institutions must themselves implement steps, described in the article, to integrate addressing ethical review with the many legal compliance issues U.S. federal and state laws create.
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Affiliation(s)
- Patrick L Taylor
- Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA.
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Affiliation(s)
- David Magnus
- Stanford Center for Biomedical Ethics and Department of Pediatrics, Stanford University, Palo Alto, CA 94304, USA
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